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Health Impact Assessment of Global Climate Change: Expanding upon Comparative Risk Assessment Approaches for Policy Making

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Climate change is projected to have adverse impacts on public health. Cobenefits may be possible from more upstream mitigation of greenhouse gases causing climate change. To help measure such cobenefits alongside averted disease-specific risks, a health impact assessment (HIA) framework can more comprehensively serve as a decision support tool. HIA also considers health equity, clearly part of the climate change problem. New choices for energy must be made carefully considering such effects as additional pressure on the world's forests through large-scale expansion of soybean and oil palm plantations, leading to forest clearing, biodiversity loss and disease emergence, expulsion of subsistence farmers, and potential increases in food prices and emissions of carbon dioxide to the atmosphere. Investigators must consider the full range of policy options, supported by more comprehensive, flexible, and transparent assessment methods.

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Annual Reviews of Public Health
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Holly Gibbs
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International grants totaling $1 million awarded to interdisciplinary Stanford research teams

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Judith K. Paulus
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Projects to enhance health security and child survival in Africa with improvements in water and sanitation, examine why poor business-management practices persist in India, study the relationship of legal courts to politics and human rights, and understand why the Middle East has lagged in economic progress were recent recipients of grants totaling just under $1 million from Stanford's Presidential Fund for Innovation in International Studies.

"These projects have great potential to advance academic knowledge, social capital and human development around the world, and to create a healthier, more promising future for hundreds of millions of people," President John Hennessy said. "When we launched The Stanford Challenge, we committed to marshal university resources to address the great challenges of the 21st century in human health, the environment and international affairs, and it is gratifying to see the response from our remarkable faculty."

The 2008 projects and their principal investigators follow:

Enhancing Health Security Through Infrastructure and Behavioral Intervention: Water, Sanitation and Child Survival in Africa. Alexandria Boehm and Jenna Davis, Civil and Environmental Engineering; Abby King, Health Research and Policy and Medicine; Gary Schoolnik, Medicine and Microbiology and Immunology. The project seeks to improve the health and well-being of the 1.2 billion people in low-income countries who lack access to clean water and the 2.6 billion who lack access to sanitation services, with a focus on mortality reduction in children. It will be carried out in sub-Saharan Africa, where the toll of water- and sanitation-related illness on health is severe, and will investigate the extent to which information and education about water and sanitation at the household level motivates behavior changes that result in reduced morbidity. Results will inform international efforts to design and implement effective water supply and sanitation interventions for more than 400 million Africans currently lacking access.

Why Are Indian Firms Poorly Managed? A Survey and Randomized Field Intervention. Nicholas Bloom and Aprajit Mahajan, Economics; Thomas C. Heller and Erik Jensen, Law School; John Roberts, Graduate School of Business. The biggest single reduction in poverty in the history of mankind was achieved by the industrialization of China since 1978, which lifted almost 500 million people out of poverty. India has not experienced this level of poverty reduction because its manufacturing firms have not achieved the productivity gains seen in China. Recent evidence suggests one key factor is the poor management practices adopted by Indian firms. This project examines why poor management practices persist in India and are much more common there. It focuses in particular on evaluating the relative importance of informational, legal and development barriers. The project will undertake a field survey of Indian firms to evaluate their knowledge of modern management techniques and a field intervention aimed at upgrading management practices in a randomized sample of Indian firms, comparing their progress to a control group of untouched firms.

Courts, Politics and Human Rights. Joshua Cohen, Philosophy, Political Science, and Law School; Terry L. Karl, Political Science; Jenny S. Martinez, Law School; Helen Stacy, Law School. This project examines the role of courts as the centerpiece of strategies for promoting human rights by asking if courts should be a preferred human rights venue or if there are other more accessible and effective ways to secure human rights. It addresses three broad themes: the interplay between national, regional and international courts in the protection of human rights; the role of governments and nongovernmental organizations in influencing legal proceedings; and how courts construct historical truth and shape public opinion, memory, attitudes and discourse about human-rights abuses. The multidisciplinary project will span countries, regions, issue areas and historical timeframes to ask what reasonably can be expected from international, regional and domestic courts in safeguarding human rights.

The Middle East and the World Economy. Matthew Harding, Economics; Lisa Blaydes, Political Science. This project examines why the Middle East has lagged in economic progress compared to much of the developing world and the implications of this underdevelopment for two overarching trends in Middle Eastern politics today: authoritarian government and Islamic fundamentalism. The researchers also will examine how political instability originating in the Middle East has affected world oil prices and world markets by constructing economic models of the world economy. The project seeks broadly to understand the macro- and microeconomic determinants of Islamic fundamentalism and authoritarian rule, and the extent to which these two outcomes have affected the stability and prosperity of the world economy. It measures global factors resulting from increased globalization and quantifies their impact on the development of economies in the Middle East.

The $3 million Presidential Fund for Innovation in International Studies was first established in 2005 by the Office of the President and the Stanford International Initiative to support new cross-campus, interdisciplinary research and teaching among Stanford's seven schools on three overarching global challenges: pursuing peace and security, reforming and improving governance at all levels of society, and advancing human well-being.

The first $1 million in interdisciplinary grants was awarded in February 2006; the second round of grants was awarded in February 2007.

"In all three rounds of funding, it has been heartening to see the imaginative and innovative ways that Stanford faculty are combining intellectual forces across disciplines to tackle some of the most pressing and persistent problems of our day," said Coit D. Blacker, chair of the International Initiative Executive Committee and director of Stanford's Freeman Spogli Institute for International Studies. "It is especially gratifying to see the younger faculty competing for these grants, eager to generate new knowledge and new solutions and help train a new generation of leaders."

