Why Climate Change Is Worsening Public Health Problems
By Chelsey Kivland and Anne Sosin
Around the world, the health care debate often revolves around access.
Dr. Tedros Adhanom Ghebreyesus, head of the World Health Organization, recently announced, "All roads lead to universal health coverage." Discussions for how to translate this vision into a road map for action is central to the agenda of the WHO's executive board meeting this week in Geneva.
Yet focusing on access is not enough. The imperative for access must be paired with a frank acknowledgment that climate change is making communities around the world more vulnerable to ill health. A 2017 commission of The Lancet, a leading health research journal, tracked the effects of climate change on health and found evidence of harms "far worse than previously understood."
As a global health professional (Sosin) and a cultural anthropologist (Kivland), we have witnessed how the global exchange of health technology, expertise and aid has contributed to dramatic gains in the delivery of health care in Haiti and other settings, especially around infectious diseases. Yet climate change threatens to undermine the health gains in vulnerable communities across the globe.
As firsthand witnesses to sharp health disparities globally, we argue that world leaders need to insist that any health care strategy must address the social and environmental vulnerabilities driving poor health in the first place.
The Health Burden of Climate Change
Climate scientists argue that global warming is exacerbating extreme weather events. And natural disasters are often the source of health crises, particularly in fragile settings. Consider the case of Puerto Rico. The official death toll of the storm was estimated at 64; however, later reports have estimated that the disruption of health care services contributed to upwards of 1,052 deaths on the island.
Lagging recovery efforts have exposed how natural disasters deepen the relationship between socio-economic inequality and health disparity. In Puerto Rico, where poverty rates are double those of the poorest continental state, people already struggling with illnesses such as diabetes and kidney disease have seen their conditions worsen as the long-crumbling health care system is overwhelmed with patients and neglected by the mainland government.
The health impacts of the storms may persist even beyond the restoration of health services.
Hurricane Harvey exposed the toxic afterlife of disastrous storms. Storm damage to 40 industrial sites released chemical toxins linked to cellular damage, cancer and other long-term health problems. As The Lancet's Commission on Pollution and Health found, air, water and soil pollution is now the leading environmental cause of death and disability, accounting for more than 9 million deaths annually. These numbers will only grow in the face of climate-induced disasters.
Restoring health care systems is vital for these communities, but it will merely treat the symptoms and not the causes of post-disaster illness. We believe that policymakers must address the link between environmental and health crises.
Haiti as Case Study
We have learned this lesson from our work in Haiti. Once a death sentence in rural Haiti, today HIV is largely controlled thanks to widespread access to antiretroviral therapy. The prevalence of the disease in pregnant women fell from 6 percent to just over 2 percent in the 10-year period from 1993 to 2003. Likewise, vaccines against cholera, introduced in 2015, have proven to be up to 90 percent effective against the disease.
However, even as vaccine coverage continues to grow, the population remains at risk for cholera and other emergent threats. Only 58 percent of the population has access to safe water and only 28 percent has access to basic sanitation. These conditions worsen in the wake of natural disasters. Hurricane Mathew in 2016 triggered spikes in cholera and other waterborne diseases, especially diarrhea, the second leading cause of death among children.
Hitting the one region of Haiti that had not yet been denuded of trees and vegetation, Hurricane Matthew seemed to complete the destruction of the country's food systems.
Since the late 1980s, the erosion of waterways, loss of habitats and destruction of agricultural land have fueled the importation of cheap, processed foods. Rice and pasta have replaced a diet once rich in fruits, vegetables and whole grains. The high-sugar, low-nutrition foods contribute to the dual health burdens of obesity and under-nutrition.
These trends are ongoing, but they are exacerbated by the disastrous shocks of extreme weather events, which are made more likely by climate change. As Hurricane Matthew came ashore, it decimated fishing villages and tore through farming communities, killing livestock, uprooting crops and denuding backyard fruit trees. The United Nations estimated that 800,000 people suffered food shortages.
