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Home › 1998 › Volume 49, Issue 11 (April) › The Scale of Our
Ecological Crisis
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Topics: Marxist Ecology
JOHN BELLAMY FOSTER, is a member of
the Board of the Monthly Review
Foundation, teaches sociology at the
University of Oregon and is coeditor of
Organization & Environment. He is the
author of The Theory of Monopoly
Capital (1986) and The Vulnerable
Planet (1994), both published )y
Monthly Review Press.
The Scale of Our Ecological Crisis
by John Bellamy Foster

One of the problems that has most
troubled analysts of global ecological crisis
is the question of scale. How momentous is
the ecological crisis? Is the survival of the
human species in question? What about life
in general? Are the basic biogeochemical
cycles of the planet vulnerable? Although
few now deny that there is such a thing as
an environmental crisis, or that it is in some
sense global in character, some rational
scientists insist that it is wrong to say that life itself, much less
the planet, is seriously
threatened. Even the mass extinction of species, it is pointed
out, has previously
occurred in evolutionary history. Critics of environmentalism
(often themselves claiming
to be environmentalists) have frequently used these rational
reservations on the part of
scientists to brand the environmental movement as
“apocalyptic.”

Lest one conclude that this is simply a political dispute between
those on the side of
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nature and the greater part of humanity, on the one hand, and
those who support the
ecologically destructive status quo, on the other, it should be
emphasized that the same
question has been often raised within the left itself—and
sometimes by individuals
deeply concerned about environmental problems. An example of
this is David Harvey’s
new book, Justice, Nature and the Geography of Difference
(1996). Harvey devotes
considerable space in this work to criticizing my book, The
Vulnerable Planet: A Short
Economic History of the Environment (Monthly Review Press,
1994, 1999), for the

“apocalyptic” character of its argument. In Harvey’s words,
[T]he postulation of a planetary ecological crisis, the very idea
that the planet is
somehow ‘vulnerable’ to human action or that we can actually
destroy the earth, repeats
in negative form the hubristic claims of those who aspire to
planetary domination. The
subtext is that the earth is somehow fragile and that we need to
become caring
managers or caring physicians to nurse it back from sickness
into health…. Against this it
is crucial to understand that it is materially impossible for us to
destroy the planet earth,
that the worst we can do is to engage in material
transformations of our environment so
as to make life less rather than more comfortable for our own
species being, while
recognizing that what we do also does have ramifications (both
positive and negative)
for other living species….Politically, the millenarian and
apocalyptic proclamation that
ecocide is imminent has had a dubious history. It is not a good
basis for left politics and
it is very vulnerable to the arguments long advanced by [ Julian]

Simon and now by
[Greg] Easterbrook, that conditions of life (as measured, for
example, by life expectancy)
are better now than they have ever been and that the doomsday
scenario of the
environmentalists is far-fetched and improbable.
Aside from the purely rhetorical flourishes—the use of such
terms as “millenarian” and
“apocalyptic” which because of the sense of religious fatalism
associated with them
imply something irrational in character (the wrath of God, the
second coming) which has
little to do with the arguments of most environmentalists—this
can be taken as a
serious criticism not only of The Vulnerable Planet but of ideas
that have common
currency in environmental circles. It is noteworthy that this
same criticism, of being
“apocalyptic,” has frequently been leveled at such figures as
Henry David Thoreau,
George Perkins Marsh, Rachel Carson, Paul Ehrlich and Barry
Commoner—indeed at
almost all figures who have contributed anything of importance
to understanding the

modern ecological crisis.
Naturally, some phrases utilized in the environmental
discussion—such as Silent Spring,
The Closing Circle, Earth in the Balance, The End of Nature,
and The Vulnerable Planet—are
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metaphorical, and while pointing to real concerns are not to be
taken too literally. When
it comes to actual argument, though, most analysts attempt to
present an accurate
portrayal of the real dimensions of the problem. Thus the
opening sentences of Chapter
One of The Vulnerable Planet convey the exact sense in which
the title of that work is to
be understood: “Human society has reached a critical threshold
in its relation to the
environment. The destruction of the planet, in the sense of
making it unusable for
human purposes, has grown to such an extent that it now
threatens the continuation of

much of nature, as well as the survival and development of
society itself.” It might have
been added that the survival of the human species was also in
doubt as a result of these
very same processes.
All of this drives us back to our initial question: what is the
proper scale with which to
view our environmental crisis? This is an issue that was taken
up not too long ago by
Stephen Jay Gould in an essay entitled “The Golden Rule: A
Proper Scale for Our
Environmental Crisis.” Gould begins his article by
acknowledging the reality of some of
the very facts cited by those who downplay the environmental
crisis. Human beings he
argues are powerless over the earth on a geological time scale
(that is in terms of tens of
millions of years):
All the megatonnage in all our nuclear arsenals yields but one
ten-thousandth the
power of the 10 km asteroid that might have triggered the
Cretaceous mass extinction.
Yet the earth survived that larger shock and, in wiping out

dinosaurs, paved a road for
the evolution of large mammals, including humans. We fear
global warming, yet even
the most radical model yields an earth far cooler than many
happy and prosperous
times of a prehuman past. We can surely destroy ourselves, and
take many other
species with us, but we can barely dent bacterial diversity and
will surely not remove
many million species of insects and mites. On geological scales,
our planet will take
good care of itself and let time clear the impact of any human
malfeasance.
Having said this, however, Gould goes on to suggest that this
way of thinking—
predicated on a geological time-scale—is irrelevant where
human time-scales are
concerned. “We cannot threaten at geological scales,” Gould
writes,
but such vastness has no impact upon us. We have a legitimately
parochial interest in
our own lives, the happiness and prosperity of our children, the
suffering of our fellows.
The planet will recover from a nuclear holocaust, but we will be

killed and maimed by
billions, and our culture will perish. The earth will prosper if
polar icecaps melt under a
global greenhouse, but most of our major cities, built at sea
level as ports and harbors,
3
will founder, and changing agricultural patterns will uproot our
populations.
Our vision in contemporary society is normally limited to our
own lifetime and that of a
few generations that come before or after us. As a teacher in the
realm of social science
I know how difficult it is to get students to think in terms of
historical time, which often
means perceiving things on a scale of centuries or millennia. All
of this, however, falls far
short of a geological time scale, which exceeds the average life
span of most species. In
this sense it is reasonable to speak metaphorically of a world in
which there is no more
spring, or of a “vulnerable planet” when as Gould says the
threatened reality is one of

the elimination of human society and even the human species,
along with innumerable,
“higher” species of direct significance to human beings, as a
result of the destruction
that humanity is wreaking on its own life support systems. We
are definitely speaking
parochially: of “our ecological crisis” and not of the demise of
the earth or of the
biosphere on a geological time-scale. Yet behind this concern
lies the fact that even the
basic biogeochemical processes of the planet—which human
beings have come to see
as quite fixed—are “vulnerable” to human transformation in
ways that are likely to
destroy the planet as a place for human habitation.
None of this of course is meant to deny the reality that, as
Gould says, we can “barely
dent bacterial diversity and will surely not remove many million
of species of insects and
mites.” But to say that we cannot claim that the planet or the
biosphere is “vulnerable”
because such “lower” life forms will survive, or because the
biosphere will recover over
tens of millions of years is to deny the right of human beings to

identify their fate and
that of the species with which they are most closely connected
with the fate of the
planet. It is to insist on a geological way of thinking (the
peculiar professional reality of
geologists and paleontologists), which though of great scientific
importance has little
direct relevance for humanity’s own existence. It is as if one
were to take the deep
ecological viewpoint, which insists that we should view human
beings as no more
important—even in our own eyes—than any other species, to the
level of absolute
absurdity of denying that it matters whether we as a species
utterly destroy our own
moment on earth. It is to deny an essential anthropocentrism
without which it is
probably impossible for human beings to respond to the
ecological crisis on the scale at
which we must—that is in the largest human terms, which
identifies our fate with that of
the planet.
Comfort or Survival?

Harvey does not stop with a mere rejection of unreasoning
“apocalypticism” but goes on
3
to insist that the environmental crisis raises no more serious
issue for human beings
directly than our own comfort. “The worst” that we can do as a
result of our
environmental depredations, he says, is “to make life less rather
than more
comfortable.” To point to anything beyond this, we are told,
opens one up to the
criticisms of those like Julian Simon and Greg Easterbrook who
accuse most
environmentalists of being “doomsday prophets.”
To be sure, one should beware of any gross exaggeration of
environmental problems.
But those sympathetic to the environment should not be lulled
by the likes of Simon and
Easterbrook—whom Paul and Anne Ehrlich in their Betrayal of
Science and Reason have
dismissed as representatives of the current “brownlash” against
environmentalism—into

playing down the severity of the ecological crisis. It has been
the world’s natural and
physical scientists and not doomsday prophets or the
scientifically uninformed who
have been at the forefront in sounding the alarm with regard to
global ecological crisis.
This can be seen by looking at the “World Scientists’ Warning
to Humanity” initiated by
the Union of Concerned Scientists and signed in 1992 by 1,575
of the world’s most
distinguished scientists, including more than half of all living
scientists awarded the
Nobel prize. According to this carefully worded statement,
representing the consensus
of concerned scientists:
Human beings and the natural world are on a collision course.
Human activities inflict
harsh and often irreversible damage on the environment and on
critical resources. If not
checked, many of our current practices put at risk the future we
wish for human society
and the plant and animal kingdom, and may so alter the living
world that it will be
unable to sustain life in the manner that we know. Fundamental

changes are urgent if
we are to avoid the collision our present course will bring.
The World Scientists go on to emphasize that, “The
environment is suffering critical
stress” in such areas as the atmosphere, the oceans, water
resources, soil, forests, and
living species. “The irreversible loss of species, which by 2100
may reach one-third of all
species now living is especially serious.” Their conclusion is
unmistakably clear: “We the
undersigned, senior members of the world’s scientific
community, hereby warn all
humanity of what lies ahead. A great change in our stewardship
of the Earth and the life
on it is required if vast human misery is to be avoided and our
global home on this
planet is not to be irretrievably mutilated.”
The main reason that the ecology of the entire planet—as we
know it—is now
threatened with “irretrievable mutilation” has to do with the
rapidly rising rate at which
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human beings are transforming the earth, on a scale that is now
truly planetary in
character, rivaling the basic biogeochemical processes of the
planet. A few facts are
worth noting. Somewhere between a third and a half of the land
surface of the earth
has been transformed by human action; the carbon dioxide
content of the atmosphere
has increased by some 30 percent since the Industrial
Revolution; humanity now fixes
more atmospheric nitrogen than all natural terrestrial sources
combined; more than
half of the fresh water sources are now put to use by human
beings; 22 percent of
marine fisheries are being overexploited (or have already been
depleted), while 44
percent are at their limit of exploitation; one-quarter of the
Earth’s bird species have
been driven into extinction by human activities; rates of species
extinction are now 100
to 1000 times those that existed prior to the human domination
of the earth. In the

