[Fwd: 's #829: Why We Can't Prevent Cancer]

[Guest guest]

's Environmental Newsletter, one of the outstanding publications

of its kind, has now changed its focus to only declining human health.

This should be a very information new direction for this excellent

newsletter

dedicated to Carson author of Silent Spring.

Garnet

-------- Forwarded Message --------

From: rachel@...

Reply-To: News

To: News

Subject: 's #829: Why We Can't Prevent Cancer

Date: Fri, 4 Nov 2005 10:35:22 -0500

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

's Democracy & Health News

" Environment, health, jobs and justice--Who gets to decide? "

Thursday, October 27, 2005

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

Featured stories in this issue...

Editorial: A New and Slightly Different View from 's

We've changed our name and, to some extent, our focus. Our goal is

to connect the dots to reveal the root causes of declining human

health, the destruction of nature, and the inequalities and

injustices that are rising like flood waters around us all. Who gets

to decide? How do the few control the many?

Why We Can't Prevent Cancer

A stunning new report nails the relationship of environmental and

workplace exposures to cancer, and makes the case that prevention is

an " urgent priority. " However, we at 's argue that adequate

prevention is not really possible within an economy that requires

perpetual growth.

A Giant in Sustainable-Ag Is Forced to Resign at Iowa State

A giant in the sustainable agriculture movement, Dr. Fred

Kirschenmann, has been forced to resign his research post at the

University of Iowa for " neglecting key stakeholders " -- meaning the

corn and soybean agribusiness corporations.

Left Behind -- the Legacy of Hurricane Katrina

" The gap in health between white and black Americans has been

estimated to cause 84,000 excess deaths a year in the United States,

a virtual Katrina every week. "

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From: 's Democracy & Health News #829, Oct. 27, 2005

EDITORIAL: A NEW AND SLIGHTLY DIFFERENT VIEW FROM RACHEL'S

With this issue, we have changed the name of 's Environment &

Health News to 's Democracy & Health News. Since 1986, we have

been reporting on studies linking environmental deterioration to

declining human health. We will continue to report on those studies,

but we want to expand our view a bit to reveal more about the

underlying causes of the problems we all face.

As we say in the new masthead statement in this issue of 's,

" The natural world is deteriorating and human health is declining

because those who make the important decisions aren't the ones who

bear the brunt. Our purpose is to connect the dots between human

health, the destruction of nature, the decline of community, the rise

of economic insecurity and inequalities, growing stress among workers

and families, and the crippling legacies of patriarchy, intolerance,

and racial injustice that allow us to be divided and therefore ruled

by the few. "

In a democracy, there are no more fundamental questions than, " Who

gets to decide? " And, " How do the few control the many, and

what might be done about it? "

When we started 's in 1986, information was hard to find. We

used to visit a library every week and photocopy medical studies and

summarize them for our readers. Now things are different -- the world

is awash in information. What's missing now is a coherent picture of

how the pieces fit together. We think the decline of democracy -- the

few now controlling the many for narrow, selfish purposes -- is an

idea that can help make sense out of the disconnected information we

encounter daily.

We hope you agree. Please let us know what you think.

Montague (peter@...)

Tim Montague (tim@...)

Editors

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From: 's Democracy and Health News #829, Oct. 27, 2005

WHY WE CAN'T PREVENT CANCER

By Montague

In 1999, cancer surpassed heart disease as the number one killer of

people younger than 85 in the U.S.[1] Now a detailed report on the

causes of cancer tells us why: cancer has been steadily increasing in

the U.S. for 50 years as people have been exposed to more and more

cancer-causing agents, including chemicals and radiation.

Clapp, Genevieve Howe, and Molly s Lefevre have just

published " Environmental and Occupational Causes of Cancer; A Review

of Recent Scientific Literature " and it is a real eye-opener.

But before we dive into this report looking for nuggets, let's set the

background.

About half of all cancer cases are fatal, and death by cancer is often

prolonged, painful, and very expensive. Those who manage to survive

cancer live out their lives molded by the after-effects of harsh

treatments popularly known as " slash and burn " -- surgery,

chemotherapy, radiation, or some combination of the three.

As more people are kept alive each year with their breasts or

testicles removed, the " cancer establishment " chalks up another

" victory " -- and no doubt the victims are glad to be alive -- but we

should acknowledge that there's something very wrong with calling this

" victory. " Slash and burn seems more like a dreadful defeat.

The truth is, an epic struggle has been going on for 50 years between

the " slash and burn=victory " camp, versus those who think the only

real victory is prevention of disease. The struggle occurs across a

fault line defined by money. To be blunt about it, there's no money in

prevention, and once you've got cancer you'll pay anything to try to

stay alive. Cancer treatment is therefore a booming business, and

cancer prevention is nowhere. That is the basic dynamic of the debate.

