How so?

When you hear the term “climate change,” most likely you think of the environment and the impact it’s having. However, climate change doesn’t just affect the environment. These changes that are occurring influence all of our health. How does this happen? What can we do to make a difference?


1111 Climate Change Public Health Emergency TNMost Americans believe that climate change is a distant problem and it won’t affect them personally. This is in part because ever since it emerged into public consciousness in the late 1980s, news stories and public awareness campaigns about have focused on images of polar bears and melting ice. This reinforced the misconceptions that the impacts of climate change are far away and removed from our daily lives. Several recent national surveys showed that 58% of Americans believe that they won’t be harmed by climate change and 61% had not given any or little thought to how it might impact people’s health. Unfortunately, climate change is not a distant, in time nor space, threat. Also, it doesn’t just change the environment. Those changes are happening now and it’s affecting human health every day. There are many ways in which it negatively influences health, including higher temperatures, air pollution, extreme weather, vector-borne diseases and decreased access to safe water and food. These events lead to illness, famine, water shortages, psychological stress, political instability, forced migration, conflicts among countries and death. This means the human toll is only going to continue to grow. Sadly, the people most likely to be affected are those that are sick or poor, which means that these disparities will get worse. Researchers have estimated that between 1980 and 2013, there have 2.52 million deaths globally that are directly related to climate disasters. Probably the most well-known and visible indicator of climate change is the increasing volatility of extreme weather events worldwide. The frequency, intensity and duration of weather events, such as heatwaves, droughts, wildfires, floods and storms, are increasing. A collaboration among 13 US scientific agencies produced the Fourth National Climate Assessment, which was published in 2018, and it highlighted that higher temperatures, severe weather events and rising seas can contribute to heat-related cardiopulmonary illness, infectious disease and mental health issues. This is why that any discussion about climate change must include a conversation about public health. Also, the message that climate change is about our health needs to reach more people.

Hotter than normal days are expected to become more frequent and severe as global temperatures warm. This means that heat stroke and heat exhaustion, which are heat-related illnesses, will become more common. In 2016, the US Global Change Research Program issued a report that predicts an increase of thousands to tens of thousands of premature deaths during summer months across the country as a result of rising temperatures. Those that are most vulnerable would be children, elderly, those chronic medical conditions, individuals taking certain medications and those who work outside or spend a lot of time outdoors. If you live in urban areas, your risk would also be higher due to the urban heat island effect. This the result of paved surfaces and the buildings retaining heat. According to the Environmental Protection Agency (EPA), the urban heat island effect can make air temperatures in cities as much as 22°F warmer than nearby rural areas. Another issue is that heat can also cause or exacerbate cardiovascular and kidney problems. For instance, the increase in high temperatures from climate change is linked to the spread of chronic kidney disease of unknown origin (CKDu) around the world. There are several factors that may contribute to the development of CKDu, but heat exposure and dehydration are the primary causes of the disease. The recent increase in number of reported cases of this across the globe clearly demonstrates the link between rising global temperatures and this illness.

