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Archive for February, 2010

Imbalance of Ecosystems and Its effect on Public and Livestock health

Dr.Kedar Karki M.V.St. (Preventive veterinary Medicine)

Central Veterinary Laboratory Tripureshwor

The health of humans, like all living organisms, is dependent on an ecosystem that sustains life. Healthy ecosystems are the sine qua non for healthy organisms. Yet there is abundant evidence that many life-support systems are far from healthy, placing an increased burden on human health. In some areas of the world, gains in life expectancy and quality of life made during the twentieth century are at risk of being reversed in the twenty-first century. The consequences of ecosystem degradation to human health are numerous, and include health risks from unsafe drinking water, polluted air, climate change, emerging new diseases, and the resurgence of old diseases owing to ecological imbalances. Reversing this damage is possible in some cases, but not in others. Prevention of ecological damage is by far the most efficient strategy.

DEFINING ECOSYSTEMS

An ecological system may be defined as a community of plants and animals interacting with each other and their abiotic, or natural, environment. Typically, ecosystems are differentiated on the basis of dominant vegetation, topography, climate, or some other criteria. Boreal forests, for example, are characterized by the predominance of coniferous trees; prairies are characterized by the predominance of grasses; the Arctic tundra is determined partly by the harsh climatic zone. In most areas of the world, the human community is an important and often dominant component of the ecosystem. Ecosystems include not only natural areas (e.g., forests, lakes, marine coastal systems) but also human-constructed systems (e.g., urban ecosystems, agro-ecosystems, impoundments). Human populations are increasingly concentrated in urban ecosystems, and it is estimated that, by the year 2010, 50 percent of the world’s population will be living in urban areas.

A landscape comprises a mosaic of ecosystems, including towns, rivers, lakes, agricultural systems, and so on. Precise boundaries between ecosystems are often difficult to establish. Often regions slide into one another gradually, over a protracted “transition” zone, as for example between the boreal forest and the Taiga regions of Canada.

ECOSYSTEM HEALTH

It is important to recognize the inherent difficulties in defining “health,” whether at the level of the individual, population, or ecosystem. The concept of health is somewhat of an enigma, being easier to define in its absence (sickness) than in its presence. Perhaps partially for that reason, ecologists have resisted applying the notion of “health” to ecosystems. Yet, ecosystems can become dysfunctional, particularly under chronic stress from human activity.Example for this can be cited the discharge of nutrients from sewage, industrial waste, or agricultural runoff into lakes or rivers affects the normal functioning of the ecosystem, and can result in severe impairment. Excessive nutrient inputs from human activity was one of the major factors that severely compromised the health of the lower Laurentian Great Lakes (Lake Erie and Lake Ontario) and regions of the upper Great Lakes (Lake Michigan). Unfortunately, degraded ecosystems are becoming more the rule than the exception.

The study of the features of degraded systems, and comparisons with systems that have not been altered by human activity, makes it possible to identify the characteristics of healthy ecosystems. Healthy ecosystems may be characterized not only by the absence of signs of pathology, but also by signs of health, including measures of vigor (productivity), organization, and resilience.

Vigor can be assessed in terms of the metabolism (activity and productivity) of the system. Ecosystems differ greatly in their normal ranges of productivity. Estuaries are far more productive than open oceans, and marshes have higher productivity than deserts. Health is not evaluated by applying one standard to all systems. Organization can be assessed by the structure of the biotic community that forms an ecosystem and by the nature of the interactions between the species (both plants and animals). Invariably, healthy ecosystems have more diversity of biota than ecologically compromised systems. Resilience is the capacity of an ecosystem to maintain its structure and functions in the face of natural disturbances. Systems with a history of chronic stress are less likely to recover from normal perturbations such as drought than those systems that have been relatively less stressed.

Healthy ecosystems can also be characterized in economic, social, and human health terms. Healthy ecosystems support a certain level of economic activity. This is not to say that the ecosystem is necessarily self-sufficient, but rather that it supports economic productivity to enable the human community to meet reasonable needs. Inevitably, ecosystem degradation impinges on the long-term sustainability of the human economy that is associated with it, although in the short-term this may not be evident, as natural capital (e.g., soils, renewable resources) may be overexploited and temporarily enhance economic returns. Similarly, with respect to social well-being, healthy ecosystems provide a basis for and encourage community integration. Historically, for example, native Hawaiian groups managed their ecosystem through a well-developed social cohesiveness that provided a high degree of cooperation in fishing and farming activity.

Another reflection of ecosystem health lies directly in the public health domain. In spring 2000, a deadly strain of the bacterium E-coli (0157:H7) entered the public water supply in Walkerton, Ontario, Canada, causing seven deaths and making thousands sick. This small town, with a population of five thousand, is in a farming community. Inadequate manure management from cattle operations was the likely source of this tragedy.

HOW HEALTHY ECOSYSTEMS BECOME PATHOLOGICAL

Stress from human activity is a major factor in transforming healthy ecosystems to sick ecosystems. Chronic stress from human activity differs from natural disturbances. Natural disturbances (fires, floods, periodic insect infestations) are part of the dynamics of most ecosystems. These processes help to “reset” ecosystems by recycling nutrients and clearing space for recolonization by biota that may be better adapted to changing environments. Thus, natural perturbations help keep ecosystems healthy. In contrast, chronic and acute stress on ecosystems resulting from human activity (e.g., construction of large dams, release of nutrients and toxic substances into the air, water, and land) generally results in long-term ecological dysfunction.

Five major sources of human-induced (anthropogenic) stresses have been identified by D. J. Rapport and A. M. Friend (1979): physical restructuring, overharvesting, waste residuals, introduction of exotic species, and global change.

