[House Hearing, 116 Congress]
[From the U.S. Government Publishing Office]
CLIMATE CHANGE, PART II: THE PUBLIC HEALTH EFFECTS
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HEARING
BEFORE THE
SUBCOMMITTEE ON ENVIRONMENT
OF THE
COMMITTEE ON OVERSIGHT
AND REFORM
HOUSE OF REPRESENTATIVES
ONE HUNDRED SIXTEENTH CONGRESS
FIRST SESSION
__________
APRIL 30, 2019
__________
Serial No. 116-17
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Printed for the use of the Committee on Oversight and Reform
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U.S. GOVERNMENT PUBLISHING OFFICE
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COMMITTEE ON OVERSIGHT AND REFORM
ELIJAH E. CUMMINGS, Maryland, Chairman
Carolyn B. Maloney, New York Jim Jordan, Ohio, Ranking Minority
Eleanor Holmes Norton, District of Member
Columbia Justin Amash, Michigan
Wm. Lacy Clay, Missouri Paul A. Gosar, Arizona
Stephen F. Lynch, Massachusetts Virginia Foxx, North Carolina
Jim Cooper, Tennessee Thomas Massie, Kentucky
Gerald E. Connolly, Virginia Mark Meadows, North Carolina
Raja Krishnamoorthi, Illinois Jody B. Hice, Georgia
Jamie Raskin, Maryland Glenn Grothman, Wisconsin
Harley Rouda, California James Comer, Kentucky
Katie Hill, California Michael Cloud, Texas
Debbie Wasserman Schultz, Florida Bob Gibbs, Ohio
John P. Sarbanes, Maryland Ralph Norman, South Carolina
Peter Welch, Vermont Clay Higgins, Louisiana
Jackie Speier, California Chip Roy, Texas
Robin L. Kelly, Illinois Carol D. Miller, West Virginia
Mark DeSaulnier, California Mark E. Green, Tennessee
Brenda L. Lawrence, Michigan Kelly Armstrong, North Dakota
Stacey E. Plaskett, Virgin Islands W. Gregory Steube, Florida
Ro Khanna, California
Jimmy Gomez, California
Alexandria Ocasio-Cortez, New York
Ayanna Pressley, Massachusetts
Rashida Tlaib, Michigan
David Rapallo, Staff Director
Britteny Jenkins, Subcommittee Staff Director
Amy Stratton, Clerk
Christopher Hixon, Minority Staff Director
Contact Number: 202-225-5051
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Subcommittee on Environment
Harley Rouda, California, Chairman
Katie Hill, California James Comer, Kentucky, Ranking
Rashida Tlaib, Michigan Minority Member
Raja Krishnamoorthi, Illinois Paul Gosar, Arizona
Jackie Speier, California Bob Gibbs, Ohio
Jimmy Gomez, California Clay Higgins, Louisiana
Alexandria Ocasio-Cortez, New York Kelly Armstrong, North Dakota
C O N T E N T S
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Page
Hearing held on April 30, 2019................................... 1
Witnesses
Dr. Aaron Bernstein, Co-Director, Center for Climate, Health and
the Global Environment, T.H. Chan School of Public Health,
Harvard University
Oral statement............................................... 8
Dr. Karen DeSalvo, Professor of Medicine and Population Health,
Dell Medical School, University of Texas at Austin
Oral statement............................................... 5
Dr. Bernard D. Goldstein, Professor Emeritus, Graduate School of
Public Health, University of Pittsburgh
Oral statement............................................... 7
Dr. Cheryl L. Holder, Associate Professor, Herbert Wertheim
College of Medicine, Florida International University
Oral statement............................................... 11
Dr. Caleb Rossiter, Executive Director, CO2 Coalition
Oral statement............................................... 13
* The prepared statements for the above witnesses are available
on the U.S. House of Representatives Repository at: https://
docs.house.gov.
INDEX OF DOCUMENTS
----------
The documents entered into the public record during this hearing
are listed below, and are available at: https://docs.house.gov.
* "Hurricane Maria's Legacy: Thousands of Puerto Rican students
show PTSD symptoms," pbs.org; submitted by Ms. Ocasio-Cortez
* Testimony of Dr. James Servino; submitted by Ms. Ocasio-
Cortez
* Testimony of Dr. Daniel L. Costa, U.S. Environmental
Protection Agency, retired; submitted by Mr. Rouda
* Statement from Ellen Atkin from Colorado; submitted by Mr.
Rouda
CLIMATE CHANGE, PART II: THE PUBLIC HEALTH EFFECTS
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Tuesday, April 30, 2019
House of Representatives,
Subcommittee on Environment,
Committee on Oversight and Reform,
Washington, D.C.
The subcommittee met, pursuant to notice, at 2:17 p.m., in
room 2154, Rayburn House Office Building, Hon. Harley Rouda
(chairman of the subcommittee) presiding.
Present: Representatives Rouda, Hill, Tlaib,
Krishnamoorthi, Gomez, Ocasio-Cortez, Comer, Gibbs, and
Higgins.
Mr. Rouda. The subcommittee will come to order. Without
objection, the chair is authorized to declare a recess of the
committee at any time. This subcommittee is convened, the
second in a series of hearings on climate change to consider
the public health effects.
I now recognize myself for five minutes to give an opening
statement.
Good afternoon. This hearing, as I mentioned, is the second
of a series of hearings on climate change that the Committee on
Oversight and Reform Subcommittee on Environmental plans to
hold during the 116th Congress.
In this subcommittee's previous hearing, our esteemed
witnesses helped us examine the history of a consensus
surrounding climate change based on overwhelming scientific
evidence, previous industry knowledge and action, and the need
to transcend partisan politics to address this most important
issue.
That hearing focused on the past. Today we will concentrate
on the current impacts that global warming is already having on
the health of everyday Americans.
According to the National Aeronautics and Space
Administration and the National Oceanic and Atmospheric
Administration, 18 of the 19 warmest years on record have
occurred since 2001, with predictions that 2019 will join this
list.
Cities throughout the United States are suffering from
increased ground level ozone caused by increasing temperatures
and continued high levels of particle pollution, which have
been linked to activities such as the burning of fossil fuels
and wildfires.
Last week, the American Lung Association released its 20th
annual State of the Air report. According to this year's
report, more than 141 million Americans--or, put in other
words, four out of 10 of us--live in counties with unhealthy
levels of ozone and/or particle pollution. This is an over 7
million person jump since last year's report.
Excessive heat drives the formation of the dangerous smog
and soot referenced in the report and exacerbates the
conditions like asthma, lung cancer, cardiovascular diseases,
and, in some cases, leads to death.
Among the report's list of U.S. cities where breathing air
is most dangerous to human health, my home state of California
dominates the list. In the wake of recent wildfires, my fellow
Californians have faced air pollution levels that exceed those
in cities in China and India.
And it is not just about California. In the last 11 years,
nearly 80 million acres have been consumed by wildfire. This is
an area greater than the state of North Carolina. States
including Montana, Kansas, Oklahoma, Washington, Arizona,
Colorado, Nevada, New Mexico, South Carolina, and Utah have all
faced extremely destructive wildfires in recent years.
I'm concerned that if we do not act now our children and
grandchildren will be forced to grapple with toxic air quality
far worse than what we are exposed to now.
Global warming also significantly alters the geographic
range of disease-carrying insects and pests, therefore exposing
an increasing number of people globally and within the United
States to vector-borne diseases, including Zika virus, malaria,
Lyme disease, and others.
It's also extremely important to note that the burden of
these impacts is not evenly shared. According to the University
of California study from 2009, climate change does not affect
everyone equally. People of color and the poor are most at
risk. Low income urban neighborhoods, communities of color, and
the elderly are particularly vulnerable to increased frequency
of high temperatures and heat waves. Buildings in urban areas
absorb and poorly dissipate the heat, adequate air conditioning
is expensive, and access to transportation to facilitate
movement to cooler areas is lacking.
Other vulnerable populations, such as children, seniors,
and women, are also already facing and will continue to face
the negative brunt of continued inaction.
Instead of acting in the public interest to address these
serious health effects, the Trump administration's proposed
rollbacks seek to weaken and gut protections for clean air and
clean water and places landmark environmental legislation
enacted to reduce air pollution in the crosshairs.
It is estimated that the Trump administration's attack on
the Obama Administration's Clean Power Plan, legally justified
under the Clean Air Act, would result in up to 1,630 additional
premature deaths and 140,000 missed school days by children by
2030.
These aren't my numbers. These are the Trump
administration's own estimates that they released alongside
their rollback proposal of this plan.
Additionally, the current administration's reopening of the
national Clean Car Standards, a determination that lacks
reasoned analysis and fails to offer reasoned explanation, has
already been met with legal challenges from a coalition of 18
state attorneys general from states including California, New
York, Illinois, Iowa, Virginia, and Maryland.
In fact, these rollbacks have even been opposed by the auto
industry. American companies like General Motors and Ford
Motors are saying the Trump administration is wrong on this.
These rollbacks are not in the public's best interest.
Instead these actions help create a world that is increasingly
less safe for all Americans.
This is not a hypothetical conversation. This is not a
false narrative. Climate change has direct and indirect effects
on human health, and these health effects are already being
felt across the United States. These effects are real now and
require action.
Today, we are joined by Dr. Aaron Bernstein, Dr. Bernard
Goldstein, Dr. Karen DeSalvo, and Dr. Cheryl Holder, who have
all spent time in their respective roles studying the impacts
of climate change on public health, the various effects that
are already being felt in communities across our country, and
they can speak to the role that the Federal Government should
play in responding to this serious set of challenges.
We also have Dr. Caleb Rossiter with us today whose
thoughts the subcommittees looks forward to hearing.
I appreciate the attention each individual on this panel
has given to this critical issue that impacts all our lives.
Thank you very much.
And I now invite my colleague, the subcommittee's ranking
member, Mr. Comer, to give a five-minute opening statement.
