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
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
Consequences of
Environmental Degradation
Medical illnesses
 Infectious diseases
 War
 Malthusian chaos and disaster
 Tragedy of the Commons

Economic Costs of Environmental
Diseases
 Estimated
at $132-165 billion/year in
the U.S. alone
 Does not count the psychological
and emotional costs of the human
suffering involved for the victims,
their families, and their communities
Overpopulation

World population - exponential growth
1 billion in 1800
 2.5 billion in 1950
 6 billion in 2000
 6.5 billion in 2006
 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

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 will live in urban areas

World migrant population = 100 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
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
Most polluted areas in US:
 2001 – LA
 2002 – Houston
 2003 – San Joaquin Valley in Central California
 2004, 2006 – LA
Health Effects of Air Pollution
 Causes
approximately 75,000
premature deaths/yr. in U.S.
 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
Increased lung cancer mortality
Decreased exercise tolerance, increased
pulmonary symptoms
Impaired sperm production
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
Automobiles
Automobiles
 Number
of autos
-US: 1 car/2 people
-Mexico: 1/8
-China: 1/100 (increasing; leaded
gasoline)
 Global
years
auto population to double in 25-50
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.
 2006 – 12,000 mi.
Automobiles
Average fuel efficiency of U.S. autos stagnant
 Relatively low oil prices
 Growing market for low-efficiency pickups,
minivans, and sport-utility vehicles
 Ford Model T – 25 mpg (1908); Avg. Ford
vehicle – 22.6 mpg (2003)

Automobiles: Alternatives
 Rapid
transit
-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 → 30% decrease in traffic, 37% 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
 Telecommuting
Automobiles: Alternatives
 Solar
cars
 Hydrogen-powered
 Byproduct
 Problem:
cars
= water
Hydrogen production
requires fossil fuels
US Energy Consumption by Fuel






Oil – 40%
Gas – 25%
Coal – 25%
Nuclear – 9%
Hydroelectric – 1%
Other Renewables – 1.5%
U.S. Energy Sources for
Electricity






Coal – 52%
Nuclear – 20%
Gas – 16%
Hydroelectric – 7%
Oil – 3%
Renewables – 2%
Energy Spending/Research
Since 1947, the U.S. has spent $145 billion
on nuclear R and D vs. $5 billion on
renewables R and D
 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”

Petroleum Industry Profits
Mergers squelch competition, drive up
prices
 Record-breaking oil company profits in
2005 and 2006
 Exxon: $36 billion in 2005
Largest in U.S. history
Exceeds GDP of 2/3 of world’s
nations

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
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
 In
produce 4.4 lbs/d garbage
a lifetime, the average American will
throw away 6500 times his/her adult
weight in garbage
U.S. Garbage Composition







Paper and Paperboard - 39%
Yard Waste - 13%
Food Waste - 10%
Plastics - 10%
Metals - 8%
Glass - 6%
Wood - 5%
U.S. Recycling Rates








Tires - 22%
Plastic containers - 36%
Glass containers - 28%
Yard waste - 41%
Paper and Paperboard - 42%
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 80% have never been
screened for toxicity
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
 4.5
billion lbs/yr pesticides (17
lbs/citizen)
 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

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
Even so, the EPA and NAS have OK’d
human subject testing
Pesticides
Pesticides

$2.4 billion worth of insecticides and
fungicides sold to American farmers each
year
 Evidence
suggests these actually 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

Fetuses and children most vulnerable
Toxic Pollutants – Economic
Costs

Americans pay more than $54 billion annually
for direct medical expenses plus special
schooling and long-term care for pediatric
diseases caused by toxins in the environment


Lead = $43.4 billion
This excludes the greatest toxic pollutant tobacco
Lead



Affects brain development, associated with
lower IQ
Elevated levels associated with violent behavior
Poor, African-Americans more commonly
exposed
Leaded Gasoline

Banned in Canada in 1990, US in 1996 (after 25year phaseout 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
 Per
EPA
 Freshwater
fish mercury levels too
high for pregnant women to eat in
43 states
Mercury

New EPA ruling ineffective:
 allows cap-and-trade of power plant
emissions
 Renmoves power plants from list of
pollution sources subject to federal
Clean Air Act
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 (approximately
1,305 sites listed; another 2,500 sites
eligible)
 Taxpayers paying increasing share of
cleanup costs
Environmental Racism
and Toxic Imperialism
Environmental Racism
 waste dumps/incinerators more
common in lower SES neighborhoods
 “Cancer Belt” (Baton Rogue to New
Orleans)
 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)
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 longterm, 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
 U.S.
has signed, but not ratified
Toxic Pollutants
 Floriculture
 Diamond
and Gold Mining
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 93 cents/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 sosund principles
save money and produce better patient
outcomes

Electronic Waste




Only 5-10% of computers recycled
Most sent overseas
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
 Clean
Water 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 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
 Alaska, Exxon Valdez, 1989 - oil spill
-wildlife devastated, $5 billion damage
 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.)

