Presentation Transcript
The Unintended Health Consequences of Globalization: The Unintended Health Consequences of Globalization Italo Subbarao DO,MBA
Director Public Health Readiness Office
Deputy Editor Journal of Disaster Medicine
Center for Public Health Preparedness
& Disaster Response
Why???...Ok What is Globalization: Why???...Ok What is Globalization Globalization "is the closer integration of the countries and peoples of the world ...brought about by the enormous reduction of costs of transportation and communication, and the breaking down of artificial barriers to the flows of goods, services, capital, knowledge, and people across borders.”
Joseph Stiglitz Noble Prize Economist
Globalization: The Flattening of the World: Globalization: The Flattening of the World
Globalization: Closing the Economic Gap between Developing and Developed Nations: Globalization: Closing the Economic Gap between Developing and Developed Nations
The Rise of Asia in the Global Economy: The Rise of Asia in the Global Economy
Globalization’s Impact on Developing Countries…Too good to be true!!: Globalization’s Impact on Developing Countries…Too good to be true!! Rapid Industrialization and Urbanization
Demand for Energy and Land
Profits maximized: No focus on standards and regulations
Demand for all populations to be involved in the “gold rush”
I thought globalization is good right??? : I thought globalization is good right???
Goal: Unintended Consequences of Globalization : Goal: Unintended Consequences of Globalization Review Global Trends in Natural Disasters
Review the Health Impact of Climate Change
Review the Concern of Pandemic Influenza and Emerging Infections
Review the Risk of Global Terrorism
Case Study of the Virginia Tech Tragedy
Climate System: Climate System
Greenhouse Effect: Greenhouse Effect
Global Warming: Global Warming
Carbon Dioxide10000 years before 2005: Carbon Dioxide 10000 years before 2005
Methane10000 years before 2005: Methane 10000 years before 2005
Nitrous Oxide10000 years before 2005: Nitrous Oxide 10000 years before 2005
Greenhouse Gases: Greenhouse Gases Carbon Dioxide 35% increase since industrial age
Combustion of Fossil Fuels
Deforestation
Methane 154% increase since industrial age
Animal (cattle and sheep) gas
Nitrous Oxide
Water Vapor
World Consumption: World Consumption
Climate Change Controversy: Climate Change Controversy Nobody argues that the earth is getting warmer and that climate change is occurring.
Controversy is global warming part of the natural planetary cycle or does man have influence?
Other issue is whether curbing CO2 emissions now will have a real impact in the immediate future.
Curbing Carbon Emissions: No Easy Solution: Curbing Carbon Emissions: No Easy Solution Alternative Energy Non-Fossil Fuel Based
Wind, Solar, Nuclear
Ethanol Corn, Sugar Cane, Catalytic
Energy Efficiency
Carbon Emission Regulation: Carbon Tax
Kyoto Protocol: UN Agreement: Kyoto Protocol: UN Agreement Protocol signed by 167 countries: US and Australia notable exceptions
China and India have signed on
Cut greenhouse gas emissions by 5% less than 1990 emissions.
If unable can purchase carbon credits but are penalized in the future.
Treaty expires 2013
Unintended Consequences of Climate Change: Unintended Consequences of Climate Change
Defining a Disaster: Defining a Disaster
Risk = Hazard * Vulnerability
Phases in Disaster Preparedness: Phases in Disaster Preparedness DISASTER
Societal Disruption: Societal Disruption Infrastructure destruction
Hospitals
Primary Health Centers
Homes
Transportation
Criteria for a Natural Disaster: Criteria for a Natural Disaster 10 or more people reported killed
100 people reported affected
Declaration of a state of emergency
Call for international assistance
http://www.em-dat.net/
Natural Disasters: Natural Disasters http://www.em-dat.net/
Comparative Review of Natural Disasters: Comparative Review of Natural Disasters http://www.em-dat.net/
Continental Comparisons : Continental Comparisons http://www.em-dat.net/
Mortality and Population Affected: Mortality and Population Affected http://www.em-dat.net/
Extreme Heat and Cold Waves: Populations susceptible: Extreme Heat and Cold Waves: Populations susceptible
Climate Change???: Climate Change???
