ENVIRONMENTS & HEALTH
By Stephanie Chalupka, EdD, RN, PHCNS-BC, FAAOHN, FNAP
Climate Change and Health Laura Anderko discusses the consequences of a changing environment on human health.
C
hanges in our environment are undeniable and occurring at a faster, more destructive pace than at any time in recent history. While the effects of extreme weather—flooding and droughts, wildfires and tropical storms, heat waves—may be most evident on the environment, they also negatively affect human health. Laura Anderko, PhD, RN, who has spent her career focusing on epidemiology, public health, and environmental health, has talked about the need to act on the potentially catastrophic health effects of climate change. These include respiratory, cardiovascular, vector-borne, and water- and food-borne diseases as well as posttraumatic stress disorder. The health care and public health systems in the United States, she believes, are not adequately prepared to deal with these consequences. Dr. Anderko was honored last year by the White House for being a “champion of change” for her work on how the environment affects public health. In addition, as the Robert and Kathleen Scanlon Endowed Chair in Values Based Health Care at the Georgetown University School of Nursing and Health Studies in Washington, DC, Dr. Anderko conducts research on and works to publicize the effects of environmental changes on human health. Here, in a recent interview, she discusses her work, her hopes for the future, and opportunities for nurses to affect climate change. Stephanie Chalupka (SC): How did you become interested in climate change and health? Laura Anderko (LA): About 10 years ago, I was working on issues surrounding the health impacts of coal-fired plants, methylmercury toxicity, and fish consumption. The impact of carbon pollution on climate change and, ultimately, human health, became clearer to me as I partnered with organizations such as the American Lung Association, providing testimony to the Environmental Protection Agency and advocating stronger carbon pollution regulations to improve air quality and reduce the impact on cardiorespiratory health.
RAISING AWARENESS
SC: What has been your role in addressing climate change and health issues? [email protected]
Laura Anderko, PhD, RN. Photo courtesy of Georgetown University School of Nursing and Health Studies.
LA: Over the past several years, my work in climate change and health has concentrated on research, education, practice, and policy and advocacy work. For instance, I’ve been working in partnership with the District of Columbia (DC) Department of Health to investigate the association between climate indicators and health impacts. We’ve explored the link between heat waves and subsequent poor air quality (increased particulate matter and ozone) and increased hospitalization rates due to asthma and myocardial infarction. This climate and health data will eventually be included in the Centers for Disease Control and Prevention’s National Environmental Public Health Tracking Program, providing information on the relationship between climate exposure and health outcomes over time. In another research project conducted in partnership with the DC Department of Health, we are exploring ways to reduce hospitalization rates for minority children with asthma. We’re working with families to create media messages that will provide AJN ▼ August 2014
▼
Vol. 114, No. 8
67
ENVIRONMENTS & HEALTH
Environmental Health Resources for Nurses Alliance of Nurses for Healthy Environments http://envirn.org/pg/groups/7007/climate-change-and-health American Lung Association www.lung.org/healthy-air/outdoor/defending-the-clean-air-act Association of State and Territorial Health Officials www.astho.org/Programs/Environmental-Health/Natural-Environment/Climate-Change/Climate-Change Centers for Disease Control and Prevention’s Climate and Health Program www.cdc.gov/climateandhealth Climate Reality Project http://climaterealityproject.org Environmental Protection Agency www.epa.gov/climatechange/impacts-adaptation/health.html Georgetown Climate Center www.georgetownclimate.org/adaptation/clearinghouse Health Care Without Harm www.climateandhealthcare.org National Aeronautics and Space Administration’s Climate Change and Human Health Project www.climatechangehumanhealth.org National Association of County and City Health Officials www.naccho.org/topics/environmental/climatechange National Environmental Education Foundation Climate Change and Health www.neefusa.org/pdf/Climate_Change_and_Health_Fact_Sheet.pdf National Institute of Environmental Health Sciences www.niehs.nih.gov/research/programs/geh/climatechange Natural Resources Defense Council www.nrdc.org/health/climate Practice Greenhealth https://practicegreenhealth.org/topics/energy-water-and-climate/climate/what-climate-change Trust for America’s Health Health Problems Heat Up: Climate Change and the Public’s Health http://healthyamericans.org/reports/environment/TFAHClimateChangeWeb.pdf US Climate Action Network www.usclimatenetwork.org World Health Organization www.who.int/mediacentre/factsheets/fs266/en 68
