Essay writing help 10 POINTS FOR BEST ANSWER?

Question

10 POINTS FOR BEST ANSWER

i am writing an essay on how the society today effects our healthy life style and comparing what it would of been like 30 years ago and what it would be like in 2020.

any ideas?

thanks

Answer 1

The research I found is about the future health = and societies responsiblity to the environmental issues = the only answer I can give is that global environment decay has increased in the past 30 years =

Maybe with websearching the environment 30 years ago = you could come up with the "past" part for your essay.

the report is quite long, however it is a very through health report

David M. Gute, Ph.D., M.P.H.

Associate Professor of Civil and Environmental Engineering

Tufts University

[e-mail]



The following represents a consideration of human health effects attributable to global climate change (GCC) in the Boston Metropolitan Area (BMA).

Executive Summary



The relationship between climate and human health has been pursued for a relatively long time. Interest has only intensified, as the possible scope of GCC has become clearer. This review will attempt to identify primary and secondary relationships in human health indicators, which may be susceptible to the influence of climate. For the BMA, the predominate primary health effect which can be hypothesized as occurring in a period of GCC would revolve around the dynamic impact of heat, ozone and airborne particulates. Secondary relationships of importance here would also include humidity, land use and factors that would increase susceptibility of specific human populations, such as the penetration of air conditioning. The application of specific models to estimate the impact of possible health effects is presented.



Description of the Problem



The degree to which specific human health effects can be attributed to the influences of climate is variable but long sought (1). Investigators working from the perspective of human health have struggled to express the dynamic relationship between agent, host and environment. Attention to the dynamism of this relationship was not prominent in the pioneering attempts at describing the potential health impacts of GCC (see Leaf, 1989 for example (2)). The recognition of the need for the specification of additional input variables and the development of models of increasing complexity grew (see Patz, J.A. et al, 1996 (3)). The practice of dynamic modeling in predicting future human health effects due to GCC is now under active consideration (see Martens, 1998 (4)).



Most analysts, and the preponderance of the literature, describe differential levels of causality between selected human health effects and GCC. Martens and Patz, for example, identify direct (stronger) and indirect (more complex and less unequivocal) relationships between climate change variables and human health effects. The single direct relationship identified is for heat stress and increased cardiovascular and respiratory morbidity (sickness) and mortality. This is a well-known and documented relationship (see Centers for Disease Control, Heat-Related Mortality -Chicago, July 1995 (5)). Thermal stress can induce heat stroke in victims, which are the most vulnerable of urban populations being comprised of infants (under one year of age) and the elderly as well as populations without access to air-conditioned environments.



Higher ambient temperatures also exert influence in terms of exacerbating the cumulative deleterious effects of ozone and particulates. This relationship, for example, falls under the Martens/Patz paradigm as an indirect relationship. Conceptually, what is being described by this designation is a more complex and less direct relationship. Other indirect relationships include ecologically mediated effects such as vector-borne diseases (the recent outbreak of St. Louis Encephalitis (SLE) and West Nile virus in New York City and two cases of malaria on Long Island as examples), marine-borne diseases (such as the multi-faceted effects of algal blooms), and food productivity effects. Also mentioned in this ãlevelä of effect is air pollution, weather disasters and sea-level-rise. Ozone depletion merits its own heading.



Martens explores three first-order models by way of example. They are 1) climate change, thermal stress and mortality, 2) the impact of stratospheric ozone depletion on skin cancer incidence, and 3) climate change and vector-borne diseases (mosquito- and tick-borne illnesses for example). I would rate these as progressively more speculative with a wider band of uncertainty found in each successive modeling exercise.



A recent book edited by Greenwood and De c**k at the London School of Hygiene and Tropical Medicine seeks to provide and frame a broader public health context (6). Paul Epstein's chapter, Emerging diseases and global change: past, present and possible futuresä in this text reminds us of the breadth of the present problem but also that valuable lessons may be gleaned from historical transition periods: plague in the 14th century which featured climactic change-the Medieval Warm period and significant anthropogenic activity (migration, urbanization, etc.). Looking to the past underscores the possible relationships between urbanization and the impact of human disease. For instance, the Cambridge Studies in Historical Geography group (7) has assembled and analyzed epidemiologic data on diphtheria, enteric fever, measles, scarlet fever, TB, and whooping cough) from 100 world cities from 1887-1912. In the 1970s McNeil eloquently wrote of the profound impact that infectious disease has exerted on human history and the many social adaptations that flowed from such influences (8). An important principle distilled from these disparate sources is historical data can at least provide some valuable context in assessing the future.

Other more speculative theories concerning the impact of GCC concern the possible environmental effects on lowering the susceptibility of host populations through compromises to the immune system (6). We know from studying known environmental agents such as Cryptosporidium that chemotherapy and AIDS patients (immuno-compromised populations) are at increased risk of severe health effects. What is not known is how the stresses of GCC may alter or buttress human immune status on a population basis.



A useful example of a selective case-study approach in considering the effects of GCC is found in International Council for Local Environmental Initiatives, Cities at Risk (9). These results are discussed later in this document.



The conclusions that emerge from this review are: 1) Be exhaustive in model specification for possible health effects but selective in terms of which effects to feature. 2) Be open to natural experiments occurring in the region: completion of the Central Artery project could reduce local ozone and particulate levels 3) Look for particular region-specific data sources which afford greater ability to yield health or environmental data that is unique and/or of enhanced precision. 4) Pay particular attention to the influence of infrastructure in terms of possible health effects (example: waterborne disease as a result of severe weather).

