White Coats, Population Science and Poison Gas: Fact-Finding Missions by Health Professionals for

Human RightsHoward Hu, M.D., M.P.H., Sc.D.Sujal Parikh Memorial Symposium

on Health & Social JusticeUniversity of Michigan

March 26, 2011

• Wow…Who is this guy???…and how does he know that he can make such a difference???

The seed of my awareness of health & human rights…

Late August, 1988…

• Founded by 1986 by Jonathan Fine

• “health professionals, with their specialized skills, ethical duties, and credible voices, are uniquely positioned to investigate the health consequences of human rights violations”

• Attacks occurred on 8/25/88

• Sulfur mustard (yperite)

• Possibly sarin

• Toxic CS gas used by military on students in Seoul, 1987

• Shootings of health care workers, land mines against students in Burma, 1990

• http://physiciansforhumanrights.org/ • International Forensic Program• Asylum Program• Campaigns

Global Health Action Darfur Survival Campaign Campaign against Torture Campaign to Ban Landmines Investigations

• Global mining operations escalating rapidly world-wide

• Classic environmental health disparities issues…

IPPNW Research Commission (1991-1994)

• Health disparities: the social implications of all this

• A “where was I” moment…

• Where are we 10 years later?• In terms of toxic waste exposures:

Stuck in 1st gear & sliding backwards…

BONE LEAD AND HYPERTENSION: Hu et al. (JAMA, 1996). Bone lead and odds of hypertension in the NAS.*

00.20.40.60.8

11.21.41.61.8

2

Lowestquartile

Highestquartile

Odds of developinghypertension

*Adjusted for age, body mass index, family history of hypertension, smoking, alcohol ingestion, dietary calcium, dietary sodium

Health Effects Institute, 2006: PM10 and CV mortality…

Potential Health Effects of Climate Change…

Climate Changes

• Temperature Rise• Hydrologic Extremes

Environmental Changes

• Heat• Severe Weather• Air Pollution• Allergies• Vector-Borne Diseases• Water-Borne Diseases• Water & Food Supply• Mental Health• Environmental

Refugees

Health Changes• Heat Stress, Cardiovascular Failure• Injuries, Fatalities• Asthma, Cardiovascular Disease• Respiratory Allergies, Poison Ivy• Malaria, Dengue, Encephalitis, Hantavirus,

Rift Valley Fever• Cholera, Cryptosporidiosis,

Campylobacter, Leptospirosis• Malnutrition, Diarrhea, Harmful Algal

Blooms• Anxiety, Despair, Depression,

Post-Traumatic Stress• Forced Migration, Civil Conflict

Adapted from J. Patz

Graham Environmental Sustainability Institute │ http://provost.umich.edu/gesi

Global Climate and Disparities: Production of Greenhouse Emissions (Density-Equalizing Cartogram)

Mark Newman, University of Michigan │ www.worldmapper.org

Graham Environmental Sustainability Institute │ http://provost.umich.edu/gesi

Jonathan Patz, University of Wisconsin

Global Climate and Disparities:Associated Mortality

First Center for Global Health International Event

Conclusions

• Health professionals can make a difference on issues related to health, globalization & human rights

• Environmental issues a major…and growing… dimension to health and human rights

• The path to cultivating a human rights dimension to one’s career in health is never linear. But, sometimes, brilliant people

arrive there early.