28. Turning Urgency to Action

Contagious Conversations  /  Episode 28: Turning Urgency to Action





Claire Stinson: Hello and welcome to Contagious Conversations. I'm your host, Claire Stinson. Every episode we'll hear from inspiring leaders and innovators who make the world healthier and safer for us all. Contagious Conversations is brought to you by the CDC Foundation, an independent nonprofit that builds partnerships to help the Centers for Disease Control and Prevention save and improve more lives. Joining me today is Dr. Judy Monroe, president and CEO of the CDC Foundation. Dr. Monroe has dedicated her career to protecting people and saving lives, and has led the CDC Foundation through one of the most eventful and challenging times for public health protection in the past 100 years.

Dr. Monroe is a former deputy director for the Centers for Disease Control and Prevention, and she previously served as Indiana's state health commissioner through the H1N1 pandemic. Among her many awards, Dr. Monroe was recognized as one of Atlanta's most admired CEOs by the Atlanta Business Chronicle in 2021. In this episode, we discuss the health impacts of climate change. We also explore how climate change affects the social and environmental determinants of health, and how we can all work to take on this monumental challenge. Welcome Judy.

Dr. Judy Monroe: Thank you. Great to be here.

Claire Stinson: Well, thanks for being a part of our conversation today. So let me start by saying we don't typically feature CDC Foundation staff on our podcast, but based on the health challenges posed by climate change, we wanted to provide an opportunity to talk with you to learn more about the work needed for the public health community, as well as the CDC Foundation. So we're really glad to have you here today. So let's get started. Climate change has been big topic for decades now. The World Health Organization now describes climate change as the single biggest health threat facing humanity. That's a huge statement. Talk to us about this.

Dr. Judy Monroe: Yes, the impacts of climate change on health are happening right now. And it's so important that everybody understand that. This is an enormous threat to global health, and it's an issue that needs to be front and center in the minds of all of us. So, everyone faces risk of health impacts associated with climate change. The Intergovernmental Panel on Climate Change has reported to avert catastrophic health impacts and prevent millions of climate change related deaths, the world must limit temperature rise to 1.5 degrees centigrade. So when we look at this, we already have, because of the climate change and the level of global temperature rise and other changes happening, we've got inevitable changes that have already occurred. And this all relates back to past emissions that have led to this, but every additional tenth of a degree of warming is going to take an additional serious toll on people's lives and health. It's a lot to get your head around.

Claire Stinson: Absolutely.

Dr. Judy Monroe: To really ... think about that. And climate change is already impacting health, as I said, in numerous ways. And so this includes leading to death and illness from increasingly frequent extreme events, weather events. And we all see that, with hurricanes and tornadoes and so forth. And then we have heat waves. Heat is now being considered the silent killer worldwide, and it impacts all kinds of things from heart disease and other conditions. Then we have, of course, disruption to food systems. So just to give an idea about what's happening here. The journal of Nature, the journal Nature, just recently published a paper that's believed to be the largest and most quantitative global study of its kind. And they found insect populations are declining by as much as 50 percent in some regions because of heat.

Claire Stinson: Oh my gosh.

Dr. Judy Monroe: Now insects are vital to health, the whole health of our ecosystems. Think about it. They pollinate flowers and food crops. They aerate soil. They consume biological waste. And they keep pest insect populations in check. They serve as the sole food source for many of our reptiles, our birds and mammals. So this is incredibly troubling to hear. And this is one of multiple studies that are coming out almost on a daily basis, showing the severity of what climate change, the impact it's having on our ecosystems. And so, when it comes, again, back to health, we've got increases in zoonosis, infections that are coming from animals to humans. I mentioned food, water, vector-borne diseases are on the rise. And then, mental health issues. Think about the trauma and the mental health impact of either severe heat or those hurricanes, droughts, tornadoes, et cetera.

