NYT on the relationship between health and climate change: unraveling the science is “tricky” but the risks are real

Note: This was cross-posted to my own blog.

Last week, the New York Times published a nuanced and thoughtful piece on the complicated scientific relationship between climate change and health outcomes. It lays out several health effects that advocates frequently bring up – vector-borne diseases, natural disasters, and temperature extremes – and examines the strength of the research behind each association.

The article’s tone is cautious, and it acknowledges early on that public health initiatives based on climate risk are politically fraught and, in some cases, the science is not as robust as some would like.

A White House report listed deepening risks. Asthma will worsen, heat-related deaths will rise, and the number and traveling range of insects carrying diseases once confined to the tropics will increase.

But the bullet points convey a certainty that many scientists say does not yet exist. Scientists agree that evidence is growing that warmer weather is having an effect on health, but they say it is only one part of an immensely complex set of forces that are influencing health.

“There’s a lot of evidence showing that extreme weather can hurt people, but what we don’t know is whether those effects are getting worse,” said Patrick L. Kinney, director of the Columbia University Climate and Health Program, adding that scientists don’t have the long-term data needed to pinpoint how climate change is affecting health.

Mary H. Hayden, a scientist at the National Center for Atmospheric Research in Boulder, Colo., who studies climate and health, said of dengue fever, a tropical disease carried by mosquitoes: “I don’t think we can dismiss the role of climate. But can we say there is a direct causal link? No, we can’t. It’s more complex than that.”

The central point of the article is that the science examining climate and its effects on health is (as most scientists will cheerfully admit) quite complicated, and the data that the scientific community has on the subject is incomplete and patchy for many countries and geographic regions. The upside to this, however, is that we now have much more data than we used to, in no small part thanks to increased political will and a greater sense of urgency.

Evidence is accumulating, however. In 2000, the first National Climate Assessment, a government document weaving together the best evidence on climate change, had just 21 pages on health. The most recent assessment included a special section on health that filled more than 400 pages.

Two peer-reviewed British journals — Philosophical Transactions B and The Lancet — have dedicated many pages to the topic this year. Europeans, unburdened by the level of political controversy over climate change in the United States, often give more conclusive interpretations of the science.

“We are in a far more certain place now,” said Nick Watts of the University College London Institute for Global Health and a co-author of the Lancet analysis. “We feel very comfortable talking about direct effects of climate change on health.”

One thing that the article pointed out was that the effects of climate health – particularly with regard to temperature extremes – is that they disproportionately affect the poor because they are more vulnerable to the elements. This is one thing that we focused on in the health chapter of Climate Risk and Resilience in China (which I co-authored) and why I like the idea of working to reduce climate-related risks to the most vulnerable populations, as that may be a less politically controversial option. No one can argue that many lives are at risk from a heat wave when so many have no access to AC.

Rose Schneider, the IH Section’s Climate Change Working Group Chair, agreed on that point of the article. “It makes sense to be ‘skeptical’ and it is true that especially in developing countries most is written about ‘projections’ of the effects on health, but it is true that the toll is much worse, especially on the poor, if from nothing else than major climate events like floods, windstorms, crop damage from drought, and sea rise. I liked the last line of the article; I’m not waiting.”

As Dr. Kinney noted, “if we wait for the health evidence to be ironclad, it may well be too late.”

Upcoming Panel Discussion: Hunger in the Age of Climate Change (Washington, DC)

When: Wednesday, May 14, 2014, 1-3pm (Lunch available starting at 12:30pm)
Where: 425 3rd St. SW, Suite 1200, Washington DC 20024

 Today the White House will announce the release of the Third National Climate Assessment.  This report is already garnering national and international press; climate change is one of the president’s primary areas of focus.  What does the report say about climate change in the United States, and what do these findings mean for hungry and poor people in the United States and globally? Join with members of the faith, environmental, and anti-hunger communities to discuss how we can work together to provide adequate nutrition even as the climate is changing in ways that require new methods of growing, storing, and transporting food.

Invited panelists include:

  • Katharine Hayhoe, one of Time’s 100 Most Influential People and author of A Climate for Change: Global Warming Facts for Faith-Based Decisions
  • William Hohenstein, USDA Climate Change Program Office
  • Lewis Ziska, USDA Agricultural Research Service
  • Jan Ahlen, National Farmers Union
  • Sam Myers, Harvard School of Public Health
  • Margaret Wilder, University of Arizona

Please circulate this invitation among your networks, and RSVP by May 9 at www.bread.org/climate.

Questions? Contact Stacy Cloyd at scloyd@bread.org

FYI: Upcoming USAID Webinar on New Climate Change Document

The USAID Office of Global Climate Change is introducing a new climate resilient development framework to the Adaptation Community.

