World on Fire

A Pew Research Center poll conducted in January of this year cited the economy and health care costs as being among the top political concerns for voters, with climate change falling closer to the bottom of the list. And yet, climate change has had—and will continue to have—tremendous ramifications on health care costs and the U.S. economy.

According to the 2023 Report of the Lancet Countdown, global extreme weather events cost the world $264 billion in 2022 and hotter days and droughts in 2021 led to more than 121 million people experiencing moderate or severe food insecurity. 

“When people talk about lowering health care costs, they have to think about the causes of those costs,” says Yang Liu, PhD, Gangarosa Distinguished Professor and Chair of Environmental Health. “Being in an increasingly unpredictable climate is one of those risk factors. People need to think about adaptation or behavioral change to avoid being in harm's way of climate change. The environment we live in has a direct and profound effect on people's health.”

Heat waves directly affect outdoor workers who may have to cut their work time, switch the start of their workday, or have their productivity impacted, all of which have economic impacts. There is also an increased exacerbation of chronic conditions—particularly in aging populations—which cost money to diagnose and treat. 

Researchers have found links between high heat and acute kidney disease, anxiety, preterm and early-term birth, fertility, anxiety, homicide rates, aggression, suicides, and death, and have also begun to make connections between heat waves and overdoses.

“In general, the population is getting sicker in terms of chronic diseases like diabetes and Alzheimer's for older populations and asthma and respiratory illness in children,” says Howard Chang, PhD, professor of biostatistics and bioinformatics. “All of those will be exacerbated by climate change. As the population gets sicker, the role climate change plays on our health will grow more apparent.”

It isn’t just the health impacts and concern over the environment that may be pushing changes toward green energy. There are political and economic advantages to improving climate change as the United States continues to compete in the global marketplace.

“Getting left behind as the energy transition evolves is another reason why presidential candidates might want to invest in some of these emission-reduction technologies. In addition to the climate benefits, they can also pay off from an economics, employment, or intellectual property type of perspective,” says Noah Scovronick, PhD, assistant professor of environmental health. “So, there are lots of reasons to act, even if the politics might superficially indicate otherwise.”

Like exposure to heat, air pollution has significant impacts on health and is one of the leading causes of morbidity and mortality around the world. Climate change itself also directly affects air pollution levels. Researchers have found correlations between air pollution and heart attacks, stroke, birth defects, Alzheimer’s disease, COPD, and premature death, among other issues. Rollins-led research released earlier this year found correlations between incidences of Alzheimer’s disease and air pollution caused by traffic, putting those living near major roadways at greater risk. Continued growth in urban areas and an aging U.S. population bring additional concerns.

While the effects of climate change cross racial, economic, and geographic areas, a disproportionate amount of climate impacts will affect lower-income neighborhoods due to several factors:

Mobility
For communities with less income, escaping a natural disaster or migrating from an area with bad weather or extreme heat can be far more difficult than populations with an economic safety net.

Recovery
Those with access to less resources may have a more difficult time recovering from the impacts of a natural disaster, like a hurricane, for instance.

Urban Heat Islands
Many low-income neighborhoods lack green spaces or shade, which intensifies the urban heat effect. 

Proximity to Pollution Sources
Lower-income neighborhoods are often situated near major interstates, industrial sites, and roadways where pollution is more abundant.

Work Settings
Outdoor workers and those relying on public transportation face more exposure to the impacts of heat and air pollution.

Access to Relief  
For many, staying cool in extreme heat is as simple as turning on the air-conditioning, but for those struggling to make ends meet, cranking up the air-conditioning or cooling down in a personal vehicle may not be a possibility.

Rollins researchers engaged with the Emory Climate & Health Actionable Research and Translation Center (CHART), part of the Emory Climate Research Initiative, are currently conducting studies analyzing emergency room data from the Emory Healthcare system and Grady Hospital during times of extreme heat to better understand the influence of high heat days on emergency room visits for a number of health outcomes, including heat stroke, acute kidney disease, and severe asthma. Through the data, they are hoping to gain a better snapshot of who is most impacted by high heat days and how, with information on the socioeconomic, daily activity, and career backgrounds of those who are being admitted to hospitals on high heat days.

