“The rich will find their world to be more expensive, inconvenient, uncomfortable, disrupted, and colorless—in general, more unpleasant and unpredictable, perhaps greatly so. The poor will die.”
Kirk R. Smith, PhD ’77, MPH ’72, professor of global environmental health, paints a grim picture of the impact of climate change on health in the 2008 Annual Review of Public Health. Smith is on the forefront of the emerging field of climate change and its impacts on the health of populations. In September, he was honored with the $100,000 Heinz award for his research exposing the relationships among air pollution, household fuel use, climate, and health.
Rapid climate change is a relatively new phenomenon in human history; however, its effects on health will in some ways be very familiar. Age-old threats, such as malnutrition and communicable disease, will rise with the temperatures and sea levels. For infectious diseases that are already widespread globally, even a slight increase in the percentage of cases will have a large effect. One million people die of malaria each year, including many young children; a 10 percent increase in the spread of malaria would result in another 100,000 deaths per year. It is clear that the burden will be inequitable, with those disadvantaged populations already burdened most with ill health facing the most serious health consequences.
Global response to climate change, while well intentioned, does not often improve health, and can sometimes lead to negative health impacts. For example, the recent push to develop biofuels has provided renewable energy resources that produce less greenhouse pollutants, especially in developed countries where fuel consumption is highest. However, it has also led to a decrease in the amount of crops that are available to feed people, which has exacerbated malnutrition problems in some areas and increased deforestation in others. (UC Berkeley’s Energy Biosciences Institute, however, is focusing on next-generation cellulosic biofuels that don’t compete with crop production, such as algae tanks or dryland grass.)
The attempts by the developed world to mitigate climate change do not often directly benefit those in the Third World, who are the most vulnerable to those health problems which are exacerbated by climate change— malnutrition and infectious disease. Similarly, even in developed countries, poor people can find some measures to be a hardship. Smith gives the example of increasing energy costs in order to encourage conservation, saying, “If you make energy more expensive, then poor people who don’t have a lot of money to spend may not be able to afford to heat their houses or cook their food.”
Some public health practitioners believe poverty alleviation should be the primary focus of the field. Climate change can be framed similarly, as it is also a contributing factor to poor health. But alleviating poverty and global warming are both ongoing and slow processes. For that reason, Smith believes in attempting to improve health even in the face of poverty and issues of climate change. “The best single definition of public health I know is to find ways to make people healthy before they are wealthy,” he says, “and then keeping them that way.”
Smith has an elegant way out of the health/climate change conundrum—to prioritize interventions with co-benefits. That is, solutions that improve both health and environment. The effects of these targeted strategies are amplified because they work to solve both sides of the equation. For example, encouraging people in high-income countries to reduce their red meat consumption can make them healthier, and it also helps to reduce the global greenhouse gas emissions generated by raising livestock. Livestock production also diverts food crop from human consumption to animal feed and thus contributes to food scarcity in poorer countries.
Another example—reducing U.S. reliance on automobile transportation—will mitigate climate change by lowering fossil fuel consumption. It would also provide health benefits in the form of reduced air pollution, automobile accidents, and perhaps increased exercise via alternate forms of transportation such as walking and cycling.
As policymakers increasingly focus on the mitigation of global warming, it is important they are aware of areas where health benefits also occur. From a practical standpoint, health co-benefits will reduce the cost to society of taking action to mitigate climate change.
Smith believes that the idea of co-benefits can hold appeal to developing countries like China and India, whose leaders might worry that changing policies would negatively affect their growth. “Co-benefits give them incentive because it’s their populations that will benefit,” he says. “The health benefits are local— reduction in indoor air pollution or urban air pollution. The greenhouse benefits are global.”
Along with Associate Professor of Environmental Health Sciences Michael Jerrett, doctoral student Seth Shonkoff, MPH ’08, and others around the world, Smith is coauthoring a series of papers on co-benefits to be published in The Lancet on November 25, with the goal of impacting the policy discussions at the 2009 United Nations Climate Change Conference in December in Copenhagen. Says Smith, “We’d like to point out to policymakers that if they exert their efforts in certain directions, they will obtain important health benefits as well as climate benefits. You’re not going to solve the entire climate problem with these activities, but you should pick these things to do first that have these co-benefits, particularly among the poor.”
Putting research to work
Smith has spent decades researching the health and climate effects from indoor cooking fires and stoves that use solid fuels. His research in this area contributed to the Intergovernmental Panel on Climate Change reports that helped earn the organization a 2007 Nobel Peace Prize, shared with former Vice President Al Gore. Smith’s research team has developed and tested more fuel-efficient, well-ventilated cook stoves in Guatemala. Not only can improved stoves reduce indoor air pollution in family dwellings locally, they also reduce greenhouse emissions globally.
Solid fuel stoves are still being used in about half of the world’s households, meaning an intervention in this area offers enormous co-benefits for both health and the environment if adopted on a wide scale. Smith is now working to put his decades of pioneering research into practice—collaborating with Impact Carbon (formerly the Center for Entrepreneurship in International Health and Development) a nonprofit organization run by Evan Haigler, MS ’07. While at Berkeley, Haigler worked with Smith on carbon methodology development and monitoring for improved stoves, and Impact Carbon uses that research to bring improved cook stoves to Asia, Africa, and Latin America.
“Kirk Smith has had a pioneering role in understanding and developing awareness of the dangers of both indoor air pollution and black carbon emissions,” says Matt Evans, director of business development at Impact Carbon. “His work with Impact Carbon is bridging the gap between research and real improvements in lives of people in the developing world. Kirk’s insight and support were instrumental in the results we have managed to achieve.”
Impact Carbon harnesses the power of entrepreneurs and the global carbon market to sustainably improve health and alleviate poverty in the developing world. In other words, the organization gets corporations to fund stove projects by purchasing carbon credits. In April, Impact Carbon established an agreement with Land Rover UK to fund the production of 20,000 stoves a year in Uganda.
“That’s co-benefits again,” says Smith, “The rubber hitting the road. The First World—Land Rover in this case—is buying carbon credits and the local people are reaping the benefits of lower air pollution and more energy efficiency with better stoves.”
Impact Carbon is also “hot on the trail” of a similar arrangement to bring 400,000 stoves to China in the near future, according to Smith. “That’s not a small amount,” he says, “We’re talking about potentially one hundred million dollars in carbon credits.”
While Smith may sound grim about the effects of climate change on society, he remains an optimist in regards to the ability of the public health community to effect positive change. Targeted interventions may not completely mitigate the effects of climate change, but they can offer a win-win situation for health and the environment.