National Institute of Environmental Health Sciences

By Megan Avakian

The fourth annual NIEHS Global Environmental Health (GEH) Day highlighted the connections between global environmental change and human health. The need for systems thinking, multidisciplinary research, and stakeholder engagement to better understand and implement solutions to global environmental change were common themes throughout the day.

"Our goal at NIEHS is to make sure that the environment's impact on global health is well understood. GEH Day is about bringing colleagues together and about putting the ‘E’ in global health,” said Trisha Castranio, NIEHS GEH Program manager and an organizer of the July 1 event.

Held virtually this year, the event drew more than 550 participants from 37 countries. “We’re delighted to be able to bring GEH Day to a wider, global audience this year,” said NIEHS Senior Advisor for Public Health, John Balbus, M.D., who also helped organize the event.

According to Balbus, this year’s GEH Day theme, Science at the Cutting Edge of Global Environmental Change and Health, reflects the institute’s desire to foster collaborations across the global health community, advance climate change and health research, and support the translation of research into public health action.

The recorded event included two keynote sessions, panel presentations highlighting NIEHS-funded climate change and health research, and the launch of the updated Climate Change and Human Health Literature Portal.

During his welcoming remarks, Rick Woychik, Ph.D., NIEHS and National Toxicology Program director, set an inspirational tone for the day, “I hope that everyone who participates in today’s symposium leaves with an increased motivation to address the challenges posed by climate and other global environmental changes,” he said.

A Planetary Perspective

Howard Frumkin, M.D., Dr.P.H., from the University of Washington, discussed global environmental change from a planetary health perspective during his keynote talk. A planetary health approach requires sustainable solutions that both respect the limits of earth systems and meet human needs.

“There's a ceiling above which we shouldn't go when it comes to altering earth systems, and a floor below which we shouldn’t go when it comes to satisfying basic human needs,” Frumkin explained.

To strike this balance, Frumkin called for a systems approach that considers how all global environmental change processes affect and interact with each other. For example, climate change interacts with other change processes, such as deforestation and ocean acidification, all of which are altering the planet in fundamental ways that impact human health.

“Scientists need to be thinking in big, cross-cutting, systems ways to solve global environmental change challenges,” he said.

This requires a multidisciplinary research approach that brings together health, climate, and social scientists with engineers, economists, ecologists. Scientists also need to work across sectors, from health and energy to agriculture and transportation, and between the worlds of science and policy.

Frumkin urged researchers to seek future-oriented, adaptable solutions to global environmental change challenges and to focus on the most vulnerable. “Poverty and inequality are the human context in which many environmental challenges play out,” he said.

He closed with an uplifting message. “As we work to advance global environmental health for all people – thinking big, thinking in systems, devising and implementing solutions, and advancing health for all – let’s do it with hope and optimism, with determination and grit, with compassion and courage.”

Adaptation for a Healthier Future

During the second keynote talk of the day, Kristie Ebi, Ph.D., from the University of Washington, focused on the process of climate change adaptation. “Adaptation is about taking action to protect population health – as well as our health care systems – in the face of global environmental change,” she said.

Ebi noted that adaptation is most effective when a broad range of stakeholders are involved, from community members and decision-makers to social scientists and public health practitioners.

She described the process of working with stakeholders to identify short, 10-year adaptation goals, as well as long-term goals, and then working backwards to map out the steps needed to achieve them. “This is an explicit and targeted approach to ensure our interventions are efficient and effective in protecting population health,” she explained.

Many countries share similar climate and health risks, vulnerabilities, and needs. “This provides an enormous opportunity for countries to learn from each other, to test interventions, and identify best practices and lessons learned, and then use that knowledge to help other countries ramp up their adaptation plans more quickly,” she said.

This may be especially useful in building climate resilient health care facilities, a growing area of interest for many countries according to Ebi. Many hospitals around the world are situated along coastlines, making them prone to sea level rise, storm surge, and other climate-related risks. Leveraging successful approaches across health care systems with similar climate vulnerabilities can create a more resilient future.

“Adaptation is not linear, and it does not follow the path of least resistance – but it gets us where we need to go,” said Ebi. “Even as the climate continues to change, adaptation minimizes health risks for our family, friends, and colleagues and ensures our health care systems are prepared.”

Linking Climate Change and Health

During panel presentations, NIEHS-funded researchers spoke about connections between climate change and human health.

Michelle Bell, Ph.D., from Yale University, highlighted that climate change is increasing the frequency and intensity of wildfires – which means more smoke and greater human health impacts. “Some populations will be more affected than others, which raises some very important environmental justice concerns,” she said. Her research suggests that by 2050, Alaska may experience up to three times its current level of exposure to wildfire smoke, with Native American populations facing the greatest health burden.

Julia Gohlke, Ph.D., from Virginia Polytechnic Institute and State University, described her community-engaged project examining differences in heat and air pollution exposures in rural and urban settings in Alabama. She works with community leaders and government representatives to develop research questions that incorporate community concerns and priorities.

Anwar Huq, Ph.D., from the University of Maryland, discussed his research on Vibrio cholerae, the bacteria that causes cholera, a devastating waterborne disease. “Cholera is known as a tropical disease because it thrives in warmer environments, but we are seeing this pathogen in new regions, perhaps due to higher water temperature and increased precipitation,” he said. As part of his NIEHS-funded project, his team is working on models to better predict and prevent cholera outbreaks in the Chesapeake Bay.

In their talk on nutrition, climate change, and health, Lindsey Smith Taillie, Ph.D., and Christina Chauvenet, Ph.D., from the University of North Carolina at Chapel Hill, highlighted that reducing red meat production and consumption could yield co-benefits. “Production of red meat is responsible for a large portion of global greenhouse gas emissions, said Taillie. “We also know that eating red meat, especially processed red meat, increases risk for certain noncommunicable diseases, like heart disease and diabetes.”