Energy and Environment

Climate Change

  • Health
    Council Special Report: A New U.S. Foreign Policy for Global Health
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    Panelists discuss the future of U.S. foreign policy on global health and ways to address future pandemics, climate change, health-related development goals, and other challenges in a divided country and geopolitical world. This meeting is made possible by the generous support of the Bill & Melinda Gates Foundation.
  • Health
    Academic Webinar: Health Risks of Climate Change
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    Elizabeth Willetts, planetary health policy director at the Harvard T.H. Chan School of Public Health, leads the conversation on the health risks of climate change. FASKIANOS: Welcome to today’s discussion of the Fall 2023 CFR Academic Webinar Series. I’m Irina Faskianos, vice president of the National Program and Outreach here at CFR. Thank you for joining us. Today’s discussion is on the record and the video and transcript will be available on our website, CFR.org/academic if you would like to share these materials with your colleagues or classmates. As always, a CFR takes no institutional positions or matters of policy. We are delighted to have Liz Willetts with us to discuss health risks of climate change. Dr. Willetts is the planetary health policy director at the Harvard T.H. Chan School of Public Health at Harvard University. She has more than twenty years’ experience mobilizing knowledge and engagement on biodiversity, climate change pollution, food systems, and community health for marginalized populations. Previously, Dr. Willetts was a longstanding member of the policy reporting team at the International Institute for Sustainable Development, and a writer and editor for the Earth Negotiations Bulletin and The Lancet. She’s authored and led multiple interagency science policy briefs on climate change for the World Health Organization and authored a regional policy guide on “Operationalizing the Environmental-Health Nexus” for the UN Economic and Social Commission for Asia and the Pacific. And she wrote a working policy paper for CFR, for our Global Health Program, entitled “Managing the Health Risks of Climate Change,” which we shared as part of your background reading for this call. She’s also a clinician and served long-term roles in resource-poor primary care medical clinics, in Micronesia, the United States, and Central America. So, Liz, thanks for being with us. I can think of nobody better to lead this conversation than you. If you could begin by talking about the relationship between climate change and health and provide an overview of the major health risks of climate change. WILLETTS: Sure. And thank you so much, Irina, and to CFR for inviting me here to this panel. I wanted to open just simply stating I am daunted by the topic, as I think anyone would and should be, as well as the incredible expertise on the attendance list here. Wanted to briefly mention, I see experts in science, policy, law, diplomacy, anthropology, other socioeconomic fields, as well as higher education. And wanted to emphasize that my expertise and focus is on the space between. So the science to policy and the policy to practice, and how we mobilize ideas and people in new ways, how we analyze the policy architecture in which we have to work, apply knowledge, and make decisions. And so, the views that I am attempting to bring to this conversation and this community of practice are from a transdisciplinary perspective. So thank you very much for tuning in. Andy Haines and I were asked to write a paper for the CFR on climate change and health security, as Irina mentioned, and specifically on the norms and frameworks used to consider both of these individually and in combination. So from this, there were several key questions related to what Irina just posed in terms of the health risks of climate change. First is, what is a health risk in terms of global health security as we know it? Does climate change create health risks recognized under frameworks for health security? And to whom do these norms and frameworks and climate change and health security serve? And, for that reason, is it possible to address the health security risks of climate change based on who is served by the definition of health security? Are we considering the health risks of climate change across the full spectrum of international climate law? Now, at this time and 2022 to 2023, that includes health risks and impacts across three pillars: mitigation, adaptation, and loss and damage. Finally, what is the policy architecture for managing health risks of climate change at the global scale? We set upon writing this paper to consider all of these questions. And for those of you who have begun to look at managing the health risks of climate change, what we find is we’re really working through several theories of change at the same time. We’re attempting to find multiple dimensions for transformational change in climate change and health, but we’re also looking to mobilize behavior change to address global, and expanding, and interrelated crises related to the environment and impacts of anthropogenic activity. So I want to just to frame the picture a bit with these attempts at collective action at change. And the first we have, in 1997, the Kyoto Protocol under the UN Framework Convention on Climate Change. It aimed for collective action by charging countries with individual emission reduction goals. That had limited success. So 2015 with the Paris Agreement we made a new commitment to a new type of collective action to commit countries to a global temperature goal. That has also had mixed success—limited success. And so now we’re seeing other theories of change for how we shift our behavior, our consumption, our production, and our action to address climate change. And that includes through rights-based approaches, looking at, you know, creating a moral shift, and creating accountability for individuals and for states in terms of tools for litigation and agenda setting. At the same time, we’re trying to look through health agendas and find instruments to guide action on climate change. So this spectrum of tools is being used at the same time and is becoming more and more urgent, and is very much related to the health risks of climate change and how we can address them. So I had also a couple of examples I wanted to bring to frame the problem as I see it, as one of mobilizing ideas and people in these science to policy, policy to practice spaces. We have loads of statistics on the health risks of climate change in terms of the emergencies we see, what’s happening in terms of droughts and floods, the bursting of dams, the air pollution, which in the United States has now come over like an umbrella across the country in terms of the wildfires we’re seeing in Canada. Then also, in other countries, the new outbreaks of infectious disease, dengue and malaria, and a whole host of other conditions that are higher priorities in other countries. There are tons of statistics. The news shows us new examples of these every day. So the statistics I wanted to show here are related to the policy architecture that we’re working with to get a little bit more of a framing for how we’re addressing the health risks. So 198 countries participate in the UNFCCC, the UN Framework Convention on Climate Change, the global decision-making body for climate action. And the majority of those countries committed in 1994 to this space when the convention entered into force. Sixteen years after that, countries agreed to advance implementation by establishing a reporting mechanism on adaptation. And that was a means of galvanizing collective action and sharing of best practices for addressing the impacts of climate change. National adaptation plans emerged in 2010. In 2022 in an assessment only thirty-eight of 198 countries had national adaptation plans. And only fifteen of those national adaptation plans were—actually had in place a monitoring and evaluation framework to assess if the plans were effective at protecting communities, habitat, infrastructure, and ultimately health and the social determinants of health at the individual and population level. This is one tool, but a big one. And I think these numbers show us that we’re not managing the health risks of climate change well, and/or we could say the framework to do it under the UNFCCC is not achieving the goal. In the interim, in the last years, health national adaptation plans, different NAPs—HNAPs, have emerged under ministries of health. This is the attempt of the health sector—ministry of health sector—to create a comprehensive framework for managing the health risks of climate change at the national scale. As of now, approximately seventy countries have some form of a health national adaptation plan developed or in development. So that’s 35 percent of countries. That’s still not getting the job done. And that is not under the UNFCCC. That is under the global health and health institutional framework agenda. Another key statistic that I just want to bring out as an indicator that we haven’t really gotten this right, and that our health risks are significant and increasing, is this. Less than ten years ago, around 2005, a new term—indeed, a new emotion emerged to reflect, in English, the stress of our inability to address the impacts of anthropogenic activity on the global environment. In other words, the stress of encroaching planetary boundaries, that term is solastalgia. It’s the distress of a changing natural environment while being in that environment. Essentially, we have changed our emotional spectrum and our language because we have not figured out how to manage the health risks of climate change. And this really is a true indicator of whether or not we’re managing the health risks of climate change well or sufficiently. So here comes a question is, are we addressing these under the UNFCCC climate regime? Are we addressing them under the global health agenda? Can we do it under both? In brief summary, climate change creates health risks that are emergent, immediate, chronic, and slow onset, and that affect the state of health of individuals and for communities, as well as the social determinants of individuals and communities. This is a tremendous risk. This is a global health security risk. So to go back to one of the framing questions for the paper we did to CFR, I can’t get to all of them in the time I have here but perhaps in the Q&A, I want to highlight a couple. And so let’s go back to the question of, what is a health risk in terms of global health security as we know it? If we look at the definitions, norms, and frameworks for the field and institutions of global health security, “health risks,” put it in quotes, “are communicable. Health emergencies aren’t interoperable. They are focused on addressing communicable risks.” Climate change is not considered a health risk or a health emergency under the definitions, norms, and frameworks for global health security. Similarly, we don’t actually know what a pandemic is. We operate as if a pandemic, which is a health emergency in global scale, is merely communicable. Yet, global environmental changes have health incidences that are worldwide, multidimensional health hazards are hitting most countries, 99 percent of the global population breathes air pollution. The UN special rapporteur on the environment calls the realities of chemical exposure a silent pandemic, because there’s this universal exposure to over five thousand chemicals, including the ones that reprogram our physiology and are heritable across generations. These are not considered pandemics. Planetary health and encroaching planetary boundaries do not fall under the definition or framing of pandemic, or the institutions aimed to address pandemics. And that includes climate change. So a concluding question there is, will we achieve global health security if we do not have the right scope for the definitions, norms, and frameworks, and if we do not include climate