Plastic

Nse Obot Witherspoon: Passionate Advocate for Children’s Environmental Health

Nse Witherspoon, MPH, the brilliant, accomplished mother of four and Executive Director of the Children’s Environmental Network (CEHN), spoke to me December 18, 2023. Ms. Witherspoon is a key leader, communicator, activist, and bridge-builder in the field of environmental health – and serves on innumerable committees and boards, including for the American Public Health Association (APHA), the CDC, CHPAC, NIH, and America the Beautiful for All Coalition. She shared her insights, approaches, wisdom, and sense of joy as she works to protect our most vulnerable and precious charges: our children.

This interview has been edited for length and clarity. 

JMK: Thank you so much for taking the time! The pictures of your children behind you look so beautiful!

NOW: Thank you. They were a gift by the board at the twentieth anniversary of my employment at CEHN – to go have a photo session at a farm in Southern Maryland. It was so much fun, and we got some much-needed family photos.

JMK: They are gorgeous. So how was COP28?

NOW: It’s probably not a surprise that the U.S. is #1 in culpability, in cumulative impacts from fossil fuels worldwide – as well as in the ability to realistically meet the required deadline of phasing out at least 80% of our oil, gas, and coal use by 2030, so six years away. And of course, a majority of the top fossil fuel emitters worldwide are developing nations. Now, maybe ten or fifteen years ago, it seemed like consequences were far away. But now we’re really up against these serious deadlines. So that’s hard. The better story is that all nations, even from last year’s COP, have continued to decrease their dependency on fossil fuels. It’s just that we are not yet at scale and pace; we need to ramp up. But it was the first time that health had a place at the table, which I know you can appreciate. There was a health declaration that was signed by 123 countries out of the 160 or so that were represented. It’s great to acknowledge that health is a part of the impact of climate change. But I heard all kinds of metrics during the sessions, and not once did I hear about health. We had some labor unions sitting on this panel, and they were talking about future workforce and a just transition. And that’s good. The reality is many people do have lucrative, comfortable lifestyles because of their work in these fossil-fuel industries. So we’re not just going to turn that off for people and expect them to go find something else. We have to create bridges, which this administration has been doing. So I raised my hand, and asked, “where does health play in here?” Because, again, what I’m hearing are gross assumptions about what the quality of life is going to be for future workforces, and what I can confirm is that our babies are being born pre-polluted, and our women of child-bearing age are being born pre-polluted, and we see chemicals in grandchildren from what their grandparents were exposed to, and we see learning disabilities skyrocketing. And it’s not just fossil fuels, right? But that is a huge part of this problem. And then, of course, I didn’t hear much on plastics. While we need global attention on fossil fuels, where is the equal attention to the plastics industry, which is coming right behind?

JMK: Beyond Plastics is very clear that this is an intentional strategy on behalf of the fossil fuel companies that they'll just double down on plastics. Also, I read about COP28 that the oil moguls are going into less developed country countries and developing infrastructure that will require them to be dependent on fossil fuels far into the future. It’s so insidious.

NOW: You know, Dubai is all based on oil, too, right? But these huge skyscrapers, and glossy buildings, and beautiful art, architecture, and design is all based on the oil. It has the biggest mall in the world. And people are driving around in exotic sports cars, though clearly not everyone's living that life. But there's a lot of money in Dubai and around Dubai. It’s one thing for the oil folks to be in Dubai, but then to have such a prominent presence at COP was a real slap in the face.

JMK: Terrible. I like how you said in an interview that you are proud of being on the right side of things, and I agree with you. Every once in a while, I tell my children – remember that I was working really hard, whatever happens.

NOW: Yes – I am able to lay my head down at night and have peace. I guess if you make a ridiculous amount of money from some of these industries and know better, you cannot claim ignorance, but maybe you just want to cover your ears and act like your shares are not going to be impacted by this. But at the end of the day, even if you don’t have children or grandchildren, you care about nieces, nephews. Usually this topic is non-controversial, that we should help out the next generation so that they are better off than us, not worse off. That’s a pretty logical formula.

JMK: I know. I try to tell people, think a hundred years ago. People still had clothes. They still had food. They still had happy lives. There are a few things we need to keep. I ask my students that – I’ll say, if there was one plastic thing that you would keep in your life, what would it be? I would say medical tubing – we don’t have a great substitute for that.

NOW: That’s an excellent question – I like that. We can’t hold on to this way of life and can appreciate it’s a struggle. There’s a lot of dependency, and you know, I have full faith that we have very smart individuals. Look at the COVID vaccine!