words of a distinguished team of scientists writing in Science
magazine: “The rates,
scales, kinds, and combinations of changes occurring now are
fundamentally different
from those at any other time in history; we are changing the
Earth more rapidly than we
are understanding it.”
Yet, the world’s natural and physical scientists, who have done
so much to alert us to the
dangers facing humanity and the planet as we know it are ill-
equipped to understand
the roots of the problem (or even the enormity of the threat
looming before us), since
they are generally unable to account for the social problems that
underlie this ecological
crisis, which demand explanations that go beyond such factors
as biology, demography
and technology—to address historical forms of production, and
particularly capitalism.
Most scientific statements on the environmental crisis end with
calls for more careful
management. Often, as in the World Scientists’ Warning,
specific measures are proposed
such as reduced dependence on fossil fuels and the substitution

of solar energy;
cutbacks in consumption; the elimination of world poverty;
controls on world population
growth; and increased sexual equality for women, including the
right to make their own
reproductive decisions.
Within the mainstream scientific viewpoint these issues are
reduced to questions of
individual and collective will—and sometimes to rational choice
by means of the market.
Since little serious thought is given to the social problem and
its relation to ecological
sustainability, the views of mainstream environmentalists
including most concerned
scientists, as Hans Magnus Enzensberger once pointed out,
often smack of a preacher’s
sermon in which “the horror of the predicted catastrophe
contrasts sharply with the
mildness of the admonition with which we are allowed to
escape.”
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7

It is only when knowledge of ecological trends is coupled with
an understanding of
capital accumulation that the full extent of our global ecological
crisis is apparent.
Capitalism, as many of the world’s greatest economists—both
mainstream and radical—
have long acknowledged, is a system that can never stand still.
If the investment frontier
does not expand, and if profits do not increase, the circulation
of capital will be
interrupted and a crisis will ensue. A “stationary” capitalism is
thus an impossibility. As
Schumpeter expressed it, “capitalism is a process, stationary
capitalism would be a
contradictio in adjecto.” But at the dawn of the twenty-first
century there is every reason
to believe that the kind of rapid economic growth that the
system demands in order to
sustain its very existence—growth that now occurs within an
orbit that encompasses the
entire planet—is no longer ecologically sustainable, since it is
biased toward high
throughputs of materials and energy, which put strains on both
the planetary taps

(resources) and sinks (the ecosystems that must absorb the
resulting waste). All of this is
made much worse by the social, economic and ecological waste
resulting from the
specific nature and form of capitalist production (going beyond
the question of mere
quantitative growth).
The fact that there are limitations to the sustainable human
intervention into nature—
which is a way of saying that human society necessarily
coevolves with nature and is not
really independent of it—does not mean that all hope of
unending human progress
should be abandoned or that there cannot be a continuing
development of wealth, in
the sense of the more complete satisfaction of genuine human
needs. But it does mean
that the human capacity to promote narrow instrumental gain by
means of the “invisible
hand” of the market for the benefit of a very few in accordance
with the principle “après
moi, le déluge!” inevitably comes up against certain general
barriers imposed by nature,

as well as more specific social and historical barriers.
In 1946 George Orwell wrote an essay entitled “Some Thoughts
on the Common Toad.”
In that essay he begins by observing tadpoles in a pool, which
leads to the argument
that spring, like nature in general, is ever resurgent; no matter
how oppressive the
society nature is ever a haven and a source of “surplus energy.”
“So long as you are not
actually ill, hungry, frightened or immured in a prison or a
holiday camp, spring is still
spring. The atom bombs are piling up in the factories, the police
are prowling through
the cities, the lies are streaming from the loudspeakers, but the
earth is still going
around the sun, and neither the dictators nor the bureaucrats,
deeply as they
disapprove of the process, are able to prevent it.” The mere
resurgence every year of the
spring, Orwell suggested, was a reality that had nothing
whatever to do with the fact
that “we are all groaning, or at any rate ought to be groaning,
under the shackles of the
8

9
capitalist system” and in that sense it completely lacked “a class
angle.” Yet, “if a man
cannot enjoy the return of the spring,” Orwell asked, “why
should he be happy in a
labour-saving Utopia?”
Today, a half-century later, Orwell’s belief that nature was
somehow isolated from the
social crisis of capitalism appears almost quaint. About a
decade and a half after he
authored his essay Rachel Carson wrote her environmental
classic, Silent Spring which
argued that,
Along with the possibility of the extinction of mankind by
nuclear war, the central
problem of our age has…become the contamination of man’s
total environment with
such substances of incredible potential for harm—substances
that accumulate in the
tissues of plants and animals and even penetrate the germ cells
to shatter or alter the

very material of heredity upon which the shape of the future
depends.
The source of this tragedy for Carson was that we live in “an
era dominated by industry,
in which the right to make a dollar at whatever cost is seldom
challenged.” The
symbolic representation of this crisis was for her a spring
suddenly devoid of songbirds.
Ironically, given Orwell’s earlier argument, one of the leading
symbols of the “silencing of
the spring” today is vanishing frogs and toads. There are some
3,960 species of frogs
and toads, the noisiest amphibians. (Herpetologists often refer
to both as frogs.) Frogs
first emerged 150 to 200 million years ago. Now the growing
silence of the spring is
deepened by the rapid disappearance of frog species all over the
globe—often in areas
remote from human contact. In 1990 the world’s herpetologists
sounded the alarm,
making “the vanishing frogs” one of the most widely heralded
global ecological
catastrophes of the decade. By 1994 a probable cause had been
ascertained as a result

of a series of experiments conducted in Oregon. UV-B,
exposure to which is increasing
due to the thinning of the ozone layer, was discovered to be
killing frog eggs exposed to
sunlight. Widely publicized, this phenomenon has become the
proverbial canary in the
coal mine, announcing to the world that the threat of a “silent
spring” is more than ever
before us and on a truly global scale.
There is no escaping this global ecological contradiction other
than through forms of
conscious, rational control that capitalism is inherently
incapable of providing. “Freedom
in this sphere [the realm of natural necessity],” Marx wrote in
Capital, “can consist only in
this, that socialized man, the associated producers, govern the
human metabolism with
nature in a rational way, bring it under their collective control
instead of being
10
11
12
13

dominated by it as a blind power, accomplishing it with the
least expenditure of energy
and in conditions most worthy and appropriate for their human
nature.” The
impairment under capitalism of the metabolic relation between
human beings and the
earth (or soil), he argued, created conditions compelling “its
systematic restoration as a
regulative law of social production, and in a form adequate to
the full development of
the human race.” Hence, the “conscious and rational treatment
of the land as
permanent communal property” is “the inalienable condition for
the existence and
reproduction of the chain of human generations”— what we
refer to today as
“sustainable development.”
There are, as Harvey warns us, dangers in such a call for
rational social control of the
human relation to nature. Capitalism too insists on the need for
social controls—and
seeks to bend the process in its own direction. Human

“hubris”—insufficiently sensitive
to ecological necessity—could create new disasters. All one can
say in response is that
confronting such problems is what social and ecological
revolution is all about. To refuse
to engage with the problem is to give up on humanity—and the
earth—with at this point
quite predictable results.
Notes
1. David Harvey, Justice, Nature and the Geography of
Difference (Cambridge, Massachusetts:
Blackwell, 1996), p. 194.
2. The epigraph for Carson’s book was taken from Albert
Schweitzer who wrote: “Man has
lost the capability to foresee and forestall. He will end by
destroying the earth.” See the
interesting discussion of “environmental apocalypticism” in
Laurence Buell, The
Environmental Imagination (Cambridge, Massachusetts:
Harvard University Press, 1995),
pp. 280-308.
3. Stephen Jay Gould, Eight Little Piggies (New York: W.W.
Norton, 1993), p. 49.

4. Paul R. Ehrlich and Anne H Ehrlich, Betrayal of Science and
Reason: How Anti-
Environmental Rhetoric Threatens Our Future (Washington,
D.C.: Island Press, 1996).
5. “World Scientists’ Warning to Humanity” in Ehrlich and
Ehrlich, Betrayal of Science and
Reason, pp. 242-50. See also John Bellamy Foster, John Jermier
and Paul Shrivastava,
“Global Environmental Crisis and Ecosocial Reflection and
Inquiry,” Organization &
Environment, vol. 10, no. 1 (March 1997), pp. 5-8.
6. Peter M. Vitousek, Harold A. Mooney, Jane Lubchenco, Jerry
M. Melillo, “Human
Domination of Earth’s Ecosystems,” Science, July 25, 1997, pp.
494-99.
7. Hans Magnus Enzensberger, “A Critique of Political
Ecology,” New Left Review, 84 (March-
14
April 1974), p. 26.
8. Joseph Schumpeter, Essays (Cambridge, MA.: Addison-
Wesley Press, 1951), p. 293. John

Stuart Mill is noteworthy among classical economists for
believing that a capitalist
economy would eventually terminate in a “stationary state” with
little or no growth in
population or output, and that this would allow for the
development of a more
comfortable relation between human beings and nature (as well
as an end to class
struggle). Insofar as he believed that economic growth would
gradually end with no
resulting social disruption he greatly underestimated the
contradictions built into the
laws of motion of capitalism. Today certain ecological
economists, such as Herman Daly,
see themselves as direct descendants of Mill, arguing for a
steady-state market
economy as the answer to the world’s ecological problems.
These thinkers are, if
anything, more unrealistic in their assessment of capitalism than
Mill himself. See John
Stuart Mill, Principles of Political Economy, Book IV, in Mill,
Collected Works (Toronto:
University of Toronto Press, 1965), pp. 752-57; Herman Daly,
Beyond Growth (Boston:

