Author: Jessie Gregson-Williams

In 2014, one American town prioritized cost-saving measures over the health of its people. The city of Flint, MI imprudently decided to trade its current drinking water system, which piped treated water from the nearby city of Detroit, to a new, familiar source: the Flint River. Inadequate treatment of this new water source prompted a deadly health crisis for the locals. The crisis persisted as government officials consistently neglected ongoing issues, despite escalating complaints about the putrid, off-tasting water supplied to Flint homes and reports of various severe health issues. Finally, two years after Flint had changed its water source,  then-President Obama spoke up about the federal government’s commitment to the residents of Flint, claiming he “will not rest until every drop of water. . . is safe to drink and cook with.” Today, many are still dealing with the lingering effects of the disaster. Fortunately, this crisis received attention, with settlements disbursed to residents and ongoing government commitment to the city’s water supply.   

The abundant government aid received by Flint during its crisis contrasts sharply with the current public health emergency unfolding in Gaza, where our government is contributing to the massacre through foreign assistance in both military and economic capacities. Specifically, since 2000, the majority of annual U.S. aid to Israel has funded military efforts, primarily in the form of maintaining and updating its missile defense system. Critically, the Palestinian people are not unfamiliar with violations against their human rights at the hands of the Israeli government. For decades, Israel has ignored obligations imposed by international and humanitarian law through the calculated denial of health resources, obstruction to healthcare access, and militant attacks on Palestinian health infrastructure. Now, in the aftermath of the initial outbreak of violence of October 7, 2023, the occupied Palestinian territory of Gaza has been the target of more relentless violence, including unlawful bombardment of healthcare facilities and obstruction of supplies for basic needs. Specifically, Israeli authorities were eager to cut innocent Gazan civilian’s access to water, medical supplies and electricity, while also maintaining full control over food deliveries into Gaza. Now, more than 96% of the water supply is unfit for consumption. The U.N. Children’s Fund expressed “the death toll will increase exponentially if incubators start to fail, if hospitals go dark, if children continue to drink unsafe water and have no access to medicine when they get sick.” The current humanitarian crisis evidently doubles as an extreme public health crisis, as Israel weaponizes basic necessities.

As those in Gaza fight to survive, one may question the absence of public outrage and intervention we witnessed from American leaders during the Flint disaster. Although the ongoing Israel-Palestine conflict is happening outside our American borders, the U.S. plays an extremely integral role here. Israel has been the largest cumulative recipient of U.S. foreign aid since its inception, currently valued at around $300 billion in assistance. Meanwhile, while the U.S. Government preaches its commitment to ensuring clean, safe water access as a basic human right, that same government is directly funding an Israeli military operation drastically limiting Gazans’ access to water. As of February 29, 2024, at least 100 Gazan civilians were killed or injured from Israeli bombardment while waiting desperately for food aid dispersal. The U.S. is funding this.

The catastrophe in Flint was devastating and preventable— with an estimated 140,000 individuals exposed to the bacteria-ridden water and at least 12 deaths. Thankfully, President Obama declared a national state of emergency, authorizing the government to provide necessary equipment and resources to the people affected using federal funding. Meanwhile, the death toll in Gaza currently exceeds 30,000, a number that even experts claim is more than likely an undercount, with around 70,000 civilians injured since October 7. The U.S. is not only complicit here, but is actively aiding the oppressors. In examining the stark disparity between the government aid and accountability seen with Flint’s public health emergency and the public health tragedy in Gaza, it serves as a reminder of the need for equitable and compassionate global responses to crises, irrespective of geographical boundaries or political affiliations, as well as the importance of government accountability.

Amidst an unprecedented U.S. environmentalist movement in the 1970s, Congress enacted groundbreaking legislation to protect the public health and welfare: The Safe Drinking Water Act (“SDWA” or “Act”). Officially signed into law by President Ford in 1974, the SDWA was revolutionary at the time, providing a national “comprehensive regulatory framework” for overseeing the drinking water supply of the country at large. The Act delegates authority to the Environmental Protection Agency (“EPA”) to set standards for drinking water safety and quality. Importantly, the SDWA expressly allows for states to monitor their own compliance with EPA standards, rather than the federal government. The Act requires a two-step process: (1) EPA establishes a maximum contaminant level goal (“MCLG”), creating a strict health-based goal, and then (2) as provided by Section 1412(b)(4)(B), EPA sets a maximum contaminant level (“MCL”), creating the enforceable standard. This is the standard states are required to meet for certain listed contaminants—a list requiring review and revision every six years. 