JMK: Right?! The day our University shut down, I was with my friend who is a microbiologist, and she said it would be 18 months at best. And it was 18 months.

NOW: Yes – if we put a couple of challenges out there worldwide, I bet we could start chipping away at some of these alternative needs.

JMK: I have a list of questions, but it’s very loosely structured. And if you have anything else interesting to tell me, I would love to hear it.

What first prompted your interest in this area? I know that like me, you were pre-med and also found other passions. Is there some story from your childhood or early training that got you where you are right now?

NOW: I call myself a recovering almost pediatrician. I had this gravity that our family has always valued children, their wellness. My father is Nigerian; my mother is German, Dutch, a little English in there. And regardless of the cultural persuasion, that was one serious unifier: you take care of yourself; you take care of the earth; and you reach your hand back and take care of children, the next generation. You want to be comfortable, but you also want to have influence. In Middle School, I was very much interested in health, so I thought, all right: pediatrician. I did all the things you’re supposed to do. My own pediatrician was one of my top mentors. I did all the summer research lab programs during college and got into a pre-med program. And so the environment was not necessarily on my radar, although I appreciated our environment and nature. My goal was being a general practitioner pediatrician. Junior year in college, I'm starting to get ready for the MCAT and knocking out the courses, and I was just miserable. It was more than the finals and the MCAT; it was something bigger I just could not explain. I am taught to listen to my intuition that we all are born with, and I think women have a unique aspect of that, especially as eventual mothers in some cases, so I went to my pre-med advisor. I told him I don’t want to go back and start over; I have a heavy science background. What else could I think about besides the traditional medical school route? He rattles off all these other things that were still health profession-related – and what I was describing was public health – preventing illness. But he just looked at me like a deer in headlights; he was trained at getting people into Med School, and he was very successful at that. Earlier in the trajectory was not his cup of tea. My good friend Jennifer and I were having the same Eureka moment. We were both from the Buffalo, NY area. We had both done the summer research programs, and we both stumbled into public health. I remember in ’97 looking for schools accredited in public health on her mom’s computer at her house. She’s one of my best friends, and it is awesome that we both have found our spot in the Environmental Public Health field. She went on to Emory, I went to George Washington (GW). That’s how I moved to Washington, D.C. in 1998. Even my own family were saying, Public Health??! And they were just trying to figure this all out. Are you going to be able to pay your bills?

Once I got here, it felt risky. I didn’t necessarily know this plan was going to fulfill this itch that I had. But the minute I got into orientation, I realized that it was the puzzle piece I was looking for. The two years at GW were some of the most exciting and stimulating I’ve had. I still harken back on them like they were yesterday. Every course I was so eager because I could see the application. I could see how what we were learning on grant writing or public policy mattered. I had my first environmental health course in grad school at GW, and Dr. John Balbus was my professor. So while we’re colleagues now, I always like to say – you were my professor 20-25 years ago and gave me my first foundation. My focus was on maternal/child health, so I had always been true to that orientation. I was just coming at it from a different way, not that I am negating why we need our healthcare professionals. We know there’s still a very trusted front line for our communities that have health insurance. But I realized that where I wanted to put my attention and passion was upstream and connected more to community health. How we function individually is one thing, but the ability to function within our community seemed to me to be something that I saw traditional medicine being disconnected from. And that could just be my bias. But most of our board are pediatricians, and they validate that. The traditional medical training is one-on-one care. We’re doing better with intakes. At least lead is asked about in a well-child visit, but that wasn’t always the case. And the questionnaire doesn’t get into any other exposure pathways.

My first job out of graduate school was CEHN – I remember coming into the same building I am sitting in now. They were moving from California, and I was interviewing in this open space because all of their furniture was still coming, and they were literally unpacking. I was a bit anxious. I didn’t have a lot of environmental health background, but thankfully, they hired me – and I didn’t know it was going to be this whole journey. I was a communication outreach specialist first, which I love to do: talking, engaging, partnering, networking, expanding their net, especially since they were in D.C. for the first time. It was really important to do a lot of listening and try to integrate children’s environmental vulnerabilities into other missions and organization agendas. Within a year I was the deputy director, then I became Interim, and then Executive Director in 2004.

JMK: Wow! That was such a quick journey!

NOW: Yes, it was like drinking out of a fire hose unexpectedly. 

