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Environmental Degradation and Social Injustice

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Environmental Degradation and Social Injustice Powered By Docstoc
					   Health Consequences of
Environmental Degradation and
       Social Injustice


    Martin Donohoe, M.D., F.A.C.P.
             Am I Stoned?
A 1999 Utah anti-drug pamphlet warns:
     “Danger signs that your child may be
 smoking marijuana include excessive
 preoccupation with social causes, race
 relations, and environmental issues”
Our Home
Portland, Oregon
  Mount Hood
Multnomah Falls, Oregon
           The Environment
 The   natural environment

 The   built environment

 The   social environment
             Causes of
     Environmental Degradation

   Overpopulation
   Pollution
   Deforestation
   Global Warming
   Agricultural/Fishing Practices
   Overconsumption / Affluenza
   Militarization
                Causes of
        Environmental Degradation
   Maldistribution of Wealth
   National and Global Political and Economic
    Institutions
   Poor education
   Media manipulation and inaccurate reporting
   Unbalanced political influence
   Citizen apathy
             Consequences of
        Environmental Degradation
   Increased poverty and overcrowding
   Famine
   Weather extremes
   Species loss
   Medical illnesses
   Infectious diseases
         Consequences of
    Environmental Degradation
 Death (40% of world’s yearly deaths linked to
  water, air, and soil pollution)
 War

 Ecological footprint (22 hectares/person)
  exceeds Earth’s biological capacity (16
  hectares/person)
 Malthusian chaos and disaster

 Tragedy of the Commons
 Economic Costs of Environmental
           Diseases
 Estimated  at $132-165 billion/year in
 the U.S. alone ($1.25-$2.0 billion in
 Oregon)
   Does not count the psychological
    and emotional costs of the human
    suffering involved for the victims,
    their families, and their communities
    Economic Costs of Environmental
          Diseases: Oregon
   Adult and childhood asthma: $30 million
   Childhood asthma: $28 million
   Adult cardiovascular disease: $342 million
   Childhood cancer: $9 million
   Childhood lead exposure: $878 million
   Birth defects: $3 million
   Neurobehavioral disorders: $187 million
                    Source: OEC, The Price of Pollution, 2/08
                   Overpopulation
   World population - exponential growth
     1 billion in 1800
     2.5 billion in 1950

     6 billion in 2000

     6.7 billion in 2008

     est. 8 billion by 2050

   More people added to the planet in the last 40 years
    than in all previous recorded history
            Overpopulation
 Africa, Asia, and Latin America primarily
  affected
 Causes:

    Poverty

    Women’s rights issues
World Population
                 Overpopulation

   Urbanization
     20-30   million people/year leave rural for urban
      areas
     2007: first time in history that more than half the
      world’s population live in urban areas
   World migrant population = 200 million
    -economic, war and environmental refugees
           Urban Sprawl

 Since the 1960’s America’s
  metropolitan areas have been
  consuming land at a rate 4x faster
  that population growth
 6,000 acres of open space lost per
  day
         Wallace Stegner
“We simply need … wild country available
 to us, even if we never do more than
 drive to its edge and look in. For it can
 be a means of reassuring ourselves of
 our sanity as creatures, a part of the
 geography of hope”
Air Pollution
Air Pollution
                 Air Pollution
   Top ten most polluted cities in the world are in
    China and India
   World’s Most Polluted Places (2007):
     Sumgayit, Azerbaijan; Linfen, China;
      Tianying, China; Sukinda, India; Vapi, India;
      La Oroya, Peru; Dzerzhinsk, Russia; Norilsk,
      Russia; Chernobyl, Ukraine; and Kabwe,
      Zambia
                 Air Pollution
   Most polluted areas in US:
     2001 – LA

     2002 – Houston

     2003 – San Joaquin Valley in Central
      California
     2004, 2006 - 2008 – LA
  Health Effects of Air Pollution
 Causes approximately 60,000 -
 75,000 premature deaths/yr. in
 U.S. (656,000 in China)
  More  than are killed by auto
   accidents
 1.8   million worldwide
Health Effects of Air Pollution

   Air pollution causes asthma and impairs
    lung development and function
   Deaths from cardiopulmonary diseases
    correlate with air pollution levels in US
    cities
     Both   day to day and over time
    Health Effects of Air Pollution
 Increased admissions for CHF, asthma,
  COPD, PVD, and cerebrovascular disease
  (stroke and TIA)
 Increased lung cancer mortality

 Decreased exercise tolerance, increased
  pulmonary symptoms
    Health Effects of Air Pollution
   Increased risk of DVT
   Impaired sperm production
   Increase in SGA and LBW infants
   Increased risk of appendicitis
       ?Via link with inflammation?
   Increased numbers of migraines
            Air Pollution
 Coarse, fine and ultrafine particles
 Ultrafines not regulated, may be most
  dangerous
 Nanoparticles may contribute to health
  risks
   Effects of Ozone Destruction
 Ozone  hole over Antarctic (2½X size of
  Europe)
 Increased cataracts (UV damage)

 Increased lifetime melanoma risk

   1/1500 - 1930

   1/68 - today
Antarctic Ozone Hole
Automobiles
             Automobiles
 Number  of autos
 -US: 1 car/2 people
 -Mexico: 1/8
 -China: 1/100 (increasing)
 Global  auto population to double in 25-50
 years, from 622 million passenger vehicles
 in 2008
                 Automobiles
   Average miles traveled/car/year in U.S.
     1965 - 4,570 mi.

     1975 - 6,150 mi.

     1985 - 7,460 mi.

     1995 - 9,220 mi.

     2008 – 12,000 mi.
                 Automobiles
   Average fuel efficiency of U.S. autos stagnant
     Cars: 27.5 mpg required by 2011, 37.5 mpg
      required by 2015
     Light trucks / SUVs: 23.5 mpg by 2011, 28.6
      mpg by 2015
     European and Japanese standards higher

   Relatively low oil prices (until recently)
             Automobiles
 Growing market for low-efficiency
  pickups, minivans, and sport-utility
  vehicles
    SUVs 50% of all private vehicles

 Ford Model T – 25 mpg (1908); Avg. Ford
  vehicle – 22.6 mpg (2003)
     Automobiles: Alternatives
 Rapidtransit
 -industry squashed in 1930’s and 40’s (GM,
 Standard Oil, Firestone, etc.)
 -Convicted under Sherman Antitrust Act
         Automobiles: Alternatives
   Car sharing
   Pay-as-you-drive auto insurance
   “Peak Pricing” and “Congestion Fees”
       E.g., London → 21% decrease in traffic, 43%
        increase in bus ridership, cleaner air
   Bicycles/walking
       30% of all trips by bike in Amsterdam; 2% in
        Portland, OR
      Alternatives to Automobiles
   Busses

   Trains
     15 x more efficient per passenger than autos

     Amtrak receives 1/3 the amount of federal
      funding (adjusted for inflation) that it received
      20 years ago
       Automobiles: Alternatives

   Electric cars
    -killed by oil companies, automakers in early
    20th century
   Natural gas, gasohol, and biodiesel
     Beware  Jevon’s Paradox (Increased efficiency
      leading to increased overall energy consumption)
   Telecommuting
     Automobiles: Alternatives

 Solar   cars
 Hydrogen-powered      cars
   Byproduct     = water
   Problem:     Hydrogen production
   requires fossil fuels
US Energy Consumption by Fuel
   Oil – 41%
   Natural gas – 23%
   Coal – 22%
   Nuclear – 8%
   Hydroelectric – 1%
   Other Renewables – 5%
         U.S. Energy Sources for
               Electricity
   Coal – 50%
   Nuclear – 19%
   Gas – 19%
   Hydroelectric – 6%
   Oil – 3%
   Renewables – 2%
      Energy Spending/Research
   Federal funding for energy R&D (1974-
    2005, in 2005 dollars):
     $50 billion: nuclear
     $20 billion: fossil fuels
     $12 billion: renewable energy
     $12 billion: efficiency
    Petroleum Industry Profits
 Mergers squelch competition, drive up
  prices
 Record-breaking oil company profits in
  2006 and 2007
    Exxon: $39.5 billion in 2007
      Largest in U.S. history
      Exceeds GDP of 2/3 of world’s
       nations
Belridge, CA Oil Fields
  Edward Burtynsky
Nigerian Gas Flare
              Oil and War
 Countries that export oil are >40 times
  more likely to be engaged in civil war
  than those that do not
 Gulf Wars I and II

 The Future?
    Other Sources of Air Pollution
   Industry - #1
   Indoor combustion of coal and biomass (wood,
    charcoal, crop residues, and animal dung) for
    cooking, heating and food preservation
      Used by almost 3 billion people worldwide
      Associated with multiple pulmonary
       conditions
                Noise Pollution
   Common in inner cities, hospital wards
   Average sound level 72dB in hospital wards
       WHO recommends no more than 35dB
   Adverse health effects include increased risk of
    HTN, ischemic heart disease, delayed wound
    healing, aggressive behavior, need for psychiatric
    and pain medications, GERD symptoms,
    hearing loss in neonates, and increased rates of
    rehospitalization
Garbage
              Garbage

 98% of the country’s total refuse is
 industrial waste; 2% municipal
 waste
  Making 1 lb of sellable product
   generates avg. 32 lbs. of waste
                Garbage
 American   produce 4.5 lbs/d garbage
   Almost 1650 lbs/yr
   Only 1.5 lbs recycled

