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Health Consequences of Health Consequences of Environmental Degradation Environmental Degradation and Social Injustice and Social Injustice Martin Donohoe, M.D., Martin Donohoe, M.D., F.A.C.P. F.A.C.P.

Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

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Page 1: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Health Consequences of Health Consequences of Environmental Environmental

Degradation and Social Degradation and Social InjusticeInjustice

Martin Donohoe, M.D., F.A.C.P.Martin Donohoe, M.D., F.A.C.P.

Page 2: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Am I Stoned?Am I Stoned?

A 1999 Utah anti-drug pamphlet A 1999 Utah anti-drug pamphlet warns:warns:

““Danger signs that your Danger signs that your child may be smoking marijuana child may be smoking marijuana include excessive preoccupation include excessive preoccupation with social causes, race with social causes, race relations, and environmental relations, and environmental issues”issues”

Page 3: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Our HomeOur Home

Page 4: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P
Page 5: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

PerspectivePerspective

The earth spins at 1,038 mph at the The earth spins at 1,038 mph at the equator, between 700 mph and 900 equator, between 700 mph and 900 mph at mid-latitudesmph at mid-latitudes

The earth rotates around sun at 18.5 The earth rotates around sun at 18.5 miles/secmiles/sec

The solar system orbits the center of The solar system orbits the center of the Milky Way Galaxy at 137 the Milky Way Galaxy at 137 miles/secmiles/sec One rotation per 225 million yearsOne rotation per 225 million years

Page 6: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

PerspectivePerspective

The sun is one of hundreds of The sun is one of hundreds of billions of stars in the Milky Way billions of stars in the Milky Way GalaxyGalaxy

The Milky Way is one of over one The Milky Way is one of over one hundred billion galaxies in the hundred billion galaxies in the known universeknown universe

The universe may be one of an The universe may be one of an infinite number of universesinfinite number of universes

Page 7: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The PlanetsThe Planets

Page 8: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Our Solar SystemOur Solar System

Page 9: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Jupiter = one pixel, Earth = invisibleJupiter = one pixel, Earth = invisible

Page 10: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Sun = one pixel, Jupiter = invisibleSun = one pixel, Jupiter = invisible

Page 11: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Portland, OregonPortland, OregonMount HoodMount Hood

Page 12: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Multnomah Falls, OregonMultnomah Falls, Oregon

Page 13: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The EnvironmentThe Environment

The natural environmentThe natural environment

The built environmentThe built environment

The social environmentThe social environment

Page 14: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Causes of Causes of Environmental Environmental DegradationDegradation

Overpopulation Overpopulation PollutionPollution DeforestationDeforestation Global WarmingGlobal Warming Agricultural/Fishing PracticesAgricultural/Fishing Practices Overconsumption / AffluenzaOverconsumption / Affluenza MilitarizationMilitarization

Page 15: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Causes of Causes of Environmental DegradationEnvironmental Degradation Maldistribution of WealthMaldistribution of Wealth National and Global Political and National and Global Political and

Economic InstitutionsEconomic Institutions Poor educationPoor education Media manipulation and inaccurate Media manipulation and inaccurate

reportingreporting Unbalanced political influenceUnbalanced political influence Citizen apathyCitizen apathy

Page 16: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Consequences ofConsequences of Environmental Environmental

DegradationDegradation Increased poverty and overcrowdingIncreased poverty and overcrowding FamineFamine Weather extremesWeather extremes Species lossSpecies loss Medical illnessesMedical illnesses Infectious diseasesInfectious diseases

Page 17: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Consequences ofConsequences of Environmental Environmental

DegradationDegradation Death (40% of world’s yearly deaths Death (40% of world’s yearly deaths

linked to water, air, and soil pollution)linked to water, air, and soil pollution) WarWar Ecological footprint (22 Ecological footprint (22

hectares/person) exceeds Earth’s hectares/person) exceeds Earth’s biological capacity (16 biological capacity (16 hectares/person)hectares/person)

Malthusian chaos and disasterMalthusian chaos and disaster Tragedy of the CommonsTragedy of the Commons

Page 18: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Economic Costs of Economic Costs of Environmental DiseasesEnvironmental Diseases

Estimated at $132-165 Estimated at $132-165 billion/year in the U.S. alone billion/year in the U.S. alone ($1.25-$2.0 billion in Oregon)($1.25-$2.0 billion in Oregon)Does not count the Does not count the psychological and emotional psychological and emotional costs of the human suffering costs of the human suffering involved for the victims, their involved for the victims, their families, and their communitiesfamilies, and their communities

Page 19: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Economic Costs of Economic Costs of Environmental Diseases: Environmental Diseases:

OregonOregon Adult and childhood asthma: $30 millionAdult and childhood asthma: $30 million Childhood asthma: $28 millionChildhood asthma: $28 million Adult cardiovascular disease: $342 Adult cardiovascular disease: $342

millionmillion Childhood cancer: $9 millionChildhood cancer: $9 million Childhood lead exposure: $878 millionChildhood lead exposure: $878 million Birth defects: $3 millionBirth defects: $3 million Neurobehavioral disorders: $187 millionNeurobehavioral disorders: $187 million

Source: OEC, The Price of Pollution, 2/08Source: OEC, The Price of Pollution, 2/08

Page 20: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Overpopulation Overpopulation

World population - exponential growthWorld population - exponential growth 1 billion in 18001 billion in 1800 2.5 billion in 19502.5 billion in 1950 6 billion in 20006 billion in 2000 6.8 billion in 20096.8 billion in 2009 est. 8-10 billion by 2050est. 8-10 billion by 2050

More people added to the planet in the More people added to the planet in the last 40 years than in all previous recorded last 40 years than in all previous recorded historyhistory

Page 21: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

OverpopulationOverpopulation

Africa, Asia, and Latin America Africa, Asia, and Latin America primarily affectedprimarily affected

Causes:Causes: PovertyPoverty Women’s rights issues – impaired Women’s rights issues – impaired

access to reproductive health care access to reproductive health care and education, and education, political/legal/economic/social political/legal/economic/social marginalizationmarginalization

Page 22: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

World PopulationWorld Population

Page 23: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

OverpopulationOverpopulation

UrbanizationUrbanization 20-30 million people/year leave rural for 20-30 million people/year leave rural for

urban areasurban areas 2007: first time in history that more than 2007: first time in history that more than

half the world’s population live in urban half the world’s population live in urban areasareas

World migrant population = 200 World migrant population = 200 million million -economic, war and environmental -economic, war and environmental refugeesrefugees

Page 24: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P
Page 25: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Urban SprawlUrban Sprawl

Since the 1960’s America’s Since the 1960’s America’s metropolitan areas have metropolitan areas have been consuming land at a been consuming land at a rate 4x faster that rate 4x faster that population growthpopulation growth

6,000 acres of open space 6,000 acres of open space lost per daylost per day

Page 26: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Wallace StegnerWallace Stegner

““We simply need … wild country We simply need … wild country available to us, even if we available to us, even if we never do more than drive to its never do more than drive to its edge and look in. For it can be edge and look in. For it can be a means of reassuring a means of reassuring ourselves of our sanity as ourselves of our sanity as creatures, a part of the creatures, a part of the geography of hope”geography of hope”

Page 27: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Air PollutionAir Pollution

Page 28: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Air PollutionAir Pollution

Page 29: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Air PollutionAir Pollution

Top ten most polluted cities in the Top ten most polluted cities in the world are in China and Indiaworld are in China and India

World’s Most Polluted Places (2007):World’s Most Polluted Places (2007): Sumgayit, Azerbaijan; Linfen, Sumgayit, Azerbaijan; Linfen,

China; Tianying, China; Sukinda, China; Tianying, China; Sukinda, India; Vapi, India; La Oroya, Peru; India; Vapi, India; La Oroya, Peru; Dzerzhinsk, Russia; Norilsk, Dzerzhinsk, Russia; Norilsk, Russia; Chernobyl, Ukraine; and Russia; Chernobyl, Ukraine; and Kabwe, ZambiaKabwe, Zambia

Page 30: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Air PollutionAir Pollution

Most polluted areas in US:Most polluted areas in US: 2001 – LA2001 – LA 2002 – Houston2002 – Houston 2003 – San Joaquin Valley in 2003 – San Joaquin Valley in

Central CaliforniaCentral California 2004, 2006 - 2008 – LA2004, 2006 - 2008 – LA

Page 31: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Health Effects of Air Health Effects of Air PollutionPollution

Causes approximately Causes approximately 60,000 - 75,000 60,000 - 75,000 premature deaths/yr. in premature deaths/yr. in U.S. (656,000 in China)U.S. (656,000 in China)More than are killed by More than are killed by auto accidentsauto accidents

1.8 million worldwide1.8 million worldwide

Page 32: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Health Effects of Air Health Effects of Air PollutionPollution

Air pollution causes asthma and Air pollution causes asthma and impairs lung development and impairs lung development and functionfunction

Deaths from cardiopulmonary Deaths from cardiopulmonary diseases correlate with air diseases correlate with air pollution levels in US citiespollution levels in US citiesBoth day to day and over timeBoth day to day and over time

Page 33: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Health Effects of Air Health Effects of Air PollutionPollution

Increased admissions for CHF, Increased admissions for CHF, asthma, COPD, PVD, and asthma, COPD, PVD, and cerebrovascular disease (stroke cerebrovascular disease (stroke and TIA)and TIA)

Increased ventricular arrythmiasIncreased ventricular arrythmias Increased lung cancer mortalityIncreased lung cancer mortality Decreased exercise tolerance, Decreased exercise tolerance,

increased pulmonary symptomsincreased pulmonary symptoms

Page 34: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Health Effects of Air Health Effects of Air PollutionPollution

Increased risk of DVTIncreased risk of DVT Impaired sperm productionImpaired sperm production Increase in SGA and LBW infantsIncrease in SGA and LBW infants Increased risk of appendicitisIncreased risk of appendicitis

?Via link with inflammation??Via link with inflammation? Increased numbers of migrainesIncreased numbers of migraines

Page 35: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Air PollutionAir Pollution

Coarse, fine and ultrafine Coarse, fine and ultrafine particlesparticles

Ultrafines not regulated, may Ultrafines not regulated, may be most dangerousbe most dangerous

Nanoparticles may contribute Nanoparticles may contribute to health risksto health risks

Page 36: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P
Page 37: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Air pollution: The Good Air pollution: The Good NewsNews

Reductions in air pollution Reductions in air pollution under Clean Air Act Account under Clean Air Act Account for up to 15% of overall for up to 15% of overall increase in life expectancy in increase in life expectancy in major U.S. metropolitan major U.S. metropolitan areasareas

Page 38: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Effects of Ozone Effects of Ozone DestructionDestruction

Ozone hole over Antarctic (2Ozone hole over Antarctic (2½X ½X size of Europe)size of Europe)

Increased cataracts (UV damage)Increased cataracts (UV damage) Increased lifetime melanoma riskIncreased lifetime melanoma risk

1/1500 - 19301/1500 - 19301/68 - today1/68 - today

Page 39: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Antarctic Ozone HoleAntarctic Ozone Hole

Page 40: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

AutomobilesAutomobiles

Page 41: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

AutomobilesAutomobiles

Number of autosNumber of autos-US: 1 car/2 people-US: 1 car/2 people-Mexico: 1/8-Mexico: 1/8-China: 1/100 (increasing, -China: 1/100 (increasing, surpassed US auto sales in surpassed US auto sales in 2009)2009)

Global auto population to double in Global auto population to double in 25-50 years, from 622 million 25-50 years, from 622 million passenger vehicles in 2008passenger vehicles in 2008

Page 42: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

AutomobilesAutomobiles

Average miles traveled/car/year in Average miles traveled/car/year in U.S.U.S. 1965 - 4,570 mi.1965 - 4,570 mi. 1975 - 6,150 mi.1975 - 6,150 mi. 1985 - 7,460 mi.1985 - 7,460 mi. 1995 - 9,220 mi.1995 - 9,220 mi. 2008 – 12,000 mi.2008 – 12,000 mi.

Page 43: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

AutomobilesAutomobiles

Average fuel efficiency of U.S. autos Average fuel efficiency of U.S. autos stagnantstagnant Cars: 27.5 mpg required by 2011, 35 Cars: 27.5 mpg required by 2011, 35

mpg required by 2020mpg required by 2020 Light trucks / SUVs: 23.5 mpg by Light trucks / SUVs: 23.5 mpg by

2011, 28.6 mpg by 20152011, 28.6 mpg by 2015 European and Japanese standards European and Japanese standards

higherhigher Relatively low oil prices (until recently)Relatively low oil prices (until recently)

Page 44: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

AutomobilesAutomobiles

Growing market for low-Growing market for low-efficiency pickups, minivans, and efficiency pickups, minivans, and sport-utility vehiclessport-utility vehicles SUVs 50% of all private SUVs 50% of all private

vehiclesvehicles Ford Model T – 25 mpg (1908); Ford Model T – 25 mpg (1908);

Avg. Ford vehicle – 22.6 mpg Avg. Ford vehicle – 22.6 mpg (2003)(2003)

Page 45: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Automobiles: Automobiles: AlternativesAlternatives

Rapid transitRapid transit

-industry squashed in 1930’s and -industry squashed in 1930’s and

40’s (GM, Standard Oil, 40’s (GM, Standard Oil,

Firestone, etc.)Firestone, etc.)

-Convicted under Sherman -Convicted under Sherman

Antitrust ActAntitrust Act

Page 46: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Automobiles: Automobiles: AlternativesAlternatives

Car sharingCar sharing Pay-as-you-drive auto insurancePay-as-you-drive auto insurance ““Peak PricingPeak Pricing”” and and ““Congestion FeesCongestion Fees””

E.g., London E.g., London → 21% decrease in traffic, → 21% decrease in traffic, 43% increase in bus ridership, cleaner 43% increase in bus ridership, cleaner airair

Bicycles/walkingBicycles/walking 30% of all trips by bike in Amsterdam; 30% of all trips by bike in Amsterdam;

2% in Portland, OR2% in Portland, OR

Page 47: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Alternatives to Alternatives to AutomobilesAutomobiles

BussesBusses

TrainsTrains 15 x more efficient per passenger 15 x more efficient per passenger

than autosthan autos Amtrak receives 1/3 the amount of Amtrak receives 1/3 the amount of

federal funding (adjusted for federal funding (adjusted for inflation) that it received 20 years inflation) that it received 20 years agoago

Page 48: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Automobiles: Automobiles: AlternativesAlternatives

Electric carsElectric cars

-killed by oil companies, -killed by oil companies,

automakers in early 20th centuryautomakers in early 20th century Natural gas, gasohol, and biodieselNatural gas, gasohol, and biodiesel

Beware Jevon’s Paradox (Increased Beware Jevon’s Paradox (Increased

efficiency leading to increased overall efficiency leading to increased overall

energy consumption)energy consumption)

TelecommutingTelecommuting

Page 49: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Automobiles: Automobiles: AlternativesAlternatives

Solar carsSolar cars

Hydrogen-powered carsHydrogen-powered cars

Byproduct = waterByproduct = water

Problem: Hydrogen production Problem: Hydrogen production

requires fossil fuelsrequires fossil fuels

Page 50: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

US Energy Consumption US Energy Consumption by Fuelby Fuel

Oil – 40%Oil – 40% Natural gas – 24%Natural gas – 24% Coal – 22%Coal – 22% Nuclear – 8.5%Nuclear – 8.5% Hydroelectric – 2.5%Hydroelectric – 2.5% Other Renewables (mostly biomass, Other Renewables (mostly biomass,

small amounts geothermal, wind, small amounts geothermal, wind, and solar) – 4.5%and solar) – 4.5%

Page 51: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

U.S. Energy Sources for U.S. Energy Sources for ElectricityElectricity

Coal – 50%Coal – 50% Nuclear – 19%Nuclear – 19% Gas – 19%Gas – 19% Hydroelectric – 6%Hydroelectric – 6% Oil – 3%Oil – 3% Renewables – 2%Renewables – 2%

Electricity generation utilizes 40% of US Electricity generation utilizes 40% of US energyenergy

Page 52: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

US Energy ConsumptionUS Energy Consumption

Transportation – 29%Transportation – 29%

Industrial – 25%Industrial – 25%

Residential – 11.5%Residential – 11.5%

Commercial – 8.5%Commercial – 8.5%

Page 53: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Energy Energy Spending/ResearchSpending/Research

Federal funding for energy R&D Federal funding for energy R&D (1974-2005, in 2005 dollars):(1974-2005, in 2005 dollars): $50 billion: nuclear$50 billion: nuclear $20 billion: fossil fuels$20 billion: fossil fuels $12 billion: renewable energy$12 billion: renewable energy $12 billion: efficiency$12 billion: efficiency

Page 54: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Petroleum Industry Petroleum Industry ProfitsProfits

Mergers squelch competition, drive up Mergers squelch competition, drive up pricesprices

Record-breaking oil company profitsRecord-breaking oil company profits The world’s 6 most profitable The world’s 6 most profitable

corporations in 2008 were oil corporations in 2008 were oil companiescompanies

Exxon: $45 billion in 2008Exxon: $45 billion in 2008Largest in U.S. historyLargest in U.S. historyExceeds GDP of 2/3 of world’s Exceeds GDP of 2/3 of world’s nationsnations

Page 55: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Belridge, CA Oil FieldsBelridge, CA Oil FieldsEdward BurtynskyEdward Burtynsky

Page 56: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Nigerian Gas FlareNigerian Gas Flare

Page 57: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The U.S. and OilThe U.S. and Oil

U.S. consumes U.S. consumes > 20 million bbl/d> 20 million bbl/d Produces 5 million bbl/dProduces 5 million bbl/d

Strategic Petroleum Reserve holds more than Strategic Petroleum Reserve holds more than 700 million bbl700 million bbl

ANWR contains 4.3 – 11.8 billion bbl oilANWR contains 4.3 – 11.8 billion bbl oil One year supplyOne year supply

23 billion bbl under remaining U.S. territory23 billion bbl under remaining U.S. territory

Page 58: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Oil and WarOil and War

Countries that export oil are Countries that export oil are >>40 times more likely to be 40 times more likely to be engaged in civil war than engaged in civil war than those that do notthose that do not

Gulf Wars I and IIGulf Wars I and II The Future?The Future?

