Downstream Problems, Upstream Solutions: Fossil Fuels and Chronic Disease
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An explanation of America's chronic disease epidemic and the role of fossil fuel and industrial agriculture.
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Downstream Problems, Upstream Solutions: Fossil Fuels and Chronic Disease
- 1. DOWNSTREAM PROBLEMS UPSTREAM SOLUTIONS
- 3. “There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in.” Desmond Tutu
- 5. 20 Years Ago Coffee (with whole milk and sugar) Today Mocha Coffee 45 calories 8 ounces 350 calories 16 ounces
- 6. 20 Years Ago Today 210 calories 1.5 ounces 500 calories 4 ounces
- 8. 20 Years Ago Today 180 lb 196 lb
- 9. 20 Years Ago Today 142 lb 166 lb
- 10. 1994
- 11. 2010
- 12. General Richard Myers, Ret.
- 14. ASTHMA rate TRIPLED since 1960 and still INCREASING
- 16. 2050 40% of GDP
- 21. RED MEAT AND CORN SUGAR HEART DISEASE, CANCER, DIABETES, OBESITY
- 22. AND ASTHMA
- 25. PHYSICAL INACTIVITY Obesity, Diabetes, Heart Disease, Cancer $75 BILLION
- 27. AIR POLLUTION: ASTHMA, CANCER, HEART DISEASE, DIABETES
- 29. EXTREME HEAT
- 33. INFECTIONS
- 34. Most Vulnerable
- 38. METHANE POLLUTION (70 x warming power of CO2 ) NOAA , Uinta Gasfields 6-11% fugitive methane
- 39. NITROGEN OXIDE POLLUTION (300 x warming power of CO2)
- 40. OF COURSE, ITS NOT THAT SIMPLE
- 42. TWO DOWNSTREAM PROBLEMS ME EITHER ONE UPSTREAM SOURCE
- 43. We can solve this.
- 45. THE POWER OF DEFAULT
- 47. OUR SOLAR POWER POTENTIAL 4/30/14
- 48. 4/30/14 SOLAR POWER GENERATION US vs Germany
- 49. OUR WIND POWER POTENTIAL 4/30/14
- 50. 4/30/14 US WIND GENERATION (and effect of policy on new installations)
- 51. 50% by 2030 4/30/14
- 52. 4/30/14
- 53. 4/30/14
- 54. LEVEL THE PLAYING FIELD STOP FOSSIL FUEL SUBSIDIES PUBLIC LAND FOR PUBLIC GOOD MAKE POLLUTERS PAY
- 55. POLICIES TO PROMOTE SAFE CLEAN ENERGY Regulate carbon pollution from major emitters Invest in clean energy End subsidies for fossil fuels, including mining and drilling on public lands. National Renewable Electricity Standard 50% of electricity by 2030, 100% by 2050 Net metering (pay for surplus generated) Charge producers of fossil fuel to cover pollution's cost to society 4/30/14
- 56. BUILDING WASTE
- 57. GASOLINE WASTE We can do better. 4/30/14 International Council on Clean Transportation
- 58. POLICIES TO INCREASE ENERGY EFFICIENCY Tighten and accelerate fuel economy standards National Energy Code conforming to 2030 Challenge standards National program to finance retrofits of existing buildings 4/30/14
- 59. 20,000 Heart Attacks PREVENTED 23,000 Deaths each year ANNUAL SAVINGS OVER $ 100 BILLION
- 60. LESS CARS= MORE CLEAN AIR FOR OUR CITIES SMART GROWTH BIKEWAYS AND WALKWAYS BETTER PUBLIC TRANSIT
- 61. Good news: We're already on our way.