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Vol. 114, No. 8
ajnonline.com
information on reducing exposure and protecting children with asthma during heat waves and times of poor air quality. As an educator, I’ve been actively involved in raising awareness among nurses and the general public about the wide range of health effects of climate change. This has occurred through partnerships with the Alliance of Nurses for Healthy Environments (ANHE), Health Care Without Harm, and the Climate Reality Project, among others, and has led to the production of Webinars that offer opportunities to more effectively communicate the health risks associated with climate change and the ways we can reduce them. In addition, a course on climate change and health was developed for undergraduate students at the Georgetown University School of Nursing and Health Studies to educate future health professionals about these emerging health risks. The US Climate Action Network recently provided funding to the ANHE to create a video series that will increase nurses’ awareness of climate change and health and provide tips for advocating a stronger Clean Air Act that will reduce greenhouse gas emissions and mitigate climate changes. As a member of the ANHE, I was involved with the creation of this Web-based series, which is now available to nurses nationally and internationally for continuing education hours. [Editor’s note: For more information, see http://bit.ly/1jgiUtv.] I have also worked to create links to practice through a partnership that brings together the Georgetown Climate Center, which is based in Washington, DC, the Westlawn Partnership for a Healthier Environment in Milwaukee, Wisconsin, and local public health officials in that city. This partnership provides Milwaukee’s residents with an opportunity to tap into adaptation resources and expertise as they plan for projected extreme climate events there, such as heat waves.
A CHAMPION OF CHANGE
SC: Please discuss the award you recently received at the White House. LA: I received the Champion of Change Award for my advocacy and policy work in climate change and public health. This was specifically in regard to my support for carbon pollution regulations in partnership with the American Lung Association, the Natural Resources Defense Council, and Health Care Without Harm. We advocated a stronger Clean Air Act by regulating carbon emissions, and this was accomplished by authoring op-eds and public health reports, providing testimony, and supporting community educational programs. [email protected]
OPPORTUNITIES FOR NURSES
SC: What are the greatest opportunities for nurses in regard to climate change? LA: Nurses can be involved at many levels in the areas of both adaptation and mitigation. Adaptation efforts include measures to reduce the vulnerability of natural and human systems to climate change effects. In 2012, $100 billion in damages was estimated to have resulted from climate-related disasters in the United States. One important adaptation action that nurses can initiate is to work with communities or hospital systems to prepare for extreme weather events, such as tropical storms or heat waves. Although some communities are beginning to draft adaptation plans, many don’t specify how health issues will be managed. Mitigation efforts are focused on actions to reduce emissions of greenhouse gases. Supporting the Clean Air Act and strengthening regulations on carbon pollution can greatly improve mitigation efforts. We know, for instance, that approximately $1.3 trillion (or 9% of our gross domestic product) was gained in public health and environmental benefits in 2010 as a result of the Clean Air Act.
GREATEST CHALLENGES
SC: What is the greatest challenge in your work? LA: It is no doubt the lack of political will to address climate change through public policy, as well as the failure to appreciate the impact climate change has on human health. Even those who are well-versed in climate science can be unaware of the range of health effects that can result from climate change.
MORE THAN AN ECONOMIC ISSUE
SC: What is your hope for the future? LA: Climate regulates life on earth. In order to survive, we need to appreciate the wide-ranging implications of climate change. The health implications are enormous. It’s much more than an economic issue. I had the opportunity to see President Obama when he visited Georgetown in June 2013 to unveil his Climate Action Plan. In his remarks that day, he told the audience that dealing with climate change doesn’t mean we have to choose between the health of our children and the health of our economy—we can have both. It’s critical that nurses accept the challenge to address the threats to human health that climate change presents and be informed of the economic benefits as well. ▼ Stephanie Chalupka is a visiting scientist at the Harvard School of Public Health in Boston and associate dean for nursing at Worcester State University in Worcester, MA. Contact author: [email protected]. The author has disclosed no potential conflicts of interest, financial or otherwise.
