Public health agencies are running out of money to tackle climate threats

Medical experts say climate change will affect nearly every aspect of public health. Many of these impacts are already being felt.

Heat deaths in the United States are severely underestimated, researchers say, with some studies putting the true total in the thousands each year. Scientists are working to understand the health effects of wildfire smoke, which is a growing problem in many states as megafires ravage the West.

“The more we learn, the worse,” said Paul English, director of Tracking California, a pollution and disease tracking data project for the nonprofit Public Health Institute for Research and Development. advocacy.

In some places, climate change is expanding the range and prevalence of mosquitoes and ticks, and the diseases they spread. A Natural climate change A study published earlier this week found that climate change has already worsened 58% of known infectious diseases. Scientists have discovered that many diseases become more transmissible, reach new areas and worsen in severity.

Other regions are concerned about water quality, as droughts and algal blooms threaten crucial drinking water sources. Changes in growing seasons cause serious allergy problems in some areas. And researchers across the country say they are just beginning to learn more about the mental health consequences of climate change.

But even as state and federal lawmakers have invested billions in clean energy, infrastructure, and forest and coastal protection projects, little or no climate funding has reached the budgets of many government departments. public health. Experts say the lack of investment in health agencies could particularly hurt low-income neighborhoods and communities of color, which already face disproportionate environmental health problems.

“The overall health burden of climate change is severely underestimated,” said Kai Chen, assistant professor of epidemiology in the Department of Environmental Health Sciences at the Yale School of Public Health. “What we see today is just the tip of the iceberg. Whether [health agencies] don’t have dedicated staff working to figure it out, they’re likely to overlook this issue. »

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Despite the challenges, some city and state public health departments are focusing more on climate change.

Minnesota health officials mapped the neighborhoods most vulnerable to heat stress, using air conditioning and tree canopy data. Washington state leaders want to equip schools to serve as safe places for people with respiratory problems when wildfire smoke fills the air. The Washington Department of Health has also hired the state’s first climate epidemiologist, as part of a campaign to fund more climate and health-related positions at the state and local level.

But many public health officials say their climate change efforts are hampered by a lack of money and attention.

Health services are quite aware of climate change and its effects on health, but the main obstacle to why they are not doing more is funding and competing priorities, the biggest being COVID- 19,” said Shelbi Davis, senior climate change analyst. with the Association of State and Territorial Health Officials.

And in some jurisdictions, political leaders are still denying the reality of climate change, making it even harder for public health officials to prepare for its effects.

Funding gaps

Federal investment in climate and health has been hard to come by. Last month, The Washington Post reported that the Office of Climate Change and Health Equity, a new office within the Department of Health and Human Services, has not been funded by Congress, more than a year after the President Joe Biden created it by fiat.

Local health officials said they are still waiting to hear if they will get additional funding under the climate bill the Senate recently passed. The bill includes funding for air pollution monitoring in low-income areas and community programs to address climate change and pollution.

The federal Centers for Disease Control and Prevention is helping state and local health departments prepare through its Climate Ready States and Cities initiative. The $10 million program helps local officials conduct research and set up resources such as cooling centers. But that program currently only supports nine states, one city and one county, even though nearly 40 jurisdictions have applied for the money.

“We have more jurisdictions applying than we have funding available,” said Paul Schramm, a health scientist with the CDC’s Climate and Health Program. “If a state does not receive our funding, it is likely to have little or no capacity to respond to the health impacts of climate change.”

The CDC program helps local health officials assess their residents’ vulnerability and develop plans to protect them from heat, pollution and other climate-related threats. Minnesota received support through the CDC program from 2009 to 2021, which funded five positions focused on research, strategic planning, and community education. But that funding was not renewed last year, leaving the state Department of Health with just one full-time employee focused on climate concerns.

“Funding hasn’t really kept pace with the kinds of impacts that are happening,” said Kristin Raab, director of the state agency’s climate and health program. “This federal funding has been a lifeblood for our program, and I would say [our remaining climate work] is minimal.

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Minnesota is experiencing shifting rainfall cycles that have caused flooding in some areas and droughts in others. He sees more heat-related illnesses, longer allergy seasons and increased threats from invasive pests.

Some states, including Florida, have adopted the CDC’s Building Resilience Against Climate Effects (BRACE) model, a framework for predicting impacts and planning and executing response strategies. But Chris Uejio, an associate professor at Florida State University who oversaw the state’s BRACE program from 2016 to 2021, said the state hasn’t committed enough resources to the work.

“Florida likes to claim to spend the least per capita on government services, but you get what you pay for, especially on longer-term issues like climate and health,” he said.

The Florida Department of Health did not respond to a request for comment.

Medical leaders say public health investments to prepare for climate change should focus on marginalized communities, many of whom suffer from underlying environmental health issues.

“States have not allocated the resources they could or should to vulnerable communities,” said Mona Sarfaty, executive director and founder of the Medical Society Consortium on Climate and Health, a coalition of medical associations. “We need to be more honest with ourselves about where the risk lies and address the risk where it is most glaring.”

Growing awareness

Climate health experts say awareness of the problem is growing, though many agencies are struggling to keep up.

“Ten years ago, we didn’t even think of making the link between a certain [health] outcome and climate,” said Gregg Thomas, director of the Environmental Quality Division for the City and County of Denver.

Denver city agencies collaborated on a cooling center plan and rolled out additional air pollution monitoring, while the Denver Department of Public Health and Environment hired epidemiologists to make the connection between climate exposures and health outcomes.

In Washington state, public health officials successfully urged lawmakers to fund more climate-related positions at the state and local levels.

“There’s been a huge increase in the public health system’s interest in climate change and willingness to invest in it,” said Rad Cunningham, senior epidemiologist with the Washington State Department of Health. “The Department of Ecology and the Department of Natural Resources were early leaders in our climate response, but there is so much public health work in the adaptation space.”

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Washington’s new climate change epidemiologist, Michelle Fredrickson, will be tasked with using climate predictions and weather data to anticipate health effects, while taking action to prevent harm and educate the public.

In some places, work on climate health has come from outside state agencies. Researchers and community leaders in Alabama used federal grants to track exposure to heat and pollution in communities across the state, a project known as ENACT. The group’s work has shown that outdoor workers often face dangerous levels of heat and that heat waves are associated with an increase in premature births.

“Local governments don’t have the capacity to solve these problems,” said Julia Gohlke, project founder and associate professor at Virginia Tech. “Public health agencies are so stretched.”

Chelsea Gridley-Smith, director of environmental health at the National Association of County and City Health Officials, said local leaders are increasingly aware of climate threats, but many agencies have not. yet “integrated” climate preparedness into all facets of their work.

“[Climate change’s effects] are ubiquitous in public health,” she said. “There are all kinds of connection points that are missed and lost.”