Impact of Peak Oil on Health and Medicine

1. Impact of Peak Oil on Health and Medicine Pamela A Gray, PhD pamelagray@transition-health.com www.transition-health.com

2. Overview • What is Peak Oil? • How does oil relate to health? • How is medicine dependent on oil? • Issues with the medical system • Global and local responses • Local solutions and actions

3. What is Peak Oil? • The maximum rate of global oil production, after which it will irreversibly decline • Oil discovery peaked in the 1960s • Production peak to follow in 40 - 60 years • Not the end of oil, but the end of cheap oil

5. Peak Oil Peak oil is a geologically imposed end to the fossil fuel era, whose first manifestation is the peaking of oil extraction, followed by natural gas and then coal.

6. Indicators of Oil Problems • Prices rising to all time high • Demand exceeding supply • Oil extraction rate flat • Wars for control of oil • Press raising issues • Fears of economic collapse

7. The Press Wakes Up “The age of oil could be ending without our really being aware of it” - NY Times, March 2006

8. “The doubling of oil prices in the past couple of years is not an anomaly but a picture of the future. Peak oil is at hand” – US Army Corps of Engineers, 2006 “The world has never faced a problem like this. Previous energy transitions (wood to coal, and coal to oil) were gradual and evolutionary; oil peaking will be abrupt and revolutionary.” Hirsch Report to DOE, 2005

9. Peak Oil • Oil depletion is a geological fact • There are as yet no scalable, fully appropriate alternatives or substitutes

10. Impact of Oil Depletion • Drastic reductions in food production • Inadequate heating and cooling systems • Breakdown of transport systems • Problems in distribution of goods • Disruptions in water treatment systems • Increased unemployment • Overload of healthcare systems • Rationing – fuel, food, healthcare

11. The Precautionary Principle When an activity raises the threat of harm to HUMAN HEALTH or the environment, precautionary measures should be taken even if some cause and effect relationships are not fully established scientifically.

12. What Is Health? Freedom from disease A condition of optimal well-being A state of complete physical, mental and social well-being, not consisting only of the absence of disease or infirmity (WHO)

13. Factors Influencing Health Air that we breathe Water that we drink Food that we eat Waste products Exercise Work Home environment Relationships Sleep/rest Being in nature

14. Fossil Fuels and Health Factors • Air – pollution • Water – pollution, purification, transport • Food – pesticide, transport, packaging • Housing – building, heating, cooking • Work – transport, technology • Relationships – communications, transport • Waste – transport, incineration, purification

15. Oil and Air Pollution • Burning of fossil fuels results in elevated rates of infant mortality, asthma, cardiovascular problems and respiratory ailments. • Reducing air pollution in 4 of the world’s largest cities could prevent 64,000 premature deaths and 37 million lost workdays over the next 2 decades

16. Oil and Water Pollution • Pollution from oil industry • Pollution from manufacturing processes • Pollution from domestic waste • Leaching from plastic into water • Health effects include: premature deaths, cancers, birth defects, bronchitis, skin diseases, asthma etc.

17. Oil and Food Pollution • Pesticides, additives, colourings, flavourings • Dioxins in meat, dairy, poultry fruit and vegetable • Irradiation reduces nutritional content • Plastics used in packaging migrate into food, • Health effects include: allergies, obesity, immune disorders, cancer, skin diseases, birth defects, nutritional deficiency problems, mental illness…

18. Fossil Fuel Depletion and Food • Petroleum is integral to the cultivation processing and distribution of our food. • “The impact of energy availability on diet will range between the ideal of varied organic food produced in a low energy, closed system requiring minimum transport – and the shock of no food at all.”

19. Oil and the Home • Oil-derived hazardous chemicals in household goods – cleaning products, toiletries, paints, carpets, furniture building materials • Up to 500 man-made chemicals in the human body • Health effects include sterility, nerve damage, allergies, endocrine disruption, immune disorders, cancers…

20. Petroleum Products in the Home • Petrochemical air fresheners • Used by 40% of households • Produce headaches & depression in mothers, earache and diarrhoea in kids • Contain dangerous volatile organic compounds • Problems disputed by manufacturers Reported in Times, 2004.

