cc  >> Kevin Check: Good afternoon.  Welcome to today's  Global Hot Spots lecture.  My name is Kevin Check.  I'm the senior director of  School and College Relations at  the Wisconsin Alumni  Association.  WAA is very pleased to continue  our partnership with the  Division of International  Studies and PLATO and  Continuing Studies to bring  this programming to you.  Today, we're happy to welcome  Professor Jonathan Patz as our  speaker.  He is professor and director of  Global and Environmental Health  at UW-Madison.  He co-chaired the Health Expert  Panel of the US National  Assessment on Climate Change.  For the past 15 years, Dr. Patz  has also been a lead author  for the United Nations  Intergovernmental Panel  on Climate Change and shared  the 2007 Nobel Peace Prize  with Al Gore.  He is president of the  International Association for  Ecology and Health and co-editor  of the association's journal,  EcoHealth. 

 He has written over 90 peer  reviewed papers and a textbook  addressing the health effects of  global environmental change.  He has been invited to brief  both houses of Congress, served  on several scientific committees  of the National Academy of  Sciences, and currently serves  on science advisory boards  for both the CDC and the EPA.  In addition to his sharing the  2007 Nobel prize, Dr. Patz  received an Aldo Leopold  Leadership Fellows Award  in 2005, shared the Zayed  International Prize for the  Environment in 2006, and earned  the distinction of becoming a  UW-Madison Romnes Faculty Fellow  in 2009.  Please join me in welcoming  Professor Jonathan Patz.  [APPLAUSE]  >> Jonathan Patz: Kevin,  thank you, very much,  for that kind introduction.  I never like giving  global warming talks  when it's really cold outside.  [LAUGHTER]  Usually tend to schedule  these in the summertime.  I was actually testifying in the  state capitol this week and  people were talking about how  cold it is and do they think  it's really global warming, and  I referred them to our Gaylord  Nelson Institute for  Environmental Studies Center for  Climatic Research here on campus  to get the real story.  Because we actually are in a  solar minimum with our lowest  number of sun spots.  So it was predicted to be cold  for the last couple of years. 

 So don't let that fool you.  If I could have the front lights  down a little bit, that would  help.  Oh, we can't?  Okay, well, how about  all the lights out?  No? Okay.  Well, let's see I think the next  one, okay, well, so I work in a  center, the Nelson Institute  Center for Sustainability and  the Global Environment, SAGE.  And in our center I have an  incredible lot of fun doing  research because I am working  with, I'm in public health but  I'm also working with people  that do air quality, air  pollution modeling, urban design  and the built environment and  how the urban environment  affects society, agriculture and  agricultural sustainability,  water resources, energy and  climate.  So I'm in an integrated center  that is so fun to be in because  we're trying to tackle these  complex issues that if we did  try to look at, for example, the  health issues of climate change  and we just dealt with the  health sector, we'd be missing  90% of the issue.  So it's really exciting to work  in a center like SAGE.  Now, I'm not a climatologist,  I'm a public health expert, but  I want to put this up because  there has been controversy in  the press lately about the  climate science and I would tell  you that what happened at East  Anglia, this one university in  the UK, that's not the driving  database of the IPCC, it was one  of many.  We have our own with NASA, NOAA,  they're all showing warming.  And so the climate science issue  over these emails, rather than  the science really, is way  overdrawn and very polarizing. 

 So I just want to tell you why  most climatologists, except for  a handful of skeptics, believe  we are having global warning and  it's from human activity, from  human pollution burning fossil  fuels.  And I'll just show you this one  graph where if you look at the  bottom these lines are  diverging, and basically the  black line is the observed  warming that we've seen.  So you can see it's been going  up lately.  The blue line is everything that  the climatologists know about  natural climate variability,  El Nino, sun spots, volcanoes,  ocean oscillation cycles, we're  entering into an El Nino cycle  shortly.  They're all sorts of ways that  climate changes because it's  always changing.  So when you look at what's known  about natural climate  variability, which is the blue  line on the bottom, and what is  measured and observed today, you  see that they diverge.  Now when you add on top of  what's known about natural  climate variability, the blue  line, if you add on top of that  anthropogenic climate forcing,  in other words, human induced  pollution, how humans are  contributing gases into the  atmosphere, the observed warming  matches perfectly with what's  expected with a combination of  climate variability and human  induced greenhouse gas effects  on the climate.  Now there's plenty of  uncertainty here so you can't  really predict the future, but  the climatologists, the models  are getting better and better.  They can look backwards a  thousand years and they can see  how well their models calibrate.  All I'll tell you is that this  is why in the last assessment  report when the climatologists  look at all sorts of different  indicators for human induced  climate change versus natural  like disproportionate warming at  the poles or changes in  nighttime temperatures, all  sorts of different things that  are the signature of human  forcing of the climate, the IPCC  is now about 90% certain that  the warming is from human  pollution. 

