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2 OVERVIEW OF THE LINKS BETWEEN SUSTAINABILITY AND HUMAN HEALTH
Pages 5-40

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From page 5...
... Consultant, Energy and Health Former Executive Director, Health and Environment World Health Organization Wilfried Kreisel explained that during the events leading up to the Rio Earth Summit in 1992, health was not a primary concern of the global sustainability movement. He noted that the environmentalists and conservationists governing sustainability advocacy did not directly focus on health issues, so health and sustainability remained detached.
From page 6...
... Kreisel noted that work from the WHO Commission on Health and Environment was used to influence Agenda 21 and the Rio Declaration, the ensuing documents from the Rio Earth Summit. Health became the cornerstone of Principle 1 of the Rio Declaration, which states that "Human beings are at the center of concerns for sustainable development.
From page 7...
... He stated that Agenda 21 was one of the broadest agendas for action developed to date, and despite being 20 years old, needs little refinement today. In the years following the Rio Earth Summit, Kreisel explained, WHO acted assertively to grow the seeds that had been sown.
From page 8...
... He noted that the health sector could become an energetic supporter of this budding green economy and help to galvanize public investment in sustainable infrastructure (including public transport, renewable energy, and building retrofits to improve energy efficiency) to mitigate and adapt
From page 9...
... . Kreisel stated that when communicating the potential health benefits from the green economy and concomitant mitigation of climate change, it is paramount to restructure the arguments within a health paradigm.
From page 10...
... Van Hoogstraten noted that with regard to climate change, he believes that a catastrophe or large forcing event is likely needed for the United States and the international community to place this on the global agenda. He pointed out that climate change, and ozone depletion as another example, are clearly global issues that cannot be addressed by other frameworks and mechanisms at the country level, even if countries act bilaterally or regionally.
From page 11...
... Van Hoogstraten explained that at the country level, for coherent national positions to be developed, treaty negotiation requires coordination among various agencies with very different mandates. In the United States, negotiations begin at the State Department by invoking the Interagency Circular 175 (or C-175)
From page 12...
... The C-175 process is very intricate, van Hoogstraten stated, with complicated interagency involvement to assess the impact a proposed agreement may have on international trade, economic affairs, defense, the environment, and so forth. In the United States, van Hoogstraten noted, political factors including the lack of bipartisan consensus on international environmental issues has prevented the ratification of many international environmental and conservation agreements.
From page 13...
... Van Hoogstraten noted that the U.S. government does not yet have a unified strategy with respect to the role it will play in major global commitments to address key environmental challenges.
From page 14...
... In turn, he said, increased concentrations of greenhouse gases in the atmosphere are a driver of climate change, which can cause temperature and precipitation changes, sea level rise, and increased extreme weather events. Human health is of great concern, since climate change can cause changes in ecosystems, water resources, and food security that affect human health; additionally, human health is impacted directly through air pollution, heat waves, and extreme climate events.
From page 15...
... In Figure 2-1, health is located in the center, surrounded by proximal risk factors, such as air pollution, radiation, water and sanitation, and chemicals, that all impinge upon health directly. Corvalán noted that more distal factors serve as drivers for the proximal causes; these include climate change, migration, degraded ecosystems, water scarcity, and desertification.
From page 16...
... , such as radiation, air pollution, and vector-borne diseases, negatively affect health and can have negative effects. There are also distal environmental health risks (outer circle)
From page 17...
... UNEP defines a green economy as one that results in "improved human well-being and social equity, while significantly reducing environmental risks and ecological scarcities" (UNEP, 2010, 2011)
From page 18...
... Many pollutants such as mercury, greenhouse gases, and particulate matter are widely distributed around the planet, affecting human health far from the emission sources. She explained that the experiences of industrialized countries with adverse health impacts from polluted air, water, and land are becoming increasingly relevant around the world as less-developed countries are rapidly strategizing on how to achieve similar industrialization.
From page 19...
... For 27 years, the NIEHS has supported a cooperative agreement with the International Program on Chemical Safety, through which it has helped to provide scientific leadership and expertise to efforts to protect public health worldwide from the effects of toxic chemicals. Birnbaum stated that in addition to training partnerships, the NIEHS has funded critical research in collaboration with other countries to better understand the impacts of environmental exposures among the most affected.
From page 20...
... Birnbaum explained that there are many definitions of both sustainability and sustainable development, but one often-cited definition is from the United Nations World Commission on Environment and Development's Brundtland Report (WCED, 1987)
From page 21...
... Socioeconomic development can produce pollution that persists in the environment, exposing vulnerable populations and threatening health. Avoiding environmental insults from development is necessary to ensure that future generations are able to meet their own needs.
