Thirty-three U.S. states have strategic plans for dealing with climate change, but only five of those currently include a public health response. That's a problem, health experts say in a report released today by the Trust for America's Health.
Global warming is already having serious effects on public health in the United States, from severe heat waves that threaten society's most vulnerable residents, to deadly diseases spreading northward, to worsening air pollution and smoke from wildfires that exacerbate respiratory ailments.
"We can see all these problems coming, but as a country we have not done enough to prepare for them," said Phyllis Cuttino, director of the Pew Environment Group's U.S. Global Warming Campaign. "We must take action to protect Americans and people around the world."
In Health Problems Heat Up: Climate Change the Public's Health, Trust for America's Health calls on Congress to increase funding for public health research, education for citizens and public health care providers, and surveillance of water quality, air quality and diseases.
Jeffrey Levi, executive director of the non-profit Trust for America's Health, also urged U.S. senators today to retain or increase the public health funding included in the House American Clean Energy and Security (ACES) bill as the Senate Environment and Public Works Committee starts working on its version of climate legislation this week. He hopes the debate will expand understanding of the impacts of climate change and lead to more support for action from government.
So far, the attention paid to the human health threats from climate change in the states and at the federal level has been minimal.
For example, 26 states have climate change commissions, but only 12 include their department of public health, Trust for America's Health found. Fifteen states have neither a climate change plan nor a commission.
More telling are the results of a survey released in January by the Association of State and Territorial Health Officials that found only 13 of 43 state health officials believed their agency had sufficient planning capacity to address climate change; and only 11 thought their health department had sufficient response expertise.
Part of the problem is that research dollars are only now beginning to come in, said Linda Rudolph, director of California's Center for Disease Prevention and Health Promotion. Scientists don't yet have the models that can predict what will happen at the local level — where public health agencies operate — and those warnings are what can drive public attention and resources.
"Currently, the majority of state and local health departments are not actively engaged in climate change planning and/or developing prevention strategies," the report's authors write.
"At the federal level, public health is not a central consideration of the current research agenda, nor is there substantial funding to help state and local health departments build capacity to prevent and prepare for climate change."
The 2009 budget for the CDC did include a $7.5 million boost for new climate change initiatives to develop and enhance programs to prepare for and adapt to health effects, and this year, the CDC began offering grants to state and local health departments to improve their climate response capacity. The 11 recipients: California; Florida; Michigan; Minnesota; New Hampshire; Austin/Travis County, Texas; Hennepin County, Minn.; Thurston County, Wash.; and Imperial, Mercer and Orange counties in California.
Disasters Spur Action In California
California is ahead of much of the nation in preparing for the health effects of global warming because it is already experiencing health disasters — a brutal heat wave in 2006 killed more than 100 people, wildfires and increased air pollution have exacerbated respiratory illnesses, and the state is experience more severe flooding, Rudolph said. Health officials there are also concerned about the northward spread of dengue fever through Central America and Mexico.
On top of those health threats, California is suffering through the third year of a drought, which creates prime wildfire condition and affects agriculture and water supplies, both of which impact health.
"We are acutely aware of the impact of the environment on the public's health, and we know that global warming will significantly increase those impacts," Rudolph said. "We know that if we wait, we will be less able to adapt to the challenges of climate change.
Urban greening is just one way California cities have tried to tackle their global warming problems, she said. By adding parks and gardens, the trees and vegetation help reduce the heat island effect in urban cores while also cleaning the air, absorbing CO2 and allowing area residents access to more healthy, outdoor activities — healthy people are more likely to survive disaster-related sickness.
"Climate change isn't something that we in government are going to be able to fix alone," Rudolph said. "We really do need all hands on deck. That means within public health we need to do a lot more to engage and educate. We need resources dedicated to health and climate change."
Public Health Recommendations
Trust for America's Health recommends that federal, state and local governments do the following:
• Increase funding for health and climate change programs and research.
• Increase funding for biosurveillance and link it to ecological surveillance systems.
• Ensure that the federal interagency working group on climate change considers policy impacts on health.
• Fund enhanced modeling to map trends at the micro level and assess the findings; cost estimate: $1-2 million.
• Create scholarships and education opportunities to develop the public health workforce for the futue.
• Have the CDC establish national guidelines and measures for climate change and require state reporting.
• Have the CDC and NIH establish joint centers to study health effects of climate change.
• Have the CDC develop a clearinghouse of information on health effects of climate change.
• Have the US Global Change Research Program elevate the interagency Working Group on Climate Change and Human Health to a formal working group.
• Conduct state and local climate change needs assessments.
• Write state and local strategic plans for dealing with climate change, including health consequences.
• Create public education campaigns targeting at-risk populations and vulnerable communities, including children.
The report "underscores how behind the curve we are as a nation," Levi said. "We know states are overwhelmed by existing challenges. We need funding so every state includes public health in strategic planning. Certainly the critical issue is having the resources."