John Balbus has been named the interim director and Garey Rice will serve as the Chief Climate Action Officer. Despite opening with little prior fanfare and a planned budget of only around $3 million (enough for around eight employees), the office has wide-ranging ambitions.
Echoing efforts by the Departments of the Treasury, Interior, and Transportation, the OCCHE allows HHS to tackle climate change from its corner of influence. OCCHE will leverage existing regulatory authority to respond to greenhouse gas (GHG) emissions impacts and reduce waste from health care providers and suppliers, including system strain from natural disasters and the impact of pollutants on public health.
The recent UN Climate Change Conference in Glasgow (COP26) highlighted the relationship between health harms and climate change and prioritized developing global mitigation efforts to address these harms. The creation of OCCHE supports the United States’ commitment at COP26 to develop climate-resilient and low-carbon health systems.
To accomplish its goals, the OCCHE uses a very broad definition of environmental justice—one that is more typically used in academic environments. According to the OCCHE, “Environmental Justice” is defined as “the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income in the development, implementation, and enforcement of environmental laws, regulations, and policies.”
This broad definition will allow the office to oversee a wide range of interconnected issues. For example, the office acknowledges that certain communities, such as those with low income or people with disabilities, are more vulnerable to climate-induced risks. As such, the OCCHE plans to coordinate directly with impacted communities, nongovernmental organizations and various levels of government to address these disparities.
The Intersection Between Climate Change and Health
The creation of OCCHE highlights the critical intersection between climate change and health equity. As climate change-related disasters increase in frequency and severity, the implementation of climate action and environment, social and governance (ESG) initiatives will increase. Additionally, the COVID-19 pandemic has accentuated the relationship between climate change and health outcomes, as discussed below.
Recent devastating hurricane and wildfire events in the Gulf South and western United States, respectively, have led to the type of health-related impacts the OCCHE seeks to address.
Hurricanes and Wildfires: Case Studies in Health Effects of Climate Change-Related Natural Disasters
Climate events such as hurricanes and wildfires have both direct and indirect effects on individual and community health. A natural disaster directly modifies physical environmental conditions, resulting in increased water contamination or air pollution, for example. Critical infrastructure, such as transportation systems or reliable housing and health care, may be damaged or inaccessible as well. Direct health impacts include weather-related deaths (such as drowning) or waterborne diseases, while indirect physical and mental health impacts may be associated with exposure to environmental contaminants in the long-term.
Hurricanes
The National Oceanic & Atmospheric Administration’s (NOAA) global climate report for August 2021 reported that the month was the sixth-hottest August in 142 years. The report notes that “[g]lobally, nine of the 10 warmest Augusts have all occurred since 2009.” In assessing the relationship between global warming and hurricanes, NOAA projects that human-caused global warming will impact sea level rise as well as increase hurricane rainfall rates, hurricane intensity and the global proportion of hurricanes that reach category 4 or 5 levels.
The Gulf South has recently experienced numerous climate events that align with these projected increases. In August 2021, Hurricane Ida made landfall as a category 4 hurricane with winds measuring up to 150 mph. In the wake of Ida’s destruction, HHS swiftly declared public health emergencies for Louisiana and Mississippi and issued waivers under the Social Security Act in order to support vulnerable populations impacted by the storm. A year earlier, Hurricane Laura, also classified as a category 4 storm, resulted in 47 direct deaths and 34 indirect deaths, with “major to catastrophic” wind and storm surge damage in Southwest Louisiana. The Governor of Louisiana reported that 10,000 homes were demolished from storm impacts.
Wildfires
In addition to hurricanes, climate-related changes such as higher air temperatures, lower rates of precipitation and drought contribute to ideal wildfire conditions. By the end of July, nearly 40,000 fires had burned in the U.S. during the first seven months of 2021. Wildfires negatively impact air quality, with smoke causing human health effects such as “reduced lung function, bronchitis, exacerbation of asthma and heart failure, and premature death.”
Navigating Climate Change During COVID-19
There are also unique public health concerns that arise when navigating increasing climate change-related events during a pandemic. Both government officials responsible for emergency response planning and individuals directly impacted by such emergencies are faced with numerous disease transmission considerations.
For example, Hurricanes Ida and Laura led to mandatory evacuation orders in some areas in addition to voluntary evacuations. Evacuation involves finding shelter outside of projected major storm impacts. As a result, remaining in a COVID-19-safe “bubble” may not be practical or even possible for some individuals. Where economically available, those evacuating may travel from their home to seek shelter with friends, family or in public shelters—potentially increasing the likelihood of coronavirus exposure and transmission rates. Individuals may be exposed to COVID-19 while traveling to their evacuation destination, or contract it while sheltering with others. As a result, cities hosting evacuees may experience unanticipated increased pressure on hospital and health care systems.
The OCCHE and the Health Care Industry
In addition to climate hazards and related health disparities, OCCHE highlights accelerating the health sector’s energy and climate transformation as one of its top priorities. The office’s initiatives advance President Biden’s pledge to cut U.S. GHG emissions at least in half by 2030 because of the potential to reduce the U.S. health sector’s high rates of GHG emissions. The health care industry can anticipate regulatory impacts related to the government’s efforts to meet this goal. Hospitals, which account for one-third of the health care sector’s total GHG emissions, are a real target for emission reductions.
The OCCHE will also play a significant role in developing climate resilience and sustainability language for inclusion in HHS grants. Along with calling for the creation of the OCCHE in January, President Biden ordered major U.S. agencies to develop adaptation and resilience plans to respond to significant climate risks and vulnerabilities. HHS’s Climate Action Plan tasks the OCCHE and the Assistant Secretary for Administration with developing climate-resilient grant policies. As the largest grant-making agency in the U.S., HHS grant policies have a far-reaching impact on actors in the health care sector. There are many types of HHS grants, and the Climate Action Plan notes that “[m]ost HHS grants are provided directly to states, territories, tribes, and educational and community organization, then given to people and organizations who are eligible to receive funding.” We anticipate that HHS grant applicants may begin to prioritize applications that incorporate sustainability and climate adaptation actions into their operations to meet potential requirements in future grant guidance.