Physical Restructuring. Activities such as wetland drainage, removal of shoals in lakes, damming of rivers, and road construction fragment the landscape and alter and damage critical habitat. These activities also disrupt nutrient cycling, and cause the loss of biodiversity.

Overharvesting. Overexploitation is commonplace when it comes to harvesting of wildlife, fisheries, and forests. Over long periods of time, stocks of preferred species are reduced. For example, the giant redwoods that once thrived along the California coast now exist only in remnant patches because of overharvesting. When dominant species like the giant redwoods (arguably the world’s tallest tree—one specimen was recorded at 110 meters tall with a circumference of 13.4 meters) are lost, the entire ecosystem becomes transformed. Overharvesting often results in reduced biodiversity of endemic species, while facilitating the invasion of opportunistic species.

Waste Residuals. Discharges from municipal, industrial, and agricultural sources into the air, water, and land have severely compromised many of the earth’s ecosystems. The effects are particularly apparent in aquatic ecosystems. In some lakes that lack a natural buffering capacity, acid precipitation has eliminated most of the fish and other organisms. While the visual effect appears beneficial (water clarity goes up) the impact on ecosystem health is devastating. Systems that once contained a variety of organisms and were highly productive (biologically) become devoid of most lifeforms except for a few acid-tolerant bacteria and sediment-dwelling organisms.

Introduction of Exotic Species. The spread of exotics has become a problem in almost every ecosystem of the world. Transporting species from their native habitat to entirely new ecosystems can wreck havoc, as the new environments are often without natural checks and balances for the new species. In the Great Lakes Basin, the accidental introduction of two small pelagic fishes, the alewife and the rainbow smelt, combined with the simultaneous overharvesting of natural predators, such as the lake trout, led to a significant decline in native fish species. The introduction of the sea lamprey, an eel-like predacious fish that attacks larger fish, into Lake Erie and the upper Great Lakes further destabilized the native fish community. The sea lamprey contributed to the demise of the deepwater benthic fish community by preying on lake trout, whitefish, and burbot. This contributed to a shift in the fish community from one that had been dominated by large benthics to one dominated by small pelagics (fish found in the upper layers of the lake profile). This shift from bottom-dwelling fish (benthic) to surface-dwelling fish (pelagic) has now been partially reversed by yet another accidental introduction of an exotic: the zebra mussel. As the zebra mussel is a highly efficient filter of both phtyoplankton and zooplankton, its presence has reduced the available food in the surface waters for pelagic fish. However, while the benthic fish community has gained back its dominance, the preferred benthic fish species have not yet recovered owing to the degree of initial degradation. Overall, the increasing dominance by exotics not only altered the ecology, but also reduced significantly the commercial value of the fisheries.

Global Change. Rapid climate change (or climate warming) is an emerging potential global stress on all of the earth’s ecosystems. In evolutionary time, there have of course been large fluctuations in climate. However, for the most part these fluctuations have occurred gradually over long periods of time. Rapid climate change is an entirely different matter. By altering both averages and extremes in precipitation, temperature, and storm events, and by destabilizing the El Niño Southern Oscillation (ENSO), which controls weather patterns over much of the southern Pacific region, many ecosystem processes can become significantly altered. Excessive periods of drought or unusually heavy rains and flooding will exceed the tolerance for many species, thus changing the biotic composition. Flooding and unusually high winds contribute to soil erosion, and at the same time add to nutrient load in rivers and coastal waters.

These anthropogenic stresses have compromised ecosystem function in most regions of the world, resulting in ecosystem distress syndrome (EDS). EDS is characterized by a group of signs, including abnormalities in nutrient cycling, productivity, species diversity and richness, biotic structure, disease prevalence, soil fertility, and so on. The consequences of these changes for human health are not inconsiderable. Impoverished biotic communities are natural harbors for pathogens that affect humans and other species.

ECOSYSTEM HEALTH AND HUMAN HEALTH

An important aspect of ecosystem degradation is the associated increased risk to human health. Traditionally, the concern has been with contaminants, particularly industrial chemicals that can have adverse impacts on human development, neurological functions, reproductive functions, and that appear to be causative agents in a variety of carcinomas. In addition to these serious environmental concerns (where the remedies are often technological, including engineering solutions to reduce the release of contaminants), there are a large number of other risks to human health stemming from ecological imbalance.

Ecosystem distress syndrome results in the loss of valued ecosystem services, including flood control, water quality, air quality, fish and wildlife diversity, and recreation. One of the major signs of EDS is increased disease incidence, both in humans and other species. Human population health should thus be viewed within an ecological context as an expression of the integrity and health of the life-supporting capacity of the environment.

Ecological imbalances triggered by global climate change and other causes are responsible for increased human health risks.

Climate Change and Vector-Borne Diseases. The global infectious disease burden is on the order of several hundred million cases per year. Many vector-borne diseases are climate sensitive. Malaria, dengue fever, hantavirus pulmonary syndrome, and various forms of viral encephalitis are all in this category. All these diseases are the result of arthropod-borne viruses (arboviruses) which are transmitted to humans as a result of bites from blood-sucking arthropods.

Global climate change—particularly as it impacts both temperatures and precipitation—is highly correlated with the prevalence of vector-borne diseases. For example, viruses carried by mosquitoes, ticks, and other blood-sucking arthropods generally have increased transmission rates with rising temperatures. St. Louis encephalitis (SLE) serves as an example. The mosquito Culex tarsalis carries this virus. The percentage of bites that results in transmission of SLE is dependent on temperature, with greater transmission at higher temperatures.

