By crushing emissions, the recession is saving our lives

If it weren't for the global slowdown, our planet would be in a far worse state than it already is.

In the penultimate blog of this series we consider the third dimension of this era of "Great Uncertainty", the profound environmental challenge we face. The story of our environmental crisis is the story of a series of symbolic breaches. On 10th May this year the Earth Systems Research Laboratory (an environmental observatory and part of the US National Oceanic and Atmospheric Administration) perched 11,000 feet up atop the Mauna Loa volcano in Hawaii recorded the first ever average daily carbon dioxide level in excess of 400 parts per million (ppm). CO2 levels last reached such levels some 5 million years ago.

400 ppm, just like every other such symbolic ceiling, was long considered an unattainable figure, a level we could simply not allow ourselves to hit – a kind of doomsday portend and the point at which we would need to become (if we were not already) very, very scared that the damage we had inflicted on the planet was likely to prove irreparable and irreversible.  But it came and went, just like all the others – and most of us, I suspect, no longer give it very much thought. Indeed, it may well be that we are becoming increasingly immune to such symbolic breaches as the process of environmental and ecological grieving becomes ever more familiar.

But most of us know we can’t carry on like this. We know, in particular, that we can’t afford to forget for a moment this third dimension of the Great Uncertainty, even as we grapple with its first two features. Nor can we seek to solve those aspects of the situation at the expense of worsening our prospects in relation to this third issue. At heart, we face not just a crisis of growth, but, much more significantly, a crisis for growth.

This is of course immensely difficult terrain on which think and act. But there are some things we can say and do.

First, we can remind ourselves of why the task is so urgent – and we need to do so. There are some things, climate change denial notwithstanding, that we can be pretty certain about. Interestingly, though perhaps unremarkably when you think about it, they are not about symbolic breaches like passing through the 400 ppm CO2 threshold. They are about the planet’s "carrying capacity"; and the point is that for CO2, alas, it’s a lot less than 400 ppm.

This concept allows us to identify a series of planetary boundaries – what Johan Rockstrom called "the safe operating space for humanity with respect to the Earth system… associated with the planet’s biophysical subsystems or processes".  Here, with the benefits of the latest science, we can start to counter-pose current figures on environmental degradation with expert best approximations of the planet’s carrying capacity (the point beyond which we simply cannot go without threatening human life, certainly as we know it, on earth).

The results are startling and alarming in equal measure. Adapted and updated from Rockstrom, they are summarised in the table below for just a small sub-set of the planetary carrying capacities we might consider:

Earth system processes Parameter Boundary Current level
Climate change Atmospheric CO(ppm) 350 >400
Biodiversity loss Extinction rate (no. of species per million per year) 10 >100
Nitrogen cycle Amount of nitrogen removed from the atmosphere for human use (million tonnes per year) 35 >120
Freshwater use Human consumption of freshwater (km3 per year) 4000 c. 3000
Ocean acidification Global mean saturation state of aragonite in surface sea water 2.75 2.9
Landmass usage Per cent of global landmass used for crops 15 c. 12

Data like this show that we are already in the "red zone" (where we exceed planetary carrying capacity) with respect to a number of earth-system processes and moving rapidly into it in a number of the others.

Second, we need to recognise that the global financial crisis has done more to reduce the pace (or at least slow the acceleration) of the process of global environmental degradation than anything directly intended to have such an effect. That is because it has served to reduced aggregate global growth rates. Of course, we need to be extremely careful here. For one’s enemies’ enemies do not always make good friends – and we can have environmentally unsustainable non-growth just as much as we can have environmentally unsustainable growth. Indeed, what is clear is that we have had both: the post-2008 story is only of the move from the latter to the former.

Nevertheless, what such reflections reveal is just how crucial the question of growth is to our capacity to respond to the global environmental crisis. Almost certainly, we will need to wean ourselves off growth if we are to do anything that takes us out of the "red zone" (and time-lag effects, it scarcely need be pointed out, are very considerable indeed).

