Mark Danner’s latest book, Stripping Bare the Body: Politics Violence War (Nation Books), was released in October. Environmentalists Against War is pleased to be a co-sponsor of Danner’s visit to San Francisco for a book-reading at the Booksmith Bookstore. The date is Friday, November 13 at 7:30 p.m.

http://www.nationinstitute.org/p/danner_book_tour

Mark Danner’s latest book, Stripping Bare the Body: Politics Violence War (Nation Books), was released in October. Environmentalists Against War is pleased to be a co-sponsor of Danner’s visit to San Francisco for a book-reading at the Booksmith Bookstore. The date is Friday, November 13 at 7:30 p.m. The Booksmith 1644 Haight Street San Francisco, California 94117. 415-863-8688

About the Book: Drawing on rich narratives of politics and violence and war from around the world and written by one of the world’s leading writers, Stripping Bare the Body is a moral history of American power during the last quarter century. From bloody battleground to dark prison cell to air-conditioned office, it tells the grim and compelling tale of the true final years of the American Century, as the United States passed from the violent certainties of the late Cold War, to the ideological confusions of the post-Cold War world, to the pumped up and ongoing evangelism of the War on Terror and the Iraq War, and the ruins they have left behind. For the past two decades, author and award-winning journalist Mark Danner has reported from Latin America, Haiti, the Balkans and the Middle East, exploring not only the real consequences of American engagement with the world, but also the relationship between political violence and power. From the fall of the Duvalier dictatorship in Haiti to the tumultuous rise of Aristide; from the onset of the Balkan Wars to the painful fragmentation of Yugoslavia; and to the invasion of Iraq and the legacy of the Bush administration, Danner, former staff writer at The New Yorker and author of Stripping Bare the Body, has visited some of the world’s most troubled regions, bringing back lessons on politics, violence, and war. The conversation will be followed by audience questions and a book signing.

By Robert M. Gould, M.D., President, SF Bay Area Chapter, Physicians for Social Responsibility

The astonishing award of the Nobel Prize for Peace to Barack Obama is a welcome global affirmation of our President’s strongly stated commitments for new American leadership dedicated to breaking with the unilateralist and militarist agenda of the Bush-Cheney administration. President Obama’s personal story, and his lofty eloquence in reaching out to diverse global communities towards a true partnership for “saving the planet” have raised universal hopes for substantive changes in U.S. policies that would truly benefit all.

If the Nobel Prize has effectively been given for a renewed sense of hope and peace personified by our President, it behooves us to do our part to make real that promise at this critical time.

We at PSR have been especially struck by Obama’s forthright embrace of the goal of a world without nuclear weapons, the central aim of The International Campaign Against Nuclear Weapons (ICAN) that PSR and our worldwide affiliates within the Nobel Peace Laureate (1985) International Physicians for the Prevention of Nuclear War (IPPNW) have been working on steadily for many years. Unique in the annals of modern presidents, Obama’s calls for nuclear abolition in Prague, Russia and most recently at the UN, at the rhetorical level have fundamentally challenged the doctrine of escalation dominance – the desire to at all times possess the overwhelming upper hand of military (nuclear) force at any increasing level of violent confrontation — that has been central to U.S. nuclear strategy since the dawn of the Cold War. Packaged euphemistically for decades as deterrence, this doctrine has rationalized nuclear weapons and related modernization programs and budgets now running at approximately $50 billion a year.

Recognizing the dangers of fresh thinking on the subject, forces of the American Right in sync with the worldviews of the Project for a New Century (PNAC), that had dominant sway during the last Administration, have bitterly counterattacked against even the mildest of disarmament measures, as exemplified by the small cuts envisioned under the current START talks with Russia. From Fox Media and Wall Street Journal Op-Eds through the recent “Nuclear Deterrence in the 21^st Century: Getting It Right” white paper of the neoconservative New Deterrent Working Group, there has been unrelenting pressure in opposition to any disarmament deals with the Russians, redeployment of missile defense systems from Poland and the Czech Republic, any Comprehensive Test Ban Treaty (CTBT), any fundamental questioning of nuclear weapons superiority defining national security, period.

In addition, at a time when the same forces have been driving dangerous confrontational policies with Iran over its potential nuclear weapons program, there has been a renewed push on the Obama Administration to expressly support the funding of costly new nuclear weapons programs such as the Reliable Replacement Warhead (RRW) housed within the framework of a robust Department of Energy (DOE) “Complex 2030.” Such programs, emblematic of the “do as I say, not what I do” perspective of the world’s nuclear powers, are what ultimately encourage the horizontal proliferation of new nuclear states, increasing the threat to all of us.

