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Different types of food poisoning include amoebiasis, campylobacter, cryptosporidiosis, gastroenteritis, giardiasis, listeriosis, salmonellosis, shigellosis, VTEC, HUS and yersiniosis.
Only a doctor can provide adequate diagnosis of symptoms, but food poisoning symptoms usually include nausea, vomiting, cramps, dehydration, gastrointestinal symptoms, weakness, fatigue and fever. New technology, called radio frequency identification (RFID) labels attach to product and transmit the condition on the food. Salmonella is the number one food contaminant causing nearly one-third of food-borne hospitalizations and deaths.
Children younger than 4 accounted for a greater proportion of reported foodborne illnesses than other age groups.
A 2005 report found that approximately 120 people die from foodborne illnesses in Australia every year. A British survey found that 82% of people, and particularly the elderly (87%), think they’re unlikely to get food poisoning from food at home. The same survey found that 89% of people don’t store raw meat properly, and 63% of people don’t wash their hands after handling raw meat or fish. The Australian Food Standards Code requires businesses which sell any sort of food to be either licensed or to notify the Authority of its details. In 2003, the Food Safety Information Council estimated that there are approximately 5 million Australians affected by food poisoning every year. A food-poisoning outbreak at a youth camp near Dubbo in 1994 was caused by the bacterium Clostridium perfringens. In the United Kingdom, the incidence of foodborne disease increased by 1.7% from 2005 to 2006 – the first increase since 2000. In the United States, the Noroviruses are the most common cause of disease transmitted through food, causing 57% of food poising epidemics in 2004.
Symptoms of bacterial infections from food poisoning are delayed because the bacteria need time to multiply.
The recent crisis of mad cow disease (bovine spongiform encephalopathy) had huge media coverage, despite the very low number of human cases. Some 40,000 cases of salmonellosis are reported in the United States each year, although the CDC estimates that because milder cases aren’t diagnosed or reported, the actual number of infections may be 30 or more times greater. According to the Economic Research Service (ERS) of the USDA, each year $6.9 billion in costs are associated with five bacterial pathogens, Campylobacter, Salmonella, Listeria monocytogenes, E. In England in 2002-03, 80% of hospital consultant episodes for bacterial foodborne intoxications required hospital admission and he mean length of stay in hospitals for bacterial foodborne intoxications was 6.7 days. In 1995, following the major Garibaldi food poisoning outbreak in South Australia, the State and Territory Health Ministers directed The Australia New Zealand Food Authority (ANZFA) to begin drafting the food standards. In a recent large-scale contamination of orange juice produced in South Australia more than 500 people have been confirmed as suffering from food poisoning after drinking the juice. A reduction in food poisoning of just 20 per cent would save Australia over $500 million a year.
Food poisoning contaminants are usually bacteria, viruses and parasites, but may also include pesticides, toxic mushrooms and dangerous or incorrectly prepared exotic foods exotic foods, such as blood clams, barracuda and puffer fish. Contaminated food was estimated to cause about 6,000 cases of illnesses other than gastroenteritis in Australia each year, where, Toxoplasmosis was estimated to be the most common non-gastroenteritis illness, causing 5,900 new symptomatic illnesses each year.
Contaminated food was also estimated to cause about 42,000 Australian episodes of sequelae following acute gastroenteritis, each year where, the most common illness common illness was reactive arthritis, responsible for an estimated 21,000 episodes, while irritable bowel syndrome was responsible for 20,200 episodes each year.
In 1985, 185,000 people in Chicago contracted salmonellosis from contaminated pasteurized milk distributed by one dairy plant.
In one outbreak in 1994, over 200,000 people across the United States contracted salmonellosis from contaminated ice cream made in Minnesota and distributed nationally.
Around sixty to eighty per cent of foodborne illness arises from the food service industry. In 2002, contaminated rice is believed to be the cause of severe food poisoning that hit more than 250 people celebrating the Islamic New Year in Melbourne’s northern suburbs. In New Zealand in 2008, 22 people were poisoned after eating comb honey contaminated with tutin and its derivative hyenanchin.
In 2007, 3 million broiler chickens were fed pet food, containing toxic wheat gluten imported from China and then sold to restaurants and supermarkets all over the United States. The cost of food poisoning recipients can run up to $5 billion in direct medical expenses and lost productivity during the year. About 75% of the new infectious diseases affecting humans over the past 10 years were caused by bacteria, viruses and other pathogens that are tied to food production that started in animals and animal products. Educating children on safe food handling behaviours is key to preventing food-borne diseases today and in the future.
To keep perishable food safe for eating, it should never be kept at temperatures between 40°F and 140°F for more than 2 hours.
The World Health Authority states that up to 30% of industrial nations’ populations suffer food poisoning every year, and research shows kitchens to be the chief culprit, while contamination of kitchen surfaces is in the top five causes of food poisoning. According to statistics from the Centers for Disease Control and Prevention (CDC), less than 0.5 percent of all food-borne illness is related to eggs. According to the Local Authorities Report on Health and Safety in Service Industries 1996 (C120 – HSE), 7% of fatalities and 17% of major injuries occurred hotel and catering.
Commercial kitchens are notoriously among the most stressful places to earn a living and are full of potential dangers to workers. The Burn Foundation of Philadelphia ranks food businesses in the top 50 occupations with cooks, food handlers and kitchen and wait staff most likely to experience a work related burn. According to the National Statistics from the DGLC, there were 2900 fires reported in restaurants, cafes and public houses in 2004 and 5100 fires were started by cooking appliances.
The National Institute for Occupational Safety and Health (NIOSH) reports that over a two year period, emergency rooms treated almost 45,000 injuries suffered by teenage restaurant workers and nearly half of the injuries involved hot grease. The federal Occupational Safety and Health Administration estimates that hand injuries cost the foodservice industry about $300 million a year in medical costs, lost time from work and workers’ compensation insurance payouts. Injuries to staff from trips and slips in their workplaces cost companies in the UK around ?512 million per year, according to the Health and Safety Executive. In a detailed analysis of food service injury causes, the 1994 Bureau of Labor Statistics (BLS) survey documents that slips and falls accounted for 34 percent of all restaurant-worker-injury cases. The largest percentage of fatalities and accidents in food businesses are struck-by accidents and falls. The HSE (1997) estimated that 70% of accidents in the catering industry could be prevented by improved safety management practice. Nearly 1 in 6 Americans — 48 million people — contracts a food-borne illness each year; 3,000 die as a result.
Climate Change: Implication for Food-Borne Diseases (Salmonella and Food Poisoning Among Humans in R. Science, Technology and Medicine open access publisher.Publish, read and share novel research. Discussion Technology - Good for Students AND Teachers Fiddling with Indicators while using Toxic Tests Ode to Dewey Clearly Articulated Proposal--Thank You! Call for Papers- International Journal of Management, Economics and Social Sciences Scholars Index is open now! It is argued that poverty places severe limits on what can be accomplished through school reform efforts, particularly those associated with the federal No Child Left Behind law. I do not believe that NCLB is needed to tell us precisely where those failing schools are located, and who inhabits them. In writing about these issues I ask for the tolerance of sociologists, economists, child development researchers, and others who read this essay because I discuss variables that are the subject of intense debate within the disciplines. It seems to me that in the rush to improve student achievement through accountability systems relying on high-stakes tests, our policy makers and citizens forgot, or cannot understand, or deliberately avoid the fact, that our children live nested lives. I believe we need to worry whether the more important keys to school reform are up the block, in the shadows, where the light is not as bright.
When I think about that gorilla it immediately seems ludicrous to me that most of what we try to do to help poor youth is classroom and school based. For all youth those 5000 hours require learning to be a member of one or more cultural groups in that community, learning to behave appropriately in diverse settings, learning ways to get along with others, to fix things, to think, and to explain things to others. It is has become increasingly clear that several decades of educational reform have failed to bring substantial improvements to schools in America’s inner cities. Currently, relatively few urban poor students go past ninth grade: The graduation rates in large comprehensive inner-city high schools are abysmally low.
