In late February, the Biden administration made a major announcement that has the potential to affect the health of Americans for generations. Notably, it had nothing directly to do with COVID-19 or even health care reform.
Instead, the news was that the recently reestablished “Interagency Working Group on the Social Cost of Greenhouse Gases” had released a preliminary report on the federal government’s best estimate of the cost to society of continuing to burn fossil fuels. A final report is due early next year, but for now, the administration values a metric ton of emitted carbon dioxide at $51, methane at $1,500 and nitrous oxide at $18,000. These are the figures that will be used in calculating the costs and benefits of the administration’s climate policies, including measures to protect Americans from the health effects of the changing environment.
As a physician in Texas and a professor of environmental economics in California, we have seen from our different vantages how people are struggling to respond to the unprecedented threat of climate change. Patients evacuate an oncoming storm in a rush, only to forget critical medications at home. Governments face grueling choices between providing essential services or cutting off the electricity to prevent a wildfire. There is no longer a question that climate change, in the form of warmer temperatures, rising seas, more frequent extreme events and compounding natural disasters is already here and is already affecting the health and well-being of many Americans.
Rather, the question now is how decisively the administration will move to address this threat.
Thankfully, unlike its predecessor, the Biden administration is taking climate change seriously. The IWG calculations are one data point that reflects this.
But neither breaking with immediate precedent nor simply continuing Obama-era policies will suffice. Rather, since 2016 when the federal government last released scientifically defensible estimates of the social cost of greenhouse gases, a deluge of new data has emerged on the health effects of climate change. What the data show is that every organ system in the human body is vulnerable. And no segment of the population is spared.
Thus, to truly “listen to the science; to improve public health and protect our environment,” as the president has directed the IWG to do, this collaboration of 14 government agencies will have to update its methods.
To date, the IWG has utilized three “integrated assessment models,” or IAMs, which represent both the economy and the climate system and are designed to capture the economic and social costs of greenhouse gas emissions. However, only one of the three IAM models used, the FUND model, explicitly factors in health effects. And those it does include—diarrhea, vector-borne diseases and cardiovascular and respiratory mortality—reflect just a narrow slice of the picture and are mostly based on science that is decades-old and now obsolete.
Today, we better understand the effects of climate change on youth depression and preterm birth among women of color, and in shifting the geographic distribution of neglected tropical diseases that wreak havoc on children, particularly in the U.S. South. We’ve learned that staples of our diets like wheat and rice are less nutritious when grown in climates with higher greenhouse gas concentrations. We understand that extreme heat and humidity will become increasingly frequent and severe, making it difficult and dangerous for farmers and construction workers to continue working outdoors. And we’ve seen that the increased frequency of weather disasters, in addition to being deadly, results in delays or deferral of essential care such as dialysis and the administration of COVID-19 vaccinations.
Further, climate change is undoing health gains we’ve made from environmental protections that are already in place. The Environmental Protection Agency estimates that from 1990 to 2020, the Clean Air Act helped avert 230,000 premature deaths, 2.4 million incidents of asthma exacerbation and 17 million missed days of work. However, last summer when the western United States was blanketed for weeks in a thick cloud of wildfire smoke, Northern California, Oregon and Washington saw some of the worst air pollution on the planet, far above levels sufficient to cause serious health effects. Air quality in the U.S. has generally improved in recent decades, but wildfires have reversed that trend in the West and Northwest and are now responsible for between 25 and 50 percent of fine particulate matter. The link to climate change is clear: warmer temperatures dry out vegetation, creating tinderbox conditions that fuel the megafires that have engulfed western states.
The administration’s climate change response should be informed by these events and new information, including in estimating the costs of climate change. The omission of the emerging costs to health is one of many reasons why the IWG’s current estimates should be understood as a lower bound.
Even still, the IWG’s calculations are just one piece of what is needed in the administration’s strategy for addressing climate change. It must at the same time minimize risks to people, communities and critical infrastructure. That means both developing a climate-resilient health care system and doing longer-term planning to move people and property out of harm’s way. At the moment, states and communities around the country are struggling to understand and manage the threats they face from climate change; a national adaptation planning process to coordinate and lead these efforts is long overdue.
For Texans who are still recovering after February’s storm and Californians who are yet to return home following last summer’s fires, the details of climate policy are likely of little interest right now. But these are the social costs of uncurbed greenhouse gas emissions borne out in people’s lives. And they reflect what we already know and can be certain of, that climate change threatens the health and well-being of Americans today. Unless we act now, this will be the case for generations to come as well.