Green Design » Health

Use Your Body and Your Brain Will Thank You

WorldChanging Team — Thu, 06 Aug 2009 19:12:02 +0000

by Sarah Goodyear
We talk a lot on this blog about abstractions -- theories of urban development, economic hypotheses, planning paradigms. But in the end, it all has to play out in the real world. And the real world of transportation is about one simple thing: moving your body from one place to another place.

So today we're going to look at some of the things people on the Streetsblog Network have been thinking about bodies -- how we use them to get around, and the price we pay when we trade our own power for the power of an internal combustion engine in our own personal automobile.

First, from Carfree With Kids, a recent post entitled "On (Not) Using My Body." The blog's author, who lives in Cambridge, Massachusetts, gets around by transit and by bike and has just had a baby. She wants to get back in shape, and it's made her think about the usefulness of her body:

Back when we were hunters, gatherers, or farmers, we didn't have time to obsess over our bodies. We just used them. I'm guessing neither anorexia nor excessive weight were big problems. Other than having recently grown a pretty fabulous baby, my body isn't doing anything for me right now. I'm not using it for work; I'm not using it for recreation; and I'm not using it much for transportation (though I do still walk some), and those cheap calories are not helping. I think the way for me to feel more satisfied with my post-pregnancy body isn't to diet or to "exercise," but to start using my body in ways that feel productive.

Making good use of your body isn't just about burning calories. A recent post on the blog Brain Rules talks about the role that exercise can play in reducing harmful levels of cortisol, a hormone the body produces when it's under stress that can actually damage brain cells over time. As the piece explains, we're simply not wired for the long-term threats we face in modern life, like economic uncertainty. We're set up, hormonally, to face quick challenges from predators:

The brain is well-adapted for solving stress-related problems that are short-term in duration. The saber-toothed tiger either ate you or you ran away from it, but the whole thing was over in less than five minutes.

Great for a jungle. Lousy for Wall Street. A recession doesn’t last for five minutes. Neither does a bad marriage, or a bad job. When you try to push a system that was adapted only for solving short-term problems into solving long-term ones, the system first becomes over-extended, then it becomes overwhelmed.

The good news is that one of the best ways to fight this kind of stress, and the toll it takes, is to exercise. That might explain why I pretty much always feel more relaxed after riding my bike, even if I have to contend with nasty city traffic along the way. Exercise doesn't have to mean going to the gym. Using your body as a tool -- as a means of transportation -- can be just as effective. And, as frequent Streetsblog commenter Larry Littlefield has discovered, a lot more fun. (H/T to @danlatorre for the brain research links.)

Streetsblog Network member blog Boston Biker has a post today that highlights another benefit of moving your body around without the aid of an automobile. In it, he addresses the driver of a car, explaining how being on a bike makes you more aware of your surroundings:

Did you know that if you are going down Cambridge Street towards the
Longfellow Bridge, that if you wait patiently at the first two red
lights, you can then make every other light if you simply go the
correct speed? Did you know that most of the lights in Cambridge turn
green exactly three seconds after the walk guy pops up? Did you know
that it takes almost as long to “lane hop” (walk out onto the dividing
median and then wait for traffic to clear on the other side) Com Ave in
Allston as it does to simply wait for the light to turn green?

I know these things, because in a very real way knowing these things helps
keep me alive. If you drive a car, you probably don’t know these
things. Your world is totally different than mine. You are stuck in a
little metal box, your vision is obscured, you are low to the ground,
your vision is limited by the cars in front of you, behind you is
filled with blind spots, your ears can’t hear past the sound dampening,
your nose smells only what is inside your car…I simply have more senses
on the job, and more inputs for those sense. Trust me, I know what I am
doing.

You've got a body. Trust it. Get out there and make it work.

This piece originally appeared on Streetsblog New York City

Help us change the world - DONATE NOW!

(Posted by WorldChanging Team in Health at 11:12 AM)

Notes From the Field: The Future of Healthcare

WorldChanging Team — Wed, 29 Jul 2009 20:02:40 +0000

by Allen Hammond

I wrote before about standing in a room with dozens of MDs sitting at terminals in the world's largest medical call center. Together with an even larger group of lay health workers, they advise thousands of patients per hour. Costs per patient are so low that I described medical call centers and telemedicine approaches as the future of medicine. But that's only part of the story.

Last week I stood in another room in India where perhaps 15 women in clean-room garb were assembling point-of-use rapid diagnostic kits-these were pregnancy tests, but the company makes similar diagnostic kits for malaria, dengue, hepatitis, HIV, glucose levels, etc., more than 30 in all. Two women dip sheets of special paper into an antibody solution; two more ran a specialized paper cutter to slice the medium into thin strips; still others assembled the strips into plastic housings, sealed them into foil envelopes, inspected the product carefully, and packed them into cartons.

These few workers turn out about 50,000 "strip test" kits a day. These could be used by consumers directly-most require putting 2 drops of urine or blood or plasma on the strip test and watching a few minutes until it give as "yes" or "no" signal-but are more accurately handled by a lay technician. And here is the key point: Most of these kits sell for less than $.10 each in India (including supplies, labor, packaging, shipping, and profit). The kits have a built-in error check, are stable for 2 years at room temperature and below, and the company has data to back up a claim of high reliability. And this is not the only company in India making these kinds of diagnostic kits.

But that's today. Next door to the diagnostic assembly building is the company's newer facility, where automated production machinery is being installed that will lower production costs significantly, to mere pennies a test. So imagine that you could walk into an "instant clinic", get tested in 5 minutes for an insignificant cost, talk to a doctor in a medical call-center about the results if you desired, pick up the medicine you need, and leave-within 20 minutes. Of course, in an industrial country, the price will be higher; the labor for the technician (30 seconds to perform the test, 30 seconds to tell you the result) probably will cost more than the test itself, not to mention shipping, customs duty, FDA approvals, etc. But the result is still a radical shift in the cost paradigm for healthcare delivery.

