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How Communities are Promoting Health and Responding to Climate Change

Sep 30, 2019, 1:00 PM, Posted by Michael Painter, Priya Gandhi

Across the United States, people are recognizing that climate change is a major threat to any vision of a healthy future. They are responding by developing solutions to not only avoid the health harms from climate change, but also actively improve health and limit climate change.

A city park offers a walking path for the community.

In Austin, Texas, city officials have grown increasingly concerned about their residents enduring more days with extreme heat. In particular, they worry that extreme heat events prevent young people from getting physical activity and harm people’s overall well-being.  

Austin leaders decided to respond by increasing green space and tree shade around some of the city’s public schools, especially those that largely serve students of color or those in lower-income neighborhoods. More trees create cooler spaces for physical activity. They also help address climate change by decreasing the need for air conditioning, which use about 6 percent of all electricity produced in the United States. Trees are effective because green space and shade reduce temperatures over heat-storing concrete.

At first glance, planting some trees may seem like a limited and short-term approach in the face of a changing global climate. Trees, however, are an important climate solution because they remove carbon from the atmosphere. Increasing levels of carbon in the atmosphere causes climate change. We need more trees—lots more.

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At the Intersection of Urban Planning and Health in the New York Metro Region

Jul 12, 2016, 4:48 PM, Posted by Mandu Sen

Urban planning plays a role in addressing health challenges in America and can help give everyone the opportunity to live their healthiest lives possible.  

A man rides his bike through the street.

More perhaps than any place in the world, the New York metropolitan region is known for its urban form—its physical layout and design. From the Manhattan skyline to the neon lights and tourist-packed streets of Times Square to the rolling hills and winding paths of Central Park, New York’s built and natural environment is part of what makes it such a vibrant, dynamic place to live. The distinctive form also has important health impacts. But, as discussed in a new report, State of the Region’s Health: How the New York Metropolitan Region’s Urban Systems Influence Health, these impacts are often poorly understood.

The report, written by the Regional Plan Association (RPA) with support from RWJF, provides an in-depth look at health in the New York metropolitan region, where 23 million people live in cities, suburbs, villages and rural communities stretching from New Haven, Connecticut to Ocean County, New Jersey. It finds that New York region residents live longer than U.S. residents overall, but they are not necessarily healthier.

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The Impact of Climate Change on Health and Equity

Jun 22, 2016, 9:00 AM, Posted by Alonzo L. Plough

Tackling the daunting health effects of climate change requires community leaders from all sectors to work together to meet the needs of everyone, especially the most vulnerable.

A flooded town after a big storm.

It’s been nearly 10 years, but I still remember the deadly heatwave that hit California back in July 2006 and claimed hundreds of lives.

The blistering heat lasted for 10 days, with temperatures soaring as high as 119 degrees—the highest ever recorded in Los Angeles County. The number of heat-related deaths was estimated to be as high as 450 across nine counties, including Los Angeles County.

During the five years that I worked as director of emergency preparedness and response for the Los Angeles County Department of Health, we constantly battled the health effects of really hot days, wildfires and droughts.

These weather phenomena directly impact health—and they are all linked with global climate change. Just this past weekend, during a trip to Yosemite National Park, President Obama noted, “Climate change is no longer a threat—it’s a reality.”

The people at greatest risk of serious harm from these climate change-related events include children, the elderly, people with chronic health conditions, the economically marginalized and communities of color.

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NewPublicHealth Q&A: Florence Fulk and Tami Thomas-Burton on the Impact of the Environment on Health

Sep 25, 2013, 1:25 PM

A misty scene of trees and sky.

Florence Fulk, MS, BS, a research biologist with the Environmental Protection Agency (EPA) and Tami Thomas-Burton, BS, MPH, of the Office of the Regional Administrator-Environmental Justice at EPA, will be speaking at the National Health Impact Assessment meeting this week on HIAs and environmental policy. NewPublicHealth caught up with Fulk and Thomas-Burton ahead of the conference to ask about EPA’s use of health impact assessments.

NewPublicHealth: What steps has the Environmental Protection Agency (EPA) taken with respect to health impact assessments?

Florence Fulk: Within EPA is the Office of Research and Development, and within that office we have a Sustainable and Healthy Communities Research Program which is providing tools, models and approaches to support HIAs across the country. We’re also demonstrating HIA as an approach to integrate and weigh tradeoff in community decision making.

