Leslie Lott
“Health Care With Harm”: A Study of the Initiative To Shut Down Henry Ford
Hospital’s Medical Waste Incinerator in
Detroit, Michigan
TABLE OF CONTENTS
Max Ortiz/ Detroit News
 PROBLEM
 BACKGROUND
 KEY ACTORS
 DEMOGRAPHICS
 STRATEDGIES
 SOLUTIONS
 RECOMMENDATIONS
 REFERENCES
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Problem
The effects of incineration have plagued both Virginia Park, as well as other Detroit residents for
years. Wayne County’s reliance on incineration for medical and municipal waste is evident in the
location of three incinerators within an area of less than three miles of each other: Henry Ford Medical
Waste Incinerator, Detroit Municipal Incinerator, and Hamtramck Medical Waste Incinerator. Many
citizens have referred to this area as Wayne County’s “toxic triangle of incineration”( Pers. Comm. Cedar
2000). The Henry Ford Medical Waste Incinerator is located on the premises of Henry Ford Hospital in a
mixed business and residential area on West Grand Boulevard in Detroit, Michigan.
Public Health
Since the incinerator’s inception in 1980, citizens have made repeated complaints because of foul
smells and thick black smoke, which penetrate the Virginia Park neighborhood on a daily basis (BatesRudd “Hospital to Close” 1999). The United States Environmental Protection Agency (USEPA) states
that medical waste incinerators have been some of Michigan’s largest polluters, for burning waste send
tons of lead, dioxins, and other toxins into the atmosphere (http://www.ecocenter.org/health.html).
For years, Virginia Park Residents, particularly children and the elderly, have been suffering from
respiratory illnesses and other related heart conditions
(http://www.essential.org/cchw/campaign/Profiles.html). Residents are plagued with nausea and
headaches that miraculously disappeared when the incinerator was closed for maintenance reasons in late
1999. David Josar reports that, Michelle Gertz, 44, is becoming increasingly convinced that the
incinerator in her neighborhood is not so safe. Her children, Brian 10, and Brittany 8, have chronic
headaches and stomachaches which she suspects are caused by the toxins and respiratory irritants that
permeate into the environment from the incinerator’s smokestacks (“Incinerator Worries” 1999). “There
have been twenty-one recorded deaths related to respiratory and other health problems on Poe Street,
located directly across the street from the incinerator”
(http://www.essential.org/cchw/campaign/Profiles.html).
Environmental Justice
Since the mid- 1980’s it has become increasingly apparent that there is a disproportionate impact
of environmental toxins and pollution on individuals who reside in poor and minority communities than
those who live in other areas. A study conducted by the United Church of Christ concluded that in
communities with two or more commercial hazardous waste facilities, the number of minorities was three
times higher than in communities without hazardous waste facilities. Environmental racism is the
deliberate targeting of people of color communities for toxic waste facilities and the official sanctioning
of a life threatening presence of poisons and pollutants in people of color communities (Bryant 2000).
Henry Ford Hospital is located in an area where people of color make up ninety-one percent of
the population with African-Americans making up the largest number of that percentage
(http://www.uscensus.gov). The Henry Ford Health System that operates Henry Ford’s Hospital has two
other hospitals in predominately Caucasian suburbs. Currently, these suburban hospitals do not incinerate
their medical waste, but send it to an autoclave in Toledo, Ohio where it is steam sterilized ( Simmons
1999). Donele Wilkens of Detroiters Working For Environmental Justice asserts “Detroit residents are
already exposed to more harmful pollutants than their suburban neighbors” (Seigel 1999). To neighbors,
community leaders, and environmental groups this is clearly an issue of environmental racism and
injustice. However, in January 2000, in response to a letter written by the Coalition to Shut Down Henry
Ford’s Medical Waste Incinerator, Steve Velick, the Chief Executive Officer of the hospital at the time
denied this as being an environmental justice issue. He states “Cottage and Wyandotte [two of the
hospitals located in the suburbs] stopped incinerating waste because their facilities did not generate
enough waste to justify the costly incinerator upgrades required to meet the EPA’s newest standards”
(2000). “Nevertheless, community leaders want to know why the hospital chooses one method in a white,
suburban community and a different one in an African-American community” (Holden and Simmons
1999).