Beacon Press, 1996).
9. Karl Marx, Capital, vol. 1 (New York: Vintage, 1976), p.
381. Marx theorized the existence
of general barriers to capital attributable to production in
general (and to natural
conditions) as well as more specific barriers attributable to
capital. See Michael
Lebowitz, “The General and Specific in Marx’s Theory of
Crisis,” Studies in Political
Economy, no. 7 (Winter 1982), pp. 5-25.
10. George Orwell, The Collected Essays, Journalism and
Letters (New York: Harcourt, Brace &
World, 1968), pp. 140-45.
11. Rachel Carson, Silent Spring (Boston: Houghton Mifflin,
1962), p. 8.
12. Ibid., p. 13.
13. Kathryn Phillips, Tracking the Vanishing Frogs (New York:
St. Martin’s Press, 1994).
14. Marx, Capital, vol 1, p. 638, Capital, vol. 3 (New York:
Vintage, 1981), pp. 948-49, 959. See
also István Mészáros, The Necessity of Social Control (London:
Merlin, 1971). Reprinted in
Mészáros, Beyond Capital (New York: Monthly Review Press,

1995).
by John Bellamy Foster
I am not as worried as Harvey about Marxism succumbing to
“the rhetoric of the
environmentalists.” Historical materialism is a mode of inquiry
(and a form of
revolutionary praxis) that, if it has any lasting meaning,
develops in response to
changing conditions and new vernacular traditions. The
Vulnerable Planet was originally1
inspired by an essay entitled “The Vulnerable Earth: Toward a
Planetary History” by U.S.
environmental historian Donald Worster. I wrote the book with
two thoughts
uppermost in my mind: that a historical materialism that did not
embrace
environmental issues was—in this day and age—hopelessly
inadequate; and that an
environmentalism not rooted in historical materialism was
hopelessly lost. I am
convinced that Marx’s critique of the political economy of
capital also contained within it

the fundamental elements of a political-ecological critique of
capitalism. Yet to deal with
ecological problems today, the classical legacy of Marxism is
not enough, and must be
supplemented with some of the insights of contemporary radical
ecology.
These days skepticism toward science is widespread.
Nevertheless, I was unprepared for
Harvey’s contention that the views of the World Scientists’
(referring to the “World
Scientists Warning to Humanity” signed in 1992 by over 1,500
senior scientists including
more than half of the recipients of the Nobel Prize among living
scientists—see my
article above) “are every bit as problematic as the literature
they rebut.” In his book
Harvey refers to Greg Easterbrook and Julian Simon as
examples of the opposing, anti-
environmental (self-styled “ecorealist”) point of view.
Among those who signed the World Scientists’ Warning we find
figures like Hans Bethe,
Robert Gallo, Stephen Jay Gould, Stephen Hawking, Jane
Lubchenco, Howard Odum,
Linus Pauling, Ilya Prigogine, Carl Sagan, James Watson, and

Edward O. Wilson. The
credibility of scientists such as these in this area has to be
considered far beyond that of
an establishment journalist like Easterbrook who ends his book
by assuring his readers
that we can “terraform” Mars if we run out of ecological space
on earth, thereby giving
us “two biospheres for every one that exists today.” Simon, for
his part, is a
conservative, anti-environmental economist, best known as a
proponent of what has
been called the “weak sustainability hypothesis”: the idea that
increases in economic
wealth as measured by the market can substitute completely for
any losses in natural
wealth.
In dismissing the World Scientists’ Warning Harvey claims that
their metaphor of a
“collision” of humanity with the earth is “abstract and
ideological.” Yet, this ignores the
significance of this particular metaphor within contemporary
science. The most recent
of the great mass extinctions (there have been five extinctions
in which 65 percent or

more of species died out in a brief geological instant) was quite
likely the result, many
scientists now believe, of the collision of an asteroid with the
earth some 65 million
years ago—the end-Cretaceous extinction resulting in the
demise of the dinosaurs.
Hence, the collision metaphor implicitly invites a direct
comparison of the human
2
3
4
impact on the earth with that of the probable cause of the fifth
mass extinction.
Recently, scientists have warned that we are on the verge of
“the sixth extinction”—this
time at the hand of humanity.
I rubbed my eyes in disbelief when reading Harvey’s charge that
I had slipped into
Malthusianism by referring to the “Malthusian term
overpopulation”—in a litany of
environmental problems on the opening page of chapter one of

my book—and by
“approvingly” quoting the Ehrlichs and other Malthusians at
various points in my writing.
It is news to me that “overpopulation” is simply a “Malthusian
term.” Marx and Engels
pointed to the possibility of overpopulation, as have many
Marxists and socialists. In his
very first essay on political economy, for example, Engels
observed that,
Even if Malthus were completely right, this transformation [i.e.
social revolution] would
have to be undertaken on the spot, for only this transformation
and the education of
the masses which it alone provides makes possible the moral
restraint of the
propagative instinct which Malthus himself presents as the most
effective and easiest
remedy for over-population.
Although it is true that Malthusians have made overpopulation
the cause of all social
and environmental problems, it does not follow logically that all
those who consider
population growth to be a problem or who at times use the term
“overpopulation”—

always to be understood in relation to existing social relations
as well as the limits of the
earth—are thereby Malthusian. In my book I attack Malthus and
Malthusianism
throughout. Where population issues are concerned I rely
primarily on the theory of
demographic transition (particularly as advanced by Barry
Commoner in opposition to
the views of Paul Ehrlich), which has a long history within
socialist analysis. Moreover,
the argument of the book clearly states that it is the
accumulation of capital not
population which is the leading source of environmental
problems.
It is hard to know what to say when Harvey points to the fact
that I occasionally quote
favorably from the Ehrlichs and other Malthusians, as evidence
of my having slipped
into Malthusianism—especially since Harvey has nothing to say
about the specific
content of the quotations to which he refers. The logic of this
escapes me. Marx quoted
approvingly from Ricardo and John Stuart Mill (noted
Malthusians), and from Carlyle (an

ultra racist, author of The Nigger Question). This does not mean
that Marx was in danger
of slipping into Malthusianism or racism.
As a further example of my alleged tendency to succumb to the
“rhetoric of
environmentalism,” Harvey chastises me for “uncritically”
taking “the principle ‘nature
5
6
knows best’ from [Barry] Commoner.” Actually The Vulnerable
Planet makes only passing
reference to Commoner’s informal ecological law of “nature
knows best” along with his
other three informal laws (“everything is connected to
everything else,” “everything must
go somewhere,” and “there’s no such thing as a free lunch,” i.e.
“nothing comes from
nothing”) which were used merely as a springboard for the
development of an argument
on the anti-ecological tendencies of capitalism. And even then it
can hardly be said that

Commoner’s principle was introduced “uncritically.” As I
observed in a footnote at this
point in the argument: “Commoner’s third law should not be
taken too literally.” As Haila
and Levins write, “The conception that ‘nature knows best’ is
relativized by the
contingency of evolution.’”
The argument of Haila and Levins (both distinguished
representatives of ecological
science, and in Levins’ case an important contributor to MR) is
worth following further.
Without categorically rejecting what Commoner himself
describes as a mere
“shorthand” expression, these authors attempt to define nature’s
requirements more
precisely. “Nature,” they tell us, “is mute, she does not give us
explicit advice; she only
forbids,” often only post factum.
For example, Commoner’s argument revolves around the
introduction of synthetic
chemicals. The petrochemical industry has managed to inject
70,000 new synthetic
chemical compounds—not the product of evolution and not
easily reabsorbable (at

least on a human time scale)—into the biosphere. As Commoner
writes, “these synthetic
compounds are sufficiently different from…natural compounds
to…disrupt normal
biochemistry, leading to mutations, cancer, and in many
different ways to death. In
effect, the petrochemical industry produces substances
that…cunningly enter the
chemistry of life, and attack it.”
The problem is that these chemicals were introduced to promote
profits without any
accounting of the overall ecological effects. It was the post
factum realization that nature
forbids such heavy reliance on these “elixirs of death” (as
Carson called pesticides, one
deadly branch of these new chemical compounds) that prompted
Carson to write Silent
Spring and Commoner The Closing Circle.
In the end what disturbs me most about Harvey’s argument is
the suggestion that we
should back off from talking about ecological catastrophe since
it is not a good basis for
socialist politics. “A socialist politics that rests on the view that

environmental
catastrophe is imminent,” he writes, “is a sign of weakness…. I
am by no means as
sanguine as many that a rhetoric of crisis and imminent
catastrophe will sharpen our
7
8
9
minds in the direction of class politics or even cooperative and
democratic responses as
opposed to a ‘lifeboat ethic’ in which the powerful pitch the rest
overboard.”
There are two issues here. First, the question of whether or not
humanity is presently on
a collision course with the earth is largely an empirical
question. It is not one that we
should deny or affirm on the grounds of political convenience.
Second, there is the issue of the basis of socialist politics.
Harvey suggests that this must
be rooted as directly as possible on class, which he sees at odds
with the general thrust

of ecological politics, with the exception of the environmental
justice movement. I would
agree that environmental politics (separated out from class
politics) cannot be the basis
for socialist politics. But it is only a narrow conception of class
(and of the environment)
that forces us to keep these elements separate. Marx repeatedly
emphasized that the
exploitation (or degradation) of the worker and of the soil were
two sides of the same
break in the social metabolism resulting from the logic of
capital. Both have to be taken
into consideration in any critique of capital. Capital, by its own
nature, tends to go
beyond its own absolute limits, and to undermine everything
beyond itself in the
attempt to absorb it within itself. What revolutionary ecology
teaches us, and what it
adds to the class struggle, is an understanding of the
thoroughness with which the
capital relation must be overthrown. Nowadays we can no
longer afford to think in
terms of justice alone, but we must also address the issue of
sustainability. Socialism

must become ecological without ceasing to be socialism. Indeed
a good case can be
made that in Marx’s view the two were inseparable.
Notes
1. See Teodor Shanin, ed., Late Marx and the Russian Road
(New York: Monthly Review
Press, 1983), pp. 243-75.
2. Donald Worster, “The Vulnerable Earth: Toward a Planetary
History,” in Worster ed., The
Ends of the Earth (New York: Cambridge University Press,
1988), pp. 3-20.
3. Harvey, Justice, Nature and the Geography of Difference
(Cambridge, MA: Blackwell, 1996),
p. 195.
4. Greg Easterbrook, A Moment on the Earth (New York:
Viking, 1995), pp. 687-88.
5. See Richard Leakey and Roger Levin, The Sixth Extinction
(New York: Doubleday, 1995),
pp. 44-56.
6. Friedrich Engels, “Outlines of a Critique of Political
Economy,” in Karl Marx, The Economic
and Philosophic Manuscripts of 1844 (New York: International
Publishers, 1967), p.221.

