Climate Change to Be Treated as Public-Health Issue

Source: By Stephanie Armour, Wall Street Journal • Posted: Tuesday, August 31, 2021

New federal office is likely to face pushback over actions that target health industry

The new HHS office reflects research findings that specific populations are disproportionately affected by climate change. Photo: Carlos Osorio/Associated Press

The Department of Health and Human Services has launched an office that will treat climate change as a public-health issue, designed to address what the White House says are health risks, including those that disproportionately affect poor and minority communities.

Many details of the new Office of Climate Change and Health Equity, which will report to a White House climate task force, were outlined in a January executive order on climate, part of President Biden’s efforts to use the power of the federal government to address the environmental effects of changing weather.

“Its mission is to protect the health of people experiencing a disproportionate share of climate impacts and health inequities from wildfires to drought, to hurricanes to floods,” HHS Secretary Xavier Becerra said at a news briefing Monday.

The new office is likely to spur initiatives touching on many aspects of healthcare, HHS officials announced Monday. It is expected to offer protections for populations most at risk—including the elderly, minorities, rural communities and children, and the office could eventually compel hospitals and other care facilities to reduce carbon emissions.

Asked how HHS would reduce carbon emissions from healthcare facilities, Mr. Becerra said: “We will use every authority to its greatest advantage because it is time to tackle climate change now.”

Officials said one of the first tasks for the office would be to take accounting of greenhouse gas emissions from various parts of the healthcare sector. They also said they don’t yet have specific goals for the reduction in emissions they want from healthcare facilities.

The move is certain to draw opposition from many Republicans and conservative activists who criticized Mr. Becerra during his spring 2021 confirmation process for policy positions he took while serving as California’s attorney general. These include his support of “environmental justice,” a movement that focuses on preventing a disproportionate share of negative environmental consequences for any population.

Health and Human Services Secretary Xavier Becerra led efforts by California to sue the Trump administration over environmental issues when he was the state’s attorney general. Photo: Drew Angerer/Getty Images

Under Mr. Becerra’s leadership, California sued the Trump administration dozens of times, often over environmental issues, and in 2018 his office created the Bureau of Environmental Justice that today has a team of attorneys fighting development projects deemed to endanger vulnerable communities.

Mr. Becerra has tapped Arsenio Mataka, who served as his environmental adviser when Mr. Becerra was California’s attorney general, to join HHS as senior adviser for climate change and health equity. John Balbus, a senior adviser at the National Institute of Environmental Health Sciences, which conducts research into the effects of the environment on human disease, is moving to the HHS Office of the Assistant Secretary for Health to help set up the new office.

Dozens of organizations, such as the American Academy of Pediatrics, the Asthma and Allergy Foundation of America, and the American Psychological Association, have lined up to urge the new office to take specific actions. But other parts of the medical industry might resist.

Hospitals, in particular, are worried the initiative will ultimately mean complying with new regulations at a time when healthcare facilities are struggling with the costs of fighting the coronavirus pandemic.

“Hospitals and health systems already are undertaking efforts to improve environmental sustainability, although, understandably, their primary focus since January 2020 has been on responding to the public health emergency caused by Covid-19,” said Michelle Hood, executive vice president and chief operating officer at the American Hospital Association, a trade group for the industry.

Hospitals worry that the initiative will bring new regulations at a time when many healthcare facilities are struggling. Photo: Zack Wittman for The Wall Street Journal

The Occupational Safety and Health Administration, for example, adopted temporary standards during the pandemic meant to improve workplace safety. As a result, many hospitals have had to run air-purification systems at a higher level, resulting in increased energy use and more carbon emissions, Ms. Hood said.

“Financial penalties would not address the root cause of these issues,” Ms. Hood said. “A smarter approach would be to bring hospital leaders, regulators and subject matter experts together to identify effective strategies for meeting the need to provide high-quality, safe healthcare while minimizing the impact on the environment.”

The HHS initiative is based on a significant body of research finding specific populations are disproportionately affected by climate change. These include those with chronic illnesses or with mobility challenges, the elderly, the poor and isolated, Black and indigenous populations and other people of color, certain occupational groups, and women and girls.

The risks include deaths and injuries from extreme events such as heat waves, storms and floods, or infectious diseases borne in food or water, said a December 2020 report in the Journal of Health Affairs. “These risks are unevenly distributed and both create new inequities and exacerbate those that already exist,” the Journal said.

Minorities are exposed to higher levels of air pollution of all kinds, according to an April study in the journal Science Advances. The average person of color lives in a census tract with higher urban heat intensity than non-Hispanic whites in all but six of the 175 largest urbanized areas in the U.S., based on the findings of a May study in Nature Communications.

Mr. Becerra sowed controversy in his efforts to address these trends during his time as attorney general of California, often finding himself opposed to interests of business developers. A common theme of the California attorney general’s office, under Mr. Becerra’s leadership, was legal action to thwart development plans over alleged failures to assess risks of catastrophe.

In March, in an example shortly before Mr. Becerra left for Washington, his California attorney general’s office joined in a lawsuit opposing two suburban housing developments in San Diego County. He said the new developments would be constructed in an area at high risk of wildfires, and that the project failed to sufficiently assess such risks.

Supporters argued the risk of climate-change-induced fire was higher if the land was left undeveloped. Dan Dunmoyer, chief executive and president of the California Building Industry Association, said the attorney general’s office essentially “weaponized” the requirement to assess catastrophic risk to deter development.

Public-health advocates say the new office may push to direct more funding to the National Institutes of Health for research into climate change’s impact on public health, as well as for regulations that aim to ensure hospitals and health systems are able to withstand and keep functioning in extreme weather events. Some public-health advocates are urging the agency to direct grants to organizations working on environmental justice.

The agency also could make hospital participation in Medicare and Medicaid contingent on meeting certain environmental goals, according to several public health advocates.

House Ways and Means Committee Chairman Richard Neal (D., Mass.) is urging HHS to use its authority to set standards and direct federal payments to get hospitals, labs, nursing homes and medical-device makers to reduce carbon emissions and waste. Possible measures could include performance targets for physical plant adaptations, waste management, supply chains and sustainable energy use, he has said.

Write to Stephanie Armour at