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
Perspective
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
The earth spins at 1,038 mph at the equator,
between 700 mph and 900 mph at mid-latitudes
The earth rotates around sun at 18.5 miles/sec
The solar system orbits the center of the Milky
Way Galaxy at 137 miles/sec

One rotation per 225 million years
Perspective
The sun is one of hundreds of billions of
stars in the Milky Way Galaxy
 The Milky Way is one of over one hundred
billion galaxies in the known universe
 The universe may be one of an infinite
number of universes

The Planets
Our Solar System
Jupiter = one pixel, Earth = invisible
Sun = one pixel, Jupiter = invisible
Earth/Moon Seen by Voyager Spacecraft
through Saturn’s Rings
Portland, Oregon
Mount Hood
Multnomah Falls, Oregon
The Environment
 The
natural environment
 The
built environment
 The
social environment
Causes of
Environmental Degradation
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Overpopulation
Pollution
Deforestation
Global Warming
Agricultural/Fishing Practices
Overconsumption / Affluenza
Militarization
Causes of
Environmental Degradation
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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
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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
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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
Premature Deaths in the U.S.
 10%
 60%
due to inadequate medical care
due to behaviors, social
circumstances, and environmental
exposures
Overpopulation

World population - exponential growth
1 billion in 1800
 2.5 billion in 1950
 6 billion in 2000
 7 billion in 2011 (1/15 humans ever to live is alive today)
 est. 9 billion by 2040


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 – impaired access to
reproductive health care and education,
political/legal/economic/social
marginalization
World Population
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
The Displaced
 World
migrant population = 42 million
 15 million refugees
 26 million internally displaced persons
 Economic, war and environmental refugees
 Vast majority of refugees hosted in the
developing world
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 cities with the worst air pollution in the
world (2012):
10 – Lahore, Pakistan
 9 – Kanpur, India
 8 - Yasouj, Iran
 7 - Gaborone, Botswana
 6 – Peshawar, Pakistan

Air Pollution

Top ten cities with the worst air pollution in the
world (2012):
5 – Kermanshah, Iran
 4 - Ludhiana, India and Quetta, Pakistan
 3 – Sanandaj, Iran
 2 – Ulaan Baatar, Mongolia
 1 – Ahvaz, Iran

Air Pollution

However, World Bank states 16 of the top 20 most polluted
cities are in China (#1 – Linfen)
 Studies differ with respect to types of pollutants measured

Most polluted areas in US:
 2001 – LA
 2002 – Houston
 2003 – San Joaquin Valley in Central California
 2004, 2006 - 2008 – LA
Most Polluted Cities in the US
Particulate Matter (2012)
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10 – Philadelphia, PA / Camden, NJ
9 – Louisville, KY
8 – Cincinatti, OH
7 – Phoenix, AZ
6 – Fresno, CA
5 – Fresno, CA
4 - Visalia, Porterville, CA
3 - LA/Long Beach/Riverside, CA
2 - Hanford/Corcoran, CA
1 - Bakersfield, CA
Health Effects of Air Pollution
 Causes
approximately 60,000 - 75,000
premature deaths/yr. in U.S. (656,000
in China, over 2 million worldwide)
 More than are killed by auto
accidents
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
 Triggers
7.4% of heart attacks worldwide
Health Effects of Air Pollution
Increased admissions for CHF, asthma,
COPD, PVD, and cerebrovascular disease
(stroke and TIA)
 Increased ventricular arrythmias
 Increased lung cancer mortality
 Decreased exercise tolerance, increased
pulmonary symptoms

Health Effects of Air Pollution
Increased risk of DVT
 Increased risk of rheumatoid arthritis
 Impaired sperm production
 Premature births (1/3 more common in
large towns/cities)
 Pre-eclampsia

Health Effects of Air Pollution
Increase in SGA and LBW infants
 Increased risk of appendicitis
 ?Via link with inflammation?
 Increased numbers of migraines
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Autism
Days lost from work/school
Air Pollution
 Coarse,
fine and ultrafine particles
 Ultrafines not regulated, may be most
dangerous
 Nanoparticles may contribute to health
risks
Air Pollution: The Good News
 Reductions
in air pollution under
Clean Air Act Account for up to 15%
of overall increase in life expectancy in
major U.S. metropolitan areas
 Act
has saved $22 trillion in health care
costs since 1972 passage
 Saved 160,000 lives in 2010
Ozone Destruction
 Ozone
hole over Antarctic (2½X size
of Europe)
 Arctic ozone hole larger
 40% of Arctic ozone destroyed
Effects of Ozone Destruction
 Increased
cataracts (UV damage)
 Increased lifetime melanoma risk
1/1500 - 1930
1/68 - today
Antarctic Ozone Hole
Automobiles
Automobiles
Number of autos
-US: 1.17 car/2 people (88% drive to work)
-Mexico: 1/8
-China: 1/100 (increasing, has surpassed US auto
sales)
-Worldwide: 1 billion cars (1/7 people)
 Over 1.2 million killed, 20-50 million
injured/disabled in road accidents annually
worldwide

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.
 2010 – 12,500 mi.
Automobiles

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Average fuel efficiency of U.S. autos stagnant
 Cars: 23.6 mpg (2012); 35.5 mpg required by
2016; 54.5 mpg by 2025
 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 = 1/3 of all vehicles sold today
 Ford Model T – 25 mpg (1908); Avg. car
today – 22.6 mpg (2010)

Automobiles: Alternatives
 Rapid
transit
-industry squashed in 1930’s and 40’s (GM,
Standard Oil, Firestone, etc.)
-Convicted under Sherman Antitrust Act
Automobiles: Alternatives
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Car sharing
Pay-as-you-drive auto insurance
Build fewer roads (the more roads you build, the more
congestion you create)
“Peak Pricing” and “Congestion Fees”

E.g., London → 21% decrease in traffic, 43%
increase in bus ridership, cleaner air
Alternatives to Automobiles

Bicycles/walking
30% of all trips by bike in Amsterdam; 2% in
Portland, OR
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
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Automobiles: Alternatives
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Electric cars
-killed by oil companies, automakers in early
20th century

Natural gas, gasohol, and biodiesel
 Natural
gas from fracking over-rated, carries
environmental and seismic risks
 Beware
Jevon’s Paradox (Increased efficiency
leading to increased overall energy consumption)
Automobiles: Alternatives
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Solar cars
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Hydrogen-powered cars
 Byproduct
 Problem:
= water
Hydrogen production requires fossil
fuels

Telecommuting
US Energy Consumption by Fuel
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Oil – 37%
 peak oil production originally predicted 2014; new
estimates much farther in future, but sources dirtier
and more expensive/more dangerous to obtain
Natural gas – 24%
Coal – 22% - peak coal production 1920
Nuclear – 8.5%
Renewables (mostly hydroelectric and biomass; small
amounts of geothermal, wind, and solar) – 7.3%
U.S. Energy Sources for
Electricity

Coal – 51%
Nuclear – 21%
Gas – 17%
Oil – 1%
Renewables (mostly hydroelectric) – 9%

Electricity generation utilizes 40% of US energy
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US Energy Consumption
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Transportation – 29%
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Industrial – 25%
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Residential – 11.5%
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Commercial – 8.5%
Energy Spending/Research

Federal funding for energy R&D (1974-2005, in
2005 dollars):

$50 billion: nuclear

Nuclear subsidies under strong consideration by Congress, supported
by Obama (2011)
$20 billion: fossil fuels
 $12 billion: renewable energy
 $12 billion: efficiency
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2010: increases in funding for renewable energy,
possibly nuclear energy
Petroleum Industry Profits
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Mergers squelch competition, drive up prices
Record-breaking oil company profits
 The world’s 6 most profitable corporations in
2008 were oil companies (in 2010, 5 of the
top 50)
 Exxon: $45 billion in 2008, over $30 billion in
2011
 2008 profits largest in U.S. history (exceed
GDP of 2/3 of world’s nations)
Belridge, CA Oil Fields
Edward Burtynsky
Nigerian Gas Flare
The U.S. and Oil
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U.S. consumes > 20 million bbl/d
 Produces 5 million bbl/d
 World’s largest crude oil importer
 Ironically, greatest export in 2011 is gas, diesel, jet
fuel, and other fuels
Strategic Petroleum Reserve holds more than 700
million bbl
ANWR contains 4.3 – 11.8 billion bbl oil
 One year supply
The U.S. and Oil
23 billion bbl under remaining U.S.
territory
 2.5 million abandoned oil and gas wells
litter U.S. (20-30 million worldwide)
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Pollution, explosion hazards
Alberta Tar Sands (shale oil), Keystone
Pipeline controversies
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?
Coal


33% of U.S. carbon emissions (41% of world’s)
Coal mining dangerous (explosions, cave-ins,
black lung disease)
 48 deaths in 2010 from “accidents”/cave-ins
 75,000 deaths from black lung disease in U.S.
(1968-2007)
Coal
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Mountain-top removal damages ecosystems
Coal-fired power plants top source of mercury
worldwide
EPA’s 2011 limits on emissions to prevent
11,000 premature deaths, 4,700 MIs, 130,000
cases of childhood asthma
Proposed Coal Shipments through
Pacific NW

150 million tons/yr from Powder River Basin
(WY, MT; 40% of US coal deposits)
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Purchased from public lands and to be sold cheaply
to markets in Asia
26 trains/day, each 1-1.5 miles long, each over
100 cars and powered by 4 diesel engines
Barges on Columbia River
Amount expected to possibly quintuple by 2030
Risks of Proposed Coal Shipments
through Pacific NW

Diesel particulate matter:
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Impairs lung development; associated with asthma,
COPD, heart disease, stroke, and cancers
Coal dust:

COPD, pneumoconiosis – black lung, contains
heavy metals
Risks of Proposed Coal Shipments
through Pacific NW
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Noise:
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Associated with fatigue, ischemic heart
disease/HTN/arrythmia, increased risk of stroke,
exacerbation of mental health problems, fatigue,
cognitive development, quality of life
Train traffic delays affecting emergency
responders
Derailments, car vs. train accidents
Risks of Proposed Coal Shipments
through Pacific NW
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Global warming, ozone, mercury
Jobs gained:
 Building and operating transfer facilities
 Temporary; dangerous
 Coal terminal workers have 3-fold increased risk
of lung cancer
Job loss:
 Local businesses cut off for 1-2 hours per day from
auto traffic
Proposed Coal Shipments through
Pacific NW

