WELCOME.
GOOD MORNING TO THE OVER 200
VIRTUAL ATTENDEES WE HOPE WILL
JOIN US TODAY.
WE'RE PLEASED WE'RE BEING JOINED
FROM ATTENDEES FROM THE U.S.,
FROM ABROAD, FROM TRAINEES TO
SENIOR FACULTY, MANY COLLEAGUES,
FEDERAL COLLEAGUES, FROM THOSE
WHO ALREADY KNOW A LOT ABOUT
PLANETARY HEALTH AND THOSE WHO
WANT TO LEARN MORE.
WE HAVE MANY OUTSTANDING
PRESENTERS.
OUR CO-CHAIRS, SONIA ANGELL AND
SANJAY RAJAGOPALAN.
I WANT TO THANK THEM FOR THEIR
HARD WORK.
I WANT TO HIGHLIGHT A SPECIAL
AND UNUSUAL SESSION WHICH WILL
OCCUR TODAY AT 3:30 THIS
AFTERNOON AFTER OUR AFTERNOON
BREAK.
IT WILL BE YOUR CHANCE BECAUSE
IT'S GOING TO BE INTERACTIVE TO
SEE HOW DIFFERENT POLICIES
INFLUENCE OUR PLANET, AND IT
WILL SUMMARIZE SOME OF THE
INSIGHTS FROM THE PRESENTATIONS
YOU'LL HEAR TODAY, AND MAY
PROVOKE ADDITIONAL RESEARCH
IDEAS.
THIS SIMULATION AS YOU CAN SEE
AT THE BOTTOM OF THE SLIDE HAS
BEEN WIDELY PRAISED.
SO, IF YOU HAVE THE TIME, PLEASE
STAY TUNED.
PLEASE STAY ON THE SEMINAR, ON
THE WORKSHOP, AT 3:30.
NEXT SLIDE PLEASE.
IT GIVES ME GREAT PLEASURE TO
INTRODUCE A SENIOR LEADER IN THE
NHLBI, DAVID GOFF, WHOSE
LEADERSHIP HAS BEEN
CHARACTERIZED BY ENCOURAGING
STAFF AND THE RESEARCH COMMUNITY
WHO WE SUPPORT TO TACKLE THE
MOST IMPORTANT UNANSWERED
QUESTIONS AND TO ENSURE THAT OUR
RESEARCH CAN BE WIDELY USED TO
IMPROVE HEALTH.
DAVID?
>> THANK YOU, LARRY.
I WANT TO ADD MY THANKS TO THE
ORGANIZERS AND CO-CHAIRS FOR
PUTTING TOGETHER THIS FANTASTIC
WORKSHOP.
NEXT SLIDE PLEASE.
SO, IT'S MY PLEASURE TO KICK
THIS OFF, AND ONE OF THE REASONS
I'M SO HAPPY ABOUT THIS IS THAT
WHILE ALL OUR WORKSHOPS ARE
REALLY IMPORTANT, THIS ONE IS
REALLY SPECIAL TO ME BECAUSE
I'VE HAD A LONG INTEREST IN THE
LINK BETWEEN CARDIOVASCULAR
HEALTH AND PLANETARY HEALTH.
NEXT SLIDE PLEASE.
MY LAST LECTURE AT THE COLORADO
SCHOOL OF HEALTH WHERE I WAS
BEFORE COMING TO NHLBI WAS ON
THE ISSUE OF PLANETARY HEALTH,
AND IT WAS BASED ON WHAT I
BELIEVE TO BE ONE OF THE MOST
IMPORTANT PAPERS RELEASED IN THE
LAST DECADE, "SAFEGUARDING HUMAN
HEALTH,."
A REPORT FROM THE ROCKEFELLER
FOUNDATION AND LANCET
COMMISSION.
THIS WAS WAS BASED ON THE
LANDMARK PUBLICATION FROM 2015
BUT IF ANY OF YOU HAVE NOT HAD
THE OPPORTUNITY READ THAT PAPER,
I STRONGLY RECOMMEND IT.
AS I SAID, IT'S REALLY, IN MY
PROFESSIONAL CAREER, ONE OF THE
MOST IMPORTANT PAPERS THAT I'VE
READ OVER THE PAST DECADE AND
HAS REALLY HELPED SHAPE MY
THINKING ABOUT THE IMPORTANCE OF
THE ISSUES WE'RE GOING TO BE
TALKING ABOUT TODAY AND HAS
ENCOURAGED ME TO THINK ABOUT HOW
I AND MY ORGANIZATION CAN
CONTRIBUTE IN THIS IMPORTANT
AREA.
NEXT SLIDE PLEASE.
IN 2021, I WAS HONORED TO BE
INVITED TO GIVE THE ANSEL KEYS
LECTURE AT AMERICAN HEART
ASSOCIATION.
I FOCUSED THAT OPPORTUNITY ON
OUR EFFORTS TO PURSUE ON HEART
HEALTHY PLANET.
IN RECOGNITION OF THE REALITY
THAT THOSE OF US WHO HAVE BEEN
WORKING ON PROMOTING HEART
HEALTH, WE CAN'T ACHIEVE A HEART
HEALTHY POPULATION ON AN
UNHEALTHY PLANET WE HAVE TO HAD
A HEALTHY PLANET TO HAVE A HEART
HEALTHY POPULATION.
NEXT SLIDE PLEASE.
SO IN THAT LECTURE I ASKED THE
AUDIENCE TO PICTURE THEMSELVES
DECADES IN THE FUTURE.
I PICKED 2060 AS THE YEAR.
WE HAD ACHIEVED THE GOAL OF
HAVING A HEALTHY PLANET WITH A
HEART HEALTHY POPULATION, AND
POSED THE QUESTION HOW DID WE
GET THERE FROM WHERE WE WERE IN
2021.
ADVANCE PLEASE.
REMEMBER, THIS WAS 2021.
AND THE SITUATION IS FAIRLY
SIMILAR TODAY.
WE HAD A WORLD WHERE THE
TEMPERATURES ARE HOT AND RISING,
WHERE THERE'S WILDFIRES THAT
WE'RE DEALING WITH, WHERE OUR
AGRICULTURE SYSTEM AND FOOD
SYSTEM PROMOTED UNHEALTHY
SITUATIONS FOR OUR POPULATION,
ESPECIALLY WITH RESPECT TO HEART
HEALTH, AND NOT JUST HEART
HEALTH.
SO HOW DID WE GET TO WHERE WE
WERE IN 2060 FROM WHERE WE HAD
BEEN IN 2021 AND WHERE WE STILL
ARE IN 2023?
NEXT SLIDE PLEASE.
I POSED THE POSSIBILITIES
LOOKING BACKWARDS WE COULD SEE
FIVE PATHWAYS OF RESEARCH THAT
WERE CRITICAL TO ACHIEVING A
HEART HEALTHY PLANET WITH A
HEALTHY POPULATION IN 2060.
AMONG THOSE FIVE PATHWAYS WAS
RESEARCH ON PROMOTING PLANETARY
HEART HEALTH, WHICH IS THE TOPIC
OF TODAY'S WORKSHOP.
SO I'M DELIGHTED THIS WORKSHOP
IS FOCUSED BOTH ON PROMOTING
PLANETARY HEALTH, AS WELL AS
INTERSECTION OF THAT WITH SOCIAL
DETERMINANTS AND WITH THE OTHER
ASPECTS LISTED ON THIS SLIDE,
ALL OF WHICH ARE INTERTWINED IN
OUR EFFORTS TO ACHIEVE A HEALTHY
POPULATION ON A HEALTHY PLANET.
NEXT SLIDE PLEASE.
SO, I KNOW THIS WORKSHOP IS
GOING TO ADD IMPORTANTLY, OH, I
THINK NEXT SLIDE PLEASE.
THANK YOU.
SO I KNOW THIS WORKSHOP IS GOING
TO CONTRIBUTE IMPORTANTLY TO OUR
UNDERSTANDING OF THE
OPPORTUNITIES THAT WE CAN PURSUE
TO ADVANCE PLANETARY HEALTH AND
CARDIOVASCULAR HEALTH.
AND SO I WANT TO THANK YOU FOR
YOUR WORK LEADING UP TO THIS,
YOUR CONTRIBUTIONS TO THE
WORKSHOP, THE TIME YOU'RE TAKING
TO CONTRIBUTE TO THIS THINKING
ABOUT THIS MAJOR CHALLENGE WE
FACE TOGETHER, AND YOUR
COMMITMENT TO THE WORK WE CAN DO
TOGETHER IN THE FUTURE.
I WANT TO THANK YOU AND PASS THE
BATON BACK TO LARRY FINE.
>> THANK YOU VERY MUCH, DAVID,
FOR GETTING US STARTED.
NEXT SLIDE PLEASE.
I'VE HAD THE PRIVILEGE OF
WORKING WITH TWO GIFTED
SCIENTISTS AND LEADERS WHO IN
THE PAST YEAR HAVE SHAPED THIS
WORKSHOP AND TAUGHT ME AND
OTHERS ON THE PLANNING COMMITTEE
SO MUCH.
THEY ARE OUR CO-CHAIRS.
SONIA ANGELL FROM JOHNS HOPKINS
BLOOMBERG SCHOOL OF HUSBAND
HEALTH IS AS YOU CAN SEE THE
BLOOMBERG DISTINGUISHED
PROFESSOR OF PRACTICE, AND
SANJAY RAJAGOPALAN, FROM
UNIVERSITY HOSPITAL AT CASE
WESTERN RESERVE UNIVERSITY, WHO
IS THE HERMAN HELLERSTEIN
PROFESSOR OF MEDICINE.
THEY ARE OUR CO-CHAIRS.
SO, SONIA, PLEASE SAY A FEW
WORDS.
>> THANK YOU SO MUCH.
IT IS SUCH A PLEASURE TO BE A
PART OF THIS PROCESS AND
EXPERIENCE.
AS WE ALL KNOW, CARDIOVASCULAR
DISEASE REMAINS A LEADING CAUSE
OF DEATH IN THE U.S. AND
GLOBALLY.
IT'S ALSO A LEADING RISK FACTOR
FOR HOSPITALIZATION AND DEATH
FROM COVID.
THIS PANDEMIC REMINDED US WHILE
WE MUST CONTINUE TO ADVANCE OUR
DEFENSES AGAINST INFECTIOUS
AGENTS THROUGH ENHANCED
SURVEILLANCE, VACCINE, AND
TREATMENTS, ADDRESSING CHRONIC
DISEASE, ESPECIALLY
CARDIOVASCULAR DISEASE, IS ALSO
PANDEMIC PREPAREDNESS.
IT'S ALSO REQUIRED FOR NATIONAL
HEALTH SECURITY, HEALTH EQUITY,
FOR CREATING RESILIENT
COMMUNITIES AND ECONOMIES.
BUT HEALTHY HEARTS REQUIRE A
HEALTHY PLANET AS DR. GOFF
LISTED UP, AND THIS PLANET IS
NOT HEALTHY.
THE SYSTEMS ARE NOT PROMOTING
CARDIOVASCULAR AND PLANETARY
HEALTH DUAL AIMS.
SYSTEMS THAT PRODUCE, ALSO
PRODUCE A THIRD OF THE WORLD'S
GREENHOUSE GASES.
FOOD SYSTEMS USE 70% OF FRESH
WATER, 80% OF DEFORESTATION, A
LEADING CAUSE OF BIODIVERSITY
LOSS.
STILL, DIETARY PATTERNS ARE NOT
IDEAL.
SYSTEMS WERE CREATED AT THE
HANDS OF HUMANS AND CAN BE
CHANGED BY US, THAT CHANGE NEEDS
TO BE STRATEGIC AND GUIDED BY
EVIDENCE.
WE NEED RESEARCH THAT WILL MOVE
US EXPEDITIOUSLY TO ACTIONABLE
SOLUTIONS AT THE LOCAL, STATE,
AND GLOBAL LEVEL.
WE'RE SO THANKFUL FOR DR. GOFF'S
LEADERSHIP IN IDENTIFYING THIS
GAP AND FOR DR. LARRY FINE AND
HIS REMARKABLE STAFF FOR LEADING
THE DESIGN OF THE SPACE FOR ALL
OF US TO COME TOGETHER AND
CONTEMPLATE HOW
TRANSDISCIPLINARY THINKING MIGHT
ADVANCE THE PLANETARY AND
CARDIOVASCULAR NEEDS OF OUR
COUNTRY AND OUR WORLD.
THE TIMELINESS OF THIS WORKSHOP
OFF COP28 IS NOT LOST.
I UNDERSTAND AS DR. GOFF SAID
THIS IS THE FIRST OF ITS KIND
FOR THE NHLBI, AS CO-CHAIR
WORKING WITH THIS TEAM TO HELP
SHAPE WHAT WE HOPE WILL BE A
REMARKABLE OPPORTUNITY FOR ALL
OF YOU, OUR TEAM ALSO RECOGNIZES
REMARKABLE OPPORTUNITY, TRAGEDY
OF THE LIMITED TIME AND TOPICAL
EXCLUSIONS THAT WERE NECESSARY.
STILL, THROUGH WORKING THROUGH
OUR WORKSHOP GOALS WE HOPE THIS
IS ONLY THE BEGINNING OF
REIMAGINING HOW WE CAN ADVANCE
THE SCIENTIFIC FIELDS THROUGH
IDENTIFYING CONCRETE SPECIFIC
RESEARCH NEEDS, METHODS,
COLLABORATIONS THAT WILL DRIVE
US TO A WORLD WITH HEALTHY
HEARTS ON A HEALTHY PLANET.
SO IF YOU'LL PLEASE ADVANCE TO
THE SLIDE ON OBJECTIVES, WOULD
LIKE TO REMIND US WHY WE'RE
GATHERED HERE TODAY.
THIS WILL WORK TO IDENTIFY KEY
SCIENTIFIC KNOWLEDGE GAPS,
RESEARCH METHODS, TOOLS AND
OPPORTUNITIES AT THE
INTERSECTION OF PLANETARY AND
CARDIOVASCULAR HEALTH.
WE'LL EXPLORE STRATEGIES TO
IMPROVE PLANETARY AND
CARDIOVASCULAR HEALTH AND
ADVANCE HEALTH EQUITY AND OUR
FINAL OBJECTIVES IS TO INCREASE
SCIENTIFIC UNDERSTANDING OF
BIODIRECTIONAL AND
INTERDEPENDENT RELATIONSHIP OF
PLANETARY AND CARDIOVASCULAR
HEALTH.
I'D LIKE TO THANK YOU ALL FOR
JOINING US THIS MORNING AND OVER
THE NEXT DAY, ESPECIALLY THANK
MY CO-CHAIR DR. SANJAY
RAJAGOPALAN FOR BEING PART OF
THIS AMAZING PROCESS WITH ME.
THANK YOU.
>> SANJAY?
>> THANKS, SONIA.
I'D LIKE TO ECHO YOUR COMMENTS
AND SINCERE THANKS TO LARRY AND
THE PROGRAM STAFF AND NHLBI AND
DAVID GOFF FOR THE SUPPORT.
DELIGHTED COP28 ENDED ON
POSITIVE NOTE, TAKING A
CONCERTED DECLARATION ON HEALTH
EFFECTS OF CLIMATE TO IDENTIFY
RESEARCH PRIORITIES AT THE NEXUS
OF PLANETARY AND CARDIOVASCULAR
HEALTH, AT THE OUTSET MIGHT BE
WORTHWHILE TO HIGHLIGHT
TRANSFORMATIVE TRENDS THAT
THOUGHTFULLY LEVERAGE COULD HAVE
MASSIVE IMPACT ON CARDIOVASCULAR
HEALTH AND REALLY REPRESENTS
MAJOR OPPORTUNITIES FOR
RESEARCH.
AND THESE ARE EMERGING
CO-CONVERGENT TRENDS IN CLIMATE
TECHNOLOGIES, CLEAN ENERGY,
SMART GRID ELECTRIC VEHICLES
THAT CAN OFFER SUBSTANTIAL CORE
BENEFITS REDUCING AIR POLLUTION,
AND CORRESPONDING RESEARCH
OPPORTUNITIES, LOW CARBON AND
NET ZERO AGENDAS, URBAN DESIGN,
PROVIDING OPPORTUNITIES TO
REDUCE CARDIOVASCULAR OUTCOMES
AND ASK WHY WITH REGARD TO
RESEARCH QUESTIONS, ADAPTATION,
INCREASING CONNECTIONS BETWEEN
BIODIVERSITY, CARDIOVASCULAR
HEALTH, AND THESE ARE JUST SOME
EXAMPLES WHERE THE FIELD IS
MOVING BUT PROVIDE SUPERB
OPPORTUNITIES FOR RESEARCH.
THE FINAL EXCITING ASPECT OF THE
FORUM HERE IS THAT THIS IS AN
UBER TEAM SPORT, ENGAGEMENT OF
TRANSDISCIPLINARY TEAMS OF A
VARIETY OF DIFFERENT SCIENTISTS
INCLUDING COMPUTATION, GEO
PHYSICAL AND HEALTH SCIENTISTS
TO EXPLORE, REALLY CRITICAL.
NEXT SLIDE PLEASE.
NEXT SLIDE.
THE FIRST SESSION IS REALLY
EXCITING, EXPLORE RELATIONSHIPS
AND DID I MECHANICSES OF
INTERACTIONS MODERATED BY DR.
CARREN SOLOMON, HARVARD MEDICAL
SCHOOL, PHYSICIAN AT THE BRIGHAM
AND WOMEN'S HOSPITAL.
RESPONSIBILITIES INCLUDE
OVERSEEING ONGOING FOSSIL FUEL
POLLUTION SERIES A TOUR DU FORCE
BRINGING AWARENESS.
I'LL SAY A FEW ADDITIONAL WORDS,
AND I'LL INTRODUCE THE FIRST
SPEAKER.
I WOULD LIKE TO POINT OUT THE
EXCELLENT BOOKLET ASSEMBLED BY
NHLBI STAFF THAT YOU CAN ACCESS
BY SCANNING THE QR CODE.
SO, WITHOUT MUCH ADO, I'D LIKE
TO INTRODUCE THE FIRST SPEAKER,
DR. SAM MYERS, WHO IS GOING TO
BE SPEAKING ON IS DESTROYING
NATURE BREAKING OUR HEARTS,
CONNECTIONS BETWEEN
CARDIOVASCULAR HEALTH AND GLOBAL
AND ENVIRONMENTAL CHANGE.
WELL KNOWN FOR WORK ON CLIMATE
CHANGE, DIRECTOR OF THE JOHNS
HOPKINS INSTITUTE FOR PLANETARY
HEALTH, FOUNDING DIRECTOR OF THE
PLANETARY HEALTH ALLIANCE.
DR. MYERS?
>> ALL RIGHT.
THANK YOU SO MUCH, SANJAY.
GREAT TO BE WITH EVERYBODY.
GREAT IF WE COULD GET MY SLIDES
UP.
SO, I'VE BEEN ASKED TO PROVIDE A
LITTLE BIT OF OPENING AND
CONTEXT FOR CONVERSATION WE'RE
GOING TO BE HAVING, SO ONCE WE
HAVE SOME SLIDES, I'M GOING TO
TRY TO OUTLINE CONNECTIONS
BETWEEN BIOPHYSICAL CHANGES AND
HUMAN HEALTH WITH FOCUS ON
CARDIOVASCULAR HEALTH.
I DON'T SEE MY SLIDES.
I'M GOING TO WAIT FOR A MINUTE.
IS THERE SOMETHING I NEED TO BE
DOING, BRITNEY?
>> I DON'T THINK SO.
>> OKAY.
CAN YOU ADVANCE THE SLIDES?
THERE WE GO.
LET'S GO AHEAD TO THE NEXT SLIDE
PLEASE.
AND WHAT I REALLY WANT TO DO IS
CONTEXTUALIZE THE NEXT TWO DAYS'
CONVERSATION A LITTLE BIT.
WHAT I THINK IS A REALLY
EXTRAORDINARY AND UNIQUE MOMENT
IN HUMAN HISTORY, WHAT WE'VE
BEEN WATCHING IS THIS
EXCEPTIONAL BALLOONING OF
HUMANITY'S TOTAL ECOLOGICAL
FOOTPRINT.
WE FIND OURSELVES IN THE MIDST
OF WHAT MANY PEOPLE CALL THE
GREAT ACCELERATION, WHERE FOR
MOST OF HUMAN HISTORY WE'VE SEEN
MODEST CONSUMPTION PATTERNS UP
THROUGH 1900, AND THEN THIS
GENTLE RISE IN GLOBAL
CONSUMPTION PATTERNS THROUGH
1950 AND THIS VERY STEEP
ACCELERATION WHERE WE'RE LOOKING
AT APPROPRIATION OF FRESH WATER,
PROLIFERATION OF CARS AND
TRUCKS, OR PRODUCTION AND USE OF
SYNTHETIC FERTILIZERS, PAPER
PRODUCTION, PLASTIC PRODUCTION,
ENERGY USE, THEY LOOK SIMILAR
WITH THIS STEEP INCREASE IN
TODAY'S CONSUMPTION RATES.
NEXT SLIDE.
NOT SURPRISINGLY, IF YOU LOOK AT
OUR IMPACT ACROSS OUR PLANET'S
NATURAL SYSTEMS YOU SEE AGAIN
VERY SIMILAR CURVES LOOKING AT
LOSS OF BIODIVERSITY OR
EXPLOITATION OF FISHERIES,
ADDITIONAL CARBON DIOXIDE TO THE
A ATMOSPHERE AND LOSS OF
FORESTS, THE NUMBER OF PEOPLE
THAT SHARE THE PLANET WITH US
HAS BEEN, AGAIN, VERY STABLE
THROUGH MOST OF HUMAN HISTORY,
GENTLE RISE THROUGH 1900, AND
THEN THIS EXTREMELY STEEP ALMOST
EXPONENTIAL GROWTH IN THE NUMBER
OF PEOPLE ON THE PLANET.
AND AT THAT SAME TIME, WE SAW AN
EVEN STEEPER INCREASE IN THE PER
CAPITA GDP, THE AMOUNT OF GOODS
AND SERVICES EACH OF US IS
ASKING OUR PLANET TO PROVIDE.
WHEN YOU MULTIPLY THE NUMBERS
AGAINST EACH OTHER YOU FIND THE
TOTAL SORT OF HUMAN IMPACT,
TOTAL GDP GROWTH GLOBALLY LOOKS
LIKE THIS ALMOST VERTICAL CURVE.
WE STAND TODAY ON THE TOP OF
THIS SORT OF VERTICAL CURVE IN
TOTAL CONSUMPTION.
NEXT SLIDE PLEASE.
THE SORT OF CORE ECOLOGICAL
FOOTPRINT OF HUMANITY, THE
COLLECTIVE IMPACT WE'RE HAVING
ON OUR PLANET'S NATURAL SYSTEMS,
IS REALLY HARD NOW TO OVERSTATE.
AS SONIA WAS SAYING WE USE 40%
OF TERRESTRIAL LAND SURFACE FOR
CROP LANDS AND PASTURE, 90 COMPS
OF WATER FOR DROPS.
WE'VE CUT DOWN AROUND HALF THE
TROPICAL AND TEMPERATE FORESTS
ON THE PLANET, DAMNED 60% OF
RIVERS, HAVING GROWING PROBLEM
OF GLOBAL SCALE POLLUTION OF
AIR, WATER, AND SOIL.
WE'RE DISRUPTING THE GLOBAL
CLIMATE SYSTEM.
ALL THESE MAJOR IMPACTS ON OUR
NATURAL SYSTEMS ARE NOW DRIVING
SPECIES EXTINCT AT A THOUSAND
TIMES THE BASELINE RATE.
THE POPULATION SIZE OF BIRDS,
MAMMALS, FISHES, REPTILES,
AMPHIBIANS, HAS FALLEN BY
TWO-THIRDS SINCE 1970, A MILLION
SPECIES ARE NOW FACING
EXTINCTION, MANY WITHIN THE NEXT
FEW DECADES.
NEXT SLIDE.
SO, THE CORE PROPOSITION OF THIS
FIELD OF PLANETARY HEALTH IS
THAT THE SIZE OF OUR TOTAL
FOOTPRINT, THAT EXCEEDS OUR
PLANET'S CAPACITIES TO EITHER
ABSORB WASTE OR PROVIDE
RESOURCES WE'RE USING
SUSTAINABLE.
AS A RESULT, OUR ACTIONS
COLLECTIVELY, ARE TRANSFORMING
NOT JUST CLIMATE SYSTEM BUT ALSO
DRIVING MASS EXTINCTION OF LIFE
ON EARTH, ALTERING BIOGEO
CHEMICAL CYCLES, CHANGING LAND
USE AND LAND COVER, DRIVING
SCARCITY OF RESOURCES LIKE FRESH
WATER AND ARABLE LAND, DRIVING
GLOBAL SCALE POLLUTION.
ALL THE COMPLEX BIOPHYSICAL
CHANGES THAT WE ARE MEDIATING IN
THE GLOBAL ENVIRONMENT ARE
INTERACTING WITH EACH OTHER IN
COMPLEX WAYS TO AFFECT
FOUNDATIONAL CONDITIONS FOR
HUMAN HEALTH AND WELL-BEING, THE
QUALITY AND QUANTITY OF FOOD
THAT WE PRODUCE, QUALITY OF AIR
WE BREATHE, OUR EXPOSURE TO
INFECTIOUS DISEASES, EXPOSURE TO
EXTREME WEATHER EVENTS, EVEN
HABITABILITY OF SOME PLACES WE
LIVE.
INCREASINGLY WE'RE SEEING LARGE
IMPACTS ACROSS EVERY DIMENSION
OF HUMAN HEALTH, AND OUR
TRANSFORMATION OF NATURE IS
LOOKING LIKE ONE OF THE PRIMARY
DRIVERS OF GLOBAL BURDEN OF
DISEASE OVER THE NEXT CENTURY.
NEXT SLIDE.
SO JUST AS WE HAVE SORT OF COME
TO UNDERSTAND OVER THE LAST
SEVERAL DECADES THAT THERE ARE
IMPORTANT SOCIAL AND CULTURAL
AND POLITICAL DETERMINANTS OF
HUMAN HEALTH, WE'RE COMING TO
UNDERSTAND THERE ARE VERY
IMPORTANT ECOLOGICAL
DETERMINANTS, THAT INDEED OUR
HEALTH IS NESTED IN A SET OF
BIOPHYSICAL CONNECTIONS AND THAT
THOSE ARE NOW CHANGING AT THE
FASTEST RATE IN THE HISTORY OF
OUR PLANET.
NEXT SLIDE PLEASE.
IN THE HISTORY OF OUR SPECIES,
NOT OUR SPECIES, I'M SORRY.
SO WHAT I THOUGHT I WOULD DO IS
TRY TO GIVE YOU A FEEL OF THE
DIVERSITY OF WAYS IN WHICH
BIOPHYSICAL CONDITIONS ARE
AFFECTING HEART DISEASE USING
SOME OF MY OWN GROUP'S RESEARCH
AND RESEARCH FROM OTHER GROUPS
AS WELL.
AND I WANT TO EMPHASIZE
SOMETHING THAT DAVID GOFF SAID
AT THE OUTSET, WHICH WAS THAT
NONE OF THE EFFECTS THAT I'M
GOING TO DESCRIBE TO YOU ARE
DIRECT EFFECTS OF CLIMATE CHANGE
PER SE.
DIRECT EFFECTS OF OTHER ASPECTS
OF BIOPHYSICAL CHANGE, SO WE
NEED A BROADER FRAME THAN JUST
CLIMATE CHANGE ALONE.
A FEW OTHER OVERARCHING POINTS
ARE, ONE, THAT MANY OF THESE
IMPACTS ARE REALLY SURPRISING,
THEY ARE NOT ONES WE NECESSARILY
WOULD HAVE ANTICIPATED.
TWO, THEY ARE OFTEN MEDIATED
THROUGH COMPLEX SYSTEMS AND,
THREE, THEY ARE UNEVENLY
DISTRIBUTED.
THEY TEND TO DISPROPORTIONATELY
IMPACT THE POOR AND FUTURE
GENERATIONS.
NEXT SLIDE.
SO HERE ARE A FEW EXAMPLES.
THIS IS WORK MY GROUP HAS DONE
IN WHICH WE'VE LOOKED AT THE
IMPACT OF RISING CONCENTRATIONS
OF CARBON DIOXIDE ON THE
NUTRIENT CONTENT OF STAPLE FOOD
CROPS.
USING THESE RINGS, ENRICHMENT
METHODOLOGY, ESSENTIALLY IS A
RING OF CARBON DIOXIDE-EMITTING
JETS, YOU CAN GROW CROPS INSIDE
THESE CIRCLES AT ELEVATED
CONCENTRATIONS OF CO2 THAT MIMIC
WHAT WE EXPECT THE WORLD TO LOOK
LIKE ABOUT THE MIDDLE OF THIS
CENTURY.
WHEN YOU DO THAT, YOU CAN
COMPARE CROPS AT HIGHER CO2 WITH
AMBIENT CO2 OUTSIDE THE RING BUT
OTHERWISE IDENTICAL FIELD
CONDITIONS AND SEE WHAT THE
ISOLATED EFFECT OF RISING CO2 IS
ON THOSE CROPS.
WHAT WE FOUND WHEN WE DID THAT,
NEXT SLIDE, WAS THAT INDEED
RISING CONCENTRATIONS OF CO2 ARE
ACTUALLY SIGNIFICANTLY REDUCING
THE AMOUNT OF REALLY IMPORTANT
NUTRIENTS IN STAPLE FOOD CROPS
LIKE WHEAT AND RICE.
NEXT SLIDE.
IN PARTICULAR, WHAT WE FOUND WAS
THAT IF WE ACTUALLY PROJECT
THOSE CHANGES ONTO DIETS OF
PEOPLE AROUND THE WORLD, ACROSS
150 COUNTRIES WE WOULD SEE
BETWEEN 150 AND 200 MILLION
PEOPLE PUSHED INTO NEW
DEFICIENCIES OF IRON, ZINC,
PROTEIN, AS A RESULT OF THIS CO2
MEDIATED EFFECT.
NEXT SLIDE PLEASE.
FROM A CARDIOVASCULAR
STANDPOINT, IT'S VERY
INTERESTING.
THIS IS SPECULATIVE BUT IT MAKES
US THINK ABOUT THE OMNI HEART
STUDY.
RIGHT NOW WHAT WE'RE DOING IS
THIS SORT OF GLOBAL EXPERIMENT
ON THE ENTIRE HUMAN DIET, WHERE
ESSENTIALLY WE'RE SUBSTITUTING
DIETARY STARCH OR CARBOHYDRATE
FOR DIETARY PROTEIN.
AND WE KNOW FROM THAT STUDY WHEN
WE DID THAT AT A LARGER SCALE,
STRONGER CONCENTRATION SHIFTS,
THAT THIS SHIFT FROM DIETARY
CARBOHYDRATE TO -- FROM PROTEIN
TO CARBOHYDRATE INCREASED RISK
OF CORE ANOTHER HEART DISEASE.
NOW WE'RE DOING SIMILAR
EXPERIMENT AT LOWER
CONCENTRATIONS, ON THE ENTIRE
GLOBAL POPULATION, AND IT IS
CONCERNING, WHAT MIGHT THE
IMPLICATIONS BE FOR
CARDIOVASCULAR HEALTH.
ANOTHER STUDY LOOKS AT CHANGES
IN INSECT POLLINATORS AFFECTING
GLOBAL HEALTH, ALSO PROTECTING
US FROM DISEASES LIKE HEART
DISEASE, STROKE, CANCER AND
DIABETES, AND WHEN WE LOOKED AT
THE GAP WE'RE ALREADY SEEING IN
FOOD PRODUCTION BECAUSE OF
INSUFFICIENT POLLINATORS
POPULATIONS, INSECT POPULATIONS
GLOBALLY HAVE BEEN DECLINING, WE
FOUND INEFFICIENT POPULATIONS
ARE REDUCING FRUIT, VEGETABLE,
NUT YIELDS BY 3 TO 5%.
WHEN WE LOOK AT THE NUTRITIONAL
EPIDEMIOLOGY RUNNING THAT
THROUGH THE IMPACT FOOD MODEL,
BIOECONOMIC MODEL, WHO WOULD
HAVE CONSUMED THOSE FOODS AND
WHAT THE IMPACTS WERE ON HEALTH,
WE FOUND ALMOST HALF A MILLION
DEATHS PER YEAR WE'RE SEEING
TODAY BECAUSE OF INCREASED HEART
DISEASE AS WELL AS OTHER
NON-COMMUNICABLE DISEASES AND WE
FOUND THESE SIGNIFICANT ECONOMIC
IMPACTS FOR LOWER INCOME
COUNTRIES.
NEXT SLIDE.
A THIRD AREA AROUND BIODIVERSITY
RELATES TO FISH CATCH.
THIS IS FROM SOMETHING WE
PUBLISHED A WHILE BACK THAT
SHOWED ABOUT A BILLION PEOPLE IN
THE WORLD ARE DEPENDING ON WILD
HARVESTED FISH TO GET ADEQUATE
INTAKES OF KEY NUTRIENTS,
INCLUDING OMEGA-3 FATTY ACIDS.
I DON'T KNOW IF YOU SAW THE
PAPER PUBLISHED IN NATURE
CLIMATE CHANGE LAST MONTH FROM
WILLIAM CHUNG'S GROUP, WE COULD
SEE 30% REDUCTION IN
SEAFOOD-BASED NUTRIENTS AS A
RESULT OF OCEAN WARMING AND BIG
CHANGES IN THE DISTRIBUTION OF
FISHERIES SO THAT IN COUNTRIES
PARTICULARLY AROUND THE TROPICS
WE COULD SEE REDUCED ACCESS TO
WILD HARVESTED FISH AND TO
NUTRIENTS INCLUDING OMEGA-3
FATTY ACIDS IMPORTANT FOR
CARDIOVASCULAR HEALTH AS A
RESULT OF SEA SURFACE WARMING.
NEXT SLIDE.
OF COURSE, INCREASED RISK AND
INTENSITY OF WILDFIRES AND
BIOMASS FIRES IS SOMETHING WE'RE
ALL AWARE.
WE'RE AWARE LAST SUMMER WHEN AIR
QUALITY IN WASHINGTON, D.C. AND
ALL ALONG THE EASTERN SEABOARD
DETERIORATED DRAMATICALLY AS A
RESULT OF THE CANADIAN
WILDFIRES.
WE'VE DONE RESEARCH IN INDONESIA
LOOKING AT THE CONNECTIONS
BETWEEN LAND USE DECISIONS
THERE, HOW THAT CHANGES THE RISK
OF THE FIRES THAT CREATE BIG
HAZE EPISODES, WHAT THE
EMISSIONS OF THOSE FIRES ARE
FROM A CHEMICAL STANDPOINT AND
HOW THEY CHANGE AS THEY MOVE
THROUGH SPACE AND TIME, AND
ULTIMATELY WHAT THE POPULATION
LEVEL PARTICULATE EXPOSURES ARE
FROM THE FIRES IN INDONESIA.
WHAT WE FOUND, NEXT SLIDE,
CUMULATIVELY WE ANTICIPATE
36,000 EXCESS DEATHS EVERY YEAR
INTO THE NEXT SEVERAL DECADES,
AS A RESULT OF THESE LAND USE
DECISIONS AND FIRES IN
INDONESIA, BUT IMPORTANTLY
ALMOST 2/3 COULD BE PREVENTED
WITH AGGRESSIVE PEATLANDS
RESTORATION IN INDONESIA.
THIS IS A PAPER WE WORKED ON
WITH THE INDONESIAN GOVERNMENT.
IN WORK I WAS NOT INVOLVED IN,
ANOTHER INTERESTING EXAMPLE WAS
SHOWING THAT CHANGES IN WATER
RESOURCE MANAGEMENT COMBINED
WITH SEA LEVEL RISE AND MORE
EXTREME STORMS ARE LEADING TO
SALT WATER INTRUSION UP THROUGH
THE BAY OF BENGAL AND INTO
COASTAL AQUIFERS IN BANGLADESH.
THE SALINITY IN GROUND WATER IN
THESE COASTAL REGIONS AS IT
RISES HAS BEEN DIRECTLY
CORRELATED BOTH WITH ECLAMPSIA
IN PREGNANT WOMEN AND
HYPERTENSION ACROSS THE ADULT
POPULATION, INTERESTING
CONNECTION BETWEEN SEA LEVEL
RISE, WATER RESOURCE MANAGEMENT,
HYPERTENSION IN THOSE
POPULATIONS.
NEXT SLIDE.
AND THEN FINALLY, POLLUTION
ITSELF.
IF YOU CAN GO BACK TO THE SLIDE
BEFORE.
THANK YOU.
POLLUTION ITSELF AS WE LEARNED
FROM THE GLOBAL POLLUTION AND
HEALTH STUDY IN " THE LANCET" A
FEW YEARS AGO IS DRIVING 9
MILLION DEATHS A YEAR.
WHEN YOU LOOK AT THE COMPOSITION
OF THOSE DEATHS, MOST OF THEM
ARE FROM AIR POLLUTION, A HUGE
CHUNK OF THE MORBIDITY AND
MORTALITY ASSOCIATED WITH GLOBAL
POLLUTION RELATES TO CARDIAC AND
LUNG DISEASE OVERALL.
NEXT SLIDE.
SO, I THINK WHAT'S REALLY
INTERESTING ABOUT THIS, RIGHT,
IS THAT, YOU KNOW, ALL OF THESE
DIFFERENT KINDS OF BIOPHYSICAL
CHANGE IN WAYS THAT AREN'T
NECESSARILY INTUITIVE OR THAT WE
WOULDN'T NECESSARILY HAVE
ANTICIPATED ARE ACTUALLY
AFFECTING CARDIOVASCULAR
DISEASE, FROM THE AMOUNT OF CO2
IN THE ATMOSPHERE TO LOSSES OF
BIODIVERSITY AND INSECT
POPULATION, TO CHANGES IN SEA
SURFACE TEMPERATURES, AND ACCESS
TO FISH IN THE DIET, TO LAND USE
DECISIONS THAT RELATE TO BIOMASS
FIRES, TO SEA LEVEL RISE, TO
POLLUTION, AND SO THERE ARE A
WHOLE HOST OF WAYS, AGAIN,
INDEPENDENT OF CLIMATE CHANGE
THAT OUR OWN SORT OF
TRANSFORMATION OF OUR PLANET'S
NATURAL SYSTEMS ARE ACTUALLY
IMPACTING RISKS OF
CARDIOVASCULAR DISEASE AND AS I
MENTIONED MANY OF THESE ARE
SURPRISING.
MANY OF THEM ARE MEDIATED
THROUGH COMPLEX SYSTEMS WHICH
MAKES THEM HARD TO EVALUATE AND
HARD TO ANTICIPATE.
THE IMPACTS WILL BE UNEVENLY
DISTRIBUTED AROUND THE WORLD,
WHICH IS REALLY IMPORTANT IN
COMMON THEME.
ONE OTHER THING INTERESTING,
THESE WILL BE UNACCOUNTED FOR.
NO ONE WILL HAVE SEA LEVEL RISE
OR BIODIVERSITY LOSS ON THEIR
DEATH CERTIFICATE.
AND YET, THESE BIOPHYSICAL
CHANGES ARE RESPONSIBLE FOR VERY
LARGE BURDENS OF DISEASE AROUND
THE WORLD.
NEXT SLIDE.
ANOTHER REALLY IMPORTANT POINT
AND SANJAY MENTIONED THIS
BRIEFLY BEFORE IS THAT THERE ARE
VERY IMPORTANT CO-BENEFITS
ASSOCIATED WITH ADDRESSING THE
EARTH CRISIS THAT WE FACE.
MANY THINGS WE NEED TO DO TO
ADDRESS THE EARTH CRISIS, BOTH
CLIMATE AND OTHER KINDS OF
ENVIRONMENTAL CHANGE, ALSO HAVE
CARDIOVASCULAR BENEFITS.
SO WE KNOW THAT SWITCHING AWAY
FROM AN ANIMAL-BASED DIET TO
MUCH MORE PLANT-BASED DIETS HAS
HUGE BENEFITS IN TERMS OF
CLIMATE CHANGE AND TOTAL
ECOLOGICAL IMPACT ON LAND, ON
WATER, BIODIVERSITY, ET CETERA.
BUT ALSO AT LEAST ON WEALTHIER
POPULATIONS SIGNIFICANT
CARDIOVASCULAR BENEFITS.
WE KNOW POLICIES TO ENCOURAGE
ACTIVE TRANSFER, WALKING AND
BIKING, GETTING AROUND 15-MINUTE
CITIES, WORKING AROUND
NEIGHBORHOODS, BUILDING OUR
CITIES SO THAT THEY ARE DESIGNED
FOR PEOPLE AND NOT FOR CARS, HAS
HUGE BENEFITS FROM A CLIMATE
STANDPOINT BUT ALSO HAS VERY
SIGNIFICANT CARDIOVASCULAR
BENEFITS.
AGAIN, THE TRANSITION TO
RENEWABLE ENERGY CLEARLY HAS
MAJOR CO-BENEFITS, HOPEFULLY
MANY OF YOU SAW THE "SCIENCE"
PAPER LAST MONTH THAT SHOWED
ALMOST HALF A MILLION DEATHS
OVER THE LAST 20 YEARS IN THE
UNITED STATES FROM COAL-FIRED
POWER PLANTS ALONE, PARTICLES
COMING OUT OF THOSE PLANTS, AND
SO THE TRANSITION AWAY FROM
FOSSIL FUEL COMBUSTION AND
TOWARD RENEWABLE ENERGY HAS
SIGNIFICANTLY -- HAS
SIGNIFICANTLY CO-BENEFITS.
AND THOSE ARE THE SORT OF DIRECT
EFFECT OF THESE POLICIES, BUT
THERE ARE OTHER KINDS OF
POLICIES THAT INVOLVE ADDRESSING
THE EARTH CRISIS, THINGS AS I
MENTIONED LIKE PEATLANDS
RESTORATION, BIODIVERSITY
CONSERVATION, PLANTING HEDGE
ROWS, MAINTAINING COVER,
REDUCING PESTICIDES THAT WILL
IMPROVE POLLINATORS WILL HAVE
IMPACTS ON CARDIOVASCULAR
HEALTH.
SO IN TERMS OF RESEARCH GAPS AND
PRIORITIES, I WOULD EMPHASIZE
WHAT WAS SAID AT THE BEGINNING
THAT WE NEED TO DO A BETTER JOB
OF MEASURING CARDIOVASCULAR
IMPACTS OF THESE DIFFERENT KINDS
OF BIOPHYSICAL CHANGES.
THESE ARE EXAMPLES OF INITIAL
STUDIES BUT THERE'S SO MUCH TO
UNDERSTAND ABOUT CHANGES IN
QUALITY AND QUANTITY OF FOODS IN
THE DIET, CHANGES IN FIRES, RISK
OF WILDFIRES, AIR QUALITY, HOW
RISING TEMPERATURES ARE GOING TO
AFFECT PEOPLE'S CAPACITY FOR
EXERCISE, WHAT THAT MEANS FOR
CARDIOVASCULAR RISK, THINGS LIKE
STRESS AND ANXIETY, AND THEIR
ROLES ON CARDIOVASCULAR DISEASE,
SO THERE'S A LOT WE NEED TO
UNDERSTAND BETTER TOWARDS THAT
QUESTION OF ATTRIBUTION.
I THINK IT'S IMPORTANT TO
MEASURE THE CARDIOVASCULAR
BENEFITS OF POLICY AND PRACTICE
INTERVENTIONS BECAUSE WE'RE
COMING TO A MOMENT WHERE WE'RE
AGGRESSIVELY TRYING TO ADDRESS
THE EARTH CRISIS AND NEED TO
UNDERSTAND HOW TO OPTIMIZE
HEALTH BENEFITS ASSOCIATED WITH
POLICIES WE'RE CONSIDERING AND
INTERVENTIONS.
SO HOW DO CHANGES IN ENERGY,
FOOD SYSTEMS, LAND USE, ET
CETERA, IMPROVE CARDIOVASCULAR
HEALTH, HOW DO WE REDUCE
VULNERABILITY TO CHANGING
BIOPHYSICAL CONDITIONS WITH
THINGS LIKE WATER RESOURCE
MANAGEMENT, PROTECTION FROM
HEAT, BETTER FIRE MANAGEMENT.
THERE'S A LOT TO UNDERSTAND HOW
POTENTIAL INTERVENTIONS THAT
WE'RE CONSIDERING WILL AFFECT
CARDIOVASCULAR HEALTH DOWN THE
ROAD.
NEXT SLIDE.
SO, FINALLY, I WELCOME ANY AND
ALL OF YOU TO JOIN THE PLANETARY
HEALTH ALLIANCE.
THIS IS A GLOBAL COMMUNITY OF
OVER 400 ORGANIZATIONS FROM 68
COUNTRIES NOW REALLY WORKING ON
ISSUES OF PLANETARY HEALTH.
THERE ARE A WHOLE VARIETY OF
WAYS TO BE ENGAGED.
WITH THAT I'LL CLOSE AND THANK
YOU SO MUCH.
>> THANK YOU, SAM, FOR THAT
REALLY BRILLIANT LECTURE AND
KICKING SESSION 1 OFF.
FOR THE AUDIENCE, PLEASE FIRE UP
YOUR QUESTIONS AND WE'LL HAVE A
VERY ROBUST SESSION WITH DR.
SOLOMON AT THE END OF SESSION 1,
A VIGOROUS DISCUSSION AND
HOPEFULLY YOU'RE PLANNING YOUR
QUESTIONS.
I'D LIKE TO INTRODUCE A SECOND
SPEAKER, DR. ANNA DIEZ ROUX,
SHE'S THE DISTINGUISHED
UNIVERSITY PROFESSOR OF
EPIDEMIOLOGY, DREXEL UNIVERSITY,
DIRECTS THE DREXEL URBAN HEALTH
COLLABORATIVE, AND SHE WAS A
FORMER DEAN OF THE SCHOOL OF
PUBLIC HEALTH FROM 2013 TO 2023.
THANK YOU, AGAIN, ANNA, LOOK
FORWARD TO YOUR TALK.
>> THANK YOU FOR HAVING ME.
GOOD MORNING.
IT'S GREAT TO BE PART OF THIS
SESSION, GREAT TO SEE NHLBI
TAKING ON LEADERSHIP LEADING
THIS KIND OF THINKING.
SO THANK YOU VERY MUCH.
I THINK WE CAN TRANSITION TO MY
FIRST SLIDE.
SO, NEXT SLIDE.
I WILL TRY TO ACCOMPLISH THREE
THINGS IN THIS PRESENTATION.
I'D LIKE TO JUST BRIEFLY REVIEW
SOME KEY CONCEPTS AND
UNDERSTANDING INEQUITIES AND
CARDIOVASCULAR DISEASE BECAUSE I
THINK THEY ARE RELEVANT TO ALSO
UNDERSTANDING THE NEXT POINT,
WHICH IS PLACING CARDIOVASCULAR
INEQUITIES IN A PLANETARY HEALTH
CONTEXT.
FINALLY, I'LL HAVE A FEW
REFLECTIONS, BRIEF REFLECTIONS,
ON SOME OPPORTUNITIES FOR
RESEARCH.
NEXT SLIDE.
KEY CONCEPTS IN UNDERSTANDING
INEQUITIES IN CARDIOVASCULAR
DISEASE.
NEXT.
SO, IT'S NO NEWS TO THIS GROUP
THAT CARDIOVASCULAR DISEASES ARE
STRONGLY AND PER VASIVELY
SOCIALLY PATTERNED, I INCLUDE
THREE EXAMPLES HERE.
ON THE LEFT SIGNIFICANT
DIFFERENCES IN CARDIOVASCULAR
DISEASE MORTALITY BY EDUCATION,
ON THE RIGHT PANEL OF THE LEFT
MOST FIGURE, CARDIOVASCULAR
DISEASE AND MORTALITY IS TWICE
AS HIGH IN THE LOWEST EDUCATION
COMPARED TO HIGHEST EDUCATION
GROUP.
LARGE DIFFERENCES BY RACE
BETWEEN BLACKS AND WHITES, IN
PARTICULAR IN THE UNITED STATES
AND MIDDLE PANEL DESPITE
DECLINING RATES OVER TIME IN
BOTH GROUPS, SOME STABILIZATION
IN RECENT YEARS.
ON THE RIGHT THE ASSOCIATION
BETWEEN COUNTY IN CARDIOVASCULAR
DISEASE MORTALITY, COUNTIES IN
HIGHEST QUARTILE OF
CARDIOVASCULAR DISEASE AND
MORTALITY RATES ARE
SIGNIFICANTLY MORE DEPRIVED IN
MANY WAYS THAN THOSE IN THE
LOWER -- THE CATEGORY OF THE
LOWER RATES.
NEXT SLIDE.
SO, THE DRIVERS OF THESE
INEQUITIES ARE MULTI-LEVEL AND
LIFE COURSE.
AND OPERATE THROUGH MULTIPLE
PATHWAYS.
WE HAVE FOUR EXAMPLES OF
CONCEPTUAL MODELS THAT HELP US
UNDERSTAND DRIVERS OF INEQUITIES
IN HEALTH, BUT IN CARDIOVASCULAR
DISEASE TOO.
IMPACT OF MULTIPLE LEVELS OF
INFLUENCE ON THE LEFT, ROLE OF
DIFFERENT PATHWAYS, BEHAVIORS,
BIOLOGICAL FACTORS, DIRECT
EXPOSURES, AS WELL.
THE LIFE COURSE DIMENSION ON THE
BOTTOM LEFT, AND ALSO THE
DISTINCTION BETWEEN WHAT
SOMETIMES ARE CALLED BASIC OR
FUNDAMENTAL CAUSES LIKE
STRUCTURAL INEQUALITY AND
RACISM, AND MORE SPECIFIC,
QUOTE, SURFACE CAUSES THROUGH
WHICH THESE THINGS OPERATE.
NEXT SLIDE.
SO, THE OTHER KEY POINT THAT I
WANTED TO MAKE IS THAT THE
ENVIRONMENT BROADLY DEFINED IS
CRITICAL TO CARDIOVASCULAR
DISEASE INEQUITIES.
THIS SHOWS EXAMPLE OF
NEIGHBORHOOD DIFFERENCES IN
CARDIOVASCULAR DISEASE, HOW
ECONOMIC INEQUALITY AND RACISM
DRIVE RESIDENTIAL SEGREGATION
WHICH REINFORCES INEQUALITIES
AND POWER AND RESOURCE
DISTRIBUTION, THAT GENERATES
DIFFERENCES IN ENVIRONMENTS,
PHYSICAL AND SOCIAL
ENVIRONMENTS, WHICH IN TURN
REINFORCE EACH OTHER.
AND AFFECT BEHAVIOR AND
BIOLOGICAL MEDIATORS AND STRESS
PROCESSES WHICH ALSO REINFORCE
EACH OTHER AND LEAD TO
CARDIOVASCULAR DISEASE.
AND I WANT TO HIGHLIGHT THE
ENVIRONMENT ENCOMPASSES PHYSICAL
AND SOCIAL DOMAINS, THE
ENVIRONMENTAL FACTORS CLUSTER
AND INFLUENCE EACH OTHER, AND
THE ENVIRONMENT OPERATES THROUGH
MULTIPLE INTERRELATED PATHWAYS.
AND MORE BROADLY, WE CAN THINK
OF THIS, YOU KNOW, SCHEMATIC
NEIGHBORHOOD SYSTEM THAT I'VE
PUT INTO THE SLIDE AS ITSELF
NESTED WITHIN A BROADER
ENVIRONMENTAL SYSTEM, WHICH
INCLUDES ASPECTS THAT ARE
GLOBAL, AS SAM WAS REFERRING TO
IN HIS PRIOR PRESENTATION.
NEXT SLIDE.
AND THE FOURTH POINT I WANT TO
MAKE ABOUT HEALTH INEQUITIES
WHICH ALSO INTERSECTS WITH SOME
OF THE THINGS THAT SAM WAS
SAYING ABOUT THE COMPLEXITIES IN
SYSTEMS, IS THAT HEALTH
INEQUITIES EMERGE FROM DYNAMIC
SYSTEMS.
SO, THEY INVOLVE FACTORS AT
MULTIPLE LEVELS, UNITS THROUGH
NORMS, SOCIAL NEIGHBORHOODS
INFLUENCE EACH OTHER AS WELL.
THERE ARE MANY RECURSIVE
RELATIONSHIPS AND FEEDBACK
LOOPS.
WE'LL HEAR MORE FROM PETER.
THERE ARE CONDITIONAL EFFECTS,
THE IMPACT OF A PARTICULAR
FACTOR DEPENDS ON THE CONDITION
OF OTHER FACTORS IN THE SYSTEM.
THERE ARE NON-LINEAR EFFECTS,
THINGS THAT HAPPEN IN
UNANTICIPATED PLACES, DISTANT IN
SPACE AND TIME.
UNANTICIPATED EFFECTS, SOMETIMES
WE CAN HAVE MULTIPLE PATHS TO
THE SAME OUTCOME.
PEOPLE GET CARDIOVASCULAR
DISEASE FROM MANY PATHWAYS AND
MANY REASONS.
BUT AT THE SAME TIME, WE ALSO
HAVE SIMILAR DISCAL CAUSES OF
MULTIPLE OUTCOMES AS WELL.
ALL OF THIS LEADS TO EMERGENT
PATTERNS NOT EASILY REDUCIBLE TO
INTERDEPENDENTENT EFFECT.
WHEN WE THINK HOW THIS INTERSECT
WAS PLANETARY HEALTH WE NEED TO
THINK ABOUT THIS SYSTEMIC
DRIVERS OF INEQUITIES AND HOW
THE BROADENING OF OUR SYSTEM TO
ENCOMPASS PLANETARY FACTORS
HELP, YOU KNOW, HELPS US
UNDERSTAND, INTERFACES WITH
SOCIAL SYSTEMS.
NEXT SLIDE.
SO THIS IS A SUMMARY OF THE FOUR
POINTS THAT I MADE.
ENVIRONMENT IS A CRITICAL DRIVER
AND ROLE OF DYNAMIC SYSTEMS.
NEXT SLIDE.
NEXT IS SHARE IDEAS HOW
CARDIOVASCULAR INEQUITIES CAN BE
SEEN WITHIN A PLANETARY HEALTH
CONTEXT ARRIVED AROUND FIVE
FUNDAMENTAL LINKS.
NEXT SLIDE.
SO THE FIRST LINK IS THAT THERE
ARE SOCIAL INEQUITIES IN
EXPOSURES LINKED TO GLOBAL
ENVIRONMENTAL CHANGE.
THESE EXPOSURES RELATED TO
GLOBAL ENVIRONMENTAL CHANGE ARE
NOT EVENLY DISTRIBUTED.
NEXT SLIDE.
THESE ARE SOME EXAMPLES.
THIS IS AN EXAMPLE OF A PAPER
JUST A FEW YEARS AGO ON PM2.5
EXPOSURES, WHICH WAS QUITE
INTERESTING BECAUSE OF THE
APPROACH IT TOOK.
ON THE TOP LEFT YOU CAN SEE
SOMETHING DESCRIBED IN MANY
PAPERS, SOCIAL GROUPS IN THIS
CASE PEOPLE OF COLOR EXPERIENCE
GREATER THAN AVERAGE EXPOSURES
FROM SOURCE TYPES CAUSING 75% OF
OVERALL EXPOSURE TO PM2.5.
ALMOST EVERY SOURCE RESULTS IN
DIFFERENTIAL EXPOSURE BY WHICH
PEOPLE OF COLOR HAVE HIGHER
EXPOSURES THAN WHITE PEOPLE.
BUT THIS PAPER WENT FURTHER AND
ALSO EXAMINED THE DRIVERS,
CONTRIBUTORS TO PM2.5, AND FOUND
THAT, FOR EXAMPLE, NON-HISPANIC
WHITES EXPERIENCED SO-CALLED
POLLUTION ADVANTAGE BECAUSE THEY
EXPERIENCE 17% LESS EXPOSURE
THAN IS CAUSED BY THEIR OWN
CONSUMPTION.
BLACK AND HISPANIC POPULATIONS
WERE EXPOSED TO ABOUT 56 TO 63%
MORE PM2.5 POLLUTION THAN IS
CAUSED BY THEIR OWN CONSUMPTION.
SO LOOKING MORE DYNAMICALLY,
STARTING TO LOOK MORE
SYSTEMICALLY AT THE DRIVERS OF
THIS AND WHO SUFFERS THE
CONSEQUENCE OF THESE EXPOSURES.
NEXT SLIDE.
ANOTHER EXAMPLE OF DIFFERENTIAL
DISTRIBUTION, SOCIAL
DISTRIBUTION, OF GLOBAL
ENVIRONMENTAL CHANGE RELATED
EXPOSURES IS ON THIS SLIDE.
YOU MAY HAVE SEEN THERE'S BEEN
MANY PUBLICATIONS ON THIS,
LOOKING, FOR EXAMPLE, AT
ASSOCIATIONS BETWEEN LAND
SURFACE TEMPERATURE AND
HISTORICAL PRACTICES OF RED
LINING IN THE UNITED STATES, AND
THIS RELATIONSHIP SHOWING HOW
THERE ARE HIGHER LAND SURFACE
TEMPERATURES IN NEIGHBORHOODS
THAT WERE REDLINED.
AND THE CATEGORY, THE
DESIRABILITY, SO-CALLED, OF THE
AIR IS RELATED ALMOST IN A
DOSE-RESPONSE RELATIONSHIP, MANY
PATHWAYS THROUGH WHICH THESE
CONTINUE TO THIS DAY.
ON THE RIGHT AN EXAMPLE FROM
"NEW YORK TIMES" A COUPLE YEARS
AGO SHOWING ONE OF THE
MECHANISMS THAT COULD LEAD TO
THESE DIFFERENCES THAT HAS TO DO
WITH REMARKABLE DIFFERENCES IN
THIS CASE IN TREE COVER, ACROSS
NEIGHBORHOODS OF DIFFERENT
INCOMES IN FOUR CITIES.