Page 59: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Other Sources of Air Other Sources of Air PollutionPollution

Industry - #1Industry - #1 Indoor combustion of coal and biomass Indoor combustion of coal and biomass

(wood, charcoal, crop residues, and (wood, charcoal, crop residues, and animal dung) for cooking, heating and animal dung) for cooking, heating and food preservationfood preservation Used by almost 3 billion people Used by almost 3 billion people

worldwideworldwide Associated with multiple pulmonary Associated with multiple pulmonary

conditionsconditions Solar cookers may replaceSolar cookers may replace

Page 60: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Noise PollutionNoise Pollution Common in inner cities, hospital wardsCommon in inner cities, hospital wards Average sound level 72dB in hospital Average sound level 72dB in hospital

wardswards WHO recommends no more than 35dBWHO recommends no more than 35dB

Adverse health effects include increased Adverse health effects include increased risk of HTN, ischemic heart disease, risk of HTN, ischemic heart disease, delayed wound healing, aggressive delayed wound healing, aggressive behavior, need for psychiatric and pain behavior, need for psychiatric and pain medications, GERD symptoms, hearing medications, GERD symptoms, hearing loss in neonates, and increased rates of loss in neonates, and increased rates of rehospitalizationrehospitalization

Page 61: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

GarbageGarbage

Page 62: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

GarbageGarbage

98% of the country’s total 98% of the country’s total refuse is industrial waste; refuse is industrial waste; 2% municipal waste2% municipal wasteMaking 1 lb of sellable Making 1 lb of sellable product generates avg. product generates avg. 32 lbs. of waste32 lbs. of waste

Page 63: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

GarbageGarbage

American produce 4.5 lbs/d American produce 4.5 lbs/d garbagegarbage Almost 1650 lbs/yrAlmost 1650 lbs/yr Only 1.5 lbs recycledOnly 1.5 lbs recycled

In a lifetime, the average In a lifetime, the average American will throw away 6500 American will throw away 6500 times his/her adult weight in times his/her adult weight in garbagegarbage

Page 64: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

U.S. Garbage U.S. Garbage CompositionComposition

Paper and Paperboard - 34%Paper and Paperboard - 34% Yard Waste - 13%Yard Waste - 13% Food Waste - 12%Food Waste - 12% Plastics - 12%Plastics - 12% Metals - 8%Metals - 8% Glass - 6%Glass - 6% Wood - 5%Wood - 5%

Page 65: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

U.S. Recycling RatesU.S. Recycling Rates Tires - 22%Tires - 22% Plastic containers - 25%Plastic containers - 25% Overall plastics – 7%Overall plastics – 7% Glass containers - 28%Glass containers - 28% Yard waste - 41%Yard waste - 41% Paper and Paperboard - 55%Paper and Paperboard - 55% Aluminum packaging - 54%Aluminum packaging - 54% Steel cans - 60%Steel cans - 60% Auto batteries - 93%Auto batteries - 93%

Page 66: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

GarbageGarbage

One half of US has no curbside One half of US has no curbside recycling pickuprecycling pickup

LandfillsLandfills IncineratorsIncinerators Garbage ExportsGarbage Exports

Page 67: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

ToxinsToxins

Page 68: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

ToxinsToxins

6 trillion tons of over 85,000 6 trillion tons of over 85,000 chemicals produced annuallychemicals produced annually2000-3000 new chemicals 2000-3000 new chemicals

registered each yearregistered each yearMore than 90% have never More than 90% have never

been screened for toxicitybeen screened for toxicityConsequence of 1976 Toxic Consequence of 1976 Toxic

Substances Control ActSubstances Control Act

Page 69: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Toxic PollutantsToxic Pollutants

The chemical industry is a The chemical industry is a $450 billion enterprise in the $450 billion enterprise in the U.S. aloneU.S. alone

Chemical manufacturers are Chemical manufacturers are not required to prove safetynot required to prove safetyThe legal burden is on the The legal burden is on the government to prove that a government to prove that a product is dangerousproduct is dangerous

Page 70: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

PesticidesPesticides

2.2 billion lbs/yr pesticides2.2 billion lbs/yr pesticides Including agricultural Including agricultural

pesticides, wood preservatives, pesticides, wood preservatives, and disinfectantsand disinfectants

8.8 lbs/person/yr in US8.8 lbs/person/yr in US

Page 71: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

PesticidesPesticides CA and NY are the only states currently CA and NY are the only states currently

tracking pesticide sales and usetracking pesticide sales and use 2008: USDA axes national survey 2008: USDA axes national survey

charting pesticide usecharting pesticide use EPA, NAS currently allows pesticide EPA, NAS currently allows pesticide

testing in humans, despite strong testing in humans, despite strong oppositionopposition

Monsanto’s Roundup purchased by US Monsanto’s Roundup purchased by US government for aerial spraying in government for aerial spraying in Colombia as part of “War on Drugs”Colombia as part of “War on Drugs”

Page 72: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

PesticidesPesticides

EPA: U.S. farm workers suffer EPA: U.S. farm workers suffer up to 300,000 pesticide-related up to 300,000 pesticide-related acute illnesses and injuries per acute illnesses and injuries per yearyear

NAS: Pesticides in food could NAS: Pesticides in food could cause up to 1 million cancers in cause up to 1 million cancers in the current generation of the current generation of AmericansAmericans

Page 73: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

PesticidesPesticides

WHO: 1,000,000 people killed by WHO: 1,000,000 people killed by pesticides over the last 6 yearspesticides over the last 6 years

US health and environmental US health and environmental costs $12 billion/yr (2005)costs $12 billion/yr (2005)

Page 74: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

PesticidesPesticides

Linked to autism, Parkinson’s Linked to autism, Parkinson’s Disease, Alzheimer’s disease, Disease, Alzheimer’s disease, diabetes, obesity (with prenatal diabetes, obesity (with prenatal exposure), depressionexposure), depression

Children living on or near farms Children living on or near farms score 5 points lower on IQ tests score 5 points lower on IQ tests and other mental and verbal testsand other mental and verbal testsMay be due to pesticide exposureMay be due to pesticide exposure

Page 75: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Anthropological Study of Children Exposed to Pesticides

Children from villages practicing organic agriculture

Children from villages practicing non-organic

agriculture

Page 76: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

PesticidesPesticides

Page 77: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P
Page 78: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

PesticidesPesticides

$2.4 billion worth of insecticides and $2.4 billion worth of insecticides and fungicides sold to American farmers fungicides sold to American farmers each yeareach year

Pesticide runoff contributes to coastal Pesticide runoff contributes to coastal dead zonesdead zones Baltic Sea, Mouth of Mississippi in Baltic Sea, Mouth of Mississippi in

Gulf of MexicoGulf of Mexico Red tidesRed tides

Pesticides inhibit nitrogen fixation, Pesticides inhibit nitrogen fixation, decrease crop yieldsdecrease crop yields

Page 79: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

PesticidesPesticides

Evidence suggests that pesticides Evidence suggests that pesticides promote pests (vs. natural promote pests (vs. natural pesticides)pesticides)

30% of medieval crop harvests 30% of medieval crop harvests were destroyed by pests vs. 35-were destroyed by pests vs. 35-42% of current crop harvests42% of current crop harvests

Implies organic farming more Implies organic farming more cost-effectivecost-effective

Page 80: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Pesticides and ProducePesticides and Produce

The Dirty Dozen: peaches, apples, bell The Dirty Dozen: peaches, apples, bell peppers, celery, nectarines, peppers, celery, nectarines, strawberries, cherries, kale, lettuce, strawberries, cherries, kale, lettuce, grapes (imported), carrots, pearsgrapes (imported), carrots, pears

The Clean 15: onions, avocados, sweet The Clean 15: onions, avocados, sweet corn, pineapples, mangos, asparagus, corn, pineapples, mangos, asparagus, sweet peas, kiwis, cabbages, sweet peas, kiwis, cabbages, eggplant, papayas, watermelon, eggplant, papayas, watermelon, broccoli, tomatoes, sweet potatoesbroccoli, tomatoes, sweet potatoes

Page 81: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

ToxinsToxins

Body burden of industrial chemicals, Body burden of industrial chemicals, pollutants and pesticides highpollutants and pesticides high Environmental Working Group Environmental Working Group

(2004)found 287 pesticides, (2004)found 287 pesticides, consumer product ingredients, and consumer product ingredients, and wastes from burning coal, gasoline, wastes from burning coal, gasoline, and garbage in umbilical cord bloodand garbage in umbilical cord blood Many other compounds not even Many other compounds not even

tested; numbers undoubtedly highertested; numbers undoubtedly higher

Page 82: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

ToxinsToxins

Fetuses and children most vulnerableFetuses and children most vulnerable Birth defects, learning disabilities Birth defects, learning disabilities

increasingincreasing Toxins play important roleToxins play important role

UK Food Standards Agency has UK Food Standards Agency has called for a phase out of 8 artificial called for a phase out of 8 artificial dyes linked to hyperactivity in dyes linked to hyperactivity in childrenchildren

Page 83: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Toxins and genderToxins and gender

Sex ratio changing:Sex ratio changing: Normal = 105 boys/girls born (skewed by Normal = 105 boys/girls born (skewed by

early male mortality)early male mortality) Fewer boys being born in industrialized Fewer boys being born in industrialized

countriescountries Other causes include obesity, older parental Other causes include obesity, older parental

age, stress, fertility aidesage, stress, fertility aides Situation far worse in ArcticSituation far worse in Arctic

Cryptorchidism increasingCryptorchidism increasing Risk factor for testicular cancerRisk factor for testicular cancer

Micropenis, hypospadias increasingMicropenis, hypospadias increasing

Page 84: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Phthalates/Bisphenol APhthalates/Bisphenol A

Found in construction materials, clothing, Found in construction materials, clothing, toys, cosmetics, pills, added to PVCs in IV toys, cosmetics, pills, added to PVCs in IV tubing/other plasticstubing/other plastics At least 47 million prescription medsAt least 47 million prescription meds Exposure levels very highExposure levels very high FDA approvesFDA approves

5 million metric tons consumed by industry 5 million metric tons consumed by industry per year (13% in the U.S.)per year (13% in the U.S.)

Exxon Mobil and BASF dominate the Exxon Mobil and BASF dominate the marketmarket

Page 85: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Phthalates/Bisphenol APhthalates/Bisphenol A

Wal-Mart, Target, Toys ‘R’ Us Wal-Mart, Target, Toys ‘R’ Us phasing out, San Francisco, phasing out, San Francisco, California, Europe, and Canada have California, Europe, and Canada have banned phthalatesbanned phthalates

Consumer Product Safety Consumer Product Safety Commission reforms of 2008 Commission reforms of 2008 eliminate lead and phthalates from eliminate lead and phthalates from toys and children’s productstoys and children’s products

Page 86: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

PhthalatesPhthalates 90% of government-funded studies found 90% of government-funded studies found

adverse health effectsadverse health effects vs. 0% of industry-funded studiesvs. 0% of industry-funded studies

Associated with:Associated with: demasculinization and alterations in demasculinization and alterations in

genitalia in male infantsgenitalia in male infants low birth weightlow birth weight lower testosterone levelslower testosterone levels lower sperm counts in adultslower sperm counts in adults obesityobesity

Page 87: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Phthalates/PVCs and Phthalates/PVCs and Medical DevicesMedical Devices

EPA regulations weak, based on EPA regulations weak, based on 50-year old study50-year old study

FDA has advised healthcare FDA has advised healthcare providers to use alternatives to providers to use alternatives to DEHP-containing PVC medical DEHP-containing PVC medical devices, esp. in neonatal unitsdevices, esp. in neonatal units

Banned by EU, CA, and WABanned by EU, CA, and WA Federal legislation pendingFederal legislation pending

Page 88: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Teflon (PFOA – Teflon (PFOA – perfluorooctanate)perfluorooctanate)

Non-stick material made by DupontNon-stick material made by Dupont Chemicals released under high heat Chemicals released under high heat

and when cookware damagedand when cookware damaged Exposure linked with cancer, birth Exposure linked with cancer, birth

defects, and liver damagedefects, and liver damage Dupont hit with largest-ever civil Dupont hit with largest-ever civil

penalty ($10.25 million) in 2006 for penalty ($10.25 million) in 2006 for concealing health consequences and concealing health consequences and transmission from mother to fetustransmission from mother to fetus

Page 89: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Toxic Pollutants – Toxic Pollutants – Economic CostsEconomic Costs

Americans pay more than $55 Americans pay more than $55 billion annually for direct medical billion annually for direct medical expenses plus special schooling expenses plus special schooling and long-term care for pediatric and long-term care for pediatric diseases caused by leaddiseases caused by lead

This excludes the greatest toxic This excludes the greatest toxic pollutant - tobaccopollutant - tobacco

Page 90: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

LeadLead

Affects brain development, associated Affects brain development, associated with lower IQwith lower IQ No safe level for neurological developmentNo safe level for neurological development

Levels between 4 and 10 significantly Levels between 4 and 10 significantly increase risk of cardio- and increase risk of cardio- and cerebrovascular diseasecerebrovascular disease

Elevated levels associated with crime Elevated levels associated with crime and violent behaviorand violent behavior Pre-natal and post-natal exposurePre-natal and post-natal exposure

Page 91: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

LeadLead

Poor, African-Americans, and Poor, African-Americans, and Hispanics more commonly Hispanics more commonly exposedexposed

Levels declining in USLevels declining in US Developing world at riskDeveloping world at risk

Due to increased environmental Due to increased environmental exposure and, possibly, early exposure and, possibly, early umbilical cord clampingumbilical cord clamping

Page 92: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Leaded GasolineLeaded Gasoline

Banned in Canada in 1990, US in Banned in Canada in 1990, US in 1996 (after 25-year phase-out 1996 (after 25-year phase-out period), EU in 2002, Africa in 2006period), EU in 2002, Africa in 2006 Ban fought by industry for decadesBan fought by industry for decades

Many countries still sell leaded Many countries still sell leaded gasoline:gasoline: Indonesia, Venezuela, North Korea, Indonesia, Venezuela, North Korea,

Iraq, Afghanistan, Jordan, Syria, YemenIraq, Afghanistan, Jordan, Syria, Yemen

Page 93: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

MercuryMercury

Released into air by coal combustion, Released into air by coal combustion, industrial processes, mining, and industrial processes, mining, and waste disposalwaste disposal 4500 tons/yr4500 tons/yr

Travels throughout atmosphere and Travels throughout atmosphere and settles in oceans and waterwayssettles in oceans and waterways

Bacteria convert it to toxic methyl-Bacteria convert it to toxic methyl-mercurymercury

Travels up food chain via fishTravels up food chain via fish

Page 94: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

MercuryMercury

16% of women of childbearing age 16% of women of childbearing age exceed the EPA’s “safe” mercury levelexceed the EPA’s “safe” mercury level

Freshwater fish mercury levels too Freshwater fish mercury levels too high for pregnant women to eat in 43 high for pregnant women to eat in 43 statesstates

Mercury dental amalgams pose health Mercury dental amalgams pose health risks to pregnant women, unborn risks to pregnant women, unborn babies, and children (FDA)babies, and children (FDA)

Contaminant in high fructose corn Contaminant in high fructose corn syrupsyrup

Page 95: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

MercuryMercury

New EPA ruling ineffective:New EPA ruling ineffective:Allows cap-and-trade of power Allows cap-and-trade of power

plant emissionsplant emissionsRemoves power plants from Removes power plants from

list of pollution sources subject list of pollution sources subject to federal Clean Air Actto federal Clean Air Act

Page 96: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

ArsenicArsenic

Contaminates groundwater in Contaminates groundwater in Bangladesh, also, India, China, Mexico, Bangladesh, also, India, China, Mexico, Argentina, Thailand, and parts of the Argentina, Thailand, and parts of the U.S.U.S. 13 million Americans have drinking 13 million Americans have drinking

water exceeding EPA’s “safe level”water exceeding EPA’s “safe level” Exposure also via seafoodExposure also via seafood

Used to pressure treat wood in US and Used to pressure treat wood in US and elsewhereelsewhere

Page 97: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Health Consequences of Arsenic Health Consequences of Arsenic ExposureExposure

Pigmentary skin changesPigmentary skin changes DiabetesDiabetes Increased risk of lung, bladder, and Increased risk of lung, bladder, and

skin cancersskin cancers

Lead, mercury, or arsenic found in 1/5 Lead, mercury, or arsenic found in 1/5 of both U.S.- and India-manufactured of both U.S.- and India-manufactured Ayurvedic medicines purchased via Ayurvedic medicines purchased via the internetthe internet

Page 98: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Manganese/CadmuimManganese/Cadmuim

Manganese:Manganese: Welders exposed via fumesWelders exposed via fumes Causes “manganism” (like Parkinson’s Causes “manganism” (like Parkinson’s

Disease)Disease) Welding companies covered up link for Welding companies covered up link for

decades (like lead paint, etc.)decades (like lead paint, etc.)

CadmiumCadmium Osteoporosis, periodontal diseaseOsteoporosis, periodontal disease

Page 99: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Cell phonesCell phones

?Link to parotid gland tumors??Link to parotid gland tumors? ?Link to brain tumors??Link to brain tumors?

Gliomas?Gliomas?Acoustic neuromas?Acoustic neuromas?

Precautionary principle – hands-Precautionary principle – hands-free headsetfree headset?Other safety benefits??Other safety benefits?

Page 100: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Toxic PollutantsToxic Pollutants

85,000 known or suspected 85,000 known or suspected hazardous waste sites in the U.S.hazardous waste sites in the U.S.Plus up to 600,000 lightly Plus up to 600,000 lightly

contaminated former industrial contaminated former industrial sites (“brownfields”)sites (“brownfields”)

Will cost hundreds of billions of Will cost hundreds of billions of dollars to mitigate environmental dollars to mitigate environmental impactsimpacts

Page 101: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Toxic PollutantsToxic Pollutants

1 in 4 U.S. citizens lives 1 in 4 U.S. citizens lives within 4 mile of a Superfund within 4 mile of a Superfund site (over 1600 sites listed; site (over 1600 sites listed; another 2,500 sites eligible)another 2,500 sites eligible) ½ live within 10 miles½ live within 10 miles

Taxpayers paying increasing Taxpayers paying increasing share of cleanup costsshare of cleanup costs Overall funding decreasingOverall funding decreasing

Page 102: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Environmental RacismEnvironmental Racismand Toxic Imperialismand Toxic Imperialism

Environmental RacismEnvironmental RacismWaste dumps/incinerators more Waste dumps/incinerators more

common in lower SES common in lower SES neighborhoodsneighborhoods

““Cancer Belt” (Baton Rogue to Cancer Belt” (Baton Rogue to New Orleans)New Orleans)

More cardiovascular diseaseMore cardiovascular disease Toxic ImperialismToxic Imperialism

Page 103: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Toxic Pollutants:Toxic Pollutants:The Basel ConventionThe Basel Convention

The Basel Convention on the The Basel Convention on the Control of Transboundary Control of Transboundary Movements of Hazardous Movements of Hazardous Wastes (designed to control Wastes (designed to control dumping of hazardous wastes dumping of hazardous wastes from the industrialized world from the industrialized world in developing countries)in developing countries)

Page 104: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Toxic Pollutants:Toxic Pollutants:The Basel ConventionThe Basel Convention

Ratified by 170 countriesRatified by 170 countries

Despite being the largest Despite being the largest producer of toxic pollutants in producer of toxic pollutants in the world, the U.S. has signed the world, the U.S. has signed but not ratified this agreementbut not ratified this agreement

Page 105: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Bathtub, Toilet, and Source of Bathtub, Toilet, and Source of Drinking WaterDrinking Water

Page 106: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Persistent Organic Persistent Organic PollutantsPollutants

Toxic, remain in environment Toxic, remain in environment long-term, resist degradation, long-term, resist degradation, can travel long distancescan travel long distances

Bioaccumulate - higher Bioaccumulate - higher concentrations as you move up concentrations as you move up the food chainthe food chain

Most are endocrine disruptorsMost are endocrine disruptors

Page 107: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Endocrine DisruptorsEndocrine Disruptors

Linked to:Linked to: ObesityObesity Insulin resistanceInsulin resistance DiabetesDiabetes PCOS, endometriosis, uterine PCOS, endometriosis, uterine

fibroids, premature ovarian failurefibroids, premature ovarian failure Male and female reproductive Male and female reproductive

tract abnormalitiestract abnormalities

Page 108: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Endocrine DisruptorsEndocrine Disruptors

Linked to:Linked to: Impaired fertilityImpaired fertility Low birth weight, impaired fetal Low birth weight, impaired fetal

development and fetal anomaliesdevelopment and fetal anomalies Multiple cancers (including breast, Multiple cancers (including breast,

colon, prostate, testicular)colon, prostate, testicular) Thyroid diseaseThyroid disease Neuroendocrine abnormalitiesNeuroendocrine abnormalities

