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The Tremendous Public Health Opportunity of Climate Action

Yale Public Health Magazine, Focus: Spring 2024
by Robert Dubrow


As the world experiences one climate change-related public health disaster after another, the declaration by a Lancet Commission of academics and editors of The Lancet medical journal in 2009 that climate change is “the biggest global health threat of the 21st century” is becoming more real. Unprecedented heat, wildfires, floods, Category 5 hurricanes, and extreme droughts are causing increasing illness and death. Clearly, the world community must urgently reduce greenhouse gas emissions. But we are also facing many other public health challenges. How do we set priorities?

Ambient air pollution from fossil fuels causes more than 5 million deaths per year globally. Fine particulate matter (PM2.5) emitted when fossil fuels are burned causes most of these deaths, from heart and lung disease, stroke, and diabetes. PM2.5 has been linked to preterm birth, low birth weight, dementia, Parkinson’s disease, respiratory symptoms, and asthma exacerbations. Two other pollutants formed when fossil fuels are burned ­– ground-level ozone and nitrogen dioxide (NO2) – also cause respiratory symptoms and trigger asthma attacks. But there is a technically and economically feasible solution: phase out fossil fuel use in favor of clean, renewable energy.

Indoor air pollution from burning fossil fuels is a related public health challenge. In kitchens with gas stoves, NO2 levels regularly exceed the Environmental Protection Agency’s standard. Children living in a home with gas cooking have a 32% higher risk of asthma than children living in a home without gas cooking. Low-income, Black, and Latino households tend to have the highest NO2 pollution. But there is a solution: enact regulations and financial incentives and subsidies to replace gas stoves with electric stoves and require electric stoves in all new buildings.

Heart disease, stroke, and diabetes account for about a third of the world’s deaths. A sedentary lifestyle and an unhealthy diet are important risk factors for these diseases. But, again, there are solutions. Although exhorting people to exercise and eat a healthier diet doesn’t necessarily work, structural solutions have great potential. We can build attractive, safe walking and cycling infrastructure that is accessible to all. We can provide financial incentives to ensure that grocery stores that sell fresh fruits, vegetables, whole grains, and legumes are present in all neighborhoods, and we could encourage consumption of these products by subsidizing them and taxing unhealthy foods such as red meat and processed meat.

To our great good fortune, the solutions to address these non-climate-change public health challenges are the same solutions we need to address climate change. When we phase out fossil fuels, we eliminate the main sources of the two most important anthropogenic greenhouse gases – carbon dioxide (CO2) and methane (CH4). More specifically, when we electrify cooking, we stop emitting CO2 and CH4 from gas stoves, and when we get people out of their cars, we reduce automobile CO2 emissions. When we shift from an animal-based to a plant-based diet, we reduce the energy intensity and related greenhouse gas emissions of agriculture, and reduce CH4 emissions from cows, a major source of CH4.

Thus, when we tackle climate change, we simultaneously address some of the other major public health challenges of our time. This is why a 2015 Lancet Commission concluded that “tackling climate change could be the greatest global health opportunity of the 21st century.”

Your Action Item For Change:

Walk, bike, or take public transportation. Living car-free can reduce your carbon footprint by up to 2 tons of carbon dioxide equivalent (CO2e) per year.

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