Oakland, California, where my grandson goes to school, announced recently that its high-school graduation rate is 48 percent (Asimov, 2005). As educators and scholars we continually talk about school reform as if it must take place inside the schools. On the other hand, the idea that schools cannot cure poverty by themselves sounds something like a vote of no confidence in our great American capacity for self-transformation, a major element in the stories we tell of our American nation. Those who blame poor children and their families, like Herrnstein and Murray, or those who blame the teachers and administrators who serve those kids and families in our public schools, like Rod Paige, Jeanne Allen, Checker Finn, William Bennett, and dozens of other well known school critics, are all refusing to acknowledge the root problem contended with by too many American schools, namely, that there is a 600 pound gorilla in the school house. Policy makers almost universally conclude that existing and persistent achievement gaps must be the result of wrongly designed school policies—either expectations that are too low, teachers who are insufficiently qualified, curricula that are badly designed, classes that are too large, school climates that are too undisciplined, leadership that is too unfocussed, or a combination of these.
For nearly half a century, the association of social and economic disadvantage with a student achievement gap has been well known to economists, sociologists and educators. The UNICEF report from the Innocenti Foundation, (UNICEF, 2005), which regularly issues reports on childhood poverty, is among the most recent to reliably document this problem. In this set of rich nations, The US is among the leaders in childhood poverty over the decade of the 1990s. Figure 4 informs us that we have the highest rate of childhood poverty among the rich nations, which is what other studies have shown for over a decade (Berliner and Biddle, 1995). One bit of good news about poverty in the US is that over the decade of the 1990s we lowered our embarrassing rate of poverty a great deal, almost 2.5 %. In Figure 5 we note the percentage of people in the US who are living at half the rate of those classified as merely poor (Mishel, Bernstein & Allegretto, 2005, p. I call attention in Figure 5 to the overall upward trend of the desperately poor in this graph, particularly the upturn after 2000. Figure 6 makes clear that poverty is strongly correlated with race and ethnicity (Mishel, Bernstein & Allegretto, p. Apparently we, the American people, do not agree with such radical ideas as those expressed in article 27 of the UN charter. We actually have many programs to help parents and children, but because they are fragmented, do not cover everyone eligible, are subject to variability in funding, they end up not nearly as good nor as serious in intent as those in many other countries. Table 1 shows that we are a leader among the rich nations of the world in terms of failing to help people exit from poverty once they have fallen in to poverty (Mishel, Berstein & Allegretto, p.
Our national problem shows in the next column, displaying the percent of people who stayed poor for the entire three years after they had fallen into poverty. In the last column of Table 1 we can see how awful it can be to stumble into poverty in the US compared to other nations. I have now pointed out that in the US the rates of childhood poverty are high, poverty is racialized, and that those who once get trapped in poverty have a hard time getting out of poverty. Since the relationship is well known let us look briefly at how US poverty is related to student achievement in just the international studies, since it is our international competitiveness that worries so many in industry and government, and it is those worries that kindled the reform movement in education.
In this table three aspects of our performance with regard to other nations are instructive. The second thing to note is that the average scores for the schools with less than 50 percent of their students in poverty exceeded the US average score, while the average scores for the schools with greater than 50 percent of their students in poverty fell below the US average score. The third thing to notice pertains to the schools that serve the most impoverished students, where 75% or more of the students are eligible for free or reduced lunch. As we go through these data and learn that poor students are not doing well in international competitions, the question we seem unable to raise and debate intelligently, is this: Why do we put so much of our attention and resources into trying to fix what goes on inside low performing schools when the causes of low performance may reside outside the school? Tables 3, 4 and 5 display the performance in 2000 of US 15 year olds in mathematics, literacy, and science, in relation to other nations.
Given these findings, and a scientific attitude, we should be asking what plausible hypotheses might differentiate the education of white, African American, and Hispanic students from one another?
Orfield and Lee’s data suggests that segregation is an overriding contributor to the obvious scoring disparities that exist between races. In the 2003 PISA studies that just came out a few months ago the US position relative to other OECD nations slipped. The pattern of results in Table 7 looks familiar, regardless of whether we examine race or social class. One more study is informative in this brief look at poverty and the performance of US students in international comparisons.
But PIRLS revealed more than the fact that for the second time in about a decade US 9 year olds showed remarkably high literacy skills. But the scores obtained by students attending schools where poverty is prevalent are shockingly low. From these recent international studies, and from literally thousands of other studies both domestic and international, we learn that the relationship between social class and test scores is positive, high, and well embedded in theories that can explain the relationship.
Can a reduction of poverty improve the achievement of the poor and the schools they are in?
We all have heard of the occasional feral child, or about the child kept locked in a closet for some years.
This is the same point made by evolutionary biologist Richard Lewontin (1982), who discussed how two genetically identical seeds of corn, planted in very different plots of earth would grow to very different heights. Figure 7 presents the smoothed curve of the relationship between genotype and phenotype, between hereditability and its expression. That is, among the lowest social classes, where the mean IQ is quite a bit lower than that of those in the higher social classes, only 10 percent of the variation we see in measured IQ is due to genetic influences.
Second, all charges of genetic inferiority in intelligence among poor people, minorities or not, have little basis. Point four arising from this study is derived from figure 8, also taken from the Turkheimer et al. Children with these kinds of environments were planted in good soil, and under those conditions the variation we see is mostly genetic and not environmental, however counter intuitive that seems. The simplest way to get a healthier environment in which to raise children is to provide more resources for parents to make those changes for themselves. Otitis media is a simple and common childhood ear infection, frequently contracted by rich and poor children alike between birth and 3 years of age. For example, recurrent otitis media as well as other childhood diseases before age 3 are found to be strongly and negatively related to breast-feeding—the less breast feeding, the greater the rate of a number of childhood diseases.
Mercury is a nerve poison, steady exposure to which causes all kinds of neurological and mental problems, as well as heart problems. Coal-fired power plants are responsible for half of all human-caused mercury emissions annually in the US. 15 % of US women of child-bearing age have enough mercury in their bloodstream to put their offspring at risk from health effects. I tear my hair out when I hear that people aren’t getting vaccinations for their children because they are afraid of autism. If your electric utility depends on coal, contact your city council and urge it to put in wind turbines and solar and generate its own electricity, getting off the dirty, poisonous grid! Thank you to all of my supporters for your generosity and your encouragement of an independent press! A minute's walk from Oxford Street and just round the corner from Marble Arch underground station. When you arrive at the venue you receive a special Free Bonus of my book "RICHES "The 7 Secrets of Wealth You Were Never Told" a€“ yours free! Duncan Bannatyne, Loral Langemeier, James Caan, T Harv Eker, Brian Tracy John Demartini, Topher Morrison, Michael Gerber and Peter Thomson plus many more of the world's leading wealth creators. I urge you - please take this opportunity to invest just 3 hours of your time to discover these simple but effective, "everyday" wealth building strategies and the "Fielding Financial Formula" 7-point plan to make your dreams a reality.
That’s 1,461,538 cases per week, 208,219 per day, 8,675 per hour, 144 per minute, 2 per second.
Known pathogens only account for an estimated 14 million illnesses, 60,000 hospitalizations, and 1,800 deaths.