Within a few years, more sophisticated diagnostic devices will be available too-a "lab-on-a-chip" that analyzes the DNA in the sample and gives a digital readout, at a cost of perhaps $1-$2 a test. We are tracking a pipeline of a dozen such diagnostic devices now in development covering a wide range of diseases and health problems. But it is hard to escape the feeling that the women I visited last week are the pioneers, already shaping the future of healthcare in a fundamental way. We will be using their products and tele-medicine in the remote rural part of India (6 hours by train from the nearest airport, plus another hour by car) where we are launching a novel approach to healthcare services.

We may not care in the U.S. whether a test costs a dollar or a dime or a penny-any of those would constitute a revolution of the type the Obama Administration is looking for-but there are 4 billion people in the world for whom low-cost diagnostic kits can be truly transformative, and for whom the difference between a dollar and a few pennies may just determine whether they seek medical care for themselves or their children.

This piece originally appeared on nextbillion.net

Read more about worldchanging health developments in our archives:
Health Care Heroes
The LUCAS Imager: Portable, Affordable Blood Tests for the Other 90 Percent

Help us change the world - DONATE NOW!

(Posted by WorldChanging Team in Health at 12:02 PM)

InSTEDD: Bringing Life Saving Tools and Technology to All

WorldChanging Team — Mon, 06 Jul 2009 15:45:00 +0000

Nominated by Jim Fruchterman

I want to make my gift of attention to InSTEDD, a bold nonprofit which is using technology intelligently to reduce the damage caused by epidemics and natural disasters to humanity’s most vulnerable communities.

I particularly like their agile approach to developing a series of free and open source software tools. InSTeDD sited their Innovation Lab in Phnom Penh, Cambodia, and this helps drive solutions that are owned locally and actually solve real problems. We at Benetech really admire InSTEDD for taking a leadership role in this more socially entrepreneurial approach to technology in the social sector, based in respect and partnership. Big social problems like pandemics and disasters can be better addressed by encouraging communities to develop and promote their capacity and their own brain trusts. The world needs more organizations tackling important problems the way InSTEDD does!

This piece is part of Worldchanging's Attention Philanthropy campaign. All week long, the Worldchanging Network will be delivering "attention grants" to worthy projects, individuals, resources and more. You can learn more about these gifts of notice and find other entries by clicking here.

Help us change the world - DONATE NOW!

(Posted by WorldChanging Team in Health at 7:45 AM)

Public Health Leaders Stress Climate Risk

Ben Block — Thu, 21 May 2009 23:22:07 +0000

When seasonal rains lift from the Mali skies, meningitis often follows. Dust-filled winds can elevate the disease's effects by damaging tissue in a person's nose or throat. If longer droughts become more common, as expected across the Sahel, the epidemic could intensify, researchers say.

Connections between climate change and public health are not unique to West Africa. Worldwide, generations are expected to suffer as a result of historical and future greenhouse gas emissions, and the poor are most at risk.

Last week, a leading medical journal urged society's caretakers to better adapt to a warmer planet, calling climate change "the biggest global health threat of the 21st century."

"We call for a public health movement that frames the threat of climate change for humankind as a health issue," The Lancet said in an editorial on Friday. "Apart from a dedicated few, health professionals have come late to the climate change debate."

Heat waves and the spread of tropical disease are often mentioned as the leading health risks associated with climate change. But it was the indirect effects of water scarcity, shifting food resources, and extreme weather that led The Lancet, in collaboration with the Institute for Global Health at University College London, to sound the alarm. These threats now cause an estimated 150,000 deaths each year in low-income countries, according to the World Health Organization.

The editorial is a significant statement for the public health community. With few comprehensive assessments of the effects of climate change on health, particularly in low- and middle-income countries, researchers often disagree about the extent that human-caused climate change affects health, said Susan Polan, the associate executive director of the American Public Health Association.

In addition to a renewed public health advocacy movement, The Lancet recommended that global leaders expedite development efforts in the poorest countries. The advice echoes the suggestions of an independent report on adaptation released by a Stockholm-based commission at the United Nations Commission on Sustainable Development last week.

The Commission on Climate Change and Development, comprised of international development, research, and governmental leaders, urges donor countries to add $1-2 billion to their total spending on foreign aid (a rarely actualized commitment of 0.7 percent of gross national income). The funding should be targeted to vulnerable low-income countries, especially in Africa and small island states, for technical support, institutional coordination, and climate warning systems, the Commission said.

"Money is needed now, and more will be needed in the future to help developing countries adapt," the report stated [PDF]. "If we fail, [the next generation] will be worse and will be more limited. If we succeed, we will have provided them at least a better chance."

The funds requested by the commission match what developed countries already promised for least-developed countries in 2001. The voluntary agreement, however, has so far attracted less than $200 million, none of which is from the United States, which did not ratify the treaty.

"It's sad to me that the richest country, the biggest [historical] contributor to climate change, has not dedicated one penny to this fund," said Saleemul Huq, a senior fellow at the International Institute for Environment and Development, at an adaptation conference in Washington, D.C., in April.

As public health concerns swirl around the specter of a flu pandemic, Friends of the Earth International Chair Meena Raman said that rising sea levels, displaced communities, and additional climate change effects posed an even larger threat to society's health.

"The pandemic is likely to be a pimple compared to the pandemics worldwide likely to be caused by the diseases of climate change," Raman said. "Those of us who have the capacity should not be asking, ‘Are we ready?' but ‘What should we do?'"

Ben Block is a staff writer with the Worldwatch Institute. He can be reached at bblock@worldwatch.org.This article is a product of Eye on Earth, Worldwatch Institute's online news service.

Photo credit: Flickr/sanjoyg, Creative Commons License.

Help us change the world - DONATE NOW!

(Posted by Ben Block in Health at 3:22 PM)

Bangladeshi Lawyer Fights Toxic Ship-Breaking

Ben Block — Tue, 28 Apr 2009 21:16:13 +0000

Six relatively unknown grassroots activists from around the globe receive a moment in the spotlight when the Goldman Environmental Prize announces its list of annual recipients. The prize, now in its 19th year, is considered the Nobel Prize for the environment. Past recipients include Nobel Peace Prize laureate Wangari Maathai, former Brazilian environment minister Marina Silva, and Nigerian environmental activist Ken Saro-Wiwa, who was killed seven months after his recognition.