The human-made contributors to climate change can largely be blamed on fossil fuel usage in powering transportation, manufacturing, businesses, and homes.

The Biden-Harris administration’s Inflation Reduction Act—passed in 2022 with Harris’s tie-breaking vote—was the nation’s largest investment in climate in its history, with $370 billion dedicated to supporting clean energy innovation and implementation. At the time of this article’s publication, Harris had not released her climate agenda, but did mention the environment as a “ freedom at stake” this election during her address at the Democratic National Convention. As governor of Minnesota, Tim Walz established a climate-forward track record that included signing a law that seeks to shift Minnesota’s electrical needs to carbon-free sources by 2040, supporting renewable energy projects, offering rebates for electric vehicles, and more. 

Trump has offered a contrasting position. In several speaking appearances and statements, Trump has shared his intent to remove the United States from the Paris Climate Agreement, increase domestic oil and gas production, promote nuclear energy production, and fast-track the approval of natural gas pipelines into the Marcellus Shale in Pennsylvania, West Virginia, and New York. 

“Greenhouse gasses and air pollutants have the same sources,” says Scovronick. “If you burn fossil fuels, you get air pollutants and greenhouse gasses. So, if you stop burning fossil fuels, you get a climate benefit and an air quality benefit. And those air quality benefits can be big ... many tens or hundreds of thousands of avoided deaths per year, if not more. The value of those deaths, if you monetize them, could outweigh the costs of policies to reduce emissions.”

Scovronick speculates that one of the reasons why policymakers may be reluctant to act on climate change relates to the global benefit of reducing emissions: If people reduce their emissions in the United States, they are benefiting the world.

“There’s a free rider problem where there's an incentive to not reduce your emissions if other people are going to reduce their emissions, which is one reason why it's been so hard to solve. It’s a collective action problem. The reason that the health co-benefits argument is so powerful is that if climate actions cause you to reduce your air pollutant emissions, most of the health benefits happen immediately, and they happen locally. So, most of the benefits will happen in the U.S. if we reduce emissions in the U.S.”

The Clean Air Act and Clean Water Act have been tremendously impactful in improving the air and water quality in the United States and raising public awareness of avoiding outdoor exposures during poor air quality days. However, that does not mean the problem has been solved.

“Higher temperatures could be causing additional air pollutants to circulate in the atmosphere that we worry about from a human health standpoint, including rising ozone levels and drought, which is causing dust storms and contributing to wildfire risks, both of which create air pollution hazards,” says Stefanie Ebelt, ScD, professor of environmental health.

For politicians looking to make a dramatic impact on human health, there are ample opportunities that can be beneficial to the health of Americans and the Earth.

Instituting a carbon tax is one idea that has been proposed, and could be applied to any number of goods and services attributed with emitting carbon (Denmark just initiated the world’s first carbon tax on cows, for instance) with the tax serving to fund green energy. Urban planning is another opportunity for improving health outcomes across the board by building infrastructure in cities that support more green space, vegetation, and shade (adding a cooling effect); making them more walkable; and connected. 

“There are other ways of cooling cities and mitigating the impacts of climate change, but it takes planning,” says Liu. “People have to think about heat management as something that's high on the policy agenda because in a city you not only have a large-scale warming effect, you also have the urban heat island. So, it's like a compounding impact on the urban population. And, over half of the U.S. population lives in cities.”

Adds Scovronick, “One of the reasons that working on climate change can be less depressing than it seems is that on the one hand, when you think about how fundamental fossil fuels are to our society, that sort of speaks to how daunting the problem is. But, on the flip side, it means that if you get serious about reducing our reliance on fossil fuels, you really will profoundly change society. So, it might be an opportunity to change it in a way that's very positive.

“We have an opportunity to make a very positive difference from a public health perspective, a socioeconomic perspective, and an equity perspective. It's just a question of when. And that will happen because we're going to have to deal with this at some point. You just hope it's sooner rather than later.”

Story by Kelly Jordan
Designed by Linda Dobson
Illustration by John Jay Cabuay