Journal of Public Health Advance Access originally published online on October 9, 2008
Journal of Public Health 2008 30(4):366-367; doi:10.1093/pubmed/fdn083
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Do we face a third revolution in human history? If so, how will public health respond?
Richard Fielding, Professor of Medical Psychology and Public Health
School of Public Health, The University of Hong Kong, Hong Kong, China
Address correspondence to Richard Fielding, E-mail: fielding{at}hkusua.hku.hk
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Consumption, comfort, convenience and choice; or collapse? |
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‘If society's implicit goals are to exploit nature, enrich the elites, and ignore the long-term, then society will develop technologies and markets that destroy the environment, widen the gap between rich and poor, and optimize for short-term gain. In short, society develops technologies and markets that hasten a collapse instead of preventing it.’1Hanlon and Carlisle2 prompt debate about increasing awareness of a world going pear-shaped, characterizing public health as: ‘prioritis(ing) epidemiological studies of relatively proximate causes of disease, at the expense of synthesis from a wide spectrum of fields which might help us grasp the sheer breadth of the emerging challenge.’ These overlooked challenges are both breathtaking and imminent.
Corporations, obliged to maximize profit, are therefore legally prohibited from charitable, ‘good’ acts or modifying their behaviour for social, moral, environmental or health ends.3 Big Tobacco epitomizes dispassionate maximization of shareholder return. Legally, corporations must pursue profit growth above all else, maximizing sales through increasing consumption. Advertising and public relations industries4 synergistically create demand promoting convenience, comfort and choice (the 3 ‘Cs’), and ensure good public image, pre-empting attempts to limit corporate activity by media and legal means.5 Governments and business ‘revolving doors’ ensure fruitful merging of decision-makers and lobbyists4,5 so that policy almost always favours corporate over public interests, even to the point of war. Up to 30% of daily newspaper stories originate as press releases. Media editorial policy is top-down and stories are selected and spun to fit policy and powerful interests. Advertising enables newspapers to survive, and advertisers dictate terms, ensuring a steady diet of uncontroversial ‘news’,6,7 sometimes about global warming, sandwiched between adverts for SUVs and cheap flights, ‘lifestyle and fashion’. Similarly, television, juxtaposing a thousand scientists advocating action on global warming with a few, corporate-funded dissenters for ‘balance’. Once the 3Cs are obtained, hard-wired resistance to loss keeps us hooked to this system.
To prevent collapse—loss of growth means loss of jobs, opportunity, motivation to study, of life, taxes as well as profit—we must keep consuming, but this is destroying the biosphere we depend on: the rate of species extinction currently averages 2 per hour.8 This economic model requires profit growth, dictating increasingly aggressive means to meet shareholder expectations. By 1995, the average income ratio between the richest and poorest 20% had increased from 30:1 to 82:1. In 2008, the world's 8.7 million millionaires controlled US$40 trillion (T) of assets,9 in a world economic output of $65T.10 During two decades of economic growth, the world has bifurcated into few who have gained vastly and most who have gained only desire, ignited by distant promise of the 3Cs for their 1 US$/day. Wealth is generated, but is sequestered by elites. Enrollment into this unsustainable system for the 5 billion wide-eyed potential consumers that are targeted is a disastrous scenario if it unfolds.
Public health cannot afford to wait 45 years for change, as with tobacco; we have, perhaps, until 2020. This is a critically urgent situation. The danger is as always, that, as a species, we will ‘adapt’. A ‘business-as-usual’ approach would see overshoot1 and collapse. As resources diminish, public health will face shifting challenges: aggression characterizes overpopulated mammal societies. Are we prepared to face this? How can we best help to engineer a rapid shift away from high consumption lifestyles in the face of the corporate juggernaut? Most professional schools and health programmes have no education on critical ecological health. Yet health professionals can influence many thousands of people.11 What are the priorities? Sustainable systems are not embodied by nuclear power or hydrogen vehicles. The elephant in the room is population. Reducing populations drastically permits continuing current levels of consumption, but who? How? Contraception-reduced population growth with drastic consumption cuts is feasible but will cause significant conflict and take a century: too long; we need a 10–20 year fix. Unlimited population and economic growth cannot last much longer. Redistribution can mitigate population demands but more development increases demand for consumption: most people alive and yet to be born will never live anywhere near Western European and North American levels, defeating Millennium Development Goals and poverty alleviation. Anticipating a technological fix is unwise, as the opening quote illustrates. As corporations gain control over emerging economies, consumption generation accelerates while simultaneously limiting the degrees of freedom for objecting, and worse, for alternatives to emerge. Cuba demonstrates good things can be done with very little under different imperatives to the corporate model. Overshooting our ecosystem is a very real danger with dramatic public health consequences for everyone, not just the poor. Change must be made or it will be forced upon us. I hope the Journal of Public Health can catalyze effective action on these issues.
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References |
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- Meadows DH, Meadows DI, Randers J, Tapley E. Limits to Growth: The 30-Year Update (2004) Vermont: Chelsea Green.
- Hanlon P, Carlisle S. Do we face a third revolution in human history? If so, how will public health respond? In: J Public Health (2008) 30:355–61.[CrossRef]
- Bakan J. The Corporation: The Pathological Pursuit of Profit and Power (2004) New York: Free Press.
- Rampton S, Stauber J. Toxic sludge is Good for You: Lies, Damn Lies and the Public Relations Industry (2005) Maine: Common Courage Press.
- Beder S. Global Spin: The Corporate Assault on Environmentalism (2002) White river Junction VT: Chelsea Green.
- Fallows J. Breaking the News: How the Media Undermine American Democracy (1997) New York: Vintage Books.
- Edwards D., Cromwell D. Guardians of Power: The Myth of the Liberal Media (2006) Ann Arbour: Pluto Press.
- Eldredge N. The Sixth Extinction. http://www.actionbioscience.org/newfrontiers/eldredge2.html.
- Thelwell E. Wealth In Emerging Markets Is Creating More Global Millionaires. The Daily Telegraph. 25 June 2008. http://www.telegraph.co.uk/money/main.jhtml?view=DETAILS&grid=&xml=/money/2008/06/25/bcnmillion12.xml.
- World Economic Output. http://en.wikipedia.org/wiki/World_economy.
- Gill M. Why should doctors be interested in climate change? Br Med J (2008) 336:1506.
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