2013-05-21T17:48:57-04:00 Paul R. Epstein, M.D., M.P.H. http://www.huffingtonpost.com/author/index.php?author=paul-r-epstein-md-mph Copyright 2008, HuffingtonPost.com, Inc. HuffingtonPost Blogger Feed for Paul R. Epstein, M.D., M.P.H. Good old fashioned elbow grease. tag:www.huffingtonpost.com,2011:/theblog//3.911193 2011-07-27T15:24:49-04:00 2011-09-26T05:12:02-04:00

Paul R. Epstein, M.D., M.P.H. http://www.huffingtonpost.com/paul-r-epstein-md-mph/
Greece, for example, has become a victim of these policies. While bailouts will help bridge the current crisis, the conditions of the bailout -- so-called conditionalities -- are the same policies that led it -- and many other nations -- into this crisis.

During the 1980s and '90s, spirals of inflation and speculation led many nations to borrow money. In turn, they were forced by the International Financial Institutions (The World Bank, International Monetary Fund and the World Trade Organization) to slash government employees and programs, and sell off public assets as conditions for more loans -- to pay back previous loans. Such neck wrenching "structural adjustment programs" -- appropriately nicknamed SAPs -- flowed from the "Washington Consensus" of deregulation, privatization and liberalization (of movement of money as well as goods). Economic collapses came in Asia in the late '90s, then globally in 2008.

Another collapse is threatening, driven by debt, deficits and potential defaults.

But more of the same medicine -- lay offs, budget cuts -- is not going to help nations move forward. Many nations are rapidly dismantling governments on local, national and international scales. These policies are pushing Greece, Portugal, Spain, Ireland and Italy deeper into negative growth. The same structural adjustment policies in the U.S. -- on local and national levels -- will also reduce the chances of recovery. Even the U.S. Chamber of Commerce is worried about dwindling support for infrastructure -- ports, railroads, bridges, etc.

We face more failed states.

Deregulation of finance lies at the core of the chaotic state into which we are descending. Deregulation began in the early '70s when President Nixon cast the Bretton Woods rules asunder. And today, finance shows little sign of self-enlightened correction.

There is an alternative to more punishment. It involves resolving the disconnection between finance and production. In addition to restructuring debts, new funds are needed globally to push and pull markets towards a new form of development.

Where can such funds come from, with nations strapped by debts and deficits?

The European Commission president, Jose Manuel Barroso, has called for new global funds drawn from a levy on currency transactions (the so-called Tobin Tax -- after Nobel Prize winning Yale economist (deceased) who proposed it in the early '70s to slow down the spirals of speculation). A Tobin Tax would denationalize the source of funds -- rather than extracting it from financially-strapped nations. European Central Bank president, Jean-Claude Trichet argues that, to be successful, the levy would have to be adopted globally.

The current tally of wagers on relative currency values is $4 trillion a day (up from $16 billion daily in 1971). A few pennies levied on each hundred dollars exchanged would raise several hundred billion dollars annually -- an amount needed consistently over several decades to invest in productive sectors.

Funds are the necessary component toward building a clean economy and a new source of funds would benefit all. Such a transfer from finance into production would constitute a sound investment into our common future.

There is a precedent for such a shift. When high interest rates in the late '80s kept money in banks, lowering rates facilitated a shift of funds into the productive sectors -- benefitting finance and industry.

A small tax on finance would address the runaway train of an unregulated, undisciplined global economy by slowing down the rapid movement of money in and out of nations that can destabilize economies -- trades disconnected from the real economy. Reigning in the unregulated, unraveling of the global casino economy -- and generating funds for clean and healthy development -- is a two-fer with promise.

Greece -- the birthplace of western civilization -- is in a sad state, and is being forced to suffer deeply for all our sins. Structural adjustments to undo public services and infrastructure, is a self-defeating strategy. Greece's fate is a lesson for governments at all levels in developed and developing countries.

