Hot Topic: Climate Change as a Public Health Crisis

Starving polar bears, severe tropical storms, killer insects—the devastating effects of climate change can seem far removed from the everyday lives of many citizens. However, recent research has estimated that over 250,000 deaths could result from climate change by 2050, demonstrating that climate change poses a great risk to the health of every person on Earth. “It’s so important that people recognize that climate change is about our health,” said Dr. Jonathan Patz, director of the University of Wisconsin’s Global Health Institute, “there are so many pathways through which climate impacts our health.” From safe water and food to breathable air, climate change threatens these health pathways through changing weather patterns with environmental consequences such as agricultural devastation and toxic air pollution. Marginalized groups such as people of color and the elderly are especially at risk of long-term health issues due to climate change.

In June 2019, over 70 prominent medical institutions, including the American Medical Association, formulated a call to action regarding their “Climate, Health and Equity Policy Action Agenda,” proclaiming climate change to be a “true public health emergency.” However, the issue of climate change has been widely politicized around the world and relatively little tangible progress has been made towards a greener future. Recognition of climate change as a public health crisis by global citizens and leaders may be necessary to motivate productive change.

Medicine in the Hot Seat: The Impacts of Rising Temperatures on Medical Treatment

In addition to damaging essential ecosystems and shrinking wildlife diversity, increasing global temperatures can have drastic effects on how various medical diseases are treated and how medical facilities function. People taking certain medications such as antipsychotics, anti-inflammatory drugs, or even allergy pills are at greater risk for damaging sun and heat exposure, which is intensified with climate change-related temperature increases. “There’s research suggesting that our prescription medications may be causing harm because of changing heat patterns,” said Dr. Aaron Bernstein, the co-director of the Center for Climate, Health, and the Global Environment at Harvard University. This creates a significant impairment on the health sector’s reliance on pharmaceutical drugs to treat numerous medical conditions.

Medical facilities can also be impacted by extreme weather events partially triggered by increases in global temperature. “There’s evidence that extreme weather events are affecting critical medical supplies so we can’t do things as we normally would do because IV fluids aren’t available,” said Dr. Bernstein continued, “and there’s evidence that extreme weather events are knocking out power… and that is a huge issue for providing care in healthcare facilities.” For example, patients receiving radiation for lung cancer were found to be at a lower likelihood of survival when their treatments were impeded by hurricanes.

Certain medical conditions can also be triggered by increased global temperatures. As an example, chronic kidney disease ‘epidemics’ are on the rise with more days of extreme heat, which can cause dehydration and lead to kidney malfunction. While kidney disease can be treated early with medications, many low-income populations, particularly agricultural workers who labor for hours under the hot sun, are unable to access healthcare to treat this condition early. Patients with late-stage chronic kidney disease require dialysis and transplants, which are even more expensive treatments, and transplants are especially hard to receive. “There’s enough here to warrant concern that heat stress and dehydration could be a real problem for poor people working in the field,” said Dr. Richard Johnson, a researcher on this issue at the University of Colorado, Denver. With already stressed transplant systems and existing healthcare disparities between socio-economic groups, rising global temperatures pose a great threat to treating epidemics in low-income populations as a result of climate change.

Killer Mosquitoes: The Rise of Vector-borne Diseases

Vector-borne diseases are infectious diseases spread by pathogens such as insects or parasites, and they are increasing alongside rising temperatures and extreme weather patterns. Rising temperatures allow for insect vectors, especially mosquitoes, to spread and transmit diseases in parts of the world that have historically been too cold for them to survive. For example, the range of mosquitoes carrying the Zika virus could increase by up to 13 percent due to increased temperatures, putting millions of citizens and fetuses around the world at risk. Most alarmingly, researchers have estimated that almost 1 billion more people could be exposed to mosquito-borne diseases by 2080 as a result of climate warming.

