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 In 1991, the Public Health Service articulated a vision for primary prevention in Strategic Plan for the Elimination of Childhood Lead Poisoning, a departure from previous federal policy focused on finding and treating lead-poisoned children. This publication detailed a 15-year strategy for primary prevention and offered a cost-benefit analysis to demonstrate the monetized benefits of this approach. A strong national effort to follow this strategy developed but was eventually abandoned.

The organized campaign against universal screening began in California, where letters questioning the reported prevalence of elevated BLL began appearing in pediatric journals and newspapers. These letters acknowledged receiving editorial assistance from Kaiser Permanente Foundation Hospitals and argued that money spent on screening, treatment and abatement would be harmful to more worthy public health efforts. The AAP president took up this attack on universal screening as well, and efforts for universal screening were gradually eroded. 

Needleman identifies racism and the belief that lead poisoning “is a product of poor mothering, not of environmental pollution” as a driving factor shaping lead detection and prevention efforts (or the lack thereof) … “this weighting of personal choice or behavior over environment is a tool used to shift responsibility away from health authorities or polluters and onto the victim” (1875).

This supplementary legal document describes recommendations for storm- and waste-water management improvements for the Formosa petrochemical plant in Calhoun County, Texas. The text is a fairly standard drainage assessment. The author describes non-trivial discharge of pollutants out of the plant’s outfalls, which drain into local waters, and the inability of the plant’s systems to prevent flooding from even small storms. For some context on this, it is pretty standard to design a stormwater system to be able to drain the 100-year storm (that is, the storm with a 1% or less chance of occurring in any given year). Formosa’s Texas plant demonstrated the inability to convey even the 2-year storm.

Emphases are mine:

“Problem areas were identified based on the results from the outfall drainage studies provided by Formosa. Thus, all the results in the OPCC rely on those studies, uncertainities associated with those studies, and the assumptions made for those studies, some of which may or may not be appropriate as I pointed out in Supplement #2 [Page 4]” (3)

“The proposed improvements assume that the conveyance capacity of the problem areas is increased 100%, which would be able to handle twice as much flow that it currently does. The results from the Drainage Study are not conclusive as to what storm event Formosa’s system currently is capable of conveying. The report does mention that the system is not capable of conveying the 2-year storm, and “sometimes” not even the 1-year storm event.” (3)

“A 45% contingency is applied to the OPCC due to the uncertainties associated with underground utilities, likelihood of existence of low road crossings and need to replace those, groundwater impacts, other unknowns, and additional costs associated with engineering, etc. 45% is reasonable and in line with industry practices in my experience, especially given the large amount of unknown information available.” (4) 

“My opinion from my July 9, 2018 report that “there have been and are still pellets and/or plastic materials discharges above trace amounts through Outfall 001” is further supported by the deposition testimony of Lisa Vitale, as representative for Freese & Nichols, Inc, that she and her colleagues have seen floating white pellets or small plastic pieces in Lavaca Bay and in the area near outfall 001 as part of her work on the receiving water monitoring program for Formosa’s TPDES permit...Ms. Vitale also testified that she told John Hyak of Formosa about these sightings as well as has sent him water samples with the pellets about five or six times, including at least one time prior to 2010. This, along with the June 2010 EPA Report I cited in my July Report, demonstrates to me that Formosa was aware of problems related to discharges of plastics from its facility since at least in 2010.” (6)

The Emergency Medical Treatment and Labor Act is a law requiring that anyone coming into the emergency department will be stabilized and treated no matter what their insurance situation is. In terms of women's health, it is important to note that this means for active labors, medical treatment is necessary and required, no matter the health insurance of the patient. The purpose of this law to prevent certain patients from being turned away in an emergency situation or refused medical treatments if they are unable to pay, putting their health at risk.

EMTALA was enacted by Congress in 1986 and was part of the Consolidated Omnibus Budget Reconciliation Acts of 1985. Congress saw different cases around America where doctors were refusing medical care to patients who could not make a deposit at the time of their admittance to the ER. An example of this is a patient Eugene Barnes, who in 1985 suffered a stab wound and ultimately ended up dying because 6+ doctors refused to help him without payment or some form of compensation. This made national news and other cases began to come to light, such as at Baptist Hospital in Miami and many other areas. News outlets began to follow these cases and this caught attention of government officials. Shortly after, EMTALA was enacted.

http://www.pitt.edu/~kconover/ftp/emtala-draft.pdf

This policy applies to American law and patients who are in need of emergency medical treatment and is to be followed by all emergency departments and personnel alike. 

This was touched upon a little in a previous question. Many cases of patient dumping were popping up around America. Patients in need  of emergency medical care were being cast aside, ignored and delayed due to their inability to pay. In addition to the stab patient, Eugene Barnes that sparked this law, there were dozens of other cases where patients needed to be transferred to larger hospitals but the hospital refused to take patients without insurance, so the patients died. There were cases of people being asked right before surgery for a deposit, and being unable to pay were discharged with no surgery. There was also a very high rate of dead babies that were arising due to the fact that mothers in labor were being turned away because the patient was uninsured. It was then realized by the government that there were no legal duties for a hospital to treat people who are in emergency situations but cannot pay, only ethical and moral duties, which apparently weren't enough in some cases. This led to the birth of the EMTALA, requiring medical attention to all ED patients as well as transfers if needed to stabilize, including mothers in labor.

This policy greatly helped sculpt emergency medicine and public health. By giving the right to the patient to have emergency medical treatment required without proof of insurance or payment, astronomically influenced the amount of patients being turned away and their possibilty of developing worse illnesses or dying. In a paper I read, a young doctor in the late 70s and early 80s remembers watching a woman in labor give birth in the doorway of the hospital and proceed to borht her child in the parking lot after being turned away for not having insurance. By requiring hospitals and doctors to see that all ED patients get care, no patient was at risk of dying or complicating their baby's health and birth due to a lack of insurance, ultimately increasing public health efforts. Not all hospitals turned away their patients, but enough did to make it a public health concern and get Congress involved. EMTALA changed emergency medicine protocols but also public health expectations and actions.

http://www.hhnmag.com/articles/5010-the-law-that-changed-everything-and…

This policy was explicitly made for vulnerable populations who couldn't afford or for whatever reason did not have health insurance. The vulnerable parties that did not have health insurance were at risk of being turned away at hospitals during crucial times of need and emergency situations. This act completely absolved the worries and fears of this vulnerable population without health insurance by making it a law that these ED patients were to receive care and stabilization. This act was made for this specific vulnerable population, to prevent discrimination.

This policy was received in good light by the public for the most part. Patients were only to benefit from this, especially those who lacked insurance. Even those with insurance didn't have to waste time proving it any longer, they were treated and stabilized and insurance issues and payment were brought up later. Any ethically sound doctors, such as the ones working in hospitals that were already implementing the actions set forth by EMTALA (before it was law) had no issues with EMTALA. No doctor should have any issues with it due to their duty to act as well as ethical and moral standards they should be holding themselves up to, written in their oath they took to become doctor. The only people that would stand to receive this act negatively would be the doctors who were actively turning away patients in need, who are clearly morally compromised. Yet, media, patients, a majority of doctors and staff found and received this act positively or with little reservation.