Another part of the human body that the increased temperatures will significantly impact is the respiratory system because increased temperatures cause a rise in the amount of ground-level ozone, which is the main ingredient in smog. Also, wildfires are burning bigger and more frequently thanks to the heat and the dryness that it brings. This unleashes dangerous particles and gases into the air. In addition, since it warms up quicker in spring and stays that way longer in fall, allergy season is lengthening and intensifying. The World Health Organization (WHO) estimates that air pollution is responsible for about seven million deaths a year worldwide and found that if the burning of fossil fuels was reduced, globally, we could avoid 2.5 million premature deaths each year by 2050. In the US, burning fossil fuels causes about 80% of our carbon pollution and the majority of other air pollutants known to cause or exacerbate a significant amount of illnesses. Several studies, using data from 1986 to 2015, found a positive correlation between increases in particulate matter (PM) pollution and mortality. PM is generated by the combustion that occurs in power plant operations or formed through atmospheric chemical transformations. The research focused on two classes of PM pollution: PM with an aerodynamic diameter of 10 μm or less (PM10) and fine PM with an aerodynamic diameter of 2.5 μm or less (PM2.5). With an increase of 10 ug per cubic meter of PM10 concentration, there was a 0.44% increase in daily mortality of any cause, 0.36% increase in daily cardiovascular mortality and 0.47% increase in daily respiratory mortality. With an increase of 10 ug per cubic meter of PM2.5 concentration, there was a 0.68% increase in daily mortality of any cause, 0.55% increase in daily cardiovascular mortality and 0.74% increase in daily respiratory mortality. The researchers felt that the stronger association between PM2.5 exposure and mortality was due to the fact that this class of PM has more small particles, which can absorb toxic materials in the air and lodge them deep within the lungs. Having higher carbon dioxide levels and as climate change alters weather patterns, the air quality in many parts of the world is only going to worsen, which results in a higher frequency of stagnation events, elevated ozone concentrations, increased wildfire activity and higher levels of wind-blown dust and pollen. Besides causing acute and chronic heart and lung diseases and even premature death, there is emerging evidence that air pollution can reduce fertility and is harmful to our brains. It’s thought to contribute to development delays and autism in children and an increase in Alzheimer’s disease for elderly adults. Several studies have proven that elevated carbon dioxide (CO2) concentrations are associated with a decrease in human cognitive performance. Since elevated CO2 levels can cause a significant number of health problems, this is why when there are elevated CO2 levels in buildings it’s a cause for concern. The current guidelines recommend keeping indoor CO2 levels below 1000–1500 parts per million (ppm). Due to climate change, today’s atmospheric CO2 levels are approximately 410 ppm (the highest they’ve been in the past 15 million years). Unfortunately, it’ll likely exceed 1,000 ppm by 2100, if we don’t start doing things to correct it now. Also, it’s safe to assume that as outdoor CO2 levels rises, indoor levels are likely to rise too. Instead of enforcing and making stricter regulations, the Environmental Protection Agency (EPA) has recently announced that they are easing back some of their air pollution regulations, like power plant emission standards. Regrettably, this isn’t the only thing that the EPA has eliminated or weakened in regards to air pollution regulations. In fact, they have done it on several fronts, including fuel-efficiency standards for cars and greenhouse gases, such as methane and mercury emissions. All of these negative changes pose a grave health threat to the American people and everyone across the world.

An additional area climate change will influence is the volume of diseases transmitted by insects and arachnids. As places warm up and frost-free seasons lengthen, disease-carrying creatures, such as mosquitoes and ticks, are expected to expand their range/activity and can shorten the time diseases need to incubate before being transmitted. Also, warmer winters are likely to increase the number of ticks that survive and lengthen their active season. While ticks have long life cycles, they’re less mobile than flying insects, so tick-borne diseases are likely to expand to other areas more slowly than mosquito-borne diseases. For those who live in areas plagued by drought, there is some good news because water is important for both mosquito and tick populations, so you’re risk level of developing these diseases is less.

While unfortunate, but not unexpected, the lack of water and high temperatures in some areas will result in food and water security issues. Currently, the global food demand is expected to increase by 14% per decade to 2050, but the global crop yields are expected to decrease by 1–2% per decade. This means that besides not having enough food, the price of what’s available will rise. Also, the food that is available will likely have less nutritional value than what is currently available because of the higher atmospheric CO2 levels. The rise of CO2 levels and warming ocean temperatures are leading to ocean acidification and the collapse of coral reef ecosystems, which will intensify the declining fish yields from overfishing and pollution. Heat has also been shown to reduce milk production on dairy farms. The US Department of Agriculture (USDA) research shows not only that cows produce less milk when it’s hot, but the milk that is produced is lower in fat, solids, lactose and protein content. There will be less safe water because as water temperatures rise and there is an increase in stormwater runoff it will result in harmful algae blooms. Storms and sea-level rise also threaten drinking water, wastewater and stormwater infrastructure. In some areas, sea-level rise will result in them becoming easily flooded, which will expose more people to contaminated flood waters.

