Shortly after his election, President Joseph Biden announced that his administration would focus on four priorities, which the White House labelled as "converging crises." These priorities are to control the COVID-19 pandemic, provide economic relief, tackle climate change, and advance racial equity and civil rights.
Global environmental health science interacts with all four priorities. For example, research shows that air pollution has contributed to COVID-19 mortality (Wu et al. 2020), and increased air pollution exposure is associated with racial and minority status in the United States (ALA 2020; Fabisiak et al. 2020; CDC 2011) and around the world (Hajat et al. 2015). Similarly, according to major national and international scientific assessments, the impacts of climate change disproportionately affect people with the fewest resources to protect themselves or adapt (Ebi et al. 2018; Smith et al. 2014).
Looking to the future, measures to reduce future pandemics and health risks of climate change, as well as to boost investment in the nation's infrastructure, will all benefit from the results of global environmental health research.
Executive Orders Include Global Environmental Health Priorities
President Biden has issued executive orders that are relevant to the converging crises of climate change, global health security, and racial inequity. These executive orders, described below, provide a roadmap toward addressing the health threats of climate change, domestically and internationally, with an emphasis on racial equity. Below, we highlight relevant portions to global environmental health priorities.
Executive Order (E.O.) 14008 , "Tackling the Climate Crisis at Home and Abroad," established a special Presidential envoy for climate change and announced the United States' leadership in implementing and building upon the Paris Agreement's objectives to meet the climate challenge, formed through the United Nations Framework Convention on Climate Change. The executive order also reinstates an interagency working group on Climate Change and National Security and requests the Secretary of Defense to lead development of a national Climate Risk Analysis. Both activities include the health and security risks associated with climate-related diseases and extreme events.
The second section of E.O. 14008 announced a "whole of government" approach to tackling the climate crisis, led by a National Climate Advisor and cabinet-level Climate Task Force to coordinate activities across agencies. This section requires each federal government agency to develop a climate adaptation plan. These plans will assess vulnerabilities, describe ways to increase resilience, and address energy and water efficiency. This section also describes initiatives within the executive branch to stimulate employment through sustainable infrastructure construction, land conservation, and revitalizing coal, oil and gas, and power plant communities.
Additionally, the second section of E.O. 14008 addresses interactions between climate change, health, and equity. Placing environmental justice clearly in the context of climate change, it establishes the White House Environmental Justice Interagency Council as well as the White House Environmental Justice Advisory Council. It also instructs the Department of Health and Human Services (HHS) to establish a new Office of Climate Change and Health Equity and to stand up a new Interagency Working Group "to Decrease Risk of Climate Change to Children, the Elderly, People with Disabilities, and the Vulnerable." It also instructs HHS to establish a biennial Health Care System Readiness Advisory Council.
E.O.13990 , "Protecting Public Health and the Environment and Restoring Science to Tackle the Climate Crisis," creates the Interagency Working Group on the Social Cost of Greenhouse Gases. This group is charged with developing estimates of the economic benefits of reducing emissions of three greenhouse gases - carbon dioxide, nitrous oxide, and methane - by analyzing the costs of damages associated with climate change resulting from their emissions. Adverse health effects are a damage to be considered. The E.O. instructs the working group to provide a final report on the social cost of these greenhouse gases by January 2022.
In addition to these two executive orders, two other executive orders and one national security memorandum address global health security and pandemic preparedness. Because of potential connections among climate change, global health security, and future pandemics, these actions are also relevant to the NIEHS Global Environmental Health program.
E.O. 13987 , "Organizing and Mobilizing the United States Government to Provide a Unified and Effective Response to Combat COVID-19 and to Provide United States Leadership on Global Health and Security," requests the Assistant to the President for National Security Affairs, in coordination with relevant agencies, the COVID-19 Response Coordinator, and the Assistant to the President for Domestic Policy, to make epidemic forecasting and modeling recommendations. It also reconvenes the Global Health Security Agenda Interagency Review Council.