21. Rise in Childhood Diseases • Type 2 diabetes in children as young as 10 • Childhood obesity, underlying other diseases • Childhood asthma increasing dramatically • Autism at national emergency level • Pediatric MS a silent epidemic • Increase in birth defects linked to petrochemicals

22. Fossil Fuels & Health Bad news: Pollution from fossil fuels produces disorders, illnesses and premature death. Good news: Reducing fossil fuel use will result in improvements in health.

23. When Things Go Wrong • Consult friends and family • Visit conventional medical practitioners • Try complementary and alternative practitioners • Attend specialised support groups • Use self help techniques

24. Oil and Medicine

25. Medical Oil Dependencies • Pharmaceuticals / Drugs • Energy intensive hospital procedures • Medical materials - plastics, gloves, syringes … • Direct energy requirements – machines, radiation, storage, heating / cooling, sterilisation • Transport - medical supplies, patients, doctors, food • Emergency services – ambulances, helicopters

26. Pharmaceutical Industry • Pharmaceuticals – $643 billion global market in 2006 • The main treatment modality in NHS (10% of costs) • About 50% are not taken as prescribed (waste issues) • 4th leading cause of death in industrial nations • Driven by profits not by improving human health • Developed by same investment groups that control the global petrochemical industries.

27. Pharmaceuticals & Oil Phenol, acids and anhydrides, alkanolamines and aldehydes Used for analgesics, antihistamines, antibiotics, antibacterials, sedatives, tranquilisers Polyethylene glycols, hydroxyethyl celluloses and water-soluble ethylene oxide polymers Used as tablet binders and pill coatings Other: Essential uses in pharmaceutical products, from aspirin to penicillin moulds. Common medications may require ethanol to extract the antibiotic agent.; polyethylene glycol is used in rectal suppositories; phenylpropanolamine is used in cough syrups.

28. Medical Materials & Oil In instruments and supplies: Use of plastics in all disposables used for maintaining sterile conditions; specialised plastics used in heart valves; common items such as isopropanol (rubbing alcohol); polyethylene and poly-vinyl acetate used in tubing, sheeting, splints, prostheses, blood bags, disposable syringes and catheters Sterilisation of equipment uses ethylene oxide; ammonium nitrate is a basic ingredient in “quick cold” applications. Nitrogen mustards are a long-standing part of chemotherapy treatment for cancer; propylene glycol is used for obtaining specimens for sputum cytology. In all specialties: Radiological dyes and films, dermatological creams, Sigmoidoscopes, speculum probes – in endotracheal tubes, intravenous tubing, oxygen masks. (Glenn D. The Hidden Energy Crisis, Texas Medicine (72), 1976)

29. “The medical profession must eventually be forced to consider whether in an age of fuel scarcity it will be possible to maintain at their present level hospital procedures consuming large amounts of energy” Loraine, J.A. in the Lancet, September 1973

30. Electrical Blackout August 2003 • 50 million people in US without power • Costs estimated at $6 billion • Trouble with hospital back-up generators • Many donor organs lost • Operations under flashlight or terminated • Air conditioning suspended • Emergency evacuation of patients • A wake-up call – but quickly forgotten

31. Low Energy Medical Systems • Alternative Medicine - Chinese Medicine, Indian Ayurvedic Medicine, Homeopathy • Complementary Medicine - Acupuncture, Touch Therapies, Counselling

32. Issues with Medical Services • Escalating costs of medical care • Little success with chronic conditions (asthma, diabetes, heart disease, cancer) • Few cures for depression • Competition for medical resources • Little time for consultations • Increase in medically induced illness • Disillusion with the medical profession

33. Global WHO Global Strategy Integrated Health Care Movement Wellness Industry Focus on Prevention UK Practice-based commissioning Expert Patient Programme Healthy Living Initiative Medical Industry Responses

34. Integrated Health Care Movement • Combine conventional medicine and CAM • Improve client / practitioner relationship • Treat whole person – mind / body / soul • Encourage self care and community support • Focus on wellness, not illness

35. Complementary and Alternative Medicine (CAM) • Homeopathy, acupuncture, herbal medicines, touch therapies, counselling • Based on ancient medical practices • Not generally dependent on fossil fuels • Treats whole person – mind, body, spirit • Cost-effective – add to NHS? • How should it be funded?