Mr. Comer. Thank you, Chairman Rouda, for holding this
hearing.
Thank you also to our panel of witnesses for taking time
out of your busy lives to join us for this important discussion
about public health. I know that we all agree about the
importance of promoting sound health policies for the benefit
of our constituents. I look forward to hearing from all of you
all.
The Fifth Assessment Report from the U.N.'s International
Panel on Climate Change projects with varying degrees of
confidence several climate-related health impacts over the
course of the 21st century. The extent of these impacts will
depend on how much warming eventually occurs, which remains
uncertain. But it seems clear that any health impacts will
affect poorer populations in developing countries with low
income the most.
At the same time, the U.N.'s IPCC states that, quote, ``The
most effective vulnerability reduction measures for health in
the near term are programs that implement and improve basic
public health measures, such as provision of clean water and
sanitation, secure essential healthcare, including vaccination
and child health services, increased capacity for disaster
preparedness and response, and alleviate poverty,'' unquote.
The conversation we are having today is an important one,
Mr. Chairman, because it appears that many of the solutions
proposed to address climate change, like the Green New Deal,
would have a detrimental impact on the ability of poorer
nations to develop the types of programs that the U.N. says are
most effective to address public health.
I fear that a premature move away from fossil fuels,
particularly for poorer areas and nations, means that they will
continue to have little access to the type of cheap, reliable
energy that enables economic growth and allows for the
provision of clean water and sanitation, widespread
vaccination, and preventative child health services.
As I have said before, coal mining is a way of life in many
parts of America, including my district. Kentucky coal remains
an important component of the Commonwealth's economy and
America's energy portfolio. Kentucky was the fourth highest
coal producer in the U.S. in 2016, mining 43 million tons of
coal.
In that same year, coal mines directly employed more than
6,600 Kentuckians, most of whom reside in my district, and
mining directly contributed billions of dollars to Kentucky's
economy. Both the first and second largest coal counties in
Kentucky, Union and Ohio Counties, are in my congressional
district.
Economic well-being is a leading indicator of health, the
likelihood of disease, and premature death. And so I'm
incredibly concerned about any proposal that would impact or
eliminate this economic engine from my district and the
Commonwealth of Kentucky.
My concerns are not limited to my constituents or the
United States, however. Inexpensive, accessible energy has led
to technological, medical, and other advances that have driven
the American economy and increased U.S. life expectancy.
Of course, we still have work to do to make sure that those
public health advancements are shared by all of society,
including our most vulnerable citizens, such as the elderly and
the poor. But I'm also concerned for populations in developing
Nations, those where the majority of people still do not have
electricity in their homes.
I am eager to hear from our witnesses how we determine the
right balance.
On the one hand, there is a push to promote policies to
address climate change that put obstacles in the way of access
to cheap, reliable energy.
On the other hand, we want to promote policies that expand
basic lifesaving health services, like clean water and
sanitation, to the poorest populations in the world.
Those policies are most easily and quickly achieved with
access to inexpensive fossil fuel energy that, by all accounts,
will remain significant sources of worldwide energy for many
years to come.
As I said, Mr. Chairman, these are important questions, and
I thank you again for holding this hearing and for our
witnesses being here today.
Thank you, and I yield back.
Mr. Rouda. Thank you.
Now I want to welcome our witnesses. Karen DeSalvo, M.D.,
professor of medicine and population health at the Dell Medical
School of the University of Texas at Austin. Bernard D.
Goldstein, M.D., professor emeritus, environmental and
occupational health, Graduate School of Public Health of the
University of Pittsburgh. Aaron Bernstein, M.D., co-director of
the Center for Climate, Health and the Global Environment at
the T.H. Chan School of Public Health, Harvard University.
Cheryl L. Holder, M.D., associate professor and co-chair of
Florida Clinicians for Climate Action, Herbert Wertheim College
of Medicine, Florida International University. And Caleb
Rossiter, Ph.D., executive director of the CO2 Coalition.
Please stand and raise your right hands, and I'll begin
swearing you in.
Do you swear or affirm that the testimony you are about to
give is the truth, the whole truth, and nothing but the truth,
so help you God?
Thank you. Please be seated.
Let the record show that the witnesses answered in the
affirmative.
The microphones are sensitive, so please speak directly
into them after you've turned the power on in front of you. And
without objection, your written statement will be made a part
of the record.
With that, Dr. DeSalvo, you now are recognized to give an
oral presentation of your testimony.
STATEMENT OF KAREN DESALVO, M.D., PROFESSOR OF MEDICINE AND
POPULATION HEALTH, DELL MEDICAL SCHOOL, THE UNIVERSITY OF TEXAS
AT AUSTIN
Dr. DeSalvo. Thank you, and good afternoon, Chairman Rouda
and Ranking Member Comer and distinguished members of the
subcommittee. Thank you for the opportunity to testify on the
important topic of protecting the public's health.
My message to the committee focuses on three areas to build
more resiliency in the face of extreme weather and climate
change. These efforts will strengthen our community's ability
to withstand, adapt, and recover.
First, we should strengthen our public health
infrastructure to support a shift from responding to crisis to
building capacity. Second, we should set higher expectations
for the healthcare system to support their patients and be
better stewards of resources. And third, encourage partnership
between public health and healthcare, especially in models that
leverage data and technology.
My recommendations are borne mostly from my experiences as
a doctor and a public health official in New Orleans, a place
that is no stranger to extreme weather events. I want to share
a story today not from my time in Hurricane Katrina, but rather
a more recent one, one that could happen almost any day, any
place in America from an extreme weather event.
It happened after Hurricane Isaac made landfall in 2012.
And though New Orleans had not flooded, we did have a
widespread power outage. Once the major systems like hospital
had power restored, we turned our attention to restoration for
the rest of the community. And we had heard that there were
seniors across the city struggling in the summer heat and
wanted to provide help to those most in need, particularly
those who could be electricity dependent, like those on oxygen.
In the absence of good data to drive our efforts, I had to
resort to going door to door to door, mostly in highrises that
were subsidized housing, to assess the need to inform
prioritizing power restoration based upon who we saw. It was a
heartbreaking view that I got as I went in those many
apartments of social isolation, physical isolation, food
insecurity, many challenges, particularly for the seniors that
we visited.
This inefficient process spurred us to want to have a more
proactive solution. So we worked with HHS to leverage Medicare
data to more efficiently identify community members who are
electricity dependent in an effort called emPOWER. It's now
scaled nationwide by HHS to help public health in disaster
response, like the one I described, but also to support
resiliency.
It's now nearly 14 years since Hurricane Katrina passed,
and in those years the Nation has really made remarkable
advances in our ability to respond to and recover from extreme
weather events of all kinds. The performance of the public
health and healthcare systems to extreme weather events like
Hurricane Harvey or the California wildfires highlight our
improvements but remind us that there are important areas where
we can and should do more, especially for the most vulnerable
in our community.
First, the public health infrastructure needs strengthening
to meet the rising health challenges of our Nation. In addition
to addressing epidemics like those from opioids, public health
also has an obligation to protect the public from health
challenges arising from climate change. For example, they will
need to continuously assess projected health burden from
extreme weather events.
To do their job, the public health infrastructure needs
flexible, sustainable, and enhanced funding. The annual outlay
for public health infrastructure is anticipated to be $32 a
person annually. Based on our current national investment from
Federal and local dollars, there remains a $13 per person gap
in annual spending to provide adequate public health
infrastructure to assure that all people in America have the
public health protection they should expect.
Second, healthcare systems have a responsibility to their
patients in the face of climate-related disasters, and moving
toward population-level care management and payment models will
help with that accountability, especially if these models
address all needs, including mental health.
Healthcare also has a responsibility to become more climate
adaptive and reduce the healthcare sector's carbon footprint in
keeping with recommendations from Healthcare Without Harm and
those from the National Institute for Environmental Health
Sciences. Though the private sector has been taking action, the
committee could ask CMS to strengthen the expectation of
building an adaptive and resilient healthcare infrastructure by
making it a requirement in the CMS emergency preparedness rule.
And third, strong partnerships between public health and
healthcare are essential, particularly those that strive to be
more efficient and effective by leveraging 21st century tools
like data and technology in the way that we did in the work of
emPOWER.
A great example of this is AIR Louisville, a collaboration
that used geotracker devices to follow the use of asthma
inhalers by frequency and by place. The information guided the
care plan for the healthcare system for those patients, but
also enabled public health to do targeted efforts to increase
tree coverage, to identify alternate truck routes for reducing
emissions, and to ultimately lead to improved health outcomes
and lower cost for citizens.
The CDC Climate and Health Program could be used if it were
resourced better to develop more models like emPOWER that could
be scaled across the country and implemented on the front lines
to support resiliency or like Louisville AIR.
Thank you again for raising the profile of the need to
better protect Americans from the public health impacts of
climate change and extreme weather events. I look forward to
your questions.
Mr. Rouda. Thank you, Dr. DeSalvo.
Dr. Goldstein.
STATEMENT OF BERNARD D. GOLDSTEIN, M.D., PROFESSOR EMERITUS,
ENVIRONMENTAL AND OCCUPATIONAL HEALTH, GRADUATE SCHOOL OF
PUBLIC HEALTH, UNIVERSITY OF PITTSBURGH
Dr. Goldstein. Chairman Rouda, Ranking Member Comer,
distinguished members of the committee, thank you for choosing
the highly important but often neglected issue of the public
health implications of global climate change.
We cannot expect the public to endorse significant action
based upon parts per million of carbon dioxide. A major answer
to the public's appropriate ``so what?'' question is health
impact.
In the framework of public health, primary prevention is
defined as totally avoiding the problem. Secondary prevention
is early detection and change in habits to avoid the
consequences. And tertiary prevention is lessening of the
already occurring medical problem.
It would take a textbook to describe all of the adverse
public health implications of global climate change. Let me
start with a simple undramatic effect that shows how climate
change and public health are intertwined.