- 62. POLICIES FOR ACTIVE/PUBLIC TRANSIT Complete Neighborhoods, Infrastructure Investment, Coordination (Health in All Policies)
- 63. 10,000 colon cancers 215,000 heart attacks PREVENTED 570,000 new diabetes cases each year ANNUAL SAVINGS $ 1-5 BILLION per METRO AREA
- 64. WHAT DO WE WANT OUR FOOD SYSTEM TO LOOK LIKE? SAFE & SUSTAINABLE ENERGY EFFICIENT FRESH AFFORDABLE HEALTHY FOOD
- 65. POLICIES FOR HEALTHY FOOD AND FARMS 4/30/14 Reward good stewards Crop diversity Natural fertilizer Crop rotation Conservation set asides Donate excess Harvest waste energy
- 66. ADVISE SUBSIDIZE Fruits, Vegetables 1% Nuts, Legumes 2% Sugar, Oil, Alcohol Meat, Dairy 63% 15% Grains 20%
- 67. 300,000 Heart Attacks/Strokes PREVENTED 260,000 New Diabetes Cases each year 144,000 Cancer Deaths 127,000 CVD Deaths ANNUAL SAVINGS: $17 BILLION ON CVD ALONE
- 68. THE BIG PICTURE
- 69. The majority of Americans want HEALTHY FOOD, CLEAN AIR, CLEAN WATER CLEAN ENERGY and more ENERGY EFFICIENCY More funding for WALKING, BIKING, & TRANSIT
- 70. WANTED: Leaders with Vision
- 71. WE'RE READY
- 72. We can do it.
- 74. A healthy high quality downstream future is within our reach* *if we act upstream now.
- 75. www.climate911.org Healthy People Healthy Planet
Editor's Notes
- INTRODUCE MYSELF. I'M A WOMAN ON A MISSION. I'M NOT JUST HERE TO ENTERTAIN YOU, I'M HERE TO GET YOU TO DO SOMETHING. AFTER YOU HEAR WHAT I HAVE TO TELL YOU, I WONT HAVE TO TWIST YOUR ARM. THE STAKES ARE SO HIGH, THE EVIDENCE SO COMPELLING, AND THE SOLUTIONS SO POSSIBLE AND PRACTICAL THAT I THINK YOU WILL JOIN ME.. FIRST I'M GOING TO TELL YOU A STORY.
- This is where I work. Its a crazy place because WE'RE MAKING SICK PEOPLE FASTER THAN WE CAN CURE THEM.
- I'm going to take you up the river to find out where all these sick people are coming from.
- ANSWER 16 OZ 350 CAL
- 4 0z 500 cal
- America 1994- obesity 15% Looking at national trend
- CHRONIC DISEASES increasing 5% per decade obesity, metabolic syndrome Now: >30% (35%) obese9% DM, 34% CVD
- FORMER HEAD OF JOINT CHIEFS OF STAFF, PUT OUT A REPORT CALLED “TOO FAT TO FIGHT” Mission: Readiness, nonprofit national security organization of retired military leaders childhood obesity is natl security threat, 25% unfit for service. the military discharges over 1,200 first-term enlistees before their contracts are up because of weight problems, spending more than $60 million a year to recruit and train replacements. Department of Defense spends over $1 billion per year for medical care associated with overweight and obesity.
- Obesity related health costs $1400/yr per obese person, $147 billion/year total US By 2050 healthcare would take up 40% of GDP
- We are now diagnosing diabetes in early to mid teens, complications like kidney failure, heart disease, amputations usually occur after 10 years, onset more rapid in the young.
- treatment costs of CVD, $94 BILLION 2010 predicted to triple by 2030 By 2050, health spending to make up 40% of GDP.
- CONTINUING UP THE RIVER, WE COME ACROSS ANOTHER CLUE. Its not just size of our plates, but what is and isn't on them. Till mid 70's corn sugar was a minimal part of US diet, from 1980-2000 price of soft drinks decreased 20% and consumption doubled, price of fresh produce increased 40% and consumption halved. Metabolized by liver, turns to fat blocks arteries, damages liver
- LOTS OF PEOPLE IN MOTOR BOATS, NO ONE IS SWIMMING OR PADDLING
- THERE IS A DIRECT CONNECTION BETWEEN OUR HEALTH AND THE WAY WE GET AROUND
- HOW MUCH DOES THIS SOFA COST? 75 billion 1/3 of the cases of America's top 10 killers result from physical inactivity. 1/3 OF COLON CANCERS, 1/3 OF POSTMENOPAUSAL AND RECURRENT BREAST CANCERS, ESOPHAGEAL AND PANCREATIC CANCERS 1/3 OF HEART DISEASE AND DIABETES CASES PREVENTABLE BY PHYSICAL ACTIVITY American Society of Clinical Oncology: In the United States, 1 in 3 cancer deaths is related to obesity, poor nutrition, or physical inactivity. "It's untenable to think that we can treat our way out of the cancer problem...”.Christopher Wild, MD, director of the IARC
- As we go upstream, its getting harder to breathe. The motors which drive us around and the power plants powering our electronic gadgets are polluting the air. 45% of Americans live in areas where air does not meet EPA air quality standards.. Air polluted by these sources also contains carcinogens and endocrine disruptors and chemicals causing birth defects.
