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3 posts from November 2021


Professor Kristie Ebi Discusses The Lancet Series, "Heat and Health" (November 23rd)

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The climate crisis threatens human health in innumerable ways including injury from extreme weather events, respiratory illness, zoonoses, water-borne, vector borne, and non-communicable diseases, malnutrition, behavioral health and psychosocial problems and finally heat related illnesses and death. Climate crisis-related health effects are and will be particularly be hard felt by the elderly and children and within minority communities.  For example, The Lancet's most recent “Countdown on Health and Climate Change” report found heat-related deaths in people older than 65 reached a record high of 345,000 in 2019, or 81% higher than the 2000-2005 average. Children under one year of age experienced an estimated 626 million additional person days of heatwave exposure in 2020 comparted to a 1986-2005 baseline average. Despite these numbers, a recent World Health Organization (WHO) report found countries’ Nationally Determined Contributions (NDCs), or pledges by governments to reduce their carbon emissions, found that only 13% of NDCs commit to quantifying the health co-benefits of carbon emission reduction policies. Listeners may recall I interviewed Professor Ebi in November 2018 concerning the UN IPCC's landmark report, "Global Warming at 1.5º C."  At: https://www.ipcc.ch/sr15/.

During this 3o minute interview Professor Ebi begins by making brief comment on the just concluded COP 26 meeting. Professor Ebi then explains the impetus for the "Heat and Health" series,  explains the physiological responses to heat stress, discusses health threats via occupation and the urban heat island effect.  She next discusses the second article in the series that identified strategies to address heat extremes in senior care settings and in hospitals and nursing homes ,or the importance of response planning for heat waves including the use of action plans and early warning systems by among others emergency and public health departments.  The discussion concludes with comments concerning related core competency education efforts at the University of Washington and the economic benefits resulting from climate crisis mitigation efforts.               

Kristie L. Ebi is Professor in the Center for Health and the Global Environment at the University of Washington. She has been conducting research and practice on the health risks of climate variability and change Kristie_Ebi - Marci Burden for nearly 25 years, focusing on understanding sources of vulnerability; estimating current impacts and future health risks; designing adaptation policies and measures to reduce the risks of the climate crisis in multi-stressor environments; and estimating the health co-benefits of mitigation policies. She has supported multiple countries in Central America, Europe, Africa, Asia, and the Pacific in assessing their vulnerability and implementing adaptation measures. She has been an author on multiple national and international climate change assessments. She has more than 200 publications and has edited fours books on aspects of the climate crisis.  Professor Ebi earned her BS at Michigan State, her MS at MIT and her MPH and Ph.D. at the University of Michigan. 

The Lancet's recently published "Heat and Health" series is at: https://www.thelancet.com/series/heat-and-health.

The World Health Organization's (WHO's) recent report, "The Health Argument for Climate Action," referenced during this interview, is at: https://www.who.int/publications/i/item/cop26-special-report.



250th Podcast: Harvard's Dr. Aaron Bernstein Discusses COP 26, the National Academy's Climate Crisis Effort and Related Issues (November 19th)

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Concerning the recent United Nation’s COP 26 meeting in Glasgow, again unverifiable pledges were made moreover to cut methane gas emissions by 30% by 2030, limit deforestation and adequately finance converting to a green economy.  The US continued to exhibit intransience and/or fecklessness moreover by refusing to sign a pledge to phase out coal despite the fact it is the single biggest source of CO2 emissions worldwide and the fact the US still generates 20% of its electricity from coal. The US also continued to oppose adequately funding countries to recover (termed "loss and damage") from climate-fueled disasters - disproportionately caused by US carbon emissions.  The US is responsible for 40% of excess carbon emissions since 1750. Concerning the US's performance, the Third World Network's Meena Raman commented, "You walk out of the Kyoto Protocol [1997].  You walk out of Paris.  You come back and want us to think you're doing more?  What you're actually encouraging is people to walk out and then come back.  And then you're applauded."  Concerning the credibility of the US "doing more," earlier this week the Biden administration announced it would launch the largest ever auction of oil and gas drilling leases in the Gulf of Mexico. A decision Earthjustice defined as amounting to a “climate bomb.” As a related aside, the Biden administration has been to date issuing oil and gas drilling permits at a faster pace than the Trump administration. In sum, based on an analysis of countries’ 2030 GHG emissions goals, the latest Climate Action Tracker finding shows global warming doubling to 2.4 Celsius above pre-industrial levels, considerably warmer than the 2015 Paris Accord goal of 1.5 Celsius of warming - that substantially runs the risk of causing runaway global warming, or what's been termed Hothouse Earth.  As for the US healthcare industry’s considerable contribution to the climate crisis, the industry has still not taken any meaningful action.  This past Friday the House passed the Build Back Better (BBB) Act that would in part provide $550 billion to address the climate crisis, or in sum allow the US to get halfway to the Biden administration's goal to reduce emissions by approximately 50% (over a 2005 baseline) by 2030. Passage of BBB in the Senate is, as widely reported, in doubt.

Listeners may recall I interviewed Dr. Bernstein’s colleague, Dr. Renee Salas, in June and again in December 2019 regarding the climate crisis.