Cancer surgeons can achieve the status of rock stars among their

peers. Those who advocate prevention will most likely find themselves

without funding, ridiculed and despised by the chemical industry, the

pesticide industry, the asbestos industry, the oil industry and all

their minions -- lawyers, bankers, engineers, reporters, professors,

and politicians -- who make a fat living off those who pump out

cancer-causing products and dump out cancer-causing by-products, aka

toxic waste.

The debate began 50 years ago when a powerful voice for prevention

spoke out from inside the National Cancer Institute (NCI). In 1948.

Wilhelm Hueper, a senior NCI scientist, wrote,

" Environmental carcinogenesis is the newest and one of the most

ominous of the end-products of our industrial environment. Though its

full scope and extent are still unknown, because it is so new and

because the facts are so extremely difficult to obtain, enough is

known to make it obvious that extrinsic [outside-the-body] carcinogens

present a very immediate and pressing problem in public and individual

health. "

In 1964, Hueper and his NCI colleague, W. C. Conway, described

patterns in cancer incidence as " an epidemic in slow motion " :

" Through a continued, unrestrained, needless, avoidable and, in part

reckless increasing contamination of the human environment with

chemical and physical carcinogens and with chemicals supporting and

potentiating their action, the stage is being set indeed for a future

occurrence of an acute, catastrophic epidemic, which once present

cannot effectively be checked for several decades with the means

available nor can its course appreciably be altered once it has been

set in motion, " they wrote.[pg. 28]

Hueper of course was right. This is why 50% of all men and 40% of all

women in the U.S. now hear the chilling words, " You've got cancer " at

some point in their lives. That's right, 1 out of every 2 men now get

cancer in the U.S., and more than 1 out of every 3 women.

Clapp, Howe and Lefevre tell us that between 1950 and 2001 the

incidence rate for all types of cancer increased 85%, using

age-adjusted data, which means cancer isn't increasing because people

are living longer. People are getting more cancer because they're

exposed to more cancer-causing agents.

Contrary to well-funded rumors, the culprit isn't just tobacco or the

hundreds of toxic chemicals intentionally added to tobacco products.

Tobacco products remain the single most significant preventable cause

of cancer, but they have not been linked to the majority of cancers

nor to many of the cancers that have increased most rapidly in recent

decades including melanoma, lymphomas, testicular, brain, and bone

marrow cancers.[pg. 1]

No, it's more complicated than just tobacco with its toxic additives.

Most plastics, detergents, solvents, and pesticides and the

toxic-waste by-products of their manufacture came into being after

World War II. From the late 1950s to the late 1990s, we disposed of

more than 750 million tons of toxic chemical wastes.[pg. 27] Over 40

years, this represents more than two tons of toxic chemical wastes

discharged into the environment for each man, woman and child in the

U.S. No wonder some of it has come back to bite us.

Since the U.S. EPA began its Toxics Release Inventory (TRI) program in

1987, total releases have been reported as declining (though EPA does

not check the accuracy of industry's self-reporting). Despite the

reported decline, in 2002, the most recent year reported, 24,379

facilities in the U.S. reported releasing 4.79 billion pounds of over

650 different chemicals. (And TRI data do not include other enormous

discharges: toxic vehicle emissions, the majority of releases of

pesticides, volatile organic compounds, and fertilizers, or releases

from numerous other non-industrial sources.) In 2001, more than 1.2

billion pounds of pesticides were intentionally discharged into the

environment in the United States and over 5.0 billion pounds in the

whole world.[pg. 27]

While all this chemical dumping has been going on, incidence rates for

some cancer sites have increased particularly rapidly over the past

half century. From 1950-2001, melanoma of the skin increased by 690%,

female lung & bronchial cancer increased by 685%, prostate cancer by

286%, myeloma by 273%, thyroid cancer by 258%, non-Hodgkin's lymphoma

by 249%, liver and intrahepatic duct cancer by 234%, male lung &

bronchial cancer by 204%, kidney and renal pelvis cancers by 182%,

testicular cancer by 143%, brain and other nervous system cancers by

136%, bladder cancer by 97%, female breast cancer by 90%, and cancer

in all sites by 86%.[pg. 25]

In the most recent 10-year period for which we have data (1992-2001),

liver cancer increased by 39%, thyroid cancer increased by 36%,

melanoma increased by 26%, soft tissue sarcomas (including heart) by

15%, kidney and renal pelvis cancers by 12%, and testicular cancer

increased by 4%.[pg. 25]

OK, so dumping chemicals into the environment has been a major

industrial pastime for 50 years, and cancers are increasing. But why

do we think these things are connected? What real evidence do we have

that environmental and occupational exposures contribute to cancer?

