interviews
Water and the American West
by Richard Frank
October 25, 2021
This interview with Richard Frank, professor of environmental practice at the UC Davis School of Law and Director of the California Environmental Law and Policy Center, was conducted and condensed by franknews.
frank | Can you tell me a little bit about the story of water and how it's tied to the West, and to California in particular?
Richard | A friend of mine who's a Court of Appeals Justice here in California wrote an opinion on a water law dispute and started it with the quote, "the history of California is written on its waters." And I think that the point is true of the entire American West.
Water policy and legal issues are inextricably tied to the development of the Western United States; water is the limiting factor in so many ways to settlement, to economic development, to prosperity, and to the environment and environmental preservation.
Can you talk about the difference between groundwater and surface water– and the policies that regulate each?
There are really two types of water when it comes to human consumption. There's surface water: that is the water that is transmitted by lakes, rivers, and streams. Then there is groundwater, and a substantial amount of water that Americans and the American West rely on is groundwater. That is water that is stored in groundwater aquifers, which are naturally occurring groundwater basins. Both groundwater and surface water are critical to the American West and its economy and its culture.
Traditionally a couple of things are important to note, first of all, water is finite. Second, water gets allocated in the Western United States generally at the state level. There's a limited federal role. Primarily, policy decisions about who gets how much water for what purpose are made state by state.
I think allocation is really interesting in that it's more state-level than federal. How was water and the allocation of water in California designed? Is it a public-private combination? What goes on in terms of the infrastructure of water?
Another very good question. The answer is it depends. Most of our water infrastructure is public in nature.
Again, in the American West, the regulation of water rights is generally done at the state level, but the federal government, historically, has a major water footprint in the American West because it has been federal dollars and federal design and management that really controlled much of the major water infrastructure in the American West — you know, Hoover Dam, and the complex system of dams and reservoirs on the Colorado River in California, with the Central Valley Project that was built and managed by the federal government with Shasta Dam on the upper Sacramento River as the centerpiece of that project. But we also have a California State Water Project, the key facility being the Oroville Dam and reservoir on the Southern River that is managed by state water managers. If we were starting over, that kind of parallel system would make no particular engineering or operational sense.
But, we are captive to our history.
And then you have these massive systems of aqueducts and canals that move water from one place to another throughout the American West. They are particularly responsible for moving water from surface water storage facilities to population centers. In the last 50 to 75 years, these population centers have really expanded dramatically, so you need massive infrastructure to deliver water from those storage facilities, the dams, and reservoirs, which generally are located in remote areas to the population centers. So it takes a lot of time and energy to transport the water, from where it is captured and stored to where it is needed for human use.
California has faced continuous drought – what measures is the state taking now to manage water?
Just to frame the issue a little bit — we have, as I mentioned, a growing population in the American Southwest at a time when the amount of available water is shrinking due to drought and due to the impacts of climate change. We have growing human demand for residential and commercial purposes and at the same time, we have a shrinking water supply. That is a huge looming crisis.
And it is beginning to play out in real-time. You see that playing out in real-time. For example, several different states and Mexico rely on Colorado River flows based on an allocation system that was created in the 1920s, which is overly optimistic about the amount of available water. From the 1920s until now, that water supply has decreased, and decreased, and decreased. Now you have interstate agreements, and in the case of Mexico, international agreements that allocate the finite Colorado river water supplies based on faulty, now obsolete, information. It is a real problem.
What measures do you take now, knowing this information?
If you look at the US Drought Monitor, it is obvious the problem is not limited to the Colorado River. We are in a mega-drought, so cutbacks are being imposed by federal and state water agencies to encourage agricultural, urban, and commercial water users to cut their water use and, and stretch finite supplies as much as possible through conservation efforts.
In California, we have the State Water Resources Control Board, the state water regulator in California, and they have issued curtailment orders. Meaning, they have told water rights holders, many of whom have had those water rights for over a hundred years, that, for the first time, the water that they feel they are entitled to, is not available. Local water districts are also issuing water conservation mandates; the San Francisco water department is doing that, in Los Angeles, the metropolitan water district, is urging urban users to curtail their efforts.
And then agriculture. Agricultural users — farmers and ranchers — have had to get water rights in many cases through the federal government, as the federal government is the operator of these water projects. They have contracts with water users, individual farmers, ranchers, or districts, and they are now issuing curtailment orders. They're saying, we know you contracted for X amount of water for this calendar year, but we are telling you because of the drought shortages we don't have that water to supply. Our reservoirs are low at Lake Shasta or at the Oroville Dam.