The temperature dependence of vector-borne diseases is also well illustrated with malaria. Malaria is endemic throughout the tropics, with a high prevalence in Africa, the Indian subcontinent, Southeast Asia, and parts of South and Central America and Mexico. Approximately 2.4 billion people live in areas of risk, with some 350 million new infections occurring annually, resulting in approximately 2 million deaths, predominantly in young children. Untreated malaria can become a life-long affliction—general symptoms include fever, headache, and malaise.

The climate sensitivity of malaria arises owing to the nature of the interactions of parasites, vectors, and hosts, all of which impact the ultimate transmission rates to humans. The gestation time required for the parasite to become fully developed within the mosquito host (a process termed sporogony) is from eight to thirty-five days. When temperatures are in the range of 20°C to 27°C, the gestation time is reduced. Rainfall and humidity also have an influence. Both drought and heavy rains tend to reduce the population of mosquitoes that serve as vectors for malaria. In drier regions of the tropics, low rainfall and humidity restricts the survival of mosquitoes. Severe flooding can result in scouring of rivers and destruction of the breeding habitats for the mosquito vector, while intermediate rainfall enhances vector production.

Ecological Imbalances. Cholera is a serious and potentially fatal disease that is caused by the bacterium Vibrio cholerae. While not nearly so prevalent as malaria, cases are nonetheless numerous. In 1993, there were 296,206 new cases of cholera reported in South America; 9,280 cases were reported in Mexico; 62,964 cases in Africa; and 64,599 cases in Asia. Most outbreaks in Asia, Africa, and South America have originated in coastal areas. Symptoms of cholera include explosive watery diarrhea, vomiting, and abdominal pain. The most recent pandemic of cholera involved more regions than at any previous time in the twentieth century. The disease remains endemic in India, Bangladesh, and Africa. Vibrio cholerae has also been found in the United States—in the Gulf Coast region of Texas, Louisiana, and Florida; the Chesapeake Bay area; and the California coast.

The increase in prevalence of V. cholerae has been strongly linked to degraded coastal marine environments. Nutrient-enriched warmer coastal waters, resulting from a combination of climate change and the use of fertilizers, provides an ideal environment for reproduction and dissemination of V. cholerae. Recent outbreaks of cholera in Bangladesh, for example, are closely correlated with higher sea surface temperatures. V. cholerae attach to the surface of both freshwater and marine copepods (crustaceans), as well as to roots and exposed surfaces of macrophytes (aquatic plants) such as the water hyacinth, the most abundant aquatic plant in Bangladesh. Nutrient enrichment and warmer temperatures give rise to algae blooms and an abundance of macrophytes. The algae blooms provide abundant food for copepods, and the increasing copepod and macrophyte populations provide V. cholerae with habitat. Subsequent dispersal of V. cholerae into estuaries and fresh water bodies allows contact with humans who use these waters for drinking and bathing. Global distribution of marine pathogens such as V. cholerae is further facilitated by ballast water discharged from vessels. Ballast water contains a virtual cocktail of pathogens, including V. cholerae.

Two other examples of how ecological imbalances lead to human health burdens concern the increased prevalence of Lyme disease and hantavirus pulmonary disease. Lyme disease, sonamed because it was first positively identified in Lyme, Connecticut, is a crippling arthritic-type disease that is transmitted by spirochete-infected Ixodes ticks (deer ticks). Ticks acquire the infection from rodents, and spend part of their life cycle on deer. Three factors have combined to increase the risk to humans of contracting Lyme disease, particularly in North America: (1) the elimination of natural deer predators, particularly wolves; (2) reforestation of abandoned farmland has created more favorable habitat for deer; and (3) the creation of suburban estates, which the deer find ideal habitat for browsing. The net result is a rising deer population, which increases the chances of humans coming into more contact with ticks.

By 1995, in the southwestern United States, hantavirus infection was confirmed in ninety-four persons in twenty states, with 48 percent mortality. Variants of the strain that causes hantavirus pulmonary syndrome have also been found in other areas of the country, as well as in Asia and Europe. The virus is apparently asymptomatic in rodents, and it is transmitted in their saliva and excreta. In humans it has a flu-like presentation, which is followed by acute respiratory distress syndrome. The primary reservoir in the Four Corners area of the southwestern United States is the deer mouse. Climatic disturbances, which in recent years are thought to be exacerbated by human activity (e.g., global warming), appear to set up conditions that trigger outbreaks. In the early 1990s, ENSO events initially caused drought conditions to develop in the southwestern United States. This led to a decline in plant and animal populations, including natural predators of the deer mouse. Heavy rains followed the drought in 1993, resulting in a bumper crop of piñon nuts, a major food supply for the deer mouse. Subsequently the deer mouse population greatly increased, bringing about increased contact with humans and triggering the outbreak of hantavirus.

Antibiotic Resistance and Agricultural Practice Antibiotic resistance is a growing threat to public health. Antibiotic resistant strains of Streptococcus pneumoniae, a common bacterial pathogen in humans and a leading cause of many infections, including chronic bronchitis, pneumonia, and meningitis, have greatly increased in prevalence since the mid-1970s. In some regions of the world, up to 70 percent of bacterial isolates taken from patients proved resistant to penicillin and other b-lactam antibiotics. The use of large quantities of antibiotics in agriculture and aquaculture appears to have been a key factor in the development of antibiotic resistance by pathogens in farm animals that subsequently may also infect humans. One of the most serious risks to human health from such practices is vancomycin-resistant enterococci. The use of avoparcin, an animal growth promoter, appears to have compromised the utility of vancomycin, the last antibiotic effective against multi-drug-resistant bacteria. In areas where avoparcin has been used, such as on farms in Denmark and Germany, vancomycin-resistant bacteria have been detected in meat sold in supermarkets. Avoparcin was subsequently banned by the European Union. Another example is the use of ofloxacin to protect chickens from infection and thereby enhance their growth. This drug is closely related to ciprofloxacin, one of the most widely used antibiotics in the year 2000. There have been cases of resistance to ciprofloxacin directly related to its veterinary use. In the United Kingdom, ciprofloxacin resistance developed in strains of campylobacter, a common cause of diarrhea. Multi-drug-resistant strains of salmonella have been traced to European egg production.