Facing strong community opposition

Nineteenth Century technology vs.
program of sustainable, clean energy for
the 21st Century
Other Sources of Air Pollution
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Industry - #1
Indoor air (chemicals)
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
 Causes 2 million deaths/yr
 Associated with multiple pulmonary conditions
 Solar cookers may replace
Other Sources of Air Pollution

World Trade Center bombings (9-11)
 3,300 fatalities
 Over 18,000 people suffering health problems linked to
attack and rescue (multiple toxic pollutants in smoke and
rubble
 First responders suffer elevated rates or asthma, abnormal
spirometry, GERD, depression, PTSD, panic disorder, and
cancer
 James Zadroga Health and Compensation Act of 2010
provides for some coverage of monitoring, treatment, and
victim compensation
Noise Pollution
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Common in inner cities, hospital wards
Average sound level 72dB in hospital wards

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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
 1,680
lbs/person/yr
 Only 1.5 lbs recycled
 Newer estimate is 7.1 lbs/d
 In
a lifetime, the average American
generates 102 tons of trash
U.S. Garbage Composition
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Paper and Paperboard - 34%
 Average American receives 41 lbs of junk mail per
year
Yard Waste - 13%
Food Waste - 12%
Plastics - 12%
Metals - 8%
Glass - 6%
Wood - 5%
U.S. Recycling Rates
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Tires - 22%
Plastic containers - 25%
Overall plastics – 7%
Glass containers - 28%
Yard waste - 41%
Paper and Paperboard - 55%
Aluminum packaging - 54%
Steel cans - 60%
Auto batteries - 93%
Garbage
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Average recycling rate for cities = 34%
 San Francisco = 78%
One half of US has no curbside recycling pickup
Landfills
Incinerators
 Between ¼ and ½ of rural Americans burn their
trash
 Accounts for 1/3 of U.S. dioxin emissions
 Outlawed in some states
Garbage
Garbage Exports
 Scrap is the leading US export
 Mafia involved in $22 billion-a-yr illicit
wasted trade


15 million grassroots recyclers / waste pickers
living in garbage dumps worldwide
Toxins
Toxins

6 trillion tons of over 85,000 chemicals produced
annually
 2000-3000 new chemicals registered each year
 2/3 of those introduced since 1983 marked “trade
secret,” making investigation difficult
 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
5
billion lbs/yr pesticides worldwide
 1.1 billion lbs/yr in U.S.
 About 3 lbs/person/yr in U.S.
Pesticides
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Only 5 states (CA, LA, MI, TX, NY) currently track
pesticide sales and use and/or collect data on pesticiderelated illnesses
2008: USDA axes national survey charting pesticide use
Pesticide warnings in English only
EPA, NAS currently allows pesticide testing in humans,
despite strong opposition
Monsanto’s Roundup purchased by US government for
aerial spraying in Colombia as part of “War on Drugs”
Pesticide black market
Pesticides

EPA: U.S. farm workers suffer up to
300,000 pesticide-related acute illnesses
and injuries per year


25 million cases/yr worldwide
NAS: Pesticides in food could cause up to
1 million cancers in the current generation
of Americans
Pesticides

WHO: 1,000,000 people killed by
pesticides over the last 6 years

US health and environmental costs $12
billion/yr (2005)
Pesticides

Linked to autism, Parkinson’s Disease, Alzheimer’s
disease, diabetes, obesity (with prenatal exposure),
depression, ADHD

Autism spectrum disorders affect 1/88 children in U.S.

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
practicing organic agriculture
Children from villages
practicing non-organic
agriculture
Pesticides
Pesticides


$2.4 billion worth of insecticides and fungicides
sold to American farmers each year
Pesticide runoff contributes to coastal dead
zones
Over 200 (e.g., Baltic Sea, Mouth of Mississippi in
Gulf of Mexico, Chesapeake Bay, off
Oregon/Washington coast)
 Red tides

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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 costeffective
Pesticides and Produce


The Dirty Dozen: apples, celery, sweet bell
peppers, peaches, strawberries, nectarines
(imported), grapes, spinach, lettuce, cucumbers,
blueberries (domestic), potatoes
The Clean 15: onions, avocados, sweet corn,
pineapples, mangos, asparagus, sweet peas,
kiwis, cabbages, eggplant, papayas, watermelon,
broccoli, tomatoes, sweet potatoes
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

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Cryptorchidism increasing

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Risk factor for testicular cancer
Micropenis, hypospadias increasing
Phthalates/Bisphenol A



Found in construction materials, clothing, toys, cashier
receipts, cosmetics, pills, dental fills/sealants, added to
PVCs in IV tubing/other plastics
 At least 47 million prescription meds
 Exposure levels very high
 FDA approves
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; Australia phasing out use in baby bottles
 9 states, Chicago, Multnomah County (Portland),
OR, and Suffolk County, NY have banned BPA in
baby bottles and sipper cups
Consumer Product Safety Commission reforms of 2008
eliminate lead and phthalates from toys and children’s
products
Sugar-derived epoxy lining could replace BPA in cans
Phthalates/Bisphenol A




2009: Ban Poisonous Additives Act (to ban use of BPA
in food and beverage containers and items used by
young children) submitted in U.S. House and Senate
2009: BPA-Free Kids Act (to ban BPA in food and
beverage containers and utensils marketed for children
aged 3 or younger) introduced into U.S. Senate
2012: EPA bans BPA in baby bottles and sippy cups,
but not food packaging
Substitutes (e.g., biphenol sulfonate or BPS) also
estrogen-like endocrine disruptors
Phthalates/BPA


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
 low birth weight
 lower and higher testosterone levels
 PCOS in women
 Early menopause
 lower sperm counts in adults; impaired sperm function
 male sexual dysfunction
Phthalates/BPA

Associated with:
 Infertility
 Decreased effectiveness of IVF
 childhood behavioral, emotional, and conduct problems
 obesity
 asthma
 heart disease
 diabetes
 elevated liver enzymes
 Meningiomas
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
Triclosan
Pesticide used as an antimicrobial in many
soaps and hand sanitizers, including those
commonly used in hospitals
 Also found in toothpastes, deodorants,
colognes
 Linked to reproductive, endocrine, and
developmental damage in animals

Triclosan
FDA: Antibacterial soaps are no more
effective than regular soap and water in
fighting infection
 AMA: It may be prudent to avoid the use
of antimicrobial agents in consumer
products
 Use restricted in EU, Canada, Japan

Food Dyes



None of the 9 artificial food dyes approved for
use in the U.S. has been proven safe
E.U. warning labels required for six food dyes:
“may have an adverse effect on activity and
attention in children.”
Animal studies suggest some may be
carcinogenic
Teflon (PFOA –
perfluorooctanate)




Non-stick material made by Dupont
Chemicals released under high heat and when cookware
damaged
Exposure linked with cancer, birth defects, heart
disease, peripheral arterial disease, 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
Flame Retardants


Polybrominated diphenyl ethers (PBDEs) found
in furniture produced before 2004 ban
Newer brominated and chlorinated flame
retardants

Slow spread of flames, but release carbon monoxide
and hydrogen cyanide when burned (these
compounds account for 60-80% of fire-related
deaths)
Pepper Spray

Contains TCE (trichloroethylene) and PCE
(tetrachloroethylene)

Both can cause liver and kidney cancer,
lymphoma, and other illnesses
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, ADHD, depression, panic disorder



No safe level for neurological development
Levels between 4 and 10 significantly increase
risk of cardio- and cerebrovascular disease
Elevated levels associated with depression,
anxiety, crime, and violent behavior

Pre-natal and post-natal exposure
Lead



Poor, African-Americans, and Hispanics more
commonly exposed
Levels declining in US
 However 83,000 tons of lead shot into
environment annually in U.S. (bullets)
Developing world at risk
 Due to increased environmental exposure
and, possibly, early umbilical cord clamping
 12 million people worldwide lead poisoned
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
 Lead paint banned in U.S. in 1978 after decades of
industry push-back
6 countries still sell small amounts of leaded gasoline:
 North Korea, Iraq, Afghanistan, Algeria,
Myanmar/Burma, and Yemen (all to phase out by
2013
Mercury
Syphilis Treatment
- 15th Century onward
- abandoned 1940 for penicillin
 Recognized as cause of disease in 19th
Century (Hunter-Russell Syndrome)
- chemists, hatters

Mercury: S/S, Dx, and Rx

S/S: neuropsychiatric symptoms, excessive
salivation/inflammation of gums, rash,
nephropathy



Linked to autism
Dx: mercury levels in air, blood, urine (>100
mcg/l in blood and/or urine = toxic)
Rx: chelation with BAL, penicillamine, DMPS,
DMSA
Minimata Disease:
Signs and Symptoms

Acute / Chronic Poisoning:
numbness, slurred speech, ataxia, unsteady gait,
deafness, poor vision, dysphagia, hypersalivation,
confusion, drowsiness/stupor to
irritability/restlessness; chronic liver disease, liver
cancer, hypertension, autoimmune disorders
 death within a few months if severe


Rx EDTA – only partially effective
Minimata Disease:
Signs and Symptoms
Congenital: high dose → infertility; medium
dose → spontaneous abortions; low dose →
congenital disease
 S/S: poor physical growth, developmental delay,
ADHD, impaired speech/chewing/swallowing,
muscle tone abnormalities, involuntary
movements, constricted visual fields, hearing
loss
- EDTA not effective

Mercury

Released into air by coal combustion,
industrial processes, mining, waste
disposal, and volcanoes; concentrated
(along with lead, arsenic, and other heavy
metals) in coal ash
 4500 tons/yr
Mercury
Travels throughout atmosphere and settles
in oceans and waterways
 Bacteria convert it to toxic methyl-mercury
 Travels up food chain via fish
 Avoid top predators (tuna, shark,
swordfish)

Gold Mining
Gold = Cyanide + Mercury
Mercury used to capture gold particles as
an amalgam
 Gold leached from ore using cyanide
 Cyanide paralyzes cellular respiration
 At least 18 tons of mine waste created to
obtain the gold for a single 3 oz., 18k ring

Gold Mining and Mercury
Contaminated groundwater often sits in
large toxic lakes held in place by tenuous
dams
 Release of cyanide and mercury into local
waterways kills fish, harms fish-eating
animals, and poisons drinking water

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
 Fish intake decreases risk for SGA
newborn, but mercury can cause SGA

Mercury

Mercury dental amalgams pose health risks
to pregnant women, unborn babies, and
children (FDA)

Contaminant in high fructose corn syrup
Arsenic

Contaminates groundwater in Bangladesh, also,
India, China, Mexico, Argentina, Thailand,
Vietnam, and parts of the U.S.
 13 million Americans have drinking water
exceeding EPA’s “safe level”
 Exposure also via rice (esp. brown), seafood
 Also found in apple and grape juices
Arsenic



Used to pressure treat wood in US and
elsewhere
 Primarily wooden structures built before 2005
Causes discoloration of skin, GI upset/N/V/D,
numbness, paralysis, and blindness
Linked to learning disabilities, heart disease, and
bladder/lung/skin cancers
Health Consequences of Arsenic Exposure






Miscarriage, low birth weight
Pigmentary skin changes
Diabetes
Heart Disease
Increased risk of lung, bladder, and skin cancers
Bone degeneration and deformities
Heavy Metals

Heavy metals found in over half of low cost
jewelry sold in the U.S.