Forty-eight million Americans are affected by food
poisoning yearly; 3,000 die. Food poisoning is more common in
summer, because bacteria growth is dependent upon temperature.
The higher it is, the worse it will be.
Heat itself directly causes illness and death. Air
pollution will increase. Ozone causes summertime asthma attacks
in children. Coal causes particulate pollution responsible for
cardiorespiratory disease and premature mortality. Another
source of particle is related to global climate change as far
as fires, as you said, sir.
Intensifying weather disasters include the force and reach
of hurricane winds and floods. The predicted dry conditions
with intermittent and heavy rains will result in wildfires,
droughts, floods, stress on water resources resorts, and major
impacts on agriculture.
Surprises will occur. Unexpected contamination of our corn
crop with aflatoxin, which a cause of liver cancer in topical
countries, occurred in 2012 under weather conditions that mimic
what can be expected of climate change. The cost was estimated
to be upwards of a billion dollars.
Particularly at risk are disadvantaged populations. I have
worked on improving federally Qualified Health Centers that
have treated such populations located in our areas of our
southern states affected by hurricanes and by the Deepwater
Horizon oil spill. These clinics will require more support.
What can Congress do? Bipartisan support for primary
prevention approaches has occurred in the past. The Montreal
Protocol to replace CFCs was passed unanimously by the U.S.
Senate.
Many who erroneously claim that humans are not primarily
responsible for global climate change seem to now agree that
global climate change is occurring. Or whenever its cause, it
is thoughtless not to be preventive in dealing with its
consequences, particularly as there is nothing we can do about
alleged causation by sun spots or a wobbly Earth.
A bipartisan approach occurred in the last Congress on what
is perhaps the greatest threat to public health, that of war,
and particularly in our nuclear era. An attempt to remove
funding for the global climate change program from the Defense
Authorization Act was defeated because over 40 Republicans
joined with Democrats to retain this program. Our military gets
it.
There's also bipartisan support for the rebuilding of
American infrastructure. Congress needs to consider global
climate change in this bill.
Strong bipartisan support exists for STEM education. We
need more Americans who understand science who will recognize
that having the five hottest years on record in a row is more
meaningful than the quibbles raised by climate deniers.
Importantly, global climate change is worthy of both a
comprehensive approach that includes nuclear power and
recognizes the forcing role of population growth. It also
should have a situation in which basically every congressional
act is looked at through the lens of global climate change if
it's pertinent.
For primary prevention, we need to accelerate the reduction
of greenhouse gasses, we need to do it as soon as possible, and
we need to recognize that, with only five percent of the
world's population, the United States cannot do it alone.
With all due respect, to respond to Ranking Member Comer's
important point about balance, the Paris Agreement was about
balance.
I end with a lesson from an old fable. We all know about
the three little pigs sent out to the world after being warned
about a big bad wolf. We also know what happened to the two
pigs who dallied, one building a house of straw, another a
house of twigs. The survivor was the pig who took the warning
seriously and whose foresight and hard work protected the pig's
home.
Well, that's a form of secondary prevention. But we also
need primary prevention. Before its huffing and puffing blows
our house down, we have to kill that wolf.
Thank you.
Mr. Rouda. Thank you, Doctor.
Dr. Bernstein.
STATEMENT OF AARON BERNSTEIN, M.D., CO-DIRECTOR OF THE CENTER
FOR CLIMATE, HEALTH AND THE GLOBAL ENVIRONMENT, T.H. CHAN
SCHOOL OF PUBLIC HEALTH, HARVARD UNIVERSITY
Dr. Bernstein. Chairman Rouda, Ranking Member Comer,
members of the subcommittee, I'm delighted to be here this
afternoon to speak with you about climate change and health. I
should mention at the outset that I'm a practicing pediatrician
at Boston Children's, and my primary responsibility is the care
of children.
As a doctor, I have cared for children with asthma whose
lungs have been so damaged by contaminated air that they were
scarcely able to breathe. I have sat with parents whose
children had Lyme disease as they worried about whether their
child's half-paralyzed face will ever get better. I have cared
for children who no longer had a will to live, having survived
floods that at once washed away their homes and their peace of
mind. And I have held in my own arms infants whose brains were
deformed by Zika virus whose prospects of living a healthy life
vanished before they were even born.
What ties all these experiences together, I am sorry to say
to those communities in this country who depend upon fossil
fuels, that it is our reliance on fossil fuels, which, when it
is extracted from the earth and burned, damage our children's
health through climate change and through the air and water
pollution they produce.
You as Members of Congress have a choice. You can choose to
continue to support policies such as the $20.5 billion of
taxpayer money given by Congress to the fossil fuel industry
each year that enable our current heavy and disabling reliance
on fossil fuels and allow more children to struggle to breathe,
more children to contract disabling and fear-stoking
infections, and more children to live in a world that is
increasingly unpredictable and unstable. Or you can choose to
lead, as so many cities, states, and countries have begun to
do, and create a healthier, more just, and sustainable path.
I will share facts in my testimony that demonstrate how
replacing fossil energy with cleaner sources has immediate and
local health benefits which can lessen health epidemics that
are foreclosing on our children's health and futures right now.
We are already approaching an expenditure of nearly a
trillion dollars on the three disease categories I will mention
today: asthma, obesity, and mental health disorders.
Let me begin by talking about asthma. One in 10 children in
the United States carries a diagnosis of asthma. Asthma
afflicts substantially more children who are poor or African
American. One in five children who are newly diagnosed in the
United States with asthma received that diagnosis because they
breathed air that has been polluted by fossil fuels.
Burning gasoline and other fossil fuels, as you've heard
from Dr. Goldstein, produces the building blocks of ozone air
pollution or smog. For an athlete, breathing ozone is the
difference between victory and defeat. For a child with asthma,
it can be the difference between life and death.
Climate change has already made asthma more burdensome as
higher temperatures spur ozone formation. Dealing with asthma
costs the U.S. economy more than $80 billion each year.
Next, let's turn to obesity. One in five school-aged
children in the United States are obese. Childhood obesity
undermines health across the life span, making diabetes, bone
diseases, heart disease, mental health disorders, and asthma,
among others, all more likely.
The obesity epidemic in the United States is so extreme
that this generation, this current generation of children that
we all know, may be the first in our Nation's history to live
shorter lives than their parents.
And the expense of obesity to the U.S. economy and
healthcare sector is staggering. At a cost of $190 billion a
year, obesity alone saps one percent of GDP.
The good news is that when we choose to address climate
change, we will also combat obesity. First, some of the same
fossil fuel air pollutants that trigger asthma also influence
obesity risk. Second, providing safe and accessible means for
people to walk, bike, and use mass transit will help turn the
tide on obesity. And third, eating diets rich in plant-based
foods and with less red meat can prevent obesity and the
diseases that accompany it.
And last, let us consider what is at stake for our
children's minds. One in six children age 2 to 10 have a
mental, behavioral, or developmental disorder such as autism or
ADHD. One in five adolescents will be diagnosed with a serious
mental illness. Since 2009, the number of adolescents and young
adults with depression and suicidality has increased by more
than 50 percent.
We can protect the developing brains of children and lessen
the stresses of adolescence through our actions on climate.
Particle matter, mercury, nitrogen dioxide, and poly aromatic
hydrocarbons, all released when fossil fuels are burned,
contribute to these conditions.
Some $200 billion per year is lost to our economy dealing
with mental health disorders in youth in this country, among
them neurodevelopment disorders. More than $150 billion are
spent on dealing with ADHD itself.
We can do something about this. Planting trees and other
vegetation can reduce urban heat, buffer air pollutants that
contribute to neurodevelopmental and mental health disorders,
and evidence increasingly shows directly prevent mental illness
itself.
Some believe that climate action is too expensive.
Considering the evidence that you've just heard regarding just
a handful of diagnoses, as well as many studies that evaluated
near term and localized health benefits of climate action for
individual states and for our Nation, you now understand such
arguments couldn't be further from the truth.
When the health value of climate actions are taken into
account, time and again the benefits far outweigh the cost of
transition.
This holds true, and perhaps especially so, in communities
that were built on the fossil fuel industry. So I cannot
underscore enough that any plan to decarbonize must plan for
the welfare of the families and children in these communities
where poverty is already too common and opportunity too scarce.
We must not leave anyone behind.
In the end, as we come to realize the toll that climate
change and the use of fossil fuel exacts on the health of our
children today and how climate action can make them healthier
today, and as we realize that we must choose to act on climate
change to protect their world so that they and their children
can continue to enjoy it as we have, as we realize that we
cannot afford the health cost of inaction, our children are
counting on you to do what's right. It's their lives and their
futures that are at stake.
Thank you.
Mr. Rouda. Thank you, Dr. Bernstein.
Dr. Holder.
STATEMENT OF CHERYL L. HOLDER, M.D., ASSOCIATE PROFESSOR AND
CO-CHAIR OF FLORIDA CLINICIANS FOR CLIMATE ACTION, HERBERT
WERTHEIM COLLEGE OF MEDICINE, FLORIDA INTERNATIONAL UNIVERSITY
Dr. Holder. Representative Rouda and other esteemed Members
of Congress, I'm grateful for your invitation to testify this
afternoon.
In the spring of 1980, I submitted my senior thesis to
graduate from Princeton University, and I wrote about the
importance of psychological factors in identifying the root
causes of hypertension. In my research, I found that external
circumstances, like poor living conditions, lack of control
over life choices, exacerbated hypertension. One of the major
takeaways from the research was that we cannot deny the impact
of outside world on a person's health.
On another spring day today, a beautiful day, 39 years
later, I sit before you all to explain why this remains the
same. I arrived in Miami-Dade County in 1987, a National Health
Service Corps Scholar, to serve the city's underserved
population. I cared for its citizens as a physician primarily
in all the publicly funded health centers across the county,
from Opa-locka in the north, Liberty City in the center, to
Homestead in the South.