So how might we do this? That’s not easy to specify in detail yet, but the starting point is, on the face of it, deceptively simple (though one should not underestimate the political difficulties of what we here propose). It is that we work collectively and globally to change the global currency of economic success – replacing the convention of growth (for that is what it is) with something else.

In effect, we need urgently to devise a more balanced and sustainable array of genuinely global (indeed, planetary) collective public goods whose promotion might eventually replace the blind and narrow pursuit of economic output as the global currency of economic success.

What’s more, it’s not too difficult to imagine what might be entailed here. Alongside GDP we would need to build a new index of economic success – a compound index, inevitably. It might include things like changes in the Gini coefficient (in the direction of greater societal equality), changes in per capita energy use (rewarding increased energy efficiency and sustainability), changes in per capita carbon emissions and other planetary boundary statistics (rewarding the greening of residual growth) and perhaps a range of more routine development indices (changes in literacy rates and so forth).

This alternative Social, Environmental and Developmental index – let’s call it SED – would be recorded and published alongside GDP and would immediately allow the production of a new hybrid GDP-SED index. Over a globally agreed timescale, the proportion of SED relative to GDP in the hybrid index would rise – from zero (now) to 100 per cent (at some agreed point in the future).

In the interim, we would, of course, gauge whether our economies were "growing", "flat-lining" or "in recession" according to the new hybrid index, moving in effect from GDP to SED in how we measured economic performance.

The changes to our modes of living over that period of time would be immense – and would need to be immense. But it’s surely what is required if we are to rectify our planetary imbalance and, even so, it’s only a necessary, not a sufficient, condition of exiting that dangerous planetary "red-zone".

This is the fourth in a five-post series on the "Great Uncertainty".

Photograph: Getty Images

Professors Colin Hay and Tony Payne are Directors of the Sheffield Political Economy Research Institute at the University of Sheffield.

Flickr/Michael Coghlan
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Why does the medical establishment fail to take women in pain seriously?

Women with mesh implants have been suffering for years. And it's not the only time they have been ignored. 

Claire Cooper’s voice wavered as she told the BBC interviewer that she had thought of suicide, after her mesh implant left her in life-long debilitating pain. “I lost my womb for no reason”, she said, describing the hysterectomy to which she resorted in a desperate attempt to end her pain. She is not alone, but for years she was denied the knowledge that she was just one in a large group of patients whose mesh implants had terribly malfunctioned.

Trans-vaginal mesh is a kind of permanent “tape” inserted into the body to treat stress urinary incontinence and to prevent pelvic organ prolapse, both of which can occur following childbirth. But for some patients, this is a solution in name only. For years now, these patients – predominantly women – have been experiencing intense pain due to the implant shifting, and scraping their insides. But they struggled to be taken seriously.

The mesh implants has become this month's surgical scandal, after affected women decided to sue. But it should really have been the focus of so much attention three years ago, when former Scottish Health Secretary Alex Neil called for a suspension of mesh procedures by NHS Scotland and an inquiry into their risks and benefits. Or six years ago, in 2011, when the US Food and Drug Administration revealed that the mesh was unsafe. Or at any point when it became public knowledge that people were becoming disabled and dying as a result of their surgery.

When Cooper complained about the pain, a GP told her she was imagining it. Likewise, the interim report requested by the Scottish government found the medical establishment had not believed some of the recipients who experienced adverse effects. 

This is not a rare phenomenon when it comes to women's health. Their health problems are repeatedly deprioritised, until they are labelled “hysterical” for calling for them to be addressed. As Joe Fassler documented for The Atlantic, when his wife's medical problem was undiagnosed for hours, he began to detect a certain sexism in the way she was treated:

“Why”, I kept asking myself, when reading his piece, “are they assuming that she doesn’t know how much pain she’s feeling? Why is the expectation that she’s frenzied for no real reason? Does this happen to a lot of women?”

This is not just a journalist's account. The legal study The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain found that women report more severe levels of pain, more frequent incidences of pain, and pain of longer duration than men, but are nonetheless treated for pain less aggressively. 