The Worldwatch Institute is honoring this year's prize winners with a series of profiles based on personal interviews.

Many of the world's largest ocean vessels reach their final destination on the beaches of Bangladesh. The coast of Chittagong, the country's main seaport, is littered with scrap metal, stained with toxic oil, and burning from the fumes of the ship-breaking industry.

Some 20-30,000 of Bangladesh's poorest citizens disassemble the ships, piece by piece, with little more than blow torches and sledgehammers. On average, one worker is killed every week, according to human rights groups.

A few years ago, two workers carrying a metal plate above their heads slipped and dropped the heavy fragment. One died. The second was knocked unconscious and taken to a nearby hospital. He was given saline but otherwise left to die.

"A colleague based in our Chittagong office called and asked what to do," said Rizwana Hasan, executive director of the Bangladesh Environmental Lawyers Association (BELA). "I said, ‘Whatever money you have, start his primary treatment.'"

Hasan, who was honored last week with the 2009 Goldman Environmental Prize for Asia, contacted the ship-breaking yard and convinced them to pay for the four surgeries required to save the worker's life. "Enough was enough," Hasan recalled. "Someone needed to take responsibility for these deaths."

Since Hasan decided to battle the ship-breaking industry in 2003, her advocacy law firm has argued that Western nations cannot legally deposit ships laden with mercury and arsenic in Bangladesh, in accordance with international hazardous waste treaties.

The country's Supreme Court ruled in Hasan's favor in a landmark case last month. The decision stated that all domestic ship-breaking yards must close if they do not possess an environmental clearance. The court also banned any vessels from entering Bangladeshi waters if the environmental group Greenpeace International lists those ships as carrying untreated toxins.

The case, which BELA brought to court, threatens to close the 36 ship-breaking companies that operate in Bangladesh, none of which currently operate with an environmental permit.

"It is a matter of concern for the ship-breaking yards operating in Bangladesh. Equally, it's a matter of concern for the exporters who find Bangladesh as a safe place [to sell the ships]," Hasan said. "I would certainly say that they must not think that it's safe anymore."

Hasan, 40, was born into a political family; her father served as a minister in the Bangladeshi Cabinet. Hasan has attempted to remain non-partisan, yet she now finds herself at the forefront of the contentious debate on the ship-breaking industry's future.

The Bangladesh Ship Breakers' Association has stated that it supplies the country with 80 percent of its iron ore - repurposed from ship scrap. With domestic demand for steel booming before the global recession hit, the used metal was considered an economic necessity. Nearly all of a ship's other contents - toilets, lifeboats, lamps, etc. - are also recycled throughout the poor country. Overall, the industry estimates that it provides for the livelihoods, directly or indirectly, of 250,000 people.

If the ship-breaking yards must adhere to environmental and labor regulations, the industry estimates that 30,000 people will lose their jobs.

Thousands of workers from various ship-breaking yards protested the Supreme Court's decision last month. BELA was a target of the protestor's posters and chants. "The posters said they'll pull off our skin and break our bones," Hasan said.

Hasan said Bangladesh should follow Sri Lanka's lead. "There was a point in time when there was ship-breaking in Bangkok, in Vietnam, in other parts of world. All of them decided not to continue," she said. "For Bangladesh to decide that they will not continue is not impossible. One just has to show that courage and provide alternatives for its people."

Ben Block is a staff writer with the Worldwatch Institute. He can be reached at bblock@worldwatch.org. This article is a product of Eye on Earth, Worldwatch Institute's online news service. Image credit: Michael (mx5tx)/Flickr

Help us change the world - DONATE NOW!

(Posted by Ben Block in Health at 1:16 PM)

Best Way to Lose Weight: Live Near the Grocery Store

Clark Williams-Derry — Wed, 08 Apr 2009 23:30:00 +0000

If you want to lose weight, move closer to your food:

A new study from the University of British Columbia shows people who live within a kilometre of a grocery store are half as likely to be overweight, compared to those living in neighbourhoods without grocery stores.

But the study's author, the esteemed Larry Frank, notes that grocery stores are only part of the story.

"It's a marker for other commercial uses, as well, so it's not just grocery stores that matter."

Frank's research has consistently shown that people who live close to a mix of stores and services tend to walk more. So the lesson here isn't to move closer to a grocery store. Instead, we should be looking to foster mixed-use neighborhoods, where more and more people can do some of their errands on foot, rather than being forced to drive for every trip.

This piece originally appeared on the Sightline Institute's blog,The Daily Score

Photo credit: flickr/Jek in the box, Creative Commons License.

Help us change the world - DONATE NOW!

(Posted by Clark Williams-Derry in Health at 3:30 PM)

Best Way to Lose Weight: Live Near the Grocery Store

Clark Williams-Derry — Wed, 08 Apr 2009 23:30:00 +0000

If you want to lose weight, move closer to your food:

A new study from the University of British Columbia shows people who live within a kilometre of a grocery store are half as likely to be overweight, compared to those living in neighbourhoods without grocery stores.

But the study's author, the esteemed Larry Frank, notes that grocery stores are only part of the story.

"It's a marker for other commercial uses, as well, so it's not just grocery stores that matter."

This piece originally appeared on the Sightline Institute's blog,The Daily Score

Photo credit: flickr/Jek in the box, Creative Commons License.

Help us change the world - DONATE NOW!

(Posted by Clark Williams-Derry in Health at 3:30 PM)

Getting The Lead Out

Clark Williams-Derry — Tue, 03 Mar 2009 20:36:44 +0000

Good news: childhood lead levels plummet.

The best news I've read all day:

In a stunning improvement in children's health, far fewer kids have high lead levels than 20 years ago, government research shows -- a testament to aggressive efforts to get lead out of paint, water and soil.

Lead can interfere with developing nervous systems and cause permanent problems with learning, memory and behavior. Children in poor neighborhoods have generally been more at risk because they tend to live in older housing and in industrial areas.

Federal researchers found that just 1.4% of young children had elevated lead levels in their blood in 2004, the latest data available. That compares with almost 9% in 1988.