When you drive from San Francisco to LA on the five, you see a lot of signage from the agricultural farming community about water. There's apparently some frustration about this. What are the other options for them?
About 80% of all human consumed water goes to agriculture. That is by far the biggest component of water use, as opposed to 20% used for urban and commercial, and industrial purposes.
Over the years, ranchers and farmers, and agricultural water districts assumed that the water would always be there — as we all do.
And the farmers and ranchers have, in hindsight, exacerbated the problem by bringing more and more land into production. You see on those drives between San Francisco and Los Angeles, particularly in the San Joaquin Valley, all these orchards are being planted. Orchards are more lucrative crops than row crops — cotton, alfalfa, and rice. But, if you are growing a row crop, you can leave the land fallow in times of drought.
We don't have to plant. If the water stopped there, or if it's too expensive to get, it may make economic sense, but if you have an orchard or a vineyard it's a high value, those are high value crops, you don't have that operational flexibility and they need to be irrigated in wet years and in dry years. Now, you see these orchards, which were only planted a few years ago, are now being uprooted because the farmers realized that they don't have the water necessary to keep those vineyards and orchards alive. For ranchers, the same thing is true with their herds. They don’t have enough water for their livestock.
The water shortage has never been drier than it is right now. Farmers and ranchers are being deprived of water that they traditionally believed was theirs and they're very understandably, very unhappy about it. They see it as a threat to their livelihood and to the livelihood of the folks who work for them. Their anger and frustration are to be expected, but it's nobody's fault.
To say, as some farmers do, that it is mismanagement by state and federal government officials, I think is overly simplistic and misplaced in the face of a mega-drought. Everybody's going to have to sacrifice. Everybody's going to have to be more efficient in how they use water. All sectors are going to need to be more efficient with the water that does exist.
Looking at this percentage breakdown of water use – is it actually important for individual users to change their water habits?
Well, every little bit helps. When you're talking about homeowners, about 70% of urban water use is for outdoor irrigation. So we're talking parks and cemeteries and golf courses and folks' yards. You know, that used to be considered part of that American dream and the California dream — you would have a big lawn in front of your house and behind your house. Truth be told, that has never made much sense in an arid environment. That's where the water savings in urban areas is critical in the way it really involves aesthetics rather than critical human needs, like water for drinking and bathing and sanitation purposes. There is a growing movement away from big lawns, and away from the type of landscaping that you see in the Eastern US — there is no drought in the Eastern United States. As Hurricane Ida and other recent storms have shown, the problem is too much water, or rather than too little in most of the Eastern United States. So it really is a tale of two countries.
We just need to recognize that the American West is an arid region. It has always been an arid region, we can't make the desert bloom with water that doesn't exist. We need to be more efficient in how we allocate those water supplies. And it seems to me in an urban area, the best way to conserve and most effective way is to reduce urban landscaping, which is the major component of urban water use.
You also write about water markets and making them better – for those who don’t know, what is the water market?
Water markets, that is, the voluntary transfer of water between water users, is more robust in some other Western states. Again Arizona and New Mexico come to mind. California somewhat surprisingly is behind the curve. We are in the dark ages compared to other states. Water markets are kind of anecdotal. There is not much of a statewide system. It is done at the local level, through individual transactions without much oversight and without much transparency. And I have concerns about all of those things.
I believe conceptually watermarks are a way to stretch scarce, finite water resources to make water use more efficient. I can, for example, allow farmers or ranchers to sell water to urban uses or commercial usage or factories in times of drought.
Farmers sometimes can make more money by farming water, than they can by farming crops.
There are efficiencies to be gained here.
The problem in my view is really one of transparency. The water markets are not publicly regulated, and some of the people who are engaging in water transactions like it that way, frankly, they want to operate under the radar.
In my opinion, water markets need to be overseen by a public entity rather than private or nonprofit entities. We need oversight and transparency, so that folks like you and myself can follow the markets to see who's selling water to whom, for what purpose, and make sure that those water transfers serve the public interests and not just the private interests.
There have been a number of stories in the New York Times and the Wall Street Journal and the Salt Lake City Tribune about efforts in some parts to privatize water transfer. Hedge fund managers are buying and selling water, as a means of profiting. And it strikes me that when you're talking about an essential public resource — and in California, it is embedded in the law that public water is an inherently public resource, that water is owned by the public and it can be used for private purposes, but it is an inherently public resource — the idea of commoditizing water through the private, opaque markets is very troublesome to me. I think it represents a very dangerous trend and one that needs to be corrected and avoided.
Why is California so behind?