That's what the new Clapp-Howe-Lefevre report is about. It is a

review of recent scientific literature -- with emphasis on human

studies, not studies of laboratory animals. Indeed, the bulk of the

new Clapp-Howe-Lefevre report is a cancer-by-cancer compendium of what

recent human studies tell us about environmental and occupational

exposures that contribute to cancers of the bladder, bone, brain,

breast, cervix, colon, lymph nodes (Hodgkin's disease and non-

Hodgkin's lymphoma), kidney, larynx, liver and bile ducts, lungs,

nasal passages, ovaries, pancreas, prostate, rectum, soft tissues

(soft tissue sarcoma), skin, stomach, testicles, and thyroid, plus

leukemia, mesothelioma, and multiple myeloma. (It is worth pointing

out -- and Clapp-Howe-Lefevre do point it out -- that this compendium

owes a great debt to a data spreadsheet on cancer and its

environmental causes prepared by Janssen, and Ted

Schettler, for which thanks are due the Collaborative on Health and

Environment.)

Many of the bad actor chemicals are well-known to us all: metals and

metallic dusts (arsenic, lead, mercury, cadmium, hexavalent chromium,

nickel); solvents (benzene, carbon tet, TCE, PCE, xylene, toluene,

among others); aromatic amines; petrochemicals and combustion

byproducts (polycyclic aromatic hydrocarbons, or PAHs); diesel

exhaust; ionizing radiation (x-rays, for example); non-ionizing

radiation (magnetic fields, radio waves); metalworking fluids and

mineral oils; pesticides; N-nitroso compounds; hormone-disrupting

chemicals (found in many pesticides, fuels, plastics, detergents, and

prescription drugs); chlorination byproducts in drinking water;

natural fibers (asbestos, silica, wood dust); man-made fibers (fiber

glass, rock wool, ceramic fibers); reactive chemicals (such as

sulfuric acids, vinyl chloride monomer, and many others); petroleum

products; PCBs; dioxins; mustard gas; aromatic amines; environmental

tobacco smoke; and outdoor air pollution.

But there is additional evidence linking chemicals with cancer:

** Elevated cancer rates follow patterns -- the disease is more common

in cities, in farming states, near hazardous waste sites, downwind of

certain industrial activities, and around certain drinking-water

wells. Patterns of elevated cancer incidence and mortality have been

linked to areas of pesticide use, toxic work exposures, hazardous

waste incinerators, and other sources of pollution.[pg. 26]

** The U.S. EPA's long-delayed and heavily industry-influenced " Draft

Dioxin Reassessment " released in 2000 admitted that the weight of the

evidence from human studies suggests that, " the generally increased

risk of overall cancer is more likely than not due to exposure to TCDD

[dioxin] and its congeners [chemical relatives]. " The report goes on

to conclude, " The consistency of this finding in the four major cohort

studies and the Seveso victims is corroborated by animal studies that

show TCDD to be a multisite, multisex, and multispecies carcinogen

with a mechanistic basis. " [pg. 26]

** Farmers in industrialized nations die more often than the rest of

us from multiple myeloma, melanoma, prostate cancer, Hodgkin's

lymphoma, leukemia, and cancers of the lip and stomach. They have

higher rates of non-Hodgkin's lymphoma and brain cancer. Migrant

farmers experience elevated rates of multiple myeloma as well as

cancers of the stomach, prostate, and testicles.[pg. 26]

** The growing burden of cancer on children provides some of the most

convincing evidence of the role of environmental and occupational

exposures in causing cancers. Children do not smoke, drink alcohol, or

hold stressful jobs. Their lifestyles have not changed appreciably in

recent years. In proportion to their body weight, however, " children

drink 2.5 times more water, eat 3 to 4 times more food, and breathe 2

times more air " than adults. " In addition, their developing bodies may

well be affected by parental exposures prior to conception, exposures

while growing in the uterus, and the contents of breast milk.

Clapp-Howe-Lefevre put it this way: " We have learned how to save more

lives, thankfully, but more children are still diagnosed with cancer

every year. The incidence of cancer in all sites combined among

children ages 0-19 increased by 22% from 13.8/100,000 in 1973 to 16.8

in 2000 and most of this increase occurred in the 1970s and 1980s.

