A “sense of urgency” for the HHS Climate Change Office

To address the global health effects of global warming without any money or permanent staff, low-income and older populations are likely to have devastating consequences ranging from weather emergencies to chronic illnesses that can lead to deaths and cost the government billions of dollars.

City and state public health officials, meanwhile, say hundreds of billions of dollars will be needed to stop climate-related health problems that are developing across the country.

“Climate change is the single greatest threat to human health,” said Jeffrey Duchin, Seattle and King County Health Officer. “And I’ve been busy with Covid for the last two years.”

HHS set up the Climate Change and Health Equality Office in September and instructed staff from other parts of the department to prioritize the office as it waited for funding to be released this year. Budget. The package passed last month, but $ 3 million in demand fell among other provisions – such as bulk Covid-19 relief – as lawmakers sought to cut costs.

“I believe some people have an urgent sense of climate change and certainly not others,” said Rachel Levine, HHS Assistant Secretary of Health, who oversees the Climate Change Office and hopes to provide more funding in the future. Years.

Levine traveled to Seattle in March to meet with Ducin and other public health officials, first responders and community advocates. Officials painted a bleak picture, saying their country’s health systems – the first to report coronavirus cases in the U.S. in February 2020 – were poorly prepared for a second crisis that led to heat stroke, forest fires and the prospect of moving critical patients. Risk hospitals in these scenarios.

Consider “cascading” effects

Nearly a year and a half after the first corovirus case, a new emergency has affected the same vulnerable, elderly and underprivileged population devastated by the current pandemic, said Ambulance doctor Stephen Mitchell, director of the emergency department at Seattle Center Harborview Medical Center. Efforts by city hospitals to improve treatment capabilities during a pandemic.

Another district hospital called Harborview at the request of fans. South Seattle providers were particularly flooded with patients from nearby low-income areas without air conditioning. Meanwhile, the extreme heat brought people into the building at a time when public health officials were emphasizing social distance to avoid Covid.

“Fortunately, we were kind of in the middle of a covid wave, so our system had little power,” Mitchell said. “Because it could have been a lot more devastating when you put one disaster on top of another.”

For Washington, which recorded 100 deaths after a heat wave, it was one of the deadliest weather events in the state’s history. There were even more casualties on the west coast of Oregon and Canada Some predictions It is estimated that more than 1,000 people died of fever-related illnesses during and shortly after the emergency in late June. Most of them were elderly and low-income people, reflecting the growing trends in climate change and health impacts around the world.

“People perceive heat easily because they see it. But they may not really acknowledge how disastrous it is for the community, ”said George Benjamin, executive director of the American Public Health Association and former secretary of the Maryland Department of Health and Mental Health.

Benjamin described the effect of urban “heat island” when cities with small green spaces – often minority communities – saw higher temperatures and poor air quality than nearby areas, with cardiovascular problems and asthma. One Johns Hopkins is studying in Baltimore Tried to connect increased crime with hot days.

The health costs of climate change and air pollution are “far exceeding” $ 800 billion annually between premature death, medical expenses, related medications and indirect taxes such as home and community instability, job loss and mental health damage. 2021 Analysis Medical Society Consortium on Climate and Health, the Natural Resources Protection Council and the Wisconsin Health Professional Climate.

Some of these factors are more directly measurable than others, but even quantifying them is difficult. For example, hundreds of Americans Died of fever last summer Causes cardiac arrest, brain damage, and failure of other organs. Even more so Died of drowning When trying to cool down. Ambulance workers and hospital staff were stretched between heat emergencies and coronavirus cases.

This is the “cascading” impact of climate change-related health issues, which Ducin and other public health experts refer to as domino-like health and equality challenges.

“Our healthcare system has already been strained by Covid-19 and then you have the added burden of a weather event causing additional stress to both our emergency medical care and our healthcare delivery system,” he said. “We really need to pay more attention to strengthening the resilience of our healthcare system to deal with these many threats.”

Funding Challenge

Without funding, the Federal Reserve’s climate staff – including Environmental Fund scientists John Balbus and Arsenio Mataka – advised current HHS Secretary Xavier Becker on his environmental policies when he was California Attorney General. Set office goals and integrate the scope of the problem.

Levin said the group plans to collect data on the impact of climate change on health, some of which exist at the Environment Agency, disease control and prevention centers or federal care programs such as Medicare and Medicaid, but should be evaluated with new lenses. . Other data lie in Patchwork state and local health systems and hospital records.

With funding, Levin hopes the Climate Office can move on to education and policy efforts. One of the main goals is to push hospitals and health care networks to reduce carbon emissions, which is likely, along with other healthcare sectors such as manufacturers of medicines and equipment. 8.5 percent United States footprint.

This is an important goal that HHS does not actually regulate, although Levin argues that they can use the “bullying platform” to push businesses into greener practices. Other public health experts, who strongly recommend the agency, suggest that federal programs such as Medicare and Medicaid may link payment reforms to climate change, encourage telemedicine, home care, and preventative medicine, which are less expensive than clinical treatment. Or operations.

“It gives us a chance to look at how we care about people,” said Victor Dzau, president of the National Academy of Medicine, who led working groups with Levine, public health experts and industry executives. Liz Fowler, head of the Innovation Center at Medicare and Medicaid, which tests various payment models, was part of these groups.

Other agencies and state governments may also apply for carbon footprints in tax incentives and accreditation institutions, Benjamin told APHA.

The carbon footprint was also in line with Biden’s goal of halving greenhouse gas emissions by 2030 and switching to clean energy, a mission that some environmentalists are worried about is already in jeopardy. Ongoing efforts to reduce high gas prices.

Nevertheless, administration officials and health experts warn that pandemic fatigue and lawmakers’ anxiety over rising federal spending could slow those goals. Congress has already cut funding for a response to Covid-19, which the White House says is needed to purchase more vaccines, treatments and tests, and a separate Department of Health has requested $ 80 billion to fund pandemic preparedness efforts.

“People naturally find it difficult to do anything about future events, even when they are given a lot of evidence that it will all happen,” Ducin said. “Which may just be our fall.”

A “sense of urgency” for the HHS Climate Change Office

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