There's no good reason for it. It's largely inexplicable that since the state was created on September 9th, 1860, we've been fighting over water. In the 19th century, it was miners versus farmers ranchers. In the 20th century, with the growth of urban communities, the evolution of California into one of the most populous states with 40 million Californians, it has been a struggle between urban and agricultural uses of water.
In the second half of the 20th century, there was a recognition that some component of water had to be left in streams to protect ecosystems, landscape, and wildlife, including the threatened and endangered wildlife. That suggestion has made agricultural users in California angry. You will see those signs that allude to the idea that food and farming are more important than environmental values. I don't happen to believe that's true. I believe both are critically important to our society. But the advocates for the environment have a proverbial seat at the water table. So that's another demand for water allocation that exists.
Do you maintain optimism?
Yes. I think it's human nature to look on the bright side. I try to do that through research scholarships and teaching. There are models for how we can do this better in the United States. Israel and Saudi Arabia and Singapore are far more efficient with their water policies and efforts. Australia went through a severe megadrought. They came out of it a few years ago, but they used that opportunity to dramatically reform their water allocation systems. That's an additional model. I think most people would agree in hindsight that their previous system was antiquated, and not able to meet the challenges of climate change and the growing water shortage in some parts of the world.
Here in the United States, we can learn from those efforts. There are also some ways to expand the water supply. Desalination for one. Again, Singapore and Saudi Arabia have led the world in terms of removing the salt content from ocean water and increasing water supply that way. In Carlsbad, California, north of San Diego, we have the biggest desalination plant in the United States right now, and that is currently satisfying a significant component of the San Diego metropolitan areas’ water needs. It's more expensive than other water supplies, but the technology is getting more refined, so the cost of desalinated water is coming down at a time when other water supplies, due to shortages and the workings of the free market are going up.
At some point, they're going to meet or get closer. Unlike some of my environmental colleagues, I think desalination is an important part of the equation.
In a proposal that came up in the recall election, one of the candidates was talking about how we just need to build a canal from the Mississippi River to California to take care of all our problems. That ignores political problems associated with that effort, as well as the massive infrastructure costs that would be required to build and maintain a major aqueduct for 2000 miles from the Mississippi to California. That's just not going to happen. Some of those pie in the sky thoughts of how we expand the water supply, I think, are unrealistic.
interviews
Medical Mistrust and the Legacy of Tuskegee
by Dr. Marcella Alsan
June 13, 2020
This interview with Dr. Marcella Alsan, a Professor of Public Policy at Harvard Kennedy School, was conducted and condensed by franknews.
Can you start with an overview of the Tuskegee Study?
"The Tuskegee Study of Untreated Syphilis in the Negro Male," was it's official title. It was run from 1932 to 1972 by the United States Public Health Service, which was a branch of the Centers for Disease Control and Prevention. It's pretty unheard of for a study to last for four decades, but it did. The core idea was that black men, both those with syphilis and a control group without, were going to be recruited in the name of observing the progression of the disease. The men were led to believe that they were getting treatment for what was euphemistically called "bad blood", but they weren't. And crucially, when penicillin was discovered in the 1940s as a highly effective, "magic bullet" for this disease, they were denied access to it. Syphilis is a disease that is transmitted sexually and also prenatally, so they were effectively allowed to spread it to their loved ones - their wives and to their children. And this was all done in the name of understanding the natural history of the infection, a lot of which was already known.
How did it end?
Well it lasted so incredibly long – beyond the 1960s, beyond the Martin Luther King Civil Rights Act. There was finally a whistleblower, a young man Peter Buxton, who came to work in Macon County and was completely alarmed by what he saw. He started writing to the CDC, exhorting them to end the study, saying that it was completely unethical. Actually online you can still see the notes from some of the internal meetings that his letters prompted. And it's scary to see that the response in the meeting from the CDC, from all these doctors is, "Well, it has become a political problem. What we need to do is not halt the study, not compensate the men, not treat them and their families, but find political cover. We need to get buy in from local chapters of the AMA and the county health department." And that is the response of the government at the time, to hide it. Eventually, Peter Buxtun tells someone with the Associated Press about the study, and the story gets published and becomes breaking news in 1972. So it is because of the press, not because of a moral consciousness, that there was cessation of the study. Eventually there was a settlement to the subjects themselves and their families, though it was comparatively meager.
And by looking at this event, what were you hoping to find?