Food and Water Security. Agricultural practices are also responsible for a growing number of threats to public health. Some of these are related to inadequate waste management, which has resulted in parasites and bacteria entering water supplies. Others are of entirely different origins and involve apparent transfer across species of pathogens that affect both animals and humans. The most recent and spectacular example is mad cow disease, known as variant Creutzfeldt-Jakob disease in humans, a neuro-degenerative condition that, in humans, is ultimately fatal. The first case of Bovine Spongiform Encephalopathy (BSE), the animal form of the disease, was identified in Southern England in November 1981. By the fall of 2000, an outbreak had also occurred in France, and isolated cases appeared in Germany, Switzerland, and Spain. More than one hundred deaths in Europe were attributed to what has come to be commonly called mad cow disease.

Improper manure management was the likely source of the outbreak of E. coli 0157:H7 in Walkerton, Ontario, Canada. Other health risks associated with malfunctioning agroecosystems include periodic outbreaks of cryptosporidiosis, a parasitic disease that is spread by surface runoff contaminated by feces of infected cattle. This parasite causes fever and diarrhea in immunocompetent individuals and severe diarrhea and even death in immunocompromised individuals.

ECOSYSTEM RESTORATION

Ecosystem pathology in some cases can be reversed simply by removing the source of stress. In cases, for example, where ecosystem degradation is the result of point-source additions of nutrients or toxic chemicals, removal of these stresses may result in considerable recovery of ecosystem health. A classic case is Lake Washington (near Seattle, Washington). This lake had become highly anoxic (oxygen-depleted) owing to a sewage outfall entering the lake. Redirecting the sewage outfall away from the lake reversed many of the signs of pathology.

In cases where it is not feasible to remove the source of stress, more innovative engineering solutions have been tried. For example, in the Kyrönjoki and Lestijoki Rivers in western Finland, spring and fall runoff leads to sharp pulses of acidity. Spring runoff from snowmelt, which releases acid from tilled or dug soils, has been particularly damaging to fish, during the critical time of year for spawning. Fish reproduction is severely curtailed, if not all together eliminated in highly acidic water. Further there have been massive fish kills resulting from the highly acidic waters. One possible remedy is to replace the original drains which take runoff from the land to the rivers with new limed drains that can neutralize the acidity. This solution has been implemented on an experimental basis and appears to substantially reduce acidic runoff.

More radical treatments for damaged ecosystems involve “ecosystem surgery.” In some cases, invading exotic vegetation (such as mangroves in Hawaii) have been removed from regions, and native vegetation has been replanted. In areas of North America where wetlands have been severely depleted owing to farming, urbanization, and industrial activity, efforts have been made to establish new wetlands.

More often than not, however, reversing ecosystem pathology is not possible. Efforts to restore the indigenous grasslands in the Jornada Experimental Range in the southwestern United States provide an example. Overgrazing by cattle has severely degraded the landscape and has lead to replacement of the native grasses by largely inedible shrubs, dominated by mesquite. Erosion by wind and episodic heavy rains have left areas between shrubs largely bare, and subsequently underlying sands have developed in dune-like fashion over a large part of the area. The resulting mesquite dunes have proven highly resistant to efforts to restore the native grasslands, although almost every intervention has been tried, including highly toxic defoliants (Agent Orange), fire, and bulldozing.

Even where it has been possible to restore some of the ecological functions of degraded ecosystems, and thus improve ecosystem health, the restoration seldom results in reestablishment of the pristine biotic community. The best that can be achieved in most cases is reestablishment of the key ecological functions that provide the required ecosystem services, such as the regulation of water, primary and secondary productivity, nutrient cycling, and pollination. In all such efforts, key indicators of ecosystem health (vigor, productivity, and resilience) are essential to monitor progress. Standard ecological indicators can be used for this purpose (e.g., measures of productivity, species composition, nutrient flows, soil fertility) along with socioeconomic and human health indicators.

Experience in efforts to restore highly damaged ecosystems suggests that ecosystem-health prevention is far more effective than restoration. For marine ecosystems, setting aside protective zones that afford a sanctuary for fish and wildlife has considerable promise. Many countries are adopting policies to establish such areas with the prospect that these healthy regions can serve as a reservoir for biota that have become depleted in the unprotected areas. Yet this remedy is not without its limits. Restoring ecosystem health is not simply a matter of replenishing lost or damaged biota. It is also a matter of reestablishing the complex interactions among ecosystem lifeforms. Having a ready source of healthy biota that could potentially recolonize damaged ecosystems is important, but it is only part of the solution.

PREVENTION OF ECOSYSTEM DISRUPTIONS

Given the difficulties in reversing ecosystem degradation, and the many associated human health risks that arise with the loss of ecosystem health, the most effective approach is simply the prevention of ecosystem disruption. However, like many common-sense approaches, this is easier said than done. In both developed and developing countries there is a strong inclination to continue economic growth, even at the cost of severe environmental damage. Apart from selfish motivations, the argument is made that economic growth has many obvious health benefits, such as providing more efficient means of distributing food supplies, providing more plentiful food, and providing better health services and funding for research to improve standards of living. These are indeed benefits of economic development, and have led to substantial increases in health status worldwide.