 So that's all I'm going to say  about climate because if you ask  me, is climate change really  happening?  I'll tell you to go ask the  climatologists that I work with.  I just work with their  information because I'm a health  person.  And I refer any of you to this  Web site: www.IPCC.ch  So this is, you've probably seen  Al Gore's movie.  How many of you have not seen  Al Gore's movie yet?  A few of you, okay.  Al Gore's movie shows that a lot  of what's going on today is  unprecedented.  Right here we're at today's  climate which is warmer than any  other climate we've had in the  last thousand years, even above  two standard deviation.  And the projected rise in  climate change, you can't  predict the future but you can  run scenarios.  What if we keep burning fossil  fuels?  What if population keeps going  up?  Or what if we reduce our  emissions, population  stabilizes, there's all sorts of  range, a whole range of  different scenarios and within  the next century, those  scenarios are ranging somewhere  between one and five degrees  centigrade warmer.  That's an average global  warming.  Best estimate, say, two and a  half to three degrees centigrade  warming by the end of this  century. 

 That's pretty rapid when you  think about the earth's systems  and you think about changing  ecosystems, adapting to that  type of warming.  So I know that reading the news,  it's very confusing and I was  hearing a representative a  couple days ago talking about,  well, you know, it's been cold  for the last two years, I don't  believe global warming anymore.  And what about the East Anglia  emails and the guy talking about  the Himalayan glaciers, you  know, it's all just made up.  Well, this is not made up.  This is a satellite image of the  north pole.  And this is summer of 1980 and  you can see the extent of ice.  Now, a few years later, 2007,  all the red stuff has melted.  Now, you guys, are you all  alumni from UW?  Most of you.  So you're smart people.  [LAUGHTER]  And I know what you're thinking,  I really do. 

 I know you're thinking,  oh, come on he picked  a really bogus year.  2007 was supper hot and extreme.  So let me show you the actual,  let me show you the extent of  ice melt, which is half of the  United States.  That's the area of ice melt.  That's how much ice has melted.  Let me show you the long-term  trend.  What you're looking at is from  1900 to present and this is a  modeled future.  What you see on the bottom line  here is worse case scenario for  how fast the glaciologists think  that the ice caps will melt.  So they're going to be melting  and melting and melting over the  future.  Now the best case scenario,  maybe they're not going to melt  quite as fast, that's the top  line. 

 This is the best case scenario  for melting glaciers.  And the red line, what is the  red line you think?  That's reality.  So the red line is observed  melting which is melting faster  than anyone expected.  And when this Arctic assessment  report came out, this report  shocked the climatologists.  They said, oh, my god.  Things are happening worse than  our worse case scenario.  So it's observations like this,  that's pretty scary because if  the Arctic goes, the changes to  the earth's albedo,  reflectivity, so the earth will  be absorbing even more, if the  Arctic tundra thaws out and  releases methane gas, which is  10 times stronger as far as a  warming gas than CO2, that could  be very problematic.  So on the cover of "Time"  magazine, be worried, be very  worried.  And of course the polar bear has  become the poster child for  climate change because it may be  no longer pretty soon.  But the polar bear is not the  only species that is threatened  by climate change. 

 One of the subheaders on this  news, on the "Time" magazine  cover was how climate change  threatens our health, which is  what I've been studying for the  last 16 years.  And if we think about climate  change and what its impacts  could be, on the bottom here  primarily we're talking about  rising temperatures, sea level  rise, and extremes of the  hydrologic cycle.  Now when do we get our biggest  thunderstorms?  Summertime.  Do you know why?  Right, because the air holds  more.  Warm air holds more moisture so  when you get warmer air it can  rain a lot harder.  So you get much heavier  precipitation events.  And what about droughts?  Droughts happen when it's really  hot and hot air evaporates  quickly.  So that's where you get extremes  of the hydrologic cycle, both  flooding and droughts from  warmer temperatures.  Sea level rise because of not  only melting glaciers,  terrestrially based glaciers  like Greenland, but also thermo  expansion of saltwater.  And all the estimates from the  UNIPCC are the conservative  estimates of just talking about  thermo expansion of water. 

 So they talk about a half a  meter sea level rise but if  Greenland were to fall into the  ocean, then we're talking about  more like 20 feet instead  of 20 inches or so.  Okay, so how will this affect  health?  Well, we know people die in heat  waves, and the urban heat island  effect is an effect that if we  have sprawling cities with black  asphalt and concrete all over  the place, these are heat  retaining surfaces.  So if you have a heat wave over  a sprawling asphalt and concrete  city, it's that much hotter.  So the urban heat island effect  is a problem.  Air pollution, I'll show a slide  how air pollution is very  sensitive to temperature.  And also biologicals in the air.  Aeroallergens.  So pollen, ragweed and pollen  responds to CO2 and warming.  And then there are these issues  of infectious diseases,  especially vector-born disease  which are mostly insect- and  rodent-born diseases, highly  sensitive to environmental  conditions, and water-born  diseases.  If we have droughts and no water  for hygiene, that's a problem,  and if we have storms and heavy  runoff and contamination of  water systems, that's a problem  too. 