Most of my patients were low income, underserved, Black or
Hispanic. And as we know, for many reasons poor people are,
better or worse, we could say they're the proverbial canary in
the coal mine. In the early 1980's, we saw the increases in
HIV, and by the end of the decade we were in the midst of a
national emergency.
The pattern is repeated with substance abuse, obesity,
early mortality for middle-aged men, and other health issues.
We saw all this before in our poorer communities.
Today, I'm an associate professor, Department of Humanity,
Health and Society at the Florida International University,
Herbert Wertheim College of Medicine, a fellow of the American
College of Physicians, and in 30 years of practice I still
mainly treat people without insurance. And even now, again, we
are seeing the same mistakes that caused millions to die
before.
Twenty of the warmest years in recorded history have
occurred in the last century, with the most recent five years
being the hottest.
I want to share a story with you that I hope will make real
what life is like for a family with small children trying to
survive in multiple consecutive 100-degree days in homes with
two rooms, one window, and no air conditioner.
My university, we do a home visit program we call Green
Family Foundation NeighborhoodHELP, and with medical students
and nursing students we went into this home in Little Haiti. It
was June 2016. It was hot. When I opened the car door, I felt
like the lifting of the lid on a grill when you were grilling
some food and it was just left too long.
My students were so excited to meet the family, and she met
us at the door wearing a lovely white tee-shirt, her hair
pulled back. She was so proud to invite us in her very tidy,
slate blue home.
We stepped in the front door, and instead of a couch,
there's a double bed with a toddler sleeping quietly. She
directed us to some chairs that were set out at the foot of the
end of the bed but not quite in the kitchen. And this is where
we would do our visit.
As we settled in, we found ourselves sort of breathing a
little bit uncomfortable because the humidity and the hot air
was a little bit hard to inhale. But the discomfort was short
lived because we wanted to face and talk with her and her
family. But we felt the sweat in our shirts, we felt the sweat
dropping, the ink had dropped on the page because we were just
sweating.
Despite our efforts, without AC, we could not hide our
discomfort. She humbly got up and moved the fan from the baby
and pointed toward us and offered us water. We said absolutely,
no. We took the water, but leave the fan on the baby. We
understood what was happening.
But luckily, another child brought us a fan from the
bedroom, and we got some relief. We said nothing of the heat,
and we continued to visit and wrapped up in about 30 minutes.
We thanked her for hosting us, grateful to be leaving, but sad
because we understand that they could not.
Heat affects mood, increases risk of dehydration, heart
attacks. And you've heard my colleagues talk about all the
different illnesses, and we all know it. People who lack air
conditioning or spend time outdoors, like farm, construction
workers, student athletes, are more exposed and at greater
risk.
I have a 70-year-old woman who came to me with COPD because
she could hardly breathe at night, and she was using her air
conditioning and couldn't afford to pay the bill. And the
allergy season had prolonged, and she couldn't buy her asthma
medicines regularly, and she needed help. So she asked me to
sign a form so she could get a break from her electric bill.
We've heard the statistics on asthma. Florida has over 2
million, and one in nine African American kids have asthma. My
typical patients, African American, impacted proportionally
from this.
The emotional toll is tremendous. My mom, who I treat who
has Zika, is worried every day about the baby she delivered.
And every time I see her, I remind that the baby is going to be
fine, and we were going to make this, and she's going to be
okay.
In 2016, I stayed silent. But now we are working together.
George Mason University and the National Medical Association
have evaluated physicians, and 88 percent of the doctors, the
Black physicians, noted that we were seeing the impact of
climate in our patients.
Last year, the Florida State Medical Association and George
Mason came together to start the Florida Coalition for Climate
Action. We want to increase the health literacy of our
physicians. We want to help prepare our patients to adapt to
the changing environment. We want this message to be taken
across the elementary schools, the colleges, the medical
schools, increase that curriculum and increase that knowledge.
Our patients want more. Our patients want what the richer
patients have. They have clean air and good standard of living.
How can we guarantee the same for our poor people? Why do they
have to sacrifice for better lives by having worse health?
I'm grateful to you for me to bring these stories from the
front lines of our Nation's capital. I hope you'll make the
right choice this time to take action to make our communities,
our cities, and our country healthful places to live, to raise
our families for many generations to come.
Thank you.
Mr. Rouda. Thank you, Dr. Holder.
Dr. Rossiter.
STATEMENT OF CALEB S. ROSSITER, PH.D., EXECUTIVE DIRECTOR, CO2
COALITION
Mr. Rossiter. I have a slide show.
Thank you, Chairman Rouda and Ranking Member Comer. As a
former congressional staffer, I'm honored to testify today.
I'm a climate statistician and the executive director of
the CO2 Coalition of 46 climate scientists and energy
economists. I ask that our recent white paper on this topic,
``Climate Change and Health,'' and my full testimony be taken
for the record.
Mr. Rouda. So moved.
Mr. Rossiter. We save the people of the planet from people
who think they're saving the planet from an always predicted
but never realized climate catastrophe. A 1999 U.N. report
predicted, and I quote, ``Entire nations could be wiped off the
face of the Earth in 12 years.'' Sound familiar?
So far, CO2 emissions have had a positive and modest impact
on Americans' health. Crop productivity is up by 15 to 30
percent because CO2 is a plant food. Weather mortality is down
because CO2 is a warming gas and many more people die from cold
snaps than increased heat. And the fracking revolution has
saved many lives by making home heating cheaper.
But it's in Africa that fossil-fueled electricity is truly
a matter of life and death. Only 25 percent of African homes
has electricity. That explains much of why life expectancy in
Africa is 20 years lower than the rest of the world.
If we could have the next slide.
As a statistics professor, I taught my students to beware
of two Latin enemies of the truth: ad hominem, which is arguing
about someone's credentials and paycheck rather than their data
and analysis; and post hoc ergo propter hoc, which is claiming
that correlation between two variables is causation.
Consider this Preston curve of life expectancy in a country
as a function of its wealth or GDP per capita. Now, life is not
bivariate. Many variables affect an outcome. But, of course, we
human beings can only digest images in two dimensions.
So we often use graphs like these which imply a strong
causal relationship but only when we're confident that removing
the effect of other important variables would not change it.
This is one of those cases, this is one of the strongest
findings in public health and social science: Being wealthy
saves lives. You see that if Africa can move from all those
dots at the sub-$1,000 per capita level just up to the $2,000
per capita level, millions of lives will be saved.
Reliable energy, reliable electricity, in turn, plays a
huge role in getting wealthy and being healthy. Reliable energy
means that Africans don't have to cook in heat with wood and
animal dung dramatically, reducing lung and heart disease. It
means that water can be purified for safe drinking,
dramatically reducing the largest cause of infant mortality.
Next slide, please.
This is a typical rural African dwelling.
Next slide, please.
Inside it, people cook in heat with fuels that rob them of
years of their lives.
Next slide, please.
This is the million-strong Cape Flats in South Africa.
Under apartheid, this was dark. This is the great achievement
of free South Africa, universal electricity and, as a result,
clean water for all.
A grid of fossil-fueled electricity would not only
eliminate deadly indoor air pollution, it would also end deadly
outdoor pollution from the dieselization of Africa. Factories,
hotels, offices, and wealthy homes fire up their generators
when the daily brownouts and blackouts hit. Mr. Chairman, you
wouldn't want to be within a mile of a diesel generator in
Lagos, yet no square mile is without one.
But, of course, for all the benefits to wealth and health,
what if fossil fuels and their carbon dioxide emissions really
have led to climate catastrophe.
Now, science is the testing of hypotheses with data. The
data are what country singer Porter Wagoner used to call the
cold hard facts of life. Using only the IPCC's words and data,
Professors Roger Pielke and Judith Curry prepared these coming
slides showing the extreme weather and rate of sea level rise
have not registered any statistically significant change during
the recent period of warming that was partially induced by CO2.
Here are the cold hard facts of life from the IPCC. Rate of
sea level rise, it says on there, no increase from when natural
warming was the driver in the first half of the 20th century.
Drought, no increase from that time.
Next slide, please.
Floods, no increase.
Next slide, please.
No trends in cyclones or hurricanes in North America.
So climate catastrophe may happen, and we need to maintain
vigilant scientific inquiry, but it hasn't happened yet.
Last slide, please.
The IPCC, as the ranking member has said, says with, quote,
``very high confidence'' that the best ways to save lives are
provide clean water, sanitation, vaccinate children, prepare
for extreme weather, and help people get out of poverty.
We agree with the IPCC. We are part of that scientific
consensus. But those solutions today are not possible without
cheap, reliable energy.
At the moment, only fossil fuels can grow the food, drive
the cars, dig the minerals, build the products, boost the
economy, and provide preventive and care health for the sick,
and that's good.
Thank you, Mr. Chairman.
Mr. Rouda. Thank you.
I now recognize myself for five minutes of questions. And
I'd like to start out with, again, thanking all the witnesses
for coming today.
The goal of this hearing was to--we've got multiple phases.
The first phase was the what we knew about climate change, when
we knew it, and why we didn't do much about it, which we had
that hearing a couple weeks ago.
The hearings we're having now in this phase, the present
situation, is to address the human toll and the economic toll
of climate change in the present. And many of you provided
obvious statistics showing that there's a clear relevance into
what we're seeing climate change's impact on the human toll.
And I'd like to start out with Dr. DeSalvo, because in
California, in 2006, my home state had a 14-day heat wave where
we saw about 36 million people directly affected, 16,000
emergency room visits, 152,000 outpatient visits, $5.4 billion
in damage, and that was over 10 years ago.
So as we see this increase in wildfires, as we see
increased abnormal storm patterns across the globe, do you see
the impact of the cost, the embedded cost in healthcare
continuing to increase?
Dr. DeSalvo. I think, first of all, you raise a really
important point, which is that the impacts of extreme weather
events fall in many corners, not just on those that are trying
to respond on the front line to the individuals, but there are
actual costs associated with it in the healthcare system.
