No country is immune from climate-change health impacts

Alice C. Gray
A beach area closed to shellfish harvesting on Cape Cod in Massachusetts, where coastal waters are hard hit by Vibrio bacteria.

Each year, The Lancet Countdown tracks more than 40 indicators on links between health and climate change. This year presents the most worrisom outlook to date as key trends worsen. The latest report finds that, with climate action, the lives of millions could be improved and saved.

Examining how climate change, air quality, and COVID-19 worsen racial health inequities for Black, Indigenous, and people of color, the U.S. Brief makes clear that these challenges can't be treated in isolation. Report authors advocate for a holistic response to these converging crises. They stress that integrated solutions can deliver better public health, a sustainable economy, environmental protection and a more equitable society.

Dr. Jeremy Hess is a senior author on the U.S. Brief and and one of the authors of the global report.

Physician Jeremy Hess is a senior author on the U.S. Brief and an author on the global report on health and climate change

He is a professor of environmental and occupational health sciences at the University of Washington School of Public Health. Hess is also a professor of emergency medicine at the UW School of Medicine, a professor of global health at the UW medical and public health schools, and a physician at Harborview Medical Center in Seattle.

"We are seeing climate change impacts on health and productivity from heat, wildfires, flooding, and other hazards, and our health systems are not well prepared," Hess said. "In the U.S. we see clear evidence of how certain communities are more burdened by pre-existing inequities. We have a great opportunity in the recovery from the pandemic to address our vulnerabilities and increase our resilience to the stresses that climate is sure to continue to bring." Hess directs the UW Center for Health and the Global Environment (CHanGE).

No country remains immune from the health impacts of worsening climate change today, according to the global 2020 Report of the Lancet Countdown on Health and Climate, published in The Lancet. The project is a collaboration of more than 100 experts from 35 global institutions including the World Health Organization, World Bank, University College London, and Tsinghua University.

The lead author of the U.S. Lancet Countdown Policy Brief is Dr. Renee Salas, the Yerby Fellow at the Harvard T.H. Chan School of Public Health's Center for Climate, Health, and the Global Environment, an assistant professor of emergency medicine at Harvard Medical School, and an emergency physician at Massachusetts General Hospital.

"This past year, we have seen the harms of our converging crises - COVID-19, climate disasters, and systemic racism," Salas said, It's been a preview of what lies ahead if we fail to urgently make the necessary investments to protect health. Just like in my emergency department, I can't take one health problem and place it in isolation because one insult on the body creates new problems and worsens old ones. We must take an integrated approach when tackling these challenges. Climate action is the prescription we need for better health and equity as we emerge from this pandemic."

Among the other authors of the 2020 global report in The Lancet is Dr. Kristie L. Ebi, professor of environmental and occupational health at the UW School of Public health, and of global health jointly at the UW medical and public health schools. Ebi is the founding director of CHanGE at the UW.

Top findings on the converging crises from this year's U.S. Policy Brief include:

● Air pollution is killing Americans. More than 68,000 people died prematurely in the United States from air pollution in 2018. Nearly 25,000 of those deaths are from particulate or PM 2.5, pollution generated by agriculture and transportation.

● Your zip code determines your health. The Brief examines how climate change further exacerbates existing racial health inequalities that exist because of ongoing discriminatory practices. Early research suggests that exposure to air pollution may make people more susceptible to severe cases of COVID-19. This could be part of the reason more Blacks, Indigenous and people of color are dying from the virus than white people.

● In addition to air pollution, heat also creates deadly conditions: In 2019, the United States experienced over 102 million more days of heatwave exposure (compared with a 1986-2005 baseline) affecting adults over age 65. In the past two decades, heat has killed twice as many older people. In 2018 heat-related deaths reached a record high of 19,000. The United States saw 2 billion potential hours of labor lost due to extreme heat across the service, manufacturing, agricultural, and construction sectors in 2019.

● Wildfire risk is increasing. Individuals in the United States experienced 1.85 billion more person-days (one person experiencing one day) of exposure to high wildfire risk in 2016-2019 compared to 2001-2004.

● Life-threatening bacteria is increasing in coastal waters.

The Eastern Seaboard is seeing an increase in conditions for harmful bacteria in salt waters. Credit: Alice C. Gray

The suitability of coastal waters for growth of Vibrio bacteria has increased by as much as 99% in the Northeast over the past five years.

Without urgent action to tackle climate change, the Global Reports's 120 world-leading health and climate academics and clinicians, and the 70 U.S. institutions, organizations and centers supporting the U.S. Brief, warn that an ever-hotter world will likely produce shocks which threaten global health, disrupt lives and livelihoods and overwhelm healthcare systems. This is especially dangerous when healthcare crises like COVID converge with climate change.

The Lancet Countdown on Health and Climate Change is a comprehensive yearly global analysis tracking the impact of climate change on human health across 41 key indicators. The report also projects the health benefits that would come from meeting the Paris Agreement targets, as well as the health harms of business as usual. The project is a collaboration of more than 100 experts from 35 global institutions including the World Health Organization (WHO), World Bank, University College London, and Tsinghua University.

The 41 indicators are organized across five categories: 1) climate change impacts, exposures and vulnerabilities; 2) adaptation planning and resilience for health; 3) mitigation actions and health co-benefits; 4) economics and finance; and 5) public and political engagement.

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