Public Health Leadership in Challenging Times: Paris Accord Mobilizes Local Action

The landmark Paris climate accord, signed in 2015 by 195 countries, was not only seen as the most promising effort to tackle climate change to date but perhaps the most significant public health compact of our time. On June 1, the Trump administration began proceedings to withdraw the United States from the Paris climate accord, outraging not only environmentalists but public health officials as well.

On June 20, the San Francisco Health Commission, the governing and policy-making body of the Department of Public Health (DPH), passed a resolution during its commission hearing that denounced the Trump administration’s shortsighted act of retreating from the Paris climate accord. The resolution reaffirmed the DPH’s strong commitment to combat climate change, and it formally endorsed the department’s recently released Climate and Health Adaptation Framework.

Local health leaders have recently taken on demanding new roles, including defending the Affordable Care Act and other crucial safety net programs, fighting the crisis of opioid addiction, and criminal justice reform. In the wake of so many critical public health issues, the DPH and its commission showed bold leadership through their commitment to addressing climate change as a key health priority. During the Health Commission hearing, Commissioner Dr. David Pating, who is chief of addiction medicine at Kaiser Medical Center, San Francisco, called this a time “to recommit our philosophy that control of the climate is good control of our health.”

Climate change may be a different type of health problem, but it poses grave danger. You get an X-ray for a broken arm and have a biopsy performed to detect cancer. However, what makes climate change unique is that you can’t see it, but it is a life-altering diagnosis. Climate change and its associated health impacts is not a conjecture. The health impacts of climate change will affect us all but will have an even greater impact on disadvantaged communities. This includes the elderly, the poor, young children, those with pre-existing medical conditions, and communities of color.

Climate change is expected to cause more variable weather, including extreme heat days and heat waves, intense storms and heavy precipitation events, sea level rise and flooding, droughts, and degraded air quality. This all has significant and cascading health impacts, ranging from increases in rates of cardiovascular and respiratory diseases to increases in incidence of heat-related illnesses, such as heat stroke, heat exhaustion, or even death — all which can lead to impaired mental health and stress.

Climate change is a public health issue, and it is the responsibility of public health departments to take action to reduce the impacts of climate change and prepare for potential risks. Since 2010, the San Francisco Department of Public Health’s Climate and Health Program has been part of a nation-wide effort to build capacity to address the health impacts of climate change. The program’s latest report, the Climate and Health Adaptation Framework, is the first comprehensive health adaptation plan for the city and county of San Francisco that describes the connection between climate change and local health impacts and outlines a set of potential strategic solutions. Each set of strategies offers opportunities to promote actions that yield health benefits and protect against climate change. The report looks beyond ways to just prepare for climate change, such as how to create a better quality of life for citizens. Proposed solutions range from expanding the use of home air filtration systems for residents in air pollution zones to finding ways to minimize pollen allergies through non-allergen planning and designing of urban greenspaces.

The Climate and Adaptation Framework is just a small example of the work being done in San Francisco and throughout the state of California that is continuing to lead a movement. “At a time when this [federal] administration is defying credible science, 194 countries, and even the pope, in walking away from our leadership in the fight against climate change, we are very proud that San Francisco is taking a leadership role, and it clearly shows the impact that leadership and cities can have,” said Health Commissioner Dan Bernal, who is chief of staff for Congresswoman and House Democratic Leader Nancy Pelosi. Climate change is a localized issue, and we will never be successful at addressing it if we don’t act locally in a unified and holistic way. We need to integrate the concept of resilience and climate preparedness across and within both private and public sectors. There is a demand for cross sector leaders to come together to solve complex issues like climate change.

The manifestation of climate health impacts is here, and it is the responsibility of our leaders to communicate that preparing for climate resilience will make a difference. And when we are pushed, we need to push back. In the vacuum of federal leadership, it is imperative that we take stance for health protective policies as the San Francisco Health Commission did.

Cyndy Comerford is the Manager of Policy and Planning and the Director of the Climate and Health Program at the San Francisco Department of Public Health.