Finding hope at the turning of the year

Finding hope at the turning of the year

Dr. Trevor Hancock

17 December 2017

698 words

We are at the winter solstice, when the sun ends its long decline and starts to turn back to us. Traditionally, this is a time of celebration, the real new year, when we mark the death of the old year and the birth of the new. It is a time to look forward hopefully to longer, warmer, sunnier days.

But finding hope is no easy task; on the contrary I find good reason for pessimism, at least at the global level. We seem stuck in the same old, tired, harmful neoliberal economic thinking and practice that has brought us to the brink of ecological system decline, perhaps even collapse. It has also brought us unacceptable levels of inequality, which breeds anger, resentment and what the Americans are now calling the ‘diseases of despair’ – drug and alcohol use and suicides that have actually reduced life expectancy in the USA.

Unsurprisingly, I have been called a merchant of doom and gloom when it comes to describing the ecological and social crises we are creating, and there is some truth to that. But as a physician, I look upon it as akin to dealing with a patient with cancer. We don’t believe we should hide the truth and pretend everything is fine, when it isn’t. On the contrary, we need to help patients face the facts and find a way to deal with their reality. But we also need to find a way to provide them with hope, as well as comfort and acceptance.

Faced with these huge global challenges, I am often asked how I can find hope and keep working in a positive way. Several years ago, a couple of my colleagues defined hope in an article in these pages in a way I find helpful; “finding positivity in the face of adversity”. This certainly describes my approach, perhaps because I like a challenge. In fact, I have come to think of hope as a vaccine against despair

I often find reason for hope – if not optimism – at the local level. Experience has shown that good things often start locally and move up, which explains why we should think globally, but act locally. In part, I think this is because at a local level we are actually closer to the problem, and also because local governments tend to focus more on quality of life. But also, there are so many more local governments than at provincial and federal levels, and thus so many more opportunities for innovation and experimentation.

When I look around, I see that the seeds of a new economy and a new way of life that were sown back in the 1960s and 1970s are slowly beginning to sprout in communities around the world. Globally, one useful source is the Optimist Daily, a free daily summary of “real news focused on the things that ARE working and the solutions that we can apply to our communities, and to our global civilization”.

Recent urban examples include an underground urban farm in Sweden that is heating the building above it; Los Angeles painting its blacktop white to reduce local summer temperatures; and a study that found that simple interventions such as public seating, inviting frontages and welcoming signage can make a big difference in how people perceive their cities.

On the energy front, a recent story highlighted “the world’s first zero-emissions fossil-fuel power plant” while another concerned a new cooling technology that “could cut an office building’s cooling electricity needs by 21 percent in summer”, while new mini wastewater treatment plants are being installed in South Africa “that recover energy, clean water and fertilizer from sewage” while obviating “the need for the facilities to be connected to sewage systems”.

There are similar stories to be found right here in Victoria. And a good place to find them is Creatively United’s Solutions Hub, described as “a free community resource hub designed to help you learn more about the many amazing people and organizations in our community who are providing positive and sustainable solutions to ensure our region remains beautiful, healthy, happy and resilient”.

Check it out, so you too can find hope at the turning of the year.

© Trevor Hancock, 2017





The business of government in the 21st century

The business of government in the 21st century

Dr. Trevor Hancock

10 December 2017

703 words

In the past two columns I have explored how Ministries other than the Ministry of Health could contribute to our health and wellbeing. But I want to step back and consider the implications of this for the way we organise government more broadly. Put simply, is the current structure of government fit for purpose in the 21st century? After all, it is based largely on the management of a set of 20th and even 19th century issues.

A recurring theme in my columns is the need to ask what business government is in. For some, those who are still stuck in the mid to late-20th century ideology of neoliberalism, the business of government is business. But if we look at what that has brought us – obscene levels of inequality and global ecological destruction, both of which threaten our personal and collective wellbeing – we can see it is a failed model. The last thing we need is more of the same.

Instead, we need to recognise that the ‘business’ of government is – or should be – to maximise human and social development in a way that is indefinitely ecologically sustainable. That will mean building simultaneously four different forms of capital: Human, social, natural and economic capital. It might be a good idea to organise government along these same lines.

