Peak Health describes a tipping point where health can no longer be supplied in response to increasing demands resulting from inadequate investment in prevention and an unsustainable increase in costs. Much like peak oil, it will necessitate a radical change in the approaches to reducing demand and the methods of supply.
Prof Glen Albrecht, Dr Bret Hart
We are quite accustomed to the notion that health outcomes will continue to improve, much as they have done over the last century. If technology and medical knowledge continue to improve, you would think this would be a fairly reasonable assumption.
Could it really be wrong ? Are we in fact living through the age when we are enjoying the best health outcomes ? The age of “Peak Health”.
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What could cause, or contribute to, falling and failing health outcomes ?
Modern health care is very energy intensive. From pharmaceutical production to powering a Hospital. As oil becomes scarcer and so more expensive, then our health costs increase or become limited. Modern agriculture is also tied to oil's fortunes. Increasingly poor soils need more fossil fuel based fertilizer and pesticides to maintain production, the machinery, processing and global distribution is similarly dependent. Food, or nutrition, is of course an integral part of health. But that is only just the beginning, the link between oil and health is far more involved. More about the link with Peak oil later.
The impacts arising from climate change have been widely discussed, the health consequences less so. As they are quite uncertain in both degree and timing of onset, it is difficult to predict how they will unfold. The most obvious perhaps, is the direct effect from higher than usual temperatures.
The sustained heat wave affecting mainland Europe in 2003 is estimated to have resulted in between 35,000 and 60,000 deaths. Similarly the 2009 SE Australian heatwave, whilst being remembered for the associated bush-fire tragedy, also saw nearly 400 hundred excess deaths.
That is the tip of the proverbial iceberg. Changes associated with a changing climate, include; altered precipitation causing droughts and floods, decreased freshwater availability and quality, increasing the risk of diarrhoea and gastrointestinal illnesses, changes in vector borne diseases such as Malaria, Dengue and Schistosomiasis, decreased food yields, increase air pollution and aero-allergens, loss of biodiversity and the spectre of mass migration due to geopolitical instability.
Mental health in particular is impacted through various means. From financial stress, loss of property and livelihood, relocation and future uncertainty.
The prestigious Lancet medical journal in Nov 2009, prosecuted Climate change as, "the biggest threat to health in the 21st century".
Biodiversity is closely linked to climate change, flora and fauna being unable to adapt to more rapidly changing climatic conditions. Even now, with habitat destruction, overfishing and pollution we are witnessing the 6th great planetary mass extinction event. Species loss is now between 100 -1000 times greater than the background rate.
Our health is closely linked to the health of our environment, intact ecosystems and the biodiversity that comprises them. We depend on natures services for clean drinking water, food production, to source most of our medicines, to process our waste, as well as it's aesthetic importance. According to the 2004 Millennium Ecosystem Assessment, the majority of ecosystems and now degraded, 25% of the Earth's land surface is cultivated, we are using half of the available freshwater, 35% of coastal mangroves and 20% of coral reefs had been lost in 20 years. Since 2004, driven by increasing population and relentless consumption, we are using, degrading and depleting more and more of what it left.
With erosion of these ecosystems, species are compressed into smaller ecological spaces, becoming more vulnerable to disease, especially infections. As the previous barriers and defenses are removed, the risk of disease transmission between different species rises.
Ocean acidification resulting from increases in atmospheric CO2, is gradually changing the chemistry of our oceans. There has been a decrease of about pH 0.1 since the industrial revolution and at current trends will amount to a decrease of pH 0.23 by mid century. That may not sound like much, but even small changes in acidity have profound affects on organisms and their habitat. From microscopic foraminfera and coccolithophores, to corals, crustaceans and molluscs, a variety of ocean life depends on forming shells and other calcified structures. There is already evidence that this process is having damaging effects. Many of these organisms are the basis of marine food webs. One fifth of the worlds population is dependent on fish as their primary source of protein.
