Thursday, January 16, 2014

"Fevered (A hotter planet and our health)" by Linda Marsa

There are growing number of books being released about climate change and this one addresses its impacts on individual health and the public systems designed to address those impacts.

Guess what? They're insufficient. Author Linda Marsa has travelled far and wide in gathering information from places where climate change is already wreaking death and destruction, spurring desperate attempts at adaptation.

In line with recent reports (2013-14) suggesting the impacts of climate change may confront all of us sooner than expected, Marsa gathers up a string of evidence that will scare the wits out of you, that special American citizen who believes in causes, effects, and the evidence linking them.

The author's focus is on the need to build a strong public health infrastructure able to cope with the widespread effects of climate change. Marsa asserts that because many of the perils associated with global warming are generally predictable, it is possible to design or adapt buildings and communities to be more resilient.

Strategies for creating a nonpolluting, clean-energy future can also improve public health.

A chapter entitled “Fever Pitch” examines the relationship between rising temperatures and the persistent and greater diffusion of diseases beyond their typical geographical distribution. Essentially, shorter, warmer winters aren't killing these things off and they actually grow stronger when they survive.

“Fevered” looks at the way global warming impacts air quality. “Rising temperatures will make bad air even more dangerous,” writes Marsa, “cooking up a witches' brew of pollutants that will sear the delicate tissue lining the lungs and aggravate an astonishing array of other health issues ranging from heart disease, to lung cancer, to dementia.”

“The Hot Zone” portends the more frequent occurrence of death by heat wave, characterized here as large tragedies going under-reported, because the dead can't always be linked directly to the heat, even though they were killed by existing ailments the extreme conditions triggered.

Chicago, France, Russia, Philadelphia, all have recent and ghastly stories related here.

“Health Care on Life Support” dissects the collapse of public health infrastructure in New Orleans during Hurricane Katrina and what came after, which was more of the same.

Marsa reports, nonetheless, that The Crescent City became something of testing ground for federal policies aimed at “disaster-proofing” healthcare there.

For example, patient records are now kept electronically, and New Orleans is also part of a federally funded pilot program that stores this information in a central information exchange, efficiencies that might have saved lives in the hurricane's wake.

The chapter entitled, “Running on Empty,” covers the dangers of malnutrition, examining the case of actress Audrey Hepburn, who endured starvation as a Dutch citizen during World War II, before transitioning to the topic of agriculture's increasing difficulty in cultivating a hotter planet.

A lot of that difficulty comes down to water – here she looks at the situation in the American southwest where the Colorado River no longer reaches its natural delta, wrung dry by a growing population.

Circumstances in Australia, which is at the forefront of climate change impact, involve “catastrophes of biblical proportions; unleashed killer heat waves, agricultural collapse, bushfires of unimaginable ferocity and hastened species extinction.”

Drought has wiped out entire agricultural communities, and it is possible “vast portions” of the country's northern regions could be submerged by rising seas, rain storms and flooding

Because of its unique vulnerability, Australia has become a living laboratory for adaptation to a warmer world. Marsa makes a trip down there. The country's system of water consumption control offer a preview of what we'll be seeing everywhere someday, or sooner.

“Holding Back The Waters” returns to New Orleans, documents efforts at retooling water management and flood control systems in a sustainable way and reverses the environmental degradation that made Katrina worse than it needed to be.

Also covered are the problems in south Florida and the apparently borrowed time the city of Miami is living on, as sea level rises to threaten the lowing lying community and its freshwater supply sources.

It's not all darkness. There are strategies not only for adapting health care systems to a warmer world, but also for developing sustainable cities as a matter of public health. By way of example, Marsa sheds light on the Orange County Water Authority's pioneering to reuse wastewater for potable purposes.

New York, covered in a fulsome network of mass transit, and characterized by vertical lifestyles, is held up as an example of the good way to live, although the fact you need to be rich to reside there is not mentioned.

Writes Marsa: “Sylvan paradises like Vermont, where you don't have to wait until farmers' market day to buy locally grown, produce, may intuitively seem like places where sustainable living would be much easier than in urban areas. But the reality it quite different. Because the population is so spread out, Vermonters use nearly four times as much gasoline as New Yorkers, and six times as much as Manhattan residents. Ironically, on just about every other barometer, Green Mountain State residents turn out to be the resource hogs: They have larger carbon footprints, guzzle more water, dump more garbage, and consume quadruple the amount of electricity as the average New Yorker. In other words, the seductive allure of rural life is simply wrongheaded at a time when the world's population is surging toward eight billion and roughly 80 percent of Americans live in cities.”

“New York,” Marsa writes, “developed as a city before the advent of the automobile, so it is compact and dense. To become more like New York, the rest of us are going to have to undo the half century's worth of damage to our health and the social fabric of our lives that resulted when we became a car-centric society and suburban sprawl became a way of life.”

But New York may be just as car-centric as any city out there. Robert Caro's “The Power Broker” painfully documented the efforts of a man who never drove a car, Robert Moses, to bind the city up in ribbons of “parkway.”

One of the few people able to thwart him was Jane Jacobs, the urbanist who extolled the dense city neighborhood as a place of social health and economic vitality.

“Fevered” is progeny of Jacobs' own books. Her vision was of a sustainable city before that term became a byword for future survival. Marsa's work links the loss of high-density, transit-served urban villages with the sprawl that characterizes most development over the past half century.

Marsa's contribution is to take the ideas Jacobs propounded in her books beyond the concerns of neighborhoods and microeconomics and link them to the causes of climate change, and the health of the people in those neighborhoods hopefully driving those economies.

The author asserts that the universal and modern dependence on individual, motorized transportation is responsible for a series of direct health hazards ranging from lung disease and obesity, and indirect impacts such as global warming.

Marsa echoes Al Gore's call for a Marshal Plan to fight global warming in his “Earth in Balance” with her own call for a medical Marshall Plan that would recapture the spirit of cooperation that arose with WW II's outbreak.

“We must become that country again,” she pleads.

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