Overview The United Nations (UN) has hired you as a consultant, and your task is to assess the impact that global warming is expected to have on population growth and the ability of societies

Climate Change and Health

By: Lola Butcher

Pub. Date: November 29, 2019 Access Date: November 1, 2022

Source URL: https://library.cqpress.com/cqresearcher/cqresrre2019112900

©2022 CQ Press, An Imprint of SAGE Publishing. All Rights Reserved. CQ Press is a registered trademark of Congressional Quarterly Inc.

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Table of Contents

Introduction

Overview

Background

Current Situation

Outlook

Pro/Con

Chronology

Short Features

Bibliography

The Next Step

Contacts

Footnotes

About the Author

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Page 2 of 30 Climate Change and Health CQ Researcher

Introduction Scientists warn that a warming planet threatens human health. A United Nations agency estimates climate change will cause 250,000 additional deaths annually between 2030 and 2050. The threat is multifaceted. Prolonged droughts are causing malnutrition in Africa, while extreme heat is leading to spikes in heat stroke in places as diverse as Baltimore and Paris. Across the globe, changing climes are worsening allergies and increasing the deadly reach of illnesses such as malaria, dengue fever and West Nile virus. But consensus is lacking about what to do. Some experts argue the threat is exaggerated because people will adapt to the changing climate. Others say nations must quickly reduce carbon emissions to limit global warming and protect human health. Environmental activists are amplifying that message. One survey found that respondents ranked climate change as the top threat in 13 of 26 countries polled. In the United States, however, only 27 percent of Republicans — versus 83 percent of Democrats — view climate change as a major threat.

Karachi, Pakistan, was left under water after Cyclone Kyarr passed over the city on Oct. 28. Climatologists warn that the effects of a warming climate, including greater flooding from stronger cyclones and hurricanes, will increase the spread of water-borne diseases, endangering the health of millions of people. (Getty Images/Anadolu Agency/Sabir Mazhar)

Overview Shakira Franklin of Baltimore was driving to work on a scorching July day in 2018 when she started having trouble breathing. “Before I knew it, I was gasping for air,” said Franklin, who has asthma.

She was not alone. As Baltimore's temperature hovered near 100 degrees that day, emergency calls from people struggling with heat stroke, cardiac arrest and high blood pressure poured in. The same situation was playing out across a large swath of the world that summer, with more than 1,600 deaths associated with heat waves and wildfires in Europe, Japan and the United States.

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Page 3 of 30 Climate Change and Health CQ Researcher

Protesters in Kyiv, Ukraine, in September demand action on climate change, which has been linked to human health problems. A 2018 survey found that people in 13 out of 26 countries polled ranked climate change as the top threat facing their nation. (Getty Images/LightRocket/SOPA Images/Pavlo Gonchar)

Deadly for some, these heat and extreme-weather events also are creating or worsening health issues for millions of people around the globe. And a growing number of experts say there is a connection between such weather events and changes in the climate. Scientists have linked climate change to, among other problems, allergies, premature births, stroke, kidney problems, malnutrition, mental health problems and the spread of malaria, dengue, Lyme disease and West Nile virus.

Until recently, climatologists and meteorologists were reluctant to attribute the severity of an individual weather event — a heat wave, an ice storm or a hurricane, for example — to climate change, says Dr. Georges C. Benjamin, executive director of the American Public Health Association, a Washington-based organization working to mitigate climate change. But as scientific evidence has accumulated, the United Nations' Intergovernmental Panel on Climate Change (IPCC) has made that connection — and many experts agree that climate change's direct impact on human health is becoming clearer.

“People are now connecting the dots,” Benjamin says. “As the health effects of climate change to date have become more visible, the discussion is shifting from protecting polar bears to protecting people.”

Members of the public who might have lacked a sense of urgency about addressing climate change when they viewed it solely as an environmental threat are becoming more engaged now that they see it as a threat to their health, Benjamin says. Climate activists say governments must do more to reduce greenhouse gas emissions associated with fossil fuels, but beyond that, consensus is lacking about how to protect people's health.