Lead is seriously bad stuff, even in tiny quantities -- a fact that was known as early as the 1920s, and arguably for millenia. Yet somehow, we considered it a good idea to add lead to gasoline, paint, and whatnot for generations. (See more on the history of lead here.) For kids, the results were a disaster. Researchers have tied elevated blood lead levels to lower IQ and SAT scores and higher crime rates, among other ills.

The slow and steady progress in removing lead from gasoline, homes -- and our kids' bodies -- is a heartening success story. But it's also a testament to how misguided our priorities were for so long. If we'd listened to what health researchers were telling us back in the 1920s, we would have saved ourselves a lot of time, money, and heartache. It makes one wonder what other ways that our public policy still fails to put health and safety first.

This article originally appeared in Sightline Institute's The Daily Score.
Photo credit: flickr/cotaro70s, Creative Commons license.

Help us change the world - DONATE NOW!

(Posted by Clark Williams-Derry in Health at 12:36 PM)

Walk, Baby, Walk

WorldChanging Team — Tue, 24 Feb 2009 20:13:49 +0000

By Benita Beamon

Is muscle power an overlooked climate solution?

What would happen if Americans got all the exercise they were supposed to – and they did it by replacing short car trips with walking or biking? Would it make a difference to our oil consumption?

Two articles conclude that it could. In “A Healthy Reduction in Oil Consumption and Carbon Emissions” by Paul A.T. Higgins and Millicent Higgins (appearing in the journal Energy Policy) and “Exercise-Based Transportation Reduces Oil Dependence, Carbon Emissions, and Obesity” by Paul A.T. Higgins (appearing in the journal Environmental Conservation), the authors contradict the “widely-held view that meeting current and future energy needs requires either extraction or technological development.” They argue that, by replacing some of the miles we drive with the daily recommended amounts of physical exercise, we could simultaneously reduce CO₂ emissions, ease oil dependence -- and slim our waistlines.

By the authors calculations, replacing short car trips with walking or biking could lead to profound reductions in oil consumption -- saving more oil over a ten year period, perhaps, than oil companies could ever extract from the Arctic National Wildlife Refuge (ANWR). At the same time, increasing daily exercise could help Americans lose between 26.8 and 57 pounds per person (!!), virtually eliminating obesity and overweight conditions for most people. From the extra exercise, the nation would save $117 billion per year in health care costs, or a little under $400 per person each year. Finally, if, as a matter of policy, those health savings were invested into CO₂ abatement strategies, the nation could reduce its CO₂ emissions by 35%.

Despite the tremendous benefits, the authors also recognize that any “muscle power” strategy faces tremendous obstacles: not only people’s “reluctance to walk or cycle even short distances under ideal conditions”, but also “poor health, disability, weather, time of travel, genetics, culture, economics,” and other factors. Still, the potential synergies– simultaneously addressing public health, climate change, and oil depletion –are exciting, and raise an important question: is there a way to encourage people to walk more?

A recent article in the Journal of Urban Health, “Characteristics of Urban Sidewalks/Streets and Objectively Measured Physical Activity” by Suminski, et al., considers this question. Although previous studies had linked walking with “pedestrian friendly” characteristics, such as high quality sidewalks and nice neighborhood aesthetics, Suminski and colleagues found that aesthetics weren’t so crucial. Instead, they found “a greater number of walkers using more defective sidewalks in less aesthetically pleasing neighborhoods with high volumes of vehicular traffic.” Aesthetics, they admit, may influence recreational walking; but walking for errands, work, or shopping requires that an area actually have such destinations within walking distance! This is pretty obvious when you think about it, but a great point to keep in mind when designing and re-designing communities for long-term transportation sustainability.

Benita Beamonis a Sightline Fellow and an associate professor of industrial engineering at the University of Washington.

This piece originally appeared on the Sightline Institute's blog, The Daily Score.

Photo credit: flickr/➨ Redvers', Creative Commons license.

Help us change the world - DONATE NOW!

(Posted by WorldChanging Team in Health at 12:13 PM)

Global Mercury Negotiations Commence

Ben Block — Mon, 23 Feb 2009 21:20:15 +0000

The world's environment ministers launched international negotiations to limit mercury pollution on Friday.

In a unanimous decision at the annual meeting of the United Nations Environment Programme (UNEP) Governing Council, held in Nairobi, Kenya, more than 140 countries agreed to reduce the global mercury supply through a multilateral treaty.

Mercury, a neurotoxin that has increasingly accumulated in people across the globe, is released into the environment during chemicals production as well as from coal-fired power plants, gold mines, and household products such as thermometers and light bulbs.

"Today we are united on the need for a legally binding instrument and immediate action towards a transition to a low-mercury world," said UNEP Executive Director Achim Steiner in a statement. "The time for action on this pollution is now."

The United States opposed a legally binding mercury treaty during the administration of President George W. Bush. President Barack Obama's administration surprised meeting attendants last week with its quick reversal of the Bush policy.

"There is a call to come together to launch an Intergovernmental Negotiating Committee to develop an international agreement on mercury. The United States now joins that call," said Daniel Reifsnyder, Obama's deputy assistant secretary for environment and sustainable development, last Monday. "It is clear that mercury is the most important global chemical issue facing us today."

Before the United States changed its position, industrialized countries including Canada, Australia, and New Zealand opposed a mercury treaty. The world's two largest commercial consumers of mercury, China and India, also resisted calls to initiate treaty negotiations. But all countries joined the United States in support at Friday's meeting.

"The U.S. position changed dramatically. It changed on a dime. It changed the entire tenor of the discussion," said Susan Keane, a senior analyst with the Natural Resources Defense Council, who attended the meeting. "Everyone here was amazed."

The UNEP decision leaves room for the final treaty to include both binding and voluntary approaches to curb mercury pollution. Negotiations are set to begin next year and to conclude by 2013.

Although the UNEP decision did not discuss details of the future agreement, the U.S. delegation suggested that the treaty bring "particular attention to sectors that have the greatest global impact, such as coal-fired power plants."

