We must act on climate change in Houston for our health
As Tropical Storm Imelda washed across Southeast Texas last September, the Emergency Department at Texas Children’s Hospital, normally abuzz with action, was unusually quiet. Physicians, nurses and staff working that night worried aloud, “What is happening to the kids who aren’t able to get here tonight?” Going in and out of patient rooms, I could see the increasingly familiar images on the news: heroic boat and helicopter rescues, aerial views of entire communities underwater, and soaked and cold families being transported to shelters.
Every 30 minutes or so, alerts flashed across cellphones, “Stay in place until further notice”; “Do not travel on roads”; “Houston ISD will be closed tomorrow.” With each alert, we wondered whether we would get home that night or if our colleagues would be able to get to work to relieve us.
Climate change is exacerbating the frequency and fervor of devastating weather events. Every storm, flood, wildfire or landslide disrupts the lives of tens of thousands of patients and providers. Patients struggle to access essential care, and providers are hindered in their capacity to deliver it. Going forward, our health care systems, including in the Texas Medical Center, must adapt to become climate resilient — equipped to address disasters as well as the long-term, insidious impacts of climate change on the health of Houstonians.
As wildfires raged in Australia in December, in Madrid, leaders from nearly every country in the world gathered for the annual United Nations Climate Change Conference. At the 2015 meeting, all countries in attendance, including the United States and China, agreed to the Paris accords, which set the goal of keeping global temperature rise
“well below 2 degrees Celsius above pre-industrial levels” by 2100 and achieving net zero global carbon emissions by
2050. Leaders did not reach consensus on next steps in Madrid, though some progress was made. Meanwhile, Houston is finalizing its own Climate Action Plan, developed in partnership with C40, a network of sustainability experts who help global cities like ours address climate change. From Madrid to Houston’s City Hall, the decisions made now will have lasting impacts on every aspect of society, including on health, for generations.
Houstonians are already experiencing the negative health impacts of climate change, many of which are readily apparent: limited access to care, acute injuries, toxic exposures, spread of infectious diseases from wading through contaminated floodwaters and profound psychological trauma. Every Houstonian is
at risk, though marginalized communities disproportionately suffer these negative impacts.
For example, multiple studies of cities across the country, including a report from the journal Environment International, have established that women who experience record hot days while pregnant are more likely to give birth preterm, with rates higher among nonwhite mothers. In Harris County, the preterm birth rates among African American and Hispanic women are 4.9 percent and 1.4 percent higher than that of White women, respectively. Climate change is compounding the challenge of correcting this disparity.
Other research has established associations between temperature, air quality and precipitation, and adverse health events including rates of asthma attacks, strokes, food insecurity, depression, and even infant mortality and gun violence — all issues facing Houstonians, especially low-income residents and communities of color.
Harris County recently published a “Vision of Health” report, which assessed the status of residents’ health countywide. The report marked an important step in raising the centrality of environmental stewardship as critical for public health locally. In Madrid, UN Secretary-General António Guterres stressed the world now stands at “a critical juncture.” Just as global and local leaders implement policies to address climate change, it is essential that Houston’s health sector also becomes climate resilient.
At a population-level, the health risks from climate change need to be included among the key social determinants of health, alongside poverty, race, employment status, housing and literacy. Individually, health care providers can educate themselves about the impact of climate change on their patients; this is relevant to every field in medicine. Our health care facilities must follow suit and become rigorously environmental. And, finally, all Houstonians can help protect their own health and that of one another by pursuing environmental stewardship in their daily lives.
Recognizing the link between environmental health and human health will provide the impetus to create a climate resilient health care system poised to meet the direct impacts of climate change on health and bring about a healthier Houston and Harris County for everyone.
Singer, M.D., M.S. in environment and resources, is a resident physician in Global Child Health at Baylor College of Medicine in Houston.