7. John Bellamy Foster, The Vulnerable Planet (New York:
Monthly Review Press, 1994,
∠ March 1998 (Volume 49, Number 10) Teamster Reform
Movement Survives Carey’s Debacle ∠
Also in this issueAlso in this issue
April 1998 (Volume 49, Number 11) , The Editors
Teamster Reform Movement Survives Carey’s Debacle , Jane
Slaughter
Marxism, Metaphors, and Ecological Politics , David Harvey
SubjectsSubjects
Ecology
Education
History
Imperialism
Inequality
Labor
Marxism
Media
Movements
Philosophy
Political Economy
Socialism
E-mail SUBMIT
1999), p. 154.

8. Yrj Haila and Richard Levins, Humanity and Nature (London:
Pluto Press, 1992), p. 13.
9. Barry Commoner, Making Peace with the Planet (New York:
The New Press, 1992), pp. 13-
14.
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ENVIRONMENTAL REFUGEES:
AN EMERGENT SECURITY ISSUE*
Prof. Norman Myers,
Green College, Oxford University, U.K.
Introduction
There is a new phenomenon in the global arena: environmental
refugees.
These are people who can no longer gain a secure livelihood in
their homelands
because of drought, soil erosion, desertification, deforestation
and other
environmental problems, together with associated problems of
population pressures

and profound poverty. In their desperation, these people feel
they have no alternative
but to seek sanctuary elsewhere, however hazardous the
attempt. Not all of them
have fled their countries, many being internally displaced. But
all have abandoned
their homelands on a semi-permanent if not permanent basis,
with little hope of a
foreseeable return.
As far back as 1995 (latest date for a comprehensive
assessment), these
environmental refugees totalled at least 25 million people,
compared with 27 million
traditional refugees (people fleeing political oppression,
religious persecution and
ethnic troubles). The environmental refugees total could well
double between 1995
and 2010. Moreover, it could increase steadily for a good while
thereafter as growing
numbers of impoverished people press ever harder on over-
loaded environments.
When global warming takes hold, there could be as many as 200
million people
overtaken by disruptions of monsoon systems and other rainfall
regimes, by droughts
of unprecedented severity and duration, and by sea-level rise
and coastal flooding.
Of the 25 million environmental refugees in 1995, there were
roughly five
million in the African Sahel, where a full ten million people
had fled from recent
droughts, only half returning home. Another four million, out
of eleven million
refugees of all types, were in the Horn of Africa including

Sudan. In other parts of
Sub-Saharan Africa, where 80 million people were considered
to be semi-starving due
primarily to environmental factors, seven million people had
been obliged to migrate
in order to obtain relief food. In early 2000 Sudan featured
eight million people who
were officially considered at risk of starvation, with another six
million in Somalia
and three million in Kenya, plus several million others in other
countries. A sizeable
though undocumented proportion of these could be
characterized as environmental
refugees.
__________________________________
* Based on Myers, N. and Kent, J. (1995) Environmental
Exodus: An Emergent Crisis
in the Global Arena, The Climate Institute, Washington DC;
and Myers, N. (2001),
Environmental Refugees: Our Latest Understanding,
Philosophical Transactions of
the Royal Society B: 356: 16.1-16.5.
13th Economic Forum,
Prague, 23-27 May 2005
Session III – Environment and Migration
EF.NGO/4/05
22 May 2005
ENGLISH only

While Sub-Saharan remains the prime locus of environmental
refugees, there
are sizeable numbers in other regions and countries. In China
with its 120 million
internal migrants, at least 6 million deserve to be regarded as
environmental refugees,
having been obliged to abandon their farmlands due to shortages
of agricultural plots
in the wake of decades of population growth. In Mexico there
are 1 million new
environmental refugees each year; some become assimilated in
cities, and a few
return home, leaving a cumulative total, as a bare minimum in
1995, of 2 million.
Finally there are those people displaced involuntarily by public
works projects,
notably large dams, and increasing by 10 million every year
(with a cumulative total
of 50 million in just China and India). Most of them resettle
elsewhere, but the
number remaining in a refugee-like situation totals at least 1
million.
The 1995 estimate of 25 million environmental refugees was
cautious and
conservative. Scattered throughout the developing world were
135 million people
threatened by severe desertification, and 550 million people
subject to chronic water
shortages. While certain of these people would have been
included in the 25 million
figure, many could well have been driven to migrate without
being counted as
environmental refugees.

Of the nearly one billion additional people added to the global
population
during the 1990s, a good proportion would have been among
communities with a cash
income of $1 per day or less. They include the people most
likely to be subsisting, or
rather struggling to survive, in environments too wet, too dry or
too steep for
sustainable agriculture. In Sub-Saharan Africa, these
environments would have
needed to support an extra 150 million people during the 1990s,
and a similar total in
India.
Poverty serves as an additional "push" factor associated with
the
environmental problems displacing people. Other factors
include population
pressures, malnutrition, landlessness, unemployment, over-rapid
urbanisation,
pandemic diseases and faulty government policies, together with
ethnic strife and
conventional conflicts. In particular, it is sometimes difficult to
differentiate between
refugees driven by environmental factors and those impelled by
economic problems.
In certain instances, people with moderate though tolerable
economic circumstances
at home feel drawn by opportunity for a better livelihood
elsewhere. They are not so
much pushed by environmental deprivation as pulled by
economic promise. This
ostensibly applies to many Hispanics heading for the United
States. But those people
who migrate because they suffer outright poverty are frequently

driven also by root
factors of environmental destitution. It is their environmental
plight as much as any
other factor that makes them economically impoverished. This
generally applies to
those refugees who migrate to areas where economic conditions
are little if any better
than back home, as is the case with many people who migrate
within Sub-Saharan
Africa and the Indian subcontinent. In this instance, with
poverty and "life on the
environmental limits" as the main motivating force, it matters
little to the migrants
whether they view themselves primarily as environmental or
economic refugees.
On top of all these sub-problems is the lack of official
recognition, whether
on the part of governments or international agencies, that there
is an environmental
refugee problem at all.
Of course the above is not to overlook parallel problems in
OSCE countries;
very much on the contrary. Well known is the displacement of
tens of thousands of
people in the environs of the Aral Sea and as a result of
desertification and general
land degradation in other parts of Central Asia. Of course "tens
of thousands" of
these environmental refugees does not compare with the tens of
millions of such
refugees in Africa and elsewhere in the developing world, but it

is specially
significant, obviously enough, for the people concerned.
Concerns for Environmental Security
All in all, the issue of environmental refugees promises to rank
as one of the
foremost human crises of our times. To date, however, it has
been viewed as a
peripheral concern, a kind of aberration from the normal order
of things--even though
it is an outward manifestation of profound deprivation and
despair. While it derives
primarily from environmental problems, it generates myriad
problems of political,
social and economic sorts. As such, it could readily become a
cause of turmoil and
confrontation, leading to conflict and violence. Yet as the
problem becomes more
pressing, our policy responses fall ever-further short of
measuring up to the challenge.
To repeat a pivotal point: environmental refugees have still to
be officially recognized
as a problem at all.
At the same time, there are limits to host countries' capacity,
let alone
willingness, to take in outsiders. Immigrant aliens present
abundant scope for popular
resentment, however unjust this reaction. In the wake of
perceived threats to social
cohesion and national identity, refugees can become an excuse
for outbreaks of ethnic
tension and civil disorder, even political upheaval. This is

already the case in those
developed countries where immigrant aliens increasingly prove
unwelcome, as
witness the experience of Haitians in the United States and
North Africans in Europe.
Almost one third of developed countries are taking steps to
further restrict immigrant
flows from developing countries. Yet measures to relieve the
plight of refugees of
whatever kind have drastically diminished in relation to the
growing scale of the
problem. Although the annual budget of the United Nations
High Commissioner for
Refugees was recently boosted somewhat, the agency is
increasingly unable to supply
food and shelter for refugees of traditional kind alone, much
less to invest in
rehabilitation or repatriation of these refugees. Meantime the
world's refugee burden
is borne primarily by the poorest sectors of the global
community. In the year 2000
the twenty countries with the highest ratios of official
(traditional) refugees had an
annual per-capita income of only $850.
Linkages to OSCE countries
Insofar as this paper postulates that the most prominent
concentrations of
environmental refugees are located in developing regions, the
OSCE countries might
respond that the "over there" problem has little to do with them
in practical terms.
True, they may sense a humanitarian reaction and supply aid for

that reason, but it is
likely to remain limited, at best, in relation to "bigger picture"
factors, which should
be viewed as exceptionally significant. Developed countries
cannot isolate
themselves from distress and disaster in developing countries:
already there are
sizeable numbers of environmental refugees who have made
their way, usually
illegally, into OSCE countries--and today's stream will surely
come to be regarded as
a trickle when compared with the floods that will ensue in
decades ahead.
Consider, for instance, the case of Italy, a country well placed
for North
Africans who can clandestinely cross from Tunisia to Sicily in a
three-hour voyage.
They number at least 120,000 per year, and their cumulative
total has exceeded 1
million. Spain is an even easier target for North Africans, who
readily cross the 15
kilometres of the Straits of Gibraltar; the numbers involved
match those of Italy. A
still more facile opportunity awaits Hispanics from Mexico and
Central America who
cross the Rio Grande into the United States with numbers of at
least 0.5 million per
year, and with a cumulative total of 6 million.
Thus the environmental refugees problem is not a problem
confined to
countries way beyond the horizon from OSCE countries. Note,

moreover, that the
problem will surely grow bigger fast. Morocco, Tunisia and
Libya are each losing
over 1000 square kilometres of productive land a year to
desertification. In Egypt,
which is uniquely dependent upon irrigation, half of irrigated
croplands suffer from
salinization--and Egypt already imports a huge share of its food.
Turkey has lost
160,000 square kilometres of farmlands to soil erosion. These
environmental
pressures are aggravated by population pressures. North Africa
today features 152
million people, and the eastern Mediterranean 100 million, with
a joint total of 252
million. Contrast the European Union 459 million, a good deal
larger. But the
Mediterranean countries are growing much faster. Projected for
2025: North
Africa/eastern Mediterranean 333 million people, for an
increase of 32%, whereas the
European Union is projected to grow to 470 million, for an
increase of 2%. Across
the Atlantic, Mexico/Central America/Caribbean today totals
185 million, way behind
the United States with 294 million. But a 2025 projection that
Mexico/Central
America/Caribbean will grow to 235 million, for an increase of
27%, whereas the
United States will grow to 349 million for an increase of just
19%.
Policy options