Infectious Disease and Globalization: : Infectious Disease and Globalization: Urbanization (Developing Countries)
Overpopulation
Travel Projections
Climate Change Impact
Globalization and Urbanization:: Globalization and Urbanization: 2006 UN Report: 1976 1/3rd of the population lived in cities
Today 50% of the worlds population lives in cities
Greatest growth is in developing countries: China and India
Overpopulation: Feed Me!!!: Overpopulation: Feed Me!!! Pollution
Improper Waste Disposal
Depletion of Natural Resources
Overcrowding/ Slums: Mixing of Human and Animal populations
Increased Consumption
Travel projections until 2017: Travel projections until 2017
Influenza A: Influenza A
Pandemic Influenza: Pandemic Influenza
Historical Consequences: Historical Consequences
Overarching Objectives: Overarching Objectives
SARS: Window to a Pandemic : SARS: Window to a Pandemic
SARS Implementation Strategies :: SARS Implementation Strategies :
Slide45: Severe acute respiratory syndrome
From Wikipedia, the free encyclopedia
http://en.wikipedia.org/wiki/SARS
Greatest Growth: Asia/Pacific and Latin America: Greatest Growth: Asia/Pacific and Latin America
Climate Change and Infectious Disease: Climate Change and Infectious Disease
Climate Change???: Climate Change??? Thursday, 14 March 2007, 19,577 recorded cases of dengue were reported. The national average incidence rate is 325.8 per 100,000 inhabitants (Source: Mercosur and MSPBS).
The dengue outbreak is concentrated in the capital city of Asunción Capital (incidence rate = 1166.6 per 100,000), .
Climate in the form of continuous rainfall has played a major role in this outbreak.
Supersize Me!!!: Supersize Me!!!
Global Terrorism: Influence of Globalization: Global Terrorism: Influence of Globalization
Global Terrorism: Are we preparing for the right threats? : Global Terrorism: Are we preparing for the right threats?
Globalization and its Impact on Health: Globalization and its Impact on Health
Educational Framework for Disaster Medicine and Public Health Preparedness: Educational Framework for Disaster Medicine and Public Health Preparedness
Goals : Goals Create an educational framework that would meet the practical needs of all health system responders.
Consistency and common lexicon among all learners and level of responders.
Create a framework that would allow for scientific evaluation and assessment.
Methodology: Methodology Systematic Review (Jan. 2004-July 2007) peer reviewed, and unpublished (ASPR, CDC,DHS)
Convened an Expert Panel
Identified Commonality and Gaps: Ethics, Law, Mortuary, Risk Communication, Mental Health, Cultural Competence, Leadership.
Learning Matrix: Learning Matrix
Slide64: For each competency and responder category, learning objectives must be developed to accommodate persons in the target group who perform at different levels and in varying degrees based on their educational level, experience, professional role, and job function in disaster planning, mitigation, response, and recovery.
Slide65: For each competency and responder category, learning objectives must be developed to accommodate persons in the target group who perform at different levels and in varying degrees based on their educational level, experience, professional role, and job function in disaster planning, mitigation, response, and recovery.
Slide66: Competencies Bio Chem N/R 10 100 1,000 MD/DO RN Para R T B Geo-Climatic Time
Next Steps: Next Steps Development of Learning Objectives
Development of Evaluation Measures
Prospective Randomized/ Control Educational Trial (web-based vs. didactic).
Bombings: Blast Injury: Bombings: Blast Injury
Triage: Sorting patients…sort of. : Triage: Sorting patients…sort of.
Injury Severity: Injury Severity
Critical Mortality Rates: Identifying Preventable Deaths: Critical Mortality Rates: Identifying Preventable Deaths
Critical Mortality and Overtriage: Critical Mortality and Overtriage
Virginia Tech Case Study: You are a Level 3 Trauma Center: Virginia Tech Case Study: You are a Level 3 Trauma Center
Unable to Medevac: Unable to Medevac Triage broke down into two groups
Injury Severity: Injury Severity
Critical Mortality: Critical Mortality
Overtriage??? Not a Friend but is it a Foe?: Overtriage??? Not a Friend but is it a Foe?
Lessons Learned:Level I or not be ready!: Lessons Learned: Level I or not be ready!