Mary McKee is Director of Public Health Practice at the Marion County Health Department in Indianapolis, Indiana. Indianapolis is the twelfth largest city in the United States with a population of 860,000. Our nine county metropolitan area has a population of 1.4 million people. She presented this paper at the same conference as Dan Bednarz (the 134th annual meeting of the American Public Health Association). I here present a review of her paper, or download her original presentation as a pdf document: A Local Health Department Plans for Peak Oil.

In her paper, McKee presents a viable way for local health authorities to prepare for peak oil. She says that time is of the essence, and that:

The effects of oil depletion on public health systems will be profound and we must plan to prepare for this impending crisis.

She makes a strong case for the involvement of local health departments in planning and preparing for peak oil, as they already have many of the processes and community linkages in place. This is due to their central role in the response to short-term natural disasters.

She defines an important distinction that I think is crucial – that energy descent will NOT be short-term. She says that:

the oil depletion crisis won’t be the type of relatively short-term crisis for which we have plans currently…there will be an unknown period of chaos followed by a new state of normal…

She calls this new phenomenon a stretched-out, slow-motion crisis that health departments can best address by incorporating energy descent into existing emergency preparedness planning structures. She then proceeds to detail a four phase process that provides a very viable starting point for local health authorities to build on.

Goals of an energy descent preparedness plan
Before describing her four step planning structure, McKee lists the goals of such a plan – they revolve around the continued delivery of essential public health services despite energy constraints, as well as acting as a source of information and inspiration for the local community.

McKee’s four step process
Before beginning, McKee says that one should aim to get senior management support, to ensure shared recognition of the problem and decision-making ability. Her four steps are:

  1. Localised problem assessment
  2. Plan development
  3. Implementation
  4. Maintenance and evaluation

Phase 1 – Localised problem assessment
There are four parts to this first phase:

1. Selecting a strong but flexible leader who is peak oil aware.

2. Team formation – aim for a multidisciplinary team including members from the local health department, wider community, and state health authority.

3. Studying the problem from the local angle – McKee says that the Peak Oil Task Force Briefing Book from the City of Portland, Oregon is a great place to start. She then suggests the WHO publication “Healthy Urban Planning in Practice” to provide a broader perspective on the problem. The latter reference includes a list of structured questions that aim to ensure that plans will promote health, fairness, equal access, environmental improvement and climate stability.

4. Scenario development – McKee suggests designing and running oil scarcity scenarios to assess the adequacy of the plan. She says that one possible situation could be the destruction of an oil refinery. I would add that oil price protests (such as in the UK in September 2000) are another. She suggests that a scenario could be run in a similar way to the OIL SHOCKWAVE simulation run in the US last year (more on that soon on

Phase 2 – Plan development
McKee suggests layering your plan into an existing comprehensive emergency management plan (if one exists) in much the same way that many organisations annexed their pandemic influenza plans to the larger document. She suggests that the pandemic influenza plan developed by Santa Clara County (California Health Department) is a good model to start with if you want to develop one.

Phase 3 – Implementation
McKee says that:

It has become apparent, after the experience of the past few years, that all disasters are local

and she lists a report about Hurricane Katrina as supporting evidence. A corollary of this is that we should not count on external help (if Katrina is any example). Rather, she suggests that we will have to rediscover how to work with and trust our neighbours. She then describes a way of reorganising people into neighbourhood groups of 10 households each led by a “captain”, in much the same way as the old civil defence model.

Phase 4 -Evaluation and maintenance
All good planning processes need to include an evaluation system. I would suggest that the plan be reviewed yearly, and modified as needed in response to new information about peak oil, world events such as localised oil shortages, refinery accidents, etc, and following the running of simulations.

McKee ends on a positive note by saying:

We received a wonderful gift over forty years ago from Dr Hubbert in the form of advance warning on when the earth’s supply of oil will be gone…it’s time for public health leaders to pick up this gift and do something with it.

Let’s hope that they can. And soon.