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.)
Cadmium

Cigarettes most common source of
exposure

Can delay pregnancy and cause
neurological damage, osteoporosis,
periodontal disease, and breast cancer
Phosphorus/Phosphates


Phosphorus in dishwater detergents
 Contribute to eutrophication, harmful algal blooms
 Banned in 16 states
Phosphate in fertilizers
 Agricultural runoff contributes to algal blooms, dead
zones
 World supply running critically low
 Composting would recycle, return to soil
Perchlorate (PERC)

Perchlorate
 Toxic air pollutant, endocrine and reproductive
toxin, likely human carcinogen, exposure increases
risk of bipolar disorder and PTSD
 Used in rocket fuel, dry cleaning
 Alternative = “wet cleaning” with compressed,
liquefied CO2
 EPA requiring phaseout of use in residential areas by
2020
Parabens

Preservative used in food products,
toiletries, cosmetics

Estrogenic

May increase risk of breast cancer
Radon



Comes from natural decay of uranium in soil
1/15 U.S. homes has elevated levels
Cause of lung cancer



Causes 15,000 to 22,000 lung cancer deaths in U.S.
each year
Home detectors available, relatively inexpensive
Remediation lowers risk
Supplements and Milk

Melamine scare with Chinese milk products


Kidney failure
37/40 herbal dietary supplements tested by
GAO in 2010 contained trace amounts of at
least one hazardous metal (lead, mercury,
arsenic)

Supplements do not require FDA approval premarketing
Artificial Turf




Made from “crumb rubber,” derived from recycled tire
bits
Contains lead, mercury, benzene, harmful bacteria
High levels of inhalational exposure among young
athletes
New York City park officials will no longer use tire
crumbs in artificial turf fields (alternative = sand-based
product)
Cell phones
?Link to parotid gland tumors?
 Link to brain tumors per WHO
 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
 Taxpayers
paying increasing share of
cleanup costs
 Overall
funding decreasing
Environmental Racism
and Toxic Imperialism



Environmental Racism
 Polluting factories/waste dumps/incinerators more
common in lower SES neighborhoods
 “Cancer Belt” (Baton Rouge to New Orleans)
 More cardiovascular disease
Toxic Imperialism
WHO estimates toxic chemical exposures responsible
for 4.9 million deaths and 86 million DALYs in 2004
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 longterm, resist degradation, can travel long
distances
 Bioaccumulate - higher concentrations
as you move up the food chain
 Most are endocrine disruptors
Endocrine Disruptors

Linked to:
 Obesity
 Insulin resistance
 Diabetes
 Early age of onset of puberty in young girls
1860 - 16.6; 1920 – 14.6; 1950 – 13.1; 1980 – 12.5; 2010 –
10.5; 2012 – 9.9 (whites), 8.8 (blacks)
 Boys too (9-10)

Endocrine Disruptors

Linked to:
 PCOS, endometriosis, uterine fibroids,
premature ovarian failure, early menopause
 Male and female reproductive tract
abnormalities
 Impaired fertility, defective sperm
 Low birth weight, impaired fetal development
and fetal anomalies
Endocrine Disruptors

Linked to:
 Multiple cancers (including breast, colon,
prostate, testicular)
 Thyroid disease
 Neuroendocrine abnormalities

Epigenetic effects
Endocrine Disruptors
 Endocrine
Society, AMA, and APHA
have called for policies to decrease
public exposure to endocrine
disruptors
Persistent Organic Pollutants
 UN
Environmental Program
organizing worldwide phaseout of top
12 through the Stockholm Convention
on Persistent Organic Pollutants
 Including
 U.S.
DDT, PCBs, and dioxins
has signed, but not ratified
Toxic Pollutants
Floriculture
 Diamond and Gold Mining
 Cosmetics (see www.safecosmetics.org)
 Fragrances
 Scented candles
 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

Medical Waste
 One
hospital bed generates between 16
and 23 lbs/day of waste
 Outbreak
of hepatitis B in India due to
black market in medical waste and supplies
(2009)
Medical Waste

Solutions:
 Strengthen EPA regulations
 Segregation and alternatives to incineration
would cost < $1/patient/day 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
40 million tons/yr
 Average lifespan of a computer is 2 years
 Only 5-10% of computers recycled
 Most sent overseas
 Some e-waste returns to U.S. in
children’s jewelry

Electronic Waste
EU now requires electronics firms to
recycle and to eliminate lead, cadmium and
mercury from their products
 Maine passed first law requiring electronic
manufacturers to pay for recycling their
discarded products
 2012: US requires electronic equipment
bought with federal dollars to be recycled

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

Water and sewage system infrastructures
decaying

1 of every 6 gallons in city pipes leaks away into
ground
Water



Global water consumption doubling every 20
years
Worldwide freshwater supplies dwindling
 Drying up: Aral Sea, Great Lakes, etc.
Water expected to be major cause of wars
worldwide in 21st Century
Water
 Clean
Water Act of 1972 has
decreased pollution in the US
 But 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
4/10 people worldwide have no access to any
latrine, toilet, bucket or box
Water Pollution and Plastics



120 billion lbs of plastics generated each year,
using 4% of world oil supplies
Every year more than 500 billion plastic bags
discarded worldwide
Bioplastics made from agricultural waste using
renewable energy could be carbon neutral or
even carbon negative
Water Pollution and Plastics

Texas-sized “great garbage patch” in North Pacific
holds estimated 100 million tons of mostly plastic trash





6 times the mass of plankton there
Most has degraded to microplastics, which bond with PCBs,
DDT, and endocrine disruptors, making this area a million
times more toxic than surrounding areas
Harmful to marine life
Works its way up food chain
Great Lakes also affected
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
 $1 trillion market
 Privatization increases costs, incites social unrest
(e.g., Cochabamba, Bolivia)
 15% of US water in private hands
Bottled Water

Bottled water a $400 billion/yr profitdriven industry

10 billion gallons/yr in U.S.
Costs up to 1,900 times more than tap
water
 Uses up to 2,000 times more energy to
produce than tap water
 Up to 44% is tap water

Bottled Water
Ratio of amount of water needed to
produce 1 plastic bottle to amount of water
in the bottle = 2:1
 Weaker standards, 33-44% is just tap water,
dangers of plastics, energy costs/global
warming, reduction of local water tables,
recycling rate of plastic bottles only 25%

Bottled Water

“Water is an efficient product. It is a
product which normally would be free, and
it is our job to sell it.”
 Suez CEO Gerard Mestrallet
Bottled Water

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,
 Chisso
Japan, 1920s-1970s
Corporation
 Methylmercury
 400
poisoning
dead; 10,000 injured
Minimata Disease
W Eugene Smith
Infamous Industrial Disasters
 Bhopal,
India, 1984 (Union Carbide,
purchased by Dow in 2001) - methyl
isocyanate gas
7000-10,000 dead within 3 days, 15,00020,000 more over next 10 years; 150,000500,000 injured and/or with resulting
health problems
Persistent water and soil contamination
Infamous Industrial Disasters

Bhopal
 U.S. has refused Indian government
extradition request for Warren Anderson
 Union Carbide settled with Indian government
for $470 million in 1989 (victims received
$1,500/death, $500/injury)
 2012: US Court absolves Union Carbide of
liability
Infamous Industrial Disasters

Love Canal:
 Hooker Electrochemical Company (parent
company Occidental Petroleum) dumps over
21,000 tons of chemical waste in 1940s and
1950s
 Miscarriages, birth defects, cancers
 Occidental found liable
Infamous Industrial Disasters
Leads to Superfund Law
 Today only seven states prohibit
construction of schools on or near
hazardous waste sites
 Half-million children attend schools
within ½ mile of toxic waste dumps in
NY, NJ, MA< and MI alone

Infamous Industrial Disasters

Chernobyl, USSR, 1986 - nuclear power plant
explosion
 200 times the radiation of Hiroshima +
Nagasaki
-25-100 died immediately, up to 1,000 injured
acutely, NCI estimates 10-75K thyroid cancers
(other estimates much lower)
- some estimates as high as almost 1 million
deaths
Chernobyl
Higher risk of neural tube defects and
childhood leukemia among those living
near nuclear power plants
 Anxiety a major problem
 Ukraine still spends 6% of its GDP each
year on Chernobyl-related matters

Infamous Industrial Disasters


1989 Alaska, Exxon Valdez - oil spill
-wildlife devastated, $5 billion damage
 Punitive damages overturned by U.S.
Supreme Court
 Renamed “Oriental Nicety,” still sailing
2001 Gulf Oil spill (Retreating Iraqi Army
pumped 8 million barrels oil into Persian Gulf to
prevent US marines from making landfall)
Infamous Industrial Disasters
2006 BP Alaskan pipeline ruptures
 2010 BP Gulf disaster (and Michigan oil
spill)
 2012: Legal settlement $7.8 billion and
counting
 2011 Exxon Mobil oil pipeline rupture and
spill into Yellowstone River

