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19. Two sides of the same coin
Air pollution here and there. And everywhere.
Two new papers on air pollution and health made a big splash this week. Both are great. But also miss the point.
Pollution in the United States
The first paper in GeoHealth tells us how air pollutants - mainly those that arise from burning stuff like gasoline, diesel, and wood - cause around 50,000 deaths per year in the United States. It is good work, and probably more correct than not, even if it is largely based on hypotheticals.
They simply ask ‘how many fewer deaths would result if we suddenly stopped burning things for energy?’
If one could imagine a light switch, where we instantly switched to zero-emitting fuels, around 50,000 fewer deaths would occur in the US. That’s impressive, but it isn’t really practical. It will surely take many years, and hard choices, to achieve zero emissions in order to reap these benefits.
But they go on to argue that we need to account for these benefits as we do the math in transitioning to new energy sources - it’s very easy to ignore these future benefits and we’ve done so, quite well mind you, for generations. It doesn’t help that $4+ per gallon prices for gasoline incurs a cost today, which is much harder to ignore. But compared to those future benefits, that gasoline is not a good value.
This paper reminds us that we are forgoing enormous rewards in the future because we are choose to ignore the smaller costs today.
Pollution Everywhere Else
The second study takes very a different tact. It argues that air pollution (and to a lesser degree, other types of pollutants like lead and contaminated water) continue to cause mortality across the globe.
And perhaps even more concerning, this global burden seems to be pretty stable over time, with not changing much over the past dozen or so years. Despite our best efforts to control pollution, we don’t see mortality improvements that we’ve been hoping for.
This work essentially distills the message down to an acknowledgement that, globally, pollution is still here and it still causes global suffering. And persists even though many developed regions - the United States, Europe, and Australia, for example - have made great strides at keeping pollution at bay which has resulted in a lowering of early death rates.
But these benefits are received only in these nations. No where else.
The challenge is that there are many developing nations who, much like the US and Europe over the last century, seek to develop their economies. The easiest and cheapest way to do build your economy: flood the nation with cheap energy that can be burned, powering factories and small businesses and construction.
Air pollution consequences, be damned, if it means we can build a new highway!
These nations who are building their economies simply want the same opportunities that have been previously afforded to more developed nations. They want safe hospitals, enriching schools, and growing economies. But in using polluting fuels, there is an impossible tradeoff - grow your nation with dirty fuels, but do so at a cost of future deaths; or defer your development, and miss out on economic opportunity (but your lungs will thank you).
These nations may eventually get a new highway. But it’s leading them the wrong direction.
Two Papers, Two Stories
These two papers are both complimentary in their topic, and contradictory in where we should focus our efforts. The first is US-focused and argues that we need to account for clear benefits that come with making better energy use choices. The second says the bigger issue is global mortality from these very same pollutants and that this global burden hasn’t really changed.
In a perfect world, everyone would have access to clean energy, where there are no emitted pollutants, and air pollution related mortality disappears. 50,000 US deaths represent a lot of suffering. It is very important to recognize and quantify these benefits, even if they might occur well into our future.
But at the same time, there are billions of people who still rely on cheap and easy (and highly polluting) fuel sources, and they don’t, and won’t, have the resources to easily switch to alternatives any time soon. And this results in millions of deaths.
My students will tell your that I always teach the ‘three Ps’ that drive environmental health burden - pollution, population, and poverty - and they are critical to understanding burdens of disease. We know pollution causes people to get sick, but this is compounded when that pollution occurs in highly populated regions. And in many parts of the Global South, often there is astounding poverty, which limits what that community can do to avoid or reduce this burden.
The point is that developed nations can make decisions that improve local conditions because they have the privilege and economic ability to do so. But in doing so, we too often forget that there are billions of people who simply don’t yet have that opportunity.
Both papers are correct. But I’m guessing your perspective on this really depends on where you live.