Human capital is concerned with the level of human development of each individual. How can we enable each person to develop to their maximum potential, whatever that may be? This calls for education and life-long learning, the protection and promotion of health, the cultivation of creativity and innovation, and the creation of caring, supportive, compassionate people who respect and cherish diversity.

Social capital, on the other hand, is concerned with the collective, recognising that humans are social animals. It is about the strength that is found in our connections with and responsibilities towards each other. There are at least three ways in which our social capital is manifested. The first, is ‘informal’ social capital, the social networks and bonds we all form through family, friends, neighbours and colleagues.

The second form of social capital concerns the formal social contract that we make with each other through governments and, to some extent, the non-profit sector. It manifests itself in universal free education, universal healthcare, employment insurance, social assistance programs, disability and retirement pensions and so on.

I call the third form of social capital ‘invisible’ social capital; the legal, political, constitutional and diplomatic systems which we have developed over centuries of trial and error that provide the basis for peaceful resolution of our differences and disputes. One of the challenges we face today is how to bring these systems of peaceful democratic governance into the 21st century age of the internet, social media, and artificial intelligence.

Natural capital is the third main form of capital; in a nutshell, it is the one planet on which we live, and which we share with a myriad other species. It is the most fundamentally important form of wealth we have, as these ecological systems and natural resources are the ultimate determinants of our wellbeing.

The final form of capital is, of course, economic capital. Currently, it is the only form of capital that seems to matter. But it is in fact the least important, which is why I address it last. We need a certain level of economic wealth in order to pay for clean water, sanitation, education and so on. But building economic capital by depleting natural, social or human capital, which is what so often happens, is a good definition of insanity!

I suggest we need a government organised along these lines, with perhaps four super-Ministries, or Cabinet Committees, each responsible for tending one form of capital, and with Cabinet as a whole ensuring they mutually support each other in doing so. Note that in this system, the Minister of Economic Development is the least important minister, there to serve the other sectors whose job it is to grow human, social and natural capital. The role of economic development is subservient, there to enable and support human and social development for all, in a manner that is indefinitely ecologically sustainable. If it doesn’t do that, it fails.

© Trevor Hancock, 2017




Other ministries should focus on health

Other ministries should focus on health

Dr. Trevor Hancock

4 December 2017

699 words

Last week I suggested that in a government that was focused on ecologically sustainable human and social development, rather than mainly on economic development, the Ministries would be named according to their function. I am using the list of prerequisites for health identified in the Ottawa Charter for Health Promotion, so next on the list is food.

Hunger should be just as unthinkable in a society this rich as is homelessness. The first task of a Ministry of Food Security and Sustainable Agriculture should be to make food banks redundant by recognising and implementing the right to food – just as the federal government proposes to do for housing. And of course, the Ministry must ensure the food we eat is healthy.

You would think that the healthfulness of the food supply would be an important concern for Ministries of Agriculture. But that is not the case today in BC. The mandate letter for the new Minister of Agriculture does not include any reference to health. Perhaps the NDP government needs to take a leaf from the federal Liberals, whose 2015 mandate letter has as its second priority “Develop a food policy that promotes healthy living and safe food”.

This will mean working with – and if need be, regulating – the food industry to reduce the availability and consumption of processed foods high in sugar, salt and fat, while increasing our consumption of vegetables, whole grains and fruit, and reducing portion size.

In addition, this Ministry would have to work to shift agriculture towards the production of healthy foods in a healthy and ecologically sustainable manner, using ecological and organic farming methods. An important part of this would be a shift to a low meat diet, which would result in less damage to the environment – in particular a significant reduction in greenhouse gas emissions – and a healthy diet for us. What’s not to like in securing these health and environmental and benefits?

Next comes income; so why not a Ministry of Income Security? It would have to enshrine at least a decent minimum wage, and preferably a ‘living wage’ for all workers. The latter is a wage high enough to ensure a normal standard of living. Both these need to be adjusted for local conditions; clearly the minimum wage needs to be higher in Vancouver than elsewhere in BC.

