Public health in a post-petroleum world
By G. Daniel Bednarz, PhD
It is better to be healthy than ill or dead. That is the beginning and end of the only real argument for [public health].
- Geoffrey Rose, The Strategy of Preventive Medicine.
The world is near the point where half of all its readily usable petroleum has been consumed. Beyond this plateau looms a bellcurve-shaped decline into the middle decades of this century to the end of the petroleum era. Some of you may recognize this phenomenon by the idiom “Peak Oil.” However, as far as I know, the profound implications of Peak Oil remain unaddressed by public health, as they are throughout most of our society.
At this point you might be thinking, “Oil is the concern of geologists, economists, and industrialists -- and maybe politicians. What does it have to do with public health?”
Public health textbooks –- excellent indicators of how the discipline thinks of itself and conceives of its mission -- devote modest space to energy, let alone to the uniqueness of oil as a resource. Most have a paragraph or two on the importance of energy and note that oil will be available for at least another fifty years. Given this perilous misunderstanding by the discipline let me reply, “fair enough” to your question and set as my main goal today making the relationship between Peak Oil and public health an “interesting” call to reflection, as opposed to “absurd” and none of your concern (Strauss, 1971).
The Ubiquity of Oil
Petroleum –- and natural gas -- plays a crucial role in industrial society. It provides fuel for transportation and machines, as well as in pesticides and fertilizers for food production, heat in the winter and air conditioning in the summer, pharmaceuticals and medicines, and an extensive array of manufactured goods -- from toothbrushes to DVDs to the elastic in our underwear.
In sum, oil is the indispensable multipurpose resource of industrial society, both in terms of the energy it provides and the products we manufacture from it. Accordingly, absent alternatives to oil public health will face a situation that will eventually become worse than the one many thought was eliminated once and for all one hundred years ago when the profession incorporated itself around the germ theory of disease prevention and intervention. Because of its impending scarcity, we face the possibility of “Overshoot.” I say more on overshoot in the final section of this report.
Alternatives to Petroleum and Natural Gas
A review of where we are regarding alternative sources of energy is needed because I speculate that most of you are wary of my premise that the world is running out of cheap oil or replacements for it. Therefore, what follows is a cautious review. My wish is to sober you by distinguishing between what is widely acknowledged: oil recovery will peak and then decline and at present there are no scalable or equally versatile alternatives to it; and what is speculation: from the dystopian vision of being catapulted back to the Stone Age after an intermezzo of several billions souls dying from war, famine and disease; to the utopian where there’s absolutely nothing to worry about because the Market and technology will save us, perhaps –- far-fetched as it seems -- by integrating human existence with computers and thereby revolutionizing our relationship to the bio-physical environment (Kurzweil, 2005).
While there are a few maverick geologists who claim that the earth produces petroleum a-biotically in its core, making it in essence a renewable resource, the evidence seems incontrovertible that oil has a primordial biotic origin. This means oil –- and also natural gas -- is finite, a one-shot affair for civilization –- in any scope of human time -- that must be replaced by alternative energy sources if our level of technological and material existence is to continue, let alone be universalized through what we call “Globalization.”
Jimmy Carter made tentative efforts to talk to the nation about fossil fuel alternatives –remember he was trained in physics—and was ridiculed as a wimpy defeatist for his efforts. That was three decades ago and, given the enormous amount of energy required to run industrial society, especially America, it is now late in the alternatives game. There is little dispute that we have not developed genuine, scalable energy substitutes since the 1970s and even if we had them in development it would be years, probably decades, before they could be incorporated fully into the infrastructure of the nation. The economic --in dollars -- and social costs --in hardships of various kinds -- of the conversion will be stupendous.
At this point, some may question my insinuation that the free market and technology will not produce a relatively painless fix, a Star Trek “Dilithium Crystals” solution, to our nascent energy problems. While space constraints prevent elaboration, I offer the following comments. The “Hydrogen Economy” sounds catchy but at present is unworkable due to a number of unresolved technological issues, plus the fact that hydrogen is no more a fuel than is electricity –you need to spend energy to produce the hydrogen that carries energy . Some advocate synthetic (liquefying) coal while pooh-poohing the cost to the consumer ($5.00 a gallon gas), the additional pollution and climate change (“global warming”) it will generate, and the ecological destructiveness of massive coal extraction; furthermore, there is no guarantee we have more than several decades of relatively low-energy coal left in the earth.