 Any of you from Milwaukee?  That was a problem, 1993 over  400,000 people were thought to  be exposed to this parasite,  cryptosporidium parasite that  causes severe diarrheal disease.  In our analysis, we found that  that was preceded by the  heaviest rainfall in the 50 year  record that we studied.  Anyway, so water contamination a  big topic.  Now, we all know that our health  depends on adequate food and  water supplies and it's good  that the next topic is going to  be symposium on food because  without food and water we're not  here.  So climate change certainly  affects those areas.  And then this issue of mental  health and environmental  refugees.  If storm surges and sea level  rise combine and if droughts  force people from their land,  there are going to be a lot of  populations on the move that are  going to be displaced.  And if anyone studies refugee  health here, you know that those  are big challenges for public  health, huge disease burdens.  So that could be maybe the  iceberg under the tip of the  iceberg.  But very hard to study. 

 Let me give you an example about  food and agriculture.  This is a paper that came out of  Science, the journal Science,  just last year.  And what you see is a map of  future warming and looking at  places that are going to have  hotter temperatures than they've  ever had before.  And on the top, anything in  orange has a greater than 70%  chance of having hotter  temperatures than ever before,  hotter summers.  And on the bottom you can see  that, let's see, the top graph  is by the middle of the century,  like 2040 to 2060, so 40 years  from now all these places may  experience hotter summers.  By the end of the century, so in  80 or 90 years, everything in  red has a greater than 90%  probability of having hotter  summers than ever recorded.  And what does that mean for  hunger and crops?  Today we have actually closer to  1 billion people at risk for  hunger, and this analysis coming  out of Ros Naylor's group that  we actually have one of our  students working with her now as  a postdoc and we're going to try  to hire her back, that number  could double by the middle of  the century as far as number of  people at risk for hunger.  So climate change could have an  enormous health issue by  affecting food availability.  Are any of you scuba divers?  Oh, good we have some scuba  divers.  And you love the coral reefs. 

 We actually all love the coral  reefs and especially if you rely  on fish as your protein source  to stay alive.  And it's estimated right now  that 27% of coral reefs are  dead.  And about half of these  attributed to climate change.  Now, I'm not an expert in this  topic so if any of you are  oceanographers, please correct  me, but there are two issues at  hand.  One is the warming temperatures  which put stress on the coral  reefs.  The other one that's even  scarier is acidification of the  ocean.  And people are really worried  that with all the CO2 in the  atmosphere being absorbed by the  ocean that forms acid and you  acidify the ocean.  And there's a lot of buffering  right now, but at some point  once the pH of the ocean starts  becoming more acidic, that could  be a major problem, not just to  scuba divers.  Were any of you in Europe in  2003?  Did you experience this heat  wave?  Did you ever, huh?  This heat wave in Europe killed  over 50,000 people in 11 days.  That's a public health disaster. 

 This heat wave was hotter, it  was so far extreme from the  normal distribution of heat  waves that climatologists say  that because climate change  causes an increase in the  extreme events, that's what  we're going to be looking at.  Not just the temperature  creeping up gradually, it's the  increase frequency of very  extreme events.  That's what the climatologists  say is the expectation as far as  heat waves and what climate  change means to ecology and to  public health.  It's these extreme events that  will increase in numbers.  We've had our own heat waves.  Do any of you recognize that  city on the cover of Nature?  Chicago.  Another good answer is, I can't  tell, it's too smoggy.  [LAUGHTER]  When we put this paper into  "Nature," the editors, they like  to have really cute subtitles,  so they called this the  Wheezy City.  Instead of the Breezy City  or the Windy City.  And we had to write them is say  this is not an air pollution  paper, this is a heat wave  paper. 