AJN ▼ August 2014
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Vol. 114, No. 8
69
By Stephanie Chalupka, EdD, RN, PHCNS-BC, FAAOHN, FNAP
Climate Change and Health Laura Anderko discusses the consequences of a changing environment on human health.
C
hanges in our environment are undeniable and occurring at a faster, more destructive pace than at any time in recent history. While the effects of extreme weather—flooding and droughts, wildfires and tropical storms, heat waves—may be most evident on the environment, they also negatively affect human health. Laura Anderko, PhD, RN, who has spent her career focusing on epidemiology, public health, and environmental health, has talked about the need to act on the potentially catastrophic health effects of climate change. These include respiratory, cardiovascular, vector-borne, and water- and food-borne diseases as well as posttraumatic stress disorder. The health care and public health systems in the United States, she believes, are not adequately prepared to deal with these consequences. Dr. Anderko was honored last year by the White House for being a “champion of change” for her work on how the environment affects public health. In addition, as the Robert and Kathleen Scanlon Endowed Chair in Values Based Health Care at the Georgetown University School of Nursing and Health Studies in Washington, DC, Dr. Anderko conducts research on and works to publicize the effects of environmental changes on human health. Here, in a recent interview, she discusses her work, her hopes for the future, and opportunities for nurses to affect climate change. Stephanie Chalupka (SC): How did you become interested in climate change and health? Laura Anderko (LA): About 10 years ago, I was working on issues surrounding the health impacts of coal-fired plants, methylmercury toxicity, and fish consumption. The impact of carbon pollution on climate change and, ultimately, human health, became clearer to me as I partnered with organizations such as the American Lung Association, providing testimony to the Environmental Protection Agency and advocating stronger carbon pollution regulations to improve air quality and reduce the impact on cardiorespiratory health.
RAISING AWARENESS
SC: What has been your role in addressing climate change and health issues? [email protected]
Laura Anderko, PhD, RN. Photo courtesy of Georgetown University School of Nursing and Health Studies.
LA: Over the past several years, my work in climate change and health has concentrated on research, education, practice, and policy and advocacy work. For instance, I’ve been working in partnership with the District of Columbia (DC) Department of Health to investigate the association between climate indicators and health impacts. We’ve explored the link between heat waves and subsequent poor air quality (increased particulate matter and ozone) and increased hospitalization rates due to asthma and myocardial infarction. This climate and health data will eventually be included in the Centers for Disease Control and Prevention’s National Environmental Public Health Tracking Program, providing information on the relationship between climate exposure and health outcomes over time. In another research project conducted in partnership with the DC Department of Health, we are exploring ways to reduce hospitalization rates for minority children with asthma. We’re working with families to create media messages that will provide AJN ▼ August 2014
▼
Vol. 114, No. 8
67
ENVIRONMENTS & HEALTH
Environmental Health Resources for Nurses Alliance of Nurses for Healthy Environments http://envirn.org/pg/groups/7007/climate-change-and-health American Lung Association www.lung.org/healthy-air/outdoor/defending-the-clean-air-act Association of State and Territorial Health Officials www.astho.org/Programs/Environmental-Health/Natural-Environment/Climate-Change/Climate-Change Centers for Disease Control and Prevention’s Climate and Health Program www.cdc.gov/climateandhealth Climate Reality Project http://climaterealityproject.org Environmental Protection Agency www.epa.gov/climatechange/impacts-adaptation/health.html Georgetown Climate Center www.georgetownclimate.org/adaptation/clearinghouse Health Care Without Harm www.climateandhealthcare.org National Aeronautics and Space Administration’s Climate Change and Human Health Project www.climatechangehumanhealth.org National Association of County and City Health Officials www.naccho.org/topics/environmental/climatechange National Environmental Education Foundation Climate Change and Health www.neefusa.org/pdf/Climate_Change_and_Health_Fact_Sheet.pdf National Institute of Environmental Health Sciences www.niehs.nih.gov/research/programs/geh/climatechange Natural Resources Defense Council www.nrdc.org/health/climate Practice Greenhealth https://practicegreenhealth.org/topics/energy-water-and-climate/climate/what-climate-change Trust for America’s Health Health Problems Heat Up: Climate Change and the Public’s Health http://healthyamericans.org/reports/environment/TFAHClimateChangeWeb.pdf US Climate Action Network www.usclimatenetwork.org World Health Organization www.who.int/mediacentre/factsheets/fs266/en 68
AJN ▼ August 2014