NEXT SLIDE.
SO IN ADDITION TO SOCIAL
INEQUITIES IN THE DISTRIBUTION
OF THESE CLIMATE CHANGE OR IN
GENERAL GLOBAL ENVIRONMENTAL
CHANGE-RELATED EXPOSURES, THERE
HAS BEEN A LOT OF DISCUSSION ON
HOW THE IMPACT OF THESE
EXPOSURES ON HEALTH CAN BE
MODIFIED BY THE CONTEXT,
INCLUDING SOCIAL CIRCUMSTANCES.
SOCIAL INEQUITIES IN THE EFFECTS
OF THESE EXPOSURES ON
CARDIOVASCULAR DISEASE RISK, FOR
EXAMPLE, AND THIS IS AN EXAMPLE
OF A CONCEPTUAL MODEL PUBLISHED
BY GRONLUND MANY YEARS AGO BUT
STILL USEFUL TODAY THINKING
THROUGH HOW RACIAL AND
SOCIOECONOMIC CHARACTERISTICS
MODIFY THE -- COULD MODIFY THE
IMPACT OF HEAT, FOR EXAMPLE, ON
ADVERSE -- ON HEALTH OUTCOMES.
NEXT SLIDE.
AND THERE HAS BEEN DOCUMENTATION
OF THESE SYNERGISMS AND
HETEROGENEOUS IMPACTS.
ON THE TOP YOU CAN SEE IMPACT OF
HEAT ON NEW YORK CITY
NEIGHBORHOODS.
YOU CAN SEE THIS PAPER IS ALMOST
TEN YEARS OLD.
AND SHOWING THAT THE MORTALITY
RATE RATIOS FOR HOT DAYS AMONG
OLDER ADULTS ASSOCIATED WITH
HEAT WERE SIGNIFICANTLY LARGER
THAN IN WEALTHIER NEIGHBORHOODS.
BELOW A MORE RECENT PAPER
SHOWING HOW PROJECTED ESTIMATED
EXCESS CARDIOVASCULAR DEATHS
ASSOCIATED WITH EXTREME HEAT IN
THE FUTURE COMPARED TO THE
CURRENT PERIOD, THE PROJECTION
SHOWED WE WERE GOING TO EXPECT A
GREATER IMPACT AMONG BLACK
PERSONS, AMONG AREAS -- PEOPLE
LIVING IN METROPOLITAN COMPARED
TO NON-METROPOLITAN COUNTIES.
HETEROGENEITY IN IMPACT OF THESE
EXPOSURES ON HEALTH.
NEXT SLIDE.
IN ADDITION TO DIFFERENTIAL
EFFECTS, GLOBAL ENVIRONMENTAL
CHANGE INTERSECTS WITH MULTIPLE
PATHWAYS THAT LEAD TO SOCIAL
DIFFERENCES IN CARDIOVASCULAR
DISEASE.
SO HERE I'VE PUT IN A CONCEPTUAL
MODEL DEVELOPED 20 YEARS AGO, MY
GOD, ON THE IMPACT OF
NEIGHBORHOODS ON CARDIOVASCULAR
DISEASE, ARTICULATING POTENTIAL
PATHWAYS.
HIGHLIGHTING IN RED ALL THE
AREAS WHERE PLANETARY
HEALTH-RELATED EXPOSURES FOR
GLOBAL ENVIRONMENTAL
CHANGE-RELATED EXPOSURES
INTERSECT WITH THESE PATHWAYS
AND CAN HAVE IMPACTS ON
CARDIOVASCULAR DISEASE
INEQUITIES THROUGH THEIR
RELATIONSHIP WITH THESE
PATHWAYS.
THERE ARE MANY MORE HERE BECAUSE
OF THIS MODEL COULD BE EXPANDED,
BUT MULTIPLICITY OF PATHWAYS
THROUGH WHICH THESE EFFECTS CAN
OPERATE TO CONTRIBUTE TO SOCIAL
INEQUALITIES IN CARDIOVASCULAR
DISEASE.
NEXT SLIDE.
IN ADDITION TO THIS, I THINK
IT'S ALSO IMPORTANT TO REMEMBER
THAT GLOBAL ENVIRONMENTAL CHANGE
IS ALSO A DRIVER OF UPSTREAM
PROCESSES THAT INTERACT WITH
SOCIAL INEQUALITY TO IMPACT
CARDIOVASCULAR DISEASE INEQUITY.
EVEN A MORE MACRO AND DISTAL
PERSPECTIVE.
NEXT SLIDE.
TWO EXAMPLES OF WHAT I MEAN BY
THIS.
SO DISRUPTION IN FOOD SYSTEM, SO
DISRUPTION TO FOOD SYSTEMS
RELATED GLOBAL ENVIRONMENTAL
CHANGE ARE RELATED TO THINGS
LINING REDUCTIONS IN ARABLE LAND
PER CAPITA, SOIL LOSS, HEAT
WAVES, INCREASE IN CO2,
REDUCTION IN BIODIVERSITY, NEW
PEST PATHOGENS, ALL THOSE THINGS
INFLUENCE TYPE AND AMOUNT OF
FOODS PRODUCED, INCLUDING SHIFTS
TOWARDS ULTRA PROCESSED AND
ANIMAL FOODS, LESS
MICRONUTRIENTS, INTERSECT WITH
COMMERCIAL DRIVERS, HAVE
DIFFERENTIAL IMPACTS BY COUNTRY
AND ALSO ACROSS SOCIAL GROUPS
WITHIN A COUNTRY.
HERE WE HAVE A MACRO CHANGE,
WHICH INTERACTS CAN SOCIAL
SYSTEMS AND ECONOMIC INEQUALITY
AND RACISM, AND TRANSLATES INTO
GREATER INEQUITIES.
NEXT SLIDE.
THIS IS ANOTHER EXAMPLE,
DISPLACEMENT AND MIGRATION.
WE KNOW THAT GLOBAL
ENVIRONMENTAL CHANGE CAN RESULT
IN FORCED DISPLACEMENTS AND
MIGRATION.
AND THESE THINGS ALSO ARE DRIVEN
BY POLITICAL INSTABILITY AND
PERSECUTION, RACISM, POVERTY,
IMPACT ACCESS TO RESOURCES AND
EXPOSURE TO ENVIRONMENTAL
EXPOSURE RELATED TO CHANGES IN
NORMS OF BEHAVIORS ASSOCIATED
WITH MIGRATION AND URBANIZATION,
HAVE MENTAL HEALTH AND
PSYCHOSOCIAL IMPACTS AND CAN
AFFECT HEALTH CARE ACCESS WITH
IMPLICATIONS FOR CARDIOVASCULAR
HEALTH.
NEXT SLIDE.
AND THE FIFTH LINK BETWEEN A
GLOBAL ENVIRONMENTAL CHANGE AND
CARDIOVASCULAR DISEASE HAS TO DO
WITH SOCIAL INEQUALITIES IN
ABILITY TO AVOID OR ADAPT TO
GLOBAL ENVIRONMENTAL CHANGE.
THIS IS ONE EXAMPLE.
THIS IS FROM A PAPER PUBLISHED A
COUPLE YEARS AGO DESCRIBING THE
PENETRATION OF AIR CONDITIONING
BY ANNUAL HOUSEHOLD INCOME AND
COOLING DEGREE DAYS, BASICALLY
HOW HOT THE DAY IS ACROSS 16
COUNTRIES, AND ON THE Y-AXIS IS
ANNUAL HOUSEHOLD INCOME, ON THE
X-AXIS IS HOW HIGH THE
TEMPERATURE IS.
WHAT YOU CAN SEE IS THAT THE --
IF YOU LOOK ACROSS INCOME
CATEGORIES, AT THE HIGHEST
INCOME PENETRATION OF AIR
CONDITIONING IS HIGH ACROSS
ALMOST THE FULL DISTRIBUTION OF
COOLING DEGREE DAYS, WHEREAS AT
THE LOWER INCOME LEVELS THE
PENETRATION OF AIR CONDITIONING
IS MUCH LOWER.
SO, OF COURSE, WE COULD DISCUSS,
YOU KNOW, HOW BENEFICIAL IS IT
GLOBALLY TO INCREASE AIR
CONDITIONING, BUT IT IS COMMON
ADAPTATION STRATEGY, FOR
EXAMPLE, TO HEAT AND WE CAN SEE
IN THIS FIGURE THAT IT IS VERY,
VERY INEQUITABLE DISTRIBUTED.
NEXT SLIDE.
SO, THESE ARE THE FIVE LINKS,
THERE MAY BE MANY OTHERS, BUT
OCCURRED DO ME IN TERMS OF
CONNECTING CARDIOVASCULAR
DISEASE INEQUITIES AND PLANETARY
INEQUITIES, EXPOSURES, IMPACT OF
GLOBAL ENVIRONMENTAL CHANGE ON
MULTIPLE PATHWAYS TO CVD
INEQUITIES, GLOBAL ENVIRONMENTAL
CHANGE AS DRIVER OF PROCESSES
THAT INTERACT, AND SOCIAL
INEQUITIES AND ABILITY TO AVOID
OR ADAPT TO GLOBAL ENVIRONMENTAL
CHANGE.
NEXT SLIDE.
SO I HAVE TWO QUICK SLIDES ON
SOME IDEAS FOR RESEARCH NEEDS IN
THIS AREA.
NEXT SLIDE.
SO, I THINK FIRST THERE IS STILL
A LOT OF USEFUL WORK THAT CAN BE
DONE IN TERMS OF DESCRIBING AND
QUANTIFYING IMPACT OF GLOBAL
ENVIRONMENTAL CHANGE ON
CARDIOVASCULAR DISEASE
INEQUITIES.
I THINK DESCRIPTION PARTICULARLY
IF IT'S DONE IN A WAY THAT
YIELDS NEW INSIGHTS JUST LIKE
THAT PM2.5 PAPER I THINK DID CAN
STILL BE A VERY POWERFUL
MOTIVATOR OF ACTION AND I THINK
WE STILL NEED IT.
SO, DISTRIBUTION OF ADVERSE
EXPOSURES, DIFFERENTIAL IMPACTS
OF EXPOSURES BY SOCIAL
CONDITIONS, HOW THESE
DIFFERENTIAL EXPOSURES CAN
CONTRIBUTE TO CVD INEQUITIES AND
CHANGES OVER TIME.
WITH SPECIAL ATTENTION TO
CLUSTERING CUMULATIVE AND
INTERACTIVE EFFECTS AND
DYNAMICS, SYSTEMIC NATURE OF
THESE PROCESSES.
AND MY FINAL SLIDE ALSO ABOUT
RESEARCH, MOVE ON, SORRY, IS
ALSO RESEARCH THAT CONNECTING
SOMETHING WAS SAM WAS SAYING AS
WELL.
RESEARCH ON THE EVALUATION OF
POLICIES AND INTERVENTIONS.
SO, HEALTH AND CARDIOVASCULAR
DISEASE CO-BENEFITS OF
MITIGATION AND ADAPTATION
POLICIES FROM THE POINT OF VIEW
OF EQUITY.
SO EVALUATING THE EQUITY
IMPACTS, USING NATURAL
EXPERIMENTS, USING SIMULATION,
THINGS LIKE HEALTH IMPACT
ASSESSMENT, A
STAKEHOLDER-ENGAGED AND
EQUITY-FOCUSED APPROACH TO
EVALUATION OF POTENTIAL
POLICIES, FOCUSING ON INEQUITIES
AND DIFFERENTIAL IMPACT BY
SOCIAL GROUPS INCLUDING
BENEFICIAL AND ADVERSE IMPACTS
BECAUSE SOME OF THESE ADAPTATION
AND MITIGATION STRATEGIES CAN
HAVE UNINTENDED ADVERSE
IMPACTION.
SOMETHING WE HAVE TO EXPLORE AND
DOCUMENT.
THAT'S MY LAST SLIDE.
THANK YOU AND LOOK FORWARD TO
THE DISCUSSION.
>> YOU NAILED A NUMBER OF ISSUES
SO IMPORTANT IN OUR DISCUSSION.
REMINDER, PLEASE DO JOT DOWN
YOUR QUESTIONS AND HOPEFULLY ALL
OF YOU WILL PARTICIPATE IN A
VERY ROBUST DISCUSSION SESSION
AT THE END.
IT'S MY PLEASURE TO INTRODUCE
NEXT SPEAKER DR. PETER HOVMAND,
COLLEAGUE OF MINE AT CASE
WESTERN RESERVE UNIVERSITY, AND
HE'S REALLY ONE OF THE LEADERS
IN SYSTEMS THINKING APPROACHES
AS PERTAINS TO THE COMMUNITIES,
ENGAGING COMMUNITIES.
HE'S GOING TO BE TALKING TO US
AND HOPEFULLY GIVING US AN
OVERVIEW OF SYSTEMS THINKING IN
HIS TALK IS INTRODUCTION TO
SYSTEMS THINKING APPROACHES TO
UNDERSTAND HEALTH AND PLANETARY
HEALTH.
AS I MENTIONED, DR. HOVMAND
COMES FROM CASE WESTERN RESERVE
UNIVERSITY, A PAM DAVIS
PROFESSOR OF MEDICINE, CENTER
FOR COMMUNITY HEALTH
INTEGRATION, SCHOOL OF MEDICINE.
ALSO PROFESSOR OF GENERAL
MEDICAL SCIENCES, BIOMEDICAL
ENGINEERING AT THE CASE SCHOOL
OF ENGINEERING.
THANK YOU, PETER.
>> THANK YOU FOR THE
OPPORTUNITY.
GOOD MORNING.
NEXT SLIDE PLEASE.
SO I WAS ASKED TO PROVIDE A
GENERAL OVERVIEW TO SYSTEMS
THINKING, HOW WE MIGHT THINK
ABOUT THAT.
AND SO I'LL PROVIDE SOME
BACKGROUND AND THEN END ON SOME
QUESTIONS FOR POTENTIAL
RESEARCH.
NEXT SLIDE.
SO SYSTEMS ARE EVERYWHERE.
WE THINK ABOUT COULD BE
WATERSHED SYSTEMS, CLIMATE IS A
SYSTEM, METABOLIC NETWORKS,
CARDIOVASCULAR SYSTEM ARE TWO
EXAMPLES OF BIOLOGICAL SYSTEMS.
INSTITUTIONS ARE SYSTEMS, SOCIAL
SYSTEMS, SO THAT WE'RE LIVING IN
SYSTEMS.
NEXT SLIDE.
THE CHALLENGE OF UNDERSTANDING
THE SYSTEMS ARE STABLE, WE CAN
RELY ON PAST EXPERIENCE TO
INFORM FUTURE BEHAVIOR BUT THE
CHALLENGE OF UNDERSTANDING
MAKING DYNAMIC -- MAKING
DECISIONS IS SOMETHING THAT JAY
FORESTER AS POINTED OUT MANY
TIMES OVER.
AND IN THIS GRAPH THIS IS
ACTUALLY A MUCH MORE FAVORABLE
SITUATION THAN WHAT SAM
PRESENTED IN TERMS OF GREAT
ACCELERATION, CHALLENGED WITH
INFORMATION DELAY IN TERMS OF
RELATIVE TO WHEN WE'RE MAKING A
DECISION, AND THERE'S ALSO
IMPLEMENTATION DELAY.
WE CAN ADDRESS SOME OF THE
INFORMATION DELAY BY USING
REALTIME DATA, FOR EXAMPLE, MORE
SOPHISTICATED TOOLS AND
ANALYSIS.
AND THERE'S SOME POSSIBILITY TO
ADDRESS THE IMPLEMENTATION DELAY
DRAWING ON SYSTEM SCIENCES, BUT
IN BOTH CASES WE HAVE THESE
DELAYS, AND THAT CREATES A
CHALLENGING SITUATION.
THIS IS AN EASIER SITUATION
BECAUSE IT'S BASICALLY
GOAL-SEEKING BEHAVIOR.
WHAT SAM PRESENTED WAS GREAT
ACCELERATION WHICH IN TERMS OF
EXPONENTIAL DYNAMICS, WE TEND TO
SIGNIFICANTLY UNDERESTIMATE THE
IMPACT OF ACTIONS.
I'LL TALK ABOUT WHAT THE
CHALLENGES THERE ARE, NEXT
SLIDE.
SO, ONE OF THE BIG CHALLENGES IS
BEING ABLE TO SEE AND UNDERSTAND
SYSTEMIC CAUSATION.
GEORGE LAKOFF TALKING ABOUT
GLOBAL WARMING HAS SPENT A LOT
OF TIME UNDERSTANDING HOW PEOPLE
THINK AND ACT IN SYSTEMS, AND
POINTS OUT THAT ONE OF THE
CHALLENGES HERE IS WE REALLY
HAVE A HARD TIME SEEING SYSTEMIC
CAUSATION.
JOHN POWELL TALKING ABOUT
STRUCTURAL RACISM, WHEN WE TAKE
A SYSTEMS APPROACH WHAT WE MIGHT
EXPECT IS BEING ABLE TO SHIFT
THE MEANING AND MEASUREMENT OF
CAUSATION, AND SOME OF THIS IF
YOU'RE LOOKING FOR MORE
PHILOSOPHY OF SCIENCE MARIO
BUNGE DOES SOMETHING SIMILAR
TALKING ABOUT HOW A SYSTEM WORKS
THAT IS BEING ABLE TO UNVEIL THE
MECHANISMS, SOME IS WHAT ANA WAS
TALKING ABOUT BEFORE.
THESE ARE CHALLENGES NOTICED.
AND NEXT SLIDE.
SO, WE COULD THINK ABOUT THE
TYPES OF INSIGHTES WE MIGHT
GAIN, WE'RE TALKING ABOUT DEEP
INSIGHTS HOW DOES SYSTEM
GENERATE DYNAMICS OF A SYSTEM,
BUT THERE ARE A RANGE OF
INSIGHTS WE MIGHT GAIN AND
LEVERAGE IN UNDERSTANDING
SYSTEMS FROM SURFACE INSIGHTS
LIKE BEING AWARE OF A SYSTEM, TO
WHAT THE COMPONENTS ARE, HOW
THEY ARE CONNECTED, HOW PEOPLE
THINK IN TERMS OF MENTAL AND
CULTURAL MODELS, WHETHER ACTORS
ARE, STARTING TO SEE MORE
GENERIC PATTERNS, UNDERLYING
STRUCTURES, IMPLICATIONS OF
ACCUMULATIONS, DELAYS,
NON-LINEAR RELATIONSHIPS, WHERE
WE COULD INTERVENE, LEVERAGE
POINTS WHERE SMALL CHANGES COULD
HAVE BIG EFFECT AND COROLLARY IS
THAT A LOT OF THESE NON-LINEAR
SYSTEMS COULD BE EFFECTIVE AT
THE APPROXIMATE LEVEL BUT HAVE I
HAVE LITTLE IMPACT AT SYSTEM
LEVEL, WHAT'S CAUSING THE
BEHAVIOR.
THE POINT IS IF YOUR GOAL IS TO
UNDERSTAND, RAISE AWARENESS,
PICTURES MAY BE SUFFICIENT.
IF YOU WANT TO UNDERSTAND
RELATIONSHIPS WE NEED SOMETHING
MORE EXPLICIT ABOUT THE
RELATIONSHIPS, SPATIAL MAPS,
WE'VE SEEN A COUPLE EXAMPLES,
NETWORK DIAGRAMS, CAUSAL MAPS.
FOR SOME DEEPER INSIGHTS WE NEED
MATHEMATICAL MODELS, STRUCTURAL
EQUATION, MULTI-LEVEL
STATISTICAL MODELS, DISCRETE
SIMULATION MODELING SYSTEM
DYNAMICS.
IF WE'RE LOOKING AT MODELS OFTEN
WE WONDER WHY THE SYSTEM IS AS
IT IS.
AND THERE WE CAN GAIN INSIGHTS
FROM STORY NARRATIVE POETRY FROM
THIS EXPERIENCE.
NEXT SLIDE.
SO ONE OF THE COMMON METAPHORS
IN SYSTEMS THINKING IS ICEBERG
METAPHOR.
WE SEE AT THE TOP ARE EVENTS,
THE FOREST FIRES THAT WE HAD
THIS SUMMER FOR EXAMPLE.
EXTINCTION EVENT.
WE SAW FROM SAM'S PRESENTATION
SOME NICE EXAMPLES OF TRENDS
OVER TIME.
SO THAT'S BENEATH THE SURFACE,
IT TAKES EFFORT TO ACCUMULATE
THE DATA, SEE WHAT TRENDS ARE,
PROJECT THEM OUT IF THEY
CONTINUE.
AND THOSE PATTERNS ARE BEING
CAUSED BY SOME STRUCTURES, AND
THEN THOSE ARE BEING --
STRUCTURES, SOME ARE BIOLOGICAL
NATURAL SYSTEMS, AND SOME A GOOD
DEAL ARE HUMAN IMPACT, DIRECTION
OF CAUSALITY HERE IS GOING FROM
THE VALUES, ATTITUDES, AND NORMS
IN TERMS OF SOCIAL SYSTEMS
INTERACTING WITH NATURAL
ENVIRONMENT THAT GENERATE
PATTERNS OVER TIME,
PROPENSITIES, THAT LEADS TO
EVENTSES WE SEE ON THE SURFACE.
THIS HAS RECIPROCAL
RELATIONSHIP, STARTING TO REACT
TO THESE EVENTS TO THINK ABOUT
CHANGING THE STRUCTURE AND
VALUE.
SO THIS IS ONE WAY WE CAN THINK
ABOUT SYSTEMS.
NEXT SLIDE.
I'M SPECIFICALLY WORKING IN THE
AREA OF SYSTEM DYNAMICS.
SO THERE ARE MULTIPLE METHODS OF
APPROACHING THIS BUT I'LL TALK
ABOUT SYSTEM DYNAMICS BECAUSE
THAT'S MY AREA AND ALSO BECAUSE
THIS TIES IN WITH THE WORK OF
EN-ROADS, BASED ON SYSTEM
DYNAMICS, LATER IN THE DAY.
SO WE'RE THINKING ABOUT
UNDERSTANDING SYSTEMS FROM
ENDOGENOUS PERSPECTIVE.
THIS IS A DEFINITION,
ACCUMULATIONS LEVELS, HOW THE
RATES OF ACTIVITY ARE
REPRESENTED BY FLOWS, AND USE OF
COMPUTER SIMULATION.
THIS PARTICULAR WAY OF THINKING
ABOUT SYSTEMS, THESE ARE
HIERARCHICAL, ENDOGENOUS
PERSPECTIVE IS MOST IMPORTANT.
USE OF COMPUTER SIMULATION
MODELS IS IMPORTANT BUT LESS
IMPORTANT THAN ENDOGENOUS
PERSPECTIVE.
NEXT SLIDE.
SO EXAMPLES OF DYNAMIC BEHAVIOR
WE'VE ALREADY SEEN SOME OF THESE
EXAMPLES EARLIER IN THE DAY.
BUT ANYTHING, TRAINED OVER TIME,
CONTRAST WITH WHAT YOU WOULD
LIKE TO SEE, AN EXAMPLE OF LEAD
EXPOSURE THAT I USE FOR CUYOGA
COUNTY.
NEXT SLIDE.
AND THEN IN TERMS OF CONTRASTING
ENDOGENOUS OR FEEDBACK
PERSPECTIVE AGAINST LINEAR CAUSE
EFFECT, THESE ARE TWO DIAGRAMS,
THEY BOTH HAVE VARIABLES RELATED
TO WORK AROUND STRUCTURAL
RACISM, AND RACISM AND PUBLIC
HEALTH CRISIS.
THE LEFT, SAME SET OF VARIABLES,
LEFT IS TRYING TO EXPLAIN
COMMUNITY RESPONSE TO STRUCTURAL
RACISM.
THE RIGHT IS THE SAME SET OF
VARIABLES BUT NOW ORGANIZED INTO
A SET OF CAUSAL LOOPS, CAUSAL
LOOP DIAGRAM IN TERMS OF
FEEDBACK MECHANISMS, THESE
MECHANISMS ARE CHARACTERIZED
BALANCING AND REINFORCING,
INTERACTING ACROSS TIME.
ON THE LEFT I'M LOOKING FOR
STRONGEST ASSOCIATION AND
DESIGNING INTERVENTION.
ON THE RIGHT FROM ENDOGENOUS
PERSPECTIVE I'M LOOKING FOR THE
STRENGTH OF THE FEEDBACK LOOPS
AND HOW THEY CHANGE AND EVOLVE
OVER TIME.
SO THESE ARE COMPLEMENTARY
PERSPECTIVES.
IT'S NOT AN EITHER/OR.
WE BENEFIT BY LOOKING AT BOTH.
THINKING ABOUT A SYSTEM AND
TRYING TO EXPLAIN FROM
ENDOGENOUS PERSPECTIVE I'M
TRYING TO EXPLAIN IN TERMS OF
THE FEEDBACK MECHANISMS.
NEXT SLIDE.
WE CAN GENERATE THESE USING --
GENERATE MAPS INFORMALLY USING
INFORMAL MAPS.
ON LEFT IS CAUSAL LOOP DIAGRAM,
THE SECOND IS STOCK AND FLOW
DIAGRAM, ON THE LEFT LOOKING AT
WHAT IT TAKES TO RAISE A CHILD
IN ST. LOUIS, ON THE RIGHT
HEALTH CARE LEADERS IN HONDURAS
LOOKING AT MATERNAL AND NEONATAL
MATERNITY.
THESE ARE IN GROUP MODEL
BUILDING WORKSHOPS, IN EITHER
CASE FORMAL TRAINING SYSTEM
DYNAMICS.
WE CAN MOVE TO MORE FORMAL
SIMULATION MODELS.
THIS IS ESSENTIALLY WHERE YOU
START TO LOOK AT DIFFERENT
INTERVENTIONS AND COMBINATIONS,
FROM SOME WORK IN HONDURAS,
MATERNAL AND NEONATAL MORTALITY,
WHERE THE MATERNAL MORTALITY
RATIO, NEONATAL RATE, THE GOAL
TO REDUCE BOTH.
YOU SEE SORT OF RANKED ORDER
FROM BASE CASE OF STATUS QUO TO
BEST CASE LOOKING FOR HIGH
LEVERAGE POINTS.
NEXT SLIDE.
THE PIECE THAT'S MORE
INTERESTING IN RECENT YEARS HAS
BEEN ABLE TO UNDERSTAND
STRUCTURE OF BEHAVIOR
RELATIONSHIP AND MAKE IT MUCH
MORE VISUALLY EXPLICIT.
SO THIS IS A VERY SIMPLE GENERIC
STRUCTURE LOOKING AT LIMITS TO
GROWTH WHERE HAVE YOU
POPULATION, CARRYING CAPACITY,
BIRTH RATE AND BASE MORTALITY
RATE.
AND THIS PARTICULAR EXAMPLE IF
YOU GO TO THE INTERFACE,
INTERFACES CAN NOW BE GENERATED
AND PUBLISHED ONEN LINE RELATIVE
EASY.
EN-ROADS LATER TODAY IS A
SUBSTANTIAL EFFORT.
TODAY IT'S NOT POSSIBLE TO DO
THIS, ALMOST AS A POWERPOINT
PRESENTATION, AND PUBLISH AT
ESSENTIALLY NO COST, INVOLVING
HIGH SCHOOL STUDENTS AND
GRADUATES.
STRUCTURED BEHAVIOR RELATIONSHIP
TALKING ABOUT FEEDBACK LOOPS IF
YOU GO TO THIS EXAMPLE THIS WILL
HAVE ESSENTIALLY TAKE YOU
THROUGH A SERIES OF EXERCISES
WHERE YOU CAN SEE THE DOMINANCE
OF THE FEEDBACK LOOPS, AND YOU
CAN SEE HOW WHEN YOU INTERVENE
IN A NON-DOMINANT LOOP THAT HAS
NO SIGNIFICANT EFFECT ON THE
DYNAMICS WHEN YOU TARGET A
FEEDBACK LOOP YOU CAN CHANGE
BASIC BEHAVIOR MODES.
SO IF WE WANT TO CHANGE
EXPONENTIAL PATTERNS THAT WERE
PRESENTED EARLIER INTO SOMETHING
MORE DESIRABLE WE'RE TALKING
ABOUT NOT JUST CHANGING THEM
NUMERICALLY, TRYING TO CHANGE IN
TERMS OF FUNDAMENTAL BEHAVIOR
MODES.
NEXT SLIDE PLEASE.
THE OTHER PART IS REALLY BEING
ABLE TO ENGAGE COMMUNITIES, SO
THIS IS FROM WORK FROM DEAN OF
BOSTON COLLEGE, AND FOUNDATION
FOR ECOLOGICAL SECURITY IN INDIA
USING METHODS LIKE COMMUNITY
BASED SYSTEM DYNAMICS, CAN
DIRECTLY ENGAGE STAKEHOLDERS,
PEOPLE WITH LIVED EXPERIENCE.
THIS IS A VILLAGE IN INDIA DOING
SOME WORK ON MANAGING WATER
RESOURCES, COMMON POOL OF
RESOURCE, AND THIS TYPE OF WORK
IS NOT ONLY FEASIBLE BUT WHAT IT
DOES IS BRING IN A MUCH MORE
LOCAL CONTEXT TO UNDERSTANDING
THE CAUSAL STRUCTURES UNDERLYING
THE SYSTEMS AROUND NATURAL
RESOURCES, HEALTH, SO FORTH.
NEXT SLIDE.
PROBABLY THE EXAMPLE I LIKE TO
HIGHLIGHT THE MOST HOW
COMMUNITY-BASED SYSTEM DYNAMICS
WORKS IS ENGAGING YOUNG PEOPLE.
THIS IS A PROGRAM FOR A NUMBER
OF YEARS AT WASHINGTON
UNIVERSITY IN ST. LOUIS ON
CHANGING SYSTEMS WHERE HIGH
SCHOOL STUDENTS WERE -- A GROUP
OF 12 TO 16 DEPENDING ON LEADING
A FOUR-DAY REGIONAL YOUTH SUMMIT
ON VARIOUS TOPICS BEGINNING ON
RACISM IN 2015, UP TO EMOTIONAL
SUPPORT IN 2019.
THE FELLOWS, THEY RETURN ONE
YEAR AFTER THE NEXT, FOR
EXAMPLE, AND OVER TIME WHAT YOU
SEE ON THE LEFT IS A SERIES OF
ACTIVITIES THEY DID EACH YEAR.
SO THEY BEGIN WITH INFORMAL
MAPPING, THINGS LIKE DRAWING
CONNECTION CIRCLES, CAUSAL LOOP
DIAGRAMS, MOVING INTO STOCKS AND
FLOWS, ACCUMULATION AND
SIMULATION, LAST YEAR EVALUATING
LEVERAGE POINTS FOR ADVOCACY
PLANS.
THAT'S HAPPENING BECAUSE BECAUSE
CAPACITY IS BEING BUILT ACROSS
PROJECTS AT A COMMUNITY LEVEL.
THIS IS ONE EXAMPLE LOOKING AT
GUN VIOLENCE.
THERE'S A VIDEO IF YOU WANT TO
SEE HOW THEY ARE TALKING ABOUT
IT.
NEXT SLIDE.
THE OTHER ASPECT THAT'S BECOMING
INTERESTING IS THINKING ABOUT
HOW TO ENGAGE COMMUNITIES TO
ADDRESS INJUSTICES, SPECIFICALLY
AROUND FAIR A.I.
THERE'S WORK BY DONNA MARTEN AT
GOOGLE, AND RUHA BENJAMIN,
THINKING ABOUT THIN DESCRIPTION,
BOTH ARE TALKING ABOUT WAYS YOU
CAN ENGAGE COMMUNITIES TO
ADDRESS SOME BIASES IN THESE
TOOLS.
THAT BECOMES RELEVANT THINKING
ABOUT HOW WE ADDRESS THE
CHALLENGE OF ACCELERATING CHANGE
IN THE CONTEXT OF HAVING
SIGNIFICANT DATA AND BEING ABLE
TO PROCESS AND LEVERAGE THIS IN
A WAY THAT WE'RE BOTH MITIGATING
INJUSTICE AND PREVENTING ISSUES
THAT SHOW UP WITH BIAS IN A.I.
AND FINDING OPPORTUNITIES TO
LEVERAGE A.I. EFFECTIVELY.
NEXT SLIDE.
SO THREE QUESTIONS I HAVE IN
MIND, HOW CAN WE ENGAGE
COMMUNITIES, ESPECIALLY YOUNG
PEOPLE, THINKING WE NEED TO DO
THIS AND DEVELOP FUTURE
SCIENTISTS, ACTIVISTS, LEADERS
TO ADDRESS GLOBAL WARM AND HELP
IN WAYS THAT LEAD TO ACTION.
BUT ALSO CREATE SENSE OF
BELONGING AND EPISTEMIC.
IT IS TALKED ABOUT IN THE BEYOND
STABLE STATE, WHAT HAPPENS WHEN
WE GIVE UP ON THE IDEA OF
UNDERSTANDING SYSTEMS, IN TERMS
OF EPISTEMIC KNOWLEDGE.
WE HAVE TO THINK CRITICALLY HOW
WE CREATE OPPORTUNITIES FOR
SENSE OF BELONGING EPISTEMIC
HOPE.
SECOND IS INCREASING RIGOR OF
SYSTEMIC EXPLANATION OF GLOBAL
WARMING, CARDIOVASCULAR HEALTH.
I SHOWED ONE EXAMPLE HOW WE
MIGHT DO THIS WITH SYSTEM
DYNAMICS.
LASTLY HOW WE CAN LEVERAGE TOOLS
TO ADDRESS EPISTEMIC UNCERTAINTY
IN A.I..
>> THANKS, PETER.
EXCEPTIONAL.
NEXT PRESENTATION, ON PLANETARY
HEALTH EXPOSURES, INCLUDES
CLIMATE CHANGE AND RELATIONSHIP
TO CARDIOVASCULAR HEALTH, GIVEN
BY DR. JONATHAN NEWMAN,
ASSISTANT PROFESSOR OF
CARDIOLOGY LANGONE NYU SCHOOL OF
MEDICINE, THE LINK BETWEEN
ENVIRONMENT AND CARDIOVASCULAR
DISEASE.
>> THANK YOU, SANJAY.
NEXT SLIDE PLEASE.
SO, THANK YOU TO THE NHLBI AND
ORGANIZERS, DR. RAJAGOPALAN AND
ANGELL.
I'M GOING TO FOCUS ON POTENTIAL
CLINICAL DIRECTIONS WITHIN THIS
BROAD TOPIC AND GET INTO SOME OF
THE IDEAS OF WAYS THAT WE MIGHT
CONSIDER SOME EXPOSURES WITHIN
CLINICAL FRAMEWORKS TO ADDRESS
BOTH ENVIRONMENTAL HEALTH AND
SOCIAL INEQUITIES.
NEXT SLIDE PLEASE.
SO, TO START, I WILL SORT OF
REFRAME A LITTLE BIT OF WHAT DR.
MYERS SHOWED A LITTLE BIT IN HIS
TALK.
I'M SHOWING HERE IN THE MIDDLE A
SLIDE FROM ABOUT SIX MONTHS AGO
OF THE RAPID WORSENING IN AIR
QUALITY IN NEW YORK CITY IN
MANHATTAN, THIS IS VIEWING
MANHATTAN FROM NEW JERSEY,
THROUGHOUT THE COURSE OF THE DAY
FROM MORE USUAL LEVELS OF FINE
PARTICULATE EMISSIONS TO A PEAK
ON WEDNESDAY, JUNE 7, OF 460,
OVER 460 MICROGRAMS PER METER
CUBED RELATED TO CANADIAN
WILDFIRES, JUXTAPOSED AGAINST
THE EMPEROR NERO IN ROME, AS
LEGEND HAS IT FIDDLING WHILE
ROME BURNS.
I'M NOT SUGGESTING HERE THAT
THIS AUDIENCE IN ANY WAY IS
UNAWARES OF THE RISKS OF CLIMATE
CHANGE AND PLANETARY HEALTH, BUT
THERE'S AN ELEMENT I THINK OF
SOCIAL UNAWARENESS THAT MAY BE
RELEVANT FOR SOME DIMENSIONS OF
THIS TALK.
NEXT PLEASE.
SO, THIS IS A REALLY ELEGANT
DIAGRAM THAT DR. RAJAGOPALAN
PUBLISHED A COUPLE YEARS AGO IN
THE NEW ENGLAND JOURNAL OF
MEDICINE ILLUSTRATING THE
MULTIPLE DIMENSIONS OF EXOGENOUS
POLLUTANTS FROM FOSSIL FUEL
COMBUSTION TO TOXIC MET A
LITTLE, TO CLIMATE CHANGE
PROCESSES RELATED TO GLOBAL
WARMING, INCLUDING EXTREME
TEMPERATURES AND WILDFIRES.
AND NOT ONLY GOING THROUGH SOME
OF THE WAYS IN WHICH THESE
EXPOSURES LEAD TO CARDIOVASCULAR
BUT IMPORTANTLY INDIVIDUAL
STRATEGIES WE CAN APPROACH TO
AMELIORATE ATTENUATE.
IN ANOTHER NICE REVIEW DRILLING
DOWN A LITTLE BIT MORE ON THE
SPECIFICS OF THE CARDIOVASCULAR
EFFECTS, DR. KHRAISHAH AND
COLLEAGUES WENT THROUGH A
WORKFLOW AND ILLUSTRATION OF THE
WAYS WHICH INDUSTRIAL EMISSIONS
LEADING TO DIRECT AND INDIRECT
EFFECTS OF CARDIOVASCULAR
DISEASE MORBIDITY AND MORTALITY
AND GOING THROUGH CHANGES IN
PATHWAYS, LET'S SAY RELATED TO
INFLAMMATION, SPECIFIC
ELECTROLYTE ABNORMALITIES,
HYPERCOAGULATION, EXTREME
DISRUPTION AND CHANGES CAN LEAD
TO INDIRECT EFFECTS, ALTERATIONS
IN CARE PATHWAYS THEMSELVES.
FURTHER WORSENING SOME ELEMENTS
OF CARDIOVASCULAR CARE.
NEXT SLIDE PLEASE.
SO, ONE THING THAT WE AND OTHERS
HAVE BEEN INTERESTED IN IS TO
UNDERSTAND THE WAYS IN WHICH IN
THE CASE OF FOSSIL FUEL
COMBUSTION PM2.5 PARTICLES LESS
THAN 2.5 MICROMETERS IN DIAMETER
HAVE A HOST OF PHYSIOLOGIC
EFFECTS, DIRECT AND INDIRECT, IN
HUMAN PHYSIOLOGY, LEADING
EVENTUALLY TO INCREASED BLOOD
PRESSURE, A VERY CLOSE SURROGATE
FOR CARDIOVASCULAR DISEASE, ONE
OF THE ONLY SURROGATES THAT THE
FDA WILL ALLOW FOR TESTING OF
NEW THERAPIES IN LIEU OF
CARDIOVASCULAR OUTCOMES, AND WE
AND OTHERS ARE STUDYING THE WAY
IN WHICH WIDELY AVAILABLE
TECHNOLOGY AS PORTABLE AIR
CLEANERS WITH HEPA FILTERS MIGHT
IMPROVE OR REDUCE LEVELS OF FINE
PARTICULATE EXPOSURE AND LOWER
BLOOD PRESSURE.
NEXT SLIDE PLEASE.
IS HE, ONE THING I WANT TO BRING
UP WHICH IS CONCEPT WELL KNOWN
TO THE AUDIENCE IS THE ISSUE OF
THE PREVENTION PARADOX, SICK
INDIVIDUALS AND SICK POPULATIONS
VIS-A-VIS CARDIOVASCULAR RISK
FACTORS, THIS IS WORK FROM
JEFFREY ROSE 20 YEARS AGO
DESCRIBING CHANGES IN BLOOD
PRESSURE DISTRIBUTIONS IN
POPULATIONS.
HOW ON THE INDIVIDUAL LEVEL, WE
CAN AFFECT WHAT MODEST REDUCTION
IN BLOOD PRESSURE, IN THIS CASE
FROM SYSTOLIC RE REDUCTION 2 TO
5, WITH STROKES AND
CARDIOVASCULAR MORTALITY, SHOWN
AS A MODEL LET'S SAY FOR
POLICIES OF SALT REDUCTION AND
REDUCING SALT INTAKE TO LOWER
INDIVIDUAL BLOOD PRESSURE,
HAVING VERY LARGE
POPULATION-WIDE BENEFITS.
I THINK SIMILAR APPROACH MAYBE
COULD BE USED IN THINKING ABOUT
THE USE OF PORTABLE AIR CLEANERS
OR INDIVIDUAL APPROACHES TO
MODIFY THE RISK OF CERTAIN
ENVIRONMENTAL EXPOSURES LIKE
FINE PARTICULATE AIR POLLUTION.
NEXT PLEASE.
SO, WE'RE CONDUCTING A TRIAL TO
TRY AND TEST THIS IN A
POPULATION WHICH AS OTHERS HAVE
TOUCHED UPON TODAY EXPOSE JUST
IN U RES -- EXPOSURES ARE NOT
HOMOGENOUS, WE'RE ATTESTING IN
PARALLEL ARM RANDOMIZE THE
CLINICAL TRIAL OF 440 PUBLIC
HOUSING RESIDENTS WITH HIGH
BLOOD PRESSURE, RANDOMIZED TO
IN-BEDROOM AIR FILTER OVERNIGHT
24 HOURS A DAY, ON AN ENDPOINT
OF SELF-MEASURED HOME BLOOD
PRESSURE TRANSMITTED REMOTELY,
I'LL GO INTO DETAILS, ENDPOINT
OF BLOOD PRESSURE OVER 30, 90,
100 DAYS, WITH ADDITIONAL
PHYSIOLOGIC AND DATA TO
UNDERSTAND BOTH EFFICACY OF
POTENTIALLY INDIVIDUAL STRATEGY
THAT MIGHT BE ABLE TO MODIFY
RISK IN INDIVIDUALS WITH STABLE
HIGH BLOOD PRESSURE.
NEXT SLIDE PLEASE.
SO, AS I THINK HAS BEEN TOUCHED
UPON A BIT, THERE'S A NICE
FRAMEWORK HERE TO THINK ABOUT
PLANETARY HEALTH THAT'S REALLY A
COMMON SOIL IN A SENSE, DRAWING
ON SOME OF DR. MYERS' SLIDES
EARLIER, AS A SOCIAL DETERMINANT
OF HEALTH IN WAYS WE CAN THINK
ABOUT PHYSICAL ENVIRONMENT AND I
THINK THIS MODEL FROM THE
NATIONAL ACADEMY OF SCIENCES AND
DR. COMMODORE-MENSAH DESCRIBES
CONTRIBUTIONS BUT IN REALITY THE
PHYSICAL ENVIRONMENT AND
PLANETARY HEALTH IS UNDERPINNING
THESE MULTIPLE DOMAINS OF HEALTH
CARE, HEALTH BEHAVIORS, AND
SOCIOECONOMIC FACTORS THAT LEAD
TO ROOT CAUSE AND POOR
HYPERTENSION OUTCOME.
NEXT SLIDE PLEASE.
SO ONE WAY THAT I THINK IS A
SIMPLISTIC MODEL TO THINK ABOUT
THIS IS A POSITIVE FEEDBACK
LOOP.
LOOKING IN CERTAIN COMMUNITIES
WITHIN NEW YORK CITY, WE SEE
UPWARDS OF 70% OF INDIVIDUALS
THAT HAVE HIGH BLOOD PRESSURE
HAVE POORLY CONTROLLED HIGH
BLOOD PRESSURE, MORE THAN 40,
50% HAVE DIABETES, THESE STATES
OF HEALTH INEQUITY INCREASED
RATES OF DIABETES, OF POORLY
CONTROLLED HYPERTENSION, RENAL
DISEASE, IN TURN INCREASE
SUSCEPTIBILITY AND REINFORCED BY
ENVIRONMENTAL INEQUITY WHICH
WERE HIGH LIGHTED SHOWING THIS
POLLUTION BURDEN AND POLLUTION
BENEFIT OR ADVANTAGE BASED ON
SOCIAL DETERMINANTS OF HEALTH,
IN WHICH THE COMMUNITIES MOST
VULNERABLE TO ENVIRONMENTAL
EXPOSURES AND FOSSIL FUEL
COMBUSTION FOR EXAMPLE ARE MOST
BURDENED BY AREAS OF HEALTH
INEQUITY.
NEXT SLIDE PLEASE.
I WANTED TO GIVE A FRAMEWORK
TOWARDS THE PLANETARY HEALTH AND
DOMAINS OF PLANETARY HEALTH,
VIS-A-VIS ECOLOGICAL CEILINGS
AND SOCIAL FOUNDATIONS AS RELATE
TO CARDIOVASCULAR DISEASE,
POTENTIALLY TO CLINICAL TRIALS.
AND BECOMING MORE FAMILIAR WITH
THIS MODEL RECENTLY, NO THE
SOCIAL FOUNDATION THIS IS
ILLUSTRATING WHICH IS IN WHICH
SHORTFALLS IN CERTAIN DOMAINS OF
INDIVIDUAL BEHAVIOR OR
INDIVIDUAL WELL-BEING SHORTFALLS
OR LACK OF ACCESS TO CLEAN
WATER, FOOD, ENERGY, HEALTH,
LEAD TO IMPAIRMENTS IN HEALTH
AND PLANETARY HEALTH ON THE
INDIVIDUAL LEVEL, AND ON THE
ECOLOGICAL CEILING BARRIER
OVERSHOOTS OF CERTAIN AREAS IN
CLIMATE CHANGE, BIODIVERSITY
LAWS, IN EXACERBATIONS OR AIR
POLLUTION ITSELF LEAD TO
WORSENING OF PLANETARY AND
INDIVIDUAL HEALTH AND WITHIN
THIS BOUNDARY REGION IS THE
REGION WHERE WE MIGHT SEE HEALTH
OF THE INDIVIDUAL AND HEALTH OF
THE PLANET MAXIMIZE TO THE
GREATER GOOD.
NEXT SLIDE PLEASE.
YOU KNOW, AS A CLINICAL TRIALS
AND CARDIOLOGIST, ONE OF THE
THINGS THAT I'M MOST INTERESTED
IN AND WE RELY UPON ARE CLINICAL
TRIALS.
UNFORTUNATELY AS DETAILED
PREVIOUSLY THERE'S ABOUT A
17-YEAR ODYSSEY BETWEEN
PRIORITIES FOR RESEARCH FUNDING,
FUNDING OF CERTAIN PRIORITIES,
AND THEN THOSE FINDINGS
EVENTUALLY BEING TRANSLATED INTO
CLINICAL PRACTICE, IF EFFICACY
PARAMETERS ARE MET.
CLINICAL TRIALS REMAIN THE GOLD
STANDARD, PREVIOUSLY WAS
MENTIONED LET'S SAY UNMEASURED
CONFOUNDERS OR CHARACTERISTICS
OF POPULATIONS BEING COMPARED,
THAT'S THE THING THAT CLINICAL
TRIALS CAN BALANCE OUT.
THESE CLINICAL TRIALS AS
POSITIVES GUIDE PROVIDER
BEHAVIOR AND CARE, ARE DRIVERS
OF CLINICAL PRACTICE GUIDELINE
WHICH IN TURN MADE PAYERS MAKE
DECISIONS ON WHAT PRACTICE
CLINICAL PATIENT ENCOUNTER WILL
NOT BE COVERED AND INFLUENCE
POLICY AND HEALTH STRATEGIES.
UNFORTUNATELY THERE ARE A WEALTH
OF RELATED ISSUES WITH CURRENT
CLINICAL TRIALS, IN GENERAL THEY
ARE COSTLY AND SLOW, THERE ARE
INEVITABLY QUESTIONS OF
GENERALIZABILITY FROM PATIENTS
THAT ENROLL IN CLINICAL TRIALS
TO LARGER POPULATIONS THAT WOULD
DERIVE BENEFIT OR APPLIED TO
CERTAIN THERAPIES, GUILTY OF
REINFORCING HEALTH AND SOCIAL
INEQUITIES, RAISING VALUE FOR
PUBLIC HEALTH QUESTIONS.
NEXT SLIDE PLEASE.
SO, I THINK ONE FRAMEWORK MAYBE
TO THINK ABOUT THAT WE'VE TRIED
TO APPLY IN SOME OF OUR WORK ARE
TO THINK ABOUT CONVENTIONAL
VERSUS DECENTRALIZED CLINICAL
TRIALS, AS POTENTIAL PATH FOR
ENVIRONMENTAL AND SOCIAL -- PATH
FOR ENVIRONMENTAL AND SOCIAL THE
QUESTION.
IN CONVENTIONAL RCTs,
RANDOMIZED CLINICAL TRIALS, UNIT
OF MEASURE IS IN-PERSON
PATIENT'S ENCOUNTER.
THERE'S THE PER PHYSICIAN
REFERRAL, IN-PERSON MONITORING
AND VISITS, CONVENTIONAL
CLINICAL TRIAL, GROUPS THAT HAVE
LOOKED AT CARBON FOOTPRINT OF
CURRENT CLINICAL PRACTICE AND
CLINICAL TRIALS, AND MORE
BROADLY OF THE HEALTH CARE
SYSTEM, IF HEALTH CARE IN
GENERAL WERE A NATION WE WOULD
BE THE FIFTH GREATEST POLLUTER
AND CARBON UTILIZER WORLDWIDE.
VERSUS DECENTRALIZED TRIALS MAY
BE RELYING MORE ON REMOTE OR
VIRTUAL OR ELECTRONIC HEALTH
RECORD EHR CONSENT MECHANISMS,
REGISTRIES AND VIRTUAL
RECRUITMENT PATHWAYS, RELIANCE
ON REMOTE PATIENT MONITORING
WHICH WE'RE TRYING TO DO, IN
PART TO BRIDGE THE DIGITAL
DIVIDE USING THESE TECHNOLOGIES
FOR UNDERRESOURCED POPULATIONS,
USING POTENTIALLY WEARABLE OR
IMPLANTABLE DEVICES, MOBILE
MONITORING, NEXT SLIDE.
MAYBE A FRAMEWORK, DECENTRALIZED
TRIALS AS POTENTIAL TO IMPROVE
PLANETARY HEALTH.
IF YOU'RE RUNNING A TRIAL OF
HIGH BLOOD PRESSURE ASKING
PARTICIPANTS TO DRIVE OR COMMUTE
TO PHYSICIAN OFFERS OR CLINICAL
TRIAL SPACE TO MEASURE THEIR
INPUTS, THAT'S GOING TO GENERATE
EMISSIONS BY PARTICIPATING IN
THE CLINICAL TRIAL, TO SAY
NOTHING OF THE DISTRACTIONS AND
TAKING PEOPLE AWAY FROM THE
LIVES THEY LEAD, CHILD CARE
RESPONSIBILITIES, MULTIPLE
EMPLOYMENTS FOR INDIVIDUALS
LIVING AT THE MARGINS OF
SOCIOECONOMIC WELLNESS.
IN CONTRAST MAYBE SHIFTING TO
DECENTRALIZED MODEL MIGHT
INCREASE EQUITY, RELIANCE ON
REMOTE TECHNOLOGY, DECREASE
EMISSION OF THE SORT OF CLIMATE
FOOTPRINT OF SOME CLINICAL
EVIDENCE BASE WE STRIVE TO
GENERATE.
NEXT SLIDE PLEASE.
SO, IN THE FEW MOMENTS THAT
REMAIN I'D LIKE TO HIGHLIGHT
SOME RESEARCH GAPS AND
UNANSWERED QUESTIONS.
NEXT SLIDE.
SO, ONE QUESTION I THINK IS
RELEVANT SHOULD ENVIRONMENTAL
RISKS BE CAPTURED IN CLINICAL
TRIALS AND COHORTS, EXISTING
TRIALS THAT ARE ONGOING AND
THOSE THAT HAVE BEEN COMPLETED.
AND I'M SHOWING TWO EXAMPLES.
YOU'LL HEAR MORE TOMORROW.
A NICE PAPER WAS PUBLISHED A
COUPLE YEARS AGO WHERE THEY
LOOKED AT DATA FROM THE LANDMARK
TRIAL, THE SPRINT TRIAL, THAT
TESTED IN ABOUT 9300 U.S.
RESIDENTS WITH HIGH BLOOD
PRESSURE AND CARDIOVASCULAR
DISEASE OR RISK FACTORS,
BENEFITS OF INTENSE BLOOD
PRESSURE LOWERING STRATEGY,
GETTING TO SYSTOLIC LESS THAN
120 COMPARED TO LESS THAN 140,
AND WHAT THEY SHOWED IS THAT
THERE WAS SIGNIFICANT
INTERACTION INDIVIDUALS LIVING
IN REGIONS WITH ZIP CODE 2.5
GREATER THAN EPA STANDARD OF 12
MICROMETERS PER METER CUBED HAD
GREATER BENEFIT OF MORE
INTENSIVE BLOOD PRESSURE
LOWERING STRATEGY COMPARED TO
THOSE LIVING IN LESS POLLUTED OR
IN AREAS BELOW THE CURRENT EPA
THRESHOLD AT THAT TIME.
MAYBE WE CAN UNDERSTAND MORE
ABOUT HIDDEN HETERO
HETEROGENEITY AND INTERVENTION
BASED ON ENVIRONMENTAL DATA
PERVASIVE FOR ALL PARTICIPANTS
WE WANT TO ENROLL IN STUDIES OF
CLINICAL INTERVENTIONS OVERALL.
ON THE OTHER SIDE I'M SHOWING
DATA FROM THE NIH ASSOCIATION OF
RETIRED PERSONS COHORT, OVER
500,000 RETIRED INDIVIDUALS,
SHOWING EFFECT MODIFICATION BY
QUINTILES OF MEDITERRANEAN DIET
CONSUMPTION, AND REALLY
ATTENUATION OF THE EFFECT FOR
CARDIOVASCULAR DISEASE, ISCHEMIC
HEART DISEASE, CEREBROVASCULAR
FROM PM 2.5 BASED ON QUINTILES
OF MEDITERRANEAN DIET IN
OBSERVATIONAL STUDY WITH DIETARY
DATA THAT HAS ITS LIMITS AND
THIS MAY REFLECT OTHER ASPECTS
OF HEALTH AND WELLNESS, THERE
MAY BE MEANINGFUL EFFECT
MODIFICATION THAT WE CAN CAPTURE
IN CLINICAL DATA ABOVE AND
BEYOND TRADITIONAL PARADIGMS OF
RISK.
NEXT SLIDE PLEASE.
SO, AGAIN, CAN WE APPLY THIS
BOUNDARY FRAMEWORK TO
ENVIRONMENTAL RISK?
I THINK THERE'S SOME INTERESTING
THINKING GOING ON IN THIS SPACE,
YOU KNOW, AS CLINICIANS AND
CLINICAL TRIALISTS WE THINK
ABOUT TRADITIONAL CARDIOVASCULAR
OR HEALTH RISK FACTORS, IN THIS
CASE MAYBE RESIDUAL THROMBOTIC
RISK, INFLAMMATORY RISK, MAYBE
WE NEED TO BROADEN THIS IN THE
SAME SORT OF BOUNDARY REGION FOR
THE PLANETARY HEALTH CONSTRUCT,
ENVIRONMENTAL RISK WORKING HAND
IN HAND WITH RESIDUAL SOCIAL
RISK, A NICE PAPER PUBLISHED
RECENTLY GETTING INTO SOME
CONCEPTUAL FRAMEWORK.
NEXT SLIDE PLEASE.
SO LASTLY, DR. DIEZ-ROUX SHOWED
DATA ON REDLINING DECISIONS FROM
THE 1930s INFLUENCING AND
CONTINUE TO PERPETUATE AREAS OF
ENVIRONMENTAL INEQUITY.
I'M SHOWING SOME PRELIMINARY
DATA FROM OUR GROUP IN NEW YORK
CITY, LOOKING AT THE EFFECT OF
ACTIVE AIR FILTERS, PACs,
VERSUS SHAM.
LOOKING, WE COMPARED JUST BASED
ON NUMBERS ALONE, THE GROUP C
AND D, REDLINE DISTRICTED
COMPARED TO A AND B.
YOU CAN SEE IN THE ACTIVE PAC
ARM, ACTIVE AIR FILTER ARM,
THERE'S REALLY NO DIFFERENCE
BETWEEN THE MEAN PM2.5 EXPOSURE,
MARRIED IN THE HOME WITH
COMMERCIALLY AVAILABLE DEVICE,
BUT WHEN YOU LOOK AT THE SHAM
DEVICES IN THIS TRIAL YOU SEE
THAT IN THE HOMEOWNERSHIP LOAN
CORPORATION REDLINE DISTRICTS,
CONTEMPORARY NEW YORK CITY,
THERE'S MUCH GREATER VARIABILITY
AND GREATER EXPOSURE COMPARED TO
THOSE IN AREAS A AND B IN NEW
YORK.
SO MAYBE THIS EXPOSOME,
QUOTE/UNQUOTE, IN THE CASE OF
PM2.5 AND AIR POLLUTION CAN BE
MODIFIED AT THE INDIVIDUAL LEVEL
AND MAYBE THINKING ABOUT RISK
FACTORS AS INDIVIDUALLY
MODIFIABLE I THINK IS A CONCEPT
THAT MAYBE WE CAN WRAP OUR HEADS
AROUND MORE FROM CLINICAL AND
TREATMENT FRAMEWORK.
NEXT SLIDE PLEASE.
BRIEF SUMMARY AND CONCLUSION, I
THINK AS HAS BEEN ALREADY SHOWN
THIS MORNING ELEGANTLY THESE
BOUNDARY DOMAINS AND SYSTEMS AND
EXCEEDING THESE SYSTEMS HAVE
MULTIPLE NEGATIVE CARDIOVASCULAR
EFFECTS.