And the folks that are largely impacted by things like heat
or wildfires are those who already have a lot of chronic
conditions or are predisposed to needing medical care or are
older seniors and have more challenges, and so the cost drivers
there are likely to be higher anyway. So somebody with--a
senior with heart failure and emphysema that needs to go to the
emergency room because of the air quality from a wildfire is
going to have additional added cost.
I think that anecdotally that's certainly been my
experience as a doctor and in public health, that when there
are events people who are sicker end up in the hospital. That's
just sort of logical.
I think what we're going to need to learn in a more
quantitative fashion as a country is what is the cost of the
changing--of extreme weather events, of climate change, and how
will that be impacting the healthcare budget that we have as a
country, especially since a lot of it will fall on the public
budget, Medicare and Medicaid.
And I think one thing the committee could do is work to get
a shared set of facts that we would all understand and know
about what the annual cost is of people presenting into the
healthcare system because of events like wildfires.
Mr. Rouda. And if you don't assume the incredibly small
percentage of scientists out there who don't believe climate
change is actually being caused by humankind and that if we
focus just on the healthcare, Dr. Bernstein, just the fact if
we had cleaner air, cleaner water due to using renewables
versus fossil fuel, there is a clear impact, correct, in the
cost of healthcare?
Dr. Bernstein. Yes. I mean, we spend, as I alluded to in my
testimony, hundreds of billions of dollars related to natural
disasters.
I would like to set the record straight about Mr.
Rossiter's testimony. As a physician, I have to look at all the
facts and what Mr. Rossiter told you were some of the facts.
In his testimony, he did not mention heat waves. There's a
very clear signal, which is robustly supported by IPCC with
very high confidence, our own national climate assessment that
heat waves are more common already because of climate change.
He also did not tell you that the best available science,
which is recently published in the Proceedings of the National
Academy of Sciences this past month, that research at Stanford
shows that warming to date over the last 50 years, which is
mostly because of emissions from the United States, has
resulted in an economic loss to GDP of 24 to 27 percent of the
world's poorest countries.
It's also true that 400,000 children in Africa die every
year because of air pollution from burning both indoor fuels
and outdoor fuels.
And I could go on, but I just want to be clear that what
you heard does not reflect the full truth as regards to what
science understands.
I might also add, with hurricanes, Hurricane Harvey, the
best available science shows that climate change, the warming
that has occurred already, increased the rainfall on Texas by
20 percent. And I could go on.
But there's absolutely clear evidence that climate change
is influencing these disasters. I agree with him that it is not
clear with droughts. Wildfires, I should add, there's
compelling evidence that wildfire risk in places like
California and the West has gone up by as much as 50 percent
because of warming to date.
So the science on these issues is out there, folks. You
have to look for it and recognize that not everyone may be
giving all the facts.
Mr. Rouda. Thank you.
Dr. Holder. Could I comment also?
Mr. Rouda. Yes, please.
Dr. Holder. On the increase in the CO2, and he talks about
increasing production, it does impact the trees, and that's
where I see it. Because the allergy season is longer, the trees
are flowering more. We're having more vibrant flowering of all
trees, which then creates more asthma and more allergies. And
then that causes a tremendous increase in cost, because that
triggers all your allergic reactions and your asthma.
So directly the cost. And you can look at who gets asthma
more in one country, in this country: Black folks who live more
in polluted environments resulting from the fossil fuels. So
the cost is already being borne by populations significantly.
But CO2 increase is increasing our flowering and worsening
our allergies.
Mr. Rouda. Thank you.
The chair now recognizes the ranking member, Mr. Comer, for
five minutes.
Mr. Comer. Yes. Thank you, Mr. Chairman.
Dr. Rossiter, what are the best steps we could take right
now to improve public health in poorer nations? Wouldn't you
say that clean water and sanitation as well as increased
capacity for disaster preparedness and response are essential
elements to be addressed when seeking to improve a nation's
public health?
Mr. Rossiter. I would say there are two major ways to
increase life expectancy in Africa dramatically. That's the
same as saying there's two major ways to reduce infant
mortality dramatically. The chart that I showed you is life
expectancy. If you saw a chart for infant mortality, it would
just be reversed, meaning poor countries have very high infant
mortality.
A typical African country is losing 80 children out of
1,000 before the first two years of life. The United States, we
lose maybe 8 to 10. And then Sweden, it might be five, and you
don't get much lower than that.
So I would say there are two major ways. One obviously is
economic, and one is government action.
On the economic front, what's happened to China in the last
30 years clearly shows that the real driver of life expectancy
is economic growth. China has engaged in a massive experiment
using fossil fuels to boost its economy. They've moved to
become a developed country from an underdeveloped country, and
the life expectancy, on average, according to the World Bank,
has gone from 55, like Africa is today, to 75.
So that's simply wealth, for two reasons. It gives you
money to take care of your own family, to make your house air
conditioned, to make your house safe to go take your children
to the doctor. But it also gives your government more money to
do things like infrastructure that can clean the water. So
that's the second major thing I would say.
But the public sector, as we know, has a huge role to play
in the United States. Malaria was eliminated in large part
because of public health investments in the early 20th century
trying to go for the sources of the mosquitos.
You have to have government action as well as private
action. But, again, government action takes money. And
governments need to have the funds from economic growth, the
tax base.
In a sense, you know, South Africa, where I've been a
professor and have worked much of my--much of my professional
interest has been on South Africa, they made a deal at the end
of apartheid, which is the whites got to keep the economy and
the majority got to keep the government.
So the economy continued to grow and the tax revenues were
provided to the government, and that's why you see nearly
universal electricity and clean water, which is very rare in
Africa, and it has tremendous impact on infant mortality.
So both economic growth and sound government health
investment is how you get your dramatic reductions.
Mr. Comer. I want to ask you a question about coal, because
a lot of the people that are leading the movement here with
various different climate change proposals are very anti-coal.
They always cite coal as a dead or dying industry.
In my district, we just opened a new coal mine this week.
So on my Facebook site, the news article about it, really, now,
this new coal company, the biggest payroll, best average wage
in this rural county. I mean, it's a viable industry that's
attacked daily by many on the other side of this issue.
My question to you is, can you explain the role that coal
would play in helping more Americans escape poverty and
maintain a higher state of health and well-being?
Mr. Rossiter. Well, you're going to think I'm advertising
for the natural gas industry, but let's have this discussion.
Obviously, inexpensive energy saves lives. You had
testimony a few weeks ago from the gentleman from the Heritage
Foundation, I think Mr. Loris, in this subcommittee about a
U.S. Government study finding that simply from fracking, the
price of natural gas for home heating came down so much that
they estimate 11,000 lives saved a year in the United States
since 2010.
Obviously, coal is implicated. If coal is almost as cheap
as that, then people are able to heat their homes because of
electricity from coal. It's a major plus. The cost of energy in
America causes people to reduce on cold.
Now, when we talk about heat waves and cold snaps,
remember, about 20 to one is the margin in our study--in our
review of studies--why cold is more dangerous to public health
than heat, because the effects of cold cause many respiratory
illnesses, heart illnesses, that then extend for many weeks
after the cold snap. Whereas with the heat waves, yes, they're
dangerous if people don't have air conditioning and water. And
as was mentioned earlier, we've gotten much better at
responding both in Europe and the United States to heat waves.
So you want to keep people from getting cold in the winter
and feeling like they can't afford to turn on the heat. That's
a big killer.
Mr. Comer. Thank you. I yield back.
Mr. Rouda. The chair recognizes Ms. Hill.
Ms. Hill. Thank you so much.
I have a few questions.
The first is that, you know, I want to point out that we've
talked a lot about the vulnerable populations that are
impacted, but I'm particularly concerned about the elderly.
Dr. Holder, can you talk about your experience in treating
elderly patients? You state that during the hottest days the
elderly suffer the most. Can you provide some details?
Dr. Holder. What happens, the physiology, it's very
difficult to regulate temperature, the extremity. And the
pediatrician will know children and elderly do not regulate
their body temperatures as easily.
So our old population may not sense the temperature change.
They may not respond properly by drinking and do not have the
response to thirst, so they won't drink as much as they should.
And they then will stay indoors, because they often do not have
the mobility and the support to go outside and get cooling or
go to a safe place. So they're much more vulnerable.
In inner cities, big cities, and in south Florida, we see
that problem with our elderly, just dehydration, heat
exhaustion, and in the worst situations, we often end up with
heat strokes and admissions and death.
But in my population, why I try to tell that we don't want
to wait for the end and the catastrophe and the heat strokes.
We want to have awareness earlier. Like when my patient came in
with her bill asking simply just to get a waiver of her
electric bill, because she couldn't pay the bills, that was a
beginning sign that she was having problems handling the
response to the heat that she needed to do. And why should she
be the one to have to go all the way to death, the emergency
room and eventual death, in response to this. We know it's
happening.
Ms. Hill. Thank you.
Dr. DeSalvo, in districts like mine fast-growing brush
fires are a reality we face far too often. In fact, just last
year I was forced to evacuate my home in Agua Dulce in Los
Angeles County as houses and acres of ranchland burned nearby.
So I'm familiar with the dangerous air quality that results
from these fires.
I'm also concerned about that impact on the elderly. And
I'm wondering if you could briefly describe the health risks of
the elderly population during a wildfire season.
Dr. DeSalvo. Yes, I think some of the really concerning
outcomes of those wildfires included some seniors that were
just unable to evacuate because they had mobility issues. They
didn't have transportation. They had hearing impairments. They
didn't know about the event coming. There's a whole list of
reasons why they're at higher risk.
And there was increased mortality not only in those
wildfires of seniors, but also in storms like Hurricane Harvey,
Hurricane Katrina. We see that as a really recurring theme
because they have physical and social challenges that prevent
them from being connected and being able to access resources.