Doggy bags are commonly taken away while the contents are in the temperature danger zone – between 50 and 60 degrees Celsius, and bacteria that commonly cause food poisoning grow very well at these temperatures. These groups include the elderly, pregnant women, infants, young children and people with chronic diseases. In the case of salmonella a relatively large inoculum of 10 million to 100 million organisms is necessary to cause symptoms because salmonella is very sensitive to acid. NSW has around 50,000 food businesses which have notified NSW Health of their activities in the food industry. In 1996-97, absenteeism due to food poisoning resulted in productivity losses of over $370 million. To prevent holiday food poisoning, experts recommend cleaning out the fridge ahead of time, to make room for your and guests’ dishes and limiting the amount of food you cook. Cold chicken served at lunch had been cooked the day before and allowed to cool at room temperature for more than 2 hours before it was refrigerated. After contracting Salmonella, most people feel better within 3-5 days, but data from the United States suggest that two people die out of every 1000 reported cases of salmonellosis.
Then it was salmonella (64%), Staphylococcus aureus (14%), Clostridium perfringens (5%) and Bacillus cereus (3.5%). In the past, bacterial infections were considered the most prevalent because few laboratories have the ability to search the norovirus and no active surveillance was conducted for this particular germ. Among all illnesses attributable to foodborne transmission, 30% are caused by bacteria, 3% by parasites, and 67% by viruses.
Much support and forward-looking commitment has been given to the development of new food safety standards by a number of major industry associations, particularly retailers, manufacturers and wholesaling and transport as well as the primary production sector. On top of that, there are over 700 local councils with different by-laws to regulate food businesses. Some serious illnesses, such as invasive listeriosis, where 20% of infections are fatal were also attributed to contaminated food. Fast food restaurants and salad bars, rare 50 years ago, are today a primary source of food consumption for many Australians.
The outbreak was the worst mass food poisoning in Victoria since 1997 when more than 550 people fell ill after eating pork rolls infected with salmonella. Exposure to honey containing this naturally occurring toxin can produce symptoms such as vomiting, delirium, giddiness, increased excitability, or in more severe cases stupor, coma and violent convulsions.
Rates of Salmonella in fruit and vegetables registered at 4% for imported goods and 1.1% for domestic production. Bacteria can grow well at these temperatures and may grow to levels that could cause illness. Of these statistics, 29% of the accidents were kitchen-related in the food preparation area. In 2009, the Health & Safety Executive reported 1,187 major injuries to food business employees when working in the kitchens of the hotel and restaurant sector. Kitchen workers, both in commercial and in large institutions, are most vulnerable because of the nature and often the pace of the work and slips and trips account for the majority of injuries in the catering trade. Floors, walkways and ground surfaces were associated with 28% of restaurant injuries in 1994, according to the study.
The data presented in this study suggest that the most powerful policy for improving our nationsi?? school achievement is a reduction in family and youth poverty. So these musings could have been written also by Jean Anyon, Bruce Biddle, Greg Duncan, Jeanne Brooks-Gunn, Gary Orfield, Richard Rothstein, and many others whose work I admire and from whom I borrow.
Although scholars dispute the ways we measure the constructs of social class, poverty, and neighborhood, we all still manage to have common enough understandings of these concepts to communicate sensibly. Our youth are in classrooms, so when those classrooms do not function as we want them to, we go to work on improving them. If we do choose to peer into the dark we might see what the recently deceased sociologist Elizabeth Cohen saw quite clearly: That poverty constitutes the unexamined 600 pound gorilla that most affects American education today (cited in Biddle, p. Approximate waking hours, per year, for students in school and in neighborhood and with family. Most recent analyses of unsuccessful school reform (and prescriptions for change) have isolated educational, regulatory, or financial aspects of reform from the social context of poverty and race in which inner city schools are located (p. In fourteen such New York City schools, for example, only 10 percent to 20 percent of ninth graders in 1996 graduated four years later.
Oakland has been reforming its schools at least since 1973 when I first started working there. We advocate, for the most part, for adequacy in funding, high quality teachers, professional development, greater subject matter preparation, cooperative learning, technologically enhanced instruction, community involvement, and lots of other ideas and methods I also promote.
He noted that it was hard to think of a more satisfying solution to poverty than education. Traub notes that when we question the schools’ ability to foster transformation we seem to flirt with the racial theories expressed by Charles Murray and Richard Herrnstein, who argued in The Bell Curve (1994) that educational inequality has its roots in biological inequality. Representation of poverty in the schoolhouse (photographs used with permission of Getty images and the US Government). It ignores how social class characteristics in a stratified society like ours may actually influence learning in schools (pp. Most, however, have avoided the obvious implication of this understanding—raising the achievement of lower-class children requires the amelioration of the social and economic conditions of their lives, not just school reform (Rothstein, p. But first, having raised the spectre of the gorilla, let me provide information on the magnitude of the American problem.
The only nation with a record worse than ours is Mexico, and, contrary to UNICEF, I would not consider Mexico a rich nation.
So in the graph presented as Figure 4 you are seeing a measure of childhood poverty in the USA after years of improvement! That is why the rates given in Figure 4 may be an underestimate of the conditions that pertain now, in 2005. 8) also reminds us that there is a charter about the rights of children to which 192 UN members have agreed. While school critics delight in talking about our inadequate achievement vis-a-vis other nations, it seems just as important to talk about other nations’ attention to the poor and the mechanisms each has for helping people out of poverty as soon as possible.
Poverty in OECD countries over a three-year period, and permanent poverty, during the 1990s. In that column we see the percent of people who stayed below the poverty level on a relatively permanent basis. Fourth and eighth grade mathematics and science scores from TIMMS 2003 (Gonzales, et al., 2004).

First, our scores in both subject areas and at both grade levels were correlated perfectly with the percent of poor students who attend a school.
That is, almost all the students in these schools live in extreme poverty and those are the students that fall well below the international average obtained in this study. Is it possible that we might be better off devoting more of our attention and resources than we now do toward helping the families in the communities that are served by those schools?
What stands out first is a commonly found pattern in international studies of achievement, namely, that US average scores are very close to the international average. If the educational opportunities available to white students in our public schools were made available to all our students, the US would have been the 7th highest scoring nation in mathematics, 2nd highest scoring nation in reading, and the 4th highest scoring nation in science. No one is sure why this happened, and we will have to see if this holds up when the 2006 PISA results are analyzed.
Mathematical literacy scores in PISA 2003, by both race and social class (Lemke, et al., 2001).
White students (disregarding social classes) and upper income students (of all races) score well. This is the PIRLS study (Ogle, Sen, Pahlke, Jocelyn, Kastberg, Roey, & Williams, 2003). Highest scoring nations in reading literacy for nine- and ten-year-olds in 35 countries (PIRLS 2001, Ogle et al., 2003). For instance, the mean score of US white children, without any concern about their social class status, was quite a bit higher than that of the Swedish children who, it should be noted, are also a very white group, and in this study the leading nation in the world.
The mean score in literacy in schools where more than 75% of the children are on free and reduced lunch was 485, 100 points below the scores of our wealthy students, and well below those of many nations that are our economic competitors. This suggests a hypothesis that is frightening to hear uttered in a capitalist society, namely, that if the incomes of our poorest citizens were to go up a bit, so might achievement scores and other indicators that characterize a well-functioning school.
I will only mention a few of the many studies that have caught my attention while thinking about this issue.
We learned from those cases that under extreme environmental conditions whatever genetic potential for language, height, or intellectual functioning a child had, that potential was unable to be expressed. In the plot with good soil, sufficient water, and sunshine, genetics accounts for almost all of the noticeable variation in the plants, while environment is much less of a factor in the variation that we see.
There is strong evidence that the influence of genes on intelligence is quite dependent on social class. Percentage of variation in IQ attributable to genes, for various levels of socioeconomic status (Turkheimer, et al., 2003, used by permission of the authors). Among the poor the normal variation we see in academic talent has been sucked away, like corn growing in bad soil. That is, if genes are not accounting for a great deal of variation in IQ among the poor, and environment is, then environmental interventions for poor people are very likely to change things. Percentage of variation in IQ attributable to shared family environment, across various levels of socioeconomic status (Turkheimer, et al., 2003, used by permission of the authors). Here we see that the variance in intelligence that is due to shared family factors is four times larger among the poor then it is among the rich.