Dr. Lynn Goldman, Dean of the School of Public Health at GW, was our Board Chair at the time. We’ve had some amazing trailblazers on our board: Peggy Shepherd with WE ACT for Environmental Justice, Phil Landrigan, Dick Jackson. I had the luxury to be mentored by some of the strongest advocates of our time. I didn’t even realize what I was being positioned for until I was there – it’s been a journey. We are now at seven full-time staff and a few part-time staff for policy and admin support…. as well as a host of phenomenal graduate-level assistants and undergrads and fellows, along with a bunch of advisors. One thing I have learned is it takes a village for real, and I have no problems asking for help when we need it.

JMK: It’s funny – because it seems like you were cut to fit this, but you really learned on the job.

NOW: Yes, and then that’s not even getting into non-profit management. I’ve done coaching along the way later on. But first, it was just go from A to B, and then get from B to C. It was incremental at first, and a lot of learning and listening and teaching, bringing in the grants and all that good stuff.

JMK: Wow! You have done so much – and have such an amazing resume. You are part of, it seems to me, every group that I know of, on the board of every organization in Children’s Environmental Health (CEH). [We both laugh.] I especially use the pivotal TENDR Consensus all the time – what a who’s who of environmental health! But would you say there’s one thing, or maybe a few things of which you are proudest?

NOW: That’s a tough list: where is my energy most important? One is happening right now that is potentially going to make that difference of continuing the paradigm shift that we’re working so hard for: the America the Beautiful for All Coalition – I’m the Co-Chair with Mark Magaña from Green Latinos. In essence, it is a conservation movement. Public Health has never really been a part of the conservation movement – Environmental Justice has never been a part of conservation. This is at least acknowledged, which is why I am taking on this role. Also, we are living at a time when Biden and Harris, in one of their early days of the administration, declared the American the Beautiful for All Initiative. In advance of the United Nations climate meeting, it is helping us with our climate change goals in an aggressive and audacious way because it is necessary and urgent, and the only way forward. With that come public health benefits, justice, equity, and a whole host of other indicators that we all care about. I am not trying to beat down conservation leaders and force public health and environmental justice down their throats. But by taking this position, I have a unique opportunity to make sure that they do not go unnoticed. And I will be honest. Some of our justice leaders in particular, when we started forming the steering committee, said, “We don’t see ourselves there. That’s a conservation set of goals.” I take that very seriously. But the big tent is going to get us there, versus conservation siloed here, housing there. That approach doesn’t work. We make incremental changes, and then the funding goes away. It’s not continuous for a host of reasons. We have two sets of goals – to support and to call out administration as needed to reach the goal by 2030 of protecting at least 30% of our private and public lands, ocean, and waters. And there is a wide variety of strategies for that. This is a heavily tribal and Indigenous-led effort, which I have never seen to this level. This should not take away from what Indigenous tribal community justice leaders have already been working on for a long time. It’s more trying to take advantage of the time we’re living in. It’s important to get Big Greens at the table with public health, with justice, with Indigenous, with tribal, with sustainable business – you name it – working together towards that goal that we all benefit from – and trying to create a platform where those strategies that are working at a more minor level can get the chance to get more money, more capacity and attention, so others can learn from those experiences. It is also a goal to overlay a Justice40 metric – so that 40% of these protected areas that we're talking about will be shown to benefit the most marginalized communities. So it’s access to Nature, it’s cleaning up our water, it’s cleaning up our air. Many of these programs have never worked together before. That’s the other beauty here. We’re navigating coalition movement dynamics. We’re navigating some harm done by others, even if it wasn’t the same individuals, but by the communities they are representing. So we’re working through that. And we’re also negotiating a lot of agendas. Everyone thinks they have the right idea, but everything can’t be thrown into the soup, or it will not be effective. How do we continue to harness and streamline and lift up the approaches that have been proven to make a difference for communities and lives and species and the environment? We are also trying to build a fund so that community organizations, tribal-led, indigenous-led groups can apply for funding to advance their work at the community level.

So for me, it’s been a dream come true. We’re only in year two; we only have six years to get to really see whether we collectively can succeed. Then, what about the next administration? What if it’s not Democratic leaning? Regardless of who occupies the White House in 2025, this has to continue. So we are doing everything we can to fundraise like crazy and create the foundation: not just money, but the relationships, the strongholds, the community connectedness that we try to create as a barrier to being so easily influenced or dismantled by whoever is in the White House because we all stand to benefit when these goals are met.