E.O. 13994 , "Ensuring a Data-Driven Response to COVID-19 and Future High-Consequence Public Health Threats," adds to E.O. 13987 by calling on HHS to "review the effectiveness, interoperability, and connectivity of public health data systems supporting the detection of and response to high-consequence public health threats, such as the COVID-19 pandemic."
Presidential decisions on national security matters are conveyed through National Security Memoranda. The first one calls on the Assistant to the President for National Security Affairs to "develop a plan for establishing an interagency National Center for Epidemic Forecasting and Outbreak Analytics and modernizing global early warning and trigger systems for scaling action to prevent, detect, respond to, and recover from emerging biological threats."
NIEHS Contributions to Administration Goals
NIEHS represents HHS on the White House Subcommittee for Global Change Research and has provided scientific knowledge and leadership to support public health activities related to climate change, health, and equity for many years.
NIEHS led development of a trans-NIH 2010 program announcement, "Climate Change and Health: Assessing and Modeling Population Vulnerability to Climate Change," funding numerous research projects to better understand vulnerability and risk factors for the health impacts of climate change. NIEHS also helped lead development of a 2019 Global Change Research Program Report on "Predicting Climate-Sensitive Infectious Diseases to Protect Public Health and Strengthen National Security". NIEHS also hosted a 2020 webinar titled "Working with NOAA Climate and Weather Data: Opportunities to Enhance Infectious Disease Modeling and Pandemic Preparedness" .
In the coming months, the NIEHS Global Environmental Health program will support efforts to implement the scientific aspects of the executive orders and the national security memorandum, working across NIH and in partnership with other relevant federal agencies. By helping to connect environmental health, environmental justice, and health disparities with the health implications of climate change and extreme weather events, the Global Environmental Health program can help inform activities and decisions, guiding them toward improving the health of all people, especially those most vulnerable.
References
- Wu X, Nethery RC, Sabath MB, Braun D, Dominici F. 2020. Air pollution and COVID-19 mortality in the United States: Strengths and limitations of an ecological regression analysis. Sci Adv 6(45):eabd4049. doi: 10.1126/sciadv.abd4049. PMID: 33148655; PMCID: PMC7673673.
- ALA (American Lung Association). 2020. State of the Air. Chicago, IL: American Lung Association. Available: State of the Air [accessed 21 April 2021].
- Fabisiak JP, Jackson EM, Brink LL, Presto AA. 2020. A risk-based model to assess environmental justice and coronary heart disease burden from traffic-related air pollutants. Environ Health 19, 34. Full Article .
- CDC (Centers for Disease Control and Prevention). 2011. Fact Sheet: Health Disparities in Unhealthy Air Quality. Atlanta, GA: Centers for Disease Control and Prevention. Available: Fact Sheet: Health Disparities in Unhealthy Air Quality [accessed 21 April 2021].
- Hajat A, Hsia C, O'Neill MS. 2015. Socioeconomic Disparities and Air Pollution Exposure: A Global Review. Curr Environ Health Rep 2(4):440-450. doi:10.1007/s40572-015-0069-5.
- Ebi KL, Balbus JM, Luber G, Bole A, Crimmins A, Glass G, Saha S, Shimamoto MM, Trtanj J, and White-Newsome JL. 2018. Human Health. In 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, pp. 539-571. doi: 10.7930/NCA4.2018.CH14.
- Smith KR, Woodward A, Campbell-Lendrum D, Chadee DD, Honda Y, Liu Q, Olwoch JM, Revich B, and Sauerborn R. 2014. Human health: impacts, adaptation, and co-benefits. In: Climate Change 2014: Impacts, Adaptation, and Vulnerability. Part A: Global and Sectoral Aspects. Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change [Field, C.B., V.R. Barros, D.J. Dokken, K.J. Mach, M.D. Mastrandrea, T.E. Bilir, M. Chatterjee, K.L. Ebi, Y.O. Estrada, R.C. Genova, B. Girma, E.S. Kissel,A.N. Levy, S. MacCracken, P.R. Mastrandrea, and L.L.White (eds.)]. Cambridge University Press, Cambridge, United Kingdom and New York, NY, USA, pp. 709-754.