But the flip side of this is that positive changes in environments for the poor, say high quality child care, are expected to have much bigger effects on outcomes we value than they would have when provided to middle-class and wealthier students. Despite the shortcomings of many parents at every level of social class, I still believe the proper place to begin solving the problem of low achievement among poor families is by making those families less poor. The two answers that immediately spring to mind about health and neighborhood, which I address next. The many medical problems that are related to social class provide obvious and powerful examples of problems affecting school achievement that are remediable with a little extra money. In a number of studies, recurring otitis media in the first 3 years of life has been related to hearing impairments, and thus to language development, and thus to reading problems in school, and therefore to deficits on tests such as the Stanford-Binet intelligence test. But breast-feeding of infants in America is done significantly less frequently by women who are poor (Center for Disease Control, 2005).
People at risk of dehydration such as infants and the elderly should see their local doctor early. Result: 230 camp participants sick with gastroenteritis, of whom 118 were treated in emergency departments and 13 admitted to hospital.
The system we have now costs governments $18.6 million (net) to enforce, and it costs small business $337 million every year to comply. It is estimated that the number of food service outlets in Australia, has grown 57 per cent with Australians spending 30 per cent of their food budget on take away food and dining out. It is generally accepted that as little as one teaspoon (approximately 10 ml) of unblended honey can have a severe effect on the human nervous system. 321 of this issue), hygienic controls targeting NoV should be conducted throughout the year. My co-authors and I found high-stakes testing programs in most states ineffective in achieving their intended purposes, and causing severe unintended negative effects, as well. For me, NCLB is merely delaying the day when our country acknowledges that a common characteristic is associated with the great majority of schools that are most in need of improvement.
Many scholars and teachers understand, though many politicians choose not to, that school reform is heavily constrained by factors that are outside of America’s classrooms and schools. Those classrooms are in schools, so when we decide that those schools are not performing appropriately, we go to work on improving them, as well. It is a fact of contemporary American life that many of the poorest of the children who come to our schools have spent no time at all in school-like settings during the first five years of their life.
Despite the fact that low-income individuals desperately need a college degree to find decent employment, only 7 percent obtain a bachelors degree by age twenty-six. Some of the most lauded of our school reform programs in our most distressed schools do show some success, but success often means bringing the students who are at the 20th percentile in reading and mathematics skills up to the 30th percentile in those skills.
These well-entrenched views that we have as a people makes helping the poor seem like some kind of communist or atheistic plot, and it makes one an apostate in reference to the myth about the power of the public schools to affect change. School reform, as opposed to other things we might do to improve achievement, really involves relatively little money and, perhaps more importantly, asks practically nothing of the non-poor, who often control a society’s resources. But an alternative explanation to Herrnstein and Murray, “is that educational inequality is rooted in economic problems and social pathologies too deep to be overcome by school alone. I can do that by benchmarking American rates of childhood poverty against the rates in other industrialized nations.
Using 2003 data to compute Gross National Income per capita (using Purchasing Power Parity [PPP] as the method of comparison), the USA ranked fourth at $37,750 per capita, while Mexico ranked 80th with $8,900 per capita (World Bank, 2005). The USA likes to be # 1 in everything, and when it comes to the percent of children in poverty among the richest nations in the world, we continue to hold our remarkable status. Note once again the upward trend for poverty among minorities after the roaring 90’s ended. It is sad, I know, that many member nations sign such a charter and then do little to live up to it.
We will not sign a charter guaranteeing the rights of already born children, though we somehow managed to get a bill through our congress that guarantees the rights of unborn children. This should also be an important indicator for judging one nation’s performance against another. One column in this table shows the percent of individuals who became impoverished once in a three years time period, say through illness, divorce, child-birth, or job loss—the big four poverty producers among those who had been non-poor. Unlike other wealthy countries, we have few mechanisms to get people out of poverty once they fall in to poverty. There are, of course, thousands of studies showing correlations between poverty and academic achievement. Table 2 presents data on mathematics and science scores for American 4th and 8th grade youth disaggregated by the degree of poverty in the schools they attend. In the five categories presented, schools with the wealthier students had the highest average score, the next wealthier set of schools had students who had the next highest average score, and so forth, until we see that the schools with the poorest students had the students who scored the lowest. In general, Table 2 informs us that our poor students are not competitive internationally while our middle classes and wealthy public school children are doing extremely well in comparison to the pool of countries that made up TIMSS 2003.
That would certainly be a competitive strategy for solving the problem of low academic performance if it is simply poverty (along with its associated multitude of difficulties) that prevents most poor children from doing well. Unfortunately PISA doesn’t do a very good job of breaking down the data by social class.
But in a country as heterogeneous and as socially and ethnically segregated as ours, mean scores of achievement are not useful for understanding how we are really doing in international comparisons. Orfield and Lee (2005) in their recent report on school segregation make clear how race and schooling are bound together, as is shown in table 6.
But relative positions of white, African American, and Hispanic students remained the same and quite discrepant. Their test scores in mathematics literacy are significantly above the international average. PIRLS stands for Progress in International Reading Literacy, a reading assessment administered to 9 and 10 year olds in 35 nations. Once again we see that millions of US white children are doing well against international benchmarks. The powerful and awful environment in which such children lived suppressed the expression of whatever genes that child had for complete mastery of language, for full height, for complete intellectual functioning, for competency in social relationships, and so forth. On the other hand, when the soil, water, and sun, are not appropriate, genetics do not account for much of the noticeable variation among the lower-growing and often sickly plants that are our harvest. For example, Turkheimer and his colleagues determined the hereditability of IQ for those who were and were not economically advantaged.
Just as in Lewontin’s corn growing example, genetic variation in intelligence in these impoverished environments is not being expressed in the measures we use to assess intelligence.
In fact, environmental changes for poor children might be predicted to have much bigger effects than similar changes made in the environments for wealthier children. This graph informs us that most of the variation in IQ at the bottom of the SES ladder is due to the environments shared by family members, and that the family’s role in the expression of intelligence is less and less important as you go up in social class standing. This is another way of saying that environments matter a lot more in the determination of IQ for poor children than they do for wealthier children. That is why high quality child-care, good nutrition, and medical attention don’t just matter for the poor: They matter a lot!
While you can eek out a living doing that, and occasionally you even see award-winning crops come from unlikely places, we all know that the crops are consistently better where the soil is richer.
For example, at the simplest level are medical problems such as otitis media and those associated with vision. Breast-feeding is also done significantly less often by those who only have high school degrees or have not finished high school and by those mothers who are under 19 and who are not married (Center for Disease Control, 2005).
Apparently they consumed a higher than normal amount of ground fish and are ill because of it.
I'm holding the same session at 2 venues so you can choose the date and time which is best for you. While the inside of the label is tangerine orange in colour, the product is fresh and safe to consume.
First, that poverty in the US is greater and of longer duration than in other rich nations. We believe that the federal No Child Left Behind (NCLB) law is a near perfect case of political spectacle (Smith, 2004), much more theater than substance.
It is this common characteristic of our failing schools that I write about, for by ignoring it, we severely limit our thinking about school reform. Although the power of schools and educators to influence individual students is never to be underestimated, the out-of-school factors associated with poverty play both a powerful and a limiting role in what can actually be achieved. In this essay it is not important to argue about the fine points at which poverty is miserable or barely tolerable, or whether a person is stuck in the lowest of the social classes or merely belongs to the working poor, or whether families are poor at the federal poverty level or at 200% of the federal poverty level (which is still poor by almost everyone’s standards).
