Monday, June 26, 2006

Thinking Globally

Blogging about health and healthcare, it's easy to focus on the microcosm, the minutiae of the lives and struggles right here on the urban streets of America. But amidst our struggles for the lives of our patients, we also must occasionally expand our focus outward towards the global issues affecting health and healthcare. The worldwide movements to eradicate AIDS, malaria and tuberculosis are high-profile issues which garner the celebrity power of Bill Gates and Bono to trumpet their cause. This is all well and good, and that trio of diseases is well deserving of our attention.

Tonight, on the way home from work, I was lucky enough to be listening to Fresh Air with Terri Gross on NPR. On this particular segment, Dr. Paul Epstein of the Center for Health and the Global Environment at Harvard Medical School was discussing his research findings indicating that global warming and climate change are having a more profound effect on public health than previously suspected. (You can listen to the interview here.)

Dr. Epstein postulates that the explosion of asthma and allergies around the world are seen to be directly related to global warming, as is the rising number of mosquitoes and insect-borne illnesses. around the world. We already know that the power and frequency of storms such as Katrina are said to be directly caused by climate change, but do any of us realize that desertification in Africa causes dust storms which travel across the Atlantic and cause exponential increases in asthma in previously unaffected children in Trinidad, and that mold spores in said dust from Africa infects Caribbean coral reefs and causes their disintegation? Do we also understand that airborne diesel fuel particles can increase the power of pollen to enter the lungs of poor urban populations who live along truck routes in our cities?

Some of this information is, sadly, not terribly surprising and seems to make sense in the sorry scheme of things. Those of us who work in urban centers already know that poor urban populations suffer more greatly from the effects of pollution, ground-level ozone (smog) and other poisons which disproportionately contaminate the air where the poor and working class live. What we may not also realize is that even affluent areas and places long considered to have healthy air are now no longer the bastions of oxygen and clarity that we once enjoyed. The air in the Caribbean, once considered a place where the wealthy could travel for their health, is now seeing pollution and ozone rates like never before.

With the release of Al Gore's new documentary, An Inconvenient Truth, perhaps a quantum leap forward will be engendered worldwide, and massive lifestyle change and sociopolitical shifts of consciousness will begin to take place on a global scale, and the powers that be which hold the purse-strings of the world economy will step up to the plate and abandon the pursuit of profit which has, to a large extent, fueled (no pun intended) the imminent demise of our planet as we know it. Then again, perhaps not, and the voices in the wilderness will continue to cry out as the asthma rates sky-rocket and desertification drastically decreases our ability to feed the hungry with our ever-diminishing amount of viable topsoil.

So, is global warming a public health issue? What has the power to convince us? Is it increased rates of asthma and environmental allergies? Is it decreased food production due to net loss of topsoil, with millions suffering needlessly from malnutrition? Is it water shortages around the world and the dehydration that it engenders? Is it exponential increases in melanoma? Or is it pandemics of insect-borne diseases which will drive us into action?

I ask myself these questions as well, dear Reader. I am as guilty as the next, as unconscious as the others, and my car pollutes no less than my neighbors'. We are all complicity, we are all suspect, and if the health effects of global warming do not touch us now, there will eventually be no escape. So, from the barrios to the suburbs, we all must start thinking, acting, and actively changing, not just for the earth, but for our very health and that of our children. After all, the personal is political, the political is personal, and health---of the individual or the collective---can be very personal indeed.
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