change in it? Major institutional structures that we looked at have not approached this gap. The International Health Regulations, the scope of the Global Fund, although in part they’re looking at that, Centers for Disease Control, the Global Health Security Index, USAID maintain a robust paradigm of global health security that does not include climate change. In the new negotiations for a pandemic instrument under the WHO, some call it the pandemic accord, there are brief provisions on multilateral environmental agreements for climate and for biodiversity. But over many, many months and rounds of negotiations, these provisions have not developed or advanced. It’s unclear whether they’re going to move forward if the pandemic accord moves forward. So this is a brief highlight to indicate our architectures are still operating in very significant silos. And I would just conclude by saying it’s—in terms of climate change and health, it’s not enough to frame and create arguments for health co-benefits of climate action. We need to change the definition, the norms, and frameworks that make up the policy architecture in which we work, move, mobilize, and act. And there’s a tremendous amount to do. So over to you Irina, to see if we got that first question. (Laughs.) FASKIANOS: (Laughs.) Thank you so much, Liz. That was a fantastic overview for all of us. And now we’re going to turn to our group. (Gives queuing instructions.) So with that, I am going to take the first question from Pam Chasek. She has raised her hand. Q: Hi, can you hear me? FASKIANOS: Yes. Q: Hi, Liz. Pam Chasek. For the purpose of this, Manhattan College, but also executive editor of the Earth Negotiations Bulletin. One of the big things that we find, both at the domestic and the international level, is this notion of protecting one’s turf and the siloization of policies. And we see that definitely with this intersection of health and the environment, or specifically climate change, where the two sides don’t talk to each other as well as they should. And that integration of health concerns into the UNFCCC, as well as bringing climate change to the WHO. But the same thing happens at the national level with regard to ministries. And so I’m wondering if you have any recommendations for how we can cross those silos in this case and also these recommendations may go elsewhere. Thanks. WILLETTS: Shall I take that one, Irina, or? FASKIANOS: Yes. Let’s—I like going one by one, so that we— WILLETTS: So, before I answer anything, I would like to say that Pam has been a mentor of mine. And so when I said I might be a little humbled and intimidated by the guest list, I would say you’re—a true expert has asked a question here. Thanks for attending, Pam. This question of the national-level integration is really the crux of the problem, because we can’t move implementation, you cannot fulfill a multilateral environmental agreement, unless you have robust implementation. And that’s going to depend on integrating at the national level. And I’ll also answer—in addition to this question, I’m going to answer one I saw on the chat related to—let me see if it’s here—can nations differentiate between natural and climate change occurrences in their actions? And so if—first of all, in terms of resources, many countries don’t have the personnel, the human capacity, the financial capacity to think about these things in silos. They have to get together. And so addressing climate change, environmental issues, and health issues all at the same time makes financial sense. It’s really a matter of how do we shift those mandates? How do we get budget lines that cross ministries of environment and ministries of health. If ministries of health are developing health national adaptation plans but don’t have a budget line to act on them, they’re not going to move forward. And so there has to be a bigger shift at looking at the architectures at the national level, like Pam pointed out, and how the ministry of finance is going to mobilize them. And there are other ministries that are involved too. Food systems are the core of many environmental health problems. If the ministry of agriculture is not involved there, if there’s not a health component to the mandate of ministry of agriculture or if there’s not a climate component, we’re not going to address these intersecting problems. But the increasing issue here is national problems, national environmental health risks, are being reflected also at the planetary boundary level. So fulfilling a multilateral environmental agreement should help address planetary boundaries on climate change, should also help affect interrelated changes at the national level. It’s a tall task. It involves a lot of capacity building, looking at language, looking at the capacity of health. Can health move beyond the scope of infectious disease at the national level? Can the environment move beyond singular foci? It’s a huge capacity problem. And I think it’s a true area to invest more time and money. FASKIANOS: Thank you. And the question that you pulled from the Q&A box was written by Nicole Ambar De Santos, who’s an undergraduate student at the Washington University in St. Louis. So I’m going to take the next question, a raised hand from Mojúbàolú Olúfúnké Okome at Brooklyn College. Q: Good afternoon. Well, this is a subject that every part of the world is concerned about. I spent the last year in Nigeria. And there’s a National Institute for Policy and Strategic Studies. And climate change is one of the thematic areas that they are looking at to advise the Nigerian government on policy that should be made. You know, I agree with you that the norms, and architecture, and framework should change. And that the responses right now are not—they’re woefully inadequate. But who’s going to lead the change? And then also, whom should we hold accountable when inadequate, and really ineffective policies are made? Even the very small baby steps that have been made are often walked back when it comes to committing resources to do the work. So how really can the idea that this change is not only necessary, it’s imperative—how is it going to get through all our thick skulls on this, because it’s very frustrating. There are all kinds of—there are many devastating climate change-induced catastrophes. Floods, you know, fires, and all that. And they kill huge numbers of people. The pandemic is still with us, you know, although it’s now controlled a bit, and there will be more in the future. So how do we really take this seriously and who leads the change? WILLETTS: Thank you so much for the question. And I think I hear the urgency and importance in your voice, and the interest in solving this problem. How are we going to do it? And I would say, my first thought when you say, who is going to lead? I would say, as someone who’s multiple decades into life, the energy and momentum of youth around the world, including their presence at events such as the UN General Assembly, the UN Framework Convention on Climate Change, the Global Youth Biodiversity Network—massive momentum from youth who are not only motivated by, for example, solastalgia and eco-emotions, but they come equipped with information, and data, and tremendous energy to affect change at every scale of government. It is overwhelming. It is bewildering. It is impressive. And I think the more we can identify and equip those youth leaders, the more we are going to affect—inspire ourselves and fight for that change. This collective action issue, as I mentioned, 1997 the Kyoto Protocol, 2015 the Paris Agreement, they’re not working very well. But now we’ve got this enormous campaign of youth energy. Let’s see what they can do to help us figure this out. You asked another question. And I wanted—I’m trying to remember what it was related to motivating action, but it made me want to raise the—kind of recall the human right to the environment, which was adopted under the UN General Assembly last year. Oh, accountability. You mentioned accountability. So if we’re trying to get accountability for individuals, for stakeholders, and to create a framework for accountability for states and businesses, taking a greater look at the UN human right to—or, everyone’s human right to a clean, healthy, sustainable environment, a rights-based approach that comes with a framework of principles, is a really good start. Because it shows what stakeholder—what information stakeholders should come to the table with to address these issues. It also shows what obligations states have to provide that information so that we’re making better consumption and production decisions, that we make better consumer decisions, that we hold businesses accountable to an agreed framework. That’s at state level. It could be kind of mobilized into the city level. It’s agreed at the global level. Rights-based approaches are a real—considered to be a real tool and the necessary part of our theory of change. So that needs to be part of. And then in terms of leadership and costs, I think businesses are already paying attention to these details. And the infrastructure industry is already looking at rules and whether it maps out to cost ten years later. If they are only putting in $100,000 to make sure they meet the metric related to an airport resilience standard, but they can see ten years down the road the cost is going to be a million, they’re investing, you know, $200,000 to 300,000 (dollars) now to prevent the other $700,000 of costs they’re expecting in the future. How can we make those case studies more obvious? Maybe that’s part of the toolset. FASKIANOS: I’m going to take a written question from Jeffrey Sturchio, who is visiting scholar for the Institute of Applied Economics at Johns Hopkins. How can COP28 take best advantage of a planned day on climate and health? Or will this just be a day devoted to talk, with no subsequent actions on climate and health? WILLETTS: This is a great question. I’m really glad that you asked this, Jeffrey. And I think I will answer it by saying what it should not do. What it should not do this Health Day is be merely a publicity. A publicity is useful at a traditional academic business conference. A publicity is not optimizing the potential of an intergovernmental negotiation. The UNFCCC and COP28 is an intergovernmental negotiation. It’s not a normal conference. So anything related to health and Health Day should recognize this is climate law. This is the circus of international environmental law. How do you impact that? How do you impact the stakeholders and the attendees there? If the outcomes and conversations of Health Day don’t have a lot to do with international environmental law and the decisions negotiators need to make this year, it will not maximize its impact. The more we can connect health conversations and commitments to the actual negotiations on the agenda, the greater likelihood there’s going to be impact, the greater likelihood they will be heard by the influencers in the room, and the greater likelihood that going into 2024 we’re shifting the conversation, because we’re marrying the conversation. The outcome of a health day may or may not be a formal commitment at the global level. If it takes the nature of being an agreed commitment at the global level, to an institution, to a forum, to the UN, it may have greater impact than if countries’ ministers of any sector commit to their own efforts back home, which will only translate to political commitments that have short timeframes. So a commitment to a greater forum, to parts of the UNFCCC, if there’s recognition of that commitment within the COP28 outcome then what you’re doing is you’re entering the law space and you’re creating a synergy there. And that that would be my thinking on that. FASKIANOS: Terrific. Thank you. I’m going to go next to Fordham University’s International Political Economy and Development program. Please identify yourself, and there you go. You’re unmuted. Q: Thank you. I’m Genevieve, again, in the IPED program at Fordham. Thank you for being with us today, Dr. Willetts. So my question is when we look at