▼
Vol. 114, No. 8
ajnonline.com
information on reducing exposure and protecting children with asthma during heat waves and times of poor air quality. As an educator, I’ve been actively involved in raising awareness among nurses and the general public about the wide range of health effects of climate change. This has occurred through partnerships with the Alliance of Nurses for Healthy Environments (ANHE), Health Care Without Harm, and the Climate Reality Project, among others, and has led to the production of Webinars that offer opportunities to more effectively communicate the health risks associated with climate change and the ways we can reduce them. In addition, a course on climate change and health was developed for undergraduate students at the Georgetown University School of Nursing and Health Studies to educate future health professionals about these emerging health risks. The US Climate Action Network recently provided funding to the ANHE to create a video series that will increase nurses’ awareness of climate change and health and provide tips for advocating a stronger Clean Air Act that will reduce greenhouse gas emissions and mitigate climate changes. As a member of the ANHE, I was involved with the creation of this Web-based series, which is now available to nurses nationally and internationally for continuing education hours. [Editor’s note: For more information, see http://bit.ly/1jgiUtv.] I have also worked to create links to practice through a partnership that brings together the Georgetown Climate Center, which is based in Washington, DC, the Westlawn Partnership for a Healthier Environment in Milwaukee, Wisconsin, and local public health officials in that city. This partnership provides Milwaukee’s residents with an opportunity to tap into adaptation resources and expertise as they plan for projected extreme climate events there, such as heat waves.
A CHAMPION OF CHANGE
SC: Please discuss the award you recently received at the White House. LA: I received the Champion of Change Award for my advocacy and policy work in climate change and public health. This was specifically in regard to my support for carbon pollution regulations in partnership with the American Lung Association, the Natural Resources Defense Council, and Health Care Without Harm. We advocated a stronger Clean Air Act by regulating carbon emissions, and this was accomplished by authoring op-eds and public health reports, providing testimony, and supporting community educational programs. [email protected]
OPPORTUNITIES FOR NURSES
SC: What are the greatest opportunities for nurses in regard to climate change? LA: Nurses can be involved at many levels in the areas of both adaptation and mitigation. Adaptation efforts include measures to reduce the vulnerability of natural and human systems to climate change effects. In 2012, $100 billion in damages was estimated to have resulted from climate-related disasters in the United States. One important adaptation action that nurses can initiate is to work with communities or hospital systems to prepare for extreme weather events, such as tropical storms or heat waves. Although some communities are beginning to draft adaptation plans, many don’t specify how health issues will be managed. Mitigation efforts are focused on actions to reduce emissions of greenhouse gases. Supporting the Clean Air Act and strengthening regulations on carbon pollution can greatly improve mitigation efforts. We know, for instance, that approximately $1.3 trillion (or 9% of our gross domestic product) was gained in public health and environmental benefits in 2010 as a result of the Clean Air Act.
GREATEST CHALLENGES
SC: What is the greatest challenge in your work? LA: It is no doubt the lack of political will to address climate change through public policy, as well as the failure to appreciate the impact climate change has on human health. Even those who are well-versed in climate science can be unaware of the range of health effects that can result from climate change.
MORE THAN AN ECONOMIC ISSUE
SC: What is your hope for the future? LA: Climate regulates life on earth. In order to survive, we need to appreciate the wide-ranging implications of climate change. The health implications are enormous. It’s much more than an economic issue. I had the opportunity to see President Obama when he visited Georgetown in June 2013 to unveil his Climate Action Plan. In his remarks that day, he told the audience that dealing with climate change doesn’t mean we have to choose between the health of our children and the health of our economy—we can have both. It’s critical that nurses accept the challenge to address the threats to human health that climate change presents and be informed of the economic benefits as well. ▼ Stephanie Chalupka is a visiting scientist at the Harvard School of Public Health in Boston and associate dean for nursing at Worcester State University in Worcester, MA. Contact author: [email protected]. The author has disclosed no potential conflicts of interest, financial or otherwise.
AJN ▼ August 2014
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Vol. 114, No. 8
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