A newly-launched federal office faces a variety of challenges if it is to succeed in its goal of connecting the dots on health in interagency climate work, health and climate experts said.
With an eight-person crew and limited budget, the Health and Human Services Department’s new Office of Climate Change and Health Equity—which opened its doors on Sept. 6— will need to keep focus within a range of competing agency interests, including its own health agency of over 80,000 employees.
“Their budget must be orders of magnitude larger to appropriately meet the scale of this crisis and optimally protect health and improve equity, especially for those disproportionately impacted,” said Renee Salas, a fellow at the Harvard T.H. Chan School of Public Health’s Center for Climate, Health, and the Global Environment.
Working within a massive, complicated, and mostly private health care system will also pose a challenge, said Jessica Wolff, director of climate and health at nonprofit Healthcare Without Harm.
“Health care CEOs understand that this is a priority, but they are mired in competing priorities,” she said. “So I think one of the key pieces for this organization is to help elevate this as a priority.”
One obvious role for the new office would be to provide public health expertise to regulatory agencies such as the Environmental Protection Agency or the Department of Transportation, according to Basav Sen, climate justice project director at the Institute for Policy Studies.
For example, the office could deliver technical information to other agencies about the health impacts of heat exhaustion, inhalation of wildfire smoke, or injuries from hurricane debris, all of which could help shore up the legal justification for a new rule.
Health policy advocates applaud any help regulators can get in writing new rules.
Ankush Bansal, a fellow at the American College of Preventive Medicine, said the new office “has an important role to play in helping understand the potential benefits—or drawbacks—of an intervention as it relates to health and equity.”
Another key part of the office’s work will be to help hospitals reduce their greenhouse gas emissions and become more resilient to the impacts of the climate change. That mandate matches up with President Joe Biden’s goal of cutting domestic emissions in half by 2030.
The U.S. health sector accounts for about 8.5% of the nation’s carbon emissions, Rachel Levine, HHS’ assistant secretary for health, said at an Aug. 30 news conference announcing the launch of the office.
The Biden administration can also improve energy efficiency at the hospitals it controls, including Department of Defense, Department of Veterans Affairs, and Indian Health Service facilities. But it can only nudge private hospitals in that direction, since the federal government doesn’t require private businesses to switch to renewable energy or install energy-efficient windows and insulation.
Still, a focus on federal health care facility emissions could move the dial, Wolff said.
“When those facilities start changing, for instance, their procurement practices to look at a low carbon and resilient supply chain, that will have a ripple effect for the industry,” she said.
‘Connect the Dots’
Georges Benjamin, executive director of the American Public Health Association, said the federal government has needed an office like this for years because HHS’ action on climate and health has never been strong enough.
“Very little is being done by the rest of the department in this area,” Benjamin said. “You want to make sure you have a place in the office of the secretary that allows people to bring together all the elements that address climate change, so you don’t have Office A doing something that is uncoordinated with Office B.”
The closest parallel is a climate and health program within the Centers for Disease Control and Prevention, which mostly works to build capacity within state and local health departments for adaptation and mitigation.
Climate-related programs among different agencies with similar goals—like separate asthma guidance for the CDC and EPA—could also see a boost in cross-agency cooperation thanks to a central climate and health office.
“If you have someone coming in from the climate office, who could connect the dots there, and create better coordination, I think that’s an example of where you can create incentives, or you could have other programs that might evolve out of it,” said Kenneth Mendez, CEO of the Asthma and Allergy Foundation of America.
The office is already exploring the options that different branches of the department have for providing technical assistance or “requiring certain types of actions,” Arsenio Mataka, senior advisor for climate change and health equity at HHS, told Bloomberg Law.