Description of Human Health as an Outcome of Interest



How should we define health? A place to start in defining health is with the World Health Organization (WHO) definition, A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. (10) [Italics mine]. It is interesting to contrast this with the definition of public health as produced in the Report of the Sanitary Commission of Massachusetts in 1850 which holds that, the condition of perfect health requires such laws and regulations, as will secure to man associated in society, the same sanitary enjoyments that he would have as an isolated individualä. (11) This juxtaposition of ensuring the health of the individual as assiduously as for the citizen of a teeming city is indeed daunting.



Health is difficult to characterize. Morbidity (sickness) and mortality are easier metrics to

record and count. Such data forms the basis of public health surveillance. Completeness, accuracy and validity can vary greatly by the specific disease or cause of death under study. As a starting point, the health outcomes shown in Table 1 would be useful follow in time and place throughout the BMA.



Another option in tracking human health is to monitor risk factors (factors which predispose populations to a deleterious health outcome; examples-uncontrolled high blood pressure, elevated serum cholesterol) or bio-markers (levels or concentrations of marker compounds which are predictive of future disease; examples-blood lead levels, PCB levels in blood and adipose tissue). This may be undertaken as a way to derive an intermediate assessment of the health status of BMA population.



The health impacts of greatest potential for being affected by GCC.



á         Heat stress



Increased mortality (particularly in the very young and elderly with pre-existing cardio-pulmonary deficit) is likely to be influenced as a result of temperature increases within the BMA. Increased hospitalizations for respiratory problems are likely sequelae of heat stress. The rise in ambient temperature is also closely correlated with increases in the production of oxides of nitrogen (NOX) and ozone. Modeling of these phenomena has been carried out for the relatively similar air masses for the metropolitan area of New York City (12).



á         Increases in airborne pollution



The agent of greatest concern for the region is likely to be ozone with asthma being the health outcome most affected. Ground-level ozone is already being assiduously attacked by regional environmental protection agencies (13) However, success at control has been grudging. It is also generally held that with rising temperature, particulates will also increase. What determines the health impacts of particulates is the relative size of the particulate as well as what is adsorbed onto the surface of these particulates.



á         Infectious disease



Infectious disease is presently monitored throughout the BMA through existing public health infrastructure. Current efforts at estimating and tracking the distribution of hosts such as mosquitoes, ticks or other animal hosts may need to be augmented. Hypothesized impacts of GCC on the human immune system are hard to assess in terms of their importance.

á         Waterborne disease



Flooding and storm run-off in agricultural areas has been linked to outbreaks of cryptosporidiosis and intrusions in sewage as well as to back-ups in storm water systems in peak events. The possible influence of these peak events particularly in densely occupied urban areas can be visualized as a result of the flooding which accompanied a major storm in Boston in October 1996 which caused millions of dollars of damage and wreaked havoc with different types of infrastructure ranging from transit to sewage systems.



á         Influence of socioeconomic status (SES) on the level and completeness of healthcare coverage with respect to the diagnosis and ascertainment of health outcomes attributable to GCC. This will influence the reporting of GCC-related health outcomes as well as potentially the efficacy of treatment received.

á         Trauma from extreme climate events and the accompanying deterioration of ISS as specified in other sections of this report.



Forecasting Case Example



The International Council for Local Environmental Initiatives (9) has compared possible impacts of GCC for twenty American cities. It predicts that through relatively simple models that Boston will witness a predicted mean temperature rise of 1.8-2.7 degrees Fahrenheit. Such increases in mean temperature are almost assuredly going to impact peak summer temperatures where ozone production has been shown to increase at a faster rate for temperatures above 85 degrees F as compared to below 72 degrees F (12). This model building exercise next addresses a relatively straightforward relationship, predicted heat stress deaths as a result of the increases in mean temperatures. This yielded an increase projected for 2050 of 153-194 summer deaths as compared to a current number of 96 due to heat stress. We can also look to recent outbreaks of infectious disease outside of usual endemic areas, e.g. two cases of malaria occurring on Long Island and the 1999 outbreak of mosquito-borne disease in New York City and the subsequent application of Malathion as a risk management response.

Options for Mitigation and Adaptation to Positive and Negative Impacts



Public health authorities will need to pay particular attention to the increased surveillance of human hosts and human and non-human vectors for relationships sensitive to GCC. Population-based public health education outreach may need to be adapted to fit the challenges of GCC. This would be particularly true in terms of reaching populations of increased susceptibility. Adaptations in normative expectations which influence individual behavior (example: whole-scale change in the prevalence of smoking or protective behavior surrounding foodborne or infectious disease).



The tracking of GCC impacts (severity of storms, temperature, humidity, sea-level rise, and peak wind speed etc.) on specific host populations within the BMA will be important to track. Are there selective effects on specific populations as defined by race, ethnicity, or geographic location that will increase susceptibility to GCC impacts? On the health outcome side of the picture, care will be needed to be extended to deriving accurate morbidity and mortality rates for conditions sensitive to GCC effects (See these conditions in Table 1). Sub-regional analysis at the level the ecologically meaningful constructs such as watersheds and at geo-political meaningful boundaries of importance will be explored.