Oil and Water


1.3 million metric tons of oil enters oceans each year
 46% seepage from natural deposits
 8% tanker spills
 Exxon Valdez 38,800 metric tons
 ABT Summer disaster off southwest coast of
Africa (1991) – 260,000 metric tons
 Remainder = industry, runoff
UN phase-out of single-hulled tankers begins 2010
Oil Pollution is Expensive to Clean
Up
Oil Slicks Kill Marine Life
Top ten most polluted places on
the planet





Air pollution – Linfen, China
Industrial chemicals – Bhopal, India
Mercury – Central Kalimantan province,
Indonesia
Pesticides – Kasargod, India
Chemical weapons manufacturing – Dzerhinsk,
Russia
Top ten most polluted places on
the planet





Organic chemicals – Sumgayit, Azerbaijan
Lead – Tianying, China
Hexavalent chromium – Sukinda, India
Radiation – Chernobyl, Ukraine
Persistent organic pollutants – Arctic Canada
Deforestation
Tropical forests constitute 7% of land surface
area, contain > 50% of plant and animal species
 Majority of tropical forests destroyed
 Over one acre of world’s forest cut down every
second



25 million trees/yr
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
 Methane 25 times more heat than CO2, large
amounts stored in permafrost
 Obesity
Global Warming



80% of carbon emissions from burning fossil
fuels; 20% from deforestation, other land use
changes
391 ppm CO2 (over 350 ppm dangerous)
CO2 currently being released at almost twice the
rate it is being removed

Plants and soil absorb 1/3, ocean waters about ¼,
the rest stays airborne
Global Warming

Sources of methane:
 Natural – 41%



Wetlands - 29%
Lakes, wild animals and termites, bodies of water - 12%
Human Influenced – 59%






Animal agriculture – 21%
Natural gas / oil – 13%
Waste disposal – 10%
Caol and biomass – 7%
Rice – 6%
Other 2%
Global Warming


The last 20 years have been the hottest ever
recorded (data go back to 1856)
 2012 hottest year on record (most other years
between 2000 and 2009 a close second)
Average global surface temperature = 58.3°
 Hottest temperature in last 10,000 years
Global Warming

Estimated 4.5-9 degree increase in average
global temperature by 2100

Far North, Pacific Northwest warming up faster
than other parts of the planet
Consequences of Global
Warming

150,000 - 300,000 deaths and 5.0 - 5.5
million disability-adjusted life years lost per
year
 WHO, UN Environment Program
 Expected to double by 2030
Consequences of Global
Warming
↑ weather extremes/natural
disasters/insurance claims
Drought, flooding, severe storms
Weather-related disasters cost U.S.
over $50 billion in 2011
 Ocean acidification → corals dying, rise of
jellyfish (cockroaches of the sea)

Consequences of Global
Warming
Floods, cholera, rising malaria zone
 Dengue fever, malaria, yellow fever, even
plague now being seen in Europe
 Increased Chagas, yellow fever,
chickungunya virus in U.S.

Weather Extremes
Headline from “The Onion”
Hurriphoonado Cuts Swath Of Destruction
Across Eastern, Western Hemispheres
Consequences of Global Warming

Polar icecaps/glaciers/Greenland ice
sheet/Patagonian
glaciers/Himalayas/permafrost melting, sea
levels rising (est. at least 3 feet over 21st Century)

Arctic ice pack has lost 40% of its thickness
compared with 1960
Consequences of Global Warming

Glacier National Park’s glaciers melting

Great Lakes ice coverage down 71% over last 40
years

Snows of Kilimanjaro down 85% compared to
1912; will be gone by 2015
Consequences of Global
Warming

Droughts

World’s oldest/biggest trees dying (10X
background rate)

Ice islands threaten shipping lanes and offshore
oil platforms
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
Climate refugees
 Disappearing locales: Tuvalu, Vanuatu, Kivalina
(Alaska), Male (Maldives)
Global Warming Increases Droughts
Agriculture
 Global
per capita cropland down over 50%
from 1961 to 0.6% acre
 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
Agriculture
 Livestock
responsible for more greenhouse
gas emissions than the entire transportation
sector
Methane,
Grass-fed
CO2, and NO
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;
20% for agriculture; 10% for domestic
purposes
Large scale irrigation/power
projects

China’s Three Gorges Dam
 World’s
largest power station (second largest
generator after Itaipu Dam on border of
Brazil and Paraguay)
 $59
billion project
 Displacing
 Loss
1.5 million people
of valuable archeological sites
China’s Three Gorges Dam
Wasted Food

Household food waste adds up to $43
billion/yr in the U.S.

40% of all food produced in U.S. wasted
An average American family of four tosses
out $590/yr food
 Americans discarded 3 times as much food
in 2005 as in 1985


96 billion lbs/yr in America (2009)
Decreasing crop diversity

75,000 plant species are edible

Humans have utilized 7000 plant species for food

Rice, wheat, and maize provide 2/3 of the world’s food
supply

20% of species provide 80% of the world’s food supply

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 80% 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
Fish getting smaller due to global warming (warm water
holds less oxygen)
Harmful Fishing Practices
 Long-lining,


bottom trawlers, drift nets
Tear up seafloor, damage corals
Large amounts of bycatch discarded

Up to 20 lbs per lb of desired catch
 Cyanide
fishing (400 kg/year)
 Dynamite Reef fishing
 Fishing with pesticides
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)
 Sharks already in severe decline due to
hunting for fins
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
Coral Reefs

Threatened by bleaching due to rising ocean
temperature, acidification from increased CO2,
runoffs from deforestation, pesticides
 pH of oceans down 0.1 from preindustrial
times to 8
 With current trends, pH will be 7.7 by 2100
 At pH 7.8, shell formation ceases
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

50% of fish now consumed worldwide is
farmed (vs. 4% in 1970)
 5-10% of U.S. fish consumption
 Almost all catfish and trout farmed
 Majority of shrimp
 1/3 of salmon
Consequences of Aquaculture

No compensation to general public for potentially
exclusionary use of public services for private profit

Feed inefficiency (2-6 lbs of wild fish to raise 1 lb
farmed fish)

Decreased diversity

Escapes, interbreeding with (and lowering fitness of)
wild stocks
Consequences of Aquaculture

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):

Farmed bivalves: eat plankton

Freshwater farm fish (with pollution controls):
rainbow trout, tilapia, catfish, arctic char
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


Americans make up half the world’s richest 1%
U.S: Richest 1% of the population owns 50% of the
country’s wealth
-poorest 90% own 30%
-widest gap of any industrialized nation
-2011 U.S. family median net income = $52,752
($76,600 – Canada); net worth = $77,300 ($89,014 Canada)
The Stock Market

20% of Americans own stock; 90% of
stocks and bonds owned by 10%
The top 1% owns 51% of all stocks,
bonds, and mutual fund assets.
 “Business” news

The Stock Market


Interesting Fact: 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%
STOCK (Stop Trading on Congressional Knowledge)
Act passes Congress (2012):
 Removes loophole exempting Congressional
lawmakers and staff members from being
prosecuted for “insider trading” for using knowledge
gained in their work (political intelligence)
Consequences of Differential Stock
Ownership
Corporations are answerable to their
shareholders
 Governments are answerable (at least in
theory) to their citizens (either through
elections or revolutions)

Maldistribution of wealth
The worldwide gap between rich and poor
doubled between 1960 and 1990, and grew
an additional 20% between 1990 and 1998,
and continues to grow today
 Gap is higher in the U.S. than in any other
industrialized nation

 Associated
with 880,000 deaths per year over
expected number if gap was same as in
Western European nations
Worldwide statistical breakdown
of wealth (2012)





Wealth over $2,138 = top 50%
Wealth over $61,000 = top 10%
Wealth over $510,000 = top 1%
Top 2% of individuals own more than 50% of
global wealth
34% of world’s wealth held in U.S. and Canada;
30% in Europe; 24% in wealthier Asian-Pacific
countries; 12% in the rest of the world
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)
Declaration of Independence
“All men are created equal.”
George Orwell
“Some people are more equal
than others”
Hudson River, 2009
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.”
Thomas Jefferson
“Experience declares that man is the
only animal which devours its own
kind, for I can apply no milder
term to … the general prey of the
rich on the poor.”
Racial Disparities: Economic

Median income of black U.S. families as a
percent of white U.S. families:
 60% in in 1968
 62% in 2002
 59% in 2010 (69% for Hispanic families)
Racial Disparities: Economic

Recession, housing crisis has hit black and
Latino families harder than white families



7.5% on Blacks live in substandard housing (vs. 2.8
% of Whites)
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 in Health Care
Coverage

Percent uninsured:
 Whites = 12%
 Asians = 17%
 African-Americans = 21%
 Hispanics = 32%
 Undocumented immigrants = 100% (emergency care
exception)
 CA Proposition 189
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

Health Disparities Among Latinos

Higher rates of:
 Overweight and obesity
 Certain cancers
 Stroke
 Diabetes
 Asthma/COPD
 Chronic liver disease/cirrhosis
 HIV/AIDS
 Homicide
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
deaths
 AJPH
medical advances averted 176,633
2004;94:2078-2081
Income Inequality






Lower life expectancy
Higher rates of infant and child mortality
20 million deaths/yr worldwide
Short height
Poor self-reported health
AIDS
Income Inequality





Depression
Mental Illness
Obesity
Crime
Diminished trust in people and institutions
Overconsumption (Affluenza)
I
= P x A x T (Human Impact =
Population x Affluence x Technology)
 U.S.
= 6.3% of world’s population
Own 50% of the world’s wealth
Overconsumption (Affluenza)

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
 U.S. only OECD country not to
guarantee paid leave

Over 40% of private sector workforce do not
have paid sick leave
 2006: San Francisco ordinance guarantees one
hour sick leave for every 30 hours worked

Guaranteed Paid Sick Leave:
International Comparisons
But are we happier?
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)

But are we happier?
Stress up / satisfaction with life down
 5% of U.S. population suffer from a
serious mental illness
 Anti-depressant use doubled between 1993
and 2005

But are we happier?

