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Thinking locally on global warming

Yale Medicine Magazine, 2015 - Spring

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Global warming is making New Haven residents sick, especially the poor and the medically fragile.

That is the conclusion of Janet Ho, M.D., HS ’15, chief resident in the Yale Primary Care program. Her research tapped local, national, and international sources, including the World Health Organization, the Connecticut Department of Public Health, and DataHaven, a nonprofit that compiles data about the New Haven region.

“I started out wanting to highlight global warming and climate change as another determinant of health,” Ho said. “But as I researched more, I was surprised by how much was already out there in major medical journals, scientific literature, and popular media, in terms of the impact both globally and locally. In fact, in 2009, The Lancet described climate change as ‘the biggest health threat of the 21st century.’ It wasn’t obesity, heart disease, AIDS, or cancer, but climate change.”

For Ho, global warming is a social justice as well as a health issue. Her research, which she presented at internal medicine grand rounds in May, showed that the health impacts of climate change disparately affect New Haven’s poor. Most Americans—even those who agree it’s occurring—believe that climate change has little direct impact on them or their communities, she said, citing research by the Yale Project on Climate Change Communications. “We hear about polar bears and loss of glaciers. We think it’s not a problem for me, not a problem for my family, not a problem for a couple of generations.”

Untrue, Ho said. The damage is starkly evident in most places, including New Haven.

Take asthma. New Haven is the 12th worst location for those living with the disease in the United States, according to the Asthma and Allergy Foundation of America. Global warming exacerbates the problem because higher surface temperatures combine with automobile exhaust—and New Haven has two major highways running through it—to produce ground level ozone, Ho said. In contrast to the layer of ‘good’ ozone high in the atmosphere that protects us against UV radiation, ground level ‘bad’ ozone directly inflames the lungs, contributing to asthma exacerbation. Global warming also contributes to increased quantities and duration of ragweed pollen, one of the most potent triggers for allergy and asthma, in New Haven.

Statistics from the State Department of Public Health and DataHaven show that the city’s poorest neighborhoods—often located next to the busiest roads—have the highest emergency department admissions for asthma, Ho noted.

Global warming has other serious public health implications for New Haven, she said. Temperatures are higher in urban areas, which increases stress on the city’s poor, unwell, and elderly, who often lack air conditioning, transportation to cooler locales, and access to primary care. Climate change also contributes to such super-storms as Sandy and Irene—increased rainfall causes the city’s sewer system to overflow, sending raw sewage directly into the West and Quinnipiac rivers. That, in turn, increases the incidence of gastrointestinal illness in poor neighborhoods bordering the waterways. The uptick in moisture also feeds such mosquito-borne diseases as West Nile virus, she added.

Doctors in New Haven and elsewhere see the consequences of global warming every day and need to act, Ho said. The health care industry itself, she noted, produces 8 to 10 percent of the nation’s greenhouse gas emissions.

“I think that health care professionals are really in a unique position to lead efforts to address global warming,” Ho said. She applauded efforts by Yale-New Haven Hospital to battle climate change, including single-stream recycling, increased local food and vegetarian dining options, energy conservation, and encouraging the use of public transit. And people can take individual action: one of her colleagues mapped out the carbon footprint of her pending nuptials, and another bicycles to work every day. The Urban Resources Initiative, a non-profit partnership between the Yale School of Forestry and local neighborhoods, promotes stewardship of the local ecosystem by collaborating with New Haven communities to plant street trees for free, reclaim and beautify vacant lots for community greenspace, and install innovative ‘green architecture’ to help with rainwater overflow. Students and faculty have petitioned Yale University to divest its fossil fuel investments.

“I’m not trying to shame people by saying, ‘Don’t drive your SUV or feel bad about the way you are living,’ ” Ho said. “It’s more that we can all find a way to modify a bit of our behavior and lifestyle to mitigate our contribution to the problem. It’s both urgent and important because climate change is happening, and it’s affecting health now, here in New Haven, and for all of us.”