National Climate Assessment 5’s Chapter on Health highlights climate change harms to human health
The U.S. Department of Health and Human Services (HHS), as part of the U.S. Global Change Research Program (USGCRP), is pleased to announce the release of the Fifth National Climate Assessment (NCA5). Led by USGCRP and its 14 member agencies, NCA5 draws on the expertise of nearly 500 authors and 250 contributors from every state, as well as Guam, Puerto Rico, and the U.S. Virgin Islands. NCA5 is the most comprehensive analysis of the state of climate change in the United States, providing authoritative, decision-relevant information on how people across the country are experiencing climate change, the risks we face now and will face in the future, and actions underway to reduce carbon pollution and build resilience.
Climate change has profound negative effects on human health. NCA5 documents climate change’s severe health impacts on many populations and highlights the especially strong risk of climate-related harms to people with few material resources. This analysis is contained in the chapter devoted exclusively to health, in each regional chapter, and in many topical chapters.
Risks to health include higher rates of heat-related morbidity and mortality; increases in the geographic range of some infectious diseases; greater exposure to poor air quality; increases in some adverse pregnancy outcomes; higher rates of pulmonary, neurological, and cardiovascular diseases; and worsening mental health. While these risks have the potential to affect all those living in the U.S., they are already having disproportionate impacts on under-resourced and overburdened communities and individuals.
The NCA5 assesses the heightened vulnerability of Black, Indigenous, and other People of Color (BIPOC) communities and the increased risks faced by sexual and gender minorities and people with disabilities. NCA5 discusses adaptation options and other solutions through a social equity lens. In addition to expanding and deepening our understanding of the linkages between social inequity and climate change risks, the NCA5 summarizes the growing evidence of the mental health and emotional impacts of climate change and offers new insights on health system risks and preparedness.
Climate-related hazards routinely disrupt health care delivery systems and threaten access to health care for many. The Missouri River and North Central flood in 2019 caused more than $10 billion in damage, blocked access to hospitals, and increased exposure to pollutants and infectious diseases across several states in the central U.S. Across the country, hospitals (9.3%), nursing homes (10.2%), and pharmacies (12.1%) are at risk of flooding. The NCA5 provides strong support for strategies now being implemented by the Department as a whole, especially those around enhancing health system resilience, especially for community health centers and safety net hospitals that serve low-income and disadvantaged communities.
As NCA5 notes, each metric ton of CO2 reduced is estimated to bring about health benefits in the US that are valued between $8 to $430 (in 2022 dollars), mainly from avoided premature death. These health benefits outweigh costs for many Greenhouse Gas (GHG) mitigation measures. Implementing timely, effective, and culturally appropriate adaptation measures, creating climate-resilient health systems, and preventing the release of carbon pollution protects human health and improves health equity. HHS is committed to supporting community-led preparedness and adaptation efforts and incorporating climate resilience into health equity activities.
The whole-of-HHS approach to addressing this issue includes work by the Centers for Disease Control and Prevention, the National Institutes of Environmental Health Sciences (a part of the National Institutes of Health), Health Resources and Services Administration, the Administration for Children and Families, the Administration for Strategic Preparedness and Response, and the Office on Climate Change and Health Equity in the Office of the Assistant Secretary for Health. Below are some of the efforts underway from HHS offices and Operating Divisions who contributed to the NCA5 as they work to tackle this public health challenge.
Centers for Disease Control and Prevention (CDC)
CDC helps communities prepare for and respond to the health impacts of climate change, with a focus on disproportionately impacted populations. This is reflected in the CDC Climate and Health Strategic Framework (Climate and Health Strategic Framework | Climate and Health | CDC), funding and technical assistance provided to communities by the CDC Climate and Health Program (Climate and Health Program | CDC), and National Institute for Occupational Safety and Health’s (NIOSH) work on heat stress and occupational health (Heat Stress | NIOSH | CDC).