NPH: Why is the EPA investing in health impact assessments?

Fulk: The primary vision for the Sustainable and Healthy Communities Research Program is to inform and empower communities to look at human health, economic and environmental factors in their decision making, and to do it in a way that fosters community sustainability. And that vision is very closely linked to the values and the function of HIAs. The number of HIAs that are being conducted in the United States and the number of people that are conducting HIAs in the United States has formed this growing community of practice, which can inform our Sustainable and Healthy Communities Research Program by understanding the decisions that communities are facing and how they’re bringing health, economic and environmental information to the process.

We also see that by growing a community of practice as a network to disseminate EPA tools, models, data and guidance, the research that we do to support HIAs also gives us a way to raise awareness about sustainable alternatives in community decisions.

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Low-Income Housing in the Bronx Gets Healthy and Green

Sep 9, 2013, 1:58 PM

In the 1970s and 80s, residents of the Bronx, one of New York City’s five boroughs, were so anxious to leave the crime-ridden area that many residential and commercial buildings—once majestic and architecturally rich—were torched and empty for decades. Now fifty years later there’s a waiting list of thousands for Via Verde, a new low- and middle-income Bronx housing complex that opened last year. Many features set the complex apart from almost any other housing development in the United States, including an emphasis on greenery from almost every vantage point of the building. This helps create a calming and beautiful atmosphere for the residents, many of whom grew up in crowded housing projects where any nearby parks were usually too dangerous to enjoy.

Why is housing important for health? A lack of affordable rental housing can push more tenants into substandard or overcrowded living situations. Living in unaffordable housing also leaves fewer resources for the things that can keep a family healthy, such as healthy food or preventative health care. Low-income housing also has a reputation for being unhealthy, and for good reason—more than 6 million housing units in the U.S. have deficiencies such as lead paint hazards; allergens, dampness and mold that can trigger asthma; and unsafe structural issues that can cause falls and other injuries. Via Verde and other similar efforts seek to change all that, with housing that is not only affordable but also safe, healthy and even environmentally sound and sustainable (which in turn also saves on costs).

The design for Via Verde was the winner of a 2006 competition hosted by the New York City Department of Housing Preservation and Development; the New York Chapter of the American Institute of Architects; the New York State Energy Research and Development Authority (NYSERDA); and the Enterprise Foundation. It was New York City’s first juried design competition for affordable and sustainable housing.

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Hurricane Sandy: Recovering from Environmental Dangers in New Jersey

Nov 28, 2012, 4:08 PM

New Jersey

Concerned by reports that volunteers and New Jersey residents are frequently unaware of environmental dangers when cleaning up homes and communities, the New Jersey Department of Health released an advisory earlier this week with advice on staying safe while scrubbing and rehabbing. Mold and materials containing asbestos and lead-based paint are examples of potential hazards in storm-damaged buildings and the advisory urged those tackling the heavy jobs to wear protective equipment appropriate for the work they are doing such as waterproof boots, gloves, goggles, and face masks.

"Homeowners doing cleanup work and the volunteers assisting them are critical assets in New Jersey's recovery efforts, but making sure they protect themselves is equally important," said New Jersey Health Commissioner Mary O'Dowd.

NewPublicHeatlh recently spoke about Hurricane Sandy clean-up safety with Donna Leusner, director of communications for the New Jersey Department of Health; Tina Tan, MD, state epidemiologist and assistant commissioner for epidemiology, environmental and occupational health and Joe Eldridge, director of New Jersey’s Consumer, Environmental and Occupational Health Service.

NewPublicHealth: What kind of environmental concerns specifically are there for those cleaning up the community after the storm?

Dr. Tan: There are concerns about individuals coming into contact with contaminated materials, whether contaminated with chemicals or infectious agents—residuals from flood waters as well as the general debris that might be around. We encourage individuals to take the appropriate precautions to try to avoid any sort of injuries or potential illnesses that could result from contact with these contaminated materials.

NPH: Are people aware of the critical basic information for safe cleanup, such as getting a tetanus shot if they’re injured during the cleanup in such terrible conditions? 

