Washington -- Recognition of the link between climate change and health is growing, driving efforts of those who are the front-line responders -- public health professionals -- to make sure health care systems and global populations are prepared for the worst.

Scientists worldwide agree that climate is changing as a result of human activity, and climate influences the biological functions basic to life.

On April 7, the theme for the World Health Organization’s (WHO) World Health Day was “Protecting Health from Climate Change.” In the United States, the theme of National Public Health Week, April 7-11, was “Climate Change: Our Health in the Balance.” On April 9, a U.S. House of Representatives committee heard testimony from climate and health experts on the same topic. (See “World Health Day Targets Human Effects of Climate Change.”)

“The public health system will be a front-line responder to potential emergency conditions caused by climate change,” Dr. Georges Benjamin, executive director of the American Public Health Association (APHA), told the House Select Committee on Energy Dependence and Global Warming. “It will also play a key role in informing, educating and empowering the nation to make the changes needed to mitigate the problem.”

The APHA, Benjamin added, has had a policy on climate change and health since 1995.

ENERGY POLICY = HEALTH POLICY

People around the world already are feeling the effects of climate-sensitive diseases that kill millions, according to WHO. Malnutrition causes more than 3.5 million deaths a year, diarrheal diseases kill more than 1.8 million annually and malaria nearly 1 million.

Other recent events foreshadow a climate-altered future -- the 2003 European heat wave that killed 70,000; major Rift Valley fever outbreaks in Africa; 2005’s Hurricane Katrina, which killed 1,800 and displaced thousands; malaria in the East African highlands; and cholera epidemics in Bangladesh.

“Global warming is unlike many other health threats,” said Dr. Jonathan Patz, a professor in the Department of Population Health Sciences and at the Nelson Institute, both at the University of Wisconsin-Madison, “because, unlike single-agent toxins or microbes, climate change affects multiple pathways of harmful exposures to our health.”

The policy changes needed to address this problem, he told the committee, will be large if the nation is serious about protecting the public from the effects of climate change.

Reducing fossil-fuel burning, for example -- in part by making it practical for more people to travel by foot, bicycle or public transportation rather than by car -- would reduce air pollution, improve personal fitness and reduce greenhouse gas emissions and subsequent global warming.

“The challenges posed by climate change urgently demand improving public health infrastructure, energy conservation and urban planning policies,” he added. “As such, climate change can present enormous health risks and opportunities quite directly via improved fitness, reduced obesity and improved air quality.”

PROTECTING PUBLIC HEALTH

Around the world, public health officials are assessing the measures already in place and determining future needs for protecting health from climate change, with a focus on women and children in developing nations and other vulnerable populations.

WHO and its partners, for example -- the U.N. Environmental Programme, the Food and Agriculture Organization and the U.N. World Meteorological Organization -- are devising a work plan and research agenda to get better estimates of the scale and nature of health vulnerability and to identify health protection strategies and tools, including better surveillance and forecasting systems and stronger basic health services.

In the United States, the Centers for Disease Control and Prevention (CDC) leads efforts to anticipate the health effects of climate change, to ensure systems are in place to detect and track them and take steps to prepare for, respond to and manage associated risks.

CDC scientists already have expertise in disease surveillance, environmental health, geographic information systems and modeling, preparedness planning and training, said Dr. Howard Frumkin, director of the CDC’s National Center for Environmental Health and of the Agency for Toxic Substances and Disease Registry, and the agency has identified the following ways to meet the health challenge of climate change:

• Improve surveillance systems for food-borne, water-borne, vector (insect)-borne, zoonotic (animal diseases in people) and other diseases with state and local partners;

• Build research capacity by boosting staffs experienced in epidemiology, infectious disease ecology, disaster preparedness, modeling and forecasting, climatology and health science and communication.

• Support capacity in universities to research the links between climate change and public health.

• Provide communication and technical assistance on the health effects of climate change to health professionals, state and local health departments, universities, science teachers, community groups, state and local officials, faith-based organizations, industry and the public.

“While we still need more emphasis on public health preparedness for climate change,” Frumkin told the committee, “many of our existing programs and scientific expertise provide a solid foundation to move forward.”

More information about climate change and health is available on the CDC and WHO Web sites.