 Ina lifetime, the average American will
 throw away 6500 times his/her adult
 weight in garbage
       U.S. Garbage Composition
   Paper and Paperboard - 34%
   Yard Waste - 13%
   Food Waste - 12%
   Plastics - 12%
   Metals - 8%
   Glass - 6%
   Wood - 5%
             U.S. Recycling Rates
   Tires - 22%
   Plastic containers - 25%
   Overall plastics – 5%
   Glass containers - 28%
   Yard waste - 41%
   Paper and Paperboard - 52%
   Aluminum packaging - 54%
   Steel cans - 60%
   Auto batteries - 93%
               Garbage

 Landfills

 Incinerators

 Garbage     Exports
Toxins
                   Toxins
   6 trillion tons of over 85,000 chemicals
    produced annually
      2000-3000 new chemicals registered each
       year
      More than 90% have never been
       screened for toxicity
      Consequence of 1976 Toxic Substances
       Control Act
           Toxic Pollutants
 The   chemical industry is a $450 billion
  enterprise in the U.S. alone
 Chemical manufacturers are not
  required to prove safety
   The legal burden is on the
    government to prove that a product
    is dangerous
                Pesticides
 2.2 billion lbs/yr pesticides
    Including agricultural pesticides, wood
     preservatives, and disinfectants
    8.8 lbs/person/yr in US

 CA and NY are the only states currently
  tracking pesticide sales and use
                  Pesticides
 EPA: U.S. farm workers suffer up to 300,000
  pesticide-related acute illnesses and injuries per
  year
 NAS: Pesticides in food could cause up to 1
  million cancers in the current generation of
  Americans
   WHO: 1,000,000 people killed by
    pesticides over the last 6 years
               Pesticides
 Linked to autism, Parkinson’s Disease,
  diabetes, obesity (with prenatal exposure)
 Children living on or near farms score 5
  points lower on IQ tests and other mental
  and verbal tests
    May be due to pesticide exposure
Anthropological Study of Children Exposed
              to Pesticides




      Children from villages        Children from villages
   practicing organic agriculture   practicing non-organic
                                          agriculture
            Pesticides
     so, the EPA and NAS have
 Even
 OK’d human subject testing

 2008:USDA axes national survey
 charting pesticide use
Pesticides
                    Pesticides
   $2.4 billion worth of insecticides and fungicides
    sold to American farmers each year
   Pesticide runoff contributes to coastal dead
    zones
      Baltic Sea, Mouth of Mississippi in Gulf of
       Mexico
      Red tides
   Pesticides inhibit nitrogen fixation, decrease
    crop yields
                 Pesticides
   Evidence suggests that pesticides promote
    pests (vs. natural pesticides)
       30% of medieval crop harvests were
        destroyed by pests vs. 35-42% of
        current crop harvests
     Implies organic farming more cost-
      effective
                      Toxins
   Body burden of industrial chemicals, pollutants
    and pesticides high
      Environmental Working Group (2004)found
       287 pesticides, consumer product ingredients,
       and wastes from burning coal, gasoline, and
       garbage in umbilical cord blood
        Many other compounds not even tested; numbers
         undoubtedly higher
                 Toxins
 Fetuses and children most vulnerable
 Birth defects, learning disabilities
  increasing
    Toxins play important role

 UK Food Standards Agency has called for
  a phase out of 8 artificial dyes linked to
  hyperactivity in children
                Toxins and gender
   Sex ratio changing:
     Normal = 105 boys/girls born (skewed by early male
      mortality)
     Fewer boys being born in industrialized countries
          Other causes include obesity, older parental age, stress,
           fertility aides
          Situation far worse in Arctic

   Cryptorchidism increasing
       Risk factor for testicular cancer
   Micropenis, hypospadias increasing
         Phthalates/Bisphenol A
   Found in construction materials, clothing, toys,
    cosmetics, pills, added to PVCs in IV
    tubing/other plastics
   5 million metric tons consumed by industry per
    year (13% in the U.S.)
   Exxon Mobil and BASF dominate the market
         Phthalates/Bisphenol A
   Wal-Mart, Target, Toys ‘R’ Us phasing out, San
    Francisco, California, Europe, and Canada have
    banned phthalates
   Consumer Product Safety Commission reforms
    of 2008 will eliminate lead and phthalates from
    toys and children’s products
                     Phthalates
   90% of government-funded studies found
    adverse health effects
     vs.   0% of industry-funded studies
   Associated with:
     demasculinization and alterations in
      genitalia in male infants
     lower testosterone levels
     lower sperm counts in adults
     Phthalates/PVCs and Medical
                Devices
 EPA regulations weak, based on 50-year
  old study
 FDA has advised healthcare providers to
  use alternatives to DEHP-containing PVC
  medical devices, esp. in neonatal units
 Banned by EU, CA, and WA
     Federal   legislation pending
              Teflon (PFOA –
             perfluorooctanate)
   Non-stick material made by Dupont
   Chemicals released under high heat and when
    cookware damaged
   Exposure linked with cancer, birth defects, and
    liver damage
   Dupont hit with largest-ever civil penalty
    ($10.25 million) in 2006 for concealing health
    consequences and transmission from mother to
    fetus
     Toxic Pollutants – Economic
                Costs
   Americans pay more than $55 billion
    annually for direct medical expenses plus
    special schooling and long-term care for
    pediatric diseases caused by lead

   This excludes the greatest toxic pollutant -
    tobacco
                           Lead
   Affects brain development, associated with
    lower IQ
       No safe level for neurological development
   Levels between 4 and 10 significantly increase
    risk of cardio- and cerebrovascular disease
   Elevated levels associated with crime and violent
    behavior
       Pre-natal and post-natal exposure
                  Lead
      African-Americans, and
 Poor,
 Hispanics more commonly exposed

 Developing   world at risk
   Due to increased environmental
   exposure and, possibly, early umbilical
   cord clamping
                 Leaded Gasoline
   Banned in Canada in 1990, US in 1996 (after 25-
    year phase-out period), EU in 2002, Africa in
    2006
       Ban fought by industry for decades
   Many countries still sell leaded gasoline:
       Indonesia, Venezuela, North Korea, Iraq,
        Afghanistan, Jordan, Syria, Yemen
                       Mercury
   Released into air by coal combustion, industrial
    processes, mining, and waste disposal
       4500 tons/yr
   Travels throughout atmosphere and settles in
    oceans and waterways
   Bacteria convert it to toxic methyl-mercury
   Travels up food chain via fish
                 Mercury
 16% of women of childbearing age exceed
  the EPA’s “safe” mercury level
 Freshwater fish mercury levels too high for
  pregnant women to eat in 43 states
 Mercury dental amalgams pose health risks
  to pregnant women, unborn babies, and
  children (FDA)
                  Mercury
   New EPA ruling ineffective:
     Allows cap-and-trade of power plant
      emissions
     Removes power plants from list of
      pollution sources subject to federal
      Clean Air Act
                  Arsenic
   Contaminates groundwater in Bangladesh,
    also, India, China, Mexico, Argentina,
    Thailand, and parts of the U.S.
      13 million Americans have drinking
       water exceeding EPA’s “safe level”
      Exposure also via seafood
    Health Consequences of Arsenic Exposure

   Pigmentary skin changes
   Diabetes
   Increased risk of lung, bladder, and skin cancers

   Lead, mercury, or arsenic found in 1/5 of both
    U.S.- and India-manufactured Ayurvedic
    medicines purchased via the internet
              Manganese
 Welders exposed via fumes
 Causes “manganism” (like Parkinson’s
  Disease)
 Welding companies covered up link for
  decades (like lead paint, etc.)
              Cell phones
 ?Link to parotid gland tumors?
 ?Link to brain tumors?

    Gliomas?

    Acoustic neuromas?

 Precautionary principle – hands-free
  headset
    ?Other safety benefits?
            Toxic Pollutants
 85,000 known or suspected hazardous
  waste sites in the U.S.
    Plus up to 600,000 lightly contaminated
     former industrial sites (“brownfields”)
 Will cost hundreds of billions of dollars to
  mitigate environmental impacts
              Toxic Pollutants
1  in 4 U.S. citizens lives within 4 mile
 of a Superfund site (over 1600 sites
 listed; another 2,500 sites eligible)
  ½   live within 10 miles
 Taxpayerspaying increasing share of
 cleanup costs
   Overall   funding decreasing
       Environmental Racism
       and Toxic Imperialism
 Environmental Racism
   Waste dumps/incinerators more
    common in lower SES neighborhoods
   “Cancer Belt” (Baton Rogue to New
    Orleans)
   More cardiovascular disease

 Toxic Imperialism
           Toxic Pollutants:
        The Basel Convention
 The Basel Convention on the Control
  of Transboundary Movements of
  Hazardous Wastes (designed to
  control dumping of hazardous wastes
  from the industrialized world in
  developing countries)
             Toxic Pollutants:
           The Basel Convention
   Ratified by 170 countries

   Despite being the largest producer of toxic
    pollutants in the world, the U.S. has signed
    but not ratified this agreement
Bathtub, Toilet, and Source of Drinking
                 Water
 Persistent Organic Pollutants

 Toxic, remain in environment long-
  term, resist degradation, can travel long
  distances
 Bioaccumulate - higher concentrations
  as you move up the food chain
 Most are endocrine disruptors
  Persistent Organic Pollutants
 UN Environmental Program
 organizing worldwide phaseout of top
 12 through the Stockholm Convention
 on Persistent Organic Pollutants
   Including   DDT, PCBs, and dioxins
 U.S.   has signed, but not ratified
          Toxic Pollutants
 Floriculture

 Diamond  and Gold Mining
 Cosmetics (see
  www.safecosmetics.org)
 Nanoparticles
             Medical Waste