 And they said, okay, well, they  fixed it.  That is Chicago during the 1995  heat wave.  So not only do heat waves cause  extreme heat that kills people  because they can't handle the  heat and it's a strain on your  cardiac system especially, but  heat waves come with stagnate  air masses and pollution that  may kill actually about a third  of the people that die in heat  waves die from air pollution.  So you have this problem of heat  waves and, on top of that,  climate can exacerbate air  pollution.  We were part of a study that  looked at a projection of  warming for the United States,  the eastern United States, east  of the Mississippi, so that  includes us, and we asked a  question, from the projected  warming across different  scenarios for the United States,  how might that affect ozone,  ground level smog ozone  chemistry?  Because it's a chemical reaction  that's driven by heat and by  ultra violet radiation that  forms secondary ozone pollution.  Now this is not the good  stratospheric ozone that  protects us from UV.  Not the good stuff.  It's the bad, ground level,  photo chemical smog that  nitrogen oxides out of the tail  pipe mixing with volatile  organic compounds like gasoline  fumes and things like that, they  mix.  The warmer the temperature the  more ground level smog ozone  that's dangerous for asthmatics,  the more you get.  And we found that by the middle  of the century, just by  temperatures alone, warmer  temperatures, that could  increase the number of red ozone  alert days by two-thirds,  by 68%. 

 Now on top of that the  climatologists say it's not just  going to get warmer, things are  going to happen with wind  patterns, and, unfortunately,  according to the climatologists,  look at the bottom text, climate  change would decrease the  frequency of surface cyclones.  And in English what that means  is more stagnate air masses.  So there's a concern as well.  Warmer temperatures and stagnate  air masses.  So I want to shift gears and  talk about some issues that are  probably a little more  indirectly affecting public  health, but frankly could be  even more enormous than heat  waves and maybe even air  pollution.  There's this question, could  global warming's greatest threat  also be the smallest?  So what's the message here?  What is the difference between  mammals and insects?  And in this case mosquitoes,  forget the fact that we can't  fly and most of you probably  don't suck blood, as far as I  know.  What's the difference between  mammals and insects?  [INAUDIBLE]  [LAUGHTER]  >> That's have very important  issue.  We are outnumbered which is why  vector born diseases, you can't  eradicate mosquitoes, we tried  and tried and tried because of  resistance and all sorts of  things, you can't eliminate  these insects, that comes into  play.  But physiologically, what's the  difference?  >> Cold-blooded.  >> Cold-blooded, right. 

 Insects are cold-blooded and  we're warm-blooded.  So when the temperature goes up  and down we put on a sweater, we  take off a sweater.  We might hold a sun umbrella or  jump in the water.  Whatever the air temperature is  our body temperature is  relatively the same.  But for an insect like a  mosquito which may be harboring  dangerous parasites like malaria  parasites or West Nile virus,  whatever the air temperature is,  that's the temperature of that  mosquito's body.  So why is that important?  If you look at a disease like  malaria, this is a disease that  we really do understand the  relationship between temperature  and disease development.  This is a graph that shows the  rate of development of the  malaria parasite inside the  mosquito.  And what you see is that, this  is temperature on the Y axis and  the number of days that you  require for that parasite to  develop in the mosquito such  that that mosquito has infective  sporozoites in its salivary  glands so when she bites the  next person, that person will  get malaria, it's temperature  driven.  In other words, if you look at  this, if it's 20 degrees, let's  say this room is 20 degrees,  it's going to take this  parasite, plasmodium vivax, in  the mosquito, it's going to take  about 16 or 17 days before that  mosquito can pass infection to  another person.  What if it's a little bit  warmer?  Is anyone here from down south?  Like Illinois or something?  [LAUGHTER]  So whoever you are, we know you  are messing with the thermostat  and you turned the thermostat up  a little bit and now it's,  I don't know, 23, 24 degrees,  23 degrees let's say. 

 Well that mosquito now  is infectious at day 11.  So by changing the temperature,  if it's a little bit warmer the  mosquitoes are infectious a few  days earlier.  Now if the scheme of things that  infectivity and the rate of  infectivity for these mosquitoes  is enormous as far as driving  malaria epidemics.  Now, I'll be the first to tell  you that climate is not  everything when you talk about  malaria or a lot of these  diseases.  There's drug resistance, there's  pesticide resistance, there's  failed bed net programs or human  populations moving in and out,  there are all sorts of key  factors.  However, if you look at this  graph, the right side of the  graph, you'll notice that these  lines flatten out.  They become asymptotic.  So the lines flatten out.  Which means that if it gets  below a certain temperature, it  takes an infinite amount of time  for the parasite to develop.  In other words, malaria cannot  develop, you cannot have malaria  in a place if it's too cold. 

 Biologically it will not happen.  Now, this is where climate is  extremely important but it's not  the only thing when you look at  the risk in a certain area.  But it's very important.  And you can map, if you take a  place like Zimbabwe, this is a  map of Zimbabwe, and the colors  are indicating climate  suitability for malaria.  Now today, right now, there's  very little malaria in the high  plateau.  And this is the high plateau,  right in the middle of the  country, these sort of cooler  colors, it's high enough, the  temperature's colder, you don't  have a lot of malaria.  And that's where the big cities  are and I think they're there  for that reason.  So if you take today's climate  and superimpose it over this  country, this is the climate  suitability, where you've got  warm enough temperatures to have  malaria transmission.  It's in these lowlands along the  Zambezi River around here and  down here.  Now climatologists say that the  world is warming. 

