Despite a wealth of evidence that carbon emissions pose a serious threat to our health, neither major party has a policy which addresses the serious and widespread impact of environmental and climate changes on our health.  Croakey will not speculate whether or not the lobbying tactics of the coal industry have anything to do with this lack of action. However, those interested in answering this question for themselves will find a new book on the coal industry essential reading.  Dr Tim Senior provides the following review of this important new publication which should be on the reading list for all federal politicians and their advisers.  Tim writes:

 I remember once a teacher telling me about a trip to a biscuit factory.” What do you think we make here?” he was asked. “Biscuits?” answered the teacher. “No. Money,” was the reply.

I was reminded of this story reading “Big Coal: Australia’s dirtiest habit.” We have been constantly told over the last decade or more how important coal is for Australia. It creates jobs for Australians. It brings in money for governments to provide us with schools and hospitals. It gives us cheap energy to power our homes and factories. In their benevolent goodness they even provide local sports clubs with jerseys and gym mats. I’ve always thought these facts a little slippery – they don’t feel right somehow, but I haven’t had a handle to grab hold of them and pin them down.

What Guy Pearse, David McKnight and Bob Burton show is that Big Coal are in the business of making money, lots of it, and are very good at ensuring that their methods of making this money are not threatened by minor concerns such as climate disruption.

Pearse, McKnight and Burton have done a convincing job of cataloguing the behaviour of Big Coal and examining their claims. At least they provide a counter argument to present in the pub, at their best they demolish some of the industry propaganda.

For example, they tell us that the university and tertiary education sector employs 4 times as many people as the coal industry. Which industry gets to negotiate its own taxes, and which gets cuts to fund schools? Perceptions are important.

The authors also do a good job of setting out why carbon capture and storage (CCS) is unlikely to work:

“All new coal-fired power stations and steel mills would need to be built differently {or retrofitted} as would thousands of existing ones. Billions of tons of CO2 would need to be piped long distances, turned into liquid form and then pumped to hundreds of communities willing to host CO2 dumping sites… A vast network of pipelines would need to be installed {in Europe, America and Australia}. An even larger network would have to be built in developing countries even faster.” (p159)

As they point out, even Exxon Mobil say this would need the duplication of the oil and gas industries infrastructure, which was developed over 100 years, in a third of the time. Successive governments have poured money into research on CCS.

Health issues run like a ribbon through the book, sometimes explicit, sometimes more implicit. There are health effects on those doing the mining, on those living near the mines, on those living near coal fired power stations, and ultimately on all of us through the effects of climate change.

The quickly traced history of coal mining is interesting, as it shows that Big Coal is consistent in resisting changes to make mining and burning safer. Moves to ensure the safety of miners at work, moves to legislate for air quality and now moves to limit greenhouse gas emissions have all been resisted by Big Coal at the time. There is even the remarkable story of Anglo Coal seeking to block a local tourism project on the grounds that the coal mine wasn’t meeting its environmental standards!

I wonder, though, if a book setting out all that is wrong about coal is going to be read by anyone not already convinced. That still makes it useful, as it gives well referenced arguments for use at family barbecues. I doubt that Gina Rinehart or Ian Plimer or their supporters will be spending much time reading this book, though.

And ultimately what will bring about change, as the last chapter describes, is people changing their minds, is people, communities, everywhere deciding that the dangers we are now encountering from climate change are worth making some very big changes for.

Apart from that last chapter, which describes hopefully the start of a change in local communities, the book is quiet on how these changes might be made.

The interesting thing, though, reading this with a health perspective, is how familiar a lot of the actions feel. We have denial of inconvenient truths, the creation of counter-arguments through friendly academics and think tanks, and we have the development of industry-friendly policy through very effective lobbying. All of this to support large profits from a product that makes people unhealthy.

We’ve seen all this before with Big Tobacco, Big Alcohol and Big Food. I wonder why these industries seem to be so successful, whereas public health and health promotion don’t have the same influence. Yes, it’s partly about money – in health millions of dollars is a huge clinical trial, in mining this is the small change for funding a cluster of local sports groups before going and lunching with the minister.

But it’s not all about money, it’s about different ways of working. Our focus in public health will usually be about what keep people healthy, and the evidence for this. Where there is no evidence we’re often honest about this, and we don’t make stuff up. Usually.

Contrast this with Big Coal, which is brilliant at organising opinion according to what will generate profit. From entwining itself in the local community to garner support, to generating the appearance of a consensus of opinion on their side, to knowing the political levers of power well enough to maintain influence, it’s a comprehensive model of political change that the health sector can only marvel at.

If only we had that ability for marshalling policy change on the social determinants of health.

However, threats to health are often taken seriously. We just have to look at the misplaced concern over wind-farms to see this. The case that changes to our climate will have an effect on our health are easy to make if we make them well. And in health we have some ready-made analogies for making these cases.

Compare these examples:

• The pneumococcal vaccine had reports of side effects a few years ago. Its administration was stopped while the cause was investigated. Only when people were confident was the vaccine program started again.

Rofecoxib was taken off the market some time after it became apparent that there was a much higher risk of heart disease on the drug. (It happened later than it should have, admittedly).

• Big Coal continuing to put out emissions harmful to health while claiming to look for a technical solution such as carbon capture and storage rather than stopping or even reducing.

What is the difference with poisoning our water supply, polluting our air or changing the climate? If we applied a health perspective, would we stop when the dangers became clear and look for alternatives?

The health sector is also good at talking about risk. Recent catastrophic weather events or crop failures have prompted the question “Is this due to climate change?” with the answer being “We can’t be certain.”

We come across this sort of uncertainty all the time in medicine. Non-steroidal anti-inflammatory medications are well recognised as increasing the risk of heart attacks, in other words, in making heart attacks occur more frequently. When someone has a heart attack, though, we don’t ask “Did anti-inflammatories cause this particular heart attack.” We agree that heart attacks are a bad thing, and that they occur more frequently with anti-inflammatories, so we limit their usage.

In the same way we expect more extreme weather events with climate change, this is a bad thing and we should do what we can to minimise this risk. Instead, we get stuck asking “Did climate change cause this particular hurricane?”

It’s at least possible that the changes required to make our energy use less harmful can use reframing and analogies developed by those working in health.

This book, then, is useful in collecting together a summary of the ways in which Big Coal marshal their considerable resources to protect their profits. The facts in this book need to be more widely known than the readership of this book is likely to be, so it’s worth reading just to start discussions more widely.

As health advocates, we perhaps need to read it in conjunction with the Climate Commission report The Critical Decade: Climate change and health to draw a direct line between the actions of Big Coal and the way this will harm people’s health across the world.

We will never have as much money as Big Coal, but we do have some compelling stories about health.

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