1/10 Americans over age 6 currently taking
a psychotropic medication
 Pharmaceutical marketing plays a
significant role

8.7 million Americans considered suicide in
2011

1.1 million attempted suicide
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
Lack of social interaction as or more harmful
than smoking, alcohol abuse, obesity
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%
 Greater income inequality associated with less trust
in people and institutions

Maldistribution of Wealth

In countries with moderate levels of
wealth, happiness is highest where income
inequalities lowest and taxes most
progressive
 Major League Baseball: teams are more
successful when players’ salaries are
more equitably distributed
Wealth

Associated with:
 Sense of entitlement
 Less attention to lower classes
 Presumption of superiority, “earned”
rights
 Less ethical behavior
The Booming Economy

Inflation-adjusted income of the median
U.S. household
 1989 - $54,600
 1997 - $49,000
 2004 - $44,389
 2009 - $49,777
 2011 - $51,861
The Booming Economy
Weekly wages for the avg. American
worker are 12% below what they were in
1973
 But productivity is up 33-78%
 $1.5 trillion needed to repair nation’s
infrastructure


Roads, bridges, water and sewer systems
Booming No Longer




Financial meltdown of 2008 →
Causes:
 De-regulation of banks, insurance companies, and
financial services companies via repeal of GlassSteagall Act
 Housing bubble, sub-prime mortgages
 Greed
Requiring huge bailouts
Consumer Protection Agency may help
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

Many advocate 30 hour workweek
Vacation Time

Americans allotted 13 days leave per year
(take less than 10)
 Italy 42
 France 37
 UK 28
 Canada 26
 Japan 25
Minimum Wage ≠ Living Wage

Federal minimum wage = $7.25/hr

18 states and DC have higher minimum wages
(Oregon = $8.80/hr, 2012)
 $10,423/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)
Supplemental Nutritional Assistance
(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
Wage theft common, worst among lowest paid
workers
 Robs workers and governments
Public service sector workers earn less than
private sector employees (after adjustment for
age, education, and years of experience)
Undocumented Immigrants

Undocumented immigrants pay taxes:


State and local income, property, and excise taxes;
employer’s share of SS, Medicare, and
unemployment taxes
BUT, they are not eligible for many public
services:

Medicaid, SNAP, SS, Medicare, unemployment
benefits, temporary cash assistance
Undocumented Immigrants
See Public Health and Social Justice
website page on migrant and seasonal farm
workers at http://phsj.org/migrant-andseasonal-farm-worker-health/
Congressional Wealth



In 4 of the last 5 years, Congress granted itself a
$5,000 cost of living salary increase
½ of legislators are millionaires (vs. 1% of U.S.
citizens)
Average personal fortune:
 Senator = $13 million
 Representative = $5 million
Exorbitant CEO Pay

CEO salaries up 759% since 1978


Average worker pay up 6%
Dodd-Frank Executive Pay provision requires
corporations to report
SEC figuring out how to implement
 Much compensation outside of salary (stock, stock
options, other perks)
 Shareholders only allowed “advisory” say on pay
voting rights

Exorbitant CEO Pay

The average CEO makes 350-400X the salary of
the average U.S. worker (1960 - 41X)
 Mexico 45:1
 Britain 25:1
 Japan 10:1
 US Military: 15-20:1 (top rank : lowest rank)
CEO Personality Characterisitics

Some data suggest certain traits common among
psychopaths are also commonly found in CEOs (and
politicians, world leaders, and serial killers):
 Grandiose sense of self worth
 Persuasiveness
 Superficial charm
 Ruthlessness
 Lack of remorse
 Manipulation of others
The Mega-Rich

Worried / Investing in personal security
Bodyguards
 Armored cars
 Bullet-proof windows; machine gun proof doors
 Home security fogs
 Panic rooms
 Fully-stocked home medical suites
 Yachts with escape submarines
 Islands

U.S. Debt

US national debt $14.8 trillion in 2011
 Over $46,250 for every US citizen

Personal savings down

Annual bankruptcies up approximately
50% between 2007 and 2010
CEO Personality Characterisitics

Some data suggest certain traits common among
psychopaths are also commonly found in CEOs (and
politicians, world leaders, and serial killers):
 Grandiose sense of self worth
 Persuasiveness
 Superficial charm
 Ruthlessness
 Lack of remorse
 Manipulation of others
U.S. Debt


Average household debt (for mortgages, car
loans, credit cards and all other debt combined)
= $114,434 (2010)
Debt exacerbated by
 Predatory lending practices, sub-prime
mortgage collapse
 Payday loans (22,000 stores, serving 10
million people/yr, $40 billion/yr business)
 Rent-to-own companies
Total Credit Card Debt Up
1990 - $243 billion
1997 - $560 billion
2002 - $1.5 trillion
2005 - $800 billion
2009 - $951 billion
Average number of credit cards per U.S. adult
= 3.5
Bankruptcies

1.6 million bankruptcies between 6/09 and
6/10
 Over 60% of bankruptcies due to health
care expenses (and ¾ of these
individuals were insured)
 exceed # of college graduates/year, # of
persons diagnosed with cancer per year
 Bankruptcy “reform” bill grossly unfair
Pensions

Pensions in jeopardy
 Shift from Defined Benefit Plans to
Defined Contribution Plans
 Reductions in / elimination of employer
contributions
The “Global Economy”

53 of the world’s 100 largest economies are
private corporations; 47 are countries
 GM was, until recently, larger than
Denmark, Thailand, Hong Kong, and
Turkey
 Apple is larger than Poland
 Wal-Mart is larger than Israel and Greece
 AT&T is larger than Malaysia and Ireland
The “Global Economy”

Until 2007, 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
 148 corporations control 40% of
world’s wealth (most are financial
institutions)
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
 Externalize health and environmental costs
 Confidential legal settlements keep
important public health and safety
information secret

 May
delay governmental intervention, cause
unnecessary morbidity and mortality
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.
6.5% today (“real rate” = 2.8% per
U.S. Treasury Department)
 Corporate taxes are at their lowest
level since WW II
Corporate Taxation

2004: Bush administration offered temporary tax
holiday on foreign earnings
 $300 billion in profit repatriated
 92% went to dividend payouts, stock
buybacks, and corporate coffers
 Only 8% went to R and D, new factories,
and hiring
Reasons for Inadequate Corporate
Taxation


Tax breaks, corporate welfare, corporationfriendly tax laws, loopholes, transferring assets
overseas
Cities and states offer incentives to companies
to locate in their communities, in exchange for
the promise of jobs

Companies often leave when a better offer becomes
available
Reasons for Inadequate
Corporate Taxation


Incentives:
 Cash grants and loans
 Sales tax breaks
 Income tax credits and exemptions
 Free services
 Property tax abatements
 Highway and school construction
$80 billion in 2011
 Income tax breaks - $18 billion
 Sales tax relief - $52 billion
Reasons for Inadequate
Corporate Taxation

Cheating and under-payment common
 Auditing program understaffed and
underfunded
 1/3 high school students admits to
stealing something from a store in the
past year
Reasons for Inadequate
Corporate Taxation



Offshore tax havens shelter capital
 Estimated 1/3 of global assets
 $11.5 trillion in individual wealth alone
83 of the largest 100 US companies have
subsidiaries in tax havens
Lost annual tax revenue:
 $250 billion worldwide
 $100 billion in US
Ugland House, Cayman Islands
18,000 Corporations Registered Here
Job Creators?
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 deferredprosecution agreements
 3/5 U.S. companies settling corporate
crime cases illegally deduct some or all of
the settlement to the IRS

Corporate Crime

Companies mandating forced arbitration
 SCOTUS allows corporate binding
arbitration contracts, limiting class action
lawsuits (AT&T v. Concepcion, 2011)

Arbitration Fairness Act would counteract
ruling
Corporate Crime




1,288 whistleblower lawsuits 2002-2008; government
ruled for whistleblower in only 17
US Supreme Court (Garcetti v. Ceballos, 2006) sharply
restricted rights of public employee whistleblowers
Congress passed Whistleblower Protection
Enhancement Act (2011)
Obama has pursued more whistleblowers than any U.S.
president
Unemployment


9-12% unemployment rate
 True percentage likely higher (approximately 16%)
 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.
 30% of U.S. workers have no retirement
savings

Job Loss and The Decline of
Labor




Millions of jobs lost, early (sometimes forced)
retirements
Free trade
Expatriation of jobs
 2000-2011: U.S.-based multinational
corporations cut 2.9 million jobs in U.S. while
increasing foreign employment by 2.4 million
40% of US jobs part-time or seasonal
Job Loss and The Decline of
Labor



Labor union membership declining since 1950
 Now 12%:
 7% in private sector
 36% in public sector
Employers generally anti-union
Employee Free Choice Act would make it easier
for workers to unionize
Labor



Unionized workers earn more, have better
health benefits, safer working conditions,
retirement and disability portfolios
Industrialized countries with a greater fraction
of workers in unions invest more in social
welfare
Corporate class turns U.S. laborers against their
natural advocates (workers in other countries,
undocumented immigrants, etc.)
Abraham Lincoln
“Labor is prior to, and independent of,
capital; that, in fact, capital is the fruit
of labor, and could never have existed
if labor had not first existed. Labor is
the superior of capital and deserves
much the higher consideration.”
Railroad magnate Jay Gould
“I can hire one-half of the working
class to kill the other half.”
Overseas Labor Markets
 Currently
made overseas:
 83% of all garments sold in the U.S.
 90% of sporting goods
 93% of shoes
Overseas Labor Markets

Overseas factories often lack adequate
occupational health and safety / pollution
controls (e.g., maquiladoras)
 Even
in U.S., up to 80% of occupational
illnesses and injuries missed
 2/3
of workers fear disciplinary reaction for
disclosing
 1/3 of physicians asked to undertreat to avoid
triggering an incident report
Value of Workers to Society
Tax accountants destroy $47 for every $1
in value they generate
 Advertisers destroy $11 for every $1 they
generate
 Bankers destroy $7 for every $1 they
generate