the negative effects of climate change on human health we often see asymmetries in the severity of who is affected because not all voices get an equal say at the table. So what suggestions do you have for policymakers in better mitigating risk for indigenous and/or marginalized groups? WILLETTS: That’s almost a technical question, in some ways. I could answer that in a science direction and a policy direction and kind of in a human catalyst direction, and my first thought is to think about science. So I worked with WHO to develop the WHO review of IPCC evidence last year, essentially looking and reading the AR6 as a clinician and then translating it into a public health document that could be interpreted in the categories—the normal categories for public health and in terms of medical diagnoses, trying to understand it in terms of global burden of disease. So to answer your question how do we create better parity to address the risks, one way to do that is to really mobilize science from the communities that are being affected. That is a gap in the current IPCC. If you look at where most of the research comes from or who’s performing the research or the health conditions assessed we’re not as broad as we need to be. We’re not looking at necessarily the most marginalized and then we’re not translating the science for the most marginalized into policy action. Someone else in this Q&A has touched on nutrition so I just want to use this as an example. If you look at the IPCC projections for climate mortality they have—they have three conditions that are the risks—are the greatest risks for mortality. One of them is childhood malnutrition. That is a condition that low-income countries and countries in vulnerable states are going to face much more than higher income countries. Malnutrition, top three for climate mortality. So food systems are critical. And, yet, if you look at how food systems and food policy has been addressed under the UNFCCC it’s not looking to address the kinds of impacts on food systems that could be very meaningful, especially for Global South and low-income countries where they’re going to be really hit hard by this. Food systems need a thread of consideration for mitigation, the cause—30 percent of emissions, 8 percent of which are from food loss and waste. Adaptation, looking at these health impacts; malnutrition, how to deal with that; how to deal with the malnutrition and chronic disease implications of mass migration; how to deal with loss and damage in food systems, the fact that economic and noneconomic losses greatly center on changes and disruptions to the agricultural sector; this is not being done to any significant level. And if we really want to address some of the greatest health impacts for marginalized communities including—I believe you mentioned indigenous communities—this needs to be a better focus. And you also expressed your question as not only the subject, like, dealing with the problem but getting the voices to the table. I think there have been strides in the last years to build stakeholder voices in these spaces and I look forward to seeing what COP28 will bring to the table, especially since there’s more literature coming forward that’s recognized in health journals and other places, that’s bringing indigenous scholarship to the table. So I look forward to seeing more and more of that and how Health Day may highlight that, and I hope it does. FASKIANOS: Fantastic. I’m going to go next to Brisa Oliveira de Avila. If you could accept the unmute and identify yourself that would be great. Q: Hello, everyone. Yes. So my name is Brisa. I am in the master’s program with the School of International Affairs at Penn State. And I was wondering what are your thoughts. We’ve been seeing, you know, recently with these heat waves and such how this impacts, of course, all of us in the day-to-day life and I’ve been seeing a lot of movement around how this impacts particularly workers, right—either workers from, you know, obvious—agricultural and stuff like that who were directly impacted by heat but also, you know, us who work maybe in offices and such. How do you feel that it adds to the policy the fact that this impacts private businesses, private stakeholders who are maybe the forces hiring all these people and they’re responsible for them and, you know, if they have—you can consider or not that this is a work environment-related accident, right, in the workforce or, you know, how long can we wait possibly for them to start putting up policies privately, let’s say, and how that affects, you know, in the more broad sense of the global health because, you know, maybe we’re going to have to start locally to then reach a global level in this. And not only work, but, you know, every other private institution that is already getting a toll because of this climate change. WILLETTS: Thank you for the question. I think it’s eye opening for me just because I don’t spend a lot of time on the occupational policies. But it’s really an interesting area because—I think you said you were from Penn State. So the workforce issues in Pennsylvania may be very, very different than what is happening in sub-Saharan Africa, for example, agricultural or physical labor workers who deal with environmental conditions on a daily basis. But if there are drastic changes to the ability of the workforce to engage and support the economy, as you said, worldwide that’s a really important topic to start talking about but also to start using in the tool belt and how do we do that. I think I’ll defer the rest of the question just because I don’t have the statistics and literature on that. But how do we think about the workforce and use statistics related to the economic impact of employees to affect change, it’s a good question and how can the health sector, since I come from a planetary health, public health, global health background—how can the health sector get behind that. It’s a good question. FASKIANOS: Thank you. So I’m going to take the next question from Esmirna Mateo, who’s an undergrad student at the City College of New York, who has a few questions based on your response to the question about who can make the change. And Esmirna comments: It sounds like the weight or leading for a change burdens the youth. What can seniors who have worked years in government and have connections do? The youth care because it will affect them in their future so why can’t those who already have power access to make change also be advocates? WILLETTS: It’s a really interesting social question and I’ve seen it before. A couple of things come to mind. One is this idea of burdening youth and certainly that is an issue. Intergenerational equity, the idea that future generations are inhibited or harmed by activities of today and kind of business operations of today, pollution of today, is a big deal. So at the same time that we’re seeing especially among youth this eco-anxiety, solastalgia, new environmental psychology field. We’re also seeing tremendous energy and interest in action and engagement and creating change. So we have these two things, really, coming at the same time. How do we create bridges there? I would say if they’re—if you’re an influencer, if you have an impactful post in science policy law, community development, any of these places, create an opportunity to bring in sharp, ambitious youth to be part of that. It’s a struggle to have a burden that you cannot address. So if we are burdening youth then perhaps the first response is give the voice and the opportunity for action to youth to kind of contribute to handling this—these issues at every scale. This is a—I come with a transdisciplinary view. There are tremendous gaps between disciplines. If finding new ways for change is of interest and within the scope and opportunity of yourself or other people what kinds of disciplinary bridges can be made and that’s a second place I would advocate for real impact—real impactful change as starting points. FASKIANOS: Thank you. I’m going next to Clemente Abrokwaa with a raised hand. Q: Hi. Thank you so much for this wonderful talk on this important topic. I have two questions. One is actually not a question; I’m just wondering about that. But the first one is looking at when the topic is important and looking at the conditions in Africa the health sector is in shambles. They don’t have—even in some countries, you know, the hospitals don’t have even beds and medication is a problem. So I’m just wondering, how serious this—the climate health—you know, change in health, how seriously it can be taken, you know, in Africa by African leaders when, you know, the immediate need is for people to get medication or the basic needs of health. My second question is actually not a question but if you could elaborate on the—and you mentioned the pandemic accord, just what it is just for me. Yeah. Thanks. WILLETTS: Thank you for the question and I couldn’t agree more. I think environmental health risks take back seats to other issues, especially issues that might be more emergent or immediate or for which we have real treatments and expertise to deal with. That being said, I think the—you know, many health systems in those situations with low resources, lack of beds, can’t deal with a pandemic either. So if our definition of global health security is only focused on pandemics, which we can’t deal with well, and isn’t scoped to consider other environmental health risks it’s almost shooting ourselves in the foot to really understanding what we’re dealing with or how we’re trying to spend money. How can countries and health systems that don’t have a lot of resources even begin to grapple with the idea of climate change? Perhaps there are different ways to look at it even if there aren’t immediate resources to deal with the health problems such as cost. Some systems may deal with really obvious problems such as droughts impacting the actual infrastructure of health centers. Some may deal with destruction of buildings and things like this. Some may deal with limitations to employees showing up to work related to XYZ other reasons. But is there a way to create more cost analysis of five-, ten-, fifteen-year scenarios and a scoping of the burden of disease related to the environment that makes sense and is useful to those types of health systems. There’s tremendous opportunity to look at global burden of disease of climate change—global burden of disease of any encroaching planetary boundary but of climate change and then to also look at the national burden of disease due to climate change. We’re not doing that, and I think the IPCC review did a tremendous amount of work—a thousand pages, so many researchers, so many volunteer expert reviewers, so many journal articles. But still it’s skewed. We don’t yet have a good regional breakdown, a good national breakdown of the kinds of risks that are going to be faced and that could be extremely useful tool to mobilize and invest in. And then the other question I would just pose in there is, you know, one of the real risks of climate change, as with various environmental natural hazards, is migration and then how does that play into stability. Political leaders, national leaders, governments, are—will need to think about stability of government and political circumstances in the face of climate change. The numbers for projections for migration are astounding, and the other thing that isn’t mapped out related to that is where are people going to go. So one environmental health risk, one natural hazard, could mobilize entire communities, entire subregions, to another subregion, kind of transferring a bit of instability and risks to another place and the health burden that comes with that. And we—I think these are undeveloped topics, and as a clinician and public health professional the main thing that gets ignored is not the emergencies, the kind of physical traumas, the injuries, diseases that need antibiotics, and things like that. The things that are ignored are what happens if all the schools are destroyed just like they happened in Pakistan? What are those kids