Page 109: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Persistent Organic Persistent Organic PollutantsPollutants

UN Environmental Program UN Environmental Program organizing worldwide organizing worldwide phaseout of top 12 through phaseout of top 12 through the Stockholm Convention on the Stockholm Convention on Persistent Organic PollutantsPersistent Organic Pollutants Including DDT, PCBs, and dioxinsIncluding DDT, PCBs, and dioxins

U.S. has signed, but not U.S. has signed, but not ratifiedratified

Page 110: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Toxic PollutantsToxic Pollutants

FloricultureFloriculture Diamond and Gold MiningDiamond and Gold Mining Cosmetics (see Cosmetics (see

www.safecosmetics.org)) NanoparticlesNanoparticles

Page 111: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Medical WasteMedical Waste

The 6,000 US hospitals generate The 6,000 US hospitals generate 2 million tons of waste per year; 2 million tons of waste per year; clinics and doctors’ offices an clinics and doctors’ offices an additional 700,000 tonsadditional 700,000 tons

850,000 tons incinerated850,000 tons incinerated 15% infectious waste 15% infectious waste incinerated pollutants include incinerated pollutants include

dioxin, mercury, cadmium and dioxin, mercury, cadmium and leadlead

Page 112: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Medical WasteMedical Waste One hospital bed generates between One hospital bed generates between

16 and 23 lbs/day of waste16 and 23 lbs/day of waste

Outbreak of hepatitis B in India due Outbreak of hepatitis B in India due to black market in medical waste to black market in medical waste and supplies (2009)and supplies (2009)

Page 113: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Medical WasteMedical Waste

Solutions:Solutions: Strengthen EPA regulationsStrengthen EPA regulations Segregation and alternatives to Segregation and alternatives to

incineration would cost < incineration would cost < $1/patient/day 80% of $1/patient/day 80% of thermometers no longer contain thermometers no longer contain mercurymercury

Remove PVCs from medical supplies Remove PVCs from medical supplies (e.g., IV tubing)(e.g., IV tubing)

Page 114: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Medical WasteMedical Waste

Organizations:Organizations:Health Care Without HarmHealth Care Without HarmGreen Health Center MovementGreen Health Center Movement

NAS: Hospitals built and operated NAS: Hospitals built and operated on more environmentally sound on more environmentally sound principles save money and principles save money and produce better patient outcomesproduce better patient outcomes

Page 115: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Electronic WasteElectronic Waste

600,000 tons of electronic 600,000 tons of electronic appliances discarded each appliances discarded each yearOnly 5-10% of computers yearOnly 5-10% of computers recycledrecycled

Most sent overseasMost sent overseasSome returns to U.S. in Some returns to U.S. in

children’s jewelrychildren’s jewelry

Page 116: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Electronic WasteElectronic Waste

EU now requires electronics EU now requires electronics firms to recycle and to eliminate firms to recycle and to eliminate lead, cadmium and mercury from lead, cadmium and mercury from their productstheir products

Maine passed first law requiring Maine passed first law requiring elctronic manufacturers to pay elctronic manufacturers to pay for recycling their discarded for recycling their discarded productsproducts

Page 117: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

WaterWater

UN adopted water as a UN adopted water as a human right in 2002human right in 2002International Covenant on International Covenant on Economic, Social, and Economic, Social, and Cultural RightsCultural Rights

US has signed but not US has signed but not ratifiedratified

Page 118: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

WaterWater

Only 2.5% of the earth’s water is Only 2.5% of the earth’s water is freshfresh

2/3 of this locked up in glaciers 2/3 of this locked up in glaciers and ice capsand ice capsAs glaciers and polar ice caps As glaciers and polar ice caps

melt, this is mixed with sea melt, this is mixed with sea waterwater

Page 119: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

WaterWater

U.S. water consumption: 81% U.S. water consumption: 81% irrigation, 6% domestic useirrigation, 6% domestic use

Worldwide freshwater Worldwide freshwater supplies dwindlingsupplies dwindlingDrying up: Aral Sea, Great Drying up: Aral Sea, Great Lakes, etc.Lakes, etc.

Page 120: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

WaterWater

Clean Water Act of 1972 has Clean Water Act of 1972 has decreased pollution in the USdecreased pollution in the USBut 80% of US waterways But 80% of US waterways never receive any never receive any comprehensive testing for comprehensive testing for pollutantspollutants

Page 121: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

WaterWater

In developing countries, 90-95% of In developing countries, 90-95% of sewage and 70% of industrial wastes sewage and 70% of industrial wastes are dumped untreated into the local are dumped untreated into the local water supplywater supply

13,000-15,000 deaths per day 13,000-15,000 deaths per day worldwide from water-related diseasesworldwide from water-related diseases

4/10 people worldwide have no access 4/10 people worldwide have no access to any latrine, toilet, bucket or boxto any latrine, toilet, bucket or box

Page 122: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Water Pollution and Water Pollution and PlasticsPlastics

120 billion lbs of plastics generated 120 billion lbs of plastics generated each year, using 4% of world oil each year, using 4% of world oil suppliessupplies

Every year more than 500 billion Every year more than 500 billion plastic bags discarded worldwideplastic bags discarded worldwide

Bioplastics made from agricultural Bioplastics made from agricultural waste using renewable energy could waste using renewable energy could be carbon neutral or even carbon be carbon neutral or even carbon negativenegative

Page 123: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Water Pollution and Water Pollution and PlasticsPlastics

Texas-sized “great garbage patch” in Texas-sized “great garbage patch” in North Pacific holds estimated 3 million North Pacific holds estimated 3 million metric tons of mostly plastic trashmetric tons of mostly plastic trash 6 times the mass of plankton there6 times the mass of plankton there Most has degraded to microplastics, which Most has degraded to microplastics, which

bond with PCBs, DDT, and endocrine bond with PCBs, DDT, and endocrine disruptors, making this area a million times disruptors, making this area a million times more toxic than surrounding areasmore toxic than surrounding areas

Harmful to marine lifeHarmful to marine life Works its way up food chainWorks its way up food chain

Page 124: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

WaterWater

Out of 191 nations in the Out of 191 nations in the world, 10 nations share 65% world, 10 nations share 65% of the world’s annual water of the world’s annual water resourcesresources

A woman in a developing A woman in a developing country walks an average of country walks an average of 6 km/day to obtain water6 km/day to obtain water

Page 125: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

WaterWater

Privatization schemes supported by Privatization schemes supported by the World Bank and IMF lead to the World Bank and IMF lead to price increases, worsen povertyprice increases, worsen poverty 5-10% of world’s water privatized - 5-10% of world’s water privatized -

increasingincreasing Privatization increases costs, incites Privatization increases costs, incites

social unrest (e.g., Cochabamba, social unrest (e.g., Cochabamba, Bolivia)Bolivia)

15% of US water in private hands15% of US water in private hands

Page 126: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

WaterWater

Bottled water a $400 billion/yr Bottled water a $400 billion/yr profit-driven industryprofit-driven industry

Weaker standards, 1/3 is just tap Weaker standards, 1/3 is just tap water, dangers of plastics, water, dangers of plastics, energy costs/global warming, energy costs/global warming, reduction of local water tables, reduction of local water tables, recycling rate of plastic bottles recycling rate of plastic bottles only 25%only 25%

Page 127: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

WaterWater

““Water is an efficient product.” It is Water is an efficient product.” It is a product which normally would be a product which normally would be free, and it is our job to sell it.”free, and it is our job to sell it.” Suez CEO Gerard MestralletSuez CEO Gerard Mestrallet

Page 128: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

WaterWater

Ratio of amount of water needed Ratio of amount of water needed to produce 1 plastic bottle to to produce 1 plastic bottle to amount of water in the bottle = amount of water in the bottle = 2:12:1

San Francisco has banned city San Francisco has banned city purchases of bottled waterpurchases of bottled water

Water expected to be the major Water expected to be the major cause of wars by 2050 or soonercause of wars by 2050 or sooner

Page 129: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Water Pollution – Water Pollution – Increased Beach ClosingsIncreased Beach Closings

Page 130: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Infamous Industrial Infamous Industrial DisastersDisasters

Minimata, Japan, 1920s-1970s (Chisso Minimata, Japan, 1920s-1970s (Chisso Corporation) - methylmercury poisoningCorporation) - methylmercury poisoning

-400 dead; 10,000 injured-400 dead; 10,000 injured Bhopal, India, 1984 (Union Carbide, Bhopal, India, 1984 (Union Carbide,

purchased by Dow in 2001) - methyl purchased by Dow in 2001) - methyl isocyanate gasisocyanate gas 7000-10,000 dead within 3 days, 15,000-20,000 7000-10,000 dead within 3 days, 15,000-20,000

more over next 10 years; tens of thousands more over next 10 years; tens of thousands injuredinjured

Persistent water and soil contaminationPersistent water and soil contamination Indian government extradition request for Indian government extradition request for

Warren AndersonWarren Anderson

Page 131: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Minimata DiseaseMinimata DiseaseW Eugene SmithW Eugene Smith

Page 132: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Infamous Industrial Infamous Industrial DisastersDisasters

Chernobyl, USSR, 1986 - nuclear Chernobyl, USSR, 1986 - nuclear power plant explosionpower plant explosion-25-100 dead, up to 1,000 -25-100 dead, up to 1,000 injured acutely, NCI estimates injured acutely, NCI estimates 10-75K thyroid cancers10-75K thyroid cancers-Higher risk of childhood -Higher risk of childhood leukemia among those living leukemia among those living near nuclear power plantsnear nuclear power plants

Page 133: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Infamous Industrial Infamous Industrial DisastersDisasters

Alaska, Exxon Valdez, 1989 - oil Alaska, Exxon Valdez, 1989 - oil spillspill-wildlife devastated, $5 billion -wildlife devastated, $5 billion damagedamagePunitive damages overturned Punitive damages overturned

by U.S. Supreme Courtby U.S. Supreme Court 2006 BP Alaskan pipeline 2006 BP Alaskan pipeline

rupturesruptures

Page 134: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Oil and WaterOil and Water 1.3 million metric tons of oil enters oceans 1.3 million metric tons of oil enters oceans

each yeareach year 46% seepage from natural deposits46% seepage from natural deposits 8% tanker spills8% tanker spills

Exxon Valdez 38,800 metric tonsExxon Valdez 38,800 metric tons ABT Summer disaster off southwest ABT Summer disaster off southwest

coast of Africa (1991) – 260,000 metric coast of Africa (1991) – 260,000 metric tonstons

Remainder = industry, runoffRemainder = industry, runoff UN phase-out of single-hulled tankers UN phase-out of single-hulled tankers

begins 2010begins 2010

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Oil Pollution is Expensive to Oil Pollution is Expensive to Clean UpClean Up

Page 136: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Oil Slicks Kill Marine Oil Slicks Kill Marine LifeLife

Page 137: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Infamous Industrial Infamous Industrial DisastersDisasters

Love Canal:Love Canal: Hooker Electrochemical Company Hooker Electrochemical Company

(parent company Occidental (parent company Occidental Petroleum) dumps over 21,000 tons Petroleum) dumps over 21,000 tons of chemical waste in 1940s and of chemical waste in 1940s and 1950s1950s

Miscarriages, birth defects, cancersMiscarriages, birth defects, cancers Occidental found liableOccidental found liable

Page 138: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Infamous Industrial Infamous Industrial DisastersDisasters

Leads to Superfund LawLeads to Superfund Law Today only seven states prohibit Today only seven states prohibit

construction of schools on or construction of schools on or near hazardous waste sitesnear hazardous waste sites Half-million children attend Half-million children attend

schools within ½ mile of toxic schools within ½ mile of toxic waste dumps in NY, NJ, MA< waste dumps in NY, NJ, MA< and MI aloneand MI alone

Page 139: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

DeforestationDeforestation

Tropical forests constitute 7% of land Tropical forests constitute 7% of land surface area, contain > 50% of plant surface area, contain > 50% of plant and animal speciesand animal species

Majority of tropical forests destroyedMajority of tropical forests destroyed One acre of world’s forest cut down One acre of world’s forest cut down

every secondevery second 50% of global wetlands destroyed 50% of global wetlands destroyed

(54% in U.S.)(54% in U.S.) 100,000 acres lost per year in U.S.100,000 acres lost per year in U.S.

Page 140: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

DeforestationDeforestation HistoricalHistorical

-Easter Island (Polynesians), Middle East, U.S. -Easter Island (Polynesians), Middle East, U.S. Southwest (Anasazi Indians)Southwest (Anasazi Indians)

ContemporaryContemporary-Mauritania, Ethiopia, Haiti deforested-Mauritania, Ethiopia, Haiti deforested-Philippines and Thailand are now net -Philippines and Thailand are now net importers of forest products, looking at Latin importers of forest products, looking at Latin AmericaAmerica

Next?Next?-Indonesia, Burma, Papua New Guinea, Russian -Indonesia, Burma, Papua New Guinea, Russian Far East, Amazon, B.C., Alaska, many othersFar East, Amazon, B.C., Alaska, many others

Page 141: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Deforestation: CausesDeforestation: Causes

New agricultural settlements New agricultural settlements (overpopulation, poverty, unsustainable (overpopulation, poverty, unsustainable farming practices)farming practices)

LoggingLogging Oil and gas explorationOil and gas exploration

Drilling in ANWR would drop gas prices 4 cents Drilling in ANWR would drop gas prices 4 cents per gallon, after a 15 year waiting period, and per gallon, after a 15 year waiting period, and assuming companies sell oil to U.S. consumersassuming companies sell oil to U.S. consumers

Cattle ranchingCattle ranching Drug cultivationDrug cultivation

-Peru, Bolivia, Columbia-Peru, Bolivia, Columbia

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Page 143: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

ClearcuttingClearcutting

Page 144: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

ClearcuttingClearcutting

Page 145: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Clearcutting with Clearcutting with CorridorsCorridors

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Page 147: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Global WarmingGlobal Warming

Page 148: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Global WarmingGlobal Warming

Greenhouse effectGreenhouse effect 30% increase in atmosphere CO2 since 30% increase in atmosphere CO2 since

industrialization began (6.25 billion industrialization began (6.25 billion tons/year)tons/year)

Fossil Fuels (CO2)Fossil Fuels (CO2) Methane, choloroflurocarbons, nitrous Methane, choloroflurocarbons, nitrous

oxide, sulfur oxidesoxide, sulfur oxides Methane 25 times more heat than CO2, Methane 25 times more heat than CO2,

large amounts stored in permafrostlarge amounts stored in permafrost ObesityObesity

Page 149: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Global WarmingGlobal Warming

The last 20 years have been the The last 20 years have been the hottest ever recorded (data go back to hottest ever recorded (data go back to 1856)1856) 2007 hottest year on record2007 hottest year on record

Average global surface temperature = Average global surface temperature = 58.358.3°° Hottest temperature in last 10,000 yearsHottest temperature in last 10,000 years

Far North, Pacific Northwest warming Far North, Pacific Northwest warming up faster than other parts of the planetup faster than other parts of the planet

Page 150: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Consequences of Global Consequences of Global WarmingWarming

160,000 deaths and 5.5 million 160,000 deaths and 5.5 million disability-adjusted life years lost per disability-adjusted life years lost per yearyear WHO, UN Environment ProgramWHO, UN Environment Program Expected to double by 2020Expected to double by 2020 ↑ ↑ weather extremes/natural weather extremes/natural

disasters/insurance claimsdisasters/insurance claims$200 billion in 2008$200 billion in 2008

Floods, cholera, rising malaria zoneFloods, cholera, rising malaria zone

Page 151: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Weather ExtremesWeather ExtremesHeadline from “The Onion”Headline from “The Onion”

Hurriphoonado Cuts Swath Of Hurriphoonado Cuts Swath Of Destruction Across Eastern, Destruction Across Eastern, Western HemispheresWestern Hemispheres

Page 152: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Consequences of Global Consequences of Global WarmingWarming

Polar icecaps/glaciers/Greenland ice Polar icecaps/glaciers/Greenland ice sheet/Himalayas/permafrost melting, sea sheet/Himalayas/permafrost melting, sea levels risinglevels rising Artic ice pack has lost 40% of its Artic ice pack has lost 40% of its

thickness compared with 1960thickness compared with 1960 Glacier National Park’s glaciers meltingGlacier National Park’s glaciers melting Snows of Kilimanjaro down 85% Snows of Kilimanjaro down 85%

compared to 1912; will be gone by compared to 1912; will be gone by 20152015

Page 153: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Glaciers CalvingGlaciers Calving

Page 154: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Polar Bears Stranded / Polar Bears Stranded / Dying OffDying Off

Page 155: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Greenland’s Ice Cap Greenland’s Ice Cap Melting: 1992Melting: 1992

Page 156: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Greenland’s Ice Cap Greenland’s Ice Cap Melting: 2002Melting: 2002

Page 157: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Greenland’s Ice Cap Greenland’s Ice Cap Melting: 2005Melting: 2005

Page 158: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Consequences of Global Consequences of Global WarmingWarming

Increased Increased allergies/asthma/anaphylaxisallergies/asthma/anaphylaxis Rising temperatures increase Rising temperatures increase

smog/ground level ozonesmog/ground level ozone Ozone stunts plant growthOzone stunts plant growth Higher levels of CO2 favor Higher levels of CO2 favor

growth of ragweed and other growth of ragweed and other pollen-producing plantspollen-producing plants

Page 159: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Global WarmingGlobal Warming

The top 1/5 of the world’s The top 1/5 of the world’s largest 145 countries account largest 145 countries account for 63% of global C0for 63% of global C022 emissions emissions (lowest 1/5 = 2%)(lowest 1/5 = 2%)

The countries likely to be most The countries likely to be most affected by global warming are affected by global warming are those least responsible for the those least responsible for the increases in global temperatureincreases in global temperature

Page 160: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Global Warming Increases Global Warming Increases DroughtsDroughts

Page 161: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

AgricultureAgriculture

Global per capita cropland down Global per capita cropland down over 50% from 1961 to 0.6% acreover 50% from 1961 to 0.6% acre

Soil erosion exceeds soil Soil erosion exceeds soil formationformationIn the past 40 years, 1/3 of U.S. In the past 40 years, 1/3 of U.S. topsoil has erodedtopsoil has eroded

Takes 1,000 years to “grow” 1 Takes 1,000 years to “grow” 1 inch of soilinch of soil

Page 162: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

AgricultureAgriculture

Livestock responsible for more Livestock responsible for more

greenhouse gas emissions than the greenhouse gas emissions than the

entire transportation sectorentire transportation sector

Methane, CO2, and NOMethane, CO2, and NO

Grass-fed cattle healthier, Grass-fed cattle healthier,

produce less methane, contain produce less methane, contain

less saturated fatless saturated fat

Page 163: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

AgricultureAgriculture

Water use has tripled since 1950, Water use has tripled since 1950,

up 6-fold over 20up 6-fold over 20thth Century Century70% of freshwater use in 70% of freshwater use in

agricultureagriculture Large scale irrigation projects Large scale irrigation projects

(e.g., China’s Three Gorges Dam)(e.g., China’s Three Gorges Dam)

Page 164: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

China’s Three Gorges DamChina’s Three Gorges Dam

Page 165: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Wasted FoodWasted Food

Household food waste adds up Household food waste adds up to $43 billion/yr in the U.S.to $43 billion/yr in the U.S.