Central to the issue are the current debates within the Administration regarding the strategic vision at the heart of the soon to be released Nuclear Posture Review (NPR), which would update the last one of late 2001, utilized by the Bush Administration to permanently place nuclear weapons at the heart of military strategy. The NPR effectively drives the development of the Single Integrated Operational Plan (SIOP), still based on a counterforce doctrine that informs the targeting of nuclear warheads and missiles against “enemy” weapons and hundreds of millions of innocent civilian populations around the globe. Given that enough nuclear-armed missiles remain on alert, “launch on warning” status, the chance of the world ending in a matter of an hour or so remains with us.

With President Obama raising an alternative vision in his recent speeches, there is an unprecedented and conceivably last real possibility to reverse the inevitable “mutually assured destruction” of a renewed global arms race.

To this end, Daniel Ellsberg has recently underscored the stakes for the planet by his recent revelations of how many deaths have been considered “acceptable” by U.S. political and military leaders in the formulation of the still, essentially unmodified SIOP.

In “A Hundred Holocausts,” it is starkly clear that the consequences of the targeting of the U.S. arsenal could, in DOE-jargon, “safely and reliably” extinguish the lives of at least 600 million people, as indicated in an early 1960’s “For the President’s Eyes Only,” highest level of national security document, when including other victims beyond roughly 325 million Soviet and Chinese deaths anticipated, as shown in the following chart:

Since being awarded the Nobel Peace Prize, President Obama has been characterized by a number of media figures as being “unworthy” given his short tenure and consequent inability to attain the concrete ambitions invoked in his speeches, and that ultimately, the Prize is a “burden” on him, that he is ultimately set-to-fail, given the present coordinates of American political realities, and the presumed impossibility of being able to effectively plot a new course away from where old habits and worldviews lead.

Now is the time for public opinion to register strongly for new directions on nuclear weapons and to challenge all of the assumptions underlying the militarist paradigm that has driven us to too many wars and fiscal ruin, and if unabated, will simply destroy our ability to cope at all with climate change.

The PSR voice for hope and peace is strengthened by the support and engagement of our membership. As we gear up for more programming in 2010, with less foundation financial support, we need “stretch” gifts from our members to ensure a strong and vital chapter. Please support the San Francisco Bay Area Chapter of PSR with a gift now.

TWO WAYS TO GIVE:

By Check to: SF Bay Area PSR, 2288 Fulton Street, Suite 307, Berkeley, CA 94704-1449

By Secure Credit Card Donation: PSR at Network for Good (https://www.networkforgood.org/donation/MakeDonation.aspx?ORGID2=942702750)

Donors provided important support in August and September to continue and expand the Balanced Menus campaign.  SFPSR staff members Lena Brook and Lucia Sayre have been hard at work on expanding the reach of this project.  “Lena and Lucia have provided significant leadership in the Bay Area to educating and assisting health care facilities to make changes in their food procurement practices, which ultimately improves the public’s health,” says SFPSR Board President Dr. Robert Gould.

SFPSR piloted the Balanced Menus campaign here in the Bay Area with four facilities for most of this year. The success of our early adopters – including UCSF and Santa Rosa Memorial Hospital – allowed us to partner with our longstanding allies at Health Care Without Harm to launch this program nationally on September 23, 2009!

With the larger scope of the project also came a new commitment: we are asking hospitals to sign on to the Balanced Menus Challenge of reducing meat purchasing by 20% over 12 months. Around the country, 14 hospitals have already accepted this Challenge. As Linda Hansen, Director of Nutrition Services at St. Joseph Health System in Sonoma County says, “It was amazingly simple to make an impact on our carbon footprint by starting with small changes in our cafeteria and working our way up to the more complex patient menu. By implementing Balanced Menus, we are able to remain cost neutral, or even achieve savings for the hospital, not to mention the savings to our healthcare system that result from providing patients, staff and visitors healthier foods.” Encouraging a reduced and sustainable meat diet is part of a primary prevention agenda to reduce the nation’s chronic diet-related illnesses, but also contributes substantially to climate mitigation, clean air and water, and protection of the effectiveness of antibiotics. SF PSR is excited to be a part of the Balanced Menus movement’s growth in the coming months.

On October 26th from 11-12:30pm, SF PSR hosted a webinar training on the Balanced Menus Challenge for California hospitals. The webinar was attended by over thirty individuals, including representatives from ten local hospitals.  Participants learned about why this program is an important as part of a hospital’s climate mitigation strategy; how food service staff has implemented Balanced Menus in their Northern California hospitals; how to start a Balanced Menus program in their hospital; and an update from Johns Hopkins’ Center for a Livable Future’s ongoing evaluation of this project.

The Balanced Menus project will also be a part of a panel at the upcoming 2009 S3: Safe, Secure, and Sustainable Symposium on Food Systems and Public Health in San Diego on November 6th. For more information about this conference go to http://www.californiafood.org/.

We are well on the way to enrolling our goal of six more hospitals this year so they can start serving healthier, more sustainably produced meat and vegetables. Your continued support ensures funding for outreach and education to make this goal a reality.

For more information contact Lena Brook: lena@sfbaypsr.org.

