Riassunto esame Environmental economics, Prof. Borghesi Simone, libro consigliato Global Sustainability - Social and Environmental Conditions, Simone Borghesi e Alessandro Vercelli

Health and the Environment

PURPOSE

This presentation aims at discussing:

• The health consequences of environmental problems

Structure of the presentation:

• Main health determinants
• Impact of environmental degradation on health

The role of health and its determinants

Health is a crucial index of the quality of life and of sustainable development. The main factors that determine the health of a population are:

• Genetic factors
• Dangerous behaviors (smoking, alcohol, drugs abuse, sedentariness, etc)
• Quality of medical care and infrastructures
• Socioeconomic factors (extreme poverty listed in the International Classification of Diseases with a specific code as other diseases)
• Ecological factors

The influence of environmental degradation on health

Bad environmental conditions are directly responsible for about 25% of all cases of illnesses (WHO, 1997). Environmental risk factors, moreover, play a role in more than 80% of the diseases regularly reported by the World Health Organization.

Account for more than one-third of the disease burden among children (WHO, 2005).

3 main channels:

1. Atmospheric Environmental degradation
2. Water
3. Soil

1) Health impact of atmospheric pollution

Large increase in respiratory diseases

Fine dust (PM10), nitric oxide (NOx) and sulphur dioxide (SO2) from traffic, heating and manufacturing can penetrate into the bronchioles provoking asthma, bronchitis, and emphysema, pneumonia (main cause of children mortality around the world)

In Italy:

• With an estimated cost up to 800 MLN$ (World Bank)
• 20% of non-smoking, otherwise healthy individuals suffer from this disease in Italian cities

In Bangladesh:

• 15,000 premature deaths
• 1 million people suffer from respiratory disease

Cardiovascular diseases:

Once inhaled, pollutants are carried round the body in the blood

• A high concentration of carbon monoxide in the air reduces the blood capacity to absorb oxygen
• A high concentration of particulates raises the

incidence of death caused by cardiovascular diseases

Urgency of action: 10% reduction in ozone and particulate emission by 2020

Could avoid:

• 37.000 premature deaths in Mexico city
• 13.000 premature deaths in San Paulo

The Chinese case:

China Daily (October 22, 2013):

• World Health Organization safety threshold PM2.5 = 20 μg/m3
• in Beijing average annual level PM2.5 = 100 μg/ m3 - micrograms for cubic meter of air
• in Harbin on that day PM2.5 > 500 μg/m3 (but >1000 in some areas)
• in Harbin visibility < 100 m (airports, highways, schools closed)

Ozone layer reduction increases exposure of the body to ultra-violet rays→ skin diseases and damages to the visual organs

2) Water consumption and health

Millennium Development Goal: halve by 2015 the number of people worldwide without access to safe water and sanitation services

World population with access to safe water: from 73% to 80% during the '90s but still

• over 1 billion without access

to safe water (120 million people in the WHO European region that covers 52 countries)• 2.6 billion without access to sanitation (OECD, 2006)↔ ↔• Lack of water poverty healthWater pollution indicators• Biological oxygen demand (BOD): oxygen consumption by living species in the water• Chemical oxygen demand (COD): oxygen consumption when a chemical product is introduced in the water– Water pollution increases the concentration of bacteria that compete for oxygen consumption with fishes and other living species in the water– Nitro phosphates favor the growth of algae. Such a process increases oxygen consumption.• Concentration of faecal coliforms in the water• Heavy metals and chemical products– Difficult to remove from drinkable water, tend to cumulate in the fish– Causes: industry, agriculture, miningImpact of water pollution on healthPresence of heavy metals (lead, cadmium, mercury, arsenic and nickel) polluting chemical

products (DDT, atrazine, dioxin, etc)

• heavy metals such as nickel cause serious damage to the nervous system
• others, such as lead, mercury and arsenic harm liver and kidneys
• heavy metals and chemicals increase the risk of tumor by polluting soil, grain, vegetables, livestock, poultry and fishing products

conditions favorable for the survival and spreading of mosquitoes responsible for malaria (e.g. Anopheles gambiae): 90% of total cases in Sub-Saharan Africa; 1 mln deaths among children aged under five

• Concentration of fecal coliform bacteria in water where there is no efficient treatment diarrhea, cholera, hepatitis, typhoid fever, etc.
• 88% of total diseases among individuals aged under 15
• 5 millions deaths per year due to digestive system diseases deriving from lack of safe water and sanitation

In developing countries 95% of water is untreated

• 80% of all diseases in developing countries are water related, leading to 1.7 millions deaths

each year (OECD, 2006)

Impact of water pollution on health: examples

The case of Bangladesh and Bengala:

