• Energy Research

Background: Anthropogenic global warming, interacting with social and other environmental determinants, constitutes a profound health risk. This paper reports a comprehensive literature review for 1989–2013 (inclusive), the first 25 years in which this topic appeared in scientific journals. It explores the extent to which articles have identified potentially catastrophic, civilization-endangering health risks associated with climate change. Methods: PubMed and Google Scholar were primarily used to identify articles which were then ranked on a three-point scale. Each score reflected the extent to which papers discussed global systemic risk. Citations were also analyzed. Results: Of 2143 analyzed papers 1546 (72%) were scored as one. Their citations (165,133) were 82% of the total. The proportion of annual papers scored as three was initially high, as were their citations but declined to almost zero by 1996, before rising slightly from 2006. Conclusions: The enormous expansion of the literature appropriately reflects increased understanding of the importance of climate change to global health. However, recognition of the most severe, existential, health risks from climate change was generally low. Most papers instead focused on infectious diseases, direct heat effects and other disciplinary-bounded phenomena and consequences, even though scientific advances have long called for more inter-disciplinary collaboration.

Background: Anthropogenic global warming, interacting with social and other environmental determinants, constitutes a profound health risk. This paper reports a comprehensive literature review for 1989–2013 (inclusive), the first 25 years in which this topic appeared in scientific journals. It explores the extent to which articles have identified potentially catastrophic, civilization-endangering health risks associated with climate change. Methods: PubMed and Google Scholar were primarily used to identify articles which were then ranked on a three-point scale. Each score reflected the extent to which papers discussed global systemic risk. Citations were also analyzed. Results: Of 2143 analyzed papers 1546 (72%) were scored as one. Their citations (165,133) were 82% of the total. The proportion of annual papers scored as three was initially high, as were their citations but declined to almost zero by 1996, before rising slightly from 2006. Conclusions: The enormous expansion of the literature appropriately reflects increased understanding of the importance of climate change to global health. However, recognition of the most severe, existential, health risks from climate change was generally low. Most papers instead focused on infectious diseases, direct heat effects and other disciplinary-bounded phenomena and consequences, even though scientific advances have long called for more inter-disciplinary collaboration.

Anthropogenic climate change, with co-factors, threatens civilization, and thus human health. I first show that climate change is an important element of a system of hazards called “Limits to Growth”. I then argue that the interaction of climate change and other Limits to Growth elements risks civilization “failure” and possibly its “collapse”. Either consequence, were one to occur, entails profound risks to global population health, yet appreciation of this is still largely outside the health literature. I then discuss these relationships (including with civilization's destiny) with bioethical schools. The oldest of these (also called medical ethics) is strongly related to health and medicine, but in a later (1970) formulation the prefix “bio” is broader than human biology, though this school also has roots in human health. Van Rensselaer Potter, widely recognized as the founder of this school, subtitled it “the science of survival”. This subtitle seems to acknowledge an at least implicit risk to civilization. I also briefly discuss environmental ethics. By calling for greater discussion of the risk of civilization failure (or its collapse) this paper makes an important and original contribution to bioethics, however conceptualized. The major scholarly contribution of this paper is its call for the human health literature to refresh its consideration of Limits to Growth, to reconsider aspects that have become marginalized in the health literature, and for health workers to deepen their engagement with related literatures, especially of human ecology. We must contemplate the unthinkable if we are to help avert it.

Anthropogenic climate change, with co-factors, threatens civilization, and thus human health. I first show that climate change is an important element of a system of hazards called “Limits to Growth”. I then argue that the interaction of climate change and other Limits to Growth elements risks civilization “failure” and possibly its “collapse”. Either consequence, were one to occur, entails profound risks to global population health, yet appreciation of this is still largely outside the health literature. I then discuss these relationships (including with civilization's destiny) with bioethical schools. The oldest of these (also called medical ethics) is strongly related to health and medicine, but in a later (1970) formulation the prefix “bio” is broader than human biology, though this school also has roots in human health. Van Rensselaer Potter, widely recognized as the founder of this school, subtitled it “the science of survival”. This subtitle seems to acknowledge an at least implicit risk to civilization. I also briefly discuss environmental ethics. By calling for greater discussion of the risk of civilization failure (or its collapse) this paper makes an important and original contribution to bioethics, however conceptualized. The major scholarly contribution of this paper is its call for the human health literature to refresh its consideration of Limits to Growth, to reconsider aspects that have become marginalized in the health literature, and for health workers to deepen their engagement with related literatures, especially of human ecology. We must contemplate the unthinkable if we are to help avert it.

The establishment of ecological public health as crucial to modern public health is overdue. While the basic concepts have been gestating for decades, receptivity within broader public health has been limited. This position is changing, not least as the population-level impacts of climate change and, more broadly, of limits to growth are emerging from theory and forecasting into daily reality. This paper describes several key elements of ecological public health thinking. These include the 'environmental' risks to human health (often systemic and disruptive, rather than local and toxic) posed by climate change and other forms of adverse global environmental change. Closer recognition of the links between social and environmental factors has been urged--an 'eco-social' approach--and, relatedly, for greater co-operation between social and natural sciences. The authors revisit critics of capitalism who foresaw the global capture and transformation of ecosystems for material human ends, and their resultant despoliation. The perennial call within public health to reduce vulnerability by lessening poverty is more important than ever, given the multifactored threat to the health of the poor which is anticipated, assuming no radical strategies to alleviate these pressures. But enhanced health security for the poor requires more than the reconfiguring of social determinants; it also requires, as the overarching frame, ecological public health.

The establishment of ecological public health as crucial to modern public health is overdue. While the basic concepts have been gestating for decades, receptivity within broader public health has been limited. This position is changing, not least as the population-level impacts of climate change and, more broadly, of limits to growth are emerging from theory and forecasting into daily reality. This paper describes several key elements of ecological public health thinking. These include the 'environmental' risks to human health (often systemic and disruptive, rather than local and toxic) posed by climate change and other forms of adverse global environmental change. Closer recognition of the links between social and environmental factors has been urged--an 'eco-social' approach--and, relatedly, for greater co-operation between social and natural sciences. The authors revisit critics of capitalism who foresaw the global capture and transformation of ecosystems for material human ends, and their resultant despoliation. The perennial call within public health to reduce vulnerability by lessening poverty is more important than ever, given the multifactored threat to the health of the poor which is anticipated, assuming no radical strategies to alleviate these pressures. But enhanced health security for the poor requires more than the reconfiguring of social determinants; it also requires, as the overarching frame, ecological public health.