That one is new for us, a little riskier; I definitely had to bridge some relationships to bring my board on and help them understand. Why should we make this a priority? But so far, so good. I am not anymore interested in the easy. This is tough for many, many reasons. We as a society have created this being so tough. As our kids say, often, when you know better, you should do better. I’m not interested in excuses. The science shows us – as you said, lived experience shows us – that our kids’ health outcomes right now are not going in the right direction. So how many more kids? How many more decades, how many more lost lives, how much more reduced quality of life, how many more lost days at school and work does it require for us to finally take it seriously? How we run our economic and healthcare systems is not working. This is not easy, and we’re not naïve in thinking it’s just a light switch you can turn on, but it does feel good to be among like-minded people who share the common goal that we must adjust our conservation goals while also addressing public health goals and justice and equity.

JMK: Yes, that is so true. You know, I just said to the head of the Office of Chemical Safety and Pollution Prevention almost that same thing. I told her the story about my daughter Katherine who died and said, how many more children must die while you all make incremental change? Change has to be bigger than that.

NOW: In public health, we're taught about mortality and morbidity – and that sticks with you – and so what’s the magic number? At least in the U.S., unfortunately, we have this history of, we wait, we wait, we wait. We try to retroactively go back and figure out why kids got sick. Why did that happen? And when the writing was there, the evidence was there. Some say it's political will. We all know policy and regulatory efforts need funding and capacity to implement. So you can have all the best policies – we’ve had good intent. But then it’s not followed up by the reality of how it actually gets done. It’s not only funding, but funding is usually a big part of that scenario. There are many ways and tactics to undermine progress – as we saw under the Trump and even the Bush administration. When you diminish staffing at federal agencies or eliminate budgets or attack science or undermine peer-reviewed academic research, so that researchers are questioned without justification, with biased reasoning – it causes distraction, it chips away at focused attention on the research, and it takes away from the ability to build momentum and build a movement. We’ve seen these tactics before. They are not new. My hope is that, regardless of who is in the White House, what we have in a couple of years is partnerships. Many of us now know each other – the tent is very, very large. Is it as big as the fossil fuel industry? No. And of course we don’t have that kind of money. But what we do have is ethics, values, and public health. We have engineers. We have the next generation, which is very engaged. Look at APHA – wanting to find their way in their professional passions to help make a difference in this world and not contribute to the status quo.

JMK: Yes, absolutely. It is amazing to know so many good people. I have to say that's one really inspiring thing about this project – and being involved in the work myself – is just that I get to talk to my heroes every day.

NOW: I’m sure it feeds your soul.

JMK: It does for sure.

NOW: We need that!

JMK: Yes – we need some filling back up of our souls after this tough work. [We both laugh.]

That’s a great segue to my next question. It’s tough to be raising kids in a world where every child is born exposed to toxic chemicals. You have kids, and so it’s personal for you. And you talk to people about the implications of this work. It's very difficult. How do you do it? What's your advice on how to frame a topic that is both essential to prevention and also productive of anxiety?

NOW: Thank you. I think that, as in fundraising, the secret sauce is that you want to emotionally connect with your potential sponsor or donor. People rarely give because of the project. The project may be a nice benefit, and they may feel good about the mission. But people fund people. I would equate the same learning experience to our general outreach and trying to connect. Even long-standing political leaders will acknowledge dissension, but we were still able to hear each other out. I may still disagree with you, but at least I have allowed you to share your personal story, your journey, why you have come to the decisions you’ve made on certain issues. And odds are, there may be things I hear in your story that I can relate to. That reduces my force field, my brick wall, which could be justified if I am a mom or dad who has lost a lot or someone who has suffered generational harm. I get it. I get why there are very suspicious perspectives and why people may not want to get to know someone who caused their family harm. And if we don’t allow ourselves the basic rapport of conversation, how will we ever get over to the place of decision and action?

So like a potential donor, I also have to make tough decisions. There are 20 million wonderful groups I would love to give to. How do I home in on the one that matters? I listen to what they are trying to do. Who are the people they have hired? Do I feel they can get the job done? I hope we could empower the same type of learning. And at least we’ve seen success in this, where people understand your genuine interest. It’s very clear, I think, within a minute. Is this just a job? Or is this something that you truly embody and believe with the wholeness of you? This is bigger than me or you or CEHN. We are talking about the health and wellbeing of our future generations, period. And the more that we diminish the ability to function and work and contribute, the more people are going to have more challenges, the more we diminish their ability from before they are even born. That child may go on to have more issues in their educational journey; they may or may not graduate from high school or learn a trade or gain economic mobility or have health insurance. That’s why I say that the human connection is really important. I will just bring in Rx Racial Healing with Dr. Gail Christopher, who is on CEHN's Advisory Board -- and I am trained by her as an Rx Racial Healing Circle Facilitator.