But I'd love to just highlight this one really important
point, which is, absolutely in the crisis of disaster they are
at higher risk. They are also at risk every day. And there are
just even minor things that we should be doing to really
support resiliency. We do want to be there for them in
disaster, but I would love to see us lean forward more to build
their capacity and make sure they're connected to resources and
people so that they can be stronger if an event does occur.
Ms. Hill. Great.
And many--this is to several of you--many older adults
depend on Medicare for their medical needs once they're
eligible. Based on the testimony we've heard today, it sounds
like there could be additional need for medical care for the
elderly as temperatures get warmer.
Dr. DeSalvo, Goldstein, and Holder, would you agree?
Dr. Holder. Absolutely. Unfortunately, we don't want to
spend the dollars that way, but we do have to be prepared.
Ms. Hill. And would you also--I guess, yes, Dr. DeSalvo and
Dr. Goldstein?
Dr. Goldstein. I agree.
Dr. DeSalvo. Yes. I think for the physiologic reasons that
you heard, they're just more prone to having medical problems
when there's heat or cold.
Ms. Hill. Do you agree that it's imperative for more
research to be done to determine the exact cost that taxpayers
would need to pay if we do not act to mitigate the effects of
climate change?
I guess raise your hands if you agree. Perfect.
Dr. DeSalvo. Yes. I mean, having a shared set of facts
would be wonderful, and then we would know the scale or
challenge that we're dealing with, and we'd know if we're
appropriately applying those resources.
Ms. Hill. Great.
And just really quickly. Dr. Rossiter, can you confirm that
you have board members Roger Cohen, Craig Idso, and William
O'Keefe on your board?
Mr. Rossiter. No, I can't. Read me the names again.
Ms. Hill. Roger Cohen, Craig Idso, William O'Keefe.
Mr. Rossiter. On my board? No.
Ms. Hill. They're not on your board?
Mr. Rossiter. No, ma'am.
Ms. Hill. Okay. Well, previously they were on your board.
And one was the former ExxonMobil manager of strategic plans,
the former director at Peabody Energy, and a former lobbyist
for ExxonMobil and former CEO of American Petroleum Institute.
Mr. Rossiter. I think that's probably accurate.
Ms. Hill. Okay. So just clarifying that the fossil fuel
industry is directly funding your nonprofit.
Mr. Rossiter. That is false and an ad hominem attack and
has nothing to do with the data at issue here.
But, no, there is absolutely no funding for our
organization and never has been from any fossil fuel industry.
And do you know why? They have stopped giving money for science
research about six years ago because of the sort of public
relations cost of doing so. So they cannot do that now. They're
beyond petroleum.
Ms. Hill. But the members of the board, members of the
board have direct ties to the industry?
Mr. Rossiter. No. But it would be fine if they did. I mean,
I have 46 climate scientists, energy economists, who have a
variety of backgrounds.
Mr. Rouda. Thank you.
Mr. Rouda. Representative Hill, thank you.
The chair now recognizes Representative Gibbs from my home
state, Ohio.
Mr. Gibbs. Thank you. Thank you, Mr. Chairman.
I think it is sad, this attack on the fossil fuel industry
that brings us the lowest cost of energy, plenty of supply. And
we see in this country a decrease in our carbon emissions in
the last 10 to 15 years mainly because of natural gas. And we
see an increase in China and India and other places around the
world.
Dr. Bernstein, I was taken aback a little bit when you were
talking about asthma in our children. I was thinking, going
back prior to all this climate change talk, prior to 1970, our
pollutants, I think they still are our main pollutants,
particulate matter, sulphur dioxide, nitrogen dioxide, carbon
monoxide, and lead and ozone.
Can you kind of reflect a little bit what you thought the
asthma rates were--I guess per capita--based prior to 1970?
Because you really, in your testimony, you really blamed a lot
of the asthma on CO2 emissions.
Dr. Bernstein. Let me be clear that the best science shows
that one in five children today in the United States are
getting diagnosed because of exposure to emissions from fossil
fuel. The data we have on asthma rates from the 1970's are not
reliable because different standards were used to diagnose
asthma.
The diagnosis of asthma is not like a diagnosis of cancer.
It requires subjective assessments of children and often can be
conflated with other diseases. In fact, there is a
discontinuity in our own national government data from--I don't
remember exactly where the cutoff is--but the diagnostic
criteria were reassessed and a new definition was made.
The important point I think here is children have asthma in
this country, 1 in 10 children; substantially more in Black
children and poor children. And we know without question that
when they breathe exhaust from cars or gas that's burned or
fumes from coal, even though I'm the first to say that our
Nation's air quality in general is doing much better than it's
done, they are going to suffer more and it's disproportionate.
Children who live closer to roads have higher rates of asthma
for sure and other----
Mr. Gibbs. But you would concur, I think, all the
innovation and all the technology change we have been making
has been helpful. I mean, the scrubbers, the catalytic
converters, and all the things we have done to help protect the
environment have been helpful. Will you concur to that or not?
Dr. Bernstein. I'm sorry, helpful for?
Mr. Gibbs. American innovation has been helpful, our
technology has been helpful to drive down, even though we still
have got 1 out of 10 children maybe with asthma.
Dr. Bernstein. That's twice as many as did when I was born.
Mr. Gibbs. Well, you just said me you couldn't tell me what
it was.
Dr. Bernstein. I wasn't born that long ago.
Mr. Gibbs. Okay. I'll have to think about that one. I mean,
I said prior to 1970.
Dr. Bernstein. Mr. Gibbs, I--Congressman, I completely
agree with you that greenhouse gases are going down, and they
are going down in large part because of the gases coming out of
Ohio.
At the same time in Ohio, you have the sixth-worst infant
mortality rate in country. You are the sixth-most obese state
among children 10 to 17. Five percent of pre-term births in the
state of Ohio are from particulate solution from coal-fired
power plants. That's one of the highest attributable fractions
of pre-term births from fossil fuels in the country.
If Ohio takes action to further reduce emissions, you will
benefit the most. But the poorest people in Ohio will benefit.
Mr. Gibbs. Okay. Thank you.
Dr. Rossiter, you talked about change and improvements,
everybody has electricity versus trying to generate their own,
trying to burn their own fossil fuel, wood or whatever.
There's been talk about climate change having a direct
impact in the frequency and scale of natural disasters. Do you
believe that climate change is affecting the nature and size of
the natural disasters? And maybe you can talk more in decades
than just a small period of time.
Mr. Rossiter. Yes. If you could put up for me, please,
slide 13.
Now, this is the temperature record by our government for
the last 120 years or so. The black line is CO2 concentration,
and this is why the IPCC says only that when you get to the red
area, where temperature's gone up in the last 50 years, that
they are comfortable and confident that at least half of that
half-degree warming comes from CO2.
Prior to that, the whole bluish area, the big one there,
the big growth of half a degree in the first half of the 20th
century is not due to CO2. There was insufficient CO2 to have
the warming effect. Physicists agree on that. So we're talking
about between a quarter and a half of the 1 degree came from
carbon dioxide.
The health effects of that obviously have to be shared in
the same way. Global temperature was coming up hard from the
19th century because of the end of the Little Ice Age before
there was the carbon dioxide effect. And so these things we're
saying about number of hot days and heat waves, a lot of this
would be the same and was the same in the 1920's before we got
to today, 100 years ago, because the Earth was warming
naturally. So it is always hard to take out the other effect.
But in answer to your question, when you count by decade,
that was the data that I was showing. If you look at slide 22--
I can finish up quickly with this, Mr. Chairman--slide 22.
This is by--no, that's not right, 22. It's got a picture of
global landfalls updated. Keep going, maybe we'll get there,
22. Yep, there we go.
This is by decade. Ignore it. Ignore it.
I happen to have a chart here of 1990 to 2016 showing no
great range. But the way--the data that I put up earlier in
red, the IPCC report, they count the hurricanes from the 1900's
by decade, because it is a chaotic event. You have to count how
many there are. Pretty easy to count. And that's the one that
showed no trends. This shows just those trends in the last 25
years. But most data should be done by decade if it's extreme
weather.
And, of course, when it gets hotter, more hot days, which
we have anyway, you have less cold days where there is
tremendous public health effect. So if you're going to count
the deaths due to heat waves, you need to count the reduced
deaths due to the fact we don't have as many very cold days.
Mr. Gibbs. Thank you, Dr. Rossiter.
I yield back.
Mr. Rouda. Thank you.
As this time, I'd like to recognize Representative Ocasio-
Cortez.
Ms. Ocasio-Cortez. Thank you very much, Mr. Chair.
Where to begin? I think, first and foremost, it's
important, as was alluded by already Dr. Bernstein, as we are
here we're sworn to tell the truth, the whole truth, and
nothing but the truth. So let's just clarify a few things. I
don't want to spend all five minutes fact-checking an actual
witness.
China is the world's leading country in electricity
production from renewable energy sources. China produces over
double the generation of renewable energy than the United
States. When we want to say things like inexpensive energy is
important, it's also important to clarify the facts, like
renewable energy and production of renewable energy is less
expensive than continued operation of certain forms of fossil
fuel, including coal.
And let's get it back to the actual subject of this
hearing, which is the impact of climate change on human health.
We are not debating whether climate change is real and we are
not debating any of those attendant effects. We are debating
and discussing here today the impacts on public health and
human health.
So, Drs. Bernstein, Goldstein, DeSalvo, and Holder, do you
all agree that climate change is currently negatively impacting
the health of Americans?
Dr. Holder. Yes.
Ms. Ocasio-Cortez. Yes.
Dr. Goldstein, according to your written testimony, the
last five years have been the hottest days on record for air
and ocean temperatures. How does such extreme heat affect the
lives of everyday Americans?
Dr. Goldstein. I think the effect is not only on everyday
Americans--for lots of reasons. I mentioned everything from
food poisoning to areas of things that we don't even consider,
such as I worked in your district as a kid growing up, driving
a truck in the Bronx before there was air conditioning. You
just couldn't get much work done on hot days.