We need a large pool of funds to drive the clean energy transformation and healthy development -- and we need to stop dismantling the apparatus that provides the support for a thriving public sector.

Paul R. Epstein is co-author with Dan Ferber, of "Changing Planet, Changing Health," published this spring by the U. of California Press.]]> tag:www.huffingtonpost.com,2011:/theblog//3.846896 2011-04-08T18:04:24-04:00 2011-06-08T05:12:01-04:00

Paul R. Epstein, M.D., M.P.H. http://www.huffingtonpost.com/paul-r-epstein-md-mph/ The Lancet named what they called the biggest global health threat of the 21st century. HIV/AIDS? Nope. Heart disease? Not at all. Cancer? Keep trying. To get your head around the biggest health threat of all, you might have to change how you think about health entirely. That's because the biggest threat of all, in the view of this blue-ribbon panel, was climate change.

In the last few years, leading medical professionals have begun to speak out about the extraordinary threats climate change poses to human well-being. The American Academy of Pediatrics stated in Pediatrics, its professional journal that "children are likely to suffer disproportionately from both direct and indirect adverse health effects of climate change." The American Nurses Association described the challenges of global climate change as "unprecedented in human history" and called for nurses to "speak out and advocate for change." Cecil Wilson, MD, the president of the American Medical Association, stated at a congressional briefing that climate change could cause "devastating events with serious human health implications."

How can our warming climate affect our health? In some surprising ways, as we describe in our new book, Changing Planet, Changing Health.

• Warming temperatures allow disease-carrying mosquitoes to spread out of the tropics and higher into the mountains, bringing malaria, dengue fever, and other currently tropical diseases with them. And we're not immune in North America: Dengue fever (breakbone fever) has moved from central America northern Mexico, and warming climate has brought Lyme disease to New Hampshire and Maine, is more than eight-fold as common than it was a decade ago.



• Devastating heat waves like the one that baked Chicago in 1995 and the one broiled Moscow in 2010 will become more common. Climate models project a blistering heat wave like the one that killed 739 people in Chicago in 1995 every summer, on average, by the 2040s.



• Extreme rains and snows will be even more common, like the deluge in 2010 that swamped Nashville with 13 inches of rain in a day. Health risks of flooding include drowning, respiratory diseases from mold and diarrheal disease from poor sanitation.



• Red tides and other harmful algae blooms in the warming coastal ocean can cause severe nausea, vomiting, and even paralysis and brain damage to swimmers, surfers, and those who eat contaminated shellfish. In 1987, for example, 150 people on Prince Edward Island who ate contaminated mussels were poisoned by domoic acid, an algal toxin that kills brain cells. All suffered vomiting, cramps and diarrhea; some suffered serious memory loss and seizures; nineteen were hospitalized, and four died. In Florida, emergency room visits already rise during red tides.



• A warmer, drier West is melting the snowpack early and turning forests become tinder. Bark beetle infestations that wipe entire stands of trees worsen the risk. Forest fires can kill, and smoke inhalation from forest fires heighten the risk for heart attacks, asthma and respiratory problems in susceptible people. In one study following severe wildfires in Florida, complaints of chest pain increased by 37 percent, asthma by 91 percent and bronchitis by 132 percent.

In Changing Planet, we also describe a full set of technology and policy solutions, each carefully vetted to provide maximum benefit for human health and the environment. We need a smart electrical grid that will increase efficiency, reduce demand and use renewable sources like wind, solar and geothermal at many homes and businesses rather than get power solely from a centralized power station. We need to move away from nuclear, coal, even with carbon capture and storage, and corn-based ethanol, all of which harm human health and the environment. These choices are based on extensive studies called life cycle analyses that look at the true costs of a technology or energy source from cradle to grave.

