Roger A Rosenblatt

February 12, 2004

Environmental Health and the Health Professional

Ecological Change and Human Health

The first step: Making the diagnosis

The Pathophysiology of the Global Health Crisis

• Fever - Global Warming

• Asthma - Environmental Degradation

• Alopecia - Deforestation

• Thrush - Loss of Biodiversity

• Scabies - Overpopulation

Symptom: Fever

Diagnosis: Global Warming

Global Warming - 1860-2000

-1

-0.8

-0.6

-0.4

-0.2

0

0.2

0.4

0.6

0.8

1

1860 1880 1900 1920 1940 1960 1980 2000

temp(F)

World Carbon Emissions from FossilFuel Burning, by Economic Region, 1950-94

Mill

ion

To

ns

0

1000

2000

3000

4000

5000

6000

1950 1960 1970 1980 1990

Developing Countries

Former Eastern Bloc

Industrial Countries

Global Climate Change:The Impact on Human Health

•

` Malaria, dengue fever, equine encephalitis, West Nile virus

Direct Effects:– Lethal heat waves– Potential extreme weather events – e.g. hurricanes

• Indirect Effects:– Increase in air pollution and respiratory disease

– Greater growth & dispersion of fungal spores – allergies– Rising sea levels

• Diseases that may become more common:

–

– Lyme disease, hantavirus,

– Cholera, Cryptosporodiosis

Symptom: Asthma

Diagnosis: Air Pollution

Symptom: Alopecia

Diagnosis: Deforestation

Deforestation Example

Symptom: Thrush

Diagnosis: Loss of Biodiversity

Extinctions of birds and animals1600 to present(Audubon society, 1998)

0

2000

4000

6000

8000

10000

1600 1700 1800 1900 2000(est.)

birdsmammals

Mass Extinctions:Loss of Biodiversity

0

10

20

30

40

50

60

70

80

90

100

1400 1600 1800 2100

SpeciesRemaining(%)

The Sixth Extinction

• Human-caused

• Proceeding extremely rapidly

• We have lost about 20% of species that existed in the year 1800

• We will probably lose 25-50% of remaining species in the next century

Symptom: Scabies

Diagnosis: Overpopulation

World Population GrowthB

illio

ns

0

1

2

3

4

5

6

7

8

9

10

11

1900 1920 1940 1960 1980 2000 2020 2040 2060 2080 2100

You Are Here(gradual economic decline)

overpopulation begins(unsustainability)

massive environmental destruction and loss of species beings

World Population Milestones

1 billion in 1804

2 billion in 1927 (123 years later)

3 billion in 1960 (33 years later)

4 billion in 1974 (14 years later)

5 billion in 1987 (13 years later)

6 billion in 1998 (11 years later)

There Is a Strong Association Between Mother’s

Age at First Birth and Subsequent Poverty

Age at First Birth (years)

< 16 16-17 18-19 20-21 22-24 25

54%

44%

36%

27%

11%7%

E = MC2

or

Environmental Impact = M(Population) xC(Consumption) squared

What can we do?

• Adopt an ecological perspective• Reduce unwanted pregnancies in our

communities• Promote sustainable economic

development• Preserve natural habitat and the species

that depend on them• Include these issues in our academic and

clinical work

Adopting a Broader Perspective

in Public Health

• The Biological Approach

• The Biopsychosocial context

• The Ecobiopsychosocial imperative

Most Pregnancies Are Unintended

20%

8%

29% 43%

mistimed pregnancies resulting in live births

unwanted pregnancies resulting in live births

unwanted and mistimed pregnancies ending in abortion

intended pregnancies resulting in live births

Slowing Population Growth by MeetingFamily Planning Needs, 1950-2100B

illi

on

s o

f P

eo

ple

0

2

4

6

8

10

12

14

16

1950 1975 2000 2025 2050 2075 2100

if no family planning programs

if family planning programs continue at 1980-85 level

if all unwanted births are avoided

Sustainable Economic Development: Some roles for the health professional

• Use resources in a sustainable manner

• Avoid polluting our natural resources

• Address occupational and environmental diseases

• Serve as role models for those who follow

Preserve Natural Habitats

• Create parks and ecological reserves

• Safeguard rare and endangered species

• Protect and create forests

• Support ecological restoration efforts

Next Steps• Work to broaden the curriculum

• Respond to NIH’s Road-Map Initiative

• Work with other complementary groups on campus

• Think about how a new discipline of Population and Ecosystem Health might evolve