Emerging Issues in Environmental Health

1. Emerging Issues in Environmental Health Duston Morris, PhD, MS, CHES, CTRS University of Central Arkansas

2. Introduction • “Over the past 50 years, mankind has changed the natural environment of the planet faster and more extensively than at any other time in human history, leading to a substantial and largely irreversible loss in the diversity of life on Earth, according to the first comprehensive evaluation of the world's major ecosystems.” – Millennium Ecosystem Report (2005) • Think of it this way…its like a bank account where many people get to make withdrawals but are not required to makes deposits. Eventually it drains the account. Then what???

3. Millennium Ecosystem Report • Some very scary findings… • About 30 percent of the Earth's land area is devoted to some kind of agriculture. • About a quarter of the world's coral reefs have been badly damaged or destroyed in the past several decades. • The amount of water impounded behind dams has quadrupled since 1960. Six times more water is held in reservoirs than flows in natural rivers. • More than half of all synthetic nitrogen fertilizer ever used on the planet has been used since 1985. • Since 1750, atmospheric concentration of carbon dioxide has increased about 32 percent primarily because of the burning of fossil fuels and land use changes. About 60 percent of that increase has taken place since 1959. • Between 10 percent and 30 percent of all mammal, bird and amphibian species are threatened with extinction.

4. So What’s The Contributing Factors?

5. World Population • http://www.worldometers.info/world-population/

6. World Population • The Impact… • Loss of half of the planet’s forests • The depletion of most of the planet’s major fisheries • The alteration of the planet’s atmosphere and climate • Clearing of 80% of the rainforest • Loss of tens of thousands of plant and wildlife species • An approximate increase of 400% of greenhouse gas emissions • Commercialization of as much as half of the earth’s surface land • The future…possible water stress, water scarcity, food shortage and fossil fuel shortage. The reason…too many people and too much consumption.

8. Global Consumptive Behavior • We continue to make unhealthy choices the easier choices. • Cigarettes • Fast-food diets • High sugar drinks • Packaged, processed foods • Technologies • Fossil fuel cars • Suburban living • Economic debt • Where does it end??

9. Infectious Disease • Worldwide, at least 30 new and re-emerging infectious diseases have been recognized since 1975 (Weiss and McMichael, 2004). • HIV/AIDS has become a serious pandemic. • Several ‘old’ infectious diseases, including tuberculosis, malaria, cholera and dengue fever, have proven unexpectedly problematic. • Diarrheal disease, acute respiratory infections and other infections continue to kill more than seven million infants and children annually (Bryce et al., 2005).

10. Declining Life Expectancy • The upward trajectory in life expectancy forecast in the 1980s has recently been reversed in several regions. • Many proximal causes have been documented… • Alcoholism • Suicide • Violence • Accidents • Cardiovascular disease • Deteriorating infrastructure • Gender inequality • Sexual exploitation • Indebtedness • Ill-judged economic development

11. Global Environmental Change • Sustainable population health depends on the viability of the planet’s life-support systems (McMichael et al., 2003a). • We extract ‘goods and services’ from the world’s natural environment about 25% faster than they can be replenished (Wackernagel et al., 2002). • Over 150,000 annual deaths result from recent change in the world’s climate relative to the baseline average climate of 1961–1990 (McMichael et al., 2004a). • Recent changes in infectious disease such as tick-borne encephalitis (Lindgren and Gustafson, 2001), cholera outbreaks (Rodo´ et al., 2002) and, possibly, malaria (Patz et al., 2002)

12. Emerging Health Issues & MGDs • United Nations established eight MDGs (Millennium Development Goals) with targets achievable by 2015. Four of these MGDs are explicitly related to health outcomes: • Extreme Poverty and hunger • Reducing child mortality • Improving maternal health • Combating HIV/AIDS, malaria and other infectious disease • The problem… • Many of the MGDs are already in jeopardy • Its important to remember that environmental sustainability is inter-linked

15. Globalization, Trade, Economic Policy & Declining Public Health • The health benefits of the complex social, cultural, trade and economic phenomena that comprise ‘globalization’ are vigorously debated. • In reality, wealthy populations have long tilted the economic and political playing field in ways that ensure a disproportionate flow of trade benefits towards privileged populations (Mehmet, 1995). • De-regulated labor • Increased labor mobility and steep economic gradients • Indices of inequality, including in health, income and environmental risk, have risen in recent decades (Butler, 2000; Parry et al., 2004).

16. Challenges for Health Promotion • In sum, global and regional inequality, narrow and outdated economic theories and an ever nearing set of global environmental limits endanger population health. • Economic, market-based system for setting goals related to environmental health and human well-being IS NOT working. • A transformation of policy, social institutions, and social norms will be needed (Raskin et al., 2002). • New health risk derive from demographic shifts, environmental change, and continuation of the current economic system that emphasizes material wealth over human health.

17. Conclusions • There is need for proactive engagement with local, national, and international agencies and programs that bear on the socio-economic fundamentals that create health disparities. • We should work to created better connections and strengthen the relationship between the health sector and civil society, including those struggling to promote development, human rights, human security and environmental protection. • Ultimately…environmental sustainability is about optimizing the human experience, especially well-being, health and survival.

18. What will you do differently?

19. References • Bryce, J., Boschi-Pinto, C., Shibuya, K., Black, R.E., & WHO child health epidemiology reference group (2005). WHO estimates of the causes of death in children. Lancet, 356, 1147-1152. • Butler, C.D. (2000). Inequality, global change, and the sustainability of civilization. Global change and human health. Global Change Human Health, 1, 156-172. • Lindgren, E. & Gustafson, R. (2001). Tick-borne encephalitis in Sweden and climate change. Lancet, 358, 16-18. • McMichael, A.J., & Butler, C.D. (2007). Emerging health issues: the widening challenge for population health promotion. Health Promotion International, 21, 15-24. doi:10.1093/heapro/dal047 • McMichael, A.J., Campbell-Lendrum, D., Kovats, S., Edwards, S., Wilkinson, P., Wilson, T. et al. (2004). Global climate change. In Ezzati, M., Lopez., A., Rodgers, A., & Murray C. (eds). Comparative quantification of health risks: Global and regional burden of disease due to selected major risk factors. World Health Organization, Geneva. 1543-1649 • Mehmet, O. (1995). Westerning the third world: The eurocentricity of economic development theories. Routledge, London, New York. • Millennium Ecosystem Assessment. Global Assessment Reports. http://www.millenniumassessment.org/en/Global.html • Parry, M.L., Rosenzweig, C., Iglesias, A., Livermore, M., & Fischer, G. (2004). Effects of climate change on global food production under SRES emissions and socio-economic scenarios. Global Environmental Change, 14, 53-67. • Patz, J.A., Hulme, M., Rosenzweig, C., Mitchel, T.D., Goldberg, R.A., Githeko, A.K., et al. (2002). Regional warming and malaria resuregence. Nature, 420, 627-628. • Raskin, P., Gallopin, G., Gutman, P., Hammond, A., Kates, R., & Swart, R. (2002). Great transition: The promise and lure of the times ahead. Stockholm Environment Institute, Boston. • Rodo’, X., Pascual, M., Fuchs, G., & Faruque, A.S.G. (2002). ENSO and cholera: A non-stationary link related to climate change? Proceedings at the National Academy Science USA, 99, 12901-12906.