Aided by efforts of PSR members, numerous policies protective of public and environmental health were adopted at the recent California Medical Association (CMA) 138^th Annual Session (October 15-19, 2009, Disneyland Hotel, Anaheim). This great outcome reflected a strong collaboration of local medical associations, hospital systems such as Kaiser, and professional organizations such as the American College of Obstetricians and Gynecologists and the California Thoracic Society. The policies adopted included addressing concerns about chemicals in flame retardants and air fresheners, raising special awareness among physicians about the dangers posed by endocrine disrupting chemicals (EDCs), and reducing exposures to this class of toxic chemicals. Measures supporting healthy food policy included resolutions calling on CMA to oppose non-therapeutic use of antibiotics in livestock, and to support increased taxes on sodas and other relevant high fructose corn syrup sweetened beverages, while encouraging physicians to educate their patients about the health risks associated with the consumption of food and beverages containing high amounts of processed simple sugars or refined sugars such as high fructose corn syrup.

Two other important policies centered on addressing the public health challenges posed by climate change were also passed. One resolution focusing on “smart growth” and air pollution reduction called on CMA to support efforts, including the participation of public health officials, to develop ambitious regional targets for local governments to reduce greenhouse gas emissions and support land use and transportation strategies to meet those targets.

In addition, SFPSR President Dr. Bob Gould successfully authored a resolution “Ecological Health Footprint for Health Care Facilities” that garnered CMA support for mitigating the impacts of health care system contributions to climate change and toxic pollution through educational efforts among health professionals using resources such as the “Eco-Health Footprint Guide” distributed by the Global Health and Safety Initiative (GHSI).  The GHSI is a sector-wide collaboration of major health care systems including Kaiser Permanente, Ascension Health, Catholic Healthcare West, St. Joseph’s Health and Partners Healthcare, that was formed to transform the way health care designs, builds, and operates its facilities, to support environmentally preferable purchasing in health care and research, and to move public policy forward that supports healthier and safer hospitals, communities, and society. SFPSR staffmembers have been involved in the development of GHSI since its inception through our work with Health Care Without Harm.

These efforts for healthier hospitals have been in complete sync with policies adopted by the CMA over the past decade to curb greenhouse gases that contribute to global climate change, to reduce petroleum demand and associated pollution, and to reduce a variety of health care-related toxic materials (many policies developed by PSR members, see www.sfbaypsr.org). Energy usage in medical facilities is highly intensive, with hospitals being the second-most energy-intensive commercial buildings in the U.S., expending about twice as much energy per square foot as traditional office space, with the health care sector spending a total of $5.3 billion on energy every year.   The increasing cost and health impacts of using energy, materials and products from petroleum-based sources are estimated to have far-reaching direct and indirect effects on the health care sector, including increasing the costs of medical supplies and equipment, transportation, energy and food (see SFPSR Balanced Menus Campaign), and related fiscal costs.

As such, partly in response to policies adopted by CMA and other state medical associations, the American Medical Association now supports educating the medical community on the potential adverse public health effects of issues such as global climate change, incorporating the health implications of climate change into the spectrum of medical education, and supporting efforts to search for novel and comprehensive approaches to mitigating climate change. PSR is well positioned locally and throughout the nation to maximize the impact of physicians to speak out and act strongly in support of ways that transform the healthcare sector to be a leader in the difficult path forward to protect humanity from the untold consequences of decades of delay in addressing such fundamental threats to our very existence.

CMA Resolution 728-09 “Ecological Health Footprint for Health Care Facilities” states: That CMA encourage the education of physicians and other health professionals with resources, such as the “Eco-Health Footprint Guide” distributed by the Global Health and Safety Initiative, in mitigating the impacts of health care system contributions to climate change and toxic pollution.

For more information about joining PSR’s efforts please visit our website at www.sfbaypsr.org.

Two SFPSR Steering Committee members will be honored at the upcoming American Public Health Association Annual Meeting & Exposition in Philadelphia November 7-11, 2009.

Bob Gould Awarded Sidel-Levy Award for Peace

The Sidel-Levy Award for Peace, which recognizes an APHA member who has made outstanding contributions to preventing war and promoting international peace, is being presented to Robert M. Gould, MD.

Gould is associate pathologist of the pathology department at Kaiser Permanente Hospital, San Jose, California. He chairs APHA’s Peace Caucus, and is an active member of the Environmental Committee of the Santa Clara County chapter of the California Medical Association. Currently on the national board of directors of Physicians for Social Responsibility (PSR), he served as National President in 2003, and has served as President of the San Francisco-Bay Area Chapter of PSR since 1989.

Among his peace efforts, Gould has authored or co-authored numerous resolutions passed by the APHA Governing Council against nuclear testing, an excessive military budget, the Strategic Defense Initiative, landmines, chemical weapons and other issues. He also has submitted many resolutions adopted by the California Medical Association including those calling for preventing dioxin waste from medical facilities, preventing human exposure to mercury, reducing the use of pesticides, replacing medical devices containing phthalates from neonatal intensive care units, reducing air pollution, abolishing weapons of mass destruction and avoiding accidental nuclear war.