PLANETARY HEALTH MAYBE IS A VIEW
FOR THIS APPROACH IS A COMMON
SOIL FOR HEALTH AND SOCIAL
INEQUITY.
RANDOMIZED TRIALS OF MAYBE
PERSONAL AND PATIENT
INTERVENTIONS WHILE WE WORK
TOWARDS THE LARGER POLICY
DIRECTIONS WHICH CLEARLY WE NEED
MAY GUIDE IMPLEMENTATION AND
ACTION.
AND NOVEL APPROACHES,
DECENTRALIZED TRIALS AND OTHERS,
MAY HELP IMPROVE HEALTH EQUITY
AND RESOURCE USE AS A WAY TO
UNCOVER HIDDEN HETEROGENEITY TO
MAYBE USE DETAILED CLINICAL
TRIAL PHENOTYPING, CORE LAB
ADJUDICATION AND REVIEW
COMMITTEES, TO UNDERSTAND THE
TRUE IMPACT IN MORE DETAIL SOME
PHYSIOLOGIC IMPACTS FROM THE
MYRIAD ENVIRONMENTAL EXPOSURES
WE HAVE.
THANKS VERY MUCH FOR YOUR TIME
AND ATTENTION.
NEXT SLIDE.
>> GREAT.
THANK YOU FOR THAT GREAT
OVERVIEW.
I THINK WE'RE JUST ON TIME, TWO
MINUTES I THINK AHEAD OF
SCHEDULE -- ACTUALLY BEHIND
SCHEDULE.
WE'RE GOING TO FORTUNATELY MAKE
THIS UP TODAY.
NEXT SPEAKER DR. SACOBY WILSON
ON THE AGENDA COULD NOT MAKE IT
TODAY.
AND WE'LL MOVE FORWARD WITH OUR
FINAL TALK AS A CONSEQUENCE,
WHICH IS GIVEN BY DR. STEVEN
DAVIS AND ATTEMPT THE NEXT NAME,
STEVEN DAVIS (INDISCERNIBLE) AND
BLACKFOOT CONFEDERACY.
FORGIVE ME IF I BUTCHERED THE
NAME, FROM MONTANA STATE
UNIVERSITY IN BOZEMAN, JOINED BY
DR. ALEXANDRA ADAMS, SAME
INSTITUTION, DIRECTORY AND
PROFESSOR OF CENTER FOR AMERICAN
INDIAN AND RULE HEALTH EQUITY IN
MONTANA STATE.
THANK YOU TO BOTH OF YOU FOR
GIVING THIS TALK AND INDIGENOUS
NATIONS THINKING IN TERMS OF
PLANETARY HEALTH.
THANK YOU SO MUCH.
I THINK YOU MIGHT BE MUTED,
STEVEN.
>> I'M WAITING FOR MY COLLEAGUE
TO KICK US OFF.
>> TERRIFIC.
>> I'M UNMUTED BUT I CAN'T SEE
ME.
I DON'T KNOW IF YOU CAN
HIGHLIGHT ME FIRST AND THEN
STEVEN.
THERE WE GO.
START MY VIDEO.
THANKS.
>> TERRIFIC.
WE CAN SEE YOU NOW.
>> GREAT.
THANK YOU SO MUCH.
>> WE HAVE PLENTY OF TIME, NOT
TO WORRY.
THANK YOU SO MUCH.
>> I'M SORRY JACOBY COULDN'T
MAKE IT.
THANK YOU TO THE PRESENTERS AND
PEOPLE LISTENING FOR HAVING US
SPEAK.
STEVEN AND I ARE SPEAKING FROM
BOZEMAN MONTANA, MONTANA STATE
UNIVERSITY.
I'M OF EUROPEAN DESCENT,
PHYSICIAN AND RESEARCHERS
WORKING IN PARTNERSHIP WITH MANY
NATIVE COMMUNITIES FOR THE PAST
25 YEARS.
IT IS WITH DEEP GRATITUDE TO
THOSE COMMUNITIES THAT I SHARE
WITH YOU TODAY.
NEXT SLIDE PLEASE.
VICTOR
VICTOR FRANKL SAID THIS.
A PAPER WAS WRITTEN INCLUDING
THREE CRITICAL ISSUES WE MUST
CONSIDER.
CONCEPTUAL FAILURES, KNOWLEDGE
FAILURES, IMPLEMENTATION
FAILURES.
WE'VE HEARD ABOUT PLANETARY
HEALTH TODAY AND A LOT OF
KNOWLEDGE FAILURES AND
IMPLEMENTATION FAILURES, AND
THESE ARE CRISES ABOUT WHAT WE
THINK, HOW WE RELATE, WHAT WE
KNOW AND DO.
WE'LL FOCUS ON HOW WE THINK AND
RELATE.
WE BELIEVE THIS IS ABSOLUTELY
CRITICAL TO WHAT WE KNOW.
THE QUESTIONS WE ASK IN RESEARCH
AND HOW WE ASK THEM.
AND WHAT WE DO WITH THAT
INFORMATION AND HOW WE IMPLEMENT
AND DISSEMINATE.
WE BELIEVE WE'RE IN A CRISIS OF
MINDSET TO NEEDS TO SHIFT TO
RELATIONAL WAY OF BEING.
NEXT SLIDE PLEASE.
AS I'VE BEEN TAUGHT BY MANY
NATIVE ELDERS PEOPLE LEARN BEST
FROM STORY.
I'LL START WITH A STORY OF MY
WORK WITH NATIVE COMMUNITIES AND
HOW THE RESEARCH QUESTIONS WE
ASK HAVE EVOLVED OVER THE PAST
20+ YEARS.
AND CONTRARY TO WHAT PEOPLE
EXPECT I'M NOT PRESENTING DATA
OR FOCUS ON HEALTH ISSUES
CRITICAL IN URBAN AND TRIBAL
NATIVE COMMUNITIES AROUND THIS
COUNTRY AND THE WORLD.
RATHER HOW THE QUESTIONS THAT
WE'RE ASKING TOGETHER HAVE
SHIFTED OVER TIME.
SO LIKE MANY RESEARCHERS I
STARTED OUT WORKING IN BASIC
SCIENCE, CLINICAL LABS, CLINICAL
TRIALS.
THANKFULLY I WAS INTRODUCED TO
STRONG MENTORS, CONCEPTS OF
COMMUNITY-BASED PARTICIPATORY
RESEARCH.
JUNIOR FACULTY AT THE UNIVERSITY
OF WISCONSIN SCHOOL OF MEDICINE
I PARTNERED WITH SEVERAL TRIBAL
COMMUNITIES AND WE STARTED TO
LOOK AT SERIES OF NHLBI-FUNDED
STUDIES HOW DO WE UNDERSTAND WHY
WE HAVE HIGH RATES OF
CARDIOVASCULAR DISEASE AND
DIABETES NEW THESE COMMUNITIES
AND RATES OF CHILDHOOD OBESITY
THAT MIGHT CONTRIBUTE TO THOSE
FACTORS.
WE DID FIND HIGH RATES OF
CHILDHOOD OBESITY AND OVERWEIGHT
COUPLED WITH HIGH RATES OF
HYPERLIPIDEMIA IN YOUNG
CHILDREN.
I BROUGHT THAT DATA BACK TO
COMMUNITIES, WE WORKED TO DESIGN
A FAMILY-BASED INTERVENTION TO
ADDRESS DETERMINANTS OF HEALTH,
TYPICAL PUBLIC HEALTH THINGS
SUCH AS PHYSICAL ACTIVITY,
NUTRITION, SCREEN TIME, SLEEP,
STRESS.
ALL PREDICTORS OF FUTURE CARDIAC
DISEASE.
THIS WAS IMPLEMENTED IN MULTIPLE
COMMUNITIES NATIONALLY, HERE IS
A PICTURE OF A PARTICIPATING
FAMILY.
THESE QUESTIONS, WHAT WOULD
BENEFIT, WHAT DOES THE COMMUNITY
THINK, WERE INCORPORATED.
IN ADDITION DURING THAT TIME I
WAS WORKING WITH A PARTICULAR
COMMUNITY IN WISCONSIN IN A
COMMUNITY ENGAGEMENT WORK GROUP.
OVER THE FIRST FIVE YEARS THIS
WORK GROUP BEGAN HAVING
INCREASING DISCUSSIONS OF THE
ROLE OF HISTORIC AND CURRENT
TRAUMA IN THE HEALTH OF THE
COMMUNITY.
WE DISCUSSED HOW ADVERSE
CHILDHOOD EXPERIENCES DUE TO
TRAUMA AND SOCIAL DETERMINANTS
OF HEALTH AS WE TALKED ABOUT
SUCH AS POVERTY, RACISM, FROM
PRIOR SPEAKERS WERE LEADING TO
POOR COPING STRATEGIES SUCH AS
USING TOBACCO, ALCOHOL, DRUGS,
UNHEALTHY FOODS THAT WERE
CONTRIBUTING TO THESE HIGH RATES
OF CHRONIC DISEASES.
SO THIS TRAUMA MODEL AND WORK OF
MANY COMMUNITY ORGANIZATIONS TO
ADDRESS TRAUMA INFORMED CARE HAD
A SIGNIFICANT IMPACT ON
COMMUNITY WELLNESS, COMMUNITY
GRADUATION RATES, ET CETERA.
IT WAS NOT ENOUGH.
NEXT SLIDE PLEASE.
SO IN 2017 I WAS INVITED TO GO
TO NEW ZEALAND FOR INDIGENOUS
KNOWLEDGE EXCHANGE AND MY FRIEND
JENNIFER AND I FROM THE MENONMI
NATION GRAN EXCHANGES WITH
NATIVE HAWAIIAN COLLEAGUES TO
SHIFT FROM PUBLIC HEALTH SUCH AS
WHAT I'VE TALKED ABOUT, PHYSICAL
ACTIVITY, EVEN TRAUMA INFORMED
CARE, TO THINKING ABOUT HOW
REVITALIZING CONNECTION TO LAND
AND CULTURE WAS MORE HOLISTIC
APPROACH TO WELLNESS.
WE SHIFTED TO THINKING ABOUT
CULTURE, MEDICINE, BEGAN WORKING
WITH THE COMMUNITY TO REVITALIZE
LANGUAGE AND CULTURE AND KINSHIP
CONNECTIONS, SOME BELONGING THAT
PETER TALKED ABOUT WAS REALLY
CRITICAL TO HEALTH.
WE CREATED A A WELLNESS MODEL TO
HELP THE COMMUNITY VISUALIZE.
THIS IS US IN NEW ZEALAND,
LEARNING KNOWLEDGE OF FERNS AND
HOW WE CANNOT SPEAK ABOUT HEALTH
AND CONNECTION TO FOREST OR
PLANETARY HEALTH WITHOUT
ACTUALLY BEING IN THE FOREST.
MUCH OF OUR LEARNING TOGETHER
OCCURS OUTSIDE IN THE
ENVIRONMENTS THAT WE'RE WORKING
TO, WORK WITH, UNDERSTAND AND
LEARN FROM.
NEXT SLIDE PLEASE.
THESE ARE SOME OF THE COMMUNITY
ENGAGEMENT LESSONS LEARNED THAT
I THINK ARE CRITICAL AS WE MOVE
FORWARD, MOVING TOGETHER WITH
HOW DO WE WORK WITH COMMUNITY
AND UP TOWARDS NATION AND
STATEWIDE CHANGES.
I THINK IT'S REALLY IMPORTANT TO
BEWARE OF DEFICIT MODEL, THEY
HAVE ALL THESE ISSUES AND
PROBLEMS AND HAVE HIGHER
EXPOSURES OF PM2.5 ET CETERA,
APPROACHING FROM DEFICIT MODEL
SHUTS PEOPLE DOWN INSTEAD OF
ACTIVATING PEOPLE.
BEING OPEN TO THE POSSIBILITY OF
PEOPLE COMING TOGETHER WITH
COMMON VISION FOR HEALTH OF
THEIR COMMUNITY, NOT JUST
COMMUNITY IN TERMS OF HEALTH OF
THE PEOPLE, BUT HEALTH OF ALL OF
THE PARTS OF THE COMMUNITY
AROUND THEM.
ENSURING THAT PEOPLE'S WHOLE
SELVES ARE ENGAGED, BODY, MIND,
SPIRIT.
STEVEN WILL ELABORATE MORE ON
THAT.
REALLY UNDERSTANDING WHAT IS THE
LOCAL KNOWLEDGE AND
UNDERSTANDING OF THE ROOT CAUSE
OF COMMUNITY ISSUES.
WE NEVER WOULD HAVE WENT DOWN
THE ROAD OF UNDERSTANDING DEEP
IMPACT OF HISTORIC AND CURRENT
TRAUMA ON THE COMMUNITY AND HOW
THAT NEEDED TO BE ADDRESSED IN A
DIFFERENT WAY, WITHOUT LISTENING
AND TALKING TO THE COMMUNITY
OVER A LONG PERIOD OF TIME.
USING EVIDENCE-BASED APPROACHES
AND COMMUNITY INPUT IN THE
INTERVENTION, LASTLY OF COURSE
MOVE AT THE SPEED OF TRUST.
SO REVITALIZING LANGUAGE,
CULTURE HEALING WITH INDIGENOUS
KNOWLEDGE IS OCCURRING IN
INDIGENOUS COMMUNITIES IN THIS
COUNTRY AND INTERNATIONALLY.
IT'S HELPING MOVE OUR VIEW OF
HEALTH FROM INDIVIDUAL TO
COMMUNITY, INTO THE HEALTH OF
THE SURROUNDING LAND AND HEALTH
OF THE PLANET.
REMEMBERING AS INDIGENOUS
COMMUNITIES HAVE ALWAYS KNOWN
THAT WE'RE ALL CONNECTED IS
CRITICAL FOR MUTUAL SURVIVAL.
MY COLLEAGUE STEVEN WILL FURTHER
ELABORATE ON THIS NEXT.
NEXT SLIGHT PLEASE.
AND STEVEN?
>>
[SPEAKING IN A FOREIGN LANGUAGE]
[ SPEAKING A NATIVE LANGUAGE ].
>> I GREET YOU IN MY FIRST
LANGUAGE, THE FIRST PEOPLE OF
THE LAND, AS RELATIVES BECAUSE I
BELIEVE WE'RE INTERCONNECTED IN
MORE WAYS THAN WE COULD KNOW OR
UNDERSTAND.
FLIP BACK TO THE PREVIOUS SLIDE
PLEASE.
I'M OF MIXED EUROPEAN AND
INDIGENOUS ANCESTRY, CAN TRACE
THAT DIRECTLY BACK TO FIRST
EUROPEAN CONTACT, COLLISION OF
TWO CULTURES.
WHICH IS TO SAY I'M DESCENDANT,
BIG SKY, A GLIMPSE OF MY
ANCESTORS AND YOUTH.
THIS IS THE LAKES INSIDE THE
MOUNTAINS, ST. MARIES'S IN
GLACIER NATIONAL PARK, BECOMING
UNRECOGNIZE THE AS CLIMATE
DESTABILIZATION WITH RAPIDLY
DISAPPEARING GLACIERS, EXTENDED
SUMMERS HAVE BECOME SUFFOCATED
WITH WILDFIRE SMOKE, DIRECTLY AS
A RESULT OF COLONIAL
MISMANAGEMENT OF FORESTS THE
LAST TWO CENTURIES.
I INTRODUCED MYSELF AS A MEMBER
OF OUR SACRED THUNDER MEDICINE
SOCIETY, I'M HONORING SACRIFICE
OF PREVIOUS SEVEN GENERATIONS BY
SHAPING AND ADVANCING THE NEXT
SEVEN.
I'M IN ENGINEERING BY TRAINING,
FUTURE RESEARCH AND SCHOLARSHIP
FOCUSED IN ATTEMPT TO HELP
BRIDGE THE DIVIDE BETWEEN
WESTERN WAYS OF KNOWING AND
INDIGENOUS WAYS OF KNOWING, ALSO
BROADENING ACCESS TO HIGHER
EDUCATION.
NEXT SLIDE PLEASE.
WHEN I GREET YOU AS RELATIVES I
HAVE EMPHASIZE THIS IS A
CONCEPTUALIZATION OF BROTHERS,
SISTERS, MOTHER, FATHER,
GRANDFATHER, GRANDMOTHERS, NOT
JUST MY AUNTS AND UNCLES OR
COUSINS, THE LAND, WATER, THE
SKIES, PLANT AND ANIMAL
RECOMMEND ACTIVES, MANY
INDIGENOUS CULTURES HOLD THIS
INTERCONNECTIVITY AS AXIOMATIC,
TRUE AND CENTRAL, TO WORLD
VIEWS, EXTENDS TO THE LIVING,
THE NON-LIVING, PLANET, COSMOS
THEMSELVES.
MANY SYMBOLS REPRESENTATIVE
BELIEFS AND CULTURES, THE CIRCLE
IS BASED ON LAKOTA CONCEPT WHERE
EVERYTHING IS RELATED,
EXEMPLIFIES BELIEFS ALL THINGS
ARE CONNECTED IN ONE CYCLE, THE
MEDICINE WHEEL IS PICTURED HERE,
FOUR COLORS MAP ENCOMPASS FOUR
SACRED DIRECTIONS, FOUR SEASONS,
ANCESTRAL TO MY ORIGINAL SYSTEMS
THINKERS UNDERSTANDING OF HEALTH
AND CONNECTION TO ALL THINGS.
NOT ONLY IS IT A MODEL FOR
PERSONAL SPIRITUAL PHYSICAL,
MENTAL AND EMOTIONAL WELL-BEING,
WE UNDERSTAND OUR ROLE, OUR
REALITY, INTERCONNECTED
INTERPLAY BETWEEN OUR MIND,
BODY, HEARTS AND SOULS.
AS MANY OTHER SOCIOECOLOGICAL
FRAMEWORKS PRESENTED TODAY
HIGHLIGHT STRONG HEALTHY
THRIVING COMMUNITIES AND NATIONS
COMPRISED OF STRONG HEALTHY
THRIVING INDIVIDUALS AND
FAMILIES SUCH AS SOCIAL
DETERMINANTS OF HEALTH, OTHER
CONCEPTUAL MODELS, EXTENDING TO
UNDERSTAND OUR PLACE IN ALL OF
REALITY, FROM PLANETARY HEALTH
PERSPECTIVE WHO DESCENDED FROM
THE CONTINENT, ENCOURAGED BY
PRESENTATIONS PRESENTED THIS
MORNING BECAUSE AS WE UNDERSTAND
THIS CONCEPT OF KIN-CENTRIC
ECOLOGY, OUR PLACE IN RELATION
TO LAND, WATER, SKIES, STARS,
NON-HUMAN BEINGS, NOT BE -- NOT
BE A TRACT.
FROM MY TRAINING, THE CLIMATE
AND FORCE WE'RE DISCUSSING ARE
ALSO A PRODUCT OF THE GEOLOGICAL
TIME SCALE INTERPLAY BETWEEN THE
LITHO SPHERE, HYDRO SPHERE AND
BIOSTEER.
BIOSPHERE.
WHEN WE UNDERSTAND THE BALANCE,
THE DIVERSITY OF THE ECOSYSTEM.
NEXT SLIDE PLEASE.
>> NEXT SLIDE.
>> THIS CONCEPT OF KINSHIP IN
RELATION IS NOT JUST HERE AND
NOW BUT ACROSS TIME.
I HIGHLIGHT THIS CONCEPT OF
SEVEN GENERATIONS BECAUSE IN
ACCORDANCE WITH MANY INDIGENOUS
PHILOSOPHIES EVERY DECISION WAS
DISCERNED TO HONOR SACRIFICE OF
PREVIOUS GENERATIONS, FULL
REGARD GIVEN TO THOSE WHO HAVE
COME BEFORE AND SEVEN
GENERATIONS TO COME, HONORING
INTERSACREDNESS OF ALL THINGS,
CORE BELIEFS GUIDE US, THE REAL
PEOPLE ARE ROOTED IN HERITAGE OF
VALUES AND BELIEF TRANSFERRED
AND PASSED ON ORALLY BY OUR
ANCESTORS GENERATION TO
GENERATION, AS OTHER INDIGENOUS
SCHOLARS BEFORE ME HAVE WRITTEN
ON THIS EMERGING CONCEPT,
HIGHLIGHTING FOUR Rs, I HOVER
THE QUESTION OF WHAT RESEARCH
AND ECHO WHAT ALEX OFFERED WHAT
ARE RESEARCH OPPORTUNITIES AND
GAPS REFRAMED FROM INDIGENOUS
PERSPECTIVE WHEN GOVERNING RULES
OF THESE RELATIONSHIPS
RESPONSIBILITY, RECIPROCITY,
REVERENCE, AND AS ALEX
HIGHLIGHTED MY ELDERS HAVE
SHARED THIS INTERGENERATIONAL
PERSPECTIVE IN WHICH WE
RECOGNIZE THAT OUR PEOPLE WERE
ONCE TREATED AS OBJECTS OF
RESEARCH, BECOMING SUBJECTS,
MAYBE UNWILLING PARTICIPANTS, TO
NOW PERHAPS WILLING PARTICIPANTS
AND SUBJECTS.
TODAY I'M ENCOURAGED TO KNOW MY
COLLEAGUES AND OTHERS LIKE ALEX
ARE COLLABORATIVELY SHAPING
COMMUNITY-BASED RESEARCH EFFORTS
AND PROJECTS, THEREFORE SHAPING
OUR NEXT GENERATION AT THIS
INSTITUTE FOR GENERATIONS.
I'LL LEAVE YOU WITH THE PHOTO OF
THE CHIEF MOUNTAIN.
WE HAVE SO MUCH ANCESTRAL WISDOM
AND KNOWLEDGE IN OUR NATIVE
LANGUAGE.
PICTURE IS THE RETURN AFTER MANY
GENERATIONS, RETURNED OUR FIRST
RELATIVES, RESTORATION OF
CULTURE WITH REINTRODUCTION OF
BISON TO THE LAND, WITH IT
COMING BACK STORIES, SONGS,
CEREMONIES.
OUR WORDS FOR THESE MOUNTAINS,
PEOPLE WERE SHAPED BY FOR
GENERATIONS, IS SIGNED LIKE
THIS.
OUR LANGUAGE IS DYNAMIC, NOT
STATIC, TO OFFER A STEM ANALOGY,
IT'S FLUX, IN CALCULUS LANGUAGE,
NOT SNAPSHOTS OR STATISTICS.
A DEEP INTIMATE CONNECTION TO
THIS PLACE, NOT ONLY WE KNEW
THESE MOUNTAINS, WE KNEW THE
FORCES THAT SHAPED OVER TENS OF
THOUSANDS OF YEARS, SINCE BEFORE
THE LAST EYE -- ICE AGE.
RELATIVES ON OTHER SIDE OF THE
DIVIDE HAVE WORDS FOR LAKE
MISSOULA, LAND OF THE GREAT ICE
WATER, THE GLACIAL LAKES THAT
SHAPED THE PACIFIC NORTHWEST.
WE UNDERSTOOD WE WERE NOT APART
FROM NATURE BUT AN INTEGRAL PART
AS BEING OF THE LAND SHAPED BY
THE LAND, WE DO TO LAND WATER
AND SKIES WE DO TO OURSELVES, A
JUXTAPOSITION OF WESTERN VIEW.
ONE OTHER THING I MIGHT OFFER IN
TERMS OF THAT PREVIOUS IMAGE,
AND STRESS AND HIGHLIGHT, OUR
CONCEPT OF MEDICINE HAS
COMPLETELY DIFFERENT CONNOTATION
IN CULTURES.
THE WORD I WOULD USE TO HUNT OR
GATHER ROOTS OR BERRIES IN A
PLACE PICTURED ON THE SCREEN,
UNDERSTANDING OF MEDICINE, IS A
CONCEPT OF WELL-BEING, MEANING
IT'S PRO-ACTIVE, PREVENTIVE, NOT
REACTIVE, PRESCRIPTIVE, OR
EPISODIC.
BECAUSE OUR ANCESTORS UNDERSTOOD
THAT FOOD WAS MEDICINE, CULTURE
WAS MEDICINE, WE'RE ULTIMATELY
STILL HERE, HAVE BECOME STORIES
WE TELL.
NEXT SLIDE PLEASE.
>> STEVEN, IT'S GOING TO TURN
BACK TO ME TO DISCUSS RESEARCH
GAPS.
THANK YOU.
WE WERE TALKING ABOUT WHAT WERE
SOME RESEARCH GAPS WE WOULD LIKE
TO PRESENT TODAY.
I THINK ONE OF THEM IS
COMMUNICATING CONNECTIONS
BETWEEN CLIMATE CHANGE AND HUMAN
HEALTH.
WE LIVE IN A VERY RURAL FRONTIER
STATE.
EVEN THOUGH A LOT OF PRODUCERS
HERE ARE PRODUCING FOOD AROUND
THE COUNTRY, THEY SEE CLIMATE
CHANGES HAPPENING, NOT ABLE TO
TALK ABOUT IT IN IMPORTANT WAYS,
THAT GETS INTO MESSING WITH
LOCAL AND STATE POLICY CHANGES,
THOSE ARE IMPORTANT TO THINK
ABOUT HOW WE COMMUNICATE THIS.
NEXT IS IMPLEMENTING BEST
PRACTICES IN SUPPORTING
COMMUNITIES, ACTION GROUPS TO
ENACT CHANGES THEY WANT IN
POLICY SYSTEMS AND ENVIRONMENT.
THEN ANOTHER ONE WE TALKED ABOUT
WAS A LOT OF BIG DATA NOW, IT'S
AVAILABLE, IT'S ALL THERE, BUT
REALLY NEEDS COMMUNITY INPUT TO
ASK THE RIGHT QUESTIONS OF THAT
BIG DATA.
I'VE SEEN SOME GREAT PROJECTS
BUT THEY ARE ASKING ALL THE
WRONG QUESTIONS.
WITHOUT COMMUNITIES HAVING INPUT
INTO THAT IT'S TRIPPED UP
PEOPLE'S INFORMATION THAT THEY
ARE OBTAINING.
NEXT I WOULD SAY WHAT WE SAW
DURING COVID WAS A REALLY
DIFFICULT SITUATION,
PARTICULARLY IN RURAL AND TRIBAL
AREAS, THAT ARE ALREADY FOOD
DESERTS AND LACK OF FOOD.
AND SO HOW DO WE HELP PROMOTE
GOOD FOOD SYSTEMS?
WE TALKED ABOUT SYSTEMS FOR
SUSTAINABILITY IN TIMES OF THE
COMING CLIMATE, FURTHER CLIMATE
CRISES.
AND THEN NEXT WE HAVE TO ENSURE
THE CRITICAL INDIGENOUS VOICE IS
AT THE TABLE, NOT ON THE MENU,
AS STEVEN TALKED ABOUT.
OFTEN INDIGENOUS VOICES ARE LEFT
OUT, PARTICULARLY OUT OF ANY
DATA, BUT PARTICULARLY AT
DISCUSSING THESE ISSUES.
NEXT SLIDE PLEASE.
SOME RESEARCH OPPORTUNITIES AS
WE SEE THEM, AGAIN THE ONES WE
TALKED ABOUT BUT MOVING AWAY
FROM EXPLOITATIVE PRACTICES AND
HOW DOES RESEARCH SERVE NEEDS OF
OUR COMMUNITIES, ALL OF OUR
COMMUNITIES, AND PLANETARY
HEALTH NOW AND FOR THE NEXT
SEVEN GENERATIONS?
WE BELIEVE THIS INTERCONNECTED
INTERGENERATIONAL RELATIONAL
APPROACH IS CRITICAL TO THE
PLANETARY AND HUMAN HEALTH.
BACK TO STEVEN.
>> I WANT TO LEAVE YOU WITH
THIS.
UNDERSTANDING THAT KINSHIP WITH
ALL CREATURES OF THE EARTH, SKY,
AND WATER WAS A REAL AND ACTIVE
PRINCIPLE.
THIS CONCEPT OF LIFE AND
RELATIONS FILLED US WITH JOY AND
MYSTERY OF LIVING, GAVE
REVERENCE FOR ALL, MADE A PLACE
FOR ALL THINGS IN THE SCHEME OF
EXISTENCE.
CHIEF STANDING BEAR.
THANK YOU.
[ SPEAKING NATIVE LANGUAGE ]
>> THANK YOU, ALEX AND STEVEN.
I WANT TO TAKE A MOMENT TO PAUSE
BECAUSE OF THE IMPACT OF WHAT
YOU JUST SHARED WITH US, AND HOW
IMPORTANT THIS MESSAGE AT THE
CONCLUSION OF THE SESSION IS TO
FRAME OUR DISCUSSIONS ABOUT THE
ULTIMATE EXISTENTIAL PROBLEM
FROM THE STANDPOINT OF
INDIGENOUS COMMUNITIES AND
ANCIENT WISDOMS THAT FRAMED HOW
INDIGENOUS COMMUNITIES HAVE
LIVED THEIR LIVES, SUSTAINABLY,
AND THAT THERE MIGHT BE POWERFUL
MESSAGING AND RESEARCH
OPPORTUNITIES.
THANK YOU VERY MUCH.
WE ARE FIVE MINUTES AHEAD OF
TIME.
WE'LL USE THIS EFFECTIVE.
WE WERE SCHEDULED TO MOVE TO THE
DISCUSSION SESSION, WHICH WILL
BE LED BY DR. CARREN SOLOMON.
THIS WAS ORIGINALLY SCHEDULED TO
BE FROM 12:00 TO 12:40 AND IF WE
FINISH EARLY MIGHT BREAK EARLY
ON AND COME BACK AFTER LUNCH AT
1:20 P.M.
IT'S MY PLEASURE TO INTRODUCE
DR. CAREN SOLOMON, DEPUTY
DIRECTOR NEW ENGLAND JOURNAL OF
MEDICINE, ASSOCIATE PROFESSOR AT
HARVARD, PHYSICIAN AT BRIGHAM
AND WOMEN'S HOSPITAL.
RESPONSIBILITY INCLUDING LEADING
EFFORTS RELATED TO COVERAGE OF
CLIMATE CHANGE, OVERSEEING
ONGOING FOSSIL FUEL SERIES, AN
EXTRAORDINARY SERIES OF PAPERS
THAT BROUGHT ATTENTION TO THIS
ISSUE BY THE WORLD'S LEADING
MEDICAL JOURNAL.
SO, I'D LIKE TO THANK HER FOR
TAKING TIME TO JOIN US TODAY AND
I TURN THIS OVER TO KICK OFF
THESE DISCUSSIONS.
CAREN, THANK YOU FOR JOINING US.
>> THANK YOU.
SO, THIS IS TERRIFIC.
I WANT TO THANK YOU FOR YOUR
EXCELLENT TALKS, I ALSO WANT TO
SAY THAT IT IS REALLY EXCITING
TO SEE NHLBI FOCUSING ON
PLANETARY HEALTH, INCLUDING
CLIMATE CHANGE, AND IMPLICATIONS
FOR CARDIOVASCULAR DISEASE,
REDUCTION AND HEALTH EQUITY.
EACH OF YOU SPEAKING TODAY
REVIEWED A LOT OF IMPORTANT DATA
AND HIGHLIGHTED SOME MANY
UNANSWERED QUESTIONS CRITICAL
INFORMING DEVELOPMENT OF
RESEARCH AGENDA.
I HAVE A LOT OF FOLLOW-UP
QUESTIONS AND EXPECT OUR
AUDIENCE WILL AS WELL.
SO, TO START, CRITICAL FOCUS OF
THE SYMPOSIUM TOUCHED ON BY ALL
SPEAKERS IS HEALTH EQUITY.
SO, BEGINNING THERE, I'M GOING
TO TURN TO ALEXANDRA AND/OR
STEVEN.
YOU UNDERSCORED TREMENDOUS VALUE
OF LOCAL KNOWLEDGE AND
UNDERSTANDING ROOT CAUSES OF
PROBLEMS, AND CLEARLY AS SANJAY
REITERATED WE HAVE A LOT TO
LEARN FROM INDIGENOUS
COMMUNITIES ABOUT LIVING IN
HARMONY WITH NATURE.
I'M HOPING THAT YOU CAN PROVIDE
SOME GUIDANCE REGARDING BEST
PRACTICES FOR WORKING ALONGSIDE
COMMUNITIES THAT ARE
DISPROPORTIONATELY AFFECTED BY
CLIMATE CHANGE AND OTHER
PLANETARY HEALTH DETERIORATION.
SO, ALEXANDRA?
>> MAYBE I'LL START AND TURN IT
OVER TO STEVEN.
I THINK REALLY THE MOST
IMPORTANT THING AS I HAD IN MY
SLIDE WAS MOVING AT THE SPEED OF
TRUST.
SO BUILDING RESPECT,
RELATIONSHIPS WITH COMMUNITIES
ARE REALLY IMPORTANT.
THINKING ABOUT THE RECIPROCITY
IN TERMS OF I'VE GOTTEN SO MANY
PEOPLE COMING TO ME SAYING WE
NEED TO PUT INDIANS IN OUR
RESEARCH.
JUST REALLY INSULTING.
IT'S REALLY TRICKY BECAUSE
THAT'S NOT THE WAY TO APPROACH
COMMUNITY, RIGHT?
YOU HAVE TO GO IN TRYING TO
UNDERSTAND HOW THE COMMUNITY AND
WHAT THE COMMUNITY NEEDS AND
WHAT THEY WANT.
GOING IN, AND HAVING TRUSTED
ALLIES FROM PERSPECTIVE OF LIGHT
RESEARCHER, I'VE FOUND PEOPLE IN
THE COMMUNITY WHO HELP ME LEARN
ABOUT THE COMMUNITY, UNDERSTAND
THE COMMUNITY, AND TEACH ME
ABOUT THE COMMUNITY AND THEN GO
IN WITH THAT VERY MUCH OF A HOW
CAN I LEARN THE MOST FROM THAT
COMMUNITY IN TERMS OF WORKING AS
A PARTNER BECAUSE I'M ALWAYS
AWED HOW MUCH MORE THEY KNOW
ABOUT ALL OF THE THINGS THAT
WE'RE TRYING TO DEAL WITH THAN I
DO.
SO, I WOULD SAY THAT
COMMUNITY-BASED PARTICIPATORY
RESEARCH IS A REALLY IMPORTANT
WAY TO DO IT BUT IT GOES BEYOND
THAT IN TERMS OF BUILDING TRUST
AND THAT RESPECT.
>> THANK YOU.
>> STEVEN, I'LL TURN IT OVER TO
YOU MAYBE NOW.
>> I WOULD ECHO THE
RELATIONSHIPS ARE THE
FUNDAMENTAL ASPECT OF ANY
INTERACTION.
WE'RE BATTLING GENERATIONS OF
ERASURE AND EXCLUSION, MANY
PROBLEMATIC PRACTICES.
BUT I'M ENCOURAGED, NOT THE
LEAST OF WHICH BY PRESENTATIONS
PRESENTED HERE, STARTING TO
REFLECT THAT RELATIONAL THAT OUR
PEOPLE KNEW SO WELL AND MOVING
AT THE SPEED OF TRUST IS KEY IN
ALL EFFORTS ANYWHERE.
>> THANK YOU.
OBVIOUSLY WE SHOULD BE APPLYING
THAT TO ALL OF OUR WORK WITH
FRONTLINE COMMUNITIES AND
OTHERS, BUT SUPER HELPFUL.
ANOTHER PIECE OF EQUITY HAS TO
DO WITH KIND OF BEST MEASURING
THE EFFECTS OF INEQUITY.
I'M GOING TO CALL ON AN AUDIENCE
QUESTION, MICHELLE ASKED HOW WE
MEASURE COST, NOT JUST FINANCIAL
BUT OTHER COSTS OF THESE
DISPARITIES THAT WE'RE SEEING,
EXPOSURES AND HEALTH OUTCOMES.
FOR EXAMPLE, IS THERE SOMETHING
BETTER THAN DISABILITY ADJUSTED
LIFE YEARS?
I'M GOING TO TURN THAT TO ANA
FIRST.
>> THANK YOU.
THAT'S A GOOD QUESTION.
I'M NOT SURE I FULLY UNDERSTAND
THE QUESTION.
CAN YOU RESTATE?
IT'S ABOUT -- THERE ARE MANY
DIMENSIONS TO MEASURING
INEQUITIES, OF COURSE.
AND IT DEPENDS ON WHAT YOUR
SPECIFIC GOAL IS.
>> VERY FAIR.
SO I THINK THAT QUESTION WAS
PRETTY FOCUSED I THINK ON REALLY
KIND OF BROADER QUESTION THAN
FINANCIAL COST BUT ARE THERE
WAYS THAT WE CAN QUANTITATIVELY
CAPTURE IMPACT?
IT'S A TOUGH ONE.
I DON'T KNOW THE RIGHT ANSWER.
THAT WE COULD QUANTITATIVELY
CAPTURE THESE IMPACTS AND REALLY
THEREFORE BE ABLE TO MAKE VERY
CLEAR HOW CERTAIN COMMUNITIES
ARE EXPERIENCING GREATER
SUFFERING AND THAT WOULD ALSO
TRANSLATE INTO INTERVENTIONS
THAT ARE TARGETED TO MITIGATE OR
FACILITATE ADAPTATION IN CERTAIN
COMMUNITIES ARE GOING TO END UP
ACTUALLY BEING, YOU KNOW, COST
SAVING AND HAVE MORE BENEFIT.
THE QUESTION IS AROUND THAT
BROAD QUESTION OF CAPTURING COST
AND COST EFFECTIVENESS.
>> YEAH, I MEAN IN GENERAL
TERMS, I MEAN, THERE ARE MANY
WAYS TO MEASURE INEQUITIES AND
SOMETIMES WE BUILD IN VALUE
JUDGMENTS IN THE WAY WE MEASURE
OR REPORT ON INEQUITIES.
IT'S IMPORTANT TO KEEP THAT IN
MIND AS WE THINK ABOUT MEASURING
INEQUITIES.
WHO IS THE COMPARISON GROUP, FOR
EXAMPLE, IS IT A RELATIVE OR
ABSOLUTE DIFFERENCE THAT WE'RE
LOOKING AT.
SO I GUESS WHAT I WOULD SAY IS
WE HAVE TO LOOK AT IT OFTEN IN
MULTIPLE WAYS.
BECAUSE EACH PIECE IS TELLING US
SOMETHING DIFFERENT, AND THAT
HAVING INPUT FROM COMMUNITIES ON
THE INTERPRETATION AND ON THE,
YOU KNOW, MEANING OF SOME OF
THESE DIFFERENCES IS VERY
IMPORTANT.
I'M NOT SURE IF I'M COMPLETELY
ANSWERING THE QUESTION BUT
THAT'S WHAT I CAN DO.
THE COST, YOU KNOW, COST-BENEFIT
ANALYSES AN IMPACT ON COST, IT'S
A WHOLE OTHER WORLD.
I THINK THERE ARE OFTEN A LOT OF
ASSUMPTIONS IN THERE ABOUT COST
TO WHOM, AND WHO PAYS FOR THE
COSTS, WHICH ARE COMPLEX AND
NEED TO BE TALKED ABOUT.
SO WE NEED TO BE CAREFUL ABOUT
THAT.
IN CHARACTERIZING INEQUITIES,
IT'S VERY IMPORTANT TO AVOID
STEREOTYPING, OR, YOU KNOW, I
THINK IT WAS ALLUDED TO BY SOME
PRESENTERS FOCUSING ONLY ON
DEFICIT MODEL BUT ALSO TALKING
ABOUT COMMUNITY ASSETS AND ALSO
THINKING DYNAMICALLY, GETTING
BACK TO, YOU KNOW, WHAT PETER
HAS BEEN TALKING ABOUT.
THAT'S WHY I LIKE THE PM2.5
PAPER SO MUCH BECAUSE IT LOOKED
NOT ONLY AT WHO WAS EXPOSED BUT
WHO WAS DRIVING THE EXPOSURES.
I THINK THAT'S AN ANGLE WE ALSO
NEED TO THINK ABOUT PARTICULARLY
AS WE'RE THINKING SYSTEMICALLY
ABOUT HEALTH INEQUITIES IN
GENERAL.
>> ABSOLUTELY.
THANK YOU.
SANJAY, BEFORE I ASK THE NEXT
QUESTION, IF I THROW OUT A
QUESTION WITHOUT POINTING IT TO
AN INDIVIDUAL SPEAKER, AM I
GOING TO DISRUPT THE
PROCEEDINGS?
>> NOT AT ALL.
I WOULD PREFER THIS TO BE A
FAIRLY UNSCRIPTED PRESENTATION
SO PEOPLE CAN SPEAK THEIR VIEWS.
GO RIGHT AHEAD.
>> I'M THROWING OUT MORE
GENERALLY THAN BEFORE WE MOVE TO
OTHER ASPECTS OF THE DISCUSSION,
WHETHER ANYBODY WANTS TO SORT OF
REITERATE OR EXPAND ON CRITICAL
WAYS THAT WE CAN ENSURE THAT ANY
RESEARCH ON PLANETARY HEALTH AND
CARDIOVASCULAR DISEASE IS EQUITY
CENTERED.
ANY TAKERS?
>> I'LL TAKE A STAB.
I'LL KICK THE DISCUSSION OFF
BECAUSE THIS IS A LOADED
QUESTION, FUNDAMENTALLY
IMPORTANT BUT I THINK IN MANY
WAYS CLIMATE CHANGE, UNLESS IT
REALLY ADDRESSES ISSUES
PERTAINING TO VULNERABLE
COMMUNITIES AND COMMUNITIES AT
RISK, CAN NEVER REALLY SOLVE THE
PROBLEM.
SO MANY WAYS THIS IS A PRIMARY
NEED FOR CLIMATE RESEARCH AND
CERTAINLY FROM CARDIOVASCULAR
ANGLE WE'VE LEARNED FROM ANA'S
WORK AND MANY OTHERS IN THE CORE
TODAY THAT SOCIAL INEQUITIES
DRIVE DISPROPORTIONATE NUMBER OF
CARDIOVASCULAR OUTCOMES AND
ENVIRONMENTAL AND CLIMATE
EXPOSURES DO SO IN A SIMILAR WAY
USING SIMILAR PATHWAYS.
AND DISPROPORTIONATELY IMPACT
THE COMMUNITIES.
IF YOU CAN'T ADDRESS THAT,
YOU'RE NEVER GOPHER TO SOLVE THE
PROBLEM.
I THINK THE YOUR COMMISSIONER
SAID THEY CANNOT BE A
TRANSITION, SOMETHING LIKE IT
CAN'T BE A TRANSITION UNLESS
THERE'S A JUST TRANSITION.
IN OTHER WORDS, IT HAS TO BE --
WON'T BE A TRANSITION UNLESS
IT'S A TRANSITION THAT WORKS
WELL FOR COMMUNITIES AT RISK.
I DON'T KNOW WHETHER OTHERS WANT
TO ADD.
>> I'LL ADD QUICKLY, I WOULD SAY
MAKING SURE THAT, AGAIN, THE
PEOPLE THAT ARE BEING MOST
AFFECTED ARE IN THE ROOM IN
THOSE DISCUSSIONS.
WHATEVER UNDERSERVED COMMUNITY
YOU'RE WORKING WITH THEY NEED TO
BE AT THE TABLE.
THAT'S CRITICAL.
OFTEN LEFT OUT.
>> I CAN'T SEE EVERYBODY BUT IF
SAM HAS A HAND UP WE'RE GOING TO
DO SAM AND THEN PETER.
>> THANKS.
JUST A COUPLE QUICK THOUGHTS.
ONE I THINK IT'S ACTUALLY
ABOUT -- EQUITY IS IMPORTANT
OBVIOUSLY BUT IT'S MORE THAN
JUST EQUITY.
IT'S ABOUT HOW WE TAILOR
INTERVENTIONS.
SO IT'S REALLY IMPORTANT TO
UNDERSTAND THE DISTRIBUTION OF
THESE FACTS ACROSS DIFFERENT
POPULATIONS SO WE KNOW WHAT TO
DO ABOUT THEM.
WHETHER IT'S RISING CO2 MAKING
FOOD LESS NUTRITION, WHAT ARE
POPULATIONS AROUND THE WORLD
THAT HAVE DIETS THAT SET THEM UP
TO BE PARTICULARLY VULNERABLE TO
THOSE CHANGES IN NUTRIENT
INTAKE, AND HOW DO WE TAILOR
INTERVENTIONS.
THAT'S JUST ONE THOUGHT.
I THINK IT'S IMPORTANT TO SHOW
DISPROPORTIONATE DISTRIBUTION
NOT ONLY BECAUSE FREQUENTLY IT'S
POOREST PEOPLE IN THE WORLD MOST
IMPACTED BUT SOMETIMES IT'S
POPULATIONS IN THE WEALTHY
PARTS, LIKE OUR WORK ON
POLLINATORS MOST IMPACTED, ALSO
AN IMPORTANT MESSAGE FOR PEOPLE
TO UNDERSTAND THAT THERE'S
NOBODY WHO IS FUNDAMENTALLY
IMMUNE FROM THESE IMPACTS.
THE SECOND THING I WANTED TO SAY
WAS THAT I AGREE ABOUT HAVING
VULNERABLE POPULATIONS
REPRESENTED IN THE ROOM BUT I
THINK WE ALSO HAVE TO RECOGNIZE
THAT THE HUGE INTERGENERATIONAL
EQUITY ISSUES, SO THE MOST
VULNERABLE PEOPLE CAN'T BE IN
THE ROOM BECAUSE THEY ARE IN
FUTURE GENERATIONS, AND ALSO
OFTEN NON-HUMAN SPECIES.
SO, WE HAVE TO ACKNOWLEDGE THAT
IN SOME WAYS WE HAVE TO THINK
ABOUT NON-REPRESENTED ENTITIES
AS WELL.
>> GOOD POINT.
PETER, DO YOU WANT TO WEIGH IN?
>> I'M THINKING BACK TO WORK OF
ALEX AND STEVEN REFERENCED, IN
COLLABORATING WITH FOLKS FROM
NEW ZEALAND, SOME WORK WE'VE
DONE, IT'S NOT JUST WHEN WE'RE
COMING TOGETHER AND FRAMING
QUESTIONS WE'RE DRAWING ON
LANGUAGE, MENTAL MODELS, IT
TAKES TIME TO JUST GET -- IT'S
NOT JUST BEING IN THE ROOM BUT
HAVING OPPORTUNITIES TO CONNECT
AND UNDERSTAND EACH OTHER'S
FRAMEWORKS.
AND HOW WE'RE PHRASING QUESTIONS
AND PRIORITIZING QUESTIONS AND
BUILDING OFF WHAT SAM WAS SAYING
IN TERMS OF ENVIRONMENT, ONE OF
THE THEMES THAT'S COME FROM SOME
OF THOSE INTERACTIONS THAT ALEX
AND STEPHEN TALKED ABOUT WHERE
WE'VE HAD SORT OF INVESTED TIME
AND EFFORT TO UNDERSTAND EACH
OTHER'S METAPHORS, WHERE WE'RE
COMING FROM.
IT'S BEEN -- AS AN EXAMPLE ONE
IS LIKE REALLY FLIPPING FROM
FOCUS ON HUMAN HEALTH TO
UNDERSTANDING ENVIRONMENT
ECOLOGY AS DERIVATIVES, AS
CHANGE TERMS INSTEAD OF
COMMUNITY HEALTH BEING
DERIVATIVE OF INDIVIDUAL HEALTH,
HEALTH IS DEFINED AT COMMUNITY
ECOLOGICAL LEVEL, HUMAN HEALTH
IS DERIVATIVE.
SO THAT'S AN EXAMPLE OF SOME
SHIFTS IN LANGUAGE, THOSE
INTERACTIONS AND I THINK IT'S
WITH THE SYSTEM DYNAMICS ONE OF
THE WAYS WE'VE BEEN ABLE TO
FLESH THAT OUT.
THE OTHER PIECE I WOULD SAY IS
IT'S NOT -- IT'S BEING CONSCIOUS
ALSO ABOUT -- AND LISTENING TO
WHAT IT IS WE MAY BRING
SOMETHING INTO CONTEXT THINKING
THAT'S WHAT'S GOING TO BE
VALUABLE BUT IT'S ACTUALLY FROM
MY EXPERIENCE LISTENING AND
FIGURING OUT IN THOSE
COLLABORATIONS WHAT IT IS THAT
COULD OFFER THAT WOULD BE
USEFUL.
AND SO I GUESS THAT'S WHAT I
WOULD SAY.
THAT ENDS UP SHAPING A LOT OF
HOW WE THEN GO ABOUT
CONCEPTUALIZING SOMETHING LIKE
EQUITY, WHAT IT MEANS, AND THEN
BEGINNING TO MOVE FORWARD TO
THINKING ABOUT WHAT DOES IT MEAN
TO CHANGE THE STRUCTURE OF A
SYSTEM AND WHAT STRUCTURAL
INEQUITIES VERSUS DISTRIBUTIONAL
INEQUITIES, HOW DO WE
DISENTANGLE.
>> ANA?
>> TWO THOUGHTS.
THINKING SPECIFICALLY ABOUT
CARDIOVASCULAR INEQUITIES, I
THINK THE FIRST THING IS THAT,
YOU KNOW, LARGE INEQUITIES IN
CARDIOVASCULAR DISEASE EXIST.
ENVIRONMENTAL FACTORS ARE MAJOR
CONTRIBUTORS ALREADY TO THOSE
DIFFERENCES, INCLUDING MANY OF
THE THINGS WE TALKED ABOUT TODAY
AND MORE.
AND I THINK THE METHODS THAT WE
USE AND EVEN SOMETIMES
CONCEPTUAL MODELS, THIS IS
EXPANDED OVER THE PAST COUPLE
DECADES DON'T FULLY CAPTURE
THIS.
IN SOME WAYS, BROADENING
THINKING TO PLANETARY HEALTH
FORCES UP TO GRAPPLE AND FIGURE
OUT WAYS TO BETTER UNDERSTAND
IMPACT OF ENVIRONMENTAL FACTORS
BROADLY DEFINED TO
CARDIOVASCULAR INEQUITIES.
QUESTIONS WE ASK, METHODS WE
USE, HOW WE THINK CONCEPTUALLY
AND SYSTEMICALLY ABOUT THESE
THINGS AS OPPOSED TO THE
TRADITIONAL BIOMEDICAL PARADIGM.
SO, THERE'S AN URGENCY ABOUT
UNDERSTANDING AND ADDRESSING THE
CARDIOVASCULAR INEQUITIES THAT
WE HAVE TODAY, AND THE SECOND
POINT THAT I WANT TO MAKE, IT'S
IMPORTANT TO REMEMBER THINGS WE
DO AS SOCIETY TO ADDRESS GLOBAL
ENVIRONMENTAL CHANGE INCLUDING
CLIMATE CHANGE MITIGATION AND
ADAPTATION STRATEGIES CAN HAVE
POSITIVE EQUITY BENEFITS OR CAN
INCREASE INEQUITIES.
SO IT'S VERY IMPORTANT FOR US TO
KEEP THAT IN MIND TOO, AS WE
THINK AND BE ABLE TO DOCUMENT
AND UNDERSTAND THOSE POTENTIAL
IMPACTS SO WE CAN MAKE SURE THAT
WE'RE NOT MAKING INEQUITIES
WORSE BY ADDRESSING -- BY THE
WAY WE DECIDE AS A SOCIETY TO
ADDRESS OR PERHAPS NOT ADDRESS,
YOU KNOW, THESE CHALLENGES.
>> SANJAY?
>> ONE THEME WAS HOW DO YOU
START TO ENGAGE IN SYSTEMS
THINKING, ANA ALLUDED TO THAT AS
WELL AS PETER, ALSO HOW DO YOU
START TO EXTRICATE SOME OF THESE
INFLUENCES THAT CO-SEGREGATE AND
TRAVEL TOGETHER, PARTICULARLY
SOCIAL AND ENVIRONMENTAL
EXPOSURES AND HOW MIGHT AS
RESEARCH QUESTIONS INVESTIGATORS
START TO PUT IN FRAMEWORKS OR
ASK QUESTIONS, WHERE THEY START
TO DISENTANGLE SOME EXPOSURES TO
TRY AND BETTER PUT A HANDLE ON
WHAT'S ACTUALLY CAUSING THINGS
SO THAT WE CAN DESIGN
INTERVENTIONS BETTER AND DO
FOLKS ON THIS PANEL HAVE
THOUGHTS ABOUT RESEARCH
METHODOLOGIES AS WELL AS
FRAMEWORKS THAT SHOULD PROBABLY
BE MUCH MORE PERVASIVE IN
RESEARCH APPLICATIONS, ET
CETERA, IN A SHIFT FROM AS ANA
MENTIONED FROM TRADITIONAL
BIOMEDICAL PARADIGM TO EXPOSOMIC
FRAMEWORKS, TOOLS IN
INFORMATICS, ANY COMMENTS FROM
MEMBERS OF THE PANEL ON WHAT
SOME OF THESE APPROACHES MIGHT
LOOK LIKE?
>> SAM?
>> I THINK ONE OF THE THINGS
THAT'S CHALLENGING ABOUT
PLANETARY HEALTH, ONE WAY THAT'S
QUITE DIFFERENT FROM CLASSIC
ENVIRONMENTAL HEALTH IS THAT
IT'S NOT NECESSARILY ALWAYS
ABOUT EXPOSURES.
AND OFTEN WHAT IT'S ABOUT IS THE
EROSION OF NATURAL LIFE SUPPORT
SYSTEMS, SO IT'S THE EROSION OF
THE LOSS OF POLLINATORS, OR, YOU
KNOW, THE LOSS OF COASTAL
BARRIERS THAT PROTECT US FROM
FLOODING, OR CHANGES IN CLIMATE.
BUT THESE ARE HARD TO THINK OF
AS EXPOSURES PER SE.
AND SO IT ACTUALLY I THINK NEEDS
CRACKING OPEN THE RESEARCH
METHODS BEYOND CLASSIC HEALTH,
EXPOSURE EPIDEMIOLOGY,
TRANSDISCIPLINARY WORK, SPEAKING
TO WHAT I LOVE IN COMMENTS FROM
ALEXANDRA AND STEVEN AND PETER
THAT EMPHASIZE NARRATIVE,
STORY-TELLING,
INTERCONNECTEDNESS.
I THINK AT THE HEART OF THE
MOMENT THAT WE'RE GRAPPLING
WITH, YOU KNOW, YOU CAN ARGUE
THERE ARE BROKEN STORIES ABOUT
OUR RELATIONSHIP TO NATURE AND
TO EACH OTHER AND ACROSS
GENERATIONS AND IT'S ONE OF THE
REASONS THIS CONVERSATION ABOUT
VULNERABLE POPULATIONS
PARTICULARLY IN INDIGENOUS
CONTEXTS MAKES ME UNCOMFORTABLE
BECAUSE I ACTUALLY SEE OURSELVES
AS ENORMOUSLY VULNERABLE IN
COMPARISON TO MANY INDIGENOUS
POPULATIONS BECAUSE WE'VE
MARGINALIZED THOSE CULTURES THAT
ACTUALLY HAD MUCH HEALTHIER
STORIES ABOUT INTERCONNECTION
WHICH ARE MUCH CLOSER TO THE
SCIENCE THAT'S COMING OUT OF THE
PLANETARY HEALTH COMMUNITY IN
THE FIRST PLACE SO WE'VE
MARGINALIZED THE CULTURES THAT
HAVE THE STORIES THAT ARE
EXACTLY THE STORIES WE NEED TO
GET OURSELVES OUT OF THE MESS WE
FIND OURSELVES IN.
NONE OF THAT HAS TO DO WITH
EXPOSURE AT THE FRAMEWORK.
IT'S MORE COMPLICATED.
>> I'M SORRY.
I COULDN'T HELP BUT RESPOND.
ONE OF THE ISSUES WITH THIS
PARADIGM WHICH IS ABSOLUTELY
IMPORTANT COULD NOT AGREE WITH
YOU MORE IS HOW DO YOU BRING
THAT INTO THE MAINSTREAM OF
RESEARCH METHODOLOGIES AND STUDY
SECTIONS AND RESEARCH GRANTS
BECAUSE I CAN TELL YOU THAT MANY
TIMES THIS SORT OF IS MINIMIZED
AS SOFT SCIENCE, MINIMIZED AS
NOT BEING RIGOROUS, AND THAT'S A
MAJOR PROBLEM BECAUSE I DO THINK
THERE'S A TREMENDOUS AMOUNT THAT
NEEDS TO BE INCORPORATED IN
TERMS OF THINKING BUT HOW DO YOU
GET THAT INTO THE MAINSTREAM
WHERE YOUR GRANTS DON'T GET
FUNDED AND NOBODY WANTS TO
LISTEN TO THESE TYPES OF THINGS,
RIGHT?
IT'S A MAJOR PROBLEM, SAM.
I WANT TO BRING THAT UP FOR
DISCUSSION BECAUSE THE CHARGE
HERE TODAY IS TO COME UP WITH
APPROACHES THAT NHLBI MIGHT
HOPEFULLY INCORPORATE THAT MIGHT
RESULT IN MORE REALISTIC
SOLUTIONS TO PROBLEMS, RIGHT?
SO, ANYBODY IN THE PANEL IF THEY
ARE SO INCLINED PLEASE JUMP IN.
>> THAT'S WHAT WE HAVE TO DO.
THAT'S THE RESPONSIBILITY AS
SCIENTISTS TO GET SPECIFIC, TO
SORT OF ARTICULATE THE WAYS
THESE GLOBAL PROCESSES END UP
AFFECTING INDIVIDUALS AND
CARDIOVASCULAR HEALTH.
THAT'S OUR JOB, I THINK.
WE CAN'T JUST WAVE OUR HANDS AND
SPEAK IN METAPHORS AND STORIES.
THAT IS IMPORTANT BUT WE DO HAVE
TO BE SPECIFIC BECAUSE THAT'S
HOW SCIENCE MOVES.
SO THERE ARE MANY OTHER USES OF,
YOU KNOW, METAPHORS AND STORIES
AND NARRATIVES.