JMK: I know her! She spoke at Benedictine last Spring!

NOW: I think that the concept is definitely onto something. It takes the best of our adult learning and psychological perspectives and theories and wraps it all into one. It’s not anti-racism. It’s human to human connection and telling our personal stories. You may be from a different part of the world, you may be 30 years older than me; there could be all these other reasons why we shouldn’t have some type of connection, but there will be a connection in our stories, something that sticks with you that I can resonate with. That starts to create a softness…. I’m now a little bit more intrigued, maybe, to listen to whatever else you have to say, instead of letting my initial biases interfere: “you have no idea what I have been through.” Well, actually, I may. You may have no idea what my family history has been or what my day-to-day experience has been. That type of model should be in all our Public Health work because it’s tough out here, right? Relationship building is step one. Building trust comes out of relationship building. It doesn’t happen overnight. But crazier things have happened where people who are polar opposites and from different political spectrums or whatnot have eventually found their way to make something meaningful happen. At least, that’s what I believe we need in the Children’s Environmental Health movement. It’s a no-brainer to support our work. But there is a disconnect because there is a lot of lip service – including in the educational system and any other place where children show up – that we care so much about them. But yet our actions, our money, our investments, our capacity at all levels, does not measure up to that declared expectation. I think if we have more people who understand – we’re so far from where we could be, and yet the potential is right there. More people can think about where they have an influence. More voices have shown us in history, movements are successful by grassroot orientation, at least in the U.S. MADD, NRA: the most successful movements have had to have strong grassroots. The Obama campaign had strong grassroots level. It’s non-negotiable. You will never make it if it’s just a whole bunch of politicians. You need local public health folks or regulatory agencies that have to now administer a new policy.

JMK: I could not agree more. It's so interesting to hear that perspective. I love the analogy applying Gail Christopher's ideas to CEH. I enjoyed her talk so much, and especially her own experience of having lost a child to health disparities – just so heartbreaking.

There's a lot of fear and guilt, as you know, around environmental contamination and sick children. Has it been personally difficult for you to deal with this over the years? Do you sometimes have to step back and take a breath and remind yourself your kids are okay?

NOW: We have 20, 17, 13, and a 7-year-old. So they are all spread out, and they have been raised among a few generations, if you will. Climate anxiety is very prevalent in our home. We don’t separate our kids too much from lived experiences. We want them to live a little bit, though they are still very protected. But especially as our oldest has gone away, as a mom, you hope you have given them the foundation over the years for them to make their own decisions, hoping there are no regrettable decisions to the points of no return. What I hear from him and his circle is that some college students are more in the know – even on a surface level of climate change and world wars and various levels of injustice – and some are not. They are just in their own bubble, and I can relate to that, being in college. I don’t know which is right or wrong, but I do like our approach of trying to keep our communications open, for example on school and other shootings, which are an epidemic. This has taken its toll on our family. We have family in the Buffalo, New York area, and then right afterwards, the Texas shooting occurred, which made it extra challenging. They were within a week of each other last year. One was at an elementary school – the other was a grocery store. The grocery store is a mile from my sister’s house, so their cousins were affected; my parents are probably five miles from it. It blew up in my house. It blew up. Everybody was very quiet during that week – even my husband was just trying to digest it. This is craziness. And then, finally, at 12 a.m., the older kids wanted to finally talk, and I just let them vent. It was so sad because as a mom, you want to be able to protect them and tell them that they are never, ever going to be in a situation like that. And we know in our heart of hearts that we can’t ever confirm that. But their feelings were validated that this is not right. Somehow, we are collectively not being heard because we still allow ourselves as a country to go through this cycle of violence, and then the visuals are a whole thing that we do, and then on to the next one. This is not the way other countries run. They have a lot of questions we can’t answer. We want them to feel that emotion – as raw and awful as it is – because sadly, they are going to continue to run into this in the world. And we want them to find something to cope.