Though the United States is a leading country in water safety, as much as half of some state populations still drink unregulated water from small systems that slip through the cracks of the regulatory protections enforced by the Act. This is because the SDWA regulates only public water sources, defined narrowly as that providing drinking water regularly to a minimum of 25 people or through 15 service connections for at least 60 days per year. Moreover, state enforcement of the SDWA has also been the subject of much criticism. In 2015, nearly 77 million Americans resided in areas with water systems in violation of the SDWA’s safety standards; however, because the statute requires self-regulation by the states and municipalities themselves, these violations were underreported, leaving many consumers unaware that their drinking water may be substandard. Maybe more concerning is that “nine out of ten violations of the SDWA are not subject to disciplinary or corrective action,” again, likely due to the Act assigning states the burden of regulating themselves.

A more modern concern about the SDWA is that it only regulates an outdated list of contaminants. For example, “PFAS,” broadly known as “forever chemicals,” are harmful human-made substances that are incredibly resilient and persist in the environment over long periods of time. PFAS can be found in a broad range of consumer products, from food to cookware, and even diapers. Thus, it is no surprise that the chemicals have been detected in U.S. air, water, soil, and the bloodstream of the many Americans. Research shows PFAS exposure can be toxic at relatively low concentrations and may result in adverse health effects, such as cancer or developmental delays to unborn children. A recent government study estimates more than half of our tap water across America could contain these toxins. Yet, the public drinking water containing PFAS meets legal standards unless and until EPA explicitly sets an MCL for the contaminant.

Fortunately, in 2021 EPA proposed a rule now in its final stage of approval. The rule includes the authorization to regulate certain PFAS in drinking water by establishing the MCLG and determining the MCL states will be required to enforce. EPA intends to implement the final rule in 2024. Still, for decades there has been effectively no government intervention nor industry regulation on how these toxic chemicals are used. Further, Americans will continue to drink tainted water until the new MCL is officially established–a process that has taken three years and counting. While the SDWA has created a consistent set of rules that still serve as a fundamental standard for ensuring public water safety, its effectiveness and practicality is tarnished by complexities. First, approximately 12% of the US population depends on federally unregulated private wells for drinking water because the scope of the Act is too slim. Second, per the Act, Americans are only protected by an underinclusive list of contaminants that EPA has established MCLs for, which shockingly only requires review once every six years. In sum, Congress should take action to rework the specifics of the SDWA so that it is more inclusive in terms of its scope of what water is regulated, how the federal government oversees state enforcement, as well updating which contaminants are subject to MCLs.

It comes as no surprise that children are heavily influenced by the social makeup of their environment, especially as they enter adolescence. Today, parents face a particularly unique fear with peer pressure: the fear that their children will develop an addiction to nicotine. Peer pressure is a contributing factor influencing children to pick up an e-cigarette, or vape, for the first time. Additionally, there is a plethora of marketing tactics purposefully utilized by e-cigarette manufacturers that influence America’s youth to buy these products. Some of these tactics include emotional appeal, targeted advertisements, social media, and even “fun” flavors and colors. In fact, the original tactics used by the tobacco industry (“Big Tobacco”) are so effective that many e-cigarette manufacturers have taken over the exact same trade secrets to advertise their products. For example, e-cigarette companies have been known to implement emotional appeal to attract teens to their products, including portraying friendship, happiness, sex, and success.

Perhaps even more alarming is the success the vaping industry has seen in using colorful, eye-catching packaging full of cartoon characters and sweet flavors. These advertisements directly target adolescents and appeal to children’s affinity to candy. Further, e-cigarette companies have found massive success in marketing to teens through social media platforms. The use of fun flavors, prestigious celebrities, and persistent marketing on youth dominated apps all exert influence on viewers’ decision to vape. Notably, this past September of 2022, Juul Labs Inc. reached a settlement agreement to pay $438.5 million to thirty-three states to resolve claims that it marketed addictive products to children. The agreement now prohibits Juul from marketing to youth and even bans advertisements featuring cartoons or anyone under thirty-five years old—but what about the rest of the manufacturers?

In 2020, likely in response to the growing fear by concerned parents, the Food and Drug Administration (“FDA”) began requiring all e-cigarette products to apply for and receive regulatory approval. This announcement led to nearly 8 million applications by distributors and manufacturers. Given the length of the approval process, regulatory delays by FDA have allowed for the e-cigarette products to stay on the market for years while waiting for review and authorization, further paving the way for the youth vape epidemic America faces today. Over two years after the established FDA requirement, the review process is ongoing and flavored vapes are still widely available on the market.