In addition, this Ministry would need to ensure a level of social assistance that would also ensure people can live a decent life. This probably means developing some form of universal basic income, as is being experimented with right now in Ontario. Moreover, as our economy is increasingly automated, we will need to find a way to redistribute the income these robots earn, using economic production to support social production.

This is not a new idea – I first heard of it decades ago – but it was given added impetus recently by Bill Gates in an interview with Quartz. Referring to the automation of factory work, he said “If a robot comes in to do the same thing, you’d think that we’d tax the robot at a similar level”, using the money to fund the displaced workers in roles that benefit the community.

Finally, one of the key tasks of this form of government is to ensure that our human and social development is ecologically sustainable, which means reducing our ecological footprint by about 80 percent. This calls for a Ministry – or perhaps a ‘super-Ministry’ – of Sustainable Resource Use and Conservation. Among its key responsibilities would be ensuring energy conservation, recognising that it is still the case that one of the largest sources of energy available to us is conservation. We would be much better off spending money on this than on new energy sources such as Site C or fracked oil and gas. And of course it would work to get us off fossil fuels and on to clean, renewable energy.

This Ministry would also work to reduce our consumption of scarce natural resources, promote repair, re-use and recycling, and protect and conserve the natural environment and the other species with whom we share the Earth, and the natural systems that are the ultimate determinants of our health.

© Trevor Hancock, 2017



Many ministries could be Ministry of Health

Many ministries could be Ministry of Health

Dr. Trevor Hancock

27 November 2017

703 words

Despite its name, the Ministry of Health is anything but focused on health. Like the ‘health care system’ it directs, it is largely focused on managing people with all manner of diseases, injuries or disabilities. Only a small part of the system is devoted to keeping people healthy and preventing them from becoming ill or injured. It would be more correct to call it the illness care system, and the Ministry of Illness Care Management.

This is not to denigrate the system, or the many good people who work there, but simply to describe its function accurately. Like everyone else, when I am ill or injured I want a good quality illness care system to care for me. But most of the time I am not ill, and I would much prefer to avoid being sick or injured. And most of what keeps us healthy or makes us ill comes from outside the health sector.

If the current system and Ministry are not focused on keeping us healthy, who is? What Ministry, or Ministries, are or should be keeping us healthy? The answer is – most of them. But if we are going to re-name the Ministry of Health, should we not do so for these other ministries, naming them for their function rather than for the issue they manage. What would they look like if their mandate was more explicitly to improve the health of the population. So let’s look at some of these other ‘health’ Ministries, and what they could be doing.

A good place to begin is a set of ‘prerequisites for health’ identified in a key 1986 World Health Organisation document, the Ottawa Charter for Health Promotion. The Charter identified peace, shelter, education, food, income, sustainable resources and a stable ecosystem, social justice and equity. And I would add good early child development experiences, clean water, clean air, clean and reliable energy and – since we are 80% urbanized and spend 90% of our time indoors – healthy built environments, including good transportation systems.

Let’s start with peace. From a public health perspective, the best sort of crime is the one that doesn’t happen; ditto for violence, abuse and neglect. So we need a Ministry of Crime and Violence Prevention and Community Safety. Its first task would be to identify and address the factors that lead to crime and violence – including domestic violence and violence against women, school and workplace violence, bullying and harassment, elder abuse, racism and so on. All the policing functions would remain, of course, but as with illness care, good prevention should reduce the problem and ultimately the cost.

Next comes shelter. In a country this rich, no one should be homeless and housing should be affordable for those on limited incomes. Again, preventing people becoming homeless is not only more humane, it is less expensive than continued homelessness. The federal government’s recent announcement that it will enshrine the right to housing in legislation is a good start, as is the commitment to re-entering the social housing arena.

A provincial Ministry of Shelter and Housing Quality would be responsible for ensuring that right is recognised and implemented and that there is an adequate supply of decent affordable housing. But since there is more to housing than availability and affordability, this ministry would also need to address such aspects as quality, suitability (e.g for people with disabilities), energy and resource efficiency. And it would need to collaborate closely with other ministries that deal with the built environment, such as community planning and transportation; more about them next week.