While there are some wonderful things happening in this world and wonderful people – and we try to surround them with a lot of those wonderful people as they’ve grown up as a support system – there are also some people who are lost, and I can’t explain why they do what they do. And when you run up against those levels of injustice? We have black children who are driving. When you are stopped by a cop…. there are so many layers of societal ills that we worry about as parents, and at the same time, we encourage them to travel the world, and live their lives, and make good decisions. So climate anxiety is real in our house. The kids talk about it. They have a hard time seeing past their thirties. They talk about having families, but they’re not sure. Is this the kind of world they want to bring children into, if we can’t get our act together? These are things I didn’t even have in my consciousness at their age. But they feel the weight; they feel the anger; they feel the frustrations. Why can’t we be normal teenagers and young 20-year-olds trying to find a job and start ourselves? No – we have to have the weight of the world on our shoulders that either you get this right or there is not future for us, and there are no grandchildren. It’s very tough. We try to be examples. We feel raw. We cry when we need to cry. We don’t hide that. And at times, we turn off the news when we need to, not discounting and not pushing away, but just at times you can only take so much because you still have to function and go to school and go to work. It’s tough. I hate that they have to navigate so many angles of life. That’s the part that is hard, where you do feel a bit helpless. When they are little, and we’re changing their diapers, we are controlling their exposures. When they are older, everything comes to their phone, even before it comes to a news channel. I didn’t deal with this in high school or college because I didn’t have that close proximity to information: the good, the bad, and the ugly. It should be much simpler than we’ve made it, for sure.

JMK: I think I have educated myself out of grandchildren, sadly. You want to tell your children what is in the world, but I’m not aware that any of my three surviving children will have kids, though I hope they will. I tell my students when they bring this up that it is true the world is a mess, and yet there have been tough times before, and babies are just the best thing in the whole wide world. Right?

NOW: Yes – we need more cute babies!

JMK: Yes – I could use some around me right now.

Okay, next, I know you are working on this: if you could single-handedly recreate U.S. policy regulating environmental chemicals and climate change, what would such a policy look like?

NOW: Yes – thank you. I think the experiment we’ve never done is put the needs of our most vulnerable first. So the first thing that the policy or regulatory guidance would be is, what is the threshold level that a young, young baby or a pregnant woman or a woman who wants to become pregnant could sustain to live a quality, healthy, long-term life? Ideally, it would be no exposures, but let’s try to at least drastically reduce exposures as a first step because we have never yet had a regulatory structure for chemicals in this country that has ever worked. So I think it needs to be totally blown up. I think we’re done with revising and need to start from scratch, and that’s heavy, but we need to do it. And the first frame would be, if this is the target we are going for, with what we know now since before TSCA, what are the levels that would allow us to have healthy generations of children? That would be my framing. And maybe there is a justice component to make sure the most harmed children would be protected by any new framework because right now there are too many loopholes. We’re not reviewing the chemicals on any kind of regular speedy basis that we would expect – that’s a harm. Even if we were keeping up with the 2,000 or so new synthetic chemicals introduced every year, I don’t believe we’re going far enough on children’s environmental health indicators that are truly feeding and leading that regulatory framework. So I would say, turn this thing on its head, and start totally fresh. Start from a point of vulnerability. It forces us to have specific steps and measurements in place, and no loopholes. And of course, it’s important to put responsibility on the point polluters. Now, industry puts out chemicals, and then we find harm. No! There is no introduction of a product until it goes through regulatory framework review, which needs to be faster, and which needs more money and capacity to do this. The framing is based not on what an adult healthy male can endure but on what a young vulnerable newborn could sustain to live a healthy life, if any exposure at all.

 

JMK: And actually, the way you are framing that would work the same with climate change, right? If you look at the exposures children are already facing and will face, it would protect everyone.

NOW: All our systems – the educational system, for instance – are not based on the needs of children, in my humble opinion. No agency is responsible in the U.S. for the health and well-being of children in a school building or a childcare facility. That’s a problem. So we need some strong accountability and some strong ramifications for what happens when you violate the rules. It’s one thing to have a regulatory framework and policies on the books and in the funding, but there will be those non-good actors. Let’s get serious about calling them out. What are the ramifications of going against said policy or regulatory framework? We still have a situation where EPA is threatened – its basic mission at the local, state and national level gets challenged. That should just not be allowed. There is no point in having an agency with a public-health, regulatory mission if its hands are tied half the time, and if industry manages to get in the way of them conducting their work. The Sackett vs. EPA case that went all the way to the Supreme Court is one prime example of that, and EPA lost. It’s atrocious, right? That ruling redefined our watersheds because known pollution was happening in Idaho, and then it went to the Supreme Court, funded by the fossil fuel industry – as an example: we’re going to stick it to you all. The EPA did its job; they fined the company who was dumping in known protected watersheds, and they said no – we’re bigger than this. And then just last year, the case, funded by our tax dollars, made it all the way to the Supreme Court, which just ruled in favor of industry. So now the EPA’s hands are tied, and there’s a whole new redefinition of what a protected watershed is. They fought against the definition – and all the time and money and energy and legal defense that were spent is ridiculous.