During this 33 minute conversation Dr. Bernstein begins by commenting on the COP 26 meeting and its results, comments on the clinicians' knowledge of the climate crisis (i.e., the John Kotcher survey that I discussed with Professor Kotcher on May 27th), C-CHANGE's policy work, use of Conditions of Participation and/or a value based payment system to regulatorily require hospitals to limit their carbon emissions (and the financial benefit thereof to hospitals), argues regulation is unnecessary to decarbonize healthcare if legislatively carbon fuels can be appropriately priced (i.e., externalize costs are accounted for), if not, use of regulatory payment incentives can be used to persuade providers.  Dr. Bernstein discusses the National Academy of Medicine's Action Collaborative's effort to decarbonize the healthcare industry and concludes with comments regarding the climate crisis in context of the current sixth mass extinction and in context of improving health equity.              

Dr. Aaron Bernstein is an Assistant Professor of Pediatrics and the Interim Director of Harvard's Center for Climate, Health and Global Environment (C-CHANGE) at the T.H. Chan Bernstein-Aaron School of Public Health. Dr. Bernstein has been a member of the Harvard President’s Climate Change Task Force and co-Chairs the University Food Standards Committee. He serves on the American Academy of Pediatrics Council on Environmental Health Executive Committee, the Board of Scientific Counselors to the CDC’s National Center for Environmental Health and Agency for Toxic Substances and Disease Registry and is Chair of the Board of Directors of the U.S. Green Building Council. In 2015, he was awarded a Lokey-Businesswire visiting professorship at Stanford University and has also been a visiting professor at Columbia University.  After receiving his bachelor’s degree in Human Biology from Stanford University, he received graduate degrees in medicine (MD) and public health (MPH), from the University of Chicago and Harvard University, respectively. He is a recipient of Stanford University’s Firestone Medal for Research and a Harvard University Zuckerman Fellowship. An avid bicyclist, Dr. Bernstein pedals to and from work year-round

Information on Harvard's C-CHANGE program is at: https://www.hsph.harvard.edu/c-change/


Brookings' Carol Graham Discusses America's Crisis of Despair (November 8th)

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Last November 9th I discussed declining life expectancy in the US with Dr. Steven Woolf, i.e., US life expectancy stopped increasing in 2010 and had been decreasing since 2014.  This is significantly due to increasing mortality rates among men, disproportionately white men aged 25-64, for approximately 30 disease conditions ranging from cancer, cerebrovascular, circulatory, genitourinary, infectious mental and behavioral, musculoskeletal, nervous, and respiratory diseases.   These premature deaths have become popularly termed, "deaths of despair," a phrased coined by Princeton's Anne Case and Angus Deaton and is the title of their 2020 book, “Deaths of Despair and the the Future of Capitalism."  These authors define these deaths, numbering on average 70,000 per year, as those resulting from alcohol and drug abuse and suicide.  For example, per CDC findings in July drug overdoses increased to 90,000 in 2020, or by 30% over 2019.  While deaths of despair have been identified at least since the 1890s, federal policy makers have yet to seriously address this issue. 

During this 35 minute interview Prof. Graham begins by recognizing Émile Durkheim's related anomic suicide work from the 1890s, she goes on to discuss why poverty is different or more hopeless in the US, moreover among white poor, and what explains this difference between races, discusses what helps to explain why deaths of despair, or diseases of despair, have not been addressed by federal healthcare policy makers, discusses her recommendation for the creation of a federal, interagency task force to address this problem and metrics to track, for example, anxiety, depression, life satisfaction and well being.           

Dr. Carol Graham is the Leo Pasvolsky Senior Fellow at the Brookings Institution, a College Park Professor at the University of Maryland and a Senior Scientist at Gallup.  She is the author of numerous books including : “Happiness for All? Unequal Lives and Hopes in Pursuit of the American Dream” (2017); “The Pursuit of Happiness: An Economy of Well- Download
Being” (2011); “Happiness Around the World: The Paradox of Happy Peasants and Miserable Millionaires” (2009); and, “Private Markets for Public Goods: Raising the Stakes in Economic Reform” (1998).  She is also the author of numerous articles in journals including Science, Social Science and Medicine, the Journal of Economic Behavior and Organization, the Journal of Population Economics, Economica, Perspectives in Psychological Science, the World Bank Research Observer, Health Affairs, Health Economics and  Foreign Affairs.  She is senior editor of Behavioral Science and Policy, and an associate editor at the Journal of Economic Behavior and Organization and on the editorial boards of numerous other economic journals.  She served on a National Academy of Sciences panel on well-being metrics and policy and won the Pioneer Award from the Robert Wood Johnson Foundation and a Lifetime Distinguished Scholar award from the International Society of Quality of Life Studies.   She has served as a Special Advisor to the Deputy Managing Director of the International Monetary Fund and served as a consultant at the Inter-American Development Bank, the World Bank, United Nations Development Program, and the Harvard Institute for International Development.  Born in Peru, she received her A.B. from Princeton, her M.A. from The Johns Hopkins School of Advanced International Studies, and her Ph.D. from Oxford.  She is the mother of three children.

Professor Graham's Brookings' writings discussed during this interview are at: https://www.brookings.edu/experts/carol-graham/.  

(Please excuse this interview's varying sound quality.)