Value of Workers to Society
Waste recycling workers generate $12 in
value for every $1 they are paid
 Hospital cleaners generate $10 in social
value for every $1 they are paid
 Childcare workers generate $7-$9.50 for
every $1 they are paid

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
Over 5,600 U.S. workers die each year due to jobrelated injuries
 Highest numbers: construction, transportation and
warehousing, forestry, fishing and hunting
 OSHA inspections rare, fines minimal
Outsourcing

2 million U.S. jobs lost to outsourcing since
1983


Exact numbers difficult to obtain, companies do not
have to report
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
Violations of Employment and
Labor Laws
26% of low-wage workers paid less than
legally-required minimum wage
 25% of workers had put in overtime
 Avg. 11 hrs, 75% not paid overtime rate
 Off-the-clock, meal break, pay stub, tipped
job violations common

Violations of Employment and
Labor Laws
Illegal deductions, employer retaliation,
and workers’ compensation violations
 Women, foreign-born, non-Englishspeaking, less educated, and non-unionized
face more violations
 Violations common in home-based work
and industry

The Global Workforce

27 million enslaved laborers
 Slavery
occurs in every country in Africa
(Unicef)
800,000 persons trafficked across
international borders annually
 Dollar value of commerce in human beings
rivals drug trafficking and illegal arms trade

The Global Workforce

215 million child laborers
¼
children in sub-Saharan Africa
 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

Thomas Jefferson
 The
care of human life and happiness,
and not their destruction, is the first
and only legitimate object of good
government
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
 Per capita income in Sub-Saharan Africa has
declined in real terms by 6% since 1975


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.
Debt and Microfinance




Muhammad Yunus (2006 Nobel Peace Prize) –
Grameen Bank
Microfinance promises growth of individual and
small business
Reality – interests and default rates often high,
corruption common
Perpetuates unfair economic system
Solution to the Third World Debt
Crisis
Debt forgiveness
Foreign Aid



In total dollars: U.S. #1
As a % of GDP, U.S. ranks 21st among the world’s
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 loans, 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%
Empathy Gap: wealthier people ruder with strangers,
less charitably generous than poor people
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 $37 billion, with another
$31 billion pledged by Buffett Foundation
Donates 5% of its worth/yr, invests 95% (typical for
charities)
Drives international public health agenda
 As do other corporate donors
(“philanthrocapitalists”)
Most grants go to organizations in high-income
countries
The Gates Foundation





Lack of external oversight, accountability
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, soda
Similar problems for Warren Buffet’s Berkshire wealth
Lancet 2009;373:1645-53
http://www.latimes.com/business/la-na-gatesx7jan07sg,0,2046572.storygallery
Federal Fund Outlay Sources (2009)





Individual income taxes: 35% maximum
 Was 91% in 1960, 70% in 1980, 50% in 1986, 39.6%
in 2000
 Poor pay a higher percent of their income in state
and local taxes
Corporate taxes: 5%
3.5% estate and gift taxes, customs, misc.
0.5% excise fees
57% borrowing (increasing national debt)
Discretionary Federal Spending (2013)
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
 104 commercial U.S. nuclear reactors (495
worldwide) – most aged, many unsafe
 More than 210 million liters of radioactive
and chemical waste stored at Hanford, WA
 Site plagued by leaks, cost overruns
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
World Military Spending (2012)
War and Peace
World military budget = 1.7 trillion (2011)
 230X what the UN spends on
peacekeeping
 US:
 Largest military budget; largest arms
supplier
 Greatest debtor to peacekeeping fund

Economic Cost of War, U.S.
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
The Military: Diversion of Resources
Away from Health Care and Other
Scientific Projects

Iraq/Afghanistan war creating enormous U.S.
debt

Federal and state budgets strapped
 States - $55 billion budget gap (2012)
War Deaths, 1945-2010
Arms Exports
Arms Imports
Weapons of Mass Destruction

Nuclear Weapons:
 1054 U.S. nuclear tests since 1940s, 331 in atmosphere
 23,360 nuclear weapons at 11 sites in 14 countries (1/2 active
or operationally-deployed)
 5200 active U.S. warheads today (½ on hair-trigger alert);
similar number in Russia
 START treaty signed by Obama, Putin
 Awaiting Senate approval
 Will limit US and Russia to 1,550 long-range warheads
(still overkill)
Weapons of Mass Destruction

Biological Weapons

Chemical Weapons

See WMD slide show on “War and Peace”
page of phsj website
“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: 15% of residents and 22% of children live in
poverty
 Rates of poverty in Blacks and Hispanics = almost
3X Whites
 2012 federal poverty level = $11,170 gross annual
income (individual); $23,050 for family of 4
Hunger rate increasing nationally
Poverty associated with worse physical and mental
health
Poverty, Health Insurance, and Food
Insecurity
15% (47 million people) in poverty (2011)
 15.7% (49 million people) lack health
insurance (2012)



Cost of maintaining COBRA health insurance for a
family consumes 84% of worker’s unemployment
benefits
Food insecurity 15% (2011)
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
Lack of clean water and sanitation cause 4 billion cases
of diarrhea and 1.6 million deaths per year
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




Americans bought > $57 billion worth of lottery tickets in 2008
(more money than is spent on movies, music, and books
combined)
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
American American buys 60 items of clothing per year (2012, vs.
31 in 1985)
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



Even so, half the world’s food is wasted (UN FAO)
Better methods of food preservation needed
Diversion of food crops to biofuels significant
contributor to rise in food prices, along with
food commodities speculation and trading
Monetization and Food Aid
US food aid purchased from alreadysubsidized US agribusiness
 US shipping lines transport food to aid
organizations in developing countries
 Undermines local farmers and destabilizes
local agriculture

Monetization and Food Aid
EU has almost entirely phased out
monetization
 UN World Food Programme (the world’s
largest distributor of food aid) has rejected
monetization and refuses monetized food
aid

Famine



Rich governments and corporations buying up
rights to millions of hectares of agricultural land
in developing countries in order to secure their
own long-term food supplies
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. = $8,233
 Average for low income developing nations =
$22-25
Medical Care

Even so, U.S. has 49 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 100
million species
 Best estimate 8.7 million +/- 1.3
million
 6.5 million on land
 2.2 million in water
Species Loss
Only 1.8 million have been identified
 50 new species identified each day
 Rate of extinction = 4,000-6,000
species/year, highest estimates = 4
species/hour
- 1,000 - 10,000X 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
- 70% decline in wild chimpanzees over last 30 years
- 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
Alpha Predators
 Precipitous
decline of alpha predators
(apex consumers) will have enormous
repercussions for ecosystems/other
species
 90% already extinct
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
Bees and bats imperiled
Causes of Species Loss
 Habitat
loss (logging, overpopulation, etc.)
- #1 cause now
 Global warming – est. #2 cause by 2050
 Overhunting
 Chemical pollution of environment
Causes of Species Loss
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); $130 billion/yr in US
 Rise of fungi and funguslike pathogens
(oomycetes)
 Account for 65% of pathogen-driven species
loss

Causes of Species Loss
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. aspirin, acyclovir, lovastatin, digoxin, vincristine,
etoposide, captopril, cyclosporine, sirolimus,
vancomycin, paralytic agents, warfarin, 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



>$20 billion market
-equal to smuggled arms market
-less than contraband drug market ($30 Billion)
Environmental crimes poorly policed, punishments
weak
Convention on International Trade in Endangered
Species (CITES)
 Still allows more than 100 million individuals of
rare species to be bought and sold each year
Invasive Species
Rabbits and cane toads in Australia
 Brown tree snakes in Guam
 Pacific rats in Polynesia
 Kudzu in the U.S.
 Asian carp (threatening U.S. Great Lakes)
 Jellyfish (“cockroaches of the sea”)

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
Worrisome Trends
 Corruption
of judiciary by campaign
contributions
 86% of US judges are elected
 Many federal judgeships remain
vacant, as Senate refuses to confirm
nominees
Bush Administration
Key administrators/committee
members/regulators former industry
representatives and/or lobbyists
 Corporate profit before public good
 Unsound/distorted/suppressed science
 “Climategate”

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
Bush Administration

American exceptionalism:
 “The American lifestyle is nonnegotiable”

Huge tax cuts primarily benefit wealthy
Obama Administration

Large industry influence

Very slow progress

Change?
Obama Administration







Overturns global gag rule
Some improvements in FDA, EPA
Withdrawal (partial) from Iraq
Failure to consider single payer health care
Supports genetically-modified crops
Appointees holdovers (philosophically and
personally) from prior administrations
?The future?
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
Status of Women

Women in the U.S. working full-time make $0.77 $0.81/$1.00 males
 Those in unions have higher salaries, better
benefits
 Part-time salary balanced $1.04/$1.00
 60% of differential due to women’s choosing
lower-paying and more portable careers in order
to support a spouse or allow for more time to
care for children or elders
Gender Pay Gap (US)
Education Worldwide
More education = longer life (for mother
and her child)
 Less education = worse health
 Infant mortality rates vary by mother’s
education
 Parents’ education is linked with children’s
health

Education Worldwide
Education increases health knowledge and
healthy behaviors
 Greater educational attainment leads to
better employment opportunities and
higher income, which are linked with better
health

Public Education in Disarray




U.S. public schools ranked lowest among developing
nations
Inadequate funding, decaying infrastructure
National HS graduation rate 65-70%
 No change from 1970s
 Lower incomes youths 6X as likely to drop out
College tuition costs rising
 Increasingly marginalizes poor, minorities
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%
Ignorance/Pseudoscientific
Beliefs

Half of US citizens do not believe in
evolution and do believe that humans and
dinosaurs coexisted (2007)
 40%
think scientists still generally disagree
about evolution
 Only 12% of U.S. Protestant pastors believe
in evolution

70% believe in global warming
Pseudoscientific Beliefs
37% believe places can be haunted (2007)
 25% believe in UFOs (2007)
 24% believe in astrology (2009)
 16% believe that people with the “evil eye”
can cast curses or harmful spells

Ignorance/Pseudoscientific
Beliefs




22% of Americans don’t know whether an atomic
bomb has ever been dropped (2000)
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)

14% have consulted a psychic or fortune teller (2009)
Ignorance/Pseudoscientific
Beliefs

Despite politicians’ statements, 72% of
Republicans believe global warming is occurring
(92% of Democrats)

Some states require instructors to teach
“creation science,” “intelligent design,” and
“climate change skepticism”
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 environmentallyfriendly 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
Advertising
 Astroturf - artificially-created grassroots
coalitions
 Corporate front groups
 Invoke poor people as beneficiaries

Corporate PR tactics
Characterize opposition as
“technophobic,” anti-science,” and
“against progress”
 Portray their products as environmentally
beneficial despite evidence to the contrary
 Corporate espionage: spying, bribes


Bribery of foreign officials illegal under Foreign
Corrupt Practices Act
Chief Seattle
“The earth is our mother. Whatever befalls
the earth befalls the sons of the earth. The
earth does not belong to man, man belongs
to the earth. All things are connected like
the blood that unites us all. Man did not
weave the web of life, he is merely a strand
in it. Whatever he does to the web, he does
to himself.”
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 Coal Foundation 4th grade lesson packet
(published by Scholastic) entitled “The United
States of Energy)
 Omits mention of toxic waste, mountaintop
removal, and greenhouse gasses
Sponsored Environmental
Education Materials (Examples)

American Nuclear Society’s “Activities with the
Atoms Family”

Dow’s “Chemipalooza”

Council for Biotechnology Information’s
“Look Closer at Biotechnology”
Textbook Publishers Facilitate
Corporate Messaging

Scholastic, Inc.

