Listen on your favorite streaming app.
We all want to live full, healthy lives. But climate change is threatening a growing number of people’s lives and well-being. So we’ve invited a guest on the show to help us see climate change not in tons of carbon dioxide, but as a matter of health.
Prof. Amruta Nori-Sarma is an Assistant Professor in the Environmental Health Department at Boston University School of Public Health. She studies the relationship between environmental exposures associated with climate change and health outcomes in vulnerable communities. Her current research aims to understand the impacts of interrelated extreme weather events on mental health across the US utilizing large claims datasets.
LHF: Hello, and welcome to Today I Learned: Climate. I’m Laur Hesse Fisher of the MIT Environmental Solutions Initiative.
Today, we’ve invited a guest on the show to help us see climate change not in tons of carbon dioxide, but as a matter of health.
ANS: My name is Amruta Nori-Sarma, and I'm currently an assistant professor in environmental health at the Boston University School of Public Health.
So the meaning of public health is the health of the population as a whole. And my research primarily focuses on the impacts of extreme weather associated with climate change on health outcomes, and in particular, health outcomes among vulnerable populations.
LHF: Prof. Nori-Sarma’s field of research is a growing one. As people around the world are being exposed to rising temperatures and rising seas, food instability, and wildfire smoke—public health officials are among those preparing and responding.
ANS: Climate change is inherently a part of every single public health issue and crisis that we are and will continue to face in the coming decades. Like if you list any public health issue, I will provide you how that links back to climate change and how it's important for everyone to be thinking about in public health.
LHF: And vice versa: all the impacts of climate change can be thought about in terms of how they affect human health.
ANS: We're interested in drought, which may have important physical and also mental health impacts. We're also interested in flooding, so inland flooding may be associated with higher rates of gastrointestinal illness, for example, as waterborne diseases propagate. We’re also interested in wildfires. And the physical health impacts of wildfire smoke are relatively well outlined, including things like cardiovascular disease and respiratory illness.
LHF: But we’re not here today to lecture you with a long list of disasters. Instead, we want to understand how the field of public health thinks through these growing challenges, so we can put ourselves in a better position to respond. So let’s take a journey through how public health officials think about climate change by zeroing in on one type of natural disaster that is intensified by climate change. It’s Prof. Nori-Sarma’s main research focus: heatwaves.
ANS: Heatwaves are an excellent example of the impacts of climate exposures on health because everybody, as the climate changes, will start to experience higher temperatures in the summertime. And we know that those heatwave periods will not only become more intense, they will happen more often, and they will also be longer in duration.
LHF: This is very much happening already, all over the world. For example, in the summer of 2023, the American southwest suffered a heatwave that NASA called “unprecedented.” In Phoenix, Arizona, it was over 110 F for 31 straight days—almost two weeks longer than the previous record.
So what happens when people have to live through these extremes?
ANS: The first people who get ill because of extreme heat are the people who have underlying health conditions that may be exacerbated by the heat exposure, like renal insufficiency, cardiovascular disease, et cetera. So they just tend to become sick a few days earlier.
LHF: This is really important for hospitals to prepare for. A heat wave can cause a sudden rush to the ER, as people with pre-existing conditions all start needing emergency care at the same time.
ANS: And then as the heat wave continues to occur, who are the people who are just really getting impacted by the extreme heat exposure that otherwise would've been perfectly healthy? For example, from heat stress, heat stroke, heat strain.
LHF: And if extreme heat is new to your area, healthcare staff might need new training.
ANS: If someone presents to an emergency department for a heat stroke, it looks very similar to somebody presenting to the emergency department for a regular stroke. But the treatment is totally different. If you're having a heat stroke, they need to get you into an ice bath and make sure you have rehydration, water and oral rehydration salts. So we need to be interacting and talking with the clinicians so that they know, oh your patient might actually be having a heat stroke and here are the things that you can do to try and reduce that adverse health event.
We've also seen in the literature that there are mental health impacts of heat exposure. My own research has shown increases in the rates of substance use disorders, mood and anxiety disorders, stress disorders, schizophrenia, self-harm, and a whole host of other mental health outcomes.
LHF: It turns out a lot of climate impacts are like this: they surface all different types of vulnerabilities that our society already has.
ANS: We think of climate change as a threat multiplier. So we do anticipate that climate change will impact different people differently depending on whether they have preexisting health conditions, depending on what types of communities they're living in, and what is the resilience that the community has to climate change.
LHF: Which is why public health includes more than just what happens in clinics and hospitals.
ANS: Do I live in a community that has the resources to respond to extreme weather? Do we have the money to build a city green space? If I don't have access to a cooling center, do I have an air conditioner in my own home? And if I have an air conditioner in my home, do I experience power outages , or do I have regular access to power? Do you have access to nearby health resources if you need to visit a hospital, is it close to you or is it far away from you?
LHF: And the answers to those questions are going to vary a lot from place to place.
ANS: One of the primary things that we have seen in our work is that it really helps to have the communities that are most impacted by the changing climate participate and have a seat at the table when it comes to discussing what is the right intervention.