Due to all of these environmental changes, there will be more mass migration. This will most likely increase collective violence because it’ll aggravate stressors, like environmental degradation and political instability in regions that already are vulnerable. Historical data shows that when water shortages and temperature/precipitation extremes increase so do conflicts and sociopolitical instability. In addition to civil unrest, sea level rise and extreme weather events will make some areas uninhabitable. Scientists estimate that by 2050, 50–250 million people could be at risk of displacement due to climate change. Climate change also poses threats to our mental health and well-being. According to the Health and Climate Report, the primary impacts include death, injury or illness; worsening of underlying medical conditions and adverse effects on mental health. The extreme weather will also harm healthcare infrastructure, which will make it more difficult for people to receive the care they need after such events. Even after extreme weather has passed, mental health challenges can linger. With the most common being post-traumatic stress disorder, depression and general anxiety. Extreme weather isn’t the only climate challenge expected to shape mental health since air pollutants also have been linked to anxiety and depression and heat has been shown to cause mood changes and can fuel aggressive behavior.

With all these visible challenges and over 97% of actively publishing climate scientists believing that the planet’s atmosphere is warming and human activity is a primary cause, you would think that it would be enough to convince people that we need to do something about climate change. However, some still argue against taking immediate and appropriate action. Often the reason they cite as to why we should continue to delay is cost. This even applies to those that no longer question the scientific truth of climate change. Their concern is that in order to address it seriously, on a national level, it would entail an investment large enough to restructure of our economy, which they feel the country can’t afford. The issue that these individuals neglect to note is the significant cost of not addressing climate change. We’re already paying billions of tax dollars every year to rebuild cities and even entire areas after climate-driven disasters. In addition, farmers are losing billions of dollars annually to catastrophic weather events. A new study finds climate change fuels billions of dollars in health costs every year. These costs can be hard to estimate, so they’ve been largely absent from policy debates. According to a report by the New England Journal of Medicine (NEJM), the reality is that high levels of greenhouse gases as the result of fossil fuel combustion, which is causing this rise in temperature and sea levels and intensification of extreme weather, are having overwhelming consequences for human health and health systems. According to the National Climatic Data Center, in 2012, more than 350 all-time-high maximum temperature records were broken in locations around the country and at least 99 million Americans experienced 10 days or more of temperatures that reached or exceeded 100 degrees. This helped to fuel the wildfires in the West, which burned more than nine million acres. The US Drought Monitor said that in September 2012, about two-thirds of the US went through a drought, which was a new record. At the same time, there were 19 named tropical storms that year, tying for third place in the record books. One of those storms was Superstorm Sandy, which has been the largest Atlantic hurricane on record so far. It killed hundreds of people in the eight countries that it passed through, including around 273 in the US, and caused more than $70 billion worth of damage in our country alone. Also, in 2012, there was an outbreak of mosquito-borne West Nile virus sickened more than 5,600 Americans (killing 286 of them), yet another record. According to the estimates, the health costs for these events totaled was $10 billion (in 2018 dollars). These dollar figures take into account more than 20,000 hospitalizations, nearly 18,000 emergency-room visits and nearly 1,000 deaths. The scary thing is that this cost estimations for 2012 are on the conservative side. Even scarier is that in 2016, 2017 and 2018, each had more billion-dollar disasters than occurred in 2012. This small example shows that climate change represents a major public health emergency right here in a nation that boasts having the world’s largest economy and one of the most technologically advanced healthcare systems.

One other consideration is certain societal factors, like poverty, discrimination, access to healthcare and pre-existing health conditions, make some populations even more vulnerable to the effects of climate change. The Union of Concerned Scientists found that these increases in frequency and severity of extreme heat events is leading to more public-health risks across the US, especially for those in urban communities of color, low-income areas and those living in counties in the Southeast. This process of those least responsible for climate change bearing the brunt of its health effects is happening across the globe. This is because low-income communities often don’t have the resources needed to voluntarily evacuate during extreme weather events or deal with exposure to air pollutants or soil/water contamination. Also, these communities are often where corporations and regulators decide to build hazardous-waste sites, power plants and waste incinerators.