So, we are seeing the destruction with wildfires of houses across the United States around the world. This really impacts and is undermining our social determinants for good health, which come … this is our livelihoods. Look, think about farmers, equality and access to healthcare and social support structure. So anyway, this is incredibly serious.

Claire Stinson: Incredibly serious. And those are stunning and ominous statistics, really important points. Thank you for sharing those. So, the World Health Organization also states that the climate crisis threatens to undo the last 50 years of progress and development, global health and poverty reduction, and to further widen existing health inequalities between and within populations. How can we work to combat this crisis?

Dr. Judy Monroe: So, this is something that everybody can take action on, but at the highest levels, it requires political will and taking really serious action and incorporating and putting policies in place that help drive behavior and decrease carbon emission. So that's front and center, but this is the job of governments, corporations, business, small businesses, organizations such as faith organizations, many non-governmental organizations, non-profits are in this space, they're starting to lean in and work even harder. I want to give tribute to those that have been working on these issues for decades. Right? We've got climate scientists and people that have been raising the flag about these issues for decades, and then individuals.

So, all of us can take action. So, I'll give a personal note. My kids, I have three adult children and they are super concerned about climate and health and climate change in general. And they all three became vegan. And boy did they put …

Claire Stinson: Oh, wow.

Dr. Judy Monroe: ... they put pressure and they are staunch vegans. Well, what do you think happened to mom and dad? Our meat consumption dropped considerably.

Claire Stinson: I bet it did.

Dr. Judy Monroe: ... because of their influence. Exactly. So, we all have micro influences, with the members of our family and so forth. So, those are some of the actions that we can all take.

Claire Stinson: Well, thank you for sharing that. And that's an important story because it's important to remember we can take everyday actions ourselves as individuals to help combat this. So, you mentioned this, but climate change is a politically charged topic for many. It's been around for decades. This is not a new topic. Why is it important to have a national conversation about health and climate change?

Dr. Judy Monroe: Yeah, I think it's just, the bottom line here is the urgency. We're in the final mile of being able to make impact. We're going to cross a threshold and in some ways we've already crossed the threshold of being able to reverse this and to manage. And so we just are, we're out of time, so that … I would say urgency. We need more people to understand the health impacts, because I think that will drive more action, because people do care about their health and the health of others. So, I think that's important. As more people understand, then they can do more individually and then they can create more demand for the political stalemates that we might have.

I will tell you raising this issue, and again, coming back to all of us being able to talk about this, I've started to raise this issue in all my meetings, everybody I talk to now I bring up climate and health, and I ask them, what are you doing about this? Whether it's individuals or organizations … fascinating reactions, because folks either start telling me what they've done, or they get a little sheepish and they say, you know, we could do more and you know what? We really should do more. So, you know what? You're planting the seed, the more conversations, what happens if ten people say that to them, guess what? You're going to start driving action. So, this national conversation is critical.

Claire Stinson: So, in your recent opinion piece in the Atlanta Journal Constitution, you mentioned that the way to counter the effects of threats from cardiovascular disease to climate change is turning to the successful approaches of the past to protect the public's health, and to give the public health protection community that supports needed to get the job done. Can you talk to us more about this and what this means?

Dr. Judy Monroe: So if you look historically at what has changed the lifespan for humans, it's public health, is the lion’s share. It's not everything, certainly healthcare and so forth. But when you look at better sanitation and immunizations and all of the things that public health has done, when you take a public health approach, that has led to decades of extra life. We don't live into our thirties now, life expectancy is well in the seventies, eighties in some communities. And so we need to draw the best and brightest to public health, because public health is about prevention. This isn't about taking care of the problem after the house is on fire, it's preventing the fire from starting. And it's just super important that we overcome the underinvestment of public health for all the gains in life and life quality, we have underinvested in our public health system, in the United States and around the world. And so that's crucial.

Claire Stinson: And would you say that COVID-19 has served as a catalyst to help us understand the importance of public health?

