Welcome!

“Decline is inevitable, suffering is optional.”

Welcome to Health after Oil (HAO), a place for news, opinion, research, discussion, networking, planning and action in response to the unprecedented and sweeping challenges peak oil, energy decline, and population pressures poses to human health and the institutions whose purpose it is to protect and promote human health. We invite submissions -original content and links- about energy and health and related fiscal/economic and environmental and ecological issues. We note in particular that: 1) Climate change and peak oil are indivisible threats, both stemming from reliance on fossil fuels; and 2) The fiscal and economic crisis now enveloping world economies are intertwined with population growth, energy decline and resource depletion. Infinite growth cannot continue on a finite planet.

Physicians, the Global Environment and the Precautionary Principle

Eric Chivian MD, Center for Health and the Global Environment, Harvard University.

Communicating Sustainability: Lessons from public health

Repost of an article by Steven Johnson, an independent writer, speaker and creative consultant specialising in sustainability, CSR and behaviour change. He blogs and tweets as @Considered. Original article at The Guardian.

Experts in public health have struggled with enabling behaviour change for years. The sustainability sector should learn what it can from their experiences:

Consumer behaviour change is the challenge of our time. As governments and brands are beginning to realise, upstream improvements are relatively easy to make compared with the herculean task of shifting consumer behaviours downstream.

While the sustainability community is just beginning to get to grips with the gravity of this challenge, our colleagues in public health have been wrestling with it for decades. Great progress has been made, but hard lessons have been learned – costly, time-consuming lessons that we can all learn from.

Continued at original site: The Guardian

“The Marks of Death” – Aldo Leopold

“One of the penalties of an ecological education is that one lives alone in a world of wounds. Much of the damage inflicted on land is quite invisible to laymen. An ecologist must either harden his shell and make believe that the consequences of science are none of his business, or he must be the doctor who sees the marks of death in a community that believes itself well and does not want to be told otherwise.”

- Aldo Leopold

Public Health, Thermodynamics and the Cat Food Commission

Dan Bednarz

A previous article discusses the future of health systems operating under neoliberal ideology as it comes a cropper in a world undergoing degrowth.[i] Here I consider how this thrusts public health[ii] into in a “Which side are you on?” dilemma[iii] likely to separate its institutional administration from its frontline professionals –and the public it is meant serve- as part of the larger process of political/economic conflict, cultural and environmental decline, chaos and (possibly) cultural renewal.

The effects of government-imposed austerity[iv], erroneously claimed to restore fiscal responsibility and restart economic growth, are a reflexive (or cybernetic[v]) reaction to protect the economic interests of wealthy elites at the expense of other citizens.[vi] The funding and operation of the public health system and the array of socioeconomic factors that ultimately ensure a nation’s health[vii] are damaged by austerity.

The deep-seated reasons for recent and continuing financial and economic crises (despite mountains of propaganda and self-delusion that a recovery is underway) lie in neoliberalism’s congenital rent seeking,[viii] its class-based dynamic to channel wealth to a tiny economic elite,[ix] and its inability to realize that modern economies are reaching the thermodynamic limits to growth.[x]  (This third characteristic is shared by most modernist forms of political thought, from the left to the right.)

It follows that neoliberal leaders of governments and their corporate masters view the ongoing economic contraction as a temporary deviation from the “natural” pattern of wealth accumulation-to-elites-trickle down-to-the-masses economics made possible by constant growth. Therefore, economic elites see an “opportunity” to use austerity as a cover to increase upward wealth transfer.[xi] A bonus is to accomplish the long-standing atavistic goal of rolling back[xii] the gains of the New Deal and Great Society.[xiii] Hence the massive governmental and corporate propaganda assaults on Social Security, Medicare and Medicaid –and other social benefits programs- as “Entitlements” that allegedly weaken the collective moral character, fiscal integrity and work ethic of the nation. The central premise of this attack -which is arrantly false yet widely disseminated without skepticism by mainstream media- is that these entitlements[xiv] for the “Lesser People”[xv] place the United States government at high risk of debt[xvi] default[xvii] or bankruptcy.[xviii]

Guest Post: Survive

 Josephine Smit and Norman Pagett

Healthy citizens are the greatest asset any country can have.”

Winston Churchill

Faced with inevitable decline in our access to hydrocarbon resources, we read of numerous ways in which we will have to downsize, use less, work less, grow our own food, use goods and services close to home, consume only what we can manufacture within our own personal environment, or within walking distance. If we are to survive, we must ‘live local’ because the means to exist in any other context is likely to become very difficult. There is rarely, if ever, any mention of the healthcare we currently enjoy, which has given us a reasonably fit and healthy 80 year average lifespan.

There seems to be a strange expectation that we will remain as healthy as we are now, or become even healthier still through a less stressful lifestyle of bucolic bliss, tending our vegetable gardens and chicken coops, irrespective of any other problems we face. And while ‘downsizing’ – a somewhat bizarre concept in itself – might affect every other aspect of our lives, it will not apply to doctors, medical staff, hospitals and the vast power-hungry pharmaceutical factories and supply chains that give them round the clock backup. Nor does downsizing appear to apply to the other emergency services we can call on if our home is on fire or those of criminal intent wish to relieve us of what is rightfully ours. Alternative lifestylers seem to have blanked out the detail that fire engines, ambulances and police cars need fuel, and the people who man them need to get paid, fed and moved around quickly. In other words ‘we’ can reduce our imprint on the environment, as long as those who support our way of life do not. Humanity, at least our ‘western’ developed segment of it, is enjoying a phase of good health and longevity that is an anomaly in historical terms. There is a refusal to recognize that our health and wellbeing will only last as long as we have cheap hydrocarbon energy available to support it.