Priority in funding has been given to teams of faculty who do not typically work together, who represent multiple disciplines and who address issues falling broadly within the three central research areas of the Stanford International Initiative. Projects are to be based on collaborative research and teaching involving faculty from two or more disciplines and, where possible, from two or more of the university's seven schools.

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Examining Long-term Radiation Effects: Case Studies of the Atomic Bombings of Japan and the Chernobyl Power Plant Thermal Explosion

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This unit explores the long-term effects of radiation through the examination of issues surrounding the atomic bombs dropped on Japan in 1945; and the 1986 explosion at the Chernobyl power plant. We hope the unit provides teachers with the tools and background information necessary to more confidently discuss recent events in Japan with their students.

Climate Change and Global Health: Quantifying a Growing Ethical Crisis

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Climate change, as an environmental hazard operating at the global scale, poses a unique and "involuntary exposure" to many societies, and therefore represents possibly the largest health inequity of our time. According to statistics from the World Health Organization (WHO), regions or populations already experiencing the most increase in diseases attributable to temperature rise in the past 30 years ironically contain those populations least responsible for causing greenhouse gas warming of the planet. Average global carbon emissions approximate one metric ton per year (tC/yr) per person. In 2004, United States per capita emissions neared 6 tC/yr (with Canada and Australia not far behind), and Japan and Western European countries range from 2 to 5 tC/yr per capita. Yet developing countries' per capita emissions approximate 0.6 tC/yr, and more than 50 countries are below 0.2 tC/yr (or 30-fold less than an average American). This imbalance between populations suffering from an increase in climate-sensitive diseases versus those nations producing greenhouse gases that cause global warming can be quantified using a "natural debt" index, which is the cumulative depleted CO2 emissions per capita. This is a better representation of the responsibility for current warming than a single year's emissions. By this measure, for example, the relative responsibilities of the U.S. in relation to those of India or China is nearly double that using an index of current emissions, although it does not greatly change the relationship between India and China. Rich countries like the U.S. have caused much more of today's warming than poor ones, which have not been emitting at significant levels for many years yet, no matter what current emissions indicate. Along with taking necessary measures to reduce the extent of global warming and the associated impacts, society also needs to pursue equitable solutions that first protect the most vulnerable population groups; be they defined by demographics, income, or location. For example, according to the WHO, 88% of the disease burden attributable to climate change afflicts children under age 5 (obviously an innocent and "nonconsenting" segment of the population), presenting another major axis of inequity. Not only is the health burden from climate change itself greatest among the world's poor, but some of the major mitigation approaches to reduce the degree of warming may produce negative side effects disproportionately among the poor, for example, competition for land from biofuels creating pressure on food prices. Of course, in today's globalized world, eventually all nations will share some risk, but underserved populations will suffer first and most strongly from climate change. Moreover, growing recognition that society faces a nonlinear and potentially irreversible threat has deep ethical implications about humanity's stewardship of the planet that affect both rich and poor.

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Feeding the World in the 21st Century: Exploring the Connections between Food Production, Health, Environmental Resources, and International Security

This project involves political scientists, economists, and medical researchers to address the question of whether hunger, poverty, disease and agricultural resource constraints foster civil conflict and international terrorism. Economists have elucidated the links between agricultural stagnation, poverty, and food insecurity, and political scientists have empirically analyzed the role of poverty in facilitating civil conflict.

Fertilizer Use and the Epidemiology and Evolution of Cholera in Bangladesh

The use of chemical fertilizers in developing countries made possible the Green Revolution, and as a result many regions once visited by periodic famines are now food self-sufficient. However, there is a growing recognition that the injudicious use of chemical fertilizers may have adverse environmental consequences including toxic algal blooms and damage to productive ocean fisheries.

Rosamond L. Naylor

The Jerry Yang and Akiko Yamazaki
Environment and Energy Building
Stanford University
473 Via Ortega, Office 363
Stanford, CA 94305

(650) 723-5697 (650) 725-1992
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Senior Fellow, Stanford Woods Institute and Freeman Spogli Institute for International Studies
William Wrigley Professor of Earth System Science
Senior Fellow and Founding Director, Center on Food Security and the Environment
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PhD

Rosamond Naylor is the William Wrigley Professor in Earth System Science, a Senior Fellow at Stanford Woods Institute and the Freeman Spogli Institute for International Studies, the founding Director at the Center on Food Security and the Environment, and Professor of Economics (by courtesy) at Stanford University. She received her B.A. in Economics and Environmental Studies from the University of Colorado, her M.Sc. in Economics from the London School of Economics, and her Ph.D. in applied economics from Stanford University. Her research focuses on policies and practices to improve global food security and protect the environment on land and at sea. She works with her students in many locations around the world. She has been involved in many field-level research projects around the world and has published widely on issues related to intensive crop production, aquaculture and livestock systems, biofuels, climate change, food price volatility, and food policy analysis. In addition to her many peer-reviewed papers, Naylor has published two books on her work: The Evolving Sphere of Food Security (Naylor, ed., 2014), and The Tropical Oil Crops Revolution: Food, Farmers, Fuels, and Forests (Byerlee, Falcon, and Naylor, 2017).

She is a Fellow of the Ecological Society of America, a Pew Marine Fellow, a Leopold Leadership Fellow, a Fellow of the Beijer Institute for Ecological Economics, a member of Sigma Xi, and the co-Chair of the Blue Food Assessment. Naylor serves as the President of the Board of Directors for Aspen Global Change Institute, is a member of the Scientific Advisory Committee for Oceana and is a member of the Forest Advisory Panel for Cargill. At Stanford, Naylor teaches courses on the World Food Economy, Human-Environment Interactions, and Food and Security. 

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