Q&A: Climate Change and Health

Professor Robert Dubrow, M.D., Ph.D., is faculty director of the Yale Climate Change and Health Initiative at the Yale School of Public Health. The program was established in 2015 to conduct innovative research, create educational programs and train future leaders in the fight to protect public health against changing weather patterns around the world. The link between climate change and human health is clear, Dubrow says, and the consequences will intensify in the coming decades with more heat waves, increased food insecurity, increased water-borne and vector-borne diseases and new conflicts as people compete for scarcer resources. Climate change, Dubrow says, is “one of the greatest public health challenges of the 21st century.”

Why is climate change a public health issue?

RD: The aim of public health is to create the conditions in which people can be healthy. A stable climate is one of those conditions. Human-produced greenhouse gas emissions have de-stabilized our climate, causing increased injuries, sickness, and death from heat waves, floods, droughts, and storms; increased air pollution from ground-level ozone, wildfires, and aeroallergens; spread of vector-borne, food-borne, and water-borne infections; and water and food insecurity. In addition, climate change contributes to violent conflict over scarce resources. Displaced populations, including those displaced by violent conflict, desertification, and sea level rise, experience a myriad of adverse health effects.

What areas of climate change and public health are of greatest concern to you?

RD: Many of us are so insulated from the natural world that we lose sight of the fact that public health depends on healthy ecosystems. For example, coral reefs, which are under intense stress due to climate change, are major sources of seafood and also protect shoreline communities from damaging storm surges and flooding, with their associated adverse health consequences. Climate change poses a grave threat to coral reefs and other ecosystems that are essential for public health.

Can you give an example of an emerging disease or change in epidemiology caused by climate shifts?

RD: Vibrio is a genus of bacteria the includes the species Vibrio cholerae, which causes cholera. However, some other Vibrio species, with names like Vibrio parahaemolyticus and Vibrio vulnificus, also cause illness, including gastroenteritis and wound and blood infections. Vibrio species live in the oceans. Their abundance in the North Atlantic Ocean has been increasing, most likely due to warming of these waters. This increase in abundance is correlated with an increased incidence of non-cholera Vibrio infections in the United States and Europe. This increased incidence may represent an effect of climate change.

In the Spring 2017 term you taught a practicum course on climate change and public health at the Yale School of Public Health that takes a local approach. Can you describe one of the student projects?

RD: One project, entitled “Bacterial contamination in Long Island Sound: improving beach closure policy and assessing the effects of climate change,” was a partnership with the East Shore Health District (Branford, North Branford, and East Haven). A team of four students examined the relationship between weather-related variables and bacterial contamination in Long Island Sound bathing water. The team found extreme precipitation events, which are projected to increase in frequency in Connecticut due to climate change, to be a significant predictor of contamination. Results were presented (and well-received) at the May 2017 Connecticut Department of Public Health Shoreline Bathing Water Meeting

What skills do public health practitioners need to confront climate change?

RD: Confronting climate change requires interdisciplinary teams, including public health practitioners, climate scientists, environmental scientists, urban planners, architects, engineers, lawyers, economists, and social and behavioral scientists. To confront climate change, public health practitioners and others need to develop the ability to form and work effectively within interdisciplinary teams, which isn’t always easy.

What are your goals for the Yale Climate Change and Health Initiative (CCHI) at the School of Public Health?

We must address climate change because we have no choice.

Robert Dubrow

RD: We aim to offer a comprehensive and rigorous educational program, to catalyze and conduct innovative research, and to build a program in public health practice. The latter program will utilize public health science to support legislative, litigative, regulatory, executive, community, and other efforts to mitigate or adapt to climate change and to achieve climate justice. CCHI aims to combine academic rigor with real-world effectiveness and to train leaders to do the same. To accomplish our goals, we need to secure additional funding and increase our core faculty.

What has been the student involvement in CCHI so far?

RD: In addition to the practicum course, I teach a standard course on climate change and public health. During the Fall 2016 term, in the environmental health sciences core course, Dr. Deziel and I taught a case study entitled “The role of nuclear power in climate change mitigation in Connecticut.” Students can attend CCHI-sponsored talks by prominent climate change and health researchers. We admitted 17 students from across the university as CCHI Student Associates. These students organized seminars and had the opportunity to meet with CCHI speakers. We have supported eight MPH student summer internships and have funded two pre-doctoral fellows.

Can humankind reverse the effects of climate change that have already occurred?

RD: Humankind will be dealing with the effects of climate change for centuries. Even if we stopped all greenhouse gas emissions tomorrow, we are still committed to another 0.5o C of warming due to climate inertia. But there is still a window of a few years during which we could avoid catastrophic climate change if we take bold action. While there are many actions that can and should be taken to reduce greenhouse gas emissions, the essence of what needs to be done as rapidly as possible is clear: generate all our electricity using renewable energy and electrify transportation and heating of homes and buildings.

What is your view so far of the commitment to climate change research under the new administration?

RD: Unfortunately, the new administration’s denial of climate change is based on its alliance with the narrow interests of the fossil fuel industry and not on science. Like evolution, climate change is settled science resting on a firm theoretical and empirical foundation, although the details are continuously being refined. The administration’s intent to defund climate change research will impede progress against the greatest public health threat of this century.

Are there any scientific advances that have come out of climate change and health research?

RD: An important advance is the realization that climate change mitigation is exquisitely aligned with immediate public health goals. For example, conversion from an energy system based on fossil fuels to one based on renewable energy will reduce CO2 emissions, and will also reduce harmful air pollutants such as particulate matter and nitrogen oxides, potentially saving millions of lives each year. Another example is that shifting from animal toward plant agriculture will reduce emissions of methane (an important greenhouse gas), and will also result in a healthier diet.

What can individuals do to minimize their impact on the environment?

RD: Individual actions such as walking or cycling for short trips, eating less meat, installing solar panels, and purchasing electric vehicles, are very important and help create a culture of sustainability. But climate change can only be solved at the level of government policy. Thus, I encourage individuals to make their voices heard by voting, contacting government officials, and participating in peaceful protests.

Are you optimistic?

RD: We must address climate change because we have no choice. Dr. Bernard Lown’s thoughts about the prevention of nuclear war are applicable to climate change as well: “We physicians who shepherd human life from birth to death have a moral imperative to resist with all our being the drift toward the brink. The threatened inhabitants on this fragile planet must speak out for those yet unborn, for posterity has no lobby with politicians.”

To learn more about CCHI, visit http://publichealth.yale.edu/climate/

This article was submitted by Denise L Meyer on July 10, 2017.