Gould was honored with the Santa Clara County Medical Association’s “Outstanding Contribution in Community Service” award in 2001 and was listed as one of Santa Clara County’s “Top 400 Physicians” in peer-reviewed surveys published in San Jose Magazine from 2001–2007.

He has authored and co-authored many writings, including Rollback! Rightwing Power in U.S. Foreign Policy, with Thomas Bodenheimer, the chapter “Public Health Effects of Biological Weapons” in the book War and Public Health, and the chapter “Prevention of Nuclear Terrorism” in the book Terrorism and Public Health. He co-wrote editorials for the American Journal of Public Health titled “Bioterrorism Initiatives: Public Health in Reverse?” as well as “Bioterrorism Preparedness: Cooptation of Public Health?” and “The Pitfalls of Bioterrorism Preparedness: the Anthrax and Smallpox Experiences.” He wrote “Public Health Challenges of Bioterrorism” for the journal San Francisco Medicine and has contributed to a number of published letters and other works on the issue of bioterrorism and biopreparedness.

In 2000 Gould served as a member of the scientific panel providing advice to the Advisory Group on Low Level Radioactive Waste Management established by then-California Gov. Gray Davis to examine options for the disposal of low-level radioactive waste. He served as a member of the steering committee that provided oversight and planning to the Centers for Disease Control and Prevention sponsored “International Summit on Breast Cancer and Environment: Research Needs.”

Gould has given numerous presentations on a wide range of health and environmental issues, including showing the Physicians for Social Responsibility presentation, “Environmental and Public Health Effects of Global Warming” to a large number of medical audiences. As an active speaker at hospital grand rounds and other community events, his topics have included “Health and Environmental Effects of Nuclear Weapons and Militarism,” “Health Impacts of War,” “Collateral Damage: Health and Environmental Consequences of U.S. Foreign Policy,” and “Public Health Issues Related to Biological Weapons and Bioterrorism.”

In 2008, Gould was the invited speaker at the Global Forum on Civilization and Peace organized by the Academy of Korean Studies and delivered the address “Protecting Generations at Risk.” He was part of a special delegation during the International Physicians for the Prevention of Nuclear War World Congress in New Delhi and met with the president and prime minister of India to advocate for Indian leadership in the global movement to abolish nuclear weapons.

Tom Hall Awarded Lifetime Achievement Award

Tom Hall, MD, DrPH, will be awarded the APHA Lifetime Achievement Award from the International Health Section.  Each year, the International Health Section of the American Public Health Association (APHA) recognizes outstanding contributions by APHA members through its Lifetime Achievement Award for Excellence in International Health. The Lifetime Achievement Award was created by the International Health Section to honor the visionaries and leaders in APHA who have shaped the direction of international health. Awardees are honored for their quality, creativity, and innovativeness of their contributions to the field of international health and for their contributions to the development of APHA or the International Health Section.

Hall is a lecturer in the University of California, San Francisco (UCSF), Department of Epidemiology and Biostatistics and Executive Director of the Global Health Education Consortium. He has served on the board of the San Francisco Bay Area chapter of Physicians for Social Responsibility since 1987, having served previously as the President of the Washington State PSR (1983-84), on the national House of Delegates for several years in the 1990’s, and on the Steering Committee of the New Zealand chapter of International Physicians for the Prevention of Nuclear War during 1985-86.

He received undergraduate, MD and MPH degrees from Harvard and his DrPH degree in international health from Johns Hopkins. He has held faculty appointments in the schools of public health of the University of Puerto Rico, Johns Hopkins, University of North Carolina (UNC) at Chapel Hill, and the University of Washington in Seattle. At UNC he was director of the Carolina Population Center. Non-academic positions have included medical director of a rural hospital, director of a regional health planning agency, and Chief Medical Officer (Research) in the New Zealand Department of Health (1985-86). He joined UCSF in 1988, directed a postdoctoral training program in HIV research (1989-96) and since then has taught and mentored students in international health. He has consulted with the World Health Organization (WHO), the World Bank and many countries on strategic health workforce planning. He is primary author of the WHO ToolKit for Human Resources Development.

September 23, 2009

Contact: Lena Brook, 415-601-0504, lena@sfbaypsr.org

Hospitals Reduce Climate Impact and Promote Health Through “Balanced Menus Challenge”

Hospitals Accept Challenge to Reduce Meat Offerings by 20 Percent in 12 Months

San Francisco Bay Area Physicians for Social Responsibility (SFPSR) has announced the “Balanced Menus Challenge,” a voluntary commitment by healthcare institutions to reduce their meat offerings in patient meals and hospital cafeterias by 20 percent in 12 months.  Balanced Menus is a climate change reduction strategy that also protects the effectiveness of antibiotics and promotes good nutrition.  Fourteen hospitals are already participating in the national Balanced Menus Challenge, which was developed and piloted by SFPSR and nationally launched  in partnership with Health Care Without Harm’s Healthy Food in Healthcare Initiative. (see hospital list at end of release).

