Globesity A new book by four public health advocates called Globesity: A Planet Out of Control? was recently reviewed by Grist’s Jonathan Hiskes.  I haven’t read the book but Hiskes’ review got me thinking about how the origins of public health practice and current efforts to address climate change are related.

It might seem like a stretch. But public health was built on the premise that the most effective way to deal with disease and the death it causes is to stop it as close to the source of that disease as possible. Today we call this the “upstream” approach: trying to get to the fewest possible sources of a problem and focusing on them rather than disparate individual behaviors.

  • The authors of the new book find the most compelling connection between health and climate in consumption. One of the authors describes “‘obesidemic environments,’ in which schools and workplace cafeterias offer only high-calorie foods; in which urban design discourages walking; in which government subsidies make fresh produce more expensive than potato chips.”

    All the extra consumption, the authors argue, leads to more use of fossil fuels and destruction of forests and ultimately to climate change.

    This connection makes sense. But the one I find even more compelling is that current efforts to pass cap and trade legislation are following in the footsteps of many successful health interventions of yore that beat huge health problems like tuberculosis, polio and, lead exposure by focusing on the biggest and fewest sources of the problem, using the best science available and changing policies and practices at a systems level.

    You might think, for example, that tuberculosis (which used to be called consumption) was knocked out by new drugs. But the reality was much different. Ultimately, as is brilliantly described in Rene Dubos‘ landmark book The White Plague, it was changes beginning in the late 19th century in federal, state and local policy that reduced the death from tuberculosis from the hundreds of thousands to the hundreds.

    While individual change is important the idea of cap and trade has often reminded me of successful health interventions. Take vaccination. It starts with prevention at the point where the intervention can have the greatest impact: at childhood. The economics of cap and trade are well thought out  but the principle of focusing on “upstream” sources has a great track record in addressing other great global problems.

    Cap and trade is not a cure for all the world’s problems but if it is successful it ought to have beneficial effects on downstream consumption. Other efforts to improve health will obviously continue. But changing the economics of consumption may add momentum to work focused on the structural causes of obesity rather than a focus on the perceived moral failures of individuals. Additionally, systematic efforts to reduce emissions will help reduce an array of climate related illnesses caused by drought and air quality issues.  

    And cap and trade, while primarily being discussed as a solution to energy and climate problems, is also very much about human health—nipping the sources of disease in the bud and preventing future epidemics and outbreaks at the level of the system, not the individual.