The third prerequisite is education, although that may be too narrow a term. What we really want is a society full of educated, innovative and creative people who continue learning throughout their lives. So we need a Ministry of Learning that takes on responsibility for all learning, both in the formal systems of pre-school, kindergarten, school, college and university and in the wider realms of workplace and community learning, including ESL and other education for new immigrants and refugees.

Next week I will explore more ‘other ministries of health’, and the following week I will propose a new way of organising government more consistent with 21st century needs.

© Trevor Hancock, 2017






Urban sprawl detrimental to public health

Urban sprawl detrimental to public health

Dr. Trevor Hancock

19 November 2017

703 words

Urban sprawl has to be one of the more damaging things we have done to the Earth – and to ourselves. That was not self-evident at the time it started in the 19th century, but it has been known for several decades, and yet we still are building sprawl. What’s more, we are exporting this destructive form of development to middle and low-income countries.

The limiting factor that kept cities compact for most of civilisation was how far one could reasonably travel and get back in a day. In the days when walking and horse transport – if you could afford one – were the only means of travel, that was not very far. But the advent of railways in the 19th century, followed by trams and buses, meant that people could live further away, and suburbs could develop.

This process began in London with the opening of the Metropolitan Railway in the 1860’s and London’s suburbs developed rapidly with the promise of country life in the city. But it really took off in North America with the advent of the automobile, leading to the car-dependent low-density urban sprawl we see today.

In a 2014 report for the Canadian Council on Urbanism, using 2011 census data, David Gordon and Isaac Shirokoff noted that “Canada is a suburban nation. Two thirds of our country’s population lives in suburbs” – and that rises to 80 percent in the largest metropolitan areas such as Vancouver. Moreover, they found that 90 percent of the population growth in metropolitan areas between 2006 and 2011 occurred in auto dependent suburbs and exurban areas, rather than in central cores or ‘transit suburbs’.

But why is that such a problem for the Earth and for us? The problem is that suburbs are very energy-inefficient and resouce intensive. Low-density housing makes public transport difficult, if not impossible, because there are too few people and it is too expensive. So everyone ends up driving. A 2008 Statistics Canada report, using data from the 2001 census, found that “the farther people live from the city centre, the more time they spend behind the wheel” – and they use a car more often and drive further.

Suburbs are also a problem because single-family dwellings are generally less energy-efficient than apartments or other forms of multi-family dwelling (although older houses in the urban core may be a problem because they have less insulation). And it is more expensive per person to provide infrastructure such as roads, water, sewers and electricity.

The result is that greenhouse gas (GHG) emissions – and other air pollutants due to transportation– are much higher in the suburbs. For example, a 2007 article by Jared VandeWeghe and Christopher Kennedy (the latter now Director of the new civil engineering program at UVic) looked at total residential GHG emissions in Toronto. They found the top ten census tracts, all in the suburbs, have an average annual emission rate almost 4 times that of the bottom ten (9 of them in the central core), largely due to vehicle emissions.

The health impacts of urban sprawl were first explored in depth more than a decade ago in the 2004 book Urban Sprawl and Public Health (one of the three authors, Larry Frank, holds the Bombardier Chair in Sustainable Transportation at UBC). While the health problems related to global warming caused by GHG emissions are global in nature, we certainly are beginning to experience health problems in Canada, and they identified many other health problems of a more local nature resulting from urban sprawl.

These include higher rates of physical inactivity and obesity due to driving rather than active transportation; respiratory and cardiovascular disease due to air pollution; more traffic injuries and deaths resulting from car-dominated transportation; and impacts on mental health and social wellbeing.

In short, continued suburban sprawl is incompatible with the overall health of this and future generations. The answer is obvious, although not simple: Stop suburban sprawl. In Victoria, that means intensifying the more central areas while preventing further suburban development in the Western communities or the Saanich peninsula. It also means holding the line against the further extension of water supply to be the Juan de Fuca electoral district, which is just a cloak for further suburban development.

© Trevor Hancock, 2017


Build telecommute centres, not interchanges

Build telecommute centres, not interchanges

Dr. Trevor Hancock

13 November 2017

701 words

The public health approach to management of disease and injury is very simple. We believe that the best way to manage it is to never have it in the first place. Well, what if we applied that thinking to the infamous Colwood crawl? What if the best approach to the crawl were to prevent it in the first place?

