Talk presented at the American Public Health Association Meetings
November 5, 2007.
Washington, D.C.

Dan Bednarz, Ph.D.
Energy & Healthcare Consultants
Pittsburgh, Pa

One of the greatest joys … is to take a flight into ignorance in search of knowledge.
– Robert S. Lynd


Good morning, and thank you for attending my presentation “Preparedness for What?” This title springs from Robert S. Lynd’s relatively unknown classic, Knowledge for what?1 Lynd, a sociologist writing in the 1930s, argued that social scientists should use their knowledge for publicly beneficial purposes.

This year’s APHA conference theme, “Politics, Policy and Public Health,” allows me to reprise his appeal and also to step back from the trenches of public health to compare two topics, one you know, terrorism, and the other, which probably only a few of you recognize as relevant to public health, energy.

As this is an oral presentation, let me offer two sets of observations up front so that you may argue (or agree) with me in your head as you hear my evidence.

Observation set 1: Terrorism is Overblown

Thomas Friedman2, voice of political pragmatism for many, wrote a few weeks ago, “9/11 made us stupid.” Colin Powell, interviewed in Gentleman’s Quarterly3at about the same time, expressed similar sentiment. Two or three years ago I would have been too cowardly to make this obvious point that “reasonable people” may revise their understanding of the terrorism threat. Further, I believe Friedman’s and Powell’s remarks have a subtext: Universal preoccupation with “terrorism” is now bad for business. Or perhaps I’m cynical and Friedman and Powell have been reading two political scientists to whom I now turn.

John Mueller wrote a book titled, Overblown: How politicians and the terrorism industry inflate national security threats, and why we believe them4. He stresses three themes:

  1. While terrorism poses some level of risk to the population, the risk is exaggerated; ironically, this magnification of their power is a central goal of terrorists.
  2. Our nation has a history of inventing or magnifying political threats: nuclear attacks during the Cold War, McCarthyism and the Red Menace during the fifties, and most recently WMD in Iraq.
  3. Public policy should focus on reducing collective fears and overreactions to terrorism, not on fueling them.

Six years after September 11, it appears our nation is not existentially at risk to terrorism. Nonetheless, many of us remain anxious, a most important point I return to later in this talk.

What kind of threat does terrorism pose? In public health terms, terrorism presents an acute, localized and short-term threat. Anyone who believes terrorists can destroy our nation must offer evidence; the time for hot-button surmise about bloodthirsty guys walking around with deadly toxins, viruses and suitcase nuclear bombs has waned.

Another political scientist, Ian Lustick, has published a book titled, Trapped in the War on Terror5. He levels harsh criticism of the public health response to terrorism:

Absent the ability of experts or anyone else to discern and publicly describe actual evidence of the character and limits to the terrorist threat, there is no real limit to the justifications for spending money that can be generated out of the pervasive readiness to support counterterrorism measures and the political profit to be made by appearing to play a vital role in the War on Terror…Thus have public health activists used the War on Terror (P87).

Were I to meet Lustick and Mueller I would offer the following exculpation: We admit to using the War on Terror as an opportunity to repair our deficient public health infrastructure – it was that or go to the end of the line.

That said I see three big picture questions of risk assessment that we in public health rarely have asked about terrorism.

  1. What are the technological capabilities and practical requirements for various mass-casualty terrorist events, like suitcase nuclear bombs, spreading smallpox, and so on?
  2. What resources and genuine opportunities (the plausible versus “Elvis might be alive” conjecture) do al Qaeda and similar non-state groups have to obtain these weapons and then employ them?
  3. Do they intend to kill as many Americans as they can at one time, or is theirs a strategy in the pursuit of goals, making terrorism a rational tactic not an intrinsically rewarding passion of hate?

A caveat is in order because there is an indirect causal relationship possible between peak oil and terrorism. As we enter the era of energy scarcity, any one of a number of previously manageable “crises” – such as terrorists blowing up an oil freighter in the Straits of Hormuz – can have a “tipping point” or multiplier effect on the world economy because there is virtually no spare capacity in world oil markets.

Observation set 2: Peak Oil Is an Unprecedented Threat

The threat from energy scarcity should be of paramount importance – we should invoke the Precautionary Principle – yet it is poorly understood and only recently begun to be articulated by public health leaders6. This emerging attention is of critical importance. A critical risk factor, however, is how much time we have for mitigation and preparation.

Whereas terrorism poses no fundamental threat to the functioning of our society, energy decline does because it can degrade non-medical and institutional determinants of health such as education, employment, housing, nutrition, transportation, and sanitation. If these institutions fail the health of the population is imperiled by infectious diseases, the consequences of exposure to heat and cold, lack of adequate nutrition, among other currently “preposterous” (in America) possibilities.