The health threats associated with climate change — and their severity — differ from one location to the next. The World Health Organization (WHO), the U.N.'s public health agency, summarizes the global risk in stark terms: “A changing, more variable climate … presents a clear and present danger to health security.”

An estimated 157 million more people in every region of the world were exposed to extreme heat in 2017 than in 2000, according to the Lancet Countdown: Tracking Progress on Health and Climate Change, an interdisciplinary research collaboration among 27 leading academic institutions, the United Nations and intergovernmental agencies. Experts say Europe and the eastern Mediterranean appear more vulnerable to heat than Africa and Southeast Asia, probably because their populations are older and more urban.

Prolonged droughts in large areas of South America, Africa and Southeast Asia are causing malnutrition, stunting the growth of children and contributing to premature deaths. Floods, attributable to heavy rains and rising seas due to global warming, can be deadly and have longer-term effects, including the spread of infectious disease from unclean water and worsening of mental illness as flooding displaces victims, according to the Lancet Countdown.

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Page 4 of 30 Climate Change and Health CQ Researcher

Mosquito-borne diseases, including Zika and dengue fever, are increasing in Southeast Asia and elsewhere. Experts say warmer temperatures in temperate climates are enabling mosquitoes, which thrive in tropical regions, to migrate into other regions and to live for longer seasons each year. (AFP/Getty Images/Philippe Huguen)

The list goes on: Deaths from dengue fever — a mosquito-borne tropical disease — are increasing in Southeast Asia and the Americas because the warming climate allows mosquitoes to thrive in more parts of the world. Mortality rates for malignant melanoma, associated with exposure to the sun's ultraviolet radiation, have increased in Europe, the Americas and the western Pacific.

In 2017, the United States had 16 extreme-weather disasters — including hurricanes and wildfires — that killed nearly 3,300 people, according to a climate change review conducted for the American Public Health Association. Cases of Lyme disease, West Nile virus and other vector-borne illnesses transmitted by insects that have spread to the United States tripled between 2004 and 2016.

Making what it calls “a highly conservative estimate,” WHO said climate change globally will cause 250,000 additional deaths each year between 2030 and 2050. Of those, 38,000 will be elderly people exposed to heat, 48,000 will be victims of diarrhea and 60,000 will die from malaria and 95,000 from childhood undernutrition.

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Page 5 of 30 Climate Change and Health CQ Researcher

But climatologist Patrick Michaels, a senior fellow at the Competitive Enterprise Institute, a public policy organization in Washington, disputes these forecasts, saying projecting the health effects of climate change is folly because people will adapt to changing conditions. He says his research shows that although heat killed hundreds of people in the Chicago area in 1995 and thousands in Paris in 2003 during heat waves, similar events in each city a few years later killed far fewer people. People had learned from experience, he says.

In the United States, heat warnings increased public awareness, cooling centers opened in large cities and health officials advised people to check on their elderly neighbors, Michaels says; in France, air conditioning became a priority.

“People decided that getting an air conditioner to plug into the window was maybe not such a bad idea for grandma's room,” says Michaels. “So there was both technological adaptation and social adaptation.”

Polling shows the public is increasingly concerned about climate change. A 2018 Pew Research Center survey found that climate change ranked as the top threat — higher than terrorism and other common worries — in 13 of 26 countries polled. Polling conducted in April by the Yale Program on Climate Change Communication, a university-affiliated research center in New Haven, Conn., found that 62 percent of Americans are at least “somewhat worried” about climate change; 38 percent think climate change already is harming Americans.

Mona Sarfaty, director of the Program for Climate and Health at George Mason University in Virginia, says the Yale survey, conducted twice a year, documents a rise in concern among the U.S. public. “We see a real shift, with people starting to feel that ‘Gee, people right near me may be impacted,’” she says.