36. Self Treatments • Exercise, nutrition • Deep breathing and relaxation • Meditation and guided imagery • Yoga, Chi Gung, Tai Chi • Positive thinking and prayer • Self medication: spending on CAM is £1.6 billion/year, OTC medicines £2.3 billion/year

37. UK Practice Based Commissioning • Central management of NHS not working • Local control handed to Primary Care • Better for health of community • Population-based budgets planned • Allows for integration of other modalities • Not enough funds for everything?

38. Expert Patients’ Program (EPP) • UK Government initiative • Help people with long term conditions maintain health and quality of life • Lay led self management courses to encourage development of skills • Taught by volunteers

39. Healthy Living Initiative • UK Government program to encourage people to lead healthier lives • Focused on families with young children • Aiming to tackle childhood obesity • Encourages 5-A-Day eating (www.5aday.nhs.uk) • Promoting more active lifestyles

40. West Cornwall Healthy Living Centre • Health professionals, voluntary and community sector organisations and individuals working together • Web-based information and support, recommendations of services, project development and support www.wchlc.org.uk

41. Reducing Our Oil Dependency Without petrol for cars, we can walk or ride a bicycle. BUT What are the alternatives for the health system?

42. World War II • Oil, food & clothes rationed. Government mandates for nutritional supplements • Medical facilities greatly restricted, women trained to offer basic medical help • Medicines in short supply – pharmacists made up old remedies. • Ethical decisions, demonstrations, armed guards • People forced to be self-sufficient (Dig for Victory)

43. Cuba • Education and medical system free • Primary Care Focus after Revolution • ‘Special Period’ - oil imports cut after fall of Russia • Healthy low fat, nearly vegetarian diet and outdoor lifestyle (cycling, walking..) • 1 doctor/167 people, 60% women doctors, living where they work • Life expectancy same as US, infant mortality below that of US

44. Transition Movement Responseto Impact of Peak Oil Plan to work together to define, implement and promote reduced fossil fuel dependent medical systems in local communities in anticipation of oil depletion.

45. Transition Action Plan • Identify the future health system we want • Back-cast from the future to today • Define an implementation program • Focus on wellness programs, not illness • Educate on preventative methods • Secure funding for new programs • Encourage self and community help

46. Specific Actions Now • Localise medicine as much as possible • Identify medical resources available locally (conventional & complementary / alternative) • Partner with existing health initiatives • Work with renewable energy providers to ensure support for critical care • Develop and promote “green” herbal medicines • Increase exercise programs – chi gung, tai chi, yoga, swimming, walking, cycling … • Support local organic food production • Teach local people to treat minor problems • Remember ancient wisdom, folk remedies

47. TP Health & Medicine Group • Open to all interested people • Formed to answer questions of how to shift to a low energy, integrated health system • Aims to identify health assets, healthcare professionals, specialties, art therapies, working in partnerships with others • Building an energy descent action plan for localised provision of medical care for all

48. Discussion Points • Ethics • Decision-making when resources are scarce • Self Care • What can people safely do for themselves? • Specialised Patient Groups • What specialties and what support is needed? • Secondary Care • Based in Centres of Excellence? • Alternative energy supplies for critical needs? • Do We Have an Emergency Plan?

49. Impact of Peak Oil on Health and Medicine Pamela A Gray, PhD pamelagray@transition-health.com www.transition-health.com