However, at the dawn of the twenty-first century, the past is not necessarily the best guide to the future. The human population is at an all-time high, and associated pressures of human activity have led to increasing degradation of the earth’s ecosystems. As ultimately healthy ecosystems are essential for life of all biota, including humans, current global and regional trends are ominous. Under these circumstances, a tradeoff between immediate material gains and long-term sustainability of humans on the planet may be the only option. If so, the solution to sustaining human health and ecosystem health becomes one of devising a new politic that places sustaining life support systems as a precondition for betterment of the human condition.

BIBLIOGRAPHY

Aldhous, P. (2000). “Inquiry Blames Missed Warnings for Scale of Britain’s BSE Crisis.” Nature 408:3–5.

Baquero, R., and Blazquez, J. (1997). “Evolution of Antibiotic Resistance.” Trends in Ecology and Evolution 12:482–487.

Bright, C. (1998). Life Out of Bounds: Bioinvasion in a Borderless World. New York: W. W. Norton.

Colwell, R. R. (1996). “Global Climate and Infectious Disease: The Cholera Paradigm.” Science 274:2025–2031.

Colwell, R. R., and Patz, J. A. (1998). Climate, Infectious Disease and Health: An Interdisciplinary Perspective. Washington, DC: American Academy of Microbiology.

Epstein, P. R. (1995). “Emerging Diseases and Ecosystem Instability: New Threats to Public Health.” American Journal of Public Health 85(2):168–172.

Huq, A., and Colwell, R. R. (1996). “Vibrios in the Marine and Estuarine Environment: Tracking Vibrio Cholerae.” Ecosystem Health 2:198–214.

Mageau, M. T.; Costanza, R.; and Ulanowicz, R. E. (1995). “The Development and Initial Testing of a Quantitative Assessment of Ecosystem Health.” Ecosystem Health 1:201–213.

Rapport, D. J. (1989). “What Constitutes Ecosystem Health?” Perspectives in Biology and Medicine 33:120–132.

Rapport, D. J., and Friend, A. M. (1979). Towards a Comprehensive Framework for Environmental Statistics: A Stress-Response Approach. Ottawa: Statistics Canada.

Rapport, D. J., and Regier, H. A. (1980). “An Ecological Approach to Environmental Information.” Ambio 9:22–27.

—— (1995). “Disturbance and Stress Effects on Ecological Systems.” In Complex Ecology: The Part-Whole Relation in Ecosystems, ed. B. C. Patten and S. E. Jorgensen. Englewood Cliffs, NJ: Prentice Hall.

Rapport, D. J.; Costanza, R.; and McMichael, A. J. (1998). “Assessing Ecosystem Health: Challenges at the Interface of Social, Natural, and Health Sciences.” Trends in Ecology and Evolution 13(10):397–401.

Rapport, D. J.; Christensen, N.; Karr, J. R.; and Patil, G. P. (1998). “The Centrality of Ecosystem Health in Achieving Sustainability in the Twenty-First Century: Concepts and Approaches to Environmental Management.” In Human Survivability in the Twenty-First Century, ed. D. M. Hayne. Toronto: University of Toronto Press.

Rapport, D. J.; Costanza, R.; Epstein, P. R.; Gaudet, R.; and Levins, R., eds. (1998). Ecosystem Health. Malden, MA: Blackwell Science.

Rapport, D. J., and Whitford, W. (1999). “How Ecosystems Respond to Stress: Common Properties of Arid and Aquatic Systems.” Bio Science 49(3):193–203.

Rapport, D. J.; Regier, H. A.; and Hutchinson, T. C. (1985). “Ecosystem Behavior under Stress.” American Naturalist 125:617–640.

Reeves, W. C.; Hardy, J. L.; Reisen, W. K.; and Milby, M. M. (1994). “The Potential Effect of Global Warming on Mosquito-Borne Arboviruses.” Journal of Medical Entomology 31(3):323–332.

Ruiz, G. M.; Rawlings, T. K.; Dobbs, F. C.; Drake, L. A.; Mullady, T.; Huq, A.; and Colwell, R. R.. (2000). “Global Spread of Microorganisms by Ships.” Nature 408:49–50.

Watson R. T.; Zinyowera, M. C.; and Moss, R. H., eds. (1996). Second Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge, UK: Cambridge University Press.

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Dietary supplements, also known as nutritional supplements or food supplements, are a preparation particularly intended for supplying nutrients including minerals, vitamins, amino acids or fatty acids, which are missing or are not consumed in adequate quantity in the diet of a person. The DSHEA (Dietary Supplement Health and Education) defines dietary supplement or the nutritional supplement as a product, which:

- Supplements the foodstuff you intake
- Contains one or even more dietary ingredients including minerals, herbs, vitamins and other botanicals, amino acids and other substances
- Comes in capsule, liquid form or pill

Different Kinds Of Dietary Supplements
There are various kinds of dietary supplements or nutritional supplements. Minerals and vitamin supplements are kinds of dietary supplements that contain micronutrients meant in order to assist a healthy and fit body to function smoothly. Herbal or botanical supplements are the type of dietary supplements, which have a remedial purpose. Herbal dietary supplements usually support a particular region of the body’s physical condition like the bones, liver or skin.

Health Advantages Of Vitamin And Mineral Dietary Supplements
Minerals and vitamins are the micronutrients, which serve a particular purpose as well as benefit the body in a very unique way. For instance, Vitamin A enhances the bone growth and vision, while Vitamin E supports the body’s immune system and assists in repairing the DNA. Mineral and vitamin deficiency impair the body’s aptitude for helping and protecting itself.

Consuming vitamins do not make up for the unhealthy diet plus vitamins are inadequate substitutes for nutrients from clean and fresh vegetables. In addition fruits and whole grains are general mineral supplements and multivitamin which can certainly act as an excellent safeguard.

