Since Inauguration Day, the Biden-Harris administration has quickly started to address a range of critical health threats facing our nation. While tackling immediate challenges like COVID-19, the administration has also moved quickly to address the climate crisis, economic recovery, and racial justice. As physicians, and climate and public health advocates, we are very encouraged by their approach because it demonstrates a clear understanding that the climate crisis is a health emergency and a critical health equity issue.
The evidence of this crisis keeps coming. New research released last week showed that more than 8 million people around the world die each year from breathing air pollution from burning fossil fuels. That air pollution is making us sicker today and driving climate change, which will cause worsening health unless we act. It also means that the administration’s early steps to switch to clean and safe renewable energy will immediately improve our health.
One particularly encouraging move is the creation of a new Office of Climate and Health Equity in the Department of Health and Human Services. The name itself demonstrates recognition that while climate change threatens the health of everyone — through air pollution, heat waves, worsening hurricanes, catastrophic wildfires, the spread of disease-carrying insects, and threats to our food and water — the harms are experienced sooner and worse by those with fewer resources and less power. As with existing health inequities, race, zip-code, income and jobs too frequently predict the uneven impacts.
As encouraged as we are with these initial steps, far more is needed. The Biden-Harris “whole of government” approach to the climate crisis means that all departments must recognize that they are on the front lines of climate change. In addition to a focus on climate in all agencies, we need to make sure that we’re looking at how these policies impact health and health equity rather than simply maintaining — or worse, deepening — an unfair and unjust status quo. What they will quickly see is that climate policies can improve health, advance equity and yield significant health care cost savings. Every agency needs ambitious action that is built on this “triple-win” premise.
A recent memo from 68 health and medical organizations, including the Medical Society Consortium on Climate & Health and Public Health Institute, outlined nine key priorities for promoting health and equity in climate actions across many agencies. For example, there are vital early opportunities in the Departments of Transportation and Agriculture, which have uniquely important levers to pull to improve health, address climate change and advance equity. These can be taken before and alongside efforts to work with Congress to enact legislation to address climate, health and equity.
During his own campaign, Transportation Secretary Pete Buttigieg demonstrated his understanding of the reality that our health is shaped largely by the conditions in which we live, work, study and play. Secretary Buttigieg has an unprecedented opportunity to put that understanding into action by mapping health, climate change and equity on to every effort at the Department of Transportation. Significant investments and policies to make public transit more affordable and convenient and make walking and bicycling far safer would bring big reductions in the chronic illnesses that drive health inequities and health care costs. Improved guidance on road design would make streets and neighborhoods safe for all users and reduce the terrible toll of auto-related deaths and disability. And critically, integrating green infrastructure into transportation projects could help protect communities from sea level rise and worsened flooding due to future climate threats.
Secretary Buttigieg should work immediately with President Biden to realize his executive order for all federal agencies to procure 100 percent Zero Emission Vehicles and to greatly expand charging infrastructure to support that transition.
Similarly, while the role of agriculture in climate and health is apparent to many — from conserving agricultural lands and changing farming practices — there are many other opportunities within the department to improve health and advance equity while addressing climate change. When former Secretary Tom Vilsack is confirmed, he and his team should move to reap climate and health equity benefits through expanded access to healthy, local and sustainably grown food through school meal and child nutrition programs and programs like the Supplemental Nutrition Assistance Program (SNAP).
Additionally, federal investments in policies that support farmers who want to diversify their crops and turn to farming practices, known as regenerative farming, can help to improve agricultural ecosystems. Practices like rotating crops and changing how we use fertilizers and pesticides can help build healthy soils that store carbon, reduce greenhouse gas contributions, clean our air and water, and improve our food security without sacrificing productivity.
We are at a turning point in our efforts to improve and protect the health of everyone living in the United States — and far beyond — by addressing climate change and keeping equity at the center of our efforts. This work isn’t just about avoiding the worst harms from climate change: It’s about improving health and creating a more equitable country on our journey toward a safer, more secure country and world.
Mona Sarfaty, MD, MPH, is the Director of the Medical Society Consortium on Climate and Health based at George Mason University.
Linda Rudolph, MD, MPH, is Senior Advisor for Climate Health and Equity at the Public Health Institute and former deputy director for Chronic Disease Prevention and Health Promotion in the California Department of Public Health.