In the decision, governments asked UNEP to study current mercury emission controls as well as cost-effective alternatives to mercury in sectors including coal-fired power plants, cement production, and non-ferrous metals mining. The report will be prepared in time for next year's Governing Council meeting in Dubai.

The two major mercury traders, the European Union and the United States, had already agreed to ban future mercury exports before the treaty announcement. The E.U. plans to phase-out its mercury trade starting in 2011. The U.S. ban will be effective in 2013, according to legislation that Obama sponsored as a U.S. senator.

"Obama has been interested in mercury for a long time, so [launching a treaty] was not a hard sell," Keane said.

Mercury pollution circulates around the globe and often accumulates in the tissue of commercially important fish species, such as swordfish and tuna. The risk of mercury contamination is greatest for populations with high per capita fish consumption, and in locations where environmental pollution is widespread.

In eastern India, nearly half of the 56 locally available fish varieties tested had mercury contamination rates above the World Health Organization's standards, according to a recent report from the U.S.-based Mercury Policy Project.

But some of the most chemically contaminated human and wildlife populations reside in remote Arctic regions where, because of prevailing winds and currents, pollutants often collect. Mercury levels in Arctic ringed seals and beluga whales tested off the coasts of Canada and Greenland are four times the levels of 25 years ago. In Sweden, toxic pike have been found in about 50,000 lakes, according to UNEP.

The worldwide rise in mercury pollution is attributed in part to increased coal burning and small-scale gold mining worldwide. Meanwhile, mercury trapped in Arctic ice and sediments is being re-released into the environment as climate change accelerates and these surfaces melt, UNEP said.

In other decisions, the UNEP Governing Council agreed to hold a meeting later this year to discuss the creation of a scientific body focused on biodiversity that would be similar to the Intergovernmental Panel on Climate Change. The council also plans to deploy a mission to Gaza next month to assess environmental damage resulting from the ongoing conflict with Israel.

Ben Block is a staff writer with the Worldwatch Institute. He can be reached at bblock@worldatch.org.

Photo courtesy UNEP. More than 50 percent of indigenous women exceed U.S. Environmental Protection Agency mercury level guidelines in many regions around the Arctic Circle.

Help us change the world - DONATE NOW!

(Posted by Ben Block in Health at 1:20 PM)

Sanjay Gupta for U.S. Surgeon General?

Alex Steffen — Tue, 06 Jan 2009 22:54:09 +0000

The Washington Post is reporting that President-elect Barack Obama has asked Dr. Sanjay Gupta (who we recently interviewed) to serve as surgeon general:

The offer followed a two-hour Chicago meeting in November with Obama, who said that Gupta could be the highest-profile surgeon general in history and would have an expanded role in providing health policy advice, the sources said. Gupta later spoke with Tom Daschle, Obama's White House health czar and nominee for Health and Human Services secretary, and other advisers to the president-elect.
The Michigan-born son of Indian and Pakistani parents, Gupta has always been drawn to health policy. He was a White House fellow in the late 1990s, writing speeches and crafting policy for Hillary Clinton. His appointment would give the administration a prominent official of South Asian descent and a skilled television spokesman.

What the post doesn't mention is that Dr. Gupta would bring to the administration a much deeper grounding in both global health issues and urban health innovations than recent surgeons general. Given his polished presentation skills and his fame, he may be able to make excellent use of the bully pulpit his position provides to educate Americans on the importance of an active U.S. role in global health issues, and the health benefits of sustainability and smart growth.

Help us change the world - DONATE NOW!

(Posted by Alex Steffen in Health at 2:54 PM)

The LUCAS Imager: Portable, Affordable Blood Tests for the Other 90 Percent

Julia Levitt — Fri, 26 Dec 2008 15:07:06 +0000

In the Global South, blood tests -- which require a lab, expensive evaluative equipment and/or the presence of a skilled technician -- are out of reach for the majority of the population. As advancements in disease awareness and disease treatment continue to take hold in the developing world, effectively combating the most deadly diseases will require a means of testing that is inexpensive enough -- and portable enough -- to give access to the millions of people in under-served communities.

A new innovation that I read about recently in Wired promises to go a long way toward changing the game. A team of scientists at UCLA's California NanoSystems Institute have found a way to turn a cell phone into a portable blood tester, using simple and available materials. The instrument, called the LUCAS imager (Lensfree Ultrawide-ﬁeld Cell-monitoring Array platform based on Shadow imaging), can be used to detect diseases, and to monitor major killers: HIV, malaria and leukemia. Dave Bullock writes:

UCLA researcher Dr. Aydogan Ozcan images thousands of blood cells instantly by placing them on an off-the-shelf camera sensor and lighting them with a filtered-light source (coherent light, for you science buffs). The filtered light exposes distinctive qualities of the cells, which are then interpreted by Ozcan's custom software. By analyzing the cell types present in a much larger sample, a more accurate diagnosis can be made in a matter of minutes. No more sending blood away to a lab and waiting days or weeks for the results.

According to Wired, Ozcan is currently seeking a manufacturer for the devices. Read more about how the instrument works, and see more photos here.

Photo credit: Dave Bullock/Wired.com

Help us change the world - DONATE NOW!

(Posted by Julia Levitt in Health at 7:07 AM)

MSF’s Top Ten – How Disconnection Affects Public Health

Ethan Zuckerman — Tue, 23 Dec 2008 19:24:58 +0000

It’s hard to look forward to something as difficult and sad as Medicine Sans Frontieres top ten list of global humanitarian crises. I noted last year that this appears to be the season for top ten lists, and that these lists range from the positive to the extremely disconcerting. MSF’s list is certainly discomfiting, but it’s also a very helpful reminder of what stories we should be paying attention to.

Two of MSF’s top ten focus on Somalia and the ethnically Somali portion of Ethiopia. MSF reports a massive refugee crisis in Somalia, connected to ongoing instability and violence. Unfortunately, MSF is able to provide little help within Somalia - the situation is simply too dangerous for their staff. Three staff were killed by a roadside bomb in Kisamayo, and MSF pulled its international staff out of the country in early 2008 - their local staff continues to work despite a high degree of risk.