World’s largest publisher of children’s educational
materials

Found in 90% of U.S. classrooms
Has taken money from Big Coal, Disney, Microsoft,
Nestlé, and Shell to produce books and lesson plans
 2011: Announces plan to terminate some industry
contracts, set up quasi-independent review board to
review corporate materials

Advertising



US now spends $290 billion/yr on advertising
 Almost $1,000/person/yr in the U.S.
10% of a two-year olds nouns are brand names
The average American can recognize over 1,000
corporate logos, but fewer than 10 plants and
animals native to his/her locality
Advertising/PR

"Those who manipulate the unseen mechanism
of society constitute an invisible government
which is the true ruling power of our country.
We are governed, our minds molded, our tastes
formed, our ideas suggested largely by men we
have never heard of. →
Advertising/PR

In almost every act of our lives, whether in the
sphere of politics or business, in our social
conduct or our ethical thinking, we are
dominated by the relatively small number of
persons who understand the mental processes
and social patterns of the masses. It is they who
pull the wires that control the public mind.“
-Edward Bernays, Pioneer of Corporate PR
and Propaganda
Worrisome Trends

Television
 Average American watches over 4 hours of
TV daily
 Average American child aged 8-18 spends 7.6
hrs/day using an electronic device or
watching TV
 TV sets now outnumber homes in America
Channel One (Primedia, for-profit)

12 minutes per day:





Includes 2 minutes of ads (mostly for junk foods,
video games)
Viewed by 8 million students in 12, 000
classrooms
Disproportionately shown in low income and
minority communities
Costs taxpayers $1.8 billion per year
Opposed by major education groups
Worrisome Trends
Public Education in disarray
 1/3 of America’s 80,000 schools need
extensive repair or replacement
 1/3 or more have mold, dust, indoor air
problems (contribute to asthma,
absenteeism
 Higher Education increasingly expensive

Nation’s Schoolchildren Call For
Cuts in Math/Science Funding
Education in America





16% of adults have not completed high school
30% have no schooling beyond high school
27% have attended but not completed college
28% are college graduates
Rates vary dramatically across racial and ethnic
groups
Educational Apartheid



High levels of de facto school segregation by
race and SES
Gross discrepancies in per-pupil spending and
teacher salaries
Achievement and graduation gaps growing
Benefits of Education
For every $1 spent on early childhood
education, up to $17 are saved from
increased school achievement, improved
health, reduced crime, and reduced reliance
on public assistance
 Income increases 11% for every year of
education

Benefits of Education
College graduates live 5 years longer than
high school dropouts
 Eliminating educational inequities would
have saved 8X as many lives as medical
advances from 1996-2002

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)
Academics at Risk

Including government scientists

Subversion of science by Bush Administration

Obama administration slow to roll out ethical
standards

Discourages young scientists
Academics at Risk
Contingent (adjunct) faculty up from 43%
(1979) to 73% today
 Paid ¼ amount of regular faculty
 No benefits
 No job security, opportunities for career
advancement
 Dramatic rise in number of administrators
 Many very well paid

Academics at Risk



University faculty members spend about 40% of their
research time writing grant applications and fulfilling
grant paperwork requirements
Funding agencies favor worthy but incremental
research over risky but potentially transformative work
Solutions:



Increase research budgets
Longer funding cycles
Fund people, rather than projects
Academics at Risk

College tuition up (440% from 1984-2009),
administrators’ salaries skyrocketing

Average debt for graduating college
students = $25,250

Total US student debt exceeds $1 trillion
Academics at Risk
Job market poor for graduating college
students
 50% of college students do internships, up
from 17% in 1992
 1/3 – ½ of internships are unpaid

Academics/Professional
Organizations Affected
Increasing corporatization of academia
 ↑Private commercial funding of
university research
 Secrecy/Gag Clauses
 For-profit colleges growing, marked by
corruption, high interest rates on loans to
the un- and under-qualified

Academics/Professional
Organizations Affected
For-profit colleges growing, marked by
corruption, high interest rates on loans to
the un- and under-qualified
 Benefit largely from taxpayer money
 Dramatic decrease in tenured faculty, rise
in administrators

Academics/Professional
Organizations Affected


Gagging of researchers at federal agencies
demoralizing, can affect recruitment of quality
scientists
2001 – 2011: Number of published papers
increased by 44%; number of retracted articles
increased 15-fold (3/4 for errors, ¼ for fraud)
Academics at Risk




Teachers underpaid
Teachers’ unions under attack
47% of K-12 teachers graduate in bottom 1/3 of
college class
Forced instruction in creationism, intelligent
design, etc.
The Medical Brain Drain
U.S. – 280 physicians/100K people (vs.
sub-Saharan Africa – 18/100K people)
 Five times as many migrating doctors flow
from developing to developed nations than
in the opposite direction
 Example of “inverse care law”:
 Those countries that need the most
health care resources are getting the least

Science in the Developing World
Lack of scientists in developing world
(1/50th of developed world per capita)
 Impaired access to scientific data
(publications/textbooks too expensive,
hence information outdated

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
Legislative Mandates

Bills allowing teaching of creationism or
“intelligent design” alongside evolution

Bills requiring global warming to be taught
as a “theory”
Anti-Science Legislators

Members of the House Science Committee
(2012)
Paul Broun (R-GA): Evolution, embryology, and the
Big Bang Theory are “lies straight from the pit of
hell;” climate change is a “hoax”
 Ralph Hall (R-TX): Agrees with TX Governor Rick
Perry that climate scientists are involved in a
conspiracy to receive research funding.
 Jim Sensenbrenner (R-WI): The science on global
warming is “inconclusive”

Anti-Science Legislators
 Members of the House Science Committee (2012)
 Todd Akin (R-MO): “If it’s legitimate rape,” women
will not get pregnant (lost 2012 election)

Dana Rohrbacher (R-CA): Claimed an earlier period
of global warming may have been caused by
“dinosaur flatulence,” suggested that if global
warming is real it could be addressed by cutting
down trees, does not believe that CO2 is a cause of
global warming
The Media


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



42,000 lobbyists (15,000 full-time)
Estimates of return on lobbying range from $28
to $100 for every $1 spent
Revolving door between lobbyists and Congress
 Between 2001 and 2011, 5,400 former
Congressional staffers have left to become
lobbyists, and 605 lobbyists have left their
positions to work for Congress
Drug Company Malfeasance


The pharmaceutical industry is the biggest defrauder of
the federal government, as determined by payments
made for violations of the federal False Claims Act
(FCA)
 Accounted for 25% of all FCA payouts between
2000 and 2010
 Defense industry – 11%
Has paid out almost $20 billion in civil and criminal
penalties over the last 20 years
Pharmaceutical Industry

$240 million dollars spent on lobbying in
2011
 1,228 lobbyists (2.3 for every member of
Congress)
 Revolving door between legislators,
lobbyists, executives and government
officials
Lobbying

Lobbying groups spent 3.5 billion in 2010
(federal lobbying, a record)


Financial sector spent over $1.7 billion on
campaign contributions for federal elections
from 1998-2008
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
Citizens United v. Federal Election
Commission (U.S. Supreme Court, 2010)


U.S. Supreme Court ruled that corporations can
effectively be treated as persons
 No limits on campaign spending
 Not persons when it comes to liability for
causing harm to the environment or the
public’s health
196 donors contributed nearly 80% of money
raised by super-PACs in 2011
Will Rogers
“We have the best Congress
money can buy.”
Privatization of Public Services

Water
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 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 AntiPersonnel Land Mines
International NonCooperation/Isolationism

Failure to sign or approve:
 Treaty to ban cluster bombs
 Comprehensive Nuclear Test Ban Treaty
 Convention on the Rights of the Child
 Convention on the Elimination of
Discrimination Against Women
International NonCooperation/Isolationism
 Convention
for the Suppression of
Traffic in Persons
 UN Convention on the Rights of
Disabled Persons
 WHO International Code of Marketing
of Breast Milk Substitutes
 UN General Assembly Recognition of
Human Right to Water and Sanitation
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 one of only 20 countries to execute
civilians (2011)
 Until recently, the US was the only
country to execute both juveniles (ended
2005) and the mentally ill (ended 2002)
The US: Rogue Nation
Failure to follow World Court Decisions
 Failure to recognize International Criminal
Court
 Largest debtor to the UN (only 40% of
dues paid)

The US: Rogue Nation
 Patriot
Act, 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 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
[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
Environmental Success Story
The Montreal Protocol (1987)
 Current
substitute, HCFCs, much less
damaging to ozone layer, also to be phased
out in developed world
 Still produced in large quantities in China
 Large black market with international
smuggling
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
Upgrades to treaty to address mixtures of
chemicals
Convention on Biological
Diversity


