The Rotarian Conversation: Your health is at risk

Jonathan Patz explores the link you didn’t know existed between climate change and disease

At the 2017 International Assembly, the annual gathering of incoming district governors, Rotary President-elect Ian H.S. Riseley made the case that to help the world’s most vulnerable people, Rotary must address climate change. “The time is long past when environmental sustainability can be dismissed as not Rotary’s concern,” Riseley said in his keynote speech. “It is, and must be, everyone’s concern.”

That statement impressed Nobel Prize-winning scientist Jonathan Patz, who called it “incredible” when he heard about it a few weeks later. Patz, who founded the field that connects the dots between climate change and public health, has earned accolades from the American Public Health Association, received a Fulbright Scholar grant, and, as a member of the Intergovernmental Panel on Climate Change, won the 2007 Nobel Peace Prize – which the panel shared with former U.S. Vice President Al Gore.

In the early 1990s, Patz was a medical resident doing a rotation through the U.S. Environmental Protection Agency. He was given the task of reviewing reports on climate change for any health content and found exactly one mention: a 1989 report raising concerns about shortages of deodorant during heat waves. “I said, ‘Are you serious? That’s all you’re talking about?  ’” he recalls. The findings – or lack thereof – propelled Patz to make environmental public health his career. 

Over the past two decades, Patz and other scientists have outlined the effects of extreme weather and pollution on health, including increased cases of heat-related deaths, asthma, allergies, and mosquito-borne diseases such as malaria; sewer overflows after heavy rains that can contaminate drinking water; and climate-related disasters such as hurricanes. 

Critics say tackling climate change is too expensive. But, Patz says, studies show that the financial and health benefits could exceed the initial costs. “Attacking climate change could be the greatest health opportunity we’ve had in over a century,” he says.

At a breakout session at the Rotary International Convention in Atlanta next month, Patz will speak about one of his group’s newest lines of research: the connection between extreme weather events and the explosion of the Zika virus. Patz spoke with senior editor Diana Schoberg at his office at the University of Wisconsin at Madison, where he is director of the Global Health Institute.

Q: The U.S. Congress and the Trump administration are moving to increase fossil fuel production and decrease regulations, including environmental regulations. What do you predict the effects of such policies will be?

A: It’s too early to tell. If President Trump is interested in economic growth and jobs and infrastructure, those things could align with the climate change agenda. I’ve seen some studies that show there are far more jobs in renewable energy than there are in parts of the fossil fuel sector. My group has been studying infrastructure. Fixing potholes is part of it, but infrastructure also means building bike trails and pedestrian overpasses to make cities safer and to promote physical fitness. 

The dirtiest energy comes from coal. Business investors think that this is yesterday’s energy. But it’s paramount for all of us working toward a cleaner energy future to have compassion and focus on what segments of the population might not benefit from changing energy sources. We ought to invest in job diversification for coal miners, for example. Could they pull out a win from this too? 

If you look to the cities and states, this is where there’s huge progress. There are many mayors who are moving toward low-carbon cities. Even if things stall on the international and federal levels, there’s no turning back progress. If you asked people to get rid of their cellphones and go back to land lines, that would never happen. Businesses are seeing how much money they are saving through conservation and renewable energy. Look at solar energy; prices have dropped 80 percent in the last seven years. 

Q: What role should scientists play in public policy?

A: We have an anti-science Congress now. Part of the problem is that scientists are not good communicators. Scientists need to become savvier about the political process, and they need to communicate the science a lot better. Good science informs good policy. 

Scientists do need to be more vigilant. We need to speak out when we see misinformation. The backgrounds of many of the current Cabinet members seem misaligned to their jobs, and that concerns me. We need to be watching very carefully. At the same time, we can’t say everything is bad, everything is crazy, every agenda is the wrong agenda. We have to be careful to become better listeners and look for common ground. The things I mentioned about jobs and infrastructure, well, there’s common ground. Let’s have a discussion. 

Q: Are there other areas of common ground?

A: Health is much more of a nonpartisan issue than climate change or environmental issues. Our work in environmental public health is becoming much more important. People start talking about jobs and money and polar bears. I love polar bears, but this issue will affect all of us. It will affect our own health and the health of the next generation.

In my own group, we don’t just study the health risk of climate change. We study the benefits of climate change policy. We’re looking at the huge opportunities for reductions in chronic diseases – for example, those related to obesity, such as diabetes and cancer. These diseases are trending upward all over the world. If you look at the United States as one example, 60 percent of American adults don’t meet recommended levels of minimum amounts of exercise. Here is an opportunity to create more bikeable, more walkable cities that would promote fitness. 

Q: You talk about the “silver lining” of climate change mitigation. What does this mean?

A: The silver lining of the climate change story is that actions that we take to reduce our consumption of fossil fuels have huge health gains. Think about air pollution: 60,000 to 80,000 people still die every year from particulate air pollution in the United States; 7 million people die prematurely every year around the world because of dirty air quality. So if we can get to a low-carbon energy system, you’re going to save lives.

We’ve done studies looking at replacing car trips with bike trips in the Upper Midwest. If you were to take half the car trips and turn them into bicycle trips, you’d save 1,300 lives every year and you’d have $8 billion in avoided mortality and health care costs in the 11 largest cities in this region. There’s an air pollution component and a physical fitness component.