Eastern Ethiopia, a region that’s majority Somali-speaking, is facing a severe food crisis. Many of the people who live in this region are pastoralists. An ongoing conflict between the Ethiopian government and rebels have made much of the region inaccessible, which is preventing herds from reaching water and food. Here MSF is constrained from acting not so much by violence, but by an uncooperative Ethiopian government, which has put major hurdles in front of the organization and which forced an MSF project to close in the region.

(While I’ve complained in the past about how little attention is paid to Somalia, the rising threat of piracy has helped attract some attention to that country’s problems. But news from the Somali region of Ethiopia is almost nonexistent - try a search for “Jijiga”, the regional capital, on Google News, or within the New York Times, where most results are from the second World War. A paper from Dr. Abdi Aden Mohamed - whose views are clearly anti-Ethiopian and pro-independence for the region - gives a sense for how isolated this region is: “… 3. There is no electricity any where in the region and most of the people in the region have never seen a Television or Cinemas. 4. No communications like postal services, and most of the people have not seen or used up to now telephones, faxes etc., because there aren’t any in the region. 5. There are no roads in the region except dirty dusty ones and trails created by the nomads and their herds.”

The difficulty MSF is having in reaching Somalia and the Somali region aren’t just coincidental - the disconnection of these areas helps explain why they are in such dire straits. Political and military strategist Dr. Tom Barnett offers the maxim “disconnection defines danger”. Countries that are tightly integrated into global communication, financial, trade and military systems tend not to fail catastrophically in meeting the needs of their people. The idea is not unrelated to Dr. Amartya Sen’s assertion than functioning democracies don’t experience famines - they’re able to access markets and seek help from other nations to avert this sort of catastrophe. (If you’re as disconnected as North Korea, you’ll find your neighbors using food aid as a carrot to try to coax better behavior from you.) This helps explain why Burma, still recovering from Cyclone Nargis, makes MSF’s list. It’s not a surprise that MSF hasn’t been able to send international staff into Burma - the military government has refused to issue visas, leaving the task of providing critically needed medical care to local staff.

I’d always assumed that MSF’s purpose in publishing this list was to fundraise. Oddly, there’s no link to giving information on their site - if you’re in the US and want to support their important work, you can find a link on the Doctors Without Borders site. The idea of disconnection suggests another reason - MSF can’t work in many of the places on their top ten list without better security for their doctors, or international support in obtaining visas. Without more “connectivity” - in Barnett’s sense - these are largely crises they have to watch from afar and help with only indirectly. Top ten lists, whatever else they’re good for, are a way of directing attention, and attention is a necessary precursor to connection.

This piece originally appeared on Ethan Zuckerman's personal blog, My Heart's In Accra.

Help us change the world - DONATE NOW!

(Posted by Ethan Zuckerman in Health at 11:24 AM)

More Green Spaces Equal Better Health for All

Sarah Kuck — Tue, 11 Nov 2008 18:57:27 +0000

A recent study offers hard evidence of something many of us have known for a long time: access to nature improves our health. According to the researchers' findings, as reported in this BBC article, the abundance of green space in a city can help protect residents from strokes and heart disease, and can reduce health inequalities related to income and social deprivation. Even small parks, they said, greatly narrow the health gaps between these populations.

When the records of more than 366,000 people who died between 2001 and 2005 were analyzed, it revealed that even tiny green spaces in the areas in which they lived made a big difference to their risk of fatal diseases.

Although the effect was greatest for those living surrounded by the most greenery, with the "health gap" roughly halved compared with those with the fewest green spaces around them, there was still a noticeable difference.

The change was particularly clear in areas such as heart disease and stroke, supporting the idea that the presence of green spaces encourages people to be more active.

However, the researchers, Dr Richard Mitchell from Glasgow University, and Dr Frank Popham, from the University of St Andrews, said that other studies had suggested that contact with green spaces also helped reduce blood pressure and stress levels, perhaps even promoting faster healing after surgery.

Creating equal access to green space is clearly an environmental justice issue: the more funding the parks in your neighborhood receive, the better kept and abundant the parks will be, resulting in better health for you and your neighbors. The big picture benefit from this study's findings is that city officials, such as planners and council members, can use this scientific evidence to help fund parks and other green spaces that will improve the health and wellness of all residents.

Image credit: Flickr/Barb46, Creative Commons License

Help us change the world - DONATE NOW!

(Posted by Sarah Kuck in Health at 10:57 AM)

Image of the Day: 1298 Ambulances in Mumbai

Robert Katz — Mon, 10 Nov 2008 21:12:22 +0000

Saving Energy, Saving Lives

1298's ambulances provide reliable 24x7 emergency medical service to the residents of Mumbai. Its business model uses a sliding price scale driven by ability to pay, which is determined by the kind of hospital to which patients choose to be taken. 1298 has recently begun to experiment with the innovative use of solar panels to help generate and save valuable energy needed to power the onboard equipment of its ambulances.

This post originally appeared on the Acumen Fund blog.

Help us change the world - DONATE NOW!

(Posted by Robert Katz in Health at 1:12 PM)

Treating Health Care as a Commons

WorldChanging Team — Thu, 09 Oct 2008 23:04:45 +0000

Two physicians explain how the commons could be used to improve medical care.

By David Bollier

From my reading of history, medical care was once a more intimate and ethical endeavor, a calling that involved a respectful communion between doctor and patient. However, in recent decades, at least in the United States, it is clear that medical care has become a technology-driven market transaction. Doctors who were once skilled at seeing illness in the context of the “whole person” are more likely, in today’s environment, to know how to rush patients through 15-minute assembly-line appointments and game the insurance/Medicare system with the right billing codes.

Paradoxically enough, a system that ostensibly aims to improve efficiency has resulted in soaring costs. As health care has become more of a market service, and less of a professional calling, Big Pharma, hospitals, insurance companies and medical device makers have become the masters of the system, with each jostling for a piece of the action. It is now standard practice for companies to offer gifts and junkets to doctors — all in the name of improved health care, of course — and to market new diseases, technologies, treatments and so forth. The goal, in short, is to “grow the market,” not necessarily to make people healthier.

Could the commons hold some answers?

Photo by interplast, , via Flickr, licensed under a Creative Commons BY-NC-ND license.