On April 8, 2014, at 4 p.m. EST, Kit Batten, USAID/GCC Coordinator, and the adaptation team at USAID will lead a special presentation covering in detail a new publication on climate adaptation for developing countries: Climate-Resilient Development: A Framework for Understanding and Addressing Climate Change. Working with decision makers in governments and across sectors, the framework has been applied in Barbados, Jamaica, Nepal, Peru, Philippines, St. Lucia, Tanzania, West Africa, and other countries that are preparing communities for a climate resilient future. The framework describes USAID’s “development-first” approach, which aims to achieve development goals despite climate change. This framework is an update of the approach presented in 2007 in USAID’s Adapting to Climate Variability and Change: A Guidance Manual for Development Planning.

The event will take place on Tuesday, April 8, from 4 to 5:30 p.m. EST.

In-person: Engility, 1211 Connecticut Avenue NW, 8th floor conference room, Washington, DC 20036

Online webinarhttp://irgltd.adobeconnect.com/climate/
Enter page as a Guest and type in your first and last name. Please include the name of your organization in parentheses.

Call-in number:
United States: 1-877-685-7326   Conference code: 8170974215
International: 1-678-735-7838    Conference code: 8170974215

Please send your RSVP by April 6th and questions about the presentation to Joyce-Lynn.Njinga@engilitycorp.com.

Climate change and public health professionals: A survey of the International Health Section of APHA

The following report summarizes the results of a climate change survey sent out to the members of the APHA IH section. The section’s chair and co-chair, members Rose Schneider and Hala Azzam, compiled the results below.

According to the Lancet Commission’s 2010 report, Managing the Health Effects of Climate Change “global warming is the biggest threat to health in the current century.” Yet most of the public health workforce have not yet been trained to deal with the challenges of climate change. The situation is exacerbated in low and middle-income countries. Faced with limited resources to mitigate or adapt to the increased frequency of extreme weather events, these countries have little infrastructure capacity to deal with, or recover from, climate change related events.

In 2012, the APHA International Health Section Climate Change Working Group (IH CCWG) conducted a brief survey of its members. Questions revolved around the current activities, level of knowledge and interest in climate change as it pertains to the work members do in developing countries. The survey was administered online and had a response rate of about 12% (186/1600 IH members) with 82% of the respondents completing the survey.

Basic demographics results indicated that more than 60% of the respondents were female, and about 40% of the respondents were between the ages of 21-39, and 30% between the ages 40-59. The respondents came from different work environments, with the largest percentage working in academia (~40%) and in NGOS (~30%). About 90 % of the respondents held a graduate or postgraduate degree, and the majority lived in the U.S. Some respondents, however, lived in Asia, Africa, Australia, the Pacific islands, Europe and Central Asia.

When asked about their climate change knowledge and awareness, half of the respondents reported that climate change is very relevant to the international work they do, and about 30% answered somewhat relevant. When asked about climate events in the country/ies where they worked, about 70% indicated changes in rainfall patterns and severe weather events such as hail, storm and floods, and about half indicated an increase in the number of hot days or nights. Awareness of the impact of climate change was high, with about 70% reporting changes in food production, food price hikes, and decreased access to water. Nearly 50% reported awareness of increased population migration, increased malaria incidence at higher altitudes, and deaths due to severe heat. At the same time, 1/3 of respondents reported not knowing what adaptation or mitigation processes or systems exist in the countries where they work. When it came to their views on the five most important activities to address climate change in international health work, more than 40% identified water conservation, climate change adaptation planning, green technologies, research, and development of evidence based approaches.

The two most frequently identified barriers for respondents to address or to integrate climate change activities into their work were; limited political/institutional support and inadequate funding. In response to what kinds of support would help overcome barriers, about 70% reported needing information on how to integrate climate change into ongoing public health activities, and close to 60% expressed the need for training and awareness campaigns, and for tools specific to climate change activities, such as vulnerability assessments, epidemiologic mapping, community preparedness planning, and basic understanding of green technologies.

In conclusion, while 80% of the respondents identified climate change as being relevant to their international health work, less than 20% currently incorporate climate change approaches into their activities. Furthermore, only 1/3 anticipated incorporating climate change into their work in the future. Yet, respondents clearly identified water conservation, climate change adaptation planning, research and development of evidence-based approaches, as well as the use of green technologies, as important activities to be implemented in international health programs. Indeed when probed about what steps, they, as individuals, currently take to reduce their carbon footprint, 93%, an overwhelming majority, stated that they turned off unneeded lights, 86% recycled at home, and more than 65% used public transport/carpooled or walked, lowered the thermostat in winter, turned off electronics, and reduced their trash. When asked about what the IH section should do in climate change roughly 3/4 of the respondents indicated the need to be more active in advocacy and policy, and more than half indicated the need for sharing information (tools, lessons learned, a virtual library, etc.), and joint sessions with other APHA sections and working groups.