   The 6,000 US hospitals generate 2 million
    tons of waste per year; clinics and doctors’
    offices an additional 700,000 tons
    -850,000 tons incinerated
        -15% infectious waste
        -incinerated pollutants include dioxin,
    mercury, cadmium and lead
        -EPA regulations weak
        -segregation and alternatives to
    incineration would cost < $1/patient/day
           Medical Waste
 Solutions:

   80%  of thermometers no longer
    contain mercury
   Remove PVCs from medical
    supplies (e.g., IV tubing)
            Medical Waste
 Organizations:
    Health Care Without Harm

    Green Health Center Movement

 NAS: Hospitals built and operated on
  more environmentally sound principles
  save money and produce better patient
  outcomes
                 Electronic Waste
   Only 5-10% of computers recycled
   Most sent overseas
       Some returns to U.S. in children’s jewelry
   EU now requires electronics firms to recycle and
    to eliminate lead, cadmium and mercury from
    their products
   Maine passed first law requiring elctronic
    manufacturers to pay for recycling their
    discarded products
               Water
 UN adopted water as a human right in
 2002
  International Covenant on
   Economic, Social, and Cultural
   Rights
  US has signed but not ratified
                    Water
 Only 2.5% of the earth’s water is fresh
 2/3 of this locked up in glaciers and ice
  caps
    As glaciers and polar ice caps melt, this is
     mixed with sea water
                 Water
 U.S.  water consumption: 81%
  irrigation, 6% domestic use
 Worldwide freshwater supplies
  dwindling
    Drying up: Aral Sea, Great Lakes,
     etc.
               Water
 CleanWater Act of 1972 has
 decreased pollution in the US
  Under threat from the Bush
   Administration
  80% of US waterways never receive
   any comprehensive testing for
   pollutants
                     Water
   In developing countries, 90-95% of sewage and
    70% of industrial wastes are dumped untreated
    into the local water supply

   13,000-15,000 deaths per day worldwide from
    water-related diseases
                 Water
 Out  of 191 nations in the world, 10
  nations share 65% of the world’s
  annual water resources
 A woman in a developing country
  walks an average of 6 km/day to
  obtain water
                          Water
   Privatization schemes supported by the World
    Bank and IMF lead to price increases, worsen
    poverty
      5-10% of world’s water privatized - increasing
     Privatization increases costs, incites social unrest
      (e.g., Cochabamba, Bolivia)
     15% of US water in private hands
                   Water
 Bottled water a $400 billion/yr profit-
  driven industry
 Weaker standards, 1/3 is just tap water,
  dangers of plastics, energy costs/global
  warming, reduction of local water tables,
  recycling rate of plastic bottles only 25%
                      Water
 Ratio of amount of water needed to
  produce 1 plastic bottle to amount of water
  in the bottle = 2:1
 San Francisco has banned city purchases of
  bottled water
   Water expected to be the major cause of wars by
    2050 or sooner
    Water Pollution –
Increased Beach Closings
     Infamous Industrial Disasters
   Minimata, Japan, 1920s-1970s (Chisso Corporation) -
    methylmercury poisoning
        -400 dead; 10,000 injured
   Bhopal, India, 1984 (Union Carbide) - methyl
    isocyanate gas
     7000-10,000 dead within 3 days, 15,000-20,000 more over
      next 10 years; tens of thousands injured
     persistent water and soil contamination
     Indian government extradition request for Warren
      Anderson
Minimata Disease
  W Eugene Smith
     Infamous Industrial Disasters
   Chernobyl, USSR, 1986 - nuclear power plant
    explosion
    -25-100 dead, up to 1,000 injured acutely, NCI
    estimates 10-75K thyroid cancers
    -Higher risk of childhood leukemia among those
    living near nuclear power plants
   Alaska, Exxon Valdez, 1989 - oil spill
    -wildlife devastated, $5 billion damage
       Punitive damages overturned by U.S. Supreme Court
   2006 BP Alaskan pipeline ruptures
Oil Pollution is Expensive to Clean
                 Up
Oil Slicks Kill Marine Life
                    Deforestation
 Tropical forests constitute 7% of land surface
  area, contain > 50% of plant and animal species
 Majority of tropical forests destroyed

 One acre of world’s forest cut down every
  second
 50% of global wetlands destroyed (54% in U.S.)
     100,000   acres lost per year in U.S.
                    Deforestation
   Historical
    -Easter Island (Polynesians), Middle East, U.S. Southwest
    (Anasazi Indians)
   Contemporary
    -Mauritania, Ethiopia, Haiti deforested
    -Philippines and Thailand are now net importers of forest
    products, looking at Latin America
   Next?
    -Indonesia, Burma, Papua New Guinea, Russian Far East,
    Amazon, B.C., Alaska, many others
            Deforestation: Causes
   New agricultural settlements (overpopulation,
    poverty, unsustainable farming practices)
   Logging
   Oil and gas exploration
       Drilling in ANWR would drop gas prices 4 cents per
        gallon, after a 15 year waiting period, and assuming
        companies sell oil to U.S. consumers
   Cattle ranching
   Drug cultivation
    -Peru, Bolivia, Columbia
Clearcutting
Clearcutting
Clearcutting with Corridors
Global Warming
          Global Warming
 Greenhouse   effect
  30% increase in atmosphere CO2 since
   industrialization began (6.25 billion
   tons/year)
  Fossil Fuels (CO2)

  Methane, choloroflurocarbons, nitrous
   oxide, sulfur oxides
                Global Warming
   The last 20 years have been the hottest
    ever recorded (data go back to 1856)
     2007   hottest year on record
   Average global surface temperature =
    58.3°
     Hottest   temperature in last 10,000 years
   Pacific Northwest warming up faster than
    anywhere else on the planet
        Consequences of Global
              Warming
   160,000 deaths and 5.5 million disability-
    adjusted life years lost per year
      WHO, UN Environment Program
      Expected to double by 2020
      ↑ weather extremes/natural
       disasters/insurance claims
        $75   billion in 2007
     Floods,    cholera, rising malaria zone
    Consequences of Global Warming
   Polar icecaps/glaciers/Greenland ice
    sheet/permafrost melting, sea levels rising
      Artic ice pack has lost 40% of its thickness
       compared with 1960
      Glacier National Park’s glaciers melting

      Snows of Kilimanjaro down 85% compared
       to 1912; will be gone by 2015
Glaciers Calving
Polar Bears Stranded / Dying Off
Greenland’s Ice Cap Melting: 1992
Greenland’s Ice Cap Melting: 2002
Greenland’s Ice Cap Melting: 2005
        Consequences of Global
              Warming
   Increased allergies/asthma/anaphylaxis
      Rising temperatures increase
       smog/ground level ozone
      Ozone stunts plant growth

      Higher levels of CO2 favor growth of
       ragweed and other pollen-producing
       plants
           Global Warming
 The top 1/5 of the world’s largest 145
  countries account for 63% of global C02
  emissions (lowest 1/5 = 2%)
 The countries likely to be most affected by
  global warming are those least responsible
  for the increases in global temperature
Global Warming Increases Droughts
                     Agriculture
   Soil erosion exceeds soil formation
      In the past 40 years, 1/3 of U.S. topsoil has eroded
      Takes 1,000 years to “grow” 1 inch of soil

   Livestock responsible for more greenhouse gas
    emissions than the entire transportation sector
     Methane,    CO2, and NO
     Grass-fed  cattle healthier, produce less methane,
      contain less saturated fat
                   Agriculture
   Water use has tripled since 1950, up 6-fold over
    20th Century
     70%   of freshwater use in agriculture
   Large scale irrigation projects
    (e.g., China’s Three Gorges Dam)
China’s Three Gorges Dam
                Wasted Food
   Household food waste adds up to $43 billion/yr
    in the U.S.
   An average American family of four tosses out
    $590/yr food
   Americans discarded 3 times as much food in
    2005 as in 1985
         Decreasing crop diversity
   75,000 plant species are edible
   Humans have utilized 7000 plant species for food
   20% of species provide 80% of the world’s food
   Consequences: decreasing genetic diversity, vulnerability
    to disease, huge crop losses (e.g., Irish potato famine)
               Factory Farming
   Factory farms have replaced industrial
    factories as the # 1 polluters of American
    waterways
   1.4 billion tons animal waste generated/yr
      130 x human waste
      1 hog farm in NC generates as much
       sewage annualy as all of Manhattan
Factory Farming
Factory Farming
            Factory Farm Waste
   Most untreated
   Ferments in open pools
   Seeps into local water supply, estuaries
      Kills fish

      Causes human infections - e.g., Pfisteria
       pescii, Chesapeake Bay
   Creates unbearable stench
   Widely disseminated by floods/hurricanes
       Agricultural Antibiotic Use

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

     Use   up 50% over the last 15 years
        Antibiotic Resistant Pathogens
   CDC: “Antibiotic use in food animals is the
    dominant source of antibiotic resistance
    among food-borne pathogens.”