going to do? What is that going to affect for their cognition, their cognitive development, their emotional development, the cohesiveness of their families? What is it going to mean for their risk of chronic disease? Typically, if there’s malnutrition in the first two years of life, so under nutrition, that might lead to stunting or wasting or just severe malnutrition, the risk of developing diabetes and metabolic diseases is far greater for that population. So if you have whole communities migrating related to environmental threats there’s a huge health problem that may be addressed with kind of emergency humanitarian operations in the first months or year. But then there are sequential health issues. So social determinant of health issues, chronic disease issues that are not going to be addressed in our current framework and for which wherever this mass migrating population goes to that health system is not going to be ready for that, and there are all sorts of details that are coming out in the literature probably under assessed but the rates of domestic violence tend to go up. What does that mean for women’s health care? What does that mean for reproductive health? What does that mean for pediatric health? All sorts of really interesting questions. So it gets very complex very fast and I would say we’re just at the kind of a smidge of development of understanding health beyond a few diseases and looking at it as a spectrum in terms of the state of health and then barely even touching the social determinants that are going to come after that. That’s going to be expensive, it’s going to have issues for stability, and as you can tell there’s so much to talk about in this issue. So I really thank you for that question. Quickly, the pandemic accord—out of the COVID-19 pandemic the mad rush to figure out how to deal with health emergencies, how to deal with pandemics because the rollout of response and production of vaccines and identification of all sorts of metrics related to surveillance was quite slow and poor and not cohesive and not equitable across countries. And so the attempt was to create a new instrument, a new kind of health law, if you will, to govern the operations of response related to pandemics under the interpretation that they’re a communicable disease. So this is a really interesting big-picture topic because we don’t have a clear answer on the origins of COVID-19. Huge focus on zoonoses and that’s related to land use change, biodiversity loss, climate change, and all sorts of other environmental drivers. So if that’s the case and a pandemic of infectious disease has caused such a problem and our response to that is to make a treaty that addresses just this we haven’t really addressed the full scope of health risks that could come from various environmental changes and the—so inherently the—you know, health experts are trying to figure out how to create a better operating framework and to consider some drivers although climate change is only a very limited piece of that right now. It’s supposed to conclude in the next year but there’s a lot of debates on how effective it can be and whether it will conclude on time. FASKIANOS: Great. I think that was Sheri Fink’s question, an adjunct associate professor in the School of Public Health at Tulane University. And we have a similar question from—or in the same vein from Marybeth MacPhee, a professor of public health at Roger Williams University: If national global approach is to addressing climate change and health, what is the potential for taking regional approaches, particularly for adaptation? That level seems to make more sense for systems problems and WHO has a regional architecture in place. WILLETTS: I think the interest in regional approaches is strong. I think it has not been developed sufficiently on the environment or the health side, and specifically if we’re looking at planetary health risks it has not been developed to consider kind of integrated environmental health risks and the spectrum of risks. But it’s important politically. Regional approaches can address transboundary issues so any kind of air pollution coming from agricultural methods, dust that goes across different borders, floods that go across different borders, coastal issues that go across. So many different problems actually need a regional approach that it needs to be developed more and politically that can be very advantageous for kind of a sharing best practices platform so that national governments can see how to take better action collectively and efficiently and then also for governments to create kind of a collective position when we’re trying to create global agreements and advance global discussions such as under the UNFCCC in one direction or another. Having a regional approach can be impactful if we can get there. In terms of health, some of the structures for development and—economics and development, structures for kind of environment sustainable development are more advanced than some of the health structures and some of the health structures are more focused on really narrow areas. The whole one health approach has been adopted as a term in a number of circles including global circles, national circles, looking at regional circles. But, again, it won’t be able to address the full spectrum of challenges and currently doesn’t address climate change unless it really expands to a broader scope of environmentally comprehensive one health and—or even to take forward some planetary health ideas. FASKIANOS: Fantastic. All right. We’re going to go next to the raised hand from Melissa Valeria Bisner, and please identify yourself, Melissa. Q: Hello. Melissa Bisner here. FASKIANOS: And what university? Q: Fairleigh Dickinson University. FASKIANOS: Great. Q: I have a question, though. Does global warming have something to do with climate change? Because I think it does because, you know, like, the—I think, like, the weather is constantly going, you know, like, up and down. Like, it’d be warm the one minute and then it’d be cold the next. FASKIANOS: Great. Thank you. WILLETTS: Thanks, Melissa. Yes, absolutely it does. They are connected. FASKIANOS: OK. Let’s go next to—I’m looking at all the—we only have a few minutes left so where should we go? OK. From Ava Eszenyi at Indiana University. The United States is a complex capitalist market that will always favor profit. How can we combat corporate lobbying that prevents climate change and regulation? WILLETTS: Well, this is a PhD topic. I would use a positive example that will be interesting to watch and I recommend watching it for the results. This year the UNFCCC has made a requirement that any attendee to COP28 disclose, essentially, whether or not it has—that that person is representing a corporate interest, specifically the fossil fuel industry. This is fairly significant because in the past up to—I think someone actually calculated this specific number—660 lobbyists from the fossil fuel industry had attended UNFCCC climate COPs in the past. So your question is about how do we make change and how do we face the real numbers and power of lobbyists from industry and I think the UNFCCC this year is attempting to try to do that by making it more visible because, essentially, for those who have never been to the UNFCCC it’s just a big arena, almost like a big group of tents with a lot of people wearing badges with their name on them and you don’t necessarily know where someone is representing. Or they may be affiliated in a different way than their badge—their delegation indicates. So this is a really interesting development. There is a lot of industry voice at UN environment meetings. It’s not just the fossil fuel industry. The food industry, the pharmaceutical industry, all of these companies have real kind of weight in the game in terms of decisions that are made to change rules or frameworks or commitments or obligations. So, you know, according to the SDGs a big focus was on partnerships, multi-stakeholder partnerships—SDG 17. This perspective that change cannot come unless everyone’s at the table is present. But how can that be shaped to make sure that there’s balance and parity? I think in the health sector this is quite interesting because there are some health players who’ve been involved in quite a few UN environmental meetings but the health professionals themselves such as clinical researchers, the folks on the front line, have not and so now we’re in this new stage of bringing those voices in to help balance out the other voice of kind of a market-based approach. How can we do that more? How can we make it more visible and how can we make sure that attendance of these decision making spaces such as global negotiations has a balanced multi-stakeholder presence? I think it’s a great question and keep an eye on it. We’ll see what kinds of reports or media articles come out of that visibility of who’s who and who’s there. FASKIANOS: Well, unfortunately, we are out of time. We have lots of questions, written questions, and raised hands. I’m sorry that we can’t get to you all. But, Dr. Liz Willetts, this has been a fantastic hour. Thank you for sharing your analysis, information, insight. We really appreciate it and we look forward to following your work at Harvard. Thanks to all of you for being part of this conversation. As a reminder, the next Academic Webinar will be on Wednesday, October 4, at 1:00 p.m. Eastern Time. Tamar Gutner, associate professor of international affairs at American University’s School of International Service, will talk about the international financial architecture. In the meantime I encourage you to learn more about CFR’s paid internships for students and fellowships for professors at CFR.org/careers. You can follow us at @CFR_Academic on X and visit CFR.org, ForeignAffairs.com, and ThinkGlobalHealth.org for research and analysis on global issues. Again, thank you for being with us today and thank you to Dr. Willetts. WILLETTS: Thank you so much for having me and for listening to my views. I really am humbled by this attendance list here today. Thank you. (END)
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CFR is an independent and nonpartisan membership organization, think tank, publisher, focusing on U.S. foreign policy. CFR is also the publisher of Foreign Affairs magazine. And, as always, CFR takes no institutional positions on matters of policy.  This webinar is part of CFR’s Local Journalists Initiative, created to help you draw connections between the local issues you cover and national and international dynamics. Our programming puts you in touch with CFR resources and expertise on international issues and provides a forum for sharing best practices. Again, thank you all for taking the time to join today’s discussion. The webinar is on the record and we will share the video and transcript afterward and post it on our website at CFR.org/localjournalists. We are pleased to have Alice Hill, Joan Meiners, and Carla Anne Robbins with us today for the conversation on responding to extreme global heat. Alice Hill is the David M. Rubenstein senior fellow for Energy and Environment at CFR. Her work focuses on the risks, consequences, and responses associated with climate change, and she previously served as special assistant to President Barack Obama and senior director for resilience policy on the National Security Council staff.  Joan Meiners is a climate news and storytelling reporter at the Arizona Republic. She previously worked as an investigative environmental reporter, and she received her Ph.D. in interdisciplinary ecology at the University of Florida. And Carla Anne Robbins is our host, and she’s a senior fellow at CFR. She’s the faculty director of the Master of International Affairs Program and clinical professor of national security studies at Baruch College’s Marxe School of Public and International Affairs. And previously she was deputy editorial page editor at the New York Times and chief diplomatic correspondent at the Wall Street Journal.  