BRATTLEBORO — On Oct. 8, I made the trek from Brattleboro to Burlington to hear how Vermont will tackle the health effects of climate change.
As a physician deeply concerned about climate change and all its impacts, I was thrilled that Vermont is forward-thinking enough to commit resources to such an important issue.
And I was not disappointed.
The two scientists presenting the program to the public - Climate Change Program Chief Heidi Hales, Ph.D. and Environmental Health Surveillance Chief David Grass, Ph.D. - were both clear, well-spoken, and extremely approachable.
They encouraged feedback and participation from all of us in their efforts to study and deal with the health impacts of climate change on Vermonters.
One of their most striking points is that global warming not only will affect our health, but already is doing so.
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Consider the following ways climate change is making us sick: temperature-related illness and death, extreme-weather effects, air pollution, water-borne and food-borne diseases, food and water shortages, and emotional impacts from both the weather disasters and the long-term outlook of climate change.
Let's look at these impacts, one by one.
• Heat: At the threshold of 90 degrees Fahrenheit, we start seeing increased numbers of ambulance calls and emergency admissions for breathing and cardiovascular problems, heat exhaustion, and an increased risk of suicidal ideation and behavior (suicidality).
The death rate goes up, especially for the elderly and young. This past summer notwithstanding, we are seeing increased numbers of 90-degree days in Vermont.
• Infection: Cases of Lyme disease have shot up dramatically in the last decade, and Vermont has more Lyme disease than any other New England state. Lyme co-infection reports are rare but increasing, as well.
West Nile and Eastern Equine Encephalitis, both mosquito-borne illnesses, are increasing. Water-borne infections like E. coli, Salmonella, Campylobacter, and Giardia, which enter the water supply when storms overwhelm our drainage systems, have an impact on our potable water supply and make swimming more dangerous throughout the summer.
• Air quality: Wildfires, pollutants, pollen, and mold all affect our air quality, and all are increasing with increased temperatures.
• Emotional health: We all remember how devastating Tropical Storm Irene was - not just physically, but emotionally. Natural disasters take a toll on all of us. And increased numbers of such disasters are in the forecast.
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But there is another way climate change affects our emotional health. It has been coined “ecodespair,” “solestalgia,” or - what I like to call it - “climate anxiety.”
This phenomenon is the sense of helplessness and hopelessness that many of us experience in the face of such an enormous and seemingly impossible crisis, made all the more devastating and confusing by the fact that so few of our elected officials seem to be willing to seriously confront the problem.
The Vermont Health Department task force, along with the Centers for Disease Control, the University of Vermont, the medical community, other stakeholders, and the public, will be monitoring as well as providing education on heat and its impacts, air pollution, blue-green algae blooms, ticks, and infections, as well as mental-health impacts.
Data collection will be key to helping Vermont quantify and respond to the problem at hand.
In addition to adapting to climate change, we also want to mitigate it. The best way to treat illness, after all, is to prevent it from happening, and this is true of climate change and its impacts as well.
Fortunately, the Journal of the American Medical Association (JAMA) issued a document on Sept. 22 that supports much of what the Vermont team has outlined but also lays out the co-benefits that climate mitigation can realize.
JAMA's findings robustly support investing in public transportation and sustainable agriculture, among other things. The publication recommends public/non-car transportation for the obvious reasons, including reducing car use, which would decrease carbon emissions, decrease air pollution, decrease the number of accidents, and increase physical fitness. Likewise, sustainable agriculture reduces emissions and increases access to healthy food.
It is estimated that investing in both public transportation and local agriculture would lead to billions in savings over the next decade or so.
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Vermont has several reasons to be at the forefront in innovations that link climate change and health-care solutions.
We are small and agricultural, and in some ways implementing change will be easier for us than for other states. Our state also has a precedent for firsts: civil unions is a recent example.
But Vermont is also the first state to vote for a single-payer health-care model, one that we will adopt in 2017. This model gives us an additional reason to pursue groundbreaking innovation.
This new medical-payment model will allow us to link funding for infrastructure and policy, using the savings we would see from improved health. Better access to public transportation and healthy food will profoundly decrease the annual costs we see in medical care every year.
The CDC has estimated that 80 percent of our health-care dollars go toward chronic illness, much of which is preventable.
Put more simply, for every $1 spent in true prevention, we save $6 - money that would go a long way to reducing our more-than-$5-billion annual health-care bill. It could easily decrease the cost of the single-payer system, which is estimated now at about $2 billion.
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The changes attributed to climate change that are being observed in our nation's health - and that are outlined in the JAMA report - are scary in part because they make real and present what can seem vague and distant.
Chronicling and understanding the health impacts of climate change are essential because they will help us justify and mobilize toward solutions, such as with our transportation system and food supply, that might otherwise seem too big and impossible to undertake.
I encourage you to learn all you can about health and climate change. Go to the Vermont Department of Health website, to visit JAMA and read about the publication's findings and to think about ways we can support our state in leading the country in decreasing carbon and improving health.