An average American family of An average American family of four tosses out $590/yr foodfour tosses out $590/yr food

Americans discarded 3 times as Americans discarded 3 times as much food in 2005 as in 1985much food in 2005 as in 1985

Page 166: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Decreasing crop diversityDecreasing crop diversity

75,000 plant species are edible75,000 plant species are edible

Humans have utilized 7000 plant species for Humans have utilized 7000 plant species for

foodfood

20% of species provide 80% of the world’s food20% of species provide 80% of the world’s food

Consequences: decreasing genetic diversity, Consequences: decreasing genetic diversity,

vulnerability to disease, huge crop losses (e.g., vulnerability to disease, huge crop losses (e.g.,

Irish potato famine) Irish potato famine)

Page 167: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Factory FarmingFactory Farming

Factory farms have replaced Factory farms have replaced industrial factories as the # 1 industrial factories as the # 1 polluters of American waterwayspolluters of American waterways

1.4 billion tons animal waste 1.4 billion tons animal waste generated/yrgenerated/yr 130 x human waste130 x human waste 1 hog farm in NC generates as 1 hog farm in NC generates as

much sewage annualy as all of much sewage annualy as all of ManhattanManhattan

Page 168: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Factory FarmingFactory Farming

Page 169: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Factory FarmingFactory Farming

Page 170: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Factory Farm WasteFactory Farm Waste Most untreatedMost untreated Ferments in open poolsFerments in open pools Seeps into local water supply, Seeps into local water supply,

estuariesestuaries Kills fishKills fish Causes human infections - e.g., Causes human infections - e.g.,

Pfisteria pesciiPfisteria pescii,, Chesapeake BayChesapeake Bay Creates unbearable stenchCreates unbearable stench Widely disseminated by Widely disseminated by

floods/hurricanesfloods/hurricanes

Page 171: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Agricultural Antibiotic UseAgricultural Antibiotic Use

Agriculture accounts for 70% Agriculture accounts for 70% of U.S. antibiotic useof U.S. antibiotic use

Use up 50% over the last 15 Use up 50% over the last 15 yearsyears

Page 172: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Antibiotic Resistant PathogensAntibiotic Resistant Pathogens

CDC: “Antibiotic use in food CDC: “Antibiotic use in food animals is the dominant source of animals is the dominant source of antibiotic resistance among food-antibiotic resistance among food-borne pathogens.”borne pathogens.”

$4billion/yr to treat antibiotic-$4billion/yr to treat antibiotic-resistant infections in humansresistant infections in humans Campylobacter fluoroquinolone Campylobacter fluoroquinolone

resistanceresistance VREF (poss. due to avoparcin use in VREF (poss. due to avoparcin use in

chickens)chickens)

Page 173: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Alternatives to Agricultural Alternatives to Agricultural Antibiotic UseAntibiotic Use

Decrease overcrowdingDecrease overcrowding Better diet/sanitation/living Better diet/sanitation/living

conditionsconditions Control heat stressControl heat stress VaccinationVaccination Increased use of bacterial cultures Increased use of bacterial cultures

and specific antibiotic treatment and specific antibiotic treatment in animals when indicatedin animals when indicated

Page 174: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Ending Agricultural Antibiotic Ending Agricultural Antibiotic UseUse

EU bans use of all antibiotic growth EU bans use of all antibiotic growth promoters effective 1/1/06promoters effective 1/1/06

Three years after a Danish ban on Three years after a Danish ban on routine use of antibiotics in chicken routine use of antibiotics in chicken farming, the prevalence of antibiotic-farming, the prevalence of antibiotic-resistant bacteria in chickens dropped resistant bacteria in chickens dropped from 82% to 12%from 82% to 12%

US Preservation of Antibiotics for US Preservation of Antibiotics for Medical Treatment Act, 2007 – awaiting Medical Treatment Act, 2007 – awaiting votevote

Page 175: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

OverfishingOverfishing

Fisheries collapsing:Fisheries collapsing:Newfoundland codNewfoundland codWest Coast salmonWest Coast salmon

1/3 of fish species threatened with 1/3 of fish species threatened with extinctionextinction90% drop in # of largest predatory 90% drop in # of largest predatory ocean fish since 1950ocean fish since 1950

Global fisheries collapse predicted Global fisheries collapse predicted by 2048 unless practices changeby 2048 unless practices change

Page 176: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Harmful Fishing Harmful Fishing PracticesPractices

Long-lining, bottom trawlers, Long-lining, bottom trawlers, drift netsdrift nets Tear up seafloor, damage coralsTear up seafloor, damage corals Large amounts of bycatch discardedLarge amounts of bycatch discarded

Up to 20 lbs per lb of desired catchUp to 20 lbs per lb of desired catch

Cyanide fishing (400 kg/year)Cyanide fishing (400 kg/year) Dynamite Reef fishingDynamite Reef fishing

Page 177: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Factory TrawlersFactory Trawlers

Page 178: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Dynamite Reef FishingDynamite Reef Fishing

Page 179: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The Military Harms FishThe Military Harms Fish

Environmental destructionEnvironmental destruction Navy sonar harming/killing off Navy sonar harming/killing off

whaleswhales Japanese/Norwegian whaling Japanese/Norwegian whaling

compounds problemcompounds problem Dolphins as mine detectors (in Dolphins as mine detectors (in

Vietnam and Iraq)Vietnam and Iraq) Weaponizing sharks, dolphins, etc. Weaponizing sharks, dolphins, etc.

(DARPA)(DARPA)

Page 180: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Coral ReefsCoral Reefs

Generate $30 billion/yr globally in Generate $30 billion/yr globally in fishing, tourism, and protection from fishing, tourism, and protection from storm surgesstorm surges

Reefs make up 1% of ocean floor, Reefs make up 1% of ocean floor, support ¼ of all marine lifesupport ¼ of all marine life

Page 181: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Coral ReefsCoral Reefs

Threatened by bleaching due to rising Threatened by bleaching due to rising ocean temperature, acidification from ocean temperature, acidification from increased CO2, runoffs from increased CO2, runoffs from deforestation, pesticidesdeforestation, pesticides pH of oceans down 0.1 from pH of oceans down 0.1 from

preindustrial times to 8preindustrial times to 8 With current trends, pH will be 7.7 With current trends, pH will be 7.7

by 2100by 2100 At pH 7.8, shell formation ceasesAt pH 7.8, shell formation ceases

Page 182: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Coral ReefsCoral Reefs

10% of world’s reefs ruined (90% in 10% of world’s reefs ruined (90% in Philippines), 30% in critical conditionPhilippines), 30% in critical condition

Jellyfish populations burgeoning Jellyfish populations burgeoning (“cockroaches of the sea”)(“cockroaches of the sea”)

Americans purchase 350,000 pieces Americans purchase 350,000 pieces of live coral broken off from reefs per of live coral broken off from reefs per yearyear vs. 90,000 for the rest of the worldvs. 90,000 for the rest of the world

Page 183: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

AquacultureAquaculture

27-33% of fish now consumed 27-33% of fish now consumed is farmed (vs. 4% in 1970)is farmed (vs. 4% in 1970)Almost all catfish and troutAlmost all catfish and trout1/2 of shrimp1/2 of shrimp1/3 of salmon 1/3 of salmon

Page 184: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Consequences of Consequences of AquacultureAquaculture

No compensation to general public for No compensation to general public for

potentially exclusionary use of public potentially exclusionary use of public

services for private profitservices for private profit Feed inefficiency (2-6 lbs of wild fish to Feed inefficiency (2-6 lbs of wild fish to

raise 1 lb farmed fish)raise 1 lb farmed fish) Decreased diversityDecreased diversity Escapes, interbreeding with (and lowering Escapes, interbreeding with (and lowering

fitness of) wild stocksfitness of) wild stocks

Page 185: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Consequences of Consequences of AquacultureAquaculture

Antibiotics (incl. chloramphenicol), Antibiotics (incl. chloramphenicol),

hormones, dyes, herbicides, hormones, dyes, herbicides,

pesticides, algicides pesticides, algicides → → increased increased

pollution and sewagepollution and sewage

Damage to local estuaries, birds of Damage to local estuaries, birds of

preyprey

DiseaseDisease

Page 186: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

AquacultureAquaculture

Good seafood (clean water):Good seafood (clean water): ClamsClams MusselsMussels OystersOysters scallopsscallops

Bad seafoodBad seafood Farmed salmon contains 10X as much PCBs as Farmed salmon contains 10X as much PCBs as

wild salmonwild salmon

Page 187: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Maldistribution of Maldistribution of WealthWealth

500 billionaires worldwide500 billionaires worldwide

top 250 billionaires worth top 250 billionaires worth

$1 trillion, the combined $1 trillion, the combined

income of bottom 2.5 billion income of bottom 2.5 billion

people (45% of world’s people (45% of world’s

population)population)

Page 188: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Maldistribution of Maldistribution of WealthWealth

U.S: Richest 1% of the U.S: Richest 1% of the population owns 50% of the population owns 50% of the country’s wealth country’s wealth -poorest 90% own 30%-poorest 90% own 30%-widest gap of any -widest gap of any industrialized nationindustrialized nation

Page 189: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The Stock MarketThe Stock Market

20% of Americans own stock; 90% of 20% of Americans own stock; 90% of

stock owned by 10% (50% by 1%)stock owned by 10% (50% by 1%)

““Business” newsBusiness” news As a group, U.S. Senators beat the As a group, U.S. Senators beat the

market by an average of 12% from market by an average of 12% from 1993-98 (study published 2004)1993-98 (study published 2004) The best fund managers average The best fund managers average

3%3%

Page 190: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Maldistribution of wealthMaldistribution of wealth

The worldwide gap between The worldwide gap between rich and poor doubled between rich and poor doubled between 1960 and 1990, and grew an 1960 and 1990, and grew an additional 20% between 1990 additional 20% between 1990 and 1998and 1998

This gap is higher in the U.S. This gap is higher in the U.S. than in any other industrialized than in any other industrialized nationnation

Page 191: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Maldistribution of wealthMaldistribution of wealth

Less than 4% of the combined wealth Less than 4% of the combined wealth

of the 225 richest individuals in the of the 225 richest individuals in the

world would pay for ongoing access world would pay for ongoing access

to basic education, health care to basic education, health care

(including reproductive health care), (including reproductive health care),

adequate food, safe water, and adequate food, safe water, and

adequate sanitation for all humans adequate sanitation for all humans

(UNDP)(UNDP)

Page 192: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

George OrwellGeorge Orwell

““Some people are Some people are more equal than more equal than

others”others”

Page 193: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Hudson River, 2009Hudson River, 2009

Page 194: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Maldistribution of Maldistribution of Wealth/Resources Threatens Wealth/Resources Threatens

National Security and Requires a National Security and Requires a Permanent War EconomyPermanent War Economy

““The U.S. has about 50% of the world’s The U.S. has about 50% of the world’s wealth, but only 6.3% of its population. wealth, but only 6.3% of its population. This situation cannot fail to be the object of This situation cannot fail to be the object of envy and resentment. Our real task in the envy and resentment. Our real task in the coming period is to devise a pattern of coming period is to devise a pattern of relationships which will permit us to relationships which will permit us to maintain this position of disparity withoug maintain this position of disparity withoug positive detriment to our national positive detriment to our national security.”security.” George Kennan, U.S. State Dept. Policy George Kennan, U.S. State Dept. Policy

Planning Study, 1948Planning Study, 1948

Page 195: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

VoltaireVoltaire

““The comfort of the rich The comfort of the rich rests upon an abundance rests upon an abundance of the poor”of the poor”

Page 196: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Primo LeviPrimo Levi

““A country is considered the A country is considered the more civilized the more the more civilized the more the wisdom and efficiency of its wisdom and efficiency of its laws hinder a weak man from laws hinder a weak man from becoming too weak or a becoming too weak or a powerful one too powerful.”powerful one too powerful.”

Page 197: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Racial Disparities: Racial Disparities: EconomicEconomic

Income disparitiesIncome disparitiesMedian income of black U.S. Median income of black U.S.

families as a percent of white families as a percent of white U.S. families = 60% in in 1968; U.S. families = 60% in in 1968; 58% in 200258% in 2002

Educational disparitiesEducational disparities Higher levels of unemploymentHigher levels of unemployment

Page 198: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Racial Disparities: Racial Disparities: EconomicEconomic

Criminal justice system Criminal justice system involvementinvolvement

Toxic waste sitings / Toxic waste sitings / environmental injustice / environmental injustice / environmental racismenvironmental racism

Persistent overt / subtle Persistent overt / subtle discriminationdiscrimination E.g., “driving while black”E.g., “driving while black”

Page 199: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Racial Disparities: Racial Disparities: Health CareHealth Care

Higher maternal and infant Higher maternal and infant mortalitymortality

Higher death rates for most Higher death rates for most diseasesdiseases

Shorter life expectanciesShorter life expectancies Less health insuranceLess health insurance Fewer diagnostic tests / Fewer diagnostic tests /

therapeutic procedurestherapeutic procedures

Page 200: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Income Inequality KillsIncome Inequality Kills Higher income inequality is Higher income inequality is

associated with increased mortality associated with increased mortality at all per capita income levelsat all per capita income levels

Equalizing the mortality rates of Equalizing the mortality rates of whites and African-Americans whites and African-Americans would have averted 686,202 deaths would have averted 686,202 deaths between 1991 and 2000between 1991 and 2000 Whereas medical advances averted Whereas medical advances averted

176,633 deaths176,633 deaths AJPH 2004;94:2078-2081AJPH 2004;94:2078-2081

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Overconsumption Overconsumption (Affluenza)(Affluenza)

U.S. = 6.3% of world’s populationU.S. = 6.3% of world’s population Own 50% of the world’s wealthOwn 50% of the world’s wealth

U.S. responsible for:U.S. responsible for:

-25% of world’s energy consumption-25% of world’s energy consumption

-33% of paper use-33% of paper use

-72% of hazardous waste production -72% of hazardous waste production

(1 ton/person/year) (1 ton/person/year)

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But are we happier?But are we happier?

Workloads increasing, vacation and Workloads increasing, vacation and free time decreasingfree time decreasing Average American wastes 62 hrs/yr Average American wastes 62 hrs/yr

sitting in rush hour trafficsitting in rush hour traffic Average American working 200 more Average American working 200 more

hrs/yr than in 1960 (#1 in world)hrs/yr than in 1960 (#1 in world) 8/10 Americans want a new job 8/10 Americans want a new job

(CNNMoney.com, 11/03)(CNNMoney.com, 11/03) Stress up / satisfaction with life downStress up / satisfaction with life down

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Erosion of social capitalErosion of social capital

Erosion of social capital is Erosion of social capital is strongest where maldistribution strongest where maldistribution of wealth is largestof wealth is largest

Americans have an average of 2 Americans have an average of 2 close friends todayclose friends todayDown from 3 in 1985Down from 3 in 1985

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Erosion of social capitalErosion of social capital

1 in 4 Americans say they have no 1 in 4 Americans say they have no one with whom they can discuss one with whom they can discuss important mattersimportant matters Includes nuclear familyIncludes nuclear family Was 1 in 8 in 1985Was 1 in 8 in 1985

““Most people can be trusted”Most people can be trusted” 1960: agree = 58%1960: agree = 58% 1994: agree = 37%1994: agree = 37%

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Maldistribution of Maldistribution of WealthWealth

In countries with moderate In countries with moderate levels of wealth, happiness is levels of wealth, happiness is highest where income highest where income inequalities lowestinequalities lowestMajor League Baseball: teams Major League Baseball: teams are more successful when are more successful when players’ salaries are more players’ salaries are more equitably distributedequitably distributed

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The Booming EconomyThe Booming Economy

Inflation-adjusted net worth Inflation-adjusted net worth of the median U.S. householdof the median U.S. household1989 - $54,6001989 - $54,6001997 - $49,0001997 - $49,0002004 - $44,3892004 - $44,389

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The Booming EconomyThe Booming Economy

Weekly wages for the avg. Weekly wages for the avg. American worker are 12% below American worker are 12% below what they were in 1973what they were in 1973

But productivity is up 33%But productivity is up 33% $1.5 trillion needed to repair $1.5 trillion needed to repair

nation’s infrastructurenation’s infrastructure

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Vacation Time DownVacation Time Down

Americans work more than any Americans work more than any other country: 1970 hrs/yrother country: 1970 hrs/yr Canada (#2): 1800 hrs/yrCanada (#2): 1800 hrs/yr Industrialized EU countries: 1600-1800 Industrialized EU countries: 1600-1800

hrs/yrhrs/yr Americans take less than 9/12 days Americans take less than 9/12 days

of allotted leave per yearof allotted leave per year Japanese alloted 18, Canadians 20, Japanese alloted 18, Canadians 20,

Germans 27, French 39Germans 27, French 39 Many advocate 30 hour workweekMany advocate 30 hour workweek

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Minimum Wage Minimum Wage ≠ Living ≠ Living WageWage

Federal minimum wage = $5.15/hr (no Federal minimum wage = $5.15/hr (no change over last 8 years)change over last 8 years) Oregon = $8.40/hr (2009)Oregon = $8.40/hr (2009) $10,300/yr for full-time job$10,300/yr for full-time job Real value down 42% compared with Real value down 42% compared with

19681968 Inadequate to pay rent, buy food and Inadequate to pay rent, buy food and

clothingclothing3 million homeless (13-17% of 3 million homeless (13-17% of homeless adults work)homeless adults work)

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Food Stamp ProgramFood Stamp Program

Covers 26 million AmericansCovers 26 million Americans 35 million Americans (1/3 of them children) 35 million Americans (1/3 of them children)

live in household that cannot consistently live in household that cannot consistently afford food)afford food)

$1.05/person/meal$1.05/person/meal 5-year residency requirement for adult 5-year residency requirement for adult

legal immigrantslegal immigrants Undocumented immigrants not eligibleUndocumented immigrants not eligible

Inadequate signup ratesInadequate signup rates

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Minimum Wage Minimum Wage ≠ Living ≠ Living WageWage

¼ of US jobs pay less than a ¼ of US jobs pay less than a poverty-level incomepoverty-level income

In 4 of the last 5 years, Congress In 4 of the last 5 years, Congress granted itself a $5,000 cost of granted itself a $5,000 cost of living salary increaseliving salary increase

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Exorbitant CEO PayExorbitant CEO Pay

CEO salaries up 500% since 1980CEO salaries up 500% since 1980 The average CEO makes 350-400X The average CEO makes 350-400X

the salary of the average U.S. the salary of the average U.S. worker (1960 - 41X; 1980 - 42X)worker (1960 - 41X; 1980 - 42X) Mexico 45:1Mexico 45:1 Britain 25:1Britain 25:1 Germany 11:1Germany 11:1 Japan 10:1Japan 10:1

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U.S. DebtU.S. Debt

US national debt $9.4 trillion in US national debt $9.4 trillion in 20082008Over $30,000 for every US citizenOver $30,000 for every US citizen

Personal savings downPersonal savings down

Annual bankruptcies up 40% Annual bankruptcies up 40% between 2007 and 2008between 2007 and 2008

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U.S. DebtU.S. Debt

Average household debt (for mortgages, Average household debt (for mortgages, car loans, credit cards and all other car loans, credit cards and all other debt combined) = $112,043 in 2007debt combined) = $112,043 in 2007

Debt exacerbated byDebt exacerbated by Predatory lending practices, sub-Predatory lending practices, sub-

prime mortgage collapseprime mortgage collapse Payday loans (22,000 stores, serving Payday loans (22,000 stores, serving

10 million people/yr, $40 billion/yr 10 million people/yr, $40 billion/yr business)business)

Rent-to-own companiesRent-to-own companies

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Total Credit Card Debt Total Credit Card Debt UpUp

1990 - $243 billion1990 - $243 billion1997 - $560 billion1997 - $560 billion2002 - $1.5 trillion2002 - $1.5 trillion2005 - $800 billion2005 - $800 billion2009 - $951 billion2009 - $951 billion

Average number of credit cards Average number of credit cards per U.S. household = 12.7per U.S. household = 12.7

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BankruptciesBankruptcies

1.1 million bankruptcies in 20081.1 million bankruptcies in 2008 Over 60% of bankruptcies due to Over 60% of bankruptcies due to

health care expenses (and ¾ of health care expenses (and ¾ of these individuals were insured)these individuals were insured)

exceed # of college exceed # of college graduates/year, # of persons graduates/year, # of persons diagnosed with cancer per yeardiagnosed with cancer per year

Bankruptcy “reform” bill grossly Bankruptcy “reform” bill grossly unfairunfair

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PensionsPensions

Pensions in jeopardyPensions in jeopardyShift from Defined Benefit Shift from Defined Benefit

Plans to Defined Contribution Plans to Defined Contribution PlansPlans

Reductions in / elimination of Reductions in / elimination of employer contributionsemployer contributions

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The “Global Economy”The “Global Economy”

53 of the world’s 100 largest 53 of the world’s 100 largest economies are private corporations; 47 economies are private corporations; 47 are countriesare countries GM was, until recently, larger than GM was, until recently, larger than

Denmark, Thailand, Hong Kong, and Denmark, Thailand, Hong Kong, and TurkeyTurkey

Wal-Mart is larger than Israel and Wal-Mart is larger than Israel and GreeceGreece

AT&T is larger than Malaysia and AT&T is larger than Malaysia and IrelandIreland

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The “Global Economy”The “Global Economy”

Until 2007, the combined Until 2007, the combined revenues of GM and Ford exceed revenues of GM and Ford exceed the combined GDP of all sub-the combined GDP of all sub-Saharan AfricaSaharan Africa

Combined sales of the top 6 Combined sales of the top 6 Japanese companies are nearly Japanese companies are nearly equivalent to the combined GDP equivalent to the combined GDP of all of South Americaof all of South America

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CorporationsCorporations

Almost 6 million corporationsAlmost 6 million corporations¼ non-profits¼ non-profits

500 companies control 70% 500 companies control 70% of world tradeof world trade

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CorporationsCorporations

““The [only] social The [only] social responsibility of business is responsibility of business is to increase its profits.”to increase its profits.”

