Knowlton, senior scientist at the Natural Resources Defense Council and APHA member

Our changing climate puts the public health at elevated risk. If left unchecked, extreme weather — from rising temperatures to flooding — could exacerbate health current conditions, increase the spread of disease and severely compromise our nation’s food production. The public health community is integral to efforts aimed at reducing the impact on climate change and keeping communities safe.  Read more from Kim Knowlton, a senior scientist at the Natural Resources Defense Council who offers an in-depth conversation about the expanding role that a changing climate has on the public’s health and how the public health community can guide new interventions that protect the environment. Knowlton, an APHA member, also tells us about new research and policy developments on the horizon in 2012.

Last year broke new records. In 2011, the U.S. saw more extreme weather events than ever before. Can you comment on the connection between climate change and extreme weather events? What can we expect for the year (or years) ahead in terms of climate-related health impacts? What is needed to better prepare communities for these impacts?

Record-breaking extreme weather is here; and it’s happening in our backyards. 2011 hammered that home, with upwards of 3,000 monthly weather records broken by extreme events that struck communities in the U.S. in just the first 10 months of the year, January through October 2011. From the Mississippi flooding to Texas wildfires to Hurricane Irene – the frequency and intensity of severe weather are staggering.

This national analysis provides a unique aggregation of state-by-state extreme weather, detailing a range of extreme weather events including record-breaking temperatures, rainfall and snowfall in all 50 states.

We want to help people bridge the real connection between extreme weather and climate change. Moreover, people everywhere need to know how to thrive in the face of a changing environment, and to be able to take steps to protect health. Intensifying extreme weather is one of the most dangerous effects of climate change, and it is what we can expect as climate change worsens.

Climate change is linked to the increased frequency of pronounced heat waves, heavy rainfall events and other erratic and destructive weather events worldwide. Last year, the Intergovernmental Panel on Climate Change and several prominent climate scientists described how the “fingerprint” of climate change can be seen in the increased frequency and intensity of certain key extreme events.

Last year’s extreme weather also highlights how preparedness pays — it will save us billions of dollars in infrastructural damages and health costs, and save lives. We now have an enormous opportunity to reduce local risks, improve our lives and create healthier communities through proactive public health planning.

Public health scored a major win this past December when the EPA finalized its long-awaited mercury and air toxics rules for major power plants. How will these standards impact air quality and what does this mean for public health? Last year, Congress voted on a record number of anti- environment policies. Is this rule at risk?

EPA’s tougher restrictions on power plant emissions through the mercury and air toxics rule are a huge public health achievement. And thankfully, we can all breathe a little better.

Since the beginning of the Industrial Revolution, there has been an extreme over-abundance of mainly CO2 pollution that we send into the atmosphere. And now, that amounts to more than 2 billion tons of dangerous carbon pollution — which is a health threat because it triggers health-harming climate changes — plus other toxic pollutants into the air each year.

Moving forward with standards to limit carbon pollution from new and existing sources like power plants is absolutely vital to protecting public health and protecting kids from dangerous air pollution. We do need to defend and protect EPA’s ability to protect our health, as they’ve been doing for 40 years. By limiting carbon pollution, which the U.S. Environmental Protection Agency is responsible for under the Clean Air Act, we’re one step closer to effectively preventing the worst effects of climate change.

What policy developments or announcement can we expect in 2012 that have implications for climate change and health?

One critical event shaping climate and health policy for years to come will be EPA’s announcement of the first-ever limits on carbon pollution from new power plants. This will be huge news because it’s the first time EPA will be issuing regulations on power plants, which are by far the biggest sectoral source of carbon pollution in the U.S. — so watch for those, which will likely be announced sometime early this year, and there will be an opportunity for the public to provide comments — and support. This is our chance to say, “Yes, we want to help prevent the most drastic, health-harming effects of climate change!”

There has been some terrific legislation proposed recently to strengthen the nation’s ability to adapt to climate change’s effects. Some members of Congress are trying to help us promote health preparedness and natural resource adaptation. Rep. Lois Capps (D-Calif.) recently introduced the Climate Change Health Protection and Promotion Act; and Sens. Sheldon Whitehouse (D-R.I.) and Max Baucus (D-Mont.) have just introduced the Safeguarding America’s Future and Environment (SAFE) Act. These proposals deserve our attention and support.

Several of your colleagues joined fellow environmental health leaders from across the world at the United Nations Climate Change Conference in Durban late last year. What are some of the key highlights and takeaways of the meeting, and how will they be carried forward in future efforts to address global climate change here at home?

My colleague Jake Schmidt, NRDC’s international climate policy director, joined the Durban talks last year and shares some of his key takeaways here. NRDC set forth a number of key features of a strong system of “transparency and accountability” for developing countries. The main agreements of 194 nations in Durban are to develop systems to better assess whether a country has the policies in place to meet detailed reporting targets on global warming pollution data, and strive for greater collective transparency, accountability, monitoring and verifying so that developing countries can feasibly work towards their emissions reduction commitments.

This is a significant step forward in curbing emissions to tackle global climate change. Every bit of progress internationally and here at home is progress that will help us achieve a more sustainable future. Many countries have agreed to the critical detailed guidelines of more frequent, transparent and credible reporting of their emissions and actions.

