Dr. Richard Jackson on Healthy Community Design and Transportation

By path2positive

Richard Jackson, MD, MPH, is a Professor at the Fielding School of Public Health at the University of California, Los Angeles. A pediatrician, he has served in many leadership positions in both environmental health and infectious disease with the California Health Department, including the highest as the State Health Officer.  For nine years he was Director of the CDC’s NationalCenter for Environmental Health in Atlanta and received the Presidential Distinguished Service award.  In October, 2011 he was elected to the Institute of Medicine of the National Academy of Sciences.



Recently, the American Public Health Association and ecoAmerica co-sponsored Making the Connection: Climate Changes Health, a four-part webinar series investigating the health impacts of climate change. In the third webinar of this series, participants learned how transportation and healthy community design can ease the clinical impacts of climate change. You can view a recorded version of the webinar here.  Dr. Jackson, a panelist from that webinar, joins us in answering participants’ follow-up questions below.

Q: Climate change is "the issue of the 21st century in terms of human health”. Does America get this, and if not, what might be different if they did?

A: I think, in many ways, the world gets it. Humanity has such a vested interest in the status quo. In the presentation I talked about the fact that something in the range of 6 trillion dollars goes into subsidies for the fossil fuel industry – so there are huge investments and economic interests in everything from steel, which is in enormous overproduction, to concrete (6% of all climate change gases are due to the production of concrete), and huge amounts of wealth are generated by building. Something like 20% of the world’s population are living in cities that are in potential inundation zones. Wealthy places like New York City will probably be OK (they have enough money to build sea walls). Places like Michigan or even parts of Canada view it as an opportunity. But the southwestern US is not going to be livable. As Winston Churchill once said “America always does the right thing after they try everything else.” So things will change, but future generations are just going to be outraged at how absurdly selfish and, frankly, ignorant we are. Yes, 98% of the scientists get it, but people who have vested interest refuse to get it. People will get it when their own lives, their own pocketbooks and their own children are overtly and apparently affected.

Q: What are energy QUADS?

A: See here. 10 to the 15th power BTUs. The energy is 8 trillion gallons of gasoline.


Q: What exactly is "rejected energy"? Is that the same as energy waste?

A: Energy that is not put to purposeful use, for example the heat of your car’s engine. (Other than for the heater in the winter.) For example, power plants must “dump” large amounts of heat.  Also, electrical energy delivery means that energy is lost to transmission and distribution.  Over the last two decades the US national loss average for electrical energy to transmission has gone from 7% to 5% and in California from about 10% to 7%.     


Q: If climate change has direct threat to human health by damaging the vital livelihood processes then what are possible adaptation options available for us to minimize the health impacts?

A: Direct threats include drought, heat, vegetation and crop loss, fires, increased energy and moisture in the atmosphere (more violent weather), sea level rise, population movement (climate refugees), infectious and other changes. Adaptation must range from global, national, regional, municipal down to personal.  There are tons of tomes on this.  At a personal level the design and location of our buildings and homes are critical.  Buildings that are energy and water efficient, machines that can withstand violent weather and sea level rise are a start.


Q: What happened to regulations (Intermodal Surface Transportation Efficiency Act) that banned "building out" (adding lanes) of congested roads unless it could conform to the air quality emissions budget?

A: Not sure. The global and national political clout of the oil, construction, concrete, steel, and automotive industries is enormous.  Also, much of energy policy is interwoven with military and defense strategy.   


Q: How do you balance density with our real need for green space?

A: Paris has 55,000 people per square mile.  New York has 25,000 people/sm.  Atlanta is tough because the city borders are so odd.  The density of the overall MSA of 28 counties is 630/sm.  People need nature contact, vegetation, water features. To keep natural landscapes open requires quality density that attract residents to urban centers.  By quality density I suggest good housing with excellent environmental features (noise reduction, landscaping, energy efficiency, water capture, sightlines), excellent public services (policing, schools, waste removal, transit) and an excellent pedestrian realm (sidewalks, cafĂ© seating, traffic calming) and of course, good parks.

I did a four-hour PBS series on designing healthy communities, and the emphasis of the series is that it has to be top down and bottom up. Top down is leadership that is committed to making things right for people, to sustainability, to contracts that address these issues. Bottom up involves community ownership. You can’t just build things and move away. It’s not just the physical design of the building, but also the management of the building day-to-day. Building managers really matter. And the same is true of parks. We can have quality urban spaces and plentiful open spaces if we build intelligently and humanely.     


Q: In one of James Hanson's popular books, Storms of My Grandchildren, he discusses/debriefs about how he could have done better in a high-level briefing to Congress and the Clinton and the GW Bush administration.  He points to missteps in focusing on data obvious to scientists that went over the heads of the policy makers and were countered by so-called expert "paid doubt" scientists and PR people who spoke more simply and more definitively to support that there was 'reasonable doubt that this is happening globally.  What should be the role of public health in creating more understandable messages that reach the public and policy makers?  What is our responsibility and how can we "justify" our use of government public health funding to work on this issue?  We need to be clear on this to tax payers & my fear is we always get blamed for not using tax payer money responsibly and for being part of the "nanny state".

A: This is an important question—I cannot do it justice briefly.  On the nanny state argument, The institute of Medicine, National Academy of Sciences says:  “The purpose of public health is to fulfill society’s interest in assuring the conditions where people can be healthy.”  

It is in society’s interest to prevent injury and illness, especially in persons not responsible for the harm.  Public health has a long tradition of work to reduce avoidable harms, for example seat belts in cars, environmental tobacco smoke, drunk driving, hazardous chemicals, dangerous work places.  Because climate heating will harm innocent victims in immense numbers, the public health community has an obligation to speak out.  Future generations will wonder why we were so culpably lethargic. 


Q: Would you speak to the hypotheses that personal computers & mobile technology might be contributing to lower PA and new APS to help people to monitor their activity? ...is there evidence that the apps or the motivation of the users may be supporting increased their physical activity?

A: I need to leave this one to a different session.  The critical point I made is that “active transportation”—walking, biking, using transit – burns more fat and less fossil fuels than does driving in a car. It is good for our own bodies, for air quality, reduces congestion, and improves mental status.

Q: Instead of, or in addition to, carbon tax, why not reduce the subsidies given to fossil fuel companies? Wouldn't that have the same effect?

A: I agree, though the subsidies to US companies are not huge and not likely to change behavior. Consumers are price sensitive and do reduce their energy consumption with various price signals. I did assert that a carbon tax should be revenue neutral, that is the amount collected should be returned to the public. As a separate argument, I believe the per person return should be adjusted to the age of the recipient, for example, children should receive more than older persons. Their lives will be impacted much more by the harms of climate heating, while many adults have benefited from the past consumption.  This funding could be directed to both child support programs (schooling, meals, etc.) and to a set aside for education, home purchase, investment, or a retirement account.  

A carbon tax comes down to 25 to 30 cents a gallon on your gasoline, and maybe 50 cents a month on your natural gas, with another 50 cents on your electricity. That generates a lot of wealth. And the money needs to be revenue neutral because Americans are so skeptical about the government getting its hands on their money. So let’s say we generated 200-300 billion dollars with these fossil fuel taxes. We need to give this money back to the younger generations. It’s tragic – they can’t vote. What we’re doing is victimizing. 

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