If we talk about Africa, and we are talking about the
increased heat in a place that's already hot, it's just the
ability to do work, the enervation that's caused by heat, is
something that we have to take into account in any of these
approaches.
Ms. Ocasio-Cortez. You bring up an excellent point. I spent
a brief amount of time living in West Africa and there I had
actually contracted malaria. And I remember even really
reflecting on the economic effect of such diseases, which can
be widespread.
I've been seeing some reports here, I actually have a
report here from a scientist in my district who has been
studying the pathogenic impacts of climate change. The
potential spread of diseases and bacterial diseases. Have any
of you all heard about this potential effect from warming air
and sea temperatures?
Dr. DeSalvo?
Dr. DeSalvo. I think that's certainly one of the concerns,
is that some infectious diseases, like those that are carried
by some kinds of mosquitoes or ticks, as there are changes in
temperature, they are more able to live in new environments.
And so that would be new infections that would arise that might
be unexpected in those environments. It might be some things as
different as Zika or West Nile and some things like Lyme that
maybe others are more familiar with.
Ms. Ocasio-Cortez. So there are areas in the country--let's
say, Dr. Holder--there are areas in the country that previously
may see diseases that they've never seen before, whether
they're spread by insects or whether they're spread by
gastrointestinal bacteria infections.
Dr. Holder. Absolutely. We see the Aedes Aegypti mosquito,
which carries the Zika, Chikungunya, and Dengue. That range
would be more subtropic. You are now seeing the range of
temperature that those live and pass disease can go all the way
up to the Carolinas.
Aedes aegypti is really particularly dangerous because it
just doesn't bite at dusk and dawn. It bites all day. It lives
inside. It lives everywhere. So that's the one that we know
pass on the Zika that came into Florida last year.
So the range has changed. Lyme disease has gone all the way
up to Maine. We are seeing West Nile virus. Vector-borne
diseases will be pretty detrimental to the U.S.
Ms. Ocasio-Cortez. And, Dr. Bernstein, you mentioned the
impacts on mental health as well. And you would say that, in
the aftermath of some of these major natural disasters, the
survivors, and particularly young people, tend to see mental
health costs?
Dr. Bernstein. Yes, there have been many studies looking at
child survivors of disasters, wildfires, floods, et cetera,
that have documented persistent symptoms, particularly of post-
traumatic stress, so flashbacks and anxiety.
Ms. Ocasio-Cortez. Thank you. Mr. Chair, I'd like to submit
to the congressional Record two documents, one from PBS on the
legacy of Hurricane Maria and students in Puerto Rico who are
now exhibiting post-traumatic stress disorder symptoms; as well
as testimony from Dr. James Servino on some of the pathogenic
risk factors with climate change with respect to New York 14.
Mr. Rouda. Without objection, so moved.
Mr. Rouda. And thank you.
The chair now recognizes Representative Gomez. I'm sorry.
Oh, you just showed up. Well, I'm sorry. Representative Higgins
snuck in behind my back. Come on. It's your five minutes time,
please. Thank you.
Mr. Higgins. Because I was a police officer prior to being
a Congressman, I learned how to sneak up on people real well.
Mr. Chairman, I don't know if this happened in my absence,
but I'd like to grant Dr. Rossiter time to respond. During your
questioning, good sir, he was personally referred to by two of
our panelists, I believe respectfully so, but with some rather
pointed statements.
Dr. Rossiter, did you take notes during that time?
Mr. Rossiter. I surely did.
Mr. Higgins. Would you like to respond to those statements
at this time, if you have not been granted that time?
Mr. Rossiter. I would appreciate it.
Mr. Higgins. Please, go ahead, Doctor.
Mr. Rouda. You can use your five minutes as you see fit. So
if you'd like to proceed.
Mr. Rossiter. Yes, sir. I appreciate it, not because I felt
that they were unfair accusations. I'm very happy to be on this
panel. I want to respond because I think they're incorrect.
Our organization had two of its doctors--Jan Breslow of
Rockefeller University, Wes Allen of Australia--produced this
white paper, which was submitted to the record recently, which
was sort of a monumental study of all the health effects of
recent warming, whatever its source.
And what's interesting is that their research found that--
well, you saw floods already on a decadal basis, no more floods
or rate of sea level rise or hurricanes than there were in the
early 20th century.
But when it comes to Zika and Lyme disease, we dealt with
those in some detail here. It appears that CO2 and warming are
minor, minor problems in the spread of Zika and Lyme disease.
Lyme had to do with reforestation. Zika had to do with
international air travel. Warmth is a factor among many, many
other factors.
But when it came to asthma, there's not a word in this
report by these scientists about asthma, because they felt it
wasn't even worth responding to.
Asthma, of course, with good epidemiological studies, as
I'm sure Dr. Bernstein is referring to, it needs to look at the
reasons people report, the reasons people treat, how they're
measured. As you mentioned, it was measured different in the
1970's. It's such a complex area with so many factors that seem
to be completely unrelated to carbon dioxide.
Carbon dioxide at today's levels is about 400 parts per
million, which is four percent of one percent. If you're on a
submarine, you're probably going to get about 5,000 parts per
million as you go out for your six-month tour. Plants grow a
lot better at about 500 or 600 parts per million, as we're
about to find out. We've already gone up 15 to 30 percent
during the fossil fuel area of plant productivity just due to
that.
So in each of these areas that are mentioned the IPCC does
not come to the conclusions that the other panelists who
mentioned it have. That's why I didn't include them in my
report. I'm happy to send back to the committee what we think
about wildfires, which are, as discussed here, clearly
influenced by so many factors about load and your safety
measures and winds, which may not be related at all to
temperature.
It's extremely difficult to isolate a cause, but I think
wildfires is one. It's a terrible public health problem. The
smoke, we know, in California is a terrible problem. But
linking it to there being more carbon dioxide in the atmosphere
or a quarter of degree more temperature I just don't think has
been proved by the data yet.
Mr. Higgins. Let me ask in my remaining time--Doctor, thank
you for your response. I wanted to give you an opportunity to
address the statements from earlier.
Do you concur, do your studies concur, are there any
studies that disagree that the primary driving factor for
public health is economic prosperity?
Mr. Rossiter. I think that that Preston curve I showed you
earlier is one of the more widely accepted.
Mr. Higgins. It is rather commonsense.
Dr. Holder. Which shows that as you get wealthy----
Mr. Higgins. It's a direct correlation. And the
availability of affordable energy is, of course, a cornerstone
for economic development.
So all of us here, we're here voluntarily. Ladies and
gentlemen, we appreciate you coming. We admire your passion and
your beliefs.
But I believe that as Americans observe these hearings,
they are getting home from work, and all of you arrived here by
some method of fossil fuel. You all wear clothing developed
from petroleum products. You all have, no doubt as doctors of
great accomplishment, you have 401(k) portfolios with
corporations that rely upon fossil fuels and carbon footprints
to some extent.
So that I think it's important, Mr. Chairman--and thank you
for having this hearing--that we have honest conversations
about an all-of-the-above energy policy for our country and
that Congress supports, of course, expansion of clean energy,
but the inclusion of fossil fuels must be part of that factor
for economic prosperity.
Thank you, Mr. Chairman.
Mr. Rouda. Thank you, Representative Higgins.
At this time, the chair would like to recognize
Representative Gomez.
Mr. Gomez. Thank you, Mr. Chairman.
Dr. Rossiter, a simple question. Do you believe in climate
change or not? Yes or no? And it's an easy yes-or-no question.
Mr. Rossiter. Very difficult. You have to define climate
change for me.
Mr. Gomez. Okay. Well, we're not going to start. That
answers it all. Thank you for being here.
One of the things that I want to kind of really emphasize,
is the GAO, the Federal Government, everybody has said that
climate change is happening. You can go and read the reports if
you need to read those reports. But I think for the American
people to say that you are asking what the definition is, then
that gives us a hint where you're coming from.
Growing up in Riverside California, the Inland Empire,
Riverside, I saw a time during the 1980's when we have so many
days of what we call red flag days. We couldn't go outside to
play because of the pollution in the air.
California spent a lot of time to clean up our air. Then we
also started--and a lot of those restrictions on emissions when
it comes to tailpipe emissions from industry really did have an
impact on our air quality throughout California.
We started combating climate change to make sure that we
would have a role in combating climate change, and we started
reducing greenhouse gas emissions. Those had an additional co-
benefit of reducing pollution and pollutants, right? They kind
of go hand in hand. People get them often confused regarding
reducing greenhouse gas emissions and the co-benefits that go
along with it, right?
But one of the things that I've noticed is that the people
that are most impacted are people that are children and
seniors, immigrants, poor and low-income families, rural
communities, people of color, indigenous people, right? These
are the people that are most impacted.
And then oftentimes when we do pass--and these are the
folks that are facing poor air and water quality. They have
issues, health issues, like asthma, heatstroke, bacterial
infections, heart and lung disease. You know if we can combat
it, it has a positive impact.
I was in the California State Legislature. One of the big
issues I had is that the money from the Greenhouse Gas
Reduction Fund wasn't going to the people that were most
impacted, right? The poor. And having a lack of air
conditioning and not having heat, which I did not have growing
up, does make a difference on people's health. Also not having
health insurance also has an impact on people's health.
So climate change policies, I believe, do--anything we do
has to prioritize the working class, the underserved, the
underpaid, the struggling, those struggling against racial
inequality, and those with preexisting conditions.
Dr. Bernstein, you have spent your career taking care of
children. What are some of the impacts you are seeing on the
children in low-income communities and communities of color?
Dr. Bernstein. Specifically related to climate change, air
pollution?
Mr. Gomez. Both.
Dr. Bernstein. I see a number of them. We see heat
exposures leading to problems for particularly kids with
chronic diseases like asthma, diabetes. That causes their
diseases to sort of get worse either with breathing or
metabolic problems.
