"The Daily Climate" - Charting a planet's changing rhythms, through a physician's eyes

The Daily Climate,  June 6, 2011

http://wwwp.dailyclimate.org/tdc-newsroom/2011/06/health-and-climate-change

By Douglas Fischer

Daily Climate editor

One complaint about Western medicine is that it is a science of parts, not the whole. Doctors, trained to focus on the disease or injury, fail to see the patient as part of a larger family or community. Key connections between the individual's health and the larger physical and social environment are missed, dots are left unconnected, prescriptions don't treat the whole problem.

In the straightforward act of rehydrating frightened cholera patient, Paul Epstein saw a larger, global problem.

This reductionism is part of a much larger Western scientific tradition, often credited to the 17th century French philosopher, René Descartes: Study the pieces, and the marvels of the whole can be revealed.

That tenet has taken root so firmly and for so long that, for most people, the approach is synonymous with science. But there's a blindness, too - one increasingly apparent as society grapples with some of today's global issues, notably climate change. 

The result is a failure to see - or at least a delay in spotting - connections between seemingly disparate systems: A disconnect between plankton blooms and ocean health and a cholera outbreak in Peru and the northward creep of parasites devastating East Coast oyster farms.

Or a failure to see a link between worsening wildfires, an explosion in ragweed blooms, asthma rates and greenhouse gas emissions. 

Making connections

Paul Epstein sees the whole. Associate director of Harvard Medical School's Center for Health and Global Environment, Epstein started his career as a physician caring for the poor in Mozambique and Boston. 

But in the fairly straightforward act of rehydrating frightened cholera patients in Africa, Epstein saw a larger, troubling problem.

He traced a cholera outbreak in the late 1980s in Mozambique to changing ocean patterns; he followed the arrival of malaria to the Kenyan highlands in 2003 to parasites hitching a ride on mosquitoes thriving in the warmer weather. He looked to the seas and saw a 1983 El Niño snuff out urchins, allowing algae to flourish in the Caribbean, hammering Jamaica's renowned ring of coral reefs to a such a degree that they have yet to recover. He followed Hurricane Andrew across Florida and Louisiana in 1992 and Hurricane Mitch across Honduras in 1998 and ended up in Switzerland, at a posh corporate retreat, as insurance industry executives considered their losses and contemplated what's next.

Epstein connects those dots in a book co-authored with science journalist Dan Ferber and published this spring: Changing Planet, Changing Health (Univ. of Calif. Press). The duo bound across the globe, linking physical changes in our climate and environment with threats to our public health and economic well-being.

Even disregarding climate change, humans have made huge changes to the global environment. 

- Changing Planet, Changing Health

Epstein isn't the only one making these connections - Stanford University's Paul Ehrlich, for one, has undertaken a massive effort to link various public health and environmental problems to human behavior. But Epstein's book charts the difficulties he faced, in the late 1980s and early 1990s, of documenting climate change and getting others to see the interconnections.

What's startling, in fact, is how clear the signals were 20 years ago. 

Disappointing outcome

In the early 1990s, scientists had bored almost two miles into the Greenland ice cap. The temperature record unlocked from that ice shows evidence of remarkable stability for the past 10,000 years. But for the 250,000 years before that, temperatures swung wildly, with each shift bookmarked by a change in atmospheric carbon dioxide levels.

The health signal, too, was clear. By 1995, scientists had amassed enough evidence to detect three "clear and ominous" fingerprints of global warming: Warmer winters, more extreme weather events, and disproportionate warming at high elevations. That same year Epstein and a team of infectious disease specialists concluded climate change would likely have "wide-ranging and mostly adverse impacts" on human health.

Yet a 2001 National Research Council report highlighted the uncertainties, finding that the potential disease impacts from global warming "remain highly uncertain."

Such a conclusion, from such an influential panel, Epstein noted, "meant that those who opposed laws or rules to lower CO2 emissions would be able to cite the uncertainties ... to justify inaction."

The outcome, he added, "was hugely disappointing."

Doubt still dominates

That was 10 years ago, yet doubt still dominates. And the debates - and reports - keep rolling. Last week it was Australia's turn, with the government's Climate Commission issuing a 70-page summary of climate science and concluding the case for action has never been more urgent. Earlier in May in the United States, the National Research Council took a whack at it, with yet another review of the science.

That Congressionally mandated report fell on deaf ears; in Australia, the discussion over Prime Minister Julia Gillard's proposed carbon tax is being hijacked by U.S.-style, tea-party politics.

What's the price of such delay? Turns out Epstein has a window there, too.

By the spring of 2010 a number of professional health groups had concluded that enough evidence existed to say climate change endangers well-being. At the same time, the U.S. economy was mired in a deep economic funk and the Deepwater Horizon spill was spewing millions of gallons of oil into the Gulf of Mexico.

Epstein hopes that, years from now, the three events will be seen as a "crossroads" moment in the history of our species - where boundless economic growth is seen as untenable and limits are accepted as the price of a sustainable future.

But as spring turns to summer a year later, as the price of oil slips past $100 a barrel, the primary energy debate is what and where to drill. It appears that, like other observations made during the course of Epstein's career, that notion remains ahead of its time.