Thursday, February 15, 2007

Health and the Environment

I read an article in the Globe and Mail today by Andre Picard. I have included the text of the article here. It sums up the link between preserving the environment and human health.


For more than a generation, health has been top of mind for Canadians. In virtually every survey, health care has been pegged as the No. 1 political and social priority.

But now the environment has supplanted health at the top of the worry list, and is probably there to stay for a long time.

This sea change in attitudes has a lot of people in the health field worried. The political predominance of health has meant the cash has flowed freely and providers have had a lot of clout.

Nobody likes being brushed aside by a green newcomer but, objectively speaking, the focus on the environment could be the best thing that ever happened to the health of Canadians, and to our beloved (but largely rudderless) medicare system.

After all, nothing has more impact on the health of individuals, and the health of a population as a whole, than the environment.

But, be careful. The term environment needs to be defined fully and appropriately.

In health terms, environment is defined as the physical, social and cultural surroundings that have an influence on individuals and communities.

This goes well beyond pollution and carbon emissions. It includes urban design, transportation policies, educational philosophy, food choices, affordable housing, employment possibilities and much more.

Put simply, where we live affects how we live, and how we live affects how healthy we are, and how long we live.

This is a discussion that is long overdue and, hopefully, the newfound interest in the environment will open that door.

The mistake that has been made in health care has been to focus on illness care, to focus on treatment of symptoms rather than on prevention.

In the past generation -- the three decades since 1975 -- health-care spending has increased to $148-billion from $7.5-billion.

It may be heresy to say so in health circles, but that money can be spent more wisely. There needs to be a rebalancing -- spending less money on sickness care and more on keeping the population healthy.

What we need to treat is what the renowned social scientist Sir Michael Marmot has dubbed "the causes of the causes of poor health."

Those root causes are largely environmental.

If we are going to have a healthy society, if our health-care system is going to be sustainable, we need to adopt a healthy, sustainable lifestyle.

The soaring interest in the environment is fuelled by the realization that our energivorous ways are killing the planet, and they are eventually going to kill us, regardless of how much treatment is available for health woes.

The green approach is to create an environment that is health-enhancing -- one where people are not only protected from biological, chemical and physical hazards, but where making the healthy choice is the easy, natural choice.

That is certainly not the case today in Canada.

The most heavily subsidized public facilities in this country are roads. As taxpayers, we massively subsidize fundamentally unhealthy and environmentally unsound public policies such as urban sprawl, commuting and the transportation of goods (namely food) over long distances.

Meanwhile, we grossly underfund public transportation, make urban dwellers absorb the full brunt of infrastructure costs (thus further subsidizing the unhealthy practices of suburbanites), and we cry poverty rather than build more bike paths, parks and recreational facilities.

These are health issues, and they are environmental issues. Même combat, as they say in French.

Instead of being green with envy, the leaders of the health sector should embrace the green movement and make them powerful allies.

Environmental leaders, too, can learn from the health sector, benefit from its experience in dealing with the crushing weight of public expectations and the frustrations of political compromise and, above all, by not repeating its mistakes.

The health system in Canada went astray when it abandoned the simplicity and common sense that are the hallmarks of good public-health policy and allowed itself to be seduced by the siren song of technology -- fancy new drugs, machines and techniques that oftentimes provide marginal benefits at high costs.

In the environment field today, the dominant discussion relates to carbon emissions. There, too, technology is being held out as the solution. Treating that sickness is necessary, but it's not enough.

Good health begins with prevention of illness. Sustaining health requires a healthy environment.

We know the science. We know the stakes. We need to act.

By healing the planet, we will heal ourselves.

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