Commentary
The environment and our responsibility to our
children and youth: A message for adults
Donald Spady MD MSc
Having heard all of this you may choose to look the other
way… But you can never say again you did not know
– William Wilberforce, British Parliamentarian, 1789
T
he present article is about the potential impact of the
environment on the health of children and youth in the
21st century and where the paediatrician might fit in. You
might expect the words ‘child’ and ‘paediatrician’ to show up
again fairly soon, but such will not be the case. There is a
reason. An expectation of recent generations has been one of
gradual improvement; thus, our standard of living is better
than our parents and theirs of their parents. However, this
expectation is about to change. Every child, everywhere, all
three billion of them over the next 50 years, will have to
confront unprecedented and generally adverse change within
their societies during their lifetime. Just as our economy is
undergoing incredible change, so is the environment. Just as
today’s economic changes are distressing to most, so will be
tomorrow’s environmental changes. Just as we precipitated
these economic changes because of our arrogance, greed and
hubris, so have we caused many of the environmental changes. Just as we must adapt to tighter times, so must we adapt
to living within stringent environmental limits. By exploring
how man’s perception and treatment of his environment has
altered it so much that its ability to sustain humanity is
threatened, and how that may affect our descendents, the
present paper will help you understand this change and will
prompt you to act, each in your own way, to prepare yourselves, your families and the doctors of the future, for what is
to come. We must do this so our descendents will be able to
enjoy flourishing human cultures.
Pogo, We have met the enemy, and he is us
– Walt Kelly
The word ‘environment’ evokes images of pristine oceans,
lakes and forests populated by diverse varieties of fish, animals and plants, but it also reminds us of polluted air, dirty
water, dead fish, fossil-fuelled agriculture, parking lots, highways and slums. John Last’s, A Dictionary of Public Health
(1), defines the environment as “the setting and conditions
in which events occur. The total of all influences on life and
health apart from genes, comprising the physical world and
the economic, social, behavioural, cultural, as well as physical
conditions and factors that are determinants of health and
well-being.” This definition implies the presence of an ecosystem, “the comprehensive web of interrelations that exist
between the components of the environment, particularly
the plants and animals, and the checks and balances that
govern their existence” (2), which provides those services
to nature that keeps it healthy for all life.
The prevailing attitude of humanity is that while we
might give lip service to the biological and physical environment, human existence really only relies on those facets
made by man – the cultures, philosophies and religions, our
economies and governments, and the physical infrastructure that lets us live in comfort and safety. In our quest for
growth and progress, we have set the natural world apart
and used it primarily for exploitation, extraction, food production and waste management (2). While we value those
resources we can use, we rarely consider nature’s services –
the autonomic nervous system of the earth, working critically in the background. Analogous to ensuring that nutrients are delivered to and wastes removed from our body
tissues, natural ecosystems purify our air and waters, generate and preserve soils, disperse seeds, dispose of the dead,
maintain biodiversity, and create places of beauty and inspiration. We largely discount these ecosystem services and seem
to have forgotten that human survival depends on their
healthy functioning. In fact, we have difficulty in accepting
that we are just another species among many and are subject
to the laws of physics and biology that govern nature.
We have attributes that let us exploit the earth far more
than any other species and have used them in many ways.
Some human groups view their environment as a resource
to use gently (eg, the ‘seventh generation’ concept of many
Aboriginal tribes); others view the environment as something to overcome. We have taken too literally the biblical
command “be fruitful and multiply, and…have dominion…
over every living thing….” (Genesis 1.28; King James version). We have used this directive to create theologies,
theories and ideologies to justify our actions. And we have
succeeded! We ‘conquered’ nature, or so we thought.
We have created artificial environments that let us live
anywhere on earth, developed civilizations and ventured
Departments of Pediatrics and Public Health Sciences, Faculty of Medicine & Dentistry and School of Public Health, University of Alberta,
Edmonton, Alberta
Correspondence: Dr Donald Spady, Departments of Pediatrics and Public Health Sciences, Faculty of Medicine & Dentistry and School of Public
Health, University of Alberta, Edmonton, Alberta, 8226B Aberhart Center 1, Edmonton, Alberta T6G 2G3. Telephone 780-407-1244,
fax 780-407-7136, e-mail [email protected]
Accepted for publication March 25, 2009
290
©2009 Pulsus Group Inc. All rights reserved
Paediatr Child Health Vol 14 No 5 May/June 2009
Commentary
into space. Our ingenuity has let us increase our population
exponentially, and we will add another three billion people
within 50 years. In doing so, we inevitably will use nature’s
resources, and when they become scarce locally, we will
conquer new lands and peoples. Today, we outsource our
needs to whoever can provide, with little concern over the
effects of these demands on their resources or their environment. Nature’s resources seem limitless. Concluding that we
are ‘above’ nature is inevitable. But, nature has limits and
we are facing them today, and our descendents will face
them even more.