But polling also shows a large partisan divide: Only 27 percent of Republicans consider climate change a major threat, while 83 percent of Democrats do, according to the 2018 Pew survey. President Trump, a Republican, once called climate change a hoax and continues to question the scientific consensus on global warming. When a 2018 study produced by 13 federal agencies and 300 leading climate scientists warned about the impact of climate change, Trump responded: “I don't believe it.” Younger Republicans, however, apparently diverge from their elders: A survey from Ipsos and Newsy found that some 77 percent of Republicans between 18 and 38 said climate change is a serious threat, slightly higher than Democrats in the same age group.

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Page 6 of 30 Climate Change and Health CQ Researcher

People cool off near the Eiffel Tower in Paris during a June heat wave. With the number of extreme-heat events growing, public health officials say governments can help prevent heat-related deaths by opening cooling centers and encouraging people to check on elderly neighbors. (Getty Images/Anadolu Agency/Mustafa Yalcin)

After years of debate, representatives from 196 countries signed the Paris Agreement on climate change in 2015, pledging to take steps to hold the increase in global average temperature to well below 2 degrees Celsius above preindustrial levels. However, Trump announced in 2017 that the United States would withdraw from the agreement, calling it a “draconian” deal that would harm the U.S. economy and impose unfair environmental standards on American businesses and workers. On Nov. 4, Trump issued a formal notification of withdrawal, beginning a one-year process of U.S. departure from the accord.

The Lancet Countdown, established by the British medical journal The Lancet to monitor climate change, said many nations are failing to meet the Paris accord's goal: “A lack of progress in reducing emissions and building adaptive capacity threatens both human lives and the viability of the national health systems they depend on, with the potential to disrupt core public health infrastructure and overwhelm health services.”

The fossil fuel industry is the biggest source of greenhouse gas emissions; 20 oil, gas and coal companies have contributed more than one-third of all carbon dioxide and methane emissions worldwide since 1965, according to the Climate Accountability Institute, an independent research institute in Colorado.

But the American Petroleum Institute (API), a Washington-based organization that represents oil and gas companies, argues that the U.S. energy sector is doing its part to reduce emissions by becoming the world's largest supplier of natural gas, which generates about half the carbon emissions of coal when used to generate electricity. “As a cleaner-burning fuel, it is essential to climate progress,” Reid T. Porter, an institute spokesperson, said in an email.

Most industries could do more to address global warming, including the health care industry, which contributes nearly 10 percent of U.S. greenhouse gas emissions, says Jessica Wolff, U.S. director of climate and health for Health Care Without Harm, an international organization that seeks to reduce the environmental footprint of the health care sector. “Health care has a healing mission, but at the same time, its operations are significantly contributing to climate change and the very diseases they are trying to treat,” she says.

A group of 19 U.S. health systems that represent about 10 percent of the nation's hospitals have joined Health Care Without Harm's climate council, committing to reduce their carbon emissions and help their communities become more resilient to climate change. Internationally, about 18,000 hospitals and health systems have signed on to Health Care Without Harm's global climate challenge, promising to be leaders in tackling the climate crisis.

“The health care sector has both the opportunity and the obligation to use its ethical, economic and political influence to work on climate change,” Wolff says.

As doctors, scientists, politicians and others consider climate change's impact on health, here are some of the questions they are asking:

Will climate change set off a global health catastrophe?

When David Attenborough, a longtime British broadcaster known for his natural-history documentaries, was invited to speak at the U.N. Climate Change Conference in Katowice, Poland, in December 2018, he did not mince words. “If we don't take action,” he warned, “the collapse of our civilizations and the extinction of much of the natural world is on the horizon.”

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Page 7 of 30 Climate Change and Health CQ Researcher

His fellow Briton, Rupert Read, a spokesperson for the Extinction Rebellion, a global organization pushing for climate action, disagrees with that time frame. “Dangerous climate change is already causing a health catastrophe in parts of the world,” says Read, a philosophy professor at the University of East Anglia.