Amazingly, two doctors writing in the Journal of the American Medical Association (JAMA) seem to think so. Drs. Christine K. Cassel of the American Board of Internal Medicine and Troyen E. Brennan, a medical doctor and lawyer with Aetna, suggest that the commons may offer some distinct advantages over the fee-for-service model that now prevails in U.S. medicine. Their article in the June 13, 2007 issue of JAMA, “Managing Medical Resources: Return to the Commons?” argues that “physician engagement in a medical commons, ideally with communities of consumers, is arguably the only approach that will ensure proper allocation of health care resources.” (The article is locked behind the JAMA paywall; those with access can find it at JAMA, vol. 297, no. 22, pp. 2518-2520. A tip of the hat to Julie Ristau, who brought this article to my attention!)

Cassell and Brennan start with the hoary “tragedy of the commons” paradigm, arguing that individual physicians cannot (and ethically should not) set limits on the utilization of medical resources for a given patient. “Society” must therefore “establish a global budget for health care or guidelines for utilization,” the authors argue.

The problem with the current system, the authors argue, is that individual physicians cannot assert their moral agency for health care choices by participating in a commons. Any money that doctors might save through “bedside rationing” would be siphoned away by insurance companies and hospitals, and would not necessarily be used to improve patient care. Individual doctors therefore have little incentive to keep a lid on costs or make ethical judgments because those choices have been taken away from them. They have no “community responsibility” for aggregate costs or outcomes.

Cassel and Brennan write that “except in prepaid group practices, there is no explicit commons that would link the moral duty to individual patients with responsibility to a community, and the moral duties [of physicians] remain exhortations….” There is no way for physicians to assess the impact that their decisions have on the larger community of patients or even their own health care institutions. They are treated as cogs in the machine, not as moral agents whose caring and ingenuity might be harnessed to individualize treatment or improve overall outcomes.

How could physicians be engaged in ways that patients would trust?” ask Cassel and Brennan. Their answer: “The commons must be reconstructed through organizational change…. [A] broader community focus and a shared responsibility are needed to build the ethical base for clinician management of health care resources.”

The authors acknowledge that this vision may seem far-fetched, in part because health care tends to be scattered among so many different providers, insurers. drug companies, labs and other vendors. Medical care is a marketplace, not anything resembling a commons. But Cassel and Brennan ingeniously suggest the creation of “virtual commons mechanisms” to encourage physicians to operate within a framework of “group responsibility.” They cite some specific systems – one is an “accountable care organization” – in which multispecialty physician groups and small practices affiliate with a hospital to serve a defined community of patients for whom they assume responsibility.

Such a virtual commons in medical care could create “a sound ethical framework for effective resource management linked to high-quality care.” It would limit cost shifting, take responsibility for all the care of a population, focus on public health and prevention, and move away from a per-unit reimbursement system for services.

The authors acknowledge that establishing a commons for medical care would be a “tall order,” but they also bluntly ask, “Is there a professional responsibility to establish the commons?” They note that “market-based and regulatory approaches place the welfare of patients in hands other than those who provide medical care.” This means that the allocation of resources occurs without the “caring, commitment, clinical experience and wisdom of experience that clinicians bring.”

Physicians have seen the medical commons enclosed, leaving them to toil as wage-slaves in the health care marketplace. Yet physicians could enjoy multiple benefits from reclaiming their profession as a commons. While they would have to shoulder new responsibilities — especially in deciding how to allocate scarce resources fairly and ethically — they would regain their moral agency and a considerable measure of their ethical standing.

Whatever challenges this would pose, it would be a huge improvement over letting insurance company bureaucrats dictate treatment from their office cubicles. A medical care commons would revamp the marketplace model that now prevails by establishing a physician-driven model based on clinical medical judgments and community needs and outcomes, not market-driven efficiencies. A commons could make it easier for physicians to make better, more ethical judgments; for patients to get more appropriate and cheaper care; and for both to have more trusting, constructive relationships with each other.

It is hard to assess the feasibility of Cassel and Brennan’s vision because their article is fairly short and elliptical. Still, their analysis is compelling. The bigger problem would be how to actualize a new commons-based system of medical care. It would entail major re-alignments of power and disrupt many entrenched and lucrative medical practices. Yet there is little doubt that a commons for medical resources would be more humane and ethical than our current system. It could also reduce medical costs because the fierce incentives to maximize profits would be mitigated or spread across more parties. What's not to like?

Editor's note: For more on this topic, read John de Graaf's recent column, "Thinking Differently About Health Care.

David Bollier writes for On the Commons, where this post originally appeared.

Help us change the world - DONATE NOW!

(Posted by WorldChanging Team in Health at 3:04 PM)

Facebook, Coca-Cola and Medical Aid in Africa

WorldChanging Team — Wed, 06 Aug 2008 21:18:28 +0000

By Hesseltje S. van Goor

A recent development on Facebook has shown that social networking may be more powerful than simply a vehicle for gossip between friends, co-workers and ex-significant others. When Coca-Cola executives responded to a Facebook-based call for humanitarian action, it showed a new opportunity for dialogue between consumers and corporations: smart organizers can harness this kind of rapid message-spreading medium to foster a conversation between the decision-makers at the top and the masses at the point-of-use.

Incensed by the irony that remote African communities had limitless access to bottles of Coca-Cola, but no infrastructure to get medicines to sick children, innovator Simon Berry decided to speak up and ask Coca-Cola to dedicate a fraction of its distribution network to carry medicines for simple, widespread and life-threatening ailments like diarrhea.

At first, Berry's ideas fell on deaf ears; after all he was the only recruit in a one-man army. Now, a modest Facebook publicity campaign has catapulted Berry's message into the Coca-Cola boardroom. Salvatore Gabola, global head of stakeholder relations for the beverage giant, took notice of the social networking momentum and has invited Berry to Coca-Cola's European headquarters to discuss his idea (read their recent correspondence here).