TERRIFIC, WE NEED TO TALK ABOUT
THEM TO MOTIVATE THE PUBLIC AND
CREATE DIFFERENT LEVEL OF
UNDERSTANDING BUT IN TERMS OF
SCIENCE WE NEED TO SHOW HOW
APPROACHES HELP US UNDERSTAND
CARDIOVASCULAR DISEASE
ENDPOINTS, CONNECTING AND
FIGURING OUT THIS FITS IN AND
HOW THIS GIVES US BETTER ANSWERS
OR HOW THIS ANSWERS IMPORTANT
QUESTIONS WE'VE NOT ANSWERED
YET.
I THINK THAT'S OUR CHALLENGE AS
SCIENTISTS.
>> THANK YOU.
PETER?
>> YEAH, JUST RESPONDING TO
THAT, I THINK WHERE YOU HAVE
PARTICIPATORY SYSTEMS, SPEAKING
FROM SYSTEM DYNAMICS IN TERMS OF
MY EXPERIENCE, I'VE SEEN SIMILAR
THINGS WITH AGENT BASED MODEL,
SOCIAL NETWORK ANALYSIS, WHEN
WE'RE ENGAGING COMMUNITIES AND
FOLKS AND COULD BE A PRETTY
DIVERSE GROUP FROM LIVED
EXPERIENCE TO SCIENTISTS, AND
WE'RE GENERATING CAUSAL DIAGRAMS
FROM STORIES, WE'RE MOVING MORE
TOWARDS DEVELOPING EXPLICIT
STATEMENTS ABOUT THE CAUSAL
MECHANISMS, AND WHAT I EKE OUT
ABOUT WHAT'S NOW POSSIBLE IN
SYSTEM DYNAMICS WITH DOMINANCE
ANALYSIS, BUT YOU CAN GO FROM A
VISUAL DESCRIPTION TO FORMAL
SIMULATION MODEL TO NOW
PROPOSITIONS THAT ARE FORMALLY
TESTABLE IN SCIENTIFIC WAY ABOUT
HOW WE WOULD EXPECT PATTERNS OF
THE DOMINANCE TO EVOLVE OVER
SCENARIOS THAT WOULD RULE IN OR
RULE OUT VARIOUS TRAJECTORIES,
AND THAT FEELS INCREDIBLY
IMPORTANT TO ME WHEN WE'RE
THINKING ABOUT, YOU KNOW, SOME
OF THESE CHANGES, INTERVENTIONS,
WE WILL NOT SEE THE MEASURABLE
IMPACT FOR SOME TIME IF THEY ARE
WORKING.
AND THE TRAP WE COULD FALL INTO
IS FAVOR SHORT-TERM FIXES THAT
CONTRIBUTE TO REINFORCING
INEQUITIES, SO IS THERE A WAY WE
CAN DEVELOP, MOVE FROM STORIES,
NARRATIVES, LIVED EXPERIENCE,
THE SCIENCE WE KNOW, TO
DEVELOPING HYPOTHESES THAT HELP
US IDENTIFY EARLY OR LEADING
INDICATORS OF WHEN WE'RE ON THE
RIGHT TRACK AND WHAT IT IS WE
SHOULD BE LOOKING FOR,
EMPIRICALLY, WHEN THINGS ARE
GOING SIDEWAYS, AND COMING BACK
TO THIS POINT ABOUT SOME OF THE
INTERVENTIONS WILL HAVE -- ALL
INTERVENTIONS HAVE UNINTENDED
CONSEQUENCES, SOME COULD AMPLIFY
INEQUITIES.
WHEN WE THINK ABOUT INJUSTICE
FROM THAT IT FEELS DIFFERENT.
IF RANDOM AND HARMED VERSUS
CONSEQUENCES OF A PLANNED
POLICY, THAT HAS A DIFFERENT
IMPLICATION MORALLY.
TO ME THAT'S EXCITING ABOUT
SYSTEMS SCIENCE WHEN WE INVOLVE
PEOPLE IN THE PROCESS.
>> ANA?
>> YEAH, NO, I WANT TO SUPPORT
WHAT PETER IS SAYING, I THINK
THE WORK THAT PETER DOES IN
MODEL BUILDING, WAYS TO ENGAGE
COMMUNITIES AND STAKEHOLDERS IN
DEVELOPING CONCRETE, YOU KNOW,
CAUSAL LOOP DIAGRAMS FOR EXAMPLE
ABOUT HOW THINGS MIGHT WORK THAT
CAN THEN BE TESTED, THAT IS
INCREDIBLY POWERFUL, I THINK.
AND SUPER USEFUL.
>> YEAH, GREAT.
I WANT TO POINT TO A COMMENT
BECAUSE I WANT TO BUILD ON THAT
COMMENT FOR PART OF THE
DISCUSSION, SO MATTHEW BERG HAS
NOTED THAT WE MAY BE TRYING TO
FIT BEHAVIORAL ENVIRONMENTAL
FRAMEWORK IN A BIOLOGICAL
SCIENCE CONTEXT AND NEED TO
SHIFT NIH FOCUS TO BE MORE BROAD
AND POINT TO THE CONGRESSIONALLY
MANDATED NIH COMMITTEE LAST YEAR
CONCERNING INCLUSION OF
BEHAVIORAL SPECIALISTS ACROSS
THIS.
SO I WANT TO BRING UP A PIECE OF
THIS RESEARCH AGENDA THAT WE
DIDN'T TALK ABOUT, AND JUST NOTE
THAT WE ALL KNOW THAT THE ROOT
CAUSE OF THIS PROBLEM IS THE
EXTRACTION AND COMBUSTION OF
FOSSIL FUELS.
AND WHILE IT IS OBVIOUSLY WELL
UNDERSTOOD AND ACCEPTED, THAT
FOSSIL FUELS ARE CAUSING CLIMATE
CHANGE AND AIR POLLUTION,
CHEMICAL AND PLASTIC POLLUTION,
THESE ARE HARMING HEALTH, THAT
MESSAGING IS NOT EFFECTIVELY
SWAYING A NUMBER OF PEOPLE.
AND OBVIOUSLY THAT'S IN PART DUE
TO DISINFORMATION CAMPAIGNS
INVOLVING THE FOSSIL FUEL
INDUSTRY AND OTHERS.
I GUESS I HAVE A QUESTION
WHETHER A PIECE OF THIS RESEARCH
AGENDA SHOULD BE TRYING TO
UNDERSTAND WHICH PUBLIC HEALTH
MESSAGES ARE MOST EFFECTIVE TO
ENGAGE PEOPLE.
A LOT OF SPEAKERS TALKED ABOUT
ENGAGEMENT, IS THAT A PIECE OF
WHAT WE SHOULD BE DOING BECAUSE
WE CAN COLLECT ALL THESE DATA
BUT IF THEY DON'T CHANGE ACTION
AND POLICY THEN THAT IS A
PROBLEM.
SAM?
>> YEAH, NO, I WOULD DISPUTE THE
INITIAL CHARACTERIZATION THE
THING WE HAVE TO DO IS MOVE TO
RENEWABLE ENERGY.
IT'S NOT ONLY CLIMATE CHANGE
WE'RE TALKING ABOUT.
I GAVE SIX EXAMPLES OF DIFFERENT
KINDS OF BIOPHYSICAL CHANGE
WHICH ARE AFFECTING
CARDIOVASCULAR DISEASE, NONE OF
WHICH ARE CLIMATE RELATED.
SO IT'S THE BROAD SORT OF EARTH
CRISIS THAT I THINK WE'RE
ADDRESSING, BUT I COMPLETELY
AGREE WITH YOU THAT THIS IS A
CENTRAL RESEARCH GAP AROUND THE
COMBINATION OF COMMUNICATIONS
AND BEHAVIOR CHANGE AND WHAT ARE
THE WAYS TO TELL THESE MESSAGES
OR TELL THESE STORIES THAT ARE
MOTIVATING TO PEOPLE.
MY SENSE IS WE TEND TO EMPHASIZE
THE CATASTROPHIC APOCALYPTIC AND
DON'T DO A GOOD JOB TELLING
ASPIRATIONAL STORY WHERE WE'RE
TRYING TO GET TO AS A SOCIETY.
BUT THAT'S A HYPOTHESIS.
THAT NEEDS TO BE TESTED AND WE
NEED TO UNDERSTAND IF THERE ARE
DIFFERENT MESSAGES THAT ARE MUCH
MORE MOTIVATING OF BEHAVIOR
CHANGE AND IF THEY DIFFER
ACROSS DIFFERENT COMMUNITIES.
THERE'S SOME WORK PEOPLE HAVE
DONE, MAYBACH AND OTHERS, I
AGREE WE NEED MORE.
>> ALEX, DID YOU WANT TO --
>> I WANT TO ECHO.
GREAT COMMENT.
WE REALIZE ESPECIALLY IN A LOT
OF THESE WESTERN STATES, OTHER
STATES, THAT THIS IS ONE OF OUR
BIGGEST PROBLEMS, THIS
COMMUNICATION GAP FROM THE
NOSTALGIC POINT OF VIEW OF THE
GLOOM AND DOOM, ALSO BECAUSE
PEOPLE ARE IN DENIAL.
PEOPLE IN DENIAL AREN'T GOING TO
WANT TO ENGAGE IN ANY OF THESE
SORTS OF CHANGES, WHETHER POLICY
OR BEHAVIOR OR HEART HEALTHY, ET
CETERA.
AND SO I REALLY THINK THE
COMMUNICATION RESEARCH IS
CRITICAL.
I THINK THE OTHER PIECE THAT
WE'VE NOT TALKED ABOUT BUT I
THINK IS THE ELEPHANT IN THE
ROOM IN MANY COMMUNITIES, THE
OUTFALL FROM COVID AND
DEVASTATION THAT MANY OF THESE
COMMUNITIES HAVE GONE THROUGH IN
THE PAST THREE YEARS, BOTH
URBAN, INNER CITY, LATINO,
HISPANIC, AND AFRICAN AMERICAN,
BUT ALSO RURAL AND TRIBAL
COMMUNITIES LOSING A LOT OF
PEOPLE.
THEY ARE NOT THROUGH THAT YET.
I THINK THIS SORT OF TWIN COVID
ON TOP OF PLANETARY HEALTH
IMPACTS, COMMUNICATION LIKE WE
HAVEN'T REALLY GONE THROUGH THE
GRIEVING, AND IT'S REALLY TRICKY
TO COMMUNICATE.
I WANT TO PUT THAT OUT THERE, AS
A PIECE WE NEED TO THINK ABOUT
BECAUSE THIS IS WHAT I HEAR.
>> THANK YOU.
I DON'T KNOW IF ANYBODY WANTS TO
ADD.
I CAN MOVE US TO ANOTHER PIECE
OF SANJAY, WHAT YOU WERE
ALLUDING TO, THE TYPES OF
RESEARCH THAT NEED TO GO INTO A
BROAD AGENDA.
INTEREST WAS -- THERE WAS A
QUESTION FROM THE AUDIENCE,
WILLIAM ASKED ABOUT RESEARCH
TAKING ADVANTAGE OF NATURAL
EXPERIMENTS, HEAT WAVES,
WILDFIRES, ET CETERA, EXPLORING
HEALTH EFFECTS, SPECIFIC TO
CERTAIN COMMUNITIES, ACROSS
THAT.
SOME SPEAKERS HAVE ALLUDED TO
THIS BUT I DIDN'T KNOW IF
ANYBODY WANTED TO SORT OF
COMMENT ON THAT PIECE OF HOW WE
USE THE VERY UNFORTUNATE THINGS
THAT ARE ALREADY OCCURRING TO
KIND OF LEARN MORE, NOT JUST
ABOUT THEIR SERIOUS CONSEQUENCES
BUT ALSO ABOUT EFFECTIVE PILOT
STUDIES OF INTERVENTIONS TO
ADDRESS THEM.
SAM?
NOT SAM, I'M SORRY.
JONATHAN?
>> YES, SO, I WOULD -- MAYBE
THERE ARE ALSO POSITIVE EXAMPLES
OF THINGS WE CAN LEARN FROM AS
NATURAL EXPERIMENTS.
I WOULD SAY SOME OF OUR --
FIRST, AS A CLINICIAN, CLINICAL
TRIALIST, MY SORT OF UNIT OF
INTERACTION OR OVERALL TRAINING
AND FRAMEWORK IS ON THE PATIENT,
RIGHT, ON THE INDIVIDUAL AS A
PARTICIPANT IN CLINICAL RESEARCH
STUDIES, CLINICAL ENCOUNTER.
THROUGH OUR STUDIES THE ONLY
REASON WE'VE BEEN SUCCESSFUL SO
FAR IS BY LEVERAGING AS I THINK
ALEX AND STEVEN HAVE SAID,
MOVING AT SPEED OF TRUST.
WE'VE LEVERAGED COMMUNITY
PARTNERSHIPS TO WORK TOGETHER IN
PARTICULAR NEW YORK CITY ROLLED
OUT AN INTERESTING PROGRAM WHICH
DR. ANGELL WILL KNOW ABOUT,
SMOKE-FREE HOUSING LEGISLATION,
IT RAISES QUESTION OF INDIVIDUAL
RIGHTS AND RESPONSIBILITIES, ALL
PUBLIC HOUSING BUILDINGS WERE
MANDATED TO BECOME SMOKE FREE,
THERE WAS ALLOWANCE FOR
PROHIBITION OF TOBACCO USE IN
CERTAIN BUILDINGS.
AND THAT WAS A NATURAL HISTORY
EXPERIMENT TO MEASURE AIR
QUALITY IN DIFFERENT PUBLIC
HOUSING BUILDINGS IN NEW YORK
CITY THAT MY COLLEAGUE AND CHAIR
DR. THORPE LED THAT DOVETAILED
WITH A LOT OF OUR RESEARCH
PROJECTS.
I THINK WHETHER IT'S LET'S SAY
USING CONGESTION PRICING TO
STUDY DIFFERENTIAL EFFECTS ON
HEALTH OUTCOMES OR OTHER MORE
POSITIVE EXPERIENCES LET'S SAY
PLANNED OR UNPLANNED THERE'S A
LOT WE CAN DO FROM A RESEARCH
PERSPECTIVE THAT MAYBE CAN
INFORM OTHER SYSTEMS STEPS WE
WANT TO TAKE.
>> GREAT POINT.
I WANT TO FOLLOW UP.
I I DO THINK IT'S INTERESTING.
YOUR DISCUSSION OF HOW RCTs
FIT INTO THIS FRAMEWORK,
OBVIOUSLY THEY ARE NOT THE
TYPICAL WAY OF ADDRESSING THESE
QUESTIONS.
BUT THEY ARE VERY IMPORTANT.
I WANT TO FOLLOW UP ON
DECENTRALIZED TRIAL QUESTION
BECAUSE OBVIOUSLY THERE ARE
POTENTIALLY GREAT ADVANTAGES IN
TERMS OF DIVERSITY OF
POPULATION.
I'M GLAD YOU BROUGHT UP THE
CARBON FOOTPRINT OF PEOPLE
GETTING IN THERE AND DOING A
BUNCH OF TESTS IN THE HOSPITAL,
ET CETERA.
BUT I GUESS MY QUESTIONS, DO WE
KNOW MUCH ABOUT THE EXTENT AND
WE MAY TO WHICH DECENTRALIZED
TRIALS ARE ENGAGING A MUCH
BROADER DIVERSITY OF INDIVIDUALS
AND IS THERE A PROBLEM IN ACCESS
TO BROADBAND, FAST INTERNET, WHO
CAN PARTICIPATE?
>> YEAH, GREAT QUESTION.
SO, I WOULD SAY FOR THE FORMER,
WE KNOW TO ALEX'S POINT AND
OTHERS WITH THE SORT OF LEGACY
OF COVID AND SORT OF
UNDERSTANDING WITH NIH
INITIATIVES PERHAPS TO ADDRESS
OR UNDERSTAND LONG COVID THERE
HAVE BEEN STRIDES TO BROADEN
ACCESS NET.
I'M NOT SAY DECENTRALIZED
EFFECTS ARE A PANACEA BUT
PERHAPS A DIFFERENT APPROACH
THAN TRADITIONAL MEDICAL
CENTER-BASED MODEL.
THE LATTER QUESTION, THIS BRINGS
UP THE CLICHÉ, DIGITAL DIVIDE.
THERE ARE MODELS NOW FOR
INSTANCE IN OUR TRIALS WE'RE
USING REMOTE PATIENT MONITORING
DEVICES THAT DO NOT RELY ON
WI-FI.
THEY USE CELLULAR TECHNOLOGY OUT
OF THE BOX, THAT BOUNCE SIGNALS
OFF THE NEAREST CELL PHONE TOWER
WHICH IN NEW YORK CITY IS NOT AN
ISSUE, IN MONTANA MIGHT BE, TO
TRANSMIT DATA REMOTELY.
YOU DON'T NEED WI-FI.
THERE ARE MODELS TO DO THIS.
NOW, THE DECENTRALIZED TRIAL
FRAMEWORK HAS SOME LIMITATIONS,
RIGHT?
YOUR QUALITY OF DATA,
ADJUDICATION OF END POINTS.
THERE'S A FRAMEWORK.
I THINK THE CLINICAL TRIAL
QUESTION IS INTERESTING BUT
IT'S, AGAIN, A MORE, YOU KNOW,
FOCUSED APPROACH THAN SOME OF
THE BROAD STRATEGIES WE'VE
DISCUSSED SO FAR AND HOW WE
RECTIFY THOSE.
TO SOME EXTENT AS A CLINICIAN
WE'VE KNOWN FOR YEARS WHAT WORKS
BUT ADHERENCE AND SCIENCE OF
ADHERENCE AND PARTICIPATION
REMAINS LIMITED.
SO HOW WE APPLY THOSE LESSONS TO
SOME OF THE SYSTEMS-BASED
THINKING IN MAYBE STRATEGIES WE
CAN TARGET AS AN INDIVIDUAL OR
TO GET THE CLINICIAN TO BRING UP
AIR QUALITY DAYS OR STRATEGIES
TO AVOID EXPOSURE WHEN, YOU
KNOW, THERE ARE CERTAIN RELEVANT
METRICS WE CAN TRACK, I THINK IS
A REALLY IMPORTANT QUESTION.
>> THANK YOU.
DOES ANYBODY WANT TO ADD TO
THAT?
I HAVE A PROVOCATIVE QUESTION
FOR THE GROUP.
BUT SO, ALL THE SPEAKERS BROUGHT
UP REALLY IMPORTANT GAPS IN
UNDERSTANDING THESE COMPLEX
RELATIONSHIPS BETWEEN PLANETARY
HEALTH DETERIORATION AND
CARDIOVASCULAR OUTCOMES AND THEN
RACE AND ETHNICITY AND
SOCIOECONOMIC FACTORS.
THERE'S A LOT UNDERSTANDING HOW
WE'RE ENDING UP WHERE WE ARE.
THERE'S THE WHOLE PIECE OF US
UNDERSTANDING HOW WE CAN IMPROVE
THINGS.
AND I JUST WANT TO THROW OUT
THAT I'VE HEARD SOME PEOPLE
ARGUE THAT WE ALREADY HAVE A LOT
OF DATA TELLING US THAT WE ARE
IN BIG TROUBLE, OKAY?
CARDIOVASCULAR HEALTH IS
ADVERSELY AFFECTED BY THE
MULTITUDE OF FACTORS WE'VE
DISCUSSED, AND THAT THE FOCUS AT
THIS POINT SHOULD REALLY BE, YOU
KNOW, LARGELY IF NOT ENTIRELY ON
ASSESSING INTERVENTIONS THAT ARE
GOING TO HELP SOLVE THEM,
OPTIMAL IMPLEMENTATION, ET
CETERA.
I ACTUALLY WANT PEOPLE'S TAKE ON
THAT.
THERE'S A CERTAIN RESEARCH
BUDGET, HOW DO WE PARSE IT OUT.
SAM?
>> YEAH, I'VE HEARD THAT A LOT
AS WELL, IN THE PLANETARY HEALTH
COMMUNITY.
THERE'S AN ELEMENT WHICH I AGREE
TO BUT I DON'T THINK IT'S AS
BINARY AS THAT.
I DON'T THINK WE CAN DEVELOP THE
INTERVENTIONS THAT WE NEED
WITHOUT MORE INFORMATION ABOUT
HOW BIOPHYSICAL CHANGES AFFECT
WHICH DIMENSIONS OF HEALTH OR
WHICH POPULATIONS, AROUND THE
WORLD, WHO IS VULNERABLE.
SO, YOU KNOW, UNDERSTANDING THAT
RISING CO2 IS GOING TO REDUCE
ACCESS TO NUTRIENTS IN
PARTICULAR POPULATIONS, ZINC OR
IRON DEFICIENCY IN SOUTH ASIA,
SUB-SAHARAN AFRICA, KNOWING
THOSE POPULATIONS IS IMPORTANT
IF WE WANT TO DEVELOP
INTERVENTIONS, KNOWING HOW
POLLINATOR DECLINE AFFECTS
HEALTH, BEING ABLE TO SEE WHAT
THE HEALTH BENEFITS OF
POLLINATOR-FRIENDLY PRACTICES,
SORT OF POLICY INTERVENTIONS TO
PROMOTE POLLINATOR POPULATIONS
IS PART OF WHAT'S GOING TO
MOTIVATE PEOPLE TO PASS THAT
LEGISLATION.
SO WHAT I WOULD ARGUE INSTEAD OF
SAYING WE DON'T NEED MORE
SCIENCE, WE NEED TO ACT, IS WE
NEED SCIENCE AT THE INTERFACE.
WE NEED TRANSLATIONAL SCIENCE
THAT HELPS US TAILOR OUR
INTERVENTIONS MORE EFFECTIVELY
AND I THINK THAT'S WHY PEOPLE
ARE EMPHASIZING CO-BENEFITS.
BUT I THINK CURIOSITY-DRIVEN
RESEARCH JUST TO CATALOG
HORRIBLE PROBLEMS WE HAVE IS
MAYBE NOT SO USEFUL BUT THAT
RESEARCH THAT IS MAKING IT
CLEAR, YOU KNOW, THESE VERY,
VERY COMPLEX SYSTEMS, CONNECTING
DOTS BETWEEN BIOPHYSICAL CHANGE
AND HEALTH, AND THEN CAN HELP US
TAILOR INTERVENTIONS LIKE
PEATLAND INTERVENTION REDUCING
FIRES IN INDONESIA BECOMES
HELPFUL.
>> THAT MAKES SENSE.
SANJAY AND GREG.
>> I AGREE IN PART WITH SAM.
I DO COMPLETELY AGREE THAT THERE
NEEDS TO BE THE SCIENCE OF
ACTION, RIGHT?
WHAT ARE THE TYPES OF
INTERVENTIONS, CERTAINLY A LOT
OF DEBATE AND QUESTIONS ABOUT
RESILIENCE, ADAPTATION IN TERMS
THE NOT ONLY MONIES GOING IN BUT
SCIENCE OF ADAPTATION
RESILIENCE.
I WOULD ARGUE FOR SOME OF THE
ELEMENTS, PARTICULARLY THINGS
LIKE AIR POLLUTION, YOU DON'T
NEED MORE STUDIES CATALOGING
NATIONAL EXPERIMENTS OF AIR
POLLUTION.
I DO AGREE THERE ARE A LOT OF
COMPLEXITIES.
I WOULD SAY WHERE I DON'T
DISAGREE WITH SAM BUT THE
TEMPORAL SCALE AND COMPLEXITY OF
INTERACTIONS ARE SO
FUNDAMENTALLY COMPLEX AND
FEEDBACK LOOPS REQUIRED TO
DISCERN AN ANSWER ARE SO MUCH IN
THE FUTURE THAT IT MIGHT BE HARD
TO DISCERN WHAT TO DO EVEN IF
YOU DESIGN THE RIGHT
EXPERIMENTS.
I JUST DON'T KNOW.
FUNDAMENTALLY THERE ARE
COMPLEXITIES AND COMPLEXITIES OF
INTERACTIONS AND TEMPORAL SCALES
THAT MIGHT NOT LEND TO QUICK FOR
OUR SIX-YEAR TRIAL HORIZON
STUDY.
OTHERWISE I DON'T COMPLETELY
AGREE WITH SAM.
NATIONAL EXPERIMENTS
PARTICULARLY POWERFUL ARE THE
EXPERIMENTS THAT CAN EL IT US --
TELL US ABOUT ADAPTATION AND
RESILIENCE MORE THAN CAUSATION
OR ASSOCIATIONS THAT'S NEEDED,
PARTICULARLY ON THINGS LIKE AIR
POLLUTION, WHICH IS, YOU KNOW,
FOR LACK OF BETTER -- RIGHT NOW
IS DOMINANT FORCE IN TERMS OF
INFLUENCING GLOBAL MORTALITY
RATES, RIGHT?
I DON'T THINK YOU NEED MORE
EXPERIMENTS THERE BUT PERHAPS
THERE ARE BETTER EXPERIMENTS TO
UNDERSTAND RESILIENCE AND
ADAPTATION, WHAT TO DO.
SOME CLEAN ENERGY INTERVENTIONS
MIGHT PROVIDE AVENUES.
>> THANK YOU.
ABSOLUTELY.
GREG?
>> YEAH, SO GREAT DISCUSSION.
THANK YOU FOR LEADING THAT.
I GUESS AS I GET OLDER I FIND I
BECOME MORE CAUTIOUS ABOUT
JUDGING SORT OF WHAT RESEARCH WE
DON'T NEED OR WHAT WE HAVE
ENOUGH OF BECAUSE I THINK WE
ALWAYS NEED TO HAVE A HIGH BAR
TO MAKE SURE THAT WHERE OUR
MONEY IS GOING, YOU KNOW,
WHETHER NIH'S MONEY IS GOING TO
MOST IMPACTFUL SCIENCE BY SOME
MEASURE.
EVEN WITH AIR POLLUTION IF YOU
LOOK AT THE INTEGRATED SCIENCE
ASSESSMENT EPA DOES THERE'S
STILL LOTS OF GAPS, THINGS WE
DON'T KNOW, WHO IS MOST
VULNERABLE, INTERACTIONS WITH
CHANGING CLIMATE, WITH THE BUILT
ENVIRONMENT, EXPOSURES INDOORS.
I DON'T THINK WE'RE DONE.
TWO OTHER POINTS I'LL JUST RAISE
THERE IS THAT, ONE, EVERY TIME
WE HAVE A LARGE STUDY, LARGE
COMPELLING STUDY BE PUBLISHED,
IT GETS MEDIA ATTENTION, VERY
USEFUL, BACK TO THE
COMMUNICATION PIECE.
THAT WHY DO WE DO A LOT OF
RESEARCH?
IT HELPS DRIVE HOME THE MESSAGE
OVER AND OVER THAT THIS IS, YOU
KNOW, BAD FOR YOU.
AND THE PUBLIC HEALTH THREAT.
THE OTHER OTHER WE HAVE TO
TRAINING THE NEXT GENERATION,
RIGHT?
THEY CAN'T START BY JUST SOLVING
THE PROBLEM TODAY.
WHEN I THINK OF THE K AWARDS,
F31s, F32s, I THINK THAT
IT'S ENTIRELY APPROPRIATE TO
HAVE A SLIGHTLY LOWER BAR FOR
IMPACT IN THAT CONTEXT BECAUSE
WE'RE NOT GOING TO GET TO
CHANGING, YOU KNOW, HAVING THE
JUNIOR FOLKS JUST IMMEDIATELY
LEARN HOW TO CHANGE THE WORLD
WITHOUT SORT OF BUILDING UP
THEIR REPERTOIRE OF BACKGROUND
AND TOOLS IN THE TOOLBOX.
>> GREAT.
BOTH REALLY IMPORTANT POINTS.
I THINK I SHOULD ASK IF WE
SHOULD BE WRAPPING UP BECAUSE I
SAW IT'S 40 MINUTES.
I'D LIKE TO --
>> TWO MINUTES MORE WE CAN GO TO
12:40 IF YOU WANT TO TAKE
ADVANTAGE.
>> I'LL TAKE ADVANTAGE.
PETER, WEIGH IN.
>> YEAH, I THINK THE POINT I
WANT TO ADD THINKING ABOUT
SHORT, WHERE TO MAKE INVESTMENTS
IN TERMS OF RESEARCH, IT'S
IMPORTANT TO PAY ATTENTION TO
THE HALF-LIFE OF KNOWLEDGE.
LIKE OF FACTS.
HOW FAST IS THE ENVIRONMENT
CHANGING RELATIVE TO WHAT WE'RE
GOING TO GAIN BY SOMETHING AND
PRIORITIZING STUDIES WHERE THE
EMPIRICAL RESULTS WILL INFORM
SOMETHING THAT WILL STILL BE
RELEVANT WHEN THEY ARE AVAILABLE
TO IMPLEMENT.
THAT TO ME SEEMS CRITICAL.
AND IT'S REALLY ABOUT FRAMING
THE QUESTIONS.
>> THANK YOU.
ANYBODY HAVE FURTHER COMMENTS?
>> ONE QUESTION, RATHER MAYBE A
COMMENT, I DON'T KNOW.
WHICH IS PETER'S COMMENT ABOUT
ENGAGING YOUNG LEADERS AND
SYSTEMS THINKING, ALSO ANOTHER
COMMENT ABOUT, YOU KNOW, REALLY
UNDERSTANDING AT MUCH -- IN
COMMUNITIES LIKE SCHOOL AGE
KIDS, INSTILL THEM WITH THE
SKILLS NEEDED TO ADDRESS -- YOU
CAN LEARN SYSTEMS DYNAMIC AS A
HIGH SCHOOL STUDENT, RIGHT?
BUT ALSO INSTILL NOT ONLY TOOLS
TO START THINKING ABOUT PROBLEMS
BUT ALSO MAYBE FORUM FOR FUTURE
STUDIES, RIGHT?
WHAT TYPES OF STUDIES COULD BE
PERFORMED IN COMMUNITIES,
YOUNGER COMMUNITIES, WHERE YOU
NOT ONLY UNDERSTAND THE IMPACT,
LIFELONG IMPACT OF EXPOSURES AND
CONSEQUENCES OF CLIMATE CHANGE
BUT ALSO USE THEM AS COMMUNITIES
TO INCULCATE NEWER SKILLS AND
TOOLS BECAUSE ULTIMATELY THEY
ARE THE ONES WHO WILL BE
AFFECTED.
THE OTHER ONES WHO MIGHT NEED TO
BE EDUCATED ON THESE TYPES OF
TOOLS AND MAYBE THAT MIGHT
RESULT IN BETTER WAYS OF
ADVANCING THESE PROBLEMS.
>> THANK YOU.
I THINK WE DO NEED -- OH.
I DON'T KNOW IF -- SHOULD I WRAP
UP?
>> I'VE BEEN QUIET DURING THIS
BECAUSE OF THE BRILLIANCE THAT
HAS ALREADY BEEN SPEAKING.
I WANT TO ADD A COMMENT WHEN YOU
ASKED ABOUT ADDITIONAL RESEARCH
THAT WE MAY OR MAY NOT NEED, AND
I THINK VERY IMPORTANT
CONSTITUENCY ARE THE PEOPLE THAT
WOULD USE THE RESEARCH
INFORMATION, MEANING THE
POLICYMAKERS AND THOSE THAT HAVE
THE POWER TO CHANGE THE SYSTEMS.
AND I THINK THAT BOTH DR. ADAMS
AND DAVIS ALSO AS WELL AS MANY
HAVE LIFTED UP SO MUCH THE
VOICES OF THOSE BEING AFFECTED
BY RESEARCH SHOULD BE MAKING THE
DECISIONS TO SOME EXTENT ALSO
ABOUT WHAT ADDITIONAL RESEARCH
WE NEED.
WHILE WE IN THE ROOM ON THIS
CALL RIGHT NOW CAN MAKE
JUDGMENTS ABOUT WHERE WE THINK
SOME OF THE DIRECTIONS ARE, THIS
COMMENT AT SOME POINT IN THE
FUTURE HOPEFULLY NHLBI COULD
CONSIDER THIS, THINK ABOUT
HAVING THOSE USING DATA WHERE
OUR EVIDENCE GOES TO IMPACT,
TRANSLATION, AND USERS NEED TO
FIND IT USEFUL.
>> TERRIFIC.
GREG, DO YOU WANT TO SAY ONE
MORE THING?
>> A QUICK COMMENT, NIH AND
NHLBI ALSO NEED TO SEE HOW
RESEARCH ALIGNS WITH THEIR
STRATEGIC GOALS BECAUSE NOT
EVERY FUNDING AGENCY HAS THE
SAME GOAL.
IF I LOOK JUST AT AIR POLLUTION
RESEARCH DIFFERENCE IN RESEARCH
FUNDED BY NIH VERSUS HEALTH
EFFECTS INSTITUTE, WELLCOME
TRUST, HEART ASSOCIATION,
DIFFERENT GOALS AND TIMELINES
AND DEFINITIONS OF IMPACT AND
THAT'S OKAY AND APPROPRIATE.
SO NIH DOESN'T AND CAN'T TRY TO
DO EVERYTHING.
AND SO SORT OF WHERE IN THE
FUNDING LANDSCAPE DOES NIH FIT
IN, WHERE DOES IT WANT TO INVEST
ITS DOLLARS.
>> THANK YOU.
I WANT TO THANK ALL OF YOU FOR
BEING ON THE PANEL AND FOR OUR
AUDIENCE MEMBERS AND QUESTIONS.
I THINK IT'S CLEAR THAT THERE IS
A LOT WE KNOW BUT ENORMOUS
AMOUNT WE HAVE TO LEARN, AND I
LIKE FORWARD, WE ALL LOOK
FORWARD TO SEEING STUDIES WE'VE
BEEN TALKING ABOUT FUNDED BY
NIH, NHLBI, AND OTHERS, MOST
IMPORTANTLY REALLY SEEING THIS
WORK TRANSLATED INTO EFFECTIVE
POLICY AND ACTION.
THANK YOU SO MUCH.
>> THANK YOU.
DR. FINE?
>> I WANT TO THANK EVERYONE.
INCREDIBLE CONVERSATION.
IT WAS SO RICH, SO MUCH MORE US
TO THINK ABOUT.
AND DRAW ON.
WE HAVE WORKED A LOT IN COVID-19
ABOUT MISINFORMATION AND
BUILDING TRUST WITH COMMUNITIES,
SO THERE'S A LOT OF THINGS HERE
THAT WE CAN BUILD ON.
YOU LEFT US WITH A LOT OF GREAT
CHALLENGES ABOUT WHAT TO DO IN
THE FUTURE, WHICH IS EXACTLY
WHAT WE WANTED.
SO THANK YOU VERY MUCH.
AND DO REMIND YOU WE WANT YOU TO
COME BACK AT 1:10, AFTER OUR
LUNCH BREAK.
AND CONTINUE THIS GREAT SERIES
OF PRESENTATIONS AND DIALOGUE.
ALL I CAN DO IS CLAP FOR YOUR
GREAT, GREAT SESSION THAT YOU
HAD.
>> TERRIFIC.
THANKS, EVERYBODY.
SEE YOU AT 1:10.
>> WELCOME BACK FROM THE LUNCH
BREAK.
I'M GOING TO HELP KICK OFF
SESSION 2, AND WE WANT TO REMIND
EVERYONE TO STAY TUNED AFTER THE
BREAK, WHICH WILL BE AT 3:15 TO
3:30.
DON'T FORGET TO COME BACK AT
3:30 SO THAT YOU CAN ENJOY THIS
PLANETARY HEALTH SYSTEMS
SIMULATION HOSTED BY JASON, A
PRO, IT'S GOING TO BE AN
EXCITING SESSION TO WATCH HIM.
PLEASE STAY TUNED.
WE'RE GOING TO START THE NEXT
SESSION AND INTRODUCE INTEGRATED
FRAMEWORK TO DRIVE
CARDIOVASCULAR HEALTH THROUGH
INFRASTRUCTURE DESIGN.
THE LAST SESSIONS WERE A BROAD
OVERVIEW.
STARTING OFF WITH THIS SESSION
WE'LL DELVE DEEPER.
OUR DISCUSSION WILL BE MODERATED
BY JOEL KAUFFMAN FROM UNIVERSITY
OF WASHINGTON, I'LL DO A MORE
FORMAL INTRODUCTION AT THE END
OF THE SESSION BEFORE HE TAKES
OVER.
SO, WITH THAT I WAS GOING TO SEE
IF WE HAD SLIDES FOR OUR NEXT
PRESENTATION READY.
IT'S MY APPRECIATE TO PLUSH TO
-- IT'S MY PLEASURE TO WELCOME
DR. RAMASWAMI FROM PRINCETON
UNIVERSITY, WHO WILL BE SPEAKING
TO US AT THE KICKOFF OF OUR
SESSION WITH INTRODUCTORY TALK
ABOUT INFRASTRUCTURE, FOOD
SYSTEMS, TRANSFORMATION FOR
HUMAN AND PLANETARY HEALTH.
DR. RAMASWAMI, OVER TO YOU.
KICKS OFF.
>> THANK YOU FOR THE
INTRODUCTIONS.
I'M ASSUMING SOMEONE WILL PULL
UP THE SLIDES.
THIS WAS A VERY EXCITING
CONFERENCE.
THANK YOU FOR HAVING ME HERE.
I'M GOING TO TALK ABOUT
INFRASTRUCTURE AND FOOD SYSTEM
TRANSFORMATIONS, PLANETARY
HEALTH.
I'M AN INTERDISCIPLINARY
PROFESSOR OF CIVIL AND
ENVIRONMENTAL ENGINEERING,
PRINCETON UNIVERSITY WHERE I
ALSO DIRECT OUR CENTER FOR
GLOBAL INDIA AND I WANT TO
ACKNOWLEDGE SEVERAL GRANTS TO
NSF, THAT REALLY HELPED ADVANCE
THE FRAMEWORK AND MULTIPLE
FRAMEWORKS THAT I'M GOING TO
PRESENT OVER HERE, I WANT TO
ACKNOWLEDGE ALL THE COLLEAGUES
AND STUDENTS OVER THE YEARS THAT
HAVE COLLABORATED WITH, WE'VE
ALL BEEN PART OF BUILDING THIS
BIG FRAMEWORK.
I WANT TO SHOUT OUT TO OUR
CONFERENCE CHAIR, ALSO THE CHAIR
OF RECENT POLICY STATEMENT WHICH
WILL BE COMING OUT FROM THE
AMERICAN HEART ASSOCIATION, THE
TITLE TO HAVE HEART HEALTHY AND
SUSTAINABLE CITIES,
ACKNOWLEDGING SANJAY
RAJAGOPALAN, THE CHAIR OF THE
WONDERFUL GROUP OF COMMITTEE
MEMBERS, AND I SERVED AS VICE
CHAIR.
I ALSO WANT TO ACKNOWLEDGE
LAURIE WHITSEL AND CO-AUTHORS.
THIS SHOULD BE COMING OUT SOON
AND I HOPE WILL BE VERY
BENEFICIAL TO THE RESEARCH AND
PRACTITIONER COMMITTEES.
NEXT SLIDE IS EXPLAINING WHAT
I'M GOING TO TALK ABOUT TODAY.
SO I'M GOING TO FIRST ARTICULATE
A RATIONALE, WHY SHOULD WE FOCUS
ON INFRASTRUCTURE AND FOOD
PROVISIONING SYSTEMS, WHETHER
URBAN OR ELSEWHERE, WHY ARE THEY
IMPORTANT FOR SUSTAINABLE,
HEALTH, WELL-BEING AND EQUITY,
DISCUSSING FRAMEWORKS I'VE BEEN
DEVELOPING OVER MORE THAN 10
YEARS NOW, I'LL SHOW A FEW
APPLICATIONS IN MY LAB, THE
URBAN NEXUS LAB.
I'LL PREVIEW THE AHA STATEMENT
ON HEART-HEALTHY AND SUSTAINABLE
CITIES.
THE FIRST TOPIC, WHY DO WE CARE
ABOUT INFRASTRUCTURE AND FOOD
SYSTEMS.
NEXT SLIDE.
DRAWING ON THREE KEY
PUBLICATIONS, FIRST WAS AN
ARTICLE IN "SCIENCE" WHICH TALKS
ABOUT META PRINCIPLES FOR
DEVELOPING SMART, SUSTAINABLE,
HEALTHY CITIES, ARTICULATES THE
FRAMEWORK THAT I HAD PREVIOUSLY
PUBLISHED IN A JOURNAL OF
INDUSTRIAL ECOLOGY, IT'S CALLED
INFRASTRUCTURE OF SYSTEMS
FRAMEWORK THAT CAN
SYSTEMATICALLY ALLOW YOU TO
CONNECT RESOURCE VIEWS,
SUSTAINABILITY, THINGS WE HEARD
IN THE FIRST SESSION BUT
RECOGNIZING THAT INFRASTRUCTURE
IS THE MEDIATOR THROUGH WHICH
RESOURCES COME TO CITIES, TO
HUMAN SETTINGS.
THE SECOND ARTICLE IN ONE EARTH
TALKS ABOUT INFRASTRUCTURE,
NEXUS WITH ENVIRONMENT AND
HEALTH, BUT ALSO OPENS UP
FURTHER TO LIVEABILITY,
WELL-BEING, EQUITY.
AND THE THIRD REVIEW PAPERS JUST
CAME OUT LAST MONTH, SAYING DO
WE HAVE A FRAMEWORK TO EXPLORE
HOW TRANSITIONS WILL ADDRESS
HEALTH, ALSO CLIMATE RESILIENCE,
WELL-BEING AND EQUITY.
WITH THAT I'D LIKE US TO MOVE TO
THE NEXT SLIDE WHERE I'M GOING
TO PROVIDE THIS RATIONALE IN
URBAN AREAS.
THE IDEA HERE IN THE ARTICLE IN
"SCIENCE" WAS PART OF A SERIES
CALLED URBAN PLANET.
THE BIG POINT HERE WAS THAT WE
NOW LIVE IN AN URBAN PLANET,
MEANING EVEN THOUGH CITIES
OCCUPY ONLY 3% OF THE LAND AREA,
THEY ARE IMPACTING THE PLANET,
AT PLANETARY SCALES.
AND SO VERY OFTEN WE TEND TO,
YOU KNOW, URBAN PLANNERS, URBAN
POLICYMAKERS TEND TO LOOK WITHIN
THE CITY BOUNDARIES.
THIS FRAMEWORK IS SAYING WITHIN
THE CITY BOUNDARY IS IMPORTANT
BUT REALLY URBANIZATION AND
URBAN AREAS ARE JUST IMPACTING
RURAL AREAS, SUPPLY CHAINS,
THERE'S GLOBAL IMPACT.
SOME OF THESE ARE WITHIN THEIR
BOUNDARIES, MAY HAVE AN INTEREST
IN LOCAL HEALTH, LOCAL EQUITY,
BUT THEN THEY ARE IMPACTING
THINGS LIKE GLOBAL GREENHOUSE
GAS EMISSIONS, REGIONAL WATER
STRESSORS, SO CITIES ALSO HAVE
TO BE THINKING ABOUT THEIR
IMPACT OUTSIDE THEIR BOUNDARY,
AND RECOGNIZING THAT THESE
TRANSBOUNDARY IMPACTS AFFECT
URBAN RESIDENTS.
FOR EXAMPLE, AIR POLLUTION IS
TRANSBOUNDARY, IT DOESN'T STOP
AT THE CITY BOUNDARY,
MULTI-SCALE, THIS IS THE
GROUNDING OF WHAT KIND OF
FRAMEWORK WOULD REALLY HELP
CONNECT INFRASTRUCTURE AND FOOD
SYSTEMS TO BOTH HUMAN AND
PLANETARY HEALTH.
MY GROUP FOCUS ON SEVEN THINGS
THAT LIE AT THE CORE OF MULTIPLE
OUTCOMES.
HEALTH, WELL-BEING, EQUITY.
THERE'S URGENCY AND HISTORIC
OPPORTUNITY BECAUSE THE SYSTEMS
ARE UNDERGOING SIGNIFICANT
CHANGE.
SO IN THE U.S., YOU KNOW, OUR
INFRASTRUCTURE IS SO OLD MANY
CITIES ARE REDOING THEIR
INFRASTRUCTURE, ZERO CARBON
INITIATIVE IS FORCING A LOT OF
PEOPLE IN A GOOD WAY,
ENCOURAGING A LOT OF PEOPLE TO
THINK ABOUT MAJOR SYSTEMS
TRANSITIONS, AND ESSENTIALLY
THIS REQUIRES INTERDISCIPLINARY
AND MULTI-DISCIPLINARY WORK THAT
BRINGS STAKEHOLDERS TOGETHER
ACROSS ACADEMIC AND PRACTICE IN
THEIR COMMUNITIES.
THE NEXT SLIDE IS PROBABLY THE
KEY SLIDE I WANTED TO SHOW WHICH
ARTICULATES WHAT YOU'RE SEEING
SEVEN SECTORS, I DON'T KNOW IF
SOMEONE WITH MOVE THE POINTER
OVER THERE.
BUT YOU SEE THE RED IS ENERGY
SUPPLY.
BLUE IS MUNICIPAL WATER SUPPLY,
WASTE, SANITATION.
THE KEY IN THE MIDDLE,
TRANSPORTATION IS THAT PINK,
SALMON PINK.
VEHICLE OPERATIONS.
FOOD SUPPLY IS IN GREEN.
AND BUILDINGS AND PUBLIC SPACES
ARE IN GRAY.
WHAT YOU SEE ON THE LEFT SIDE OF
YOUR SCREEN ARE THE
ENVIRONMENTAL IMPACTS AT THE
GLOBAL SCALE.
THESE SYSTEMS ARE CONTRIBUTING
TO ALMOST ALL OF OUR GREENHOUSE
GAS EMISSIONS, 96%, CONTRIBUTING
TO ALMOST ALL OF OUR WATER
WITHDRAWALS, 94.7% OF GLOBAL
WATER WITHDRAWALS ARE ASSOCIATED
WITH THESE SECTORS.
ON THE RIGHT SIDE DATA FROM THE
GLOBAL BURDEN OF DISEASE AND
OTHER STUDIES WHICH IS SHOWING
PREMATURE MORE AT THAT TIMED,
ASSOCIATED WITH THESE SYSTEMS.
YOU HAVE INCLUDING POLLUTION BUT
ALSO INADEQUATE ACCESS.
POOR ACCESS TO SANITATION,
HAVING POLLUTING FUELS FOR
HOUSEHOLD COOKING, SO THAT IS
SHOWN AS AIR POLLUTION, INDOOR
AND OUTDOOR RELATING TO ENERGY
SYSTEM.
YOU HAVE THOSE SAME SECTORS THAT
ARE CAUSING ALL THIS
ENVIRONMENTAL IMPACT MAKING THE
CASE IF WE TRANSFORM
INFRASTRUCTURE PROVISIONS AND
FOOD PROVISION SYSTEMS WE CAN
SUBSTANTIALLY IMPROVE BOTH
ENVIRONMENT AND HEALTH OUTCOMES.
SO, THE FRAMEWORK DEVELOPED FROM
THIS IS ON THE NEXT SLIDE.
IT'S CALLED SOCIAL -- WELL,
BEFORE THAT I WANT TO HIGHLIGHT
WE USE ICONS IN MY LAB JUST TO
HIGHLIGHT WHAT THESE SYSTEMS
ARE, BUILDING MATERIALS AND
ENERGY, FOOD SYSTEMS, GREEN
INFRASTRUCTURE, MOBILITY, WATER
AND WASTE AND INTERACTIONS.
NEXT SLIDE IS OUTCOMES, LOOKING
AT WELL-BEING NOT JUST OBJECTIVE
MEASURES OF HEALTH BUT HOW
PEOPLE THINK AND FEEL ABOUT
THEIR LIVES OR SUBJECTIVE
ASSESSMENTS OF WELL-BEING,
MULTIPLE ENVIRONMENTAL IMPACTS.
WE JUST SAW WATER AND ENERGY,
COULD EXPAND TO LAND AND
BIODIVERSITY.
EQUITY AND LIVEABILITY, AND
CO-BENEFITS.
THAT WAS OF THE FRAMING OF
SECTORS AND OUTCOMES, ULTIMATELY
THE SYSTEMS ARE IMPACTING THE
EARTH TO PROVIDE SERVICES FOR
HUMANITY.
NEXT SLIDE IS SYSTEMS FRAMEWORK.
I'M GOING TO GIVE EXAMPLES OF
HOW IT'S IMPORTANT THAT PEOPLE
HAVE -- WE TALKED ABOUT
DIFFERENCE SYSTEMS FRAMEWORK.
THIS FRAMEWORK FOCUSES ON THAT
LINKAGE BETWEEN NATURAL
RESOURCES AND ENVIRONMENT,
INFRASTRUCTURE AND FOOD
PROVISION SYSTEMS, AND HEALTH
AND WELL-BEING OUTCOMES AT
DIFFERENT SCALES, SCALES ARE
IMPORTANT.
NEXT SLIDE, THIS IS WHAT I CALL
SOCIAL ECOLOGICAL INFRASTRUCTURE
SYSTEM FRAMEWORK.
WE SEE THAT RIGHT ON TOP.
SEIS.
AND I'LL WALK YOU THROUGH THE
FRAMEWORK.
WHAT YOU'RE SEEING, AND THIS WAS
IN OUR ARTICLE IN "SCIENCE,"
THAT HAS NOW BEEN ADAPTED INTO
THE OTHER PAPER, ON THE LEFT
SIDE IS THE BOUNDARY OF THE
CITY, YOU CAN SEE THERE'S A MAN
AND WOMAN IN THE CITY, THERE ARE
LOTS OF PEOPLE AND WE'RE LOOKING
AT THESE PROVISIONING SYSTEMS,
BUILDINGS, GREEN AND PUBLIC
SPACES, WASTE AND SANITATION,
FOOD SUPPLY, WATER SUPPLY,
TRANSPORTATION, AND ENERGY
SUPPLY.
THE REALITY IS VERY FEW CITIES
CAN PROVIDE ALL THESE THINGS
USING RESOURCES WITHIN THEIR
BOUNDARIES, ALMOST NO CITY DOES
THAT.
CITIES RELY ON LARGER NETWORKS,
EVENTUALLY GLOBAL TRADE.
FOOD IS GLOBALLY TRADED.
SO WE HAVE IMPACTS WELL OUTSIDE
OUR BOUNDARY.
ULTIMATELY LOOKING FROM THE
REGIONAL TO THE NATIONAL TO EVEN
THE GLOBAL SCALE.
AND SO WE HAVE MULTI-SCALE AIR
POLLUTION AND GREENHOUSE GAS
EMISSION FOOTPRINTS MY GROUP
PIONEERED METHODS TO MEASURE.
AND BRING THEM BACK TO
RESPONSIBILITY FOR URBAN
PROVISIONING SYSTEMS.
SO THIS ALLOWS URBAN
PROVISIONING SYSTEMS TO TAKE
GLOBAL RESPONSIBILITY, IN
ADDITION TO LOCAL AIR POLLUTION
AND THOSE EFFECTS, AND BELOW
YOU'RE SEEING SOCIAL INEQUALITY.
SUBSTANTIAL INEQUALITY, NOT ONLY
IN ACCESS TO THESE
INFRASTRUCTURE AND FOOD
PROVISION SYSTEMS WITHIN THE
CITY BUT ALSO THE KINDS OF
EXPOSURES WE CAUSE.
IF I CHOOSE TO MOVE POWER PLANT
OUTSIDE COMMUNITY THEY GET MOVED
SOMEWHERE ELSE AND IMPACT
SOMEONE ELSE.
THIS KIND OF SYSTEMS APPROACH
MAKES VISIBLE NOT ONLY
INEQUALITY WITHIN YOUR CITY BUT
ALSO TRANSBOUNDARY ASPECT OF
INEQUALITY CAUSED BY THE
DECISIONS WE'RE MAKING AROUND
INFRASTRUCTURE.
I HOPE THIS IS SOMETHING WE CAN
HAVE THE PUBLIC HEALTH COMMUNITY
ADOPT, I'VE HEARD US TALK ABOUT
SOCIAL AND ECOLOGICAL
DETERMINANTS OF HEALTH.
I THINK INFRASTRUCTURE GETS
IGNORED.
SOCIAL IS MEANT TO INCLUDE THE
BUILT ENVIRONMENT.
WE SAY BUILT ENVIRONMENT.
OUR PURPOSE WITH THIS MAKING
INFRASTRUCTURE EXPLICIT IS TO
SAY IT IS THE ENVIRONMENT BUT
ALSO THE HUMAN-MADE SYSTEMS THAT
TRANSFORM THEM AND BRING THEM TO
US, AND THAT NOT ONLY CAN WE --
YOU KNOW, WE CAN LOOK AT
BIODIVERSITY, ENVIRONMENTAL
IMPACT, BUT WE SHOULD LOOK AT
INFRASTRUCTURE BECAUSE IT
MEDIATES THAT LINK.
HENCE THE NAME.
WE THINK EMPHASIZING THAT ALLOWS
YOU TO LOOK AT THE SOLUTIONS.
BUT INFRASTRUCTURE, NOT ONLY
CAUSED THE PROBLEM, BUT
TRANSFORMATION OF INFRASTRUCTURE
CAN PROVIDE SOLUTIONS AND THAT'S
WHAT WE'RE DOING.
WE'RE TRANSFORMING
INFRASTRUCTURE AND FOOD SYSTEMS.
NEXT SLIDE EXPLORES THE EFFECT.
IF YOU LOOK AT INFRASTRUCTURE
AND FOOD SYSTEMS FROM THIS
PERSPECTIVE IT'S NOT JUST ONE
CITY, IT'S MULTIPLE CITIES THAT
ARE NETWORKS BETWEEN CITIES
GOING FROM LOCAL TO GLOBAL
SCALE.
AND IF YOU LOOK AT ENVIRONMENTAL
IMPACT, WE HAVE MULTI-SCALE
HOUSEHOLD AIR POLLUTION,
UNHEALTHY DIETS FROM THE LEFT
SIDE, POOR NEIGHBORHOOD ACCESS,
TO GREEN INFRASTRUCTURE,
NUTRITIOUS FOOD, WALKABLE
STREETS, YOU HAVE URBAN/REGIONAL
HEAT, NOISE, FLOODING, YOU HAVE
NATIONAL AND REGIONAL PATTERNS
OF AIR POLLUTION, FLOODING,
DROUGHT.
ULTIMATELY GLOBAL CLIMATE
CHANGE.
IT ALLOWS US TO SAY THE RISKS
THAT IMPACT US HERE ARE NOT JUST
ORIENTED OR LIMITED TO
COMMUNITY.
SHOWN BELOW, WE COULD NUDGE
PEOPLE TO TRANSFORM LIFESTYLES
AND BEHAVIORS, CHANGE
NEIGHBORHOOD DESIGN, LOOK AT
URBAN METROPOLITAN
TRANSPORTATION AND LAND USE
PLANNING.
WE COULD LOOK AT NATIONAL
POLICIES LIKE CARBON GRIDS,
CREATING CLEAN INDUSTRY,
POTENTIALLY LOOK TO
ORGANIZATIONS LIKE THE U.N. TO
USE THE FRAMEWORK TO GUIDE THESE
CHANGES.
I'M GOING TO MOVE QUICKLY, EACH
ADDED A FEW THINGS.
NEXT SLIDE.
THIS IS FROM OUR ONE EARTH
ARTICLE.
YOU SEE ESSENTIALLY THE SAME
THING, AGAIN SOMEONE CAN USE THE
POINTER, WE HAVE SEVEN PHYSICAL
PROVISIONING SYSTEMS, PHYSICAL
PROVISIONING SYSTEMS CONNECT TO
SOCIAL PROVISIONING SYSTEMS LIKE
EDUCATION, HEALTH CARE, AND
THESE PROVISIONING SYSTEMS ARE
EMBEDDED IN MULTI-SCALE SOCIAL
AND NATURAL SYSTEMS.
AND THEY HAVE ALL THESE
OUTCOMES.
MY GROUP, WE FOCUS ON
ENVIRONMENTAL SUSTAINABILITY,
HUMAN HEALTH AND WELL-BEING.
ECONOMY AND SECURITY.
AND AS WELL AS EQUITY.
WE'RE LOOKING AT DISTRIBUTIONAL
EQUITY, DEFINED THEM AS
INEQUALITY AND FAIRNESS IN
DISTRIBUTION, OF BURDENS AND
BENEFITS, ACROSS BOTH
DETERMINANTS AND OUTCOMES WITH
THE GOAL OF REDUCING DISPARITIES
FOR THE MOST DISADVANTAGED AND
THE MOST HISTORICALLY
MARGINALIZED.
THE PURPOSE OF THE PAPER WAS TO
THINK ABOUT HOW TO THINK ABOUT
EQUITY IN SYSTEMS ORIENTATION.
IF YOU MOVE TO THE NEXT SLIDE.
I WANT TO HIGHLIGHT THE THIRD
ASPECT OF THIS, WHICH I THINK WE
TALKED A LITTLE BIT ABOUT, THAT
IT'S JUST NOT ENOUGH FOR
RESEARCHERS TO TALK ABOUT THESE
THINGS PARTICULARLY EQUITY, AND
THE NEXUS, BECAUSE THERE ARE
INHERENTLY GOING TO BE TRADEOFFS
AND CO-BENEFITS.
IT'S SO ESSENTIAL BECAUSE VALUE
SYSTEMS ARE DIFFERENT, THE
EFFECTS ARE DIFFERENT, HEALTH
EFFECTS AND ENVIRONMENTAL
EFFECTS THAT WE ENGAGE WITH
SCIENCE OF CO-PRODUCTION, AND
THIS IS JUST SAYING THAT
RESEARCHERS AND PRACTITIONERS
SHOULD ENGAGE TOGETHER AND I
SHOW A PICTURE OF MYSELF AND MY
POSTDOC, I BELIEVE, IN THE NEXT
SLIDE WORKING WITH FOOD POLICY
COUNCIL AS WE LAUNCHED FOOD
ACTION PLANNING.
