Georges Benjamin, MD, CEO of APHA and Lisa Patel, MD, MESc, executive director of the Medical Society Consortium on Climate and Health — of which APHA is an affiliate — weigh in on EPA's recent decision to repeal its own finding that greenhouse gases pose harm to human health.

Recently, our consortium received a letter from a 12-year-old Girl Scout after her classmates became sick during a record-breaking heat wave in Sacramento last summer. 

“For my Silver Award project, I’m working to help protect kids from extreme heat by asking schools to teach students how to recognize and respond to heat illness,” she wrote. “A lot of students don’t know the signs of heat illness or when they need to ask for help.” 

Her note was thoughtful and determined. It was also deeply unsettling. Children should not have to design public health interventions for themselves. That is our responsibility. 

Earlier this month, the federal government announced the repeal of the U.S. Environmental Protection Agency’s endangerment finding, the 2009 scientific determination that carbon dioxide, methane and other greenhouse gases threaten public health. In plain terms, it is declaring that the pollution driving climate change no longer counts as a health threat, as it is described in a specific provision of the Clean Air Act. As physicians and public health leaders representing hundreds of thousands of clinicians nationwide, we strongly oppose this decision. 

The endangerment finding is not a technical footnote in environmental law. It is the legal foundation that allows the U.S. to limit emissions from vehicles under the Clean Air Act. Removing it threatens to unravel many of the policies that protect Americans from heat waves, wildfire smoke, extreme storms, and deteriorating air quality at precisely the moment when these dangers are accelerating. 

This is not abstract to us. We see it in our clinics and emergency departments every day. Heat is already the leading weather-related cause of death in the U.S. Rising temperatures intensify ozone pollution that triggers asthma attacks and worsens chronic lung disease. Wildfire smoke now exposes tens of millions of Americans each year to dangerous particulate levels, affecting communities far from where fires burn. Floods, storms and extreme heat events are also driving injuries, mental health harms, pregnancy complications and disruptions in access to medical care. 

Children are especially vulnerable. Their lungs are still developing. They breathe more air relative to their body size. And they will live longest with the cumulative consequences of rising temperatures and worsening pollution. Nearly one in 15 U.S. children already has asthma. 

Policies that allow more pollution will only make it harder for children to breathe, learn and thrive. The consequences will not fall evenly. Communities located near highways, refineries and power plants already face higher exposure to pollution. Outdoor workers labor in rising heat and smoke. Low-income communities and communities of color, often with fewer resources to adapt, are experiencing disproportionate health burdens from climate-related hazards. 

Weakening federal protections will widen these inequities, turning policy choices into preventable illness. Supporters of repeal often argue that weakening environmental protections is necessary for economic growth. The evidence tells a different story. 

Analyses of the Clean Air Act consistently show that the health and economic benefits of reducing pollution far outweigh the costs. Preventing illness and premature death saves money and strengthens productivity. Clean energy industries are also among the fastest-growing sectors of the global economy. Abandoning science-based safeguards to prioritize the profits of the fossil fuel industry does not strengthen America’s competitiveness. It undermines it. 

Repealing the endangerment finding will not change the science linking greenhouse gas pollution to human disease. It ignores the legal obligation to act on that evidence. When our government steps back from protecting the public, the costs do not disappear. They shift to families facing higher medical bills, to hospitals caring for more climate-related illness, and to communities struggling to recover from increasingly severe disasters. 

This is why the APHA, alongside other leading health organizations, has filed suit against EPA to challenge this illegal repeal — refusing to let the agency walk away from its sworn mandate to protect the air we breathe. 

Medicine and public health have a simple mission: prevent suffering where possible and treat illness where necessary. Policies that knowingly increase exposure to pollution and climate hazards run counter to that mission. Physicians and public health professionals may represent many specialties and institutions, but we share a common responsibility to speak when evidence clearly shows that policy decisions will harm the health of our patients. 

This is why we urge policymakers to restore the endangerment finding and maintain science-based protections that safeguard the air Americans breathe. Children should not have to write letters asking how to protect themselves from extreme heat. A nation committed to health would already be protecting them. 

 Photo by Portishead1, courtesy iStockphoto