While the public health community has made strides toward understanding the significant and complex threat to human health posed by climate change, a strategic federal program of research and decision support is not yet in evidence. Expediting the development, funding, and implementation of the needed action calls for leadership from the White House and the U.S. Global Change Research Program and should be reflected in the President’s Fiscal Year 2011 budget.
The public health community has increasingly acknowledged that climate change poses a significant and complex threat to human health, and has made strides toward improving understanding of the links between the changing physical environment and human health concerns.
As noted in the overview of a Climate and Health Workshop at the NOAA Southeast Regional Climate Center: “The ultimate success of adaptation and mitigation strategies in response to climate change and human health will depend on the depth of understanding of the mechanistic links between climate change and the complex components of human health.”
Efforts to increase nationwide resilience to the human health impacts of climate change must be supported by a robust, cross-cutting research program housed in the U.S. Global Change Research Program (USGCRP). The research program should be backed by a strategic plan for developing and coordinating this dimension of an integrated research program on impacts and adaptation. The plan should include creating channels for the stakeholder input needed to identify vulnerability issues and needs for information and decision support. Based on available public information, this level of planning is not yet apparent.
Nature of the threat
The National Research Council, in its 2009 report Restructuring Federal Climate Research to Meet the Challenges of Climate Change, notes that climate change threatens to exacerbate existing risks to human health, amplifying vulnerabilities and reducing the “ability of communities and individuals to cope with or adapt to climate and other stresses…Substantial inequalities in coping capacity exist worldwide, including in the United States where poor, elderly, uninsured, and minority populations are much more vulnerable. In the United States, a robust public health infrastructure, such as sanitation and wastewater treatment facilities, has proven the best defense against adverse health effects from climate change.”
The NRC divides climate change health impacts into five categories:
1. Direct impacts through changing weather patterns (e.g., storms, floods, temperature extremes)
2. Indirect impacts through changes in water supply, water quality, and air pollution, and in ecosystems leading to shifts in disease vectors
3. Systemic impacts through shifts in food supplies, refugee patterns, coastal and agricultural livelihoods, and society’s responses to climate change, such as geoengineering, carbon taxes, and biofuel production
4. Low-probability high-consequence impacts, such as extremely rapid climate change or sea level rise
5. Co-benefit impacts (sometimes called “no regrets” strategies), in which climate mitigation efforts are chosen to help protect health by reducing health-damaging air pollution emissions, lowering the vulnerability of poor populations, improving the built environment, and other means
The high-priority research and health impact assessment activities identified by the NRC include:
• The readiness of the nation to predict and avoid public and occupational health problems caused by heat waves and severe storms
• Characterization and quantification of relationships between climate variability, health outcomes, and the main determinants of vulnerability within and between populations
• Development of reliable methods to connect climate-related changes in food systems and water supplies to health under different conditions
• Prediction of future risks in response to climate change scenarios and of reductions in the baseline level of morbidity, mortality, or vulnerability
• Identification of the available resources, limitations of, and potential actions by the current U.S. health care system to prevent, prepare for, and respond to climate-related health hazards and to build adaptive capacity among vulnerable segments of the U.S. population
At the November 9, 2009 meeting of the National Research Council Human Dimensions of Global Change Committee, the Interagency Working Group on Climate Change and Health reported on its progress. This ad hoc advisory group was born out of identification of research gaps and convened by the National Institute for Environmental Health Science, the Center for Disease Control, and the Environmental Protection Agency. The USGCRP Office has also provided staff support for this “new interagency cross-cutting group on climate change and human health, which is an effort that will serve to examine the potential for programmatic reorganization around societal benefit areas, such as recommended by the NRC.”
Undoing the damage
To date, it appears the Interagency Working Group has worked to identify federal research and science needs in broad human health areas likely to be affected by climate change. But in order to incorporate these objectives into federal research budgets and strategic planning, a plan for research, assessment, and decision support is needed, including an assessment of how to best coordinate and leverage the capacities of specific participating agencies within the USGCRP.
An assessment of current and projected health impacts of climate change across different regions of the country and sectors of the population is also needed as critical baseline for determining research priorities and decision support needs. We hope the incipient revitalization of the National Assessment process will help build the networks necessary to channel the currently missing stakeholder input.
Both the USGCRP and national climate change preparedness suffered during the Bush-Cheney period. The White House stifled honest communication on these issues by the nation’s public health leadership. The USGCRP leadership held back from pushing hard for the needed research and assessment agenda. Damage was done in ways that still remain to be undone with effective action.
The President will soon announce his FY2011 budget, which will include a budget request for climate and global change research. We are into the second year of the Obama Administration now and it is time to start seeing some visible results of the activity of the the White House Office of Science and Technology Policy and the USGCRP interagency leadership group in undoing the damage of the past decade.