WE'VE ALSO WORKED WITH CITIES ON
ZERO CARBON TRANSITION.
BUT REALLY KEEPING THIS WORK IN
THE LAB, JUST DOING IT AS A
MODEL DOESN'T ADDRESS TRADEOFFS
AND CO-BENEFITS PARTICULARLY
WITH EQUITY WITH GROUPS
EXPERIENCING BENEFITS
DIFFERENTLY.
I'M GOING TO GO RAPIDLY THROUGH
EXAMPLES AND INTRODUCE THE AHA
STATEMENT.
WE CAN GO FASTER BECAUSE I THINK
IT'S 1:30 NOW.
I WANT TO SHARE ONE EXAMPLE OF A
PAPER THAT CAME OUT IN NATURE
CLIMATE CHANGE, LOOKING AT WHAT
WE CAN DO WITHIN CITIES.
MULTI-OR SECTOR, CROSS-SECTOR
ACTION FOR CARBON MITIGATION
WITH LOCAL BENEFITS.
I ACKNOWLEDGE CO-AUTHORS.
WE'RE SAYING WHAT HAPPENS IN THE
NEXT SLIDE IF INDIVIDUAL CITIES
STARTED SHARING RESOURCES,
AWARENESSES ENERGY, PARTICULARLY
IN CHINA CREATE ENORMOUS
RESOURCE EFFICIENCIES AND REDUCE
YOUR GRID DEMAND.
IT'S HELPFUL TO LOOK AT IF ALL
THE CITIES ADOPTED THESE
STRATEGIES, YOU CAN ACHIEVE IF
YOU LOOK AT THE NEXT SLIDE,
ACHIEVE SIGNIFICANT AMOUNT OF
DECARBONIZATION, WHAT WE'RE
SHOWING HERE IS THAT THOSE
CROSS-SECTOR ACTIONS CAN
CONTRIBUTE ABOUT 40% OF WHAT
NATIONAL STRATEGIES CONTRIBUTED,
A POWERFUL WAY TO LOOK AT WHAT
URBAN AREAS CAN DO FOR NATIONAL
DECARBONIZATION, AND IN THE NEXT
SLIDE, WE ALSO MODELED WHAT WAS
THE IMPACT OF THOSE ACTIONS FOR
ALL THE CITIES IN CHINA, USING
STRAIGHT FORWARD AIR POLLUTION
MODEL.
EVERY YEAR WE COULD AVOID 45,000
PREMATURE DEATHS FROM THIS.
WHAT WAS INTERESTING IS THAT
SOME CITIES, THE 1:1 BENEFIT, IF
YOU DO THESE THINGS, RENEWABLE
ENERGY, YOU WILL ACHIEVE
BENEFITS, BUT SOME ARE NOT
LOCAL, BECAUSE OF THE
TRANSBOUNDARY NATURE, THAT'S
WHAT WE SHOW HERE.
SOME CITIES HAD HIGH CARBON AND
HIGH HEALTH BENEFITS, SOME
CITIES HAD LOW CARBON AND LOW
HEALTH BENEFITS, ALSO ALIGNED
WITH OUR UNDERSTANDING OF
CORRELATION.
THERE WERE OTHER CITIES WITH
OTHER BENEFITS BECAUSE OF THE
TRANSBOUNDARY DYNAMICS.
THE IDEA IT'S NOT SIMPLE.
WE NEED GOOD MODELS TO MODEL
THESE RELATIONSHIPS.
AND THEN THE REMAINING I'M GOING
TO BREEZE THROUGH, ANOTHER WORK
STREAM WITH MY POSTDOC DANA
BOYER CONNECTING FOOD SYSTEMS,
ENVIRONMENTAL IMPACT, DIETARY
CHANGES AND OTHER INTERVENTIONS.
NEXT SLIDE TALKS ABOUT
INEQUALITY AND EXPOSURE TO WASTE
BURNING IN INDIAN CITIES.
WE MAY HAVE A LOT OF MODELS BUT
FUNDAMENTALLY IF YOU'RE DATA DO
NOT CAPTURE WHAT'S HAPPENING ON
THE GROUND WE'RE MISSING HALF OF
THE ENVIRONMENTAL DETERMINANTS
AND IN THIS CASE THERE WAS VERY
LITTLE DATA BEFORE OUR STUDY ON
HOW MUCH WASTE BURNING HAPPENS
IN INDIAN CITIES UNTIL WE SHOW
HIGH AND LOW U.S. NEIGHBORHOODS,
AND SIGNIFICANT WASTE BURNING
THAT HAS CAUSED A LOT OF HEALTH
IMPACT AND WE WERE THE FIRST
STUDY TO BRING THIS UP AS AN
UNCOUNTED SOURCE.
CASE STUDIES, FINE SCALE
MEASURES ARE ALSO IMPORTANT IN
ADDITION TO MULTI-SCALE LOOK.
THE LAST SET OF PAPERS TACKLED
WELL-BEING.
SO WE TALK ABOUT INFRASTRUCTURE
AND FOOD SYSTEM CORRELATES,
SUBJECTIVE WELL-BEING, THIS IS
MOTIVATED BY THE W.H.O.
DEFINITION ON THE NEXT SLIDE
THAT HEALTH IS NOT THE ABSENCE
OF DISEASE MERELY, IT SEEKS TO
IMPROVE HOW PEOPLE THINK AND
FEEL ABOUT THEIR LIVES, WHICH
RELATES TO AGENCY, BUT ALSO
PHYSICAL AND STRUCTURAL DESIGN.
AND SO THIS WAS A COLLABORATION
WITH UNIVERSITIES OF MINNESOTA,
A POSTDOC IN MY LAB.
I'M GOING TO GIVE A FEW EXAMPLE
PAPERS WHERE SINCE WE WERE
INTERESTED IN THE FOOD SYSTEM IF
YOU GO TO THE NEXT SLIDE --
>> I'M SORRY, IS THIS THE LAST
COUPLE SLIDES?
>> YES.
>> OKAY.
>> WE'RE LOOK AT HOW YOU CAN
MEASURE WELL-BEING, BECAUSE OF
GARDENING, PEOPLE WHO GARDEN,
AND SO VERY INTERESTING
CONNECTIONS WITH WELL-BEING.
AND THE LAST THING I WANT TO DO,
NEXT SLIDE, IS TO INTRODUCE THE
AHA POLICY STATEMENT WHICH YOU
SEE FOLLOWS, BUILT UPON SYSTEMS
IDEAS.
WE CAN LOOK AT SPECIFIC PATHWAYS
TO ZERO CARBON TRANSITION
THROUGH SPATIAL PLANNING,
EFFICIENCY, DECARBONIZING
ELECTRICITY.
IF YOU INVEST IN GREENERY, YOU
CAN SPECIFICALLY CONNECT
INFRASTRUCTURE WITH HEALTH AND
THE LAST TWO SLIDES WE CAN JUST
FLIP THROUGH, THE FRAMEWORK HOW
SPATIAL PLANNING AND
INFRASTRUCTURE, NEXT SLIDE,
CHANGES THE IMPACT RISK EXPOSURE
AND THAT IN TURN ADDRESSES THE
CARDIOMETABOLIC OUTCOMES.
I'LL STOP THERE AND SHARE MY
CONTACT INFORMATION.
THANK YOU FOR LISTENING.
>> THANK YOU.
VALUABLE PERSPECTIVE TO LINK
HEALTH AND INFRASTRUCTURE WITH
LENS ON EQUITY.
IN THE INTEREST OF TIME CAN WE
GET THE NEXT SPEAKER'S SLIDES
CUED UP.
I'D LIKE TO WELCOME DR. WEI
PENG, ASSISTANT PROFESSOR, ALSO
FROM PRINCETON UNIVERSITY, SHE'S
GOING TO GIVE A TALK ON
INTEGRATING AIR QUALITY AND
HEALTH CONSIDERATIONS INTO LOW
CARBON ENERGY DECISIONS.
>> THANKS FOR THE INVITE.
IT'S GREAT TO FOLLOW MY
COLLEAGUE'S TALK BECAUSE SHE
GAVE A VERY GOOD OVERVIEW OF THE
SYSTEMS THINKING AND NOW I WANT
TO DIVE INTO ONE OF THE CRUCIAL
FACTORS AND SYSTEMS, WHICH IS
ENERGY.
NEXT SLIDE PLEASE.
I'LL START WITH THE BIG PICTURE,
ENERGY SYSTEM IS GOING TO
EXPERIENCE UNPRECEDENTED CHANGE
IN THE NEXT FEW DECADES.
IN THIS COUNTRY, FOR EXAMPLE,
SET A GOAL TO REACH NET ZERO BY
2050.
WHERE WE ARE AND WHERE WE WANT
TO BE THREE DECADES FROM NOW,
THIS IS REALLY THE TYPE OF
TRANSFORMATION THAT NEEDS TO
HAPPEN.
IT'S GOING TO FUNDAMENTALLY
CHANGE THE WAY WE DRIVE, THE WAY
WE LIVE, THE WAY WE USE ENERGY,
AND TO SOME PEOPLE EVEN THEIR
JOBS AND LIVELIHOODS.
AROUND THE WORLD MORE THAN 100
COUNTRIES ARE IN THE PROCESS OF
THINKING ABOUT NET ZERO TARGETS,
THAT INCLUDES ALL THE MAJOR
EMITTERS LIKE CHINA, EUROPEAN
UNION, ET CETERA.
I GET THIS QUESTION A LOT.
CAN WE GET THERE?
I WISH I HAD THE SUPERPOWER OF
PREDICTING THE FUTURE BUT
UNFORTUNATELY I DON'T.
SO THIS IS REALLY THE QUESTION
THAT I DON'T KNOW, REALLY NOBODY
KNOWS.
IF THE PAST CAN TELL ABOUT THE
FUTURE, NEXT SLIDE PLEASE, SINCE
I GREW UP IN CHINA THAT WAS
SHANGHAI IN 1980s, AND
SHANGHAI THREE DECADES AFTER
THAT.
SO, I KNOW IT IS MUCH EASIER TO
BUILD NEW INFRASTRUCTURE THAN
TEARING DOWN EXISTING
INFRASTRUCTURE, ESPECIALLY
CONSIDERING HOW POWERFUL AND HOW
DEPENDENT WE HAVE BEEN ON THE
FOSSIL INDUSTRY, BUT THE POINT I
WANT TO MAKE IF WE HAVE THE
RIGHT PEOPLE, THE RIGHT
INCENTIVE DOING THE RIGHT THING,
THEN SO MUCH CAN BE ACHIEVED IN
THREE DECADES, AND THERE'S
REASON TO REMAIN OPTIMISTIC.
NEXT SLIDE PLEASE.
EVEN THOUGH I CANNOT ANSWER THE
QUESTION, CAN WE GET THERE, AS A
RESEARCHER PERHAPS THE QUESTION
THAT WE CAN BE MORE HELPFUL
ABOUT IS HOW CAN WE GET THERE?
NEXT SLIDE.
AND THIS IS WHERE THE ENERGY
SYSTEM MODELING HAS BEEN SUPER
HELPFUL BECAUSE USING THE MODEL
WE FOUND THERE ARE MANY
TECHNOLOGY PATHWAYS THAT CAN GET
US THERE AND WE ALSO KNOW
GENERAL FEATURES AN DIRECTIONS
TO MAKE EFFORTS ON.
THIS FIGURE IS TAKEN FROM THE
WHITE HOUSE REPORT ABOUT THE
U.S. LONG-TERM STRATEGY TO REACH
NET ZERO.
YOU CAN SEE FROM THE LEFT
LOOKING AT THE REPRESENTATIVE
PATHWAY TO 2050, WE NEED TO
TRANSFORM, DECARBONIZE
ELECTRICITY, TECHNOLOGY CHOICES,
END USE.
ON TOP OF THAT, EVEN IF WE HAVE
A DIFFERENT VIEW IN TERMS OF
WHAT KIND OF ENERGY TECHNOLOGY
WOULD BE MORE AVAILABLE, LESS
AVAILABLE, FOR EXAMPLE IF YOU
DON'T REALLY THINK NUCLEAR
SHOULD BE PART OF THE PICTURE OR
IF YOU THINK THAT RENEWABLE
ELECTRICITY WOULD NOT SCALE UP
AS QUICKLY AS WE THINK, NO
WORRIES.
BECAUSE USING ENERGY SYSTEM
MODEL WE CAN SHOW YOU TENS OR
THANS OF WAYS TO GET TO NET
DEZEE ROW EVEN WITH DIFFERENT
ASSUMPTION ABOUT THE FUTURE, AND
I SHOW SOME EXAMPLES ON THE
RIGHT PART OF THE SLIDE.
THIS THE REASON ENERGY MODELS
HAVE BEEN USEFUL AND WIDELY USED
BY THE DECISION MAKERS, GLOBALLY
LIKE THE IPCC PROCESS AND ALSO
DOMESTICALLY BY A LOT OF
AGENCIES AND ALSO MORE RECENTLY
BY NATIONAL CLIMATE ASSESSMENT.
ON ONE HAND AS PART OF THE
COMMUNITY I FEEL EXCITED ABOUT
HOW OUR EFFORTS TURNED INTO
ACTION.
ON THE OTHER HAND, I ALSO THINK
THERE'S FUNDAMENTAL ISSUE IN THE
WAY WE'RE USING INTERPRETING
ENERGY RESULTS, IF YOU REALLY
LOOK AT OUR MODELING RESULT,
HEAVILY FOCUSED ON TECHNOLOGY.
WE THINK THE MODEL IS A BUNCH OF
TECHNOLOGIES COMPETING WITH EACH
OTHER BUT THERE'S NO HUMAN
PHASE, OR COMPANY PHASE, LIKE
REAL WORLD PHASES TO HELP US
MAKE THE CONNECTION BETWEEN WHAT
DOES IT MEAN TO EACH INDIVIDUAL
IN THE TRANSITION.
THIS IS ONE SCENARIO FOR THE
U.S. TO REACH NET ZERO.
YOU CAN SEE IF YOU LOOK AT
TOMORROW PRIME ENERGY USE, HEY,
WE NEED TO BRING DOWN THE TOTAL
PRIMARIAN ENERGY USE BY 30% AND
FOSSIL FUEL SHARE FROM 84% WHERE
WE ARE TODAY TO 25% BY
MID-CENTURY.
SO ONCE WE MOVE OUR FOCUS FROM
TECHNOLOGY, THERE ARE TWO SETS
OF QUESTIONS.
ONE HAND, THE QUESTION BECOMES
IS IT REALISTIC TO MAKE THIS
TRANSITION?
FOR EXAMPLE, GIVEN HOW DEPENDENT
WE ARE ON FOSSIL FUEL NOW CAN WE
SCALE DOWN AND PHASE OUT FOSSIL
FUEL THAT QUICKLY?
CAN WE REALLY SCALE UP RENEWABLE
INVESTMENT THAT QUICKLY GIVEN
ALL THE TRANSMISSION GRID
BARRIERS AND ALSO PUBLIC OPINION
OPPOSITION, ET CETERA.
THE OTHER SET OF PERHAPS PERHAPS
FOR RELEVANT TO TODAY WHAT ARE
IMPLICATIONS ON EACH LIVING
HUMAN BEING, IN PARTICULAR WHAT
DOES IT MEAN FOR AIR QUALITY AND
HEALTH AND ALSO DISTRIBUTION OF
THOSE EFFECTS BECAUSE WE KNOW
THAT ON ONE HAND FOSSIL FUEL IS
REALLY THE DOMINANT REASON WE
HAVE A LOT OF POLLUTION ISSUES,
BUT ON THE OTHER HAND SOME OF
THE LOW CARBON STRATEGIES LIKE
MITIGATION ACTIONS MAY ALSO LEAD
TO NEW SOURCES OF AIR POLLUTION
AND HEALTH DAMAGES.
THIS IS WHERE THE CO-BENEFITS
COME INTO A VERY IMPORTANT ROW.
IT CAN MAKE ENERGY POLICY MORE
ATTRACTIVE.
FIRST OF ALL, BENEFITS ARE
IMMEDIATE.
NOT FUTURE GENERATIONS.
WE'RE REALLY TALKING ABOUT LIKE
TODAY WE'RE GOING TO BENEFIT
FROM THE TRANSITION.
IN ADDITION IT'S ALSO TANGIBLE,
NO LONGER TALKING ABOUT POLAR
BARS LOSING HABITAT, WE'RE
TALKING ABOUT OUR HEALTH AND
HEALTH OF OUR FAMILY.
FINALLY, IT MAKES ENERGY
TRANSITION MORE PERSONALLY
RELEVANT.
I HAVE A 3-YEAR-OLD, HE HAS ALL
KINDS OF ALLERGIES.
WHEN WE HAVE A HIGHLY POLLUTING
DAY IT'S PERSONALLY RELEVANT TO
ME BECAUSE I DON'T WANT LIMB TO
BE MISERABLE ON THAT DAY.
NEXT SLIDE PLEASE.
THAT BECOMES THE CORE QUESTION
OVER THE PAST DECADE,
INTEGRATING AIR QUALITY AND
HEALTH CONSIDERATION INTO OUR
ENERGY DECISIONS.
NEXT SLIDE.
THANKS TO DECADES OF EFFORTS
FROM THE COMMUNITY, NOW WE HAVE
A GOOD UNDERSTANDING OF HIGH
LEVEL, WHAT IS GUIDING PRINCETON
-- GUIDING PRINCIPLE TO
STRATEGY.
ONE EXAMPLE, WE DID A SYNTHESIS
ANALYSIS AROUND IF WE WANT TO
INTEGRATE AIR QUALITY ON HEALTH
CONSIDERATION INTO THE EFFORTS
TO DECARBONIZE THE POWER SECTOR,
WHERE ARE THE MOST IMPORTANT
THINGS TO FOCUS ON?
SO, WE THINK THERE ARE FOUR
AREAS.
FIRST, WHEN WE REPLACE OLD
INFRASTRUCTURE, RETIRING
EXISTING COAL PLANTS, TARGET
HIGHLY POLLUTING SOURCES IN
DENSELY POPULATION REGIONS THAT
WILL BRING A LOT OF HEALTH
BENEFITS TO EXPOSED POPULATION.
THE SECOND PART OF THE PUZZLE IS
WE BUILD NEW INFRASTRUCTURE, WE
REALLY NEED TO FOCUS ON SCALING
UP .
WITH MORE ELECTRIC CARS WE'LL
NEED TO INCREASE ELECTRICITY
DEMANDS, IN THIS COUNTRY WE'RE
GOING TO INCREASE HOW MUCH
GENERATION WILL COME FROM POWER
PLANTS AND HOPEFULLY THOSE NEW
DEMANDS WILL BE MET BY
DECARBONIZED ELECTRICITY RATHER
THAN FOSSIL FUELS.
THIRD IS CONNECTING STATES, TWO
IMPORTANT ELEMENTS.
ONE IS BECAUSE THE POWER GRID IS
CONNECTED.
SO WHEN WE RETIRE OR ADD IN ONE
REGION, IN THE ONLY AFFECT
LOCALLY, ALSO AFFECTS THE WHOLE
GRID REGION BECAUSE OUR SUPPLY
AND DEMAND DECISIONS ARE AT A G
LEVEL.
ON TOP OF THAT WE'LL TRANSPORT
FROM ONE TO THE OTHER.
WE THINK ABOUT CONNECTING SPACE,
WAYS TO MINIMIZE CROSS-STATE
DAMAGES FROM ELECTRICITY TRADE
AND ALSO POLLUTION TRANSPORT.
THE MOST DIFFICULT PART IS HOW
WE CAN PUT EQUITY AT CENTER OF
LOW CARBON ENERGY INFRASTRUCTURE
DESIGN.
SO, TO A LARGE EXTENT THE
DECISIONS WE MADE IN THE PAST
REGARDING FACILITIES AND WHERE
ARE WE GOING TO BUILD IT, THOSE
ARE REALLY THE FUNDAMENTAL ISSUE
WHY WE HAVE INJUSTICE TODAY.
AS A RESULT WHEN WE THINK ABOUT
ENERGY TRANSITION TO NET ZERO
IT'S CRUCIAL TO THINK AHEAD OF
TIME HOW ARE WE THINKING ABOUT
TECHNOLOGY CHOICES AND DECISIONS
AND PUTTING EQUITY AS THE CENTER
OF THE NEW INFRASTRUCTURE DESIGN
SO WE WON'T HAVE THE SAME
PROBLEM AND ISSUE THREE DECADES
FROM NOW.
ALTHOUGH WE HAVE A GOOD
UNDERSTANDING OF BROAD STRATEGY
THE KEY CHALLENGE IS AROUND
SPECIFIC POLICY DESIGNS.
I WANT TO GIVE A QUICK EXAMPLE
ABOUT THE ELECTRIC VEHICLES.
IF YOU LOOK AT -- SOME
REGIONALIZATION IS MESSED UP.
I HOPE I CAN EXPLAIN WELL
ENOUGH.
IF YOU LOOK AT THE POLICIES
TODAY WE HAVE A BUNCH OF POLICY
TARGETS WHICH INCLUDE EV CELLS,
ALSO ECONOMY-WIDE EMISSIONS.
WE HAVE A WIDE RANGE OF POLICY
INSTRUMENT CHOICES, IT CAN BE
PURCHASE INCENTIVE, FUNDING FOR
CHARGER INFRASTRUCTURE, ALSO
FUNDING FOR EP MANUFACTURE --
EV MANUFACTURING, ET CETERA.
HOW CAN WE PUT HEALTH AS ONE
CONSIDERATION FOR POLICY
ASSESSMENT, AND ON TOP OF THAT,
HOW CAN WE THINK ABOUT NOT ONLY
EMBRACING POLICY INSTRUMENT
CHOICES THAT WOULD BE USEFUL IN
ACCELERATING ADOPTION BUT ALSO
AT THE SAME TIME ENSURING GOOD
AIR QUALITY AND HEALTH OUTCOMES.
WE MAKE ENERGY CITIESES FOR
TODAY -- ENERGY DECISIONS FOR
TODAY AND OPENING THE DOOR TO
ACCELERATE ENERGY POLICY IN THE
FUTURE.
SO HERE IS ANOTHER IMPORTANT SET
OF QUESTIONS, HOW CAN HEALTH
CONSIDERATIONS PLAY A ROLE SO
THAT WE CAN REALLY REDUCE THE
BARRIERS TO HAVE MORE EFFECTIVE
CLEAN ENERGY POLICY IN THE
FUTURE.
AND THAT IS WHERE THE SOCIAL
POLITICAL AND TECHNOLOGY
CONCERNS ARE IMPORTANT.
FOR EXAMPLE, HOW CAN WE USE
HEALTH AS A WAY TO INCREASE
PUBLIC SUPPORT, ACCELERATE
ADOPTION, STRENGTHEN GREEN
COALITION, EVEN LIKE INCREASE
MARKET SHARE FOR THE LOW CARBON
TECHNOLOGIES.
NEXT SLIDE PLEASE.
THE FRONTIER, TURNING WHAT WE
KNOW INTO ACTIONABLE KNOWLEDGE
AROUND POLICY DESIGN, FOR
INTEGRATIVE ENERGY AND HEALTH
DECISIONS.
I THINK THERE ARE THOSE
INSTITUTIONAL CHALLENGES AND
SCIENCE CHALLENGES.
NEXT SLIDE.
SO, REGARDING INSTITUTIONAL
CHALLENGES I THINK THE KEY THING
IS HOW CAN WE NAVIGATE COMPLEX
DECISION MAKING LANDSCAPE.
I HAVE TWO SUBPOINTS ON THIS.
FIRST OF ALL, WE DO NEED TO
START TO THINK ABOUT BRIDGING
AGENCIES, TRADITIONALLY HAVE
VERY DIFFERENT FUNCTIONS AND
GOALS.
SO IF YOU THINK ABOUT ENERGY,
FEDERAL LEVEL WE HAVE DEPARTMENT
OF ENERGY, IF YOU THINK ABOUT
AIR QUALITY WE HAVE EPA, CDC FOR
HEALTH, DEPARTMENT OF HEALTH AND
HUMAN SERVICES.
BUT THIS KIND OF LIKE DIFFERENT
GOALS OF DIFFERENT AGENCIES IS
NOT REALLY PROVIDING THE RIGHT
CONTACT TO THINK ABOUT
INTEGRATIVE DECISIONS, THINKING
ABOUT THE VENN DIAGRAM TO MAKE
GOOD DECISIONS THAT TACKLE ALL
THREE ISSUES.
ANOTHER SIDE IS THINKING ABOUT
COORDINATING EFFORTS ACROSS
MULTIPLE LEVELS OF GOVERNMENTS.
SO, FOR ENERGY FOR AIR QUALITY
AND HEALTH WE NOT ONLY HAVE
EFFORTS AT FEDERAL LEVEL, WE
ALSO HAVE ACTIONS AT STATE
LEVEL, AND HOUSEHOLD AND
COMPANIES LEVEL, CHANGING FROM
THE FRAMEWORK ON LEFT TO RIGHT A
LOT OF HEALTH AND AIR QUALITY
ISSUES ARE AT STATE AND LOCAL
LEVELS, NOT ONLY IMPORTANT
ACTORS TO RESPOND TO ENERGY
PROGRAM, THEY ARE ALSO LEADING
ACTORS FOR AIR QUALITY
MEASUREMENT SUCH AS STATE
IMPLEMENTATION PLAN FOR AIR
QUALITY CONTROL.
ALONG THOSE LINES HOW CAN WE
REALLY EMPHASIZE THE ROLE OF
STATE AND LOCAL ACTORS AND AT
THE SAME TIME THINK ABOUT THE
LINKAGE BETWEEN THE FEDERAL
GOVERNMENT AND ALSO CREATE
EFFECTIVE RESPONSE, THAT CREATES
NEW CHALLENGES WHEN THINKING
ABOUT POLICY COORDINATION ACROSS
MULTI-LEVEL STRUCTURE.
THERE ARE ALSO IMPORTANT SCIENCE
CHALLENGES.
THE KEY CHALLENGE IS HOW CAN WE
GENERATE ROBUST INSIGHT FOR
COMPLEX SYSTEMS.
I HAVE A FEW ELEMENTS TO
DISCUSS.
FIRST OF ALL HOW CAN WE
UNDERSTAND THE HEALTH DRIVERS
AND HEALTH OUTCOMES.
I WANT TO GIVE ONE QUICK EXAMPLE
ABOUT EXPOSURE DISPARITIES, WHAT
MATTERS, WHAT DETERMINES
EXPOSURE DISPARITY, IT'S THE
CORRELATION BETWEEN WHERE
POLLUTION IS HIGH AND WHERE
DISADVANTAGED POPULATIONS LIVE.
SO WHEN WE THINK ABOUT WHAT
WOULD CHANGE IN THE FUTURE,
THERE ARE TWO ASPECTS GOING TO
CHANGE WHERE THE POLLUTION IS
HIGH.
THE GLOBAL ENERGY TRANSITION IS
GOING TO INFLUENCE OUR FUTURE
CLIMATE AS A RESULT OF CHANGE IN
CONDITIONS AND THAT WILL BE
CRUCIAL WHEN THINKING ABOUT
POLLUTION FORMATION AND
POLLUTION REMOVAL.
DETERMINING WHERE POLLUTION IS
HIGH.
MORE IMPORTANT IS NATIONAL,
STATE, LOCAL ENERGY DECISIONS
ARE GOING TO INFLUENCE OUR
EMISSIONS DIRECTLY INFLUENCING
WHERE FUTURE POLLUTION SOURCES
WOULD OCCUR.
ON TOP OF THAT, THINKING ABOUT
PROJECTING WHERE DISADVANTAGED
POPULATIONS MAY LIVE IN THE
FUTURE WE NEED TO THINK ABOUT
ECONOMIC TRENDS INCLUDING
POPULATION GROWTH, URBANIZATION,
AGING, ET CETERA.
THOSE DEMOGRAPHIC TRENDS NOT
ONLY INFLUENCE WHERE THE
DISADVANTAGED COMMUNITIES LIVE,
IT ALSO PROVIDES THE FOUNDATION
FOR A LOT OF ENERGY TRANSITIONS
I WAS TALKING ABOUT EARLIER AT
NATIONAL, STATE, LOCAL LEVEL.
HERE WE HAVE A VERY COMPLEX
SYSTEM AND INTERACTIONS LINKING
HEALTH DRIVERS TO HEALTH
OUTCOMES, AND THAT'S WHERE I
THINK A LOT OF SCIENTIFIC
UNDERSTANDING IS NOT THERE YET.
THE OTHER PART IS WE ALSO HAVE
IMPORTANT MULTI-SECTOR
LINKAGINGS.
I WANT TO USE ELECTRIC --
>> WE'RE RUNNING OUT OF TIME.
>> YEAH, SURE.
I CAN QUICKLY GO THROUGH AND
JUMP THROUGH A FEW AS WELL.
BRIEFLY, IF YOU THINK ABOUT THE
EV ADOPTION, IT WOULD INFLUENCE
TRANSPORTATION SECTOR, IT'S
INDUSTRY AND POWER AS A RESULT
CHANGING HEALTH EXPOSURE AND
HEALTH IMPACTS.
JUMP TO THE NEXT ONE.
I CAN END ON THIS.
CRAFTING USABLE KNOWLEDGE FOR
REAL WORLD DECISIONS REQUIRES
LEARNING AND KNOWLEDGE FOR
CO-PRODUCTION.
INTERDISCIPLINARY LEARNING NOT
JUST ABOUT ENERGY SYSTEMS, ALSO
ABOUT HEALTH, EQUITY AND ETHICS,
KNOWLEDGE CO-PRODUCTION, WORKING
CLOSELY WITH THE RELEVANT
STAKEHOLDERS AS WE TALKED IN THE
PREVIOUS SESSION.
I'LL END WITH THIS.
I LEAD A PROJECT, THE CORE FOCUS
THINKING ABOUT HOW WE CAN BRING
AIR QUALITY AND HEALTH TO ENERGY
POLICY.
I LOOK FORWARD TO DISCUSSIONS
TODAY AND LEARNING FROM THE
OTHER PANELISTS AND AUDIENCE
TODAY.
THANK YOU.
>> THANK YOU.
JUST SO ALL OF OUR PANELISTS
KNOW, THERE ALREADY AMPLE TIME
FOR DISCUSSION.
WE'LL HAVE A CHANCE TO EXPAND ON
CONCEPTS IN THE DISCUSSION
SECTION.
INCOME DR. JESS FRANZO, INTERIM
DIRECTOR OF INTERNATIONAL
RESEARCH INSTITUTE FOR CLIMATE
AND SOCIETY, COLUMBIA CLIMATE
SCHOOL, COLUMBIA UNIVERSITY.
WELCOME.
WE LOOK FORWARD TO YOUR TALK ON
HARNESSING FOOD SYSTEMS AS A
SOLUTION FOR CHANGING CLIMATE.
>> THANK YOU FOR THE OPPORTUNITY
TO BE HERE.
I'LL TRY TO KEEP THIS UNDER 15
MINUTES.
I'M GOING TO TALK ABOUT FOOD
SYSTEMS AND RELATIONSHIP WITH
CLIMATE, WHAT WITH KEY DO NOW,
IT'S AN IMPORTANT MOMENT OUT OF
COP28.
FOOD WAS A LITTLE BIT IN THE
NEGOTIATIONS AND IN THE FINAL
TEXT BUT NOT SO MUCH.
IT'S REALLY IMPORTANT THAT WE
BRING THIS TO LIGHT.
CLIMATE HAS SIGNIFICANT IMPACT
ON FOOD AND HEALTH SYSTEMS CAN
SIGNIFICANT REPERCUSSION ON
DIET AND DISEASE.
FAR LEFT, DIRECT EFFECT, EXTREME
WEATHER EFFECT, FLOODS, DOUBTS,
HEAT WAVE, WARMING TEMPERATURES,
SEA LEVEL RISE, OCEAN
ACIDIFICATION, AND I'LL BE
FOLLOWED BY DR. DAHER TALKING
ABOUT WATER, WITH IMPACT ON
WATER, FOOD INSECURITY, TWO
PATHWAYS IN YELLOW, FOOD SYSTEM
AND HEALTH SYSTEM PATHWAY IN
WHICH THROUGH FOOD WE HAVE
INEFFICIENT QUANTITY AND QUALITY
BEING CONSUMED OR ACCESSED,
INCREASED DISEASE AND STRESS
WITH IMPLICATION ON NUTRITION,
STUNTING AND WASTING,
MICRONUTRIENT DEFICIENCIES,
OBESITY, DIET-RELATED
NON-COMMUNICABLE DISEASES.
NEXT SLIDE.
FOOD SYSTEMS ARE PART OF THE
PROBLEM.
FOOD SYSTEMS ACCOUNT FOR 30% OF
GREENHOUSE GAS EMISSIONS.
THAT COMES FROM LIVESTOCK
FERMENTATION, AS WITH RISE, WITH
THE ENERGY INVOLVED IN GROWING,
MOVING, PACKAGING OF FOOD AND
THE RUNOFF, WHETHER MANURE OR
WASTE.
LIVE STOCK IS A BIG CONTRIBUTOR
PARTICULARLY BECAUSE IT -- OF
THE ENTERIC FERMENTATION WHICH
RELEASES METHANE, FOOD SYSTEMS
ARE A VICTIM OF CLIMATE CHANGE
BUT CONTRIBUTORS, PART OF THE
PROBLEM.
WE KNOW THE FOODS WE'RE GROWING
HAVE CERTAIN ENVIRONMENTAL
STRESSES, SHOWING YOU FIVE
DIFFERENT ENVIRONMENTAL
STRESSES, GREENHOUSE GAS
EMISSIONS, LAND USE CHANGE,
WATER USE, NITROGEN AND
PHOSPHORUS APPLICATION, CAUSING
POLLUTED WATERS THROUGH NUTRIENT
RUNOFF.
LIGHT BLUE IN TOP TWO BARS ARE
LIVE STOCK, BEEF AND LAMB, LIVE
STOCK PRODUCE A LOT OF
GREENHOUSE GASES, LAND USE
CHANGE, TYPICALLY IN TROPICAL
FOREST, DEFORESTATION.
DIFFERENT FOODS HAVE DIFFERENT
ENVIRONMENTAL STRESSES DEPENDING
WHERE THEY ARE GROWN AND HOW
THEY ARE GROWN.
THAT'S REALLY IMPORTANT.
AVOCADOS AND NUTS ARE BIG WATER
CONSUMERS, STAPLE GRAINS USE A
LOT OF WATER AND CHEMICALS.
NEXT SLIDE.
NOT ONLY THE FOODS WE'RE
CONSUMING HAVE ENVIRONMENTAL
FOOTPRINTS BUT HAVE IMPACTS ON
HUMAN HEALTH; ON LEFT DIETARY
RISKS FOR MORBIDITY AND
MORTALITY IN THE WORLD, DIETS
MEANT TO NOURISH US ARE KILLING
US.
THIS IS DATA FROM THE GLOBAL
BURDEN OF DISEASE, MOST OF THAT
DEATH IS DUE TO NON-COMMUNICABLE
DISEASES, CARDIOVASCULAR DISEASE
BEING THE TOP.
DIETS CONTRIBUTE TO OTHER
NON-COMMUNICABLE DISEASE, ON THE
RIGHT IS WORK SHOWING TYPE 2
DIABETES, SUBOPTIMAL DIETS ARE
THE MAIN RISK FACTOR, AND OTHER
FACTORS CONTRIBUTING TO
DIABETES, LACK OF INTAKE OF
WHOLE GRAINS, EXCESS INTAKE OF
REFINED GRAINS AND PROCESSED RED
MEATS.
NEXT SLIDE.
DIGGING FURTHER INTO DIET AND
FOODS THAT ARE POTENTIALLY
PUTTING PEOPLE AT RISK FOR
CARDIOVASCULAR DISEASE AND TYPE
2 DIABETES, I'VE HIGHLIGHTED IN
RED WHERE YOU CAN SEE HIGHER
RISK OF CARDIOVASCULAR DISEASE
AND TYPE 2 DIABETES, A LITTLE
BIT OF STROKE IN THERE, RED MEAT
AND PROCESSED MEATS, SHOWN IN
MANY STUDIES THAT BUILT UPON
THAT, WHEN WE LOOK AT HEALTH AND
ENVIRONMENT BENEFITS, RED MEAT,
RED PROCESSED MEATS ARE THE
OUTLIERS OF HAVING A DOUBLE
IMPACT ON HEALTH AND THE
ENVIRONMENT, WHEN EATEN OR
PRODUCED IN EXCESS.
NEXT SLIDE.
BUR IT'S NOT SUCH AN EASY
PICTURE, IN THAT WHAT IS HEALTHY
IS SUSTAINABLE.
THAT'S NOT NECESSARILY TRUE.
THIS IS WORK BY MIKE CLARK AND
COLLEAGUES.
IT'S SHOWING THESE SPIDER WEBS
ON THE LEFT PART OF THE SPIDER
WEB IS HEALTH.
ON THE RIGHT IS ENVIRONMENT.
YOU CAN SEE THERE'S MORTALITY,
CORONARY HEART DISEASE,
COLORECTAL CANCER, DIABETES,
STROKE.
ON THE LEFT ARE THOSE FIVE MAJOR
ENVIRONMENTAL STRESSORS LOOKED
AT IN ENVIRONMENTAL PAPERS.
WATER USE, ACIDIFICATION.
NUTS, HEALTHY, PROTECTIVE, BUT
HIGH WATER USE.
OR LOOK AT THE THIRD ROW, ON THE
VERY FAR RIGHT, UNPROCESSED RED
MEATS.
RISKS ON THE NON-COMMUNICABLE
DISEASE SIDE, HIGH RISK ON
ENVIRONMENT SIDE.
AT THE BOTTOM, SSB, THAT'S
SUGAR-SWEETENED BEVERAGES.
NOT GREAT FOR HEALTH.
BUT PRETTY LOW ENVIRONMENTAL
FOOTPRINT.
SO, HEALTHY FOODS ARE NOT ALWAYS
NECESSARILY THE MOST SUSTAINABLE
FOODS.
IT'S NOT ALWAYS AN EQUAL
PAIRING.
NEXT SLIDE.
LAST THING WE KNOW HEALTHY DIETS
ARE INEQUITABLE, ACCESS TO
HEALTHY DIETS ARE UNAFFORDABLE
FOR MANY PEOPLE IN THE WORLD.
THIS MAP IS SHOWING YOU THE
PERCENTAGE OF THE POPULATION WHO
CANNOT AFFORD A HEALTHY DIET.
THE DARK BROWN IS WHERE 75% OR
MORE OF THE POPULATION CANNOT
AFFORD A HEALTHY DIET.
3.2BILLION PEOPLE CANNOT AFFORD
THAT HEALTHY DIET WHICH IS
INCREDIBLE WHEN YOU THINK ABOUT
THAT STATISTIC.
I WANT TO HIGHLIGHT, IT WAS GOOD
TO HEAR FROM DR. PENG TALKING
ABOUT THE ENERGY SECTOR, THAT IS
THE BIGGEST CONTRIBUTOR TO
GREENHOUSE GASES.
IF WE DO NOTHING ON FOOD, WE
WILL NOT REACH THE PARIS CLIMATE
CHANGE TARGETS TO STAY BELOW 1.5
DEGREES.
IF WE FIX THE ENERGY SECTOR, WE
FIX TRANSPORTATION,
INFRASTRUCTURE, FROM DR.
RAMASWAMI'S PRESENTATION WE
STILL WON'T MEET PARIS AGREEMENT
IF WE DO NOTHING.
67% CHANCE STAYING BELOW 1.5 WE
NEED TO DO MANY THINGS,
IMPROVING EFFICIENCY OF WHAT'S
GROWN, INCREASING YIELDS IN SOME
PARTS OF THE WORLD LIKE
SUB-SAHARAN AFRICA, INCREASING
PLANT-BASED DIET CONSUMPTION,
CONSUMING RIGHT AMOUNT OF
CALORIES, NOT OVERCONSUMING.
AND CUTTING FOOD LOSS WASTE IN
HALF.
WHAT THAT LAST BAR SHOWS IS THAT
WE NEED TO DO ALL OF THAT IF WE
WANT TO HAVE A STANDING CHANCE
TO STAY BELOW 1.5 DEGREES.
NEXT SLIDE.
UNFORTUNATELY THIS CUT OFF.
THAT'S OKAY.
SOME INDIVIDUALS, COMMUNITIES,
AND COUNTRIES NEED TO MAKE
BIGGER CHANGES THAN OTHERS.
ENERGY INTENSIVE LIFESTYLES FOR
MANY ARE SIGNIFICANT
ANTHROPOGENIC CONTRIBUTORS TO
CLIMATE CHANGE WITH
DISPROPORTIONATE IMPACT IN
PLACES THAT ARE RESOURCE
CONSTRAINED.
SIX ECONOMIES EMIT HALF THE
GREENHOUSE GASES, U.S., CHINA,
BRAZIL, INDIA, INDONESIA AND
E.U.
WE CONSUME A LOT OF MEAT,
SOMETIMES 30 TIMES MORE MEAT
THAN BANGLADESH PER DAY OR PER
WEEK.
WE REALLY NEED TO SEE AND
UNDERSTAND THE INEQUITIES THAT
WE'RE FACING WHEN IT COMES TO
DIETS AND WHO NEEDS TO TAKE
BIGGER ACTION ON FOOD SYSTEMS.
I'LL GO THROUGH THIS AND TALK
ABOUT RESEARCH.
TO HIGHLIGHT AGAIN IT'S NOT ONLY
THAT WE HAVE TO FIX AGRICULTURE
PRODUCTION, ENSURE PEOPLE GET
ACCESS TO HEALTHY DIETS, MOVE TO
PLANT-BASED DIET, CUT FOOD WASTE
IN HALF, WE NEED DIFFERENT
POLICY LEVERS TO BE ABLE TO HELP
FARMERS, HELP CONSUMERS MAKE
HEALTHIER SUSTAINABLE CHOICES.
FROM AGRICULTURE PRODUCTION TO
TRANSPORT, TO FOOD ENVIRONMENTS,
WHERE YOU ENGAGE WITH THE FOOD
SYSTEM EVERY DAY, YOU GO INTO A
MARKET, GO INTO A RESTAURANT,
MAKE CHOICES.
AS WELL AS AROUND LABELING AND
PROMOTION AND DIETARY
GUIDELINES.
WE NEED GOVERNMENTS TO TAKE
DIFFERENT ACTIONS ACROSS
DIFFERENT ASPECTS OF THE SUPPLY
CHAIN.
IT'S A SYSTEM.
IT'S COMPLICATED.
IT'S MESSY.
A SILVER BULLET WON'T SOLVE
CLIMATE CHANGE AND FOR
OURSELVES.
THERE'S A RANGE OF INCENTIVES
AND DISINCENTIVES AND
REGULATION, AND KNOWLEDGE
GARNERING THAT NEED TO HAPPEN
ACROSS THE ENTIRETY OF FOOD
SUPPLY CHAINS AND FOOD SYSTEMS.
GOVERNMENTS AND PRIVATE SECTOR
ARE RESPONSIBLE AND NEED TO TAKE
MORE ACTION, TO LEAVE IT IN THE
HANDS OF CONSUMERS IS UNFAIR.
NEXT SLIDE.
I'LL PRESENT THREE AREAS, AND
I'LL BE QUICK.
THE PROBLEM WHEN WE'RE TALKING
ABOUT FOOD SYSTEMS IS THAT YOU
HEAR THIS ARGUMENT THAT FOOD
SYSTEMS ARE FAILING US.
WHEN YOU LOOK AT WHAT'S THE
FAILURE ABOUT, AGRICULTURISTS
WILL SAY WE NEED TO PRODUCE MORE
FOOD.
NUTRITION COMMUNITY SAYS, NO, WE
NEED TO PRODUCE DIFFERENT KINDS
OF FOODS.
WE NEED TO FILL THE NUTRIENT
GAP.
THOSE WHO WORK ON SOCIAL JUSTICE
SAY, NO, WE NEED LOCALIZED
SYSTEMS, AUTONOMY, DEMOCRACY,
SOCIAL AND FOOD JUSTICE.
THOSE WHO WORK IN ENVIRONMENT
SAY WE NEED TO REDUCE THE
ENVIRONMENTAL FOOTPRINT OF FOOD
SYSTEMS.
THE PROBLEM IS NONE OF THESE
GROUPS CAN AGREE ON HOW WE MOVE
FORWARD WITH FOOD SYSTEM
TRANSFORMATION, AND WHAT SHOULD
BE PRIORITIZED.
IT'S VERY COMPLICATED BECAUSE WE
HAVE MANY DIFFERENT SECTORS AND
DISCIPLINES THAT NEED TO COME
TOGETHER TO TRANSFORM FOOD
SYSTEMS.
NEXT SLIDE.
>> TWO MINUTES LEFT.
>> OKAY.
I'M MEETING MY TIME.
I'M TIMING MYSELF.
I GET AN EXTRA 30 SECONDS FOR
SLIDES NOT MOVING FORWARD.
WHEN WE'RE THINKING ABOUT IN THE
NUTRITION WORLD, HOW DO WE
ENSURE THAT WE HAVE STRONGER
INTERSECTION BETWEEN FOOD
SYSTEMS, ENVIRONMENT, CLIMATE,
NUTRITION, WE NEED A LOT OF
DIFFERENT METHODS, A LOT OF
DIFFERENT INTERVENTIONS, AND A
LOT OF GOALS TO COME TOGETHER.
IT IS INCREDIBLY CHALLENGING TO
WORK ACROSS METHODS EVEN IN OUR
OWN DISCIPLINES, BUT ACROSS
DISCIPLINES WITH DIFFERENT GOALS
AND INTERVENTIONS IN MIND.
IT'S NOT EASY TO TRANSFORM THE
ENERGY SECTOR, FOOD SYSTEMS,
LET'S DO IMPORTANT RESEARCH THAT
GETS TO SOLUTIONS; THERE'S A LOT
OF METHODS AND INTERVENTIONS
THAT NEED TO COME TOGETHER THAT
REQUIRE TIME AND ENERGY FOR
DISCIPLINES TO BE ABLE TO BE
MARRIED.
NEXT SLIDE.
AND MY SECOND TO LAST SLIDE, ONE
OF THE THINGS I WANT TO
EMPHASIZE IS WE'RE IN A TIME
WHERE FACTS AND EVIDENCE ARE
UNDER SCRUTINY.
SOMETIMES OPENLY DISREGARDED OR
SUSPECT.
TO ME RESEARCH CAN CHART A
POSITIVE PATH FOR THE WORLD AND
BRING WHOLESALE CHANGES IN
ATTITUDES, POLITICAL THOUGHT AND
ACTIONS.
MANY PEOPLE ON THE CALL ARE
RESEARCHERS, AND WE HAVE A VERY
IMPORTANT ROLE IN PUSHING
FORWARD SCIENCE, DATA, EVIDENCE.
AND ENSURING THAT WE HOLD OUR
POLICYMAKERS TO USE THAT
EFFECTIVELY.
SECOND, NEXT SLIDE, AND JUST
LAST I'M NOT GOING TO PRESENT
THIS MUCH BUT THIS IS WORK DONE
BY SEVERAL COLLEAGUES TO MAP OUT
FOOD SYSTEMS.
THE BOTTOM BAR STARTS WITH
GOVERNANCE OF FOOD SYSTEMS.
NATIONAL GOVERNANCE.
WE NEED GOVERNANCE TO START
TAKING ACTION ON FOOD SYSTEMS.
AND ENSURING THAT THEY ARE --
THEIR HANDS ARE ON THE WHEEL.
PRIVATE SECTOR CONTROLS, WHAT WE
EAT, THEY ARE IN CONTROL.
THEY ARE THE DRIVERS OF THE FOOD
SYSTEM GOVERNANCE.
WE NEED OUR GOVERNMENTS TO TAKE
ACTION AND CARING ABOUT THE
KINDS OF DIETS THAT PEOPLE GET
ACCESS TO AND KIND OF FOODS
WE'RE GROWING IN THE WORLD, FOR
BOTH HUMAN AND PLANETARY HEALTH.
I'LL END THERE.
THANK YOU SO MUCH.
>> THANK YOU FOR LAYING GROUND
WORK TO START THINKING ABOUT
FOOD SYSTEMS.
I CAN'T WAIT FOR THE PERSPECTIVE
IN THE DISCUSSION.
I'D LIKE TO WELCOME DR. BASSEL
DAHER, RESEARCH SCIENTIST, TEXAS
A & M, CONVERGENCE RESEARCH
INCUBATOR, ADJUNCT ASSISTANT
PROFESSOR IN AGRICULTURE
ENGINEERING AND RESEARCH FELLOW
AT INSTITUTE FOR SCIENCE,
TECHNOLOGY, PUBLIC POLICY AT
TEXAS A & M.
>> IT'S A PLEASURE TO BE PART OF
THIS DISTINGUISHED PANEL.
ALSO A PLEASURE TO FOLLOW DR.
FANZO, WHOSE BOOK, THE ONE SHE
SHARED ON THE LAST SLIDE, I
THINK THIS BOOK SHOULD BE OF
INTEREST TO THIS CROWD SO HIGHLY
RECOMMEND IT.
MY TALK ABOUT FOCUS ON WATER
SYSTEMS AT THE NEXUS AND HUMAN
AND PLANETARY HEALTH.
BUT I'M HOPING THROUGH MY
PRESENTATION AND AS I BUILD
INTERCONNECTIONS WE ARRIVE TO A
BROADER SYSTEM LEVEL PICTURE AND
SYSTEM LEVEL INTERCONNECTIONS OF
WATER SYSTEMS AND OTHER SYSTEMS
THAT ARE CONNECTED.
I'D LIKE US TO REFLECT FOR A FEW
SECONDS HERE ON THIS GLOBAL
RISKS REPORT FROM 2020, AN
ANNUAL PUBLICATION BY THE WORLD
ECONOMIC FORUM ISSUED AT THE
BEGINNING OF EVERY YEAR, WHICH
INCLUDES THIS GRAPH OF RISKS
EXPECTED FOR THAT SPECIFIC YEAR
WHICH IS RESULT OF SURVEY THAT
IS USUALLY CONDUCTED WITH MORE
THAN A THOUSAND BUSINESS
EXECUTIVES, ACADEMICS,
GOVERNMENT ENTITIES, NGOs,
INTERNATIONAL ORGANIZATIONS,
AMONG OTHERS.
HAVE A LOOK AT RISKS THAT WERE
IDENTIFIED IN 2020.
SEE ON THE UPPER LEFT CORNER
INFECTIOUS DISEASES, THAT MADE
IT TO THE LIST, AND HAD
RELATIVELY HIGH IMPACT COMPARED
TO OTHER RISKS BUT WAS LOWER ON
THE LIKELIHOOD SCALE.
REFLECT ON THE OTHER RISKS AND
CHALLENGES WE ENDED UP FACING.
WHAT STARTED AS PUBLIC HEALTH
CRISIS SHOWED US FOOD SUPPLY
CHAIN FAILURES, UNEMPLOYMENT,
FINANCIAL CRISIS, ENERGY PRICE
SHOCKS.
ALL OF THE CRISES, ALL THESE
THINGS ARE CHALLENGES THAT WE
SAW DURING THAT YEAR, THAT WERE
REALLY CATALYZED BY THE PUBLIC
HEALTH CRISIS.
A FEW REFLECTIONS FROM THE
SURVEY, NEXT PLEASE, THAT WE
LIVE IN A WORLD WITH WIDE RANGE
OF CHALLENGES.
WE SEE HERE DIVERSITY OF THESE
DIFFERENT CHALLENGES FROM
ECONOMIC, ENVIRONMENTAL,
GEOPOLITICAL, TECHNOLOGICAL,
SOCIETAL, AMONG OTHERS.
HIGHLY INTERCONNECTED, DO NOT
EXIST IN SILOS, DO IMPACT ONE
ANOTHER.
ANOTHER REFLECTION IS THAT THESE
CHALLENGES AND RISKS ARE OFTEN
HARD TO PREDICT, AND WE OFTEN DO
NOT HAVE THE LUXURY OF TIME TO
RESPOND TO THESE CHALLENGES.
THEREFORE WE NEED TO HAVE THE
NECESSARY INFRASTRUCTURE READY
FOR US TO RESPOND TO THE NEXT
SHOCK WHEN IT HAPPENS, NOT AS IT
HAPPENS.
THAT REQUIRED ACADEMICS TO WORK
TOGETHER WITH DIFFERENT SECTORS
FROM PUBLIC TO PRIVATE, AS WELL
AS ACTIVE ENGAGEMENT OF CIVIL
SOCIETY IN ORDER TO ADDRESS
CHALLENGES.
TO BETTER UNDERSTAND AND BE
PREPARED TO IMPROVE OUR
UNPREPAREDNESS, TO ADDRESSING
THESE CHALLENGES AS WE MOVE
FORWARD, IT'S CRITICAL THAT WE
LOOK AT THESE SYSTEMS AND
INTERCONNECTED MANNER AND BE
INSPIRED BY SYSTEMS THINKING AS
AN APPROACH FOR US TO MOVE
FORWARD AND I WOULD ARGUE THAT
IMPROVING OUR FUTURE RESILIENCE
WILL REQUIRE INVESTING IN A NEW
TYPE OF INFRASTRUCTURE, AND
ENABLING ENVIRONMENTS THAT ALLOW
US TO FIRST OF ALL DEVELOP
RESEARCH AT THE INTERFACE OF
CURRENT DISCIPLINES, NO ONE
DISCIPLINE WILL BE ABLE TO
ADDRESS ALL THESE COMPLEXITY, NO
ENGINEER, NO SOCIAL SCIENTIST,
NO PUBLIC POLICY PERSON WILL BE
ABLE TO ADDRESS THAT.
ALSO NO ONE SECTOR WILL BE ABLE
TO ADDRESS ALL OF THESE
COMPLEXITIES SO WE NEED TO
INVEST IN ENABLING ENVIRONMENTS
THAT WOULD MAKE IT EASIER FOR
THESE SECTORS AND THESE ACTORS
TO COOPERATE.
THE WATER SITUATION TODAY,
REFLECTING ON HOW -- WHAT BECAME
MORE PROMINENT OVER THE YEARS
LOOKING AT HOW IT WAS ONE OF THE
TARGETS AS PART OF AN
ENVIRONMENTAL GOAL, PART OF THE
MILLENIUM DEVELOPMENT GOALS
WHICH CAME BEFORE, AND HOW IT
TOOK A MORE PROMINENT ROLE NOW
WITH SUSTAINABLE DEVELOPMENT
GOAL DEDICATED TO WATER FOCUSING
ON ENSURING AVAILABILITY AND
SUSTAINABLE MANAGEMENT OF WATER
AND SANITATION FOR ALL BY 2030.
AS WE CROSS OF HALFWAY LINE TO
2030, IN 2020 STILL HAD MORE
THAN 2.2 BILLION PEOPLE WHO
LACKED ACCESS TO SAFELY MANAGE
THE DRINKING WATER, 3.3 BILLION
PEOPLE STILL LACK SAFETY MANAGED
SANITATION, 2.2 BILLION LACK
BASIC HAND WASHING FACILITIES.
WITH REALLY A LOT OF THE
COUNTRIES, MORE THAN 25
COUNTRIES, THAT ARE FACING
EXTREME HIGH WATER STRESS
ANNUALLY, I'D LIKE TO REFLECT ON
HOW A LOT OF THESE COUNTRIES ARE
LOOKING AT MIDDLE EAST AND SOUTH
ASIA, WHERE A LOT OF POPULATION
CENTERS GLOBALLY EXIST, INDIA,
CHINA, ALSO MIDDLE EAST WHICH IS
EXPECTED TO DOUBLE IN POPULATION
BEFORE 2050.
I'D LIKE TO REFLECT ON RELATIONS
WHEN SCARCITY AND CONTAMINATION
AND LOOK AT EVIDENCE IN
LITERATURE THAT SUPPORTS THAT.
NEXT PLEASE.
WATER IMPACT ON HUMAN HEALTH,
THERE'S AMPLE EVIDENCE IN
LITERATURE, FIRST OF ALL
1.7 MILLION DEATHS PER YEAR ARE
ATTRIBUTED TO UNSAFE WATER,
IMPROPER SANITATION, POOR
HYGIENE WHICH LEADS TO DISEASES
IN DIFFERENT PLACES GLOBALLY.
AND AS WE LOOK AT WATER
AVAILABILITY, AND THE LACK OF
DRINKING WATER, THERE'S EVIDENCE
LINKING DEHYDRATION WITH
DISEASE, INCREASED RISK OF
CARDIOVASCULAR DISEASES, AS WELL
AS RELATION BETWEEN HYPERTENSION
AND HYDRATION PARAMETERS AND
ACUTE HYPOHYDRATION, VASCULAR
FUNCTION IMPAIRMENT, BLOOD
PRESSURE REGULATION.
REALLY, THE LINK BETWEEN
AVAILABILITY AND ENSURING WE'RE
GETTING THE RIGHT HYDRATION AND
RIGHT ACCESS TO WATER AND HUMAN
HEALTH IS VERY CLEAR HERE, ALSO
QUALITY OF WATER.
RISK OF CONTAMINATED WATER, 88%
ACCORDING TO CDC, 88% OF
DIARRHEA-ASSOCIATED DEATHS ARE
CAUSED BECAUSE OF LACK OF ACCESS
TO SAFE WATER AND SANITATION AND
HYGIENE.
THERE'S EVIDENCE BETWEEN LINKS
ON CONTAMINATED WATER SOURCE,
CHOLERA, DYSENTERY, SANITATION,
DIARRHEA, STH INFECTION AND
SCHISTO.
REFLECTING WITH IMPACT ON
PLANETARY HEALTH, WATER
SCARCITY, SO WATER IS UNDERGOING
PRESSURES OF DIFFERENT SYSTEMS,
WE'RE LOOKING AT URBAN GROWTH,
LOOKING AT GROWTH IN AGRICULTURE
SECTOR, IN ENERGY SECTOR, AND
THE NEED FOR MAINTAINING
ECOSYSTEMS, COMPROMISING ACROSS
DIFFERENT SECTORS WHICH WITH ALL
PROJECTED TO GROW AS WE MOVE
FORWARD.