It was Jean Anyon, among others, who some time ago alerted us to the fact that many of the families in those impoverished neighborhoods are so poorly equipped to raise healthy children, that the schools those children attend would have a hard time educating them, even if they weren’t also so poorly organized and run. So, in relation to the needs of low-income students, urban districts fail their students with more egregious consequences now than in the early twentieth century. Statistical significance and a respectable effect size for a school reform effort is certainly worthy of our admiration, but it just doesn’t get as much accomplished as needs to be done.
Traub also noted that school reform is accompanied by the good feelings that come from our collective expression of faith in the capacity of the poor to overcome disadvantage on their own. And if that's true, then there really is every reason to think about the limits of school” (Truab, 2000, p. We should not be in the same league as Mexico, but, alas, we are closer to them in poverty rate than to others whom we might, more commonly, think of as our peers. First, the expansion of jobs and income growth in our nation stopped at the end of the 1990s, and the gains that had been made have been lost. New immigrants, African-Americans, and Hispanics, particularly those among these groups who live in urban areas, are heavily over represented in the groups that suffer severe poverty. But still, at the very least, signing is an acknowledgment of the underlying concept and only two nations have refused to sign this treaty. There we see that the US rate is quite high, but not much different than that of many other nations. We can claim the highest rate of the permanently poor of all the other industrialized nations!
Nothing there will surprise us, though I do wonder why, after hundreds of studies showing that cigarettes were related to a great number of serious illnesses we eventually came to believe that the relationship between smoking and cancer, or smoking and emphysema, was causal. For example, Table 7 presents the PISA 2003 scores in mathematics literacy, the latest international scores we have. But lower social class children of any race and black or Hispanic children of all social classes are not performing well.
Further, when we take social class into consideration by looking at the scores of students who attend schools where there are few or no children of poverty, we learn that this group of public school children performed quite well. In that finding, as in the segregation data, we see a contributor to many of our nations’ educational problems.
The total sample studied began with almost 50,000 women, followed from pregnancy on, in the National Collaborative Perinatal Project. And also as in Lewontin’s example, at the top end of the SES scale, almost three quarters of the variation we see in measures of intelligence is due to genetic influences. This suggests that unless environments for the most impoverished improve we will not see the expression of the normal human genetic variation in intelligence that is expected.
This often appears to be the case, a conclusion reached by Duncan and Brooks-Gunn (2001) using different data.
After a certain point of environmental adequacy is achieved by means of economic sufficiency, it apparently doesn’t much matter what gets added to the environment. Healthy trees do not often grow in forests that are ailing, though there are always some resilient ones that thrive, making us forget that most do not. I seek only employment that can supply families with the income that gives them the dignity and hope needed to function admirably, allowing them to raise their children well. This literature makes clear that poor children have more untreated cases of otitis media than do those that are financially better off, especially those with medical insurance. When the bacteria count reaches a critical level, the orange turns to grey to indicate spoilage. Salmonella infection is one of the most common forms of food poisoning in Australia, but it is only one of a number of pathogens popping up with greater regularity in our food. Temperature as a function of salmonella food poisoning cases in the Republic of Macedonia5. IntroductionUsing the classic epidemiologic triad (host, agent, and environment), it is clear that climate, which impacts all three sectors of the triad, can have a dramatic effect on infectious disease. Second, that poverty, particularly among urban minorities, is associated with academic performance that is well below international means on a number of different international assessments. Our collectively gloomy conclusions led me to wonder what would really improve the schools that are not now succeeding, for despite the claims of many school critics, only some of America’s schools are not now succeeding (Berliner, 2004). We know well enough what we mean when we talk of poverty, communities of poverty, the very poor, and the like.
And in our country the individuals living in those school neighborhoods are not a random cross section of Americans. With the sharp increase in housing prices that has occurred since then, no noticeable increases in the real wages for the poor, an economic expansion that has failed to create jobs, and a reduction in tax revenues (resulting in a reduction of aid to the poor), it is quite likely that our rate of childhood poverty is back to where it was.
Almost all economists believe that the level of income at which the government declares a person to be poor misleads us into thinking there are fewer poor than there really are. Poverty is unequally distributed across the many racial and ethnic groups that make up the American nation. Thus, while this is a paper about poverty, it is inextricably tied to issues of race in America. If you compare the data from Denmark, Ireland or the Netherlands to that of the US it is easy to see the difference between societies that abhor poverty, and one such as ours, that accepts poverty as a given.
And yet when we now have research establishing analogous connections between poverty and educational attainment we ignore them. Given the high inter-correlations between poverty, ethnicity, and school achievement in our country, it is (sadly) not inappropriate to use ethnicity as a proxy for poverty. In contrast, almost all African American and Latino students, usually poorer than their white age-mates, are in schools where there are students very much like them racially and socio-economically. These data are disaggregated by both race and social class (Lemke, Sen, Pahlke, Partelow, Miller, Williams, Kastberg, & Jocelyn, 2004). In fact, these higher social class children from the US walloped the Swedes, scoring 585, an average of 24 points higher than the average score obtained by Swedish students.
When I look at the studies of the effects of small class size for the poor, or the effects of early childhood education for the poor, or the effects of summer school programs for the poor, the largest effects are found among the poorest children.
Resilient children and the occasionally exemplary school that exists amidst poverty should be lauded and supported.
The cause of otitis media may not be directly linked to poverty, but its prevalence and lack of treatment in children is quite clearly affected by poverty. Evidence of the impact of climate change on the transmission of food and waterborne diseases comes from a number of sources, e.g.
Scores of poor students are also considerably below the scores achieved by white middle class American students.
We also know that the lower social classes and the communities in which they live are not at all homogenous. Our neighborhoods are highly segregated by social class, and thus, also segregated by race and ethnicity.
In the course of a full year students might spend just over 1000 hours in school, and almost 5 times that amount of time in their neighborhood and with their families.
Schooling alone may be too weak an intervention for improving the lives of most children now living in poverty. That would be about 2 or more percentage points higher than the figure given in this UNICEF report.
I have found no way to separate the two, though here I focus on poverty, perhaps the more tractable issue. Instead we look for other causal mechanisms, like low expectations of teachers, or the quality of teachers’ subject matter knowledge, to explain the relationship. From those tables we see clearly that our white students (without regard for social class) were among the highest performing students in the world. Latinos and African Americans are as segregated by poverty, as they are by race and ethnicity, which may be the more important issue with which our schools have to deal. Clearly those who are poor do not have the mathematical skills to compete internationally, and those particular children are often African American and Hispanic. Public school students by the millions, from US schools that do not serve many poor children, are doing fine in international competition. Middle- and upper-class white families in the suburbs live quite separately from the poor and ethnically diverse families of the urban areas. At the lowest end of the socioeconomic spectrum were families with a median income of $17,000 a year in 1997 dollars. However, Occam’s razor, suggests that the simplest explanation should be given precedence when attempting to explain any phenomenon.
Thus it seems to me that Turkheim et al., bring us remarkably good news from their study of genetic influences on IQ. But the focus of our attention must be on the fact that most children in poverty and most schools that serve those children are not doing well.
Third, that poverty restricts the expression of genetic talent at the lower end of the socioeconomic scale. It is a simplification, and therefore a mistake, to treat a group as if the individuals who comprise that group were the same. So all educational efforts that focus on classrooms and schools, as does NCLB, could be reversed by family, could be negated by neighborhoods, and might well be subverted or minimized by what happens to children outside of school. Apparently this is about where we as a nation want the rate to be, since the graph makes it abundantly clear that if we cared to do something about it we could emulate the economic policies of other industrialized nations and not have the high rate of poverty that we do. Of course the low expectations of teachers and their subject matter competency are important. But our African American and Hispanic students, also undifferentiated by social class, were among the poorest performing students in this international sample. This is quite heartening since these data prove our President and former Secretary of Education wrong in their belief that teachers in the US cannot teach reading.
School and community resources differ by social class, and therefore differ also by race and ethnicity.