   $4billion/yr to treat antibiotic-resistant
    infections in humans
     Campylobacter fluoroquinolone resistance
     VREF (poss. due to avoparcin use in chickens)
        Alternatives to Agricultural
              Antibiotic Use
   Decrease overcrowding
   Better diet/sanitation/living conditions
   Control heat stress
   Vaccination
   Increased use of bacterial cultures and
    specific antibiotic treatment in animals
    when indicated
     Ending Agricultural Antibiotic Use
   EU bans use of all antibiotic growth promoters
    effective 1/1/06
   Three years after a Danish ban on routine use of
    antibiotics in chicken farming, the prevalence of
    antibiotic-resistant bacteria in chickens dropped
    from 82% to 12%
   US Preservation of Antibiotics for Medical
    Treatment Act, 2007 – awaiting vote
                     Overfishing
   Fisheries collapsing:
     Newfoundland   cod
     West Coast salmon

   1/3 of fish species threatened with extinction
     90%   drop in # of largest predatory ocean fish since
      1950
     Global fisheries collapse predicted by 2048 unless
      practices change
   Large amounts of bycatch discarded
   Harmful Fishing Practices
 Long-lining,   large factory trawlers, drift
  nets
 Cyanide fishing (400 kg/year)

 Dynamite Reef fishing
Factory Trawlers
Dynamite Reef Fishing
     The Military Harms Fish
 Environmental destruction
 Navy sonar harming/killing off whales
    Japanese/Norwegian whaling
     compounds problem
 Dolphins as mine detectors (in Vietnam
  and Iraq)
 Weaponizing sharks, dolphins, etc.
  (DARPA)
                  Coral Reefs
   Generate $30 billion/yr globally in fishing,
    tourism, and protection from storm surges
   Reefs make up 1% of ocean floor, support ¼ of
    all marine life
   Threatened by bleaching due to rising ocean
    temperature, acidification from increased CO2,
    runoffs from deforestation, pesticides
                      Coral Reefs
   10% of world’s reefs ruined (90% in
    Philippines), 30% in critical condition
   Jellyfish populations burgeoning (“cockroaches
    of the sea”)
   Americans purchase 350,000 pieces of live coral
    broken off from reefs per year
       vs. 90,000 for the rest of the world
           Aquaculture

 27-33% of fish now consumed is
 farmed (vs. 4% in 1970)
  Almost all catfish and trout

  1/2 of shrimp

  1/3 of salmon
                     Aquaculture
   Consequences
       decreased diversity
       antibiotics (incl. chloramphenicol), hormones, dyes,
        herbicides, pesticides, algicides → increased
        pollution and sewage
       damage to local estuaries, birds of prey
       disease
                     Aquaculture
   Good seafood (clean water):
       Clams
       Mussels
       Oysters
       scallops
   Bad seafood
       Farmed salmon contains 10X as much PCBs as wild salmon
    Maldistribution of Wealth

 500   billionaires worldwide
   top 250 billionaires worth $1 trillion,
   the combined income of bottom 2.5
   billion people (45% of world’s
   population)
    Maldistribution of Wealth

 U.S:Richest 1% of the population
 owns 50% of the country’s wealth
 -poorest 90% own 30%
 -widest gap of any industrialized
 nation
             The Stock Market
   20% of Americans own stock; 90% of stock
    owned by 10% (50% by 1%)
     “Business”   news
   As a group, U.S. Senators beat the market by an
    average of 12% from 1993-98 (study published
    2004)
      The best fund managers average 3%
     Maldistribution of wealth
 The worldwide gap between rich and
  poor doubled between 1960 and 1990,
  and grew an additional 20% between
  1990 and 1998
 This gap is higher in the U.S. than in
  any other industrialized nation
   Maldistribution of wealth
 Less than 4% of the combined wealth of the
 225 richest individuals in the world would pay
 for ongoing access to basic education, health
 care (including reproductive health care),
 adequate food, safe water, and adequate
 sanitation for all humans (UNDP)
       George Orwell

“Some people are more equal
       than others”
  Maldistribution of Wealth/Resources
Threatens National Security and Requires a
        Permanent War Economy
   “The U.S. has about 50% of the world’s wealth, but
    only 6.3% of its population. This situation cannot
    fail to be the object of envy and resentment. Our
    real task in the coming period is to devise a pattern
    of relationships which will permit us to maintain this
    position of disparity withoug positive detriment to
    our national security.”
       George Kennan, U.S. State Dept. Policy Planning Study,
        1948
           Voltaire


“The comfort of the rich rests
upon an abundance of the poor”
             Primo Levi
“A country is considered the more
 civilized the more the wisdom and
 efficiency of its laws hinder a weak
 man from becoming too weak or a
 powerful one too powerful.”
    Racial Disparities: Economic
 Income disparities
    Median income of black U.S. families as
     a percent of white U.S. families = 60%
     in in 1968; 58% in 2002
 Educational disparities

 Higher levels of unemployment
    Racial Disparities: Economic
 Criminal justice system involvement
 Toxic waste sitings / environmental
  injustice / environmental racism
 Persistent overt / subtle discrimination

    E.g., “driving while black”
    Racial Disparities: Health Care
 Higher maternal and infant mortality
 Higher death rates for most diseases

 Shorter life expectancies

 Less health insurance

 Fewer diagnostic tests / therapeutic
  procedures
        Income Inequality Kills
 Higher income inequality is associated with
  increased mortality at all per capita income
  levels
 Equalizing the mortality rates of whites
  and African-Americans would have averted
  686,202 deaths between 1991 and 2000
     Whereas   medical advances averted 176,633
     deaths
       AJPH   2004;94:2078-2081
    Overconsumption (Affluenza)
   U.S. = 6.3% of world’s population
     Own   50% of the world’s wealth
   U.S. responsible for:
    -25% of world’s energy consumption
    -33% of paper use
    -72% of hazardous waste production
     (1 ton/person/year)
           But are we happier?

   Workloads increasing, vacation and free time
    decreasing
      Average American wastes 62 hrs/yr sitting in
       rush hour traffic
      Average American working 200 more hrs/yr than
       in 1960 (#1 in world)
      8/10 Americans want a new job
       (CNNMoney.com, 11/03)
   Stress up / satisfaction with life down
      Erosion of social capital
 Erosion of social capital is strongest where
  maldistribution of wealth is largest
 Americans have an average of 2 close
  friends today
    Down from 3 in 1985
         Erosion of social capital
   1 in 4 Americans say they have no one with
    whom they can discuss important matters
     Includes nuclear family
     Was 1 in 8 in 1985

   “Most people can be trusted”
     1960: agree = 58%
     1994: agree = 37%
       Maldistribution of Wealth
 In countries with moderate levels of
 wealth, happiness is highest where
 income inequalities lowest
   Major League Baseball: teams are
    more successful when players’
    salaries are more equitably
    distributed
      The Booming Economy
                  net worth of the
 Inflation-adjusted
 median U.S. household
  1989 - $54,600

  1997 - $49,000

  2004 - $44,389
      The Booming Economy
 Weekly wages for the avg. American
  worker are 12% below what they were in
  1973
 But productivity is up 33%

 $1.5 trillion needed to repair nation’s
  infrastructure
             Vacation Time Down
   Americans work more than any other country:
    1970 hrs/yr
     Canada (#2): 1800 hrs/yr
     Industrialized EU countries: 1600-1800 hrs/yr

   Americans take less than 9/12 days of allotted
    leave per year
       Japanese alloted 18, Canadians 20, Germans 27,
        French 39
    Minimum Wage ≠ Living Wage
   Federal minimum wage = $5.15/hr (no change
    over last 8 years)
       Oregon = $8.49/hr (2009)
     $10,300/yr  for full-time job
     Real value down 42% compared with 1968

     Inadequate to pay rent, buy food and clothing

        3 million homeless (13-17% of homeless
         adults work)
             Food Stamp Program
   Covers 26 million Americans
       35 million Americans (1/3 of them children) live in
        household that cannot consistently afford food)
   $1.05/person/meal
   5-year residency requirement for adult legal
    immigrants
      Undocumented immigrants not eligible

   Inadequate signup rates
    Minimum Wage ≠ Living Wage
   ¼ of US jobs pay less than a poverty-level
    income

   In 4 of the last 5 years, Congress granted
    itself a $5,000 cost of living salary increase
           Exorbitant CEO Pay
   CEO salaries up 500% since 1980
   The average CEO makes 350-400X the salary of
    the average U.S. worker (1960 - 41X; 1980 -
    42X)
     Mexico 45:1
     Britain 25:1

     Germany 11:1

     Japan 10:1
                  U.S. Debt
   US national debt $9.4 trillion in 2008
     Over $30,000 for every US citizen


   Personal savings down

   Annual bankruptcies up 40% between
    2007 and 2008
                    U.S. Debt
   Average household debt (for mortgages, car
    loans, credit cards and all other debt combined)
    = $112,043 in 2007
   Debt exacerbated by
     Predatory lending practices, sub-prime
      mortgage collapse
     Payday loans
     Rent-to-own companies
  Total Credit Card Debt Up
1990 - $243 billion
1997 - $560 billion
2002 - $1.5 trillion
2005 - $800 billion
2007 - $850 billion

 Average number of credit cards per U.S.
 household = 12.7
         Bankruptcies/Pensions
   Record 1.6 million bankruptcies in 2002
    ½  bankruptcies due to health care expenses
     exceed # of college graduates/year, # of
      persons diagnosed with cancer per year
     Bankruptcy “reform” bill grossly unfair

   Pensions in jeopardy
          from Defined Benefit Plans to Defined
     Shift
      Contribution Plans
       The “Global Economy”
   53 of the world’s 100 largest economies are
    private corporations; 47 are countries
      GM is larger than Denmark, Thailand,
       Hong Kong, and Turkey
      Wal-Mart is larger than Israel and Greece

      AT&T is larger than Malaysia and Ireland
          The “Global Economy”

   The combined revenues of GM and Ford
    exceed the combined GDP of all sub-
    Saharan Africa
   Combined sales of the top 6 Japanese
    companies are nearly equivalent to the
    combined GDP of all of South America
           Corporations

 Almost 6 million corporations
    ¼ non-profits

 500 companies control 70% of world
  trade
          Corporations
“The [only] social responsibility of
business is to increase its profits.”
                      - Milton Friedman
                 Corporations
   “Corporations [have] no moral conscience.
    [They] are designed by law, to be concerned only
    for their stockholders, and not, say, what are
    sometimes called their stakeholders, like the
    community or the work force…”
                                     -Noam Chomsky
            Corporations