ALSO, WATER STRESS ECOSYSTEMS
RESULT IN LOSS OF BIODIVERSITY,
AS WELL AS IMPACT, SO IT HAS AS
WE'RE LOOKING AT WATER
CONTAMINATION AS WELL, AND ITS
IMPACT ON BIODIVERSITY AND
ECOSYSTEMS.
GLOBAL WATER QUALITY DECLINED AS
WE FOCUS ON QUALITY, HAS LED TO
AGRICULTURAL LOSSES FROM SALINE
WATER EQUIVALENT TO ANNUAL FOOD
REQUIREMENTS OF 170 MILLION
PEOPLE WHICH AGAIN REFLECTING ON
THE IMPACT OF WATER QUALITY ON
AGRICULTURE SYSTEMS AND HOW IT
IMPACTS ON FOOD AVAILABILITY,
OFTP AFFECTING THOSE WHO ARE
LEAST ABLE TO FACE THE
CHALLENGES.
WATER SYSTEM AS WELL IS UNDER
GROWING PRESSURES FROM TRENDS
THAT WE'RE SEEING IN TERMS OF
POPULATION GROWTH, EXPECTING TO
HIT 10 BILLION BY 2050, GROWING
CLIMATE CHANGE TRENDS AFFECTING
THE AVAILABILITY OF WATER AND
DIFFERENT PLACES, AGAIN OFTEN
AFFECTING THOSE WHO ARE MOST
VULNERABLE AND LEAST ABLE TO
RESPOND TO THESE CHALLENGES,
GROWING URBANIZATION WHERE MOST
PEOPLE ARE LIVING IN CITIES AND
THAT TREND KEEPS CONTINUING.
WE FACE DIFFERENT SHOCKS,
INCLUDING EXAMPLES WE SEE WITH
COVID-19 AND THE RAPID OR SUDDEN
DEMAND FOR MORE ACCESS TO WATER
FOR MORE HYGIENE AND HAND
WASHING PURPOSES.
THE IMPACT OF NATURAL DISASTERS
AND IMPACT OF THAT ON
INFRASTRUCTURE AND ON WATER
CONTAMINATION, AS A RESULT, AS
WELL AS TRENDS THAT RESULT FROM
CONFLICTS AND LEADING TO
MIGRATION WHICH ALSO COULD PUT
PRESSURES ON HOST COUNTRIES, WHO
ARE ALSO MIGHT BE VULNERABLE AND
FACING -- ALREADY FACING
PRESSURES ON WATER SYSTEMS.
THERE ARE ALSO SOME SYSTEMIC
CHALLENGES AND CROSS-CUTTING
CHALLENGES, WITH THE LACK OF
INTEGRATED APPROACHES TO WATER
MANAGEMENT AND LACK OF FINANCING
AS WELL.
THE WORLD BANK IN 2023 REPORT
ESTIMATED $6.7 TRILLION NEEDED
FOR WATER-RELATED INFRASTRUCTURE
BY 2030, AND THERE'S A MAJOR
INVESTMENT GAP THERE IN MEETING
THOSE FINANCING NEEDS.
THAT PRESSURE ON WATER SYSTEM IS
ONLY PART OF THE PICTURE.
NEXT SLIDE PLEASE.
AS WE PROJECT INTO 2050 AND
THESE NUMBERS ARE RELATIVE TO
YEARS 2015, WE ARE EXPECTING TO
NEED 55% MORE WATER, 60% MORE
FOOD, AND 80% MORE ENERGY.
THESE ARE GRAND CHALLENGES,
COMPLEX CHALLENGES, BUT THESE
ARE VERY MUCH CONNECTED,
INTERCONNECTED CHALLENGES.
THAT IS AT A TIME MORE THAN 2
BILLION PEOPLE LACK ACCESS TO
SAFE DRINKING WATER, 700 MILLION
SUFFER FROM CHRONIC HUNGER, MORE
THAN 700 MILLION PEOPLE STILL
LACK ACCESS TO ENERGY.
UNLESS WE TAKE A SYSTEMS
APPROACH TO ADDRESS THESE
CHALLENGES, QUANTIFY THEM AND
DEVELOP NECESSARY TOOLS, WE WILL
NOT BE ABLE TO ADDRESS THESE
CHALLENGES AS WE MOVE FORWARD.
THE CHALLENGE WE'RE LOOKING AT
AND THIS WAS KIND OF A
CONCEPTUALIZATION, TYING THIS
BACK TO HUMAN HEALTH AND
PLANETARY HEALTH, NEXT SLIDE
PLEASE, IS --
>> ONE MINUTE LEFT.
>> OKAY.
>> NEXT SLIDE PLEASE.
IS BEING ABLE TO MEET ALL OF
THESE DEMANDS AND BRIDGE THOSE
GAPS, WHILE MEETING HUMAN HEALTH
AND WELL-BEING NEEDS, BUT WHILE
ALSO WITHIN THE BOUNDARIES OF
OUR PLANETARY HEALTH, UNDER
THESE GROWING PRESSURES AND
STRESSES ON OUR INTERCONNECTED
RESOURCE SYSTEMS AT A TIME WE
STILL LACK THE PROPER DECISION
SUPPORT TOOLS TO GUIDE
EVIDENCE-BASED DECISION MAKING,
LACK CROSS-SECTOR MECHANISMS FOR
COORDINATION, WE HEARD A LOT
FROM SPEAKERS TODAY ABOUT HOW WE
HAVE DIFFERENT SECTORS WITH
DIFFERENT PLAYERS, DIFFERENT
OBJECTIVES, WITH NO PROPER
MECHANISMS FOR THEM TO DO THIS
KIND OF INTEGRATIVE PLANNING
WITH NO RIGHT TOOLS TO DO THIS
KIND OF TRADEOFF ANALYSIS THAT
MEETS DIFFERENT OBJECTIVES WHICH
MIGHT BE POTENTIALLY
CONFLICTING.
NEXT SLIDE PLEASE.
SO MOVING FORWARD, SOLUTIONS,
THE MESSAGE I'D LIKE TO LEAVE
YOU WITH IS AS WE'RE THINKING OF
WATER-RELATED CHALLENGES,
SOLUTIONS TO WATER CHALLENGES
WON'T EXCLUSIVELY COME FROM THE
WATER SECTOR.
SIMILARLY SOLUTIONS TO PUBLIC
HEALTH CHALLENGES WON'T
EXCLUSIVELY COME FROM THE HEALTH
SECTOR.
WE NEED TO UNDERSTAND HOW
SECTORS ARE INTERCONNECTS,
QUANTIFY, DEVELOP TOOLS AND HELP
US EVALUATE THE TRADEOFFS
BETWEEN DIFFERENT PATHWAYS
FORWARD AND DIFFERENT
INTERVENTIONS WHETHER TECHNICAL,
POLICY, SOCIAL, BEHAVIORAL, AND
IMPACTS ON CO-CREATED METRICS
THAT NEED TO BE CO-CREATED WITH
DIFFERENT SECTORS AND
STAKEHOLDERS.
THERE'S A NEED TO WORK ON
DEVELOPING INTERDISCIPLINARY
RESEARCH THAT IDENTIFIES
OPPORTUNITIES, ENABLES US TO
DEVELOP NEW KNOWLEDGE THAT
INDEPENDENTLY WE WON'T DEVELOP
UNLESS WE COLLABORATE AND
COOPERATE AND DEVELOP NEW
ENVIRONMENTS FOR PARTNERSHIPS
BETWEEN PRIVATE, PUBLIC,
SOCIETY, AND ACADEMIA, AND LAST
BUT NOT LEAST ALSO ENSURING THAT
AS WE'RE BUILDING THOSE
INTERDISCIPLINARY RESEARCH TEAMS
AND LOOKING AT INTERACTING WITH
AND BUILDING THESE ENVIRONMENTS
FOR BETTER COOPERATION ACROSS
SECTORS THAT WE KEEP THOSE TWO
ENVIRONMENTS CLOSELY ALIGNED AND
INTEGRATED IN A WAY WITH EACH
OTHER WITH CONTINUOUS FEEDBACK
AS WE DEVELOP THIS RESEARCH
WHILE ENGAGING STAKEHOLDERS VERY
EARLY ON IN THE PROCESS AND
DRIVING OUR RESEARCH AGENDA AS
A RESULT OF FEEDBACK AND INPUT
FROM THAT ENGAGEMENT.
LAST SLIDE, TEN SECONDS, THESE
ARE RESEARCH OPPORTUNITIES THAT
ARE, AGAIN, ALIGNED WITH WHAT I
JUST MENTIONED.
SO HOW DEVELOP NEW DECISION
TOOLS AND METHODOLOGIES, TO
IDENTIFY IDENTIFICATION OF
SYNERGIES AS WE THINK OF FOOD
SYSTEM TRANSFORMATION, ENERGY
TRANSITION, AND WATER SECURITY
WITHIN THE BOUNDS OF MEETING
HUMAN HEALTH AND PLANETARY
HEALTH NEEDS, WHAT ARE THE
METRICS THAT WE NEED TO USE,
WHAT DOES SUSTAINABILITY AND
RESILL RESILIENCY MEAN, WHAT
DOES SUSTAINABLE AND RESILIENCY
MEAN FOR ONE COMMUNITY OVER
ANOTHER, THE IMPORTANT NEED OF
CONTEXTUALIZING THESE CHALLENGES
AND WORKING CLOSELY WITH
COMMUNITIES, ALSO IN TERMS OF
GOVERNANCE STRUCTURES, WHAT ARE
THESE GOVERNANCE STRUCTURES AND
POLICY FRAMEWORKS THAT WOULD
ALLOW FOR THIS TYPE OF
INTEGRATED APPROACHES, AND THE
LAST TWO, MORE LIKE MAYBE TEAM
SCIENCE RESEARCH QUESTIONS, WHAT
CONSTITUTES ENABLING ENVIRONMENT
THAT ALLOWS FOR THIS TYPE OF
CROSS-DISCIPLINARY RESEARCH
COLLABORATION KNOWING THAT
DIFFERENT DISCIPLINES HAVE
DIFFERENT APPROACHES,
METHODOLOGIES, LANGUAGES, SO
THAT'S ALSO SOMETHING THAT'S
WORTH EXPLORING AS WE MOVE
FORWARD.
I'LL STOP HERE AND I HAVE MY
CONTACT INFORMATION IF ANYONE
WOULD LIKE TO CONTINUE THE
CONVERSATION.
THANK YOU VERY MUCH.
>> THANK YOU VERY MUCH.
WE CAN SEE CROSS-CUTTING THEMES
ACROSS MANY OF THE TALKS TODAY.
WE'RE DELIGHTED TO WELCOME DR.
ANA NAVAS-ACIEN, DEPARTMENT OF
ENVIRONMENTAL HEALTH SCIENCES,
COLUMBIA MAILMAN SCHOOL OF
PUBLIC HEALTH, PHYSICIAN
EPIDEMIOLOGIST, P.I. OF
ENVIRONMENTAL STUDIES IN
MULTIPLE NHLBI INCLUDING STRONG
HEART STUDY, MULTI-ETHNIC STUDY
OF ATHEROSCLEROSIS.
>> IF YOU CAN START WITH THE
NEXT SLIDE.
VERY GOOD.
I WANT TO THANK THE PREVIOUS
PANELISTS, FOCUS WAS AT THE
MACRO LEVEL.
I'M GOING TO MAYBE BRING THE
MICRO LEVEL, HOW COMMUNITIES ARE
AFFECTED BY THESE ISSUES IN
THEIR LIVES, IN THEIR HEALTH,
WHAT CAN WE DO TO HELP PREVENT
OUTCOMES.
I WANT TO START WITH THE GLOBAL
BURDEN OF DISEASE RELATED TO
ENVIRONMENTAL CONTAMINANTS.
FOR CARDIOVASCULAR DISEASE, IT
HAS BEEN ESTIMATED BY THE WORLD
HEALTH ORGANIZATION THAT WE
COULD ELIMINATE 31% OF THE
CARDIOVASCULAR BURDEN IF WE
COULD ELIMINATE SOME SPECIFIC
CONTAMINANTS.
THE ONES INCLUDED SO FAR BASED
ON EVIDENCE AVAILABLE ARE AIR
POLLUTION, TOBACCO SMOKE,
SECONDHAND SMOKE, AND AMONG
CHEMICALS, THE ONLY ONE THAT HAS
INCLUDED SO FATHER HAS BEEN
LEAD.
AND LEAD EXPOSURE IN
CARDIOVASCULAR DISEASE HAS
BECOME MORE ESTABLISHED, AND
ACTUALLY ONE OF THE ARGUMENTS
FOR THE RECENT INITIATIVE TO
PROTECT COMMUNITIES FROM LEAD
PIPES AND PAINT ACROSS THE
UNITED STATES WHICH IS A
BIPARTISAN INFRASTRUCTURE LAW
PASSED RECENTLY, HAS BEEN BASED
ON THE BENEFIT FOR THE
CARDIOVASCULAR SYSTEM FROM
REMOVING LEAD.
AND IF YOU GO TO THE NEXT SLIDE,
YOU CAN SEE ALSO THE AMERICAN
HEART ASSOCIATION RECENTLY
ESTABLISHED CONTAMINANT METALS
INCLUDING SPECIFICALLY LEAD,
AND CADMIUM.
THIS IS RELEVANT BECAUSE THIS
EXPOSURE IS HAPPENING, I'M
FOCUSING ON METAL BUT MANY OTHER
ENVIRONMENTAL CONTAMINANTS,
HAPPENING THROUGH HIGH RISK
EXPOSURE AND CHRONIC LOW LEVELS
TO OUR DAILY LIFE.
ALL THE THINGS WE'VE BEEN
DISCUSSING AT THE VERY MACRO
LEVEL, POLLUTION IN THE AIR,
ENERGY, THE WAY WE IMPLEMENT
ENERGY, FOOD SYSTEMS, WATER
SYSTEMS WILL IMPACT LOW-LEVEL
CHRONIC EXPOSURES.
NEXT.
IF WE TAKE FOR INSTANCE ARSENIC
IN THE WATER AS AN EXAMPLE OF
CONTAMINANT THAT AFFECTS
COMMUNITIES ACROSS THE U.S., YOU
CAN SEE IT IS SUBSTANTIAL
EXPOSURE IN PRIVATE WELLS
THROUGH GROUND WATER, PEOPLE WHO
RELY ON GROUND WATER, VERY
IMPORTANT IN RURAL COMMUNITIES,
AND COMMUNITY WATER SYSTEMS THAT
OFTEN RELY ON GROUND WATER, AND
THIS IS A DIRECT CONNECTION WITH
CLIMATE CHANGE, DROUGHT, AND
WATER SCARCITY, THE NEED TO RELY
ON GROUND WATER.
AS WE KNOW WITH CLIMATE CHANGE
THESE LEVELS OF CONTAMINANTS IN
GROUND WATER ARE LIKELY TO
INCREASE.
NEXT.
AND WHILE THIS CONTAMINATION IS
OFTEN NATURALLY OCCURRING IT'S
RELATED TO ANTHROPOGENIC
ACTIVITIES OFTEN RELATED TO
ENERGY POLICY DECISIONS, WARS IN
THE WORLD, AS YOU CAN SEE IN THE
UNITED STATES WE'VE DONE VERY
IMPORTANT MINING IN COMMUNITIES,
ESPECIALLY IN THE WESTERN PART
OF THE COUNTRY, AND URANIUM
MINING DETRIMENTAL PARTICULARLY
AFFECTING INDIGENOUS COMMUNITIES
WHICH TEND TO BE CLOSE TO THESE
MINING AREAS.
THIS IS A REAL ISSUE.
URANIUM CONTAMINATION IN
DRINKING WATER IS A REALITY IN
THE COUNTRY, THIS IS SOMETHING
UNDERSTUDIED.
URANIUM IS A KIDNEY TOXICANT,
NEPHROTOXIC ELEMENT WITH
POTENTIAL EVIDENCE FOR
CARDIOVASCULAR TOXICITY BUT
RESEARCH IS TINY SO HOW THIS
VARIABILITY IN URANIUM
CONTAMINATION IS CONTRIBUTING TO
DISEASE RISK IS UNKNOWN.
NEXT.
I WAS TELLING YOU I WANTED TO
BRING YOU TO A MORE COMMUNITY
PERSPECTIVE.
IF YOU TAKE THIS COMMUNITY IN
SOUTH DAKOTA, EACH OF THESE DOTS
IS THE WATER THAT THEY ARE
DRINKING.
THIS IS THE WATER THEY HAVE IN
THE HOUSE.
THEY DON'T HAVE ANY OTHER WATER.
AND THE DOTS ARE RED IF THEY
HAVE HIGH ARSENIC AND URANIUM,
BLUE ARSENIC, BLACK YOUR
URANIUM.
EVERYBODY IN THE FAMILY,
CHILDREN, ADULTS, PREGNANT
WOMEN, ARE GOING TO BE AFFECTED
BY THIS CONTAMINATION ON CHRONIC
BASIS.
NEXT.
SO EPIDEMIOLOGICAL FRAMEWORK AND
APPROACHES ARE ABLE TO INTEGRATE
MULTIPLE SOURCES OF EXPOSURE
INCLUDING IN THIS CASE WATER
CONTAMINANTS, WHICH COULD BE
QUITE DIFFICULT TO DO, IF WE TRY
TO REALLY GO TO THESE ASSESSMENT
AT THE ENVIRONMENTAL LEVEL, BUT
THROUGH THE USE OF METAL
BIOMARKERS WE'RE ABLE TO
ACTUALLY QUANTIFY INDIVIDUAL
EXPOSURES.
NEXT.
AND WHEN WE'VE DONE THAT TYPE OF
WORK, WE'VE COMPARED TWO
DIFFERENT POPULATIONS, BOTH FROM
THE NHLBI, WITH HELP FROM THE
NIEHS, TO FUND ENVIRONMENTAL
BIOMONITORING AND METALS
ASSESSMENT, RURAL COMMUNITIES IN
THE U.S., MESA STUDY, URBAN
COMMUNITIES, YOU CAN SEE
AMERICAN INDIAN COMMUNITIES IN
THE STRONG HEART STUDY ARE
AFFECTED BY HIGHER ARSENIC,
HIGHER URANIUM, HIGHER TUNGSTEN,
METALS THAT CLUSTER IN DRINKING
WATER, SUPPORTING THIS
CLUSTERING IN THE URINE IS
REFLECTING SOURCE OF WATER
CONTAMINATION AND ACTUALLY IN
ADDITIONAL WORK WE'VE DONE WE
HAVE QUANTIFIED HOW MUCH OF THE
URINARY EXPOSURE IS RELATED TO
THE WATER CONTAMINATION.
THIS IS IMPORTANT BOTH IN THE
STRONG HEART STUDY AND ALSO EVEN
IN URBAN COMMUNITIES LEVELS OF
CONTAMINANTS IN THE WATER AFFECT
HUMAN EXPOSURE.
NEXT.
SO TO UNDERSTAND THE HEALTH
EFFECTS AND IMPLICATIONS OF
EXPOSURES, EPIDEMIOLOGICAL
STUDIES ARE REALLY IMPORTANT.
THE RESOURCE FROM NHLBI COHORTS
ARE CRITICAL.
NEXT.
THE STRONG HEART STUDY IN
PARTICULAR HAS BEEN A ROLE MODEL
OF PARTICIPATORY SCIENCE, SINCE
THE EARLY '80s WHEN THE COHORT
STARTED 9.
THE WORK HAS BEEN POSSIBLE
BECAUSED DAY-TO-DAY ELABORATION
OF COMMUNITY MEMBERS,
INVESTIGATORS, THIS IS A PICTURE
OF THE STEERING COMMITTEE WHICH
HAS INCLUDED FROM THE BEGINNING
COMMUNITY MEMBERS, AT THE BOTTOM
YOU SEE A PICTURE OF THE FIELD
TEAM, LOCAL RESEARCH TEAM,
FORMED BY LOCAL COMMUNITY
MEMBERS WHO ARE IN CHARGE OF
DOING THE -- IMPLEMENTING THE
STUDY, REALLY HAS BEEN A ROLE
MODEL FOR PARTICIPATORY-BASED
RESEARCH FOR DECADES GOING ON.
NEXT.
AND THROUGH THAT WORK, BRINGING
IN ENVIRONMENTAL EXPOSURES TO
UNDERSTANDING THE ROLE IN
CARDIOVASCULAR DISEASE, WE WERE
ABLE TO DOCUMENT THAT ARSENIC
EXPOSURE WAS RELATED TO HIGHER
RISK OF CARDIOVASCULAR DISEASE,
MORTALITY AND INCIDENCE IN
ADULTHOOD, OLDER ADULTHOOD.
YOU CAN ALREADY IDENTIFY
CLINICAL EFFECT WITH THE LEFT
VENTRICULAR MASS INDEX,
INDICATES THE HEART IS ALREADY
AFFECTED AT EARLY AGES,
REPLICATED IN OTHER RURAL
COHORTS IN THE UNITED STATES, IN
COLORADO AREA, AND ALSO IN
ANIMAL MODELS THAT TRY TO
REPLICATE THE HUMAN FINDINGS.
NEXT.
IN ADDITION TO UNDERSTANDING HOW
MUCH RISK OF DISEASE THERE IS
BASED ON THIS ENVIRONMENTAL
EXPOSURE, BY HAVING TRACKING
OVER TIME WE CAN ACTUALLY
DOCUMENT WHAT HAPPENS WHEN YOU
REMOVE ENVIRONMENTAL TOXICANTS
FROM THE ENVIRONMENT.
WHAT HAPPENS TO THE COMMUNITIES,
CAN YOU SEE ANY BENEFIT?
AND LEAD AND BLOOD PRESSURE
CONNECTION HAS BEEN SHOWN FOR
DECADES, ACTUALLY FOR MORE THAN
A CENTURY, IT'S BEEN SHOWN LEAD
POISONING INCREASES BLOOD
PRESSURE LEVELS.
AND WE HAVE THE OPPORTUNITY IN
THE STRONG HEART STUDY TO
DOCUMENT BECAUSE OF LEAD HAS
BEEN DECLINING IN THE U.S. THAT
HAPPENED ALSO IN STRONG HEART
STUDY COMMUNITIES, WE WERE ABLE
TO SHOW HISTOGRAM SHOWS DECLINE,
SO POSITIVE NUMBERS ARE PEOPLE
WHO DECLINED OVER TIME, AND
NEGATIVE NUMBERS WHICH ARE FEWER
PEOPLE WHO DIDN'T DECLINE.
THEY ACTUALLY INCREASED.
YOU CAN SEE DECLINE THAT ALSO
HAPPENED IN SYSTOLIC BLOOD
PRESSURE LEVELS, AS SHOWN IN
REMOVING EXPOSURE HAS ACTUALLY A
REAL BENEFIT FOR HUMAN HEALTH.
THIS PAPER IS COMING IN A COUPLE
WEEKS.
NEXT.
GIVEN THESE FINDINGS, WORK PRIOR
TO SYSTOLIC STUDY BUT RELATED,
WE WERE INTERESTED IN WORK LED
BY MARIA, SAYING IF THERE
DECLINE AND CARDIOVASCULAR
DISEASE HAS DECLINED IN THE U.S.
CAN WE LEVERAGE THE NHANES
COHORT SAND IMPLEMENTING
FRAMEWORK WHERE PERIOD IS THE
EXPOSURE AND MEDIATOR IS THE
CHANGES IN LEAD LEVELS AND
CADMIUM, CAN WE DOCUMENT IF THIS
EXPLAINS CHANGES IN
CARDIOVASCULAR DISEASE, IF YOU
GO NEXT WHAT WE FOUND IS THAT
ACTUALLY THE CHANGES IN BLOOD
LEAD WERE EXPLAINED QUITE A
SUBSTANTIAL AMOUNT OF THE
REDUCTION IN PREVENTION IN
CARDIOVASCULAR DISEASE DEATHS,
SAND THIS IS ON STOP OF
CONTROLLING FOR RISK FACTOR FOR
CARDIOVASCULAR DISEASE,
TREATMENT, AND ACCESS TO HEALTH
CARE, OTHER DEMOGRAPHIC CHANGES
IN THE POPULATION.
OF 231 DEATHS PER 100 SOMEHOW
BETWEEN THE PERIODS, 22% COULD
BE EXPLAINED BY CHANGES IN LEAD
REDUCTION.
ACTUALLY, THIS WAS ONE OF THE
BIGGEST RISK FACTORS THAT
EXPLAINED ANY CHANGES IN
CARDIOVASCULAR DISEASE.
SO THIS DOCUMENTS THESE
ENVIRONMENTAL EXPOSURES ARE VERY
IMPORTANT FOR CARDIOVASCULAR
DISEASE, WE ACTUALLY CAN DO
SOMETHING ABOUT THIS FOR
PREVENTION BY TARGETING THESE.
NEXT.
I'M IN EPIDEMIOLOGY.
YOU CANNOT CONTINUE WITHOUT
TRYING TO THINK OF WHAT CAN WE
MOVE INTO PREVENTION
INTERVENTION.
AND NEXT.
SO ARSENIC WAS IMPORTANT, FIRST,
SORRY, I WANT TO ACKNOWLEDGE
THAT BIG INFRASTRUCTURE
HAPPENED, KIND OF IN PARALLEL TO
OUR REPORTING OF THE ARSENIC AND
CARDIOVASCULAR DISEASE FINDINGS.
BUT BECAUSE TO TRY TO BRING IN
SAFE DRINKING WATER TO THE
COMMUNITIES IN THE STRONG HEART
STUDY AREA, NEXT, BUT ONE OF THE
ISSUES, AND IN CONNECTION WITH
THAT WORK, WE PUT TOGETHER -- WE
DEVELOPED BRINGING IN DIFFERENT
DISCIPLINES TO TRY TO ADDRESS
THE PROBLEM OF ENVIRONMENTAL
HAZARDOUS CONTAMINATION RELATED
TO MINING AND NATURALLY
OCCURRING IN THE NORTHERN
PLAINS, PART OF THE SUPERFUND
RESEARCH PROGRAM.
I WANT TO HIGHLIGHT THIS PROGRAM
WHICH IS FUNDED THROUGH A
DIFFERENT MECHANISM BECAUSE
FUNDING COMES FROM DEPARTMENT OF
THE INTERIOR, BUT IT'S HANDLED
LEAD BY NIEHS, AND THIS PROGRAM
IS UNIQUE IN THE NIH BECAUSE IT
BRINGS IN MULTI-DISCIPLINARY
SCIENTISTS, A WONDERFUL MODEL TO
DEALT WITH CLIMATE HEALTH
ISSUES, BRINGS IN SCIENTISTS,
ENGINEERS, EARTH SCIENTISTS,
BIOMEDICAL SCIENTISTS INCLUDING
BASIC SCIENTIST AND
EPIDEMIOLOGIST, COMMUNICATION,
PARTICIPATORY SCIENCE, APPLYING
THAT MODEL TO SPECIFIC
COMMUNITIES IN THE NORTHERN
PLAINS.
IF WE GO NEXT, BRING IN
TRADITIONAL KNOWLEDGE,
INDIGENOUS PRINCIPLES TO THE
WORK IS REALLY CRITICAL.
INCLUDING COLLECTIVE LEADERSHIP,
VALUE OF TRADITIONAL KNOWLEDGE,
VALUE FOR WATER, SEVEN
GENERATION PRINCIPLE WHICH IS SO
IMPORTANT FOR THE ISSUES OF
CLIMATE AND HEALTH, HOW
DECISIONS THAT WE MAKE TODAY ARE
GOING TO AFFECT DECISIONS SEVEN
GENERATIONS DOWN THE ROAD, AND
ASPECT OF RELATIONALITY
CONNECTED WITH SYSTEMS SCIENCE,
CONNECTIONS BEING CIRCULAR
RATHER THAN LINEAR AND ACCEPTING
RESEARCH GOAL TRIBES DEVELOPED
WHICH HAS BEEN DISCUSSED ALSO
EARLIER AND I DON'T WANT TO --
WE DON'T HAVE TIME BUT
ESPECIALLY CONCEPT OF
SOVEREIGNTY.
NEXT.
SO, ON AS PART OF THE SUPERFUND
RESEARCH PROGRAM,
MULTI-DISPLINARY CENTER, WE HAVE
FIVE PROJECTS.
EACH PROJECT HAS A LITTLE BIT OF
SLIGHTLY ANGLE, MORE BIOMEDICAL
IN BLUE, ENGINEERING AND EARTH
SCIENCE IN BROWN,
INTERCONNECTION AMONG THE
PROJECTS.
AND ALSO BRINGING IN INCREDIBLE
AMOUNT OF PARTNERSHIPS, BOTH
TRIBAL LEVEL, TRIBAL
ORGANIZATIONS, AS WELL AS
DIFFERENT GOVERNMENTAL
ORGANIZATIONS.
TOGETHER WITH US AT THE
UNIVERSITY LEVEL, AND PARTNERS,
RESEARCH PARTNERS LOCALLY,
ALLOWS US TO DO THIS AMBITIOUS
WORK.
NEXT.
ONE OF THE RELATED PROJECTS WAS
TO BRING IN SAFE DRINKING WATER
TO THE COMMUNITY MEMBERS THAT
STILL RELY ON PRIVATE WELLS.
WE CALL THIS PROJECT THE STRONG
HEART WATER STUDY, PARTICIPATORY
RANDOMIZED TRIAL IN SOUTH DAKOTA
THAT BROUGHT IN FILTERS TO
ELIMINATE ARSENIC FROM THE
DRINKING WATER, RANDOMIZATION
WAS SIMPLE EDUCATIONAL
INTERVENTION STANDARD AND VERSUS
MORE COMPREHENSIVE INTERVENTION,
EVERYBODY RECEIVED SAFETY WATER.
NEXT.
I WANT TO BRING SOME PICTURES,
SORRY, FIRST I WANT TO BRING IN
THE NEED TO DO THIS VERY
MULTI-LEVEL CONCEPTUAL FRAMEWORK
WHEN DOING INTERVENTIONS OF THIS
SCALE, THINKING WHEN YOU'RE
BRINGING INTERVENTIONS, IT'S
COMPLICATED, THINK ABOUT
BENEFITS AND RISK, BRING IN THE
INDIVIDUAL LEVEL, HOUSEHOLD
LEVEL, COMMUNITY, TRIBAL LEVEL,
AND THEN THE FEDERAL LEVEL ALSO.
NEXT.
WHAT I WANTED AND THE PAPER FOR
THIS WORK IS GOING TO BE PUBLISH
THE VERY SOON.
WE FOUND A SUCCESS IN THE
INTERVENTION COMING AS SOON
AS -- STILL UNDER REVIEW BUT
POSITIVE INITIAL REVIEWS.
I WANT TO SHOW THE PICTURE FROM
CHRISTINE GEORGE, P.I. OF THE
STUDY, WITH MYSELF.
WHEN WE FIRST PRESENTED THE
PROJECT I TOOK THIS PICTURE WHEN
SHE WAS TALKING.
YOU CAN SEE THE COMMUNITY
MEMBERS DIFFERENT LEVELS OF
LEADERSHIP, WONDERFUL EXPERTISE
HERE IN THIS PICTURE FROM TRIBAL
WATER, HEALTH DEPARTMENT, AND
REPRESENTING THIS PROJECT, YOU
CAN SEE THERE'S A LOT OF
CONCERN, THERE'S A LOT OF
ATTENTION.
THIS IS AN IMPORTANT ISSUE.
BUT IT'S NOT NECESSARILY THE WAY
WE PRESENTED, THE IDEAS WE
THINK, AND NOT RESONATING
COMPLETELY.
THERE IS A LOT OF DEBATE AND
DISCUSSION, AND TALKING WHICH IS
REALLY IMPORTANT.
AND I WANT NEXT, IF YOU GO TO
THE NEXT PICTURE, I REALLY LIKE
THE FINAL PICTURE BECAUSE AFTER
SEVERAL HOURS OF REALLY STRONG
DEBATE AND DISCUSSION ABOUT HOW
TO DO THIS WORK, WE CAME TO SOME
REAL CONNECTION, HELP US A LOT
TO ACTUALLY PUT THIS WORK
TOGETHER.
AND THIS REQUIRES A LOT OF TIME,
EFFORT, WORKING WITH
COMMUNITIES, BEING CONNECTED.
AND INCORPORATING A LOT OF
FEEDBACK AND DOING THIS REALLY
COLLECTIVELY.
NEXT.
AND THE OTHER ASPECT I WANT TO
TALK ABOUT IS TECHNOLOGY.
REALLY IN THE FIELD OF
ENVIRONMENTAL TOXICANTS, NOT
ONLY METALS, ABILITY, ANALYTICAL
ABILITY, IT'S REALLY -- IT'S
BEEN POWERFUL, ALLOWING US TO DO
THIS WORK.
NEXT.
THIS IS PARTICULARLY IMPORTANT
WHEN YOU GO TO COMMUNITIES LIKE
MESA, I WAS TELLING YOU EARLIER,
PLEASE NEXT.
>> WE HAVE ABOUT A MINUTE LEFT.
>> OKAY.
VERY GOOD.
WHEN WE GO TO MESA TECHNOLOGY,
YEAH, I'M ALMOST DONE.
WE FOUND IN IN MESA, RELATED
TO TOTAL MORTALITY, NEXT, SO --
NEXT.
I WANT TO JUST FINALLY SAY THERE
ARE OPPORTUNITIES FOR
INTERVENTION THAT ARE BEYOND
PREVENTION OR POLICY LEVEL OR
INFRASTRUCTURE LEVEL, SO NEXT.
I WANT TO BRIEFLY MENTION THE
OPPORTUNITY OF METAL CHELATION
AND RECOGNIZE, NEXT, A CLINICAL
TRIAL, NEXT, SORRY, I SHOULD NOT
HAVE ANIMATIONS.
AND THIS IS A TRIAL THAT WAS
CONDUCTED A NUMBER OF YEARS AGO,
THERE IS NOW A SECOND TRIAL,
COLLECTIVELY BETWEEN THE TWO
TRIALS HOPEFULLY WE CAN LEARN
SOMETHING ABOUT THE POTENTIAL.
NEXT.
ABOUT THE POTENTIAL -- THIS IS
THE SECOND TRIAL, WHICH WILL BE
REPORTED VERY SOON AND
COLLECTIVELY WE HOPE TO LEARN
ABOUT THIS POTENTIAL OPPORTUNITY
FOR CARDIOVASCULAR DISEASE
TREATMENT.
NEXT.
AND THIS IS -- IF YOU DO NEXT,
THIS WILL BE MY FINAL SLIDE.
IN CARDIOVASCULAR DISEASE
PREVENTION, MOST OF THE
GUIDELINES FROM THE AMERICAN
HEART ASSOCIATION AND COLLEGE OF
CARDIOLOGY AND IN GENERAL FOCUS
ON LIFESTYLE AND CLINICAL CARE,
THAT RECOGNITION AND JUST THE
FACT NHLBI IS ORGANIZING THIS
PANEL, THIS WORKSHOP, IS REALLY
RECOGNIZED HOW IMPORTANT ADDING
THE ENVIRONMENTAL PIECE TO
CARDIOVASCULAR DISEASE
PREVENTION IS.
THANK YOU SO MUCH FOR YOUR
ATTENTION AND HAPPY TO START THE
DISCUSSION.
>> THANK YOU.
EXCELLENT TALK.
I WANT TO THANK THE SPEAKERS FOR
EXTREMELY THOUGHT-PROVOKING
TALKS.
WE'LL BRING THEM ALL BACK TO THE
GALLERY AT THIS POINT.
ALSO BRING IN OUR CO-CHAIRS TO
KICK OFF THE DISCUSSION LED BY
DR. JOEL KAUFMAN, UNIVERSITY OF
WASHINGTON SEATTLE.
PROFESSOR, PHYSICIAN,
EPIDEMIOLOGIST, DIRECTOR OF
WASHINGTON CENTER FOR DISEASES,
EDITOR IN CHIEF OF ENVIRONMENTAL
HEALTH PERSPECTIVES PUBLISHED BY
NATIONAL INSTITUTE OF
ENVIRONMENTAL HEALTH SCIENCES.
WE'RE FORTUNATE HE ACCEPTED OUR
REQUEST TO MODERATE WITH HIS
EXPERT PERSPECTIVE.
THANKS AND WELCOME.
>> HELLO, THANKS FOR THAT
INTRODUCTION.
I WANT TO ASK THAT PEOPLE FEEL
FREE TO PUT THEIR QUESTIONS INTO
THE Q&A SO WE HAVE INPUT FROM
LARGE NUMBER OF ATTENDEES HERE.
THIS WAS QUITE A VARIED SET OF
DISCUSSIONS THAT WE HAD HERE.
I WANT TO CIRCLE BACK AROUND TO
A FEW OF THE TALKS AND THINK A
LITTLE BIT MORE ABOUT REALLY THE
COMPLICATED NATURE OF TRYING TO
THINK ABOUT SOLUTIONS WITH
SYSTEMS APPROACHES WHICH WAS A
THEME OF SEVERAL OF THE TALKS
THAT WE HAD IN THIS AND START ON
THAT CONVERSATION.
I THINK WE ALL RECOGNIZE THAT
THERE'S A VERY COMPLEX
INTERCONNECTED NATURE OF TRYING
TO MEET THE CHALLENGES TO BOTH
IMPROVE HEALTH AND UNDERSTAND
THE RELATIONSHIP BETWEEN
PLANETARY HEALTH AND HUMAN
HEALTH.
AND I MIGHT CIRCLE BACK AT FIRST
TO THINKING ABOUT THE QUESTION,
THE COMMENT DR. FANZA HAD ABOUT
SORTING OUT OUR MESSAGES, A GOOD
LINKAGE TO DISCUSSIONS WE HAD IN
THE FIRST SESSION.
IF I CAN GET A FINER POINT ON
THAT, HOW DO YOU SEE THE
MESSAGING THAT WOULD MOVE THIS
CONVERSATION FORWARD THE MOST
AND MAYBE DRIVE ACTION AND
INTEREST IN THESE QUESTIONS.
>> YEAH, THANKS SO MUCH FOR THE
QUESTION.
MAYBE DR. PE NEXTG COULD COME IN
TOO.
I WROTE DOWN THREE THINGS SHE
SAID ABOUT THE ENERGY TRANSITION
THAT REALLY RESONATED.
IT HAS TO BE IMMEDIATE, THERE'S
IMMEDIATE BENEFIT FOR ACTING.
IT HAS TO BE TANGIBLE.
YOU UNDERSTAND IF YOU DO ACT IT
WILL RESULT IN SOMETHING.
AND IT'S PERSONAL.
I DON'T THINK -- THE PROBLEM I
SEE IN THE FOOD SYSTEMS WORLD IS
THAT THERE'S A LOT OF DIFFERENT
PLAYERS.
AND IT'S NOT JUST THE FARMERS
AND PRODUCERS AND FISHER FOLK.
THERE'S A WHOLE SECTOR OF
TRADERS AND RETAILERS.
AND WITHIN THAT, THESE DIFFERENT
SCIENCE DISCOURSE, THERE'S A LOT
OF DIFFERENT DISCIPLINES FROM
ECONOMISTS TO MEDICAL
PROFESSIONALS THAT ARE TRYING TO
UNDERSTAND THE IMPACTS OF FOOD
ON WHAT WE WANT FOOD SYSTEMS TO
RESULT IN, BETTER HEALTH AND
NUTRITION, BETTER
SUSTAINABILITY, FAIR LIVELIHOOD,
SOCIAL EQUITY.
I THINK THERE HAS BEEN A
COALESCENS AROUND MESSAGES, BUT
THERE'S STILL A LOT OF
DISAGREEMENT IN THE SCIENCE,
THERE'S A LOT OF DISAGREEMENT ON
HOW WE TRANSMIT THE EVIDENCE TO
POLICYMAKERS.
AND I THINK WHERE WE STAND NOW,
WE DO A LOT OF WORK TRYING TO
PRESENT DATA TO POLICYMAKERS.
SOMETHING CALLED THE GLOBAL
SYSTEMS DASHBOARD, A PAPER IS
COMING OUT ON GLOBAL MONITORING
OF FOOD SYSTEMS PERFORMANCE.
TO US POLICYMAKERS ARE OFTEN
NAVIGATING IN THE DARK.
THEY DON'T KNOW HOW THEIR FOOD
SYSTEMS ARE PERFORMING, WHAT
ACTORS ARE DOING WHAT ACROSS
FOOD SYSTEMS.
IT BECOMES DIFFICULT TO RELAY
MESSAGES THAT ARE COMMON AND THE
DATA NEEDS TO FEED INTO THAT.
I THINK I DON'T THINK WE'RE AS
FAR ALONG AS THE ENERGY SECTOR.
MAYBE DR. PENG CAN TALK ABOUT
THAT.
THE ENERGY TRANSITION HAS GONE
FURTHER THAN FOOD SYSTEM
TRANSITION AND I THINK SOME IS
AROUND THE SCIENTIFIC COMMUNITY
COMING TOGETHER AROUND CORE
MESSAGES.
BUT WE ALL COME FROM DIFFERENT
DISCIPLINES AND HAVE DIFFERENT
ENTRY POINTS, FOOD SYSTEM ACTORS
THAT WE ENGAGE WITH, MAKES IT
MORE COMPLICATED.
>> PROFESSOR RAMASWAMI?
>> I THINK -- CAN YOU HEAR ME?
>> YES.
>> I THINK BY GETTING INTO
SECTORS I WANT TO GET ONE LEVEL
HIGHER THAN THAT.
THAT IS THAT ALL THESE KEY
PROVISIONING SYSTEMS ARE
IMPORTANT.
SO FOOD, ENERGY, WATER,
MOBILITY, CONSTRUCTION
MATERIALS, BECAUSE THEY AFFECT
HEAT, STRESS, ALL OF THAT.
TO ME THAT'S THE ULTIMATE FIRST
MESSAGE, KEY PHYSICAL
PROVISIONAL SYSTEMS ARE
EXTRAORDINARILY IMPORTANT.
SECOND, THAT URBAN AREAS ARE
IMPORTANT BECAUSE 85% OF US LIVE
IN URBAN AREAS.
THAT'S THE HIGHEST LEVEL, THEIR
ARE PROVISIONAL SYSTEMS, MOST OF
US LIVE IN CITIES IN THE U.S.
AND IT'S GOING TO BE SO IN THE
FUTURE.
AND SO IF WE CAN THINK ABOUT
URBAN HEALTH FROM A PLANETARY
PERSPECTIVE, SYSTEMS
PERSPECTIVE, YOU CAN GET BOTH --
YOU CAN HAVE A FRAME FOR
EVALUATING.
I JUST WANTED TO SAY BEFORE WE
SAY, WELL, THIS SECTOR AND THIS
SECTOR, OF COURSE THEY ARE ALL
IMPORTANT.
I'M NOT SAYING ONE MORE THAN THE
OTHER BUT HOLISTICALL YOU NEED
ALL, FOOD, ENERGY, WATER,
HOUSING, TO LIVE.
IT'S NOT JUST HEALTH RISKS.
IT'S ALSO YOUR ABILITY TO LIVE
AND THRIVE.
I JUST WANT TO SAY TO ME THAT'S
THE MOST FUNDAMENTAL MESSAGE.
URBAN SYSTEMS MATTER, PHYSICAL
PROVISION SYSTEMS MATTER BECAUSE
THEY ALSO SHARE EDUCATION,
HEALTH CARE.
I'LL STOP THERE.
THAT WAS THE GIST, WHATEVER I
WAS TRYING TO SAY.
THERE ARE SECTORAL QUESTIONS YOU
JUST CAN'T LIVE ANYWHERE WITHOUT
THOSE PROVISIONS.
>> DR. PENG?
>> YEAH, SO IN MY VIEW THINKING
ABOUT EFFECTIVE MESSAGING WE
FIRST THINK ABOUT WHO WE WANT TO
TALK TO, WHAT KIND OF DECISIONS
WE WANT TO CHANGE.
IF I CAN SPEAK ABOUT THE ENERGY
SIDE, WHAT WE HAVE FOUND OVER
THE PAST FEW YEARS I'VE HAD THE
PRIVILEGE TO WORK WITH
RESEARCHERS WE FOUND, YES, AT
VIRTUAL LEVEL WHEN WE MESSAGE
AROUND HEALTH, MAKING MORE
RELEVANT, MAKE THEM -- INCREASE
SUPPORT LEVEL FOR ENERGY POLICY
BUT A HUGE GAP BETWEEN
INCREASING SUPPORT TO CHANGING
THE DECISIONS.
BECAUSE AT THE INDIVIDUAL LEVEL
THERE'S LIMIT TO SOME EXTENT.
THAT'S THE REASON OVER THE PAST
LIKE TWO YEARS ACTUALLY WE HAVE
BEEN THINKING ABOUT MAYBE WE'RE
NOT TARGETING THE RIGHT AUDIENCE
IN THE FIRST PLACE BECAUSE IF
YOU ARE THINKING WHO CAN CHANGE
THE SYSTEM, WHAT ACTIONS THAT
CAN REALLY INTEGRATE ENERGY AND
AIR QUALITY AND HEALTH DECISIONS
IN THIS COUNTRY IN PARTICULAR I
THINK THE STATES ARE MORE
EFFECTIVE ENTRY POINTS BECAUSE
STATE AGENCIES RIGHT NOW WE HAVE
WINDOW OF OPPORTUNITY THANKS TO
INFLATION REJECTION ACT WHICH IS
CONGRESS INVEST INTO LOW CARBON
ENERGY, STATES ARE THE IMPORTANT
ACTOR THAT CAN DIRECTLY APPLY TO
FUNDING RESOURCES THAT CAN ALSO
HELP BUSINESSES AND LOCAL ACTORS
TO RESPOND AND TAKE ADVANTAGE OF
A LOT OF PROGRAMS.
AT THE SAME TIME STATES ARE AT
THE FOREFRONT FOR AIR QUALITY
STATE IMPLEMENTATION PLAN, A LOT
OF PUBLIC HEALTH INITIATIVES.
THAT'S WHY WE HAVE BEEN CHANGING
OUR FOCUS RECENTLY, THINKING
ABOUT MAYBE STATE AGENCIES ARE
THE RIGHT ACTORS WHERE WHEN WE
THINK ABOUT RIGHT MESSAGING AND
RIGHT IMPORTANT, USEFUL RESEARCH
INSIGHT, THOSE PLACES WHERE MORE
EFFECTIVE ACTION COULD
POTENTIALLY TAKE PLACE.
>> DR. NAVAS?
>> YES, I AGREE.
ACTUALLY THE IDEA OF THE STATE I
LIKE IT A LOT.
I THINK IT'S VERY TRUE, STATE,
TRIBAL ORGANIZATIONS, THIS
LEVEL, IT'S VERY RELEVANT.
I WAS THINKING IN TERMS OF
MESSAGING HEALTH CARE SYSTEM IS
VERY IMPORTANT.
I THINK IT'S REALLY BEHIND, HAS
BEEN QUITE BEHIND, ESPECIALLY IN
THE TRAINING IN MEDICAL SCHOOLS,
THINGS ARE CHANGING, BUT I THINK
IT'S BEEN A CHRONIC DEFICIT IN
EDUCATION.
SO I THINK THAT HAS MADE THE
MESSAGES IN THE CLINICAL WORLD,
THE HEALTH WORLD, IN GENERAL, TO
ACCEPT YOU KNOW SPECIFIC PUBLIC
HEALTH OR AREA.
TO THINK THIS IS NOT RELEVANT OR
SECOND LEVEL PRIORITY.
AND I THINK INCORPORATING BETTER
TRAINING, BETTER -- SO THOSE
MESSAGES ARE INCORPORATED INTO
THE MEDICAL CLINICAL THINKING I
THINK IS IMPORTANT.
OTHERWISE IT DOESN'T GET
TRANSMITTED TO THE REST OF THE
POPULATION.
EACH YEAR IN THE CLASS THAT I
TEACH ENVIRONMENTAL INJUSTICE AT
COLUMBIA UNIVERSITY I ASK
UNDERGRADUATE STUDENTS WHAT DO
YOU THINK OF THE RISK FACTORS
FOR CARDIOVASCULAR DISEASE,
MONEY SAYS ANYTHING ABOUT
ENVIRONMENT.
NOTHING.
NOTHING-- NOBODY SAYS ANYTHING
ABOUT ENVIRONMENT, FOOD SYSTEMS,
NOTHING.
THEY MIGHT SAY SOMETHING ABOUT
THE FOOD OR DIET OR DIET OR
SOMETHING LIKE THAT, BUT THAT'S
IT.
I THINK THIS SHOWS WE HAVE A LOT
TO DO IN THAT AREA.
>> DR. DAHER?
>> AS I REFLECT ON THE COMMENT
ON THE IMPORTANCE OF ALL OF
THESE SECTORS, THEY ARE
INTERCONNECTED.
ONE OF THE KEY MESSAGES THAT WE
NEED TO PUT OUT IS THE CURRENTLY
UNTAPPED POTENTIAL BY THE LACK
OF NATIONS, CURRENTLY EXISTS,
HOW WE CAN TAP INTO THIS SPACE
AND IMPROVE SYNERGY BY LOOKING
AT WAYS THAT THESE SECTORS COULD
BETTER COORDINATE AND BETTER DO
INTEGRATIVE PLANNING AND
GOVERNANCE OF THESE
INTERCONNECTED RESOURCE SYSTEMS.
>> YES, DR. RAMYASWAMI.
>> ON THIS QUESTION OF WHAT'S
THE BEST POLICY SCALE, I WANT TO
PUSH BACK.
BY STATE, I DON'T KNOW IF YOU
MEAN STATE OF MINNESOTA, THAT
KIND OF STATE, I THINK THAT'S
TRUE IF YOU'RE LOOKING AT THE
SUPPLY SIDE.
HOWEVER, ENERGY SUPPLIED, HOW DO
YOU CHANGE POLL CIRCUMSTANCES SO
MUCH OF DECARBONIZATION CAN BE
ACHIEVED BY URBAN PLANNING,
WHICH CAN HAVE CARDIOVASCULAR
BENEFITS THROUGH ACTIVE
LIFESTYLES, NON-MOTORIZED
TRAVEL.
IT'S MULTI-SCALE, NOT ONE SCALE
AND IN SOME WORK WE'VE SHOWN
THAT THOSE LEVELS ARE JUST NOT
BEING COUNTED WHEN YOU DO -- NET
ZERO DOESN'T CONSIDER THOSE
KINDS OF THINGS, THAT CITIES CAN
DO.
THAT'S WHERE LOCAL PLANNING
MATTERS, METROPOLITAN AND
REGIONAL PLANNING, MULTI-SCALE,
NOT A STATE OR NATION, YOU WANT
TO LOOK AT INSTITUTIONS ACROSS
SCALE.
I WANT TO SAY IN ANY SECTOR YOU
SEE THAT, THERE'S LOCAL LEVEL,
CITY LEVEL, NEIGHBORHOOD LEVEL
PLANNING, METROPOLITAN REGIONAL,
THEN THE STATE, EVEN REGIONAL
PUBLIC UTILITY COMMISSIONS,
BROADER REGION, FEDERAL POLICY.
AND SO ONE OF THE NICE THINGS IN
THE AMERICAN HEART ASSOCIATION
IS WE'RE ACTUALLY IDENTIFIED AT
WHICH SCALE THE POLICY ACTORS
ARE RELEVANT.
SO YOU CAN GET CROSS-SCALE
CONNECTION GOING ON BECAUSE IT
IS A MULTI-SCALE MULTI-SECTOR,
TOTALLY AGREE, MULTI-SECTOR,
MULTI-SCALE.
AND THEN THOSE PLACES WHERE YOU
CAN CONVENE PEOPLE ACROSS SCALE,
THAT'S WHERE YOU CAN GET
COORDINATION HAPPEN.
I WANT TO SAY WHICH SCALE IS
IMPORTANT DEPENDS WHICH LEVEL.
IF YOU LOOK AT DEMAND SIDE
LEVELS, URBAN, HOW URBAN AREAS
ARE DESIGNED, ARE A HUGE PART OF
THE DEMAND SIDE.
>> SANJAY, DO YOU HAVE A
QUESTION?
>> I THINK YOU'RE STILL MUTED.
>> SORRY.
SORRY ABOUT THAT.
I JUST WANT TO FIRST OF ALL
CONGRATULATE ALL THE SPEAKERS
BUT I HAD TWO QUESTIONS, MAYBE
COMMENTS.
ONE, TO JESS.
SUPERB TALK ON FOOD SYSTEMS.
THE QUESTION IS ONE OF THE OTHER
ASPECTS TO BE CONSIDERED WHEN
YOU PUT THIS WORKSHOP TOGETHER
WAS ALL OF THE THINGS THAT ARE
HAPPENING IN THE PRIVATE SECTOR
ON NEW TECHNOLOGIES LIKE
CELL-BASED MEATS, FERMENTATION
TECHNOLOGY, ALL THINGS THAT HAVE
DUBIOUS HEALTH EFFECTS RIGHT
NOW.
WE DON'T UNDERSTAND ENOUGH ABOUT
IT.
I WANT TO ASK HER FOR SOME
COMMENTS ON WHAT THE INTERESTING
QUESTIONS MIGHT BE.
THE SECOND QUESTION TO ANU, AND
WEI, BRILLIANT TALKS.
THE QUESTION WITH REGARDS TO HOW
DO YOU -- THERE'S GOOD
COMMENTARIES AND TALKS FROM
DIFFERENT ORGANIZATIONS ABOUT --
AND WE'VE TALKED ABOUT
COLLECTING HEALTH INFORMATION,
RIGHT, ON ALL DECISIONS.
THERE ARE URBAN PLANNING
DECISIONS, ET CETERA.
IT'S VERY GOOD.
HOW DO YOU ACTUALLY MAKE THAT
HAPPEN?
HOW SHOULD IT -- SINCE YOU HAVE
THE CONFLUENCE OF DIFFERENT
ACTORS, HOW SHOULD THIS
ACTUALLY -- ANY WORDS OF ADVICE
OR WISDOM HOW THIS SHOULD HAPPEN
ESPECIALLY WHEN PLANNING MANY
SECTORIAL INTERVENTIONS, ANY
FINAL POINTS TO FURTHER
ELIMINATE HEALTH IMPACT PLANNING
OF URBAN DECISIONS?
>> I WITH START WITH THE ALT
PROTEIN SPACE, A HUGE FIELD.
THERE'S PLANT-BASED PRODUCTS,
ALL THE WAY TO LAB GROWN MEAT,
MIMICKING, LOOKS, SMELLS, TASTE
LIKE MEAT BUT NOT MEAT.
IT'S AN INTERESTING TIME.
IF YOU GO TO KENYA YOU'LL SEE
SOME OF THESE PLANT-BASED MEATS
MIMICKING MEAT IN SUPER MARKETS,
IT'S NOT JUST HIGH-INCOME
COUNTRIES.
YOU'RE SEEING IT IN LOW TO
MIDDLE INCOME COUNTRIES.
THE INDUSTRY IS $12.7 BILLION
INTO ALT PROTEINS, A HUGE
INDUSTRY BUT ALL TIED UP IN
PRIVATE SECONDER AND VENTURE
CAPITALISM.
AND WE CAN ASSESS THESE
PARTICULARLY THOSE HIGHLY OR
ULTRA PROCESSED FOODS.
WE CAN ONLY DO SO MUCH RESEARCH
ON THAT BUT WE NEED TO OPEN UP
THE RESEARCH AGENDA AND ALLOW
FOR PUBLIC RESEARCH TO BE DONE
ON MANY OF THESE PRODUCTS.
IT'S QUITE TIED UP IN THE
PRIVATE SECTOR.
D BEZOS EARTH FUND IS BUILDING
CENTERS OF RESEARCH EXCELLENCE
TO TRY TO UNDERSTAND ALT
PROTEINS AND THEIR FUTURE,
DEMAND FOR THEM AND HEALTH AND
ENVIRONMENT IMPACTS.
WE LOOK AT THE LIVE STOCK
INDUSTRY IN THE UNITED STATES,
WHAT IF IT CONTRACTED WITH
SUBSTITUTION ALTERNATE PROTEINS
FILL IN, AND THERE'S
CONSEQUENCES.
THERE'S BENEFITS TO THE
ENVIRONMENT, BUT WE ESTIMATED
LOSS OF 1.2 MILLION JOBS IF LIVE
STOCK SECTOR IF AMERICANS
SHIFTED 10 TO 15% OF BEEF
CONSUMPTION TO ALT PROTEINS.
SO IT'S AN INTERESTING SPACE.
AND I THINK WITH ALT PROTEINS
IT'S REALLY GOING TO COME DOWN
TO PRICE, TASTE, AND WHAT
CONSUMERS VALUE.
DO THEY CARE ABOUT ANIMAL
WELFARE, ABOUT THE ENVIRONMENT,
ABOUT HEALTH, FARMERS AND
RANCHERS?
AND THEY ARE GOING TO MAKE
CHOICES BASED ON THAT.
WE HAVE UNDERSTAND HOW POWERFUL
AND COMPLEX THAT CHOICE IS WHEN
SOMEONE WALKS INTO THE MARKET
AND DOES THAT.
BUT THE BIGGEST ISSUE HAVE, WE
NEED TO OPEN UP THAT SPACE AND
ALLOW FOR PUBLIC UNIVERSITIES TO
BE ABLE TO START UNDERSTANDING A
LOT OF THESE PRODUCTS BECAUSE
RIGHT NOW IT'S LOCKED INTO
VENTURE CAPITALISM.
SO, YEAH.
>> LET ME CIRCLE BACK AROUND
KNOWING THAT A BIG PART OF THIS
SYMPOSIUM IS TO TRY TO
UNDERSTAND RESEARCH GAPS AND
THINK ABOUT HOW THE KINDS OF
SYSTEMS THAT WE'VE TALKED ABOUT
IN THIS SESSION PARTICULARLY
LEND THEMSELVES TO NEW -- TO
RESEARCH GAPS THAT HAVE TO BE
FILLED.