One in five of these mothers was younger than 21, one-third of them were on public assistance, and more than one-third did not have a husband. The simplest explanation available is that poverty, and all it entails, causes a restriction of genetic variation in intelligence. The racism and pessimism expressed in the Bell Curve by Herrnstein and Murray (1994) can now be seen as completely unjustified because among the very poor genes are not very powerful influences on intelligence, while environments are. There are also theoretical and unintended consequences of global climate change on food safety.
Among the lowest social classes environmental factors, particularly family and neighborhood influences, not genetics, is strongly associated with academic performance. Improving classrooms and schools, working on curricula and standards, improving teacher quality and fostering better use of technology are certainly helpful. But I keep thinking about that 600 pound gorilla out there asking for more attention than it is getting. These were the most impoverished of the family groupings studied, the kind of people that we ordinarily refer to as very poor.

We do not need to wait until we understand the micro-environments of the poor to know that the macro- environment of the poor needs to be changed if we desire to let all the genetic talent that exists among the poor flower.
Climatic factors influence the growth and survival of pathogens, as well as transmission pathways as “in [3]”.
Among middle class students it is genetic factors, not family and neighborhood factors, that most influences academic performance. But sadly, such activities may also be similar to those of the drunk found on his hands and knees under a street lamp. That big ape may be causal in the relationships we consistently find between poverty and achievement. Unlike most other studies of hereditability in twins there were enough of these families in the sample to do a separate estimate of the hereditability of IQ in their children. Fourth, compared to middle-class children, severe medical problems affect impoverished youth. When asked by a passerby what he was doing, the drunk replied that he was looking for his keys. Wechsler IQ was measured for the twins when they were 7 year-old, old enough to get a good fix on what their adult IQ was likely to be. It has been estimated that climate change in the year 2000 contributed to about 2.4% of all diarrhoea outbreaks in the world, 6% of malaria outbreaks in certain developing countries and 7% of the episodes of dengue fever in some industrial countries.
Data on the negative effect of impoverished neighborhoods on the youth who reside there is also presented. Fifth, and of greatest interest, is that small reductions in family poverty lead to increases in positive school behavior and better academic performance.
There are direct impacts, such as diseases and conditions that may result in morbidity or mortality related to extreme temperatures, and other, more indirect health effects such as diseases related to consumption of contaminated drinking water, foodborne or vector-borne diseases and zoonoses, or health conditions related to lack of food and water. There are projections regarding the expansion of diseases from the southern to the northern latitudes, especially re-emerging diseases that had already been eradicated, such as malaria, yellow fever, etc. Changes have also been detected in the distribution of rodent borne diseases, such as the hantavirus disease and leptospirosis.
Geographical, weather and environmental changes are likely to affect the vectors of disease and to have a corresponding impact on the distribution of diseases such as leishmaniasis, Lyme disease, tick-borne encephalitis, malaria (in endemic regions), dengue, etc.
An increased burden of disease related to drinking water and food may be expected due to inadequate distribution at a global level and the projections for decreased availability of drinking water and food production (cholera and food poisoning).
Exposure to extremely high temperatures may lead to cardiovascular or respiratory diseases, whereas extreme disturbances in climate conditions (floods, warm winds) may lead to injuries, choking, respiratory disorders, diarrhoea, etc. Increased temperature and floods are the cause of` an increase in water contamination and resulting food- and waterborne diseases. Climate change is also likely to have an impact on the distribution of aeroallergens, especially pollen, and thereby cause changes in the distribution of allergic diseases. On the positive side, health conditions related to extreme low temperatures will decrease [6,7]Weather effects, especially related to temperature, act in an indirect manner as regards transmission of infectious diseases.
Temperature may affect both the causes of infectious diseases and their carriers (vectors) or water supplies. The link between weather impacts and infectious diseases has led to the development of scenario models to predict the expansion of infectious diseases due to climate change. Changed lifestyles, food production, modern urban planning, climate change and variations in the quality of the environment increase the danger of expansion of zoonoses.Before the prospect of anthropogenic climate change emerged, epidemiologists were not greatly interested in climate-health relations [8]. Modern epidemiology has focused mainly on studying risk factors for noncommunicable diseases in individuals, not populations.
Meanwhile, there have been occasional studies examining deaths due to heatwaves, some epidemiological studies of air pollution incorporating temperature as a covariate, and a continuation of the longer standing research interest in meteorological effects on microbes, vectors, and infectious disease transmission. Overall, the health risks of climate-related thermal stress, floods, and infectious diseases have been the most amenable to conventional epidemiological studies. The current burden of disease attributable to climate change has been estimated by WHO as part of the Global Burden of Disease (2000) project as “in reference [5]”, as a comprehensive standardised risk assessment exercise that underwent critical review.
The extent of climate change (relative to the 1961–90 average climate) by the year 2000 is estimated to have caused in that year around 160 000 deaths worldwide and the loss of 5 500 000 disability-adjusted life-years (from malaria, malnutrition, diarrhoeal disease, heatwaves, and floods). This exercise was conservative in several respects, including being limited to quantifiable health outcomes.
Nevertheless, is it reasonable to attribute a proportion of global deaths from malaria, malnutrition, or other such outcomes in 2000, to the global warming that has taken place since around 1975? The fact that equivalent estimations are routinely made for other such relationships involving a disease with known multivariate causation—eg, the proportion of all stroke deaths in 2000 attributable to hypertension—suggests that, in principle, wherever a well documented exposure-effect relation exists, the incremental change in health outcome can legitimately be estimated for an incremental exposure (eg, temperature) [8]. Climate change is perhaps the most significant environmental problem which mankind will face in the coming century. Efforts to reduce the extent of climate change are of course important, but it is likely that we will have to deal with at least some impacts on health. There are direct impacts, such as diseases and conditions that may result in morbidity or mortality related to extreme temperatures, and other, more indirect health effects, such as diseases related to consumption of contaminated drinking water, foodborne or vector-borne diseases and zoonoses, or health conditions related to lack of food and water.
In 2006 a report on the Vulnerability and Adaptation of Climate Change in Health Sector has been published [9]. This report was the first of its kind in the country, insofar as it sought to provide quantitative estimates of the possible impacts of climate change on health. Climate change and food security and utilization The Food and Agriculture Organization (FAO) defines food security as a ‘‘situation that exists when all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food that meets their dietary needs and food preferences for an active and healthy life’’ [10]. This definition comprises four key dimensions of food supplies: availability, stability, access, and utilization. Its subdimensions include the agro-climatic fundamentals of crop and pasture production [11] and the entire range of socio-economic and cultural factors that determine where and how farmers perform in response to markets.Climate change affects agriculture and food production in complex ways. It affects food production directly through changes in agro-ecological conditions and indirectly by affecting growth and distribution of incomes, and thus demand for agricultural produce. In temperate latitudes, higher temperatures are expected to bring predominantly benefits to agriculture: the areas potentially suitable for cropping will expand, the length of the growing period will increase, and crop yields may rise. A moderate incremental warming in some humid and temperate grasslands may increase pasture productivity and reduce the need for housing and for compound feed. These gains have to be set against an increased frequency of extreme events, for instance, heat waves and droughts in the Mediterranean region or increased heavy precipitation events and flooding in temperate regions, including the possibility of increased coastal storms [13]; they also have to be set against the fact that semiarid and arid pastures are likely to see reduced livestock productivity and increased livestock mortality. In drier areas, climate models predict increased evapotranspiration and lower soil moisture levels. As a result as “in [10]”, some cultivated areas may become unsuitable for cropping and some tropical grassland may become increasingly arid.