 Internalize   profits

           health and
 Externalize
 environmental costs
       Corporate Taxation

 Nearly 1/3 of all large corporations
 (assets > $250 million or annual
 sales > $50 million) pay no annual
 income tax
        Corporate Taxation
 Corporations   shouldered over 30% of
  the nation’s tax burden in 1950 vs. 8%
  today
 Corporate taxes are at their lowest
  level since WW II
   Reasons for Inadequate Corporate
               Taxation
 Tax breaks, corporate welfare,
  corporation-friendly tax laws,
  loopholes, transferring assets overseas
 Cheating and under-payment common

 Offshore tax havens shelter capital
                  Corporate Crime
   Each year in America, we lose;
      $3.8 billion to burglary and robbery

      $100-$400 billion to health care fraud; $40 billion to auto
       repair fraud, $15 billion to securities fraud, etc.; the S and
       L fraud cost between $300 billion and $500 billion
   Fines meager, often considered a cost of doing business
   Corporate crime under-prosecuted, prosecutors under-
    funded
              Corporate Crime
   25% decrease in federal prosecutions of white
    collar crime, including corporate crime, since
    1999
   Increase in non-prosecution and deferred-
    prosecution agreements
   3/5 U.S. companies settling corporate crime
    cases illegally deduct some or all of the
    settlement to the IRS
                Unemployment
   9-12% unemployment rate
     True percentage likely higher
     Only 1/3 of the unemployed are eligible for
      unemployment insurance
     Women   slightly more likely to be unemployed
      than men
     Black women 2X white women

   Under-employment rate approximately 10%
    The Rise of the Permatemp
 Temporary agency workers
    1989 - 1.2 million

    1998 2.8 million

    2006 - est. 4.0 million

 Results: job insecurity, fewer benefits, no
  retirement savings, more uninsured, etc.
   Job Loss and The Decline of
               Labor
 12 million quality jobs lost in the
  U.S. between 1980 and 2005
 Free trade

 Expatriation of jobs

 40% of US jobs part-time or
  seasonal
     Job Loss and The Decline of
                Labor
   Labor union membership declining since 1950
      Now 12%:

         8% in private sector

         4% in public sector

   Employers generally anti-union
   Unionized workers earn more, have better
    health benefits, safer working conditions,
    retirement and disability portfolios
      Overseas Labor Markets
 Currently made overseas:
    83% of all garments sold in the U.S.
    90% of sporting goods
    93% of shoes
 Overseas factories often lack adequate
  occupational health and safety / pollution
  controls (e.g., maquiladoras)
       Worker Health and Safety
   ILO: 2.2 million die of work-related
    injuries and diseases worldwide each year
      Considered vast underestimate, due to
       poor reporting in many developing
       countries
                  Outsourcing
   2 million manufacturing jobs lost between 2001
    and 2003
   Over the last few years, compared to other
    firms, CEO compensation has increased five
    times faster at the 50 U.S. firms that do the most
    outsourcing of jobs
Asian Sweatshop
          The Global Workforce
   27 million enslaved laborers
     Slaveryoccurs in every country in Africa
      (Unicef)
   Over 250 million child laborers
     60%  exposed to hazardous conditions; 25%
      exposed to hazardous chemicals
     Violations of child labor laws common in U.S.
Child Labor
     Outsourcing the Government
   More than ½ of federal jobs now outsourced to
    private corporations
   More than ½ of contracts no-bid
   Threat to democracy
   Outsourcing of military
     Mercenaries
     Demoralizes troops
      The Third World Debt Crisis
   Over 40 of the poorest countries in Africa, Latin America, and
    Asia owe a total of almost $300 billion in foreign debt
      countries borrowed when loans cheap and easy to get

      money lent to corrupt/undemocratic governments during
       Cold War
      corruption

      world prices for main exports declined

      new loans (at higher interest rates) required to pay interest on
       debt
     The Third World Debt Crisis


   Creditors
     US, UK, Japan, France and Germany

     interest rates up to 20-22% in 1980’s
     The Third World Debt Crisis
   Each African child inherits approximately $379
    in debt at birth
       debt 100-200% of GDP for Tanzania, Zambia,
        Ethiopia, and others
   Live Aid (1985 raised $200 million)
       Equal to the amount all African countries pay back
        on foreign debts each week (in 2001)
  The Third World Debt Crisis
 Countries spend more each year
  repaying debt than on education and
  healthcare.
 Debt will never be paid off
                Effects of the
           Third World Debt Crisis
   Indebted countries drastically cut wages, which slows
    the economy and decreases purchases of U.S. imports
      makes U.S. jobs less secure

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

   Government price controls eliminated
      basic goods more expensive
              Effects of the
         Third World Debt Crisis
   Government spending on food, fuel and
    farming subsidies reduced
   Social service (healthcare/education) program
    spending cut
   Countries strip and sell their natural resources
      increased global pollution, etc.
Solution to the Third World Debt
              Crisis


      Debt forgiveness
                  Foreign Aid
   In total dollars: Japan #1, U.S. #2
      Even though the U.S. economy is more than twice
       the size of Japan’s
   As a % of GDP, U.S. ranks 21st among the world’s
    22 wealthiest nations
   More money flows out of developing countries in
    the form of interest payments, profits of foreign
    corporations, and clandestine investments in
    financial markets of rich countries than flows into
    them as loands, aid, and foreign direct investment
               Foreign Aid
 U.S. Aid: Over 1/3 military, 1/4 economic,
  1/3 for food and development
 Most U.S. aid benefits U.S. corporations, is
  spent on military, goes to Egypt, Israel,
  Turkey, Pakistan, and the Philippines
                     Foreign Aid
   Aid agencies often forced to buy from U.S.
    companies at inflated prices
      70% of aid effectively returned to U.S.

   Food aid inefficient, benefits large agribusiness
    at expense of local farmers/economies
       Takes $2 taxpayer money to generate $1 in food aid
               Foreign Aid
 0.9% of the total federal budget, 1.6% of
  the U.S. discretionary budget
 Yet 64% of Americans believed in a 1997
  poll that foreign aid was the largest federal
  expenditure
 On average, Americans think that 24% of
  the federal budget goes toward foreign aid
     U.S. Charitable Giving

 Approximately   $250 billion/year
   2.5% of income
  2.9% at height of Great Depression
           U.S. Charitable Giving
            by Income Bracket
   $15K and under: 26%
   $15K - $30K: 9%
   $30K - $50K: 5.3%
   $50K - $100K: 3.8%
   $100K - $200K: 3.0%
   $200K and over: 3.4%
      American Charitable Giving
   Religious Groups: 35%
   Education: 13%
   Multipurpose Foundations: 10%
   Social Services: 8%
   Health: 8%
   Arts and Culture: 6%
       American Charitable Giving
   Science: 5%
   Environment and Animals: 3%
   International Aid: 2%
   Other: 9%
    - Includes individual, corporate, foundation, and bequest donations
   Less than 10% goes to groups which directly help the
    poor
            The Gates Foundation
   Endowment of approximately $35 billion, with another
    $31 billion pledged by Buffett Foundation
   Donates 5% of its worth/yr, invests 95% (typical for
    charities)
   At least 41% of its assets invested in companies that
    counter the foundations charitable goals or socially
    concerned philosophy
       E.g., Oil and chemical companies, agrobusiness,
        pharmaceutical industry
       http://www.latimes.com/news/nationworld/nation/la-na-
        gatesx07jan07,0,6827615.story
    Distribution of federal income taxes - 2007

   Military: $558 billion
   Health: $428 billion
   Interest on debt: $399 billion
   Income security: $124 billion
   Education: $93 billion
   Veterans’ benefits and services: $69 billion
    Distribution of federal income taxes - 2007

   Nutrition: $54 billion
   Housing: $38 billion
   Natural resources and the environment: $31
    billion
   Job training: $6 billion
   Other: $255 billion
   The Military and Pollution

 World’s   single largest polluter

 6-10%   of global air pollution

 2-11%   of world raw material use
       The Military and Pollution
   97% of all high level and 78% of all low
    level nuclear waste
     1054 U.S. nuclear tests since 1940s, 331 in
      atmosphere
     104 U.S. nuclear reactors

     More than 210 million liters of radioactive
      and chemical waste stored at Hanford, WA
        Site   plagued by leaks
    The Military and Pollution
 Pentagon  generates 750,000 tons
  hazardous waste/year
 Numerous toxic waste sites

 Exempt from most environmental
  regulations
        The Military and Pollution
   “The more birds that the [Department of
    Defense] kill[s], the more enjoyment [people]
    will get from seeing the ones that remain: ‘Bird
    watchers get more enjoyment spotting a rare
    bird than they do spotting a common one.’”
       From a 2002 court summary of the U.S. Defense
        Department’s argument for exemption from the
        Migratory Bird Treaty Act of 1918
                 War and Peace
   World military budget = $1,232 billion in 2006
     228X what the UN spent on peacekeeping

   US:
     Largest military budget; largest arms supplier
        $32  billion in arms sales in 2008, up from $12
         billion in 2005
     Greatest   debtor to peacekeeping fund
The Military: Diversion of Resources
     Away from Health Care
 3 hours world arms spending = annual WHO
  budget
 1/2 day of world arms spending = full
  childhood immunizations for all world’s
  children
 3 days of U.S. military spending = amt. spent
  on health, education, and welfare for U.S.
  children in 1 year
    The Military: Diversion of Resources
     Away from Health Care and Other
             Scientific Projects
   3 weeks of world arms spending/yr. = primary
    health care for all in poor countries, incl. safe water
    and full immunizations
   25% of the world’s 2.5 million research scientists
    and engineers work entirely on military R and D
        Anthropologists co-opted under U.S. Army’s Human
         Terrain Team
   Iraq/Afghanistan war creating enormous U.S. debt
    / federal and state budgets strapped
War Deaths, 1945-2000
Arms Exports
Arms Imports
“Every gun that is made, every warship launched,
 every rocket fired, signifies in the final sense a
 theft from those who hunger and are not fed,
 those who are cold and not clothed.”

