Sonia Y. Angell, MD, MPH shared her eye-opening talk, “The Heart-Breaking Effect of Hurting Our Planet,” during the October Jam Session hosted by the Johns Hopkins Center for Health Equity. Angell is a Bloomberg Professor of the Practice of American Health at the Johns Hopkins Bloomberg School of Public Health, in the Department of Epidemiology where she Chairs the Food Systems Steering Committee of the Food Systems for Health focus area of the Bloomberg American Health Initiative.
Angell began her talk by asking participants to share words that they associated with “cardiovascular health” and “climate change.” Notably, there was no overlap between the two lists; Angell then launched into a discussion of the ways in which climate change affects health, particularly cardiovascular health, despite the public view of the two as separate issues.
“Over half of all known human pathogenic diseases can be aggravated by climate change,” she said, pointing to the various mechanisms for disease (such as air, water, food, etc.) and how environmental changes, such as warming, precipitation, floods, and droughts effect these mechanisms and exacerbate the risk of infectious diseases. For individuals with cardiovascular disease, this risk is even higher because heart disease itself is a risk factor for infectious diseases, she added.
After establishing the increased risk from environmental change faced by individuals with cardiovascular disease, Angell shifted focus to the ways in which average Americans perceive threats related to climate change and how they receive information about climate change. Citing a study from Yale University, Angell shared findings that suggest that, while over 50% of participants felt “worried about harm from environmental problems in their local area,” less than 25% reported that they were hearing about environmental problems from people they knew including, Angell highlighted, their physicians. For Angell, this lack of communication from healthcare providers about environmental problems and their impact on health is problematic, particularly because healthcare providers consistently rate amongst the most trusted professions in the USA.
She continued her overview of the effects of climate change on health by shifting focus from an “event dominated” view (i.e., natural disasters) to a “life course anchored experience” perspective. She shared data demonstrating the steady increase in the Earth’s temperature, a phenomenon that she points to as an ongoing problem that will increasingly impact the health of future generations.
Climate drivers, such as increased temperatures, sea levels, and extreme weather, she explained, can lead to negative health outcomes that disproportionately impact populations based on race, housing, age, gender, socio-economics, access to healthcare, and pre-existing health conditions. Using research from the US Global Change Research Program, Angell illustrated how changes in temperature, air quality, food and water quality, and changes in infectious agents increase risk of heat-related illnesses, cardiopulmonary diseases, infections, and declines in mental health. Because of social inequities, these risks become even greater for socially and economically disadvantaged populations, as well as for individuals with pre-existing conditions, such as cardiovascular diseases.
Angell examined the impact of climate change on cardiovascular health on various populations. She compared New York City census maps that demonstrate strong correlations between race, poverty, premature mortality, and heat vulnerability, stressing that heat vulnerability disproportionately impacts populations (primarily people of color) that already experience health discrepancies due to racial discrimination and higher levels of poverty. Referring to a 2020 article in Climate, Angell shared how redlining “led to a whole change in the fabric of the community at large” leading to "very clear physical characteristics between communities that have created, still to this day, a lasting risk.” For example, the study found that neighborhoods considered “more desirable” had more tree canopy than those considered “less desirable.” With fewer trees, “less desirable” neighborhoods experience greater increases in surface temperature than “more desirable” neighborhoods.
“Racist systems and policies, such as redlining, have created racial lines between neighborhoods, with the “more desirable” neighborhoods being primarily white and “less desirable” neighborhoods being primarily non-white, people of color are put at higher risk of heat vulnerability and related health issues, including increased rates of strokes, exposure to pollutants, and heat stress.
In addition to heat vulnerability, she said, socially and economically disadvantaged populations are at higher risk for aggravated food insecurities due to environmental factors that disrupt food supply, such as severe weather, increased carbon dioxide, and temperature changes that impact how food is grown and distributed. In turn, food insecurity directly correlates to increased risk for chronic diseases, which increase risk for other health issues and premature mortality.
Angell concluded her presentation with a review of systemic and political changes necessary to reduce carbon emissions and address the acute effects of climate change on public health. Thank you to Dr. Sonia Angell for this enlightening presentation!