Welcome all. Thank you for being with us. I’m going to turn the conversation now to Carla to have a discussion amongst the three of you. And then we’ll open up to everybody on the call for their questions and comments. So we look forward to hearing from all of you. Carla, over to you. ROBBINS: Thank you, Irina. And, Joan, I didn’t know that about you. Another hyper-educated journalist. So they hired you with—I had a very hard time with a Ph.D. getting a job in journalism. People looked at me like if I’d spent those five years, you know, in an insane asylum it would have been easier to get a job in the business. So I congratulate you, you know, on getting past your academic background. So this is great. I’m so looking forward to this conversation. We’ve all followed the news of the wildfires in Canada and the extreme heat in places—even in places where you wouldn’t expect it. You know, last week it was 105 degrees in Eugene, Oregon, 108 in Portland, and 102 in Spokane, Washington. And also been fascinated by long-term changes. I don’t know if you guys have seen the Times had this interactive—I think, about four or five years ago—how much hotter is it in your hometown than when you were born.  And so I put in Glen Cove, New York, where I was born. And they didn’t go back as far as my birthday. We won’t talk about that. But it said—it said was only eight days versus seven days for 1960. But when I put in Miami, where I used to work, it said the city had eighty-five days above ninety in 1960 and today 133 days on average above ninety. That’s an enormous difference, nearly 50 percent more. So, Joan—sorry, Alice, I think I’ll start with you. Alice, can you start off with some sense of the reach, scale, and likely trajectory of this problem? I mean, that 50 percent increase for Miami is a really shocking thing, and particularly when there’s still so many people out there who are saying, well, you know, this is just weather. You know, temperatures go up, temperatures go down. HILL: Well, that’s an excellent question. And I’m just delighted to join you, Carla and Joan, to talk about this very important issue of extreme heat. Of course, with climate change we have this accumulation of greenhouse gases—carbon, methane, other gases—forming around our atmosphere and trapping heat around the Earth. The way it usually gets communicated is as a global average temperature rise of surface temperatures. But that, as your question notes, doesn’t really capture what’s occurring with the heat. Heat is one of the most certain outcomes of climate change. And by the way, in any article, I think, it would be helpful if we remind readers that it’s human-caused. There is really no dispute about this. I’m a former judge. I don’t think that this would find—the theory that this is naturally occurring would not find the light of day in a courtroom. And I don’t think litigants on either side of the issue would pursue it. So we know that it’s human-caused. And we know that heat is the most likely thing. But the heat won’t, as you’ve said, fall evenly. This is an average rise. It doesn’t sound like much, 1.5 degrees centigrade is what we’re trying to keep it to. By the way, we already hit that this summer. That’s above pre-industrial times. Most American readers don’t know what 1.5 degrees centigrade is, because compared to Fahrenheit. And then it just doesn’t sound like that much. But when you start quoting or experiencing the types of temperatures that Joan has experienced in Phoenix, that you’re talking about in Miami, that we have this heat dome right now in a large part of the United States, those are very high temperatures.  And that was predicted as a part of climate change, that we would have these extreme heat events. And those extreme heat events are the events that are the most deadly, and for which all communities are the least prepared—because we simply haven’t built and constructed our cities and our communities for the type of heat events that we’re experiencing, much less those that are in the future. And if you really want to feel frightened, this summer’s been very hot. July was the hottest month ever recorded. And this will probably be among the coolest summers for anyone born this year that they will ever experience in their lifetime. So we’re headed for a heap of heat going forward. ROBBINS: So—and this sounds so incredibly uninformed, and I will stipulate with the fact that I’m not—climate change is not my thing. I wrote about proliferation and all sorts of other things over the years. How come it’s so disproportionate, even—the distance between Miami and New York isn’t even that great. So if it’s—you know, the difference in New York is only one day more, of the average of over ninety, but in Miami it’s the difference between, you know, eighty-five and 133. I mean, that’s an enormous, enormous difference. You know, why is it—what is it about climate change that does it? And what’s the implication? Does that mean the global south is going to suffer more, or people who are in a band around the equator? Or where are the disproportionate effects, and why? HILL: Well, then—you’re absolutely right. It doesn’t fall equally. It depends on meteorological conditions, the geography, the topography, and other factors, including oceans. It’s very complex. But we know, and we have measurements that go back over—well over 150 years—that can tell us that we’re getting hotter. We see that we’re getting hotter in our poles. The Arctic is warming four times as fast as the rest of the world. So that’s why you’re seeing discussion of an ice-free Arctic Ocean. That was just incomprehensible. But China shipping tankers are going across. We have ecotourism in the Northwest Passage. We have Russia building up its northern passage with a lot of military investments. So that that area is warming very quickly and will be very active, as nations flex their muscles for security reasons and also seek to exploit it for the minerals and other things, oil potentially, that is there. And then you’re right, the countries that will probably suffer the most are the humid, because once you combine humidity—the humid countries. So that will be our tropical nations. Once you combine humidity with heat, it can turn deadly very quickly. There’s a phenomenon that I had never heard of before I started working on climate change called the wet bulb temperature. And essentially it captures the fact that as we, as humans, our method for keeping ourselves cool is to perspire. But if it’s too humid outside, even if we’re perspiring, it doesn’t cool us off. And that means that an outdoor laborer, for example, could die within five hours just because the internal temperature would—of their body would rise. And we have already seen several of those events hit in India, for example. And it will be a growing challenge. The security experts predict that that will drive some migration going forward because it will just be deadly to live in some of these spots. ROBBINS: Thanks. So, Joan, you are in—it’s not the heat but the humidity, but at least it’s dry in Phoenix. But you’ve also worked in New Orleans. It’s always hot in Phoenix in the summertime, but you’ve seen particular extremes this summer. I think, like, thirty-one days of something over just a ridiculously high number. Can you tell us about how it’s affecting life there? Alice was talking about the dangers. This is a place that’s accustomed to heat, at least people are accustomed to the heat, if not adapted to heat. MEINERS: Yeah. I think that’s really interesting, the idea of being accustomed to heat, because we’re accustomed to a very narrow range of heat, right? I mean, my background is in ecology and evolution. Everything that’s alive on the planet right now has evolved in a very specific temperature range. And now—and everything that we’ve built as human society has been built for a specific temperature range, sometimes referred to as the Goldilocks Zone. And now we’re pushing things outside of that temperature range.  And, yes, climate, that fluctuates in natural cycles. And, yes, it has been warmer and cooler in the past. I got all kinds of emails related to that from my readers. But we’re really pushing the boundaries of what we have adapted to. And Phoenix experienced—we’re already the hottest large city in America. We just set the record for the hottest month as in any U.S. city, with three days in July where temperatures hit over 119. And almost the entire month, except for the last day, was highs of over at least 110. But the most damaging thing is that the overnight lows are not dropping as much as they used to. And part of that is climate change. And part of that is what we call the urban heat island effect. So when—as population grows, and we build more, and we build in certain ways, those impervious surfaces that we’re adding, as roads or as houses or other structures—manmade structures, they absorb heat during the day from the sun, and then they hold onto it and radiate it back out at night. So that is really the way that I think people living in Phoenix are experiencing the heatwave that we just went through the most. And we have a very large homeless problem here. We have an estimated 10,000 people that are unhoused in the county. And they are obviously most at risk from these extreme highs, and then not getting that relief overnight because the temperatures just don’t drop. We set a record in July for the highest overnight low. So we had one night where temperatures did not drop at our weather station, which is located at the airport—temperatures did not drop below ninety-seven for an entire twenty-four-hour period. So that’s—those are really hard conditions to be living outside.  We have a lot of heat-associated deaths that happen in this area. There’s a lot of effort to deal with those, but it’s—but it’s really hard, because, you know, the mitigation opportunities, I think, in the moment are somewhat limited. We had 425 heat-associated deaths last year. We’re on pace to exceed that this year. That’s county-wide. And about half of those are people that are experiencing homelessness. So it’s very—honestly, it’s very distressing to live here and see that. I mean ten thousand people that are experiencing homelessness, they’re not invisible. You do see them.  I have spent some time in the downtown area that we call the zone where many of those homeless people live, reporting in the evening, talking with people about what they’re experiencing. And, you know, it’s kind of a whole nother category of what we’ve all come to know as, like, climate grief—talking to someone who, you know, you know somebody in that area of the zone is not going to make it through the night, likely. And, you know, you’re going talk to them and then go home to your air conditioning.  And you know, Phoenix, going back to the idea of, like, we’ve constructed this place here for a specific temperature range. We’re very reliant on air conditioning now. And it’s a problematic feedback cycle where air conditioning uses a lot of energy. We don’t have—we still do use a lot of natural gas in Arizona. So we still are getting a lot of our energy from fossil fuel derived sources. And air conditioning also spits out other compounds that are known to be very potent greenhouse gases. And then as that contributes to climate change, then we have to turn the air conditioning up, and it uses more energy.  So it’s a troubling feedback cycle here. And then the other way, just wanted to add, that that heat is different in the desert than in Miami, you know, it’s a dry heat. It might—you might be able to survive at higher temperatures without that wet bulb effect that Alice mentioned. And you are able to more—physiologically, you’re able to more effectively cool down your body when it’s less humid because your sweat can evaporate off of your skin and then create that cooling effect. But the impact that that has on the environment is that soil moisture is at an all-time low in these parts.  