To me this is not a political issue; it’s a health issue. The price of carbon should include the cost to health and the cost to the environment. In 2014, MIT came out with a study that showed that in the United States, the health benefit from reducing PM 2.5 [fine particle pollution] would be anywhere between 26 percent and 1,050 percent of the upfront cost of getting to clean energy. So in other words, the benefit from better air quality could be up to 10 times greater than the upfront investment for solar or wind. The health benefit could swamp the cost. 

Another study looked at carbon dioxide. It might cost on average up to $30 to remove one ton of CO2 using clean energy technology. But when you remove a ton of CO2, you’re also removing particulate pollution, nitrogen dioxide, and sulphur dioxide. For every ton of CO2 you remove, you get rid of all the other nasty pollutants such that you would have a $200 health benefit.

Q: Rotary President-elect Ian Riseley said climate change and its effect on vulnerable populations should become a higher priority on the organization’s agenda. What parts of the world will be hardest hit and why?

A: Any place that has climate-sensitive diseases is very vulnerable. Anywhere you’ve got high levels of malnutrition, diarrheal illness from lack of sanitation, or diseases like malaria, those are highly sensitive places – for example, India and sub-Saharan Africa. And then you’ve got low-lying communities that will have to up and move, including some islands in the Pacific or deltas in Asia. I’ve seen new studies coming out of Southeast Asia showing an increase in pre-eclampsia – hypertension of pregnancy – due to sea level rise and storm surges that are causing salination of the freshwater aquifers. Then you’ve got different segments of the population, like the elderly, who are more at risk in heat waves, or small children, who are most at risk of malnutrition, diarrhea, and malaria. 

And when it comes to infectious diseases, I argue that in a globalized world, an increased disease risk anywhere in the world can affect anyone. 

Q: Are there any winners when it comes to a changing climate?

A: In the former Soviet Union, they’re talking about longer growing seasons. But infectious diseases are also moving north. We’re already seeing that here in Wisconsin. Disease-carrying ticks from southern regions are showing up here. 

Q: What can Rotary clubs do at the community level? 

A: The communities are where the action is. If you go on the clean energy theme that we’ve been talking about, one intervention could be creating programs for safe routes to school, which promote exercise and reduce air pollution [by encouraging students to walk or bike to school]. That’s at the community level. In poor countries, we’re talking about projects focused on cookstoves and cleaner fuels. 

Q: You’ll be at the Rotary Convention to talk about the Zika virus. What is the link between Zika and climate change?

A: Dengue fever is the most prevalent mosquito-borne virus in the world. Temperature, humidity, and rainfall have enormous effects on vector-borne diseases like dengue fever, and a study of 18 years in Southeast Asia showed that El Niño years were banner years for disease. Zika virus is closely related to dengue – it’s transmitted by the same mosquito, the Aedes aegypti mosquito. It’s the same family of viruses, Flaviviridae. So there’s no reason to think that the ecology of Zika is any different from dengue fever. 

A study recently published in the Proceedings of the National Academy of Sciences showed that the climatic conditions during the extreme El Niño in 2015-16 were the most conducive for seeing an epidemic of dengue fever and Zika since 1950. An analysis by my group shows indeed that the El Niño brought very high temperatures to Brazil, and we’re looking at the human case data right now as opposed to the mosquito data.

Q: In 2014 you spoke to the Rotary Club of Madison about the relationship between climate change and our work to eradicate polio. What is the connection? 

A: Climate change is not just about temperature. It’s about extremes of the water cycle – more floods and more droughts. Since polio is transmitted through poor sanitation, anything that compromises water systems is going to create a greater challenge for polio eradication. My group has done studies on the implications of heavy rainfall events. We have what are called combined sewage overflow events. Over a trillion gallons of sewage-contaminated storm water overflows into surface waters every year in this country. With climate change, when it rains, it’s going to rain harder. We did a study for the Chicago area and found that heavy downpours brought about by climate change would double the number of combined sewage overflows into Lake Michigan [the source of the city’s drinking water]. It’s going to be a major challenge for polio eradication because if you’ve got trouble right now with sanitation, you’re going to have more trouble when you have these heavy rainfall events. Another challenge comes from population migration brought about by environmental changes.

Q: What can one person do? 

A: Lead by example. Be engaged with community initiatives. Demand that local governments be fair in providing equitable transportation, safe routes to school, things that you know are beneficial both to the environment and to human physical and mental health and equity. Be engaged at the community level and then scale it up even further. Vote and hold politicians accountable.

Breakout sessions at the Rotary Convention in Atlanta

Jonathan Patz will speak at a breakout session titled “Zika and Dengue: Creating Partnerships to Interrupt Transmission” at the Rotary International Convention in Atlanta, 10-14 June. It’s one of more than 100 breakout sessions to choose from. Start planning your convention experience at riconvention.org, where you can view the latest list of breakout and general sessions and keynote speakers, and download the Rotary Events app. Here are some highlights.

Tell our story

Becoming an Effective Rotary Communicator

Social Media 101: Using Social Media to Promote Rotary and Engage Your Community

Plan high-impact projects 

Learning from Our WASH Failures

Service Projects: Is What You Are Doing Worth It?

Develop leadership skills

The Fine Art of Cultivating Rotary Connections

Conflict Management in Voluntary Organizations

Recruit and engage members

Welcoming the LGBTQ Community into the Family of Rotary

First Impressions Matter: Talking to Prospective and New Members

Work together to expand your reach

Rotarians and YALI: Building Partnerships with Young African Leaders

Rotary and Peace Corps: Partnering to Empower Communities

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