Q&A: The Lancet Countdown’s Howard Frumkin: ‘Nobody is exempt’ from climate change’s effects: Report released at meeting outlines what can be done on climate

Let’s start with the basics. What is The Lancet Countdown?

It’s a project that came out of a couple of Lancet commissions on climate and health between 2009 and 2015. Those commissions identified climate change both as an urgent health problem, global in scale, and as a promising public health opportunity, because the things we need to do to tackle climate change yield lots of health benefits.

Importantly, they yielded the recommendation that there should be global surveillance on climate change and health. And that’s what gave rise to The Lancet Countdown.

It’s a project consisting of about 20 or 25 universities, government agencies, non-governmental organizations, and other partners, all of which together are aggregating data on climate change and health, making that data available in a dashboard form and committing to do this for many years to come so that it’ll be an ongoing way to track our progress in tackling climate change.

It’s a simple idea. When you go to the doctor, and the doctor takes a temperature, or takes blood pressure or finds something abnormal, you expect the doctor to follow that over time, to be sure that it’s not getting worse, to be sure that the interventions are working and to change course if needed.

But we haven’t done that before on a global scale when it comes to climate and health. This is a big idea. It combines not only health impacts of climate change but also upstream factors that are causing climate change and societal responses. It allows us to see how we’re doing in primary prevention and some of the adaptation efforts that will help protect us from climate change, and even such indicators as how much money we’re putting into those efforts.

It’s a soup-to-nuts, upstream-to-downstream, across-the-board, global-scale dashboard on climate change and health, the first of its kind.

In addition to the global report, about half a dozen countries created country-specific versions of the countdown report. Those involved downscaling some of the global data to the country itself and, in some cases, including…other kinds of data that weren’t available globally, but that were available at the national level, to enhance the picture further.

For example, in the U.S. we had data on the spread of Lyme disease and on the prolongation of the allergy season, data that weren’t available at the global level. It was that U.S. report that was released jointly by APHA and The Lancet Countdown and unveiled at the APHA meeting.

What are some of the key takeaways from the U.S. briefing?

The first was that climate change is having a very significant impact on human health here and now, not off in the future, not far away, but right within the U.S. Vulnerable populations such as the elderly and the poor are especially affected, but that nobody is exempt. This is a very big public health hazard in the present tense and within our own borders.

The second takeaway is urgency. Some of the trends that we wish were getting better have actually worsened over the last couple of decades. We’ve wasted time. We’ve squandered opportunities to tackle the problem at an earlier stage when doing so would have been easier, more tractable and less expensive.

Delay has been costly in both human and financial terms; further delay will be more costly. We need to tackle the problem urgently.

The third key message is one of hope and optimism: We are seeing some signs of positive change, for example, the shift toward decarbonizing the economy in the U.S. with the rise of renewable energy, the decline of coal and the growing efficiency of motor vehicles.

Many of those changes are already yielding health benefits and will continue to do so going forward. That’s the good news story, and it underlines the public health opportunities in tackling climate change.

The countdown outlines policy-level steps that can be taken to fight climate change. Why start there?

Well, it’s really important to start at two different levels simultaneously. One is policy. At the federal and state levels, we need to do things like shift our primary energy sources, shift our transportation system and change the incentives in our food system so that all those systems can contribute less to climate change.

But it’s also important to start at the very personal and community levels. We need to shift our preferences in eating toward less meat-heavy diets. We need to shift our preferences in transportation away from gas-guzzling, single-occupancy vehicles to walking, biking and transit. We need to use less energy, insulate our houses better, use fewer resources, reuse and recycle more. All of those traditional environmental behaviors and attitudes are very important at the individual and community level, but they need to be accompanied, of course, by policy changes.

And then, of course, in the public health sector, where we are responsible for driving a lot of adaptation, protecting the public from the impacts of climate change, we need to step up and do even more than we’re doing, protecting people from disasters like floods and fires and droughts, protecting people from the expansion of infectious diseases, protecting people from expanding allergic illnesses, protecting people from respiratory hazards due to worsening air pollution.

The Annual Meeting was the capstone for the Year of Climate Change and Health. Why was this the right place to talk about the countdown?

It’s no surprise that APHA was a co-releaser of the report. APHA consists of public health people. And we understand intimately the importance of surveillance. It’s one of the core public health functions.

Howard Frumkin announced the release of The Lancet Countdown 2017 report for the U.S. at APHA’s Annual Meeting.

Photo courtesy EZ Event Photography

We understand that if you don’t track the health characteristics of a population, you can’t identify problems, you can’t target interventions, you can’t track progress and you can’t change course when needed. That’s at the center of public health.

What The Lancet Countdown represents, really, is nothing more than a massive effort at public health surveillance, looking not only at health parameters but looking at related parameters upstream.

I think The Lancet Countdown can be a model for further efforts within the U.S. The global effort will continue, but lots of the important data are available within the U.S. but not globally. That’s especially true of state- and local-level efforts, because those are hard to aggregate on a global scale.

If we begin collectively, inspired by the countdown in part, to track those indicators, we will be in a much better position, both to communicate climate change and to tackle climate change. Let’s all be tracking data at the state and local level. Let’s aggregate those so that we can compare jurisdictions with each other, and let’s use data as the springboard to action.

For more on The Lancet Countdown Report, visit www.lancetcountdown.org.