Policies must change as well. We need to rejigger the international financial system to encourage countries to invest in measures that protect their environment and the health of their citizens. To promote good health in the 21st century, we need to become resilient and adaptable.]]> tag:www.huffingtonpost.com,2011:/theblog//3.823681 2011-02-15T16:00:06-05:00 2011-05-25T18:30:24-04:00

Paul R. Epstein, M.D., M.P.H. http://www.huffingtonpost.com/paul-r-epstein-md-mph/ Levying a tiny tax on financial transactions could help build a healthier and more stable future.

Political discontent simmered for decades in Egypt, but soaring food prices helped push public frustration past the boiling point. As the political drama there continues to unfold, it's critical to address the complex financial and environmental dynamics that have driven global food prices to record levels.

Rising oil prices and the shift from food crops to biofuels are part of the problem. But two other factors deserve increased attention -- climate change and financial speculation.

Extreme weather events -- like the heat wave that sparked fires across Russia's breadbasket last summer -- are tightening supplies. The impacts of severe weather in one area on distant nations (witness the food riots in Mozambique last summer as Russia cooked) emphasize the limits of adaptation. And changing weather patterns, with more droughts, floods, severe hurricanes, and winter weather anomalies, are predicted to increase in a warming world.

Lester Brown, president of the Earth Policy Institute, warns that for each degree of temperature increase, crop yields are anticipated to drop by 10 percent. He notes that, with climate change and altered weather patterns, come growing water scarcity, desertification of once-arable land, and the inundation of globally important farmland -- such as the Mekong and Red River deltas, which produce most of Vietnam's rice.

Experts also blame an explosion of speculation in food commodity markets for food price volatility. The original purpose of these markets was to help farmers and food processors lock in predictable prices so they could make smart business decisions. The financial speculators that now dominate the markets don't intend to buy or sell grain or meat. Their interest lies in capitalizing on food shortages and price volatility. Thanks in part to deregulation, the speed of this global gambling can lead to boom and bust cycles that are detached from the actual value of food.

The G20 finance ministers, who will meet this week in Paris, have an opportunity to take bold steps toward tackling both of these underlying causes of the food price crisis. French president Nicolas Sarkozy, currently the G20 chair, is pushing for an international agreement to adopt taxes on financial speculation that could generate massive revenues for urgent needs, including climate programs in developing countries.

Here's how this would work. A tiny levy would be charged on each financial trade, including every sale of stocks, bonds, foreign currency, credit default swaps, commodity futures, or other derivatives. Because trillions of dollars worth of transactions occur every day, even a small tax of 0.05 percent could raise more than $600 billion annually.

Directing a portion of this revenue to programs to combat climate change and support global health programs would dwarf current public contributions. Speaking at the World Economic Forum in Davos, financier and philanthropist George Soros backed the idea of using some of the revenues from such a financial transactions tax (which supporters often refer to as an FTT) to fight climate change.

German Chancellor Angela Merkel is another strong proponent and is exploring the possibility of moving ahead with a "coalition of the willing" rather than waiting for all G20 countries to get on board.

Other financiers and governments would do well to follow the path of enlightened self-interest. The UK showed how shifting funds from finance to industry could be good for business when it took actions in the early 1990s to reduce high interest rates that were stagnating money in bank savings. Soon after, its economy took off.

In a recent study, the International Monetary Fund found that taxes on financial speculation are not only technically feasible but that most G20 countries (and many others) have already implemented some form of an FTT. For example, the London Stock Exchange has long levied a 0.5 percent stamp tax on all stock trades.

Though the Obama administration hasn't yet endorsed the idea of taxing financial speculation, there is support in the U.S. Congress. In the last session, members introduced several bills to create various types of financial transactions taxes. Rep. Pete Stark (D-CA) is poised to re-introduce legislation that would put a levy on foreign currency transactions to generate revenue for deficit reduction and for global public goods, like the clean energy transformation.

As the G20 meets, advocates in 20 nations around the world, including the United States, will carry out a variety of actions to send a message to G20 leaders to support levying a FTT.