Pollution of air, water and land, resulting from the burning of fossil fuels, deforestation, industrial processes and waste, is also having a significant impact on our health. Whilst there have been some improvement in reducing air borne pollutants such as Sulphur dioxide and Nitrogen oxides, the causes of smog and acid rain, and the reduction of Chloroflourocarbons ( CFCs ) and the degradation of the ozone layer, worldwide, the problem grows, as more countries industrialise and consumption driven waste increases.
We now advise pregnant women to avoid eating large fish due to the mercury that we have released into the environment.
50 -100 thousand Americans die each year from air pollution due to the small particulates ( PM2.5 ) released from burning fossil fuels. In the developing world the problems are far greater and often less documented or recognised.
Persistent organic pollutants ( POPs ) are toxic organic chemicals, resistant to environmental degradation. They include pesticides, solvents and pharmaceuticals. Because they bio-accumulate in humans and animals and bio-concentrate in the food chain, their impact is therefore likely to escalate over time. There has been increasing recognition over the last 15 years that these compounds can cause death and illness including cancer, disruption of the, endocrine, reproductive and immune systems. The problem is largely hidden as many more chemical compounds are developed and knowingly or unknowingly liberated.
These are perhaps, the major environmental factors that may adversely affect health outcomes over the coming decades. It is by no means an exhaustive list.
Occupationally, we are becoming increasingly sedentary, working more desk-bound hours, our recreation or leisure time is also more often inactive. Increasingly overweight and unfit, there is an obesity epidemic sweeping the western world with it's attendant complications. The prevalence of diabetes continues to rise. Although uncommon and confined to the elderly just 3 - 4 decades ago, it now afflicts more young adults and even, very occasionally, children. Increasing rates combined with earlier onset will more than stretch our health services in coming years as medical costs, welfare and lost productivity start to catch up with us.
Medical costs are also rising elsewhere in the health sector, due to expensive technology, both diagnostic and treatment related. An aging population means fewer taxpayers per health and welfare consumer. The health budget can therefore consume a greater proportion of the total budget for the same level of service. It is a double bind, as increasing population growth in turn puts greater stress on the environment. Deliberately increasing the population, as has been proposed, to offset changing demographics just delays and magnifies the inevitable.
Societies, communities and families are now more fragmented, decreasingly resilient. The isolation and disconnection inevitably promotes anxiety and depression and with less local community and less extensive family support, the costs of care are now borne by the tax payer.
As more and more people are being treated for infectious diseases, the organisms responsible are becoming less and less susceptible to them. Drug resistance is accelerating. Tuberculosis, staphylococcus, once routinely managed, are re-emerging due to multiple antibiotic resistance. Strains of Malaria are now showing resistance to the even latest drug treatment, Artemesinin.
Conversely, the rate of discovery and release of new drugs however is falling. There are fewer new options for treatment. With regard to antibiotics, the situation is desperate. Loss of biodiversity accentuates this, as many pharmacological agents, including nearly all antibiotics and anti-cancer drugs have a natural source or origin. The success in managing infectious diseases that we have seen over the last half a century may well turn out to have been a golden age.
These are, it would seem, a converging and compounding set of circumstances that represent a perfect storm. Our health is on the receiving end. We could start to address many of the factors or drivers of this if we chose to do so. But we don't.
We view our situation and our future through a myopic economic lens, unable to focus on, or even see, the real and looming problems, their importance or their urgency.
So what will happen to our health when Peak Oil squeezes our economy ? Growth will fail, either as a consequence of an energy crunch, or maybe, as a deliberate response to protecting an indispensable asset. Or even, a consequence of the burgeoning and unservicable debt accrued during these years of relative plenty.
What will happen to research and development, new pharmaceuticals, old pharmaceuticals, when oil is scare.
But perhaps there is a silver lining, a lower energy life can be a healthier life. More physically active, more locally integrated with healthier communities, growing local food, less processed food, less consumption generally. Peak oil managed well may be a blessing in disguise.
