Month: September 2017

Categories
Environment Global Climate Change Greenhouse gases

Terminate Fossil Fuel Subsidies

Craig Generating Station, Craig, Colorado

            During a break at a renewable energy meeting sponsored by LPEA (our electrical co-op) several years ago, a friend and I discussed the pros and cons of generating power with coal. She said that she would favor renewable generation of our energy if it didn’t require subsidies.

We both are plagued by asthma and carry expensive inhalers to use if we have trouble catching our breath. My friend admitted that our air would be better if we weren’t downwind from coal burning power plants. However, it bothered her that some of the taxes she paid went to support a photovoltaic manufacturer that had recently declared bankruptcy.

She expressed surprise when I told her that fossil fuel companies also received tax support. Indeed, subsidies for fossil fuels are more than 5 times larger than subsidies for renewable energy! Worldwide subsidies cost an astounding $444 Billion. In the USA $24 Billion in taxes go to fossil fuel subsidies. That is more than $73 of our tax money for each American, every year!

But subsidies are not the only cost we pay to support the fossil fuel industries, which include coal, oil and natural gas. Burning fossil fuels also costs us all because they are one of the largest causes of climate change—but even that is not the most immediate cost. The most serious cost of fossil fuels is to our health.

It is estimated that 91,045 people die annually as a direct result of air pollution in the USA. In addition, air pollution increases the number of people who suffer from emphysema, heart attacks and strokes—and asthma. Figures from the World Health Organization state that 36% of lung disease deaths, 27% of deaths from heart disease and 34% deaths from strokes are caused by air pollution. That is a huge toll—much larger, but more insidious, than the death rate from terrorism.

What does this have to do with population? My goal is for people to be healthy and to have healthy children. Ideally children should be planned, loved and well cared for. This means that we need to keep our planet healthy, too. Access to voluntary contraception is one of the best ways of assuring these goals. It is also important to minimize our impact on the planet, for our children’s sake.

When people think that they are saving money by having inexpensive electricity, they don’t know the true cost of their power. What is on the bill from LPEA is only a small fraction of the real cost. It is estimated that health care necessitated by the air pollution from fossil fuel-generated power costs over 9 times what we pay the power company! The rate LPEA charges is 12.56¢ per kilowatt-hour. Therefore, the true rate is $1.14 per kilowatt-hour if you include the cost of health care necessitated by air pollution from conventional power sources.

What does this mean to our country? If you look at the period from 2007 to 2015, during which there was rapid growth of solar and wind generation, almost 8000 lives were saved by not generating electricity with fossil fuel. About $70 billion in health care costs was saved by this renewable energy rather than business as usual.

In addition to more immediate health costs, climate change is already causing damage through storms, forest fires and other destruction. It is difficult to put a value on money saved by averting greenhouse gas emissions, however the value of keeping 1 metric ton of CO2 out of the atmosphere is in the range of $35. The savings from slowing climate change in this 8-year period of increasing wind and solar is estimated to be $56 Billion!

Only about 7% of our nation’s “juice” currently comes from wind and solar. Think what a difference it would make to our health if 20% or even 50% of all the electricity used in the country came from renewables. A first step is to get rid of subsidies to the unhealthy fossil fuel industries.

I agree with what Davin Montoya, board president of LPEA, wrote last year: “In fact I think the entire board supports renewable energy; but it should be done in a responsible way. I will only support a program that benefits the entire membership not a select few.” My conclusion, knowing the hazards of air pollution from burning coal to generate electricity, is different from Montoya’s. Renewable energy benefits us all in helping us to be healthier and to spend less on medical care.

© Richard Grossman MD, 2017

Categories
children Nutrition Public Health

Keep Children Healthy

I am writing this column in Northern Ghana, where 1 in 16 children dies before 5 years of age. Although that number is high when compared to developed countries, there has been amazing progress since 1960 when one in 5 died.

The under-five mortality rate is a valuable statistic because it gives an overall idea about the state of health and healthcare in a country. It reflects the social, economic and environmental conditions in which children live. It is defined as the number of children who die before their 5th birthday per 1000 live births, and is also called the child mortality rate.

The UN set 8 Millennium Development Goals, one of which was to: “Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate.” In Ghana during that period the rate went from 127 to 62 deaths per 1000 births. This halving reflects global progress; worldwide child mortality dropped from 90 to 45 in this period. Although we didn’t hit the goal, cutting the death rate in half is still an amazing accomplishment. Sadly, worldwide almost 6 million young children still die each year.

There is hope, however. Ghana recently trained several thousand Community Health Workers (CHWs). These “barefoot doctors” live close to the people they serve and treat illnesses as well as advocating prevention.

I traveled with a midwifery training-team to a village clinic. This part of the country has more than its share of maternal and infant deaths. Two midwives from the Baptist Medical Centre did an excellent job of teaching the clinic’s staff, which included 2 midwives and 3 midwifery students. Two rooms away another student midwife performed a delivery so quietly that I was amazed when a nurse brought out the healthy baby who was just minutes old.

While in the health center I saw a bottle of high-potency vitamin A capsules and was reminded of a remarkable study performed in this region. The overall death rate of children was lowered by 20% if they were given vitamin A supplementation. It appears the vitamin helps children fight infections such as measles and diarrhea, even where vitamin A deficiency is not prevalent.

If we are concerned about overpopulation, why should the death of children trouble us? Of course there are humanitarian reasons to keep children alive and healthy—they are our future! Demographers have found that people choose to have large families where there is a high child mortality rate.

It may appear paradoxical that preventing deaths will help eventually to slow population growth, but it is true. One of the best-known demographers of Africa, John Caldwell, cited three requirements before people will choose to have smaller families: educating girls and women, making effective contraception available and reducing the under-five mortality. He said that people only consider having a small family when child mortality is less than 130 per 1000. I could understand that number better when I converted it to a percentage—13%. That means that one in seven children dies—the thought is distressing!

In addition to training midwives, Ghana has instituted other ways to have healthier children. As I walk to the hospital I pass a nutrition center where small children are fed healthy, local food. Young kids with kwashiorkor (protein deficiency) and marasmus (severe malnutrition) are referred from the hospital, from outlying clinics and by CHWs. They spend 2 weeks or longer there being fed; many are still breast feeding. Every child is accompanied by a parent who is taught many ways to promote health, including nutrition and good hygiene.

Three days ago a young pregnant woman came to the hospital complaining of headache. Her blood pressure was elevated and the doctor noticed that she kept bumping into things, as though she couldn’t see well. Her mother gave the history that the patient had had an episode of shaking—a seizure. The doctor diagnosed eclampsia, the worst form of Pregnancy Induced Hypertension (PIH), with cortical blindness—a type of stroke. It was necessary to induce labor to save the mother’s life and hopefully her vision will improve. Unfortunately the very premature baby didn’t survive.

I am in Ghana studying PIH because it is more common here than in the USA. PIH can endanger the mother’s health and life, and has no treatment other than delivery of the baby. It is one of the most common causes of loss of life for babies and mothers, yet is poorly understood. Perhaps my study will shed light on this cause of obstetrical tragedies.

© Richard Grossman MD, 2017