Editor’s note: This commentary is by Rebecca Jones, M.D., a dermatologist who practices in Brattleboro.
Notes after attending “Integrating Climate Resilience into Public Health,” presented by the Vermont Department of Health’s Climate Change Adaptation Program, a project funded by a grant from the CDC.
[O]n Oct. 8 I made the trek from Brattleboro to Burlington to hear how Vermont will tackle the health effects of climate change. As a physician deeply concerned about climate change and all its impacts, I was thrilled that Vermont is forward thinking enough to commit resources to such an important issue. And I was not disappointed. The two scientists presenting the program to the public were Climate Change Program Chief Heidi Hales, Ph.D., and the Environmental Health Surveillance Chief David Grass, Ph.D. Both were clear and well spoken, and were extremely approachable. They encouraged feedback and participation from all of us in their efforts to study and deal with the health impacts of climate change on Vermonters.
One of their most striking points is that global warming not only will, but already is impacting our health. Consider the following ways climate change is making us sick: temperature-related illness and death; extreme-weather effects; air pollution; water-borne and food-borne diseases; food and water shortages; emotional impacts from both the weather disasters and the long-term outlook of climate change.
HEAT: Even at temperatures below 90°F we start seeing increased ambulance calls and emergency admissions for breathing and cardiovascular problems, heat exhaustion and suicidality. The death rate goes up, especially for the elderly and young.
INFECTION: Cases of Lyme disease have shot up dramatically in the last decade, and Vermont has more Lyme disease than any other New England state. Lyme co-infection reports are rare but increasing, as well. West Nile and eastern equine encephalitis, both mosquito-borne illnesses, are increasing. Water-borne infections like E. coli, salmonella, campylobacter and giardia, which enter the water supply when storms overwhelm our drainage systems, impact our potable water supply and make swimming more dangerous throughout the summer.
AIR QUALITY: Wildfires, pollutants, pollen and mold all impact our air quality and all are increasing with increased temperatures.
EMOTIONAL HEALTH: We all remember how devastating Hurricane Irene was — not just physically, but emotionally. Natural disasters take a toll on all of us. And increased numbers of such disasters are in the forecast. But there is another way climate change impacts our emotional health. It has been coined “ecodespair,” “solestalgia,” or what I like to call “climate anxiety.” It is the sense of helplessness and hopelessness many of us experience in the face of such an enormous and seemingly impossible crisis, made all the more devastating and confusing by the fact that so few of our elected officials seem to be willing to seriously confront the problem.
JAMA’s findings robustly support investing in, among other things, public transportation and sustainable agriculture. They recommend public/non-car transportation for the obvious reasons that reducing car use would decrease carbon emissions, decrease air pollution, decrease accidents, and increase physical fitness.
The Vermont Health Department task force, along with the CDC, UVM, the medical community, other stakeholders and the public, will be monitoring as well as providing education on: heat and its impacts, air pollution, blue green algae blooms, ticks and infections, as well as mental health impacts. Data collection will be key to helping Vermont quantify and respond to the problem at hand.
In addition to adapting to climate change, we also want to mitigate it. The best way to treat illness after all is to prevent it from happening, and this is true of climate change and its impacts, as well. Fortunately the Journal for the American Medical Association issued a document on Sept. 22 that supports much of what the Vermont team has outlined, but also lays out the co-benefits that climate mitigation can realize. JAMA’s findings robustly support investing in, among other things, public transportation and sustainable agriculture. They recommend public/non-car transportation for the obvious reasons that reducing car use would decrease carbon emissions, decrease air pollution, decrease accidents, and increase physical fitness. Likewise sustainable agriculture reduces emissions and increases access to healthy food. It is estimated that investing in both public transportation and local agriculture would lead to billions in savings over the next decade or so.
Vermont has several reasons to be at the forefront in innovations that link climate change and health care solutions. We are small and agricultural, and in some ways implementing change will be easier for us. Our state also has a precedent for firsts: civil unions is a recent example. But Vermont is also the first state to vote for a single-payer health care model, one that we are adopting in 2017, and this gives us an additional reason to pursue groundbreaking innovation. This new medical payment model will allow us to link funding for infrastructure and policy with the savings we would see from improved health. Better access to public transportation and healthy food will profoundly decrease the annual costs we see in medical care every year. The CDC has estimated that 80 percent of our health care dollars go toward chronic illness, and much of that is preventable. Put more simply, for every dollar spent in true prevention, we save six. This would go a long way in reducing our over $5 billion annual health care bill, and could easily decrease the cost of the single payer system, which is estimated now at about $2 billion.
The changes attributed to climate change that are being observed in our nation’s health, and that are outlined in the JAMA report, are scary in part because they make real and present what can seem vague and distant. Chronicling and understanding the health impacts of climate change are essential because they will help us justify and mobilize toward solutions, such as with our transportation system and food supply, that might otherwise seem too big and impossible to undertake.
I encourage you to learn all you can about health and climate change; to go to the Vermont Department of Health website; to visit JAMA and read about their findings; and to think about ways we can support our state in leading the country in decreasing carbon and improving health.