Dr. Judy Monroe: I believe so. Now I think that's an interesting question, because in some circles, absolutely. And there's been a bright light that has been placed on public health and the importance of public health. I'm actually co-chairing the Governor's Public Health Commission in Indiana right now looking at, we're charged by the Governor to take a hard look at all of the public health system and then make recommendations this summer on what can be improved, all the way from workforce to financing governance technology, the data systems and so forth. So, I think every state should be doing this and taking a hard look. And some of that is driven by the pandemic and the recognition. And then as you know, during the pandemic, there have been a lot of naysayers about public health and anti-science sentiment, and that, I believe we need the conversations again, so to help people understand, because folks tend to sometimes believe what they've read in social media or what … if you get bad information and then you share that bad information, or false information, we need to turn that around.

Claire Stinson: Absolutely. And we've learned a lot through this podcast, we've interviewed people who focus on rumors, misinformation, myths, things like that. So, we've learned so much through this podcast.

We'll be right back with Dr. Judy Monroe.

Climate change is the greatest health threat of the 21st century. We all face health impacts associated with climate change, including extreme weather events, worsening air quality, changes in the spread of infectious diseases, threats to food and water quality and quantity, and effects on our mental health. At the CDC Foundation, we are working to propel health to the forefront of the climate change conversation, and accelerate the nation's resilience in the face of a changing world. Learn more at cdcfoundation.org/climate-health.

And now back to our conversation with Judy.

Pivoting back to climate change, which populations are most vulnerable to climate change and why?

Dr. Judy Monroe: Yeah. So first all, no one is safe from all the risks. There are individuals and communities that are at much higher risk, and those are people in low income and disadvantaged countries and communities. Climate sensitive health risks are really disproportionately felt by the most vulnerable and the disadvantaged. These include women, children, ethnic minorities, poor communities, migrants and displaced persons, older populations, and then those with underlying health conditions. So by the time you add this up, it's a lot of people that this impacts. Climate change really has a big impact on the social and environmental determinants of health. So that's everything from the air that we breathe, clean air, safe drinking water, sufficient food and secure shelter. And then I would mention that those communities and countries that have a weak health infrastructure are least able to cope without the assistance to prepare and respond. So, they're highly vulnerable to climate changes.

Claire Stinson: Important to remember that no one is immune from the effects of climate change. So, here at the CDC Foundation, we focus on partnerships. What role do partnerships play in bringing the message of health to the forefront of the climate change conversation?

Dr. Judy Monroe: So, recently two public health icons, Dr. Bill Foege and Dr. Larry Brilliant, who really led the strategy to eradicate smallpox in the early 1970s, did a session on becoming better ancestors, looking at the nine lessons that they learned through smallpox with building coalitions, being one of the key lessons to really take on complex problems of the world.

Claire Stinson: Important to remember. So what is the CDC Foundation doing to advance this issue?

Dr. Judy Monroe: So, there are a couple of things to unpack here. First of all, there are short- and medium-term actions that can take place to address the health impacts of climate change. And those really are focused on those vulnerable populations that we talked about–building their resilience to the current rate of climate change and helping them adapt. And there are a number of things that communities can do. In the longer term, the effects will be increasingly dependent on, to the extent that we have these coalitions and we have the political will to do the transformational action to reduce emissions, and avoid the breaching of dangerous temperature thresholds to this potential irreversible tipping point. And in that regard, just a shout out to all the innovation. There are some really interesting innovations that are taking place that are very hopeful in terms of getting carbon out of the system. And there's a wide variety of opportunities.

So here at the CDC Foundation, we're focusing on priority areas. One of those for us is really looking at leading a national community-based response. And this comes from our lessons during the pandemic, we had an opportunity to build a network of about 300 community-based organizations during the pandemic. We were able to have funding for them as well as technical assistance, national webinars, really building on each other's experience and helping one another. We'd love to see that move toward expanding the number of communities that have that technical assistance and support to be able to build their own resilience. And that'll vary by community. If you're in the path of wildfires versus hurricanes, it can be quite different. So, that's the first.