- Milton Friedman- Milton Friedman

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CorporationsCorporations

““Corporations [have] no moral Corporations [have] no moral conscience. [They] are designed by conscience. [They] are designed by law, to be concerned only for their law, to be concerned only for their stockholders, and not, say, what are stockholders, and not, say, what are sometimes called their stakeholders, sometimes called their stakeholders, like the community or the work like the community or the work force…”force…”

-Noam Chomsky-Noam Chomsky

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CorporationsCorporations

Internalize profitsInternalize profits

Externalize health and Externalize health and environmental costsenvironmental costs

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Corporate TaxationCorporate Taxation

Nearly 1/3 of all large Nearly 1/3 of all large corporations (assets corporations (assets >> $250 million or annual $250 million or annual sales sales >> $50 million) pay $50 million) pay no annual income taxno annual income tax

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Corporate TaxationCorporate Taxation

Corporations shouldered over Corporations shouldered over 30% of the nation’s tax 30% of the nation’s tax burden in 1950 vs. 8% todayburden in 1950 vs. 8% today

Corporate taxes are at their Corporate taxes are at their lowest level since WW IIlowest level since WW II

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Reasons for Inadequate Reasons for Inadequate Corporate TaxationCorporate Taxation

Tax breaks, corporate welfare, Tax breaks, corporate welfare, corporation-friendly tax laws, corporation-friendly tax laws, loopholes, transferring assets loopholes, transferring assets overseasoverseas

Cheating and under-payment Cheating and under-payment commoncommon 1/3 high school students admits to 1/3 high school students admits to

stealing something from a store in the stealing something from a store in the past yearpast year

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Reasons for Inadequate Reasons for Inadequate Corporate TaxationCorporate Taxation

Offshore tax havens shelter capitalOffshore tax havens shelter capital Estimated 1/3 of global assetsEstimated 1/3 of global assets $11.5 trillion in individual wealth $11.5 trillion in individual wealth

alonealone 83 of the largest 100 US companies 83 of the largest 100 US companies

have subsidiaries in tax havenshave subsidiaries in tax havens Lost annual tax revenue:Lost annual tax revenue:

$250 billion worldwide$250 billion worldwide $100 billion in US$100 billion in US

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Corporate CrimeCorporate Crime

Each year in America, we lose;Each year in America, we lose; $3.8 billion to burglary and robbery$3.8 billion to burglary and robbery $100-$400 billion to health care fraud; $40 $100-$400 billion to health care fraud; $40

billion to auto repair fraud, $15 billion to billion to auto repair fraud, $15 billion to securities fraud, etc.; the S and L fraud cost securities fraud, etc.; the S and L fraud cost between $300 billion and $500 billionbetween $300 billion and $500 billion

Fines meager, often considered a cost of Fines meager, often considered a cost of doing businessdoing business

Corporate crime under-prosecuted, Corporate crime under-prosecuted, prosecutors under-fundedprosecutors under-funded

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Corporate CrimeCorporate Crime 25% decrease in federal prosecutions of 25% decrease in federal prosecutions of

white collar crime, including corporate white collar crime, including corporate crime, since 1999crime, since 1999

Increase in non-prosecution and deferred-Increase in non-prosecution and deferred-prosecution agreementsprosecution agreements

1,288 whistleblower lawsuits 2002-8; 1,288 whistleblower lawsuits 2002-8; government ruled for whistleblower in government ruled for whistleblower in only 17only 17

3/5 U.S. companies settling corporate 3/5 U.S. companies settling corporate crime cases illegally deduct some or all of crime cases illegally deduct some or all of the settlement to the IRSthe settlement to the IRS

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UnemploymentUnemployment

9-12% unemployment rate9-12% unemployment rate True percentage likely higherTrue percentage likely higher Only 1/3 of the unemployed are eligible Only 1/3 of the unemployed are eligible

for unemployment insurancefor unemployment insurance Women slightly more likely to be Women slightly more likely to be

unemployed than menunemployed than men Black women 2X white womenBlack women 2X white women

Under-employment rate Under-employment rate approximately 10%approximately 10%

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The Rise of the The Rise of the PermatempPermatemp

Temporary agency workersTemporary agency workers1989 - 1.2 million1989 - 1.2 million1998 2.8 million1998 2.8 million2006 - est. 4.0 million2006 - est. 4.0 million

Results: job insecurity, fewer Results: job insecurity, fewer benefits, no retirement savings, benefits, no retirement savings, more uninsured, etc.more uninsured, etc.

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Job Loss and The Decline Job Loss and The Decline of Laborof Labor

12 million quality jobs lost in 12 million quality jobs lost in the U.S. between 1980 and the U.S. between 1980 and 20052005

Free tradeFree tradeExpatriation of jobsExpatriation of jobs40% of US jobs part-time or 40% of US jobs part-time or

seasonalseasonal

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Job Loss and The Decline Job Loss and The Decline of Laborof Labor

Labor union membership declining since Labor union membership declining since 19501950 Now 12%:Now 12%:

8% in private sector8% in private sector37% in public sector37% in public sector

Employers generally anti-unionEmployers generally anti-union Unionized workers earn more, have better Unionized workers earn more, have better

health benefits, safer working conditions, health benefits, safer working conditions, retirement and disability portfoliosretirement and disability portfolios

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Overseas Labor MarketsOverseas Labor Markets

Currently made overseas:Currently made overseas: 83% of all garments sold in the 83% of all garments sold in the

U.S.U.S. 90% of sporting goods90% of sporting goods 93% of shoes93% of shoes

Overseas factories often lack Overseas factories often lack adequate occupational health and adequate occupational health and safety / pollution controls (e.g., safety / pollution controls (e.g., maquiladoras)maquiladoras)

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Worker Health and Worker Health and SafetySafety

ILO: 2.2 million die of work-ILO: 2.2 million die of work-related injuries and diseases related injuries and diseases worldwide each yearworldwide each yearConsidered vast Considered vast

underestimate, due to poor underestimate, due to poor reporting in many developing reporting in many developing countriescountries

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OutsourcingOutsourcing

2 million manufacturing jobs lost 2 million manufacturing jobs lost between 2001 and 2003between 2001 and 2003

Over the last few years, compared to Over the last few years, compared to other firms, CEO compensation has other firms, CEO compensation has increased five times faster at the 50 increased five times faster at the 50 U.S. firms that do the most U.S. firms that do the most outsourcing of jobsoutsourcing of jobs

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Asian SweatshopAsian Sweatshop

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The Global WorkforceThe Global Workforce

27 million enslaved laborers27 million enslaved laborers Slavery occurs in every country in Slavery occurs in every country in

Africa (Unicef)Africa (Unicef) 800,000 persons trafficked across 800,000 persons trafficked across

international borders annuallyinternational borders annually Dollar value of commerce in Dollar value of commerce in

human beings rivals drug human beings rivals drug trafficking and illegal arms tradetrafficking and illegal arms trade

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The Global WorkforceThe Global Workforce

Over 250 million child laborersOver 250 million child laborers60% exposed to hazardous 60% exposed to hazardous

conditions; 25% exposed to conditions; 25% exposed to hazardous chemicalshazardous chemicals

Violations of child labor laws Violations of child labor laws common in U.S.common in U.S.

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Child LaborChild Labor

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Outsourcing the Outsourcing the GovernmentGovernment

More than ½ of federal jobs now More than ½ of federal jobs now outsourced to private corporationsoutsourced to private corporations

More than ½ of contracts no-bidMore than ½ of contracts no-bid Threat to democracyThreat to democracy Outsourcing of militaryOutsourcing of military

MercenariesMercenaries Demoralizes troopsDemoralizes troops

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The Third World Debt The Third World Debt CrisisCrisis

Over 40 of the poorest countries in Africa, Latin Over 40 of the poorest countries in Africa, Latin America, and Asia owe a total of almost $300 America, and Asia owe a total of almost $300 billion in foreign debtbillion in foreign debt countries borrowed when loans cheap and countries borrowed when loans cheap and

easy to geteasy to get money lent to corrupt/undemocratic money lent to corrupt/undemocratic

governments during Cold Wargovernments during Cold War corruptioncorruption world prices for main exports declinedworld prices for main exports declined new loans (at higher interest rates) required new loans (at higher interest rates) required

to pay interest on debtto pay interest on debt

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The Third World Debt The Third World Debt CrisisCrisis

CreditorsCreditorsUS, UK, Japan, France and US, UK, Japan, France and

GermanyGermany interest rates up to 20-22% in interest rates up to 20-22% in

1980’s1980’s

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The Third World Debt The Third World Debt CrisisCrisis

Each African child inherits Each African child inherits approximately $379 in debt at birthapproximately $379 in debt at birth debt 100-200% of GDP for Tanzania, debt 100-200% of GDP for Tanzania,

Zambia, Ethiopia, and othersZambia, Ethiopia, and others Per capita income in Sub-Saharan Africa Per capita income in Sub-Saharan Africa

has declined in real terms by 6% since 1975has declined in real terms by 6% since 1975 Live Aid (1985 raised $200 million)Live Aid (1985 raised $200 million)

Equal to the amount all African countries Equal to the amount all African countries pay back on foreign debts each week (in pay back on foreign debts each week (in 2001)2001)

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The Third World Debt The Third World Debt CrisisCrisis

Countries spend more each Countries spend more each year repaying debt than on year repaying debt than on education and healthcare.education and healthcare.

Debt will never be paid offDebt will never be paid off

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Effects of the Effects of the Third World Debt CrisisThird World Debt Crisis

Indebted countries drastically cut wages, Indebted countries drastically cut wages, which slows the economy and decreases which slows the economy and decreases purchases of U.S. importspurchases of U.S. imports makes U.S. jobs less securemakes U.S. jobs less secure

Currency is devalued.Currency is devalued. imports more expensive; exports imports more expensive; exports

cheapercheaper Government price controls eliminatedGovernment price controls eliminated

basic goods more expensivebasic goods more expensive

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Effects of theEffects of theThird World Debt CrisisThird World Debt Crisis

Government spending on food, fuel Government spending on food, fuel and farming subsidies reducedand farming subsidies reduced

Social service (healthcare/education) Social service (healthcare/education) program spending cutprogram spending cut

Countries strip and sell their natural Countries strip and sell their natural resourcesresources increased global pollution, etc.increased global pollution, etc.

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Solution to the Third World Solution to the Third World Debt CrisisDebt Crisis

Debt forgivenessDebt forgiveness

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Foreign AidForeign Aid

In total dollars: Japan #1, U.S. #2In total dollars: Japan #1, U.S. #2 Even though the U.S. economy is more Even though the U.S. economy is more

than twice the size of Japan’sthan twice the size of Japan’s As a % of GDP, U.S. ranks 21As a % of GDP, U.S. ranks 21stst among the among the

world’s 22 wealthiest nationsworld’s 22 wealthiest nations More money flows out of developing More money flows out of developing

countries in the form of interest payments, countries in the form of interest payments, profits of foreign corporations, and profits of foreign corporations, and clandestine investments in financial markets clandestine investments in financial markets of rich countries than flows into them as of rich countries than flows into them as loans, aid, and foreign direct investmentloans, aid, and foreign direct investment

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Foreign AidForeign Aid

U.S. Aid: Over 1/3 military, 1/4 U.S. Aid: Over 1/3 military, 1/4 economic, 1/3 for food and economic, 1/3 for food and developmentdevelopment

Most U.S. aid benefits U.S. Most U.S. aid benefits U.S. corporations, is spent on corporations, is spent on military, goes to Egypt, Israel, military, goes to Egypt, Israel, Turkey, Pakistan, and the Turkey, Pakistan, and the PhilippinesPhilippines

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Foreign AidForeign Aid

Aid agencies often forced to buy from Aid agencies often forced to buy from U.S. companies at inflated pricesU.S. companies at inflated prices 70% of aid effectively returned to 70% of aid effectively returned to

U.S.U.S. Food aid inefficient, benefits large Food aid inefficient, benefits large

agribusiness at expense of local agribusiness at expense of local farmers/economiesfarmers/economies Takes $2 taxpayer money to generate $1 Takes $2 taxpayer money to generate $1

in food aidin food aid

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Foreign AidForeign Aid

0.9% of the total federal budget, 0.9% of the total federal budget, 1.6% of the U.S. discretionary 1.6% of the U.S. discretionary budgetbudget

Yet 64% of Americans believed in Yet 64% of Americans believed in a 1997 poll that foreign aid was a 1997 poll that foreign aid was the largest federal expenditurethe largest federal expenditure

On average, Americans think that On average, Americans think that 24% of the federal budget goes 24% of the federal budget goes toward foreign aidtoward foreign aid

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U.S. Charitable GivingU.S. Charitable Giving

Approximately $250 Approximately $250 billion/yearbillion/year 2.5% of income2.5% of income2.9% at height of Great 2.9% at height of Great DepressionDepression

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U.S. Charitable GivingU.S. Charitable Givingby Income Bracketby Income Bracket

$15K and under: 26%$15K and under: 26% $15K - $30K: 9%$15K - $30K: 9% $30K - $50K: 5.3%$30K - $50K: 5.3% $50K - $100K: 3.8%$50K - $100K: 3.8% $100K - $200K: 3.0%$100K - $200K: 3.0% $200K and over: 3.4%$200K and over: 3.4%

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American Charitable American Charitable GivingGiving

Religious Groups: 35%Religious Groups: 35% Education: 13%Education: 13% Multipurpose Foundations: 10%Multipurpose Foundations: 10% Social Services: 8%Social Services: 8% Health: 8%Health: 8% Arts and Culture: 6%Arts and Culture: 6%

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American Charitable American Charitable GivingGiving

Science: 5%Science: 5% Environment and Animals: 3%Environment and Animals: 3% International Aid: 2%International Aid: 2% Other: 9%Other: 9%

- - Includes individual, corporate, foundation, and Includes individual, corporate, foundation, and bequest donationsbequest donations

Less than 10% goes to groups which Less than 10% goes to groups which directly help the poordirectly help the poor

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The Gates FoundationThe Gates Foundation

Endowment of approximately $35 Endowment of approximately $35 billion, with another $31 billion billion, with another $31 billion pledged by Buffett Foundationpledged by Buffett Foundation

Donates 5% of its worth/yr, invests Donates 5% of its worth/yr, invests 95% (typical for charities)95% (typical for charities)

Drives international public health Drives international public health agendaagenda

Most grants go to organizations in Most grants go to organizations in high-income countrieshigh-income countries

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The Gates FoundationThe Gates Foundation Lack of external oversight, accountabilityLack of external oversight, accountability At least 41% of its assets invested in At least 41% of its assets invested in

companies that counter the foundations companies that counter the foundations charitable goals or socially concerned charitable goals or socially concerned philosophyphilosophy E.g., Oil and chemical companies, E.g., Oil and chemical companies,

agrobusiness, pharmaceutical industryagrobusiness, pharmaceutical industry

Lancet 2009;373:1645-53Lancet 2009;373:1645-53 http://www.latimes.com/news/nationworld/nation/la-http://www.latimes.com/news/nationworld/nation/la-

na-gatesx07jan07,0,6827615.story na-gatesx07jan07,0,6827615.story 

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Distribution of federal income Distribution of federal income taxes - 2007taxes - 2007

Military: $558 billionMilitary: $558 billion Health: $428 billionHealth: $428 billion Interest on debt: $399 billionInterest on debt: $399 billion Income security: $124 billionIncome security: $124 billion Education: $93 billionEducation: $93 billion Veterans’ benefits and services: $69 Veterans’ benefits and services: $69

billionbillion

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Distribution of federal income Distribution of federal income taxes - 2007taxes - 2007

Nutrition: $54 billionNutrition: $54 billion Housing: $38 billionHousing: $38 billion Natural resources and the Natural resources and the

environment: $31 billionenvironment: $31 billion Job training: $6 billionJob training: $6 billion Other: $255 billionOther: $255 billion

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The Military and The Military and PollutionPollution

World’s single largest polluterWorld’s single largest polluter

6-10% of global air pollution6-10% of global air pollution

2-11% of world raw material 2-11% of world raw material useuse

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The Military and The Military and PollutionPollution

97% of all high level and 78% of all 97% of all high level and 78% of all low level nuclear wastelow level nuclear waste 1054 U.S. nuclear tests since 1940s, 1054 U.S. nuclear tests since 1940s,

331 in atmosphere331 in atmosphere 104 U.S. nuclear reactors104 U.S. nuclear reactors More than 210 million liters of More than 210 million liters of

radioactive and chemical waste radioactive and chemical waste stored at Hanford, WAstored at Hanford, WA Site plagued by leaksSite plagued by leaks

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The Military and The Military and PollutionPollution

Pentagon generates 750,000 Pentagon generates 750,000 tons hazardous waste/yeartons hazardous waste/year

Numerous toxic waste sitesNumerous toxic waste sites Exempt from most Exempt from most

environmental regulationsenvironmental regulations

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The Military and The Military and PollutionPollution

““The more birds that the [Department The more birds that the [Department of Defense] kill[s], the more enjoyment of Defense] kill[s], the more enjoyment [people] will get from seeing the ones [people] will get from seeing the ones that remain: ‘Bird watchers get more that remain: ‘Bird watchers get more enjoyment spotting a rare bird than enjoyment spotting a rare bird than they do spotting a common one.’”they do spotting a common one.’” From a 2002 court summary of the U.S. From a 2002 court summary of the U.S.

