Environmental Justice is - Still - Unrelated to the Climate Crisis
In my redlining complaint last week concerning the CDC’s recently announced Environmental Justice Index (EJI), I did not note the EJI fails to recognize or account for the climate crisis. For example, it is neither identified in the EJI fact sheet nor moreover discussed in the EJI’s exhaustive 94-page technical document. The word “climate” does appear once in the latter when the CDC states non-English speakers may be more vulnerable during “extreme climate events.” Leaving aside the fact that they of course are, that the CDC appears to understand the climate crisis as “events,” CMS characterizes similarly as a series of distinct and periodic “catastrophes,” “disasters,” or “emergencies,” is to be candid, pathetic. Unfortunately for federal healthcare policy officials, the climate crisis is instead a persistent, quotidian condition threatening every dimension of human health, and all other life forms, everywhere. As the February UN Intergovernmental Panel on Climate Change (IPCC) report concluded, “everywhere is affected, with no inhabited region escaping the dire impacts from rising temperatures.” To appreciate why this is read The Lancet’s latest or 2021, “Countdown on Health and Climate Change” report, appropriately subtitled, “Code Red for a Healthy Future.”
At page six the EJI technical document states there have been “calls for . . . federal tools that address the cumulative impacts of environmental injustice on health.” Yes, there have been innumerable calls to address the greatest cause of environment injustice - the climate crisis. For example, I wrote in March an essay for STAT titled, “HHS’s Failure to Address the Health Harms of the Climate Crisis Constitutes Environmental and Institutional Racism” (see below). Nevertheless, the EJI will report data regarding various forms of air pollution, moreover resulting from fossil fuel combustion, but air pollution is evidently simply just air pollution. There are no need to account for associated or consequential anthropogenic greenhouse gas (GHG) warming effects that inflict far more - in fact innumerable - and unrelenting health harms disproportionately suffered by minority populations generally and by Medicare and Medicaid beneficiaries more specifically.
Because there are evidently none, the EJI does not name or identify CMS as a data source under the document’s “Methods” discussion. To be fair this is likely because CMS has no relevant data because the agency continues to do nothing to make climate crisis-related regulatory improvements to either the Medicare or Medicaid programs. Nor is there any discussion of the fact that the climate catastrophe or disaster, some term apocalypse, the fact that a collapsing biosphere is not good for our health, in the document’s brief “Next Steps for the EJI” paragraph.
This is all status quo for the Department of Health and Human Services (HHS), whose mission is ironically, “to enhance the health and well-being of all Americans, by providing for effective health and human services and by fostering sound, sustained advances in the sciences underlying medicine, public health, and social services.” For example, if you read HHS Secretary Becerra’s and CMS Administrator’s Brooks-Lasure’s recent statements concerning passage of the Inflation Reduction Act (IRA), that some hopefully term the “Temperature Reduction Act,” neither mention the legislation’s climate-crisis related provisions. The CMS Administrator held a 30-minute call this past Thursday regarding the IRA and it too ignored the legislation’s climate-related tax credit provisions. Far more significantly, the HHS Office of the Surgeon General and the HHS Office of Civil Rights, among related others, have never addressed the problem. Again, the climate crisis, presently this summer’s record-breaking drought, flooding, heat and wildfires worldwide, and “health and well-being” are unrelated.
If the CDC, moreover HHS, continues to fail to address climate crisis health harms, maybe we should recognize NYU’s Philip Alston’s 2019 report “Climate Change and Poverty,” that he wrote while serving as the United Nation’s Special Rapporteur on extreme poverty and human rights, and create, using his phrase, a “climate apartheid” index.
We still remain some distance away from genuinely, honestly accepting the fact there is a relationship between climate, specifically GHG pollution, and human health – despite the fact we have known since at least the mid-1960s that there is a correlation. Most recently, in an upcoming Health Affairs article, anticipated to appear September 9, I make note of the fact that even under a unified Democratic government, HHS has now squandered two regulatory rule making cycles, i.e., proposed and final rules in 2021 for 2022 and proposed and final rules in 2022 for 2023, without implementing any regulatory policy reforms that would either improve Medicare and/or Medicaid’s clinical response to climate-related health harms. Nor has the department done anything to mitigate the healthcare industry, including CMS-qualified Medicare and Medicaid providers, dumping approximately 550 million tons of GHG pollution into the atmosphere every year.
If you’ve listened to my podcast over the past several years (at: www.thehealthcarepolicypodcast.com), you’ll know that I’ve made this point ad nauseum in one way or another via 25-plus climate-related interviews. As for my related writings, here are my most recent.
“How To Solve HHS’s Failure to Address the Climate Crisis,” Health Affairs Forefront (forthcoming, 9/9/22).
“FDA User Fee Legislation Needs to Mitigate the Pharmaceutical Industry’s Carbon Pollution,” STAT (June 8, 2022):
“HHS’s Failure to Address the Health Harms of the Climate Crisis Constitutes Environmental and Institutional Racism,” STAT (March 28, 2022):
“The World’s Most Powerful Public Health Governing Committee’s Flagrant Violation of Reality,” 3 Quarks Daily (February 21, 2022):
“The National Academy of Medicine’s Climate Crisis Effort Must Turn Words into Action,” STAT (October 15, 2021):
“Public Reporting: The First Step in Addressing the Health Care Industry’s Bloated Carbon Footprint,” (with Walt Vernon) STAT (June 29, 2021):
“We Must Connect the Climate Crisis with Human Health,” 3 Quarks Daily (2/15/21):