It follows that peak oil as well can damage the institutions of medicine and public health. This is elementary systems theory: the less energy flowing into a system the less its outputs and the less complexity it can sustain. In short, energy scarcity, if not addressed by our political and business leaders, as well as numerous other institutions and citizen movements – our entire society, in essence – portends staggering chronic, system wide and long-term non-linear change -and possibly social breakdown or collapse. Some of you have read Jim Kunstler’s The Long Emergency7, a prophetic and prolific title for what lies ahead for public health.

Parenthetically, the Surge Model of preparedness disaster response is inappropriate for peak oil for two reasons:

  1. Our society will be distressed, as if Katrina had hit the entire nation.
  2. This Long Emergency promises to get worse before it gets better; and it is likely the case that we will come out of this using significantly less energy than we do now. No one can predict to my satisfaction where we are headed but I have no doubt business-as-usual is not in the forecast.

What lies ahead? Time limitations do not allow me to develop how peak oil might affect public health8, both here in the US and throughout the world. However, here are three scenarios from energy analyst Robert Hirsch9. He proposes, by the way, that it is reasonable to assume that world GDP will decline in a one-to-one ratio with world oil decline. The socioeconomic and public health implications of this are profound.

  1. A Best Case, where maximum world oil production is followed by a multi-year plateau before the onset of a monotonic decline rate of 2-5% per year;
  2. A Middling Case, where world oil production abruptly reaches a maximum, after which it drops into a long-term, 2-5% monotonic annual decline; and finally
  3. A Worst Case, where the sharp peak of the Middling Case is degraded by oil exporter withholding10, leading to world oil shortages growing more rapidly than 2-5% per year, creating the most dire world economic impacts.


Allow me to switch to a narrative form to explain how I came to compare terrorism and peak oil.

I learned of peak oil in September 2004 while working at a Center for Public Health Practice. (After 9/11 this center was awarded one of the approximately two dozen CDC preparedness grants.) At first I was skeptical about peak oil, probably because it is difficult for Americans to understand you can run out of stuff. How could energy become scarce? The original premise seemed surreal. As I read more and realized my vast ignorance about fossil fuels and energy, I began to wondered how this imbalance between terrorism and the impending energy crisis could exist in public health.

It’s quite simple intellectually, but a horse pill emotionally, which helps explain why what is obvious so often is hidden in plain sight. In his discussion of why we are trapped in the War on Terror, Lustick describes the allocation of social resources – what we call public policy – this way,

the government does not implement policies because they are necessary but because they satisfy the winners in a continuing and ruthless pursuit of particular interests (P97).


With this in mind, let me quote at length from Cass Sunstein11 writing in the Journal of Risk and Uncertainty on the social-psychology of terrorism public policy making:

When strong emotions are involved, people tend to focus on the badness of the outcome, rather than on the probability that the outcome will occur. The resulting "probability neglect" helps to explain excessive reactions to low-probability risks of catastrophe. Terrorists show a working knowledge of probability neglect, producing public fear that might greatly exceed the discounted harm. As a result of probability neglect, people often are far more concerned about the risks of terrorism than about statistically larger risks that they confront in ordinary life.


Let’s apply this to our reactions – actually I can only speak of my reaction – to September 11. We all remember where we were that Tuesday morning. I was at home as my wife phoned, “Turn CNN on – you won’t believe what’s happening.” I watched for several minutes and then went into the kitchen and turned on the radio. I learned that Flight 93 possibly was somewhere over me in the skies of Western Pennsylvania. Looking out the window I fantasized that I would any second hear a loud explosion from that plane’s impact into the US Steel Building, which is about five air miles from my home. The 66-story building presents an opportunity for spectacular carnage. Then I became even more paranoid: I imagined the plane aimed at the nuclear power plant outside Pittsburgh. A few minutes later word came that Flight 93 had crashed in a rural location.

In the following days and weeks my feelings told me there was a 100% probability of more attacks. I was exhibiting “probability neglect,” for which the flurry of activity in public health, government, the media and friends and neighbors around terrorism provided constant cultural reinforcement. No one knew had any doubt there would be subsequent attacks. Indeed, John Mueller informs us that the death rate from automobile accidents rose that fall because many people refused to board airplanes, opting for the statistically more hazardous automobile12.

Part of my professional duties included emergency preparedness; we went through the debate over small pox vaccinations and other bio-terror scenarios, Tom Ridge’s color-coded terror alerts, the “wrap your house in plastic” slapstick, and a host of “what if” worries offered to us by concerned citizens and colleagues: rural electric lines are exposed, chemical plants are not secure, water treatment and sanitation facilities are out in the open, shipping containers are vulnerable, and so on.