I recall a perhaps apocryphal story from the early days of the ‘information superhighway’ in the 1980s that the US Department of Transportation was willing to allow highway funds to be used for the digital highway. True or not, it is the right idea – one way to deal with congestion is to arrange it so that people don’t need to travel in the first place. Welcome to telecommuting!

Obviously not every commuter can telecommute, and probably many of those who could would still need to be in their office from time to time. But if on average commuters could telecommute one day a week, that alone would reduce traffic volume by 20 percent. This would also have environmental health benefits; fewer cars means less air pollution and lower emissions of carbon dioxide, thus helping to reduce global warming, with all its anticipated adverse health impacts.

Telecommuting can take one of two main forms; working from home or working from a remote office. The latter could be a satellite office for a Ministry or large business or a shared public or private facility where people from different sectors could work a day or two a week.

From a public health perspective I favour the shared office space for several reasons. Working at home can be very socially isolating, but also would mean equipping every home with office technology, and finding a suitable workspace in the home, thus requiring more equipment and probably shifting costs to the employee.

On the other hand, a neighbourhood telecommute centre could provide several public health and other benefits. First, of course, it becomes a place where people gather, thus building community connections. Add a daycare or other health and social services, perhaps a library, a coffee shop or small café and you have even more benefits. And you get more family and community time too, given that time spent commuting is time not spent with family and in the community.

Tie the centre into local walking and biking trails and bus service and you have the benefits of active transportation. And even if people do drive, they are not driving as far, which reduces pollution and greenhouse gas emissions, and they are not spending as much time commuting. A recent Canadian study, for example, found that “working from home is associated with decreases in overall travel time by 14 minutes and increases in odds of non-motorised travel by 77 percent”.

A recent UK study found that workers reported that a 20-minute increase in commute time was equivalent in terms of their reduced job satisfaction to a 19 percent pay cut. Dr Kiron Chatterjee, who led the research, noted that “An important message for employers is that job satisfaction can be improved if workers have opportunities to reduce the time spent commuting, to work from home, and/or to walk or cycle to work – such commuting opportunities are likely to be good news for employee wellbeing and retention and hence reduced costs to businesses.”

All of which brings me to the infamous McKenzie interchange, a Ministry of Transport version of bypass surgery; drastic, and too late in the disease process. As far as I can see, the effect of the interchange will be to get frustrated commuters to their next stoplight and tailback a few minutes quicker.

It would have been a much better use of public money if they had taken that $90 million or so and invested it in eight or nine $10 million telecommute centres in the Western Communities; the environmental social and health benefits would have been significant.

So before investing more public money on a failed 20th century approach by building more interchanges, the new provincial government should undertake a full and comprehensive impact assessment of telecommuting as well as other solutions such as really good public transit. We would all be healthier for it.

© Trevor Hancock, 2017




Pollution is not inevitable cost of prosperity

Pollution is not inevitable cost of prosperity

Dr. Trevor Hancock

6 November 2017

702 words

In two previous columns I explored the scale of chemical pollution in society and the health and environmental toll it takes, as revealed in the recently released report of the Lancet Commission on Pollution and Health. In this final column in the series, I examine the reasons the Commission believes underlie the neglect of this important issue.

The first is a belief that pollution is just the cost of development, that all countries as they develop have to go through the pollution stage before they become wealthy enough to stop it. The Commission “vigorously challenges that claim as a flawed and obsolete notion”.

Pollution is in fact very costly, both in health terms and in dollars, and thus is a drag on economic development. The Commission notes that the productivity losses due to pollution-related diseases “reduce gross domestic product (GDP) in low-income to middle-income countries by up to 2% per year”, while it is estimated that “welfare losses due to pollution . . . amount to . . . 6.2% of global economic output”.

On the other hand, the report also notes that “an estimated US$30 in benefits . . . for every dollar invested in air pollution control” in the USA, while “the removal of lead from gasoline has returned an estimated $200 billion . . . to the US economy each year since 1980”. Given that we do not even know the health impacts and thus the costs of many pollutants, the benefits of controlling them are likely to be large.