Epidemiologic studies have consistently linked higher risks of

childhood leukemia and childhood brain and central nervous system

cancers with parental and childhood exposure to particular toxic

chemicals including solvents, pesticides, petrochemicals, and certain

industrial by-products (namely dioxins and polycyclic aromatic

hydrocarbons [PAHs]). " [pg. 26]

All in all, the Clapp-Howe-Lefevre report makes a compelling case that

many industrial chemicals contribute to many kinds of cancers. But

where this report really shines is in its clear call for

prevention. In all, there are relatively few products or substances

associated with cancer.[pgs. 10-11, 37-40] Everything doesn't cause

cancer, and many of the things that do could be shunned and phased

out. In principle, a great deal of prevention is possible.

Thirty years into the prevention-vs-treatment debate -- in 1981 -- two

famous British scientists -- Sir Doll and Sir Peto

-- published an extremely influential study in which they estimated

that " only " 2 to 4% of all cancers are caused by environmental or

workplace exposures. With 1.2 million new cases of cancer each year in

the U.S., half of them fatal, 2% to 4% = 12,000 to 24,000 deaths each

year, most of them preventable. Doll and Peto said tobacco caused 30%

of all cancers and food caused another 35%. We now know that cancer

results from the interaction of our genes with exposure to several

cancer-causing agents. All the necessary exposures must occur to cause

a cancer -- if any one of them is missing, the cancer will not occur.

This is why prevention is important -- it really can work.

Because cancer requires multiple exposures to cancer-causing agents,

it is wrong and misleading to say that " Exposure to product A causes X

percent of all cancers. " It simple doesn't work like that. Perhaps

Doll and Peto in 1981 did not know how such things worked, and they

boldly proceeded to estimate what percent of all cancers were

attributable to particular exposures. It was wrong, but their report

served as powerful ammunition for the prevention-is-pointless crowd.

If " only " 2 to 4% of all cancers were caused by environmental

exposures, then there was little incentive to prevent human exposure

to environmental agents, the argument went. What a welcome message

this was for the cancer-creation industries (petrochemicals, metals,

pesticides, asbestos, radiation, and others) and for the cancer

treatment industry! Damn the torpedoes -- full speed ahead!

The prevention-is-pointless crowd latched onto the Doll and Peto study

and spread it everywhere. By the end of 2004, the original 1981

Doll-and-Peto paper had been cited in 441 subsequent scientific

papers.[pg. 4] But even more importantly, the federal National Cancer

Institute and the American Cancer Society (which, together, you could

call the " cancer establishment " ) adopted the Doll-Peto perspective,

that cancer is a lifestyle disease -- the victims themselves are

responsible -- and that prevention of environmental and occupational

exposures is not worth the effort. Remember this was the beginning of

the Reagan counterrevolution and the Doll-Peto paper fit right into

the new ideology -- government is bad, big corporations are good,

we're all individually responsible for whatever bad things happen to

us, and greed is good because it makes the world go 'round. In any

case, the NCI and the ACS largely adopted the Doll-Peto perspective,

and they poured the bucks into new cancer treatments, pretty much

ignoring prevention. Meanwhile, cancer incidence rates climbed

relentlessly -- making the cancer-treatment industry healthier and

wealthier, which allowed it to further erode support for prevention.

Now we are starting to shake off the stupor induced by the misleading

Doll-Peto arithmetic, which pretended to prove that environment and

occupational exposures are of no consequence.

Listen to this marvelously clear-eyed conclusion from the

Clapp-Howe-Lefevre report: " Comprehensive cancer prevention programs

need to reduce exposures from all avoidable sources. Cancer prevention

programs focused on tobacco use, diet, and other individual behaviors

disregard the lessons of science. " [pg. 1]

And this: " Preventing carcinogenic exposures wherever possible should

be the goal and comprehensive cancer prevention programs should aim to

reduce exposures from all avoidable sources, including environmental

and occupational sources. " [pg. 6]

And this: " Further research is needed, but we will never be able to

study and draw conclusions about the potential interactions of

exposure to every possible combination of the nearly 100,000 synthetic

chemicals in use today. Despite the small increased risk of developing

cancer following a single exposure to an environmental carcinogen, the

number of cancer cases that might be caused by environmental

carcinogens is likely quite large due to the ubiquity [presence

everywhere] of carcinogens. Thus, the need to limit exposures to

environmental and occupational carcinogens is urgent. " [pg. 29]

And this: " The sum of the evidence regarding environmental and

occupational contributions to cancer justifies urgent acceleration of

policy efforts to prevent carcinogenic exposures. By implementing

precautionary policies, Europeans are creating a model that can be

applied in the U.S. to protect public health and the environment. To

ignore the scientific evidence is to knowingly permit tens of

thousands of unnecessary illnesses and deaths each year. " [pg. 1]

What a blast of fresh air!