Role Of Health Care
Health care professionals and their institutions pledge to provide services that defend human
beings against illness. Furthermore, health systems serve to incorporate vital public health principles in
the daily operations of their facilities, including taking an active role in disease prevention (Michigan
Environmental Justice Coalition 1999). The Health Care Without Harm Organization(HCWH) explains “
[y]et, unknown to many of us, the purchasing and waste disposal practices of health care institutions often
undermine their own purpose, and our expectations of them, by contributing to sickness” (HCWH 1999).
Further, health professionals have taken the Hippocratic Oath of ‘first, do no harm,’ and practices such as
incineration are directly inflicting harm on communities that health care providers claim they strive to
protect.
Alternatives to Incineration
Community leaders maintain that there are affordable, safe and more efficient alternatives that are
now being used by an increasing number of hospitals. However, relying on incineration for the disposal of
medical waste from hospitals is slowly becoming a rarity in southeast Michigan, particularly Wayne
County. In a 1998 survey of twenty-five Wayne County hospitals found that Henry Ford Hospital is the
only one still burning their waste in an incinerator on site. One third of these hospitals send their waste a
steam based autoclave in Toledo (Seigel 1999). Various technologies have been to sterilize and reduce the
volume of medical waste without incineration. Currently, autoclaves are the most common treatment
alternative in the United States. An autoclave destroys infectious agents through a process of steam
sterilization. However this process does not burn waste, therefore reducing the risk of dioxin production
(HCWH 1999).
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Background
The Henry Ford Health Care System was founded in 1915 to “provide comprehensive health care
for residents of Detroit and southeast Michigan” Henry Ford Hospital has 900 beds and an education and
research complex on site. Currently there are only two processes which produce emissions on the site of
the facility: a medical waste incinerator, fuel fired steam boilers and emergency boilers. The incinerator
was installed in 1980 (Velick 2000).
Until recently, Henry Ford Hospital incinerator burned approximately 600 million pounds of
medical and solid waste annually. While the waste stream includes used surgical dressings, latex gloves,
old medicines, and amputated body parts, it is mainly comprised of discarded paper and plastics that
could be recycled or disposed as ordinary hospital waste (Pers. Comm. Holden 2000). The Center For
Disease Control (CDC) estimates that only six percent of the waste stream is infectious and only two
percent of the hospital waste stream is any significant threat to human and should be burned in a
crematorium or other incinerator. The rest of the waste or more than ninety percent can be handled in the
same way solid waste is handled by reducing, reusing, and recycling
(http://www.ecocenter.org/health.html). Excessive burning of plastics, paper, and other non-infectious
wastes results in the emission of dioxins, furans, arsenic, lead, mercury, cadmium, carbon monoxide, acid
gases, and toxic particulates.
The USEPA states in their draft of the Dioxin Reassessment which hospital incinerators are one
of the three largest sources of dioxins to the environment. Their research findings show that dioxins not
only cause cancer, but may lead to developmental, and immune system problems to those who are
exposed to these toxins over an extended period of time. Additionally, the EPA asserts that medical
waste incinerators are the second leading source of mercury, which is a neurotoxin. Incinerators also emit
pollutants and particulates that are respiratory irritants that can exacerbate problems for asthma sufferers
( HCWH 1999).
The citizens whom inhabit the area surrounding the incinerator can attest that they have seen the
effects of these toxins on themselves, their family, and the community at large. A 1998 Wayne State
University Report found that Michigan residents living near pollution sources such as incinerators, have
lower birth rates and higher rates of cancer. A five year Michigan Department of Community Health
study shows that the rate of children hospitalized for asthma is at least three times higher in a cluster of
inner city zip codes surrounding Henry Ford Hospital than in Wayne County, outside of Detroit.
Additionally, the Report asserts that asthma rates among African-American children is increasing. For
further evidence, a report commissioned by the New York University Research Program focused on
Ambulatory Care Sensitive Conditions in Michigan from 1983 through 1994 sites that in the four zip
codes surrounding the incinerator, the average number of hospital emissions of children aged zero
through four are at numbers four times the state average (1998).
Community Organization
Although the incinerator has been criticized since its inception, a neighborhood residents of the
Virginia Park District’s Council did not start actively working on this campaign until late 1996-early 1997
when the facility failed an opacity test, the only restriction on particulate air emissions for medical waste
incinerators in Michigan at that time (Pers. Comm. Holden 2000). Opacity measures and limits the
amount of particulate content of what is coming out of a smokestack and provides no limitations on toxin
levels. Failure of this test brought some community attention to the incinerator and provided an
opportune time for community leaders to begin a dialogue with the Health System.
