Global Health Portal

Courtesy of Sarah Pressman Lovinger

For the people who think that climate change doesn’t affect them — or won’t in the future — Dr. Sarah Pressman Lovinger, MD has some statistics to the contrary. Following some choice events in 2005, Dr. Lovinger added “climate change and public health” expert to her resume. She is an adjunct lecturer in Climate Change and Public Health at Northwestern University, the executive director at Chicago Physicians for Social Responsibility, and a Climate Change and Public Health Consultant for ClimateMD. (She also works part-time as a doctor for a local community health center.) The Global Health Portal recently spoke with Dr. Lovinger about how not only polar bears need to worry about global warming.

Your email signature reads, “Ask me why climate change is the biggest public health threat of the 21st century.”
According to the World Health Organization, there are 150,000 climate change-related deaths worldwide annually, but I think the number is a lot higher than that. As a result of the kind of physical changes that we are all aware of, there are more floods, drought, heat waves, air pollution, and wildfires, which all lead to changes in infectious disease patterns.

As a caveat, in all parts of the world, there are people who are more vulnerable to the effects of climate change than others. There is an economic divide. China is the biggest polluter worldwide, but the United States has the biggest per capita rates of fossil fuel use. However, most of the effects are felt in the developing world.

Could you elaborate on some of the effects of climate change?
Floods. We can have deadly flooding from tropical storms like hurricanes or typhoons. Increases in the number of hurricanes are probably linked to climate change. They cause disruption of lives and contaminated drinking water sources, and hospitals see their backup generators fail.

In the Midwest, we have excess precipitation events, like heavy rain, which overloads sewage systems and then sewage discharges into the Great Lakes. It can lead to contaminated water supplies. The 1993 outbreak in Milwaukee of cryptosporidium for example led to about 400,000 reported cases of diarrheal illness and more than 100 deaths. Flooding can also cause immediate drowning deaths and other kinds of hazards from large lightning storms and a lot of contamination.

In the developed world, cropland gets flooded. The other side of flooding is drought. Rain patterns have shifted with climate change. Just as there are excess water events, there are also drought and more desertification. I’m not here to predict what is going to happen in 20-30 years, but what we are seeing is not good for agriculture and water supplies. In the developing world, where they are already on the edge, people suffer from starvation and malnutrition, and people are forced to drink contaminated water. They are at risk for developing cholera.

What are some other problems?
There are also higher rates of air pollution, with more air pollution on warmer days. If the temperature is warming, there is more air pollution. Air pollution is linked to asthma. Seasonal allergy rates are through the roof, and nobody really knows why. Spring is coming earlier, so maybe the flowers are blooming earlier. The same is true of allergens. There is a longer growing season and a lot more mold with all of the precipitation, which is in turn bad for allergy sufferers and especially children.

Another problem are heat waves, which can be deadly. In 2003, there was a three-week heat wave primarily in France and Spain, with an estimated 30,000-70,000 related deaths.

What most interests you about this topic? Or most scares you?
Changes in infectious disease patterns. Vector-borne disease patterns are carried by insects, mosquitoes, fleas, or ticks. In the developing world, there are higher rates of malaria and dengue fever and there is no treatment for dengue fever. People with dengue fever suffer from fevers and pain, and if you get exposed for a second time, you can get dengue hemorrhagic fever, which can bleed into your internal organs. Lyme disease rates are also linked to climate change. The breed of tick that carries Lyme disease can survive better in warmer temperatures. West Nile virus was not established in the United States until 1999, after which it spread to almost every state. Then there are flood-related illnesses, like cholera. Other forms of dysentery, like salmonella and E-coli, are also linked to heavy storms.

Is work being done to hopefully stave off some of these effects?
There is climate change mitigation. The public health community talks about adaptation as well. We do need to rein in fossil fuel emissions, but we also need to deal with the change and be prepared. The Centers for Disease Control has given grants, under its Climate-Ready States and Cities Initiative. These adaptation plans look at what our climate-related health risks are now, in the near future, 100 years from now, and how we need to prepare. What do our doctors and medical staffs need to prepare? There are plans underway. Evanston for example has a climate adaptation task force and there is a lot of planning going on.

Are there any effects that Chicagoans should be especially concerned about?
In Chicago, our issues are heat waves, air pollution and asthma, seasonal allergies, and flooding, which can lead to moldy basements and contaminated water. You have the most highly developed country and a great public health system, and so this is all being monitored. There are plans in place to deal better with climate change related-diseases.

What issues do different parts of the country face?
Every area faces different issues. Flooding is the major consequence of climate change worldwide. There has been a lot of good FEMA work and a lot of good disaster management work since 2005, when Hurricane Katrina happened. But in New York, during Hurricane Sandy, they had to evacuate two hospitals at the last minute — the backup generators failed because of flooding. Coastal areas and the East Coast are the most vulnerable, in my opinion.

What about people who deny that climate change is happening?
I do not engage with deniers. It is science. Here is my analogy. I am an M.D. and I was trained in science. Let’s say your aunt developed a fever, cough, and shortness of breath, so her doctor sent her to the ER. She got blood tests, was diagnosed with pneumonia, and received antibiotics. All of those activities are completely based on science. You can’t pick and choose your science.

What sparked your interest in the intersection of medicine and climate change?
In 2005, two things happened. I saw An Inconvenient Truth. That really made me a lot more concerned about climate change. Then Hurricane Katrina happened. I was appalled by everything that happened there. I wanted to change my career path to make more of a difference.

Tell me about your work for Chicago Physicians for Social Responsibility.
Chicago Physicians for Social Responsibility has an environmental health issues focus. We work on advocating for a healthier Chicago, on climate change and environmental toxins. We help doctors make their offices more sustainable. We give lectures on climate change and health to medical students as well as the general public.

This is the scariest thing I’ve heard about climate change. What can people do?
The most important thing that we can do is, if somebody has an ailment or is a parent of a child with asthma, they should stay in touch with their doctors. Take heat waves seriously.

The health effects of climate change are the human side of climate change. As people make those links more and more, they might become more committed to leading sustainable lifestyles. They may start to become more politically active and support candidates who are willing to take action on climate change. That is the good thing: health effects are more personal than a polar bear on an ice floe.