The latest strategy from the cancer-creation industries is to claim

that we can't take action to prevent environmental and occupational

exposures because we don't have enough information. We're simply too

ignorant to make a move. More study is needed. [see 's #824,

#825.] Clapp-Howe-Lefevre allow the eloquent writer

Steingraber to answer this argument. They say, " A main concern for

Steingraber, author of Living Downstream: An Ecologist Looks

at Cancer and the Environment, is not whether the greatest dangers

are presented by dump sites, workplace exposures, drinking water,

food, or air emissions:

" I am more concerned [writes Steingraber] that the uncertainty over

details is being used to call into doubt the fact that profound

connections do exist between human health and the environment. I am

more concerned that uncertainty is too often parlayed into an excuse

to do nothing until more research can be conducted. " [pg. 29]

Clapp, Howe and Lefevre go on: " At the same time, uncertainty and

controversy are permanent players in scientific research. However,

they must not deter us from enacting regulations and policies based on

what we know and pursuing the wisdom of the precautionary principle.

This is not new thinking, as demonstrated by Sir Austin Bradford

Hill's 1965 address to the Royal Society of Medicine:

" All scientific work is incomplete [wrote Sir Austin Bradford Hill] --

whether it be observational or experimental. All scientific work is

liable to be upset or modified by advancing knowledge. That does not

confer upon us a freedom to ignore the knowledge we already have, or

to postpone action that it appears to demand at a given time. " [pg. 29]

Clapp, Howe and Lefevre then offer some guidelines for preventive

action:

(1) The least toxic alternatives should always be used.

(2) Partial, but reliable, evidence of harm should compel us to act on

the side of caution to prevent needless sickness and death.

(3) The right of people to know what they are being exposed to must be

protected.

Clapp, Howe and Lefevre observe that " the United States has much to

learn " from the proposed European chemicals policy, known as REACH:

(1) requiring that industry be responsible for generating information

on chemicals, for evaluating risks, and for assuring safety; another

way of saying this is, " No data, no market. "

(2) extending responsibility for testing and management to the entire

manufacturing chain -- everyone who uses a chemical has a duty to

familiarize themselves with the consequences;

(3) using safer substitutes for chemicals of high concern; and,

(4) encouraging innovation in safer substitutes.[pg. 29]

In the words of ecologist Steingraber: " It is time to start

pursuing alternative paths. From the right to know and the duty to

inquire flows the obligation to act. " [pg. 29]

But while we're working in clear-eyed mode here, let's take our

exploration a bit further and look this problem squarely in the face.

The U.S. economy and culture are premised on endless growth. If I

loan you $100 in the expectation that you will pay me back $103 next

year, that extra 3% must come from somewhere. That " somewhere " has

physical dimensions -- something must be dug up or grown to produce

the additional 3%. That something must also be moved, processed, moved

again, packaged, promoted and sold, moved again, used, moved again,

and eventually discarded. Even if it is recycled many times,

ultimately it will be discarded into a natural ecosystem somewhere (at

which point nature begins moving it once again). The inescapable

second law of thermodynamics tells us that each of these steps will

inevitably be accompanied by waste, disorder and other disruptive

unintended consequences. Even if you create the extra 3% per year by

providing a " service " instead of a " product, " you still require food,

water, shelter, energy, clothing, tools, transportation, commercial

space, medical care, municipal support services (like police, fire,

emergency services, and sewage treatment), leisure activities,

communications and information, schooling, and on and on.

An economy that is growing at 3% per year is doubling in size every 23

years -- requiring, every 23 years, a doubling in the number of

cities, food sources, mines, factories, power plants, vehicles,

highways, parking lots, schools, sewage treatment plants, hospitals,

prisons, discards, trash and dumps. For a very long time this kind of

rapid growth seemed tolerable. But now things are different -- the

earth is full of people and their artifacts. We can no longer throw

things " away " without affecting someone somewhere.

Something else is new as well. The modern, globalized financial

environment (in which money flows easily across international

borders), creates tremendous competitive pressure to attract

investment by increasing return to investors. That in turn creates

pressure to pass costs along to the general public. Economists call it

" externalizing " costs. If I dump my chemicals and make you sick, I

gain if I can get you to pay your own medical bills, and I gain again

if I can get taxpayers to clean up my mess. Firms have a natural

incentive to externalize their costs to the extent possible, but the

present " globalized " financial environment has increased that

incentive greatly, to improve return to investors.

In sum, let us review the pressures that prevent prevention.