While FDA sorts out its administrative delays, families are filing personal injury suits against e-cigarette manufacturers. Juul currently has a number of pending lawsuits filed against it in relation to severe lung conditions, stroke, seizures, and nicotine addiction. These claims are made possible through product liability, which holds a manufacturer, distributor, or seller of a dangerous product financially liable for injuries caused by their defective product. Although legal success is possible, this litigation can be a time-consuming and expensive way to reach justice for those injured without addressing the initial problem of vape accessibility among the youth.

Perhaps the best solution here lies in implementing stringent regulations at the federal level, which would preempt any loose state laws. Policymakers should aim to halt children and teens’ access to vapes while maintaining other effective ways for adults to quit smoking. The youth of America deserve to be protected from this kind of harmful marketing that can detrimentally impact their health and their future as a whole. In the modern age of technology, marketing influence is practically inescapable. Thus, legislators and policymakers alike should step in and assist FDA to protect American youth now before it is too late.

Every few decades there is a shift in diet culture. Currently, we are experiencing the war on sugar as consumers become increasingly aware of the growing overconsumption of sugar and the risks associated with it. As a result, high-intensity sweeteners are now a common alternative to ordinary sugar that make up little to no calories when added to food or drink, creating desirability for those attempting a calorie deficit. These sweeteners are frequently used in beverages or foods marketed as “diet” or “sugar-free.” Research from 2019 shows a whopping two-thirds of Americans were attempting to limit their sugar intake. In efforts to keep up with these trends, the food industry had to begin adjusting the contents of their products while adhering to the Food and Drug Administration’s (“FDA”) regulations.

Among the high-intensity sweeteners on the market are saccharin and aspartame. Both are chemical formulas used as food additives to produce an intensely sweet flavor without the calories of sugar; notably, aspartame is 200 times sweeter than sugar. Both saccharin and aspartame are currently approved and regulated by the FDA. High-intensity sweeteners are regulated as a food additive, unless its use is generally recognized as safe (such as stevia leaf). Before a food additive can be used in food and marketed as such, it must undergo premarket review and obtain approval by the FDA. During the premarket review of the current high-intensity sweeteners permitted for use, the FDA established an acceptable daily intake level (“ADI”) for each of the sweeteners. The FDA has included a chart on its website showing the number of tabletop sweetener packets a 132 pound individual would need to consume to reach the ADI: 75 packets of aspartame and 45 packets of saccharin. The FDA also claims that even for consumers whose daily consumption of a sweetener is high, it generally does not present safety concerns if it is still less than the ADI.

Yet, the question remains for consumers conscious about their health but with a persistent sweet tooth: should I be choosing products with sugar or artificial sweetener? This complex question is best answered by comparing Diet Coca-Cola (“Diet Coke”) to regular Coca-Cola (“Coke”). Diet Coke contains artificial high-intensity sweeteners, including aspartame, while regular Coke contains traditional sugar in the form of high fructose corn syrup. However, high consumption of both Diet Coke and regular Coke may be linked to a higher risk of heart disease and other health problems. The question is not “which version of sweetener is better for you,” but “which version of sweetener is less bad for you.” A can of Coke contains 39g of sugar, which amounts to about 7 teaspoons of sugar. The FDA suggests a Daily Value of 50 grams per day for added sugars based on a 2,000 calorie daily diet. Thus, drinking a Coke will make up 78% of one’s suggested daily added sugar intake. Contrary to what many believe, Diet Coke (although containing 0g of sugar) may still present similar health issues as regular coke, such as a spike in blood sugar caused by its artificial sweeteners. Spikes in blood sugar have been linked to heart problems, type-2 diabetes, weight gain and the other various health problems commonly associated with traditional sugar intake.

Overall, the convoluted truth is that western diet trends heavily influence how products are presented in the media and then marketed to the public. Evidently, there is a surprising lack of concrete scientific evidence to heavily sway individuals in one direction or another in terms of choosing high-intensity sweeteners over classic sugar. Remarkably, the one consensus is that neither of the two are particularly “good” for health as both are addictive and stimulate the brain in a similar fashion. In sum, moderation is key as consuming excess amounts of either sugar or artificial sweeteners can be cause for concern. It is important not to blindly follow the intentional marketing of “diet” or “zero sugar” products without doing further research on what exactly is replacing that sweet flavor. But, to avoid the issue altogether, perhaps opt for a sparkling water sweetened naturally with fruits instead of deciding between a diet or regular Coke.