In August 1997, the EPA released the first federal standards and guidelines (the MCAT rule)
regulating hospital and medical waste incinerators. Existing facilities will have three to five years to
comply with these rules (HCWH 1999). At the time of the release of these guidelines, Henry Ford’s
incinerator did not comply with the new federal standards for emissions. Wayne County granted a
consent order approving the renewal of their permit contingent on reducing pollution to levels acceptable
to the USEPA. The Consent Order includes limits on final emissions and stack testing to confirm that the
incinerator is operating in compliance. Waste changing rate has been reduced from 1800 pounds per hour
to 1000 pounds per hour. Additionally, certain pollutants will be monitored by a Continuous Emissions
Monitoring System (Wayne County Dept. of the Environment 2000)
Community member and other environmental organizations realized that HFHS would be making
critical decisions during the next few months, which would decide how the incinerator would operate in
the future. The Sierra Club and the Ecology Center, in particular, were unwilling to approve letting the
incinerator continue to operate at these Federal levels. Both groups believe that Fed guidelines
compromised with environmental safety by not providing adequate protection of the health of the
community by allowing tons of toxins to be released into the environment each year. These groups felt
that complying just to these standards was not doing enough. Employing a waste reduction program,
phasing out mercury based products and attempting to reuse and recycle many of the products thrown
into the waste stream quickly were placed on the agenda as well. Community members claim that
“hospital has an obligation not only to live up to the letter of the law(and whatever loopholes may be in it)
but to live up to the Hippocratic Oath” (Seigel 1999). So, community health and environmental
organizations from around the greater Detroit Area decided that forming a collation would be the best
tactic to use to effectively use community resources in the area to lobby for the shutdown of the
incinerator and drastic changes in waste management practices.
The hospital, despite hearing the Coalition’s demand for HFHS to shut down the incinerator
decided that spending $2.1 million dollars on upgrading on upgrading the incinerator to comply with new
Fed Regulations was the best option (Bates-Rudd “Hospital Claims” 1999). Mike Whelan, Henry Ford
Hospital’s Vice President of Support Services claimed the “hospital did a very extensive study evaluating
fifty-two alternatives….[and] they claimed that other methods of dealing with medical waste would have
raised expenses and health costs or would have required the waste to be transported through residential
areas, creating safety problems for the community” (Seigel 1999).
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Key Actors
Henry Ford Hospital
Henry Ford Hospital has been operating an on site medical waste incinerator since 1980. The board of
executives including Nancy Schlicting have always maintained that the “all scientific and technical
standard indicate that incinerator is safe to operate and the WCDEQ has confirmed it meets all air quality
standards”(Schlicting 2000). They cite examples that show their attempt to be a “good corporate citizen”
such as spending two million dollars to upgrade the incinerator to meet USEPA “stringent” air quality
standards.
Further, issues of potential environmental injustices have been repeatedly denied. However,
the hospital executive’s became very responsive and open to meeting with the coalition to discuss their
concerns and questions about the operating of the incinerator.
James Williams, VPCC member
Photo by Daniel Mears/ Detroit News
Virginia Park Citizen’s Council(VPCC)
Virginia Park Citizens Council is a local neighborhood council that has actively opposed an
incinerator being located in their community since 1996. One of the most vocal members of this
organization is resident James Williams who was incensed by the unequal treatment of residents in his
area as opposed to suburban residents. He also has become increasingly convinced that the incinerator
located across the street from his home may be causing some of his health problems. “I want to be a good
neighbor to the hospital, not a patient in it.”(Barry 2000). Williams and other council members have been
a liaison between the neighborhood residents and the coalition at large. VPCC helps to educate their
neighbors of the potential health effects of incinerator and encourage them to attend town meetings and
rallies to ensure that their voices would be heard by the HFHC Also, organized the usage of yard signs
which said “Shut It Down, HENRY FORD” and encouraged the community to come to public hearings
and rallies.
Coalition To Shut Down Henry Ford Medical Waste Incinerator
This coalition was established over four years ago and involves over thirteen community, public
health, and environmental organizations including: Virginia Park Citizen’s District Council; Detroiters
Working For Environmental Justice; Southeast Michigan Group of the Sierra Club; the Ecology Center;
the Sugar Law Center for Economic and Social Justice; the National Wildlife Federation; and the
Michigan Chapter of the American Lung Association. Additionally two local grassroots community
groups focusing on shutting down incinerators in their own communities, Hamtramck Environmental
Action Team and Clean Air Please! Of Madison Heights, offered support as well. The coalitions received
political endorsement from two local governmental officials: Wayne County Commissioner Jewel Ware
and State Representative Hansen Clarke. The primary goals of the coalition are to (1) shut down the
medical waste incinerator (2) prevent HFHS from sending their waste to a commercial incinerator (i.e.