(1) In general, it is difficult to make prevention pay, but

remediation can pay handsomely; this is certainly true for the cancer

industry. In general, financial-political-legal incentives are set up

to reward those who create problems and those who supply remedies.

(2) Economic growth entails the continual creation of ever-more and

ever-larger messes. Even if we managed to " green " commerce in every

way we can think of today, damage to nature would still be roughly

proportional to the size of the human economy because the second law

of thermodynamics cannot be evaded. And we now know that damage to

nature gives rise to human disease in myriad ways. (For evidence,

follow leads found here, here, here, and here.) Now that the

earth

is full, a growing economy creates palpably-growing health problems,

including immune system degradation giving rise to cancers.

(3) The modern economy creates irresistible pressure to increase stock

prices, which in turn creates relentless pressure to externalize costs

by hook or by crook.

So let's not kid ourselves. Yes, cancer must be prevented

because for the most part it can't be cured -- it can only be slashed

and burned away at enormous cost, personal, social and monetary.

But saying cancer must be prevented is one thing. Expecting

that it can be prevented within the framework of the modern

economy is another. We can never stop working to prevent cancer -- and

precautionary policies will always make sense no matter what kind of

economy we have -- but until we shift to an economy that doesn't

require growth, we'll find ourselves right where we are now -- on an

accelerating rat wheel. As a result, we can expect to be living with

more and more cancer at greater and greater cost to ourselves and to

our children, accompanied by ever-increasing pain. It is not a pretty

picture. But at least we can now see it clearly.

===============

[1] Clapp, Genevieve Howe, and Molly s Lefevre,

Environmental and Occupational Causes of Cancer; A Review of Recent

Scientific Literature (Lowell, Mass.: University of Massachusetts at

Lowell, The Lowell Center for Sustainable Production, September, 2005.

Available here and here and here. Unless otherwise noted,

throughout this issue of 's, footnote numbers inside square

brackets refer to pages in this report.

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From: Grist, Nov. 2, 2005

A GIANT IN SUSTAINABLE-AG IS FORCED TO RESIGN AT IOWA STATE

Seedy business: Who controls research at Iowa State University?

By Tom Philpott

Plunked down in the land of huge, chemical-addicted grain farms and

the nation's greatest concentration of hog feedlots, Iowa State

University's Leopold Center for Sustainable Agriculture has always

had a tough row to hoe.

Imagine trying to operate an Anti-Cronyism League from Bush's West

Wing, and you get an idea of what the Leopold Center is up against.

Industrial agriculture runs the show in Iowa, sustained by regular

infusions of federal cash and its government-sanctioned ability to

" externalize " the messes it creates. The state grabbed $12.5 billion

in federal agriculture subsidies between 1995 and 2004 -- second only

to Bush's own home state. Iowa leads all states in hog production: It

churned out 14.5 million pigs in 2001 alone, the vast majority from

stuffed, environmentally and socially ruinous CAFOs (confined-animal

feeding operations).

Yet since springing to life in 1987 by fiat of the Iowa legislature --

funded ingeniously by state taxes on nitrogen fertilizer and pesticide

-- the Leopold Center has become an invaluable national resource for

critics of industrial agriculture and seekers of new alternatives.

Now, however, a sudden purge at the top has called the Center's much-

prized independence from industrial agriculture into question.

The Leopold Center operates under the authority of Iowa State

University's College of Agriculture. Last Friday, the college issued a

press release announcing that the Leopold Center's director of five

years, Fred Kirschenmann, had " accepted a new leadership role as a

distinguished fellow of the center. "

The college went on to state that it had named an interim director,

effective Nov. 1.

Kirschenmann himself, however, tells a more interesting tale than

what's contained in the press release's bland prose. He says his move

from director to " distinguished fellow " came suddenly and without his

own input.

" On Wednesday [Oct. 26] I received a letter from the interim dean

asking me to resign by Friday and decide by then if I would accept the

position of distinguished fellow at the center, " Kirschenmann told me

yesterday.

" I wrote her [the interim dean] back telling her I thought she was

moving too fast, that there wouldn't be time for a smooth transition.

She wrote back that it was a done deal -- she had already named a new

director. "

Kirschenmann says the interim dean, Wintersteen, had been on

Leopold's advisory board for years and had served on the search

committee that hired him in 2000. " She was always very supportive of

what we were doing, " Kirschenmann says. " Until about two years ago.