The USDA recommends 5-6 oz of meat/fish/poultry/beans per day, yet for meat alone, Americans on average eat 8 oz daily.  Hospital food service operations often mirror this trend, offering sizable servings of meat several meals per day. High consumption of conventionally produced meat and processed meat contributes to an increased risk of cardiovascular disease, obesity, diabetes, metabolic syndrome, dementia, and some kinds of cancer.  Overconsumption of meat contributes to the overwhelming cost of the US health system (estimated to be $147B as a result of obesity management alone) as well as environmental damage such as climate change, water and air pollution.

Most hospitals buy substantial amounts of meat, typically through large distributors who source from the U.S. commodity beef, pork and poultry markets. U.S. food production relies heavily on fossil fuels, and red meat production is particularly energy intensive as it requires significant inputs of synthetic fertilizers and pesticides to grow crops for feed. The food system accounts for over 10 percent of overall energy use in the United States. Globally, livestock for meat and dairy production accounts for 18 percent of greenhouse gases, more than all of Earth’s cars, trains, and planes combined.

“While food choice is distinctly personal, the healthcare community should be at the forefront in modeling a healthy food agenda for the nation,” said Lena Brook, Senior Program Associate at the San Francisco bay Chapter of Physicians for Social Responsibility. “Encouraging a reduced and sustainable meat diet is part of a primary prevention agenda to reduce the nation’s chronic diet-related illnesses, but also contributes substantially to climate mitigation, clean air and water, and protection of the effectiveness of antibiotics.”

Most US meat is produced under a system that relies on the routine feeding of antibiotics to make animals grow faster and consume less feed grain. Arsenic compounds and hormones are given to animals for similar reasons. These additives further contaminate animal manure, which then moves off the crowded facilities, polluting land, air and water. Sustainably raised meat and poultry precludes the use of antibiotics for non-therapeutic purposes. Approximately 70 percent of all antibiotics used in the U. S. are given to healthy animals to promote growth and compensate for crowded conditions and poor husbandry practices in conventional animal production.

“As institutions with considerable buying power, hospitals can demonstrate leader­ship to the marketplace by reducing the overall quantity of meat and poultry served and through purchasing of sustainably produced meat,” stated Brook.  “The health care sector is increasingly aware of its responsibility to model healthy behavior for the community.  Reducing their meat purchasing will help reduce the overall cost of medical care in this country, with benefits ranging from savings in actual food service costs to reduction in pollution, but most importantly, to contribute to healthy lifestyles that will improve the health of Americans.”

“It was amazingly simple to make an impact on our carbon footprint by starting with small changes in our cafeteria and working our way up to the more complex patient menu,” said Linda Hansen, CDM, CFPP, Director of Nutrition Services at St. Joseph Health System in Sonoma County, CA. “By implementing Balanced Menus, we are able to remain cost neutral, or even achieve savings for the hospital, not to mention the savings to our healthcare system that result from providing patients, staff and visitors healthier foods.”

“As we debate health care reform in the US, it is important to recognize that eating less conventionally produced meat will reduce drivers of many of the major chronic diseases that threaten the sustainability of our health care system stated Ted Schettler, MD, MPH, of the Science and Environmental Health Network. It is good for people and good for the planet.”

For more information about the “Balanced Menus Challenge,” go to http://noharm.org/us_canada/issues/food/menus.php

Physicians for Social Responsibility is a non-profit advocacy organization that combines the power of community activism with the knowledge and credibility of physicians and other health professionals to promote public policies that support human health.  The San Francisco Bay Area Chapter of PSR (SF PSR), founded in 1979, was the first to be organized in the country and remains one of the largest of the 31 US chapters, with over 2000 members. SF PSR is the preeminent medical and public health voice in our region on a broad range of critical social and environmental health issues. To learn more about SFPSR, visit www.sfbaypsr.org.

HCWH is an international coalition of more than 430 organizations in 52 countries, working to transform the health care industry worldwide, without compromising patient safety or care, so that it is ecologically sustainable and no longer a source of harm to public health and the environment. HCWH has an ambitious healthy food agenda, which includes buying fresh food locally and/or buying certified organic food; avoiding food raised with growth hormones and antibiotics; supporting local farmers and farming organizations; introducing farmers markets and on-site food box programs; reducing food waste; and establishing an overarching food policy at each health facility.  More than 250 hospitals have signed the HCWH “Healthy Food in Healthcare Pledge.”  Signers pledge to work toward developing sustainable food systems in their facilities.  To learn more about HCWH’s work on food and other issues related to health care www.healthyfoodinhealthcare.org

