Cli­mate health

Ad­vo­cates of Obama plan pre­dict fewer ill­nesses

Modern Healthcare - - THE WEEK IN HEALTHCARE - Rachel Lan­don

Pres­i­dent Barack Obama’s speech last week lay­ing out his cli­mate ac­tion plan grat­i­fied pub­lic health ad­vo­cates wor­ried about the harm­ful ef­fects of cli­mate change on child and adult asthma, al­ler­gies and other res­pi­ra­tory dis­eases, heart dis­ease, di­a­betes, and other air- and heatre­lated con­di­tions, as well as wa­ter-borne and in­sect-borne dis­eases.

The pres­i­dent’s plan calls for a cut in green­house-gas emis­sions, with new car­bon diox­ide stan­dards for power plants, the coun­try’s great­est pro­ducer of car­bon pol­lu­tion, as well as money pledged to­ward the de­vel­op­ment of clean en­ergy.

“Im­ple­ment­ing new power plant rules could pre­vent count­less pre­ma­ture deaths, heart at­tacks and cases of chronic bron­chi­tis, re­duce co-pol­lu­tants and slow hos­pi­tal uti­liza­tion rates that con­trib­ute to ris­ing health care costs,” Amer­i­can Pub­lic Health As­so­ci­a­tion Ex­ec­u­tive Di­rec­tor Dr. Ge­orges Ben­jamin said in a state­ment. He called the im­ple­men­ta­tion of such stan­dards “the dif­fer­ence be­tween a long, healthy life or de­bil­i­tat­ing, ex­pen­sive chronic ill­ness for hun­dreds of thou­sands of Amer­i­can chil­dren and adults.”

The Asthma and Al­lergy Foun­da­tion of Amer­ica says 25 mil­lion Amer­i­cans, in­clud­ing more than 7 mil­lion chil­dren, have asthma, while 50 mil­lion Amer­i­cans have al­ler­gies. Those asthma and al­lergy num­bers are sig­nif­i­cantly higher than they were just a lit­tle over a decade ago. In 2001, about 20 mil­lion peo­ple in the U.S. had asthma. Be­tween 2001 and 2009, the num­ber of Amer­i­cans with asthma rose by 25%, from about 1 in 14 peo­ple to 1 in 12. And al­though it is dif­fi­cult for ex­perts to pin­point ex­actly why th­ese rates have risen, it is widely agreed upon that in­creased air pol­lu­tion and al­ler­gens worsen the symp­toms for those with asthma and al­ler­gies.

Young chil­dren and the el­derly, those liv­ing in ur­ban en­vi­ron­ments and low-in­come pop­u­la­tions tend to be more sus­cep­ti­ble to heat and res­pi­ra­tory ill­nesses. In 2009, about 1 in 10 chil­dren had asthma, and the fol­low­ing year, 3 in 5 chil­dren with asthma ex­pe­ri­enced at least one asthma at­tack in the pre­vi­ous 12 months.

In­creas­ing heat waves, droughts and wild­fires thought to be re­lated to cli­mate change also con­trib­ute to health prob­lems. Wild­fires are cur­rently burn­ing in Cal­i­for­nia, Ore­gon, Idaho, Arizona, New Mex­ico, Colorado, Hawaii and Alaska, where tem­per­a­tures peaked at a near­record 91 de­grees last week.

“When you have wild­fires, you have an in­crease in fine par­tic­u­late air pol­lu­tion,” said Bar­bara Got­tlieb, di­rec­tor of en­vi­ron­ment and health at Physi­cians for So­cial Re­spon­si­bil­ity. In­hala­tion of th­ese par­ti­cles can cause ir­ri­ta­tion. The finer par­ti­cles can lodge in the lungs, cre­at­ing a more se­ri­ous im­pact.

Ac­cord­ing to the AAFA and the National Wildlife Fed­er­a­tion, warmer tem­per­a­tures and higher con­cen­tra­tions of car­bon diox­ide en­cour­age the growth of rag­weed, the main trig­ger of fall hay fever. Pol­li­na­tion sea­sons are start­ing ear­lier and last­ing later than they once did, with the U.S. Global Change Re­search Pro­gram re­port­ing that pollen sea­sons have been ex­tended by more than two weeks since 1995.

Dr. Leonard Bielory, di­rec­tor of the STARx Al­lergy and Asthma Cen­ter in Spring­field, N.J., and his col­leagues pro­ject pollen in­creas­ing by 20% to 30% by the year 2020. “Whether it’s pollen or pol­lu­tion, it can make al­ler­gies worse,” Bielory said.

As cli­mate change trig­gers more cat­a­strophic storm and wa­ter events, such as su­per­storm Sandy and ma­jor flood­ing of the Red River, in­door al­ler­gens from the likes of mold, dust mites and cock­roaches in­creas­ingly be­come a con­cern. Any of th­ese can make breath­ing more dif­fi­cult, and at worst, in­crease the fre­quency and sever­ity of asthma at­tacks.

Some ex­perts cau­tion, how­ever, that it’s sci­en­tif­i­cally un­cer­tain what causes such health prob­lems at the in­di­vid­ual level. “It’s hard to know in a given in­di­vid­ual what their at­tack is due to,” said Dr. David Pe­den, chief of the di­vi­sion of pe­di­atric al­lergy, im­munol­ogy, rheuma­tol­ogy and in­fec­tious dis­eases at the Univer­sity of North Carolina School of Medicine.

Pe­den said cli­mate change is cre­at­ing a real-life “ex­per­i­ment” in­volv­ing bil­lions of hu­man sub­jects. It’s “an ex­per­i­ment that I don’t want to con­duct, but I think we will.”

Re­vers­ing the health ef­fects of cli­mate change, or at least stop­ping them in their tracks, is what many pub­lic health or­ga­ni­za­tions hope can be ac­com­plished un­der Obama’s plan. “That change be­gins to oc­cur is the im­por­tant thing,” Ben­jamin said. “If you don’t start now, you’ll look back in 10 years and think we’ve lost 10 years.”

GETTY IM­AGES

The num­ber of Amer­i­cans with asthma rose by 25% be­tween 2001 and 2009.

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