 What will the projection be in  50 years for this country?  Well, 50 years from now the  highlands become warm enough so  they're plenty suitable for  better malaria transmission.  So this is an area that we have  a lot of concern about  infectious diseases like malaria  changing not only in their  transmission intensity but also  in their geographic  distribution.  And, again, climate's not  everything.  If there's a big difference  between, say, Dengue Fever in  Mexico and in Texas.  Where in Texas we have air  conditioning, screens on windows  and in Mexico they don't.  So Dengue Fever, the mosquito,  aedes aegypti, is already in  Texas, so there's a lot that we  can, infrastructure differences  but we'll still have to be  paying more to reduce the risk.  So we're worried that some of  these diseases are going to be  moving around.  Now I've talked a lot about  temperature effects but if any  of you came out of the Climatic  Center here or know anything or  the Department of Geography and  you guys know climate, you'll  remind me, as climatologists do,  that global warming, it's not  just warming, and that's why  it's called climate change  because it's about warmer  temperatures but also extremes  of the hydrologic cycle,  flooding and drought.  And this is a graph from the  Millennium Ecosystem Assessment,  another national assessment  body, showing that since the  1950s there's been an increase  in the number of floods around  the world.  And this graph, which is  impossible for you to read, but  I'll just tell you, this graph  is extremely important. 

 And that's because this is a  graph showing the projections  for the character of rainfall.  What type of rainfall will  increase with climate change?  And what you're seeing is these  are looking at simply types of  rainfall.  Over here on the left is light  rainfall and drizzling, in the  middle is moderate rainfall and  on the right, that's heavy  rainfall.  And what the climatologists show  is that it's the heavy rainfall  events that are going to be  increasing.  Now, we have a lot of rivers and  lakes in Wisconsin, and rainfall  in our neck of the woods is,  we're already having trouble  dealing with runoff and  contamination like we did a  couple years ago and like we did  in Milwaukee in 1993.  And the climatologists are  saying it's going to be ramped  up, the heavy rainfall runoff is  going to be ramped up.  That's concerning.  This is a slide of combined  sewage overflows, well not  really, it's a slide of Niagara  Falls.  [LAUGHTER]  But what is depicted here  is the fact that we already,  today, without climate change,  we have storm sewage overflow  events.  It rains too much, many places,  like over 700 municipalities in  the United States, still combine  sewage with storm water. 

 Why?  That's how they designed the  system.  It's very expensive to redo it.  And that's what we're living  with.  So there's a lot of places that  combine sewage and storm water.  And we have enough overflows  with our current runoff events  such that it would keep Niagara  Falls running for 18 days.  We have over a trillion gallons  of sewage contaminated  storm water overflowing every  year.  Now put on top of that climate  change projections for more  intense runoff and the fact that  many places, including Milwaukee  and other places, have failing  water infrastructure.  The pipes of leaking.  A colleague of mine over at the  Great Lakes Water Institute at  UW Milwaukee put dye down in  some wells near the stadium, I  think, and found the dye coming  up, I think she put it in sewage  and found it ending up in  drinking water.  This is a major problem around  the country, failing water  infrastructure. 

 So I think actually for our  country, this is a very real  issue.  People think about malaria, they  think about Africa.  This is definitely, this is a  home-grown problem that we're  going to be faced with.  And here we've actually got a  great initiative.  It was started in the Gaylord  Nelson Institute for  Environmental Studies, linked up  with the DNR and UW Milwaukee  and now we've got Department of  Health, there are so many people  involved now, I'm not going to  start mentioning them because  I'll leave some out.  But we have this UW and state  agency initiative called the  WICCI, W-I-C-C-I, which is  Wisconsin Initiative on Climate  Change Impacts.  And so we're talking all these  climate change models and  downscaling them to our state to  ask the question how will that  affect agriculture, how will  that affect health?  So this is a pretty neat  enterprise and we've already  been looking at, for example,  that rainfall issue, it's  exactly the same for our state  as I showed you from the US  global estimates.  This is showing that's it's the  very heavy rainfall events that  are going to be increasing for  the state of Wisconsin.  And this is just a photograph  from my colleague Sandra  McLellan at UW Milwaukee,  showing after a heavy rainfall  this is all the runoff going out  into the Milwaukee Harbor.  And there are E coli and all  sorts of bacteria associated  with that. 

