On Thursday, March 12, the Johns Hopkins University Bloomberg School of Public Health in Baltimore hosted the world’s first gathering devoted to Peak Oil and Health, with support from the federal Centers for Disease Control and Prevention (CDC) in Atlanta. These are two of the nation’s most prestigious institutions in the fields of public health and health education, and about a hundred people attended in person, with a larger number tuning in to the simultaneous web-cast. The audience was offered a wealth of information about the many ways in which today’s health care services rely on infrastructure and practices that depend upon petroleum. The most likely impacts of peak oil on public health were discussed, along with opportunities for public health professionals to prepare for the roles they will play in a post-peak oil world.

Early in the program Congressman Roscoe Bartlett reviewed the evidence for the coming peak in oil production, adding “We can’t say we haven’t been told.” Five federal government reports from four different agencies have unanimously concluded that peak oil will happen, and informed us that the consequences will be dramatic, he said. At the same time, Bartlett reported that he’s seen no evidence that the Obama administration understands that we are approaching the end of the era of fossil fuels. In Bartlett’s view, today’s federal government efforts to prepare are inappropriately focused on trying to fill any future energy supply gap with substitutes for fossil fuels—although there is in fact no set of substitutes that can make up the difference. “We are still in a phase of irrational exuberance over alternatives,” he concluded, “despite the failure of hydrogen only a few years ago, and despite the recent failure of corn ethanol.”

The conference program was structured as training for health professionals. The early morning sessions built on Bartlett’s introduction to make the case for a near-term peak in global oil supply. A survey of the socioeconomic impacts was also offered. Peak Oil activists would have recognized many of the charts, reports, sources, and authorities cited to bring newcomers up to speed on the “big picture” that peak oil is real, it is imminent, and it will change the way most of us live our lives.

The audience was presented with a series of well-organized points familiar to the peak-oil aware.

  • Awareness: Our federal officials to this day do not seem to comprehend that the world is at the end of the era of oil.

  • Scope: Solid evidence demands that we stop our denial about the seriousness of the energy problems ahead: global peak oil represents an unprecedented risk management problem.
  • Disruption Potential: Peak oil is likely to have significant impact on our most important existing systems, including transportation, building operations, and industrial agriculture.
  • Regional Vulnerability: The United States is highly vulnerable because of our import-dependence and our spread-out infrastructure, with some regions more at risk than others, including cities with urban sprawl.
  • Trend: However bad our economic problems are today, it is likely we will experience greater problems in the near future as oil supplies decline.
  • Sector-specific Impacts: We are likely to experience peak oil first as a liquid fuels crisis and to feel its impact primarily in the transportation sector, where there is no ready liquid fuel substitute for oil.
  • Limited Mitigation Options: There are no “silver bullets” that can substitute for oil (“Maybe there are a few rusty bb’s” Congressman Bartlett joked).
  • Scarce-resource Allocation: We should begin to devote the remaining oil to ramping up a transfer to renewable energy infrastructures.
  • Triage: Meanwhile prudence requires us to begin planning for shortages by developing protocols for rationing oil, by means other than price, to key sectors and priorities.

My conversations with other attendees during the breaks indicated that whether or not peak oil was news to them, the presentation of evidence had been compelling. Perhaps this speaks to the value of a background in the sciences, which I presume is more common in this audience than among the general population.

Insights pertaining to the public health implications of peak oil became the focus for the remainder of the day. (There were parallels between the public health insights and the general peak oil insights listed above, and I have indicated them using the underlined

  • Awareness: The public health community has barely begun to address peak oil; ignorance of the problem is today’s norm; the health system takes for granted long-term resource availability, and has made minimal preparation for disruptions in supply.

  • Scope: Peak oil has the potential to significantly disrupt each of the three essential pillars of sustainable well-being—economic, sociopolitical, and environmental
  • Disruption Potential: Peak oil will have its public health impacts in the United States on a medical care system that is natural resource-intensive, cost-intensive, and neither encourages nor supports saving resources; peak oil will intensify known public health hazards, create new hazards, and impact the entire public health preparedness system.
  • Regional Vulnerability: Especially in rural regions, delivery of health care is highly dependent on private vehicle transport to get health care providers to their centralized locations, to bring critically ill patients to service facilities, and to meet the clinical care and outpatient needs of widely dispersed populations.
  • Trend: Public health services in the United States have already experienced increasing demands coupled with decreasing ability to meet them; fewer people can afford private health insurance; most officials surveyed expect further funding cuts ahead.
  • Sector-specificity: The public health system is highly vulnerable because of its deep dependence upon oil for transport of patients and providers, for the disposable plastic supplies which are the foundation of modern antiseptic hygiene, as well as for energy-intensive hospital operations and for pharmaceutical feedstock.
  • Limited Mitigation Options: Public health planners can undertake scenario planning, and set up hospital-level committees to make decisions about scarce medical supply allocations
  • Scarce-resource Allocation: Peak oil can be expected increase the duration and severity of disaster events, and of post-event responses; public health officials are accustomed to planning for the allocation of scarce resources during emergencies, but have not yet factored peak oil into such planning.
  • Triage: Peak oil disaster preparedness is inadequate or non-existent; there is a significant risk of a mental health “surge” overwhelming the minimal surplus capacity of hospital emergency departments; it is crucial that allocation of finite petroleum-based healthcare be perceived as fair to preserve trust and adherence to other policies (e.g., quarantines).

The series of conclusions above paints a picture of a nation under-prepared for the impact that peak oil will have on health. As Brian Schwartz of the Bloomberg School concluded, “It is probably now too late to mitigate all the threats.” Yet the conference also provided grounds for encouragement. There was broad agreement, for example, with the CDC’s Jeremy Hess that “Public health workers have a responsibility to let people know that peak oil is a very real and imminent public health issue.” Peak oil education, he argued, must become part of the job of insuring public health. As this happens, the field’s professionals will draw on their experience in framing threats to health care in ways that reach the public effectively. They will also call on their expertise in allocating scarce resources through procedures that people can perceive as fair and transparent, and therefore oriented towards maintaining public trust and social cohesion. As Bloomberg’s Stuart Chaitkin suggested, “What is needed is a global energy revolution with three platform planks: end denial; change behavior (retrofit, travel less, eat low on the food chain, develop a preventative healthcare system); and plan for likely shortages.”

It is a credit to the leadership of Virginia Caine, Public Health Coordinator of Indianapolis, Dan Bednarz, an energy and public health consultant in Pittsburg, PA, Howard Frumkin and his colleagues at the CDC, and the Bloomberg School faculty that the subject of peak oil is now being more widely addressed within the public health community. Frumkin published a feature article in the Jan-Feb 2009 issue of Public Health Reports titled “Energy and Public Health: The Challenge of Peak Petroleum.” Bednarz has shared his insights on the health implications of peak oil for years on energybulletin.org. The collaboration of these leaders and two of the public health field’s leading institutions has set the stage for a broader peak oil awakening among civil servants and educators in the health fields.

In the meantime, there are steps that Community Solutions members might consider taking to support the progress of this awakening. It was noted, for example, that the CDC does not set its own budget or program priorities; citizens may therefore wish to contact their individual congressperson to recommend that public health preparedness for peak oil be adequately funded by the U.S. Congress from now on. County-level public health agencies are also open to input from citizens, and might welcome the chance to co-host an event introducing peak oil to the local community. As the Bloomberg School’s Cindy Parker concluded, “We need those of you in health care who understand peak oil to get out there and share what you know. Bold action is the key.”

PowerPoint slides of the conference presentations are available online at

Rob Content is Program Manager of Community Solutions.