David Rand: Climate inaction endangers public health

Editor’s note: This commentary is by Dr. David Rand, DO, MPH, who is an assistant professor of Medicine at the University of Vermont Larner College of medicine, co-medical director of the Oncology-Hematology Unit and an Internal Medicine/Oncology hospitalist at the Medical Center. He is also on the Steering Committee of the Vermont Climate and Health Alliance.

Several weeks ago I was pleased to speak at the Statehouse in support of the 2020 Plan for Climate Action in Vermont. On behalf of the Vermont Climate and Health Alliance, which represents hundreds of medical and health professionals across Vermont, I joined members of a broad-based, 30-organization coalition in voicing our strong for the plan. I’m pleased to note that the Vermont Medical Society is also part of the coalition. 

As your doctors, nurses, veterinarians and other health care providers, you expect us to act to protect your health. You expect us to say what needs to be said. As stewards of the health of Vermont’s people, we are obligated to speak out, stand up, and act to protect public health. That is why we joined the diverse coalition supporting a plan designed to protect our communities, especially our most vulnerable Vermonters. 

Why am I and so many of my colleagues in the medical and health community extremely concerned? Let’s start with the global picture. 

In the fall of 2018, 100 leading medical health organizations, representing over 6 million health care professionals declared: “climate change is a global health emergency.” 

In 2019, the World Health Organization listed the Top 10 threats to human health. Climate change topped the list. I expect the same in 2020. 

Nationally, the Centers for Disease Control and Prevention predicts severe health risks to all Americans from global warming. 

The American Psychiatric Association reminds us that climate change and extreme weather events can severely impact our mental health, in both the short and long term. 

Here are just a few examples of what my colleagues and I are seeing here in Vermont in our daily work: 

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• Every day that the average temperature in Vermont reaches at least 87 degrees, there is an additional death among those 65 or older. Our patients with lung disease are often the first to notice hot weather, and they call us when it’s very hot or humid outside – because they can’t breathe. 

• It’s not just our lung disease patients who are hurting – people with virtually any chronic medical illness are more prone to exacerbation of their ailments on the hottest days of the year. 

• Both in the clinic and in the hospital, we are caring for an increasing number of patients with serious consequences of tick-borne illnesses such as Lyme and anaplasmosis. 

• We see clear and unmistakable evidence that vulnerable Vermonters are the most threatened by the changes coming at us – the elderly, people in poverty, children, and people with disabilities. They are hit first and hardest. 

The science is clear and unequivocal – climate change is a major threat to human health in the 21st century. This fact has been crystalizing for more and more medical professionals, which is why, two years ago, the Vermont Climate and Health Alliance, joined by the Vermont Medical Association, the Vermont Public Health Association, the Vermont Veterinary Medical Association and other groups sent a letter to the legislature stating so.

Today our message to the legislature, to the governor, and to all Vermonters is that our collective patient – the earth – is in worse condition today than it was two years ago. Our patient has a fever, low blood pressure, and is in the intensive care unit. Left unchecked, by the time Vermont’s schoolchildren are our age, carbon pollution will shatter many systems that we all rely on for health and security. I hope that everyone reading this will take a few moments to visit the climate and health websites created by the CDC and by the Vermont Department of Health. If you do, you will understand why we are speaking out. 

We created this problem together. We will only get out of it together — doing what we need to do and move swiftly off of fossil fuels. The time for inaction and protecting the status quo is over, especially considering we have cleaner, healthier, more affordable, job-creating options available to us now

In keeping with our oath as medical and health professionals to protect the well-being of our fellow Vermonters, the Vermont Climate and Health Alliance is committed to working hard to advance the climate solutions in the 2020 Action Plan, and then doing far more. The health and safety of our people, our animals, and the planet requires it. 

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Bruce Wilkie

The only way we can be successful in addressing climate change is to adopt zero population growth policies.

Phyllis Jay

Thank you Dr David Rand and colleagues for your efforts to safeguard the health of Vermonters now and in the future! Because of your work we can proudly view Vermont as a leader and a model for other states to emulate.