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

                       ~Dwight D. Eisenhower
                  Poverty and Hunger
   US: 13% of residents and 18% of children live in
    poverty
      Rates of poverty in Blacks and Hispanics = 2X
       Whites
      2008 federal poverty level = $10,400 gross annual
       income (individual); $21,200 for family of 4
   Hunger rate increasing nationally
   Poverty associated with worse physical and mental
    health
Poverty, Health Insurance, and Food
        Insecurity in Oregon
 Poverty 12.9% (2007)
 Between 2006 and 2007, 17.3% lacked
  health insurance for a year or more
   Including 103,000 children

 Food insecurity 9.4% (2007)
                    Poverty
 At least 1 billion people live in urban slums
 1.1 billion people lack access to safe, clean
  drinking water
  -1.8 million child deaths/year
 2 billion have no electricity

 2.6 billion do not have adequate sanitation
  services
                  Poverty
 2.8 billion live on less than $2/day
 3 billion have never made a phone call

 3.8 billion have no cash or credit with
  which to make purchases
 770 million unable to read

 2006: net transfer of capital of $784 billion
  from poorer countries to rich ones
Human Poverty
Poverty
Poverty, Hunger, and Micronutrients
   Cost of providing vitamin A and zinc
    supplements to malnourished infants and
    toddlers under age 2 = $60 million/year
       Benefits (including prevention of blindness and
        malnutrition) > $1 billion/yr
   Cost of providing iron and iodized salt = $286
    million/year
       Benefits (including prevention of iron-deficiency
        anemia, cretinism) = $2.7 billion/yr
           Poverty and Priorities
   Amount of money needed each year (in addition
    to current expenditures) to provide water and
    sanitation for all people in developing nations =
    $9 billion
   Amount of money spent annually on cosmetics
    in the U.S. = $8 billion
          Poverty and Priorities
   Amount of money needed each year ( in
    addition to current expenditures) to provide
    reproductive health care for all women in
    developing countries = $12 billion
   Amount of money spent annually on perfumes
    in Europe and the U.S. = $12 billion
           Poverty and Priorities
   In 2006, Americans spent $31 billion on toys
    and video games
      Almost as much as the rest of the world
       combined
         80% of U.S. toys made in China



   Consider alternate gifts, charitable donations
Toy Exports
Toy Imports
U.N. Declaration of Human Rights

“Everyone has the right to a standard
of living adequate for the health and
well-being of himself and of his family,
including food, clothing, housing and
medical care”
                 Famine
 1.5 billion not consuming enough calories
  to prevent stunted growth/other health
  risks
 Hunger kills 18,000 people per day, most
  under age 5
 Hunger-related causes kill as many people
  in 8 days as the atomic bomb killed at
  Hiroshima
                     Famine
   UN FAO: enough food produced daily to
    provide every living person with over 2700
    calories/day
   Diversion of food crops to biofuels contributing
    to rise in food prices
   One week of developed world farm subsidies =
    annual cost of food aid to solve world hunger
   Hunger: solution requires political will
         Feast and Famine
 For the first time in history, there are
 now an equal number of people – 1.1
 billion – who get too much to eat as
 those who don’t have enough to eat
Famine
Famine Affects the Old and Young
                Medical Care
   50% of global health care budget spent in the
    U.S.
   Currently only 10% of funding devoted to
    diseases affecting 90% of world’s population
   Per capita expenditure on health care:
      U.S. = $4,000

      Typical poor African/Asian country = $5-10
                 Medical Care
   Even so, U.S. has 46 million uninsured, ranks
    24th worldwide in overall population health as
    judged by disability-adjusted life expectancy and
    ranks 42nd in global life expectancy
      Lack of universal health care limits workforce
       mobility
      2008 study: 7% say they or a family member
       has married in order to get health insurance
 Headline from The Onion


  Uninsured Man Hopes His
Symptoms Diagnosed This Week
          On House
             Infectious Diseases
   Increased morbidity and mortality due to
    changing distributions of disease vectors,
    reservoirs, and agents
    -overpopulation and population shifts
    -malnutrition
    -drought
    -decreased immunity
                Infectious Diseases
   Malaria
    -610 min zone expands
    -50-80 million additional cases/year by 2100
   TB
   Viral encephalitis
   Schistosomiasis
   AIDS
   Influenza
   Trypanosomiasis
             Infectious Diseases
   Onchocerciasis
   Dengre
   Leishmanasis
   Rabies
   Hookworm
   Yellow fever
   West Nile Virus
                  HIV/AIDS
   2008: 33 million infected
   2007: 2 million deaths
   Sub-Saharan Africa hardest hit
   Only 20% of HIV+ individuals in low and
    middle-income countries know they are infected
   Less than 1/3 of those needing therapy receive
    any medication
HIV Prevalence
Malaria Deaths
              Species Loss
 Earth  contains an estimated 5 to 10 million
  species
   Only 1.5 million have been identified

 Rate of extinction = 4,000-6,000
  species/year, highest estimates = 4
  species/hour
  - over 1000 x background rate of extinction
                   Species Loss
   50,000 vertebrates
    - 7,100 of 10,000 bird species threatened with
    extinction
    - 1/4 of 4,400 mammalian species
    - 1/2 of 232 primate species (including man?)
          bush meat trade contributing
    - 1/3 of 24,000 fish species
    - 30-50% of 10,300 reptile and amphibian species (may
    be higher, limited assessment)
   Almost ¾ of flowering plants at risk of extinction
Precipitous Decline of Alpha Predators will have enormous
        repercussions for ecosystems/other species
                  Species Loss
   More than 1600 animals on ES list today –
    many more at risk
     73%   of plants and animals that have gone
      extinct since 1973 were not listed
   Yangtze River dolphins extinct as of 2007
   Polar bears, Adelie penguins at risk of extinction
    due to global warming
             Causes of Species Loss
   Habitat loss (logging, overpopulation, etc.) *
   Overhunting
   Chemical pollution of environment
   Exotic species invasions (e.g. rabbits/Australia; role of
    ballast water, link of shipping with GDP):
       Cost = $1.4 trillion/yr (5% of global economy)


   HUMANS
    Extinction: Lost Pharmacopoeia
   Drugs from plants and native peoples’ health knowledge
    -More than 1/2 of the top 150 prescription drugs
    contain an active compound derived from or patterned
    after natural products
    -e.g. digoxin, vincristine, paralytic agents, etc.
   Of the more than 250,000 known flowering species,
    <0.5% have been surveyed for medicinal value
A Cure for Cancer?
        The Black Market in
        Endangered Animals
 $10 billion market
  -equal to smuggled arms market
  -less than contraband drug market ($30
  Billion)
 Convention on International Trade in
  Endangered Species (CITES)
         Worrisome Trends
 Environmental  Audit Laws
 Increased federal pre-emption of state
  laws
 WTO/World Bank/IMF Policies

 MAI
         Worrisome Trends
 GATT, NAFTA, CAFTA, other trade
  agreements
 Food Disparagement Laws

 SLAPP Lawsuits

 Corruption of judiciary by campaign
  contributions
    86% of US judges are elected
        Bush Administration
 Key administrators/committee
  members/regulators former industry
  representatives and/or lobbyists
 Corporate profit before public good

 Unsound/distorted/suppressed science
              Bush Administration
   Eco-harassment
     Criminalizing activists

   Rollbacks of key environmental laws
   Lax enforcement of existing laws
       OMB estimates annual benefits of major federal
        regulations between 1996 and 2006 = $99 billion -
        $484 billion, annual costs = $40 billion - $46 billion
   Huge tax cuts primarily benefit wealthy
       Status of Women in
         the Third World
 Poverty

 Impaired   access to employment and
  education
 Lack of reproductive health services,
  early childbearing, large families
          Status of Women in
            the Third World
 Political marginalization
 Discriminatory and “cultural practices”
    -forced prostitution, female genital
  mutilation, etc.
 Trafficking, sex slavery
                Status of Women
   Economic discrimination
     women do 67% of the world’s work
     receive 10% of global income

     own 1% of all property

   Poverty
       Women make up 45% of the global employed
        workforce, yet are 70% of the world’s poor
Would You Sign a Petition to Ban
    Dihydrogen Monoxide?
 1. It can cause excessive sweating and vomiting
 2. It is a major component in acid rain
 3. It can cause severe burns in its gaseous state
 4. It can kill you if accidentally inhaled
 5. It contributes to erosion
 6. It decreases effectiveness of automobile brakes
 7. It has been found in tumors of terminal cancer
   patients
          Geographic Ignorance
   Percent of US teens unable to locate the
    following on a map:
     United States – 11%
     Pacific Ocean – 29%

     Japan – 58%

     United Kingdom – 68%
       Pseudoscientific Beliefs

    Percentage of Americans who believe “at
    least to some degree” in these “phenomena”

                       1997            1976
 Astrology            37%             17%
 UFOs                 30%             24%
 Reincarnation        25%             9%
 Fortune-Telling      14%             4%
         Pseudoscientific Beliefs
   Half of US citizens do not believe in evolution
    and do believe that humans and dinosaurs
    coexisted (2007)
   37% believe places can be haunted (2007)
   25% believe in UFOs (2007)
   22% of Americans don’t know whether an
    atomic bomb has ever been dropped (2000)
         Pseudoscientific Beliefs
   20% of Americans don’t know the earth
    revolves around the sun (1999)
   18% believe in Bigfoot and the Loch Ness
    Monster (2007)
   8% of men / 18% of women believe in
    astrology and fortune tellers (2007)
                     Greenwash

