Our fundamental mission as healthcare providers is to protect the health of our patients. While heroic worldwide efforts are underway to combat COVID-19, the greatest emerging threat to women’s health, indeed to the health of all people, is the global climate crisis (what we previously referred to, rather innocuously, as climate change). The climate crisis remains the proverbial elephant in the room, for the sequelae of this climate catastrophe will likely produce a worldwide public health disaster, the impact of which will be far-reaching and devastating, greatly outweighing the consequences of all our current public health concerns. This is a call to action for healthcare providers.
Climate Crisis Science
From 1901 through today the global mean surface temperature of Earth has increased by approximately 1° Celsius (Figure), primarily due to increasing levels of carbon dioxide (CO2, the most abundant atmospheric greenhouse gas (GHG) that is non-condensable at ambient temperatures), from 280 parts per million (ppm) to 410 ppm (1,2). This increase in CO2 concentration is unprecedented over the past 800,000 years, occurring 200,000 years after the evolution of Homo sapiens and 20,000 years after the development of agriculture and civilization (3–6). Concentrations of CO2 were last at their current levels 15–20 million years ago during the Middle Miocene period when both average temperature and sea level were respectively ~3–6°C and 25–40 meters higher (6).
Figure: Temperature Departure from 20th Century Mean (NOAA National Centers for Environmental Information, Climate at a Glance:Global Time Series, published January 2020, retrieved on January 28, 2020 from https://www.ncdc.noaa.gov/cag/)
This piece was originally posted on Medium by Dr. Santosh Pandipati: Maternal-Fetal Medicine/Rationalist|Humanist/Subscriber to the Scientific Method and the Four Noble Truths/Perpetually a Beginning Cyclist, Runner, Photographer.
- Healthcare Provider Strategies to Combat Climate Change by Improving Women’s Health and Empowerment USGCRP, 2017: Climate Science Special Report: Fourth National Climate Assessment, Volume I [Wuebbles, D.J., D.W. Fahey, K.A. Hibbard, D.J. Dokken, B.C. Stewart, and T.K. Maycock (eds.)]. U.S. Global Change Research Program, Washington, DC, USA, 470 pp., doi: 10.7930/J0J964J6.
- IPCC, 2014: Climate Change 2014: Synthesis Report. Contribution of Working Groups I, II and III to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change [Core Writing Team, R.K. Pachauri and L.A. Meyer (eds.)]. IPCC, Geneva, Switzerland, 151 pp.
- Keeling CD, Piper SC, Bacastow RB, Wahlen M, Whorf TP, Heimann M, Meijer HA. Atmospheric CO2 and 13CO2 exchange with the terrestrial biosphere and oceans from 1978 to 2000: observations and carbon cycle implications. In: Ehleringer JR, Cerling TE, Dearing MD, eds. A History of Atmospheric CO2 and its Effects on Plants, Animals, and Ecosystems. New York, NY: Springer Verlag; 2005:83–113.
- MacFarling M, Etheridge CD, Trudinger C, et al. The Law Dome CO2, CH4 and N2O Ice Core Records Extended to 2000 years BP. Geophysical Research Letters 2006;33(14):L14810 10.1029/2006GL026152.
- Lüthi D, Le Floch M, Bereiter B, et al. 2008. High-resolution carbon dioxide concentration record 650,000–800,000 years before present. Nature 2008;453: 379–82.
- The Timetree of Life. S. Blair Hedges and Sudhir Kumar (Editors). Oxford University Press, New York. 2009.
- Tripati AK, Roberts CD, Eagle RA. Coupling of CO2 and Ice Sheet Stability Over Major Climate Transitions of the Last 20 Million Years. Science 2009;326(5958):1394–7.
- GISTEMP Team, 2019: GISS Surface Temperature Analysis (GISTEMP). NASA Goddard Institute for Space Studies. Dataset accessed 2019–05–08 at https://data.giss.nasa.gov/gistemp/.
- Hansen J, Ruedy R, Sato M, Lo K. Global surface temperature change, Rev. Geophys. 2010;48: RG4004, doi:10.1029/2010RG000345.
- NOAA National Centers for Environmental Information, State of the Climate: Global Climate Report for Annual 2018, published online January 2019, retrieved on May 8, 2019 from https://www.ncdc.noaa.gov/sotc/global/201813.
- USGCRP, 2018: Impacts, Risks, and Adaptation in the United States: Fourth National Climate Assessment, Volume II [Reidmiller, D.R., C.W. Avery, D.R. Easterling, K.E. Kunkel, K.L.M. Lewis, T.K. Maycock, and B.C. Stewart (eds.)]. U.S. Global Change Research Program, Washington, DC, USA, 1515 pp. DOI:10.7930/NCA4.2018
- Diaz S, Settele J, Brondizio E. Global assessment report on biodiversity and ecosystem services of the intergovernmental science-policy platform on biodiversity and ecosystem services. 2019:bit/ly/IPBESReport.