We’re in a—you know, we had a relatively wet year this year in some parts of the southwest. We still are waiting on a lot of our monsoon rains specifically in the Phoenix area. But it’s just incredibly dry here. Those temperatures and the lack of rain, which is all related to kind of the atmospheric destabilization related to greenhouse gases, retain more heat now so it’s just sucking the moisture out of the soil and making it harder to live here. And then when you talk about interventions for protecting people from the heat, one of the things that the city of Phoenix wants to do is plant more trees. Well, planting trees and getting them to take root and survive is difficult when you don’t have much water and the heat is just sucking it out of the soil. So there’s all of these things going on at once. And you see it in so many different ways just living here. ROBBINS: Thank you. And I’m going to talk more about government and public policy in a minute. So it’s—I wanted to go back to Alice for a moment. For a long time, it seemed like the climate conversation was a choice between heading off climate change or adapting to it. It almost seemed like they were the adaptation people and the—wrestling about climate change. Is that debate over with? Or is it too late to turn this back? HILL: Well, that debate is—it’s not a debate anymore. You know, when we first started getting together, that is the countries across the globe, over 190 countries have been meeting almost for thirty years on an almost annual basis to talk about what should be done about climate change. When that started, the discussion was almost exclusively about mitigation. And mitigation in this context is used to talk about reducing greenhouse gas emissions or somehow dealing with the accumulation of this thick blanket that’s around the globe that’s heating us up. And in the early years there was, I’m told, an active effort to discourage discussion of adaptation, because, of course, if we had acted on climate thirty years ago in a vigorous way—which initially it looked like might happen—we wouldn’t be in the situation that we’re in now. So folks, scientists, didn’t want to talk about adaptation because that might be seen as giving a free pass on the very important work of reducing emissions. And now, because, as we’ve seen this summer—I mean, it is evident in every corner of the globe that climate change has arrived. We’ve seen flooding in unprecedented levels in Slovenia. The French and Germans have offered help there. And Ukraine even offered to send a helicopter in the midst of that disaster. We’ve seen the wildfires in Hawaii, Greece, in Portugal. We have seen flooding in Beijing, where they had more rain in August—four times more rain than normally. Hail the size of cantaloupe in Italy. I mean, everywhere is evidence. And heat is the most certain consequence of climate change. But as attribution science has improved, that is the science that says this event would not have occurred like that—the Pacific Northwest heat dome that happened a couple of years ago they said would never have occurred, the scientists, absent climate change. And that attribution science continues to improve. And so we can put our fingerprints on—or, identify the fingerprints of climate change on particular events. When I started in this business, you couldn’t say. You could just say it’s consistent with a trend. But now we can. So with that background, adaptation has moved to the fore. That doesn’t mean that it’s getting the attention that is necessary because, as Joan has said, everything we have in place was built based on an assumption that our climate was stable. That assumption is no longer valid. But we have everything in place. In fact, our current building codes are based on that assumption. So even if we take confidence that we’re building something new, that should better withstand a rain bomb, as the emergency managers call it, or a wildfire. Maybe not, because we haven’t done that work yet. So we have a lot of stuff that’s vulnerable to what’s going to happen. So we need to focus on adaptation. But if you look at the amount of money that governments and philanthropies are giving to adaptation, it’s very small in comparison to mitigation. The numbers vary, but it’s well below 50 percent. The poorer nations of the world have been asking for a loss and damage fund to help them pay for adaptation going forward. That still hasn’t been funded. Developed nations promised $100 billion a year to the developing world towards climate change starting 2020. The developed world has not honored that. And the money that has come forward has been mostly for mitigation. One of the reasons for that is mitigation is easier to do. As hard as it is, it’s—and it’s easier to measure. You just measure the amount of carbon that you didn’t send into the atmosphere, or that you took out of the atmosphere. But adaptation is many, many thousands of decisions. How high should the drainage pipe be? How much flammable-resistant material do you need? What’s the setback on the vegetation? What is safe? What’s the elevation of the home? What’s the area—is the area going to be flooded and burned again? Should we even build there? And those local decisions become highly politicized very quickly. Another reason adaptation, I think, has suffered. It was the head of the British climate change adaptation committee who summed it up. She said that it’s under-resourced, underfunded, and often ignored. And she likened it to the poor cousin that comes to your dinner—you know, your holiday dinner, and is seated at the end of the table, and no one talks to that poor cousin. That’s still a little bit what adaptation feels like. A lot of people saying, yeah, we got to get on it. We’re going to do a lot, including the secretary general of the U.N. But the money hasn’t materialized nor have the ideas materialized that will keep people safe for the kinds of events we’re already experiencing, much less those in the future. And we have to remember that even though it’s the biggest—or the highest record, all these records broken this year, with climate change we’re moving forward to even bigger events. And they actually get exponentially bigger. So we’re just at the beginning of experiencing what climate change will mean for communities like Phoenix, Miami, Hawaii, you name it. ROBBINS: So I want to—we already have one question, and I want to throw it open to—since so many journalists, and I’m sure they have many questions. But I did want to ask Joan, this is, as you said, the hottest city in America. And while there may be sort of a political back and forth, you know, on the climate issue—and you do—I’m sure—you said you get emails from people all the time saying, isn’t this just weather? That said, people experience this. So what sort of public policy is going on there? And, you know, you have written about housing, for example. You know, is there anything positive going on there to try to deal with adaptation to at least ensure that people can live better, can survive, move on from this in some way? MEINERS: Yes. So, Phoenix—the city of Phoenix launched the first publicly funded Office of Heat Response and Mitigation in 2021. The opinions on how much progress they’ve really made are a little bit mixed, but they do have—you know, they recently put out a list of thirty-one different strategies that they’re working on pursuing to try to—long-term strategies for mitigating the impact of heat. Such, as I mentioned, planting more trees, especially in neighborhoods where the impact of extreme heat in the urban environment is not even. We definitely have a lot of neighborhoods that are cooler. They’re the wealthier ones typically. And then lower income, typically minority, neighborhoods tend to be hotter with less shade. So they’re working on trying to even that out, plant more trees. They have a cool pavement program where they’re painting the road. I think they have about 100 miles of roads that have been painted with a lighter coating that also has somewhat mixed effects, because it reduces kind of the overall heat in the general environment, but it can reflect heat back up onto an individual person who’s walking down that street and actually make it hotter for them. They’re talking about launching a cool roofs program. And then on the more immediate response side, they are doing things like trying to launch a water truck that’s going to drive around and make sure that people have water, although that’s not up and running yet two years in. And they have a network called the Heat Relief Network of about 200 cooling centers, which are mostly private businesses that have agreed to let people come inside into the air conditioning on very hot days without necessarily buying anything from the business. I did write last year about how it’s unclear how effective many of these things are, because we don’t—they don’t have anybody going and looking at visitation at these cooling centers. They don’t have anybody looking at the being—they don’t—there’s not a good way to study, you know, what would happen if this cooling center wasn’t open. And a lot of them do close overnight. So I mentioned the overnight temperature. It’s very—even if you were able to spend the day in air conditioning, it takes a very big toll on your body to spend the night outside when it’s ninety-seven degrees. So and then, you know, we mentioned that Arizona State University is local. They have a very strong emphasis on sustainability. They have a lot of—a lot of global leaders in sustainable innovation are based here.  And so my sense is that there’s kind of a lot of really promising ideas, and directions, and intentions. And it kind of relates to what Alex was saying about, you know, the United Nations approach to climate change where, you know, they had a whole meeting last year where they created a loss and damage fund, which sounds like a great idea to have rich countries help poor countries pay for the impacts of climate change. But then they didn’t put any money into it. So, you know, it’s a little bit—I actually attended an opening of—I can’t remember the exact name, but there was a new center at Arizona State University for studying water and, you know, the drought crisis and how we’re going to deal with that. And they had a launch event. It was funded to the tune of $40 million. They had a launching event where they invited me and they had a panel of experts.  And they were talking about how it’s time to stop talking about what we should do and start doing it. And I’m kind of sitting in the audience like, OK, so when does that happen, exactly? So, yeah, there’s a lot of—there’s a lot of talk and promise, but also, like Alice said, you know, there seemed like there was talk and promise about addressing climate change aggressively thirty years ago, and now look where we are. So, I don’t know. Phoenix is going to get harder to live in. We’re going to have to make some really hard decisions. And I don’t know exactly what the breaking point is going to have to be before those changes happen. ROBBINS: And so much of this is because, as Alice said, these are regulatory issues. And these are government telling people they have to do things. And that sort of stirs up a lot of local resistance. We have questions, yay. So I’m going to turn it over to Holly, is it, Edgell -I hope I’m pronouncing it correctly- who is the editor of race, identity, and culture at KWMU FM in St. Louis. Holly, do you want to ask your question, or should I read it? OPERATOR: Carla, you’re supposed to read the question. ROBBINS: I’m not necessarily supposed to read the question. Holly can read it if she wants. So she can—it’s up to you, Holly. I can read it. I’m curious to know who is leading the way in designing and building affordable homes that take into account extreme heat, i.e., with HVAC and also with design construction practices that can keep us cool and have net-zero impact. Alice? Joan? Yeah. HILL: Sure. So we have a LEED-certified program, which looks at the issue of getting to buildings that don’t emit a lot of harmful pollution. But we don’t have a robust equivalent of that for building codes. And one thing to keep in mind, under our Constitution in the United States the decisions about where and how people build are decisions that occur at the