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David Katz, M.D.

David Katz, M.D.

Posted: December 8, 2010 08:21 AM

It has been a banner week for biomedical news. The Institute of Medicine released a provocative and somewhat controversial report on calcium and vitamin D intake; the American Cancer Society announced results of an enormous study reaffirming the link between body mass index and mortality; there was at least aleatory passage of a historic food safety bill in Congress; and a long awaited update to federal policy governing child nutrition was passed and awaits the President's signature.

Ordinarily, this content would populate my public health reflections to their far horizon. But seen from just a bit of altitude; viewed through a wider angle lens than my habitual routine accords -- these headlines announce modest news about modest measures related to our singularly immodest perspective on our own health. There is far more to health than is generally dreamed of within the purview of biomedicine.

I know, because my horizons have been widened. This past week I was privileged to join an illustrious group, convened by the Wildlife Conservation Society at their headquarters on the grounds of the Bronx Zoo, to address the contention that there is only one health. The "one health" concept stipulates, essentially, that the health of people will be promoted along with the health of the planet, its diverse ecosystems, and its biodiversity, or it won't be promoted at all.

What made the group illustrious? Aside from the fact that virtually everyone in the assemblage, with the exception of me, has a career devoted to protecting the native magnificence of our planet, the group was noteworthy for every aspect of its pedigree. Outstanding work, outstanding achievement, extraordinary devotion. Intelligence, passion, eloquence, fortitude, resourcefulness. Participants represented premier organizations, from the Wildlife Conservation Society, to Conservation International, to the Nature Conservancy, to World Wildlife Fund, to Harvard University, Stanford University, Columbia University, and in the case of my modest contributions, Yale University.

What was I doing there? Ah, there's the rub! Alas, this group -- to which I should simply be sending accolades -- has ostensible need of me.

The scientists at the meeting -- many of whom have spent arduous years in some of the planet's most dazzling, important, fragile and embattled ecosystems -- from the Arctic to the Amazon, from the Australian Outback to the Mongolian Steppes, from the jungles of Borneo to the jungles of Brazil, from the island of Madagascar to the islands of Fiji -- have collectively reached this fundamental conclusion: nobody really cares.

Well, I suppose that takes it a step too far. Lots of people do care about our planetary cohabitants and the places they and we call home. But not nearly enough people care, and people care not nearly enough to make the requisite differences. Not enough to stop the damage. The places and their denizens are ever more imperiled as we collectively squander every successive opportunity to rectify the trajectory of our impacts.

So the conservationists and wildlife biologists have conceded that the only way to make the case for what they do is through the lens of public health, and that's where I -- and others like me -- come in. We, from the human health community, are being asked to draw up chairs at the big table -- the "let's save the planet" table and help elucidate how saving oceans and lakes, mountains and jungles -- will help save people.

More specifically, the enterprise incubated at the meeting I attended involves the generation of specific, collaborative research projects to show the costs to human health of ecosystem-degradation-as-usual: the costs to human health of burning down rain forests; the costs to human health of cyanide fishing of coral reefs; the costs to human health of disrupting traditional food sources; the costs to human health of increased CO2 in our atmosphere.

We gathered secure in the conviction that there are such costs, that they can be measured, and that they are high. But that they need to be on the marquee is sad testimony to our world view. The global human population does not, apparently, acknowledge intrinsic value in the status of the globe. My conservation colleagues' unfortunate need of me is predicated on the sad inability of our species to see intrinsic value in any other species.

Environmental scientists can readily show on their own the cost to the rain forest of burning down the rain forest; public health counterparts are needed to help show the immediate cost to human lungs downwind of those fires. Environmental scientists can show on their own the cost to coral reefs of cyanide fishing; public health scientists are needed to help show the toll on nutritional status of coastal peoples dependent on the diversity of sea life those reefs formerly supported. Environmental scientists can show on their own the impact on biodiversity of human incursions into pristine areas; public health colleagues are needed to help demonstrate the association with emerging infectious diseases and potentially devastating outbreaks. Environmental scientists can tell us what species are being dispossessed by deforestation; public health counterparts are needed to help tally the human cases of malaria directly attributable to the enterprise.

And so I go from my routine allocation of effort to cultivating the health of humans who, in our masses, routinely abuse the planet, to offering what I can to a group trying to save the planet from those abuses. I love the people I care for, and that's why I do what I do. And what I do is important both for the immediacy of its responsiveness to human need, and its scope.