- As we go upstream, its also getting warmer.
- Warmer summer days increase deaths among elderly with chronic diseases like asthma, diabetes, heart disease. For every ten degrees over average T, deaths increase 5%. Deaths of children from vehicular heat stroke have more than doubled in recent decades, and rates of heat stroke/exhaustion in hs athletes are at an all time high. Studies show a reliable link between increased temperature and rates of domestic violence, murder, assault, and intergroup violence
- Warmer temperatures are driving increased transmission of infectious diseases like dengue fever and west nile virus.
- Climate change increases air pollution. Dust storms in the drought stricken SW have caused a 10fold increase in Valley Fever. pollen counts have doubled, pediatric asthma rates tripled, wildfires increased 4 fold, making rural air as bad as Beijing. Summertime ozone levels are rising in our cities.
- We've had substantial crop losses due to drought, hail, and floods, with resulting increase in food prices. Fungal toxins on land contaminate grain crops while shellfish build up dangerous levels of toxins from marine algae.
- named climate change the greatest threat to US national security in the Pacific Theater. Military speaks of climate change as a “threat multiplier”
- Lets go a bit further upstream to see what's causing these changes in climate
- Air pollution includes Carbon pollution, the #1 human contribution to climate change.
- Next we have Methane .The largest amount of which comes from fossil fuel. . The next largest source are animals we raise for meat and dairy, with each cow producing over 1000 liters/d. The next largest after that is decay of wasted food in landfills
- Nitrous oxide is the third largest contributor to climate change. By far the largest source is synthetic fertilizer, with the highest fertilizer application rates going onto crops grown for animal feed. This is not necessary to feed the world. Numerous studies show that here and in developing countries, sustainable farming practices produce equal or better yields while adding carbon back into the soil
- Whats this, more extreme weather? Its the SILVER TSUNAMI, a giant wave of aging hippies threatening to engulf our health care system. These people are not only more likely to have DM, CVD, cancer, and respiratory diseases. They're also more susceptible to health effects of air pollution/climate change to make this a perfect storm, we've also got the SILVER STETHOSCOPEs. HALF OF US DOCTORS ARE OVER 50 and will retire in the next 10 years. Projected health workforce shortage 90,000 mds by 2020, 135,000 by 2030. So in case you thought we'd just take care of you if you get sick, NEWSFLASH: WE CAN'T. Christopher Wild, Intl Agency for Research on Cancer: "It's untenable to think we can treat our way out” PREVENTION IS THE ONLY OPTION.
- And all of these factors interact. This is Spaghetti Junction in Atlanta. Its a good description of how All the different factors we've discussed can exacerbate each other. Heat and wildfire smoke worsen air pollution, which raises blood sugar and heart disease especially in people on high fat/high meat diets.
- WE'VE MADE IT ALL THE WAY UPSTREAM TO THE HEADWATERS.
- We've got the remedy.