Benefits Of Herbal Dietary Supplements
The herbal dietary supplements are different from mineral and vitamin dietary supplements as they encompass medicinal value. The herbs also called as botanicals are the humanity’s oldest fitness care tool and in addition basis of various modern medicines. Taking the herbal dietary supplement in combination with healthy diet and good standard of living can be advantageous. Thereby, large number of people intake natural or the herbal dietary supplements in order to cure different health conditions and to promote their general well being.

Herbal dietary supplements come in different forms including dried or fresh products, solid or liquid extracts and capsules, tablets, powders as well as tea bags. Herbal supplements improve energy, relieve stress, promote weight loss, improve memory and enhance mental performance.

Who Can Greatly Benefit From These Dietary Supplements?
Several groups of people due to distinct nutritional requirements particularly benefit by taking dietary supplements. They include:

1. Women of childbearing age who need additional iron and calcium
2. Lactating or pregnant women
3. Teenagers and children with irregular and unbalanced eating habits
4. Vegans or vegetarians
5. Seniors
6. People or dieters avoiding several food groups
7. People having eating disorders and medical conditions including deficiency diseases, lactose intolerance, absorption problem or similar problems
8. Individuals who often consume fast and processed food

Apart from selecting dietary, herbal or nutritional supplements, it is essential to consider the following points:
1. Check the efficacy and safety of the dietary, herbal and nutritional supplement you intake
2. FDA do not analyze the ingredients and the content of the dietary supplements
3. The producers of dietary supplements must fulfill FDA’S GMP – good manufacturing practices for the food
4. Particular health claims on the dietary supplements label are not granted by FDA and must incorporate a disclaimer which states that the dietary supplement is not at all intended to treat, diagnose, prevent or cure any diseases

Nevertheless, if you are thinking consuming a dietary supplement instead of drugs it is feasible to consult your doctor first in order to avoid any side effects.

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Nutritional supplements can strengthen bones, cartilage and joints resulting in improved flexibility, bone strength, and pain relief. Nutritional supplements have disabling effects on inflammatory arthritis and joint pain. Nutritional supplements provide the nutrients needed to lubricate joints and rebuild cartilage, resulting in reduced arthritis and joint pain. In fact nutritional supplements have become popular alternative treatments for arthritis and osteoporosis. Supplements with calcium, magnesium and vitamin D are very essential for maintaining bone health, as Calcium helps in strong bone formation, Vitamin D helps in Calcium absorption and utilization, and magnesium helps in bone formation and joint support. Vitamin supplements prevent the breakdown of cartilage. Inclusion of Boron, Copper, Silicon and Zinc in bone health supplement is essential, because Boron activates Vitamin D, and Silicon and Zinc helps in bone formation and osteoporosis support. Vitamins D, A, C, E and B3 supplements help in reducing pain and inflammation in people with osteoarthritis. Vitamin E supplements helps in significantly relieving from arthritis and joint pain. Nutritional supplements with glucosamine (glucosamine sulfate and N-Acetyl D-Glucosamine), chondroitin sulfate and crucial minerals help to build and maintain healthy, flexible cartilage which is very important for joint health. Glucosamine has become a popular natural nutritional supplement for the treatment of arthritis especially osteoarthritis. Nutritional supplement containing Glucosamine and Chondroitin plays an important role in the maintenance of joint cartilage. Nutritional supplement with Glucosamine, Chondroitin, MSM (methylsulfonylmethane), Manganese and Vitamin C helps in maintaining joint health. Glucosamine and Chondroitin included in this joint health supplement promote wound healing by providing the necessary building blocks for new joint cartilage. Nutritional supplement with Omega 3 fatty acids helps people with rheumatoid and other inflammatory forms of arthritis and joint pain. Nutritional supplement with Bromelain, a substance derived from pineapple, has natural pain relieving properties, and reduces pain more effectively with fewer side effects. Nutritional supplements made of avocado and soybean extracts have found to reduce pain and level of disability and increase the mobility range in people with bone disease. Intake of calcium supplements daily helps in maintaining bone strength and bone density, and helps in preventing osteoporosis. The nutritional supplement with SAMe (S-Adenosyl-Methionine) which is a form of the amino acid, methionine, stimulates the production of glycosaminoglycans which are important components of connective tissue. SAMe helps to maintain the quality of cartilage. Nutritional supplement with MSM (methylsulfonylmethane) promotes healthy tissues & cells. If you suffer from osteoarthritis, try to include nutritional herbal supplements in your diet, along with omega-3 fatty acids, vitamin C, folic acid, and vitamins D and vitamin E supplements. Herbal supplements like turmeric and ginger have anti-inflammatory properties. Vitamin C and omega-3 fatty acids from fish oil and flaxseed also have the same effects. Folic acid supplements decreases joint sensitivity and increases your mobility range. Vitamins D and Vitamin E supplements not only prevent the disease but also slow the progression of the disease. Magnesium supplements are important for bone and joint health and reduce some of the side effects of high levels of calcium supplementation. Glucosamine and Chondroitin Sulfate are extremely helpful for osteoarthritis. If you are Rheumatoid Arthritis patient, take vitamin C supplements, herbal supplements like turmeric and ginger, and supplements with magnesium and omega-3 fatty acids. Herbal supplements, and Supplements with Vitamin C and omega-3 fatty acids can reduce inflammation, while magnesium supplements can suppress the spread of the disease.