Closing the Vulnerability Gap
Haiti is often cast as behind the global curve. But as a reflection of the dangerous intersection of climate change, poverty and ill health, it is in fact predictive of what is to come in the rest of the world. Haiti teaches us that our own health is not bound up simply in the present decisions we make about health care systems but rather more broadly situated in the changing natural environment.
Closing the access gap has been a long battle and the gains cannot be underestimated. Yet the challenge ahead is even more daunting. Whereas increasing access has centered on extending health care technologies to underserved populations, closing the vulnerability gap will require approaches that extend beyond the health sector and national borders.
In the past year, the health care debate in the U.S. has centered on attempts to limit or expand access to care. Meanwhile, the Trump administration has left the Paris agreement and unraveled environmental protections for national and transnational corporations—with little resistance from health advocates. We believe that leaders must recognize that environmental policy is health policy. Rollbacks of environmental regulations will cause far greater consequences on health, in the U.S. and globally, than any health care bill.
Fixing health care systems while we undermine the environmental conditions for health are a textbook example of what Haitians describe as "lave men, swiyè atè"—washing your hands but drying them in the dirt.
3 Ways #ClimateChange Affects Our Health Today https://t.co/ezKI1wbytd @350 @climatehawk1 @foe_us @SierraClub @MichaelEMann @greenpeaceusa— EcoWatch (@EcoWatch)1509630195.0
Reposted with permission from our media associate The Conversation.
By Karen L. Smith-Janssen
Colette Pichon Battle gave a December 2019 TEDWomen Talk on the stark realities of climate change displacement, and people took notice. The video racked up a million views in about two weeks. The attorney, founder, and executive director of the Gulf Coast Center for Law & Policy (GCCLP) advocates for climate justice in communities of color. Confronted with evidence showing how her own South Louisiana coastal home of Bayou Liberty will be lost to flooding in coming years, the 2019 Obama Fellow dedicates herself to helping others still reeling from the impacts of Katrina face the heavy toll that climate change has taken—and will take—on their lives and homelands. Her work focuses on strengthening multiracial coalitions, advocating for federal, state, and local disaster mitigation measures, and redirecting resources toward Black communities across the Gulf South.
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"These are not just wildfires, they are climate fires," Jay Inslee, Governor of Washington State, said as he stood amid the charred remains of the town of Malden west of Seattle earlier this month. "This is not an act of God," he added. "This has happened because we have changed the climate of the state of Washington in dramatic ways."
'These Aren't Wildfires'<p>Sam Ricketts, who led climate policy and strategy for Governor Jay Inslee's 2020 presidential campaign, tweeted on September 11 that "These aren't wildfires. These are #climatefires, driven by fossil fuel pollution."</p><p>"The rate and the strength and the devastation wrought by these disasters are fueled by climate change," Ricketts told DW of fires that have burnt well over 5 million acres across California, Oregon, Washington State, and into neighboring Idaho. </p><p>In a two-day period in early September, Ricketts notes that more of Washington State burned than in almost any entire fire season until now, apart from 2015. </p><p>California, meanwhile, was a tinderbox after its hottest summer on record, with temperatures in Death Valley reaching nearly 130 degrees Fahrenheit, according to the U.S. National Weather Service. It has been reported as the hottest temperature ever measured on Earth.</p>
<div id="29ad9" class="rm-shortcode" data-rm-shortcode-id="8346fe7350e1371d400097cd48bf45a2"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1306969603180879872" data-partner="rebelmouse"><div style="margin:1em 0">Drought-parched wetlands in South America have been burning for weeks. https://t.co/pjAKdFcKPg #Pantanal https://t.co/ImN2C5vwcp</div> — NASA Earth (@NASA Earth)<a href="https://twitter.com/NASAEarth/statuses/1306969603180879872">1600440810.0</a></blockquote></div><p>As evidenced by Australia's apocalyptic Black Summer of 2019-2020, fires are burning bigger and for longer, with new records set year-on-year. Right now, Brazil's vast and highly biodiverse Pantanal wetlands are suffering from catastrophic fires.</p>