   Public relations / ad campaigns
    -Chevron’s “People Do” Campaign, butterflies/refinery
    -BP invests $100 million annually in clean energy = amt. it
    spends annually to market its new name and environmentally-
    friendly image of moving “Beyond Petroleum”
    -Dupont Freon Campaign in 1970’s
    -Grants to a few scientists who challenge environmental
    warnings
    -tobacco ads in 1950’s
   Bluewash: association with UN principles/logo
                  Astroturf
   Artificially-created grassroots coalitions
     Utilize specially tailored mailing lists,
      field officers, telephone banks, fax
      machines, intense lobbying
     May be one or two individuals, or run by
      a PR firm, or have “volunteer” employee
      members
          Corporate Front Groups
   The American Council on Science and Health
   The Alliance for Responsible CFC Policy
   The Oregon Lands Coalition
   National Wilderness Institute
   The Environmental Conservation Organization
   The Foundation for Clean Air Progress

   Similar semantics for new laws/congressional bills
         Corporate PR tactics
 Invoke poor people as beneficiaries
 Characterize opposition as
  “technophobic,” anti-science,” and
  “against progress”
 Portray their products as environmentally
  beneficial in the absence of (or despite the)
  evidence
   Sponsored Environmental
     Educational Materials
 Corporate-sponsored   and
 supported by a loose coalition
 of antiregulatory zealots,
 corporate polluters, lapdog
 scientists and misguided parents
       Sponsored Environmental
     Education Materials (Examples)

   Exxon’s “Energy Cube”
    -“Gasoline is simply solar power hidden in
    decayed matter”
    -“Offshore drilling creates reefs for fish”
   Pacific Lumber Company
    -“The Great American Forest is. . . renewable
    forever”
      Sponsored Environmental
    Education Materials (Examples)
   International Paper
    -“Clearcutting promotes growth of trees that
    require full sunlight and allows efficient site
    preparation for the next crop”
   American Nuclear Society’s “Activities with
    the Atoms Family”
   Dow’s “Chemipalooza”
            Worrisome Trends
   Advertising Budgets ↑↑
     US now spends $250 billion/yr on advertising
     10% of a two-year olds nouns are brand
      names
   Public Education in disarray
     1/3 of America’s 80,000 schools need
      extensive repair or replacement
           Worrisome Trends
 Television
   Average American watches over 4 hours
    of TV daily
   TV sets now outnumber homes in
    America
 HigherEducation increasingly
 expensive
                   Academics at Risk
   Increasing corporatization of academia
       Private commercial funding of university research:
            $264 million in 1980
            $2 billion in 2001
   Secrecy/Pseudoscience
       AAPG Notable Achievement in Journalism prize to Michael
        Crichton for State of Fear (which denies global warming)
   Subversion of science by Bush Administration
   Brain drain
   Lack of scientists in developing world (1/50th of
    developed world per capita)
                  The Media

   Most media organizations owned by
    multinational, multi-billion dollar
    corporations that are involved in a number of
    businesses apart from the media, such as
    forestry, pulp and paper mills, defense, real
    estate, oil wells, agriculture, steel production,
    railways, and water and power utilities
    Global Warming: Controversial?
   Of 928 articles in peer-reviewed scientific journals, 0%
    were in doubt as to the existence or cause of global
    warming
   Of 636 articles in the popular press (NY Times,
    Washington Post, LA Times, WSJ), 53% expressed
    doubt as to the existence (and primary cause) of global
    warming
                                         Science 2004;306:1686-7
                                 (Study covers 1993-2003)
   IPCC / Al Gore share 2007 Nobel Peace Prize
                   The Media
   2005: 5 corporations control majority of US
    media (down from 50 in 1983
   Mass Media Sources, 2002:
      92% white

      85% male

      Where party affiliation identifiable, 75%
       Republican
      Predominantly conservative/centrist
                    Lobbying
   38,000 full-time lobbyists in Washington, DC
   Lobbying groups spent just under 2.5 billion in
    2006 (record)
   All single issue ideological groups
    combined (e.g., pro-choice, anti-abortion,
    feminist and consumer organizations,
    senior citizens, etc.) = $76.2 million
               Lobbying
 Agribusiness/oil industry lobbying dwarf
  environmental lobbying
 Active lobbying (new laws, not enforce
  existing laws or fund existing programs)
 “Lobbying for lethargy” (maintain status
  quo)
       Corporate Influence Leads to Large
    Taxpayer Subsidies to Polluting Industries

   Mining - $3.6 billion/yr
   Nuclear power - $10.5 billion/yr
   Coal - $8 billion/yr
   Ranching (grazing on public lands) - $52 million/yr
   Timber (below cost sales of national forest trees) –
    approx. $350 million/yr
   Oil and gas - $550 million/yr
    Privatization of Public Services
   Roads
   Public schools
   Child support enforcement
   Military
   Others

   Iraqi reconstruction, disaster capitalism
    The Decline of Democracy
 True democracy demands an informed
  citizenry (education), freedom of the press
  (media), and involvement (will, time,
  money)
 “Information is the currency of
  democracy”
    Thomas Jefferson
           Colonial Exploitation
   Cecil Rhodes (Rhodesia, Rhodes Scholarship,
    DeBeers Mining Company):
    “We must find new lands from which we can
    easily obtain raw materials and at the same time
    exploit the cheap slave labour that is available
    from the natives of the colonies. The colonies
    would also provide a dumping ground for the
    surplus goods produced in our factories.”
          Colonial Exploitation
   Winston Churchill (speaking in favor of
    RAF’s “experimental” bombing of Iraqis in
    1920s, which killed 9,000 people with 97
    tons of bombs):
    “I am strongly in favor of using poisoned
    gas against uncivilized tribes to spread a
    lively terror…against recalcitrant Arabs as
    an experiment”
          Colonial Exploitation
   Christopher Columbus’ log entry upon meeting
    the Arawaks of the Bahamas:
    “They…brought us…many…things…They
    willingly traded everything they owned…They
    do not bear arms…They would make fine
    servants…With fifty men we could subjugate
    them all and make them do whatever we want.”
          The US: Rogue Nation
   History: Native Americans, slavery, current
    excesses, disparities and injustices

   Co-opting Nazi and Japanese WWII scientists

   Minimum 277 troop deployments by the US in
    its 225+ year history
         The US: Rogue Nation
   Since the end of WWII, the US has bombed:
      China, Korea, Indonesia, Cuba, Guatemala,
       Congo, Peru, Vietnam, Laos, Cambodia,
       Nicaragua, El Salvador, Grenada, Libya,
       Panama, Afghanistan, Sudan, Yugoslavia, and
       Iraq
      The US: Rogue Nation
 Conservative   estimate = 8 million
  killed
 US invasions/bombings often largely
  at behest of corporate interests
 European colonial history similar
         The US: Rogue Nation
   The US spends vastly more on militarization
    than on peacemaking
   The US maintains military bases in 69
    “sovereign” nations around the world
   Continued funding of the Western Hemisphere
    Institute for Security Cooperation
            International Non-
         Cooperation/Isolationism
   Failure to sign or approve:
     Kyoto Protocol on Climate Change

     International Covenant on Economic, Social,
      and Cultural Rights
     Convention on the Prohibition of Anti-
      Personnel Land Mines
     Comprehensive Nuclear Test Ban Treaty
           International Non-
        Cooperation/Isolationism
   Failure to sign or approve:
     Convention on the Rights of the Child

     Convention on the Elimination of
      Discrimination Against Women
     Convention for the Suppression of
      Traffic in Persons
           International Non-
        Cooperation/Isolationism
   Failure to sign or approve:
     Protocol 1, Article 55 of the Geneva
      Conventions, which bans methods or
      means of warfare which are intended, or
      may be expected, to cause widespread,
      long-term and severe damage to the
      natural environment
            International Non-
         Cooperation/Isolationism
   Failure to sign or approve
     The Stockholm Convention on Persistent
      Organic Pollutants
     The Basel Convention on the Control of
      Transboundary Movements of Hazardous
      Wastes
     The Cartagena Protocol on Biosafety (re GM
      foods)
          The US: Rogue Nation
   Death Penalty:
     US executes more of its citizens than any other
      country
     US is the only country to execute both juveniles and
      the mentally ill
   Failure to follow World Court Decisions
   Largest debtor to the UN (only 40% of dues
    paid)
      The US: Rogue Nation
 PatriotAct, government spying,
  revocation of habeas corpus,
  presidential signing statements
 Cited by Human Rights Watch,
  Amnesty International for Human
  Rights Violations
                Positive Trends