JMK: It’s terrible – we have such meager protections to start with for ourselves and for our lands, and then for industry to undermine those!

You’ve already begun answering my next question a bit. In your view, how would you answer the central question that I am occupied with in the last project and in this one: if we know that we are destroying the planet on which all life depends and poisoning our children, and we know there are solutions ready at hand, how is it that we are allowing climate change and widespread environmental degradation to happen? Or in other words, how can we be this stupid?

NOW: Yes. Our kids ask this all the time. It comes down to corporate greed. I still can’t believe the number of children who belong to those families that are truly benefiting economically by continuing the status quo and by pushing aside the facts that are in their face, by denying that climate change is happening, and on and on. They are impacting societal norms and making things worse. But then again, you have stories of corporate leaders: one bought a farm in Vermont so he could have organic fruits and vegetables for his family. There is a contrast between what he admits in public versus what he does privately. That is certainly not the communal society we are trying to create: I’m going to hoard, hoard, hoard…I’m going to do what is good for me. But last I checked, no one is in a CDC hazmat suit, so everyone is breathing the air, however rich you are. That’s the irony in this. And unless you are drinking some purified water that you can confirm comes from a trusted source, even bottled water can have some contamination. You have to breathe, eat, and drink to live, regardless of your zip code and wealth. It’s hard for me to even get in the head of those who knowingly participate in injustice and pollution. What gives me hope, though, is that there are more and more sustainable business leaders who are trying to think about their whole line of production. And they recognize this is a long haul, but at least they are starting to invest. They are bringing people on who can help them with the alternatives to keep business going but in a different way so that they don’t harm their employees, themselves, and their planet. But there are not enough green businesses. Unless someone gives me some reason to think otherwise, when you look at who the biggest resistance to change is, who the biggest lobbyists are, persuading candidates to go against energy efficiencies, sustainable energy, resiliency – most of the bad actors are from industry. The only thing I can surmise is that there is a certain level of greed among the 1-2% that has had a huge influence over generations in contaminating major waterways, food, air, and soil. They would have to admit that they and their industry are part of that in order to even be part of the solution. I haven’t seen that reckoning at the pace we need it. We still allow certain manufacturing – coal is archaic – these pipelines are still lifted in presidential campaigns – and used as a target for economic gain and community development. We know all the harm these pipelines create. There is still a disconnect between science and lived experience – and the small group of people who refuse to see, and therefore then to be a part of acting on that knowledge.

JMK: Absolutely.

NOW: Many times, when Democrats talk behind closed doors to Republicans leaders, there is a lot more alignment than we would think. I am broad-brushing: there are some Republicans, when you look at their voting record, they are so-so – it’s not that every Republican is a “no” on every environmental-health related regulatory or policy effort. But there is a stark difference between Democrat and Republican elected officials, and that is a problem. We’re not going to get everybody, and that is fine. But there is so much more of the moderate middle that we need to appeal to whatever influences them – for some it’s data, for some it’s lived experience. One reason the Food Quality Protection Act was passed unanimously in Congress in 1996 was because there were lawmakers whose grandchildren were being personally impacted by pesticide exposures. So you hate for it to get to that point, but I think we’re all at this five-alarm stage where, whatever your point of influence is – I may want the moral/ethical one – we have to act. Lead was not taken out of the catalytic converter for public health. They found out that the engine worked better without lead. That’s not the answer I would want, but it got us to the end we wanted.

JMK: Yes – naked selfishness – and how bad does it have to be? One in 23 boys are getting autism. Most children are losing IQ points. I guess part of it is messaging so people realize it is their children and it is the children they care about.

NOW: Right? Some people are saying that we are now dealing with a national defense crisis – because we won’t have minimum requirements for military and defense positions, not to mention leadership positions – that we are continuing to diminish the ability to even have qualified candidates. I’m in the present, and yes, we can forecast all day. That is getting into the fear aspect of communication, which we try to stay away from. We don’t sugar-coat in our communications; but we don’t diminish the reality. It’s so overwhelming and seems so much bigger than air and water. But we have found over the years that people get stumped with issues of climate – what I am supposed to do? It’s easier to say I’m fine. My kids are fine right now, so I just need to put food on the table and pay for childcare, and not worry about what that child is exposed to in childcare. We have to find a way to break through in increments, in bite sizes, and in a visionary way. If people don’t see themselves in whatever solution we’re talking about, it is going to be hard to dedicate their time and energy and encourage family and neighbors to do the same. People have to know that their actions are going to make a difference – signing on to this letter, talking to my principal, whatever the action may be – people we’re trying to get want to see their actions will be related to ends. Can we confirm that we are always going to reach the ends? No, but we are going to get closer – and the more voices we have under our broad tent, the more difference it makes.

