|
|
|
Interview with CHE Partner, Anthony J. DeLucia, PhD
 Board of Directors, Kingsport Tomorrow, Former Chairman, American Lung Association
Steve Heilig: Tell us your own background and how you came to do the work you do. I am trained as a bench scientist, but had an interest in exercise so I worked at ways to blend the two. I stuck to animals and effects of ozone on the lungs for my dissertation. I then studied exercising humans and ozone for my post-doctorate. I went to Louisiana State University in New Orleans and started working with tobacco exposure and primates and brought that to Eastern Tennessee.
I was continuing my air pollution and lung toxicology work and teaching medical students.
In 1988 the American Lung Association (ALA) beckoned and I started serving state and locally. While my bench research totally wound down, my advocacy and passion completely picked up and my interests morphed into biomedical ethics, medical education, and an increasing traveling role with my Association work. By 1995 I was representing ALA on its council, then its board by 1998, and was Chair from 2002-03. I was lucky to have a day job where my University President could see that I was an asset to the institution as a representative to the Environmental Protection Agency (EPA) and the National Institute of Environmental Health Sciences (NIEHS) on committees and task forces.
Locally, I felt it was necessary to keep pushing on the tobacco and clean air fronts, which I did through Kingsport Tomorrow and our regional clean air team. I began to see the big picture with economics through the conferences and committees we held with tobacco growers and manufacturers - negotiation and consensus building were at a premium. At the University our focus was becoming very community-focused including rural communities where asthma, obesity, heart disease and mental health are real challenges.
During my year with ALA I attempted to promote best practices, use of technology and new partnerships. My issue, instead of indoor air, became the built environment and I met Dick Jackson to see how much Ken Olden and NIEHS was becoming a real devotee of the built environment connections.
All this worked into a thing I see as "my higher calling", culminating in my running for office, continuing to nag on the issues related to health, environment, energy, housing, transportation and agriculture. I like the big picture and instead of crises du jour, I like to plan, plan, plan. Kingsport Tomorrow is great for that. We have Vision 2017 of Kingsport, now 2025 of the entire region and that includes things like Visual Image Surveys with results like the citizen preferences being "Clean, Green, Sidewalks, Parks, and Neighborhoods".
I consider myself a resource person and am willing to work with anyone. Currently we are looking at poverty in the Delta (Mississippi, Tennessee, Arkansas, Louisiana), made all the more evident by Katrina. Smart growth is the issue and I am working with Local Government Commission, International City County Management Association and the EPA.
I do this work because it fulfills me.
Please describe the primary mission and work of your organization, if you are part of one.
Since I wear an academic hat, I buy into doing the translational research with NIEHS and National Cancer Institute (NCI). Our University is very service-oriented, and I belong to groups like Community Campus Partnerships for health and advocate service learning. Even without funding, we have tackled tobacco, active living, drug and alcohol free communities and water quality. With Kingsport Tomorrow, we are focused on improving our community through citizen participation. We have tackled a lot of different issues. Health topics are big right now, but linking them to economics and the people’s vision: People, Places, Play, Jobs and Government. We are trying to get Governor Huckabee here with his Healthy America initiative because the fixit medical system is broke and we have some ways to try to save it. Tennessee was mentioned in the Economist for letting over 300,000 of our sickest folks off Medicaid.
What is/are the most striking recent development(s) related to your work, both scientifically and otherwise?
I've alluded to the big picture. It seems everyone is on the role of diet, nutrition, stress, sleep, exercise, exposures and what our chronic disease outcomes are. We're adding more and more to the complexity with mental health connections to the chronic diseases (Type A's and heart attacks, stress and asthma, and now depression and obesity and c-reactive protein). I feel fortunate to have gotten the inflammation thing down pretty good back in the '70's and now marvel at how we're learning about how it plays out with all the complex inputs. The whole immune switching "hygiene hypothesis" blows me away. I think the fetal origins of adult disease is going to be a biggie and the work with regulatory molecules is just beyond belief. Heavy metals are at very low levels. Besides lead, what about all the mercury, aluminum and chromium? There is no threshold for just about anything related to cancer and since inflammation may be a common insult to figure into cancer, heart, asthma, gastro-intestinal and joint, are we just too stupid to see the connections yet?
Can you tell us the most salient lessons you've learned in pursuing your goals?
I enjoy the process, and that includes the failures. I don't put as much faith in the precise science as people would expect. I see efforts that seem discombobulated- like tobacco control, fighting childhood obesity, urban sprawl and sustainable economic and community development - to be fun to work through, from the minutest mechanisms to the biggest tie-ins like global climate change. What could be more daunting than to realize that your role in getting things done is more as an enabler for generations that have yet to be born? Give them a chance by providing the necessities. People like Dick Jackson, Phil Landrigan, Ken Olden and Lynn Goldman have all made me smarter by pointing the way. Involvement with the equity, environmental and social justice issues appeal to me like I would have never imagined because of the belief in getting others to contribute, enlightened self-interest.
This country needs help, fast. Even science is GOBSAT (Good old boys sitting around the table). Big academic medicine is too big and self-serving, with too much emphasis of lobbies, big this, big that.
We still think green as in dollars, not green as in the environment and the relationship between the two and health. If I go back to issues like indoor air (radon and black mold) I have a totally different mindset when I hear a technocrat try to overwhelm people with their quick fixes rather than looking systemically at issues and trying to have a teamwork approach to the solutions, especially involving the little guy.
What do you see as the biggest need/unrealized goal in environmental health at this time, and the biggest obstacle to attaining that goal?
We've got to design things better, rather than wait for them to be broken to fix them. The green building movement would be the paradigm shift for me. Include that with healthy healthcare facilities, schools and homes and we have environmental health at the core, not the periphery. And it would be based on a love of green, that nature connection that Wendell Berry and others talk about in eco-psychology. That carries the ball for many of the issues we are talking about. In other words, it is compatible with health, not disease. We are a long way from that! People like Bill Clinton sort of had the idea and assembled people who could run things from the center. I wish we could agree on things like universal health care, smoking cessation, asthma trigger avoidance and the role of exercise and diet and stress management.
I guess I want evidence-based public health to take a leading role with diseases like asthma, where we need to get a clue of how we can turn the ship around. Yet healthcare dollars are in fixit medicine instead of wellness and prevention, that public health solutions try to address, especially with the "built environment/healthy cities" stuff. We sure are going to have a lot of vulnerable young and old and other high risk (fetus, genetically and socio-economically predisposed people, etc.) to deal with. Tracking would be nice, so we know what's signal and what's noise, at least until we are in the brave new world of systems biology like Leroy Hood talks about where the nanotechnology (itself a danger) and the genetic fingerprint creates the risk/status for each individual and health/medicine is more sound at making cost benefit judgments. TOP
Posted: 23 January 2006
|