#climatefires Started in Australia<p>Governor Inslee this month invoked the phrase climate fires for arguably the first time in the U.S., according to Ricketts.</p><p>But the term was also used as fires burnt out of control in Australia in late 2019. In the face of a 2000km (more than 1,200 miles) fire front, and government officials and media who <a href="https://www.dw.com/en/trump-climate-change-denial-emissions-environment-germany-fake-heartland-seibt/a-52688933" target="_blank">played down the link to climate change</a>, Greens Party Senator Sarah Hanson-Young and a friend decided that reference to bushfires was inadequate. </p><p>"We both just said, we've got to start calling them climate fires, that's what they are," the Australian Senator told DW.</p><p>Hanson-Young says scientists have been warning for decades that these would be the effects of global heating. "We've been told these kinds of extreme weather events and destruction is what climate change would look like, and it's right here on our doorstep," she said from her home state of South Australia — where by early September fire warnings had already been issued.</p><p>"Calling them climate fires was making it absolutely crystal clear. It is essential that there's no ambiguity," she said </p><p>Having deliberately invoked the term, Hanson-Young soon started to push it on social media via a #climatefires hashtag. </p>
How to Talk About the Urgency of Global Heating<p>The need to use more explicit language when talking about extreme weather events linked to climate change is part of a broader push to express the urgency of global heating. In 2019, activist Greta Thunberg tweeted that the term "climate change" did not reflect the seriousness of the situation. </p><p>"Can we all now please stop saying 'climate change' and instead call it what it is: climate breakdown, climate crisis, climate emergency, ecological breakdown, ecological crisis and ecological emergency?" she wrote. </p><p>"Climate change has for a long time been talked about as something that is a danger in the future," said Hansen-Young. "But the consequences are already here. When people hear the word crisis, they understand that something has to happen, that action has to be taken."</p><p><span></span>Some terms are now used in public policy, with state and national governments, and indeed the EU Parliament, declaring an official climate emergency in the last year. </p>
Words That Reflect the Science<p>But while the West Coast governors all fervently link the fires to an unfolding climate crisis, U.S. President Donald Trump continues to avoid any reference to climate. In a briefing about the fires, he responded to overtures by Wade Crowfoot, California's Natural Resources Secretary, to work with the states on the climate crisis by stating: "It'll start getting cooler. You just watch." Crowfoot replied by saying that scientists disagreed. Trump rejoined with "I don't think science knows, actually." </p><p>It was reminiscent of the anti-science approach to the coronavirus pandemic within the Trump administration, <a href="https://www.dw.com/en/donald-trump-admits-playing-down-coronavirus-risks/a-54874350" target="_blank" rel="noopener noreferrer">at least publicly</a>. Fossil fuel companies are also benefiting from his disavowal of climate science, with the Trump administration having <a href="https://www.dw.com/en/opinion-trumps-paris-climate-accord-exit-isnt-really-a-problem/a-51124958" target="_blank" rel="noopener noreferrer">pulled out of the Paris Agreement</a> and reopened fossil fuel infrastructure like the Keystone XL pipeline. </p><p>But the science community has responded, with Scientific American magazine endorsing Trump's Democratic presidential challenger Joe Biden, the first presidential endorsement in its 175-year history. </p><p>Hanson-Young says the use of explicit language like climate fires has also been important in Australia due to the climate denialism of politicians and the press, especially in publications owned by Rupert Murdoch. As fires burnt out much of Australia's southeast coast, they were commonly blamed on arson — a tactic also recently used in the U.S.</p>
Climate Rhetoric Could Help Decide Election<p>The language of climate has begun to influence the U.S. presidential election campaign, with Democratic nominee Joe Biden labelling President Trump a "climate arsonist."</p><p>Biden is touting a robust climate plan that includes a 2050 zero emissions target and a return to the Paris Agreement. Though lacking the ambition of The New Green Deal, it has been front and center of his policy platform in recent days, at a time when five hurricanes are battering the U.S. Gulf Coast while smoke blanketing the West Coast spreads all the way to the East. </p><p>People are experiencing the climate crisis in a visceral way and almost universally relate to the language of an emergency, says Ricketts. "They know something is wrong."</p>
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