A second reason is that production, use and disposal of chemicals has increasingly been moved to low and middle-income countries, where awareness is less, costs lower, regulations weaker and enforcement more lax. While this may translate into increased profits for the corporations that move their work to these countries, it exposes local people to levels of chemical use and pollution that would not be tolerated in high-income countries.

It seems to me that it should be a matter of national and international ethical corporate behaviour that no high-income country allow its corporations to operate in another country using practices that would not be permitted in their home country. Why should people in middle and low-income countries pay a health price for chemicals that we use and benefit from, and at lower costs than if we produced them here?

This leads to a third key issue: “the opposition of powerful vested interests has been a perennial barrier to control of pollution, especially industrial, vehicular, and chemical pollution”. The Lancet Commission is blunt in stating that these industries “impugn the science linking pollution to disease, manufacture doubt about the effectiveness of interventions, and paralyse governmental efforts to establish standards, impose pollution taxes, and enforce laws and regulations.”

In his introductory chapter to a section on ‘Contaminants in the Age of the Anthropocene”, part of a just released Encyclopedia of the Anthropocene, Dr. Pierre Mineau – a Saltspring Island-based environmental scientist – supports this analysis. But importantly, he also reminds us that “we all share in the responsibility for not insisting that better systems be put in place to prevent either misguided introductions [of chemicals] or slow and inadequate controls” on their use. And, he might have added, we can try to avoid using them in our homes and communities.

On the positive side, the Lancet Commission concludes, we know what we need to do and how to do it. And importantly, if we apply these methods in middle and low-income countries, we can help them “avoid many of the harmful consequences of pollution, leapfrog the worst of the human and ecological disasters that have plagued industrial development in the past, and improve the health and wellbeing of their people.”

As with so many other health and environment issues, we see here a decades-long refusal to take seriously the concerns of public health professionals and environmental activists, who time and again are left saying ‘we told you so’. It does not give us great comfort. It is time we all insisted that governments put the wellbeing of people and the environment on which they depend – not just here, but around the globe – ahead of the wellbeing of corporations and their shareholders.

© Trevor Hancock, 2017


Pollution and health: A neglected issue

Pollution and health: A neglected issue

Dr. Trevor Hancock

30 October 2017

702 words

Perhaps the most startling claim made by the Lancet Commission on Pollution and Health, in its October 19th report, is that “despite its substantial effects on human health, the economy, and the environment, pollution has been neglected” and its health effects “underestimated in calculations of the global burden of disease”. Considering all the attention that pollution issues have garnered over the years, that seems, on the face of it, a rather preposterous claim.

Yet dig a little deeper and the reason for that claim becomes apparent. In essence, while pollution certainly gets a lot of public and media attention, for the most part that has not translated into public policy that effectively curbs pollution. On the contrary, “in many parts of the world, pollution is getting worse”, particularly air, chemical and soil pollution in rapidly developing low and middle-income countries. Meanwhile the health and environmental consequences have been largely ignored, accepted as the cost of doing business, the price of development.

Contrary to previous estimates, which have found a lower burden of disease and premature death due to pollution, the Commission – which included three Canadians, including Professor Bruce Lanphear at SFU – concludes that “diseases caused by pollution were responsible for an estimated 9 million premature deaths in 2015 – 16% of all deaths worldwide”. To give some sense of proportion, the commission points out this is “three times more deaths than from AIDS, tuberculosis, and malaria combined and 15 times more than from all wars and other forms of violence”.

But these are ‘only’ deaths; on top of this we need to include all the illness and disability associated with pollution. The costs are enormous; the productivity losses are estimated to be up to 1.7 percent of annual health care spending in high-income countries and 7 percent in some rapidly developing middle-income countries.

And yet all this is an underestimate. Of the three main categories of pollutants, the Commission argues, only one group has been sufficiently well studied that the health effects are well understood and included in their estimate. This category includes in particular the links between indoor and outdoor air pollution and a number of conditions such as heart disease, chronic lung disease and cancer.