The air pollution issues I alluded to in my testimony are
quite apparent, as you talked about your childhood, when it's
hot out in particular we see ozone action days, particularly
problematic for children who are obese, who also tend to have
asthma, especially trying to get children outside to exercise.
In the summer we are telling them to stay inside because it is
too dangerous to be outside.
We see effects on infectious diseases. I alluded to Lyme
disease. It should be clear and important to know that
particularly--I'm sorry Representative Higgins and
Representative Gibbs are no longer here, but their constituents
are actually substantially at risk for the diseases that are
being moved northward.
And it is not just Lyme. These ticks carry other diseases,
Babesiosis, Anaplasmosis. Other ticks carry other diseases that
are growing substantially.
Mr. Gomez. I wish we can--five minutes is not a lot of time
to kind of debate some of these issues, but I've seen it with
my own eyes in California. And we have been leading the country
when it comes to combating climate change and taking those
dollars and reinvesting.
You know, I get it, you can actually reduce--if we focus on
providing healthcare to people, you are going to have a bigger
impact than just reducing climate change, right? But then the
other side doesn't want to even provide healthcare to other
people.
So some of the arguments from the other side just infuriate
me. And one of the things we're going to continue doing is
really talking up climate change. And I understand the
reduction of greenhouse gas emissions to reduce, you know,
combat climate change is essential. But the co-benefits that go
along with it, including cleaner air and cleaner water, making
sure people have better health outcomes, they're all tied
together. And we're going to continue focusing in on that.
Mr. Chairman, thank you for having this hearing. I really
appreciate it. And I yield back.
Mr. Rouda. Thank you, Representative Gomez.
At this time, the chair recognizes Representative Tlaib for
five minutes.
Ms. Tlaib. Thank you, Chairman.
I want to thank all of you so much for your testimony in
this critically important discussion about human impact on
people's public health, especially women and children, when we
do nothing about climate change.
Through the chair, I'm going to respectively disagree with
Dr. Rossiter and just tell you, I lived in a community and I
still am raising my two boys where it is very hard to see the
direct impact.
However, I thought that smell was normal, I thought that
CO2 was normal, that it wasn't impacting people's lives the way
now I see a third of the classroom when I read to them raising
their hand when I say, ``How many of you have asthma?''
I do this intentionally because I want to stay grounded in
understanding and believing in them because of the trauma of
not being believed when you say you're being poisoned by C02
and other kinds of pollutions out there.
I have the most polluted ZIP Codes in the state of
Michigan. One of five children have asthma, Dr. Rossiter. And I
can tell you, we have the only oil refinery in the state of
Michigan. We have some of the largest-polluting corporate
polluters in the state in my district, in the 13th
congressional District.
Dr. Bernstein, you discussed in your written testimony
about--I think you called it fumes across the fence line. I
found that African American children in southeastern Michigan
suffer over 2,400 asthma attacks annually caused by oil and gas
pollution in the air and miss over 1,700 days of school.
This is something I talk to school administrators about,
the fact that they have high rates of absences, when you hear
about corporate polluters getting violations passed that
weekend because they've outputted more than their air permit
required.
And it really is something that I think for those at home,
for my 13th congressional District residents, I just want them
to know I believe them, and there are doctors and scientists
out there that believe them, that CO2 output is killing people.
Asthma attacks kill people at three times higher rate among
adults. In 48216, in the ZIP Code 48216, has hospitalization
among adults three times.
These are real public health impacts. And so I'm going to,
through the chair, respectively disagree with the information
provided by Dr. Rossiter. And I don't have a question for you
at all.
However, Dr. Goldstein and Dr. DeSalvo and Dr. Holder and
Dr. Bernstein, I want to know the direct impact on women,
especially women of color, when this administration has not
pulled its weight to protect kids. What can parents and
communities do at the grassroots level to keep children safe?
Dr. DeSalvo. I'll be happy to start because I appreciate
very much the verb you just used, which is ``do,'' which is
something I hope the committee will look hard at and find ways
that there can be bipartisan common ground for actions that we
could take together that would protect people today.
And so some examples would be requiring more partnership
between public health and healthcare on the front lines and
using data in the way that I described in my testimony.
We know a lot about communities, children, people of color,
but we're not always accessing that information to be targeted
and strategic in protecting people from any kind of an impact
and also supporting them after they've had some negative
impact.
So publicly available tools like emPOWER, that started in
the Obama Administration, continue to this day, are a way that
local communities can identify people at risk, get them the
help they need, not during disaster, but to help build
resiliency.
And so I hope that we'll be able to find ways to work
together in the near-term to support people who really need our
help.
Dr. Holder. In Florida, we've developed a whole--there's a
whole list, if you go online, of all the community resources
that we've been--the action groups that have come together to
fight this. Because we're at the front line in Florida. We're
feeling the sea level rise. We're seeing our beach erode. We
had Zika. We have extreme----
Ms. Tlaib. Dr. Holder, when you say front line, I love
that, because I always say, you want to see what doing nothing
on climate change, you want to see what doing nothing looks
like? Come to the 13th congressional District and I'll show you
block by block of people with cancer and asthma, respiratory
issues.
Again, doing nothing does result in death, and people
really are hurt by the fact that government is doing nothing to
protect them.
Dr. Holder. Absolutely. We also, with the Florida
Clinicians, that's one of the goals. But on the ground we have
local communities, poor communities that are developing
resource centers in the hearts of the poorer communities, that
before a storm the poor folks can go and get water, they can
get food. Because if you've never prepared for a storm, if you
don't have money, you can't get water, you can't get food, and
you can't go to a shelter without your own food and water. So
they're creating these sites in the community and giving mental
health services at those sites.
So we're mobilizing efforts to help the poor community as
far as bias. But we want--we need--the government to come in
and support and recognize that whatever the cause of fossil
fuels and everything else, the poor, the most vulnerable are
suffering now.
And should we sacrifice that population so everybody else
can have? I don't know. To us, that's not the answer. For us,
it's how do we mobilize our forces to help the current
situation now and the vulnerable now.
Dr. Goldstein. There are data out there suggesting, which
makes sense, that there is more domestic violence against women
the hotter it is. We can understand why that would happen.
There is data on ozone. We did some of it in New Jersey. If
you go to emergency rooms during the summer and you look at
ozone levels and look at asthma admissions, you find that you
can explain a significant percentage of the ozone--the ozone
cases seen in emergency rooms in northern New Jersey are based
upon what the ozone levels were. The hotter it is, the more
ozone you're going to have.
So these can be looked at. The ozone one you can do
something about as a family.
You asked about the front line things. Well, ozone builds
up during the day. And the old question of should you jog in
the smog is more important to children. They should be playing
in the morning before the 11 o'clock ozone level starts
building up. If you are a jogger, you should jog in the morning
rather than after work.
These are things that we have to--we should not have to do
these things, we should not have these ozone levels, we should
not have these other issues that are being caused by things
that we have nothing to do--nothing to control.
Mr. Rouda. Thank you.
Dr. Holder. Could I add? One thing we know in primary care,
women bring the kids, women come to doctors. So if you want to
know what the impact is on families, we already know.
So some of the data, it's nice to have, but if you've gone
to the doctors, women are there. So the impact of climate and
health and storm preparation, everything for the family often
disproportionately falls on the women.
And at night, I have to say, my postmenopausal and
menopausal women are complaining to me, says you have to get
that temperature down to 73 degrees to sleep well. When you
can't afford it and it's hotter at night you don't sleep well.
So women are paying the cost for sleep, we're paying the
cost for taking care of the families, we're paying the cost for
preparing, we're paying a huge cost right now.
Mr. Rouda. Thank you, Doctor.
I'd like to submit two documents into the record. The first
one is the testimony of Dr. Daniel L. Costa, U.S. Environmental
Protection Agency, retired; and the statement for the record
from Ellen Atkin from Colorado. Without objection, these are so
moved into the record.
Mr. Rouda. I'd also like to thank the witnesses for
testifying today.
Without objection, all members will have five legislative
days within which to submit additional written questions for
the witnesses to the chair, which will be forwarded to the
witnesses for your response. And I ask that you please respond
as promptly as you are able.
In closing, I'd like to point out that the purpose of these
hearings is not to debate the economic advantages that fossil
fuels have provided us and other parts of world over the last
couple hundred years. That goes without saying. The point is,
is that the current consumption of fossil fuels and the impact
it has on climate change is real and that our ability to move
to renewables faster and more effectively has a positive impact
on all of us.
One of the main areas talked about was asthma. As a father
of four growing up in Ohio and our children in Ohio, two of my
four children have been identified as having asthma due to
environmental issues in Ohio.
Moving to California, we have been fortunate that we no
longer have to experience what it's like to have your child
wake you up in the middle of the night, wheezing, trying to
breathe, with their lips turned purple as they try and figure
out how to breathe.
But we were lucky. There are many, many children who suffer
continually around our country and around the world who did not
have the opportunity to get quality medical treatment or to
move to a place where they can meet the needs of their
children.
I often talk about climate change. We can debate about how
severe it will be or how fast it will come, but we can't debate
any longer that it is coming.
And I often cite the Department of Defense, who recognizes
climate change as a primary national security threat. I tend
not to think of the Department of Defense as a bunch of
liberals claiming that the sky is falling. These are
individuals who look pragmatically at the true national
security threats facing our country and we should listen to
what they are telling us. And what they are telling us is
climate change is real, it is now, and it needs our immediate
attention.
And finally, before we adjourn, I personally try to look at
the decisionmaking that we make as elected leaders as to what
side of history do we want to be on. And I hope that all of us,
whether it is you in your community or us here serving our
country in the House of Representatives, that we make our
decisions based on what side of history do we want to be on for
our kids, our grandkids, and future generations.
And with that, we are adjourned. Thank you.
[Whereupon, at 3:51 p.m., the subcommittee was adjourned.]
[all]