From page 22...
... . Birnbaum explained that the environmental risk transition describes the changing contribution of environmental risks that occurs with development, and thus underlies the epidemiological transition.
From page 23...
... , nearly $84 billion of economic productivity will be lost from 2005 to 2015 as a consequence of cardiovascular disease, diabetes, and stroke in 23 low- and middle-income countries. Birnbaum explained that this has important implications for development, given that in much of the developing world individuals pay out of pocket for health care expenses, thus compounding lost productivity from noncommunicable diseases with the financial burden of living with a chronic disease.
From page 24...
... Birnbaum explained that addressing the rising burden of noncommunicable diseases and their environmental determinants, especially in low- and middle-income countries, will pay the greatest economic dividends as countries progress through the epidemiologic transition. This includes the importance of building research in programmatic capacity to understand pathophysiological mechanisms and strategies for prevention, and decreasing injuries through improved road traffic safety and prevention of occupational hazards.
From page 25...
... These effects include climate change, urbanization, and the disruption of essential ecosystem services like biodiversity, soil health, and coastal protection. Understanding the potential negative health effects of global environmental change, she said, and the manner by which they can be averted is at the core of the discussion of sustainable development.
From page 26...
... Environmental Protection Agency Today's Challenge Paul Anastas stated that in addition to focusing on sustainability, his presentation would touch on the frameworks or constructs of green chemistry and the need for systems thinking to achieve transformative innovation. He started with the idea of persistence, noting that if the world's population lived at the same state of development as North America, Japan, and Western Europe, then we would need the equivalent of four Earths to provide all the needed resources and to allow for sustained ecosystems, sustained health, and so forth.
From page 27...
... . Anastas stated that there are frequent newspaper headlines about potential environmental health concerns from everyday products ranging from tainted toothpaste to lead-laced baby bibs to formaldehyde in clothing.
From page 28...
... For example, climate change is inextricably linked to energy; energy is inextricably linked to water; water to agriculture; agriculture to human health; and yet our approaches are too often reactionary and fragmented along statutory or organizational lines. Anastas stated that it is time to think about decision making as an integrated, interrelated system if society is to make significant progress.
From page 29...
... Anastas stated that there are 12 principles of green chemistry (see Box 21) that are not merely noble goals to benefit the birds and trees but rather a comprehensive design framework that protects human health.
From page 30...
... Anastas added that this approach has been adopted by corporations around the world and has been recognized by the U.S. Presidential Green Chemistry Challenge Award since 1996 in areas ranging from medicine, to energy, to electronics, to chemicals, to agriculture, and beyond.
From page 31...
... Anastas stated that green chemistry learns from nature and focuses on biomimicry, which involves examining natural models and processes to solve human challenges. As an example, the current ceramics production process is resource intensive, involving heating, beating, and treating materials.
From page 32...
... Van Hoogstraten stated that while some people may argue against focusing on health or note that it is a risky choice, there can be a benefit in repackaging the same issue in a different way, and emphasized that the health aspects of some of these complex problems may provide that opportunity. John Balbus then noted that U.S.
From page 33...
... . Jamie Bartram added a comment on the household, community, and global exposures that Birnbaum outlined with the environmental risk transition (depicted in Figure 2-3)
From page 34...
... Birnbaum agreed that this is important and pointed out that The Lancet published a series of articles in November 2010 looking at ways to economize the benefits of climate change mitigation in order to exemplify the money that could be saved from health care expenditures. She continued to state that there is a need to develop accountability measures and economizing information on the advantages of controlling diseases related to environmental exposures, and to generate a larger effort around these areas.
From page 35...
... , respectively, have only been integrated recently. Anastas pointed out that HUD, DoT, and EPA came together on this issue wonderfully and noted that the Committee on Environment, Natural Resources, and Sustainability of the National Science and Technology Council is looking into additional interagency sustainability initiatives that can pull across the federal agencies.2 Hernando Perez emphasized that occupational health seems conspicuously absent in these discussions and asked Anastas to comment on whether or not he thinks this is something that should be incorporated into green chemistry.
From page 36...
... PowerPoint presentation at the Institute of Medicine workshop on Ensuring and Strengthening Public Health Linkages in a Sustainable World, Washington, DC.
From page 37...
... Research Triangle Park, NC: Environmental Health Perspectives and National Institute of Environmental Health Sciences. IPCC (Intergovernmental Panel on Climate Change)
From page 38...
... 2011. Towards a green economy: Pathways to sustainable development and poverty eradication.
From page 39...
... 2011a. Global status report on noncommunicable diseases 2010.
From page 40...
... World Meteorological Organization.


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