One in three American adults will have diabetes by 2050, testimony to the importance of work I and others do related to diabetes prevention. But all three of those three American adults, and their counterparts around the globe, will have need of a habitable, vital planet in 2050 and every year thereafter. So I can't help but view my invitation to the One Health table as a promotion.

For there is indeed but one health for all -- people, animals and planet -- to share. Our neglect of this imperative, our blindness to this blunt reality is at our collective peril. It is borne by either egomania, or mindlessness.

If mindlessness is our excuse, we must concede we are much like a parasite or virus that replicates at the expense of its host. And once its mindless replication toasts the host, the parasite, too, is doomed. One health, indeed. Are we that parasite, and earth the host?

If not, and sentience is our distinction, we are the more malignant for it. If we are destroying our host mindfully, there can be but one explanation: we are so ego maniacal as to think that the short term pursuit of our own profit -- however measured -- justifies the plunder of the planetary body that sustains pursuit and profit alike.

We are pillaging the planet that hosts us for short term gain. If anything ever epitomized penny-wise, pound-foolish conduct -- it is to profit in the short term at the long term expense of the source of all profit, and of life itself. Indeed, one of the objectives of the One Health initiative is to show that even in the short term, costs of environmental degradation outweigh profits; health economists were at the table to advance this agenda. In all likelihood, our plunder of the planet has established a new frontier for calamitous folly: penny-foolish and pound-foolish alike.

We have but one home. We have but one health. That we can manage to see it only through the lens of short term human impacts is testimony to the limits of our sight. But this view, too, will make the case.

Eventually the lens won't matter. Sooner, later, just in time, or tragically too late -- every view will reveal just one health, or just what's left when it's gone.

David L. Katz, MD, MPH, FACPM, FACP
Director, Prevention Research Center
Yale University School of Medicine
www.davidkatzmd.com
www.turnthetidefoundation.org

 

Follow David Katz, M.D. on Twitter: www.twitter.com/DrDavidKatz

It has been a banner week for biomedical news. The Institute of Medicine released a provocative and somewhat controversial report on calcium and vitamin D intake; the American Cancer Society announce...
It has been a banner week for biomedical news. The Institute of Medicine released a provocative and somewhat controversial report on calcium and vitamin D intake; the American Cancer Society announce...
 
 
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HUFFPOST BLOGGER
Alison Rose Levy
Connect the Dots www.healthjournalist.com
09:21 AM on 12/11/2010
As a health journalist covering the health-environmental nexus (for over two decades), I see a lot we can do in addition to our choices in our daily lives. I'm completing a book on this right now.

One issue that sits right at the center of this nexus is food and how it is grown. For the last year, supporters of healthy food have been fighting a bill in Congress, which under the guise of safety, institutionalizes industrial food and has a wide range of problems, some of which have been tempered and some of which have not. This week is the final opportunity to stop its passage and encourage Congress to come up with regulations that address the causes, rather than the symptoms of contamination in our food supply.

For more on this issue, see my HuffPo blog: http://www.huffingtonpost.com/alison-rose-levy/will-the-food-safety-bill_b_740312.html

To contact your Senator: http://salsa.democracyinaction.org/o/750/p/dia/action/public/?action_KEY=5337

For an analysis of competing interpretations of the Food Safety bill S510, go here: http://www.facebook.com/note.php?note_id=10150363021545193

For the three and a half years that I've reported on Huffington, I've consistently covered stories that link, health, the environment with activism opportunities. To increase your impact and awareness, please follow me, and sign up for my free ezine at www.healthjournalistblog.com
HUFFPOST SUPER USER
kori77
10:24 AM on 12/10/2010
We need to wake people out of the false cultural stories that were put in place to legitimize domination societies---no one as done more work on this that David Korten, his new book Agenda for a New Economy is well worth the read. Or visit his website at www.livingeconomiesforum.org
04:46 PM on 12/08/2010
http://www.globalgoodnews.com/health-news-a.html?art=129169471748767953 :

{{{ SOURCE: link.reuters.com/byd27m Journal of Clinical Oncology, online December 6, 2010. :

Harms often surface years after cancer drug approval

Within four years of approval, five of the 12 drugs researchers [ U of T ] looked at had earned a 'black box warning' from the U.S. Food and Drug Administration, which approves new medications...............}}}
04:25 PM on 12/08/2010
this gives me opportunity to repurpose comment to Arrianna's summit with Dr Chopra et al WONDERFULL ABSTRACT WORDS