state and local level. They do not—they’re not federal decisions. The federal government can provide incentives for better decision-making, but it really falls to the state and local governments. We do have a system of NGOs that—or, nongovernmental organizations that create model building codes. To my knowledge, those organizations, and this isn’t a problem unique to the United States, are still trying to figure out what a building code would look like that would be resilient to future impacts of climate change. So as I said, we’re still building things to the old codes that—or the codes—even if they’re brand-new codes, they’re looking to the past. They haven’t incorporated the future risk. So what you get then is one-offs. I think I read at one time, for affordable housing Habitat for Humanity was trying to do some resilience work. In Alabama, you have an effort called Fortified, where builders get a fortification or fortified certificate that shows that the building is Hurricane resistant, and also might be—I don’t know about the carbon pollution side, but least hurricane resistant. And then you have a lot of architects who are being very creative, going back to ancient methods for cooling buildings. So making sure that they get that passive airflow. And this is going to be very important, that we rethink about what buildings can do in very extreme conditions, including heat, because during these extreme conditions, you might well lose your power. And if you lose your power, you’re not going to have that backup air conditioning system. So if you can’t open your windows, you might be just in an oven going forward and have to evacuate the building. So you’ll see—I’ve talked to architects in Austin, Texas who were trying to do innovative designs to look back at how Texans historically built, at how Mexico historically built houses. But the architects will be honest. They’ll say, you know, you got to find a client who’s willing to pay for it. And often it comes down, if it’s a developer, it’s an issue of money. And they—the developer wants to sell the house—or build the house as cheaply as possible. And when I was working on trying to get stronger building codes when I was in the White House, I was told a developer said: If it costs a dollar more, we’re against it. And I think that’s part of the reason why we’ve had so much trouble getting to model building codes that reflect the future risks, because there probably will be, in some instances—maybe not wildfire, but with flooding or other—additional costs, so that the building is more resilient. So you get one-offs, where you’ll get a very exciting building built that it does all these things. But to my knowledge, it hasn’t been adopted on a widespread basis yet. And I think that’s going to require incentives from governments to encourage better decision-making and better choices going forward. I don’t think that the federal government has risen to that challenge yet, in a meaningful way. And so it means that we’re going to see more damages going forward. And, of course, if you follow NOAA’s work, and the rise in the so-called billion-dollar events—extreme weather events that cost more than a billion dollars, one single event—the average number of events—I think it was, like, ten years ago. And now it’s eighteen. And I just read that, as of the first six months, we had fifteen separate billion-dollar events here in the United States. So we’re suffering a great deal more damage as we experience these first instances of climate-worsened extremes. MEINERS: I add that in Arizona, if you like.  ROBBINS: Sure, absolutely. And I’m going to add in a question for you on top of that, just very quickly, which is Kerry Snyder, who is the editor for science, health, and technology at KJZZ. And, Carrie, you can jump in after this if I haven’t summed it up—on top of this. She’s asking, and you as a reporter, should climate change/global warming be called “pollution,” to better explain its human cause? And I’m just wondering, since you have a somewhat skeptical audience in your readership, is there better language we could be used be using? So jumping in on either or both of those. MEINERS: Yeah. I do think that that is a direction that could help. You know, we have all sorts of different kinds of pollution, from—I recently wrote about, you know, there was a roundtable event where a bunch of experts got together and talked about different ways to notify the public about extreme pollution advisories and get the word out. And pollution can come in so many different forms. I mean, here we have dust storms that are bad for your health if you’re outside. And I—you know, I get alerts on my phone about, you know, don’t spend time outside, that there’s a dust storm. We have ozone, We have, obviously, you know, soot—that that type of pollution that you can see. Ozone you can’t see. And so I think that it makes sense to describe it that way and help people understand, A, that it’s bad and, B, that we’re causing it and, C, that we want to get that—those levels down. So I like that suggestion. And then, just to touch back on the housing question, I’ve actually spent the whole year working on an investigation into how Arizona is building, because Maricopa County is the fastest-growing county in in the country in terms of number of new residents that moved here in 2022, according to Census records. And we’re building at a very fast rate. And, like I mentioned, the urban heat island effect, it only gets hotter the more we build. So it matters a whole lot the ways that we’re building.  And I’ll just give a quick plug for an investigative story I have publishing Thursday that looks at where we did an independent review of all the building codes, like Alice was talking about, in in Maricopa County municipalities, which is the county where Phoenix is, and compared kind of which—because Arizona does not have a statewide building code. And so each jurisdiction adopts upgrades on their own, on their own timescale, and according to their own values. And kind of just to tease the results that haven’t—the findings that haven’t published yet, we found that the places that are really pursuing more sustainable models of homebuilding, which do exist. You know, LEED certification is one example that isn’t necessarily the way to go, but because it just adds so much cost to the process to get it LEED certified, but it’s just kind of a way of saying that there are these ways of building that are possible. We found that a lot of the areas that have—that are requiring more sustainable climate-aware modes of homebuilding, are not actually where most of the building is happening. So we have to figure out some way to—if we’re approaching this as the way to protect people from the heat and reduce, you know, greenhouse gas emissions at every level of geography, and type of construction, and type of generation, use of energy, we need a different approach. Because the way that we’re building homes in Arizona is not going to get people housed in a cooler environment anytime soon, based on our findings. And part of that is this kind of piecemeal approach to adopting building code upgrades, which are only—are typically only issued every three years, but do represent big leaps and bounds in progress because of how quickly some of that energy efficiency technology is moving. So mixed feelings about that. But, yeah, that story’s out on Thursday, if you’re interested. ROBBINS: We will send out the link, absolutely. So, Charles Ellison has both written in his question and put his hand up. Charles, would you like to pose your question? Q: Sure, I can. Can you hear me? ROBBINS: Yes. And you want to identify yourself? Q: Sure, Charles Ellison. Yeah, I’m the contributing editor for the Philadelphia Citizen. And thank you all for this discussion. Really do appreciate it. I’m also an Emerson Collective fellow for this year, a climate contributor, focusing on climate issues. So I’m real curious about the racial equity dimensions of this discussion. You know, because I would say—I know the point was made earlier that we wouldn’t be where we are now, you know, had we just moved more aggressively thirty years ago on climate adaptation. And I would argue that, well, didn’t do that because we weren’t moving aggressively on racial equity—issues the way we should have been, and still shouldn’t be doing now, thirty years ago. And I’m just wondering why the racial equity dimensions just continue not taking center stage on these types of discussions.  I’m in Toronto right now at a convening of state and provincial legislators. And they’re even acknowledging it. They’re saying, you know what? We should be having discussions about the history of redlining, segregation, about how climate crisis started in the first place—hundreds of years ago with slavery and the rise of capitalism—and we’re not. But to your point, I think it’s Joan, you know, you were talking about, you know, more people moving into Phoenix. Well, 10 percent of that growth into Phoenix are Black residents who are moving into Phoenix.  So the racial equity dimensions really on these climate discussions have got to be more centered. And it’s just not happening at the rate that it should be. And I’m wondering, are you all having those discussions as you’re talking about climate crisis and as it’s getting worse? Thank you. ROBBINS: Thank you. Alice, is that penetrating any of— HILL: Sure. Excellent question. And I want to just get to the pollution question first, because I will—I absolutely agree that using pollution is a powerful thing. But I will tell you, I just wrote a piece not two days ago. And the editor said, I don’t get this. Why are you saying carbon pollution? So it may not be widely understood, was my—the message I got from that. And so I put in a—you know, a little explainer, what I was referring to. But just to flag that. I think it is more accurate that it’s pollution. It’s human caused, and it’s very much damaging us. And, Charles, your question, absolutely. The impacts of climate change fall unequally geographically, and they fall unequally economically. So we see that the people who tend to be flooded may have been in areas that were redlined. And therefore—and that’s what recent academic work has shown. We see right now a battle over carbon capture in disadvantaged communities, and the concern that that will be a noxious industry, that will be again on the backs of those who’ve suffered from racial discrimination and economic discrimination. I would say that in recent years the topic has become a subject that is more commonly discussed. There is a lot of work looking at FEMA’s programs. FEMA in the past tended to value just property. And if you just look at property, the who owns the most expensive property? You’re going to find that it’s going to be a more White people on the most expensive property. And if you’re going to base aid on that, you’re going to see some wide discrepancies. And that is, in fact, what the research showed.  