Hamtramck Commercial Medical Waste Incinerator) (3) reduce the waste stream and its toxicity (4) start
a extensive recycling program on site (Pers. Comm. Doyle 2000)
Southeast Branch of the Sierra Club
Anna Holden, who is the chair of the Southeast Branch, is the lead member and spokeswomen for the
Coalition. Anna has been an active part of both the civil rights and environmental movements since the
early 1960’s. In 1999, she published two articles about the campaign to shut down the incinerator, in an
attempt to raise even more national public awareness of health and environmental justices issues. Both
her dedication and experience with similar campaigns makes her a valuable asset to this struggle. Finally,
as an organization, the Sierra Club provided financial resources and a well renowned name, adding
legitimacy to the cause.
Detroiters Working For Environmental Justice(DWFEJ)
DWEFEJ has emphasized the apparent environmental injustice occurring in the Virginia Park
neighborhood. Donele Wilkens, director of DWEFEJ, has become the “face of the coalition” due to her
eloquent and powerful speaking ability. She explains, “Environmental racism is real. In neighborhoods
across Detroit and around the nation, it is destroying the health of our people” (Wilkens and Sullivan
2000). Through the effort DWEJ, the Coalition has received national attention through hosting a press
conference in Detroit “declaring a national state of emergency on environmental racism and economic
injustice” that focused on local environmental injustices, including Henry Ford’s Incinerator. The
keynote speaker for this event was Damu Smith of Greenpeace USA, who was instrumental in the
struggle to prevent the Shintech Corporation from placing a hazardous waste facility in a predominately
African-American neighborhood in Louisiana. This press conference enabled the Coalition began to
publicize their concerns and efforts under the umbrella of the national environmental justice movement.
Jewel Ware, Wayne County Commissioner
Jewel Ware joined the coalition in 1998 when she was informed of the health threats that community
members in her district were experiencing due to location of Henry Ford’s incinerator in their
neighborhood. As a prominent local official, she has the respect of many local community leaders and
enlisted local ministers to endorse a series of advertisements in local newspapers, demanding that Henry
Ford shut down its incinerator. Also in 1999, Ware sponsored several town meetings that helped to
facilitate an active dialogue between that addressed the questions and concerns of citizens in the area.
Ware stated in September 1999, “Henry Ford Hospital likes to boast about its leadership in medicine.
[Failure to comply with opacity and cadmium] tests show that Henry Ford also leads as a polluter. As a
health care provider, it ought to be ashamed that its incinerator poses such a serious health hazard to the
public” (Josar “Environmentalists” 1999).
The Ecology Center
The Center’s Environmental Health Project has focused on a medical waste project that promotes
environmentally responsible health care and provides technical assistance to community and local
officials. Specifically, this project attempts to educate the community of the harmful health effects of
incineration and advocates the shut down of all incinerators in the southeast Michigan area. Their
activism brought much needed resources into the campaign including experts on public health,
researchers, and past experience in campaigns to shut down incinerators. The Ecology Center’s staff
member’s who focus on their medical waste project, Tracey Easthope and Mary Beth Doyle were also
instrumental in shutting down the University Of Michigan’s medical incinerator while the Henry Ford
campaign was beginning to become more aggressive. Additionally Tracey Easthope is an important
member of the campaign for she is a scientific expert on incineration and its potential effects on public
health. With the Center’s connections to the national Health Care Without Harm Organization, Health
System officials experienced national public relations embarrassment as being a health care provider that
is inflicting harm on the very individuals it strives to keep healthy.
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Demographics
In order to somewhat accurately portray the demographics of the area, the four zip
codes (48202, 48206, 48208, 48201) located around the Henry Ford Hospital were chosen for analysis.
The population of these four zip codes combined is 93, 962. Of these individuals, 85, 868 are people of
color who are largely African-American. Thus, the percentage of people of color in this area is ninetyone percent of the total population. Additionally, sixty percent of the families that live within a two and a
half mile radius of the incinerator are at or near the poverty level (about $15,000 per year for a family of
four).
The following chart represents a summary of information based on 1990 Census data for all four
zip codes.
Zip Codes
Total
% of People of
% of
Population
Color in Pop.
