Chapter 1
The Heath Imperative
Climate change threatens public health. Carbon pollution limits could save thousands of lives.
“As the climate continues to change, the risks to human health continue to grow…Every American is vulnerable to the health impacts associated with climate change.”
— U.S. Global Change Research Program’s draft Climate and Health Assessment, April 7, 2015
The health threats from climate change are considerable: intensified cases of asthma and other respiratory diseases, longer pollen-allergy seasons, increased cases of heat stroke and other heat-related illnesses, and increased risks of insect- and waterborne diseases.
Climate change is “one of the most serious public-health threats facing our nation,” warned Dr. Georges Benjamin, executive director of the American Public Health Association.
Physicians report that patients are already experiencing its effects. But with strong limits on carbon pollution, the public could see health benefits from cleaner air “almost immediately,” research shows. The U.S. Environmental Protection Agency’s Clean Power Plan promises to reduce not only carbon pollution but also other harmful air pollutants, preventing deaths and illnesses and saving billions in health care costs and lost productivity.
That’s why health groups have been among the leading advocates for strong limits on carbon pollution.
“Implementing new power plant rules could prevent countless premature deaths, heart attacks, and cases of chronic bronchitis; reduce co-pollutants; and slow hospital-utilization rates that contribute to rising health care costs,” Dr. Benjamin said in a 2013 statement. He called the proposed standards “the difference between a long, healthy life or debilitating, expensive, chronic illness for hundreds of thousands of American children and adults.”
With strong limits on carbon pollution, the public could see health benefits from cleaner air “almost immediately.”
Other groups, including the American Academy of Pediatrics and American Heart Association, have also expressed support for carbon limits. Cutting carbon pollution would have “an immediate, positive impact on public health; particularly for those who suffer from chronic diseases like asthma, heart disease, or diabetes,” said the American Lung Association.
The EPA has estimated that the Clean Power Plan will annually prevent up to 150,000 asthma attacks, up to 6,600 premature deaths, 3,700 cases of bronchitis in children, and more than 1,800 visits to the hospital for cardiovascular and respiratory illnesses when fully implemented in 2030.
Cutting carbon pollution from power plants carries the added benefit of reducing other harmful air pollutants, such as sulfur dioxide, nitrogen oxides, and particulate matter. These pollutants contribute to smog and soot that worsen heart and lung disease, aggravate asthma, and contribute to premature death.
Strong limits on carbon pollution, similar to those in the Clean Power Plan, could prevent 3,500 premature deaths, 1,000 hospitalizations, and hundreds of heart attacks each year by 2020, according to a 2014 study by scientists from Harvard, Syracuse, and Boston universities on the health “co-benefits” of reducing carbon pollution.
States with the most lives saved, according to the study, are Pennsylvania, Ohio, Texas, Illinois, Michigan, New York, North Carolina, Georgia, Missouri, Virginia, Tennessee, and Indiana. Kentucky and West Virginia, where coal use is high, are among the states with the greatest estimated percent increase in premature deaths avoided.
A year later, in a different study, researchers said the public could see health benefits “almost immediately” from strong carbon standards, with the greatest clean-air and health benefits occurring when stringent targets for carbon reduction are combined with measures that promote energy efficiency and cleaner energy sources.
“The more the standards promote cleaner fuels and energy efficiency, the greater the added health benefits,” said Charles Driscoll, Syracuse University professor of environmental systems engineering and lead author of the study, published in May 2015 in Nature Climate Change.
“Ultimately…all our families are going to be vulnerable. You can’t cordon yourself off from air or from climate.”
The health risks from climate change have been well documented in extensive studies by, among others, the World Health Organization and the U.S. Third National Climate Assessment. Warnings of the risks have also come from a wide range of professional medical societies, including the American Academy of Pediatrics and the American Thoracic Society.
In a survey of its members, the American Thoracic Society found that climate change is already affecting its patients’ health.
Among the most common impacts were increases in chronic-disease severity from air pollution (reported by 77 percent of respondents), allergic symptoms from exposure to plants or mold (58 percent), and severe weather injuries (57 percent). The survey was conducted by George Mason University’s Center for Climate Change Communication, and the results were published February 2015 in the Annals of the American Thoracic Society.
Additionally, 61 percent of physicians surveyed in 2014 by the National Medical Association, a professional society of African-American doctors, reported their patients’ health already has been affected by climate change.
Those surveyed cited “most notably injuries due to extreme weather, health effects of hotter temperatures, detrimental impacts on chronic diseases due to air pollution, and more allergy problems — and they anticipate that some of these problems will increase in the next 10 to 20 years.’’
“There are a whole host of public-health impacts that are going to hit home,” President Obama said on April 7, 2015, in launching an initiative to highlight the health effects of climate change.
“Ultimately…all our families are going to be vulnerable,’’ Obama added. “You can’t cordon yourself off from air or from climate.” The White House plans to hold a Climate Change and Health Summit in the summer of 2015 featuring Surgeon General Vivek Murthy.