Hospitals Participating in the Balanced Menus Challenge

UCSF Medical Center, CA

John Muir Health System, CA

Santa Rosa Memorial Hospital, CA

San Francisco VA Medical Center, CA

New Milford Hospital, CT

Union Hospital of Cecil County, MD

Carroll Hospital Center, MD

Anne Arundel Medical Center, MD

St. Joseph’s Manor/ Covenant Health System, MA

Anne Arundel Hospital, MD

Truman Medical Centers, MO

Good Shepherd Medical Center, OR

Oregon Health & Science University

Thomas Jefferson University Hospital, PA

Cooper University Hospital, NJ

Help strengthen U.S. climate and energy legislation

Reducing Global Warming through Healthcare Systems Food Purchasing

Our industrialized food system is failing to protect public health.  How food is produced and distributed profoundly affects its nutritional quality, our environment and resources, and the social and economic fabric of rural communities.  Poor nutrition is a risk factor for four of the six leading causes of death in the United States – heart disease, stroke, diabetes and cancer.  Diet-related diseases contribute as much as $93 billion to the nation’s annual medical bill, according to a study by the Centers for Disease Control and Prevention.  In California, a state-sponsored study in 2000 using data from 1998-1999 estimated the total direct and indirect costs due to physical inactivity, being overweight, and obesity would reach $28 billion by 2005.  Yet rather than investing in fresh fruits and vegetables, whole grains, and other high fiber foods important for good health, our current food system favors the production of feedlot-raised animal products and highly refined, calorie-dense foods.  It promotes the long-distance travel of food and the use of chemical fertilizers and pesticides, creating environmental pollution, unnecessary waste and associated health problems.

In the next phase of our effort, will focus on the “Balanced Menus” campaign, wherein hospitals will reduce the amount of meat protein served in their cafeterias and on patient trays. Most hospitals purchase substantial quantities of meat annually, typically through large distributors who source from the US commodity beef, pork and poul­try markets. The upfront cost for these products is low, giving a veneer of affordability to serving meat two to three times a day on patient trays and in cafeterias. However, the hidden cost of meat produced and distributed via our industrial agricul­tural system is high. Industrial meat and poultry production relies on the addition of antibiotics (70% of all antibiotics used in this country are given to healthy animals, to promote growth and compensate for stressful growing conditions), arsenic, and hormones as well as crowded conditions that pollute air and water. The ris­ing social costs of antibiotic resistance, air and water pollution, and associated impacts to the health of communities are ulti­mately borne by healthcare systems.

Current Balance Menus Leaders

UCSF Medical Center

John Muir Health System

Santa Rosa Memorial Hospital

San Francisco VA Medical Center

Globally, livestock for meat and dairy production accounts for 18% of the world’s greenhouse gases, more than every single car, train, and plane on the planet. Meat production practices also cut to the heart of other health and environmental impacts. U.S. food production relies heavily and wastefully on fossil fuels, and red meat production is particularly energy-inefficient. Nearly 80% of the grains grown in the United States are produced for livestock feed.  Cattle, swine, and their waste also release large quantities of methane and nitrous oxide, greenhouse gases far more potent than carbon dioxide. Waste lagoons from concentrated livestock operations also produce significant amounts of methane, a potent climate change gas. Studies suggest that certified organic and grass-fed livestock operations may reduce greenhouse gas emissions and that high-quality pasture can also lower methane emissions from cattle rumination.  Yet, all cows, and sheep naturally produce methane and we know that plant-based diets can be half as energy and emissions-intensive as diets dominated by red meat. According to the United Nation Intergovernmental Panel on Climate Change, eating meat-free one day per week may be the most important thing an individual can do from a climate change perspective. In fact, in late 2008, the National Health Service in the United Kingdom announced their plan to eliminate meat from hospital menus.

Americans eat three times the amount of meat recommended by the USDA. Hospital food service operations often mirror this trend, offering sizable servings of meat several meals per day. The abundance of meat in our food environment directly and negatively impacts the health of Americans. While food choice is distinctly personal, the healthcare community can help reshape this environment. A reduction in the overall amount of meat served in hospital facilities provides health, social and envi­ronmental benefits that are consistent with prevention-based medical practices. As institutions with considerable buying power, hospitals can demonstrate leadership to the marketplace by reducing the overall quantity of meat and poultry served and through preferential purchasing of sustainably produced meats.

The underlying strategy behind this project is to reduce meat in hospital food service to promote the health and taste benefits of seasonal vegetables and grains, to utilize cost savings to purchase higher-quality and sustainable meat options, to demonstrate the growing demand for alternative meat to producers and distributors, to educate patients, and staff about the climate change, environmental, health, and economic implications of the conventional meat production system and to create demonstrable reductions in the climate and environmental footprint of Bay Area hospitals. Implementing “Balanced Menus” strategies offers cost savings as well as concrete public and environmental health benefits. For example, Santa Rosa Memorial Hospital, designed a “Balanced Menu” that increases vegetarian options and incorporates the use of local grass-fed beef and free range chicken.  They predict that not only will this menu benefit the health of their patients and the environment, but it will be cost neutral as well.  Despite a 35-50% price increase for the better quality, sustainably raised proteins, the menu overall should net the hospital close to $5,000 per year in savings.