In 1990, Wackernagel and Rees (3) conceived the ‘ecological footprint’ to quantify our demand on nature. In
2008, our ecological footprint was 31% more than earth’s
capacity to meet our needs (4). In terms of nature’s services,
humanity is drawing down both principal and interest, and
just like living off our savings, this ultimately leaves us with
nothing. As individuals, when we live beyond our means,
we tap our savings, borrow if necessary and reduce our consumption, fairly confident that we can pay our debt. As
societies, we also do this, borrowing or stealing from other
nations to meet our needs, but as a world, we cannot do it.
This is it. There is no other earth to borrow from.
And if we could borrow, we surely would, because if we
continue our pattern of living, by 2050, we will need
2.5 earths to meet our needs (4), and many more earths
than that if everyone on earth lived like us. This is especially true for energy, for here we face life-changing problems.
Soon, likely within five years, we will face ‘peak oil’ – the
time when world oil production is maximal and then starts a
permanent decline, eventually resulting in an absolute lack
of readily accessible petroleum (5); natural gas will peak
somewhat later (6), and then coal (7). All will functionally
be gone by 2100. These fossil fuels undergird our way of life
(8), and because most of our economic growth and industrial development, plus the spinoffs from that, such as stable
governments, education, food, health, transportation and
employment depend on cheap and abundant energy, this
loss of fossil fuels will lead to the greatest social challenge
and change that humanity has ever seen on a global scale.
This loss will be associated with increasing oil and gas costs,
economic and social disruption, food insecurity, poorer
health, uncertain health care delivery and general hardship
(8-10). Renewable solar, tide and wind energy will help
soften the blow, but will not negate it, and for the most part,
will not replace the fuels essential for cheap transport.
We also will want to borrow from another earth, just to
eat, because food security will be a common problem.
Oceans will lack fish and their ecosystem services will be
impaired (11). We will lack petroleum and natural gas for
fuel and fertilizer production, so our ability to produce
adequate food for everyone will diminish (8). Agriculture
also uses 75% of the world’s fresh water, and water is becoming increasingly scarce. By 2025, 1.8 billion people will face
absolute water scarcity, and 4.5 billion will live under conditions of water stress (12).
To this must be added the effects of climate change (climate
Paediatr Child Health Vol 14 No 5 May/June 2009
instability, higher temperatures, drought, desertification, rising
sea levels, biodiversity loss, changing local ecologies and
changing growing conditions) (13). The muted emphasis
on climate change in the present article does not reflect its
real importance to humans because it will affect all of us,
most likely adversely, and for centuries. But even if there
was no climate change, our assault on nature’s capacity to
sustain our way of life poses near-fatal dangers to our
environment and to our societies.
The decades ahead will be times of reckoning, of dealing
with the problems of diminished biocapacity, resource
depletion, climate change and overpopulation; all driven by
our need to dominate. If we do not soon change how we
live, nature will force a new way on us. But what do we do?
Do we acknowledge these problems, do we deny their existence or do we leave them for our children to deal with? You
must discover for yourself and become knowledgeable
because these changes are so profound and the life ahead so
different that as you continue to practice medicine, patients
and parents will look to you to help them understand, to
help them decide what to tell their children and how to
help them.
We are happy in proportion to the things we can do without
– HD Thoreau
It is traumatic to accept that instead of being governed by
power, economic growth and the bottom line, we must live
within the limits of the natural world and replace our
growth economy with a steady state economy – a system
that permits qualitative development but not overall quantitative growth (14). We still want sport utility vehicles and
Mcmansions, weedless gardens, iPods (Apple Inc, USA),
kiwi fruits and trips to Bali. We may think ‘nature can
handle my bit of garbage,’ or ‘it is not my problem.’ But, it
cannot and it is your problem; it is everyone’s problem. Just
as our society now faces crippling financial debt, humanity
will soon face the debt owed to nature. Politics, philosophy
and economics undergird cultural development, and they
have taken us from living only in nature to living in an
advanced civilization, but they cannot trump biological and
physical reality (2). Everyday, as health professionals, in
clinics, intensive care units and emergency rooms, we face
this reality. The science of medicine is based on it. But we
seem unable to transfer that reality to our own way of life.
Yet, for our descendents to survive with a culture, rather
than just as a species scrambling for existence, it requires
that we accept this reality and learn to live sustainably. This
does not mean the oxymoron ‘sustainable growth’; it means
that we recognize that we are a part of – not apart from –
nature, and must live within nature’s limits. It means a radical
new paradigm of living, not just fine-tuning our current way
of life. The first and hardest step is to face reality; to learn,
acknowledge and act. This is our most important task.
But where do tomorrow’s children fit in? It is by how we
raise our children and grandchildren, and how we affect the
environment within which they live that much of their
future life and health are determined. The philosopher
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Commentary
John Hoyt wrote, “people are often heard to say they are
concerned about the kind of world we will leave to our
grandchildren, but equally critical is the kind of grandchildren we shall leave to the earth. The values and attitudes
imparted to the children and youth of today are crucial in
building the political will for sustainable societies in the next
century” (15). The children one generation from now will
grow up living in a world of constraint and conservation, and
may adapt to this constrained world much more easily than
the child born today. Today’s child, unless we are very careful,
will learn the paradigm of living that has directed our own
activities, and they will tell their children what life was like
‘in the olden days.’ This is a recipe for frustration and anger.
