Public health’s role in the face of climate change
Warnings about global climate change from the environmental community have largely gone unheeded, but public health professionals have the ability to reframe the debate and move the issue into public’s consciousness.
Public health workers are listened to, but so far they have been largely silent on the topic, Edward W. Maibach told a gathering at the School of Public Health’s annual Alumni Day. He contended that the environmental sciences have run their course on the issue and two thirds of Americans have negative associations with environmentalism.
“You are the answer,” Maibach, M.P.H., Ph.D., director of the Center for Climate Change Communication and professor in the Department of Communication at George Mason University. “There is a lot that can be accomplished by reframing climate change into human health issues.”
All of the speakers agreed that the consequences of climate change on human health will be profound.
Global warming will eventually affect virtually every area of human health, including respiratory ailments, cancer, food-borne diseases, nutrition, human development, mental health and heat-related mortality, said keynote speaker, Christopher Portier, Ph.D.
As the director of the National Center for Environmental Health and Agency for Toxic Substances and Disease Registry, Portier outlined a wide range of public health implications and the need for more research in order for communities worldwide to adjust to the consequences and mitigate the effects.
Portier also called for strengthening not just the public health infrastructure, but health care itself, which he characterized as “not organized or optimized.” Infrastructure and capacity improvements are needed worldwide to meet the shifting spectrums of disease, populations and ecosystems.
Some climate models, said Portier, show regions of the world becoming more arid, while other areas will become increasingly coastal. Farming and food production are obvious areas that will need to change, he said, pointing to the example of Finnish potato farmers who have been faced with earlier-than-usual blight. In Alaska, warmer coastal water temperatures are causing parasitic blooms and melting permafrost, forcing some people to move inland and jeopardizing water and sewage safety in other communities.
Throughout history, said Portier, change and progress have resulted from failures. The ineffectiveness of witch doctors led to the science of medicine; the plague and dysentery led to improved sanitation; and disease spreading across continents began immigration control. He cautioned, however, that failing to meet the challenges of climate change might be too severe to recover from.
“The planet is on the edge. We don’t want to find [out] the consequences here,” he said.
Vectors, heat waves and the need for research
Two of the panelists, Durland Fish, Ph.D., and Jeremy Hess, M.D., M.P.H., further probed the effects of climate change in their particular areas of specialty.
Fish, a professor in the department of the Epidemiology of Microbial Diseases at Yale, called for broadening the field of environmental health to include vector-borne diseases, noting that other biologic disciplines are further along in understanding the importance of climate change. Fish pointed to the mosquito as an example of how unprepared we are for evolution of the species, and of disease. “West Nile virus was the scariest thing that ever happened in my career,” he said.
Warming temperatures will increase mosquito populations and lead to higher mortality for all mammals, not just humans, potentially impacting food supply, he said. Mosquito species will move to new locations and earlier foliage will extend their breeding season in many climates, allowing more reproductive cycles. As a result, Fish predicted, malaria, dengue fever and other tropical diseases will affect many more parts of the world.
Hess, assistant professor at the Emory Schools of Medicine and Public Health and a consultant to the CDC’s Climate Change Program, described the narrow range of thermal comfort humans have and how the 2006 heat wave in California resulted in 1,000 emergency department visits and 140 deaths.
“Mitigation is not enough,” said Hess, “we need to adapt.” Those adaptations may not just be in developing emergency plans, but include measures such as planting more trees in cities and altering building techniques to keep buildings cooler. We need to pay attention to extreme events.
Maibach’s group at George Mason has released a primer for public health professionals to mobilize change in their communities around specific issues such as air quality or extreme weather preparedness.
Social media as a public health tool
The gathering began with a professional development workshop featuring Peggy Neu, president of The Monday Campaigns. She explained how the Meatless Monday campaign was developed and promoted through relatively inexpensive outlets such as social media and the blogosphere.
The group’s initial goal was to reduce American meat consumption by 15 percent to more closely align with the Institute of Medicine’s dietary guidelines. Recent polls show that 50 percent of Americans know about Meatless Monday and that it has influenced 27 percent to consume less meat.
The group has since launched a number of other public health initiatives, including Quit & Stay Quit Monday and Move It Monday, which seek to reduce smoking and promote exercise It is also piloting a new initiative—Man Up Monday—to encourage men to take more responsibility for their sexual behavior and health.
The organization distributes free educational and promotional materials on its website and has a partnership with national health organizations and the schools of public health at Columbia, Johns Hopkins and Syracuse universities.
The Monday Campaign capitalizes on the idea of Monday as a shared experience, a new start and the day in which people are most open to change. It is also the day in which negative health events such as occupational injuries, stroke, heart attacks, and suicide spike.
“We’ve stolen a day of the week for health” she said.