There is much scope for preventive policies, with the aim of
reducing the need
to migrate by ensuring an acceptable livelihood in established
homelands. First of
all, we need to expand our approach to refugees in general in
order to include
environmental refugees in particular. We cannot continue to
ignore environmental
refugees simply because there is no institutionalised mode of
dealing with them. If
official standing were to be accorded to these refugees, this
might help to engender a
recognised constituency for e.g. those 900 million people who
endure desertification,
4 million of whom have become environmental refugees in the
Sahel alone. While
desertification entrains costs of $42 billion a year just through
the loss of agricultural
produce, the United Nations' Anti-Desertification Action Plan
would cost no more
than $22 billion a year. Yet the amount subscribed so far falls
far short of the target,
ostensibly on the grounds that arid-land dwellers have no
constituency and hence lack
political leverage.
Secondly, we need to widen and deepen our understanding of
environmental
refugees by establishing the root causes of the problem--not
only environmental
causes but associated problems such as security concerns, plus
the interplay of the two
sets of forces. There are many conceptual grey areas as

concerns proximate and
ultimate causes, the contributory roles of population pressures
and poverty, the
linkages to ethnic tensions and conventional conflict, and so
lengthily forth.
Consider too the root causes of famine. If a famine has been
human-made, it
can be human-unmade, whereas natural factors can only be
managed and
accommodated. Just as the recurrent droughts in Sub-Saharan
Africa cannot all be
blamed on climate, so the recurrent famines cannot all be
blamed on drought--and the
same must apply, to some degree at least, to droughts (plus
desertification) in Central
Asia. Drought has often served to trigger famines by disrupting
the social, economic
and political processes that would normally ensure sufficient
access or entitlement to
food.
Probably most important of all is that there can be little
progress except within
an overall context of what has come to be known as Sustainable
Development. This
applies notably to reliable access to food, water, energy, health
and other basic human
needs--lack of which is behind many environmental refugees'
need to migrate. In big
picture terms, sustainable development represents a sound way
to pre-empt the
environmental refugee issue in its full scope over the long run.
As a prime mode to
tackle the issue, then, there would be a handsome payoff on
investment to foster

Sustainable Development in developing countries through
greater policy emphasis on
environmental safeguards, together with efforts to stem
associated problems such as
poverty, population and landlessness.
Let us conclude this paper with an unusually pragmatic mode
of promoting
Sustainable Development, whether in the Horn of Africa or
Central Asia, whether in
the Himalayan foothills or the borderlands of the Caucasus
mountains. A prime way
to tackle desertification, salinization, in fact several sorts of
land degradation, is
through planting trees for shelter belts, to retain soil moisture,
and to resist soil
erosion. Certain types of trees offer additional benefits, e.g.
leguminous species add
nitrogen to infertile soils, or they supply built-in insecticides,
or they offer industrial
timber. Probably the biggest benefit lies with reforestation in
montane areas, in order
to rehabilitate hydrological systems and watershed functions,
and thus avoiding floods
and drying-outs for river systems downstream. All in all, and in
whatever part of the
world, restoring tree cover almost always presents an
exceptional win-win outcome.

Ecology of Increasing Diseases: Population Growth and
Environmental Degradation
Author(s): D. Pimentel, S. Cooperstein, H. Randell, D.
Filiberto, S. Sorrentino, B. Kaye, C.
Nicklin, J. Yagi, J. Brian, J. O'Hern, A. Habas and C.
Weinstein
Source: Human Ecology, Vol. 35, No. 6 (Dec., 2007), pp. 653-
668
Published by: Springer
Stable URL: http://www.jstor.org/stable/27654237
Accessed: 13-12-2016 06:41 UTC
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Hum Ecol (2007) 35:653-668
DOI 10.1007/s 10745-007-9128-3
Ecology of Increasing Diseases: Population Growth
and Environmental Degradation
D. Pimentel S. Cooperstein H. Randell D. Filiberto
S. Sorrentino B. Kaye C. Nicklin J. Yagi J. Brian
J. O'Hern A. Habas C. Weinstein
Published online: 31 July 2007
? Springer Science + Business Media, LLC 2007
Abstract The World Health Organization (WHO) and
other organizations report that the prevalence of human
diseases during the past decade is rapidly increasing.
Population growth and the pollution of water, air, and soil
are contributing to the increasing number of human
diseases worldwide. Currently an estimated 40% of world
deaths are due to environmental degradation. The ecology
of increasing diseases has complex factors of environmental
degradation, population growth, and the current malnutri
tion of about 3.7 billion people in the world.
Key words Ecology environmental degradation
increasing disease malnutrition pollution

population growth
Introduction
The ecology of increasing diseases in humans is exceed
ingly complex because of the biology and diversity of
infectious organisms and the effects of environmental
degradation on the prevalence of disease (World Resources
Institute 1998; Pimentel et al 1998; McMichael 2001;
World Health Organization 2003e; Weiss and McMichael
2004; United Nations Environment Programme 2005).
Today, just six infectious diseases (acute respiratory
infections, human immunodeficiency virus/autoimmune
deficiency syndrome (HIV/AIDS), diarrhea, tuberculosis,
malaria, and measles) cause approximately 90% of all
D. Pimentel (M) S. Cooperstein H. Randell D. Filiberto
S. Sorrentino B. Kaye C. Nicklin J. Yagi * J. Brian
J. O'Hern A. Habas C. Weinstein
College of Agriculture and Life Sciences, Cornell University,
Ithaca, NY 14853-0901, USA
e-mail: [email protected]
deaths from infectious diseases worldwide (WHO 2005c).
About 40% of the deaths (62 million per year) are attributed
to various environmental factors especially organic and
chemical pollutants (Pimentel et al 1998; Robbins 2000).
In addition, more than 3.7 billion humans suffer from
malnutrition (WHO 2004a), and 2.2 million infants and
children die each year from diarrhea, which is caused
largely by contaminated water and food (Population
Resource 2004).
In this article, we assess the relationship between
increasing population numbers and growing environmental

degradation. In addition, we examine the effects of both
factors on the current and future disease incidence
throughout the world.
Population Growth and Disease Transmission
Health hazards associated with population growth include
emerging and re-emerging diseases, poor vector control,
poor sanitation, water and food contamination, air pollu
tion, and natural disasters (Daily and Ehrlich 1996; Sachs
2000). Based on the current human growth rate of 1.2%, the
current world population of nearly 6.5 billion will double to
13 billion in the next 58 years, thereby greatly intensifying
pollution and disease problems (PRB 2006). The US
population is growing at twice the rate of China's
population (PRB 2006; US Census Bureau 2004, 2005).
In 70 years the US population is expected to double to 600
million, and will reach China's population of 1,300 million
in another 70 years, based on current growth rates (PRB
2006).
Today nearly half of the world's population live in cities,
and by 2025, it is projected that two thirds of the world's
population will have settled in large urban areas (PRB
2005). Densely crowded urban environments, especially
4? Springer
2016 06:41:22 UTC
654 Hum Ecol (2007) 35:653-668

those without adequate sanitation, are of public health
concern because they promote disease epidemics, like
measles and new diseases and influenza.
The severe acute respiratory syndrome (SARS) disease
resulted from the crowding of humans and their livestock in
cities in China (National Institute of Allergy and Infectious
Diseases 2004a). SARS probably originated in civet cats
that were being cultured and eaten by Chinese fanners.
Eventually the vims was passed to farmers and then other
people. In the 2003 outbreak, there were more than 8,000
cases of SARS with about 774 deaths (NIAID 2004a).
Environmental Pollution and Degradation
Global increases in air, water and soil pollution exacerbate
human exposure to environmental pollutants and malnutri
tion, resulting in an estimated 40% of the total human
deaths each year (Pimentel et al 1998). Even more harmful
to human health than these sources of pollution are tobacco
smoke and indoor cooking smoke (WHO 2004h). More
than 4 billion humans suffer from continuous exposure to
smoke from these sources (Bruce et al 2002). Increasing
automobile and energy use is also contributing to poorer air
quality in urban areas and to the growing number of human
illnesses and deaths worldwide (Union of Concerned
Scientists 2004).
Many humans are regularly exposed to toxic chemicals,
including mercury, benzene, and pesticides. Approximately
2.8 billion kilograms of toxic chemicals are released into
the US environment annually (US Census Bureau 2004).
Common household and industrial chemicals may cause
learning disabilities in 5 to 10% of US children (Miller
2004; Shettler et al 2000). Environmental factors, includ

ing various chemicals, ultraviolet and ionizing radiation,
and tobacco and cooking smoke account for 75% of all
cancers (Sharpe and Irvine 2004). Annually, approximately
10 million people are diagnosed with cancer with about 6
million cancer deaths reported worldwide (WHO 2004d). In
the United States, cancer-related deaths increased from
331,000 in 1970 to about 563,000 in 2002 (USCB 2003).
The majority of cancers are linked to the environment,
including chemicals and radiation (National Cancer Institute
2004).
Water Pollution and Diseases
Waterborne infections account for 80% of all infectious
diseases worldwide and 90% of all infectious diseases in
developing countries (Epstein et al 1994; Robbins 2000).
Lack of sanitary conditions contributes to approximately 4
billion human diarrhea infections, resulting in more than 2
million deaths each year, mostly occurring in infants and
young children (One World Health 2004). Even in
developed countries, waterborne diseases have major
impacts. In the USA, they account for 900,000 infections
and about 900 deaths each year (Seager 1995; Global Water
Issues 2002).
Approximately 1.2 billion people in developing nations
lack clean water because most household and industrial
wastes are dumped directly into rivers and lakes without
treatment, contributing to many waterborne diseases in
humans (Gleick 1993; MacDonald 2001; WHO 2004e).
Currently, about 50% of the developing world's population
is exposed to polluted water sources (United Nations