• in well waters used for drinking by the local population since the 1980s, the quantity of arsenic found was fifty times greater than the permitted safety level (The Economist, 2001)
• contaminated population could number between 35 and 77 MLN people; prolonged exposure to arsenic causes skin disease and tumours of lungs, bladder, liver and kidneys (Smith et al., WHO, 2000)

Water consumption/pollution: additional economic consequences

• Defensive expenditures increase (in developing countries 25% of inhabitants in urban centers pay for drinkable water)
• Hengshui city: total health loss caused by water pollution amounts to 0.06% of GDP (Wei, Meng and Bai, 2003)
• Xi'an city: total health loss caused by water pollution ranges between 0.23 and 2.02% of GDP (Xu, Cao and Hu, 2004)
• Tianjin city (Huaihe basin): water pollution and scarcity posing major

development constraint (Xuemei B., HidefumiI., 2001)• Decentralization in China that gives more resources to local authorities to fund defensive measures can improve performance (Kahn and Liu, 2008)

3) Soil pollution

Most chemical, biological, and radioactive pollutants settle on the soil contaminating the crops and agricultural products

• Gasoline: lead
• Fertilizers: atrazine, dioxin -radioactive waste
• Production of nuclear energy - accidents (e.g. Chernobyl)
• Wars: Inequality and health

Environment-Health: the indirect links Bidirectional arrows denotes the existence of very complex relationship between all the variable in the diagram. How this arrows can be interpreted?

Env. Degradation affects the economic system: env. deg. reduces labor productivity, and so had an impact on economic performances at microeconomic and aggregate level (because also a GDP loss). Also, env. deg. causes the economy as a whole to suffer from need to reconstruct (destruction of infrastructures caused by fires, hurricanes,

etc..).
N.b: “Dynamics” as ambiguous term, both positive and negative meaning. Infact env. deg. can also increase economic performance.
- Economic dynamics affect env. deg: Env. Kuznets Curve, how economic growth affects env. deg.
At the end, economic dynamics affect health -> then, increase in life expectancy that we observed over time is related to the improvement of economics system (higher GDP per capita that we can enjoy).
- Health can affect economic dynamics because healthy people are more productive, and tend to increase economic performance.
-Env deg. affects population dynamics because it kills people. Ceateris paribus it increase the mortality rates and migration (“Environmental refugees”, projected to become the largest group of refugees in the future), as well as birth rates.
Migration can cause an environmental footprint that affect env. deg. (also considering the concentration in clusters, not a uniformal distribution usually) -> spread of diseases.arrows express cause and effect and the same time. So there are not only direct link, but also indirect links that we should take into account.

Inequality and health: empirical evidence

• More unequal societies tend to have lower average health (e.g. life expectancy)
• Concave relationship between life expectancy and per capita GDP both across countries (Preston, 1975) and within countries (e.g. Wilkinson for UK, Deaton for US)

The income-health relationship

Life expectancy reaches a maximum.

Yp -> Income of a poor person. Using the function, I can read in the vertical axis the correspondent life expectancy (B).

Yr -> Income of a rich person. A= It's life expectancy.

OC -> Calculating the average life-expectancy of a person.

If you redistribute income so to not have inequality (equal society), you end in Ye, and the life expectancy correspondent is OD which is higher than OC -> life expectancy is higher if the society is Equal.

The health-inequality relationship

• Inverse

relationship between health and inequality: The higher the (in)equality, the higher (lower) the life expectancy● The inverse relationship reflects a concave relationship between health and per capita income● Indirect relationship between inequality and health The Relative Income Hypothesis● Inequality adversely affects health (direct relationship)● Rich: insecurity (petty crime, riots, social and political instability)● Poor: anger, envy, psychosocial stress, depression from unsuccessful comparison● Benchmarks: neighbors ("Keep up with the Jones"), relatives, friends, colleagues, TV stars etc..● What matters is how inequality is perceived: Meritocratic or not? Learning from other disciplines● "..in human and non-human primates (such as baboons and macaques) the experience of a low status severely damages health producing "obesity, glucose intolerance, increased atherosclerosis, raised basal cortisol levels and attenuated cortisol responses to

"experimental stressors" (Wilkinson, 2002, p.15 and literature there cited). The physiological mechanism is based "on the effects of sustained activation of the hypothalamus-pituitary-adrenal axis and the sympathetic nervous system. The stress response activates a cascade of stress hormones that affect the cardiovascular and immune systems" (ibidem, pp.15-16)."

● Short-termism: myopic emphasis on short-term objectives to the cost of jeopardizing the achievement of longer-run objectives

● Analogy with economic short-termism in financial markets and labor markets (managers, temporary contracts etc..) Happiness and health

The income-health relationship (Preston, 1975) Similar relation with:

The Easterlin paradox (1974): the income-happiness relationship

The happiness-income relationship

● Concave rel