No one regulatory mechanism will solve all of the problems of food insecurity, climate change, and financial instability. But, with national budgets strapped and the financial sector benefitting handsomely from the global economy, it becomes even more important for speculators to do their fair share. A tax on financial speculation could be the first of many innovative mechanisms to link the economy with the environment and help build a healthier, more stable, and more secure future.]]> tag:www.huffingtonpost.com,2011:/theblog//3.808624 2011-01-13T12:51:24-05:00 2011-05-25T18:25:24-04:00

Paul R. Epstein, M.D., M.P.H. http://www.huffingtonpost.com/paul-r-epstein-md-mph/
Some commentators have invoked changes in atmospheric circulation over Siberia to explain the severe winter weather besieging Europe and parts of the U.S. But there is another part of this puzzle lying closer to our own shores. Warming may be leading to cooling via melting Arctic ice.

For the past 16 months a climate phenomenon known as the North Atlantic Oscillation (NAO) has been locked in one mode; a negative phase, an unusually long stretch with unusually high atmospheric pressures over the Arctic, and low pressure to the south.

Highs persist over cold areas, for cold air is heavy and sinks. Lows, meanwhile, form over warm regions, for hot air rises. And winds and weather fronts flow "downhill," as it were, from highs to lows.

So why might a High pressure system be locked in over the North Atlantic?

During the past decade Arctic ice (where the North Pole sits) has melted and thinned much faster than models predicted. (The floating North Polar cap is only several feet thick.) In addition, many Greenland outlet glaciers are melting from above, calving from below (as they meet warmer seas), and sliding and slipping along their bases into the sea. This melting ice spreads cold, fresh water across the North Atlantic Ocean surface, contributing to a North Atlantic High.

To the south in the Atlantic, the Azores bask in warm sea surface temperatures, as does most of the globe, for the world ocean is where heat has built up over the last century. Indeed, since the late 1950s, the world ocean has accumulated 22 times as much heat as has the atmosphere, and the warmed ocean is the engine for changing weather patterns globally.

Meanwhile, in the Middle East, unusually hot and dry conditions have become the new norm (ask our soldiers and the residents), creating persistent Lows in that region. It is the large gradient between the Atlantic High and the Middle East Low that pushes and pulls the bitter winds and weather fronts now whipping off the North Atlantic across Europe.

For the U.S, the North Atlantic High is a blocking high, deflecting fingers of the Jet Stream deep down into the south, bringing lots of continental polar air to usually temperate and sub-tropical states. And with warming seas and atmosphere overall, there's plenty of water vapor evaporating to generate large amounts of snow, sleet and rain.

The details of this argument are not critical. What is important is that global warming (of the atmosphere and oceans) is causing climate change -- meaning changing temperatures and weather patterns. Weather has become more extreme -- drier and hotter in some areas and wetter and cooler in others -- and precipitation is coming in heavier downpours across the globe. And the warming world ocean and shrinking ice cover are playing leading roles in driving the weather extremes.

Changes in winds and weather patterns with global warming, we have begun to discover, are not limited to the warm seasons. Winter weather anomalies are an emerging feature of climate change and result in orthopedic injuries and travel accidents, deaths, crop failures, power outages, business interruptions, and insured and uninsured losses. Harsh winter weather may, in the future, play an even more disruptive role to society than the heatwaves and spread of infectious disease more commonly considered.

Climate instability -- with greater volatility and wider swings to extremes -- raises the risks of major anomalies that threaten our health and economies. "God does not play dice," Albert Einstein famously said (as he grappled with the uncertainty of quantum mechanics). With regard to weather it seems we have stepped into a high stakes global casino.

But there is hope. An unstable system can re-stabilize and establish a new equilibrium. But we must back off the forces changing Earth's climate -- burning fossil fuels and felling forests -- and fast. We can hope that growing recognition of the mounting risks of climate change help spur a new level of commitment, domestically and internationally. Bold measures are needed, backed by global funds, to stabilize Earth's climate and provide new impetus for a healthy global economy.