Similarly, wind, solar, biomass, nuclear, and hydroelectric at present can provide only a small fraction of the energy we now get from oil and natural gas; moreover, they are reliant, either in construction or maintenance, on oil and gas. Finally they are not, repeat, not wholly “clean” technologies that avoid worsening the already perilous situation of climate change underway. As things stand, nothing rivals oil and natural gas for their convertibility, energy density and other features, such as their role in increasing agricultural yield to phenomenal levels (“The Green Revolution”) –levels that cannot be maintained without them, and --according to recent figures -- per capita agricultural yield probably went into decline in the late 1980s.
The questions to put to those who are now coming along with “too good to be true” energy solutions stem from the laws of thermodynamics; these laws are immutable, they do not respond to wishes, fantasies, rhetoric, public relations or propaganda. When appreciated, these physical laws temper us to the real task of finding scalable and ecologically safe energy alternatives. To reiterate, the challenges of such an energy source conversion are manifold and currently are barely being addressed, relative to the enormity of the tasks of discovery, development, and subsequent conversion.
Peak Oil and the Limits to Growth
Twenty years ago some spoke of the limits to growth. But today we now know that growth is the engine of change. Growth is the friend of the environment.
- President George H. W. Bush, 1992.
As a transition into discussing public health in a post-petroleum world, I want to review an important assessment by Matthew Simmons, an oil industry consultant and investment analyst. As some of you may know Simmons claims to have explained Peak Oil to the G. W. Bush administration , which itself has several former oil executives as members. Simmons’ (2000) analysis in “Revisiting the Limits to Growth Could the Club of Rome Have Been Correct, After All?” runs counter to his vested interests. He is, after all, in the business of making money with money, for which you need a constantly growing –- that is, limitless -- economy. Also keep in mind that the financial and oil industries tip toe around Peak Oil, referring to “interruptions” in supply but rarely, if ever, to the fact that oil and natural gas are finite resources .
He notes that in the mid 1990s when he began to discuss Peak Oil he would receive criticism –- from his community of economists, financiers and oil industry executives -- that he was a “Malthusian” or a “Club of Rome” doomsdayer. Simmons began to wonder why The Limits to Growth, published in 1972, could still years later draw such acrimonious criticism. He decided to read the book and then realized the disparagement he’d been hearing about Limits was either distorted or wholly untrue. He writes, “Nowhere in the book was there any mention about running out of anything [emphasis in origina;] by 2000…the book was focused on how the world might look” in 2070. “There was not one sentence or even a single word ...about an oil shortage...by the year 2000.” (Simmons, 2000: 4). To his surprise, he learned that the book was an academic exercise in computer simulation –quite cutting edge for its time -- of the overshoot consequences of population and economic growth. A main conclusion was that –- surprise -- there are ecological limits to population and economic growth and therefore to the “Carrying Capacity” of the earth, that is, how many people it can support at a sustainable level. Limits to Growth projected that the earth’s ultimate carrying capacity was not sustainable under virtually any continual growth scenario beyond the year 2070.
Simmons offers this observation, which is relevant to public health and, overall, to those concerned with eliminating poverty and promoting economic development in the world:
The world is now 30 years into this 100-year view. It did grow as fast as the book warned. The gap between the rich and the poor never narrowed. Instead, the gap between the “haves” and the “have-nots” grew by a significant measure [from 35/65 in 1970 to 20/80 in 2000] …The current strain on many of our precious resources … would have been far worse by 2000 … had these [poor] people also begun to significantly improve their standard of living at the same time. An accidental safety valve for many potential scarce resources turned out to be the widening of the rich/poor gap." (2000: 5).
Simmons stresses that the Soviet Union’s collapse triggered sharp declines in public health and concomitant resource consumption in Russia; in essence he argues that the collapse delayed Peak Oil. He stresses that if the gap between rich and poor had narrowed and the Soviet Union not ended, “…the world could have easily reached an energy consumption rate of between 220 and 240 million BOE [barrels of equivalent oil energy] per day by 2000, assuming such vast energy additions could have been supplied” [emphasis added] (2000: 9).
If we concede that as a rule as poverty declines public health improves we must also acknowledge that energy consumption increases as living standards improve. Simmons observes, “A casual reading of the possible future limits to water, arable land, fish stocks, etc. causes one to question how the world could even cope with continued population growth and a narrowing of the rich/poor gap” (2000: 13). He also lists the infrequently mentioned fact that economic growth translates into increases in pollution. Then he observes with irony, “These are the issues that should now [in 2000] be dominating ... discussions of the world’s public policy planners” (2000: 13).