 Luckily, after the 1993  disaster, the cryptosporidium  outbreak in Milwaukee, the  intake for the drinking water  for Milwaukee, they moved the  water intake way out into Lake  Michigan.  So actually it's a very low  probability that that same type  of event will happen again.  But on the other hand, you've  got failing pipes and  infrastructure all over the  city, and if you are swimming at  beaches after one of these  things then you're also going to  be at risk.  So I want shift gears a little  bit.  I've talked about some of the  health concerns of climate  change and I'm soon about to  give you some good news about  some opportunities that we have,  but first I want to make you  feel a little bit guilty and  talk about the ethics of climate  change.  Because we published this map a  couple years ago showing that,  on the bottom, the bottom map  these are some of the more  climate sensitive health  problems.  Malnutrition, diarrheal disease,  malaria, a lot of those diseases  are in developing countries.  So you can see Africa swelling  up with risk for climate  sensitive diseases in the next  few decades.  And this is from the World  Health Organization, this data,  and these maps are not cartoons.  These are data driven cartograms  that were created in our center. 

 So on the bottom you see the  climate sensitive diseases but  on top these are emissions of  CO2, cumulative emissions for  the last 50 years.  So what country is most  responsible for climate change  in the last 50 years?  Which one?  That big swollen giant US right  there.  Now China, in the last two years  China surpassed us.  China now out-pollutes us as far  as greenhouse gases, but this is  for the last 50 years aggregate,  who's most responsible for the  conditions we have today, it  would be pretty much the US,  Germany, China's up there, but  the developed world.  And so when you think about our  lifestyle, Americans produce or  emit six times the global  average CO2 per capita.  So compared to the average  global citizen we are six times  as energy consuming.  And I think that's, I don't  know, I think there's an ethical  issue there.  Are there any lawyers?  [LAUGHTER]  We have a lawyer, oh, good.  Okay, I have a question for this  next slide.  This is a slide about secondhand  tobacco smoke. 

 Now when we banned cigarettes,  it wasn't because we knew  cigarettes were harmful.  We put labels on cigarette packs  and don't smoke if you're  pregnant, especially, heaven  forbid.  Now forget about the nicotine  adjustment issue and making  people more addicted than they  needed to be, that's a whole  other ethical issue, but we did  not have smoking bans on tobacco  until this headline:  Secondhand Smoke.  So what you choose to do  to yourself, and if you can kill  yourself, no problem, it's your  choice.  But when what you choose to do  for yourself harms an innocent  person that is not engaged in  that dangerous behavior, that's  when we have the smoking bans.  So I ask my lawyer here, should  we be liable, what's the  difference between this picture  and this picture of  industrialized countries smoking  away, harming the rest of the  world?  Are we liable?  >> The answer's an army.  >> An army, okay.  So I want to give you some good  news because I really think  there is very good news.  First of all, the amount of  energy that we consume does not  make us live longer.  You get to about this point of  energy consumption as far as oil  burned per person per year,  sure, energy is good and I'm  working on a laptop. 

 But anyway, some energy is good  but the bottom line is if you  burn more and more energy you're  not living any longer.  And in fact, you may start to go  down.  So burning more energy does not  make us healthier.  Now, if we were to fight climate  change, there are some major  sectors like electric power is  about a third of greenhouse  gases.  Transportation is about a third  of greenhouse gases that we  emit.  So let's focus on transportation  because transportation has a  huge impact on our health.  It's estimated from the World  Health Organization, and this  number has gone up again, that  about 1 billion deaths occur  every year prematurely because  of air pollution.  Urban air pollution.  Another number the World Health  Organization puts out is that  about 2 million people die every  year in traffic fatalities.  So here are some problems linked  with transportation. 

 What's wrong with this picture?  [LAUGHTER]  Now by the way, I mean,  the escalators, I don't think  are for wheel chairs.  You wouldn't get on an escalator  so this has nothing to do with  handicap access.  This is simply how we've  designed things, and we have  designed our cities just like  we've designed this fitness  center.  We have designed cities for the  automobile and not for people,  not for people walking, not for  people biking.  We've designed American cities  around the automobile.  And if you think about the  status of Americans, our number  one epidemic according to the  CDC is overweight and obesity.  And you may have seen Michelle  Obama taking on the childhood  obesity problem.  This is just a incredibly  challenging issue.  Americans were 17-pounds heavier  than we were 30 years ago.  15% of children are overweight. 

 Diabetes is on the rise.  60% of American adults do not  meet the minimum recommended  level of exercise unless they  live in Madison, Wisconsin.    Or Davis, California.  But except for Madisonians, and  anyway we've got a nice system  here.  But most cities in America,  Americans are not exercising.  Now you can join up with a  health spa and pay a lot of  money, which I don't think most  people can afford.  But here's a great opportunity,  we've designed cities around  cars and we're not going enough  exercise and obesity is our  number one epidemic, 40% of car  trips are less than two miles.  That could be gotten around by  walking and bus or bicycling.  Here's another issue, another  fact, our 10 leading causes of  death in the United States, most  all of them are related to three  things: sedentary lifestyle,  air pollution or motor vehicle  crashes.  So now we all die of something,  right?  So a lot of people die from  cardiovascular disease but much  of American cardiovascular  disease knocks off some of our  years because of sedentary  lifestyle. 