- Brand U, Blamey N, Garbelli C et al. Methane Hydrate: Killer Cause of Earth’s Greatest Mass Extinction. Paleoworld 2016;25(4):496–507.
- Peter Brannen. The ends of the world. New York:Harper Collins, 2017.
- David Wallace Wells. The uninhabitable Earth: life after warming. New York:Penguin Random House 2019.
- Haines A, Ebi K. The imperative for climate action to protect health. N Eng J Med 2019;380(3):263–73.
- Watts N, Amann M, Ayeb-Karlsson S, et al. The Lancet countdown on health and climate change: from 25 years of inaction to a global transformation for public health. Lancet 2018;391:581–630.
- Stephenson J, Newman K, Mayhew S. Population dynamics and climate change: what are the links? J Pub Health Vol 2010;32(2):150–6.
- Sorensen C, Murray V, Lemery J, Balbus J. Climate change and women’s health: Impacts and policy directions. PLoS Med 2018;15(7):e1002603.
- Aguilar L, Granat M, Owren C. (2015). Roots for the future: the landscape and way forward on gender and climate change. Washington, DC: IUCN & GGCA.
- Glemarec Y, Qayum S, Olshanskaya M. Leveraging co-benefits between gender equality and climate action for sustainable development: mainstreaming gender considerations in climate change projects. UN Women, October 2016.
- Potts M, Henderson C. Global warming and reproductive health. Int J Gyn Obstet 2012;119:564–7.
- Kuehn L, McCormick S. Heat exposure and maternal health in the face of climate change. Int. J. Environ. Res. Pub Health 2017;14:853.
- O’Neill B, Liddle B, Jiang L, et al. Demographic change and carbon dioxide emissions. Lancet 2012;380:157–64.
- John Guillebaud. Voluntary family planning to minimise and mitigate climate change. BMJ 2016;353:i2102.
- Stephenson J, Crane S, Levy C, Maslin M. Population, development, and climate change: links and effects on human health. Lancet 2013;382:1665–73.
- Ahmed S, Li Q, Liu L, Tsui AO. Maternal deaths averted by contraceptive use: an analysis of 172 countries. Lancet 2012;380:111–25.
- Diamond-Smith N., Potts M. A woman cannot die from a pregnancy she does not have. International Perspectives on Sexual and Reprod Health 2011;37(3):155–7.
- United Nations: Sendai Framework for Disaster Risk Reduction 2015–2030.
- Willett W, Rockstrom J, Loken B, et al. Food in the anthropocene: the EAT-Lancet commission on healthy diets from sustainable food systems. Lancet 2019;393(10170):447–92.
- IPCC, 2018: Summary for Policymakers. In: Global Warming of 1.5°C. An IPCC Special Report on the impacts of global warming of 1.5°C above pre-industrial levels and related global greenhouse gas emission pathways, in the context of strengthening the global response to the threat of climate change, sustainable development, and efforts to eradicate poverty [Masson-Delmotte, V., P. Zhai, H.-O. Pörtner, D. Roberts, J. Skea, P.R. Shukla, A. Pirani, W. Moufouma-Okia, C. Péan, R. Pidcock, S. Connors, J.B.R. Matthews, Y. Chen, X. Zhou, M.I. Gomis, E. Lonnoy, T. Maycock, M. Tignor, and T. Waterfield (eds.)]. World Meteorological Organization, Geneva, Switzerland, 32 pp.
- Hannah Ritchie and Max Roser (2020) — “CO₂ and Greenhouse Gas Emissions”. Published online at OurWorldInData.org. Retrieved from: ‘https://ourworldindata.org/co2-and-other-greenhouse-gas-emissions’ [Online Resource].
- Hawken P, editor. Drawdown: The Most Comprehensive Plan Ever Proposed to Reverse Global Warming. New York, NY:Penguin Books 2017.
- Zhang W et al. Projected changes in maternal heat exposure during early pregnancy and the associated congenital heart defect burden in the United States. J Am Heart Assoc. 2019;8:e010995. DOI: 10.1161/JAHA.118.010995.
- Zhang W et al. Prenatal exposure to disaster-related traumatic stress and developmental trajectories of temperament in early childhood: Superstorm Sandy pregnancy study. J Aff Disorders 234 (2018) 335–345.
- Dancause et al., Prenatal stress due to a natural disaster predicts adiposity in childhood: the Iowa flood study. J of Obesity. Volume 2015, article ID 570541.
- Xiong et al. Hurricane Katrina experience and the risk of post-traumatic stress disorder and depression among pregnant women. Am J Disaster Med. 2010; 5(3):181–187.
- Pacheco SE. Catastrophic effects of climate change on children’s health start before birth. J Clin Invest. 2020. https://jci.me/135005/pdf.