Households
>$15,000/year
48202
24,565
91%
58%
48201
16, 221
75%
79%
48206
38, 035
99%
56%
48208
14, 925
92%
65%
Source: 1990 U.S. Census Data
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Strategies
Coalition Building
Establishing a coalition in 1998 provided a strong and threatening presence that demanded the
opinions and concerns about incineration be heard. Connecting individuals from diverse backgrounds and
resources provided a variety of perspectives and a significant amount of human resources that are needed
for this campaign to be a success.
Drawing Support From National Non-Government Organizations
Making connections with nationally known organizations such as Sierra Club, Health Care
Without Harm, Detroiters Working For Environmental Justice and Greenpeace provided national
attention, resources, and legitimacy to this campaign.
Civil Disobedience
Nonviolent rallies have been one of the primary methods used by the coalition to gain public
awareness of the harmful effects of the incinerator on the residents of the community. Although these
four rallies received little media attention, they became a public relations embarrassment to HFHS. to
Constant Community Pressure
In the beginning of the campaign the coalition target of influence was the board of executives and
the public relations department in a broad sense. When letters and phone calls to the board were not
causing executives to desire to meet with coalition members to discuss their concerns, the community
decided it needed to formulate a different, more effective approach. Eventually it was decided that they
would target a specific executive within HFHS who possessed power within the health system, would
respond to pressure, and had the insight and conscience to realize it was in the hospitals best interest to
shut down the incinerator. This woman was Nancy Schlicting, Senior Vice President of the Henry Ford
Health System. Citizens demanded that their opinion be heard by making hundreds of phones calls and
supplying a daily shipment of postcards to her office. Additionally, Virginia Park Citizen’s Council
began to solicit bold, red yard signs stating “Shut it Down, Henry Ford” which were prominently placed
in lawns around the facility.
Media Attention
The coalition had limited coverage by the mainstream media, so leafleting, direct contact with
citizens, town meetings and speakers at community meetings helped spread to the community at large.
Postcards were distributed and signed by neighbors and other concerned South Eastern Residents urging
HFHS to shut down its incinerator. In November 18,the same day as the “Great American Smokeout”
protesters received some media attention when they demanded that Henry Ford “Stop Smoking” (Seigel
1999).
Coalition members also placed a huge banner on the front of a church across the street from the
incinerator that stated “Henry Ford, Stop Smoking” which remained in that same position on the church
for months. By in large, most of the publicity came from public radio, alternative community
newspapers, and radio/television stations targeting African-American communities. (Simmons and
Holden 1999).
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Solutions
On February 4, 2000 Henry Ford Health System officially announced that it was “committed to
phasing out incineration over a reasonable period of time” (Schlicting 2000). The Coalition to Shut
Down Henry Ford Incinerator congratulated Henry Ford but plan to “press for a definitive and
expeditious time line to achieve the shutdown. In less than four years the Coalition was successful in
achieving their main goal. This type of outcome is unprecedented but Coalition members and HFHS
admit that community pressure and acute knowledge of the science and technology of medical waste
incinerators was what eventually caused Nancy Schlicting, executive Vice President to make this decision
(Doyle “Cleaner Air” 2000). Schlicting states herself in a letter to the Michigan Environmental Justice
Coalition that “[u]fortunately we have to deal with negative news coverage and community concerns
about it. This is taking time away from our core mission. We are concerned about our reputation and
relationship to the community we are dedicated to serve (Schlicting 2000). Mary Beth Doyle, a
representative of the Ecology center stated in an interview “when you drive to work every day seeing
more and more signs on neighbors lawns and a huge banner that is demanding the health system that you
are an executive vice president for to “stop smoking” I believe it would tend to wear on your
nerves”(Pers. Comm 2000).
The most incredible victory of this battle was that Henry Ford did not have to shut down their
incinerator at all. In 1998 the hospital spent 2.1 million dollars in improving pollution control that
included a monitoring system and an air scrubber designed to remove chemicals from smoke. This
retrofit was commissioned in response to the EPA’s MCAT rule. Additionally, in 1999 reported
incinerator emissions were ten times better than the Environmental Protection Safety Standards required
by law. The incinerator, at the time of its decided closure, was under compliance of all laws regulating
hospital and medical waste incinerators.
