Energy policy and public health: Q&A with Denise Patel

A policy statement adopted by APHA’s Governing Council last fall calls for addressing U.S. energy policy to protect public health. We asked APHA member Denise Patel, co-chair of the Association’s Topic Committee on Climate Change and Health, to tell us more about the policy statement and why action is urgently needed.

Q: What is this new policy statement about?
A: “The Public Health Impact of Energy Policy in the United States” policy statement looks at the ways we as a society develop, use and dispose of energy and waste products and its broad impacts on human health and the environment. The policy takes a systemwide view at energy policy to look beyond the sources of energy to examine ways that energy efficiency and conservation, transportation and waste management can be employed to have the greatest impact to improve health. Public health professionals have an important role in advocating for energy solutions centered on addressing health and equity, and so it also recognizes the need for U.S. energy policy to advance a just and equitable transition from a system reliant on fossil fuels that create air pollution and cause climate change to 100% renewable energy.

Q: For those new to the issue, how does energy policy affect public health?
A: Energy powers our lives — from providing light, heat and cooling in our homes and offices to the cars and buses we take to get around every day to manufacturing all of the medical devices we use in our hospitals. We currently rely on a system that is based on developing and using energy sources that are harmful to human health. From cradle to grave, our societal use of coal, oil, natural gas and uranium has devastating environmental health impacts and adds to our overall burden of disease. Communities of people living near extraction and waste sites suffer even more from related air and water pollution. Workers in those industries suffer from occupational diseases such as black lung or risk radiation poisoning. Burning fossil fuels pollutes the air and leads to increased rates of asthma, respiratory illness and cardiovascular disease. Carbon emissions from fossil fuel use are the leading cause of climate change, the greatest threat to public health of our lifetime.

But addressing this global challenge also provides us with a great opportunity to change the way we develop and use energy. Health-centered energy policy can improve health outcomes across populations by minimizing energy use, reducing emissions and choosing healthier energy sources. Renewable energy, like wind and solar, has the potential to replace much of the fossil fuel and nuclear energy we currently use. Focusing on energy efficiency and creating built environments that support active and public transportation has enormous benefits to promote healthier lifestyles and reduce air pollution. It is also an opportunity to build more sustainable communities. In places like West Virginia and Pennsylvania, the coal industry once supported local economies with good paying jobs and are now devastated, which is taking a toll on worker and community health. Coal companies are leaving behind toxic legacies as they shutter mines and power plants and skirting their obligations to provide health and pension benefits for miners suffering from black lung disease as they file for bankruptcy. It is no coincidence that we are seeing increases in opioid abuse in these same communities as people attempt to cope with economic loss. We know good jobs are an important social determinant of health and we need to work to address the economic conditions, as well as the health impacts from pollution, that underpin our health through our energy policy.

Q: APHA has been active on climate change for many years and, in fact, in 2017 celebrated a Year of Climate Change and Health. How does this new measure specifically address the health effects of climate change?
A: As health professionals, we see the health impacts from climate change every day from extreme weather events, such as heat waves, droughts and hurricanes, to a rise in climate-related illnesses and diseases. In 2017, we saw two of the most destructive hurricanes in history hit the United States. Maria killed nearly 3,000 people in Puerto Rico and Harvey destroyed entire neighborhoods in Texas. In 2018, the Intergovernmental Panel on Climate Change, the Lancet Countdown on Health and Climate, and the National Climate Assessment identified extreme heat as the leading cause of deaths due to weather. All three reports noted that increasing drought conditions are devastating to agricultural production, raising prices on foods and limiting food availability. And, they noted, that it’s not just extreme weather that is affecting health. Changes in seasonal temperatures and warmer winters are creating conditions that allow tick and mosquito populations that carry vector-borne diseases like Lyme and West Nile virus to flourish and spread geographically.

We have also witnessed that climate impacts are not felt equally. APHA Executive Director Georges Benjamin has said that climate change is a civil rights issue, and he is absolutely right. From siting power plants to extracting natural gas through hydraulic fracturing, low-income communities and communities of color experience the greatest harm to their health. At the same time, those communities feel the greatest impacts from climate devastation, whether its poor farmers suffering crop failures or coastal communities devastated by storm damage. As we transition to new industries, workers caught in the transition need to be supported with retraining and education programs and investing in jobs that provide stability and a good income because we know that is linked to positive health outcomes. By focusing on reducing climate-causing emissions from energy production and transportation and calling for a just and equitable transition away from fossil fuels toward 100% renewable energy, this energy policy aims to address the root causes of negative health outcomes from our current energy system to creating policies that support a healthier energy system that is more sustainable.

Q: Why is it so important for organizations like APHA to take a position and speak out on energy policy?
A: We know the science is telling us we need to do a lot more to cut emissions a lot faster than we are. In 2015, nations around the world agreed to the Paris Climate Agreement, which set a goal of reducing global warming emissions to keep global temperatures below 2 degrees Celsius, and an aspirational 1.5 degrees Celsius to protect island nations. Since then, we have seen every nation commit to the agreement and the Trump administration lead the United States out. At the end of 2018, world leaders gathered in Poland at the COP24 meeting to map out a pathway to meet the 2 degrees Celsius/1.5 degrees Celsius targets, but largely missing from the conversation was the political will to address climate change on the scale necessary to stave off the worst impacts of climate change. Fortunately, in the United States, we have seen cities, states and many industries step up on climate action. Public health advocates, and especially doctors and nurses, are some of the most trusted voices in our society. Organizations like APHA provide a powerful voice and incredible leadership by speaking out on energy policy. In 2017, APHA announced that it was divesting from fossil fuels and plans to run its offices on 100% renewable energy. Since then, the Lancet has noted divestment as an effective policy for political and economic change, and numerous health associations have followed suit. And, as public health professionals, it is our responsibility to ensure that as we work to meet the current health challenges of climate change, we are also advocating for energy policies that protect human health and the environment.