‘Sense of urgency’ for HHS climate change office

Without any money or permanent staff to address the public health effects of global warming, low-income and elderly populations are likely to suffer devastating consequences, from weather emergencies to chronic diseases that can lead to preventable deaths. And the government may have to spend billions of dollars.

Meanwhile, city and state public health officials say it will take hundreds of billions of dollars to curb ongoing climate-related health problems nationwide.

“Climate change is the biggest health threat to humanity,” said Seattle and King County Health Officer Jeffrey Duchin. “And I’ve been preoccupied with COVID over the past two years.”

HHS established The Office of Climate Change and Health Equity in September and hired staff from other parts of the department to sketch out the office’s priorities as it waits for this year’s funding. Budget. That package passed last month, but fell short of a $3 million request with scores of other provisions – such as bulk-up Covid-19 relief – as lawmakers sought to reduce costs.

“I believe some people have a sense of urgency about climate change, and of course, others do not,” said HHS assistant health secretary Rachel Levine, who oversees the Office of Climate Change. and hope to build momentum for more funding later. years.

Levine traveled to Seattle in March to meet with Duchin and other public health officials, first responders and community advocates. Delegates paint a grim picture as their county health system – the first to report coronavirus cases in the US in February 2020 – prepares for a second crisis bringing heat stroke, wildfires and the prospect of taking serious patients out. There were no- at-risk hospitals in those scenarios.

Minding ‘Cascading’ Effects

Nearly a year and a half after the first coronavirus case, a new emergency struck the same vulnerable, elderly, and underserved population that had been ravaged by the ongoing pandemic, emergency room physician Steven Mitchell, of Downtown Seattle’s Harborview Medical Center said in a statement. The director of the department and a leader said. Efforts by city hospitals to level up treatment capacity during the pandemic.

Another area hospital called Harborview to ask for ventilators. Providers in southern Seattle were particularly inundated with patients from nearby low-income neighborhoods without air conditioning. Meanwhile, the scorching heat pushed people indoors at a time when public health officials were insisting on social distancing to avoid the spread of COVID-19.

“Thankfully we were in the midst of an escalation of COVID, so there was little capacity in our system,” Mitchell said. “Because it could have been much more overwhelming, when you put one disaster on top of another.”

For Washington, which recorded 100 heat-related deaths after a heat wave, it was one of the deadliest weather events in the state’s history. Oregon and Canada’s west coast record even more deaths some forecast More than 1,000 people are estimated to have died of heat-related illnesses during and immediately after the emergency in late June. Most of them were elderly and low-income people, reflecting larger trends in climate change and health impacts around the world.

“It’s easy for people to get heat because they see it. But they can’t really recognize how devastating it is to a community,” said executive director of the American Public Health Association and Maryland’s Department of Health and Mental Hygiene Former Secretary of State Georges Benjamin said.

Benjamin described an urban “heat island” effect in which city areas with few green spaces – often minority communities – tended to have more cardiovascular problems and asthma, as well as higher temperatures and poorer air quality than nearby areas. Used to see A Johns Hopkins study in Baltimore Demanded to link rising crime with hot days.

The health costs of climate change and ensuing air pollution add up to more than $800 billion annually between premature deaths, medical costs, related drugs and indirect tolls such as loss of home and community instability, lost jobs and mental health. 2021 Analysis By the Medical Society Consortium on Climate and Health, the Natural Resources Defense Council and the Wisconsin Health Professionals for Climate Action.

Some of these factors are more directly measurable than others, but even they are hard to quantify. For example, hundreds of Americans died of heat stroke last summer Which can lead to cardiac arrest, brain damage and other organ failure. more now died of drowning As he tried to cool down. Emergency workers and hospital staff were drawn thin between summer emergencies and coronavirus cases.

These are the “cascading” effects of health issues related to climate change, as Duchin and other public health experts refer to health and equity challenges like dominoes.

“Our health care system was already stressed by COVID-19, and then you have the additional burden of a climate-induced weather event that adds additional stress to both our emergency medical services and our health care delivery system,” he said. said. “We really need to focus more on increasing the resilience of our health care system to deal with these many threats.”

funding challenge

Without funding, climate workers from the federal Health Department—including Environmental Defense Fund scientists John Balbus and Arsenio Mataka, who advised now-HHS Secretary Javier Becerra on environmental policy when he was California’s attorney general—did Has focused largely on meeting with various federal agencies. Create office goals and piece together the scope of the problem.

Levine said the group plans to collate data around the health impact of climate change, some of which is present in federal care programs such as the Environmental Protection Agency, the Centers for Disease Control and Prevention or Medicare and Medicaid, but through a new lens. need to be assessed through Other data is contained in patchwork state and local health systems and hospital records.

With the funding, Levine hopes the Climate Office can move forward in education and policy efforts. A major goal is prompting hospitals and health networks to reduce their carbon emissions, which is projected along with other health sector businesses, such as pharmaceutical and equipment manufacturers. 8.5 percent of America’s total footprint.

It’s a big target that HHS doesn’t actually regulate, although Levine insists they can use the “bullying pulpit” to push businesses toward greener practices. Other public health experts closely advising the agency suggest that even federal programs such as Medicare and Medicaid could combine payment reforms for climate goals, encouraging telehealth, home care and preventive medicine, including clinical Has a lower footprint than testing or operation that costs more to maintain and higher.

“It gives us an opportunity to look at the way people care,” said Victor Dezou, president of the National Academy of Medicine, who has led working groups with Levine, public health experts and industry executives. Liz Fowler, head of the Centers for Medicare and Medicaid Innovation, has been part of those groups that test different payment models.

APHA’s Benjamin said, other agencies and state governments can also build carbon footprint requirements into tax incentives and facility recognition.

The carbon footprint plan would also be in line with Biden’s goal of halving the nation’s greenhouse gas emissions by 2030 and transitioning to clean energy, a mission that some environmental advocates are concerned is already under threat. Current efforts to reduce high gas prices.

Still, administration officials and health experts are wary that pandemic fatigue and lawmakers’ concerns about federal spending could slow these goals. Congress has already reduced COVID-19 response funding, which the White House has said is needed to buy more vaccines, treatments and tests, and has set aside $80 billion for pandemic preparedness efforts by the Department of Health. has demanded.

“People are naturally challenged to really act about future events, even when they are given a lot of evidence that these things are going to happen,” Duchin said. “Which may just be our downfall.”

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