While all Americans are at risk, some populations are especially vulnerable to the health effects of climate change, including children, the elderly, low-income communities, and people with heart, lung, or kidney ailments.
“As the effects of climate change result in increased negative health and environmental outcomes, children will disproportionately bear the burden of these outcomes,” according to the American Academy of Pediatrics.
Americans 65 years and older — a population that is projected to nearly double by 2050 — are more vulnerable to extreme heat, air pollution, and infectious disease.
“Older people are at much higher risk of dying during extreme heat events,” said the Third National Climate Assessment.
Climate change also will disproportionately affect certain communities. Coal-fired power plants tend to be located in low-income and minority communities, according to a study by the NAACP, the Indigenous Environmental Network, and Little Village Environmental Justice Organization.
Additionally, African-American children are twice as likely to be hospitalized for asthma as white children and are more likely to die from asthma. Latino children are 40 percent more likely to die from asthma than white children.
As heat waves become more frequent and intense, rising temperatures are a major concern. On average, extreme heat kills more Americans every year than hurricanes, tornadoes, floods, and lightning combined.
Rising temperatures can increase the risk of heat exhaustion, heat stroke, cardiovascular disease, kidney disease, and even death.
City dwellers are at particular risk because of elevated temperatures in cities — known as the “urban heat island effect” — because paved surfaces absorb the sun’s rays and later re-radiate heat and also because there is a lack of tree cover. “Urban heat islands, combined with an aging population and increased urbanization, are projected to increase the vulnerability of urban populations to heat-related health impacts in the future,’’ according to the 2014 National Climate Assessment.
Rising temperatures also can worsen ground-level ozone smog, aggravating asthma symptoms and other respiratory illnesses. Added to the mix are ragweed pollen and other allergens in the air — expected to worsen as rising carbon dioxide levels cause plants to grow bigger and produce more pollen over longer seasons.
Today’s increased levels of carbon dioxide can cause ragweed to produce twice as much pollen; by 2075, that could be four times as much.
One in three Americans — 109 million people — are exposed to both unhealthy ozone levels and ragweed pollen. Both exposures can worsen asthma, and both higher ozone smog and pollen levels are associated with climate change, NRDC says in its May 2015 “Sneezing and Wheezing’’ report.
According to the report, the top 10 “sneeziest and wheeziest’’ U.S. cities are Richmond, Memphis, Oklahoma City, Philadelphia, Chattanooga, Chicago, Detroit, New Haven, Allentown, and Atlanta. “While these urban areas rank as the worst for both ragweed and high ozone levels, the most vulnerable regions nationally are the Los Angeles Basin, the region around St. Louis, the Great Lakes area, the MidAtlantic states, and New England,” the report says.
Scientists have projected that ozone concentrations in the New York metropolitan region will increase as a result of climate change, driving up the number of ozone-related emergency-room visits for asthma among children in the area by 7.3 percent — more than 50 additional ozone-related emergency-room visits per year in the 2020s, compared to the 1990s, according to a report in the American Journal of Preventive Medicine.
Hotter weather also enables disease-carrying insects to expand their range, bringing new risks of illnesses such as Lyme disease, dengue fever, and West Nile virus. As temperatures increase and rainfall patterns change — and summers become longer — these insects can remain active for longer seasons and in wider areas, increasing the health risks for nearby populations.
“Tropical diseases that were once rare on our soil could become more common due to climate change,’’ warned more than 75 health professionals and scientists in a letter to congressional leaders.
“We are concerned about new infectious diseases arising in the Midwest as the organisms that carry them move north due to rising temperatures,” according to a statement signed by 180 science faculty and researchers from 38 Iowa colleges and universities. “We are now seeing new species of mosquitoes and ticks in Iowa capable of transmitting diseases such as dengue fever and ehrlichiosis. With increasing temperatures, more rainfall, and longer summers, these mosquitoes and ticks can live longer and expand their range.’’
Among other health effects of climate change, more severe storms can lead to drownings, drinking-water contamination, outbreaks of infectious disease, and moldy houses. Floodwaters also can overwhelm sewage systems, increasing exposure to infectious diseases.
Climate change will worsen wildfires, and smoke can pose serious health risks to people hundreds of miles away from the source, a 2013 NRDC report found. Wildfire smoke can cause asthma attacks and pneumonia, and worsen chronic heart and lung diseases.
Lower birth weights are found among babies born to mothers exposed to wildfire smoke during pregnancy, according to a 2012 paper published in Environmental Health Perspectives.
The health costs from climate change–related events already total in the billions, according to a 2011 economic analysis in Health Affairs.
Limiting climate change and its harmful health effects helps create healthier, more secure communities and is a legacy we can be proud to leave our children and grandchildren.
The Clean Power Plan isn’t just a program to help stabilize the climate. It is also a valuable investment in Americans’ health and well-being.
From Clean Power: The Case for Carbon Pollution Limits
Next chapter: Extreme Weather, Extreme Trouble →