The second area that we're looking at is the public health workforce and the workforce in general that understands climate change, and again, the resilience for communities, but also what can be done. And so, we had an opportunity at the Foundation during the pandemic to hire over 3,500 CDC Foundation field staff embedded in health departments across the country. We want to build on that experience as well, and to help be one of the supporters to build out a climate health workforce.

The third area that we're looking at is building climate change leadership in public health. And so this is having your health officers or deputy directors or leaders in governmental public health that understand the policies well enough that they can help drive policy change at their local or state level. And so that's a really important area.

And then, communicating the health impacts of climate change. That goes back to our early discussion. How do we make sure that we get more and more people talking about this and sharing accurate information, and then folks taking action, because of all of our behaviors and all of our opportunities that each of us have?

And then lastly, we are partnering with Health Care Without Harm. And they've been working for a while, looking at the healthcare system, which actually is a contributor to the carbon in the system and the greenhouse effect, and to decarbonize the healthcare system, because they're there for our health. So, it makes sense that they would lead the way. And so we've been in conversation and partnership with Gary Cohen, the CEO of Health Care Without Harm. And we believe that's a really important area.

Claire Stinson: Quite a variety of ambitious goals. What do you think is our biggest challenge ahead here at the CDC Foundation to tackle these issues?

Dr. Judy Monroe: Yeah, so when I think about the challenge, I think the energy and the sense of urgency is a challenge, because we've got to really move on this. Being able to maintain focus, because there's always things that divert all of our attention and then that urgency and focus being turned into the actions. So we've got … there's plenty that's been written about what we can do and the actions that can be taken. And that I think our challenge is one of time and distraction.

Claire Stinson: So let's talk about health equity. How will the question of health equity inform the overall message of health as a cornerstone of climate change action?

Dr. Judy Monroe: Yeah, so we've been doing a lot with health equity here at the CDC Foundation. We have a Chief Health Equity and Strategy Officer, Dr. Lauren Smith, who's been leading that. And we're really looking at equity being baked into all that we do. Again, when you talk about areas with weak health infrastructure, you look at the communities that are most disadvantaged and most vulnerable. We've got to have an equity lens and an equity intention of overcoming the inequities when we take on climate change and health.

Claire Stinson: Absolutely. An important point. So talk to us about your thoughts on the future of public health, Dr. Monroe.

Dr. Judy Monroe: So, we've been doing a lot at the CDC Foundation with other partners, with CDC, looking at the future of public health. And there couldn't be a more important time in my mind, in the history of human beings and the history of the world. We're on this threshold of a whole new era, some have called it the fourth industrial age. And here we are with pandemics and climate change, systemic racism, all of these converging at such a critical time. So again, public health has been the answer for a long time. We need to invest in it. And so, looking to the future of public health, but we need a revitalized and modernized future of public health system when it comes to governmental public health and working in partnership.

So, it comes back to the workforce and having a workforce that understands the complexity. This is complex systems that we're working with. You need folks that can embrace that, think about that and approach it. Data modernization is an area that's been talked about, advancing public health law, and then very importantly, the community engagement that we talked about. So, the grassroots, but then also grass tops of public health, working with CEOs of companies, working with government leaders and so forth. This is bringing the entire system together. It's all of us that will make the change. And that's the approach that we're taking.

Claire Stinson: Well, thanks for sharing that. It sounds like we have the tools and the time is now.

Dr. Judy Monroe: The time is now.

Claire Stinson: Thanks for being a part of Contagious Conversations.

Dr. Judy Monroe: My pleasure.

Claire Stinson: Thanks for listening to Contagious Conversations, produced by the CDC Foundation and available wherever you get your podcasts. Be sure to visit cdcfoundation.org/conversations for show notes. And if you like what you just heard, please pass it along to your colleagues and friends, rate the show, leave a review and tell others—it helps us get the word out.

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