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?
-Amazon, B.C., Alaska, many others
Deforestation: Causes
New agricultural settlements (overpopulation,
poverty, unsustainable farming practices)
 Logging
 Oil and gas exploration
 Cattle ranching
 Drug cultivation
-Peru, Bolivia, Columbia

Clearcutting
Clearcutting
Clearcutting with Corridors
Global Warming
 Greenhouse
effect
30% increase in atmosphere CO2 since
industrialization began (6.25 billion
tons/year)
Fossil Fuels
Methane, choloroflurocarbons, nitrous
oxide
Global Warming

19 of the last 20 years have been the
hottest ever recorded (data go back to
1856)
 2005

the hottest
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

150,000 deaths and 5.5 million disabilityadjusted life years lost per year
 WHO, UN Environment Program
 Expected to double by 2030
 ↑ weather extremes/natural
disasters/insurance claims
 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
 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

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
Alternatives to Agricultural Antibiotic
Use: Vegetarianism
European Union bans antibiotics
as growth promoters in animal
feed (1/06)
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

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



10% of world’s reefs ruined (90% In
Philippines), 30% in critical condition
Reefs make up 2% of ocean floor, support ¼ of
all marine life
Americans purchase 350,000 pieces of live coral
broken off from reefs per year
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 33-50% 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 riches 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
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
 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
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
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

Inflation-adjusted net worth of the 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%
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)
 $10,300/yr for full-time job
 Real value down 37% compared with 1968
 Inadequate to pay rent, buy food and clothing
 3 million homeless (44% work)
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 431 X 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 ceiling raised to $9
trillion for 2006
 $30,000 for every US citizen
 Personal savings down, annual
bankruptcies up
U.S. Debt
Average household debt (cars and credit
cards)
2001: $17,024
2004: $18,619
 Debt exacerbated by
 Predatory lending practices
 Payday loans
 Rent-to-own companies

Total Credit Card Debt Up
1990 - $243 billion
1997 - $560 billion
2002 - $1.5 trillion
2005 – $800 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
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 subSaharan 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
 Externalize
profits
health and
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;
 $4 billion to burglary and robbery
 $200 billion to corporate fraud
Americans lose $1 million/hr. to securities
fraud.
Fines meager, often considered a cost of
doing business
Corporate Crime



25% decrease in federal prosecutions of white
collar crime, including corporate crime, since
1999
Increase in non-prosecution and deferredprosecution agreements
3/5 U.S. companies settling corporate crime
cases illegally deduct some or all of the
settlement to the IRS
Unemployment


5-6% unemployment rate (true percentage likely
higher)
 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
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

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
The Global Workforce
 27
million enslaved laborers
 Slavery
occurs in every country in Africa
(Unicef)
 Over
250 million child laborers
 60%
exposed to hazardous conditions;
25% exposed to hazardous chemicals
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
a % of GDP, U.S. ranks 2nd to last
among the world’s 22 wealthiest nations
 As
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
Distribution of one federal income
tax dollar - 2004


29¢ - military and defense
20¢ - interest on national debt
10¢ - military debt
 10¢ - non-military debt



20¢ - health care
5¢ - income security
Distribution of one federal income
tax dollar - 2004







4¢ - education
4¢ - Veterans’ benefits
3¢ - nutrition
2¢ - housing
2¢ - natural resources
0.4¢ - job training
12¢ - other
The Military and Pollution
 World’s
single largest polluter
 6-10% of global air pollution
 2-11% of world raw material use
 97% of all high level and 78% of all low
level nuclear waste
The Military and Pollution
 Pentagon
generates 500,000 tons toxic
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
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
 Iraq/Afghanistan war creating enormous
U.S. debt / federal and state budgets
strapped

“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 = 2X
Whites
 Hunger rate increasing nationally
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

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
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 25,000 people per day, most
under age 5
 Hunger-related causes kill as many people
in 2 days as the atomic bomb killed at
Hiroshima
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
 One week of developed world farm
subsidies = annual cost of food aid to
solve world hunger

Famine
Famine Affects the Old and
Young
Medical Care


50% of global health care budget spent in the
U.S.
Per capita expenditure on health care:
U.S. = $4,000
 Typical poor African/Asian country = $5-10