Paul R. Epstein, M.D., M.P.H. is associate director of the Center for Health and the Global Environment at Harvard Medical School. He and science writer Dan Ferber are co-authors of the forthcoming book, Changing Planet, Changing Health, to be published this spring by the University of California Press.]]> tag:www.huffingtonpost.com,2010:/theblog//3.796425 2010-12-14T10:46:55-05:00 2011-05-25T18:20:30-04:00

Paul R. Epstein, M.D., M.P.H. http://www.huffingtonpost.com/paul-r-epstein-md-mph/
In the past two decades, extreme heat events have killed tens of thousands around the globe, including populations here in the United States. Heatwaves are more frequent, of longer duration and more intense -- and the lack of nighttime relief accompanying climate change makes today's heat waves all the more lethal. Heat waves can cause illness and death from heart disease, diabetes, stroke, respiratory disease and even accidents, homicide and suicide.

At the same time, increased evaporation arising from warming seas is generating heavier downpours. (The world ocean has accumulated 22 times as much heat as has the atmosphere since the 1950s.) Across the continental U.S., two, four and six inch-a-day rains have increased 14, 20 and 27 percent, respectively, since 1970. This year, sudden, heavy downpours -- some lasting several days -- caused lethal flashfloods in Rhode Island, Tennessee, Arkansas, Oklahoma, Illinois, Iowa, Wisconsin and Minnesota. Rains two inches a day and above are associated with water-borne disease outbreaks, when flooding overwhelms sewer systems and contaminates drinking water.

Increases in winter weather anomalies are emerging. Though winters have become shorter (two-to- three weeks shorter in the Northern Hemisphere, depending on latitude), they have grown more perilous. With warming, more winter precipitation is falling as rain rather than snow, increasing the chance of ice storms when temperatures do drop. Globally, westerly winds are also changing with climate change, affecting the shifts in weather fronts. And such conditions -- along with heavier, wetter snowstorms -- can be treacherous for travel and ambulation. (In Boston, we've dubbed this "orthopedic weather.")

Meanwhile, warmer winters favor insect migration. In the past decade case reports of tick-borne Lyme disease rose ten-fold in Maine and northern counties are experiencing Lyme for the first time. In Alaska, especially warm winters have ushered in swarms of allergy-inducing, stinging insects, along with mosquitoes and devastating pine bark beetle infestations. The spread of forest and crop pests -- requiring chemicals for control -- pose additional long term health and environmental risks.

There's more. Elevated carbon dioxide levels from burning fossil fuels boosts pollen production from ragweed and the pollen grains hitch rides on particulates from diesel and coal combustion, helping to deliver the allergens deep inside our lungs. Meanwhile, the allergy and asthma season has lengthened some two-to-three weeks with climate change, while, since 1980, asthma rates have more than doubled in the U.S.

The American Medical Association is working actively to educate health care professionals about the projected rise in climate-related illness. Medical and public health groups are also taking leading roles in advocating for climate and energy policies, and measures -- like electric vehicles, "smart" grids and healthy cities initiatives -- that will improve public health, create jobs and combat climate change. And physicians and other health care professionals have begun serving as role models for patients by adopting environmentally responsible, energy- and waste-reducing practices in the health sector.

We are deeply concerned that climate instability and changing weather patterns threaten our health and the vitality of our life-support systems. The U.S. must take a leadership role in advancing the clean energy transformation and international climate negotiations over the coming year. The harm to our health and our well-being, and the associated health and social costs, will continue to mount unless we take comprehensive action to stabilize the global climate system.

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Cecil B. Wilson, M.D. is President of the American Medical Association and Paul R. Epstein, M.D., M.P.H. is associate director, Center for Health and the Global Environment, Harvard Medical School.

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