How climate change poses a threat to health equity

Tom Sullivan | October 13, 2021

The impact that environmental conditions are having on the health of individuals and communities is becoming more and more apparent.  

Consider: Air pollution from fossil fuel emissions is responsible for more than 8 million deaths worldwide in 2018, making up approximately 18 percent of total global deaths, according to a Feb. 2021 study, Deaths from fossil fuel emissions higher than previously thought, by researchers from the Harvard John A. Paulson School of Engineering and Applied Sciences. The research also found that Eastern North America, Europe and South-East Asia are among the geographical areas with the highest related mortality rates.  

“Climate change is a major threat to any vision of a healthy future,” the Robert Wood Johnson Foundation noted in a report titled The intersection of health, equity and climate change. “It’s not just about more extreme weather: It’s changing our environment and undermining the work of building communities where everyone has a fair and just opportunity to lead a healthier life.”  

As it becomes increasingly clear just how much climate change can influence the health of patients and populations, the need for CEOs and other executives in health care and all sectors to take action is coming into sharper focus as well.  

Executives need a plan for climate change and health equity 
“In health care, we have a special responsibility to one another to inspire solutions that intelligently challenge the status quo,” said Michael Dowling, CEO, Northwell Health during the health system’s Raise Health Forum 

That responsibility applies to addressing health equity as well as environmental conditions, notably clean air, safe drinking water, access to healthy food and infrastructure both within health care organizations and surrounding communities.   

Upcoming webcast: A bold cross-industry initiative to accelerate health equity

During Northwell’s virtual event, a range of experts from the architectural, government, health care and venture capital fields discussed the need for leaders across industries to prepare for expected impacts of climate change now and work to advance health equity simultaneously.  

“This is about thinking ahead and creating a climate change plan to be effective in meeting the needs of the population you serve,” said Karen Hacker, MD, Director, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. “We are aware of what types of things are going to happen, the big challenge is how do we get in front of these things?”  

Environmental conditions are among the three key drivers of health, according to the Deloitte Health Equity Institute. The other two are economic and social conditions. 

“It’s important in underserved communities to provide education about what climate change means to individuals’ own personal health, including how it impacts food, time spent in a car versus walking, how walking to the grocery store three times a week can improve a person’s health and reduce emissions, how their health is affected by the choices they make,” said Corey Stern, a Partner at Levy Konigsberg. “Then tie together individual health with community health because the decisions we make can have a drastic effect on the health of the community and on climate change.” 

We have a moment now in history to do this right. My hope is that this is a movement and we work together for all people.

Whitney Austin Gray, PhD, International WELL Building Institute

Photo credit: WELL Building Institute

First step: Understanding climate change’s impact on public health
Deena Shakir, a Partner at Lux Capital, said one of the key learnings from the pandemic is the interconnectedness of climate and our health.  

“There’s potential for those two things to create effects that will last for generations, such as wildfires, social distancing. The zoonotic nature of the virus has thrown a lot into question,” Shakir said. “We’ve had supply chain issues across manufacturing in and around health care. It is clear that we have a lot of work to do to reduce the impact on the planet, not just for future generations but for the air we breathe today.”  

Making matters worse is the decades-old split between architecture and urban planning on the one side and public health on the other, said Whitney Austin Gray, PhD, SVP of Research, International WELL Building Institute. Gray added that as health care focus turned more toward pharmaceutical interventions than creating healthy living spaces, the current reality is that most people spend 90 percent of their lives indoors, according to the oft-cited U.S. Environmental Protection Agency report from 1989, and much of that time is likely in a building that was not designed with the health of humans in mind.  

But with Green and WELL building trends gaining momentum Gray also noted that the U.S. has opportunities to reestablish that connection and return to focusing on buildings and open spaces that promote health and wellness.  

But where to start?  

“The first thing is to begin to understand how climate change is impacting our health, food supply, plants, air pollution,” Hacker said.  

Building on understanding those critical issues, she also urged health care executives — and employers more broadly — to think about how to reduce their carbon footprint and waste, support the workforce with a healthy environment, and consider sustainability when developing strategies for climate change and health equity.   

Affordability is critical to addressing climate change and advancing equity  
“Climate change affects the social and environmental determinants of health,” according to the World Health Organization.   

WHO estimates that climate change will cause nearly 250,000 additional deaths per year between 2030 and 2050, likely from malnutrition, malaria, diarrhea and heat stress at an annual cost between $2 billion and $4 billion by 2030, not including expenses related to agriculture, water, sanitation and other health-determining sectors.  

“These factors are not deterministic but, rather, they highlight opportunities for intervention to improve outcomes and wellbeing,” said Kulleni Gebreyes, Director of Deloitte’s Health Equity Institute. 

Health equity roadmap: A methodical approach to addressing disparities

In addition to developing plans to address climate change and health equity, successfully embracing such opportunities will require forward looking strategies that remove obstacles to participation for as many Americans as possible.  

“When you look at the future amid climate change, if we take certain precautions now when we know there are ticking time bombs rather that picking up the pieces when those bombs go off, we’ll be in a much better position,” Stern said.   

Stern pointed for example to the lead-based pipes that are central to the U.S. water system as one example. When those pipes were installed as long as 60 years ago, the nation’s understanding of the dangers lead presents was lacking but had the U.S. been proactive enough at the time to identify problems with lead, there may have been alternatives. That’s merely one historical example but it’s the mindset Stern suggested today’s leaders adopt, particularly when it comes to underserved communities that lack the resources to replace lead pipes.  

“To deal with climate change by having more efficient vehicles, people have to be able to afford them,” Stern said. “If you want to eat a plant-based diet and stop factory farming you have to be able to afford types of foods that are not necessarily available at the Piggly Wiggly.”  

The journey to progress requires partnerships  
Addressing climate change is becoming an imperative for health care executives and one that should be undertaken with strong considerations relative to advancing health equity to ensure that both problems do not worsen. But no single organization can  succeed alone. 

“This is not work that health care do by itself. We have to engage in partnerships and include the community by asking and listening, engaging with them and partners, whether it’s the transportation sector, the food sector or housing sector, to really make a difference,” Hacker said. “It’s that kind of strategy that will help up address climate change.”   

Health care leaders and policymakers have a long road ahead and considerable work remains to achieve the manner of changes necessary to reduce climate change and advance health equity.  

“But if we stay optimistic and stay together by sharing views with each other to build a community of caring, we will succeed,” Dowling said. “Progress is a journey and we must keep moving forward.”

Homepage hero image: Markus Spiske

About the Author

Tom Sullivan, EVP & Editor-in-Chief of Digital Content

Tom Sullivan brings more than two decades in editing and journalism experience to Health Evolution. Sullivan most recently served as Editor-in-Chief at HIMSS, leading Healthcare IT News, Health Finance, MobiHealthNews. Prior to HIMSS Media, Sullivan was News Editor of IDG’s InfoWorld, directing a dozen reporters’ coverage for the weekly print publication and daily website. Contact: or @SullyHIT on Twitter.