We have to prepare them for a new life.
Tomorrow’s problems require perspectives of creativity,
constraint, conservation and consideration, not growth and
consumption. How do we give our children those perspectives? Because predictions can only be nonspecific, the prescription can only be general. We need to teach them to
live gently on this earth, to value it, to assiduously conserve
its resources and take care of it because it is all they have,
and it has to last forever. Their world view should promote
an ethic of conservation, sustainability, and respect for
nature and for their neighbours because support systems will
be essential. Travel will probably be less common, so life
will be more local. Our children will need to learn how to
get fulfillment in life from their families and community,
from work, from education, not only in science and mathematics, but also from art, literature and music, and not so
much from computers and consumption. We have to prepare them to face change with the confidence that they can
solve the problems of tomorrow, whatever they are, with the
methods of tomorrow. This requires a conscious and arduous
effort on our part – not just parents but everyone, especially
those influential in society – to model these roles and needs,
and not to continue ‘life as usual’.
RefeRenCes
1. Last JM. A Dictionary of Public Health, 1st edn. New York:
Oxford University Press, 2007.
2. Catton WR. Overshoot. The Ecological Basis of Revolutionary
Change. Urbana and Chicago: University of Illinois Press, 1982.
3 Wackernagel M, Rees W. Our ecological footprint. Reducing
Human Impact on the Earth. Gabriola Island: New Society
Publishers, 1996.
4. Hails C, Humphrey S, Loh J, Goldfinger S. Living Planet Report
2008. Gland: WWF (World Wide Fund for Nature), 2008.
5. Hirsch RL, Bezdek R, Wendling R. Peaking of world oil production
and its mitigation. Aiche J 2006;52:2-8.
6. British Petroleum. BP Statistical Review of World Energy. Annual
Report. London: BP, 2008.
7. Zittel W, Schindler J. Coal: Resources and future production.
Energy Watch Group, 2007.
8. Haber W. Energy, food, and land – the ecological traps of
humankind. Environ Sci Pollut Res Int 2007;14:359-65.
9. McPherson GR, Weltzin JF. Implications of peak oil for
industrialized societies. Bull Sci Technol Soc 2008;28:187-91.
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To be an effective model for our children means we must
be knowledgeable about the world, not the world of entertainment and excess, but about the environment and how it
is changing. We need to learn about things we can do to
reduce our impact on the earth and then act on our learning. Without education, we lose the drive to change our
own lifestyles, to go from consumption to conservation and
to teach others. Without education we cannot rebut the
denier, convince the skeptic or effectively prompt governments to change. Of course, education is only part of action.
The other part is motivation – a much tougher step than
education. We often say ‘I would do anything for my child.’
Now is your chance.
And what of paediatricians, indeed all doctors. Medicine
in 2050 may well differ from today, but the basics will not
change. The problems and concerns of parents and children will still be there, but the solutions may be different.
We must seriously consider how and what we teach our
students and residents because their practice of medicine
may be based on simpler technology, fewer drugs and
expert clinical skills. The opportunity will remain of
ensuring that children recover from their illnesses, and
that they will have the best chance to live a full and useful
life. The requirement to advocate for the needs of all children will persist. Paediatricians will be doctors, teachers,
psychologists, advocates, advisors, mentors and friends;
just like always.
ConClusion
Predictions often ridicule the predictor, but I am sure that the
challenges all the children of the 21st century will face will be
greater than those faced by any other generation in the history of humankind. In many children’s stories, the ending is
“…and they lived happily ever after.” Let us work to ensure
that this ending ultimately persists. It is up to us as parents,
teachers, physicians and responsible adults to make it so.
10. Frumkin H, Hess J, Vindigni S. Energy and public health:
The challenge of peak petroleum. Public Health Rep
2009;124:5-19.
11. Worm B, Barbier EB, Beaumont N, et al. Impacts of biodiversity
loss on ocean ecosystem services. Science 2006;314:787-90.
12. Palaniappan M, Gleick PH. Peak water. In: Gleick P, Cooley H,
Cohen MJ, Morikawa M, Morrison J, Palaniappan M, eds. The
World’s Water 2008-2009. The Biennial Report on Freshwater
Resources. Washington, Covelo, London: Island Press, 2009.
13. Frumkin H, Hess J, Luber G, Malilay J, McGeehin M. Climate
change: The public health response. Am J Public Health
2008;98:435-45.
14. Daly HE. A failed growth economy and a steady-state economy are
not the same thing; they are the very different alternatives we face.
A Steady-State Economy. UK: Sustainable Development
Commission, 2008.
15. Hoyt JA. Politics for a humane, sustainable, future. Earth Ethics:
Evolving Values for an Earth Community. Washington: Center for
Respect of Life and Environment, 1996:8.
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