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Cheap health insurance has become the issue of the moment in South Carolina and across the country. More small businesses are increasingly unable to provide cheap health insurance plans to their employees because of the rising cost and the lack of federal and state legislation that would allow small businesses to purchase cheap medical insurance in pools. In the meantime South Carolina and other states are looking to cut the costs of the Medicare and Medicaid health insurance programs for the elderly and the poor. However, more affordable forms of health insurance plans are available as some private companies are experimenting with a new variation of cheap health insurance known as health discount plans. In the article that follows we’ll explain the various aspects of cheap health insurance in South Carolina and how to find a plan that works for you.

Health Care Costs due to Managed Health Care

The current health care system in America is inaccessible to approximately 47 million poor and lower middle class people. In order to address the growing health care insurance crisis in the U.S. that resulted in health care cost growth in the 1970s and 1980s, health maintenance organizations (HMOs) sprung up. These were initially as non-profit groups designed to separate unnecessary tests and treatments from those that the patient required in an effort to keep costs down. Managed care organizations began screening requested procedures by physicians to pre-authorize what the HMO would or would not cover. However, the number of people who are the riskiest to insure-diabetics, cancer, etc.-continues to rise. Many South Carolina managed care industry experts say the cost of cheap health insurance is still high because of the existing pool of insured people who use the health care system more than an average amount.

The other battle that is ongoing in South Carolina involves the health insurance companies and hospitals, the latter which cannot turn anyone away from care by law. However, as the number of South Carolinians who cannot afford cheap health insurance increases, hospital emergency rooms are handling the majority of the load. More people have to turn to hospitals as their primary health care givers given a lack of adequate or non-existant health insurance coverage.

Cheap Health Insurance Plans Through the Workplace

Most cheap medical insurance policies in South Carolina are usually written through group coverage offered at work by your employer through a private South Carolina cheap health insurance company. This is usually the more cost effective way to purchase cheap health insurance now available since a large number of employees allows South Carolina companies to reduce their insurance premiums. Similar to buying in bulk, the more health insurance plans a business can purchase for its employees the less expensive the insurance is per employee. In South Carolina, like the rest of the nation, the number of companies that can provide cheap health insurance for their employees is declining.

Personal Health Insurance Plans

Health insurance plans can be purchased by individuals and families from virtually every insurance provider in South Carolina. Trying to purchase health insurance on an individual basis can be more expensive if the person already has a health problem, known as a pre-existing condition. Many companies will not cover people with pre-existing conditions if they have no continuation of coverage-renewing health insurance coverage after only a prescribed short period of time-picked up from an earlier cheap health insurance policy.

South Carolina Health Insurance Pool

The South Carolina Health Insurance Pool is a state health insurance plan designed to provide coverage for those that either do not have or have lost medical coverage at no fault of their own and are uninsurable. The pool was created by the General Assembly to help people who couldn’t get health insurance coverage from any other source, including people with certain disabilities. Blue Cross and Blue Shield of South Carolina currently administers the pool.

Coverage is available to a person who has been a state resident for at least 30 days and meets the following criteria:

They were turned down for private health insurance coverage for health reasons;
They were accepted for private health insurance, but have pre-existing illnesses or conditions excluded from coverage, for a period exceeding 12 months;
They are paying health insurance premiums for comparable coverage which are more than 150 percent of the premium levels charged by the pool;
In certain situations, other individuals whose last health insurance coverage was an employer based group health plan may be eligible for coverage.

No matter what your age, there are also several federally sponsored programs to help you if can’t afford the premiums for individual health insurance, providing you meet their eligibility guidelines.

Medicare, a health insurance program for people age 65 or older, certain younger people with disabilities, and people with end-stage renal disease.
Medicaid, a program for the poorest individuals and low-income families with children.
The Children’s Health Insurance Program (CHIP), a plan that provides health care to children whose parents make too much to qualify for Medicaid, but earn too little to afford individual health insurance.

Types of Cheap Health Insurance Coverage

Cheap health insurance plans generally fall into one of two categories: indemnity plans and managed care plans (HMOs, PPOs or POS plans). An indemnity plan allows you to choose your own doctors and pays for your medical expenses totally, in part, or up to a specified amount. Managed care plans generally provide broader coverage within a specified network of health-care providers.

Although you can purchase cheap health insurance plans that cover specific areas of health care (surgical, hospital, physician expense plans) most plans cover varying degrees of health care in a number of different areas. This health insurance coverage, known as major medical insurance, offers extremely broad coverage with a very high maximum benefit that’s designed to protect you against losses from catastrophic illness or injury.

When comparing cheap medical insurance plans, check to see if they provide additional benefits that you may need, including prescription drugs, preventive care, mental health benefits, maternity care, and vision care. A comparison of various health insurance policies and rates through many South Carolina health insurance companies can be obtained at www.insurances.sc.

Cheap Health Insurance Recipient Costs

With most cheap health insurance policies available in South Carolina, the way to control cost is to cut down on the out-of-pocket expenses. Since most health care insurance policies require you to make a co-payment (the amount you pay a health care provider with every visit), anything involving a lot of time spent in the doctor or dentist’s office can become expensive. Most also require a deductible (costs you must cover out of your pocket for any major expense before your cheap health insurance policy picks up the remaining costs). You may also have coinsurance, the percentage of cheap medical insurance cost you will still have to pay after you reach your deductibles.

Another thing to consider is COBRA health insurance. This law allows employees who leave a job the ability to stay on that South Carolina company’s employee health insurance for up to 18 months although they have to pay the full amount of the coverage. Check the COBRA benefits to see if purchasing a less expensive individual health insurance plan may be in your best interest.

How to Buy Cheap Health Insurance

If you need to purchase individual health insurance, it can be expensive. Unlike group plans, in which the costs and risks associated with health care are spread among many people; individual health policies are “medically underwritten” to take into account your personal health history. Any “pre-existing” condition such as heart disease, diabetes, and even pregnancy, can nix your chances of acceptance or boost your premiums.