Even so, U.S. has 41 million uninsured, ranks
24th worldwide in overall population health as
judged by disability-adjusted life expectancy
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
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
- 1,100 of 4,400 mammalian species
- 1/3 to 1/2 of 232 primate species (including man?)

bush meat trade contributing
- 1/3 of 24,000 fish species
- 1/4 to 1/3 of 10,300 reptile and amphibian species
(may be higher, limited assessment)
Precipitous Decline of Alpha Predators will have enormous
repercussions for ecosystems/other species
Causes of Species Loss
Habitat loss (logging, overpopulation, etc.) *
 Overhunting
 Chemical pollution of environment
 Exotic species invasions (e.g. rabbits/Australia)


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
WTO/IMF Policies
MAI
GATT, NAFTA, CAFTA, other trade
agreements
Food Disparagement Laws
SLAPP Lawsuits
Bush Administration




Key administrators/committee
members/regulators former industry
representatives and/or lobbyists
Corporate profit before public good
Unsound/distorted/suppressed science
Eco-harassment

Criminalizing activists
Bush Administration




Rollbacks of key environmental laws
Lax enforcement of existing laws
Huge tax cuts primarily benefit wealthy
Federal and state government deficits
astronomical

Program and funding cuts
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”
Astrology
 UFOs
 Reincarnation
 Fortune-Telling

1997
37%
30%
25%
14%
1976
17%
24%
9%
4%
Greenwash


Public relations / ad campaigns
-Chevron’s “People Do” Campaign,
butterflies/refinery
-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 ↑↑
 Public Education in disarray
 Television
 Higher Education increasingly
expensive
Academics at Risk

Increasing corporatization of academia

Private commercial funding of university research:



Secrecy/Pseudoscience



$264 million in 1980
$2 billion in 2001
AAPG Notable Achievement in Journalism prize to Michael
Crichton for State of Fear (which denies global warming)
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)
Mass Media Sources, 2002
 92%
white
 85% male
 Where party affiliation identifiable,
75% Republican
 Predominantly conservative/centrist
Lobbying

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
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

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
The US: Rogue Nation

In 2002, the US spent about $1,211 per US
citizen on defense



vs. $2.27 per citizen on international peacekeeping
efforts
The US maintains military bases in 69
“sovereign” nations around the world
Continued funding of the Western Hemisphere
Institute for Security Cooperation
International NonCooperation/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 NonCooperation/Isolationism

Failure to sign or approve:
Convention on the Rights of the Child
 Convention on the Elimination of Discrimination
Against Women Convention on Economic, Social
and Cultural Rights
 Convention for the Suppression of Traffic in
Persons

International NonCooperation/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 NonCooperation/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)
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 weatherrelated 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
Recently we received the interesting Department of Labor news release
concerning 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? They
would know the situation, and it wouldn’t matter. Or could workers be advised of the
situation, and some 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
 Major cause of Antarctic and Arctic ozone
holes
 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
 Economic analyses show large
environmental and health benefits

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, 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
 Enhance fair trade policies
Solutions
 Zero
waste production systems
 Extended producer responsibility /
Extended product liability
 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

Solutions
 Eliminate
fossil fuel industry tax
breaks and subsidies
 Carpooling
 Sweden
plans to be world’s first
oil-free economy by 2020
Solutions
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)
 Streamline EPA
-25% of 14 billion superfund payouts have
gone to lawyers and consultants

Solutions
Composting / Recycling organic wastes
 Decrease light pollution ($2 billion energy
wasted per year) and see the stars!
-Czechoslovakian anti-light pollution law

Solutions
Insulation
 Energy-efficient lighting

 Decrease
excessive packaging
 15¢/plastic
bag tax in Ireland ↓’d use by 90%
 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
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
Solutions:
Living Wage
130 cities and counties have adopted living
wage laws
 Including NY, LA, Chicago, and
Philadelphia
 15 states now have minimum wages that
exceed the federal requirement

Solutions
 Join
and contribute to environmental
and social justice groups (Greenpeace,
Doctors without Borders)
 Local
 Land
grassroots groups especially good
purchases
 Litigation (e.g., EJLDF, NRDC)
Solutions
 Green
investing
-returns as good or better than the S &
P 500
 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
 US
voter turnout low
 Wealthy vote at twice rate of poor
 Whites > Blacks > Hispanics
 Old > Young
 Property owners > Renters
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 Environmental Weekly
Sierra
The Amicus Journal
Bulletin of Atomic Scientists
Multinational Monitor
Some articles in NEJM, JAMA, JGIM, SSM,
Policy, Politics, and Nurs Prac, others
Contact Information
Martin Donohoe, MD, FACP
503/819-6979 (ph)
martin.donohoe@verizon.net