Defense Department’s argument for Defense Department’s argument for exemption from the Migratory Bird Treaty exemption from the Migratory Bird Treaty Act of 1918Act of 1918

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War and PeaceWar and Peace

World military budget = $1,232 billion in World military budget = $1,232 billion in 20062006 228X what the UN spent on 228X what the UN spent on

peacekeepingpeacekeeping US:US:

Largest military budget; largest arms Largest military budget; largest arms suppliersupplier $32 billion in arms sales in 2008, up from $32 billion in arms sales in 2008, up from

$12 billion in 2005$12 billion in 2005 Greatest debtor to peacekeeping fundGreatest debtor to peacekeeping fund

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The Military: Diversion of The Military: Diversion of Resources Away from Resources Away from

Health CareHealth Care 3 hours world arms spending = 3 hours world arms spending =

annual WHO budgetannual WHO budget 1/2 day of world arms spending = 1/2 day of world arms spending =

full childhood immunizations for all full childhood immunizations for all world’s childrenworld’s children

3 days of U.S. military spending = 3 days of U.S. military spending = amt. spent on health, education, and amt. spent on health, education, and welfare for U.S. children in 1 yearwelfare for U.S. children in 1 year

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The Military: Diversion of The Military: Diversion of Resources Away from Health Resources Away from Health

Care and Other Scientific Care and Other Scientific ProjectsProjects

3 weeks of world arms spending/yr. = 3 weeks of world arms spending/yr. = primary health care for all in poor countries, primary health care for all in poor countries, incl. safe water and full immunizationsincl. safe water and full immunizations

25% of the world’s 2.5 million research 25% of the world’s 2.5 million research scientists and engineers work entirely on scientists and engineers work entirely on military R and Dmilitary R and D Anthropologists co-opted under U.S. Army’s Anthropologists co-opted under U.S. Army’s

Human Terrain TeamHuman Terrain Team Iraq/Afghanistan war creating enormous U.S. Iraq/Afghanistan war creating enormous U.S.

debt / federal and state budgets strappeddebt / federal and state budgets strapped

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War Deaths, 1945-2000War Deaths, 1945-2000

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Arms ExportsArms Exports

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Arms ImportsArms Imports

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““Every gun that is made, every warship Every gun that is made, every warship launched, every rocket fired, signifies in launched, every rocket fired, signifies in the final sense a theft from those who the final sense a theft from those who hunger and are not fed, those who are hunger and are not fed, those who are cold and not clothed.”cold and not clothed.”

~ Dwight D. ~ Dwight D. EisenhowerEisenhower

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““The problem in defense spending is The problem in defense spending is to figure out how far you should go to figure out how far you should go without destroying from within without destroying from within what you are trying to defend from what you are trying to defend from without.”without.”

~Dwight D. Eisenhower~Dwight D. Eisenhower

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Poverty and HungerPoverty and Hunger

US: 13% of residents and 18% of children US: 13% of residents and 18% of children live in povertylive in poverty Rates of poverty in Blacks and Hispanics Rates of poverty in Blacks and Hispanics

= 2X Whites= 2X Whites 2009 federal poverty level = $10,830 2009 federal poverty level = $10,830

gross annual income (individual); gross annual income (individual); $22,050 for family of 4$22,050 for family of 4

Hunger rate increasing nationallyHunger rate increasing nationally Poverty associated with worse physical Poverty associated with worse physical

and mental healthand mental health

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Poverty, Health Insurance, Poverty, Health Insurance, and Food Insecurity in and Food Insecurity in

OregonOregon Poverty 12.9% (2007)Poverty 12.9% (2007) Between 2006 and 2007, 17.3% Between 2006 and 2007, 17.3%

lacked health insurance for a year lacked health insurance for a year or moreor more Including 103,000 childrenIncluding 103,000 children Cost of maintaining COBRA health Cost of maintaining COBRA health

insurance for a family consumes 84% of insurance for a family consumes 84% of worker’s unemployment benefitsworker’s unemployment benefits

Food insecurity 9.4% (2007)Food insecurity 9.4% (2007)

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PovertyPoverty

At least 1 billion people live in urban At least 1 billion people live in urban slumsslums

1.1 billion people lack access to safe, 1.1 billion people lack access to safe, clean drinking waterclean drinking water-1.8 million child deaths/year-1.8 million child deaths/year

2 billion have no electricity2 billion have no electricity 2.6 billion do not have adequate 2.6 billion do not have adequate

sanitation servicessanitation services

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PovertyPoverty

2.8 billion live on less than $2/day2.8 billion live on less than $2/day 3 billion have never made a phone call3 billion have never made a phone call 3.8 billion have no cash or credit with 3.8 billion have no cash or credit with

which to make purchaseswhich to make purchases 770 million unable to read770 million unable to read 2006: net transfer of capital of $784 2006: net transfer of capital of $784

billion from poorer countries to rich billion from poorer countries to rich onesones

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Human PovertyHuman Poverty

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PovertyPoverty

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Poverty, Hunger, and Poverty, Hunger, and MicronutrientsMicronutrients

Cost of providing vitamin A and zinc Cost of providing vitamin A and zinc supplements to malnourished infants and supplements to malnourished infants and toddlers under age 2 = $60 million/yeartoddlers under age 2 = $60 million/year Benefits (including prevention of blindness Benefits (including prevention of blindness

and malnutrition) > $1 billion/yrand malnutrition) > $1 billion/yr Cost of providing iron and iodized salt = Cost of providing iron and iodized salt =

$286 million/year$286 million/year Benefits (including prevention of iron-Benefits (including prevention of iron-

deficiency anemia, cretinism) = $2.7 billion/yrdeficiency anemia, cretinism) = $2.7 billion/yr

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Poverty and PrioritiesPoverty and Priorities

Amount of money needed each year Amount of money needed each year (in addition to current expenditures) (in addition to current expenditures) to provide water and sanitation for to provide water and sanitation for all people in developing nations = $9 all people in developing nations = $9 billionbillion

Amount of money spent annually on Amount of money spent annually on cosmetics in the U.S. = $8 billioncosmetics in the U.S. = $8 billion

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Poverty and PrioritiesPoverty and Priorities

Amount of money needed each year ( Amount of money needed each year ( in addition to current expenditures) in addition to current expenditures) to provide reproductive health care to provide reproductive health care for all women in developing for all women in developing countries = $12 billioncountries = $12 billion

Amount of money spent annually on Amount of money spent annually on perfumes in Europe and the U.S. = perfumes in Europe and the U.S. = $12 billion$12 billion

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Poverty and PrioritiesPoverty and Priorities

Americans bought Americans bought > $57 billion worth of > $57 billion worth of lottery tickets in 2008 (more money than is lottery tickets in 2008 (more money than is spent on movies, music, and books spent on movies, music, and books combined)combined)

In 2006, Americans spent $31 billion on toys In 2006, Americans spent $31 billion on toys and video gamesand video games Almost as much as the rest of the world Almost as much as the rest of the world

combinedcombined 80% of U.S. toys made in China80% of U.S. toys made in China

Consider alternate gifts, charitable donationsConsider alternate gifts, charitable donations

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Toy ExportsToy Exports

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Toy ImportsToy Imports

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U.N. Declaration of Human U.N. Declaration of Human RightsRights

““Everyone has the right to a Everyone has the right to a standard of living adequate standard of living adequate for the health and well-being for the health and well-being of himself and of his family, of himself and of his family, including food, clothing, including food, clothing, housing and medical care”housing and medical care”

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FamineFamine

1.5 billion not consuming enough 1.5 billion not consuming enough calories to prevent stunted calories to prevent stunted growth/other health risksgrowth/other health risks

Hunger kills 18,000 people per Hunger kills 18,000 people per day, most under age 5day, most under age 5

Hunger-related causes kill as Hunger-related causes kill as many people in 8 days as the many people in 8 days as the atomic bomb killed at Hiroshimaatomic bomb killed at Hiroshima

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FamineFamine

UN FAO: enough food produced UN FAO: enough food produced daily to provide every living person daily to provide every living person with over 2700 calories/daywith over 2700 calories/day Even so, half the world’s food is wasted Even so, half the world’s food is wasted

(UN FAO)(UN FAO)

Diversion of food crops to biofuels Diversion of food crops to biofuels contributing to rise in food pricescontributing to rise in food prices

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Monetization and Food Monetization and Food AidAid

US food aid purchased from US food aid purchased from already-subsidized US already-subsidized US agribusinessagribusiness

US shipping lines transport food US shipping lines transport food to aid organizations in to aid organizations in developing countriesdeveloping countries

Undermines local farmers and Undermines local farmers and destabilizes local agriculturedestabilizes local agriculture

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Monetization and Food Monetization and Food AidAid

EU has almost entirely phased EU has almost entirely phased out monetizationout monetization

UN World Food Programme (the UN World Food Programme (the world’s largest distributor of world’s largest distributor of food aid) has rejected food aid) has rejected monetization and refuses monetization and refuses monetized food aidmonetized food aid

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FamineFamine

Rich governments and corporations Rich governments and corporations buying up rights to millions of hectares buying up rights to millions of hectares of agricultural land in developing of agricultural land in developing countries in order to secure their own countries in order to secure their own long-term food supplieslong-term food supplies

One week of developed world farm One week of developed world farm subsidies = annual cost of food aid to subsidies = annual cost of food aid to solve world hungersolve world hunger

Hunger: solution requires political willHunger: solution requires political will

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Feast and FamineFeast and Famine

For the first time in history, For the first time in history, there are now an equal there are now an equal number of people – 1.1 billion number of people – 1.1 billion – who get too much to eat as – who get too much to eat as those who don’t have enough those who don’t have enough to eatto eat

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FamineFamine

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Famine Affects the Old and Famine Affects the Old and YoungYoung

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Medical CareMedical Care

50% of global health care budget spent 50% of global health care budget spent in the U.S.in the U.S.

Currently only 10% of funding devoted Currently only 10% of funding devoted to diseases affecting 90% of world’s to diseases affecting 90% of world’s populationpopulation

Per capita expenditure on health care:Per capita expenditure on health care: U.S. = $8,160U.S. = $8,160 Typical poor African/Asian country = Typical poor African/Asian country =

$5-10$5-10

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Medical CareMedical Care

Even so, U.S. has 46 million uninsured, Even so, U.S. has 46 million uninsured, ranks 24ranks 24thth worldwide in overall worldwide in overall population health as judged by disability-population health as judged by disability-adjusted life expectancy and ranks 42adjusted life expectancy and ranks 42ndnd in in global life expectancyglobal life expectancy Lack of universal health care limits Lack of universal health care limits

workforce mobilityworkforce mobility 2008 study: 7% say they or a family 2008 study: 7% say they or a family

member has married in order to get member has married in order to get health insurancehealth insurance

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Headline from Headline from The OnionThe Onion

Uninsured Man Hopes His Uninsured Man Hopes His Symptoms Diagnosed This Symptoms Diagnosed This

Week On Week On HouseHouse

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Infectious DiseasesInfectious Diseases

Increased morbidity and mortality Increased morbidity and mortality due todue tochanging distributions of disease changing distributions of disease vectors, reservoirs, and agentsvectors, reservoirs, and agents-overpopulation and population shifts-overpopulation and population shifts-malnutrition-malnutrition-drought-drought-decreased immunity-decreased immunity

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Infectious DiseasesInfectious Diseases MalariaMalaria

-61-6100 min zone expands min zone expands-50-80 million additional cases/year by 2100-50-80 million additional cases/year by 2100

TBTB Viral encephalitisViral encephalitis SchistosomiasisSchistosomiasis AIDSAIDS InfluenzaInfluenza TrypanosomiasisTrypanosomiasis

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Infectious DiseasesInfectious Diseases

Onchocerciasis Onchocerciasis DengreDengre LeishmanasisLeishmanasis RabiesRabies HookwormHookworm Yellow feverYellow fever West Nile VirusWest Nile Virus

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HIV/AIDSHIV/AIDS

2008: 33 million infected2008: 33 million infected 2007: 2 million deaths2007: 2 million deaths Sub-Saharan Africa hardest hitSub-Saharan Africa hardest hit Only 20% of HIV+ individuals in low Only 20% of HIV+ individuals in low

and middle-income countries know and middle-income countries know they are infectedthey are infected

Less than 1/3 of those needing Less than 1/3 of those needing therapy receive any medicationtherapy receive any medication

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HIV PrevalenceHIV Prevalence

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Malaria DeathsMalaria Deaths

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Species LossSpecies Loss

Earth contains an estimated 5 to 10 Earth contains an estimated 5 to 10 million speciesmillion speciesOnly 1.5 million have been Only 1.5 million have been identifiedidentified

Rate of extinction = 4,000-6,000 Rate of extinction = 4,000-6,000 species/year, highest estimates = 4 species/year, highest estimates = 4 species/hourspecies/hour- over 1000 x background rate of - over 1000 x background rate of extinctionextinction

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Species LossSpecies Loss 50,000 vertebrates50,000 vertebrates

- 7,100 of 10,000 bird species threatened - 7,100 of 10,000 bird species threatened with extinctionwith extinction- 1/4 of 4,400 mammalian species- 1/4 of 4,400 mammalian species- 1/2 of 232 primate species (including man?)- 1/2 of 232 primate species (including man?)

bush meat trade contributingbush meat trade contributing- 1/3 of 24,000 fish species- 1/3 of 24,000 fish species- 30-50% of 10,300 reptile and amphibian - 30-50% of 10,300 reptile and amphibian species (may be higher, limited assessment)species (may be higher, limited assessment)

Almost ¾ of flowering plants at risk of Almost ¾ of flowering plants at risk of extinctionextinction

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Precipitous Decline of Alpha Predators will Precipitous Decline of Alpha Predators will have enormous repercussions for have enormous repercussions for

ecosystems/other speciesecosystems/other species

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Species LossSpecies Loss

More than 1600 animals on ES list More than 1600 animals on ES list today – many more at risktoday – many more at risk 73% of plants and animals that have 73% of plants and animals that have

gone extinct since 1973 were not gone extinct since 1973 were not listedlisted

Yangtze River dolphins extinct as of Yangtze River dolphins extinct as of 20072007

Polar bears, Adelie penguins at risk of Polar bears, Adelie penguins at risk of extinction due to global warmingextinction due to global warming

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Causes of Species LossCauses of Species Loss

Habitat loss (logging, Habitat loss (logging, overpopulation, etc.) - #1 cause overpopulation, etc.) - #1 cause nownow

Global warming – est. #2 cause Global warming – est. #2 cause by 2050by 2050

OverhuntingOverhunting

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Causes of Species LossCauses of Species Loss

Chemical pollution of environmentChemical pollution of environment Exotic species invasions (e.g. Exotic species invasions (e.g.

rabbits/Australia; role of ballast rabbits/Australia; role of ballast water, link of shipping with GDP):water, link of shipping with GDP):Cost = $1.4 trillion/yr (5% of Cost = $1.4 trillion/yr (5% of global economy); $130 billion/yr global economy); $130 billion/yr in USin US

HUMANSHUMANS

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Extinction: Lost Extinction: Lost PharmacopoeiaPharmacopoeia

Drugs from plants and native peoples’ health Drugs from plants and native peoples’ health knowledge knowledge -More than 1/2 of the top 150 prescription -More than 1/2 of the top 150 prescription drugs contain an active compound derived from drugs contain an active compound derived from or patterned after natural productsor patterned after natural products-e.g. aspirin, acyclovir, lovastatin, digoxin, -e.g. aspirin, acyclovir, lovastatin, digoxin, vincristine, etoposide, captopril, cyclosporine, vincristine, etoposide, captopril, cyclosporine, sirolimus, vancomycin, paralytic agents, sirolimus, vancomycin, paralytic agents, warfarin, etc.warfarin, etc.

Of the more than 250,000 known flowering Of the more than 250,000 known flowering species, <0.5% have been surveyed for species, <0.5% have been surveyed for medicinal valuemedicinal value

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A Cure for Cancer?A Cure for Cancer?

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The Black Market in The Black Market in Endangered AnimalsEndangered Animals

$10 billion market$10 billion market-equal to smuggled arms market-equal to smuggled arms market-less than contraband drug market -less than contraband drug market ($30 Billion)($30 Billion)

Convention on International Trade Convention on International Trade in Endangered Species (CITES)in Endangered Species (CITES) Still allows more than 100 million Still allows more than 100 million

individuals of rare species to be bought individuals of rare species to be bought and sold each yearand sold each year

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Worrisome TrendsWorrisome Trends

Environmental Audit LawsEnvironmental Audit Laws Increased federal pre-Increased federal pre-

emption of state lawsemption of state laws WTO/World Bank/IMF WTO/World Bank/IMF

PoliciesPolicies MAIMAI

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Worrisome TrendsWorrisome Trends

GATT, NAFTA, CAFTA, other GATT, NAFTA, CAFTA, other trade agreementstrade agreements

Food Disparagement LawsFood Disparagement Laws SLAPP LawsuitsSLAPP Lawsuits Corruption of judiciary by Corruption of judiciary by

campaign contributionscampaign contributions86% of US judges are elected86% of US judges are elected

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Bush AdministrationBush Administration

Key administrators/committee Key administrators/committee members/regulators former members/regulators former industry representatives and/or industry representatives and/or lobbyistslobbyists

Corporate profit before public Corporate profit before public goodgood

Unsound/distorted/suppressed Unsound/distorted/suppressed sciencescience

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Bush AdministrationBush Administration

Eco-harassmentEco-harassment Criminalizing activistsCriminalizing activists

Rollbacks of key environmental lawsRollbacks of key environmental laws Lax enforcement of existing lawsLax enforcement of existing laws

OMB estimates annual benefits of major OMB estimates annual benefits of major federal regulations between 1996 and 2006 federal regulations between 1996 and 2006 = $99 billion - $484 billion, annual costs = = $99 billion - $484 billion, annual costs = $40 billion - $46 billion$40 billion - $46 billion

Huge tax cuts primarily benefit wealthyHuge tax cuts primarily benefit wealthy

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Obama AdministrationObama Administration

Change?Change?

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Status of Women in Status of Women in the Third Worldthe Third World

PovertyPovertyImpaired access to Impaired access to

employment and educationemployment and educationLack of reproductive health Lack of reproductive health

services, early childbearing, services, early childbearing, large familieslarge families

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Status of Women in Status of Women in the Third Worldthe Third World

Political marginalizationPolitical marginalization Discriminatory and “cultural Discriminatory and “cultural

practices”practices” -forced prostitution, female -forced prostitution, female genital mutilation, etc.genital mutilation, etc.

Trafficking, sex slaveryTrafficking, sex slavery

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Status of WomenStatus of Women

Economic discriminationEconomic discrimination women do 67% of the world’s workwomen do 67% of the world’s work receive 10% of global incomereceive 10% of global income own 1% of all propertyown 1% of all property

PovertyPoverty Women make up 45% of the global Women make up 45% of the global

employed workforce, yet are 70% of the employed workforce, yet are 70% of the world’s poorworld’s poor

Page 337: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Would You Sign a Would You Sign a Petition to Ban Petition to Ban

Dihydrogen Monoxide?Dihydrogen Monoxide?