So now FEMA is trying to come up with different metrics. The impacts on the community and other ways of measuring harm. They’ve also, and you may be aware of this, changed their policy about proof of ownership, because it found that some Black communities didn’t have deeds to their property that had been handed down generation to generation. And so when FEMA demanded proof of ownership of the damaged building, it couldn’t be produced. And FEMA has recognized that that was a practice that resulted in inequality and came from inequality. So I think it’s more at the forefront than certainly in my experience, starting in 2009. But we have a long way to go because we are not making the types of investments anywhere, but also as we start, who’s living in the river bottom? It’s going to be Black people who were forced there because that was the only land that was available to them. And now, generations later, who’s going to help them get out of that river bottom that is going to flood? And we don’t have the answers to those questions yet. It falls on local communities whether they want to do so-called buyouts to help people get out. And these programs may be available, but if there’s not the local will to adopt it, there could be even more negative impacts. So I don’t have the answers. I can just tell you, I see many more people discussing it and looking at it. In fact, there was just—there’s very little legislation done on resilience. But I think there’s community disaster resilience zones, was a bipartisan piece of legislation last year that’s going to take a variety of data sets and overlay them and identify the most disadvantaged communities in the United States, and figure out how we’re going to get more money to those communities to help them prepare for climate and other types of disasters. So there’s recognition that we’ve done a poor job and we’ve got to do better going forward. ROBBINS: I want to ask a reporting question of Joan that’s been posed. But before I do that, I just want to have a correction here. I used to do corrections of the Times. Holly Edgell is the managing editor of the Midwest newsroom for NPR. So great job, Holly. So I just wanted to get that out to everyone. So Luis Joel Mendez Gonzalez, who is the—I’m just looking here at our list here—covers government preparedness around climate change for the Centro de Periodismo Investigativo, the Center for Investigative Journalism. Luis, do you want to ask your question, or should I ask it for you? Sure. Anyway, well, the question that he posed is, I think, Joan, that—he asked, where can he find public data about heat-related deaths in the U.S., and are data on territories like Puerto Rico and the U.S. Virgin Islands included as well? I know you’ve done a lot of investigative reporting. So what are the best data sources for people, particularly in different parts of the country? MEINERS: Heat-related deaths is the tough one. Because we are Phoenix and it’s so hot here, our county public health department tracks heat-associated deaths probably better than most places. But it’s kind of similar to the issue with COVID, where if someone has COVID and then has a heart attack and dies, do you call that a heart attack death or COVID death? And you’re going to have go fighting over that. We have the same situation with heat-associated deaths. It’s sometimes hard—there are sometimes multiple factors. So it’s hard to point to exactly what was the cause of death, is my understanding. And there is a data—there is also a data availability issue, where I think the CDC is starting to track this. I’m not sure if it includes Puerto Rico and the Virgin Islands. It’s not good-quality data yet. I think that there’s more attention being given to the need for that. But it might be more of a situation at the moment where your local public health department might have better records. Of course. that hard to piece together if you want to do something bigger picture. But that is one of the issues, is just how do we even define heat-associated death? How do we count those? Who’s keeping track of all of this? I think that’s an ongoing conversation. And then I just wanted to just speak briefly to the—to the racism question of, unfortunately, I think that sort of the answer to why aren’t we talking more about racism in addressing—in climate mitigation? I think the answer to that is, kind of, racism. As part of this housing project that I’ve been working on, I spent some time up on the Navajo Nation in northeast Arizona. And there are thousands—tens of thousands of homes there that lack running water and electricity, and are not—you know, of course, it’s a sovereign nation—but, you know, just have not received equivalent funding as other parts of the U.S. for those kind of—that kind of infrastructure, and have not received the attention for it either. So they are weathering these increasing temperatures without power, in many cases without running water. And so there’s many ways that this is happening. And I wish I had a better answer for how we approach that. But I think it’s a good thing to keep talking about. ROBBINS: Alex, do you—I mean, you do a lot of research. Are there good sources of data that would be useful for journalists that we—you know, that we haven’t already talked about? Not just for heat-related deaths, but other things that have a direct impact on people’s lives and in the country, but with climate now? Is the federal government keeping data? Or is it independent NGOs that we should be looking at? Is it—you know, is it some sort of international data sources? HILL: Well, that’s a great question. I mean, one of the challenges we have is that—what kind of data are we talking about? But let’s say we’re talking about data for future risks from climate change. We haven’t solved that problem here in the United States. And I was in the White House, there was an attempt to try to pull together all of the fantastic science that is being done by NOAA, and NASA, and others to make it more user-friendly so that a person could figure out whether a particular location would suffer. I’ll never forget, I met a part-time mayor from Perdido Beach, Alabama. This is about ten years ago. And she said to me, you know, I get it. I get that my community has climate risks. We’ve got sea-level rise, bigger storms. It’s right there—Perdido Beach is right there on the Gulf Coast. She said, but I’m a part-time mayor. I don’t have anyone to help me figure out what’s ahead, or do a grant, or anything else. And we haven’t solved that. We haven’t made it easy for her yet. And it’s not easy for anyone.  There has been a private philanthropic effort, or funded by philanthropy, called The First Street Foundation. And they have partnered with Redfin. So now you can go in and type your address and figure out—they’ll give you some modeling score—based on a score, telling you what your property is at risk for. Now the challenge for that is modeling is generally a black box. So we don’t—I’ve talked to actuaries and modelers who have criticized. They don’t know 100 percent what’s behind all modeling. And they just—there’s some of the assumptions, whenever you’re modeling something going forward you’re making some assumptions. So but First Street Foundation has done this, and the government has not. I believe that we need to have publicly available data sets and information for informed decision. But we’re not seeing that. And what we’re instead seeing is an arms race in the private sector among the big consultancies to provide, and they’re gobbling up the modeling firms. And they will sell products to the private corporations, but the—you know, what is the city of—what does the city of Phoenix get? Phoenix may be large enough it can purchase such datasets or analysis, but you get to the smaller places, they can’t do it. And so that’s where we’re going to see—again, to this question of inequity—we’re going to see inequity also in terms of which communities are able to deal with this better than others. Within their own communities there will be inequities. But if you’re talking about a city at large that’s poor, it’s going to be really challenged. And unfortunately, the federal government has not figured out a way to make what I think is a public good available so that we would have better planning across the board. ROBBINS: So we have—thank you for that. We have three minutes left. Lori—I’m sorry—Lori Valigra, who’s the business and economy reporter at the Bangor Daily News has a question. Lori, I’m just going to read it really quickly. So Lori says that we had our hottest day in Maine on July 6th, ninety-two degrees. How can residents in an area not accustomed to high heat prepare for it and adjust to it? You know, Joan, you see this every day in a really hot place. Are there lessons that are applicable to Maine as well? MEINERS: Yeah. And I think it’s really good to be thinking about that in Maine. Some of the scariest heat wave death events have been in places that are not actually that hot, but just, you know, don’t have air conditioning in every single house to be able to respond to something like a heatwave. So knowing other ways that you can respond is really—can be lifesaving. In Phoenix, there are signs all over the place, at every hiking trailhead, all kinds of things. I mean, generally, you know, stay in the shade, drink water. The quickest way to cool down is to—if you get overheated—is to immerse yourself in water. I talked to some exercise physiologists that that deal—at the Korey Stringer Institute—that deal with heat exertion, and that’s what they say. Get people into an ice bath if it’s an emergency situation. Other than that, going back to the—those are obviously for if you’re outside. And then knowing kind of that the signs of heatstroke and heat illness are also important. So kind of it starts out with excessive sweating, kind of flushing and feeling lightheaded. And then as it progresses, that actually becomes, you know, your skin is cool and clammy, you’re not sweating because your body is confused and trying to retain that water. Those are things to just be aware of so that you know when it’s time to really go to the emergency room. But otherwise, going back—circling back to the housing idea, you know, if you know that it’s coming, close your blinds in the morning, try to make sure that you are stocked up with supplies. Talk to your local representatives about blackout prevention, things like that.  And look into—Arizona this year got some weatherization funding from the bipartisan infrastructure law. And to go in and add better—upgrade insulation, and kind of update vents and cooling systems in houses. So that’s something that can be looked into too. I talked to an insulation expert who said that, you know, what builders have been required to put into homes in terms of insulation over the years has just changed drastically in recent times, and can make a huge, huge difference. So if you don’t know what’s inside your walls, and you have a little bit of extra money to put towards that, that could be something that would make a big difference. HILL: May I just add one additional? ROBBINS: Yes, please. Quickly. HILL: There was a very famous study of a community—two very similar communities right next to each other in Chicago. I think it was in the 1990s. Terrible heatwave. And one community suffered far greater deaths than the other community, even though on base they looked very similar. And researchers determined that one of the differences was social connection. We’d see that people who live alone, the elderly, are at greater risk of dying. And those that had neighbors checking up on them, that knew Betty hadn’t shown up, were more likely to be saved. So for all of us as we face more disasters it’s recommended, and I think there’s a big payoff, that we know our neighbors, we know our communities better, and figure out how we can work together to keep everybody safe. ROBBINS: That is a great way to end. And I really appreciate Joan and Alice for joining us. This was a great conversation. I’m going to turn it back to Irina now. And thank you for all the great questions. FASKIANOS: I echo Carla’s thanks for doing this. We appreciate it. And to all of you for your wonderful questions and comments. We will be sending out a link to this webinar, to the recording and transcript as well as any other resources that Alice and Joan want us to include. I neglected to mention that Alice is the author of a book, The Fight for Climate After COVID-19. So, I commend that to all of you. And you can follow them, I think, on X, if you still are on X. Alice Hill at @alice_c_hill, Joan Meiners at @beecycles, and Carla Anne Robbins at @robbinscarla. And, as always, we encourage you to visit CFR.org, ForeignAffairs.com, and ThinkGlobalHealth.org for the latest developments and analysis on international trends and how they are affecting the United States. And please do share with us your suggestions for future webinars and speakers. You can email us at [email protected]. So thank you all again for today’s conversation. We appreciate it. ROBBINS: Thanks, guys. HILL: Take care. MEINERS: Thank you so much.    
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