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Climate change is already taking a toll on our health

A warming climate already contributes to disease and early deaths worldwide, as populations experience greater risks from extreme weather events, poor air quality and infectious disease.The World Health Organization estimates that 150,000 people die every year from the effects of climate change, and millions more suffer from illness, malnutrition and other health problems due to a warming planet. (See Health Dangers From a Warming Planet.)Cutting greenhouse gas emissions is essential to halting climate change, but global warming pollution can stay in the atmosphere for centuries. We need to prepare for continued impacts on public health.

We asked health directors how ready they are

How prepared is our nation’s public health system to cope with the public health challenges of climate change? As the "first line of defense," what do public health departments need to be prepared? What can the public health community do to help prevent the more severe consequences of climate change?To answer these questions, Environmental Defense Fund surveyed a representative sample of directors of local health departments from around the country, in collaboration with the National Association of City and County Health Officials and George Mason University. Just over 60 percent of the sample completed the survey. (For details, see the report [PDF].)

Key findings: U.S. health system generally not well prepared

Based on responses, our survey found that:

• Most local health directors recognized that climate change is already occurring in their jurisdiction.
• A majority thought that climate change is likely to affect one or more serious health problems in their jurisdiction over the next 20 years.
• More than half felt climate change was an "important priority" for their health department.
• Few reported that climate change was a top priority for their health department.
• Most thought they lacked expertise to prepare for the public health dangers from a changing climate.
• Most thought that state and federal public health agencies lacked the expertise to help them prepare for the public health dangers from a changing climate.
• Most felt they lacked the resources needed to address climate-related health threats, with additional funding and staff most frequently cited.

Recommendations: Protect, prevent and enhance

Our recommendations can be summed up thus: protect, prevent and enhance.Protect public health from climate change effects. We need to assure that our public health system is efficient, competent and responsive. To achieve this goal, the federal government should:

• Sponsor a study to make recommendations for a public health system that can respond to 21st-century health threats, from climate change to emerging diseases and bioterrorist acts.
• Increase funding for health systems to assess, monitor and rapidly respond to health and safety threats. For example, funding is needed to strengthen surveillance networks, develop adequate rapid response systems for extreme weather events, and train public health personnel.
• Increase funding for research on climate change and health, to develop better climate and weather modeling on a local scale, to pinpoint vulnerabilities of specific communities, and to find effective ways to communicate climate-related health threats and how individuals and communities can best protect themselves.

Prevent climate-related health dangers by slowing global warming as much as possible. We must drastically cut greenhouse gas emissions to levels needed to avert dangerous climate change, including massive sea level rise, temperature increases, flooding and droughts.The federal government should:

• Adopt a strict limit on U.S. greenhouse gas emissions and promote global reductions.
• Fund research on how best to communicate with and motivate the general public to make changes in their daily lives that will help reduce greenhouse gas emissions.

The public health and medical community should:

• Educate policymakers on the costs of inaction and the public health benefits of steps to curb global warming pollution.
• Study, develop and implement best practices for communicating with the general public to spur personal behavior changes.
• Study, develop and adopt best practices for reducing greenhouse gas emissions from public health and health care facilities and operations.

Enhance public health by guiding climate change policies towards “win-win” situations. Align reducing greenhouse gas emissions with critical public health goals. For example, transportation policies that increase physical activity also address the obesity epidemic, and agricultural policies that reduce methane emissions can also improve nutrition.The federal government should:

• Ensure that representatives from public health agencies are on interagency committees that develop comprehensive climate change policies.
• Assess the health co-benefits and potential harmful effects of major climate change policy initiatives.
• Expand the resources of state and local public health agencies so that they may participate more effectively in state and local policy decisions.

The public health community should:

• Seek opportunities to work with transportation, energy, agricultural, environmental and other state and local agencies.
• Educate policy makers about the potential health co-benefits and harmful effects of climate change policies.

The bottom line is that being prepared for existing threats like bioterrorism and pandemic flu mesh with readying ourselves for health threats from climate change.We can also curb overall health spending in this country through energy, transportation and nutrition policies that are double winners, serving climate and health goals. The old adage “an ounce of prevention is worth a pound of cure” holds true.

More information

• Report: Are We Ready? Preparing for the Public Health Challenges of Climate Change [PDF]
• Climate Change and Health:  Are you in a high-risk group? Learn about the health dangers, and get tips for a healthy, low-carbon life.

Young Girl Worries About Her Grandmother

Jenny, 10 years old, is sitting in her 3rd period class in Philadelphia not paying attention to the lesson. She is distracted—worried about her 72 year-old grandmother, Sybil.Sybil is diabetic and takes medications for blood pressure and heart disease. It has been a record hot May and Sybil has been complaining of the heat.Last night was particularly hot. A power outage for the past three days means they cannot run their air conditioner; it was really hot in the apartment.Sybil was acting odd this morning – confused and somewhat listless. The power is still not on, and it is even hotter today.Jenny is worried, trying to decide if she should tell the teacher and ask to go home. The news last night talked about the heatwave and what people should do.If anything happens to Sybil, Jenny doesn’t know what she would do – no other relatives live nearby; all her friends are here.

Expectant Mother Worries About Her Baby

Mrs. Reyes is pregnant, has been ill for two months, and her physician can’t seem to figure out what is causing her symptoms.The Minneapolis summer has been beautiful, warmer and wetter than she remembers as a kid. She is proud of her garden and has been spending the warm evenings trying to keep ahead of the weeds.Mosquitoes seem to be even worse than usual, a constant menace in her garden. Her symptoms started a few days after receiving multiple bites one evening.Mrs. Reyes had a high fever that lasted a few days, with nausea and a rash. She thought it was summer flu. But then she started feeling extremely tired with incapacitating pain in her knees, elbows, and other joints. Yesterday, the pain became so severe that she couldn’t stand straight.She is worried that whatever she has will affect her unborn child. Her doctor has never seen anyone with her symptoms and diagnosed her with arthritis, but that is not consistent with her other symptoms.Finally, at her insistence, her doctor contacts the Centers for Disease Control and Prevention, where he learns that her symptoms are consistent with chikungunya fever.There have been occasional outbreaks of chikungunya since it was introduced in the US in 2010, but mostly along the Gulf coast. Aedes mosquitoes carry this viral disease, but Minneapolis was thought to be too far north.The CDC started a review of medical records in Minneapolis, conducted a seroprevalence survey, and discovered there had been several hundred cases of chikungunya. All of those that came to medical attention were misdiagnosed.

Little Leaguer Worries About His Asthma

Johnny is 13 and lives in Los Angeles. He is a scrappy first baseman on his little league team and likes playing ball better than anything else in the world.What Johnny doesn’t like is that high pollen and poor air quality exacerbate his asthma. He has to make sure he takes his inhaler to his practices and games, and has had to take a puff between innings during some recent games.Today’s game is really important with a playoff seed on the line. Johnny’s been looking forward to the playoffs all year and wants to help his team win more than anything else.But the unusually hot weather and clear skies have caused a high ozone day, and the increased rain last year means there is more pollen than usual.The game is tied 3-3 in the fifth inning and Johnny’s on deck with 2 runners on. The team needs a hit from their clutch first baseman.But Johnny can’t breathe even after several puffs from his inhaler. His coach stops the game and calls for an ambulance to take Johnny to the emergency room.