Educational Scientific and Cultural Organization 2004a).
Approximately 2.5 billion people lack adequate sanitation,
contributing to more than 5 million deaths each year of
which more than half are children (United Nations 2001).
Developing countries discharge approximately 95% of their
untreated urban sewage directly into surface waters (United
Nations 2003). For example, only 4.6% of India's 5005
cities and towns have sewers and wastewater treatment
facilities (Eddy 2004). Often people use the untreated water
downstream for drinking, bathing, and washing.
Agricultural runoff also threatens the world's drinking
water with animal and chemical wastes. In the United
States, nearly 50% of lake water is polluted by erosion
runoff containing nitrates, phosphates, and other agricul
tural chemicals (Gleick 1993; Environmental Protection
Agency 2002). An estimated 20% of rivers are impaired
due to runoff from nearby intensive livestock operations
(EPA 1998).
In some countries, drastic environmental changes have
led to an explosion in diseases affecting humans. For
example, the construction of dams and similar alterations to
natural water flow has increased the number of snails that
are intermediate hosts for schistosomiasis. Schistosomiasis
is associated with contaminated fresh water and is expand
ing worldwide, currently infecting more than 200 million
people, with death estimates of up to 200,000 per year
(Special Programme for Research and Training in Tropical
Diseases, TDR 2004). For example, the 1985 construction
of a dam 100 km from the mouth of the Senegal River in
West Africa was followed by an explosion in Schistosoma

mansoni in the human population. By 1994, 72% of the
population was infected whereas there had been no
documented cases prior to the dam's construction (Morgan
et al 2001). Additionally, various models suggest that
climate change could lead to the spread of schistosomiasis
to more areas in Africa, Southeast Asia, and South America
(Martens 1995). Schistosomiasis is relatively stable in
Africa (it has been there longer) but continues to colonize
new snail hosts in South America, increasing its distribution
(DeJong et al 2001).
Malaria is another water-related concern for human
health. Currently more than 50% of the world's population
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is exposed to malaria, nearly a 10% increase in just 10 years
(Breman et al 2004). Malaria infects more than 500 million
humans each year, killing approximately 1.2 to 2.7 million
per year (Breman et al 2004; Snow et al 2005).
Approximately 90% of all malaria cases occur in Africa,
as do approximately 90% of the world's malaria-related
deaths (Breman et al 2004). Of interest is the fact that
urbanization appears to reduce the incidence of malaria
(Hay et al 2005). This may be due to a relative lack of
breeding sites in urban areas.

Pesticides are one of the prime methods of malaria
control. Dichloro-diphenyl-trichloroethane (DDT), when
first used for treating homes, resulted in dramatic reduc
tions in the incidence of malaria in people. For example, in
South Africa the use of DDT has been highly successful
from 1945 to 1995 and there has been no sign of DDT
resistance in vectors over the 50-year period (Guaasekasan
et al 2005). However, when DDT was also used for
agricultural purposes, it exposed most of the mosquito
populations to DDT and the mosquitoes evolved high levels
of resistance to DDT, making DDT relatively ineffective
(ICAITI 1977). Most nations have abandoned the use of
DDT for use in agriculture. Yet, DDT appears to be one of
the most effective insecticides for controlling malaria when
sprayed on the inside walls of houses and Chris Curtis of
the London School of Hygiene and Tropical Medicine
reports no serious environmental problems when treating
the inside of houses (Curtis 2002). Mosquitoes do not
develop resistance because the quantities used are small;
spraying is required only once or twice a year, and only a
few mosquitoes (those inside houses) are actually exposed
to DDT (Walker et al 2003; Shapiro 2004). Additionally,
the negative effects usually associated with DDT, such as
bird kills, are greatly reduced by using only small quantities
of DDT inside houses (Pimentel 2005). However, it must be
emphasized that DDT is a hazardous chemical (John
Rappole, personal communication, Smithsonian Nation
Zoological Park, Front Royal, VA.). Since most mosquito
bites occur after dark when people are inside their homes
the use of DDT could dramatically reduce the incidence of
malaria in endemic areas (Walker et al 2003; Shapiro
2004).

A major concern in Africa is that malnourished people
are more susceptible to malaria. Young children who are
malnourished are twice as likely to die compared with well
nourished children (Caulfield et al 2004).
Environmental changes, including increased water pol
lution, have fostered much of the increase and high
incidence of malaria. Deforestation in parts of Africa has
exposed land to sunlight and promotes the development of
temporary pools of water with more neutral pH than
puddles in forested areas where organic matter is abundant
and pH is acidic (pH 4.5-5.5). The new pools facilitate the
breeding of human-biting, mal aria-transmitting mosqui
toes (Coluzzi 1994; Patz et al 2000). Moreover, changing
land use activity allows newr mosquito species to move in
and proliferate. For example, between 1971 and 1986
Brazil experienced a 76% increase in malaria transmitted
by mosquitoes (Patz et al 2000). As a result of mining
operations, migrants help malaria pathogens to migrate
between deforested areas (Patz et al 2000). In addition,
global wanning is improving environmental conditions for
mosquito proliferation, malaria, and other diseases
(Epstein et al 1998; Patz 2002). In sub-Saharan Africa
the average person in an endemic area receives 121 bites
from malaria-infected mosquitoes each year (Hay et al
2005). In addition, mosquito vectors are evolving resis
tance to insecticides, while the protozoan pathogens are
evolving resistance to anti-malarial drugs, reducing the
effectiveness of the control efforts (Lambert 2004; Whitty
et al 2004).
Atmospheric Pollution and Diseases
Each year, air pollutants kill about 3 million people
worldwide (WHO 2002c). Respiratory diseases such as

asthma, acute respiratory infections, and lung cancer are
strongly linked to environmental contaminants such as
tobacco smoke, indoor smoke from cooking with biomass,
and emissions from vehicle exhaust, power plants and other
industrial processes. Respiratory diseases disproportionate
ly affect vulnerable populations such as infants, children,
women, the poor, and people in developing countries
(WHO 2002c). An estimated 2.1 million children, younger
than 5 years, die from acute respiratory infections world
wide (WHO 2003c).
Air pollution is a significant source of respiratory disease
in the world, with 50% of chronic respiratory illness
probably associated with air pollution (Ourplanet 2004).
In most developed nations, the primary source of outdoor
pollution is vehicle exhaust and power plant emissions.
About 20% of the lung cancer deaths in the USA are caused
by particulate matter from vehicle exhausts (Pearce 2002).
In cold-climate developing countries, like parts of China
and the former Soviet Union, the prime source of outdoor
air pollution is coal-powered home heating and automobile
exhausts. In developing nations with warm climates, dust
and vehicle exhaust are the prime sources of air pollution
(Lvovsky 2001). Indoor air pollution from open cooking
fires and tobacco smoke is an equally lethal source of
respiratory disease, especially in rural areas in developing
countries (WRI 1998). By 1993, air pollution levels in all
20 of the world's largest cities exceeded World Health
Organization guidelines (WHO/UNEP 1992). Further, the
highest levels of air pollution are found in developing
countries.
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The Environmental Protection Agency's limit for partic
ulate matter (PM) in the air has a diameter of greater than
10 |xg (PM10), and this particulate matter is strongly linked
to respiratory disease. Los Angeles, with the highest PM10
level in the USA, averages less than 50 [ig/m2 (Samet et al
2000). However, in heavily polluted cities in the developing
world, like Beijing and New Delhi, fine particulate matter
averaged more than 300 |xg/m3 (Alberini et al 1997).
Air pollution is excessive in China, which has seven of
the ten most polluted cities in the world (Energy Informa
tion Agency 2003). If air pollution in China could be
brought within Chinese air quality standards, approximately
178,000 premature deaths from respiratory diseases in
urban areas could be prevented each year (McDonalds
2005). From 1955 to 1984, the prevalence of respiratory
diseases occurred at a rate five times higher in China than
in the USA, making respiratory diseases the leading cause
of death in China (Zimmerman et al 1996; WRI 1998).
In general, air pollutants exacerbate asthma, which
ultimately can become severe enough to cause death.
Worldwide, the incidence of asthma has increased, with
between 100 and 150 million people suffering from asthma
(WHO 2000c). In the USA, asthma is one of the most
chronic diseases in children, affecting about 5 million
children annually (Keeler et al 2002).

Globally, but especially in developing nations where
people cook with coal, fuelwood, dung, and other biomass
resources over open fires, nearly 4 billion humans suffer
continuous exposure to smoke (Bruce et al 2002). This
smoke contains more than 4,000 hazardous chemicals
including many carcinogens (DeKoning 1985). Fuelwood
cooking smoke is estimated to cause the death of 1.6
million children each year worldwide (WHO 2002c).
Because women do most of the cooking, they are twice as
likely as men to be diagnosed with respiratory illness
(Ezzati and K?mmen 2001).
Smoking is another major contributor to respiratory
illness. Currently there are 1.3 billion tobacco smokers
worldwide (WHO 2005b). More than 4,000 hazardous
chemicals are produced in cigarette smoke, 200 of which
are highly toxic (LSC 2004; LungUSA 2004). In the long
term, the carcinogenic compounds in tobacco smoke are
linked to a heightened risk of cancer among children
exposed to environmental tobacco smoke (ETS) in their
childhood (D'Souza 1997). Each year between 150,000 and
300,000 cases of lower respiratory tract infections in infants
and young children up to 18 months are attributed to ETS
(EPA 1992).
At present 4.9 million people worldwide die annually
from smoking (Von Schirnding et al 2000) with projections
suggesting that 10 million will die per year by 2025, 70%
of whom will reside in developing countries (Jenkins et al
1997). In the USA, about 440,000 people die each year
from smoking related illnesses, which is about 20% of all
US deaths (Center for Disease Control 2004c). The number
of smokers worldwide is expected to double by 2010