The big culprit here, according to the Commission, is combustion of fossil fuel and – in low income countries – biomass. This accounts for “85 percent of airborne

particulate pollution and for almost all pollution by oxides of sulphur and nitrogen” with the biggest problem being coal (which is why we need to close down the coal industry and drastically reduce fossil fuel use).

The second category is pollutants where we have some evidence of links to health problems and growing evidence of causation, but not enough to quantify the burden of disease. This includes associations between soil pollution with heavy metals and toxic chemicals at mines and industrial sites, and between fine particulate air pollution and conditions such as diabetes, and some diseases of the central nervous system.

The third category is, in many ways, the most troubling. It includes “new and emerging pollutants” such as certain pesticides (e.g. neonicotinoids and glyphosate), nano-particles, pharmaceutical wastes and substances that disrupt endocrines (hormones) or the developing neurological system. Moreover, some of these are widely dispersed in the environment and in our own bodies and the bodies of many other species, the phenomenon of ecotoxicity I referred to last week.

In light of the likely significant but as yet unquantified health effects of the second and third categories, the Commission believes that its estimate of 9 million deaths “could thus be the tip of a much larger iceberg”. So why is this significant health problem neglected? Why does any government in its right mind allow its population to be exposed to these pollutants at levels that are known to harm health?

I will explore the roots of this neglect in my next column, but sadly, I think that part of the reason is that, as the Commission notes, “Pollution disproportionately kills the poor and the vulnerable. Nearly 92% of pollution-related deaths occur in low-income and middle-income countries”. You can’t help but think that the cynical and sinister calculus is that these lives are cheap, and they don’t matter.

© Trevor Hancock, 2017

Protecting health in our chemical society

Protecting health in our chemical society

Dr. Trevor Hancock

23 October 2017

701 words

Last week The Lancet – one of the world’s leading medical journals – published another in its series of Commission reports on various aspects of Planetary Health, this time on pollution and health. Next week I will delve into the report in some detail, but first I want to go back 36 years, to when I was the co-author of a major report for the Local Board of Health for Toronto on the health impacts of our chemical society. We sought to document the overall health, social, environmental and economic impacts of our widespread use of chemicals, and suggest actions we should take to reduce or eliminate those impacts.

Our report – Our Chemical Society – defined a chemical society as “one which believes its quality of life is, in large measure, dependent upon, and directly related to, the widespread production and use of chemicals”. We noted that at that time there were 60 – 100,000 chemicals in commercial use. Of these, 34,000 were on the US EPA’s 1978 Toxic Effects List, very few of which had been adequately tested.

Harmful or potentially harmful chemicals are pervasive in our lives. Some are intended to be inhaled, consumed or applied to our bodies, including food additives and synthetics, tobacco and alchohol, pharmaceutical drugs, cosmetics and toiletries, including scents and air fresheners. But many others are not, but get into our environments and ultimately our bodies anyway; they are in the paints, solvents and fabrics we use and and the materials with which we build and furnish our homes, schools and workplaces. Some, of course – the pesticides and herbicides – were designed to be toxic to various life-forms.

Much of this exposure has occurred since the end of the Second World War, after which the chemical industry really took off. One consequence is a phenomenon known as ‘ecotoxicity’; the widespread contamination of ecosystems and food chains with low levels of muliple persistent organic pollutants and heavy metals. As a result we – and all other species – carry a body burden of dozens, even hundred of these chemicals, with health consequences that are largely unkown – and probably unknowable, because of their potential interactions.

In the face of this onslaught we recommended taking a much tougher line on controlling chemicals, suggesting that “it is better to ban a product subsequently found to be safe than to permit the use of a product subsequently found to be harmful”. Because once a chemical is out in the environment, you can’t take it back or remove it – only nature can. Thus we suggested reversing the onus of proof; no longer treating chemicals as if they were human, and thus innocent until proven guilty, but guilty until proven innocent.

To tackle the vast backlog of safety testing, we suggested introducing the concept of social utility, prioritising for testing those chemicals judged to be likely to have high utility and putting others – such as yet another scented product – at the back of the line, and thus not on the market. We argued for stronger controls on the advertising and marketing of chemicals, and we urged people and organisations to try to be as chemical-free as possible. In addition, we urged the passage of an Environmental Bill of Rights, greater public involvement and transparency in the regulation of chemicals and even a Select Committee or a Royal Commission to investigate the situation.

