CLIMATE CHANGE AND THE CDC
The Centers for Disease Control and Prevention (CDC) works 24/7 to protect America from health threats, fight disease, and support communities and citizens to do the same . Climate Change is expected to increase both the severity and frequency of health problems and create unprecedented and unanticipated health challenges over the next few decades:
Climate change increases ground-level ozone (key component of smog) and/or particulate matter air pollution. This is associated with respiratory and cardiovascular health problems, such as diminished lung capacity, increased hospital admissions and emergency room visits, and increases in premature deaths. Heat, precursor chemicals, and methane emissions affect ozone levels. Particulate matter concentrations are affected by wildfires and air stagnation . Estimates of health-related costs associated with air pollution assuming no change in regulatory controls or population characteristics range from 1,000 to 4,300 additional premature deaths nationally per year by 2050 and costs of $6.5 billion (in 2008 US dollars) . Additionally, deaths from chronic lung diseases increased by 50% from 1980 to 2010, and chronic respiratory diseases are expected to become the third leading cause of death and possibly the costliest illness in the coming years . Current US air quality policies are projected to reduce ozone generating emissions, but climate change is increasing the frequency of regional weather patterns conducive to increasing ground-level ozone, and unless the reductions can offset the influence of climate change, tens to thousands of additional ozone-related illnesses and deaths are expected per year . Figures 2 & 3 show projected changes in ozone mortality rates in 2030 .
As it is CDC’s mission to protect America from health threats, the threat of climate change due to air pollution is a real challenge that will affect its operating model in years to come.
CURRENT ACTIONS AND ORGANIZATION
In 2006, the CDC Climate and Public Health Framework was created to address and prepare for the impact of climate change on public, and in 2009, the CDC formally established the Climate and Health Program within the CDC’s National Center for Environmental Health (NCEH) . The program is using the CDC’s prevention expertise to help state and city health departments prepare for climate change health effects. The mission of the program is to:
- Lead efforts to identify populations vulnerable to climate change.
- Prevent and adapt to current and anticipated health impacts.
- Ensure that systems are in place to detect and respond to current and emerging health threats.
The program is currently helping 16 states and 2 cities (Figure 4) utilizing the BRACE framework (Figure 5) to drive projections and analyses for use in public health planning and response activities .
The CDC is also encouraging communities to address the health threats associated with air quality per the following recommendations :
- Share forecasts of air quality index (AQI) from Airnow.gov  through local TV stations, radio programs and newspapers. See Figure 6 for the AQI from Thursday, November 3rd, 2016 and Figure 7 for the AQI Levels.
- People with pollen allergies should limit outdoor activities during days with high pollen counts.
- Incorporate active modes of transportation through urban planning to reduce vehicle miles and traffic-related pollution.
It should be noted that the CDC is only one government agency tackling climate – many others are also addressing this problem.
ADDITIONAL STEPS NEEDED
While there is progress and change being made at the CDC from an organizational and action standpoint, additional steps are still needed. The currently funded states and cities in the CDC’s program are very limited when compared to the overall United States, and based on the data projections for health-costs (dollars and deaths), a more active and urgent approach is required. CDC should be using their position to implement changes at the national level rather than just working with other groups at the state and city level. The same BRACE framework and recommendations should be applied. Some possible solutions/actions include:
- Approaching national newspapers and publications to include the Air Quality Index (AQI) in their weather sections – For example, USAToday does not currently include AQI; however, this would increase awareness among populations vulnerable to pollutants in the air.
- Increasing the amount of protected bike lanes to encourage people to use alternative forms of transportation – Between 1874 and 2011, there were only 78 protected bike lanes, but there are currently 292 protected lanes as of the end of summer 2016 
- Improving the distribution of Air Quality and Climate Change information to providers and at risk patients, which could be done through partnership with academic centers or patient foundations such as the Cystic Fibrosis Foundation, American Lung Association, or COPD Foundation.
Sixteen (16) states and two (2) cities against a world of climate change is not enough. (776 words)