Temperature rise will also expand the range of many agricultural pests and increase the ability of pest populations to survive the winter and attack spring crops.Global and regional weather conditions are also expected to become more variable than at present, with increases in the frequency and severity of extreme events. The result can be a substantial decline in labor productivity and an increase in poverty and even mortality. Essentially all manifestations of climate change, be they drought, higher temperatures, or heavy rainfalls have an impact on the disease pressure, and there is growing evidence that these changes affect food safety and food securityExtreme rainfall events can increase the risk of outbreaks of water-borne diseases particularly where traditional water management systems are insufficient to handle the new extremes [11]. Likewise, the impacts of flooding will be felt most strongly in environmentally degraded areas, and where basic public infrastructure, including sanitation and hygiene, is lacking. This will raise the number of people exposed to water-borne diseases and thus lower their capacity to effectively use food.Vulnerability refers to the degree to which a system or societies are susceptible to, and unable to cope with, adverse effects of climate change, including climate variability and extremes.
Vulnerability is a function of the character, magnitude and rate of climate change and variation to which a system is exposed, its sensitivity and its adaptive capacity [12].
Since impacts and adaptive capacity of systems may vary substantially over the next decades and within countries, vulnerabilities can be highly dynamic in space and time. Consequently, there is a strong need to build resilient agricultural systems that have a high capacity to adapt to stress and changes and can absorb disturbances. Climate change will affect agricultural food systems in all countries, including exporters and importers as well as those at subsistence level. Many impacts, such as increased land degradation and soil erosion, changes in water availability, biodiversity loss, more frequent and more intense pest and disease outbreaks as well as disasters need to be addressed across sectors. To describe the effect of climate change on a more global scale, the World Health Organization has released data regarding the estimated effects on human health as of the year 2004. What is readily apparent from these data is that developing regions of the world have been disproportionately affected by climate change relative to developed regions.
This imbalance stands in stark contrast to the imbalance in greenhouse gas emissions, which are almost entirely attributable to developed countries, and countries with rapidly developing economies.
The WHO report also includes estimates of the future global burden of disease that will result from climate change. It is predicted that by 2030 there will be 10% more diarrhoeal disease than there would have been with no climate change and that it will primarily affect the health of young children; indeed, the impact on children might well be amplified by the effects of such diseases on malnutrition, development and cognition. If global temperatures increase by 2–3°C, as expected, it is estimated that the population at risk for malaria will increase by 3–5%, which means that millions of additional people would probably become infected with malaria each year [14].3.
Current impacts of climate and weather Nowadays, a wide range of events shape the behaviour and social interactions of the human host. The spread of childhood communicable diseases mirrors school calendars and community activities. Holidays promote travel and new social interactions, increasing the spatial distribution of disease transmission, even more efficiently vectored through packed planes and other modes of mass transportation.
Seasonal shifts in immunity and host susceptibility, exacerbated by increased exposure through crowds during the colder months, will also increase patterns of infectious disease spread [15].
The first detectable changes in human health may well be alterations in the geographical range (latitude and altitude) and seasonality of certain infectious diseases – including vector-borne infections such as malaria and dengue fever, and foodborne infections (e.g. Warmer average temperatures combined with increased climatic variability, would alter the pattern of exposure to thermal extremes and the resultant health impacts, in both summer and winter. By contrast, the public health consequences of the disturbance of natural and managed food-producing ecosystems, rising sea levels and population displacement for reasons of physical hazard, land loss, economic disruption and civil strife, may not become evident for up to several decades. New challenges associated with the emergence of large epidemics related to food consumption are arising as a result of globalization, increased trade in food products, increased consumption of fast food, international travel, environmental contamination by human faecal matter in areas with poor sanitation, the increased frequency of natural disasters related to climate change, the introduction of new technologies in food production processes, etc. There are different ways in which weather conditions can affect the incidence of foodborne diseases. Firstly, the prevalence of specific pathogenic organisms in animals may increase with higher temperatures. Secondly, the food cooling chain is harder to maintain in higher temperatures and prolonged warm weather increases the risk of mistakes in food handling. Thirdly, higher air temperatures may speed up the replication cycles of foodborne pathogenic organisms, which leads to a higher degree of contamination. Higher temperatures, in interaction with inadequate hygiene conditions, improper food handling, and lack of hand-washing, may lead to an increased number of epidemics resulting from consumption of unsafe food. In the Republic of Macedonia, foodborne and climate-sensitive pathogenic organisms causing the greatest concern in the context of climate change include the following:Alimentary toxic infections (ATI) – These diseases were reported throughout the period 1991–2008, with fairly uniform prevalence each year.
During the period there were a total of 26 092 cases of ATI, an average of 1450 cases a year. During the period, ATI continually ranked between fourth and sixth among the ten most frequently reported infectious diseases in the Republic of Macedonia, depending on whether ATI epidemics had been more common in any specific year. Syndromes related to ATI tend to be seasonal (with an increase during the summer months), with a few very large outbreaks reported in 2008, connected to specific closed communities and having one common source. Shigellosis – In the Republic of Macedonia during 1991–2008, a total number of 2652 cases of shigellosis were reported, or 147 cases a year, with a total morbidity of 132.6 per 100 000 inhabitants for the entire period.
The trend has significantly decreased over the last eight years, with the average being 35 reported cases each year. This is most likely due to improved access to safe food and drinking water as well as other provisions, proper and hygienic disposal of liquid and solid waste substances, and increased levels of health education and information among the general population regarding hygiene, safe food preparation, etc.Campylobacter – The risk of infections caused by Campylobacter is directly proportional to the increase in temperature. Recent studies show increased incidence of campylobacteriosis at 2–5% per each degree Celsius rise of temperature, based on weekly temperature data.
Notwithstanding that it is mandatory to report cases of campylobacteriosis in the Republic of Macedonia, there is currently no reliable information on its distribution, although estimates indicate that its incidence exceeds 18 000 cases annually.Other foodborne pathogenic organisms causing concern in the context of climate change – These include Brucella, Hepatitis A, E. As far as these pathogenic organisms are concerned, the effect of climate change remains within the area of speculation.
However, due to their possible sensitivity to climate conditions and their importance for public health in the Republic of Macedonia, they have been included in the programmes for monitoring and prevention of climate-change-related infectious diseases.
Hepatitis A is constantly present in the Republic of Macedonia and there were 290 reported cases in 2009, 243 reported cases in 2008 and 257 reported cases in 2007.Waterborne communicable diseases – About 10% of the population in the Republic of Macedonia still lacks access to clean and safe water, be it for drinking or for meeting their basic needs.
In addition, there are year-on-year growing trends for certain groups of communicable diseases, especially those associated with contaminated food and water (salmonellas, alimentary toxic infections, shigelloses).
Climate change will most probably have an impact on the incidence of waterborne infections, not only as a result of changing average meteorological parameters (e.g.
Such extreme weather events will have an impact on the available quantity of water, on the quality of the water or on the availability of clean and safe water.
An example of this is the epidemic of cryptosporidiosis associated with the urban drinking water supply of Milwaukee, Wisconsin, USA in 1989, which resulted in 400 000 cases.
Heavy rainfall may contaminate watercourses by bringing human and animal faecal products and other waste substances into surface waters.
There is evidence of contamination of the water during heavy rainfall by Cryptosporidium, Giardia and E.
Contamination most commonly occurs in the event of high saturation of the soil due to a more efficient transport of microorganisms. Floods and low water levels may both lead to contamination of water and higher disease incidence and mortality due to diarrhoea. Warming and the higher variability of rainfall increase the risk of greater burden of these diseases. No cases have been registered in the Republic of Macedonia so far.Giardia lamblia – This has recently been added to the list of infections that are mandatory to report. At the moment no incidence data is available, other than information on laboratory isolates. Leptospirosis – There is firm evidence showing that leptospirosis is affected by climate conditions. Due to the lack of diagnostic facilities, it is assumed that a large number of cases have not been reported. Regions at high risk might include the rice fields in the region of Kocani, in addition to urban areas, riverbanks and lakes.Vector-borne communicable diseases – Vector-borne infections are passed onto humans from arthropods or mammals, including rodents.