The CDC has several staff members who supported the development of the Fifth National Climate Assessment, including Paul Schramm, who is the federal coordinating lead author for the Health Chapter; Dr. Charles Beard, Dr. Aaron Bernstein, Dr. Shubhayu Saha, and Dr. Ambarish Vaidyanathan, who are authors of the Health Chapter; and Claudia Brown, who is an author of the Southeast Chapter. Additionally, Dr. Ambarish Vaidyanathan is a technical contributor to the Focus on Western Wildfires, and Dr. Evan Mallen and Megan McLaughlin, ORISE fellows at the CDC, are technical contributors to the Southeast Chapter.
National Institutes of Health (NIH)
To address these mounting challenges, the NIH formed the NIH Climate Change and Health Initiative. The Initiative, which is led by the National Institute of Environmental Health Sciences of NIH, with great support throughout the NIH, brings forward the power of the research community in helping to address these urgent issues.
The NIH will work in partnership with other federal agencies, partners, and communities to address some of the research gaps identified in the fifth National Climate Assessment. This will include continuing to build transdisciplinary teams that will work to find improved ways to address environmental justice and health equity issues in climate change and health and to improve health for all.
Office of Climate Change and Health Equity (OCCHE)
OCCHE coordinates activity across HHS, supporting the Department’s Operating Divisions in understanding climate-related health risks to populations they serve and identifying effective strategies for advancing the resilience and sustainability of healthcare, public health and human services. It also offers resources and support to communities and care providers with forecasting tools like its Climate and Health Outlook, and tools like the Health Sector Resource Hub (which documents relevant funding supports and care resources). OCCHE coordinates HHS’ participation in initiatives like the White House-HHS Health Sector Climate pledge which has engaged more than 115 health care organizations across the country in aligning with the Biden Administration’s goals for preparedness and emissions reduction. OCCHE’s Director John Balbus is a part of the USGCRP group and has supported the development of NCA5.
Health Resources and Services Administration (HRSA)
HRSA works to establish partnerships to provide training and technical assistance related to climate and emergency preparedness to raise awareness and facilitate knowledge transfer among clinicians, support staff, and the public health workforce for grantees and partners. HRSA’s work helps to support primary care providers to ensure climate resilience and resilient infrastructure, share best practices, and assist providers in leveraging resources for coordination for their patients (including referrals to other Federal programs such as low-income housing energy assistance/water programs or the Low Income Home Energy Assistance Program (LIHEAP) or the Low Income Household Water Assistance Program (LIHWAP)).
These activities, which include webinars and focus groups, assist with building organizational awareness and capacity to mitigate, prepare for, respond to, and recover from public health emergencies, natural disasters, and other emergencies, and/or potential health effects associated with changing climate.
Administration for Children and Families (ACF)
Climate change has a disproportionate impact on low-income communities. ACF’s Office of Community Services (OCS) administers multiple anti-poverty programs that also work to mitigate the effects of climate change and promote environmental justice, including the Community Economic Development (CED) program, the Community Services Block Grant (CSBG), LIHEAP, and the Rural Community Development (RCD) program. OCS provides regular guidance to grant recipients on how these programs can also help before, during, and after extreme weather and other disasters. That guidance can be found on the OCS Disaster Flexibilities Hub.
Administration for Strategic Preparedness and Response (ASPR)
The Administration for Strategic Preparedness and Response (ASPR) assists the country in preparing for, responding to, and recovering from public health emergencies and disasters. Climate change continues to be critical to ASPR’s work as more frequent and severe weather and climate-related disasters and public health emergencies occur, creating new risks and increasing existing vulnerabilities in our society. ASPR has adapted its preparedness, response, and recovery capabilities to meet the rapidly evolving environment. We have changed the structure of our response and recovery teams to make them nimbler and better equipped to respond to the more frequent missions caused or exacerbated by climate change.
ASPR maintains a focus on underserved communities and vulnerable populations during response and recovery efforts. We recognize that we cannot mitigate climate change risks by ourselves, so ASPR makes it a priority to share its data and the best available resources with healthcare and public health partners so that they can navigate the challenges posed by climate change.