Fast forward 36 years and not much has changed – certainly none of what we recommended has happened. The Lancet Commission reports that “pollution has been neglected” and its health effects under-estimated, noting that “more than 140,000 new chemicals and pesticides have been synthesised since 1950”. Of these, the 5000 chemicals produced in the highest volume “have become widely dispersed in the environment and are responsible for nearly universal human exposure”.

Moreover, “fewer than half of these high-production volume chemicals have undergone any testing for safety or toxicity” – note that is ANY testing! It is as if we are subjects in an unauthorised experiment to which we have never given consent. Why have governments allowed this to happen? Why does human health count for so little? We should be outraged, and we should insist that governments placed human wellbeing ahead of corporate profit and the economy.

© Trevor Hancock, 2017

Seeking common vision and common action

Seeking common vision and common action

Dr. Trevor Hancock

15 October 2017

702 words

There is an emerging community-based movement in the capital region – and elsewhere around the world – that recognises that ecological, social and economic conditions and human wellbeing are not separate issues but are inextricably linked. Here in Victoria a number of related initiatives have sprung up, mostly in just the past couple of years, that are working to address these intersecting issues holistically, but in somewhat different ways.

Several of these initiatives came together last month at one of the Conversations for a One Planet Region that I have been organising this past year. The Conversations are just that, an attempt to get the conversation started here on what it would mean – and what it would be like – to live in a region that only had an ecological footprint equivalent to our fair share of the Earth’s resources. Since we currently use the equivalent of 5 planets’ worth, this would be an 80 percent reduction; how do we do that while maintaining a high quality of life and good health for all?

Greater Victoria Acting Together (GVAT) is “a broad-based coalition of local groups and community organizations” working to advance the common good. Its focus is on “relational learning and capacity building”, through which it seeks to build respect and trust across sectors and give civil society a greater voice.

Creatively United for the Planet works to celebrate those who are making a difference in our region, “showcasing local change-makers and grassroots solutions for a better world”. They do so through community events (such as the Earth Day Festival), sharing engaging stories and videos and – coming soon – through a series of community TV programs on Shaw.

Cities for Everyone “supports more affordable housing and transportation in order to provide security, freedom and opportunity for people with all incomes and abilities”; it has a strong focus on more ecologically sustainable urban development in order to achieve this purpose.

Then there is Common Vision, Common Action. This past weeekend I was involved in a most unusual non-partisan policy conference, (full disclosure: I was a member of the organising committee). The conference brought together 100 or so participants to establish “a regional agenda for social and ecological justice”. While not explicitly about health, it was very much about how to improve the wellbeing of all the people who live here, while at the same time ensuring the ‘health’ of the natural systems of which we are a part and upon which we depend.

While the conference was non-partisan it was very much political, in that it sought to create a common platform and “a framework for advocacy and action among residents, community organizations, candidates and local governments from now until the 2018 municipal elections and beyond”.

The conference began, in a spirit of reconciliation, by focusing on the Indigenous peoples who lived here for thousands of years before European colonisation began a couple of hundred years ago. Joan Morris, a member of the Songhees Nation, talked about the pain, suffering and loss that Indigenous people had experienced as a result of colonialism, and that continues to this day.

She was followed by Paul Cheoketen Wagner, a wonderful storyteller and activist from the W̱SÁNEĆ (Saanich) Nation. In his very moving remarks he told us we must seek and demonstrate leadership that values all of life, human and non-human, and that we need to love and protect this place as we would love and protect our own children.

In the policy discussions that followed, the participants sought to express these values and sentiments across a range of issues that are largely within the realm of or subject to the influence of local government: Land use and housing, transportation, food and water systems, ecological areas and parks, education, energy systems, arts and culture, and systems of governance, inclusivity and economics.

The result is a draft plarform that proposes a wide range of policy initiatives – and advocacy actions directed to the provincial and federal governments where the local power is absent – that people of good will can work from and run on; people who cherish this place, the planet itself and the wellbeing of all the people who live here and all the life on our planet.

© Trevor Hancock, 2017