THE ONLYHOPE FOR SALVATION OF THE PLANET [PARDON THE PUN] IS GREEN

that is bringing abstract words into physical reality
full spectrum sustainability in action in actual behaviiour

higher states of consciousness is better behaviour and that is more than kindness, living peaceful dynamic; million sof nice words

better behaviour is in a word green.
Deepak , Shapiro, Williamson etc might write for the green section ; are they themslves a smillionaires setting the example :they can afford a Tesla electric car, to demolish sickbuilding syndrome house and built [BauBiolgie, LEEDS, Vastuvidya] with all natural non-toxic materials, energy efficiency and selfsufficiency, active passive solar, composting, recycling , repurposing

more than the negative: no pollution no waste less animal consumerism, more economical behaviour

it spositive use every day of full spectrum green, not just preaching better behaviour : organic food, vedic organic agriculture

the only hope is millionaires going green the only hope is 2 000 000 000 christians going green

atheists i'm assuming have no veste dinterest insaving th eplanet [habitat, lifesupport, nourishment] since it's just a chance purposeless thign anyhow

green and cosmic architecture , vastu vidya , maharishi sthapatya veda building an dplanning

green mediicne ,natural health care, maharishi Ayur Veda, TCM, naturopathy, master herbalism, information and energy medicine

reconnecting to natural law with maharishi jyotish and yagya

take 2 rests a day and drink plenty of holy water
04:15 PM on 12/08/2010
very encouraging ..for many years magazines in the alternative medicine [ natural health ] space have been green also have championed sustainability and have linked pollution to sickness

e.g. www.cape.ca

in canada Dr Joseph Krop MD had to spent $ 500 000 [ from donations from CHFA.ca health food stores ] to hang onto his liscence when CPSO didnt like his practicing environmental medicine
http://www.aaemonline.org/

Maharishi Ayur Veda simply says health is healthy habits [ balance ] and that includes individual society business education mind body spirit and ecology
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HUFFPOST SUPER USER
Overtone
See bio on the Aesop Institute website
01:17 PM on 12/08/2010
A wake up call is needed!

The Ticking Time Bomb, by John Atcheson describes the threat to life of irreversible climate change.

Potentially destructive solar storms occurred in April, September and November. The latter, a huge one, narrowly missed earth. Imagine the impact of widespread, lengthy, blackouts!

Decentralized power production is a wise insurance policy - as well as a surprising way for disruptive green technologies to start to supersede the costly need for imported oil!

Political opposition may be minimal, since such blackouts would clearly be national emergencies.

A solar storm can cause power system collapse. In the U.S., damage could cause 130 million people to suffer a long-term blackouts. The cost - $1-2 trillion the first year. Roughly the price tag of both the wars in Iraq and Afghanistan!

Superseding grid dependency has now become a wise insurance policy for our population and the entire planet. See: www.aesopinstitute.org

The potential for power outages can be used to stimulate rapid commercialization of potentially cost-competitive, renewable, energy conversion systems.

Superseding oil and all fossil fuels can be accomplished very much faster than conventional wisdom (and predictable skepticism) would suggest is possible.

Once it is clear this can be done, it can open serious discussion of a 20 hour week. See that article on the Aesop Institute website.

Replacement of the missing income can be accomplished with diversified investments not dependent on savings.

Free time might open a path to the beginnings of a learning civilization.
12:49 PM on 12/08/2010
Dr. Katz, it is true that nobody cares about the planet and its creatures. Having worked to stop sickening pollution I have learned that most do not care about human health either - even when it affects children. The only thing that gets through is a tabulation of the monetary costs, which environmental health advocates are beginning to tabulate.

One of the reasons people do not care is because medical societies that deal with public health such as the env/occ and public health, have been either taken over or silenced by corporate dollars. They are the first to try to convince the public there is really no danger, or rather - the medical literature does not support your concerns. There are people advocating for public health but they are generally alone in their fight and the last to back them up are members of the medical community.

As we pour more money into fixing the damage that pollution has caused, we are at the same time finding loopholes for polluters (and among them I include companies that peddle inadequately tested chemicals in their products).

