Sunday, August 24, 2008

The Geopolitical Angle of Public Health

Conflict is never good for public health, though for some commentators that’s such a limp-wristed reason not to fight. The bellicose bloggers such as Ralph Peters and Victor David Hanson reminds one of the bit of apocrypha said of George S. Patton by some, “our blood, his guts” (rendered sardonically by an actor playing a dogfoot in the movie “Patton”). It also brings to mind the saying “amateurs discuss tactics, professionals discuss logistics” (yep, we’re going to be able to mount any sort of meaningful response to Russia’s incursion in Georgia while in the midst of two other conflicts). However, when your mind is in the clouds maneuvering squadrons, fleets and brigades around, there just isn’t time to pay attention to the fallout, such as hunger, dislocation, and epidemics.

Or maybe public health has more of a role in generating conflict than these bush-league Clausewitzs will acknowledge. There are some interesting perspectives on this in a recent article in the Asia Times – actually, there are several interesting perspectives, including the one that all Russian politicians are clever because the stupid ones are dead, whereas we currently have the stupid ones running everything right now. But what drew my attention was Russia’s demographic dilemma and how that might be a cause for its aggressive behavior (though the US and EU trying to extend NATO up to Russia’s doorstep might also have a role. . .).

The article paints a bleak picture demographically for the Russians running things in the country – falling birth rates among ethnically Caucasian Russians, abortion used as a means of birth control, declining life expectancy – and probably a whole host of other issues (I need to take a stroll over to the WHO web site sometime and review the statistics). The geopolitical angle around Russia trying to reclaim its old republics is:

Demographics stand at the center of Putin's calculation, and Russians are the principal interest that the Russian Federation has in its so-called near abroad. The desire of a few hundred thousand Abkhazians and South Ossetians to remain in the Russian Federation rather than Georgia may seem trivial, but Moscow is setting a precedent that will apply to tens of millions of prospective citizens of the Federation - most controversially in Ukraine.

We’ve only explored the fertility angle, and haven’t drilled into other issues of morbidity (caring for the millions made ill from poor diet, alcoholism and smoking), demographic troughs (fewer younger people to care for millions of elderly) or, most speculatively, fertility and neurobehavioral disorders from exposures to persistent organic pollutants and mercury. It may seem presumptuous to elevate pollutant exposures as a significant demographic contributor to geopolitical conflict. However, it’s probably prudent not to neglect them in strategic analysis, given the widespread nature of human exposure to these substances, coupled with the kinds of health effects they might be associated with, along with the uncertainty regarding occurrence and magnitude of those effects.

It’s interesting that we obsess on the resurgent Russia, an energy and geopolitical player on the world stage, and don’t give any consideration that behind the façade is a country full of sick and aging people. It’s both a warning to us, as well as a clue for how to manage Russia’s aggressive tendencies. No word yet on how we manage our aggressive tendencies.

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