Healthcare leaders are getting more involved with the politically contentious topic because the sector has an “incredible moral authority and voice to educate the public about these issues and help be a driver for policies that are going to change the equation,” said Gary Cohen, a 2015 MacArthur “genius” fellow and president of advocacy group Health Care Without Harm. He noted that medicine and nursing are among the most-trusted professions, and that the healthcare industry accounts for about 18% of the economy, 8% of emissions and a significant amount of garbage sent to landfills.
“There really is no other sector that has that power,” Cohen said. “It's not even close.”
But healthcare, like so many other industries, has procrastinated on suggesting solutions because it either hasn't made business sense, or it has been viewed as a difficult, far-off problem. “We are just beginning as a society to view it as a reality and not just a concept for tree-huggers,” said Al Gini, a business ethics professor at Loyola University in Chicago.
More than two-thirds of the public believes there is solid evidence of global warming, and a growing percentage believes it is a very serious problem. Still, conservatives remain more likely to be skeptical of climate change than liberals and independents, and Congress has been bitterly divided along party lines over the issue, stalling any type of legislative action.
Beyond the immediate ecological effects, research shows that climate change significantly amplifies public health risks. For example, warmer global temperatures cause more frequent extreme weather events, such as heat waves, droughts, floods and hurricanes. Aside from destabilizing community health networks and food sources, those weather conditions will make people more susceptible to heart problems, stroke and infectious diseases. Burning fossil fuels also leads to more air pollution, one of the most common causes of respiratory conditions and premature death.
“Most of us have looked at the issues and believe climate change is a serious threat to health,” said Dr. Andy Haines, professor of public health and primary care at the London School of Hygiene & Tropical Medicine. “It could be catastrophic.” Rare tropical diseases, such as dengue fever and chikungunya, have already appeared in some of the poorest areas of the U.S.
“We have to explain to people that this is no longer just global health,” said Dr. Tochi Iroku-Malize, chair of the family medicine department at the Hofstra North Shore-LIJ School of Medicine in Hempstead, N.Y. “You have to think of these illnesses here.”
If climate change's public-health perils aren't stimulating action, the financial ones could. A Health Affairs study found that the health costs from six climate-related trends in specific regions totaled more than $14 billion between 2000 and 2009, and the costs from similar events will only worsen with further global warming. And that total didn't include the costs of damages to buildings and infrastructure, which healthcare leaders agree could be a major problem.
HHS, the Centers for Disease Control and Prevention and the U.S. Surgeon General have made some efforts to inform and prepare providers for such problems, but much more needs to be done, according to a recent Government Accountability Office report. The feds have a horse in this race, too. The GAO report said because the government is the largest purchaser of healthcare services through Medicare and Medicaid, its expenses “could increase in future years due to climate-related impacts.”
Now, groups like Health Care Without Harm, the World Health Organization and the World Medical Association will use Paris as a stage for advocating broader change.
The rhetoric leading up to the Paris climate talks has intensified from healthcare groups. Doctors for Climate Action, started by the Royal Australasian College of Physicians, said the conference must result in “meaningful and urgent action to combat the adverse health impacts of climate change.” The United Kingdom's Lancet Commission on Health and Climate Change said this summer, “Tackling climate change could be the greatest global health opportunity of the 21st century.”
Because world leaders will be present, the pressure to get something done is almost palpable. Most believe a deal will be reached, and Obama delivered a symbolic message this month by rejecting the controversial Keystone XL oil pipeline, based on concerns over its environmental impact. Much preparation has been done ahead of the conference, and healthcare officials have taken notice.
Some countries have already submitted “intended nationally determined contributions,” documents that offer a rough outline of their climate commitments. The U.S., one of the largest global polluters per capita, has said it will reduce greenhouse gas emissions by up to 28% of 2005 levels by 2025, although several other countries have set much more aggressive targets, according to Dr. Jonathan Patz, director of the Global Health Institute at the University of Wisconsin at Madison.