(UNESCO 2004b).
Skin cancer is another threat to global human health.
Between 2 and 3 million non-melanoma skin cancers and
132,000 melanoma skin cancers occur globally each year
(WHO 2002d). Skin cancer incidence is doubling about
every 17 years in the USA (Health Link 2004). The
American Cancer Society reported about 800,000 cases of
non-melanoma skin cancers in 1995, and in 2001 the number
of cases had risen to more than 1 million (Health Link 2004).
The WHO predicts a 10% increase in skin cancer incidence
in the USA by the year 2050 (WHO 2003b, e).
The rise in skin cancer incidence is associated with
anthropogenic pollution. As the ozone layer decreases, this
increases cancer-inducing UV-B radiation (McMichael 1993;
Martens and McMichael 2002; Mckenzie et al 2003).
Exposure to sunlight, including UV-B radiation, accounts
for 70% of skin cancers in the USA (SoRelle 2004).
The use of leaded gasoline is another source of concern
related to atmospheric pollution. Lead poisoning causes
anemia, kidney problems, and brain damage. Children
exposed to lead are particularly at risk for brain damage
and reduced learning capabilities (Canf?eld et al 2004).
Currently, an estimated 1.7 million children in the USA are
exposed to hazardous levels of lead and have blood levels
above the acceptable level of 10 u.g/dl (Council on
Environmental Quality 1996; CDC 2004g).
Chemical Pollution and Disease

Newly developed technologies increase the varieties,
potencies, and quantities of chemicals that are released into
the air, soil, and water each year. The release of chemicals
has damaged many important ecosystems and caused
serious disease problems in humans. The USA releases
over 2.8 billion kilograms per year of toxic chemicals
(USCB 2004). Over 85,000 industrial chemicals are used in
commerce and an additional 2,300 chemicals are added
each year (Zeeman et al 1996; Lucier and Schecter 1998).
The biological activity and human toxicity of most of these
chemicals is unknown (Thornton et al 2002).
Chemical exposures contribute to a variety of serious
human diseases, including cancer, birth defects, immune
system defects, reduced intelligence, behavioral abnormal
ities, decreased fertility, altered sex hormones, altered
metabolism, and specific organ dysfunctions (Carpenter et
al 2002). Americans of all ages carry a burden of at least
116 chemicals extraneous to their bodies, some of which
were banned more than three decades ago, such as DDT
and BHC (CDC 2003a). Other chemicals found in virtually
every person are lead, mercury, dioxins, and PCBs
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(Carpenter et al 2002). These chemicals find their way into

our bodies through the air we breathe, the water we drink,
our food, and our every day environmental exposure. In
fact, 48 states have advisories limiting fish consumption
because of contamination, like mercury; found in fish
(Anderson et al 2004). In Oklahoma, ponds tested from
2000 to 2003 by the Environmental Protection Agency
have been found to have mercury levels above the 0.5 ppm
that can be dangerous for pregnant women and children
(Tyree 2006). Despite advisories, currently 6% of women
of childbearing age in the USA have potentially hazardous
levels of mercury in their blood, which can cause
developmental and neurologicial defects in fetuses (Jones
et al 2004). Coal-fired power plants are the largest source
of mercury pollution.
In studies conducted in California and New Mexico,
16% of those surveyed were allergic or sensitive to
common chemicals (Kreutzer et al 1999). The cost of
multiple chemical sensitivity (MCS) to society is high when
the effects of lost productivity, health care, and support for
disabled workers are totaled (Ashford and Miller 1998;
McCampbell 2002). Between 33 and 77 million people in
Bangladesh are at risk of poisoning from naturally occuring
arsenic in wells dug very deep (Arsenic 2005). The scale of
this impact is greater than the Bhopal accident in India that
killed 8000, injured over 120,000, and has an ongoing
health impact (Vosters 2003).
Perhaps of more serious concern to public health are
cancers resulting from chemicals. About 10 million new
cancer cases are diagnosed each year worldwide (Eaton 2003).
Some cancers are linked to the use of polluted water 70% of
the water in five of China's seven major river systems is
unsuitable for human use (The Economist 2004). In the USA,
1.4 million cases of cancer were reported in 2004 (USCB

2004). A woman's lifetime risk of breast cancer has increased
from 1 in 22 in 1940 to one in seven today (Evans 2004).
The risks associated with chemical exposures are
compounded by immunosuppressive activities of some
chemicals. These chemicals increase the risk of infectious
diseases (Van Loveren et al 1995; WHO 1999). Pesticides
are one class of hazardous chemicals. Worldwide about 3
billion kilograms of pesticides are used per year, with about
0.5 billion kilograms applied per year in the USA (Pimentel
2005). Although the total quantity of pesticide use has not
increased significantly during the past decade, the toxicity
of individual pesticides has increased from 10- to 100-fold
compared with those in use in 1950 to 1960 (Pimentel
1997). In 1990, the number of work-related pesticide
poisonings in the developing world was estimated to be
25 million cases per year with approximately 220,000
fatalities (Jeyarathnam 1990; Richter 2002). Approximately
99% of the global deaths related to pesticides occur in
developing countries (WHO/UNEP 1990).
The number of human pesticide poisonings in the USA
was reported in 1990 to be about 67,000 per year in one
study (Litovitz et al 1990); later, the number was reported
to have increased to more than 300,000 per year (Klein
Schwartz and Smith 1997). This may reflect the higher
toxicity of the new pesticides in use today, compared with
the early pesticides, as well as the increased pesticide drift
problem. Aircraft application of pesticides causes the most
serious drift problem, with 40% to 60% of the pesticide
applied drifting away from the target area (Cox 1995).
Aerially applied pesticides are estimated to drift up to
1,600 m from the application site and may drift up to 80 km

downwind (Cox 1995). In California, 51% of the agricul
tural pesticide poisonings were the result of pesticide drift
(Kegley et al 2003).
Approximately 57% of non-fatal pesticide poisonings
reported in the USA involve children younger than 6 years
(Sanbom et al 2002). For example, in Washington State,
reports confirm that dietary doses of pesticides were
exceeded in 44% to 56% of the children with non-fatal
pesticide poisoning (Sanbom et al 2002).
Land Degradation Effect on Disease Incidence
Soil is contaminated by a wide array of chemicals and
pathogens. Humans may acquire chemical pollutants and
pathogens directly from the soil (i.e., by contact with the
soil) or indirectly, through food and water contamination.
At times, soil particles themselves may be pollutants,
entering the eyes, nose, and mouth and acting as irritants
or allergens.
Exposed soil is highly susceptible to wand and water
erosion. Wind erosion can cause serious health problems by
blowing into the air soil particles and microbes into the air,
which irritate the respiratory tract and eyes, and aggravate
allergies and asthma. In China, farmland erosion and
desertification has led to Beijing experiencing 11 dust
storms during one year (WHO 2002b). Many types of
pathogens have been recorded in blowing soil. For
example, 19 pathogen species that infect humans have
been recorded in blowing soil in various regions of the
earth, including anthrax, TB, flu virus, and hantavirus
(Griffin et al 2001). Erosion disperses toxic chemicals,
such as heavy metals and pesticides, leading to contami
nated food and water resources. Soil depth is also critical to

food crop production. For example, reducing soil depth by
25 cm was found to reduce crop productivity by about 60%
(Stallings 1964).
As the human population expands and land is cleared of
trees, loss of forest cover can contribute to an increase in
the prevalence of human infections by helminthes, such as
hookworms. After deforestation in Haiti, hookworm infec
tions rose from zero to 12% of the population in 1990 and
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658 Hum Ecol (2007) 35:653-668
15% in 1996 (Lilley et al 1997). Children suffer greater
morbidity from helminth infections than adults because
children need more protein than adults per kilogram of
body weight; under severe parasitic infections, they may be
unable to utilize protein efficiently enough to remain
healthy.
Many helminth species that infect humans are found in
soil contaminated by human feces, thereby exacerbating the
cycle of exposure. Worldwide, more than 2 billion people
are infected with one or more helminth species, either by
direct penetration or by consumption of contaminated food
or water (Hotex et al 1996). In locations where sanitation
is poor and people are overcrowded, such as parts of urban

Africa, up to 90% of the population may be infected with
one or more helminth species (Wamae and Mwanza 2000).
In China, approximately 600 million people (nearly half the
population) have water that is contaminated by human and
animal wastes (The Economist 2004).
Food Contamination, Disease, and Malnutrition
Although it is difficult to estimate, annually about 2.1
million people die from diarrheal diseases worldwide
(WHO 2002e). In industrialized nations, approximately
360 million foodborne disease cases occur annually and in
developing nations an estimated 1.9 billion annually (WHO
2002e). In the United States, approximately 76 million
foodborne diseases occur in humans each year, causing
5,000 deaths (Mead et al 1999; DeWaal et al 2000; NIAID
2002a). In addition, foodborne diseases cost the U.S. $5 to
$6 billion each year (Table I).
Poultry, hogs, cattle, and other livestock are easily
contaminated with Salmonella and various Escherichia coli
and Campylobacter microbes, especially when the animals
are crowded together in livestock facilities with inadequate
waste disposal systems (Lederberg et al 1992; Altekruse et
al 1997). Additional microbial contamination can result
from unsanitary conditions during slaughtering, processing,
and handling. In the USA, hen eggs and poultry have been
identified as the main source of Salmonella enteritidis,
which can cause severe gastrointestinal illnesses and
sometimes death in humans, especially among children
and the infirm (Prier and Solnick 2000; WHO 2002d). Over
the past 10 years S. enteritidis infections have increased
significantly on several continents (WHO 2002d).