So one of the most excellent extreme heat adaptation plans that we have in the US is the New York City heat adaptation plan. And one of the things that they recommend is when it's hot outside, go visit a cooling center. Go to the nearest mall that is air conditioned, or go to a movie theater. So we carried that heat adaptation plan over into the city of Ahmedabad, which is in the northern state of Gujarat, India. And the feedback that we received from the community in Ahmedabad was, it's not feasible to ask the most vulnerable populations who are living in very low income and sometimes slum communities in the city to go into a shopping mall or a movie theater because they would be stopped by security at the door of the mall or they wouldn't be able to afford the cost of admission to a movie theater. What turned out to be more feasible in that context was to extend the opening hours of urban green spaces. These are places that are going to be at least a few degrees cooler than the surrounding city environment during those extreme heat periods. And these are also places that many different communities were able to access and feel like they were welcomed there.
You can do kind of a combination of taking the best practices from communities that have currently experienced extreme heat or other types of climate exposures, and then bringing a local perspective to that as well.
LHF: And while we’ve talked so far about adapting to the effects of climate change, public health also comes into play when we work to prevent future climate change. Because many of the same actions that, in the long run, would help us stop warming the planet, are actually good for our health right now. Take coal power—it’s the most climate-polluting major source of energy, and pretty much every plan to deal with climate change calls for coal to be drastically reduced. But it also creates other kinds of pollution that are impacting people right now.
ANS: Reductions in coal combustion is gonna have implications for future climate change, [jump] but that's not going to change our climate until, you know, 2040, 2050. But in the near term, it's gonna reduce the incidences of black lung and lung cancer and, you know, other types of adverse health outcomes today. Or, you know, one of the other things is increasing green spaces and public transportation options. These have implications for lung health, but also mental health. And then downstream, there are improvements to our climate. We don't have to look to 20 years from now to see the benefits of these policies. We can see them right away.
LHF: I grew up and live in the Philadelphia area, and we’re seeing flooding, wildfire smoke and heat trends like I have never seen before. Think about where you live – your area might be experiencing similar or different impacts. Now put on your public health goggles: which people, and which communities, will need the most help?
ANS: One of the most effective tools that we've seen in adapting to extreme heat, for example, is neighbors checking in on their neighbors that they know are vulnerable or friends checking in on their friends. A very simple, I know that my neighbor is elderly and I know that they might be alone in their home during this heatwave. I should check in on them and make sure that they don't need anything. These societal and social ties can be [01:07:00] very helpful in reducing the impacts of climate exposures. Often the most valuable resource that we have is the people living around us and the communities that we have.
LHF: That’s it for today’s episode, but there is so much more to learn about climate change and public health. Check out our show notes online, and our Educator Guide for this episode, where you can explore local public health challenges and solutions. That’s all at tilclimate.org.
TILclimate is produced by the MIT Environmental Solutions Initiative at the Massachusetts Institute of Technology. David Lishansky is our Editor and Producer. Aaron Krol is our Scriptwriter and Associate Producer — and did our artwork. Ilana Hirschfeld is our Production Assistant. Michelle Harris is our fact-checker. Sylvia Scharf is our Climate Education Specialist. The music is by Blue Dot Sessions. And I’m your Host and Producer, Laur Hesse Fisher.
Thanks to Prof. Amruta Nori-Sarma for joining us, and thank you for listening.
- Read more about Professor Nori-Sarma: https://www.bu.edu/sph/profile/amruta-nori-sarma/
- “Climate change is inherently a part of every single public health issue and crisis that we are and will continue to face in the coming decades.”
- The U.S. Global Change Research Program provides detailed briefs on the numerous ways climate change affects public health, from temperature-related illness to extreme events to food safety and nutrition: https://health2016.globalchange.gov/
- For a shorter roundup of the many public health impacts of climate change, see this story from Yale Climate Connections: https://yaleclimateconnections.org/2019/08/how-climate-change-threatens-public-health/
- “We think of climate change as a threat multiplier. It exacerbates people's existing vulnerabilities. So we do anticipate that climate change will impact different people differently depending on whether they have preexisting health conditions, depending on what types of communities they're living in, and what is the resilience that the community has to climate change.” The World Health Organization explains the factors that can make people and communities more or less vulnerable to the public health risks of climate change: https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health
- The most urgent public health challenges connected to climate change will vary from place to place. Readers in the U.S. can learn about the major impacts expected in their region from the Centers for Disease Control and Prevention: https://www.cdc.gov/climateandhealth/docs/Health_Impacts_Climate_Change-508_final.pdf
- “I think that heat waves are an excellent example of the impacts of climate exposures on health because everybody, as the climate changes, will start to experience higher temperatures in the summertime. And we know that those heat wave periods will not only become more intense, they will happen more often, and they will also be longer in duration.” Learn more about heat and health from the World Health Organization: https://www.who.int/news-room/fact-sheets/detail/climate-change-heat-and-health
- There are many measures that communities, public health officials and policymakers can take to protect our health and well-being in a warming world. The U.S. Environmental Protection Agency runs down public health adaptation strategies for a variety of climate impacts, with examples of solutions in action: https://www.epa.gov/arc-x/public-health-adaptation-strategies-climate-change
- For an overview of climate change, check out our climate primer: Climate Science and Climate Risk (by Prof. Kerry Emanuel and the MIT Environmental Solutions Initiative).
- For more episodes of TILclimate by the MIT Environmental Solutions Initiative, visit tilclimate.mit.edu.
We fact-check our episodes. Click here to download our list of sources.