Ydnas Sedohr

Ever since the ice age ended, global warming has been in progress. In fact, global warming or climate change is what ended the ice age. So that is nothing new in many millenniums. As long as I have lived in VT it has always been hot and humid in the summer. That hasn’t changed in almost fifty years. And guess what, it has always had an impact on the health of the elderly, sick, and weak. This is no recent phenomenon. It happens everywhere except maybe in Antarctica. The severe plague of tick borne diseases can be attributed to the slaughter of coyotes, the prime predator of the rodents that host the deer tick population. Do these professionals believe citizens who will be economically overburdened by GWSA and TCI will hunker down in place in hopes of seeing a light at the end of the tunnel? No, they’ll leave for greener pastures like the Okies in the dust bowl.

Susan Leigh Deppe, MD, Psychiatry

Dr. Rand is correct. And the psychiatric effects of trauma due to climate grief and repeated disasters are potentially staggering–in suffering and economic, medical and social costs. We can transition to energy efficiency, conservation and clean renewable energy, and build good jobs while protecting people with low and moderate incomes.

Tim Vincent

If the entire state of Vermont went dark – zero emissions, no electricity consumption – the impact on global warming would barely be statistical noise.


Just for the record,Burlington’s record high for today [2/28 ] is 55 degrees. That was set in 1903! Which begs the question,how many cars & trucks were on the roads? How many homes were heating with oil/coal/wood? Electricity? What was the World population then,and what is it today? With all do respect Dr. Rand,the “Climate” of this Planet has been and will continue to Evolve,with or without us.

Kim Fried

Run for the hills, the sky is falling. No I guess the hills won’t be safe either. But the same old same old proposals that we know will fail and are frankly getting tired of hearing.

Grace Gershuny

The good news is that the most effective action we can take to address climate change will also improve our health by helping to clean the water and produce more nutritious fresh food. Building the soil carbon sponge requires minimal financial investment, but a major shift in how we manage land.

Many farmers are already moving in this direction, but we need a lot more concerted effort and rapid adoption of soil health building land management approaches, more people caring for the land, and public commitment to supporting the movement for regenerative land care. See for more information.

Paul Manganiello

Thank you for your commentary. I would just like to underscore your statement, “The science is clear and unequivocal – climate change is a major threat to human health in the 21st century.” Global warming is a health THREAT THAT IS PRESENT, not something that is off in the future. The basis of global warming is due to our consumption of fossil fuels. We need to conserve energy, improve energy efficiency, and use alternative energy sources. The quickest way to get there is to institute a carbon tax with rebates to low income individuals. This is going to take not only individual efforts, but a societal effort, we all need to be in this effort together

Irene Stewart

All these proposals are very costly. I would like to have the DR. write back with the yearly cost for a VT family, of four, 2 adults, 2 children, commuting about 110 miies per day from outside Chittenden County to work IN Chittenden County. Easy to list utopian ideas, different with a dollar sign is assigned for one family. Please let the readers of your commentary know the approximate cost, yearly, for this family.

Rebecca Wilson

Thank you Dr. Rand for writing this thoughtful article. I wholeheartedly agree with your insight.

John Klar

“We created this problem together. We will only get out of it together .” “We” created it by individual action: the doctor is proposing to solve it via the collective. Does the good doctor keep a tiny lawn, or perhaps mow it with a push mower (for best health)? Perhaps that should be the law. “Creating jobs” refers to manufacturing unaffordable and inefficient EV cars — manufactured using…. fossil fuels. We need doctors as economists as much as we need economists to perform open heart surgeries.

John Freitag

I am afraid while the Doctor has the right diagnosis, but he is offering the wrong treatment. Global warming is not a Vermont problem and will not respond to treatment of the equivalent of a scrape on a pinky while a virulent disease ravages the whole body.
For those of us who believe the science, feel that climate change is the paramount issue of the day and believe we must get to the root of the problem if there is to be any healing of our environment, to have this commentary ignore even mentioning the critical importance of the upcoming presidential election is tantamount to malpractice.

Scott Beck

We have limited resources to fight climate change while the cost of healthcare continues to escalate faster than wallets can open. Ironic.

Karen Mckenny

Thank you David for your clear and concise outline of the issue and what it means specifically to Vermonters. While Vermont may be a small piece of the pie in terms of impacts we can make if everyone has that attitude nothing will be done. We each need to do what we can personally while also using our voice, our vote, and our messaging to let our leaders now this is an issue now and one that will only get worse. I want to look my children and grandchildren in the eye and say–I did make a difference.

Will Hatch

The carbon footprint of Vermont is like a grain of sand on a thousand mile beach, but we’re still talking about this nonsense.

How about we audit the Federal Reserve and start fixing our financial problems first?


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