 So if we could get rid of  sedentary lifestyle and air  pollution, that could be a huge  benefit.  And this is why solving our  transportation problems could  enhance fitness, reduce air  pollution and reduce greenhouse  gases.  It could be this triple win and  it's why I firmly believe that  mitigating climate change could  be one of our greatest public  health opportunities that we've  had in over a century.  That we've designed unhealthy  cities, we have an unhealthy  lifestyle because of it and to  have greener transportation and  greener urban design could be  not only just good for climate  change but great for our  immediate health benefit.  And I have a graduate student  who's running some numbers.  We've done Madison and if the  average commute in Madison  is 3.4 miles and you burn some  calories if you were to bicycle  to work, basically you would  lose nine or 10 pounds a year  until you got to your ideal body  mass.  And as far as risk reduction,  heart attacks reduced by 47%,  strokes by 39%, breast cancer  34%, colon cancer 43%, diabetes  31%.  Exercise, we know, is extremely  important.  And every year that passes, the  importance of exercise is more  and more validated.  This is a very important public  health issue. 

 And also if you were to green  our transportation and have  multiple options besides just  the automobile, it goes in sync  with the new CDC recommendations  for physical activity.  Where instead of the old  recommendation for get a bunch  of intense exercise a couple  times a week, the new  recommendation is 30 to 60  minutes of moderate activity  every day, maybe one day off,  but this is where commuting,  active commuting, active  transport commuting by either  walking to a bus, walking to  work, biking to work or a  combination, this is where we  can have some great headway.  Now air pollution is the second  in the triple win project.  Air pollution is something we  know about.  We know air quality is important  to our health.  And we had a perfect example, a  test case that happened in  Atlanta and it happened again in  Beijing.  In the 1996 summer Olympics, the  planners reduced traffic in  Atlanta because they wanted  cleaner air for the athletes.  Traffic decreased by 23%, and,  not surprisingly, ground level  smog ozone decreased by 28%.  They ended up seeing 42% fewer  asthma cases in children from  that reduced traffic and reduced  air pollution they saw 42% fewer  childhood asthma cases in the  emergency room.  Now, again, because I'm dealing  with UW alumni I will tell you  that it wasn't just because  people weren't driving to the  ER. 

 These guys are epidemiologists,  they have a control here.  Children's emergency room visits  for non-asthma didn't change.  So it was a real effect.  So we know that cleaner air is  healthy.  And we've extended our analysis  from Madison, we've just  submitted this paper actually,  to look at the 11 largest cities  in the Midwestern United States,  and we asked the question if we  only reduce car trips that were  less than five miles and only  within urban environments, what  does that represent?  It represents about 20% of  vehicle miles traveled.  Now, that's pretty high and it  may be unreasonable but Davis,  California, has 18% bike  commuting.  European cities have between 30%  and 50% bicycle commuting.  So 20% we think is a valid  number to use for scenario.  So if we took 20% of car trips  off the road just in urban areas  in the 11 largest cities, we'd  have a change in ozone and  particulate air pollution such  that hundreds of lives would be  saved every year, actually  hundreds of thousands of  hospital admissions would be  avoided and you'd have billions  of dollars in healthcare  savings.  These are not guesstimates. 

 I'm not giving you the exact  numbers because this is under  review right now but billions of  dollars in health cost from  using a cost monetization model.  So this is a tremendous benefit.  Now this week in our state  capitol there is a discussion  right now on bills that have  been introduced following the  governor's task force on global  warming.  There's a bill on clean energy  and clean transportation.  And I was there testifying and I  heard one word over and over and  over and over and over again and  the word was cost.  What's it going to cost?  What's it going to cost in jobs,  what's it going to cost as far  as, coal is cheap so if you use  other sources it's going to cost  us a lot.  Or we've got to put scrubbers on  and pay for all the pollution  reduction.  Well, I didn't hear anything  about benefits.  What would be the benefit of  having cleaner energy  technology?  And I showed you the cost  benefit, I mean the benefits for  reducing air pollution for the  11 largest cities that you'd  save billions of dollars in  health costs, you'd save lives,  that's not even in the argument.  It's not even in the equation. 