An extreme example is “Yentl Syndrome”. This is the fact that half of US women are likely to experience cardiovascular disease and exhibit different symptoms to men, because male symptoms are taught as ungendered, many women die following misdiagnosis. More often than should be acceptable, female pain is treated as irrelevant or counterfeit.

In another significant case, when the news broke that the most common hormonal birth control pill is heavily linked to a lower quality of life, many uterus-owning users were unsurprised. After all, they had been observing these symptoms for years. Social media movements, such as #MyPillStory, had long been born of the frustration that medical experts weren’t doing enough to examine or counter the negative side effects. Even after randomised trials were conducted and statements were released, nothing was officially changed.

Men could of course shoulder the burden of birth control pills - there has been research over the years into one. But too many men are unwilling to swallow the side effects. A Cosmopolitan survey found that 63 per cent of men would not consider using a form of birth control that could result in acne or weight gain. That’s 2 per cent more than the number who said that they would reject the option of having an annual testicular injection. So if we’re taking men who are afraid of much lesser symptoms than those experienced by women seriously, why is it that women are continually overlooked by health professionals? 

These double standards mean that while men are treated with kid gloves, women’s reactions to drugs are used to alter recommended dosages post-hoc. Medical trials are intended to unearth any potential issues prior to prescription, before the dangers arise. But the disproportionate lack of focus on women’s health issues has historically extended to medical testing.

In the US, from 1977 to 1993, there was a ban on “premenopausal female[s] capable of becoming pregnant” participating in medical trials. This was only overturned when Congress passed the National Institutes of Health (NIH) Revitalisation Act, which required all government funded gender-neutral clinical trials to feature female test subjects. However, it was not until 2014 that the National Institutes of Health decreed that both male and female animals must be used in preclinical studies.

Women’s exclusion from clinical studies has traditionally occurred for a number of reasons. A major problem has been the wrongful assumption that biologically women aren’t all that different from men, except for menstruation. Yet this does not take into account different hormone cycles, and recent studies have revealed that this is demonstrably untrue. In reality, sex is a factor in one’s biological response to both illness and treatment, but this is not as dependent on the menstrual cycle as previously imagined.

Even with evidence of their suffering, women are often ignored. The UK Medicines and Healthcare Regulatory Agency (MHRA) released data for 2012-2017 that shows that 1,049 incidents had occurred as a result of mesh surgery, but said that this did not necessarily provide evidence that any device should be discontinued.

Yes, this may be true. Utilitarian thinking dictates that we look at the overall picture to decide whether the implants do more harm than good. However, when so many people are negatively impacted by the mesh, it prompts the question: Why are alternatives not being looked into more urgently?

The inquiry into the mesh scandal is two years past its deadline, and its chairperson recently stepped down. If this isn’t evidence that the massive medical negligence case is being neglected then what is?

Once again, the biggest maker of the problematic implants is Johnson&Johnson, who have previously been in trouble for their faulty artificial hips and – along with the NHS – are currently being sued by over 800 mesh implant recipients. A leaked email from the company suggested that the company was already aware of the damage that the implants were causing (Johnson&Johnson said the email was taken out of context).

In the case of the mesh implants slicing through vaginas “like a cheese-wire”, whether or not the manufacturers were aware of the dangers posed by their product seems almost irrelevant. Individual doctors have been dealing with complaints of chronic or debilitating pain following mesh insertions for some time. Many of them just have not reported the issues that they have seen to the MHRA’s Yellow Card scheme for identifying flawed medical devices.

Shona Robison, the Scottish Cabinet Secretary for Health and Sport, asked why the mesh recipients had been forced to campaign for their distress to be acknowledged and investigated. I would like to second her question. The mesh problem seems to be symptomatic of a larger issue in medical care – the assumption that women should be able to handle unnecessary amounts of pain without kicking up a fuss. It's time that the medical establishment started listening instead. 

 

Anjuli R. K. Shere is a 2016/17 Wellcome Scholar and science intern at the New Statesman

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