1. It can cause excessive sweating and vomiting1. It can cause excessive sweating and vomiting

2. It is a major component in acid rain2. It is a major component in acid rain

3. It can cause severe burns in its gaseous state3. It can cause severe burns in its gaseous state

4. It can kill you if accidentally inhaled4. It can kill you if accidentally inhaled

5. It contributes to erosion5. It contributes to erosion

6. It decreases effectiveness of automobile brakes6. It decreases effectiveness of automobile brakes

7. It has been found in tumors of terminal cancer 7. It has been found in tumors of terminal cancer

patients patients

Page 338: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Geographic IgnoranceGeographic Ignorance

Percent of US teens unable to locate Percent of US teens unable to locate the following on a map:the following on a map: United States – 11%United States – 11% Pacific Ocean – 29%Pacific Ocean – 29% Japan – 58%Japan – 58% United Kingdom – 68%United Kingdom – 68%

Page 339: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Pseudoscientific BeliefsPseudoscientific Beliefs

Percentage of Americans who believe Percentage of Americans who believe “at least to some degree” in these “at least to some degree” in these “phenomena”“phenomena”

19971997 19761976 AstrologyAstrology 37%37% 17%17% UFOsUFOs 30%30% 24%24% ReincarnationReincarnation 25%25%

9%9% Fortune-TellingFortune-Telling 14%14% 4%4%

Page 340: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Pseudoscientific BeliefsPseudoscientific Beliefs

Half of US citizens do not believe in Half of US citizens do not believe in evolution and do believe that humans evolution and do believe that humans and dinosaurs coexisted (2007)and dinosaurs coexisted (2007)

37% believe places can be haunted 37% believe places can be haunted (2007)(2007)

25% believe in UFOs (2007)25% believe in UFOs (2007) 22% of Americans don’t know whether 22% of Americans don’t know whether

an atomic bomb has ever been dropped an atomic bomb has ever been dropped (2000)(2000)

Page 341: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Pseudoscientific BeliefsPseudoscientific Beliefs

20% of Americans don’t know the 20% of Americans don’t know the earth revolves around the sun (1999)earth revolves around the sun (1999)

18% believe in Bigfoot and the Loch 18% believe in Bigfoot and the Loch Ness Monster (2007)Ness Monster (2007)

8% of men / 18% of women believe 8% of men / 18% of women believe in astrology and fortune tellers in astrology and fortune tellers (2007)(2007)

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Page 343: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

GreenwashGreenwash

Public relations / ad campaignsPublic relations / ad campaigns-Chevron’s “People Do” Campaign, -Chevron’s “People Do” Campaign, butterflies/refinerybutterflies/refinery-BP invests $100 million annually in clean -BP invests $100 million annually in clean energy = amt. it spends annually to market its energy = amt. it spends annually to market its new name and environmentally-friendly image new name and environmentally-friendly image of moving “Beyond Petroleum”of moving “Beyond Petroleum”-Dupont Freon Campaign in 1970’s-Dupont Freon Campaign in 1970’s-Grants to a few scientists who challenge -Grants to a few scientists who challenge environmental warningsenvironmental warnings-tobacco ads in 1950’s-tobacco ads in 1950’s

Bluewash: association with UN principles/logoBluewash: association with UN principles/logo

Page 344: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

AstroturfAstroturf

Artificially-created grassroots Artificially-created grassroots coalitionscoalitionsUtilize specially tailored mailing Utilize specially tailored mailing

lists, field officers, telephone lists, field officers, telephone banks, fax machines, intense banks, fax machines, intense lobbyinglobbying

May be one or two individuals, or May be one or two individuals, or run by a PR firm, or have run by a PR firm, or have “volunteer” employee members“volunteer” employee members

Page 345: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Corporate Front GroupsCorporate Front Groups The American Council on Science and HealthThe American Council on Science and Health The Alliance for Responsible CFC Policy The Alliance for Responsible CFC Policy The Oregon Lands CoalitionThe Oregon Lands Coalition National Wilderness InstituteNational Wilderness Institute The Environmental Conservation The Environmental Conservation

OrganizationOrganization The Foundation for Clean Air ProgressThe Foundation for Clean Air Progress

Similar semantics for new Similar semantics for new laws/congressional billslaws/congressional bills

Page 346: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Corporate PR tacticsCorporate PR tactics

Invoke poor people as beneficiariesInvoke poor people as beneficiaries Characterize opposition as Characterize opposition as

“technophobic,” anti-science,” and “technophobic,” anti-science,” and “against progress”“against progress”

Portray their products as Portray their products as environmentally beneficial in the environmentally beneficial in the absence of (or despite the) absence of (or despite the) evidenceevidence

Page 347: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Chief SeattleChief Seattle

““You must teach your children that the You must teach your children that the ground beneath their feet is the ashes of ground beneath their feet is the ashes of your grandfathers. So that they will your grandfathers. So that they will respect the land, tell your children that respect the land, tell your children that the earth is rich with the lives of our kin. the earth is rich with the lives of our kin. Teach your children what we have taught Teach your children what we have taught our children, that the earth is our mother. our children, that the earth is our mother. Whatever befalls the earth befalls the Whatever befalls the earth befalls the sons of the earth. If men spit upon the sons of the earth. If men spit upon the ground, they spit upon themselves.”ground, they spit upon themselves.”

Page 348: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Sponsored Environmental Sponsored Environmental Educational MaterialsEducational Materials

Corporate-sponsored Corporate-sponsored and supported by a and supported by a loose coalition of loose coalition of antiregulatory zealots, antiregulatory zealots, corporate polluters, corporate polluters, lapdog scientists and lapdog scientists and misguided parentsmisguided parents

Page 349: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Sponsored Environmental Sponsored Environmental Education Materials Education Materials

(Examples)(Examples)

Exxon’s “Energy Cube”Exxon’s “Energy Cube”

-“Gasoline is simply solar power hidden -“Gasoline is simply solar power hidden in decayed matter”in decayed matter”

-“Offshore drilling creates reefs for fish”-“Offshore drilling creates reefs for fish”

Pacific Lumber CompanyPacific Lumber Company

-“The Great American Forest is. . . -“The Great American Forest is. . . renewable forever”renewable forever”

Page 350: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Sponsored Environmental Sponsored Environmental Education Materials Education Materials

(Examples)(Examples) International PaperInternational Paper

-“Clearcutting promotes growth of -“Clearcutting promotes growth of trees that require full sunlight and trees that require full sunlight and allows efficient site preparation for allows efficient site preparation for the next crop”the next crop”

American Nuclear Society’s American Nuclear Society’s “Activities with the Atoms Family”“Activities with the Atoms Family”

Dow’s “Chemipalooza”Dow’s “Chemipalooza”

Page 351: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Worrisome TrendsWorrisome Trends

Advertising Budgets ↑↑Advertising Budgets ↑↑ US now spends $250 billion/yr on US now spends $250 billion/yr on

advertisingadvertising 10% of a two-year olds nouns are 10% of a two-year olds nouns are

brand namesbrand names Public Education in disarrayPublic Education in disarray

1/3 of America’s 80,000 schools need 1/3 of America’s 80,000 schools need extensive repair or replacementextensive repair or replacement

Page 352: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Worrisome TrendsWorrisome Trends

TelevisionTelevisionAverage American watches Average American watches

over 4 hours of TV dailyover 4 hours of TV dailyTV sets now outnumber homes TV sets now outnumber homes

in Americain America Higher Education Higher Education

increasingly expensiveincreasingly expensive

Page 353: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P
Page 354: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Academics at RiskAcademics at Risk Increasing corporatization of academiaIncreasing corporatization of academia

Private commercial funding of university Private commercial funding of university research:research:$264 million in 1980$264 million in 1980$2 billion in 2001$2 billion in 2001

Secrecy/PseudoscienceSecrecy/Pseudoscience AAPG Notable Achievement in AAPG Notable Achievement in

Journalism prize to Michael Crichton for Journalism prize to Michael Crichton for State of FearState of Fear (which denies global (which denies global warming)warming)

Subversion of science by Bush Subversion of science by Bush AdministrationAdministration

Page 355: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Academics at RiskAcademics at Risk Contingent faculty up from 43% (1079) Contingent faculty up from 43% (1079)

to 73% todayto 73% today Paid ¼ amount of regular facultyPaid ¼ amount of regular faculty No benefitsNo benefits No job security, opportunities for career No job security, opportunities for career

advancementadvancement Tuition up, administrators’ salaries Tuition up, administrators’ salaries

skyrocketingskyrocketing Brain drainBrain drain Lack of scientists in developing world Lack of scientists in developing world

(1/50(1/50thth of developed world per capita) of developed world per capita)

Page 356: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The MediaThe Media

Most media organizations owned by Most media organizations owned by multinational, multi-billion dollar multinational, multi-billion dollar corporations that are involved in a corporations that are involved in a number of businesses apart from the number of businesses apart from the media, such as forestry, pulp and media, such as forestry, pulp and paper mills, defense, real estate, oil paper mills, defense, real estate, oil wells, agriculture, steel production, wells, agriculture, steel production, railways, and water and power railways, and water and power utilitiesutilities

Page 357: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Global Warming: Global Warming: Controversial?Controversial?

Of 928 articles in peer-reviewed scientific Of 928 articles in peer-reviewed scientific journals, 0% were in doubt as to the journals, 0% were in doubt as to the existence or cause of global warmingexistence or cause of global warming

Of 636 articles in the popular press (NY Of 636 articles in the popular press (NY Times, Washington Post, LA Times, WSJ), Times, Washington Post, LA Times, WSJ), 53% expressed doubt as to the existence 53% expressed doubt as to the existence (and primary cause) of global warming(and primary cause) of global warming

Science 2004;306:1686-7Science 2004;306:1686-7

(Study covers 1993-2003)(Study covers 1993-2003) IPCC / Al Gore share 2007 Nobel Peace IPCC / Al Gore share 2007 Nobel Peace

PrizePrize

Page 358: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The MediaThe Media

5 corporations control majority of US 5 corporations control majority of US media (down from 50 in 1983)media (down from 50 in 1983)

Mass Media Sources, 2002:Mass Media Sources, 2002: 92% white92% white 85% male85% male Where party affiliation identifiable, Where party affiliation identifiable,

75% Republican75% Republican Predominantly conservative/centristPredominantly conservative/centrist

Page 359: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

LobbyingLobbying

Over 15,000 full-time lobbyistsOver 15,000 full-time lobbyists Estimates of return on lobbying Estimates of return on lobbying

range from $28 to $100 for every range from $28 to $100 for every $1 spent$1 spent

Pharmaceutical lobby spent $1.3 Pharmaceutical lobby spent $1.3 billion on lobbying between 1998 billion on lobbying between 1998 and 2007and 2007 More than any other industryMore than any other industry

Page 360: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

LobbyingLobbying

Lobbying groups spent just under 2.5 Lobbying groups spent just under 2.5 billion in 2006 (record)billion in 2006 (record)

Financial sector spent over $1.7 billion on Financial sector spent over $1.7 billion on campaign contributions for federal campaign contributions for federal elections from 1998-2008elections from 1998-2008

All single issue ideological groups All single issue ideological groups combined (e.g., pro-choice, anti-abortion, combined (e.g., pro-choice, anti-abortion, feminist and consumer organizations, feminist and consumer organizations, senior citizens, etc.) = $76.2 millionsenior citizens, etc.) = $76.2 million

Page 361: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

LobbyingLobbying

Agribusiness/oil industry Agribusiness/oil industry lobbying dwarf environmental lobbying dwarf environmental lobbyinglobbying

Active lobbying (new laws, not Active lobbying (new laws, not enforce existing laws or fund enforce existing laws or fund existing programs)existing programs)

““Lobbying for lethargy” Lobbying for lethargy” (maintain status quo)(maintain status quo)

Page 362: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Corporate Influence Leads to Corporate Influence Leads to Large Taxpayer Subsidies to Large Taxpayer Subsidies to

Polluting IndustriesPolluting Industries Mining - $3.6 billion/yrMining - $3.6 billion/yr Nuclear power - $10.5 billion/yrNuclear power - $10.5 billion/yr Coal - $8 billion/yrCoal - $8 billion/yr Ranching (grazing on public lands) - $52 Ranching (grazing on public lands) - $52

million/yrmillion/yr Timber (below cost sales of national forest Timber (below cost sales of national forest

trees) – approx. $350 million/yrtrees) – approx. $350 million/yr Oil and gas - $550 million/yrOil and gas - $550 million/yr

Page 363: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Privatization of Public Privatization of Public ServicesServices

RoadsRoads Public schoolsPublic schools Child support enforcementChild support enforcement MilitaryMilitary OthersOthers

Iraqi reconstruction, disaster Iraqi reconstruction, disaster capitalismcapitalism

Page 364: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The Decline of The Decline of DemocracyDemocracy

True democracy demands an True democracy demands an informed citizenry (education), informed citizenry (education), freedom of the press (media), freedom of the press (media), and involvement (will, time, and involvement (will, time, money)money)

““Information is the currency of Information is the currency of democracy”democracy” Thomas JeffersonThomas Jefferson

Page 365: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Colonial ExploitationColonial Exploitation

Cecil Rhodes (Rhodesia, Rhodes Cecil Rhodes (Rhodesia, Rhodes Scholarship, DeBeers Mining Company):Scholarship, DeBeers Mining Company):

““We must find new lands from which we We must find new lands from which we can easily obtain raw materials and at can easily obtain raw materials and at the same time exploit the cheap slave the same time exploit the cheap slave labour that is available from the natives labour that is available from the natives of the colonies. The colonies would also of the colonies. The colonies would also provide a dumping ground for the provide a dumping ground for the surplus goods produced in our factories.”surplus goods produced in our factories.”

Page 366: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Colonial ExploitationColonial Exploitation

Winston Churchill (speaking in Winston Churchill (speaking in favor of RAF’s “experimental” favor of RAF’s “experimental” bombing of Iraqis in 1920s, which bombing of Iraqis in 1920s, which killed 9,000 people with 97 tons of killed 9,000 people with 97 tons of bombs):bombs):““I am strongly in favor of using I am strongly in favor of using poisoned gas against uncivilized poisoned gas against uncivilized tribes to spread a lively terror…tribes to spread a lively terror…against recalcitrant Arabs as an against recalcitrant Arabs as an experiment”experiment”

Page 367: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Colonial ExploitationColonial Exploitation

Christopher Columbus’ log entry upon Christopher Columbus’ log entry upon meeting the Arawaks of the Bahamas:meeting the Arawaks of the Bahamas:

““They…brought us…many…things…They…brought us…many…things…They willingly traded everything they They willingly traded everything they owned…They do not bear arms…They owned…They do not bear arms…They would make fine servants…With fifty would make fine servants…With fifty men we could subjugate them all and men we could subjugate them all and make them do whatever we want.”make them do whatever we want.”

Page 368: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The US: Rogue NationThe US: Rogue Nation

History: Native Americans, slavery, History: Native Americans, slavery, current excesses, disparities and current excesses, disparities and injusticesinjustices

Co-opting Nazi and Japanese WWII Co-opting Nazi and Japanese WWII scientistsscientists

Minimum 277 troop deployments by Minimum 277 troop deployments by the US in its 225+ year historythe US in its 225+ year history

Page 369: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The US: Rogue NationThe US: Rogue Nation

Since the end of WWII, the US has Since the end of WWII, the US has bombed:bombed: China, Korea, Indonesia, Cuba, China, Korea, Indonesia, Cuba,

Guatemala, Congo, Peru, Vietnam, Guatemala, Congo, Peru, Vietnam, Laos, Cambodia, Nicaragua, El Laos, Cambodia, Nicaragua, El Salvador, Grenada, Libya, Panama, Salvador, Grenada, Libya, Panama, Afghanistan, Sudan, Yugoslavia, Afghanistan, Sudan, Yugoslavia, and Iraqand Iraq

Page 370: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The US: Rogue NationThe US: Rogue Nation

Conservative estimate = 8 Conservative estimate = 8 million killedmillion killed

US invasions/bombings often US invasions/bombings often largely at behest of corporate largely at behest of corporate interestsinterests

European colonial history European colonial history similarsimilar

Page 371: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The US: Rogue NationThe US: Rogue Nation

The US spends vastly more on The US spends vastly more on militarization than on peacemakingmilitarization than on peacemaking

The US maintains military bases in The US maintains military bases in 69 “sovereign” nations around the 69 “sovereign” nations around the worldworld

Continued funding of the Western Continued funding of the Western Hemisphere Institute for Security Hemisphere Institute for Security CooperationCooperation

Page 372: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

International Non-International Non-Cooperation/IsolationismCooperation/Isolationism

Failure to sign or approve:Failure to sign or approve: Kyoto Protocol on Climate ChangeKyoto Protocol on Climate Change International Covenant on International Covenant on

Economic, Social, and Cultural Economic, Social, and Cultural RightsRights

Convention on the Prohibition of Convention on the Prohibition of Anti-Personnel Land MinesAnti-Personnel Land Mines

Treaty to ban cluster bombsTreaty to ban cluster bombs

Page 373: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

International Non-International Non-Cooperation/IsolationismCooperation/Isolationism

Failure to sign or approve:Failure to sign or approve: Comprehensive Nuclear Test Ban Comprehensive Nuclear Test Ban

TreatyTreaty Convention on the Rights of the Convention on the Rights of the

ChildChild Convention on the Elimination of Convention on the Elimination of

Discrimination Against WomenDiscrimination Against Women Convention for the Suppression of Convention for the Suppression of

Traffic in PersonsTraffic in Persons

Page 374: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

International Non-International Non-Cooperation/IsolationismCooperation/Isolationism

Failure to sign or approve:Failure to sign or approve: Protocol 1, Article 55 of the Protocol 1, Article 55 of the

Geneva Conventions, which bans Geneva Conventions, which bans methods or means of warfare methods or means of warfare which are intended, or may be which are intended, or may be expected, to cause widespread, expected, to cause widespread, long-term and severe damage to long-term and severe damage to the natural environmentthe natural environment

Page 375: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

International Non-International Non-Cooperation/IsolationismCooperation/Isolationism

Failure to sign or approveFailure to sign or approve The Stockholm Convention on The Stockholm Convention on

Persistent Organic PollutantsPersistent Organic Pollutants The Basel Convention on the The Basel Convention on the

Control of Transboundary Control of Transboundary Movements of Hazardous WastesMovements of Hazardous Wastes

The Cartagena Protocol on The Cartagena Protocol on Biosafety (re GM foods)Biosafety (re GM foods)

Page 376: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The US: Rogue NationThe US: Rogue Nation

Death Penalty:Death Penalty: US executes more of its citizens than US executes more of its citizens than

any other countryany other country US is the only country to execute both US is the only country to execute both

juveniles and the mentally illjuveniles and the mentally ill Failure to follow World Court Failure to follow World Court

DecisionsDecisions Largest debtor to the UN (only 40% Largest debtor to the UN (only 40%

of dues paid)of dues paid)

Page 377: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The US: Rogue NationThe US: Rogue Nation

Patriot Act, government Patriot Act, government spying, revocation of habeas spying, revocation of habeas corpus, presidential signing corpus, presidential signing statementsstatements

Cited by Human Rights Cited by Human Rights Watch, Amnesty International Watch, Amnesty International for Human Rights Violationsfor Human Rights Violations

Page 378: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Positive TrendsPositive Trends

Majority of U.S. citizens rate the Majority of U.S. citizens rate the environment as one of the most environment as one of the most important issues facing the country, important issues facing the country, think the government is doing too little think the government is doing too little to safeguard the environment, and favor to safeguard the environment, and favor environmental protection over economic environmental protection over economic expansionexpansion

Power/voice of green groups increasingPower/voice of green groups increasing Involvement of religious groups growingInvolvement of religious groups growing

Page 379: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Positive TrendsPositive Trends

Insurance industry urging Insurance industry urging reductions in global reductions in global emissionsemissionsdue to dramatic increase in due to dramatic increase in weather-related claimsweather-related claims

Analogy with smokingAnalogy with smoking

Page 380: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The “Benefits” of Sterility-The “Benefits” of Sterility-Causing Chemicals in the Causing Chemicals in the

Workplace?Workplace? 12 September 197712 September 1977

Dr. Eula Bingham, Assistant Secretary for Occupational Safety Dr. Eula Bingham, Assistant Secretary for Occupational Safety and Healthand Health

[Regarding] worker exposure to DBCP.[Regarding] worker exposure to DBCP.While involuntary sterility caused by a manufactured While involuntary sterility caused by a manufactured

chemical may be bad, it is not necessarily so. After all, there are chemical may be bad, it is not necessarily so. After all, there are many people who are now paying to have themselves sterilized to many people who are now paying to have themselves sterilized to assure they will no longer be able to become parents... assure they will no longer be able to become parents...