Through this project, Bay Area health care institutions will use their purchas­ing power to expand local markets for sustainable meat and poultry, as well as create public policy support for sustainable production, while at the same time building synergy between food services oper­ations and clinical nutrition efforts. With “Balanced Menus” hospitals will also support local farmers and ranchers that produce sustainable meat and poultry.

By Jeff Ritterman, M.D.

Imagine a guidebook on formulating social policy, with instructions on how to extend life expectancy, decrease infant mortality, improve child well-being, reduce obesity, lower homicide rates, decrease school dropout rates, lower teen pregnancy, increase levels of civic trust, improve voter turnout, decrease drug abuse, lower incarceration rates, decrease rates of mental illness, and improve social mobility based on merit.

There’s convincing evidence for all of this and more in The Spirit Level: Why More Equal Societies Almost Always Do Better, by Richard Wilkinson and Kate Pickett (Allen Lane). To learn more, go to their Web site, www.equalitytrust.org.uk.

The core message is that the countries that distribute their incomes the most equally have the longest life expectancy and the highest quality of life.

The same is true for states within the U.S.; the more income equality, the longer the life span. Unfortunately, the United States is now the most unequal of the wealthy countries, with the exception of Singapore.

As income inequality increases, we trust one another less. For those concerned that I am confusing correlation with causality, I refer you to the thoughtful discussion of this in The Spirit Level. The authors review the extensive data on civic trust and make a convincing argument that causality is the best fit.

Increasing income inequality puts us on a pathway toward a less trusting, more individualistic and less community-minded society. As community cohesion erodes, we all suffer.

The graphic below shows just how much the U.S. is lagging behind other wealthy countries due to our highly unequal income distribution.

The leading countries in life expectancy, Sweden and Japan, are also among the most equal of the wealthy nations. Interestingly, they have accomplished this relative equality in completely different ways: In Sweden, the tax system redistributes income; in Japan the income is given out relatively equally before any tax adjustments. Combinations of the two methods are also possible.

We in the U.S. are becoming more and more unequal. Our poor showing in life expectancy and quality of life is a direct result. It wasn’t always this way, and it does not need to remain so. Income distribution has varied widely.

In the Gilded Age of the robber barons, income distribution in the U.S. was very unequal (see the graphic below). This was one of the causes of the Great Depression. FDR’s New Deal can be interpreted, in large measure, as a program to reverse income inequality.

In a stunningly short time, called the Great Compression by economic historians Claudia Goldin and Robert Margo, America underwent a significant redistribution of income. While historians offer a variety of explanations for the Great Compression, what is clear is that income was much more fairly distributed.

This relative equality produced the middle class America that I grew up in. Of course, there were rich and poor people, but nothing like the extremes of wealth and poverty that we see today. This middle-class America lasted until the late 1970s, when the trend toward greater inequality began to accelerate.

Today, we are faced with the same degree of income inequality as existed during the Great Depression. We can take our cue from FDR. It’s time for another great compression. It’s time to put folks back to work, to strengthen and help rebuild our labor unions, and to protect our most vulnerable community members.

Policies that lessen income inequality lead to an improvement in life expectancy and social well-being. Such policies would include raising the minimum wage, improving worker pensions and benefits, strengthening labor unions, passing progressive tax reform, adequately funding education, passing universal health-care coverage and guaranteeing a minimum standard of living for everyone. The vast majority of society benefit from more equality, as greater social cohesion improves life for us all.

Lessening income inequality should be our main organizing principle. If a policy leads to more equality, it is likely to lead to greater social well-being and longer life expectancy.

As we face the challenge of climate chaos, some have argued that there is no time to worry about luxuries like equity and equality. I agree wholeheartedly with the urgency of our situation, but equality and equity are indeed highly relevant.

The more equal the country, the greater the likelihood of recycling. People who live in more equal societies tend to care more about the earth. Addressing climate change and social equity simultaneously is likely to provide the best outcome. We need a Green New Deal.

We can learn a valuable lesson from societies less developed than our own that have attained equivalent life expectancies. Costa Rica, for example, has a life expectancy close to ours with less than one-seventh the carbon footprint. The new Economics Foundation has declared Costa Rica to also be the happiest country on earth. Clearly, long and happy lives are possible without causing climate change.

The issue of income inequality is largely invisible, but there is a widespread sense of unease about the direction we are headed and a feeling that life is not fair.

The data on the deleterious effects of inequality can help us understand our unease and what we need to do about it. Greater equality results in improvement in health and life expectancy and reduces many of the social ills that currently seem intractable. Making this knowledge widespread is a prerequisite to developing the political will to move toward greater equality and a healthier society for us all.