In response to the needs expressed by the respondents, we have compiled a brief key resources list that we hope will be useful to readers:

We thank the I.H. Section members for their participation in the survey.
Rose Schneider, RN, MPH Rschneider@jhu.edu
Hala Azzam, PhD, MPH, CPH Hazzam@coempower.com
IH Climate Change Working Group

Global Health News Last Week

Note: There will be no news round-up next week, as the IH section will be conducting its usual array of activities during APHA’s Annual Meeting.  Please tune in for updates on section sessions and activites at the conference.  Meanwhile, you can get your global health news fix from the DAWNS digest, Humanosphere, or the Healthy Dose.

October 16 was World Food Day.
October 17 was International Day for the Eradication of Poverty.


  • Scientists are warning officials negotiating a global treaty on mercury that banning the deadly chemical completely would be dangerous for public health because of the chemical’s use in vaccines. 
  • The Washington Post runs an editorial critical of the GOP presidential candidates’ hostility toward foreign aid.
  • An influential panel of MPs warned that changes in UK aid policies may make overseas aid more prone to corruption and misuse.
  • Attendees at the Asia Pacific Conference on Sexual and Reproductive Health and Rights have called on countries in the region to introduce comprehensive sexuality education in schools.
  • The Kaiser Family Foundation has released a report which finds that global HIV/AIDS funding dropped by 10% in 2010.


  • HP Signed a Memorandum of Understanding with USAID to collaborate in the fight against global poverty through initiatives directed at issues such as public health.
  • GAVI CEO Seth Berkley pens an op-ed in Huffington Post on the economic value of childhood vaccines.
  • The Pan African Parliament has passed a resolution that urges African nations to prioritize maternal, newborn and child health programs.
  • USAID is initiating research to find out whether developing world families will adopt a new cooking technology and adapt their cooking methods to save their health.
  • At an event in Washington, the Aspen Institute’s Global Leaders Council called for increased accessed to contraception worldwide. 
  • Microfinance initiatives to fund development could benefit from reinvigorating their aims and taking on new, integrated approaches, according to experts at the 2011 International Forum on the Social and Solidarity Economy in Montreal.


  • A new study, by researchers from the National Institutes of Health, Gilead Sciences Inc. and universities in Belgium and Italy, suggests that a microbicide gel, which was originally developed to fight AIDS in Africa, could lower the incidence of herpes in many women.
  • RTS,S a malaria vaccine developed by GlaxoSmithKline, is showing great of promise in the early stages of its huge clinical trial.  The American Society for Tropical Medicine and Hygiene Council Member and Science Director at the PATH Malaria Control Program, Rick Steketee, explores the impact of the new RTS,S clinical trial results and what this breakthrough means for science and neglected tropical disease research. On the other hand, Sarah Boseley wonders where the money will come from once the vaccine has passed its trials, and Karen Grepin is not as excited about the new GSK malaria trial results as many others.
  • Adults who have fallen behind on mortgage payments exhibited higher rates of depression and are skipping meals and medications because they cannot pay the bills, a study published in the American Journal of Public Health found.
  • Teenage drivers have fewer crashes after they’ve been driving for a while, but new research in the American Journal of Public Health suggests that a few months behind the wheel do not improve their driving skills much.
  • A recent study finds that the best way to fight TB in patients with HIV is to treat as early as possible.


  • The famine in Somalia isn’t getting much public attention, but not because things are improving. Aid workers predict things will get worse before they get better. Much-needed rain is coming, but the rainfall could deepen the crisis for the four million people there who need help.
  • Numerous UN agencies are ready to be deployed if Southeast Asian nations ravaged by flooding request for assistance.
  • A report by Roll Back Malaria Partnership released at the start of the Gates Foundation’s Global Malaria Forum says that the world is making positive steps towards eradicating malaria. Specifically, 29 countries are on track to stop malaria within a decade.
  • Environmental hazards sicken or kill millions of people — soot or smog in the air, for example, or pollutants in drinking water. But the most dangerous stuff happens where the food is made — in peoples’ kitchens.
  • World Health Organization officials say the rapid and extensive globalization of food production has increased the incidence of food contamination worldwide.
  • Speculators in the agricultural commodities markets are forcing grocery prices to rise too quickly and erratically, according to some top economists marking World Food Day Sunday.
  • Climate change poses an immediate and serious threat to global health and stability, as floods and droughts destroy people’s homes and food supplies and increase mass migration, experts warn.
  • A survey of 87 countries showed more than half the countries reported more or much more awareness of mental illnesses in the past three years. Unfortunately, there is not a whole lot of new money behind that awareness.