Despite all of the negative impacts, the issue of resolving climate change shouldn’t be viewed as a problem but an opportunity. The good news is that the barriers in place that must be overcome to achieve it are primarily sociopolitical, not economical or technical. Individual lifestyle actions, like walking/cycling rather than driving, eating less meat, reducing food waste and conserving energy, are the easiest actions for each one of us to undertake. Not only would this help the environment, but they offer many benefits for personal wellness. However, individual actions are far from enough to address the challenge we collectively face. The United Nations (UN) Intergovernmental Panel on Climate Change found that, as a global society, we need to cut greenhouse gas emissions in half by 2030 and entirely by 2040 in order to avoid the most catastrophic effects of climate change. Sadly, these emissions hit a record high in 2018. This means that we will need rapid but equitable changes in energy, transportation and other economic sectors to begin to meet the necessary emissions-reduction targets. In order to accomplish this, we need policy changes that drive the transition to a clean-energy economy and protects communities. One main focus should be on reducing air and water pollution from fossil fuel combustion and designing cities so they include more green spaces and with active commuters in mind. Also, we need to avoid massive costs in healthcare and emergency relief and ensure energy, food and water security for everyone. This means that at-risk communities should be given access to economical renewable energy. We should also put into place programs that help them to gain access to for affordable, climate-friendly heating or cooling options and strong resilience measures to better cope with climate impacts.

To make these changes to our institutions and society we’ll need a concerted, organized and forceful effort. One step is for the US healthcare system to recognize that it’s part of the problem, since it accounts for nearly 1/10th of US greenhouse gas emissions, which means that it would rank seventh in the quantity of such emissions internationally if it were its own country. Several health systems are taking a stand by cutting their greenhouse gas emissions and working toward carbon neutrality. One excellent example is Gundersen Health System, which achieved energy independence several years ago and actually produces more energy than it consumes by using wind power, solar power and methane from a local landfill. Doctors are trusted sources of health information, so they need to help educate their colleagues and patients about the health effects of climate change, why we need to have rapid reductions in fossil fuel use and emphasize the health benefits that will happen as we move to alternate sources of energy. Another issue is that fossil fuel companies have used their vast resources to spread disinformation and influence policymakers against the public interest. This is why the American Medical Association and the Royal College of General Practitioners passed resolutions in 2018 that called for the financial divestment from fossil fuel companies. This move had them joining several other medical societies, including the now fully divested Canadian Medical Association. These actions help to set an example for other healthcare organizations, medical schools and individual doctors. When doctors support financial divestment, it has been an effective tool in other health movements, like cigarettes and smoking.

One other area that the medical community needs to focus on is making it clear that the easing of EPA regulations isn’t a benefit to the American people. Thankfully, in June 2019, 74 medical and public health groups united to raise awareness of the health impacts that climate change is causing. They released a report stating that climate change is a public health emergency. Some of the groups involved are the American Medical Association (AMA), American Heart Association (AHA), American Lung Association (ALA), American College of Physicians and multiple state-level and academic public health organizations. Since most of these groups are non-political, it could help strength the effort. The groups state that they are concerned about the health, safety and well-being of millions of people in the US because they’ve already been harmed by human-caused climate change and health risks in the future will be dire without urgent action now to fight climate change. The groups are encouraging public officials to strengthen US commitments under the 2015 UN climate agreement from which President Trump has vowed to withdraw the US from at the earliest possible time. Another item they’re pushing for is some form of carbon pricing. The only issue is that they don’t suggest any form of potential taxation on emissions, nor a plan/timeline for increasing the reduction of fossil fuel extraction. Health professionals can demand that any proposed climate policies come with a credible assessment of their health effects, help prioritize research examining the health effects of carbon-reduction strategies and discuss climate action with lawmakers in ways that make it personal, like telling stories about the people they see who are effected by it. Health professionals need to continue to point out the actual reality of the situation, which is that climate change is a threat to our health and well-being now and that it’s likely to get much worse if we don’t take action to address it.

There is no question that as climate change continues to alter disease patterns and disrupt health systems, its effects on human health will become harder to ignore. People, particularly those who have influence over regulations and laws, need to realize that we’re going to have to pay to deal with climate change either in the frontend or backend. What we, as Americans, shouldn’t tolerate is having to pay for it in the form of illness, injuries and lost lives. If you care about yours or your loved ones’ health, you should care about climate change.