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A growing body of research is identifying the health hazards of hydraulic fracturing, better known as fracking, a process used to extract oil and natural gas from bedrock. Chelsea Clinton, vice chair of the Clinton Foundation, wrote about the public health concerns around fracking in a recent First Opinion, “End fracking exemptions, a threat to maternal and public health,” with her Columbia University Mailman School of Public Health colleagues Terry McGovern and Micaela Martinez.

In addition to her work with the Clinton Foundation, Clinton is an adjunct assistant professor at the Mailman School. She has written several books for young readers, including the New York Times bestsellers “She Persisted: 13 American Women Who Changed the World” and “She Persisted Around the World.” She also has a new podcast, “In Fact with Chelsea Clinton.”

Clinton joined host Patrick Skerrett for this week’s episode of the First Opinion podcast. Excerpts of the conversation are below, lightly edited for clarity.

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As a youth and a teenager, you were able to see public health, both its successes and failures, up close. Can you remember your earliest experience with public health?

There are two experiences that really come to mind. When I was a little girl growing up in Little Rock, Arkansas, in the 1980s, I began to care intensely about endangered species and the environment and today what we would call climate change. And I have this vivid memory of my grandmother telling me that she wanted to get me a present for Christmas that would enable me to do something and not just receive something. And she, over the next few years, would give me annual memberships to the World Wildlife Fund and Greenpeace and Conservation International. I remember being so excited when I would receive newsletters in the mail — which may sound so bizarre to anyone who maybe has never opened a piece of paper mail — and remember reading in some of those newsletters about how kind of our environmental crises were also health crises, and that was really illuminating to me.

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Another important early experience I had was when Magic Johnson talked about being HIV-positive. I was standing in the headquarters of my father’s 1992 presidential campaign in Little Rock. I think I was either stuffing envelopes or sealing envelopes for the campaign (because that’s what you can do when you’re a kid and your dad’s running for president) and watching Johnson on television refuse to be stigmatized or shamed for his HIV status. And that really started a lifelong interest in the public health crisis of AIDS and especially in the public health crisis that is the ongoing stigma, unfortunately, around HIV status here in the United States and across the world.

Your recent First Opinion essay focused on fracking and its effects on health, especially maternal health. Can you explain what fracking is for people who aren’t familiar with it?

Hydraulic fracking has actually been around for a long time. The Halliburton Corporation pioneered and patented fracking technology shortly after World War II in 1949, but it didn’t become more widely used until much later. It is a way of extracting, arguably, anything that might be underground. It works by injecting highly pressurized water and other chemicals into shale formations to extract whatever is the target. In 1997, a federal court ruled that the Environmental Protection Agency, under the Safe Drinking Water Act, had the authority to regulate fracking. So there was a short window of time during which the EPA was gearing up to monitor and regulate fracking. But then in 2005, the Bush-Cheney administration put a stop to that, largely pushed by Halliburton. We are still living in the era of the Halliburton loophole, as the disastrous 2005 decision from the Bush-Cheney administration has been called.

When Hillary Clinton was secretary of state, she promoted fracking in Bulgaria, Romania, and other countries. Has your work on the health impact of fracking sparked some interesting dinner discussions?

Well, in the times of Covid-19, we haven’t really had very many dinner conversations, although certainly, as we all become vaccinated, I’m looking forward to many of those over the summer. I think it’s safe to say that my mother knows how I feel about fracking. And I think it’s safe to say that she’s really aware of the research that has emerged since she left her position as secretary of state — especially research from 2016 through 2019, and even last year, that has been published in this area. One of the things I’ve most admired about both of my parents is their ability to respond to new evidence and evaluate different points of views and different stories. I don’t know if she’s changed her mind about this, but I certainly hope that she would have, if she hasn’t. And the next time I’m lucky enough to see my mom in person for dinner, I will ask her.

So it sounds like — and tell me if I’m wrong here — you might be saying that instead of having a well-regulated fracking industry, it would be better not to have one at all.

If I could wave a magic wand, yes. But I would much prefer to have a well-regulated fracking industry than what we currently have. I also believe that a well-regulated fracking industry would effectively be the end of the fracking industry, at least with the current toxic mix of commonly used chemicals.

Thank you so much for joining me today.

Thanks for letting me talk about so many things clearly I care a lot about. And I really do think, especially on fracking because — so much research has come out truly in the last five years. If you didn’t pay attention to this issue 10 years ago, don’t feel bad about that. If you’re paying attention to it now for the first time, because the evidence base has shifted really powerfully, great. We had lots of hypotheses a decade ago, but now we have lots of proof.