Transcript Ecosystem Health - Pesticide Truths

Ecosystem Health
Balancing Climate Change
with Health Care
John Howard MD, FRCPC
Professor of Paediatrics and Medicine
Schulich School of Medicine
University of Western Ontario
Chair, Canadian Association of Physicians
For the Environment
Objectives
• To emphasize that health is not the same as
health care
• To suggest that there are other important
issues other than health care
What is
Ecosystem Health??
The Evolution of the
Doctor-Patient relationship
1) Traditional Medical Model
2) Patient-Centered Model
3) Ecosystem Health Model
Traditional Medical Model
Where we were
HEALTH
Disease
Patient
1. What is the disease?
2. How do I fix it?
Patient-Centered Model
1. What is the disease?
2. How do I fix it?
3. What is my patient's
unique illness??
4. How do I help my
patient?
HEALTH
Illness
Disease
Patient
Context
Ecosystem Health
• The health of the “context” and the
interaction of the “context” with human
health
- the physical, social, economic and
political environment
Ecosystem Health Model
HEALTH
1.
2.
3.
4.
Illness
Disease
Patient
5.
6.
Home
Community
Region
World
What is the disease?
How do I fix it?
What is my patient's
unique illness??
How do I help my
patient?
Why is this patient
here?
What can I do to
prevent others from
having the same
illness?
What is Health?
Spiritual
Environmental
Moral
Social
Nutritional
Community
Physical Health
Mental
Personal Health
Economic
Political
Societal Health
Ecosystem Health
Spiritual Health - Aboriginal
The Earth is our Mother, the female giver
of Life to all her children, some of whom
are human beings.
We are related to the animals, the plants,
the birds, the insects, and they are
related to us. Our lives depend on
them.
Cost of global human need programs
Annual cost in Percent of current
billion dollars
military spending
Provide safe clean water
50
6.4
Moral
Health
Retire developing
nation’s debt
30
3.8
Provide shelter
21
19
2.7
2.4
15
10.5
5
150.5
1.9
1.3
0.6
19.1
Eliminate starvation and
malnourishment
Provide health care
Stabilize population
Eliminate illiteracy
TOTAL
Is society’s attitude to
climate change
morally healthy?
Revelations
• Many/all diseases have a significant
Ecosystem Health component
• We need to put less money in
sickness care!
•
•
•
•
Uncertainty is more important than certainty
Bigger is better!
Things can be done!
Accountability should be replaced by
responsibility
37%/5years
7.4%/year
2008 Ontario Expenditures
Other
25%
Environment
0%
Health
Education
18% Social Support
11%
Sickness
Health
46%
Where are we going? 2016
2010
% of Provincial Budget
50
45
40
35
30
1991
1996
2001
2006
Year 2044 = 100%
Health Care
• NOT a determinant of health
• “The majority of the health care dollar is spent
in the last 6 months of one’s life” - 1993
• Average health expenditures on people who
are in their last year of life is between 50 and
100 times more than expenditures on those
who are not. - Health Canada -2005
Is there a crisis?
If so what is the crisis?
CAPE is a group of physicians,
allied health care practitioners and
citizens committed to a healthy and
sustainable environment.
www.cape.ca