I MEAN, WE KNOW THAT THERE'S,
YOU KNOW, GENERALLY ALL THE
SYSTEMS ARE INTERRELATED,
BIDIRECTIONAL, THERE'S
CO-BENEFITS TO, YOU KNOW, LOTS
OF THINGS, SMART CITIES HAVE
LOTS OF CO-BENEFITS TO THEM.
WHAT IS SORT OF HEART HEALTH
RESEARCH QUESTIONS THAT WE CAN
SORT OF SINK OUR TEETH INTO I
THINK AS PLACES WHERE THE GAPS
NEED TO BE FILLED.
I'M SURE A FEW PEOPLE HAVE AN
IDEA, I'M SURE SANJAY DOES.
>> MAYBE I'D REFRAME, NOT
REFRAME BUT RATHER DEFLECT THAT
QUESTION WITH YOUR PERMISSION
AND INDULGENCE, JOEL, TO ANU.
FROM URBAN HEALTH PLANNING
PERSPECTIVE GIVEN THE FACT
THERE'S A HUGE OPPORTUNITY NOW,
WHAT ARE SOME OF THE RESEARCH I
GUESS QUESTIONS AND PRIORITIES
WE CAN PROBABLY HANG TOGETHER
WITH SOME OF THE INTERVENTIONS
HAPPENING, MULTI-SCALE AND
MULTI-DIMENSIONAL INTERVENTIONS
AS PART OF THE IRA, ARE THERE
THINGS YOU GUYS THINK MIGHT BE
PARTICULARLY IMPORTANT THAT'S
NOT HAPPENING RIGHT NOW?
I GUESS WOULD BE MY QUESTION.
IS IT MERELY ENGAGEMENT TO BE
PART OF URBAN PLANNING DECISIONS
BY THE CARDIOLOGIST?
WHAT DOES THAT LOOK LIKE TO YOU
GUYS?
>> MUTED AGAIN.
ANU, YOU'RE MUTED.
>> CAN YOU HEAR ME NOW?
>> YES.
SO I THINK THERE'S MULTIPLE
KNOWLEDGE GAPS.
LET ME GO BACK TO THE EARLIER
QUESTION SANJAY ASKED BECAUSE IT
RELATES TO THE KNOWLEDGE GAPS.
AND THAT IS HOW DO YOU GET
GOVERNANCE, NOT POLICY BUT
GOVERNANCE ACROSS SCALE WHICH
INCLUDES INDIVIDUAL BEHAVIORS,
NEIGHBORHOOD DESIGN,
METROPOLITAN DESIGN, ALL THOSE
THINGS.
I WOULDN'T SAY THAT
THEORETICALLY A STATE CAN
IMPOSE, METROPOLITAN REGION CAN
ENGAGE WITH UTILITY.
SO WHAT I FOUND IS ANYWHERE
WHERE THE INSTITUTION IS STRONG
ENOUGH TO GET MULTI-SCALE
MEANING, FOR EXAMPLE WHEN I
FIRST WORKED WITH DENVER ON
GREENHOUSE GAS, THEY HAD
INCREDIBLE CAPACITY TO CONVENE
ACROSS SCALE.
SO THE UTILITY WAS THERE.
THE METRO REGIONAL
TRANSPORTATION PLANNERS WERE
THERE, LOCAL COMMUNITIES, YOU
KNOW.
AND THAT'S WHY I THINK WHOEVER
HAS THAT SKILL CONVENING, IT
DOESN'T HAVE TO BE THIS SCALE OR
THAT SCALE.
IF YOU DO BY FIAT, PEOPLE WON'T
DO IT UNLESS YOU ACTUALLY ENGAGE
THEM.
THAT'S MY FIRST TAKEAWAY.
I THINK IT'S THE SCIENCE THAT
HASN'T CAUGHT UP.
FOR EXAMPLE THE MODELS USED IN
GLOBAL MODELS, THEY PAY NO
ATTENTION TO WHAT'S HAPPENING IN
THE CITY.
EVEN THE NATIONAL MODEL DOESN'T
HAVE -- IN FACT WE'RE HOPING TO
PUBLISH THIS PAPER IN NATURE
SUSTAINABILITY, IT'S NOT BECAUSE
THEY DON'T WANT TO, IT'S BECAUSE
IT'S COMPUTATIONALLY DIFFICULT
AND EXPENSIVE.
YOU TALKED ABOUT CROSS-SECTOR
INTERACTION, YOU NEED VERY FINE
DATA.
SO I THINK IT'S ON THE SCIENCE
SIDE REALLY UNDERSTANDING THESE
ARE MODELS ACROSS SCALE.
THERE AREN'T METHODS BECAUSE
THESE THREE SCALES ARE USING
VERY DIFFERENT METHODS, FOR GOOD
REASON, BECAUSE IT'S ACTUALLY
TOO COMPLEX TO PULL THEM
TOGETHER.
AND I THINK THE THIRD THING I
WORRY ABOUT TOO MUCH ON MILES
PER HOUR.
IF YOU DO THIS ALL THESE HAPPY
THINGS HAPPEN.
I SHOWED TRADEOFFS.
I DON'T THINK WE'VE DONE A GOOD
JOB DEMONSTRATING CAUSALITY AT
ALL.
WE SHOW BETTER DIET, BUT WHAT
INTERVENTIONS WILL ACTUALLY
IMPROVE DIETS, HOW DO YOU ADJUST
FOR, YOU KNOW, DIFFERENCES IN
INCOME.
TO ME FROM -- IN TERMS OF HEALTH
RESEARCH I THINK HOW DO YOU GET
AT CAUSALITY TO DEMONSTRATE THAT
THESE INTERVENTIONS ARE ACTUALLY
UNPACKING ALL THE COMPLICATION
THAT COMES FROM INCOME EFFECTS,
RACE, SO ON.
SO THAT'S WHERE I SEE THESE
THREE THINGS.
ON THE PHYSICAL SIDE WE DON'T
HAVE VERY GOOD MODELS THAT
REALLY CONNECT ACROSS SCALE.
SO IF MANY INTERESTING THINGS
ARE HAPPENING IN CITIES WITH
WALKING, BICYCLING, REDUCING
TRAVEL DEMAND, SO I THINK THE
BIGGER QUESTION IS WE SHOULDN'T
BE SO OPTIMISTIC.
YOU KNOW, WHEN I READ THE IPCC
CHAPTER, ALSO VERY POSITIVE.
YOU COULD EASILY SAY, WELL, AN
ENVIRONMENTALIST WROTE IT
BECAUSE IT'S JUST VERY POSITIVE.
I'LL STOP THERE.
SKEPTIC COULD SAY, WELL, DO YOU
REALLY KNOW THIS?
>> THANK YOU.
DR. PENG, YOUR HAND IS UP AGAIN.
>> YES, I AGREE WITH ANU ABOUT
IMPORTANCE OF IMPROVING MODELING
CAPABILITY FOR MULTI-SECTOR
SYSTEMS BUT I THINK SANJAY ASKED
A RIGHT QUESTION, HOW TO MAKE
THIS HAPPEN.
IF YOU THINK ABOUT THE POLICY
PROCESS, IT'S NEVER A CONTINUOUS
STEADY PROCESS.
THERE'S ALWAYS CRITICAL WINDOW
OF OPPORTUNITY WHERE THE
OPPORTUNITY FOR US TO EMBRACE.
IF YOU THINK ABOUT COORDINATING
ENERGY AND AIR QUALITY AGENDA,
IN CHINA THAT WAS 2013.
WHEN WE HAD VERY SEVERE -- I'M
CHINESE.
VERY SEVERE AIR, HIGHLY
POLLUTING EVENTS, AS A RESULT
CENTRAL GOVERNMENT DECLARED WAR
AGAINST AIR POLLUTION.
THAT WAS THE WINDOW OF
OPPORTUNITY FOR CHINA TO START
TO TAKE THE ACTION IN
COOPERATING THOSE.
ACTIONS TOGETHER.
I SEE SIMILAR WINDOW OF
OPPORTUNITY OPENING UP IN THE
UNITED STATES RIGHT NOW, THANKS
TO INFLATION REDUCTION ACT, A
HUGE AMOUNT OF EFFORT FROM ALL
LEVELS TO ACCELERATE ENERGY
TRANSITION.
AT THE SAME JUSTICE40 INITIATIVE
OPENED THE DOOR TO THINKING
ABOUT THE COORDINATION BETWEEN
ENERGY AND ALSO JUSTICE.
SO THAT WAS THE REASON WHEN I
WAS SAYING WHY I FEEL THAT
STATES COULD BE THE STARTING
POINT NOT TO SAY OTHER ACTORS
ARE NOT IMPORTANT.
MY POINT WAS I DO SEE STATES AS
VERY NATURAL ENTRY POINT NOW
THAT WE HAVE A WINDOW OF
OPPORTUNITY OPEN UP IN
PARTICULAR, EXCEPT CALIFORNIA,
MOST OF THE OTHER STATES WE'VE
INTERACTED WITH ARE SCRAMBLING
FOR HELP, ASKING FOR WHAT DATA
IS AVAILABLE NOW BECAUSE THEY
ONLY HAVE TWO MONTHS TO RESPOND
TO FUNDING OPPORTUNITY FROM
GOVERNMENT, EPA, ELSEWHERE.
IN MY VIEW THERE ARE TWO THINGS
PRIORITIES RIGHT NOW, ONE
EMBRACING THE CURRENT WINDOW OF
OPPORTUNITY TO SYNTHESIZE
EVERYTHING WE KNOW AND PROVIDE A
TOOL THAT'S AVAILABLE NOW SO THE
STATES CAN MAKE GOOD DECISIONS
TODAY.
AT THE SAME TIME THIS IS A
STARTING POINT.
WE SHOULD BE THINKING ABOUT
THROUGH THIS PROCESS LET'S BUILD
PARTNERSHIPS AND TRUST,
ANTICIPATING THE FUTURE WINDOW
OF OPPORTUNITY SO WE VIEW THE
CAPACITY FOR MODELING
PERSPECTIVE SO THAT WE HAVE THE
FUTURE WINDOW OF OPPORTUNITY
OPEN WE HAVE BETTER TOOLS AND
BETTER PARTNERSHIPS TO REACT
FAST AND ALSO BETTER NEXT TIME.
>> OKAY.
DR. NAVAS?
>> THANK YOU FOR ALL OF THESE
VERY INSPIRING IDEAS AND
COMMENTS.
WHAT I WAS THINKING MYSELF WHICH
GOES ALONG VERY WELL WITH WHAT
ANU AND WEI HAVE SAID IS WITH
ALL THE CHANGES THAT ARE GOING
ON RIGHT NOW, THE OPPORTUNITIES,
THE WATER INFRASTRUCTURE
CHANGES, THE URBAN PLANNING
CHANGES, FROM THE RESEARCH SIDE
I THINK IT'S A REALLY GREAT
OPPORTUNITY TO TRY TO GO IN
PARALLEL TO BE ABLE TO DOCUMENT
WHAT THE HEALTH IMPACTS WOULD
BE.
EITHER DOING REALLY WELL DONE
HEALTHY BALANCED IMPACT
ASSESSMENT, HAVING REAL DATA
THAT COULD BE ABLE TO DOCUMENT
WHAT IS THE IMPACT, POTENTIAL
BENEFITS OR LESS SOE SO THAT WE
CAN TRY TO MAYBE IDENTIFY WHICH
ARE THE MOST EFFECTIVE
INTERVENTIONS.
THIS IS NOT EASY AT ALL TO DO.
BUT I THINK THERE IS REALLY A
LOT OF OPPORTUNITY.
THE OTHER THING I WAS GOING TO
MENTION THAT EVEN THOUGH I AGREE
THAT URBAN SETTINGS ARE CRITICAL
AND IMPORTANT, I REALLY WANT TO
KEEP BRINGING AND REMINDING US
OF THE MORE MAYBE ONE OF OUR
COMMUNITIES LIVING IN MORE
REMOTE AREAS, BECAUSE THERE ARE
LOTS OF ISSUES, ENVIRONMENTALLY,
THAT AFFECT THOSE COMMUNITIES,
AND I DON'T THINK IT'S ENOUGH,
BECAUSE YOU'RE MANY MORE
MILLIONS OF PEOPLE IN ONE PLACE,
THAT THAT'S ENOUGH FOR US TO
PRIORITIZE DECISION MAKING.
I THINK THIS CAN LEAVE MANY
PEOPLE BEHIND AND IT'S NOT -- I
DON'T THINK IT'S GOOD AS A
SOCIETY TO TOTALLY DISREGARD
COMMUNITIES IN RURAL AREAS.
THE SAME FOR URBAN COMMUNITIES.
CLEARLY IN OUR COMMUNITIES ARE
EQUAL, AND I THINK INEQUALITIES
ASPECTS I THINK ARE VERY, VERY
IMPORTANT BECAUSE ALL OF THESE
URBAN DESIGNS AND PLANNING ARE
NOT ALSO BENEFITING EVERYBODY
EQUALLY.
THAT'S A REAL CHALLENGE NOWADAYS
BUT SOMETHING THAT IS VERY
IMPORTANT FOR US TO KEEP FROM
THE RESEARCH PERSPECTIVE AND
ALSO PRACTICE PERSPECTIVE.
>> I NEED TO TURN TO QUESTIONS
IN THE Q&A AFTER DR. DAHER.
>> QUICKLY, I THINK THE GOAL OF
THE CHALLENGE THAT WE FACE HERE
WHILE WE'RE LOOKING AT DIFFERENT
SECTORS WITH DIFFERENT
OBJECTIVES IS HOW SECTORS
MEASURE SUCCESS AND EVALUATE
THEIR SUSTAINABILITY AND
RESILIENCE.
I THINK THERE'S AN IMPORTANT
NEED FOR US TO IDENTIFY WHAT ARE
THESE COMMON COLLECTIVE OUTCOMES
AND METRICS THAT YOU CAN
IDENTIFY ACROSS SECTORS SO WE
CAN ACHIEVE BETTER ALIGNMENTS
ACROSS STRATEGIES THAT ARE PUT
FORWARD ACROSS DIFFERENT
SECTORS.
ONE QUICK EXAMPLE TO SHARE THAT
WE'RE WORKING ON CURRENTLY WITH
CITY OF SAN ANTONIO, DEVELOPING
ETHNICITY LEVEL, WORKING AT THE
DISTRICT LEVEL WITH ONE OF THE
CITY COUNCIL MEMBERS, DEVELOPING
DASHBOARD WITH LOCALIZED
INDICATORS, SO BASICALLY GOING
BACK TO ANU'S COMMENT ON
IMPORTANCE OF COLLABORATING WITH
SOMEONE WITH CONVENING POWER,
WHEN WE DO THIS KIND OF
STAKEHOLDER ENGAGEMENT MEETINGS
I'M NOT INVITING FOR THESE
MEETINGS, THE CITY COUNCIL
MEMBER IS THE ONE WHO IS
INVITING ALL OF HER CONSTITUENTS
AND STAKEHOLDERS ACROSS FOOD,
ENERGY, HEALTH, EDUCATION, WHO
COME AND CONTRIBUTE TO THESE
MEETINGS AND AS A RESULT WE'RE
DEVELOPING THIS DASHBOARD TO ACT
AS FUTURE TOOL TO EVALUATE
PROGRAMS FOR THE CITY AND THAT
WOULD GUIDE FUTURE INVESTMENT IN
DIFFERENT PROGRAMS WHILE
UNDERSTANDING THE IMPACT,
POSITIVE AND NEGATIVE, OF
DIFFERENT PATHWAYS AND DIFFERENT
PROGRAMS INCLUDING HEALTH AND
WATER AND OTHERS.
>> QUICKLY SOME OF THESE
COMMENTS, THE FIRST WOULD BE A
COMMENT FROM CARL MAYER ON
ORIGINAL CONVERSATION THAT WE
STARTED WITH ON MESSAGING,
SAYING HE WOULD SUGGEST MULTIPLE
MESSAGES ARE IMPORTANT TO THE
EXTENT THEY DON'T CONFLICT.
THAT IS THIS IS THE MOST
IMPORTANT THING TO DO TO REACH
DIFFERENT PUBLICS, INDIVIDUALS
WITH VARIED VALUES, WE NEED TO
KNOW OUR AUDIENCE, SIMILAR FOR
POLICY.
DOES ANYBODY WANT TO ADD
ANYTHING TO THAT COMMENT BASED
ON WHERE WE LANDED THERE?
AND THEN A QUESTION FOR DR.
NAVAS.
SHE ANSWERED OFFLINE, ON MEDICAL
HEALTH CARE EDUCATION, INCLUDING
PLANETARY HEALTH IN THAT.
I THINK THERE'S LOTS OF DEMANDS
ON MEDICAL EDUCATION.
IT REMAINS THE CASE, ALTHOUGH
CHALLENGED IN THE LAST FEW YEARS
I THINK BY PUBLIC OPINION THAT A
DOCTOR'S WORD STILL MEANS A LOT
TO PEOPLE AND GOOD IF WE COULD
MESSAGE BETTER TO THE HEALTH
CARE COMMUNITY ON PLANETARY
HEALTH FOR SURE.
THERE WAS A QUESTION, HOW MUCH
REFIRES, ESPECIALLY ASHES
CONTAINING CHROMATE COPPER AND
ARSENIC, AN INTERESTING
QUESTION, JUST A PAPER IN
"NATURE COMMUNICATIONS" THIS
WEEK SHOWING WE HAVE TO WORRY
ABOUT THE BURNING OF
COPPER-CONTAINING TREES,
COPPER-TREATED WOOD IN THIS
CASE, CCA TREATED WOOD, BUT
CHROMIUM IN THE SOIL IS
TRANSFORMED BY WILDFIRES INTO
HEXAVALENT CHROMIUM, THE MORE
TOXIC CHROMIUM SPECIES.
DID YOU WANT TO ADD ANYTHING,
ANA?
>> YEAH, THANK YOU FOR THE
QUESTION.
THERE IS NOT REAL RESEARCH DONE
IN THAT REGARD.
THE WILDFIRES RESEARCH,
CONNECTING THAT TO DISEASE, THAT
WOULD BE SUPER INTERESTING TO
DO.
IN ONE OF THE SLIDES, REALLY
QUICKLY, COPPER IS RELATED TO
CARDIOVASCULAR DISEASE, IN THE
MESA STUDY.
COPPER IS A VERY INTERESTING
METAL, VERY REACTIVE.
SO ANYWAY, YEAH, WORK TO DO IN
THIS AREA.
A LOT OF WORK TO DO.
>> ANU YOUR HAND HAS BEEN UP.
>> THANK YOU.
I JUST WANTED TO APPRECIATE
ANA'S COMMENT, TREMENDOUS.
WHEN WE WROTE OUR REVIEW PAPER
THE NUMBER OF -- TWO THINGS.
THERE'S A LOT OF URBAN
INEQUALITY.
AND THE SUBSTANTIAL NUMBER OF
PEOPLE, EVEN JUST LOOKING AT
HOMELESSNESS IN THE U.S., SO
THROUGH HOMELESSNESS THERE ARE
PEOPLE WHO ACTUALLY DON'T HAVE
ACCESS TO TOILET, SANITATION,
AND SO I WANT TO SAY IT'S NOT
LIKE URBAN PLACES ARE DOING VERY
WELL.
THE SECOND IS IN THIS URBAN
SYSTEMS APPROACH IT'S NOT MEANT
TO EXCLUDE RURAL, I WANT TO
EMPHASIZE, WHERE YOUR PRODUCTION
COMES FROM IS ENGAGING THE RURAL
AND SO I HAVE SEEN SOME GREAT
EXAMPLES WITH FARMERS MARKETS,
WITH FOOD SYSTEMS, WHERE THE
URBAN FOOD SYSTEM IS ENGAGING
WITH THE RURAL FOOD SYSTEM,
THROUGH THESE LOCAL SUPPLY
CHAINS, FOR HEALTHY FOOD, SO
JUST TO CLARIFY DOESN'T MEAN
IT'S IGNORING EVERYONE ELSE BUT
IF YOU LOOK AT WHERE RESOURCES
ARE COMING, IF YOU LOOK AT
MIGRATION, INDIA AND OTHER
PLACES, THEY ARE CONNECTED.
ONE OF THE MESSAGES WAS IT JUST
GIVES A DIFFERENT FRAME TO
THINK.
P IT WAS -- IT WAS SHOCKING THE
AMOUNT OF DEPRIVATION IN U.S.
URBAN AREAS WHEN YOU LOOK AT IT.
>> WE NEED TO BE WRAPPING UP FOR
A BREAK.
I DO WANT TO PLANT ONE MORE SEED
FOR FUTURE DISCUSSION WHICH WAS
SORT OF INTO THAT IN EARLIER
CONVERSATIONS TODAY, AND IN THE
PRESENTATIONS IN THIS SESSION.
AS WE THINK ABOUT THE SORT OF
COMPLEX MULTI-SYSTEM
MULTI-DIRECTIONAL INPUTS ON
PLANETARY HEALTH, I THINK THAT
WE AS HEALTH SCIENTISTS HAVE NOT
ALWAYS INTEGRATED ON A GLOBAL
SCALE THE ROLE OF ECONOMIC
DEVELOPMENT AND WEALTH
DISTRIBUTION INTO THE CALCULUS
AS MUCH AS WE PROBABLY SHOULD
BE.
AND THEN IMPLIES NOT JUST TO
URBAN SETTINGS, SAY, IN THE
UNITED STATES WHERE WE HAVE
CRISES OF HOMELESSNESS AND
SANITATION ACCESS AND SO FORTH
BUT GLOBALLY AS ECONOMIC
DEVELOPMENT IMPROVES QUALITY OF
LIFE GENERALLY IMPROVING HEALTH,
INTERSECTIONS BETWEEN ECONOMIC
DEVELOPMENT AND INCREASING
GREENHOUSE GASES VERSUS
RENEWABLES IS A BIG TOPIC I
THINK IN THIS FIELD AND THAT
HEALTH OFTEN DOESN'T GET PUT
INTO CONTEXT AS MUCH AS IT NEEDS
TO BE.
ALL RIGHT.
I SEE WE'RE AT TIME.
I'LL TURN IT BACK TO WHOEVER IS
RUNNING THE SHOW AND LET THEM
TAKE IT FROM HERE.
>> I THINK THAT'S ME.
LARRY FINE.
AGAIN, ANOTHER INCREDIBLE SET OF
DISCUSSIONS WITH REALLY RICH IN
TERMS OF RESEARCH OPPORTUNITIES,
CHALLENGES, HOW TO FORM OUR
INFORMATION, RESEARCH
INFORMATION, SO IT AFFECTS
POLICIES, YOU'VE ALSO JUST
POINTED OUT THE COMPLEXITY OF
THE SYSTEMS AND OUR NEED TO
BUILD DATA SYSTEMS THAT ALLOW US
TO IMPROVE OUR MODELS AND TO
ADDRESS THESE WEALTH OF ISSUES
THAT YOU'VE RAISED.
THANK YOU VERY MUCH.
AGAIN, YOU EXCEEDED MY
EXPECTATIONS, I'M SORRY WE
DIDN'T HAVE MORE TIME TO ALLOW
YOU TO ELABORATE FURTHER.
IN THE WORKSHOP PAPERS THERE
WILL BE ANOTHER OPPORTUNITY TO
CRYSTALLIZE AND MAKE SURE THAT
WE'RE CLEAR ABOUT WHAT WE THINK
THE RESEARCH FUTURE SHOULD HOLD
AND WHY THAT'S SO IMPORTANT.
AGAIN, I WANT TO THANK YOU VERY,
VERY MUCH.
WE'RE GOING TO TAKE A TEN-MINUTE
BREAK, COME BAG AT 3:40 FOR THE
SIMULATION EXERCISE, GIVE US
ANOTHER CHANCE TO EXPLORE THE
COMPLEXITY OF THE SITUATION.
ALSO SHOW WHAT THE MODELS
SUGGEST ABOUT SOME OF THE
INTERVENTIONS THAT WOULD HAVE
THE GREATEST IMPACT.
ALSO THE DIVERSITY, TO ALLOW US
TO -- EACH OF US TO MAKE CHOICES
WHERE WE THINK WE SHOULD PUT
ACTION AND SEE WHAT HAPPENS.
SO PLEASE COME BACK IN TEN
MINUTES, AT 3:40.
AND THANK YOU VERY MUCH FOR A
GREAT AFTERNOON SO FAR.
>> THANK YOU FOR JOINING THIS
SESSION, AGAIN.
I'M REALLY EXCITED TO INTRODUCE
DR. JASON JAY TO TAKE US THROUGH
THIS SIMULATION EXERCISE WHICH
IS I THINK TRANSFORMATIVE IN ITS
OWN WAY BECAUSE IT EXPOSES US TO
THE TYPES OF THINKING WE'VE BEEN
TALKING ABOUT THIS MORNING AND
AFTERNOON.
DR. JAY IS SENIOR LECTURER AND
DIRECTOR M.I.T. SLOAN
SUSTAINABILITY INITIATIVE, ONE
OF JASON'S STUDENTS MYSELF I CAN
TELL YOU HE'S NOT ONLY A
BRILLIANT ORATOR BUT SUPERB
THINKER, TEACHES MASTER'S LEVEL
COURSES, HELPED SECURE M.I.T.'S
SLOAN POSITION, PUBLICATION ALSO
APPEARED IN CALIFORNIA
MANAGEMENT REVIEW, M.I.T. SLOAN
MANAGEMENT REVIEW, STANFORD,
WORLD ECONOMIC FORUM, I'VE READ
HIS BOOK, I HIGHLY RECOMMEND IT,
THE AUTHOR OF THE INTERNATIONAL
BESTSELLER, "BREAKING THROUGH
GRIDLOCK," A FACILITATOR FOR
BUSINESSES SUPPORTING
HIGH-QUALITY CONVERSATION AND
SHARED COMPLIMENT TO AMBITIOUS
SUSTAINABILITY GOALS.
I'M GOING TO TURN THIS OVER, YOU
MIGHT NOTICE A LINK POSTED IN
THE CHAT WHICH I WOULD HAVE YOU
CLICK TO PARTICIPATE IN THE
POLLING.
THANKS AGAIN, JASON.
>> THANK YOU FOR HAVING ME,
SANJAY.
THE FIRST IMPORTANT CAVEAT IS
THAT THE DOCTOR BEFORE MY NAME
IS A Ph.D. IN ORGANIZATIONAL
STUDIES.
AND I'M NOT A MEDICAL DOCTOR.
MY WIFE IS A PHYSICIAN AT MASS
GENERAL IN GENERAL MEDICINE, DR.
RAY, I'M ALSO NOT A CLIMATE
SCIENTIST, OR ENVIRONMENTAL
SCIENTIST AS MANY OF YOU ARE.
SO I WANT AT ANY POINT IN THIS
TO CHALLENGE, RAISE QUESTIONS,
YOU CAN DO THAT THROUGH THE
CHAT, THROUGH THE Q&A FUNCTION,
YOU CAN DO THAT BY WAVING AT ME
ON THE VIDEO FOR THOSE WHO ARE
ON THE PANEL HERE.
I HAVE A SCREEN WHERE I CAN SEE
ALL OF THAT.
I'VE GOT MY CONTENT OVER HERE.
WHAT WE'RE GOING TO DO IS
EXPLORE PART OF THIS TOPIC OF
PLANETARY HEALTH.
THE SECOND CAVEAT BESIDES MY
DOCTORHOOD IS THE CAVEAT ABOUT
CLIMATE VERSUS PLANETARY HEALTH.
SO, THE SCOPE FOR WHAT WE'RE
GOING TO DO NOW FOR THIS NEXT
HOUR AND CHANGE IS REALLY
FOCUSED ON CLIMATE CHANGE.
I THINK THIS IS A REALLY
IMPORTANT POINT MADE THROUGHOUT
THE DAY, A SET OF PLANETARY
BOUNDARIES HUMANS ARE CROSSING
WHICH A VARIETY OF HEALTH
IMPACTS RELATED TO THAT.
WE'VE GOING TO ZOOM IN ON REALLY
NARROWLY LOOKING AT CLIMATE
IMPACTS BUT AS ANY OF YOU KNOW
WHO WORK IN THIS FIELD CLIMATE
IS COMPLEX.
THIS IS FROM THE W.H.O.
CLIMATE CHANGE CREATES HEALTH
RISKS, WHICH THEN CREATES HEALTH
OUTCOMES, BUT THOSE HEALTH
OUTCOMES ARE MEDIATED VERY MUCH
BY VULNERABILITY FACTORS, EQUITY
CONSIDERATIONS THAT HAVE TO DO
WITH GENDER, SOCIOECONOMIC
DIFFERENCES, MARGINALIZED AND
UNDERREPRESENTED GROUPS.
THERE'S NOT AN EASY TRANSLATION
FROM CLIMATE IMPACTS TO DIRECT
HEALTH OUTCOMES BUT I WANT US TO
BE CONNECTING THE DOTS AS WE GO
TOGETHER TODAY.
WHAT WE'RE GOING TO DO IS
UNDERSTAND THE CLIMATE CHANGE
IMPACTS AND THE POSITIVE IMPACTS
WE CAN HAVE TRYING TO MITIGATE
SOME OF THESE EFFECTS.
SO, THE WAY I THINK ABOUT THE
PROBLEM WE'RE TRYING TO SOLVE IS
REALLY DEPICTED BY THIS PICTURE
WHICH IS MAYBE FAMILIAR TO SOME
OF YOU WHO HAVE BEEN WORKING
THIS SPACE.
THIS COMES FROM IPCC SPECIAL
REPORT, 2019, AND THE Y-AXIS
HERE IS MEASURED IN DEGREES
ABOVE PRE-INDUSTRIAL LEVELS, SO
WE'VE WARMED THE PLANET ABOUT
1.1 TO 1.2 DEGREES ALREADY.
AND AS A RESULT WE'RE ALREADY
SEEING THE EFFECTS OF CLIMATE
CHANGE, DETECTABLE IMPACTS AND
RISKS ON THESE -- THIS WAS A
GRAPH OF TERRESTRIAL INDICATORS
OF CLIMATE IMPACT SO DRY LAND
WATER SCARCITY, SOIL EROSION,
WILDFIRE DAMAGE, TROPICAL CROP
YIELD DECLINE, FLOOD SUPPLY
INSTABILITY THAT RESULT FROM
THAT, WE'RE SEEING THESE EFFECTS
BUT IF WE KEEP GOING IN THE
DIRECTION WE'RE GOING THE
BUSINESS AS USUAL FORECASTS ARE
THAT WE END UP IN A WORLD 3 TO 5
DEGREES WARMER ABOVE
PRE-INDUSTRIAL LEVELS.
IN THAT SITUATION WE ENTER INTO
THIS ZONE THAT EVEN WITH ALL OF
THE MASSAGING AND CONSENSUS
BUILDING PROCESS IN THE IPCC YOU
END UP WITH A LANGUAGE OF VERY
HIGH RISK OF SEVERE IRREVERSIBLE
IMPACT WITH LIMITED ABILITY TO
ADAPT.
AND SO THE KEY PROBLEM WE'RE
TRYING TO SOLVE IN TERMS OF A
GAP BETWEEN CURRENT STATE AND
GOAL STATE THE CURRENT STATE
WE'RE LIVING INTO A FUTURE
THREE-SOMETHING EVEN MORE
DEGREES ABOVE PRE-INDUSTRIAL
LEVELS AND WANT TO GET THAT DOWN
TO A SAFER LEVEL.
YOU CAN SEE WHY SO MANY
CONVERSATIONS CENTER AROUND THIS
FIGURE OF 1.5 DEGREES CELSIUS,
SOME RISKS ARE SIGNIFICANT, WE
CAN STILL HANDLE AND ADAPT,
MANAGE THEM.
SO THE QUESTION IS HOW ARE WE
GOING TO GET THERE?
THE SECOND CHALLENGE THAT WE
HAVE, THE SECOND PROBLEM WE HAVE
IN CLIMATE COMMUNICATION IS
SOMETHING THAT MY COLLEAGUE IS
FOND OF POINTING OUT, JOHN
STIRMAN, SHOWING PEOPLE RESEARCH
DOESN'T WORK.
THAT'S A HARD THING TO SAY AFTER
A DAY OF PEOPLE PRESENTING
RESEARCH TO EACH OTHER BUT WE'RE
A WONKY CROWD.
WHAT THIS IS ABOUT IS THAT IF I
SHOW ANY GROUP OF POLICYMAKERS
AND DECISION MAKERS OTHER
CITIZENS A SORT OF PARADE OF
CONSEQUENCES IN THE FORM OF
POWERPOINT DECK, IT'S UNLIKELY
TO BUILD AN UNDERSTANDING OF THE
ISSUE, IN A RICH COMPLEX
EMBODIED WAY, OR A WILLINGNESS
TO TAKE ACTION.
AND SO WE HAVE TO DO SOMETHING
DIFFERENT.
WE HAVE TO MAKE THIS AN
INTERACTIVE EXPLORATION WHERE WE
CAN BUILD AN UNDERSTANDING FOR
YOURSELVES, OURSELVES, ABOUT THE
CLIMATE CHALLENGE.
AND THAT'S WHAT WE'RE GOING TO
DO.
THE FIRST POINT OF
INTERACTIVITY, THE MECHANISM FOR
ME TO ENGAGE NOT JUST THE 21
PEOPLE ON THE PANEL BUT
ADDITIONAL 36 ATTENDEES AND EVEN
ADDITIONAL FOLKS WHO MIGHT BE
WATCHING OVER LIVE STREAMING,
EVEN YOU CAN PARTICIPATE IN
THIS.
I'M GOING TO USE A POLL
EVERYWHERE TOOL, AND WHAT THIS
DOES IS ALLOWS ME TO POSE A
QUESTION TO YOU, AND FOR YOU TO
ANSWER THAT QUESTION AND FOR
YOUR ANSWER TO SHOW UP REAL TIME
ON THE SCREEN.
SO, WE POSTED THE LINK IN THE
CHAT EARLIER, I'LL POST IT ONE
MORE TIME HERE FOR THOSE WHO
HAVE ACCESS TO THE CHAT.
IF YOU HAVE A PHONE, YOU CAN
HOLD YOUR CAMERA TO THE SCREEN
AND GRAB THE QR CODE OR TYPE
THIS INTO A BROWSER.
KEEP THAT OPEN ON YOUR PHONE OR
ANOTHER WINDOW ON THE COMPUTER
SO AS I ASK DIFFERENT QUESTIONS,
YOUR ANSWERS WILL POP UP ON THE
SCREEN.
FIRST QUESTION I'VE ASKED HERE
IS JUST A WARMUP.
WHAT CITY ARE YOU FROM?
SO WE'VE GOT A NICE RANGE OF
FOLKS FROM BOZEMAN TO MIAMI,
BOSTON, PALO ALTO, ALL THE
CORNERS OF THE UNITED STATES.
EXCELLENT.
IN A COUPLE POLLS, I WILL SAY
ANSWER WITH ONE WORD OR A
HYPHENATED NAME.
THE REASON IS SO THAT THE WORDS
STAY TOGETHER IN THIS WORD
CLOUD.
PALO ALTO STAYED TOGETHER
BECAUSE OF THE HYPHEN, NEW
ORLEANS GOT SPLIT UP.
THAT'S JUST GETTING THE
TECHNOLOGY RUNNING.
HERE IS THE REAL QUESTION.
MY REAL QUESTION IS HOW ARE WE
GOING TO SOLVE THE CLIMATE
CHALLENGE?
WHAT ACTIONS WILL HELP US LIMIT
WARMING TO NO MORE THAN 1. 1.5
DEGREES, MOVING THAT, WHAT IS IT
THAT'S GOING TO ALLOW US TO DO
IT?
TECHNOLOGY, COLLECTIVE ACTION,
THIS COULD BE ANYTHING THAT
YOU'VE HEARD ABOUT, A PARTICULAR
TECHNOLOGY, PARTICULAR POLICY,
PARTICULAR IDEA FOR HOW TO
TACKLE THE CLIMATE CHALLENGE.
AND YOU CAN ANSWER MORE THAN
ONCE.
AND WE CAN HAVE A FEW DIFFERENT
IDEAS POPPING UP HERE.
I'VE SEEN NO MEAT IN DIETS,
REDUCED EMISSIONS, EDUCATION,
COLLECTIVE ACTION.
AGAIN, IF YOUR ANSWER IS
SOMETHING THAT'S MULTIPLE WORDS
PLEASE PUT A HYPHEN CONNECTING
THEM SO THE TOOL CAN KEEP THEM
TOGETHER.
WE'VE GOT A A FEW KINDS OF
IDEAS.
CLEAN TECHNICALLY, ELECTRICITY,
INTENTIONAL BEHAVIORS, FEELING
THE CONSEQUENCES, THAT'S WHAT'S
GOING TO WAKE PEOPLE UP AND
WE'LL TAKE ACTION.
SYSTEMS THINKING, SUE THE FOSSIL
FUEL COMPANIES, REDUCE MEAT.
THIS IS GREAT.
I WANT TO GET THESE IDEAS OUT
HERE INTO THE PICTURE.
NOW, WHAT I WANT TO ALSO POINT
OUT IS THAT PUT YOURSELF IN THE
SHOES OF A TOP DECISION MAKER,
SOMEBODY WHO MIGHT BE A STATE
GOVERNOR, OR HEAD OF A MAJOR
HOSPITAL, OR CEO OF A MAJOR
CORPORATION OR INVESTOR WHO IS
PLACING CAPITAL WITH NEW
TECHNOLOGIES.
AND OR CIVIL SOCIETY LEADER,
HEAD OF NGO.
YOU ASK THE QUESTION, YOU KNOW,
HOW ARE WE GOING TO SOLVE
CLIMATE CHANGE?
THIS IS THE ANSWER THAT YOU GET,
WHICH IS A WHOLE ARRAY OF
DIFFERENT POSSIBILITIES.
AND THE REALITY OF TOP DECISION
MAKERS IS THAT YOU ONLY HAVE SO
MUCH BANDWIDTH FOR ATTENTION,
RIGHT?
YOU'RE WORRIED ABOUT THE WAR IN
ISRAEL AND PALESTINE, UKRAINE,
INFLATION, YOU KNOW, EQUITABLE
ACCESS TO HEALTH CARE, AND
THERE'S A VARIETY OF ISSUES
BEFORE YOU HAVE ATTENTION TO
THINK TO THINK ABOUT THE
ENVIRONMENT WITHIN WHICH YOU'RE
WORRIED ABOUT THINGS WE HEARD
ABOUT, HEAVY METALS, WATER
POLLUTION, AIR POLLUTION, THIS
MUCH INTENTIONAL BANDWIDTH TO
THINK ABOUT CLIMATE.
WITHIN THAT THIS IS THE ANSWER
YOU GET OF ALL THE DIFFERENT
POSSIBLE WAYS WE COULD GO ABOUT
TRYING TO SOLVE CLIMATE CHANGE.
IT IS THAT -- IT IS THE ABILITY
AND HOPE WE MIGHT BE ABLE TO
UNTANGLE SOME OF THIS VARIETY
AND COMPLEXITY AND UNDERSTAND
WHAT ACTIONS, HIGH LEVERAGE, LOW
LEVERAGE, THAT SPURRED THE KIND
OF INQUIRY THAT WE'RE IN AT MIT
SLOAN AND YOU'RE NOW PART OF.
EARLIER TODAY WE HAD A GREAT
PRESENTATION THAT TOUCHED ON
SYSTEM DYNAMICS CONCEPTS, WHICH
IS ABOUT STOCKS AND FLOWS,
FEEDBACK LOOPS.
AND THAT IS VERY MUCH KIND OF
THE UNDERLYING DISCIPLINE WE USE
HERE TO BUILD AND INTERACTIVE
SIMULATION TOOL CALLED EN-ROADS
WHICH WE'RE GOING TO USE AS A
PLACE TO RUN EXPERIMENTS AND TRY
TO UNDERSTAND HOW THESE
DIFFERENT LEVERS MIGHT INTERACT
WITH ONE ANOTHER.
THIS IS THE TOOL.
WE HINTED WITH SOME TEASER
SLIDE.
THIS IS A TOOL THAT WILL IS
GETTING TO BE WIDELY USED WITH
POLICYMAKERS AND MORE BROADLY.
SO ABOUT 6500 LEADERS ACROSS
GOVERNMENT, BUSINESS, NGOs,
ACADEMIA USED THIS EN-ROADS
TOOL.
WE'RE KEEPING THE TALLIES.
WE HAVE TESTIMONIALS FROM
DEMOCRATS, REPUBLICANS, AND
PEOPLE AROUND THE WORLD.
WE'VE BUILT A NETWORK OF
FACILITATORS, EN-ROADS
AMBASSADORS, WHO ARE ENGAGING IN
EVENTS ALL AROUND THE WORLD.
WE'VE PASSED THE 200,000 MARK IN
TERMS OF PEOPLE WHO PARTICIPATED
IN THIS, IN 7,000 EVENTS, 139
COUNTRIES.
WHAT WE'RE TRYING TO DO IS SPUR
A GLOBAL CONVERSATION ABOUT WHAT
MIGHT REALLY WORK.
SO, WE'RE GOING TO TEST YOUR
IDEAS ON THE EN-ROADS TOOL.
SO FIRST I'M GOING TO GIVE YOU A
LITTLE TOUR AND BACKDROP.
THIS RUNS ON A SYSTEM DYNAMICS
MODEL.
SO THERE'S THOUSANDS OF
EQUATIONS BEHIND THE SCENES
HERE.
BUT IT BEHAVES THE SAME AS THE
BIG SUPERCOMPUTER MODELS, SO IF
WE LOOK AT ANY GRAPHS OF
HISTORICAL -- IT'S BEEN
CALIBRATED FROM HISTORICAL DATA.
WE CAN LOOK AT THE HISTORY OF
THE TEMPERATURE MODEL VERSUS
ACTUAL, WE COULD LOOK AT HISTORY
OF COST OF SOLAR ELECTRICITY,
ACTUAL VERSUS MODELED SO YOU CAN
GET A SENSE OF THE THINGS WE
CALIBRATE TO, HISTORY OF
GREENHOUSE GAS EMISSIONS, SO ON.
THIS IS DESIGNED TO PRODUCE
REALITY UP THROUGH 2022, AND
THERE'S REAL DATA IN THE SYSTEM
THROUGH 2022.
BUT IT BEHAVES THE SAME, IT'S
CALIBRATED TO BEHAVE AS THE BIG
SUPERCOMPUTER MODELS BUT RUNS
INSTANTLY ON ANY BROWSER FOR
ANYBODY, IT'S FREELY AVAILABLE.
AND SO I APPRECIATE WHAT WAS
SHARED IN THE CHAT, A LINK TO
THE TOOL TO PLAY WITH IT ON YOUR
OWN TIME.
A HUGE CAVEAT ABOUT EN-ROADS FOR
THIS CROWD, IT IS GLOBALLY
AGGREGATED.
WHAT THAT MEANS IS ALMOST ALL
THE GRAPHS THAT WE'RE GOING TO
BE LOOKING AT ARE GRAPHS FOR THE
WHOLE WORLD, AND WHEN WE TAKE
ACTION, WHEN WE PULL THE LEVERS,
RUN AN EXPERIMENT, WE'RE GETTING
TO PLAY AN ALL-POWERFUL BEING
THAT IS ABLE TO MAKE THAT CHANGE
HAPPEN AT A GLOBAL SCALE.
AND THAT ALLOWS US TO UNDERSTAND
IN A BIG PICTURE LEVEL WHERE ARE
THE BIG LEVERS FOR CHANGE ON
CLIMATE.
BUT THE HUGE LIMITATION OF THAT
IS THAT ALL OF THE DIVERSITY AND
VARIETY AND NUANCE OF WHAT
HAPPENS AT THE NATIONAL SCALE,
STATE SCALE, URBAN SCALE, WHICH
HAS BEEN A HUGE EMPHASIS OF
TODAY'S DISCUSSIONS, IS BLURRED
OUT.
AND SO WE'RE GOING TO HAVE TO
GRAPPLE WITH THAT AS WE GET INTO
ANY CONVERSATION ABOUT IT.
BUT WE'VE FOUND THAT THIS KIND
OF GLOBAL LEVEL SETTING IS A
REALLY IMPORTANT PART OF
UPGRADING THE QUALITY OF
CONVERSATION ABOUT CLIMATE.
SO, ON THE GRAPH HERE IS
MEASURED IN -- ON THE LEFT HERE
IS OUR SOURCES OF ENERGY,
MEASURED IN EXIT JULES PER YEAR,
ALL THE ENERGY THAT HUMANS USE,
COAL, OIL, GAS, RENEWABLE ENERGY
WHICH IS MODELED SEPARATELY
UNDER THE HOOD, SOLAR, WIND,
GEOTHERMAL, HYDRO.
AND THEN -- HYDROPOWER.
BIOENERGY HERE.
THERE'S THE BAND OF NUCLEAR
ENERGY, THIS TEAL BAND AT THE
TOP.
NEW RADICAL ZERO EMISSIONS
TECHNOLOGY, LIKE NUCLEAR FUSION,
NOT YET ON THE PICTURE BUT WE
COULD GET THERE IF WE RUN THAT
EXPERIMENT.
ON THE RIGHT IS THE STACK OF
GREENHOUSE GASES THAT ARE
RELATED BUT NOT COMPLETELY TO
THAT ENERGY SYSTEM.
SO YOU HAVE THIS GREEN BAND OF
LAND USE EMISSION, THIS IS FROM
DEFORESTATION, LOSS OF PEAT LAND
AND CARBON SINKS.
THE GRAY BAND IS CO2 FROM
BURNING FOSSIL FUELS, WHICH IS
IN 2022, LET'S SEE, 35 GIGATONS,
35 BILLION TONS FROM THAT.
THE ORANGE BAND IS FLUORINATED
BANDS USED IN INDUSTRIAL
PROCESSES.
THIS LIGHT BLUE IS METHANE, AND
THIS DARK BLUE IS NITROUS OXIDE.
THESE GASES AND THEIR FATE AND
TRANSPORT AND LIFETIME IN THE
ATMOSPHERE ARE MODELED
SEPARATELY, DIFFERENT RESIDENCE
TIMES, DIFFERENT IMPACTS ON
CLIMATE BUT WE PUT THEM ON ONE
YEAR, 100-YEAR CO2 EQUIVALENCE
UNITS TO VISUALLY UNDERSTAND HOW
THAT STACKS UP.
AND THEN THIS STACK OF
GREENHOUSE GAS EMISSIONS,
ANOTHER WAY TO THINK ABOUT THIS
IS -- I'LL CHANGE THE CAUSALITY,
THE SEQUENCE OF CAUSALITY HERE,
IS THAT THIS GREENHOUSE GAS
EMISSIONS IS KIND OF LIKE THE
FAUCET IN THE BATHTUB OF THE
PLANET'S ATMOSPHERE.
EVERY YEAR WE'RE PUTTING MORE
GREENHOUSE GASES INTO THE
ATMOSPHERE.
AS A RESULT, THE CONCENTRATION,
THE WATER IN THE TUB, IS RISING
AND 2022, 450 PARTS PER MILL,
HEADED TO 800 BY THE END OF THE
SEVEN SENT -- CENTURY, THAT
HOLDS IN THE HEAT THAT WOULD
OTHERWISE RADIATE OUT, MAKING
THE PLANET WARMER SO BY 2100
WE'VE WARMED THE PLANET 3.4
DEGREES CELSIUS IN THE BASELINE
SCENARIO.
THIS IS AN AMERICAN CROWD,
YOU'RE ORIENTED TO FAHRENHEIT, 6
DEGREES FAHRENHEIT ABOVE
PRE-INDUSTRIAL LEVELS.
AND WITH THAT LEVEL OF WARMING
COMES A WHOLE SUITE OF IMPACTS
THAT YOU, YOU KNOW, MAY HAVE
HEARD ABOUT, AND MAY BE
CONCERNED ABOUT.
SO, WE SEE SEA LEVEL RISE, ABOUT
374 MILLION PEOPLE AT RISK TO
ANNUAL FLOODING, 217 LIVING
BELOW THE HIGH TIDE LINE,
FLOODING IS ON A DAY-TO-DAY
BASIS.
WE'LL SEE DECREASES IN CROP
YIELDS, FOOD SECURITY AND EQUITY
AND ACCESS TO FOODS WE'VE TALKED
ABOUT.
MAZE, WHEAT, RICE, SOYBEANS,
CORNERSTONES OF THE GLOBAL
SYSTEM AND AGRICULTURE,
SIGNIFICANT DROPS IN YIELD WHICH
HAS IMPACT ON FOOD SECURITY.
IT MEANS THAT WE'LL SEE
ADDITIONAL DEATHS FROM EXTREME
HEAT IN A VARIETY OF REGIONS.
SUB-SAHARAN AFRICA AND MIDDLE
EAST ARE NOT HERE BECAUSE DATA
IS INSUFFICIENT.
AND MODELS HASN'T BEEN
SUFFICIENT TO GET THOSE NUMBERS.
YOU CAN SEE THERE ARE CERTAIN
GLOBAL HOT SPOTS WHERE WE
ANTICIPATE ADDITIONAL DEATHS
FROM EXTREME HEAT.
AND THE FREQUENCY OF THOSE
EXTREME HEAT EVENTS RIGHT NOW
VERY EXTREME HEAT EVENTS LIKE
HEAT DOME IN THE PACIFIC
NORTHWEST, LIKELY OCCUR ABOUT
SEVEN YEARS OUT OF 50, WE'RE
HEADING TOWARD A SCENARIO 3.3
WHERE IT'S 29 YEARS OUT OF 50 WE
SEE VERY EXTREME HEAT EVENTS
WHICH AS WE KNOW HAVE SOME VERY
IMPORTANT HEALTH EFFECTS.
THEN THIS AMOUNT OF ENERGY,
FOSSIL FUEL COMBUSTION, IS
RELATED TO AIR POLLUTION AS WE
HEARD IN SOME EARLIER
PRESENTATIONS TODAY.
THE PM2.5 AIR POLLUTION WHICH
HAS IMPORTANT CARDIOVASCULAR AND
NEUROLOGICAL IMPACTS IS ON THE
RISE, AS YOU'RE BURNING THIS
AMOUNT OF FOSSIL FUEL.
SO THAT'S A TOUR.
AND THEN LEVERS WE CAN PULL TO
AFFECT THESE OUTCOMES ARE DOWN
HERE.
WE CAN PLAY WITH ENERGY SUPPLY
LEVERS THAT CHANGE THE MIX OF
ENERGY ON THE GRID, AND THAT WE
USE TO PRODUCE PRIMARY ENERGY.
THIS BASKET IS ABOUT ENERGY USE.
SO IN TRANSPORTATION AND
BUILDINGS, WE HAVE OPPORTUNITIES
TO BE MORE EFFICIENT OR TO
ELECTRIFY OUR FORMS OF ENERGY
UTILIZATION.
AND THOSE ARE IN TURN UNDERNEATH
DRIVEN BY POPULATION ECONOMIC
GROWTH WHICH IN OUR SCENARIO IS
JUST USED AS A U.N. MEDIAN
FORECAST OF POPULATION, AND
WORLD BANK ASSUMPTION ABOUT THE
FUTURE ECONOMIC GROWTH THAT
DRIVE THOSE.
AND THEN THE THIRD BASKET HERE
ARE THE NON-ENERGY-RELATED
ASPECTS OF ANTHROPOGENIC IMPACT
ON THE CLIMATE WHICH IS ABILITY
TO CHANGE PATTERN OF
DEFORESTATION, TO PLANT NEW
TREES, TO AFFECT METHANE AND
OTHER NON-CO2 GREENHOUSE GASES
AND TO USE TECHNOLOGIES TO DO
CARBON REMOVAL, TO REMOVE CARBON
FROM THE ATMOSPHERE, AND THERE'S
A BUNCH OF DETAILED SETTINGS
WHERE WE CAN PLAY WITH SPECIFIC
TECHNOLOGIES THAT MIGHT COME UP
OR MIGHT BE OF INTEREST TO YOU
ALL.
SO, THAT'S KIND OF THE TOUR.
NOW WHAT I'M GOING TO DO IS GO
TO YOUR SUGGESTIONS HERE ABOUT
WHAT CAN WE DO TO TRY TO TACKLE
THIS ISSUE.
AND SO, I'M GOING TO JUST KIND
OF GRAB A FEW.
EDUCATION, THERE'S A COUPLE
THINGS HERE WHICH I CALL META
SOLUTIONS, MEANING THAT
EDUCATION, MASS MOBILIZATION OF
POLITICAL ADVOCACY,
UNDERSTANDING, SYSTEMS THINKING,
I WANT TO CALL ALL OF THOSE
INTENTIONAL BEHAVIORS, I'LL CALL
THOSE META SOLUTIONS, WHICH IS
THE WAY WE CAN USE
SOCIAL/POLITICAL ORGANIZING AND
POWER TO ACTUALLY PULL THESE
LEVERS.
WE'LL COME BACK TO THAT LATER.
FOR NOW WHAT I WANT TO DO IS
LOOK AT SOME KIND OF TECHNO
ECONOMIC LEVERS THAT ARE
AVAILABLE TO US, AND WHICH HAVE
BEEN MENTIONED HERE.
SO, I'M GOING TO SORT OF GRAB A
COUPLE THAT STAND OUT FOR ME.
NUCLEAR IS HERE.
FUSION IS HERE.
I DON'T KNOW IF THAT WAS THE
SAME PERSON WHO SAID NUCLEAR
FUSION OR IF TWO PEOPLE SAID
NUCLEAR AND FUSION.
LET'S GO AHEAD AND PLAY WITH
THOSE.
I PARTICULARLY LIKE THAT LEVER
BECAUSE THAT WAS ONE OF THE
ORIGINAL MOTIVATIONS FOR WHY
CLIMATE INTERACTIVE BUILT
EN-ROADS WAS THAT BILL GATES
WHEN HE WAS GETTING INVOLVED IN
CLIMATE INVESTING SAID WE JUST
NEED TO INVENT NUCLEAR FUSION
AND WE'LL SOLVE THE CLIMATE
CRISIS, HIS FIRM IS BREAKTHROUGH
ENERGY VENTURES.
WE HAD A SYSTEMS INTUITION THAT
WASN'T THE CASE, BUT WE WANTED
TO TEST IT OUT.
SO THE MODEL, THAT WAS ONE OF
THE ORIGIN STORIES FOR THE
MODEL.
LET'S SEE WHAT HAPPENS IF WE
INCREASE AMOUNT OF NUCLEAR
ENERGY AND SEPARATELY DO WHAT
HAPPENS IF WE INVENT NUCLEAR
FUSION, A NEW ZERO CARBON SOURCE
OF ENERGY.
SO, FIRST LET'S DO THE
EXPERIMENT OF NUCLEAR ENERGY.
AND THE WAY I'M GOING TO DO AN
EXPERIMENT IS THAT I'M GOING TO
SAY, ALL RIGHT, I'M GOING TO
CLICK AGGRESSIVE GLOBAL SUBSIDY
ON NUCLEAR ENERGY.
I WANT YOU AS AN ACTIVE LEARNER
TO MAKE A HYPOTHESIS IN YOUR
MIND ABOUT HOW BIG A CHANGE
THAT'S GOING TO BE.
THE MORE MENTALLY ACTIVE YOU ARE
IN THE EXPERIMENTATION PROCESS,
THE MORE YOU'LL LEARN FROM THE
EXERCISE.
IN FACT, I'M GOING TO MAKE YOU
TAKE A STAND ON THIS.
AND I'M GOING TO POSE ANOTHER
POLL QUESTION HERE.
IF I DO A GLOBAL SUBSIDY ON
NUCLEAR ENERGY, WHAT IS GOING TO
BE THE IMPACT ON TEMPERATURE?
AND SO THIS QUESTION WILL NOW BE
AVAILABLE ON YOUR POLL
EVERYWHERE ON YOUR BROWSER TAB
OPEN TO ANSWER THE PREVIOUS
QUESTION.
WHAT WILL BE THE TEMPERATURE
CHANGE?
I'M GOING TO HIDE THE RESULTS
FOR A SECOND SO YOU DON'T BIAS
EACH OTHER IN THE BEGINNING AND
WATCH THE RESPONDENT COUNT RACK
UP, NO CHANGE, HELP AND COOL THE
PLANET .1 TO .5 DEGREES OR MORE,
OR SOME COUNTERINTUITIVE EFFECTS
THAT MAYBE INCREASE TEMPERATURE
AS A RESULT?
LET'S TAKE A LOOK AT YOUR
RESPONSES HERE.
OKAY.
SO THE MAJORITY OF YOU SAY .1 TO
.5 DEGREES OF IMPROVEMENT, WITH
A FEW OF YOU BEING MORE
OPTIMISTIC.
AND I WILL SAY WHEN WE ENGAGE
WITH REPUBLICAN POLITICAL
LEADERS AND AUDIENCES, NUCLEAR
IS OFTEN THE FIRST EXPERIMENT
THEY WANT TO TRY.
AND SO IT'S ONE WE ALWAYS LIKE
TO RUN.
SO LET'S SEE WHAT THE RESULTS
ARE.
OKAY.
SO THAT'S A 7-CENT PER KILOWATT
HOUR GLOBAL SUBSIDY ON NUCLEAR
ENERGY.
FIRST QUESTION TO ASK WITH AN
EXPERIMENT LIKE THIS, DID IT
WORK IN THE SENSE DID IT PRODUCE
THE OUTCOME WE THOUGHT IT WAS
GOING TO PRODUCE IN THE
NARROWEST SENSE?
AND WHAT WE'RE DOING IS GOING
FROM 14 OR 15 EXIT JULES OF
ENERGY FROM NUCLEAR TO 95, WE'RE
MULTIPLYING BY FACTOR OF MORE
THAN SIX.