Then she became very critical. "

Her critique centered on the idea that in its work the Leopold Center

was neglecting " key stakeholders, " Kirschenmann adds. " But she never

really clarified who those stakeholders were. "

Might she have been refering to agribusiness interests? " You can draw

your own conclusions, " Kirschenmann says. She never cited any reason

for the de facto purge, save for " some verbiage about how I would be

free to pursue my own work without having to worry about

administrative duties. "

To be sure, Iowa State's College of Agriculture draws agribusiness

cash the way a penned-up pig wallowing in its own waste draws flies. I

have a call into the college for a list of corporate donors; until

that call is returned, let it suffice that this is the sort of

research the college commonly proffers: A study claiming to show that

the genetically modified seed industry deserves a greater " level of

intellectual property protection... than what existed in the North

American seed corn market in the late 1990s. " Collaborators: a pair of

scientists from GM seed titan Pioneer Hi-Bred International Inc., a

subsidiary of DuPont.

Here are glowing testimonials from two of the college's " partners " :

Deere and Cargill.

Kirschenmann says he accepted the " distinguished fellow " position

because Wintersteen assured him he could continue doing his own work

on sustainable agriculture. And that work is important. Under

Kirschenmann the Leopold Center bluntly criticized and rigorously

documented the environmental and social calamities being wrought by

industrial agriculture.

Will he continue to be able to do that work at Leopold? " We'll see how

it goes, " he told me.

Copyright 2005. Grist Magazine, Inc.

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From: British Medical Journal, Oct. 22, 2005

LEFT BEHIND -- THE LEGACY OF HURRICANE KATRINA

Hurricane Katrina puts the health effects of poverty and race in plain

view

By Atkins and Ernest M. Moy

The sinking of the Titanic, during which women in first class cabins

were more likely to survive than those booked into cheaper decks, has

been used to illustrate the effects of income and social class on

health. In the aftermath of hurricane Katrina, Americans have been

shocked and shamed to realise that they still don't have enough

lifeboats for all of our citizens. Live images of uncollected corpses

and families clinging to rooftops made vivid what decades of

statistics could not: that being poor in America, and especially being

poor and black in a poor southern state, is still hazardous to your

health.

This may truly be a " teachable moment " about the impact of poverty and

race on health. The gap in health between white and black Americans

has been estimated to cause 84,000 excess deaths a year in the United

States, a virtual Katrina every week.[1] Because the victims gradually

succumb to various diseases such as diabetes, cardiovascular disease,

alcohol and drug abuse, cancer, and HIV infection, they rarely capture

the public's attention in the way the victims of Katrina have. As a

result, health inequality has persisted despite decades of important

health gains, economic growth, and progress on racial issues in the

United States.

It would be a mistake, however, to assume that the problems

highlighted by hurricane Katrina are a unique legacy of southern

racism or a problem affecting black Americans or America alone. The

same factors that placed the poorest residents of New Orleans in

harm's way -- unemployment, poverty, neglect of communities, and

alienation -- contribute to health disparities for poor children and

adults and those from minority groups throughout the United States,[2]

in the United Kingdom,[3] and in other Western countries.[4,5] But the

aftermath of hurricane Katrina provides clear lessons about what

changes in policy government and private agencies must make to tackle

health inequalities.[6]

Fund prevention, not rescue. The recent UN International Strategy for

Disaster Reduction notes the need to " invest to prevent, " [7] yet a

comprehensive plan for protecting the Gulf Coast languished for years

because it seemed too expensive to implement: the costs of hurricane

Katrina to the US treasury are now expected to rise as high as $200

billion. Pressure on healthcare budgets for the poor continues to

squeeze services for primary care and prevention owing to soaring

costs for emergency visits and for admissions to hospital and long

term care, many of which might be preventable with better functioning

systems of ongoing care. Nowhere are the high costs of deferring

investment in health more evident than in a poor state such as

Louisiana, which ranks 48th among 50 states in levels of health

insurance, 45th in public health spending, 50th in overall health and

second in the costs to the federal government of caring for its older

and disabled citizens.[8,9]

Strengthen the infrastructure for public health. The individual

heroism evident among those who responded to the emergency in

Louisiana and Mississippi and in health workers who struggle every day

to meet the needs of poor communities cannot make up for a frayed

infrastructure. Recent reports have called attention to the neglect of

the public health infrastructure in the United States and the United

Kingdom.[10,11] Strengthening this infrastructure will depend on

improving the workforce, information systems, and organisation both

locally and nationally.