JMK: That is so true. At the end of my last book, I tried to envision a future that is better because otherwise, we’re not going to get there. We have to imagine it first.

NOW: And to be fair, we’ve never seen the future that we’re laying out – but what we can do by is process of elimination – what we are doing right now is not working. In fact, it’s backfiring.

JMK: Yes, and in some limited ways, we could return to the past for environmental solutions.

NOW: Yes! My maternal grandmother lived to 102. She spent the first part of her life on a farm in Pennsylvania. My grandfather lived to his mid-nineties. They ate sugar, drank alcohol once in a while, but they had a balanced diet. It’s not like they were going to the gym and walking every day. There was something else about the foundation of their lives that added to their longevity. All people should have that ability to age with decency, and with as much of their health as possible. And what we know is that young children are dealing with long-term illnesses. We weren’t dealing with that in previous generations. Infectious disease has turned into chronic disease, fueled by a lot of the things that we are doing on a day-to-day basis.

JMK: I absolutely could not agree more. So in that vein, what do you think will be the status of children’s health in the year 2050?

NOW: I think we are at such an urgent place right now, where it’s either we do some of these things or we don’t – there is no grey area anymore. We’ll either meet those climate goals or not. And sadly, by 2050, climate impacts will be totally prevalent. If we are able to meet the paradigm shifting we are talking about where vulnerable populations lead our decision-making, our funding, our appropriation, our learning, our training mechanisms, we will have a much stronger hold on reversing all these negative environmental health outcomes.

Take the COVID pandemic – three months it took to slowly clean up the water and air all around the world – for the air to feel a little bit lighter. Granted, a lot of people were not moving around; a lot of people were not driving, so it’s not like we can turn that switch on tomorrow. But I am seeing more attention to individual practices that we have been trying to get people to do – for instance, in the DC area, I am seeing more electric vehicles than ever before – and I think our younger generations are a big part of that. They understand it’s non-negotiable, and they are looking to see if the adults around them are taking that seriously. So by 2050, I envision that we are reducing negative health outcomes, learning disabilities, juvenile diabetes, asthma, childhood cancers, because we have gotten serious about reducing air, soil, and water contamination with targeted strategies. Built environment is another one. Our indoor air quality will also have to be enhanced. Since people will likely still be spending a good amount of their time indoors, our homes, childcares, schools, and places of employment must have good air and water quality – all these indicators that are well tracked. Any new buildings would account for these things from the beginning. Every existing building, which are the majority, would have to have some level of attention and investment so we are not perpetuating negative health outcomes. I would like to believe we will be healthier, more joyful, with higher levels of justice, Public Health, and conservation goals being met. I’m thinking about more people enjoying the outside, being connected to nature. They feel better; their health is better; they are not traumatized by loss, an abundance of loss. They are able to just live their lives to the fullest extent. That just gives me complete joy, just thinking about the possibilities there.

JMK: The way you describe it gives me goosebumps. Your mouth to God’s ear! I hope it may be so.

So last question. Is there anything you would like to ask about my project or about my experiences?

NOW: This isn’t your first book, right? So what would you like to get out of this piece that didn’t happen the first time around?

JMK: I want academics, and I hope the general public, to understand that there is this whole other world that people are not aware of. They think that maybe their child has asthma, but actually, they’ve been exposed to a pesticide like mine were. They are told that scientists and physicians don’t know what caused their child’s autism or cancer or ADHD, but in fact, we do know those things. So I want them to understand that whole truth – and that these diseases are preventable. And I want people to see this whole other world of dedicated, amazing, brilliant people who are working so hard to make things better. There are so many people in the public eye who are terrible people, and yet, if you think who really should be our heroes, it’s these people working behind the scenes, who are usually pure in their intentions, and who are really just trying to make things better for children.

NOW: Oh, now you just gave me goosebumps! Well, no surprise in that answer at all – and I’m really happy for you. I know the book is going to be tremendously successful and look forward to promoting it once it’s out. Every single person you’ve interviewed sounds like it’s been just wonderful.

JMK: They have been. Thank you so much! Happy holidays too.

NOW: I hope you get some time to rejuvenate a bit because we have to keep working, right? [We both laugh.]

JMK: So good to see you.