CLIMATE CHANGE CREATES risks that scientists have been warning about for decades. Fortunately, many actions that reduce the greenhouse gas emissions that drive climate change and hedge against longer-term risks can also benefit public health right now. Reductions in greenhouse gas emissions often go hand in hand with reductions in air pollutants with well-established relationships to heart attacks, asthma, and premature death. These pollutants have also been linked to autism and Alzheimer’s. Although the federal government has withdrawn from the Paris climate accord, cities and states continue to play leadership roles in reducing greenhouse gas emissions, and the policies they enact can yield substantial health dividends to their residents.

A Massachusetts proposal to put a price on carbon pollution through a carbon-fee-and-rebate policy would generate nearly $3 billion in health benefits – saving lives, preventing heart attacks and other adverse health outcomes, and reducing hospitalizations in Massachusetts and its neighboring states – between 2017 and 2040. For states with larger populations and economies, the health co-benefits may be far greater. The health benefits of carbon policies occur nearly at the same time and place as the emissions reductions themselves, making these benefits particularly relevant for decision makers at the state and local levels.

State policymakers, of course, might also recognize that climate change itself poses substantial health risks to their constituents and see fit to act on this basis as well. Extreme weather has been hitting the United States  in many forms. Last April and May, for example, record-breaking floods along the Mississippi River and its tributaries washed away homes and crops, following a storm that dropped up to 10 inches of rain in some places. Tropical cyclones and hurricanes, like Hurricane Sandy, are becoming more powerful. Extreme heat, which causes death and disability, has become all too common. All of this extreme weather is expected to become more common as climate change progresses. Other consequences of climate change that pose health risks likewise are on the horizon. Sea level rise is already contributing to floods in coastal cities like Miami, and fires in the West, driven by more heat and drought, are longer, stronger, and more frequent. Diseases borne by ticks and mosquitoes may be spreading northward due to a lack of freezing weather to block their spread.

Given what’s at stake for health with climate change, medical professionals have taken note. The recently constituted Medical Society Consortium on climate change and health, which is made up of 11 different medical societies, including the American College of Physicians, the American Academy of Family Physicians, the American Academy of Pediatrics, and the National Medical Association, seeks to embolden the nation’s doctors to speak on the issue of climate change. Despite this concern from doctors, not to mention most of the Fortune 500 companies, all major religious groups, and the US military, the federal government is in the process of halting any movement in the direction of carbon mitigation.

Fortunately, cities and states can lead on mitigation while growing their economies (as California has demonstrated) and improving the health of their residents. Carbon fee-and-rebate policies are not the only policy available to states and local policymakers.

A recent study by Abt Associates found that the Northeastern states, which comprise the Regional Greenhouse Gas Initiative, the nation’s first cap-and-trade pact, not only enjoyed lower energy and electricity bills and significantly reduced emissions in the electricity sector but also more than $5.7 billion in health savings and other benefits between 2009 and 2014.

Other policies, such as those that increase walkability or enhance green space, also can benefit health by increasing physical activity and reducing stress levels. While no single city or state can prevent breaking our national carbon budget, if enough cities and states enacted carbon rules, this would lead to significant progress and may lead to a national carbon policy, just for the sake of consistent rules across the country.

This shows why what happens in Massachusetts is so important. Showing that a carbon fee-and-rebate rule can save lives and promote economic growth might just spur others to follow suit.

Solving global-scale problems such as climate change can be difficult but it has been done. Nations acted in concert to cut production of ozone-depleting chemicals in the 1980s. This prevented a global epidemic of skin cancers, and the ozone layer is now beginning to recover. Much can be learned from successes of the past. The health argument proved forceful in the battle to protect the ozone layer and it can do the same for climate change, especially when health benefits are well within reach of a human lifetime, and when local decisions carry local benefits.

Jonathan J. Buonocore is a program leader and Aaron S. Bernstein is an associate director at the Center for Health and the Global Environment at the Harvard T. H. Chan School of Public Health. Jonathan I. Levy is a professor in the Department of Environmental Health at the Boston University School of Public Health.

One reply on “Cities and states must take lead on climate change”

  1. Electricity bills just about doubled in the last few years. Increasing the cost of carbon is very regressive. It burdens the low income population segment unfairly.

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