- Let me take a minute to explain what kind of prescription this is. Its not us telling you what To do. Why can't we just go back to our offices and tell our patients to eat veggies and get some exercise? Lets take a survey: How many of you have ever not done what your doctor told you to do? How many ever did what doctor told you not to do? 1) Doesn't work. Nonadherence to medication 50%, lifestyle 70%. 2) Because its not treating the problem. When everyone gets same kind of sick at same time, its because something in their environment is the cause. With our excessive focus on high tech medical miracles we tend to forget how much environment determines health. Of the 30 year increase in life expectancy gained in the last century, only 5 of those extra years came from advances in medicine. Our environment, not just the air but our food environment and our built environment, has more effect on health than almost anything except smoking. Dr Tom Frieden, head of CDC: "longevity and health are more determined by your ZIP code than they are by your genetic code,"
- HOW DO WE FIX THE ENVIRONMENT? JOHN SNOW CHOLERA EPIDEMIC IN LONDON. MAPPED WHERE CHOLERA PATIENTS LIVED AND NARROWED SOURCE DOWN TO A WATERPUMP. DID HE GO AROUND THE NEIGHBORHOOD TELLING EVERYONE NOT TO DRINK WATER? HE WENT TO HIS LOCAL GOVERNMENT AND (not without a struggle) GOT THEM TO TAKE THE HANDLE OFF THE PUMP. “The pestilence was stayed.” Public health problems need public health policy solutions. HOW ARE WE GOING TO TAKE THE HANDLE OFF THE FUEL PUMP, THE SOFT DRINK DISPENSER, and the BARCALOUNGER?
- To stop air pollution and global warming we need to stop burning fuel. We have wind and solar resources to create 10 times more electricity than we use STRATEGY CHANGE from All of the Above, to Leave it All Below, 2/3 OF KNOWN RESERVES HAVE TO STAY UNDERGROUND. No mining drilling on public lands No exports
- Natural Experiments: Atlanta Olympics- traffic decreased 20%, ozone decreased almost 30%, and kids ER visits for asthma down over 40%. Dublin banned coal, CV deaths dropped 10%
- MODERNIZE OUR OUTDATED TRANSPORTATION SYSTEM, BRING AMERICAN CITIES INTO THE 21ST CENTURY, GET CITY PEOPLE OUT OF THEIR CARS People who live in compact connected cities with walkable neighborhoods, and good public transit- walk more, weigh less, have less diabetes, lower blood pressure, and live longer than people who live in areas with sprawl. They spend a lower percentage of income on housing/transportation combined, and have higher rates of economic mobility (moving from poverty to middle class). We need to spend more
- Increased average daily time spent on active transport 18 minutes/d SF bay area Decrease everything from diabetes to depression and dementia Midwestern metrop areas- 50% short trips by bike save over $5 billion in health spending per year: $3.8 billion/year saved due to health benefits of exercise and $2.5 billion due to benefits of cleaner air.
- TO DEVELOP SUSTAINABLE FOOD SYSTEMS, WE HAVE TO PUT OUR MONEY WHERE OUR MOUTH IS. Nutritionally in the US we get what we pay for. CORN- 40% ethanol, 36% feed, most of rest is exported. Rest used for corn syrup. Even with changes to Farm bill, Farmers make more money from growing corn fencepost to fencepost than by putting land into conservation or diversifying their crops. Inefficiencies of feed vs food, productivity in consumable calories per acre in US is lower than Bangladesh. Lower price increases veg consumption. Align subsidies with federal dietary recommendations. 84% of US adults favor govt action to decrease heart disease and decrease prices of fruits and vegetables.
- Heavy meat eaters eat an avg 700 cal more/d A recent study shows that consuming 5 servings of veg/d Decreases cancers by 25%, heart disease by 20%, diabetes 25%.
- YOU ARE LEADERS IN YOUR COMMUNITY. TO A LARGE EXTENT THE FUTURE IS IN YOUR HANDS. I'VE SHOWN YOU WHAT'S UPSTREAM AND WHERE WE'RE HEADED DOWNSTREAM IF WE DON'T CORRECT OUR COURSE. When it comes to public health we are on a LONG AND SLOW MOVING RIVER. What we do and the decisions we make as a country in the next FEW years will determine the downstream future for generations to come.
- WE NEED LEADERS WITH VISION, not distracted by big dollars from short sighted industries, WHO UNDERSTAND THAT TODAY'S UPSTREAM IS TOMORROW'S FUTURE
- We can beat BIG OIL if we get that silent majority, our neighbors and colleagues, to speak up and demand healthy decisions. A recent poll showed that 1 out of 4 citizens are willing to participate in a campaign to push elected officials for healthy climate policy. They're waiting for respected people in their communities to step forward and begin. You've seen the problems and the common sense solutions.
- Really folks, I speak not just for myself but my colleagues when I say we would much rather see you HERE than in our hospitals and clinics. Please speak out to support policy for healthy communities and help guide our country safely downstream.