Finally, Simmons discusses the status of OPEC to counter the widespread notion that they are both prosperous and floating on a sea of virtually limitless oil. For example, he informs us that Saudi Arabia, a nation we think of as being composed entirely of rich jet-setters, had 6 million citizens in 1970 and 22 million by 2000; by 2030, at the current fertility rate, the population will be 45 to 50 million people . “Most people still think Saudi Arabia is a very rich country. To the contrary, its economy is now in shambles as a result of the population explosion which has … occurred” (Simmons, 2005: 14). Simmons calculates that if all OPEC, most of whom have poverty rates between 25% to 50% and burgeoning populations, were to attempt to narrow the rich/poor gap they would likely be unable to remain oil exporting nations --they would consume all their oil domestically.
Furthermore, as Peak Oil passes world-wide and OPEC too descend down the bell curve, they face a grim future because most of them have no other viable economic exports and their populations are growing exponentially.
Although time prevents us from delving into this, the little known conditions of OPEC are startling, especially in light of our massive military presence in the region to “protect our vital strategic interests.”
Peak Oil and Public Health
So what is the future of public health in a post-petroleum world? Let’s go through several wide-ranging scenarios organized around the concept of overshoot to get a feel for how they would affect public health.
I say “get a feel” advisedly. It is my opinion that the distress of this topic has opened the door to all manner of prophets and prognosticators. From left to right, from anti-modernist survivalists to computer science utopians, to permaculturalists to Marxists to fascists, and so on, many are foretelling the future. But we all know that experts are typically wrong about the future; they too suffer from confirmation bias, overlooking or misconstruing their past mistakes, and from misunderstanding statistics and misapplying probability theory. And some will dissemble for a bit of fame and fortune. Also, bright and gifted people are wont to ignore a great deal of disagreeable information, thinking their intelligence is sufficient.
Further, we are not rational creatures; we possess rationality, but we are –especially when under collective social stress—subject to the spell of mythic “quick fixes” and explanations (Morrison, 2002). Relatedly, I mention Isaiah Berlin’s famous Hedgehog/Fox dichotomy, where the hedgehog knows a great –“optimal” -- deal about one area and the fox knows a sufficient –“satisfycing” -- amount about many things. Since peak oil cuts across so many fields and is of such potential magnitude, there will be many highly intelligent hedgehogs who think what they know (in depth) is most important to peak oil. I’m a fox, myself.
Given what we know about ourselves I believe that we should, on the one hand, look skeptically at those who have totalizing analyses, answers, and predictions. On the other hand, we should not mistake motive debunking –“you make this argument because you’re misanthropic”—as refutation. To inject some sixties pop culture triteness, “Something’s happenin’ here…”
So I begin with this question: what do we know with some degrees of empirical and logical certainty?
1. Oil is a resource modern society relies upon to operate.
2. Populations and economies are growing as oil production is about to plateau and then decline.
3. We presently have no scalable substitutes for oil (and don’t forget that it has multiple uses beyond transportation).
4. When critical resources, or one critical resource, become scarce, if no substitute is available, something will have to change in the population-economic activity-ecology equation.
5. If society does not make changes, nature will do it, typically through the biological mechanism of a population Die-Off that reestablishes the balance.
This is, I suggest, a bare-bones a scientific grounding from which to assess Peak Oil.
The following scenarios are minimalist; the more detail given the less credible the scenario because things virtually never work out just as predicted. And, most important, human actions can, if taken in time, alter the future –this is my primary reason for engaging in this project.
• No Overshoot
Most classically trained, or “free market”, economists argue that Peak Oil is a temporary setback or literally of no consequence –it’s a meretricious concoction of tree huggers who cannot admit that the Market solves all problems. “Yes, we’re running out of oil, but so what?” they retort. All that’s needed is a substitute(s) for fossil fuels. Once our intellectual talent is focused on the task, we’ll find scalable and suitable energy alternatives and we’ll carry on with progress and growth for a long time, even into outer space and to other planets. We are, after all, an exceptional species capable of great ingenuity and, as we realized from the fall of communism, we have reached “The End of History” (Fukuyama, 1992), meaning that all human social problems are resolvable in the capitalist framework. As well-known free-market enthusiast Julian Simon said, “The material conditions of life will continue to get better for most people, in most countries, most of the time, indefinitely.” Accordingly, all environmental issues in addition to or associated with Peak Oil will be solved in due time. There will be no overshoot -- it is an impossibility.
This definition of the situation assumes 1) that the Market and technology are receiving signals from the earth that are timely and decipherable; 2) that the economy does not rest on the foundation of the earth’s ecology; and 3) that humans are detached from and managers of nature, not a part of it. Moreover, it assumes 4) that technological fixes carry no serious unintended negative side-effects, that they are relatively costless to society, and that they can be implemented “just in time.”