   Majority of U.S. citizens rate the environment as one
    of the most important issues facing the country,
    think the government is doing too little to safeguard
    the environment, and favor environmental
    protection over economic expansion
   Power/voice of green groups increasing
   Involvement of religious groups growing
           Positive Trends
 Insurance  industry urging reductions in
  global emissions
   due to dramatic increase in weather-
    related claims
 Analogy with smoking
   The “Benefits” of Sterility-Causing
     Chemicals in the Workplace?
                                                             12 September 1977
Dr. Eula Bingham, Assistant Secretary for Occupational Safety and Health
      [Regarding] worker exposure to DBCP.
      While involuntary sterility caused by a manufactured chemical may be
bad, it is not necessarily so. After all, there are many people who are now
paying to have themselves sterilized to assure they will no longer be able to
become parents...
      If possible sterility is the main problem, couldn’t workers who were old
enough that they no longer wanted to have children accept such positions
voluntarily? Or…some [workers] might volunteer for such workposts as an
alternative to planned surgery for a vasectomy or tubal ligation, or as a means
of getting around religious bans on birth control when they want no more
children?
      Sincerely,
      Robert K. Phillips, National Peach Council
     Environmental Success Story
     The Montreal Protocol (1987)
   Phaseout of chlorofluorocarbons (CFCs) by
    1996
       CFC MDIs phased out in US by 2008
        (tetrafluoroethane or HFA = substitute)
   Major cause of Antarctic and Arctic ozone holes
       Should disappear by 2060
   Current substitute, HCFCs, much less damaging
    to ozone layer, also to be phased out
                    REACH
   Registration, Evaluation, and Authorization of
    Chemicals
   European Treaty requiring companies to test
    chemicals already on the market by a set
    timetable and test new products before putting
    them on the market
                    REACH
   Cost of evaluations < 1% of chemical industry’s
    total sales
   Economic analyses show REACH could bring
    environmental benefits worth €95 billion over
    the next 25 years and result in health cost
    savings of €50 billion over the next 30 years
             Solutions
Based on the Precautionary Principle
 “When evidence points toward the
 potential of an activity to cause significant,
 widespread or irreparable harm to public
 health or the environment, options for
 avoiding that harm should be examined
 and pursued, even though the harm is not
 yet fully understood or proven”
       The Precautionary Principle:
           Practical Essentials
   Give human and environmental health the
    benefit of doubt
   Include appropriate public participation in the
    discussion
   Gather unbiased, scientific, technological and
    socioeconomic information
   Consider less risky alternatives
    The Precautionary Principle
 Endorsed by APHA, ANA, CMA, others
 Puerto Rico, San Francisco have adopted,
  among others
 Big business, US Chamber of Commerce
  oppose
           Solutions
 Shift from a throw-away economy
  to a reduce/reuse/recycle
  economy
 Support local economies

 Rebuild decaying infrastructure

 Enhance fair trade policies
              Solutions
 Recognize  nature’s net worth
 Calculate economic prosperity based
  on Genuine Progress Index or Global
  Happiness Index, rather than Gross
  Domestic Product
              Solutions
 Decrease  energy consumption
 Zero waste production systems
 Extended producer responsibility /
  Extended product liability
 Production-side environmentalism
  (reducing “planned obsolescence”)
 Recycling laws
                 Solutions
 Restructure tax system
  -decrease taxes on work and savings
  -increase taxes on destructive activities
  (e.g., carbon emissions, toxic waste
  generation)
 Stronger clean air and water standards

 Drink tap water
               Solutions
 Eliminate  fossil fuel industry tax
  breaks and subsidies
 Carpooling
 Keep car longer
   > ½ of energy consumption
    attributable to vehicles occurs during
    manufacturing
                      Solutions
   Sweden plans to be world’s first oil-free
    economy by 2020
   EU to cut CO2 emissions 20% by 2020
       UK committed to 80% reduction by 2050
   California mandates 25% cut in global warming
    gasses by 2020
   Climate Security Act: weaknesses include unfair
    “cap and trade” provisions, carbon capture and
    storage (CCS)
                       Solutions
   Solar and wind power; appropriate biofuels (i.e.,
    cellulosic ethanol, algal bio-diesel; not food crops),
    not CCS (carbon capture and storage) or nuclear
       CCS raises specter of Lake Chad and Lake Monoun
        disasters
   Increase tax breaks, subsidies, research for renewable
    energy
      Renewable energy now 1% of transportation fuel
       market (ethanol) and 2% of the electricity market
       (wind, solar, biomass)
               Solutions
 Streamline EPA
  -25% of 14 billion superfund payouts have
  gone to lawyers and consultants
 Composting / Recycling organic wastes

 Safe disposal of pharmaceuticals

 Shift medical research agenda
                Solutions
 Decrease light pollution ($2 billion energy
  wasted per year) and see the stars!
  -Czechoslovakian anti-light pollution law
 Insulation

 Energy-efficient lighting

    Australia mandates use of compact
     fluorescent lightbulbs by 2012
               Solutions
 Decrease  excessive packaging
   15¢/plastic bag tax in Ireland ↓’d use by
    90%
   San Francisco, Canada, and China
    outlawing plastic bags
 Safe storage of nuclear wastes

 Green electricity - $3/month
                 Solutions
 Sustainable forest management
 Plant trees

    The average urban tree removes nearly
     one ton of greenhouse gas during its first
     40 years of life
 Stop receiving catalogues

    contact Direct Marketing Association
                        Solutions
   Prevent Congress from weakening NEPA
    (National Environmental Policy Act)
       Requires federal officials to conduct environmental
        impact assessments; allows citizens to challenge the
        government’s conclusions
   Oppose Congressional attempts to create
    “Sunset Commissions” with the power to review
    federal programs and recommend which
    programs live, die, or get realigned
                Solutions
 Punish environmental scofflaws with large
  fines and jail time
 Increase enforcement budgets to combat
  international environmental crime
 Establish International Court of the
  Environment
                           Solutions
   Bioprospecting
   Ecotourism
   More equitable distribution of medical research
    funds and health care dollars
     Worldwide
     In U.S.
           Every $1 invested in community-based programs to
            increase physical activity, improve nutrition, and prevent
            tobacco use saves $5.60 in health care costs
                    Solutions
   Federal Research Public Access Act
     Would   require federal agencies that fund over
      $100 million in external research/yr to make
      their study results publicly available on-line
     Currently before Congress
               Solutions
 Strengthen family planning programs
 Decrease “demand” for large families

     education

     status of women

     child mortality
    Solutions: Fair, Representative
               Elections
 Publicly financed campaigns and campaign
  finance reform
 Open debates, free air time for candidates

 Proportional representation

 Instant runoff voting/cumulative
  voting/range (rating) voting
              Solutions:
             Living Wage
 Over 140 municipalities have adopted
  living wage laws
    Including NY, LA, Chicago, and
     Philadelphia
 15 states now have minimum wages that
  exceed the federal requirement
                  Solutions
     and contribute to environmental
 Join
 and social justice groups (Greenpeace,
 Doctors without Borders)
   Local   grassroots groups especially good
 Land  purchases
 Litigation (e.g., EJLDF, NRDC)
               Solutions
 Green  investing
  -returns as good or better than the S &
  P 500
 Terror-free investing

 Celebrities/Jocks for Justice
                   Solutions
   Activism / Letter writing / Protesting /
    Whistleblowing
     US Supreme court ruled in 2006 that public
      employees have no free-speech rights re
      whistleblowing and no constitutional
      protections against retaliation by bosses
   Join community groups – become involved
    in local as well as national issues
           Günter Grass


“The first job of a citizen is to
 keep your mouth open.”
       Margaret Mead

“Never doubt that a small group
of thoughtful, committed
people can change the world.
Indeed, it is the only thing that
ever has."
          Solutions: Vote
 USvoter turnout low
  Wealthy vote at almost twice rate of
   poor
  Whites > Blacks > Hispanics

  Old > Young

  Property owners > Renters
Voter Turnout
             Solutions
 Campaign    finance reform
 Fair, representative elections

 Publicly financed campaigns

 Better candidates
               Solutions
 Increased exposure to nature
 Improvements in education
   Multidisciplinary
    Literature
    History
    Law
    Photography
    Community    Service
          The Role of Literature
   Vicarious experience
   Explore diverse philosophies
   Promotes empathy, critical thinking, flexibility,
    non-dogmatism, self-knowledge
   Encourages creative thinking
   Allows for group discussion/debate
            Why Use Literature
   Encourage appreciation of non-medical
    literature
   Develop reading, analytical, speaking and writing
    skills
   Promote ethical thinking (narrative ethics)
   Identification with authors who are health
    professionals (e.g., Keats, Chekhov, Maugham,
    Williams, Sanger, Nightingale, etc.)
                 Homelessness

Doris Lessing

“An Old Woman and Her Cat”

From the Doris Lessing Reader (New York: Knopf, 1988)
         Race and Access to Care
Ernest J Gaines

“The Sky is Gray”

in Gray, Marion Secundy, ed. Trials,Tribulations, and
   Celebrations: African American Perspectives on Health, Illness,
   Aging and Loss. Yarmouth, Maine: Intercultural Press, 1992
                             Poverty
   Orwell, George. How the Poor Die. In Sonia Orwell and Ian
    Angus, eds. The Collected Essays, Journalism and Letter of George
    Orwell, IV; In Front of Your Nose, 1945-1950. New York:
    Harcourt, Brace and World, Inc: pp.223-233.
   Checkhov, Anton. Letter to AF Koni, January 26, 1891,
    Letter to AS Survivor, March 9, 1890. In Norman Cousins,
  ed. The Physician in Literature Philadelphia: WB Saunders, 1982.
 Eighner, Lars. Phlebitis: At the Public Hospital. In
  Travels with Lizbeth. New York: St. Martin’s Press, 1993.
            “Activist” Journals
   American Journal of Public Health
   Public Citizen’s Health Letter
   PNHP Newsletter
   Mother Jones
   Harpers
   Z Magazine
   Hightower Lowdown
             “Activist” Journals
   Rachel’s Democracy and Health News
   Rachel’s Precaution Reporter
   Sierra
   The Amicus Journal
   Bulletin of Atomic Scientists
   Multinational Monitor
   Dollars and Sense
   Some articles in NEJM, JAMA, JGIM, SSM, Policy,
    Politics, and Nurs Prac, others
Contact Information and References


Public Health and Social Justice Website

        http://www.phsj.org
       martindonohoe@phsj.org

				
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