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Recommendations
The community members involved in the effort to shut down Henry Ford’s Medical Waste
incinerator have been successful in achieving their main goal. At this point, Henry Ford Health System
has committed to ceasing operation of their incineration facility on June 30, 2001. However, many of the
members of the coalition believe that this is not the end of the struggle. In particular the Ecology Center,
Sierra Club, and the National Wildlife Federation want to ensure that the Health System will begin to
make an effort to significantly decrease the amount of their waste stream and its levels of toxicity.
Additionally, much emphasis has been made on helping the hospital set up extensive recycling programs.
As part of the discussion at the time when Henry Ford announced that they were going to phase out
incineration in February 2000, they also proposed building a recycling center, along with the autoclave on
the site where the incinerator used to be. However, after hiring an environmental consulting firm that
many in the coalition believe to be pro-incineration, HFHS decided that the facility would be too costly.
This new update has been a minor defeat, but the Coalition has responded by encouraging HFHS
to hire Resource Recovery Systems, a firm that focuses on planning for large scale recycling programs
within industries. However, this firm has little experience working with hospitals, which may become a
problem in the later months. Additionally, the National Wildlife Fund is pushing the hospital to commit
to a mercury abatement plan. Currently, HFHS has decided that it may consider replacing its incinerator
with an onsite autoclave.
The struggle to shut down Henry Ford’s Medical Waste Incinerator provides hope and a model
for all communities struggling to shut down a hazardous waste facility in their own neighborhood. It is a
reminder that citizens themselves are advocates and that are able persuade industry to commit to ending
many of the environmental and economic injustices of the world.
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References
Personal Communications
Cedar, Rob. Hamtramck Environmental Action Team. Personal Communication on 16 October 2000.
Doyle, Mary Beth. The Ecology Center. Personal Communication on 18 October 2000.
Holden, Anna. Southeast Branch of the Sierra Club. Personal Communication on 21 November 2000.
Journals, Magazines, Books and Newspapers
Bryant, Bunyan. Environmental Advocacy: Working For Economic and Environmental Justice. An
Unpublished book. 2000.
Barry, John B. “Unjust Burden: Sierra Club Joins Growing Movement For Environmental Justice.” The
Planet June 2000.
Bates-Rudd, Rhonda. “Henry Ford to Shut Down Incinerator.” Detroit News 23 Feb. 2000. Metro.
Bates-Rudd, Rhonda. “Hospital Claims Its Air is Cleaner.” Detroit News 15 December 1999. Metro.
Bates-Rudd, Rhonda. “Hospital to Close Incinerator After Neighbors Complain.” Detroit News
29 Mar. 2000. Metro.
Doyle, Mary Beth. “Cleaner Air Coming To Detroit.” From the Ground Up. April/ May 2000.
Holden, Anna, and Charles E. Simmons. “Community Health and Environmental Justice: Burning Issues
in Detroit.” Everyone’s Backyard: Journal of the Grassroots Movement for Environmental
Justice.” Fall 1999.
Josar, David. “Environmentalists: Close Waste Incinerator.” Detroit News 22 Sept. 1999. Metro.
Josar, David. “Incinerator worries neighbors.” Detroit News 26 July 1999. Metro.
Seigel, Ron. “Demonstrators Charge Medical Waste Incinerator Causes Secondhand Smoke.” Michigan
Citizen 28 Nov.-4 Dec. 1999.
Simmons, Charles E. “Environmental Justice and Human Rights.” Michigan Citizen 26 Sept.-2 Oct.
1999.
Letters
Michigan Environmental Justice Coalition. Letter to Walter Douglas, Vice Chair Public Responsibility
Committee, Henry Ford Health System. 15 June 1999.
Schlicting, Nancy M. Letter to Alison Horton, Michigan Environmental Justice Coalition. 18 February
2000.
Velick, Steven. Letter to Honorable Jewel Ware, Wayne County Commissioner. 19 Jan. 2000.
Pamphlets and Press Releases
Health Care Without Harm. Health Care Without Harm: The Campaign For Environmentally
Responsible Health Care. Falls Church. 1999.
Wayne County Department of Environment. Air Quality Management Division. Community Bulletin.
Detroit. 2000.
Wilkens, Donele and Quita Sullivan. “Local Groups Join In Issuing A Declaration.” Press Release.
18 Jan. 2000.
World Wide Web Resources
Unknown. <http://www.essential.org/cchw/campaign/Profiles.html > (19 Sept. 2000).
Unknown. “The Ecology Center’s Medical Waste Project.” The Ecology Center
<http://www.ecocenter.org/health.html> ( 24 Sept. 2000).
United States. U.S. Census Bureau. http://www.census.gov (19 Sept. 2000)
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