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NewPublicHealth Interview: Susan Dentzer, Editor-In-Chief of Health Affairs

May 10, 2011, 5:23 PM, Posted by NewPublicHealth

The May issue of Health Affairs features the journal’s first issue about environmental health concerns. NewPublicHealth spoke with Health Affairs Editor-In-Chief Susan Dentzer about the issue.

NPH: One of the articles in the May issue is by Aaron Wernham, director of the Health Impact Project, on conducting health impact assessments when making environmental and land-use decisions. Why is that important?

Susan Dentzer: It’s often, if not always, the case that in almost every jurisdiction--before you build a major highway or other major projects, you have to do a very systematic assessment about the overall impact on the environment. So, obviously what should take place is--in addition to that-- is to find out what is going to be the impact on health. For example, what if you build a major highway and it happens to go by a school?

Other studies in the issue draw on information that we already are well-aware of, which is that if you have particulates in the atmosphere, or other forms of air-pollution through auto exhaust, that’s going to have an impact on the kids in the school. So, using the health impact assessment tool before any major [environmental] project seems a good place to start in terms of understanding what the impact is going to be on health. The assessment lets you get health into the mix of the decision-making process and you can weigh the pros and cons and the trade-offs of any kind of community-level initiative.

NPH: Three of the articles focused on environmental factors that have been shown to impact children’s health. Can you tell us about some of the findings?

Susan Dentzer: Absolutely. We've known for some time now that exposures that children undergo can have a bigger impact on children than they do on adults. For a few reasons. One is, just by virtue of the concentration of these things in the atmosphere or and children’s’ body weight --proportionately, these things have a bigger impact. Plus, we know from the way children develop that there are these windows of exposure as children’s’ bodies are changing very, very rapidly. Cells are multiplying, brain cells are growing in infancy and toddler-hood. All of those things create vulnerability so that any kind of toxic substance that may not be so toxic to adults will be potentially much more toxic to children. And we know this, for example, from lead exposure, which unequivocally caused a decline in brain function in many children. Several IQ points or more for children who have been exposed to lead are lost.

So, what a number of studies in our new issue do is take that knowledge forward and say, for example, what is the cost of this exposure to children? One of the studies suggests that the health care related costs alone of chemical and other toxic exposures to children is about $77 billion dollars annually. That’s about 3 ½ percentage points of U.S. health care costs. Now, that’s not 100 percent, but we could all acknowledge we’d rather have that money to spend on other things, like keeping children healthier. And, if you just put that up against say, what we spend on the Children’s Health Insurance Program, which isn’t by any means the only way we help to cover kids in America, it greatly exceeds our annual expenditure on children’s health insurance alone.

So, in a crazy way, we’re exposing kids to a lot of things that are harmful to them and then spending a lot of money on the other side fixing them up. And a classic case of this is asthma. We know that lots of asthma in children now is caused by exposures to pollutants, second-hand smoke, those kinds of things. So, we in effect-make these children sick and then we pay to get them healthier or to stabilize their disease.

NPH: The studies about children and environmental exposures were posted on your web site last week. Have you already received comments?

Susan Dentzer: Certainly from academics. For one thing, everybody notes that we do have this sort of crazily siloed health and health care, and even policy related to health and environment in this country, where the environmental science people have known for some time that these threats and exposures are real. They’ve kind of been, frankly, ignored by others who are so busy focusing on other things--like finding a way to produce high quality health care for children with asthma. So, what people have said to us is great. Now, we’re going to help break down these silos so that we can understand what the effects are of these exposures and actually incorporate that into the health care that we deliver to children and families. For example, one of the pieces in our issue has a so-called navigation guide which is really a very elaborate way of helping the health care community understand the evolving science on the environmental health side and be able to make explicit recommendations to people about what they should do to protect their health.

When you are looking at something like environmental science, frankly we’re not going to do a whole lot of randomized controlled trials and randomize children into camps of some who are exposed and camps of children who are not exposed and then decide what the exposure is. That’s unethical. So, what we have to do is a very, very different kind of science. But, getting the clinical community to understand how that’s done is a challenge. So this navigation guide basically says, here’s how you can walk through the environmental health science and use that to decide what recommendations should be made to patients and incorporate these into, not only guidelines for clinicians about what to do, but also, how they communicate these risks to patients and explain to patients what steps there are available so they can avoid these exposures when possible.


This commentary originally appeared on the RWJF New Public Health blog.