The Lancet publishes a damning review of Trump’s legacy, including damage to occupational health and the environment

A special issue of the prestigious British journal The Lancet was released on February 11, titled Public policy and health in the Trump era, with an Editor’s introduction which captures the broad scope and tone:

“President Biden must contend with the continued COVID-19 pandemic and economic fallout in addition to Trump’s corrosive legacy. Each roll-back from regulation
and every retreat from global cooperation that defined the Trump era has become an action item on a daunting but crucial list: racism, income inequality, immigration
protection, universal health coverage, nutrition, the environment, workplace safety, reproductive rights, antiscience, and isolationism.”

Discussion of  “The environment, workplace, and global climate” starts on page 27, with a list of Trump’s regulatory rollbacks related to air pollution and emissions, and toxic chemicals and occupational hazards. It states that Trump used the Covid-19 pandemic as a “cover” for rollbacks, and comes to some shocking conclusions, based on official data:   “Between 2016 and 2019, the annual number of environmentally and occupationally related deaths increased by more than 22000, reversing 15 years of steady progress”,  and  “The Trump administration’s regulatory rollbacks have increased disease, injury, and death among workers in the USA. Its weakening of mine health and safety standards and mine enforcement programmes has led to increased injury deaths among workers employed in mining, quarrying, and oil and gas extraction .… and increased mortality from coal workers’ pneumoconiosis … Despite rising deaths from work-related silicosis, the administration terminated a silicosis prevention programme launched during the Obama era.”

The Report concludes with a long list of recommendations for Executive Action (which includes rejoining the Paris climate agreement) and for Legislative Action, including: “Implement the Green New Deal, end subsidies and tax breaks for fossil fuels, and ban coal mining and single-use plastics.”  The all- encompassing scope of the review is reflected in these concluding paragraphs:

“The path away from Trump’s politics of anger and despair cannot lead through past policies. President Biden must act for the people, not for the wealthy and the corporations they control. Resources to combat climate change, raise living standards, drop financial barriers to higher education and medical care, meet global aid responsibilities, and empower oppressed communities within the USA must come from taxes on the rich, and deep cuts in military spending…. For health care, overreliance on the private sector raises costs and distorts priorities, government must be a doer, not just a funder—eg, directly providing health coverage and engaging in drug development rather than paying private firms to carry out such functions.”

This report was authored by a Lancet Commission on Public Health and Policy in the Trump Era,  comprised of thirty-three experts from medical, public health and law schools, universities, Indigenous communities, clinical settings, public health agencies, unions, and legislative bodies, in the U.S., the U.K., and Canada. The Commission website states: “Convened shortly after President Trump’s inauguration in 2017, the Lancet Commission on public policy and health in the Trump era, offers the first comprehensive assessment of the detrimental legislation and executive actions during Trump’s presidency with devastating effects on every aspect of health in the USA. The Lancet Commission traces the decades of policy failures that preceded and fueled Trump’s ascent and left the USA lagging behind other high-income nations on life expectancy.”

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