A Blast from the Past – Health Facilities and the Energy Crisis: A Conversation with M. King Hubbert circa 1978

A conversation with the famous M. King Hubbert by the American Hospital Association, 1976.

There are several important take home messages from this interview.

• The basic impacts of peak oil on our health care systems were understood 1/3 of a century ago.
• Everyone alive today has grown up in a period of growth. That era is coming to a close, but are we ready to face that reality?
• All baby boomers lived through the burning of more than half of the world’s cheap oil.
• It is no surprise that the environmental effects of burning all those hydrocarbons, in a closed system, in such a short period of time, are also showing up now. As the late Barry Commoner has said:

• Everything Is Connected to Everything Else.
• Everything Must Go Somewhere.
• Nature Knows Best.
• There Is No Such Thing as a Free Lunch.

Caution! Paradigm Shift Ahead: “Adolescent mobility health”

This is a multimedia presentation by Professor Hank Weiss, delivered Tuesday, October 02, 2012 at the Safety 2012 World Conference (47 min).

Adolescents warrant special attention. From a road safety perspective, they carry the largest crash and morbidity/mortality risk of any age group. This has led to considerable research and safety programs, but these efforts have plateaued in many countries and remain fixed within a road safety perspective. From a broader perspective, little has been done about the many non-traffic health risks related to teen driving (increased drug and alcohol use, anti-social behaviour, sexually transmitted infections, inactivity and obesity). From a sustainable transport perspective, a contemporary imperative, teens are where the transition from non-driver to driver takes place; an opportune time for interventions to minimize environmental harms.

Professor Weiss introduces a new paradigm termed ‘mobility health’ to bridge the siloed domains of safety, adolescent health and sustainable mobility. In this passionate speech to an international audience, he advocates changing the current narrow paradigm of adolescent road safety to a cross-level/cross-disciplinary, more potent, timely and healthy vision of less driving through mobility modal shift from cars to active and public transport.

Neoliberalism, Degrowth and the Fate of Health Systems

Dan Bednarz

Allana Beavis

There are unprecedented and widely unappreciated dangers posed to public health, nursing, medicine and allied health professions by the ongoing global economic contraction. This is a multilayered and, frankly, emotionally difficult topic to digest. Before discussing how health systems are affected we first lay out the larger social-ecological context of modern society’s predicament. This includes a brief overview of the idea of degrowth,[i]^,[ii],[iii] which is a response to ecological overshoot and reaching the physical resources and ecological limits to growth, and why it must supplant growth as the cardinal metaphor of modern culture. Then we outline how the inability to perceive that the world has reached the end of growth –by mistakenly seeing the present as a Great Recession- threatens health systems.

Sustainable Healthcare by Kim Adams

 What is sustainable healthcare?

The Alliance for Natural Health has defined sustainable healthcare in the following way.

A complex system of interacting approaches to the restoration, management and optimization of human health that have an ecological base, that are environmentally, economically and socially viable indefinitely, that work harmoniously both with the human body and the non‐human environment, and which do not result in unfair or disproportionate impacts on any significant contributory element of the healthcare system.

Alliance for Natural Health  (http://www.anh-europe.org)

Based on this definition, there is very little about our existing healthcare system that is sustainable.  To achieve sustainability, it is necessary to look beyond what we have now to what we really want.

Reports from Health Care Practitioners

Health after Oil will occasionally offer reports from practitioners who are aware they are working in health systems that are unsustainable and in need of transformation. We begin this series with two practitioner accounts of reactions to the implementation of President Obama’s recently Supreme Court upheld health legislation. The first is by Dr. S., a psychotherapist in a rural setting. She discusses the possible implications of the Affordable Care Act (ACA).  The second post is by Michael Bennett, a nurse, commenting on how the ACA has overlooked the issue of ecological sustainability. Dan Bednarz, Ed. 

Obama’s Affordable Care Act as Prelude

By Dr. S.

As a solo mental health practitioner in a remote rural California community, I’d like to share my experience with what is happening along the way to the collapse of our health care system. I opened my private psychotherapy practice in this rugged and remote area of California in 2006 because it was a community where there were no locally based full-time practitioners. Residents who needed mental health care were either foregoing treatment or driving an hour each way for their 50-minute hour of talk therapy or their 10-minute “med check” with a psychiatrist.

I reasoned if I established mental health services here in this rural community when the health system/economy was still running, then as the collapse unfolded I would be able -in this localized setting- to offer my services in whatever alternative socioeconomic system of exchange emerges.  While there is still no local psychiatrist here, over these past six years I have been able to establish a successful private practice. This has been made possible by 1) advertising in the local community newspaper, 2) working hard to get into as many insurance networks as possible so that people with insurance can see me and 3) offering a sliding fee scale for clients without insurance.

While I have always favored shifting health care to a single-payer system, I did not oppose President Obama’s Affordable Care Act (ACA). As this “reform” is beginning to take shape in California, however, I am seeing that it will most likely put me out of business and thus leave our rural community once again without access to local mental health services. This is not only an economic concern to me but personally and professionally frustrating because the localization of health services will be critical in the net available energy descending society we are now entering.

Today I want only to discuss why the ACA is working against my efforts to build a localized practice.