154: Climate Health – Public Health Week

Dr. John Balbus, from the U.S. Department of Health and Human Services, explains the connection between weather and population health as part of our celebration of National Public Health Week; ASTHO’s Caroline Brazeel says work starts today on the...

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Dr. John Balbus, from the U.S. Department of Health and Human Services, explains the connection between weather and population health as part of our celebration of National Public Health Week; ASTHO’s Caroline Brazeel says work starts today on the 2022 Profile of State and Territorial Public Health; ASTHO publishes a new blog article offering an update on federal and state guidelines for delivery of behavioral health via telehealth technology; and Alabama State Health Officer Dr. Scott Harris discusses the future of telehealth on a new episode of the Public Health Review podcast now online.


APHA Webpage: National Public Health Week

ASTHO Toolkit: Extreme Weather and Climate Readiness

ASTHO Blog Article: Joining Forces to Advance Resiliency to Complex Disasters

ASTHO Blog Article: United for One Health

ASTHO Profile of State and Territorial Public Health

ASTHO Blog Article: State, Federal Policies Increase Virtual Access to Behavioral Health Care

ASTHO Public Health Review Podcast: Public Health’s Role in Telehealth

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This is Public Health Review Morning Edition for Monday, April 11th, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.


Rapidly changing weather patterns impact every aspect of life, including public health. National Public Health Week wrapped up over the weekend, so we're covering those topics today and tomorrow. This morning, we talk about the connection between weather and population health with Dr. John Balbus from the U.S. Department of Health and Human Services. It's the morning conversation.

Most people think about weather when they think about climate change, but there's also a public health impact. Can you explain the connection for us?


Absolutely. Climate change is indeed about long-term shifts in weather patterns, and this has a host of effects on the natural systems that provide us with safe and clean water, with safe and clean food and air. And going along with these long-term shifts just as we're witnessing, is also a jump in the severity and frequency of extreme weather that we know has clear effects of our health. This is what we've been seeing, whether that's extreme heat waves, or widespread wildfires and air pollution from their plumes, or the impacts of the more severe hurricanes that we've been seeing and the storm surge that's being lifted by the sea levels.

So, there's a lot of different connections between the changes that we're witnessing in climate and things that really impact our health. One way to think about it is that these changes in our natural systems have knock-on effects on the fundamental social determinants of health—that is everything from economic wellbeing and safe housing, secure food supplies, and of course the natural built environment. That's part of the social determinants of health.

Globally, it's estimated that these impacts of climate change are going to add at least $2–4 billion of direct health costs by 2030 with an additional quarter million deaths per year on a global basis.


How is health equity, then, affected by all of this?


So, you know, I mentioned that the climate changes can be thought of as effecting those fundamental social determinants of health. So, just as we've seen health disparities and the underlying disparities in things like asthma, and obesity, diabetes, et cetera, that we can associate very clearly with historic patterns of racial discrimination, of financial discrimination—these kinds of longstanding health disparities that we see changing COVID outcomes are absolutely the same factors that lead to different outcomes in a heat wave, in a hurricane.

That people who are in neighborhoods that have been, for example, redlined—these discriminatory financial practices that deprived neighborhoods for decades of financial resources—are often in areas that have substandard housing, that don't have the infrastructure, that don't have the adaptive capacity when these manifestations of climate change come along. So, it's the same communities that we've seen effected by COVID: the low-income communities, communities of color, the essential and outdoor workers—that are not just experiencing the bad outcomes from COVID, but also really having the highest burden of health impacts from climate change.


Is the public health response then the same, or should there be additional tactics, measures taken to deal with the weather impacts?


Well, there's absolutely a lot of overlap between all the work that we're doing now in this recovery from the COVID pandemic. Recognizing the profound importance of these health disparities­—that's one of the most important things we need to do for COVID. It's also one of the most important things that we need to do for climate change impacts.

But then on top of that, climate change brings very specific kind of physical threats of flooding—so, we have to be thinking about the infrastructure of our wastewater systems; very specific impacts of extreme heat or other kinds of storms—so, we have to be thinking about the infrastructure investments in housing and in housing insulation and weatherization. And so, there's a tremendous amount of overlap, and it's really important that we think about the communities affected by climate change as we're working on this COVID recovery.

But then, we also need to blend that in with the specific things to address those specific threats from climate change. Part of this is with the health sector. You know, one of the biggest impacts is the impact that we see when a hospital goes down from a severe outage, like happened in Texas, or a severe hurricane like we saw on the Gulf coast. So, part of this is also really building the resilience of our health system all the way from the tertiary hospitals to the community health centers.


Tomorrow, our coverage of National Public Health Week concludes with a conversation about the definition of mental wellness. Nathaniel Counts with Mental Health America is the guest.


ASTHO starts work today on the 2022 Profile of State and Territorial Public Health. Information gathered during the survey is used to inform advocacy efforts across the states and territories.

ASTHO's Caroline Brazeel explains the process


States and island jurisdictions will have from today through August 5th to fill out the survey. During that time period, we are hosting weekly TA calls where you guys can call in on Tuesday afternoons and ask us any questions you've got. We'll do one-on-one calls with you to answer any questions you've got about the survey.

And then, once the survey closes on August 5th, we go through a period of data validation where we take a look at all of your responses. We cross check them against the data you've submitted in previous years to make sure that there's no glaring issues and that things haven't changed so dramatically that we would need to get on the phone with you and just make sure that it's right. We do a cleaning process, and then we began analytics.


The data will be compiled and then posted to an online dashboard that agencies can use to support their messaging and outreach efforts. The last survey was done in 2019. Brazeel says the new report coupled with the data gathered more than two years ago will offer users a comparison of public health before and after the pandemic. You can see the 2019 data by clicking the link in the show notes.


ASTHO has an update on federal and state guidelines for delivery of behavioral health via telehealth technology. The latest policy changes are reported in a new blog article. There's also a link to recent White House announcements regarding the behavioral health crisis. Read all of it using the link in the show notes.


Finally today, two experts get together to talk about the rise of telehealth during the pandemic and the future of telemedicine on a new episode of the Public Health Review Podcast. The conversations are available now. Listen everywhere you stream audio, or by clicking the link to the episode in the show notes.


Before we go, we want to remind you to follow the show—that way you'll never miss a single report. Also, don't forget to recommend the daily on your social media channels.


That'll do it for today's newscast. We are back tomorrow morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.

John Balbus MD MPH

Interim Director, Office of Climate Change and Health Equity, HHS

Caroline Brazeel MPH

Senior Director, Population Health and Innovation, ASTHO