In regions already inhabited by deadly insect vectors, changes in vector incubation periods due to changing temperatures and precipitation levels could amplify the number of vectors in these regions. “If it’s warmer, to a certain point anyway, the mosquitoes live longer, and the incubation period is much shorter,” said Dr. Michael A. Robert, an assistant professor of mathematics at the University of the Sciences, “that creates a scenario when there can be a lot more transmission.” In under-resourced populations that are already struggling with vector-borne diseases, these statistics are particularly alarming, as pre-existing medical facilities dealing with lower human and medical resources can be completely overwhelmed with these climate change-related increases in infectious diseases. Rising temperatures can also prompt human migration and a decrease in natural predators of these infectious vectors, further intensifying the problem.

Climate Change Consequences on Access to Safe Water and Food

In addition to threats to medical treatment and vector-borne diseases, climate change can have detrimental effects on a population’s ability to access clean water and quality food. With an increase in extreme weather events and global temperatures, destroyed crop fields, persistent droughts, and difficulty growing diverse crops are threatening food security. The UN has found that over 500 million people live in places affected by erosion due to climate change, affecting various populations’ crop yield and nutrition. Milk production is also limited by climate change, and reduced food production can lead to an increase in grocery store prices. “Unfortunately, the consumer ultimately will pay for this rising cost. Everyone has to eat,” said Nate Robinson, a Michigan farmer who has been forced to raise his prices due to lower crop yields.

Extreme weather and increased temperatures are also predicted to jeopardize access to clean water, especially for low-income populations. Rising temperatures can decrease the supply of clean water from rain, snow, and rivers, while a greater amount of extreme weather events can worsen the quality of water due to storm runoff. In communities that already struggle with access to clean water, climate change can only compound this problem, while simultaneously increasing the need for water to prevent dehydration from hotter weather. For example, in Jordan, droughts due to lack of rainfall have been detrimental to the country’s water supply, and the increasing effects of climate change have scientists seriously concerned about sustainability. “We don’t know just how bad those impacts of climate change will be or how large the population will grow,” said Dr. Steven Gorelick, director of the Global Freshwater Initiative at Stanford University, “but it appears to us that Jordan’s freshwater future is pretty grim.”

A Case Study: Climate Change, Health, and Obesity in the Pacific Islands

The Pacific Islands are at one of the greatest risks of health consequences due to climate change because of the geographic characteristics that make them especially vulnerable to rising sea levels, droughts, and extreme weather. The region is facing threats to its health, social, and economic sectors that cannot be ignored. A study by the UN University Institute for Environment and Human Security on the islands of Kiribati, Nauru, and Tuvalu found that over 70 percent of households on these islands have been affected by climate change. Many people on these islands believe that they will have to migrate if these effects amplify, but almost 75 percent will be economically unable to do so.

This precarious position is compounded by the issue of obesity on these islands, which is worsening as a result of climate change. Due to economic and agricultural devastation related to climate change, the Pacific Islands have been forced into increasing dependence on imported food from countries such as Australia and New Zealand. In 2013, New Zealand exported over NZ$7.5 million worth of preserved meat products to the Pacific Islands. These imported foods are often very high in fat, sugar, and carbohydrate, lacking essential vitamins and other nutritional components. The health effects of these imported foods include a rise in obesity (over 50 percent in some Pacific Island countries) and Type II diabetes (over 40 percent of Fijian adults have been diagnosed with diabetes). The connection between climate change, obesity, and health in the Pacific Islands serves as a tangible warning of the widespread population consequences that can occur if climate change is left unresolved. All of these consequences only increase the urgency of implementing sustainable solutions to climate change. It is clear to see that climate change hurts the earth and its inhabitants. Every day, climatologists and physicians discover even more troubling symptoms of climate change, as well as possible solutions. However, soon the damage to the earth will be too great to ignore, and scientists’ prescriptions will be too little too late. We just have to accept the diagnosis and treat it soon—time is of the essence.