Jeff Ritterman is a cardiologist practicing in Richmond, Cali., a member of the Richmond City Council, and a steering committee member of SF Physicians for Social Responsibility

Some Thoughts on Nagasaki Day

by Bob Gould, M.D., President, SF Bay Area Physicians for Social Responsibility

My Mom passed away last week at the age of 86, after a three-year battle with metastatic colon cancer. Over the last two months, our family and close friends were able to share our love with her and help her have a “soft landing.” Through all the sadness we felt losing her, what was striking was how fortunate we were being able to participate so intimately in her passing, to have the time and opportunity to be able to organically share and process the memories of someone so close—in our own variation of what has been the collective experience of humanity grappling with life and personal loss through the eons.

In this past week encompassing the 64^th Anniversary of the atomic bombings at Hiroshima and Nagasaki, I couldn’t help but think about how our experience of having the ability to share and process profound personal grief differs so fundamentally from the Japanese Hibakusha survivors who were wrenched so suddenly from the daily rhythms of life, loss and collective history by the supreme violence of nuclear war that literally vaporized their families and communities with no warning, allowing no such personal and communal closure with such awesome loss. And how, despite the hopes for fundamental change raised by new political leadership in our own nation, the forces arrayed for future global nuclear annihilation remain as influential and powerful as ever.

Early this year, PSR and our colleagues in IPPNW sent a “Medical Appeal for a World Without Nuclear Weapons” signed by numerous leaders in medicine and public health to Presidents Obama and Medvedev stating that the time was ripe to negotiate a Nuclear Weapons Convention and take dramatic steps to fulfill our treaty obligations to move towards complete nuclear disarmament. President Obama echoed these sentiments in his extraordinary speech in Prague, stating “To put an end to Cold War thinking, we will reduce the role of nuclear weapons in our national security strategy and urge others to do the same,” … “We will seek to include all nuclear weapons states in this endeavor.”

These were powerful and welcome words from our President, followed by the tentative START agreement reached with Medvedev calling for reductions in the U.S. and Russian strategic arsenals. Unfortunately, left off the table were other critical components necessary for comprehensive moves towards nuclear disarmament, including ending destabilizing missile “defense” programs such as those targeted for deployment in Poland and the Czech republic, and taking nuclear missiles off “alert” status so as to avoid the dangers of accidental nuclear war.

These initial, limited moves towards setting a disarmament agenda have been met with vigorous attacks from the Right, as exemplified by the report “U.S Nuclear Deterrence in the 21^st Century: Getting It Right” released in July by the New Deterrent Working Group, in coordination with prominent editorials and op-eds in the Wall Street Journal and elsewhere. The basic message has been that nuclear weapons remain at the core of U.S. security and that the U.S. must continue to maintain and strengthen its nuclear arsenal and avoid any substantive negotiations with the Russians, including the minimal proposed START cuts.

These throwback recommendations, so redolent of the “Team B” report of the late 1970s that kicked-off the dangerous nuclear weapons policies of the Reagan Administration, have unfortunately been reflected in recent Congressional efforts to constrain the disarmament moves by Obama. Under an amendment inserted in the fiscal 2010 defense authorization bill, President Obama would be required to certify that a new U.S.-Russian treaty includes no limits on U.S. deployments of missile defenses, “space capabilities” or sophisticated conventional weaponry. In addition, the president would have to certify that his fiscal 2011 budget request for the National Nuclear Security Administration “sufficiently” funds nuclear stockpile maintenance programs as well as efforts to “modernize and refurbish the nuclear weapons complex.”

In other words, at a time when we are in the midst of the worst global economic crisis since the Great Depression, with burgeoning unemployment and projected deficits looming on the order of $10 trillion, coupled with the imperative need to provide the funding for universal healthcare and preventing/mitigating the disastrous effects of climate change, we are called on to continue to commit our increasingly scarce and precious resources to building a new generation of nuclear weapons that can destroy human life more quickly in the name of “security.”

We know we can do better. As outlined by the 2006 “Weapons of Terror” report issued by the Weapons of Mass Destruction Commission (chaired by former International Atomic Energy Agency Chief Hans Blix), as well as the 2008 report “Towards True Security” by the Union of Concerned Scientists, Federation of American Scientists, and Natural Resources Defense Council, there are very simple, mutually reinforcing steps that would allow significant nuclear stockpile reduction to the level of 1000 warheads per nuclear power—and that would provide the basis for moving to PSR/IPPNW’s goal of complete abolition of nuclear weapons. On this Nagasaki day, let us all commit to redoubling our efforts to fight against the forces of rightwing realpolitik and reclaim a vision of the world that will permit no repetition of the awful events of August 1945, so that we can get on with our work of saving our planet for renewed cycles of life and remembrance for all those fortunate to follow in our wake.