Unhealthy Temperature

Rethinking Public Health as Climate Changes

By Jen A. Miller
Portrait of Jordan Emont, Brown University medical student, by Dana Smith

While the images of climate change tend to focus on the big and bombastic—ocean water cresting over roofs, rescue boats gliding past submerged cars—its everyday effects are being felt right now in impacts to personal health.

The World Health Organization (who) estimates that between 2030 and 2050, climate change is expected to cause 250,000 more deaths per year from malnutrition, malaria, diarrhea, and heat stress. who also predicts that the direct cost of treating illnesses linked to climate change to be between $2 billion and $4 billion a year by 2030.

“When we think about climate change, people think about these global health implications. But how is climate change going to impact small communities?” asks Jordan Emont, a student at the Warren Alpert Medical School of Brown University, who is creating materials to help educate and prepare doctors for climate change.

Rhode Island is the fastest-warming state in the contiguous U.S., according to the Washington Post.

Part of the reason for this, says Rachel Calabro, climate change program manager at the Rhode Island Department of Health, is the heat island effect. This means that cities are heating up during the day and not cooling off at night, making it hard for people—especially those without air conditioning—to recuperate from the heat. What that has meant for residents is worsening health for people with underlying conditions and increased numbers of emergency room visits.

And climate change is impacting more than temperatures. Increased rainfall is fostering mold growth, which in turn is raising asthma rates, while increasing carbon dioxide emissions are triggering pollen production that aggravates seasonal allergies.

“Climate change is … a threat multiplier,” Calabro says. “So if you’re already being challenged … by underlying health conditions or other social or economic issues, climate change is going to make those more challenging.”

(Above) View up a coal-burning plant cooling tower. Photograhy ©Michael Turner

Climate & Community Health

While the Department of Health is working to directly tackle climate change-related health issues, such as by improving the urban tree canopy to try to cool the cities, it is also leading state efforts to address and raise awareness of climate change health issues in local communities.

To encourage local-level projects, the Department of Health’s Climate Change Program awarded 10 mini grants to community groups and municipalities for things like workshops on climate change and emergency preparedness, introductions to community school and garden maintenance, and how local food production is a part of combating climate change.

The funds also helped senior citizens in Barrington sign up for the CodeRED emergency alert system, which texts, calls, and/or emails residents in a given area with public safety notifications. A youth program used the funds to create emergency preparedness kits and develop materials about the effects of climate change to be part of standard move-in packets for affordable housing units, and the Providence Housing Authority provided air conditioner brackets for residents in family developments.

And communities with significant health disparities can apply to become “health equity zones” that receive additional support from the department for interventions to become healthier and more resilient not only to environmental health challenges, but a range of issues from food insecurity to mental health.

The Department of Health is also partnering with other state agencies to identify who most needs information about the public health issues raised by climate change and how to get those messages across.

For example, they worked with infectious disease professionals to identify groups of people who spend a lot of time outdoors—from workers at outdoor clubs to people like youth team coaches and school nurses—to warn them about the dangers of mosquito- and tick-borne illnesses and what they can do to prevent bites. They’ve also partnered with the Pawtucket Red Sox to educate fans at the games about Lyme disease and heat, since the summer is peak time for both tick bites and heat illness.

They have also started a program for outdoor workers, like landscapers and roofers, who are at danger for heat illness, because, says Calabro, they’ve seen an increase in heat illness on high-heat days.

“There have been some deaths in the past, so we really want to make this a priority, especially for employers and the workers … It’s about how to reach our target populations with some of this messaging who don’t normally engage with the Department of Health.”

Preparing Doctors for Public Health Ahead

Emont, the Brown University medical student, is tackling how to prepare doctors to help their patients with climate change-related health issues.

He earned a masters of public health degree from Yale University before coming to Brown, which is when he first became aware of this need.

Climate change, he says, “is likely to be one of the more prominent risk factors for disease for our patients when we become doctors. It doesn’t seem possible that we are getting so little information related to that.”

When he surveyed first-year medical students and asked them about their experience in, current level of knowledge of, and interest in climate change and health, he found that 77.5% had no prior experience with climate change and health. He also found that while 96% of respondents thought that it’s important for medical providers to know about the health impacts of climate change, less than 9% thought their medical school was providing them with sufficient education on it.

As a result of his work, a lecture on climate change has been added to a health science system class. He is also working with the Department of Health to create a video about climate change’s impact on asthma. He hopes that this video—and others—can be given to students as part of their coursework and that he can create a series of podcasts to go with them.

“Across the board in terms of climate change, there are big gaps in figuring out how we convince people that this is important—not just in 20 years, but now,” he says.