Both are correct, according to the WHO. It has compiled a list of catastrophes that have occurred in recent decades, such as a 2003 heat wave that killed more than 70,000 across Europe. In Ethiopia, droughts have caused famines along with high levels of child undernutrition since the 1980s. In 2010 alone, 6 million people in Pakistan needed urgent medical care from floods, which had destroyed more than 200 health care facilities.

The WHO projects an even higher level of catastrophe in coming years, including increasing incidences of respiratory and cardiovascular disease; injuries and deaths from extreme-weather events; the spread of infectious diseases; and food and water shortages stemming from ecological changes caused by global warming.

Worried about rising sea levels, the leaders of small, island nations asked the United Nations to take a new look at the consequences of climate change. In late 2018, scientists convened by the world body said that without immediate action to reduce greenhouse gas emissions, increased coastal flooding may displace millions by 2040.

The IPCC, a group of more than 100 scientists from 36 countries, reported that some 50 million people living in the United States, Bangladesh, China, Egypt, India, Indonesia, Japan, the Philippines and Vietnam will be affected by increased coastal flooding if the atmosphere warms by 2.7 degrees Fahrenheit (1.5 degrees Celsius) above preindustrial levels — and such warming could happen by 2040.

Previously, the scientists had focused on the damage resulting from an average temperature increase of 3.6 degrees Fahrenheit (2 degrees Celcius), the threshold that had been considered to trigger the most severe effects of climate change. The IPCC's report says that if that threshold were reached, a “rapid evacuation” will occur in the tropics.

“In some parts of the world, national borders will become irrelevant,” said Aromar Revi, director of the Indian Institute for Human Settlements, an education institute that focuses on urbanization, and an author of the report. “You can set up a wall to try to contain 10,000 and 20,000 and 1 million people, but not 10 million.”

Michaels, at the Competitive Enterprise Institute, says it is wrong to focus on the IPCC's worst-case scenario. The IPCC analysis gives “multiple lines of evidence” to expect the scope and pace of global warming will be less worrisome than the most dire scenario depicted, he says. “Yes, global warming is real and people have something to do with it,” says Michaels, a past president of the American Association of State Climatologists. “But the magnitude of the warming that we are going to see is going to be at the low end of the projected range.”

Rep. Buddy Carter, R-Ga., a member of the House Select Committee on the Climate Crisis, agrees. Climate change “is something that needs to be addressed, but it certainly isn't a ‘doomsday’ scenario,” he said in an email. “The climate is changing, but it's been changing since day one. Instead of forecasting doom, we need to be working on innovation, mitigation and adaptation to actually address the issue.”

Michaels points to hydraulic fracking — the process of extracting oil and gas from subterranean rock by injecting liquid under high pressure to create fractures — as an example of how technological innovation can address climate change in unforeseen ways. Less than two decades ago, the consensus that the United States had depleted its natural gas deposits was upended when fracking technology improved. For the past decade, the nation has been the world's leading producer of natural gas, which emits less carbon dioxide than coal when burned in power plants.

“Imagine if we had passed a law in some fit of hyper-environmentalism, saying, ‘There shall be no more exploration for new sources of fossil fuels,’” he says. “What would we have forgone as a result of that? A lot.”

Representing people who live on Georgia's coastline, Carter advocates mitigation measures such as using federal grants to elevate houses in flood-prone areas. “We need to be focused on things like ensuring homes, bridges and roadways are in positions where they won't be flooded,” he says.

Wolff, at Health Care Without Harm, agrees that planning can mitigate some health effects of climate change. “We have to do some adaptation and become resilient to the changes that are going to happen because the atmosphere has already warmed,” she says.

For example, after a 2010 heat wave killed more than 1,300 people in Ahmedabad, India, leaders developed a heat action plan that included training health care staff, distributing water and painting roofs with white reflective paint to reduce the heat in homes. When a similar heat wave hit in 2015, fewer than 20 people died.