 Of course, we did bring it up  and we told them it should be in  the equation, but this was not  in the equation.  And I want to show you one slide  and then I'm going to stop.  This is a brand new, hot off the  press study.  It came out Friday, last Friday,  from our Center for  Sustainability in the Global  Environment where Greg Nemet,  who is an expert in energy  policy, he's also in the  La Follette School of Public  Affairs, Greg Nemet and  colleagues asked a question  about cost of reducing CO2.  People are arguing, how much  should we pay for reducing CO2?  And he compared the cost  of regulating CO2 with the  published benefits of reducing  CO2, health benefits from  reduced air pollution.  And he looked at studies from  all over the world and took the  best studies and basically found  this comparison.  The bottom number is about the  upper limit of what we're  talking about or willing to  spend to decarbonize our energy.  It's about $30 per ton  of carbon dioxide.  That's what we're quibbling over  about, well, gosh, should we  spend that much?  That's a lot of money.  What's it going to do to our  economy?  But, out of the discussion, is  the top number, which is the  average health benefit from  reduced air pollution from  getting CO2, especially from  coal burning, getting CO2 out of  our air. 

 The average health benefit  is $49 per ton.  So in this discussion about  should we clean our energy,  what's it going to cost, they're  not even talking about more than  half of the cost benefit  equation.  How many of you remember the  arguments during the Clean Air  Act.  You know we have the Clean Air  Act, it's been fantastic, but we  had the same argument.  It's going to cost way too much  to put scrubbers on every  smokestack, it's going to cost  us so much we shouldn't do it.  Well, after the Clean Air Act  was mandated and had been in  place, Congress required EPA to  do an assessment of the Clean  Air Act and guess what they  found?  They found a far greater amount  of benefits, the benefits far  outweigh the cost.  I don't remember exactly, it  might be on order of magnitude,  like every 15 cents on the  dollar, you'd have 85 cents of  benefits.  So it's the same story I think.  So when you guys are hearing  these debates, think about not  only the cost but also the  potential benefits, the  co-benefits of cleaner  transportation, cleaner energy.  So I'll end by just saying  here's a quote from Gandhi, of  course, we need to be the change  that we wish to see in the  world. 

 And that's a picture of my house  with the solar.  But I'm a professor here so not  a lot of Americans can afford  solar panels, but there's plenty  to do for conservation.  And I do have to show you my new  station wagon that I really love  here.  [LAUGHTER]  Now when I put this up,  I need to caveat this to say,  am I self-patronizing,  I'm such a wonderful  environmentalist.  That's not the story.  The story with this bike is I  used to live in an east coast  city where I tried to ride my  bike to work, maybe twice, and  quickly realized that I would be  killed far more quickly than  from benefiting from that  exercise.  So living in a community like  Madison where we are gold ranked  for bikeability, affords me,  as an average citizen,  to get around like that,  to take groceries like that.  Most cities, we can't do that.  And we need to strive for  building healthier cities.  Urban planning is public health  policy. 

 And if you live in a place like  Madison, you can do that.  But if you don't, then you need  to work with your urban planners  and your community to model  Madison and Davis and Portland,  Oregon, and cities like that.  I'll just say quickly, if any of  you are interested in coming to  London, our International  Association has a big meeting  there in August, so show up.  Also if any of you know  teachers, there's a Web site for  educational, it's mostly for  K-12 or for middle school  really, ecohealth101.org  has some of these issues for  educators.  Speaking of education, I just  want to tell you about two very  exciting initiatives, brand  spanking new at UW Madison.  Straight down from the  chancellor, there is a brand new  initiative on global health.  Now we have a great Center for  Global Health in the medical  school but now this is expanding  to a university-wide,  multidisciplinary,  multi-sectoral, whole  university-wide initiative on  global health.  To look now, as I mentioned,  urban design, climate,  agricultural, these are all  related to public health.  So we want to take a very  integrated approach.  We want to be the university  that doesn't just have a Center  for Global Health that only  focuses on international health  issues and the immediate crises,  those are important and a high  priority, we want to be the  university that takes advantage  of every amazing college on  campus and pulls together from  engineering, from vet sciences,  medicine, Nelson Institute for  Environmental Studies, policy,  La Follette, the law school,  we have everything, one-stop  shopping here on this campus. 

 So the chancellor wants our  global health initiative to be  the unique, integrated, most  comprehensive, broad-thinking  approach that can happen.  So there's a brand new  committee.  It's up and running.  There's going to be a retreat  with a lot of, there's actually  a keynote speaker, Howie  Frumkin, coming from the CDC on  March 5th.  It's a closed meeting.  It's basically a retreat, but I  just want to let you guys know  that's happening.  At the same time, there is a  chancellor-driven initiative,  brand new initiative  on sustainability led by the  acting director Gregg Mitman,  the acting director of the  Gaylord Nelson Institute  for Environmental Studies.  So around the issues that I've  presented, we have some great  new initiatives on campus  on global health  and on sustainability.  And what I've just talked about,  it's where these things come  together.  I, frankly, don't practice  public health, I practice  sustainable public health which,  to me, is just like sustainable  development, health for today's  generation without sacrificing  that opportunity for the next  generation. 

 So with that, I thank you,  very much, for your attention.  [APPLAUSE]