Arthropod vectors, such as mosquitoes and ticks, are cold-blooded and thus especially sensitive to climatic factors. In addition, rodents are reservoirs of a large number of human diseases and the population of rodents is subject to the impact of weather conditions.
Warm winters and warm springs may increase the population of rodents, a phenomenon that has been reported over the last few years. Climate is an important factor for the distribution of vectors, in addition to other factors such as the destruction of their habitats, pest control and the density of hosts.
Some vector-borne diseases sensitive to climate change have already been reported in the Republic of Macedonia (e.g. Temperature as a function of salmonella food poisoning cases in the Republic of MacedoniaThe second largest number of human foodborne diseases is caused by the Salmonella spp. In 2007, the European Union incidence was 31.1 cases per 100 000 population (151 995 confirmed cases), with eggs being the biggest contributors to these outbreaks, followed by fresh poultry and pork. Higher ambient temperatures have been associated with 5–10% higher salmonellosis notifications for each degree increase in weekly temperature, for ambient temperatures above 5°C. Roughly one-third of the transmission of salmonellosis (population attributable fraction) in England and Wales, Poland, the Netherlands, the Czech Republic, Switzerland and Spain can be attributed to temperature influences.
Temperature has the most noticeable effect on salmonellosis and food poisoning notifications one week before disease onset, indicating inappropriate food handling and storage at the time of consumption. Indeed, an analysis of foodborne illnesses from England and Wales showed that the impact of the temperature of the current and preceding week has decreased over the past decades, indicating that the potential risk from elevated temperatures related to climate change can be counteracted through concerted public health action.
Thus, regardless of climatic factors, health-behaviour interventions and food-safety regulations should be able to attenuate possible negative consequences on public health. Significantly higher mean annual temperatures were also recorded in 1999, 2002, 2003 and 2007, with the most dramatic variations of temperature recorded during the summer period. In the Republic of Macedonia, foodborne and climate-sensitive pathogenic organisms causing the greatest concern in the context of climate change include the following: Salmonellosis – Recent studies on foodborne diseases show that disease episodes caused by Salmonella bacteria increase by 5-10% per each degree Celsius rise in temperature. Data of average maximum weekly temperature for the same period were obtained from the National Hydrometeorological Office. We investigated the epidemiological characteristics of salmonellosis both at the national level and in the city of Skopje using a retrospective research as a method of analysis.
We created a Seasonal Index for the same period for monthly distribution of the reported cases for Skopje and for the entire country.
The monthly number of reported Salmonella cases for Skopje was related to the average monthly temperature on the same month using Regression statistical analyses. These techniques helped us in assessing any short-term effects of temperature on the disease.
According to an official estimate from 2009, 20.5% of the total population registered in the country (2,052,722) lives in Skopje [21].
Specific morbidity distribution of salmonellosis (rate per 100,000) in Skopje and countrywide are shown as follows (Figure 1).
While a decreasing tendency was registered at the national level, the analysis for Skopje showed increasing tendency of salmonella incidence.
The highest values of the Seasonal Index for Salmonella cases were registered in the summer months, i.e. The largest percentage of outbreaks of salmonellosis in the review period, were registered in the months with the highest seasonal index.
A total of 42 outbreaks of salmonellosis or an average of 5 outbreaks per year was registered for the same period with a total 6,015 exposed persons. Our investigation indicates that higher and sustained temperatures for longer periods of time are likely to lead to increasing cases of salmonellosis.
The 1 month lag time of rising salmonella cases suggests that temperatures might be influential earlier in the production phase.
The largest increase of air temperature in the next decades for the Republic of Macedonia is expected in the summer season, associated with a strong decrease in precipitation, due to climate change [22]. It is anticipated that there will be a corresponding rise in the incidence of salmonellosis.
According to the scenario the largest increase of air temperature in the Republic of Macedonia is expected in the summer season (1,4-5,4°C). The largest increase of air temperature in the next decades for the Republic of Macedonia is expected in the summer season, associated with a strong decrease in precipitation. Climate change in the Republic of Macedonia will have an impact in terms of higher air temperatures and reduced rainfall during the summer period.
The scenarios show that the total available amounts of water (the river basin of the Vardar river) for the year 2100 will most probably be 18% less than today (estimates vary between 13% and 23%). The regions of the Republic of Macedonia with a Mediterranean climate are likely to experience reduced availability of water, increased number of dry periods and increased health-related impacts resulting from heat waves.
Those regions with a continental climate are likely to suffer an increased number of floods and impacts resulting from extreme weather conditions.
The local projections of climate change indicate that different climatic regions of Macedonia will respond slightly different on large-scale climate changes. The difference between a strong increase in temperature in summer season and weaker in winter season is not that evident as in sub-Mediterranean climate region where the city of Skopje belong.
Although empirical downscaling projections of climate change on a local level contain uncertainties relating to the results, they present a step forward towards the need for implementing adaptation measures now.
The Canadian Study showed that, for Alberta, the log relative risk of Salmonella weekly case counts increased by 1.2% for every degree increase in weekly mean temperature [23]. In our Study under conditions of increasing maximum monthly mean temperature for 1°C, the salmonellosis incidence increase for 5.2% per month. Similar higher ambient temperatures have been associated with 5-10% higher salmonellosis notifications for each degree increase in weekly temperature. The strongest effects were found for temperatures 1 week before the onset of illness rather than the longer lag of 1 month found in the Australian study. A significant positive association between mean temperature of the previous month and the number of salmonellosis notifications in the current month, with the estimated increases for a 1°C in temperature ranging from 4% to 10% in five Australian cities were reported [24].
In the UK, the monthly incidence of food poisoning was most strongly associated with the temperatures occurring in the previous two to five weeks [25]. The time lag of 1 month of rising salmonella cases suggests that temperatures might be influential earlier in the production phase [26]. Roughly one-third of the transmission of salmonellosis (population attributable fraction) in England and Wales, Poland, the Netherlands, the Czech Republic, Switzerland and Spain can be attributed to temperature influences [27]. In our investigation the higher and sustained temperatures for longer periods of time are likely to lead to increasing cases of salmonellosis. Indeed, an analysis of foodborne illnesses from England and Wales showed that the impact of the temperature of the current and preceding week has decreased over the past decades, indicating that the potential risk from elevated temperatures related to climate change can be counteracted through concerted public-health action [28].7. Conclusion The climate change process has already started and efforts should be concentrated towards the assessment of the current and future vulnerability of the population in the Republic of Macedonia, with the aim of identifying the necessary interventions and adaptation. The influence of global climate change, including its effects on people's health, can be reduced or avoided by undertaking measures for adaptation. The primary goal of the climate change adaptation measures in the health sector is to reduce the burden of disease, injury, invalidity, suffering and morbidity. The adaptation measures are not solely intended for the health sector, they are also relevant to other fields and sectors such as energy, sanitation and water supply, education, agriculture, economy, tourism, transport, development and housing, etc.
The incidence of Salmonella cases among humans in the Macedonian population varies seasonally, and may be expected to be change in response to global climate changes. During the review period, the highest values of the Seasonal Index for Salmonella cases were registered in the summer months, i.e. The results suggest that ambient temperature can be a potential predictor of Salmonella infections at a seasonal scale.
It is clear that one overall challenge is the generation and maintenance of constructive dialogue and collaboration between public health, veterinary and food safety experts, bringing together multidisciplinary skills and multi-pathogen expertise. Such collaboration is essential to monitor changing trends in the well-recognised diseases and detect emerging pathogens. It will also be necessary understand the multiple interactions these pathogens have with their environments during transmission along the food chain in order to develop effective prevention and control strategies. Reducing the effects of communicable diseases related to climate change requires continuous epidemiological surveillance, as well as preparedness to take immediate epidemiological measures to respond to the threats.

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