Climate Change is a Public Health Crisis

As 2020 mercifully comes to a close, the Covid-19 pandemic continues to rage out of control, with nearly 20 million cases and over 344,000 deaths in the U.S. alone since the beginning of the year. According to the New York Times, at least 3,800 Americans died yesterday from the coronavirus. Certainly, the development of several effective vaccines in record time is a bright spot in an otherwise dismal picture, but even there logistical challenges have led to a much slower roll out than originally projected.

Given these horrific circumstances, we are understandably preoccupied with this historic outbreak, but it shouldn’t blind us to the other looming public health threat: the climate emergency. The Lancet, one of the world’s preeminent research medical journals, published a comprehensive study earlier this month focusing on public health data from 2019, warning that heat waves, air pollution, and extreme weather events are inflicting increasing damage on human health. In particular, the links between death, disease, and burning fossil fuels couldn’t be clearer.

“Many carbon-intensive practices and policies lead to poor air quality, poor food quality, and poor housing quality, which disproportionately harm the health of disadvantaged populations,” wrote the dozens of physicians and public health experts from around the world who authored the report.

Among the deadliest effects of global warming are the longer, more intense heat waves now taking place across the planet. As with coronavirus, older people are most at risk. In the past 20 years, the number of people over 65 who have died as a result of extreme heat has increased more than 50 percent. At least 296,000 people died from the heat in 2018, the most recent year for which global data are available, and almost 20,000 older Americans died from heat waves last year.

Furthermore, the Lancet report notes that climate change is a threat to critical public health resources such as hospitals, primary care facilities, and emergency services. Two thirds of the more than 800 cities contacted by researchers said they expect climate change to “seriously compromise public health infrastructure.” With this infrastructure already near the breaking point due to the pandemic, we are obviously in a perilous situation. If nothing else, the past year has underscored how ill-equipped the public health system is to manage major, long-running disasters, even in developed nations such as the U.S., Britain, and Italy.

In another investigation released this month, the Johns Hopkins Bloomberg School of Public Health and Trust for America’s Health conclude that most U.S. states aren’t properly prepared to protect their residents’ health from climate change. Perhaps of deepest concern is the study’s observation that some of the states most vulnerable to climate-related health harms are the least prepared to handle them. Even the states best prepared to deal with these threats, such as Utah, Maryland, Vermont, Virginia, and Colorado, still have plenty of work to do.

The analysis identified three areas of public health readiness that require the most attention:
  • Prehospital care provided by emergency medical services.
  • Mental and behavioral healthcare, including access to social service networks and substance abuse treatment.
  • Social capital and cohesion, the degree to which residents are connected to one another and to local organizations and governments.

Again, the current pandemic has exposed an alarming degree of weakness in all three areas, so these findings should come as little surprise. As the NRDC contends in its summary, given the recent rate of climate change, “we need more progress at the state level—and fast.”

What can we do? Among the report’s recommendations are:
  • More effective federal leadership in developing a national climate and health strategy.
  • Investing in research, training, and public health infrastructure at the state and federal levels.
  • Addressing racial, socioeconomic, and other health inequities that are the root of many climate vulnerabilities.
  • Ensuring community members have a leading role in planning so that those most at risk are at the table.

All of the above suggests that strengthening the public health system should be the top priority for 2021. As we move forward to repair this system, we should keep in mind how the interrelated dynamics of economic inequality, racial injustice, and a broken social contract have all contributed to the deep hole in which we find ourselves at the start of a new year. Only if we do so will we make lasting progress.