Adopt policies that support responsible choices. Democracies cannot

completely protect their citizens from the freedom to make bad

choices. Yet hurricane Katrina's effects vividly illustrate how the

choices available to us differ depending on where we live and how much

money we have. Many who " chose " to stay in the path of the storm had

no cars with which to escape, no faith that their property would be

protected, and no insurance to cover their losses. Similarly,

promoting personal responsibility as the solution to health problems

such as obesity will not work if we do not reduce the barriers to

exercise and healthy diets in poor urban communities, where parks and

supermarkets are less common than fast food chains and stores selling

alcohol. The problem is particularly acute in the US, where efforts to

intervene early against chronic diseases such as hypertension and

diabetes are hampered by a system that continues to leave 45 million

citizens without health insurance.

Improve communication about critical threats to health. The failure of

basic communication after the hurricane fed a downward spiral of the

early recovery efforts. The lack of an authoritative source of

information fostered confusion and rumours which exacerbated the chaos

and sense of panic. Similar challenges hinder efforts to confront

health problems in poor and ethnic minority communities, where a

legacy of distrust of government and medical establishments provides

fertile ground for misunderstanding, myths, and conspiracy theories

about health issues. Rebuilding trust will require actively including

the community in any planning and research which affects them,

improving cross cultural training of health workers, and tapping into

the informal information networks in these communities.

Build strategies that foster accountability. A variety of

investigations will eventually sort out the failings and scattered

successes of the preparations for and response to hurricane Katrina.

And, although our ability to measure health disparities is improving,

we still need better mechanisms to promote accountability for reducing

them. Public and private healthcare organisations and both local and

national governments will need to negotiate their shared

responsibility for a problem that has many sources and no single

solution.

Strengthen communities. It now seems that many of the most horrific

stories to come out of New Orleans -- roving gangs of rapists, snipers

firing on helicopters -- were exaggerated or untrue. But the

perception of crime and disorder which impeded the response to

hurricane Katrina also undermines efforts to attack health

disparities. Problems of drugs and alcohol misuse and attendant crime

and violence take direct tolls on health and lower the priority given

by government and other organisations to health issues. The healthcare

sector alone cannot tackle problems which require support from good

schools, businesses, religious institutions, other community

organisations, and law enforcement agencies.[3,12]

In the rush to rebuild in the southern states, Americans should pause

to think more deeply about what it would take to create more equitable

and healthier communities in New Orleans and throughout the affected

areas. It is essential that these lessons are heeded in any plans for

recovery. It is even more important that we and others apply these

lessons to help the many other individuals and communities with poor

health who continue to languish out of the public eye.

==============

Atkins, chief medical officer, Center for Outcome and

Effectiveness Agency for Healthcare Research and Quality, Rockville,

MD 20850, USA (datkins@...)

Ernest M Moy, senior service fellow, Center for Quality Improvement

and Patient Safety Agency for Healthcare Research and Quality,

Rockville, MD 20850, USA

Declaration of competing interests: DA and EMM are employed by the

Agency for Healthcare Research and Quality, a government research

agency which produces an annual report on healthcare disparities in

the US. The views expressed are solely those of the authors and do not

reflect the official position or policy of the Agency for Healthcare

Research and Quality or the US Department of Health and Human

Services.

References

[1] Satcher D, Fryer GE Jr, McCann J, Troutman A, Woolf SH, Rust G.

What if we were equal? A comparison of the black-white mortality gap

in 1960 and 2000. Health Aff 2005;24: 459-64.

[2] National healthcare disparities report. Rockville, MD: Agency

for Healthcare Research and Quality, 2005.

[3] Acheson D. Report of the independent inquiry into inequalities in

health. London: Stationery Office, 1998.

[4] Blendon RJ, Schoen C, DesRoches CM, Osborn R, Scoles KL, Zapert K.

Inequities in health care: a five-country survey. Health Aff 2002;21:

182-91.

[5] Beiser M, M. Reducing health disparities: a priority for

Canada (preface). Can J Public Health 2005;96(Suppl 2): S4-5.

[6] Payne AW. At risk before the storm struck. Washington Post 2005

Sep 13: HE01.

[7] Secretariat of the International Strategy for Disaster Reduction.

Invest to prevent. 2005.

[8] United Health Foundation. America's health: state health rankings

2004. 2005.

[9] Center for Medicare and Medicaid Services. Health care financing

review: Medicare and Medicaid statistical supplement, 2003.

[10] Committee on Assuring the Health of the Public in the 21st

Century, Institute of Medicine, Board on Health Promotion and Disease

Prevention. The future of the public's health in the 21st century.

Washington, DC: National Academy Press, 2003.

[11] Wanless D. Securing good health for the whole population: final

report. London: Stationery Office, 2004.

[12] Smedley BD, Stith AY, AR, eds. Unequal treatment:

confronting racial and ethnic disparities in health care. Washington,

DC: National Academy Press, 2003.

Copyright 2005 BMJ Publishing Group Ltd

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