The size of the campaign's Facebook following – 3,811 at our last visit – is still tiny relative to Coca-Cola's consumer base. But the viral, self-publicizing nature of Berry's campaign is nothing to sneeze at when you're an executive of a company like Coca-Cola, facing significant skepticism from the kinds of creative-minded, marketer-wary users who populate Facebook and other sites like it. If Coca-Cola can indeed facilitate a medical supply network, the company stands to gain enormous approval from some tougher consumers. I, for one, hope Coke decides (for any reason) to act on Berry's suggestion. Allying the social conscience of global multinationals with a worthy cause may prove to be an important first step towards a better world.

If you are interested in reading more about this campaign, check out Simon's blog for the latest on his work and his growing band of eager volunteers. Also, if you have some ideas that might be useful to the project, or would like to get involved directly, feel free to do so here.

Hesseltje S. van Goor is a soon-to-be-Media-Management-graduate with a day-time job as marketing executive for Systemlink Ireland. She spends her spare time working on her dissertation and researching green technology.

Photo credits: Flickr/Nick Gripton and Flickr/Tielmann; bike image appeared on Simon Berry's blog.

Help us change the world - DONATE NOW!

(Posted by WorldChanging Team in Health at 1:18 PM)

Facebook, Coca-Cola and Medical Aid in Africa

WorldChanging Team — Wed, 06 Aug 2008 21:18:28 +0000

By Hesseltje S. van Goor

A recent development on Facebook has shown that social networking may be more powerful than simply a vehicle for gossip between friends, co-workers and ex-significant others. When Coca-Cola executives responded to a Facebook-based call for humanitarian action, it showed a new opportunity for dialogue between consumers and corporations: smart organizers can harness this kind of rapid message-spreading medium to foster a conversation between the decision-makers at the top and the masses at the point-of-use.

Incensed by the irony that remote African communities had limitless access to bottles of Coca-Cola, but no infrastructure to get medicines to sick children, innovator Simon Berry decided to speak up and ask Coca-Cola to dedicate a fraction of its distribution network to carry medicines for simple, widespread and life-threatening ailments like diarrhea.

At first, Berry's ideas fell on deaf ears; after all he was the only recruit in a one-man army. Now, a modest Facebook publicity campaign has catapulted Berry's message into the Coca-Cola boardroom. Salvatore Gabola, global head of stakeholder relations for the beverage giant, took notice of the social networking momentum and has invited Berry to Coca-Cola's European headquarters to discuss his idea (read their recent correspondence here).

The size of the campaign's Facebook following – 3,811 at our last visit – is still tiny relative to Coca-Cola's consumer base. But the viral, self-publicizing nature of Berry's campaign is nothing to sneeze at when you're an executive of a company like Coca-Cola, facing significant skepticism from the kinds of creative-minded, marketer-wary users who populate Facebook and other sites like it. If Coca-Cola can indeed facilitate a medical supply network, the company stands to gain enormous approval from some tougher consumers. I, for one, hope Coke decides (for any reason) to act on Berry's suggestion. Allying the social conscience of global multinationals with a worthy cause may prove to be an important first step towards a better world.

If you are interested in reading more about this campaign, check out Simon's blog for the latest on his work and his growing band of eager volunteers. Also, if you have some ideas that might be useful to the project, or would like to get involved directly, feel free to do so here.

Hesseltje S. van Goor is a soon-to-be-Media-Management-graduate with a day-time job as marketing executive for Systemlink Ireland. She spends her spare time working on her dissertation and researching green technology.

Photo credits: Flickr/Nick Gripton and Flickr/Tielmann; bike image appeared on Simon Berry's blog.

Help us change the world - DONATE NOW!

(Posted by WorldChanging Team in Health at 1:18 PM)

Resources: U.S. Impacts of Climate Change, Human Development

Alex Steffen — Mon, 21 Jul 2008 22:02:43 +0000

Two new reports offer useful tools for thinking about the future, both focused on the United States and both needed.

The first report, Analyses of the Effects of Global Change on Human Health, Settlements and Welfare comes out the U.S. Environmental Protection Agency, and details the ways in which climate change may exacerbate a number of problems we don't usually think of as environmental. Among their findings were these key impacts:

* Heat: Almost every part of the country will experience higher average temperatures, but the impacts of increased heat will be particularly acute in urban areas in the Northeast and Midwest and across many areas of the West. The rapidly aging U.S. population as well as children and the poor will be particularly vulnerable to health impacts, such as cardio-vascular and pulmonary disease as well as higher death rates. * Extreme Weather: More intense storms, such as those that have led to severe flooding in the Midwest, will have costly impacts on individual health and welfare, as well as government services, infrastructure and economies. In other regions drought will tax water supplies in the rapidly growing west, increase threats of wildfire and damage weather-related economies such as agriculture, fishing and recreation. * Health: Climate change will significantly worsen the health threats associated with heat and air pollution; elevate the incidence of food-, water- and vector-borne disease and have costly impacts on public health systems. Some of these adverse impacts will not be avoidable, even with efforts to adapt to them. * Quality of Life: Climate change will affect the livelihoods and lifestyle of Americans. These disruptions will affect everything from economic prosperity to the way people play and their faith in government. * The West: The West is a “critical crossroads” for climate change. Its rapidly growing population will face scarcity of water, more wildfires, coastal flooding and costly disruptions to its resource-based economies.

The second report, The Measure of America: American Human Development Report 2008-2009 is the work of the American Human Development Project, a multidisciplinary effort to apply for the first time the same kind of holistic thinking about human health and welfare which is becoming coming commonplace in other nations. As Amartya Sen says in the foreword:

“We get in this report not only an evaluation of what the limitations of human development are in the United States, but also how the relative place of America has been slipping in comparison with other countries over recent years. In the skilled hands of Sarah Burd-Sharps, Kristen Lewis, and Eduardo Borges Martins, the contrasts within the country - related to region, race, class, and other important distinctions - receive powerful investigation and exposure. In these growing gaps we can also see one of the most important aspects of the souring of the American Dream, which is so much under discussion today."

Taken together, the two reports are sobering, sure, but they also offer hope that we here in the U.S. are actually beginning to grapple with the magnitude of our challenges.

Help us change the world - DONATE NOW!

(Posted by Alex Steffen in Health at 2:02 PM)