How Politics, Economics and Ecology Can Help or Hurt Our Health

It is a com­plex, even daunt­ing view—where does one begin when try­ing to solve prob­lems this way?

Schettler is an exceed­ingly log­i­cal thinker, and his vision for a more evolved kind of health care came from the down-to-earth expe­ri­ence of help­ing to clean clam flats along the St. George River in Maine dur­ing the 1980s. “I was liv­ing and prac­tic­ing on the coast there, and work­ing with a local orga­ni­za­tion to clean up the river because we had these rich clam flats that had been closed for years because of peri­odic spikes of E. coli. If any­one ate the clams they would get very sick.”

Meanwhile, paper mills were dump­ing diox­ins into other rivers nearby, and Schettler learned that fish from those rivers some­times had even higher chem­i­cal lev­els than fish caught in urban har­bors. But fac­tory bosses claimed that reg­u­lat­ing waste from the pulp mills would cost com­mu­nity jobs, which prompted dozens of young fac­tory work­ers to protest. Schettler, despite being steeped in tra­di­tional med­i­cine, was unable to ignore these inter­re­la­tion­ships: a degraded nat­ural envi­ron­ment, a pre­car­i­ous local econ­omy, and peren­ni­ally sick peo­ple. “These things—the effect of the envi­ron­ment on peo­ples’ health—were never dis­cussed at the med­ical con­fer­ences,” he said. “So it caused in me a major re-examination.”

Schettler went back to school, earned a master’s degree in pub­lic health, and began apply­ing a scientist’s rigor to his wide-ranging pool of inter­ests. Since then, he has researched con­nec­tions between poverty, iron defi­ciency, and lead poi­son­ing; insec­ti­cide use, Parkinson’s, and Alzheimer’s dis­ease; income dis­par­i­ties and asthma.

He calls this new approach to med­i­cine “the eco­log­i­cal par­a­digm of health.”

“It sounds like tree-huggers or some­thing,” Schettler said in an inter­view. “But I mean ‘eco­log­i­cal’ in the sense that there are these mul­ti­ple sys­tems, one within the other—a fam­ily within a com­mu­nity, within a soci­ety, within a culture—and that’s the way ecol­o­gists tend to talk about ecosys­tems. It’s accept­ing up front that humans do not stand apart from the envi­ron­ment. We’re a major species, along with the mos­qui­toes and fish and trees and bac­te­ria. And there are all of these won­der­ful interrelationships.”

Our Health and Ecosystem Health

Currently get­ting over a case of Lyme dis­ease, Schettler notes that the con­di­tion wasn’t even on the radar three decades ago. Likewise, West Nile Virus. And dengue fever, first iden­ti­fied in the late 18th cen­tury, has soared since the 1960s, now infect­ing up to 100 mil­lion peo­ple world­wide each year.

“Can there be any doubt that human health is enor­mously depen­dent on eco­log­i­cal sys­tems that we are hav­ing a major influ­ence on?” Schettler says. “It’s all one world. Our ten­dency to describe the nat­ural world as some­thing with­out humans is part of the problem.”

Such a holis­tic approach to human health is often received as heresy within tra­di­tional med­i­cine, but Schettler is hardly a Don Quixote tilt­ing at wind­mills. He has tes­ti­fied before the U.S. Senate about links between Parkinson’s and pes­ti­cide use. He has been inter­viewed on pub­lic radio and co-authored two oft-quoted books, Generations at Risk: Reproductive Health and the Environment and In Harm’s Way: Toxic Threats to Child Development. Both explore Schettler’s belief about the envi­ron­men­tal under­pin­nings of a host of dis­or­ders, from learn­ing dis­abil­i­ties to can­cer. And both lay out the lim­i­ta­tions of Western med­i­cine in com­ing up with clear causes and effec­tive treatment.

Breast can­cer is a prime exam­ple. Dissatisfied with research into the ori­gins of the dis­ease, Schettler began to won­der whether chem­i­cals found in can­cer­ous breast tis­sue actu­ally encour­aged tumor growth. He found that a girl’s expo­sure to DDT before the age of 14 cor­re­sponded to a greatly increased risk for breast can­cer later in life. “If we’re look­ing only at adults, we’re miss­ing this impor­tant win­dow of sus­cep­ti­bil­ity,” Schettler says. “But in med­i­cine we weren’t going there. We were respond­ing only to the ill­ness. I was inter­ested in its origins.”

Food is another favorite “wedge issue,” a way of exam­in­ing dis­eases like dia­betes in rela­tion to agri­cul­tural poli­cies. Schettler, not­ing America’s cur­rent epi­demic of child­hood obe­sity and dia­betes, began exam­in­ing not only blood sugar lev­els in chil­dren but also the neigh­bor­hoods in which they lived. He found that many did not have a sin­gle mar­ket sell­ing fruits and vegetables.

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