To determine the acceptability of a particular applicant, a health insurance underwriter can require information regarding the following:

The individual’s age: Age determines rates and whether coverage will be issued at all.
The individual’s gender: at younger ages, males have a lower rate of illness and injury than females. That changes by age sixty.
The individual’s health history and physical condition: Someone who has had a previous condition that can contribute to a future illness/injury is not considered an ideal risk. In response to a less than ideal medical history, modified coverage may be offered depending on the individual’s health, higher than normal premiums may be issued, or the person may be denied coverage altogether.
The individual’s occupation and hobbies: Some occupations such as construction workers have higher insurance rates, along with people who enjoy dangerous activities such as skydiving or bungee jumping. At times certain occupations are considered so hazardous that insurance companies will not cover them at all.

Your first step in getting cheap health insurance coverage is to understand exactly what you need. Think carefully about what coverage you must have. Do you need health insurance for your whole family, or just yourself? Do you want to choose your providers? If you’re over 65, do you need insurance to fill the gaps in Medicare? Do you need – and can you afford – long-term disability and/or long term care coverage? Even if you begin by soliciting cheap health insurance quotes you must still know exactly what you want in terms of health insurance coverage so you will be comparing apples to apples when weighing any cheap health insurance premium quote.

After that, contact a South Carolina insurance agent in your area. Ideally, you can start with an independent South Carolina insurance agent who is familiar with the insurance companies that do business in your area. This agent is also not bound to write coverage for any particular health insurance company so he or she can give you an honest appraisal of various health insurance policies.

When you’ve found the right coverage, you’ll give information to your agent to complete the necessary forms. Be honest. It’s important to disclose your medical history thoroughly and accurately. Report all of your health problems to your agent. If any of your health information is misstated or incomplete, the company might refuse to pay your claims and could cancel your policy.

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Barack Obama’s ambitious health care plan is fairly simple and straightforward. His plan seeks to dramatically and swiftly increase the number of people that have health insurance. He insists that this plan will save the typical American family approximately $2500 in annual costs. Since the average Ohio health insurance premium is less than most other states, savings to Ohio residents may average less than $2500.

The Obama plan is designed to give the federal government more control over health care decisions and dollars, a major difference from the current decentralized system of employer-based insurance and state-based insurance regulation. Here in Ohio, health insurers have been effectively held in check by the Ohio Department of Insurance. This, however, is not the case in many other states.

The Obama Plan

Many parts of the Obama plan resemble initiatives from the Clinton health plan of 1994 and the Kerry Health plan of 2004.
Essentially, Obama’s health care plan is divided into three sections:

1. Modernizing the US health care system to lower costs and improve quality
2. Promoting prevention and strengthening public health
3. Quality, portable and affordable health coverage for every person

The “Savings”

The $2500 in savings will come from health care reform, using some of the following initiatives:

*Making health insurance universal, which may reduce spending on uncompensated care.
*Improving management and prevention of chronic conditions.
*Increasing insurance industry competition and reducing underwriting costs and profits.
*Providing reinsurance for catastrophic coverage, which will reduce insurance premiums.

Shifting Cost Burden

While all of these ideas are feasible, the underlying theme seems to be simply shifting some of the cost burden from the private sector to the government. And of course, much more control of our health dollars and decisions would come from Washington D.C and not Anthem or UnitedHealthCare.

The Obama plan will actually compete directly with Ohio private health insurance companies in a “National Health Insurance Exchange.” The federal government (not health insurance carriers) would determine the quality of health benefits that Americans would receive. And these new rules would apply to both the new national health plan and all participating private health plans.

Preventative Coverage Would Be Emphasized

Obama’s health care plan will encourage “healthy lifestyles” with specific emphasis on wellness. Employer wellness programs will be increased, and cafeterias and vending machines in the workplace may see healthier food.

School-based health screening programs may increase along with increased support for physical education.

For Ohio individuals and families, the Obama plan would require preventative services on many federally-supported health programs such as Medicare, Medicaid and SCHIP. One benefit may be possible discounts to on health insurance premiums for enrollment in wellness and prevention programs.

Currently, some Ohio individual health insurance policies offer a similar discount, such as Anthem’s Lumenos Health Incentive Account (HIA).

Ohio Group Health Insurance

Employer-based health insurance would radically change under the Obama plan. Here in Ohio, both small and large employers are able to choose among many different health plans for their employees. The Obama plan would force employers to offer a specific level of health benefits to their employees or pay a tax to finance a national health program. Currently, the amount of provided health benefits and the size of the tax have not been specifically discussed.

Perhaps the best and most economical health insurance plan for Ohio residents would be a concept already in place…HSAs (Health Savings Accounts). Thus, instead of imposing a top-down change on the health care system, it would seem to be prudent to transfer direct control of health care dollars to individuals and families. This would allow Americans to choose their own health plans and benefits, while making health insurance companies compete directly for consumer’s dollars by providing a real value to patients.

All of this could be accomplished by specific tax and regulatory changes designed to utilize the power of free-market competition. Health care spending could be reduced, preventative treatment could be emphasized and portability could be promoted. Reforming the tax treatment of health insurance and aiding employers that help their employees buy health insurance would help quite a bit.

For now, Ohio health insurance rates are remarkably low compared to many other states. There are many reputable health insurance companies that offer a wide array of policies, including Health Savings Accounts. That shouldn’t change much for the next two years. In 2011, things might change…hopefully, for the better.

For additional information on Ohio health insurance plans, or an instant Ohio health insurance quote, please visit http://www.ohioquotes.com

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