If possible sterility is the main problem, couldn’t workers If possible sterility is the main problem, couldn’t workers who were old enough that they no longer wanted to have children who were old enough that they no longer wanted to have children accept such positions voluntarily? Or…some [workers] might accept such positions voluntarily? Or…some [workers] might volunteer for such workposts as an alternative to planned volunteer for such workposts as an alternative to planned surgery for a vasectomy or tubal ligation, or as a means of surgery for a vasectomy or tubal ligation, or as a means of getting around religious bans on birth control when they want no getting around religious bans on birth control when they want no more children?more children?

Sincerely, Sincerely,

Robert K. Phillips, National Peach Council Robert K. Phillips, National Peach Council

Page 381: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Environmental Success Environmental Success StoryStory

The Montreal Protocol The Montreal Protocol (1987)(1987) Phaseout of chlorofluorocarbons (CFCs) Phaseout of chlorofluorocarbons (CFCs)

by 1996by 1996 CFC MDIs phased out in US by 2008 CFC MDIs phased out in US by 2008

(tetrafluoroethane or HFA = substitute)(tetrafluoroethane or HFA = substitute) Major cause of Antarctic and Arctic Major cause of Antarctic and Arctic

ozone holesozone holes Should disappear by 2060Should disappear by 2060

Current substitute, HCFCs, much less Current substitute, HCFCs, much less damaging to ozone layer, also to be damaging to ozone layer, also to be phased outphased out

Page 382: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

REACHREACH

Registration, Evaluation, and Registration, Evaluation, and Authorization of ChemicalsAuthorization of Chemicals

European Treaty requiring European Treaty requiring companies to test chemicals already companies to test chemicals already on the market by a set timetable and on the market by a set timetable and test new products before putting test new products before putting them on the marketthem on the market

Page 383: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

REACHREACH

Cost of evaluations Cost of evaluations < 1% of chemical < 1% of chemical industry’s total salesindustry’s total sales

Economic analyses show REACH Economic analyses show REACH could bring environmental benefits could bring environmental benefits worth worth €95 billion over the next 25 €95 billion over the next 25 years and result in health cost years and result in health cost savings of €50 billion over the next savings of €50 billion over the next 30 years30 years

Page 384: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutionsBased on the Precautionary Based on the Precautionary

PrinciplePrinciple““When evidence points toward the When evidence points toward the potential of an activity to cause potential of an activity to cause significant, widespread or significant, widespread or irreparable harm to public health or irreparable harm to public health or the environment, options for the environment, options for avoiding that harm should be avoiding that harm should be examined and pursued, even though examined and pursued, even though the harm is not yet fully understood the harm is not yet fully understood or proven”or proven”

Page 385: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The Precautionary The Precautionary Principle:Principle:

Practical EssentialsPractical Essentials Give human and environmental Give human and environmental

health the benefit of doubthealth the benefit of doubt Include appropriate public Include appropriate public

participation in the discussionparticipation in the discussion Gather unbiased, scientific, Gather unbiased, scientific,

technological and socioeconomic technological and socioeconomic informationinformation

Consider less risky alternativesConsider less risky alternatives

Page 386: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The Precautionary The Precautionary PrinciplePrinciple

Endorsed by APHA, ANA, CMA, Endorsed by APHA, ANA, CMA, othersothers

Puerto Rico, San Francisco have Puerto Rico, San Francisco have adopted, among othersadopted, among others

Big business, US Chamber of Big business, US Chamber of Commerce opposeCommerce oppose

Page 387: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutionsShift from a throw-away Shift from a throw-away

economy to a economy to a reduce/reuse/recycle economyreduce/reuse/recycle economy

Support local economiesSupport local economiesRebuild decaying Rebuild decaying

infrastructureinfrastructureEnhance fair trade policiesEnhance fair trade policies

Page 388: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Recognize nature’s net worthRecognize nature’s net worth Calculate economic Calculate economic

prosperity based on Genuine prosperity based on Genuine Progress Index or Global Progress Index or Global Happiness Index, rather than Happiness Index, rather than Gross Domestic ProductGross Domestic Product

Page 389: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Decrease energy consumptionDecrease energy consumption Zero waste production systemsZero waste production systems Extended producer responsibility Extended producer responsibility

/ Extended product liability/ Extended product liability Production-side Production-side

environmentalism (reducing environmentalism (reducing “planned obsolescence”)“planned obsolescence”)

Recycling lawsRecycling laws

Page 390: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Restructure tax systemRestructure tax system-decrease taxes on work and -decrease taxes on work and savingssavings-increase taxes on destructive -increase taxes on destructive activities (e.g., carbon emissions, activities (e.g., carbon emissions, toxic waste generation)toxic waste generation)

Stronger clean air and water Stronger clean air and water standardsstandards

Page 391: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Drink tap waterDrink tap water Incredibly cheap and, in the US, almost Incredibly cheap and, in the US, almost

always safealways safe Exceptions include private well Exceptions include private well

water, from which 15% of Americans water, from which 15% of Americans get their drinking waterget their drinking water

Not regulated by Safe Drinking Not regulated by Safe Drinking Water ActWater Act

40% contaminated to some degree 40% contaminated to some degree with arsenic, radon, nitrateswith arsenic, radon, nitrates

Page 392: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Eat less meatEat less meat It takes 12 lbs of grain and It takes 12 lbs of grain and

2500 gallons of water to 2500 gallons of water to produce one lb of hamburgerproduce one lb of hamburger

Eliminate fossil fuel industry Eliminate fossil fuel industry tax breaks and subsidiestax breaks and subsidies

Page 393: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

CarpoolingCarpooling

Keep car longerKeep car longer> ½ of energy consumption > ½ of energy consumption attributable to vehicles attributable to vehicles occurs during occurs during manufacturingmanufacturing

Page 394: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions Sweden plans to be world’s first oil-free Sweden plans to be world’s first oil-free

economy by 2020economy by 2020 EU to cut CO2 emissions 20% by 2020EU to cut CO2 emissions 20% by 2020

UK committed to 80% reduction by 2050UK committed to 80% reduction by 2050 California mandates 25% cut in global California mandates 25% cut in global

warming gasses by 2020warming gasses by 2020 EPA to regulate carbon emissions under EPA to regulate carbon emissions under

Clean Air Act (2009)Clean Air Act (2009) Climate Security Act: weaknesses include Climate Security Act: weaknesses include

unfair “cap and trade” provisions, carbon unfair “cap and trade” provisions, carbon capture and storage (CCS)capture and storage (CCS)

Page 395: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Solutions Solutions Solar and wind power; appropriate Solar and wind power; appropriate

biofuels (i.e., cellulosic ethanol, biofuels (i.e., cellulosic ethanol, algal bio-diesel; not food crops), algal bio-diesel; not food crops), not CCS (carbon capture and not CCS (carbon capture and storage) or nuclearstorage) or nuclearCCS raises specter of Lake Chad CCS raises specter of Lake Chad and Lake Monoun disastersand Lake Monoun disasters

Page 396: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Increase tax breaks, subsidies, Increase tax breaks, subsidies, research for renewable energyresearch for renewable energyRenewable energy now 1% of Renewable energy now 1% of transportation fuel market transportation fuel market (ethanol) and 2% of the electricity (ethanol) and 2% of the electricity market (wind, solar, biomass)market (wind, solar, biomass)

Page 397: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Streamline EPAStreamline EPA-25% of 14 billion superfund -25% of 14 billion superfund payouts have gone to lawyers and payouts have gone to lawyers and consultantsconsultants

Composting / Recycling organic Composting / Recycling organic wasteswastes

Safe disposal of pharmaceuticalsSafe disposal of pharmaceuticals Shift medical research agendaShift medical research agenda

Page 398: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Decrease light pollution ($2 billion energy Decrease light pollution ($2 billion energy wasted per year) and see the stars!wasted per year) and see the stars! 2/3 of US population and over ½ of EU 2/3 of US population and over ½ of EU

population can’t see Milky Waypopulation can’t see Milky Way

-Czechoslovakian anti-light pollution law-Czechoslovakian anti-light pollution law InsulationInsulation Energy-efficient lightingEnergy-efficient lighting

Australia mandates use of compact Australia mandates use of compact fluorescent lightbulbs by 2012fluorescent lightbulbs by 2012

Page 399: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions Decrease excessive packagingDecrease excessive packaging

1515¢/plastic bag tax in Ireland ↓’d ¢/plastic bag tax in Ireland ↓’d use by 90%use by 90%

San Francisco has outlawed plastic San Francisco has outlawed plastic bagsbags

Canada, China, and 4 other Canada, China, and 4 other countries have bannedcountries have banned

Safe storage of nuclear wastesSafe storage of nuclear wastes Green electricity - $3/monthGreen electricity - $3/month

Page 400: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Sustainable forest managementSustainable forest management Plant treesPlant trees

The average urban tree removes The average urban tree removes nearly one ton of greenhouse gas nearly one ton of greenhouse gas during its first 40 years of lifeduring its first 40 years of life

Stop receiving cataloguesStop receiving cataloguescontact Direct Marketing contact Direct Marketing

AssociationAssociation

Page 401: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Prevent Congress from weakening NEPA Prevent Congress from weakening NEPA (National Environmental Policy Act)(National Environmental Policy Act) Requires federal officials to conduct Requires federal officials to conduct

environmental impact assessments; allows environmental impact assessments; allows citizens to challenge the government’s citizens to challenge the government’s conclusionsconclusions

Oppose Congressional attempts to create Oppose Congressional attempts to create “Sunset Commissions” with the power to “Sunset Commissions” with the power to review federal programs and recommend review federal programs and recommend which programs live, die, or get realignedwhich programs live, die, or get realigned

Page 402: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Punish environmental scofflaws with large Punish environmental scofflaws with large fines and jail timefines and jail time

Increase enforcement budgets to combat Increase enforcement budgets to combat international environmental crimeinternational environmental crime

Establish International Court of the Establish International Court of the EnvironmentEnvironment

Alien Tort Claims Act designed to hold Alien Tort Claims Act designed to hold corporations accountable for human corporations accountable for human rights abuses overseasrights abuses overseas

Page 403: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

BioprospectingBioprospecting

EcotourismEcotourism

Rewilding (Contemporary vs. Rewilding (Contemporary vs. Pleistocene)Pleistocene)

Page 404: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

More equitable distribution of medical More equitable distribution of medical research funds and health care dollarsresearch funds and health care dollars WorldwideWorldwide In U.S.In U.S.

Every $1 invested in community-Every $1 invested in community-based programs to increase based programs to increase physical activity, improve nutrition, physical activity, improve nutrition, and prevent tobacco use saves and prevent tobacco use saves $5.60 in health care costs$5.60 in health care costs

Page 405: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Federal Research Public Access Federal Research Public Access ActAct Would require federal agencies Would require federal agencies

that fund over $100 million in that fund over $100 million in external research/yr to make their external research/yr to make their study results publicly available on-study results publicly available on-lineline

Currently before CongressCurrently before Congress

Page 406: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Strengthen family planning Strengthen family planning programsprograms

Decrease “demand” for large Decrease “demand” for large familiesfamilies educationeducation status of womenstatus of women child mortalitychild mortality

Page 407: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Solutions: Fair, Solutions: Fair, Representative ElectionsRepresentative Elections

Publicly financed campaigns and Publicly financed campaigns and campaign finance reformcampaign finance reform

Open debates, free air time for Open debates, free air time for candidatescandidates

Proportional representationProportional representation Instant runoff voting/cumulative Instant runoff voting/cumulative

voting/range (rating) votingvoting/range (rating) voting

Page 408: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Solutions:Solutions:Living WageLiving Wage

Over 140 municipalities have Over 140 municipalities have adopted living wage lawsadopted living wage laws Including NY, LA, Chicago, and Including NY, LA, Chicago, and

PhiladelphiaPhiladelphia 15 states now have minimum 15 states now have minimum

wages that exceed the federal wages that exceed the federal requirementrequirement

Page 409: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Join and contribute to Join and contribute to environmental and social environmental and social justice groups (Greenpeace, justice groups (Greenpeace, Doctors without Borders)Doctors without Borders) Local grassroots groups Local grassroots groups

especially goodespecially good Land purchasesLand purchases Litigation (e.g., EJLDF, NRDC)Litigation (e.g., EJLDF, NRDC)

Page 410: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Green investingGreen investing-returns as good or better -returns as good or better than the S & P 500than the S & P 500

Terror-free investingTerror-free investing Celebrities/Jocks for JusticeCelebrities/Jocks for Justice

Page 411: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions Activism / Letter writing / Activism / Letter writing /

Protesting / WhistleblowingProtesting / Whistleblowing US Supreme court ruled in 2006 US Supreme court ruled in 2006

that public employees have no free-that public employees have no free-speech rights re whistleblowing speech rights re whistleblowing and no constitutional protections and no constitutional protections against retaliation by bossesagainst retaliation by bosses

Join community groups – become Join community groups – become involved in local as well as involved in local as well as national issuesnational issues

Page 412: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

GGüünter Grassnter Grass

““The first job of a citizen The first job of a citizen is to keep your mouth is to keep your mouth open.”open.”

Page 413: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Margaret MeadMargaret Mead

““Never doubt that a small Never doubt that a small group of thoughtful, group of thoughtful, committed people can committed people can change the world. Indeed, it change the world. Indeed, it is the only thing that ever is the only thing that ever has."has."

Page 414: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Solutions: VoteSolutions: Vote

US voter turnout lowUS voter turnout lowWealthy vote at almost twice Wealthy vote at almost twice rate of poorrate of poor

Whites > Blacks > HispanicsWhites > Blacks > HispanicsOld > YoungOld > YoungProperty owners > RentersProperty owners > Renters

Page 415: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Voter TurnoutVoter Turnout

Page 416: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Campaign finance reformCampaign finance reformFair, representative Fair, representative

electionselectionsPublicly financed Publicly financed

campaignscampaignsBetter candidatesBetter candidates

Page 417: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

SolutionsSolutions

Increased exposure to natureIncreased exposure to nature Improvements in educationImprovements in education

MultidisciplinaryMultidisciplinaryLiteratureLiteratureHistoryHistoryLawLawPhotographyPhotographyCommunity ServiceCommunity Service

Page 418: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

The Role of LiteratureThe Role of Literature

Vicarious experienceVicarious experience Explore diverse philosophiesExplore diverse philosophies Promotes empathy, critical thinking, Promotes empathy, critical thinking,

flexibility, non-dogmatism, self-flexibility, non-dogmatism, self-knowledgeknowledge

Encourages creative thinkingEncourages creative thinking Allows for group discussion/debateAllows for group discussion/debate

Page 419: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Why Use LiteratureWhy Use Literature

Encourage appreciation of non-medical Encourage appreciation of non-medical literatureliterature

Develop reading, analytical, speaking and Develop reading, analytical, speaking and writing skillswriting skills

Promote ethical thinking (narrative Promote ethical thinking (narrative ethics)ethics)

Identification with authors who are Identification with authors who are health professionals (e.g., Keats, health professionals (e.g., Keats, Chekhov, Maugham, Williams, Sanger, Chekhov, Maugham, Williams, Sanger, Nightingale, etc.)Nightingale, etc.)

Page 420: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

HomelessnessHomelessness

Doris LessingDoris Lessing

““An Old Woman and Her Cat”An Old Woman and Her Cat”

From the Doris Lessing Reader (New York: From the Doris Lessing Reader (New York: Knopf, 1988)Knopf, 1988)

Page 421: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Race and Access to CareRace and Access to Care

Ernest J GainesErnest J Gaines

““The Sky is Gray”The Sky is Gray”

in Gray, Marion Secundy, ed. in Gray, Marion Secundy, ed. Trials,Tribulations, and Celebrations: Trials,Tribulations, and Celebrations: African American Perspectives on Health, African American Perspectives on Health, Illness, Aging and LossIllness, Aging and Loss. Yarmouth, Maine: . Yarmouth, Maine: Intercultural Press, 1992Intercultural Press, 1992

Page 422: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

PovertyPoverty Orwell, George. Orwell, George. How the Poor DieHow the Poor Die. . In Sonia In Sonia

Orwell and Ian Angus, eds. Orwell and Ian Angus, eds. The Collected Essays, The Collected Essays, Journalism and Letter of George Orwell, IV; In Journalism and Letter of George Orwell, IV; In Front of Your Nose,Front of Your Nose, 1945-1950. New York: 1945-1950. New York: Harcourt, Brace and World, Inc: pp.223-233.Harcourt, Brace and World, Inc: pp.223-233.

Checkhov, Anton. Checkhov, Anton. Letter to AF KoniLetter to AF Koni, , January 26, 1891,January 26, 1891, Letter to AS Survivor Letter to AS Survivor, , March 9, 1890. March 9, 1890. In Norman Cousins, ed. In Norman Cousins, ed. The The Physician in Literature PhiladelphiaPhysician in Literature Philadelphia: WB Saunders, : WB Saunders, 1982. 1982.

Eighner, Lars. Phlebitis: At the Public Eighner, Lars. Phlebitis: At the Public Hospital. Hospital. In In Travels with LizbethTravels with Lizbeth. New York: St. . New York: St. Martin’s Press, 1993.Martin’s Press, 1993.

Page 423: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

““Activist” JournalsActivist” Journals

American Journal of Public HealthAmerican Journal of Public Health Public Citizen’s Health LetterPublic Citizen’s Health Letter PNHP NewsletterPNHP Newsletter Mother JonesMother Jones HarpersHarpers Z MagazineZ Magazine Hightower LowdownHightower Lowdown

Page 424: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

““Activist” JournalsActivist” Journals Rachel’s Democracy and Health NewsRachel’s Democracy and Health News Rachel’s Precaution ReporterRachel’s Precaution Reporter SierraSierra The Amicus JournalThe Amicus Journal Bulletin of Atomic ScientistsBulletin of Atomic Scientists Multinational MonitorMultinational Monitor Dollars and SenseDollars and Sense Some articles in NEJM, JAMA, JGIM, SSM, Some articles in NEJM, JAMA, JGIM, SSM,

Policy, Politics, and Nurs Prac, othersPolicy, Politics, and Nurs Prac, others

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Page 426: Health Consequences of Environmental Degradation and Social Injustice Martin Donohoe, M.D., F.A.C.P

Contact Information and Contact Information and ReferencesReferences

Public Health and Social Public Health and Social Justice WebsiteJustice Website

http://[email protected]