I find this formulation na�ve and myth-inspired in extremis. But if I am wrong and it is correct the challenge to public health is nil, therefore, I have spent the last few minutes building a spurious argument.
As for public health under this no overshoot scenario, it will continue on as it is: under funded relative to its preventive mandate, which is broad and hard to define, and relative to the resources allocated to treatment medicine. No one in this audience needs to be reminded of the vast funding disparities between treatment-style medicine and public health. It is no exaggeration to say that in America one hundred pounds of cure at whatever cost is preferable to an ounce of prevention. Indeed, public health funding is reminiscent of Solzhenitsyn’s description of his years in the Soviet Gulag: just enough nourishment is provided to keep you alive and working as more tasks are tacked onto your work routine.
In this era of extreme emphasis on individualism –the “Ownership Society”—we have off in the corner the embarrassing spectacle of public health emphasizing collective, community-wide solutions for the common good. Accordingly, government views public health with ambivalence. On the one hand, public health works; even the Pat Robertsons of this world have no argument with germ theory and the fact that life-threatening microbes evolve and need to be interdicted, the truism that commercially served food must be inspected, and so on. In addition, citizens trust public health to protect all of us –rich to poor. It is too risky for any politician to attack public health head on to dismantle it, but public health is so misunderstood by the public and by many in government that it is not important enough to properly fund. So it limps along.
• Short-Term Overshoot
As previously noted, my view is that at the least we are in for a period of transition to new energy source(s). Accordingly, systems such as transportation, food production and distribution, government services, health and medical care, living arrangements, and so on, will have to either adjust to a temporary condition of scarce and expensive energy, or they will stop functioning. In this picture there will be a recession, the overshoot will be corrected, followed by a recovery.
Obviously, the longer the transition lasts the more serious harm it will bring to society. As with the previous scenario, there is no assumption here that there are limits to growth, or that the overshoot is anything more than a temporary phenomenon that the market will correct; we just have to solve the energy problem, and this may require massive government investments and policy adaptations and “interference” in market forces to complete the transition successfully. This is reminiscent of the traditional “Keynesian” role of government in the market. Nonetheless, this slight overshoot may impel many citizens and public health professionals, practitioners and academics, to question pure free market capitalism and give serious consideration to limits to growth ideas, lest another overshoot come along. (I say more on this in the next two scenarios.)
Under this scenario the public health system will be distressed even more than it is now, but it will survive and whatever damage is done to the economy and other social institutions will be repaired.
Ironically, from a utilitarian public policy perspective, we could expect support for public health to increase as the most cost-effective, democratic, national security oriented, and humane approach to protecting the health of the nation. This is both ethical and logical. However, we must keep in mind that the United States is the only Western nation that still officially denies climate change and, along with Australia, treats evolution as a “theory” alongside Creationism. Also, the great hopes raised for building the public health infrastructure after September 11 are now largely dashed as, overall, public health systems continue to decline throughout much of the nation.
There is a great chance here for a “false dawn” subplot. Using coal or other bio-fuels aggravates climate change, and after decades of governmental denial I think we can agree that even if there were no impending petroleum scarcity crisis, climate change in itself could set off the same chain of events discussed here.
Finally, if the overshoot continues and no viable long-term solution is in sight, then the natural progression is to the next scenario, an economic depression.
• Long-Term Overshoot
If Peak Oil passes with no viable energy alternatives in place or in development the outlook for industrial society is dire overshoot on the downside of the curve to the end of the petroleum era . The increasing shortages and then widespread scarcity will create waves of economic, political and social crises, including widespread violence created by resource scarcity (Homer-Dixon, 1999).
Some of you may have read the book, The Long Emergency (Kunstler, 2004), a title that connotes an extended period of hardship and in all probability a society-wide realization that there are limits to growth . This means that standards of living in Western countries, especially the United States, will decline permanently as industrial society tries to reorganize and find a new balance –at a lower level of material comfort and consumption -- with the natural environment, one that ends the overshoot and avoids future ones. Kunstler seems fond of mid-nineteenth century rural life and sees this as a stabilization point for the overshoot. I have no way of assessing if this return to past ways of the mid-nineteenth century is viable, or if this is simply where his heart has led him.
As the crisis continues, it is likely that academic public health will lose its support from government, as will much of the government funded research now conducted in universities. Simply put, academic public health may go out of existence along with many other “Big Science” academic fields that rely on state and federal government support because it is, as much as those in the audience are distressed to hear it, a luxury of the petroleum era.