SUBSIDY WORKS IN THAT SENSE, AND
WHAT YOU CAN SEE AS THAT BAND OF
NUCLEAR EXPANDS, IT IS REDUCING
THE GAS AND COAL THAT WE'RE
BURNING TO PRODUCE ELECTRICITY.
IT'S POSSIBLE THAT A FEW OF YOU
WERE THINKING ABOUT THIS MORE AT
THE UPPER END, .5, A DEGREE OR
MORE.
SO, WE NEED ASK THE QUESTION
WELL, WHY DON'T WE SEE A BIGGER
CHANGE IN THE TEMPERATURE
PICTURE FROM THE MASSIVE
INVESTMENT IN NUCLEAR ENERGY?
WHAT DO WE THINK IS GOING ON?
IF YOU WANT TO SHARE ANY LIKE --
WHEN HE POSE A QUESTION LIKE
THAT I WOULD LOVE TO HEAR YOUR
THOUGHTS ABOUT WHY THAT'S THE
CASE.
SHARE THOSE VIA THE CHAT OR
THROUGH THE Q&A IF YOU HAVE
ACCESS TO THE Q&A.
OR IF SOMEONE WANTS TO UNMUTE,
WHAT'S GOING ON HERE, WHY DON'T
WE SEE A BIGGER CHANGE FROM THIS
INTERVENTION?
BRIAN SAYS REPLACING NUCLEAR
WITH RENEWABLES, RENEWABLES
DECREASE.
THANK YOU ON THE Q&A.
THAT'S EXACTLY RIGHT.
WHEN WE LOOK AT WHAT IS
DECREASING WHEN WE INCREASE
NUCLEAR, YES, IT IS SUBSTITUTING
A WAY FOR SOME FOSSIL FUELS, BUT
ALSO SHRINKING THE AMOUNT OF
RENEWABLE ENERGY BECAUSE WE'RE
CHANGING THE COST STRUCTURE,
CHANGING ON THE MARGIN THE
DECISION THAT A POWER PLANT
BUILDER, ELECTRIC UTILITY, IS
GOING TO MAKE.
SO WE'RE TRADING ONE FORM OF
GREEN ENERGY FOR ANOTHER, AND
NUCLEAR GREEN OR NOT, IT'S LOW
CARBON, WE'RE TRANSFERRING ONE
FORM OF LOW CARBON ENERGY FOR
ANOTHER.
THAT IS DAMPENING EFFECT.
THE OTHER THING THAT PEOPLE WILL
NOTICE IS IT WAS VERY SMALL.
YES, WE'RE ENDING UP WITH SIX
TIMES BIGGER BUT STILL ONLY
PROVIDING RELATIVELY SMALL
PERCENTAGE OF THE GLOBAL ENERGY
NEEDS OF THAT SCALE.
ALSO, THE FINAL THING IS THAT
NUCLEAR ENERGY TAKES A LONG TIME
TO BUILD.
YOU HAVE TO GET THE LAND,
OVERCOME ALL KINDS OF NIMBY
OPPOSITION, PLANS ARE COMPLEX.
THERE'S A RAMP-UP PERIOD TO GET
TO THAT LEVEL, AND YOU'RE
CONTINUING TO BURN COAL, OIL,
AND GAS.
LET'S TRY THE OTHER EXPERIMENT
WHICH IS KIND OF IN A WAY
SIMILAR, A NUCLEAR FUSION.
THIS REQUIRES A BIG
TECHNOLOGICAL BREAK THROUGH
BECAUSE WE DON'T HAVE IT YET.
THERE IS COMMONWEALTH FUSION IN
THE BACK YARD IN MASSACHUSETTS
WORKING ON THIS.
NOBODY HAS PRODUCED A TRULY NET
POSITIVE FUSION REACTION.
LET'S SAY WE HAVE A BIG
BREAKTHROUGH.
I LOVE TECHNOLOGY.
I THINK THIS HAS GREAT POTENTIAL
BUT LET'S SAY WE GET A
BREAKTHROUGH IN NEW ZERO CARBON
TECHNOLOGY, CHEAPER THAN COAL,
NEW EMISSION, LESS RADIATION
CONCERNS THAN REGULAR NUCLEAR,
LET'S SEE WHAT HAPPENS IF WE GET
THAT BREAKTHROUGH.
I'M NOT GOING TO DO THE POLL BUT
I WANT YOU TO DO THE MENTAL
PREDICTION ABOUT HOW BIG A
CHANGE WE'RE GOING TO SEE FROM
THAT.
OKAY.
SO, THERE IS OUR NUCLEAR FUSION.
WE'VE ADDED THAT TO THE ENERGY
MIX.
IT'S PRODUCING 145 EXAJOULES A
YEAR OF ENERGY, GOOD CHUNK OF
THE GLOBAL ENERGY MIX.
AND IF WE REFRESH CAREFULLY WE
SEE THAT WE'RE GETTING A TENTH
OF A DEGREE OF FAHRENHEIT
IMPROVEMENT THAT'S NOT QUITE
ADDING UP TO A TENTH OF A DEGREE
IN CELSIUS TERMS.
AGAIN, MUCH SMALLER IMPACT THAN
SOMETIMES PEOPLE HOPE AND,
AGAIN, THE REASON IS SIMILAR TO
WHAT WE SAW WITH NUCLEAR, THAT
WE'RE SUBSTITUTING A WAY FROM
RENEWABLES ALONG WITH THAT
SUBSTITUTION AWAY FROM COAL, OIL
AND GAS.
THAT'S GOING TO PARTLY MITIGATE
EFFECTS, AND THERE'S A VERY
SIGNIFICANT TIME DELAY WITH
THESE NEW TECHNOLOGIES BECAUSE
IT'S NOT JUST SOMEONE INVENTS
FUSION IN A LAB, THAT'S GREAT
NEWS.
BUT THEN YOU'VE GOT TO BUILD A
FIELD INSTALLATION, THEN TRAIN
PEOPLE, BUILD A WHOLE INDUSTRY
AND SUPPLY CHAIN AND REGULATORY
APPARATUS TO DEPLOY NEW
TECHNOLOGY AND WE CONTINUE TO
BURN COAL, OIL, GAS.
THESE ARE IMPORTANT.
THEY ARE VALUABLE.
EVERY TENTH OF A DEGREE MATTERS.
BUT OFTEN THE EXPERIENCE OF
FOLKS IS THAT WE GET LESS IMPACT
THAN WE THOUGHT WE WOULD.
LET ME GO BACK AND LOOK AT MAYBE
ONE MORE EXAMPLE HERE FROM FREE
RESPONSES BEFORE I ASK YOU TO
START VOTING ON SOME OF THE
SOLUTIONS.
SO, THERE'S A FEW HERE THAT TALK
ABOUT NO MEAT IN DIETS, REDUCED
MEAT.
THIS IS A GREAT QUESTION.
AS YOU MAY KNOW, THE REASON WHY
PEOPLE ARE CONCERNED ABOUT --
THE REASON PEOPLE ARE CONCERNED
ABOUT MEAT IS BASICALLY TWO
ASPECTS.
ONE, IN ORDER TO GROW A COW TO
MAKE DAIRY OR STEAK OR
HAMBURGERS THAT COW NEEDS TO EAT
A LOT OF PLANTS.
NEEDS TO EAT A LOT OF GRAIN.
USUALLY GRASS FED UNTIL A
CERTAIN POINT, FINISHED WITH
CORN IN THE UNITED STATES.
AND THE LAND THAT IT TAKES TO
GROW ALL OF THAT FEED IS VERY
EXTENSIVE COMPARED TO IF I WAS
JUST FEEDING PEOPLE THAT
VEGETARIAN DIET.
THERE'S BEEN A NUMBER OF
ATTEMPTS TO CALCULATE THE RATIO.
AN ORDER OF MAGNITUDE MORE LAND,
WATER, OTHER RESOURCES.
THAT'S GOING TO PUT LESS
PRESSURE ON FORESTS IF WE CAN
DECREASE MEAT CONSUMPTION.
AND FOR THAT REASON, THE FOOD
FROM ANIMALS IS HERE UNDER THE
DEFORESTATION PART OF THE MODEL.
THERE'S A SECONDARY EFFECT,
WHICH IS THAT LARGE MAMMALS
PARTICULARLY COWS AND SHEEP AND
LAMB, HAVE ENTERIC FERMENTATION,
RELEASE METHANE THROUGH BURPS,
AND ALL ANIMAL MANURE IS A
METHANE, NITROUS OXIDE SOURCE,
SO THERE'S OTHER GREENHOUSE
GASES WHICH CAN BE RELEASED
THROUGH THE ANIMAL DIGESTION.
SO IF WE REDUCE FOOD FROM
ANIMALS, THEN MAYBE THAT WILL
HELP.
SO WE'VE GOT 30% OF DIET BY
2100.
THAT'S KIND OF OUR BASELINE
ASSUMPTION THAT COMES FROM FAO
SORT OF UNDERSTANDINGS AND
FORECASTS.
SO WHAT HAPPENS IF WE COULD
DRAMATICALLY REDUCE THAT NUMBER,
AND CUT THAT FROM 30% OF DIETS
DOWN TO 10% OF DIETS.
THAT NUMBER MAY SEEM LOW TO YOU
BECAUSE THIS IS AN AMERICAN
AUDIENCE, IN AMERICA WE'RE USED
TO GETTING A LOT MORE OF DIE
FRET AN -- DIET FROM ANIMAL
PRODUCTS, WE'RE THINKING ABOUT
MEAT CONSUMPTION, PLANT BASED
SUBSTITUTES AVAILABLE IN KENYA
OR IN SOUTH ASIA YEA AND OTHER
PLACES WITH GROWING ECONOMIES.
LET'S DO AN EXPERIMENT, CUTTING
TO GET DIETS TO SHIFT.
LET'S HIT ENTER AND SEE WHAT
HAPPENS.
#R* THAT GOT US ANOTHER TENTH OF
A DEGREE OF AVOIDED FUTURE
WARMING.
THERE'S A COUPLE REASONS.
ONE IS THAT IT'S REALLY
SIGNIFICANTLY SLOW
DEFORESTATION.
ANIMAL AGRICULTURE IS THE BIG
DRIVER OF DEFORESTATION.
AND THERE'S GREAT SIDE BENEFITS,
RIGHT?
SO THIS IS ONE OF THE PLACES
WHERE ALSO THE PLANETARY HEALTH
VERSUS CLIMATE MODEL DISTINCTION
IS REALLY IMPORTANT.
BECAUSE WE'RE JUST LOOKING AT
GREENHOUSE GAS EMISSIONS HERE
BUT NOTICE THAT THIS CESSATION
OF DEFORESTATION HAS TREMENDOUS
EFFECT ON SOIL EROSION, A NUMBER
OF OTHER CONSIDERATIONS RELATED
TO DEFORESTATION.
THE OTHER THING THAT'S HAPPENING
HERE IS THAT WE ARE REDUCING
METHANE AND OTHER GASES, SO IF I
REDO THAT CHANGE, CHANGING
DIETS, WE'VE BENT THE CURVE ON
NON-CO2 MEANING METHANE, NITROUS
OXIDE IN PARTICULAR, BENT THE
CURVE ON EMISSIONS WHICH IS VERY
IMPORTANT, PART OF WHAT'S
GUESSING US THIS EXTRA TENTH OF
A DEGREE.
YOU CAN SEE THAT WITH THIS
REDUCTION OF METHANE AND LAND
USE EMISSIONS HERE.
SO, NOW, FOR ME PERSONALLY, THAT
WAS A SURPRISE.
THAT WAS A SMALLER CHANGE THAN I
THOUGHT, A DRAMATIC SHIFT.
SO WHY DON'T WE GET MORE CLIMATE
IMPACT, POSITIVE IMPACT, FROM
SUCH A HUGE CHANGE CUTTING
ANIMAL FOOD CONSUMPTION BY 2/3?
AGAIN, THROUGH CHAT OR THROUGH
THE Q&A, WHAT DO YOU THINK?
WHAT MIGHT BE GOING ON HERE,
WHAT ARE YOU NOTICING IN SOME
GRAPHS THAT WE'RE LOOKING AT
THAT MAKE THIS LESS IMPACTFUL
THAN PEOPLE OFTEN IMAGINE?
TO HELP I'LL MAKE SURE TO GO
BACK TO SOME OF THESE GRAPHS.
POPULATION IS STILL GROWING.
EXCELLENT ANSWER, JEN.
THE MEAT CONSUMPTION HERE IS
PERCENTAGE OF DIET BY 2100.
BUT THAT'S A PERCENTAGE OF DIET.
ABSOLUTE AMOUNT OF FOOD
CONSUMPTION IS GOING UP WITH THE
POPULATION.
SO GLOBALLY WE'RE AT 8 BILLION
PEOPLE.
WE'RE HEADING TOWARDS A FUTURE
OF $10.4 BILLION PEOPLE.
AND THAT MEANS THAT WE ARE GOING
TO NEED THAT MUCH MORE FOOD
PRODUCTION.
AND THE WARMING THAT WE'RE DOING
IS ALSO AFFECTING CROP YIELDS.
SO, THIS IS KIND OF WHAT'S
CALLED A REINFORCING FEEDBACK IN
THE CLIMATE SYSTEM WHICH IS THAT
THE MORE GREENHOUSE GAS
EMISSIONS WE DO, THE MORE WE
HEAT THE PLANET, WE DRIVE
DEFORESTATION, THAT HEATS THE
PLANET, BUT THE HEATING OF THE
PLANET DECREASES CROP YIELDS.
THAT DECREASING MEANS TO MAKE
THE SAME AMOUNT OF FOOD WE NEED
MORE LAND.
WE HAVE TO GROW ON LARGER
AMOUNTS OF LAND TO HANDLE CROP
LOSSES FROM CLIMATE CHANGE WHICH
MEANS WE'RE PUTTING MORE
PRESSURE ON FORESTS.
ALL OF THAT TOGETHER THAT IS
PART OF THE THINGS THAT ARE
DAMPENING EFFECTS, THAT'S A VERY
IMPORTANT PIECE.
THE OTHER PIECE IS AS YOU'LL GET
TIRED OF ME TALKING ABOUT THE
TIME DELAYS.
ALL THE WHILE THAT YOU'RE
WORKING TO DECREASE THOSE, TO
CHANGE THOSE DIETS, WE'RE STILL
DEFORESTING SO THERE'S -- THE
EARLIER AND THE SOONER THOSE
EFFECTS CAN HAPPEN, THE BETTER.
ANYTHING THAT TAKES A WHILE WILL
BE LESS EFFECTIVE.
THERE'S ANOTHER INTERESTING
PHENOMENON WHICH IS THAT A LOT
OF LOSS OF FOREST BIOMASS AND A
LOT OF EMISSIONS FROM FORESTS
ISN'T JUST ABOUT CLEAR CUTTING
THE LAND FOR AGRICULTURE BUT
IT'S ABOUT DEGRADING FORESTS FOR
OTHER PURPOSES INCLUDING
BIOENERGY AND WOOD PRODUCTS,
UNRELATED TO FOOD CONSUMPTION.
AND THEN ON THE METHANE FRONT,
YES, WE TAKE A GOOD DENT OUT OF
ANTHROPOGENIC METHANE BUT
THERE'S STILL A BIT OF EMISSION
LEFT BECAUSE METHANE IS NOT JUST
ABOUT AGRICULTURE, ALSO ABOUT
INDUSTRY.
WE'VE GIVEN YOU A FEEL FOR
WHAT'S GOING ON HERE WE'VE
GOTTEN TO REDUCE TEMPERATURE BY
2/10 OF A DEGREE.
I WANT US TO SOLVE GLOBAL
CHANGE, 30 MINUTES TO DO IT.
NEXT I'M GOING TO A KIND OF
TOOL, ANOTHER POLL, WHICH WILL
ALLOW YOU TO VOTE ON WHAT DO YOU
WANT ME TO DO.
SO, IN THIS POLL YOU'LL HAVE --
IF YOU TAP ON THE IMAGE WHEREVER
YOU TAP A PIN WILL APPEAR.
THAT WILL TELL ME THAT YOU VOTED
FOR ANOTHER EXPERIMENT.
REMEMBERING WE'VE GOT AN ARRAY
OF LEVERS HERE, ENERGIES APPLY,
ENERGY USE, AND
NON-ENERGY-RELATED AMISSIONS,
POLL EVERYWHERE LINK, I'LL GROW
THIS QR CODE AGAIN IN CASE IT'S
EASIER TO DO ON YOUR PHONE, GO
AHEAD AND TAP ON WHAT SHOULD WE
TRY, WHAT EXPERIMENTS SHOULD WE
RUN?
>> MORE THAN ONE OR ONLY ONE?
>> NO, YOU CAN TAP MULTIPLE.
I BELIEVE I'VE GOT IT SO YOU CAN
TAP MULTIPLE TIMES.
IF IT'S NOT LETTING YOU TAP
MULTIPLE TIMES, IT MIGHT MAKE
YOU UNDO AND MOVE IT.
BUT I THINK YOU CAN MAKE A
COUPLE VOTES.
I'LL KEEP THE POLL OPEN SO YOU
CAN DECIDE WHAT WE WANT TO DO.
THREE OF YOU ARE VOTING FOR
PLANTING TREES.
AFORESTATION.
WHICH IS GREAT.
THIS IS ABOUT -- WE'VE
DEFORESTED A LOT OF LAND.
LET'S AFOREST, PLANT NEW TREES
AND RECOVER.
THIS IS ALSO A COMMON IDEA
BECAUSE IT IS THE MOST COMMON
FORM OF CARBON OFFSET.
IF YOU GO TO SAY I'M TAKING THIS
AIRPLANE TRIP TO TAKE MY FAMILY
TO DISNEYLAND, I'LL BUY CARBON
OFFSETS A LOT OF OF TIMES THEY
ARE AFFORESTATION PROJECTS.
A TRILLION TREES INITIATIVE
ADVANCED BY A VARIETY OF PEOPLE,
MARK BENIOFF, SALES FORCE, FORCE
IN THE TRUMP FAMILY.
WE THINK ABOUT AFFORESTATION AS
A LEVER, WHAT PERCENTAGE OF LAND
THAT'S AVAILABLE FOR
AFFORESTATION SHOULD WE USE TO
PLANT TREES?
THIS IS A SERIOUS ENDEAVOR,
RIGHT?
WE'RE SAYING LIKE IF I TURN THIS
NUMBER TO 50%, THAT'S GOING TO
MEAN OF ALL THE AVAILABLE LAND
WHERE WE COULD PLANT TREES HALF
IS FOREST, WE'RE GOING TO PLANT
TREES.
LET'S SEE WHAT HAPPENS WHEN I
CLICK ENTER ON THAT ONE.
OKAY.
SO DID IT WORK, FIRST OF ALL?
YES, WE PLANTED THE TREES.
THE TREES GREW.
WE ENDED PUTTING 3 GIGATONS INTO
THE TREE PLANT TAIGS.
PLANTATION.
WE GOT ANOTHER POINT .06,
ROUNDING UP TO 1/10 OF IS A
DEGREE OF AVOIDED FUTURE
WARMING.
EXCELLENT, IF WE WERE ALL IN A
ROOM TOGETHER WE COULD GO
"WHOOP" EVERY TIME WE GET A
TENTH OF A DEGREE.
YOU'LL HAVE TO IMAGINE THAT IN
THE VIRTUAL ENVIRONMENT.
I WISH I GOT MORE THAN THAT 1/10
OF A DEGREE.
THE BIG STORY, FIRST OF ALL
THERE'S A QUESTION OF MAGNITUDE.
YOU CAN SEE THAT MAGNITUDE
CLEARLY ON THIS GRAPH WHICH IS
THAT YES WE'RE PUTTING AWAY 3
BILLION TONS INTO THE TREES, BUT
THAT'S HAPPENING AT THE SAME
MOMENT THAT WE'RE BURNING 34
BILLION TONS FROM OUR FOSSIL
ENERGY SYSTEM.
THE IDEA THAT WE'RE GOING TO
OFFSET OUR FOSSIL FUEL EMISSION
BY PLANNING TREES IS JUST A
MISMATCH OF SCALE OF AN ORDER OF
MAGNITUDE.
SECONDLY THIS DELAY PROBLEM,
THAT YOU HAVE TO GET THE LAND,
PLANT THE TREES, TREES HAVE TO
GROW.
WHEN YOU FIRST PLANT A SAPLING
IT'S ABSORBING MILLIGRAMS, THEN
GRAMS BEFORE IT'S ABSORBING
KILOGRAMS OR TONS OF CO2 AND
WE'RE TRYING TO GET TO BILLIONS
OF TONS.
THIS IS PART OF THE ISSUE.
SATURATION, ONCE THE TREES REACH
MATURITY THEY ARE IN QUILL
L ICK -- EQUILIBRIUM.
LESS AS THE TREE REACHES
MATURITY.
DAMPENED IMPACT.
WHAT ELSE HAVE WE GOT HERE?
I'M CHECKING THE VOTES.
TWO VOTED FOR A CARBON PRICE.
WHAT IS A CARBON PRICE?
WE HEARD -- YOU MAY HAVE SEEN
EARLIER IN THE DAY, SOME STUDIES
LOOKING AT DIFFERENT WAYS OF
THINKING ABOUT CLIMATE ACTION AS
BEING REPRESENTED BY A CARBON
PRICE, A CONVENIENT WAY TO DO
THAT.
LET'S CALIBRATE WHAT THAT MEANS.
CARBON PRICE IS BASED ON THE
IDEA THAT RIGHT NOW, IT IS FREE
FOR ALL OF US TO POLLUTE.
WE CAN JUST, YOU KNOW, BURN GAS
IN OTHER CARS, BURN COAL IN OUR
POWER PLANTS, KEEP THE PLANET,
CAUSE THE DIFFERENT EFFECTS
WE'VE BEEN TALKING ABOUT,
THERE'S NOT REALLY ANY -- IT'S A
COMMON RESOURCE ALL OF US HAVE
THE RIGHT TO BURN AND PUT THINGS
IN THE ATMOSPHERE.
CARBON PRICE SAYS NO.
IT COSTS SOCIETY MONEY, COSTS
LIVES, COSTS HEALTH AND
MORBIDITY AND MORTALITY.
SO WE NEED TO CHARGE PEOPLE FOR
THE PRIVILEGES OF USING THE
ATMOSPHERE AS DUMPING GROUND.
SO LET'S PUT A PRICE ON CO2
EMISSIONS.
THAT CAN BE A CARBON TAX, LIKE
YOU EMITTED 10 TONS OF CO2 SO
I'M GOING TO CHARGE YOU $500 AS
A TAX, 50 BUCKS A TON.
OR IT CAN BE YOU HAVE A PERMIT
TO POLLUTE ONLY SO MUCH BECAUSE
WE'RE TRYING TO CAP EMISSIONS.
AND WE'RE GOING TO REDUCE THAT
CAP OVER TIME.
YOU HAVE TO REDUCE YOUR
MISSIONS.
IF YOU CAN'T REDUCE YOUR
EMISSIONS, YOU'VE GOT TO BUY
YOURSELF A PERMIT FROM SOMEBODY
WHO WAS ABLE TO REDUCE
EMISSIONS.
AND IN THE BUYING AND SELLING OF
PERMITS WHAT'S CALLED A CAP AND
TRADE SYSTEM, A PRICE IS
REVEALED OR DISCOVERED, WHICH IS
THE PRICE OF CO2 EMISSIONS.
AROUND THE WORLD NOW AS A LITTLE
SNAPSHOT OF WHERE WE ARE, THE
WORLD BANK KEEPS TRACK OF CARBON
PRICING INITIATIVES.
SO, EMISSIONS TRADING SYSTEMS
ARE LIKE THE CAP AND TRADE,
CARBON TAX IS MORE THE DIRECT
CHARGE.
AND YOU'LL SEE THERE'S A VARIETY
OF JURISDICTIONS PRICING CO2 IN
DIFFERENT WAYS.
IN NEW ENGLAND WE HAVE REGI,
CALIFORNIA HAS A SIMILAR SYSTEM.
EUROPEAN UNION HAS THE MOST
ROBUST CAP AND TRADE SYSTEM.
AND THE PRICES VARY GREATLY.
SWITZERLAND, SWEDEN, URUGUAY
ABOVE $130 A TON.
EUROPEAN UNION TRADES AT $80 TO
$100 A TON.
WE DON'T HAVE A NATIONAL CARBON
PRICE, HERE IN NEW ENGLAND THE
REGI SYSTEM $15 TO $20 A TON.
A WEIGHTED AVERAGE, THE
EFFECTIVE CARBON PRICE ON
AVERAGE IS $5 A TON OF CO2 ON A
GLOBAL AVERAGE.
SO, EXPERIMENT WE'LL TRY HERE
IS --
[ NO AUDIO ]
SO WHAT HAPPENS IF THE REST OF
THE WORLD DOES WHAT EUROPE IS
DOING, AND PRICES CO2 AT $100 A
TON?
I'LL HIT ENTER.
WE'LL SEE WHAT HAPPENS.
OKAY.
6/10 OF A DEGREE OF AVOIDED
FUTURE WARMING.
DOING THIS REPLAY, SO NOTICE
THIS IS ON TOP OF THE OTHER
THINGS THAT WE'RE DOING.
SO WE'RE ALREADY MITIGATING SOME
OF OUR FOSSIL EMISSIONS BY
HAVING A MAJOR NUCLEAR AND
FUSION RENAISSANCE, AND OVER AND
ABOVE THAT WE'RE GETTING 6/10 OF
A DEGREE OF AVOIDED FUTURE
WARMING.
IF I GO TO A FRESH MODEL WHERE
WE'RE NOT TRYING ANY OTHER
EXPERIMENTS, I'LL KEEP THIS OPEN
TO DO MORE ISOLATED TYPE OF
EXPERIMENTS, AND SAY WHAT HAPPEN
IF THE ONLY THING WE DO IS $100
PRICE ON CARBON, AGAIN, 6/10 OF
A DEGREE OF AVOIDED FUTURE
WARMING.
SO THAT'S INTERESTING.
SOME OF YOU MAYBE TUNED IN TO
THE IDEA CARBON PRICING MATTERS,
THAT'S WHY YOU VOTED FOR IT.
THAT'S WHAT YOU EXPECTED.
SOME MAY NOT HAVE REALIZED
THAT'S SO IMPACTFUL.
LET'S UNPACK FOR A SECOND WHAT'S
GOING ON.
THERE'S TWO THINGS THAT I WANT
US TO NOTICE ON THE LEFT SIDE
GRAPH HERE.
ONE IS THAT THE OVERALL HEIGHT
OF THE MOUNTAIN IS DECREASING.
SO WHAT DOES THAT MEAN?
THAT MEANS WE'RE USING LESS
ENERGY.
AND THE REASON WE'RE USING LESS
ENERGY IS THAT WE'VE MADE ENERGY
MORE EXPENSIVE.
SO WE'RE CHARGING PEOPLE MONEY
TO POLLUTE WITH THE SOURCES OF
ENERGY WE'RE USING.
SO PEOPLE ARE GOING TO BUY
SMALLER CARS, MORE ENERGY
EFFICIENT CARS AS THEY DO IN
EUROPE, THEY ARE GOING TO
INSULATES HOMES, USE LED LIGHT
BULBS, MIGHT TAKE THE SUBWAY OR
BUS, MIGHT CARPOOL IN THE CAR
THEY HAVE.
SO THERE'S AN ENERGY EFFICIENCY
AND CONSERVATION IMPROVEMENT
THAT COMES FROM THAT.
AND THEN THERE'S A SECOND THING
GOING ON, THAT THE REDUCTIONS
HAPPENING ARE NOT -- REMEMBER
BEFORE WHEN OUR EXPERIMENT
WAS -- I'M GOING A FRESH MODEL
HERE.
WHEN THE EXPERIMENT WAS LET'S
SUBSIDIZE NUCLEAR, INCLUDING
RENEWABLES, ALL ELSE BEING
EQUAL, COSTS BEING EQUAL,
RENEWABLES ARE VARIABLE AND
REQUIRE BATTERY STORAGE AND SO
PEOPLE WILL SUBSTITUTE AWAY FROM
THEM.
WHERE AS I'M MOST SPECIFICALLY
GOING AFTER THE MOST CARBON
INTENSIVE FUELS WITH CARBON
INTERVENTION.
COAL IS DECREASING, NALTREXONE
GAS DECREASING BUT RENEWABLES,
NUCLEAR AND FUSION, ARE ALL
INCREASING.
BECAUSE WE'RE ADVANTAGING THE
LOW CARBON ENERGY SOURCES HERE.
I CAN VISUALIZE THAT IN ANOTHER
WAY ON THESE GRAPHS.
THIS IS A KAYA IDENTITY,
POPULATION TIMES GDP, AND WHAT
HAPPENS WE HAVE TWO SIMULTANEOUS
EFFECTS.
WE'RE REDUCING ENERGY INTENSITY
OF GDP, BECOMING ENERGY
EFFICIENT, AND DECARBONIZING
ENERGY SUPPLY, THIS GRAPH HERE.
THIS DELTA MULTIPLIED BY THIS
DELTA IS RESULTING IN A
PARTICULAR REDUCTION IN CO2
EMISSIONS.
IF YOU'RE PAYING CLOSE ATTENTION
THERE'S ANOTHER EFFECT GOING ON
HERE WHICH IS QUITE INTERESTING.
WHICH IS THAT AS WE INCREASE
CARBON PRICE, OUR ECONOMIC
PRODUCTIVITY IS ALSO INCREASING,
WHICH IS COUNTERINTUITIVE,
PARTLY HAS TO DO WITH STAGE OF
MODEL, REFLECTS IMPORTANT
PHENOMENON THAT GDP PER CAPITA
IS HARMED BY CLIMATE CHANGE.
SO, THE FACT THAT WE ARE WARMING
THE PLANET BY -- SORRY, I'M
GOING TO ANOTHER FRESH MODEL
HERE, THE FACT THAT WE'RE
WARMING THE PLANET BY 3.3
DEGREES MEANS THERE'S HUGE LOSS
OF ECONOMIC PRODUCTIVITY.
ALL THAT LOSS OF COASTAL
INFRASTRUCTURE, HEAT STRESS AND
HEALTH EFFECTS, ALL THE LOSS OF
CROP PRODUCTIVITY, ALL OF THOSE
THINGS TOGETHER CREATE ECONOMIC
DAMAGE.
THERE'S A LOT OF UNCERTAINTY
ABOUT THE ECONOMIC DAMAGE
FUNCTION, WE USE A MIDDLE OF THE
ROAD ESTIMATE, CONSERVATIVE BY
OUR POINT OF VIEW, BUT NOTICE
THAT THIS ALSO ECONOMIC DOWNTURN
IS FROM COVID.
AND THIS ECONOMIC DOWNTURN IS
FROM CLIMATE.
MASSIVE EFFECTS ON GLOBAL
ECONOMY.
WHEN WE MAKE THE CLIMATE BETTER
WE ACTUALLY RESTORE SOME
PROSPERITY, BECAUSE WE'RE
BREAKING THE CLIMATE LESS.
SO THAT'S ANOTHER SORT OF FACTOR
OF PART OF WHAT'S GOING ON HERE.
AND NOW, MANY PEOPLE WILL ARGUE
THAT THE CARBON PRICE ITSELF
WILL HAVE ECONOMIC -- NEGATIVE
ECONOMIC EFFECT, A VERY
IMPORTANT CONSIDERATION,
PARTICULARLY IN CONVERSATIONS
WE'VE HAD TODAY THERE'S SERIOUS
EQUITY CONSIDERATIONS BECAUSE --
THIS GOES TO THE POINT ABOUT
TRADEOFFS AND UNINTENDED
CONSEQUENCES THAT WERE BROUGHT
UP IN PREVIOUS SESSION.
WHICH IS THAT OUR ENERGY COST IS
INCREASING PRETTY DRAMATICALLY,
NOT BY ORDER OF MAGNITUDE OR
DOUBLING BUT WE'RE GOING FROM
$22 A GIG AJOULE TO $30, THAT'S
50% INCREASE, SUBSTANTIAL
INCREASE IN ENERGY COST, HITTING
LOW INCOME PEOPLE HARDEST WHO
SPEND HIGHER PROPORTION OF
INCOME ON ENERGY.
WE HAVE TO BE CAREFUL ABOUT
DISTRIBUTIONAL IMPACT OF THIS
CHANGE TO GIVE THE ECONOMY MORE
TIME TO ADJUST, INSTEAD OF
RAMPING UP CARBON PRICE OVER TEN
YEARS, I RAMP UP OVER 20 YEARS,
TO GET TO THAT $100 A TON, IT
DOESN'T, YOU KNOW -- WE DON'T
LOSE TOO MUCH EFFECT ON THE
CLIMATE BUT WE GAIN A BIT OF
SMOOTHER TRANSITION ON THE
ENERGY PRICE SIDE.
BUT AN EVEN BETTER SOLUTION TO
EQUITY CONSIDERATIONS IS TO TAKE
THE MONEY IN TO THE GOVERNMENT
IN THE FORM OF PERMIT AUCTIONS
OR CARBON TAXES, AND WRITE
CHECKS FOR PEOPLE.
IF YOU DO WHAT'S CALLED A FEE
AND DIFFERENT, I WRITE A CHECK
TO EVERY PERSON IN THE ECONOMY,
FOR IT'S MONEY I GET FOR MINE
CARBON PRICE WHAT HAPPENS IS IF
I'M A PRIVILEGED PERSON WHO
LIVES IN A SINGLE FAMILY HOME,
WITH TWO CARS, ANNUAL TRIP TO
DISNEYLAND, I'LL PAY A BIG
CARBON BILL EVERY YEAR BUT I'M
GOING TO GET A CHECK BACK THAT
DOESN'T -- THAT'S SMALL.
I'LL HAVE A FLEET PAYMENT -- NET
PAYMENT.
IF I'M LOWER INCOME, LIVE IN
APARTMENT, TAKES THE BUS,
DOESN'T FLY, THAT CHECK I GET IN
THE MAIL IS GOING TO BE BIGGER
THAN MY CARBON BILL, A
PROGRESSIVE CASH TRANSFER IN A
SENSE.
YOU CAN MEANS TEST TO MAKE IT
EVEN BETTER.
A NUMBER OF POLICY PROPOSALS ARE
OUT THERE HOW TO DO A
PROGRESSIVE REVENUE NEUTRAL
CARBON PRICE.
AND THAT'S A VERY IMPORTANT
TOPIC.
I'VE SPENT A LOT OF TIME TALKING
ABOUT THE CARBON PRICE HERE, BUT
NOTICE THAT WE'RE NOT QUITE
THERE YET.
WE'RE STILL 2.4 DEGREES, WE WANT
TO REACH THE PARIS ACCORD
OBJECTIVE OF 2 DEGREES, IDEALLY
1.5, SO WHAT ELSE CAN WE TRY?
I'M GOING TO COME BACK TO OUR
VOTING THING HERE AND PAUSE FOR
A SECOND HERE AND LET FOLKS VOTE
FOR ANY OTHER THINGS WE HAVEN'T
TRIED YET WHILE I ALSO LOOK AT
THE CHAT.
I SAW COMMENTS.
A REALLY IMPORTANT COMMENT ABOUT
THE NEED FOR MULTI-SCALE MODELS,
THIS IS I THINK MADE VERY
VISIBLE BY OUR EXERCISE HERE,
SUPER INTERESTING TO UNDERSTAND
THAT WE'RE GOING TO HAVE HEAT
STRESS AT GLOBAL LEVEL BENEED TO
UNDERSTAND IN A MORE
GEOGRAPHICALLY DISAGGREGATED
WAY.
THERE ARE TOOLS, WHAT I'M DOING
WORKSHOPS LIKE THIS, I'LL OFTEN
FLIP OVER TO A TOOL CALLED
PROBABLE FUTURES.
WHICH IS A SET OF INTERACTIVE
MAPS THAT IS ORGANIZED AROUND
TEMPERATURE SCENARIOS.
SO, AGAIN, REMEMBER OUR BASELINE
WAS A 3-DEGREE SCENARIO WHERE
THIS IS A MAP OF THE NUMBER OF
DAYS PER YEAR ABOVE 28 DEGREES
CELSIUS, WHERE YOU START TO SEE
IMPORTANT HEAT STRESS,
PARTICULARLY IN VULNERABLE
POPULATIONS.
AND CAN YOU SEE HOW CURRENTLY
THIS IS 1 TO 7 DAYS OF THAT KIND
OF HEAT STRESS, 3-DEGREE WORLD
HAS THAT BECOMING MORE LIKE 28
DAYS IN THE SOUTHEAST, AND THAT
KIND OF HEAT MAKING ITS WAY UP
NORTH, SO YOU CAN USE SOME OF
THESE TOOLS TO EXPLORE WHAT THIS
COULD LOOK LIKE IN A
GEOGRAPHICALLY DISAGGREGATED
WAY, BUT JUST RECOGNIZING THE
SCIENCE ON THIS IS STILL PRETTY
YOUNG AND THERE'S PLENTY MORE
WORK TO DO TO CLARIFY ALL OF
THAT.
OKAY.
WE HAVE TWO VOTES HERE FOR
REDUCING COAL.
WHICH IS GREAT.
AND THAT'S IMPORTANT.
LET'S TAKE A LOOK.
NOTICE THAT COAL IS VERY
IMPORTANT.
IN OUR -- SO IN OUR PICTURE
WE'VE ACTUALLY SIGNIFICANTLY
REDUCED COAL AS A RESULT OF OUR
CARBON PRICE.
AND FOR A MEDICALLY AND
HEALTH-ORIENTED AUDIENCE LET'S
REMEMBER THAT ONE OF THE
CRITICAL REASONS WHY WE WANT TO
DO THAT IS BECAUSE IT'S GOING TO
REDUCE AIR POLLUTION.
IF I DO A REDO OF OUR CARBON
PRICE HERE, IN ADDITION TO
CLIMATE EFFECTS, AND WHATEVER
ECONOMIC CONSEQUENCES, THE
CARBON PRICE A LOT OF ANALYSES
SUGGEST IT WILL PAY FOR ITSELF
JUST IN REDUCE THE POLLUTION AND
HEALTH BENEFITS.
SO COAL IS A VERY IMPORTANT
TOPIC.
IT IS I THINK BECAUSE AGAIN THIS
IS A U.S. FOCUSED CONVERSATION
TODAY, IT'S IMPORTANT TO
RECOGNIZE THAT THIS IS A VERY
MUCH GLOBAL PICTURE.
THE HEAT -- SORRY, AIR
POLLUTION, GEOGRAPHY OF AIR
POLLUTION THAT'S GLOBALLY REALLY
A STORY ABOUT INDIA AND CHINA,
AS WELL AS INDONESIA AND OTHER
RAPIDLY DEVELOPING COUNTRIES IN
SOUTHEAST ASIA AS WELL AS THERE
ARE OTHER GEOGRAPHIES WHERE AIR
POLLUTION IS A SERIOUS
CONSIDERATION, BUT THE MOST
INTENSE POPULATIONS INTERSECTION
BETWEEN POPULATION CENTERS AND
VULNERABILITY DUE TO LACK OF AIR
CONDITIONING AND FILTRATION AND
AIR POLLUTION IS IN SOME OF
THESE REGIONS, AND IT'S THESE
MIDDLE INCOME COUNTRIES ARE THE
ONES WHO HAVE THE MOST
SUBSTANTIAL COAL -- THIS
DIRECTIONAL SLASH IS COAL, SO
POWER PLANTS FROM COAL ARE
SOMETHING WE BUILD A LOT OF AS
WE'RE HEADING TO BECOMING A
MEDIUM-INCOME COUNTRY AND IN THE
VERY HIGH-INCOME COUNTRIES OVER
TIME WE'RE STARTING TO
DECARBONIZE THAT PART OF OUR
ENERGY SYSTEM BUT THAT'S NOT
TRUE IN INDIA AND CHINA.
SO, THE REDUCTION OF COAL AND
LIFE-SAVING POTENTIAL OF THAT
JUST THE CAVEAT THOSE ARE --
SOME ARE AFFECTS THAT ARE
REGIONAL SPECIFIC.
WHAT ELSE COULD WE DO TO REDUCE
COAL?
IF I JUST DRAG THIS SLIDER OVER
AND DO A TAX ON COAL, YOU'LL SEE
IT'S NOT REALLY HAVING MUCH OF
AN EFFECT.
THAT'S BECAUSE WE'VE ALREADY
TAXED COAL THROUGH THE CARBON
PRICE.
IF I -- A FRESH MODEL WITH
NOTHING ELSE IF I TAX COAL I'LL
SEE 2/10 TO 3/10 OF A DEGREE OF
IMPROVEMENT BECAUSE NOTHING ELSE
HAS SORT OF REDUCED COAL
UTILIZATION.
OVER AND ABOVE TAXATION THE
OTHER IDEA WHICH I THINK IS A
VERY IMPORTANT IDEA IS JUST STOP
BUILDING NEW COAL PLANTS.
THERE'S A LOT OF PEOPLE IN THE
WORLD WHO DEPEND ON COAL AS
THEIR PRIMARY SOURCE OF ENERGY.
MY WIFE IS FROM CALCUTTA, THAT'S
HOW WE HAVE THE LIGHTS ON THERE.
TURNING OFF THE COAL PLANTS IS
THREATENING.
IF YOU STOP BUILDING NEW ONES
AND HAVE ALL THE NEW ENERGY
NEEDS MET WITH RENEWABLES AND
SORRY LOW CARBON ENERGY SOURCES,
THEN THAT CAN BE QUITE
IMPORTANT.
SO, REDUCING THAT NEW COAL
INFRASTRUCTURE, LETTING THE OLD
COAL PLANTS DIE OUT, THAT TURNS
OUT TO BE ANOTHER KIND OF
MECHANISM WE CAN USE TO REDUCE
COAL.
MY PUP HAS COME TO VISIT.
HI.
AND YOU CAN SEE IT'S NOT HAVING
MUCH OF AN IMPACT ON THIS
PICTURE BECAUSE WE'VE ALREADY IN
A SENSE REDUCED COAL
SIGNIFICANTLY ALTHOUGH YOU CAN
SEE FROM THE -- LET ME
SIMULTANEOUSLY SHOW THE AIR
POLLUTION AND GREENHOUSE GASES.
YOU KNOW, STOP BUILDING NEW COAL
PLANTS, THIS IS HAS AN AIR
POLLUTION BENEFIT MORE THAN
DEGREE HOUSE GAS BENEFIT ONCE
WE'VE ALREADY DONE A CARBON
PRICE.
IF THE ONLY THING WE DO, RESET
EVERYTHING ELSE, THE ONLY ACTION
WE TAKE IS TO JUST STOP BUILDING
NEW COAL PLANTS, THAT IS A
PRETTY IMPORTANT -- AGAIN,
THAT'S AT LEAST A 2/10 OF IS A
DEGREE IMPROVEMENT, BUT WITH
DOING NOTHING ELSE, WITHOUT THE
CARBON PRICE WHAT HAPPENS IS YOU
STOP BUILDING NEW COAL BUT
EXPAND NATURAL GAS.
WHEN YOU DO THAT YOU'RE
SIMULTANEOUSLY BURNING CO2 FOR
GAS, AND YOU'RE INCREASING
THE -- PRESERVING OR INCREASING
AMOUNT OF METHANE THAT'S LEAKING
FROM THE NATURAL GUESS SYSTEM.
NOT SEEING BIG ENOUGH IMPACTS
FROM OVERAND ABOVE WHAT WE'VE
DONE FOR COAL BUT INTEREST.
IN THE INTEREST OF TIME, I'M
GOING TO CHEAT A LITTLE BIT HERE
AND GO WITH THE SOLUTIONS THAT
YOU DID VOTE ON, BUT WHICH I
KNOW ARE GOING TO BE
PARTICULARLY IMPACTFUL.
ONE OF THOSE IS ENERGY
EFFICIENCY MEASURES IN BUILDINGS
AND INDUSTRY.
SO, A CARBON PRICE DOES HELP US
BECOME MORE ENERGY EFFICIENT.
BUT ECONOMIC INCENTIVES ARE NOT
THE ONLY FACTOR THAT GETS IN THE
WAY OF ENERGY EFFICIENCY.
THERE'S A LOT OF
LANDLORD-TENANTS PROBLEMS, FOR
EXAMPLE, WHERE THE TENANTS WILL
PAY FOR ENERGY BILLS BUT
LANDLORD IS BUILDING THE
EQUIPMENT.
YOU HAVE TO OVERCOME SOME OF
THOSE WITH DIRECT ENERGY
EFFICIENCY SUBSIDIES AND
MEASURES IF YOU WANT TO GET THAT
TO HAPPEN.
BUILDING CODE CHANGES AND OTHER
THINGS LIKE THAT.
WE CAN INCREASE BUILDING
EFFICIENCY OVER AND ABOVE WHAT
WE'VE DONE SO FAR, AND THAT
REDUCES AMOUNT OF ENERGY THAT WE
HAVE TO PRODUCE IF WE DO ENERGY
EFFICIENCY IN BUILDINGS, 3/10 OF
A DEGREE.
THEY SAVE MONEY BUT YOU HAVE TO
HELP PEOPLE OVERCOME THE
BARRIERS OF ENERGY EFFICIENCY.
THERE'S PRESCRIPTIONS FOR
BOILERS IN THE U.K.,
WEATHERIZATION TO HELP PEOPLE
REDUCE HOME ENERGY USE.
WHY SHOULDN'T THE -- THERE ARE
TWO CEOS IN NEW YORK CITY WHO IN
THE LAST YEAR FOR WHICH DATA --
FURTHER MEASURES TO REDUCE
METHANE GASES, TEND TO BE POTENT
IN THEIR IMPACTS.
SO, JUST LOOKING AT THE CHART
HERE, IF OVER AND ABOVE WE CAN
REDUCE THESE GASES THAT HAS A
SUBSTANTIAL IMPACT AND WITH A
REALLY AGGRESSIVE GLOBAL EFFORT,
BY THE WAY OUT OF THE COP
NEGOTIATIONS, AN AGREEMENT TO
WORK ON METHANE WITH THE U.S.
STARTING TO PUT IN PLACE METHANE
POLICY WAS A KEY PART OF THE
GLOBAL AGREEMENT SO THERE'S GOOD
NEWS ON THIS FRONT.
THIS IS A POWERFUL LEVEL FOR TWO
REASONS THAT HAVE TO DO WITH
SOME BASIC CLIMATE SCIENCE
PHENOMENA.
THE METAPHOR I USED EARLIER
WAS -- I USED TWO.
ONE ABOUT THE BATHTUB OF THE
ATMOSPHERE.
SO THE BATHTUB METAPHOR TEACHES
US THAT THERE'S A FAUCET AND
DRAIN, WE EMIT, SOME OF THE
GREENHOUSE GASES ARE BROKEN DOWN
OR ABSORBED.
METHANE BREAKS DOWN FASTER IN
THE ATMOSPHERE THAN CO2 DOES.
WHEN YOU TURN OFF THE FAUCET,
THE METHANE FAUCET, IT DRAINS
OUT FASTER AND SO YOU HAVE A
NEARER-TERM FASTER IMPACT ON
TEMPERATURE.
AND THEN SECONDLY, OUR OTHER
METAPHOR WAS THE IDEA CO2 IS A
BLANKET THAT HOLDS TEMPERATURE,
HOLDS HEAT INTO THE ATMOSPHERE
AND BY THAT METAPHOR WE CAN
THINK ABOUT METHS -- METHANE AS
A THICK BLANKET THAT HOLDS IN
HEAT MORE DRAMATICALLY.
SO THAT GREENHOUSE EFFECT IS
MUCH STRONGER WITH THE MORE --
THE HIGHER GLOBAL WARMING
POTENTIAL OF GASES.
SO THERE'S THIS DOUBLE EFFECT
THAT YOU GET, MANY PEOPLE ARE
TALKING NOW ABOUT HOW AS A NEAR
TERM ACTION WE NEED TO REDUCE
METHANE TO BUY TIME FOR THE
SORTS OF THINGS THAT WILL TAKE
LONGER LIKE CHANGING OVER THE
ENERGY SYSTEM.
SO, NOW, I WANT TO JUST PAUSE
FOR A SECOND AND TAKE STOCK OF
WHAT WE'VE GOT HERE.
WHICH IS THAT WE HAVE A SET OF
ACTIONS, AT A GLOBAL SCALE, THAT
HAVE GOTTEN US FROM A 3.3-DEGREE
WORLD TO 1.9-DEGREE WORLD.
MY ONLY DISSATISFACTION WITH
THIS IS THAT WE DID WAVE A MAGIC
WAND AND GET A MAGICAL
BREAKTHROUGH WITH THAT FUSION
THAT SOMEONE PROPOSED EARLIER.
SO I WANT TO RUN THE EXPERIMENT
OF NOT HAVING TO INVENT FUSION,
AND WHAT DOES THAT DO FOR US?
WELL, OKAY, YOU KNOW, WE DID
LOSE A TENTH OF A DEGREE SO
THERE'S SOME -- THAT'S A KIND OF
UNCERTAINTY, DO WE GET THIS
IMPROVEMENT OR NOT?
BUT NOTICE THE WHOLE FATE OF THE
PLANET ISN'T HANGING ON THAT
NECESSARILY.
YOU KNOW, HOW MUCH IS IT HANGING
ON THE SUBSIDY FOR NUCLEAR?
WE COULD -- SIMILAR MAGNITUDE
HERE, IF YOU THOUGHT THAT THERE
WERE OTHER HEALTH CONSEQUENCES
EARLIER PEOPLE TALKING ABOUT
URANIUM CONTAMINATION IN WATER
SUPPLIES, IF YOU'RE CONCERNED
ABOUT THAT AND WANT TO PEEL THAT
OFF, NOT HAVE THE TECHNOLOGICAL
MIRACLE OF NUCLEAR, WE STILL AT
THIS 2-DEGREE WORLD WITH
RENEWABLES AND STORAGE POWERED
GRID, SO THERE'S REASONS THAT
PEOPLE MIGHT WANT TO DO THAT
FOR THE SAKE OF STAYING WITH
WHAT YOU ALL SUGGESTED, LET'S
LOOK AT THIS SCENARIO FOR A
SECOND.
WHAT I WANT US TO DO IS THINK
ABOUT THIS IN A PARTICULAR WAY.
WHICH IS IT'S ONE THING TO SEE
THIS AS A SET OF GRAPHS.
IT'S ANOTHER THING TO
CONTEMPLATE WHAT DOES THIS
FUTURE MEAN?
SO THE LAST POLL QUESTION THAT
I'M GOING TO ASK YOU THROUGH OUR
POLL EVERYWHERE HERE IS A
QUALITATIVE POLL, AND IT'S THE
FOLLOWING QUESTION.
WHAT WOULD YOU LOVE ABOUT BEING
PART OF THIS FUTURE?
AGAIN, THIS POLL IS OPEN, IT'S
THE SAME URL.
THE QR CODE IS HERE, THE LINK IN
IN THE CHAT.
RESPOND WITH A PHRASE, IT CAN BE
A QUICK THOUGHT, A THOUGHT
BUBBLE.
WHAT WOULD YOU LOVE ABOUT
GETTING TO BE PART OF THIS
FUTURE?
I'M GOING TO TAKE YOU THROUGH A
TOUR OF WHAT THE CHANGES ARE.
WHAT WOULD YOU LOVE ABOUT
GETTING TO BE PART OF THIS
FUTURE?
THIS MAY BE A TECHNOLOGICAL
BARRIER TO ANSWER, SOME MIGHT BE
DRIVING HOME FROM WORK AND
JOINING THE WEBINAR FROM THE
CAR.
AND THAT'S VALID.
FOR ME, I LOOK AT THIS AND I
SAY, LOOK, THERE'S STILL
PROBLEMS TO SOLVE.
WE HAVEN'T CREATED A TRULY SAFE
FUTURE BUT WE'VE CREATED A
FUTURE THAT I'M MUCH MORE PROUD
AND HAPPY AND COMFORTABLE
LEAVING TO MY KIDS AND
GRANDKIDS.
WHERE WE'VE SAVED A LOT OF
LIVES, DUE TO AIR POLLUTION,
WE'VE LEVELED OUT THE
TEMPERATURE, WE'VE GOTTEN THE
CLIMATE PROBLEM UNDER CONTROL.
IT'S NOT JUST CONTINUING TO
INCREASE INTO THE FUTURE
GENERATIONS, RIGHT? WE GO BACK
TO INDIGENOUS WISDOM WE HEARD
EARLIER ABOUT THINKING ON A
SEVEN-GENERATION TIME HORIZON,
THE OLD WORLD WE WERE GOING TO
KEEP COOKING THE PLANET WITH
EACH PASSING GENERATION.
THIS IS A WORLD WHERE WE'VE
REINED EXCESSES AND SAVED LIVES.
THERE'S REGIONAL SPECIFICITY,
BUT WE'VE TAKEN A HUGE AMOUNT OF
THAT BURDEN OUT OF THE SYSTEM.
AND MY HOPE IS THAT SEEING THIS,
AND EXPERIMENTING WITH IT ON
YOUR OWN TIME AND OWN TERMS, YOU
GET A CHANCE TO FALL IN LOVE
WITH THIS FUTURE AND COMMIT
YOURSELVES AS YOU ALREADY HAVE
DONE AS WE'VE SEEN TODAY, TO
HELPING TO CREATE THIS FUTURE
BECAUSE GETTING TO THE LEVEL OF
ACTION ON A GLOBAL SCALE THAT'S
REFLECTED IN THESE LEVERS WILL
IN FACT TAKE EXACTLY WHAT YOU
ALL DESCRIBED AS EDUCATION,
UNDERSTANDING INTENTIONAL
BEHAVIORS, COLLECTIVE ACTION.
IT WILL TAKE WORKING TOGETHER.
MY HOPE IS THAT ALL OF US
TOGETHER AND ALL OF THE
INSTITUTIONS AND ORGANIZATIONS
THAT WE'RE REFLECTING AND PART
OF CAN JOIN IN THIS GLOBAL
CONVERSATION AND HELP PROPEL
FURTHER.
PLEASE SEE US AS A RESOURCE.
HOPEFULLY THIS WAS SOMETHING
INFORMATIVE AND MAYBE INSPIRING.
>> JASON, THAT WAS PHENOMENAL.
THE EXERCISE WAS AN IDEAL
CONCLUSION TO OUR SESSIONS, IN
THE MORNING AND AFTERNOON.
REALLY UNDERSCORES IMPORTANCE OF
SYSTEMS THINKING.
ALTHOUGH OBVIOUSLY THERE ARE
SOME LIMITATIONS TO THE MODEL,
REALLY PROVIDES A VERY UNIQUE
PERSPECTIVE TO NOT ONLY STARTING
TO THINK ABOUT RESEARCH
QUESTIONS BUT HOW TO FRAME THEM
FROM FROM INTERCONNECT THENESS.
WE HAVE TO WRAP UP.
I'LL TURN OVER TO LARRY TO CAP
PROCEEDINGS AND PROVIDE
CONCLUDING REMARKS.
>> THANK YOU.
ECHOING WHAT SANJAY SAID, THAT
WAS PHENOMENAL.
I THINK IT FITS IN VERY WELL
WITH TODAY, IN THAT MANY
HOPEFULLY A DECADE FROM NOW
WE'LL HAVE A MODEL THAT NOT ONLY
WILL DO CLIMATE CHANGE BUT IT
WILL DO PLANETARY HEALTH ON A
BROADER SCALE.
AND IT MAY NOT BE THAT MUCH
DIFFERENT THAN THIS MODEL BUT I
THINK THAT'S THE CHALLENGE.
THERE ARE RESEARCHERS TO CREATE
DATA TO ALLOW MORE COMPLEX
MODEL, PERHAPS ADD SOME POSSIBLE
SOLUTIONS THAT MIGHT DEVELOP, ET
CETERA, THAT WE HAVE MORE DATA
ON, ET CETERA.
I THINK IT WAS A GREAT
CONCLUSION FOR THE DAY.
ALL I WANT TO SAY, I HOPE THAT
YOU'VE ALL HEARD, WHAT YOU'VE
HEARD SO FAR TODAY HAS ENTICED
YOU TO COME BACK TOMORROW AT 10
A.M.
AND CONTINUE OUR MUTUAL
EXPLORATION OF PLANETARY HEALTH
AND CARDIOVASCULAR HEALTH.
AND TOMORROW WE'LL CONTINUE OUR
FOCUS, NOT EXCLUSIVELY BUT WE
WILL HAVE MORE ON THE URBAN
ENVIRONMENT, AND HOW TO IMPROVE
HEALTH PARTICULARLY
CARDIOVASCULAR HEALTH THROUGH
REDUCING EXPOSURES, HOW TO
RECONFIGURE OUR ENVIRONMENT AND
ECONOMY, ET CETERA.
LATER ON IN THE DAY TOMORROW WE
WILL FOCUS ON THE RESEARCH TOOLS
AND METHODS THAT CAN ASSIST US
TO ENSURE THAT WE UNDERSTAND THE
HEALTH BENEFITS AND UNINTENDED
CONSEQUENCES OF SOLUTIONS AND
THEIR BENEFITS AND THE HEALTH
COASTS OF NOT ADDRESSING THESE
PLANETARY ISSUES.
SO I HOPE TO SEE YOU TOMORROW AT
10 A.M.
I THANK EVERYONE WHO
PARTICIPATED TODAY.
IT WAS A FANTASTIC DAY.
AND I KNOW TOMORROW WILL BE
EQUALLY AS GOOD.
THANK YOU ALL.
HOPE YOU HAVE A GREAT EVENING.
>> LARRY, I'LL TURN THIS OVER TO
SONIA FOR FINAL REMARKS FOR WE
MOVE ON.
>> GOOD IDEA.
>> ECHOING HOW WONDERFUL IT WAS
TO HAVE EVERYBODY ENGAGED, GREAT
QUESTIONS, GREAT DISCUSSION, I'M
EXCITED FOR TOMORROW AS WELL.
LOOKING FORWARD TO SEEING YOU.
>> THANKS SO MUCH.
BYE-BYE.
>> GOOD EVENING. 9925 06:20:55,666 >> BYE.