Calls for:
 conservation of biological diversity
 sustainable use
Includes Nagoya Protocol on Access to Genetic
Resources and the Fair and Equitable Sharing of
Benefits Arising from their Utilization - aimed at
stopping biopiracy and ensuring that developing
countries get their fair and equitable benefits from
biodiversity and indigenous knowledge
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

Institute of Medicine/National Research Council
have endorsed for FDA policies
Puerto Rico, San Francisco have adopted,
among others
 Big business, US Chamber of Commerce
oppose

The Four Laws of Ecology
Barry Commoner


1. Everything is Connected to Everything Else.
There is one ecosphere for all living organisms
and what affects one, affects all.
2. Everything Must Go Somewhere. There is no
"waste" in nature and there is no “away” to
which things can be thrown.
The Four Laws of Ecology
Barry Commoner


3. Nature Knows Best. Humankind has
fashioned technology to improve upon nature,
but such change in a natural system is likely to
be detrimental to that system.
4. There Is No Such Thing as a Free Lunch.
Everything comes from something. There's no
such thing as spontaneous existence.
Connectedness



Globalization – benefits and drawback
Homogenization:
 7,000 extant languages
 78% speak the 85 largest languages
 Within one century, nearly ½ expected to
disappear
Technology/Social Media: dual capacities for
good and evil
Solutions
 Shift
from a throw-away economy
to a reduce/reuse/recycle
economy
 Support local economies
 Enhance fair trade policies
Solutions

Rebuild decaying infrastructure:

Federal outlays for basic infrastructure:
1968 = 3.3% of GDP
 2011 = 1.3% of GDP


Am Soc Civil Engs estimates $2.2 trillion needed,
over 5 years, to adequately maintain and upgrade the
nation’s roads, dams, drinking water, school
buildings, etc.
Solutions

Recognize nature’s net worth (Natural
Capitalism)

Annual value of ecosystem services worldwide = $33
trillion (1997 estimate)


$44 trillion (2012); nearly 2X global GNP of $24 trillion
Calculate economic prosperity based on
Genuine Progress Index or Global
Happiness Index, rather than Gross
Domestic Product
Solutions

Consider democratic alternatives to
capitalism

Participatory economics (with component
of natural economics) – aka Parecon

Ground-up system
Solutions
 Decrease
energy consumption
 Zero waste production systems
 Extended producer responsibility /
Extended product liability
 70+
laws in US
 Cover electronic devices, mercury-containing
thermometers, fluorescent lamps, paint,
batteries, pharmaceuticals
Solutions
Production-side environmentalism
(reducing “planned obsolescence”)
 Recycling laws
 Only 11 states have bottle deposit laws
(recycling rates 63% vs. 12% in those
without)

Solutions
Pharmaceutical Take-Back Laws
 Drug companies fighting
 Combat the spread of illegal, dangerous
black market pharmaceuticals
 Cause 100,000 deaths/yr worldwide
 $75 billion business

Solutions

Restructure tax system
 Decrease taxes on work and savings
 Increase taxes on wealthy
 Lower
taxes on wealthy are not associated
with economic growth, are associated with
more inequality
 Maximum
income (France, England
considering)
Solutions

Restructure tax system
 Increase capital gains tax from 15% to (at
least) prior 25% rate
 Resume transaction tax on stock
sales/purchases
 Increase taxes on destructive activities (e.g.,
carbon emissions, toxic waste generation)
Solutions
Greater regulation of financial markets
 Eliminate confidential legal settlements
relevant to public health and safety
 Stronger clean air and water standards
 Revise and update TSCA

Solutions

Drink tap water
 Incredibly cheap and, in the US, almost always safe
 Exceptions include private well water, from
which 15% of Americans get their drinking water
 Not regulated by Safe Drinking Water Act
 40% contaminated to some degree with
arsenic, radon, nitrates
Solutions
Eat less meat
 It takes 12-16 lbs of grain and 2500
gallons of water to produce one lb of
hamburger
 Catch-share agreements to decrease overfishing
 Eliminate fossil fuel industry tax breaks
and subsidies

Solutions
 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

Solutions
EPA to regulate carbon emissions under
Clean Air Act (2011)
 Climate Security Act: weaknesses include
unfair “cap and trade” provisions, carbon
capture and storage (CCS)
 New EPA rules re mercury, coal ash (2011)

Solutions
Replace annual crops with perennials
 Sequesters CO2
 Support organic farming
 converts carbon from a greenhouse gas
into a food-producing asset

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, Lake
Nyos, and Lake Monoun disasters
 Implies dangers likely to be associated
with carbon capture and storage
Solutions
 Increase
tax breaks, subsidies, research
for renewable energy
Renewable energy now 3% of
transportation fuel market (ethanol)
and 9% 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



Europe, Canada have take-back systems
Shift medical research agenda
Solutions

Decrease light pollution ($2 billion energy
wasted per year) and see the stars!
 2/3 of US population and over ½ of EU
population can’t see Milky Way
-Czechoslovakian anti-light pollution law
Solutions
Insulation
 Energy-efficient lighting
 Europe bans incandescent lightbulbs
(2009)
 Australia mandates use of compact
fluorescent light bulbs by 2012

Solutions

Decrease excessive packaging
 ¼ of world lives with ban or fee on plastic bags
 15¢/plastic bag tax in Ireland ↓’d use by 90%
 More than 30 states have enacted or proposed plastic bag
restrictions
 Los Angeles, San Francisco, Portland (OR), Mexico City
have outlawed plastic bags
 Canada, China, Italy, Bangladesh, and a few other countries
have banned; others considering ban
 Charge for paper bags (LA) – markedly decreased use
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
Alien Tort Claims Act designed to hold corporations
accountable for human rights abuses overseas
Solutions
 Safe
storage of nuclear wastes
 Green electricity - $3/month
 Bioprospecting
 Ecotourism
 Rewilding (Contemporary vs. Pleistocene)
Solutions

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
Address Social Factors
Responsible for Illness and Death

Deaths in 2000 attributable to:
 Low education: 245,000
 Racial segregation: 176,000
 Low social support: 162,000
 Individual-level poverty: 133,000

AJPH 2011;101:1456-1465
Address Social Factors
Responsible for Illness and Death

Deaths in 2000 attributable to:
 Income inequality: 119,000 (populationattributable mortality – 5.1%)
 Area-level poverty: 39,000 (populationattributable mortality – 1.7%)

AJPH 2011;101:1456-1465
Deaths per year









Tobacco = 400,000 (+ 50,000 ETS)
Obesity = 300,000
Alcohol = 100,000
Microbial agents = 90,000
Toxic agents = 60,000 (likely higher)
Firearms = 35,000
Sexual behaviors = 30,000
Motor vehicles = 25,000
Illicit drug use = 20,000
Address Social Factors
Responsible for Illness and Death

Deaths in 2000 attributable to:
 AMI – 193,000
 CVD – 168,000
 Lung CA – 156,000

AJPH 2011;101:1456-1465
Major Contributors to Illness and
Death
40% of US mortality due to tobacco, poor
diet, physical inactivity, and misuse of
alcohol
 Every $1 invested in programs covering
above items saves $5.60 in health care
costs


Up to $1/$50 for tobacco control
Maldistribution of Wealth is
Deadly
 880,000
deaths/yr in U.S. would
be averted if the country had an
income gap like Western
European nations, with their
stronger social safety nets
Prevention



2-4% of national health care expenditures
Every $1 spent on building biking trails and
walking paths would save nearly $3 in medical
expenses
Every $1 spent on wellness programs,
companies would save over $3 in medical costs
and almost $3 in absenteeism costs
Public Health Spending

Public health spending minimal

Mortality rates fall 1-7% for every 10%
increase in public health spending
Solutions




Reverse medical and scientific brain drain
Programs for education and return to home
country
Eliminate unnecessary health care waste; reuse/send overseas hospital and surgical supplies
Open-access publication (see Dr Gavin Yamey’s
slide show on the “Activism and Education”
page of the phsj website
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
 Members of Congress spend between 30%
and 70% of their time fundraising
 50% of Senators and 42% of Representatives
become lobbyists after leaving office
Solutions: Fair, Representative
Elections




Open debates, free air time for candidates
Proportional representation
Instant runoff voting/cumulative voting/range
(rating) voting
Halt disenfranchisement, overturn voter
restriction laws
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:
Maximum Wage


British-, French-, and New Zealand-proposed
income-cap legislation (“maximum wage”)
U.S. proposals to create maximum wage of
$400,000 (president’s salary)
 25X annual pay of the lowest-paid federal
worker
 Patriot Corporations Act would cap pay at
100X pay of lowest paid worker
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
 Terror-free investing
 Celebrities/Jocks for Justice
Solutions


Activism / Letter writing / Protesting /
Whistleblowing
 US Supreme court ruled in 2006 (Garcetti v.
Ceballos) that public employees have no freespeech rights re whistleblowing and no
constitutional protections against retaliation
by bosses
Join community groups – become involved in
local as well as national issues
The health impact pyramid
Frieden, T. R. Am J Public Health 2010;100:590-595
Copyright ©2010 American Public Health Association
“Western science and efficiency has made
major contributions to minor needs”
- Buddhist Monk, quoted in Wade Davis’ The
Wayfarers
Solutions: Vote
 US
voter turnout low (139/172
worldwide)
 Wealthy vote at almost twice rate of
poor
 Whites > Blacks > Hispanics
 Old > Young
 Property owners > Renters
Voter Turnout
Solutions
 Fair,
representative elections
 Campaign finance reform
 Publicly financed campaigns
 Better candidates
 Lower voting age to 16
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
Synthesis/Regeneration
“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
Günter Grass
“The first job of a citizen is to
keep your mouth open.”
Mahatma Gandhi
“You must be the change you
wish to see in the world.”
Alice Walker
“The most common way people give
up their power is by thinking they
don’t have any”
Edward R Murrow
“A nation of sheep will beget a
government of wolves”
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."
African Proverb
If you think you are too small to
have an impact, try going to bed
with a mosquito in your tent
Contact Information and References
Public Health and Social Justice Website
http://www.phsj.org
martindonohoe@phsj.org