Public health in the community is another matter, as is the knowledge base the field has produced over the past century; these will survive in some form and perhaps even “prosper”. Since public health is a local matter, the support for public health departments should vary from state to sate, and even locale to locale, being strongly supported in some areas and eliminated in others, probably depending on the strength of communitarian versus individualistic values.
The major questions then become, When --how long will it take? -- and at what economic levels and social sacrifices will society stabilize? Put differently, will industrial society be able to find an alternative energy source that will allow it to survive in any semblance of its pre-peak oil activity and organization?
The amount of widespread suffering within this scenario will be enormous and distressing. People will search for a source of hope –to persevere -- as society’s collective mental health –the threat of massive depression seems obvious -- is placed at extreme risk. Although religion can help to fill this need, still we live in a secular society and a scientifically based explanation –that has as a subtext a narrative of optimism—will be needed, not as competition to religion but as a complement to faith-based exegesis.
This narrative will in all likelihood be based upon the insights and knowledge generated by various scientific fields: evolutionary biology, human ecology, demography, geography, human genetics and evolution, anthropology, among others. The core messages:
* There are ecological and geological limits to growth.
* Perpetual technological progress cannot be sustained by the planet.
* The earth is LIKE a living system, and humans have a place in it, but are not masters of this system that is the earth.
Not incidentally, public health is likely to transform itself to conceive of the earth as its central concern because this is the next logical step for it to take. And just what does this mean? One tiny example: public health would encourage citizens to do an “ecological footprint” inventory in the same way it now advocates body mass indexes. In more familiar terms, one can hear “Systems Theory” every day in the hallways of schools of public health. Unfortunately, it is social systems, not ecological systems of the earth that public health academics discuss at great length; but the idea is the same: things are interconnected –everybody in public health acknowledges this simple insight.
Indeed, the Institute of Medicine’s Future of Public Health (2002) gives slight attention to the ecology either for the future of public health or for academic public health education. For example, the Institute’s Power Point diagrammatic slide on “Assuring Conditions for Population Health” makes no reference to the earth’s ecology. The factors listed are socio-cultural:
* The Community
* Health Care Delivery System
* Government & Public Health Infrastructure
* The Media
* Employers & Business
The gorilla in the parlor is not acknowledged. By the way, I like gorillas; like all primates, they are social and have significant empathy, but you do have to be aware of their presence.
If the overshoot cannot be resolved by humans, nature will enforce its solution, at which point human actions will be stochastic and irrelevant to the collective outcome.
• Unrecoverable Overshoot
Die-off is a natural conservation process that is actuated when rising demand for the earth’s resources intersects the declining availability of those resources. As Tainter, (1988) notes, collapse is nature’s way of economizing, and the one thing we know about all civilizations, which are above all else economically complex, is that every one that has ever existed has collapsed. Greer (2005: 1) writes that the 1992 update of the Limit to Growth concluded that to avoid industrial collapse and a subsequent die-off “would have required the citizens of the United States to accept Third World living standards.” In other words, we would have to engage in voluntary de-consumption, which the vast majority of Americans would find an absurd violation of all that they believe about their national identity.
Even if this is the long-term consequence of Peak Oil, it will not arrive according to a Hollywood action script; most likely it will take decades to unfold as a series of rolling and interconnected crises, each one more difficult to cope with than the previous one because resources become scarcer and scarcer as more and more systems break and infrastructure decays as population rises as a demographic certainty for at least the next several decades. However, new forms of socio-cultural organization emerge as it becomes clear to the members of the collapsing society that the old ways no longer work and new ways begin to “make sense.” But let us be clear: overshoot created by a lack of energy means the human population of the earth will shrink to a sustainable number.
Although anthropologists tell us that humans are capable of appraising their circumstances and acting prudently to save their society, the signs that such foresight is occurring on anywhere near the scale it needs to occur are not apparent. On the other hand, evolutionary biologists (Morrison, 2002) appear certain that our genes have led us into plague species status, which means that we are overrunning the planet with people and pollution. This genetic explanation implies that there is little we can do to save ourselves as a species.
Abiding by the criteria I laid out at the beginning of this section of overshoot, I think a die-off of human life --as well as great destruction to the earth’s biosphere -- possible within this century . Oil is the initial resource to become critically scarce. But as most of you know we face a plethora of interrelated environmental crises, what E.O. Wilson terms the “Bottleneck” humanity must pass through to survive what it has wrought.
What should we in public health do? At the least, acknowledge what petroleum means to contemporary society and, especially, to the foundation and future of public health. And then talk but not fall into the trap or “mortis-through-rigor”. From there, we begin the processes of genuine strategic planning. Much is written and said about bridging the gap between practitioners and academics; this is the pressing issue to do so.
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