In January, the Medical Care Blog’s editors published a consensus statement on climate policy and health. This statement was co-signed by many of our authors, editors, and editorial board members of the Medical Care journal. As we look ahead to our focus theme for 2024, we want to begin with a look backward as well. The American Public Health Association (APHA) has a legacy of adopting position statements that acknowledge and propose responses to environmental health hazards, including the changing climate.
APHA has a long history of member-driven scientific policies to address environmental and climate health that stretches back decades. We’ll skip describing the rigorous process of how APHA members develop, review, revise, and eventually adopt these policies. Suffice it to say, the author groups commit weeks of their lives to developing these statements. In the end, following adoption by the APHA’s Governing Council and before publication online, APHA removes the authors’ names and the policy becomes a statement made by and on behalf of APHA itself.
[I’ll add a disclaimer here. If I sound a little romantic about the process, it’s likely because I’m too close to it. I’ve served as a co- or lead-author on multiple APHA policies. I’m also in my final year of service on the APHA Science Board, which helps review those policies.]
A legacy of public health and climate policy
APHA’s very first environmental policy addressed pollution’s impact on climate was approved back in 1987, with a statement about depletion of the ozone layer (#8709). Less than a decade later, the first comprehensive policy on climate change was adopted in 1995 (#9510).
[Want to learn more about the policy statements adopted by the APHA? You can search the entire history here. Although full texts of archived policies more than 20 years old require APHA membership to access.]
Prior to the pandemic, the years 2015 to 2019 saw a surge in policies related to environment. In 2015, APHA adopted a new, comprehensive set of recommendations to address the health effects of climate change (#20157). Then in 2017 and 2018, policies focused more narrowly on children’s health (#201710), air pollution (#201711), and the impact of US energy policy on health (#20183).
Environmental health and justice was a major focus of the policy mechanism in 2019, as five separate policies were adopted that year. Statements addressed issues from animal feeding operations (#20194), to drinking water (#20195), impact of climate change on mental health (#20196), environmental justice (#20197), and post-climate disaster recovery support (#20198)
Most recently, APHA adopted a 2022 policy titled, “Advancing Environmental Health and Justice: A Call for Assessment and Oversight of Health Care Waste” (#20224). This policy represents a critical recognition of the healthcare sector’s role in creating environmental risks, including greenhouse gasses. The statement addresses the intersection of infectious disease, climate change, waste, and environmental health and justice.
Here at the blog this year, we will further address the role of the healthcare sector in both causing and responding to climate change.
The APHA Center for Climate, Health, and Equity
The APHA organization’s leadership and staff have also beenhard at work promoting this vision in recent years. In 2018, APHA partnered with the Public Health Institute to publish a lengthy “Equity Guide” for local health departments on the issue of climate change, health, and equity [pdf].
Then in 2019, APHA announced the creation of its Center for Climate, Health, and Equity. I would strongly encourage readers to follow up on this post by reading Surili Patel’s blog post over on the NACCHO website, summarizing the new center’s mission and vision. As she says, “APHA maintains that the public health field is on the front lines of the climate change crisis, addressing and reducing climate health effects.”
Policy trending the wrong way
This post is also timely in a very real sense. Media outlets and legal scholars predict that the Supreme Court will again rule against air quality regulations in the case of Ohio v EPA. The policy in question, known as the “Good Neighbor Plan”, was launched to restrict sources of smog that cross state lines.
This “emergency relief” (for polluting states, oil pipeline, and steel companies) case follows several relevant rulings by that court. Those rulings have greatly altered the scope of the EPA to regulate climate, air, and water quality. In 2022, the case of West Virginia v EPA determined that federal agencies must cite “clear congressional authorization” when making decisions of “vast economic and political significance.” That impact, however, was to undermine the EPA’s ability to enforce its own regulations on power plant emissions that drive climate change. Then in 2023, the case of Sackett v EPA essentially permitted dumping of pollution into US wetlands.
The evidence is clear that the judicial branch intends to counteract past progress on environmental issues, not support new advances. Despite the relatively short time I’ve spent working with the EPA as a Scientific Advisor, I have seen firsthand that the organization reflects a mission of introducing the best possible science into its rule-making. Bluntly put, tying the hands of that agency by requiring explicit legislative branch direction will only increase the risks for harm. Preventing the EPA from doing its job will result in enduring hazards and harm to everyone across the planet.
Back into focus
As we embark on our year of focus on climate change and health at The Medical Care Blog, it’s important to recognize we stand on the shoulders of many public health and environmental scientists who are already active in advocating for more attention on this issue. It’s only together, as a team, that we will see the results we hope to achieve. That we need to achieve.
Indeed, APHA will be hosting its online Climate, Health, and Equity Summit from Feb 29 to Mar 1. If you’ve read this far and want to learn more, I would encourage you to register here. I hope to see you there!
Ben King