Please recruit your colleagues in the medical community to this effort - so far they have been the missing link.
12:43 PM on 12/08/2010
What can average people do for the environment, Dr. Katz? Is there anything specific that can be done that is worthy doing by those who are not credentialed in the health or science fields? Besides trying to rein in your carbon footprints and belonging to environmental organizations, I mean. I feel like we are running out of time, and I'm not doing enough, but wonder what the best use of my limited time and money might be? I'm sure this is the question most of us have.
04:47 PM on 12/08/2010
I hope Dr. Katz answers your question.
As a resigning ATSDR scientist explained to me - you do not have to be a scientist to get involved in these issues. Often, science jargon is thrown around to shut up people opposing pollution in their communities. Often they are telling lies, half-truths and working for the moneyed interests. As he said to me - common sense rules.
Please involve yourself in local environmental issues. Those who speak up are usually small in number and attacked for wanting to protect health - human and otherwise. Try to increase the numbers of people willing to speak out by speaking out yourself - in letters, at public meeting, at your school organizations etc.
Please just fight back.

It is nearly impossible to trace back environmental causes of a particular illness because we are all exposed to so much. Prevention - as in prove this is safe before you force it upon me - is the only thing that will turn this around.
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HUFFPOST BLOGGER
David Katz, M.D.
Director, Yale Prevention Research Center; Editor-
09:10 PM on 12/08/2010
Thank you for caring! Support one or more of the organizations I mention in the post- they are all fighting the good fight. Organizations like Wildlife Conservation Society are using their resources to demonstrate the short-term financial folly of environmental degradation. Let your local, state, and federal elected officials know you vote- and this matters to you. If and when they hear that message from enough of their constituency- but not before- it will start to influence their votes, and shape policy. Of course, we can each privately 'go green' to the best of our ability, but it is on the battle field of public policy that this will be won, or lost.

Again, my thanks!
10:33 PM on 12/08/2010
I agree with all that you say (and thank you for your response), but it is hard not be to discouraged when you live in a Big Ag state like Iowa. The degree to which our state's land and waters have been ravaged by pesticides, herbicides, and fertilizers, not to mention the waste from factory farms, is just terrible.Big Ag is such a big player that the politicians do not stand up to them and the pollution just gets worse and worse. To be honest, when my kids graduate I want to leave because Iowa strikes me as a state that is lost to corporations that work against the environment--the ConAgras, Cargills, Pioneers, et al. The waters are unswimmable, the land turned over to monoculture, the universities powered by coal and fairly uninterested in change even though they are supposed to be leaders.

Sigh. Well, I am a member of Greenpeace and do intend to start writing more letters, etc.
11:47 AM on 12/08/2010
The 'one health' concept is an excellent one. All things are indeed connected and more and more we have the scientific evidence to prove it. We have just reported that genetics now demonstrates that genes cannot be the cause of common diseases:
http://www.bioscienceresource.org/commentaries/article.php?id=46
That means environment must be the entire cause of ill health, i.e. junk food, pollution, lack of exercise, etc. The reason we wrote an article about human genetics (when we are a food and agriculture website) is that we believe that if people live right, agriculture and therefore the planet will more or less fix itself. Because there is indeed only 'one health'. Bravo!
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HUFFPOST SUPER USER
RMankovitz
Researcher, inventor, entrepreneur, author
11:41 AM on 12/08/2010
As a researcher and author of several books on nature-based illness prevention, I completely agree with the conclusions of the author. Decades of research in the fields of anthropology, paleopathology, primatology, zoopharmacognosy (animal self -healing), ethnobiology, and evolutionary psychology have convinced me that the keys to human wellness can be found in nature’s teachings.

In our arrogance and ignorance, we have wrongly assumed we could fool (with) Mother Nature, and the results have been, and continue to be, disastrous. Our hubris is so out of control that we believe the fate of the planet is in our hands. Our planet is not in trouble, we are. In our absence, nature has millions of years to cleanse herself of our legacy, regenerate, create many new species, and perhaps evolve an improved human model. Nature has a long history of dealing with societies that do not respect their environment. They are extinct (see Collapse by Jared Diamond).

An example, including references, of how nature evolved humans to remain healthy, can be found in “The Wellness Project.”

Roy Mankovitz, Director
http://www.MontecitoWellness.com
A research organization
03:08 PM on 12/08/2010
Very well put. Thank you.
11:17 AM on 12/08/2010
Interesting article and perspective.

Dr. Katz, one of my favorite sayings is: "Treat your body like a house of worship - with respect." As you well know, millions do not abide by that saying. So, if we can't respect our own bodies, how could we ever respect our magnificent planet?

Ken Leebow
http://www.HighSatiety.net
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HUFFPOST BLOGGER
David Katz, M.D.
Director, Yale Prevention Research Center; Editor-
09:13 PM on 12/08/2010
I don't know, Ken- but both our bodies, and the planet, are the poorer for want of respect. Aretha was right that it's a priority! Let's hope we find our way to it in time.