Along with Marianne Wanamaker, who is an economist out of University of Tennessee Knoxville, we decided that we wanted to look at this event around the time the Ebola pandemic was starting. We started to hear about the idea of mistrust and about how people in West Africa weren't "complying" with the public health officials. For example, they still wanted to bury their dead, even though they were being told that it was high risk. There were all these questions around why they weren't trusting authority, and this issue of trust and medicine and history really came into consciousness.
In economics, we're going through a causal revolution where we try to be very precise about what we say is a correlation versus what we say is a causal relationship. We are developing all these new habits, including embracing randomized trials. But of course, in this case, you would never want to randomly assign some people to medical mistrust and some people not. So we really do need to kind of look back to what we call natural experiments, things that happened in history, to answer this question.
Which is how you used the Tuskegee Study.
Right. As economists, we leveraged the sharp timing of the 1972 disclosure. Our expertise is really taking observational data and trying to wrangle it into a causal analysis, using all of these differences- the time, the geography, the demography.
We hypothesized that for African American after 1972, when the news of Tuskegee broke, there would be a heightened degree of mistrust compared to before 1972. We also hypothesized that there would be a reduction in demand for health services. We also thought that the effects would be strongest for men who were close to the epicenter of Tuskegee, Alabama.
And what do you find out about how generations of men were affected by the study?
What we can confidently say is that we see about a one-third drop in demand for outpatient visits, lengthier hospitalization stays, and an increase in mortality up to 10 years after the disclosure.
Clearly not all mistrust and all of healthcare inequality can be explained by this one event, and that wasn’t our goal. What we are able to capture in this specific instance is how mistrust affects demand, why there are reasons for mistrust.
And it’s not just Tuskegee, it's the broader history going back to when this country enslaved African American people, and a repeated history of African American people being used against their will and knowledge in the name of science. Tuskegee is one example of that. We were trying to point to a specific instance and say, here we identify the historical episode, the deceit, and the spillover effects.
One of the findings of your study is that men who are most similar to the men in the Tuskegee study, in terms of geography, in race, in age, are most affected. Why is that such an important note?
Right. Our finding is not about the exact men that got experimented on, it's about other men who heard about it and felt like they were at risk too. Our results identify subjects who felt like, "this could be me." Which I think is important because it identified this spillover phenomenon that recognized that these are not one-off instances, that there are reverberations throughout entire networks of individuals.
Which brings up what I think is a really important, I think, a very interesting research question, and very interesting social question – if we apologize and we atone, can we avoid some of the spillover effect? It wasn't until Bill Clinton's presidency that there was a formal apology. That is decades later. There was only a smattering of the initial cohort involved in this study still alive when Bill Clinton formally apologized. Had the release of information in 1972 been different, and had it come with acknowledgement and atonement, would the effects have been different? We just can't know for sure.
Can you talk about the mechanisms of medical mistrust that lead to worse health outcomes?
I ran a trial in Oakland, California. This was a randomized trial now where it was published in the American Economic Review, where myself, along with other researchers from the Bay area, recruited African American men, from barber shops in the East Bay. We built a pop up clinic, and Uber donated ride sharing services to bring these men to our clinic. We randomly assigned the men to either have an African American male doctor or a white or Asian doctor. We focused the question on how that assignment affects the demand for preventative care.
Preventative care allows you to improve health outcomes dramatically, if you can catch cancer early on, take steps against diabetes, control blood pressure, et cetera. To have effective preventative care, you need partnership, and what we found was that specifically for invasive services, and by invasive I mean like a small prick of blood or a flu vaccine, it mattered incredibly to the African American men that we recruited, to have an African American doctor.
Our best look at the data said that this was really driven by the fact that they felt comfortable in communicating with doctors. We’ve done studies that have replicated that finding. It does really matter to have a diverse population of people who are helping bridge these historical inequities and helping to overcome a very valid, trust gap.
Do you feel like there's an appropriate conversation around the role that mistrust is playing in the disparity of health outcomes in this particular pandemic?
In economics, we think about mistrust on the demand side of things - as lowering demand for healthcare. But if we think about it as more of a feedback loop, then we can understand it as the actions of the supply side by our providers and healthcares system that then affects trust and then demand. When we talk about alleviating mistrust, it has to include what we can do on the supply side to help overcome these historical traumas.
With COVID-19, and contact tracing, it is imperative to think about these dynamics. This pandemic is not coming out of the blue, it is being layered on top of this vast history of gross racial inequality and injustice. We can’t pretend that just because it's a crisis, that it can be all hands on deck. I think we still really need to be thoughtful about having a diverse set of communicators and people that we're employing to do this work in the communities that are being hardest hit. The conversation around mistrust is a fruitful conversation to have, as long as it didn't start and end with, 'There's mistrust."