may share the fate of dinosaurs unless they begin intensive study on
the health impacts of poverty, resource depletion and climate change, an
environmental health scholar asserts.
Epidemiology has a heroic past, Colin Butler, a professor of environmental health at the National Centre for Epidemiology and Population Health, in Canberra, writes in The Scientist. The legendary Dr. John Snow,
considered the father of modern epidemiology, gathered evidence for the
transformative recognition that cholera outbreaks in London in the
1850s were caused by contaminated drinking water, not "bad air" or
supernatural causes. Twentieth century epidemiologists identified causes
of many chronic and infectious diseases, including HIV/AIDS and lung
Today, Butler writes, in his article "An Evolving Science for an Evolving Time," public
health faces threats from problems that need more intense and better
funded study. Nearly one seventh of the world's population go to bed
hungry, he says, and 2,000,000 more battle chronic fatigue caused by
iron deficiency. He calls poverty, resource depletion, and "its dark
shadow, climate change", the "elephants in the room."
are running out of oil and depleting other stocks of fossil fuel, the
burning of which transfers once-buried carbon to the ocean and air," he
writes. "In a few decades, we are likely to run short of phosphate,
which is essential for fertilizer. We are thus damaging food security,
and, before too long, coastal infrastructures via sea-level rise. Growth
in population size and ongoing consumerism will increase the challenges
even further. Since prevention is the main thrust of public health,
addressing these problems sooner would be better."
was named one of "100 doctors for the planet" by the French
Environmental Health Association, was a founding board member of Doctors for Environment Australia, and is co-editor of EcoHealth: the journal of the International Association of Ecology and Health.
Many other authorities also argue for more study on social and environmental health impacts. In an article in the journal Epidemiology, "Why Epidemiologists Cannot Afford to Ignore Poverty," Harvard scholar Nancy Krieger writes
that inadequate study of the impact of poverty and health care
inequality not only makes suffering invisible but distorts understanding
of the etiology and distribution of disease. Donald Spady, a
pediatrician at the University or Alberta in Canada who studies child
health epidemiology, believes the effects of resource depletion,
including energy and water, and climate change, on human health and
health care delivery, have been inadequately explored. He envisions all
these factors having considerable economic, social, ethical and human
health consequences. A recent study by Columbia University's Mailman School of Public Health found
that in the year 2000, 874,000 deaths in the U.S. were caused by
poverty, low levels of education, racial segregation, low social
support, and income inequality. These causes combined caused as many
deaths as were caused by heart attacks, strokes and lung cancer.
Overall, the study found 4.5 percent of U.S. deaths that year were
attributable to poverty alone.