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Unformatted text preview: Series www.thelancet.com Vol 370 September 15, 2007 965 Energy and Health 1 A global perspective on energy: health eff ects and injustices Paul Wilkinson, Kirk R Smith, Michael Joff e, Andrew Haines The exploitation of fossil fuels is integral to modern living and has been a key element of the rapid technological, social, and cultural changes of the past 250 years. Although such changes have brought undeniable benefi ts, this exploitation has contributed to a burden of illness through pollution of local and regional environments, and is the dominant cause of climate change. This pattern of development is therefore unsustainable at a global level. At the same time, about 24 billion of the worlds population, disadvantaged by lack of access to clean energy, are exposed to high levels of indoor air pollutants from the ine cient burning of biomass fuels. Even in high-income countries, many people live in fuel poverty, and throughout the world, increasingly sedentary lifestyles (to which fossil-fuel-dependent transport systems contribute) are leading to chronic disease and injuries. Energy security is also an issue of growing concern to many governments in both the developed and developing world, and a potential source of international tension and con ict. In this Series, we examine the opportunities to improve health, reduce climate eff ects, and promote development through realistic adjustments in the way energy and food are produced and consumed. Energy use, health benefi ts, and challenges ahead The harnessing of energy sources in the service of human needsfuel for cooking and space heating; electricity; transport enabling access to livelihoods, social networks, and services; industrial production; and com- municationsenhances and protects human health in many ways. Indeed, one reason why low-income groups are generally less healthy than high-income groups is due to a lack of access to these benefi ts. At the same time, energy production and use currently pose health eff ects both on workers and the public through industrial hazards, environmental pollution, and injury risks. In view of the scale of the energy enterprise in society, the resulting burden of disease is substantial globally, albeit of diff ering character in rich and poor nations. Another aspect of the present system of world energy is the lack of energy security. Poor people tend to have an insecure energy supply at the household and local levels, which can have important health eff ects. Additionally, energy security is a problem at the international level that aff ects all energy-importing countries, and could alter foreign policy in ways that damage health. Disturbingly, however, the way that energy is generated and used is clearly moving the world into global climate change. Health consequences will mainly aff ect people who are already impoverishedeg, making rainfall even more precarious in parts of Africa, changing the patterns of vector-borne diseases, ooding...
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