Charting Our Course

If you’re lucky, sometime in the course of a research career you might find yourself reaching out a tentative hand to turn the knob on an unfamiliar door, and upon looking inside, be surprised to be peering out across a vast, pristine, untraveled landscape spreading to the horizon.

Thinking back, that’s the way I felt when I was approached by scientists at the Goddard Institute of Space Studies in New York around the turn of the millennium. They had developed a complex model of the Earth’s climate system which showed that waste products from our energy-intensive lifestyle were already having profound impacts on our climate, and that those changes would accelerate in the future in the absence of collective action to limit emissions. They asked if I’d be interested in looking into the potential health impacts of climate change. That sounded interesting, so I did a little poking around to see what was out there on the topic.

To my surprise, the public health community hadn’t yet engaged with the topic of climate change circa 2000. People like me who were trained as environmental epidemiologists and risk assessors were busy dotting ‘i’s and crossing ‘t’s on the health effects of air pollution and other well-established risk factors, since that’s where the National Institutes of Health and other key funding agencies were directing their extramural research dollars. A “new” topic like climate change had no constituency within the environmental health science-policy ecosystem, and almost no one was doing research on it in spite of the enormous health impacts that climate change might bring.

I was keen to change that and was lucky to get funding from an innovative program at the Environmental Protection Agency focused broadly on climate change impacts. Building a diverse team of climate modelers, air pollution experts, and geographers, we set out to analyze how future climate change could worsen air quality and adversely impact health. The study eventually concluded that, as soon as the 2020s, climate change would be having a measurable, negative impact on air quality in the eastern US. If unabated, the climate crisis could lead to more pollution-related premature deaths and asthma exacerbations.

At the same time, there is growing recognition that most climate-smart policy changes also bring direct health benefits for local populations via cleaner air; greener, more walkable and bikeable communities; access to healthy, locally-grown produce; and other pathways.

Fast forward to 2020. The Global Burden of Disease project tells us that ambient air pollution remains one of the biggest risk factors for early death.  While progress has been made on some pollutants, the one most sensitive to climate change – ozone smog – is trending upward in many parts of the world.

Impacts of climate change on public health are now seen as a major motivator for climate action.  To be sure, there has been much progress in the two decades since I got involved in this field. In 2015, major world powers came together to form the landmark Paris Climate Agreement. The Obama administration, with leadership from EPA Administrator Gina McCarthy and others, made a real effort to highlight climate change as a human health challenge. The historic Clean Power Plan, proposed in the latter years of the Obama administration, marked the first federal program explicitly focused on greenhouse gas mitigation.  And the economic case for the program was driven largely by health benefits that would accrue to the US population via cleaner air. Meanwhile, forward-thinking cities like New York and Boston were setting ambitious goals to become largely carbon free by 2050.

Now that the adverse health impacts of climate change have become apparent, local action to curb climate-active pollutants is taking off. Those actions hold promise to reduce our future and global impact on the climate system and will have profound benefits for our children and grandchildren. At the same time, there is growing recognition that most climate-smart policy changes also bring direct health benefits for local populations via cleaner air; greener, more walkable and bikeable communities; access to healthy, locally-grown produce; and other pathways. A key goal now is to build the evidence base to understand and quantify these health benefit pathways. With that knowledge in hand, we can chart our course to a healthy, equitable, low-carbon future.

Photo via Getty Images