The proliferation of confinement livestock has unknown
consequences on human health. A study conducted in
Milford, Utah by the Utah District of Health Department
studied the period of 1992-1998 when a 44,000 head sow
operation (with a target of 120,000 sows) was constructed.
The town of Milford experienced a fourfold increase in
diarrhea cases and threefold increase in respiratory ill
nesses. These rates were significantly higher than those
found in similar populations and in the state as a whole
(Thu 2000).
Staphylococcus and Salmonella are two airborne patho
gens in or near livestock facilities. These airborne microbes
can infect farm workers and people living downwind from
the livestock facility (Thu 2002). Thus, diarrhea and
various infections are common near large livestock facili
ties. (Thu 2002). Foodborne illnesses are estimated to cause
from S6.5 to $34.9 billion in damages and treatment costs
each year (Guelph University 2005).
Malnutrition, which includes inadequate intake of
calories, protein, iron, iodine, and numerous essential
vitamins, is a major disease related to environmental
degradation (Myers and Kent 2001). The World Bank
World Development Report estimated that deficiencies
of vitamin A, iron, and iodine waste as much as 5% of
global gross domestic product (GDP), while addressing
these deficiencies would cost just 0.3% of global GDP
(World Bank 1993). Malnutrition prevails in regions in
which the overall food supply is inadequate, where
populations lack economic resources to purchase food,
and where political unrest and instability interrupt food

supplies. In addition, rapidly expanding human popula
tions intensify the food-supply problems by diminishing
the per capita availability of cropland (Pimentel and
Pimentel 2003).
In 1950, 500 million people (20% of the world
population) were malnourished (Grigg 1993). Today more
than 3.7 billion people (nearly 60% of the world popula
tion) suffer from malnutrition (WHO 2004a)?the largest
number in history. Each year, approximately 6 million
children under the age of 5 die from malnutrition (Food and
Agriculture Organization 2002). Even in the USA, over
11% of all households experienced food insecurity during
2002 and 3.5% of those households has at least one family
member who went hungry (Nord et al 2003). Malnutrition
at an early age can lead to physical and mental under
development as an adult; this underdevelopment facilitates
a poverty trap where people are stuck at a low-level of
productivity, at a great cost to society and the environment
(Academy of Natural Sciences 2004).
Vitamin A malnutrition diminishes and impairs the
immune responses to infectious diseases in children.
Vitamin A supplements have been shown to decrease
mortality by 30% in vitamin A deficient children ages
6 months to 5 years (Stephensen 2001). Each year, vitamin
A deficiency causes approximately 2.5 million deaths
(International Development Research Centre 2004). Vita
min A shortages can also cause mental disabilities in
children (Obasanjo 2004; Academy of Natural Sciences
2004). More than 13 million people suffer night blindness
or total blindness from a lack of vitamin A (Academy of
Natural Sciences 2004).

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Table I Economic Costs of Diseases in the USA
Environmentally Induced Infectious Diseases vs Behavioral
Expenses
Environmental
Disease Financial cost (per year)
Intestinal infections
Foodborne diseases
Influenza
Antibiotic-resistant bac. infect.
Tuberculosis
Malaria prevention
Digestive diseases
Asthma
Smoking related costs
Cancer
Arthritis
Total
B eh a vi oral/geneti c
STDs (excluding AIDS)
Hepatitis B virus infection

Hepatitis C virus
AIDS
Cardiovascular
Inactivity
Obesity
Alcohol abuse
Diabetes
Total
Combined total (conservative)
$23 billion (direct medical costs and lost productivity)^
$ 5-6 Billion in medical and productivity costs ($1 billion to E.
coli b)
$17 (pandemics could cost from $ 71 to $167 Billion0)
$4 Billion in treatment costs and increasing (May be as high as
$30 Billion)d
$1 Billion0
$2 Billion1" (Target Budget for Africa?Actual is $545.5
million)
$80 Billion ($27 billion more in first two items)s'h
$14.5 Billion (2000 estimate up from $6.2 billion in 1990V
$75-97 Billion^
$189.5 billion ($64.2 billion medical costs, $115.3 lost
productivity)1
$86 billion ($51 billion in direct costs)1"
-$500 Billion
$5-10 Billion ajl
$154-720+ Million in direct and indirect costs a,n
$5.5 Billion
$20 Billion0
$329 Billion ($129 billion in lost productivity)p0 ($260 billion
from heart disease and stroke)q

$76.6 Billion
$48 Billion (excluding $22 billion in related heart disease/
$100 Billion ($4.5 billion in direct medical costs of related
diseases/
$132 Billion ($92 billion in direct costs)1
-660 Billion (rounding down for overlap)
$1.16 Trillion
Association of Texas 2004
aNSTC 1995
bUSDA 2002
c WHO 2003a
dNIAID2000
c American Lung
fWHO2004f
gNIH 1994
h Sandier et al 2002
'National Committee for Quality' Assurance 2001
j CDC 2004f
k American Lung Association 2004
'NIH 2002
mUSCB2004
"NIAID 1998
? Kaiser Family Foundation 2004
p WHO 2004b
qCDC-OC 1997
rNutristrategy 2004
SUS Health and Human Services 2002
tNDIC2002
Similarly, iron intake per person has been declining
during the past 10 years, especially in developing countries
(WHO 2004g). Globally, from 4 to 5 billion people are iron
deficient and 2 billion suffer from anemia (WHO 2004g).
Worldwide, an estimated 9 million deaths can be attributed

to iron deficiency (WHO 2004g). In addition, about 1.6
billion people live in iodine-deficient environments and
suffer from iodine deficiency disease (United Nations
2004). Iodine deficiency also causes mental disabilities in
children (United Nations 2004).
Malnutrition, complicated by parasitic infections, is
frequently found in poverty-stricken areas with inadequate
sanitation. In developing nations, more than one third of the
infectious disease burden is due to malnutrition (Mason et
al 2004). For children, malnutrition increases their suscep
tibility to infectious diseases and death by 42 to 57%
(Pelletier et al 1994). Malnourished individuals, especially
children, are seriously affected by parasitic infections
because these infections also reduce nutrient availability.
The presence of intestinal parasites frequently diminishes
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660 Hum Ecol (2007) 35:653-668
appetite and food intake, and also increases the loss of
nutrients by causing diarrhea and dysentery. Hookwomis,
for instance, can suck as much as 30 ml of blood from an
infected person each day, gradually weakening individuals
and lowering their resistance to other diseases (Hotez and
Pritchard 1995). Latham et al (1990) measured the caloric
gain that Kenyan schoolboys obtained once given treatment

to eliminate their multiple helminth infections. Based on
these data, it is possible to estimate the daily amount of
food intake that is necessary to offset the helminth
infections. The daily recommendation for children 9 to
13 years is about 2,000 kcal (Institute of Medicine 2002).
The Kenyan schoolboys gained about 86 kcal per meal per
day. At the average of three meals per day, this accounts for
a gain of 258 kcal once the helminth infection was
eradicated. Thus, prior to treatment, the schoolboys utilized
between 12 and 14% of their daily food intake to offset the
effects of their helminth infections which is probably
average. We estimate the range of food lost to parasitic
infections to be between 10 and 20% of an individual's
daily food intake.
Drug Resistance in Microbes
Drug resistance and rapid genetic changes in microbes
contribute to global disease outbreaks, diminishing the
ability of humans to successfully ward off or control
illness (NIAID 2004b). Many microbe types have evolved
resistance to antibiotics (Antibiotic Resistance 2004; Levy
and Marshall 2004). The bacteria resistant to antibiotics
cost the USA more than $4 billion in added treatments
and lost productivity each year (Table I). The evolution of
drug resistance in microbes can be surprisingly rapid. In
1979, only 6% of the European Pneumococcus strains were
resistant to penicillin, but one decade later that percentage
had grown to 44% (Platt 1996). Currently in the USA, more
than 90% of the Staphylo coccus aureus, one of the most
common disease-producing microbes, are resistant to
penicillin and similarly effective antibiotics (American
Society of Microbiology 1994). A study of 113 French
pig fanners reported that nasopharyngeal carnage of S.
aureus resistant to macrolide was more frequent in fanners

than non-farmers. The large-scale antibiotic use associated
with today's industrial livestock farming, in addition to
antibiotic dnig resistance in bacteria gaining entrance to the
human food chain, pose serious public health problems
(CDC 2005). Rapid increase in drug resistance by disease
organisms is caused by the widespread use and overuse
of 300 antibiotics by the medical profession (ASM
1994). In addition, eight times more antibiotics are used
in livestock production than are used to treat humans (UCS
2001). The concurrent overuse of antibiotics for both
humans and livestock enhances selection for drug
resistant microbes, further exacerbating the problem of
antibiotic resistance.
Reemerging Diseases
The worldwide increase in tuberculosis results from
population crowding and drug resistance. Currently an
estimated 2 billion people worldwide are infected with
TB, with an estimated 3 million deaths annually (NIAID
2002b; WHO 2004b). In the USA, an estimated 10 to 15
million people (mostly foreign-born nationals) are infected
with latent TB, but do not display the symptoms (NIAID
2002b).
Each year about 8 million people worldwide develop TB
(NIAID 2002b). Drug-resistant TB strains and reduced
medical treatment account for this increase. TB infections
are further complicated by the use of illegal drugs and the
rise of HIV infections, both of which help to spread the
disease and lead to frequent reinfection. Tuberculosis is
rapidly increasing in the Russian Federation. From 1990 to
2000, the number of reported cases per year has increased

from 51 to 90 per 100,000 people (CDC 2004e).
Influenza or flu is one of the most serious virus diseases
in the world. From 300 million to 900 million people are
infected with the flu which resulting in 250,000 to 500,000
deaths each year (WHO 2003a). In the USA, 200,000
people are hospitalized from the flu, with about 36,000
deaths each year (CDC 2004a). Another cause for concern
is avian influenza, a highly pathogenic form of the flu virus
that has passed from birds to humans in isolated cases, and
represents a potentially serious threat as it is particularly
deadly, with a mortality rate of 76% in recent human
outbreaks in Southeast Asia (WHO 2005a).
The flu costs the USA about $17 billion per year in
medical and lost productivity costs each year (Table I). Flu
vaccine to treat one person costs about $10.40; thus,
everyone in the USA could be treated at a cost of $3.1
billion (Stanford 2004). However, a flu pandemic in the
USA could cost the nation from $71 to $167 billion in
health care and lost productivity costs (WHO 2003a).
Brucellosis is another resurgent communicable disease.
The causative bacteria, Brucella spp., infect cattle, sheep,
goats, and some wild mammals worldwide and are
harbored in an animal's udder. Humans usually contract
the disease from infected animals or contaminated dairy
products. Roth et al (2003) report that the number of cases
of brucellosis is increasing, especially in developing
countries, with about 360,000 cases reported per year.
Newly Emerging Diseases
Changes in biological diversity, evolution of parasites, and
invasion by exotic species all frequently result in disease

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