Beyond Climate Change

To the Editor—Climate change has been implicated in an increasing number of public health concerns: heat waves, floods, food shortages, drought, vector-borne disease pandemics, worsening poverty, and violent conflicts [1, 2]. In North Carolina, experts predict we will experience an increased incidence of heat-related illness, longer allergy seasons, new food and water contamination, and more severe weather [3].

Cutting carbon emissions, an essential step in halting climate change and lowering atmospheric carbon concentrations, brings significant health benefits. The 2015 Lancet Commission on Health and Climate Change stated that, “reductions in emissions reduce air pollution and respiratory disease, whilst safer active transport cuts road traffic accidents and reduces rates of obesity, diabetes, coronary heart disease, and stroke” [2]. Research has also documented significant health benefits from air pollution control measures. At the 2015 NC BREATHE conference, which was cosponsored by Medical Advocates for Healthy Air, Kim Lyerly of Duke University reported that the steady downward curve in North Carolina's respiratory death rate mirrored reductions in several air pollutants in the decade following the 2002 Clean Smokestack Act [4].

Despite hundreds of recent scientific studies showing a profound causal relationship between air pollution and declines in public health [5], political and media maneuvering by fossil fuel companies and the overwhelming and frightening prospect of climate change have obscured the connections between our economic behavior and our daily practice decisions. A key to overcoming this hurdle is changing the conversation from a political confrontation to a discussion about best health practices. Limiting carbon emissions treats both climate change and improves public health.

In an effort to promote public health, the British Medical Association voted last year to divest from fossil fuel companies [6]. World Bank President Jim Yong Kim, a public health physician, has also called for fossil fuel divestment, as well as investment in renewable energies. The Go Fossil Free campaign lists 349 institutions worldwide that are making commitments to divest from coal and other fossil fuels.

Health professionals have an obligation to protect the public health. We are uniquely qualified to leverage our reputation and professional relationships to effectively advocate for needed changes in energy policy. Our hospitals and universities, as well as professional associations such as the American Medical Association, have an opportunity to lead a public health movement by divesting from fossil fuel companies. As medical professionals, we should stop profiting from an activity known to cause harm [6].

• ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.