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These scenarios were not designed to explore the entire range of possible futures for ecosystem services; other scenarios could be developed that would have more optimistic or more pessimistic outcomes for ecosystems, their services and human well-being. The scenarios were developed using both quantitative models and qualitative analysis. For some drivers (such as land-use change and carbon emissions) and some ecosystem services (such as water withdrawals and food production), quantitative projections were calculated using established, peer-reviewed global models.

Adverse ecological surprises, such as runaway climate change, may be of sufficient magnitude to have serious adverse health consequences including severe damage to infrastructure and economic conditions. Many environmental conditions needed for good public health could worsen. For example, microbiological water pollution in developing countries could become an even more important source of ill-health than at present. Environmental contamination with persistent pollutants and heavy metals could increase and cause unexpectedly severe harm to health.

How have ecosystems changed and what are the health implications? T More land was converted to cropland in the 30 years after 1950 than in the 150 years between 1700 and 1850 (C26). Cultivated systems - areas where at least 30% of the landscape is in croplands, shifting cultivation, confined livestock production or freshwater aquaculture - now cover one quarter of Earth’s terrestrial surface. Roughly 20% of the world’s coral reefs were lost and an additional 20% degraded in the last several decades of the twentieth century (C19).

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