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Page 8 of 30 Climate Change and Health CQ Researcher

But adaptation strategies will not undo the climate change that has already been put in motion by carbon dioxide pumped into the atmosphere, Read, the Extinction Rebellion spokesperson, says. The only hope is for an immediate and dramatic reduction in greenhouse gas emissions.

“So things are bound to get worse for a long time to come on a human scale whatever we do,” he says. “And if we don't rise up to the kind of challenge that people like [teen activist] Greta Thunberg and Extinction Rebellion are laying down now, then things will get worse basically forever.”

Should doctors take responsibility for educating the public about the health effects of climate change?

When her patient — a 64-year-old with asthma that worsens during allergy season — asked why her eyes and nose were running for longer periods every year, Dr. Mary Rice, a pulmonologist at Beth Israel Deaconess Medical Center in Boston, had the answer ready.

“Because of global warming, the plants are flowering earlier in the spring,” she said. “After hot summers, the trees are releasing more pollen the following season. And the ragweed — it's extending longer into the fall.”

For that reason, Rice said, her patient may need stronger medicines, more air filters in her home and more days wearing a mask.

The Medical Society Consortium on Climate and Health at George Mason University — composed of the American College of Physicians and other medical societies — seeks to encourage doctors to educate themselves and others about climate change. In 2014, Sarfaty, its director, surveyed three groups of U.S. doctors — allergists, pulmonologists and physicians who belong to the National Medical Association, which represents African American doctors — to ask if they treated patients whose health was affected by climate change. “About 70 percent said that they did — and 50 percent said patients' health was impacted to a ‘great’ or ‘moderate’ extent,” she says.

But attempts by health officials and scientists in recent years to sound the alarm about the health effects of climate change have not always resonated with the public.

Patients need to hear from their own physicians, says Molly Rauch, public health director for Moms Clean Air Force, a New York City-based coalition of more than 1 million parents working to promote healthy air.

“We need to be hearing these messages from the people to whom we entrust our health and our children's health,” Rauch says. “We need to get information from the people who are already talking to us about smoking and bike helmets. That's going to be much more powerful than experts releasing a report or health officials issuing a brochure.”

The 2018 Lancet Countdown brief for the United States agrees. “Given that the bedrock of public health is education about threats to health, it is critical that health providers inform their patients, communities, and policy makers about the health harms of climate change,” the report said.

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Page 9 of 30 Climate Change and Health CQ Researcher

Its authors pointed to research showing that primary care providers are among the most trusted voices to deliver a message about the health effects of climate change, outranking family and friends, government agencies and climate scientists.

Some physicians are on board, and organizations such as Florida Clinicians for Climate Action are emerging to encourage them. That group, formed in 2018, urges physicians and nurses to educate the public and policymakers about the health effects of climate change in Florida and the United States, and one goal is to “move public opinion.”

Such education is appropriate only if the context is right, says Dr. Aaron Bernstein, co-director of the Center for Climate, Health and the Global Environment at Harvard University, who also is a pediatrician at Boston Children's Hospital. “Our first obligation as [health care] providers is to meet people where they're at,” he says. “Our job is not to convince them that climate change is happening, and our job is not to use people's illnesses as a means to educate them on climate change or any other potential topics.”

Through the center, Bernstein works to address the causes of climate change with the goal of improving the health of children around the world. If he's caring for a child hospitalized for, say, an infection unrelated to climate, he does not proselytize. “But if someone is asking, and it matters to their understanding of what they are going through, then yes,” Bernstein says. “And it does come up.”

Sarfaty says some physicians — particularly those who treat children, patients with lung problems and older people — find that discussing climate change is essential to helping patients cope with specific medical conditions.

“But I would say that most physicians feel that there's no time,” she says.

Physicians responding to a consortium survey in 2016 identified lack of time and lack of payment as obstacles to discussing climate change wi

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