As Terror Alerts and potential threats came and went, my feelings, and this is a natural reaction I would suggest, changed: “What are we doing? What are we preparing for?” Also, statements like those of FBI Director Robert Mueller claiming he knew there were 5,000 terrorists in the US awaiting orders from Osama began to ring hollow. With time passing some of those 5,000 “sleepers” would have died, some simply gotten distracted by other life issues – age, romance, health, family obligations; and some would have broken ranks and attacked.

Concluding Thoughts

While I have no doubt that peak oil is demonstrably more dangerous to public health than terrorism I am reluctant to dismiss the palpable fear and anxiety virtually all Americans felt after 9/11. What Sunstein, Lustick and Mueller have to say is important but incomplete – something more than misunderstanding probabilities or the competition for public resources was behind our collective reaction.

A phrase that entered our discourse after 9/11 gave me a hint: “Terrorism is an existential threat.” It is sufficiently ambiguous so as to imply both a personal and cultural threat of annihilation. After 9/11 G. W. Bush’s poll ratings climbed into the 90% range on the basis of – well, on the basis not of deeds (he ignored a CIA memo titled “Bin Laden Determined to Strike in U.S.”) but of rhetoric that assuaged the “existential” fear aroused by 9/11. My view is that his speechwriters devised sotto voce messages promising to restore “The Order of Things”13 to our culture and personal sense of security.

Lea Winerman writes in Monitor on Psychology:

Americans traumatized by the 9/11 terrorist attacks turned to Bush in part because, subconsciously, his clear and values-driven message helped assuage their fear of death14.

Winerman interviewed:

Sheldon Solomon and two of his colleagues, Tom Pyszczynski15… and Jeff Greenberg …[who] developed [what they call] terror-management theory in the 1980s. According to the theory, based on the work of cultural anthropologist Ernest Becker16… human beings deal with the knowledge that they will someday die by maintaining a strong belief in their cultural worldview. That faith provides meaning to their lives and a sense that their individual lives matter, as well as the promise of symbolic–or literal–immortality if they uphold their society’s values.


In short, 9/11 exposed our vulnerability to death in a way that made the deaths of that day absurd and violated our culturally “acceptable” modes of dying. This is why most Americans “could not believe” what took place and felt vulnerable to a “senseless” death. Recall that the political right and the left agreed more attacks were inevitable. They differed over motive attribution: insane religious rage or “Blowback.” Now, years later, we are beginning to realize – as only Tom Friedman could put it – that “9/11 made us stupid.” “Stupid” is not the correct description, of course, but from Friedman it is an insight.

In closing I ask each of you to think about terrorism and peak oil in light of what Robert S. Lynd wrote seven decades ago, Knowledge is power only if man knows what facts not to bother with.

1 Lynd, Robert S. 1939. Knowledge for what? The place of social science in American culture. Princeton: Princeton University Press.


2 Friedman, Thomas. 2007. “9/11 is over.” The New York Times, September 30.

3 Isaacson, Walter. 2007. Interview of Colin Powell. Gentleman’s Quarterly, October.

4 Mueller, John. 2006. P.4. Overblown: How politicians and the terrorism industry inflate national security threats, and why we believe them. New York: Free Press.

5 Lustick, Ian. 2006. Trapped in the War on Terror. P. 87. Philadelphia: University of Pennsylvania Press.

6 Frumkin, Howard, Jeremy Hess, Stephen Vindigni. 2007. “Peak petroleum and public health.” JAMA, 298:1688-1690.

7 Kunstler, James Howard. 2005. The long emergency: Surviving the converging catastrophes of the twenty-first century. New York: Atlantic Monthly Press.

8 An overview of peak oil and its direct connection to climate change and other ecological issues: Bednarz, Dan. 2007. “Energy, climate and the future of health.” Energy Bulletin, July 5.

9 Robert L. Hirsch, “Planning for the Mitigation of Maximum World Oil Production.” 10 September 2007. ASPO (Association for the Study of Peak Oil & Natural Gas.

10 Jeffrey J. Brown, “Declining net oil exports–a temporary decline or a long term trend?” GraphOiloghy Sept 25, 2007.

11 Sunstein, Cass. 2003. “Terrorism and Probability Neglect.” Journal of Risk and Uncertainty. 26 (March/May): 121-136.

12 Mueller, John. 2006. Overblown. P.3. New York: Free Press.

13 Foucault, Michel. 1971. The order of things: An archaeology of the human sciences. New York: Pantheon Books.

14Winerman, Lea. Monitor on Psychology, Volume 36, No. 1 January 2005.

15 Pyszczynski, Tom, Jeff Greenberg, Sheldon Solomon. 2003. In the wake of 9/11: The psychology of terror. Washington, DC: American Psychological Association.

16 Becker, Ernest. 1973. The Denial of death. New York: The Free Press.