Latest from AMSA Global Health
“That? That’s not a disease, that’s just someone who lived in a city!” the tutor scoffed. “It’s carbon from air pollution. That’s probably what your lungs will look like by the time you die, too.”
In my first-ever wet lab, my tutor handed me a flaccid, disembodied lung and asked if I could identify the oblique fissure.
I couldn’t. I was two weeks into medical school straight out of an Arts degree, and had absolutely no idea what was going on in any of my classes. So, I tried to wriggle my way out of answering the question by asking the tutor what horrible disease had turned the patient’s lungs all black and spotty.
“That? That’s not a disease, that’s just someone who lived in a city!” the tutor scoffed. “It’s carbon from air pollution. That’s probably what your lungs will look like by the time you die, too.” He reclaimed the lung and handed it to the person next to me. (She successfully identified the fissure.)
That afternoon, I went home to my house — on a busy street, right in the middle of Sydney — and wondered what the traffic rumbling past my window was doing to my lungs. I pictured my young, healthy respiratory system slowly being poisoned and tarred by invisible particulate matter streaming out of nearby exhaust pipes. A few days later, I went out and bought a fiddle leaf fig tree to put in a pot next to my bed, in the vague hope that it might somehow clean the air in my room enough to save my lungs from a supposedly inexorable decline into carbon-black spottiness.
Notwithstanding the current trend for keeping indoor plants in our bedrooms, urban air pollution is a significant and growing health issue in Australia. The World Health Organisation (WHO) has found that a number of Australian cities, including Melbourne, Hobart and Canberra, have air pollution levels well above what they deem to be safe for human health. This puts residents in these cities at an increased risk of all sorts of health problems; not just the lung cancer, COPD and asthma issues that immediately spring to mind when we think of air pollution, but also stroke and ischaemic heart disease. Across Australia, cars, factories and power stations all seep tiny, invisible particles of pollution into the air – which build up in our bodies, turn our lungs black, and often make us sick.
Worldwide, the statistics are genuinely startling. The WHO has estimated that no less than 90% of the world’s population is currently breathing unsafe air, and that air pollutants are responsible for about a third of deaths from stroke, chronic respiratory disease and lung cancer, as well as a quarter of heart attack deaths. And, of course, air pollution also exacerbates climate change, which has been described by the Lancet as “the greatest global health challenge of the 21stcentury.”
The extent of health problems caused by air pollution has driven the WHO to team up with UN Environment and the Climate & Clean Air Coalition to launch a campaign called. This campaign “mobilizes communities to reduce the impact of air pollution on our health & climate,” and is driven by the knowledge that reducing air pollution is one of the most effective measures that governments and communities around the world can take to improve public health.
Throughout Julyby asking students to #MoveMindfully on their daily commutes. In a collaboration between AMSA Code Green, AMSA Mental Health and AMSA Healthy Communities, the #MoveMindfully campaign has promoted the benefits to physical, mental and planetary health of leaving cars at home and using active or public transport to get around. We’ve asked students to send us photos of themselves using alternatives to cars, and to tell us about why moving mindfully is important to them. You can see some of their responses in this post.
Of course, global air pollution is not something that’s going to be solved by a few Australian medical students swapping cars for active transport. That’s why the WHO is working around the world to encourage governments to “adopt national air quality standards, strengthen emission standards, and provide incentives for the purchase of cleaner vehicles, low-energy appliances, and energy-efficient housing”. Fortunately, there’s an important role for individuals – and particularly future health professionals like us – to play in calling on local leaders to implement these measures, as well as expediting the transition away from polluting fossil fuels and towards clean, renewable energy sources.
In the meantime, though, ditching the car and using active transport is a great place to start.
As AMSA President Alex Farrell said last week, “as individuals, we must recognise active transport can be an effective way to support our mental and physical health, as well as other people’s health, and the environment.”
AMSA Global Health Code Green Co-Cordinator
While a lot has been said about the causes of obesity, there is a common thread to all – we reach too often for the packet of chips and not often enough for the gym gear. But, even this sentence alone makes it painfully clear that the individual is at fault. They are the ones who put food in their mouth and stay on the couch, and there’s no denying the truth in that. In 2018 in Australia, the majority of adults are overweight or obese(1), a pattern that’s replicated around the world, and obesity comes with serious health impacts. Health impacts like increased risk of noncommunicable diseases such as some cancers, cardiovascular disease, and type II diabetes to name a few(2).
So, we know that there’s a problem. But, what would be better to know is why there is a problem. After all, if we could stop this behaviour before it begins, we might have a much smaller fight on our hands. Why are we giving into temptation now and not before? Again, opinions differ – the food industry, industrialisation – others still credit increasingly stressful lives.However, as with many problems, taking a step back often makes it much clearer. We live in environments that have become increasingly obesogenic, meaning they are conducive to weight gain. They encourage overconsumption by making you hungry all the time, with constant exposure to advertising for foods that our brain finds rewarding, and then making sure that these foods are as readily available as possible.
So, who’s at fault? The food industry, in the end, is no more than a collection of companies, who some would argue have no obligation to look after the health of the public. Creating an obesity epidemic was probably never their aim.
Is it the people who put the food in their mouths and then don’t exercise enough to use up the energy? Where does food availability come in? Should this be regulated more carefully by governments and where does one draw the line? At what point do we take away the choice of the consumer because we deem them unable to make a good choice?
The likely conclusion is that it’s neither and all, and we can think about this with an analogy. Imagine that the burden of maintaining a healthy lifestyle and a healthy weight (for the purposes of this post), is a large boulder that you need to push throughout the course of your life. For those who live in an obesogenic environment, the boulder has to be pushed up hill, while those who live in healthier environments push their boulders on less of an incline. That is, the same burden that is placed on the individual (the boulder), becomes easier or harder to push depending on the environmental factors that surround it.
It is essential for individuals to be considered in the context of their environments. Humans haven’t changed – our environment has. We need action at all levels to level the playing field for everyone who has to make choices about their health every day. At the moment, our public health response to improving the healthy environment in Australia and globally is not good enough.
Blaming the individual may be convenient but it’s not productive and won’t actually fix the problem.
One of the main targets of AMSA Healthy Communities, the newest global health group that focuses on noncommunicable disease prevention and awareness promotion, is the obesogenic environment. This year, we hope to alter the environments that we live in for the better, by pushing for state governments to improve the food environment in healthcare facilities, not only making healthy choices easier to make for all those who engage with the healthcare system, but also setting an example for other industries nationally and other health systems globally.
This is just one of the many exciting ideas that we have planned for this year and beyond. If you would like to be involved with AMSA Healthy Communities, or have any ideas that you’d like to see become a reality, please feel free to contact me at firstname.lastname@example.org.
AMSA Healthy Communities National Coordinator
- Australian Institute of Health and Welfare (AIHW). 20 June 2018. Australia’s health 2018. https://www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/table-of-contents.
- World Health Organisation (WHO). 1 June 2018. Noncommunicable diseases. http://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases.
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