The next and most important step is mobilizing them to follow through and implement, so that these systems are really working on the ground as soon as possible. The first reports are due starting in 2014, so countries need to take real action and begin to establish a system to document these details and begin collecting the necessary information.

Additionally, my other colleagues have said the major advances include bolstering the Durban Platform by putting developed and developing nations together on the same platform on commitments to reduce greenhouse gas emissions and setting up bodies to collect and govern tens of billions of dollars a year for poor countries. Equally important, Durban provided an invaluable global arena that spawned side events, cultivated important relationships for networking and sparked energy around the health community involvement.

You were the lead researcher of a study that was published in Health Affairs in November 2011 that showed the cost of climate change over the past decade is estimated at $14 billion due to lives lost and health care dollars spent. Can you discuss future economic and health risks if climate change is left unaddressed?

Let me clarify just a little that the Health Affairs study estimated health-related costs from just six climate change-related events in the U.S. over the years 2002-2009. That’s just got to be a huge under-estimate of the total health costs if we could wrap our arms around all the climate change-related events that occurred over those years, in every state.

While people are beginning to understand the personal costs of climate change, such as  property damage and rising insurance costs, there’s still an unfortunate disconnect between climate change and our health — yours, mine and our families’. There is a much bigger price we’re paying than we ever thought before simply because we don’t often think about how much climate change-related events are costing in terms of health dollars.

The Health Affairs study seeks to bridge that gap.And, it’s the first report to develop a uniform method of quantifying the associated health costs for extreme weather and disease events that are expected to be exacerbated by climate change. Climate change is a set of issues with a human face; it’s about people’s health.

The six climate change-related cases from this analysis take an in-depth look at specific examples of extreme weather and disease events that are expected to be exacerbated by climate change. The key episodes include ozone air pollution, heat waves, hurricanes, outbreaks of infectious disease, river flooding and wildfires across the U.S., and their associated health costs exceeded $14 billion and over 760,000 encounters with the health care system, not to mention increasing medical costs that drive up the costs of health insurance for us all.

These are all economic and health impacts that cause us suffering, hospitalizations, loss of productivity and, much worse, death. We want people to start thinking about what we stand to gain by preparing for climate change’s effects. These costs hurt families and communities, and they hurt our economy too.  It’s time we start to pay attention because we simply can’t afford not to.

Where do you see the greatest opportunities to address the health impacts of climate change and are there any strong state or local examples where public health action is making a difference?

Only 13 U.S. states currently include public health measures in their climate change adaptation plans. That leaves 37 states, or 74 percent of the nation, without much of anything in the way of planning on climate and health. We can do better. Our leaders need to make climate change preparedness a priority.

Some cities are already stepping up. Seattle, Chicago, Milwaukee, Philadelphia and New York, for example, are among the cities making strides in terms of adapting their water infrastructure for climate changes. Now we need to collectively encourage the federal government, policymakers, municipalities and communities alike to develop, strengthen and prioritize aggressive climate-health preparedness plans. We all need to emulate more of the energy that some local communities are showing in the way of climate change preparedness and innovation!

Emergency planning at all levels should also incorporate risks from climate change. For example, maps describing flood zones need to account for increased risks caused by extreme rainfall and sea level rise resulting from climate change. While these plans are made at the local level, the Federal Emergency Management Agency must also prioritize addressing and preparing for climate change by providing guidance and resources to state and local governments.

What are some key federal activities and national reports on climate and health that are planned for this year?

Besides the EPA power plant rules and the comment period, one very important process that’s underway is the 2013 National Climate Assessment. The assessment aims to become an inclusive, broad-based, sustained process to support decision-making about how climate change is affecting society. This takes place every four years under the Global Change Research Act of 1990. It aims to pull together and interpret current evidence about the effects of global change on our environment, our communities, and human health and welfare in the U.S., and projects major trends into the future for 25 to 100 years. Go here for more information. This is a real opportunity to get involved in the ongoing national dialogue on climate change and health, learn what’s happening, and provide feedback to the U.S. Global Change Research Program.

Where can the public health community go for more information about climate change and health?

Different parts of the country will experience different major types of climate-health threats. For communities in coastal states, sea level rise and associated flooding will be huge concerns, as will hurricanes and storms. For many northeastern cities, for example, heat waves have been huge health problems when they strike — and climate change is projected to increase their frequency, intensity and duration in the years ahead.

The first step is understanding what climate change means for you. It’s about raising awareness. To help people figure out what effect climate change is having on health in their backyards, the Natural Resources Defense Council created Web pages here and here. When you visit, you’ll see U.S. maps that let you zoom in to where you live and see both effects and preparedness measures to take.

The voices of the APHA network, its Sections and other components, health thought-leaders and the general public are invaluable, as well as the IPCC and the World Health Organization and federal agencies now engaged on climate change and health — the Centers for Disease Control and Prevention, National Institute of Environmental Health Sciences and many others. Together, we can urge people who work on their behalf in state capitals, in Washington and on county planning boards, that planning ahead to prepare for climate change is a priority. Climate change is a matter of health, and its effects are happening in our backyards. We need to act now.