The American College of Physicians believes that physicians and the broader health care community should engage in environmentally sustainable practices that reduce carbon emissions, support efforts to mitigate and adapt to the effects of climate change, and educate others about the health risks posed by climate change. By addressing climate change, we can not only avert environmental catastrophe but also gain public health improvements such as cleaner air and better respiratory health from reduced dirty fuel use and improved cardiovascular health through more active transportation like walking and cycling.
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In November 2022, the Annals of Internal Medicine published Environmental Health: A Position Paper of the American College of Physicians, which sought to inform physicians about environmental health and offer policymakers recommendations to reduce the adverse health consequences of climate change, improve air and water quality, reduce exposure to toxic substances, and address environmental injustice. This paper built on ACP’s 2016 paper Climate Change and Health, which responded to a Board of Regents-approved resolution that called on the College to support efforts to address research, education and response to the medical consequences of climate change. ACP’s policy recognizes that human and planetary health are interconnected, and that climate change is a global human and environmental health crisis requiring immediate action to limit global temperature rise.
The World Health Organization calls climate change “the single biggest threat facing humanity” and highlights that “health professionals worldwide are already responding to the health harms caused by this unfolding crisis.” In March 2023, the Intergovernmental Panel on Climate Change (IPCC), the UN body responsible for assessing the science related to climate change, issued its 6th Synthesis Report with a warning that the pace and scale of current climate action are insufficient to tackle climate change. The report found that widespread and rapid changes in the atmosphere, ocean, cryosphere and biosphere have already occurred with global temperatures now about 1.1 degrees Celsius above pre-industrial levels. The IPCC reports that “there is a rapidly closing window of opportunity to secure a livable and sustainable future for all,” and that those who have historically contributed the least to climate change are being disproportionately impacted. ACP has called for immediate climate action to limit global temperature rise to 1.5 degrees Celsius, a milestone the IPCC has identified as a tipping point beyond which the risk of extreme drought, wildfires, floods, and food shortages are significantly increased and warned we will likely pass sometimes in the 2030s if current trends continue.
Despite these challenges, physicians can help address climate change by reducing energy use and greenhouse gas emissions in their own practices, advocating for climate change adaptation and mitigation policies, and learning about how climate change affects their community.
As the urgent need for action to address climate change increases, the Biden Administration has pledged to “put the United States on a path to achieve net-zero emissions, economy-wide, by no later than 2050.” This goal aligns with the United States’ commitments under the Paris Climate Accord, in which 196 countries promised to reduce emissions in order to limit global temperature rise to well below 2 degrees Celsius above preindustrial levels, and ideally no higher than 1.5 degrees above preindustrial levels.
In August 2022, Biden signed into law the Inflation Reduction Act of 2022 (IRA), which contained the most comprehensive set of funding and policies the United States has so far designed to mitigate the causes and effects of climate change. The combined measures in the IRA are expected to reduce U.S. greenhouse gas emissions by about 40% below 2005 levels by 2030. ACP supported these provisions in the IRA through letters to Congress and public statements, including:
- Methane emission reduction: Methane is a greenhouse gas that contributes significantly to climate change. The IRA included the first charge for methane gas emissions imposed by the federal government. The methane emissions charge will begin in 2024 and applies to emissions over a certain threshold from production and processing facilities in the natural gas and petroleum industries.
- Support for clean energy: The IRA allocated $9 billion for rebate programs and tax credits for consumers to make clean energy investments in their homes, including through electric appliances and solar energy, and for energy efficiency investments such as better home insulation. The IRA also included significant manufacturing incentives to produce more clean technology, including tax credits to accelerate the production of solar panels, wind turbines, and batteries. These economic incentives will make clean energy much more accessible to the public and help build the infrastructure necessary to make widespread use of clean energy possible. Hospitals and other health care facilities may be able to access clean energy tax credits and other incentives to help reduce their greenhouse gas emissions and build resiliency.
- Electric vehicle tax credits: The transportation sector is one of the largest contributors to greenhouse gas emissions in the country. The IRA established tax credits for clean vehicles to encourage the reduction of individual emissions. The Department of Energy has compiled a list of model year 2022 and 2023 qualifying vehicles.
- Agricultural conservation: The IRA allocated $19.5 billion for agricultural conservation including increased funding to the United States Department of Agriculture for forest management and mitigation-focused conservation activities, as well as funding to support renewable energy use in rural communities. Nearly $2 billion was also funded for wildfire risk reduction activities.
- Environmental justice: The effects of climate change are felt particularly hard by socially vulnerable communities. The IRA aimed to mitigate these inequities through investments in community-led projects to improve public health and increased infrastructure funding for safe and sustainable transportation systems.
ACP has joined other medical organizations in advocating for Congress and the Environmental Protection Agency (EPA) to support action that would reduce air pollution, and to speak out to oppose attempts to weaken the Clean Air Act and repeal emissions reduction programs. ACP also has called for increasing funding to the National Center for Environmental Health at the Center for Disease Control and Prevention, in support of funding initiatives including lead poisoning prevention, strengthening state programs in the National Asthma Control Program, and expanding the National Environmental Public Health Tracking Network nationwide.
For more information about ACP’s advocacy related to Climate Change, see “Where We Stand.”
While recent federal action is promising, most states have set their own policy goals to address climate change and its health impacts, especially as environmental priorities have shifted across different presidential administrations and Congresses. 32 states and DC have adopted or are developing climate change action plans, and 24 states and DC have set targets for greenhouse gas emissions reductions. 30 states, DC, and three U.S. territories have Renewable Portfolio Standards for what percentage of renewable energy they aim to generate from renewable sources by a target date, and multiple states have set goals for eliminating all greenhouse gas emissions by 2050 or sooner. Other states have established policies on carbon pricing as well as standards relating to transportation emissions and low carbon and alternative fuels. A bipartisan group of state governors representing the majority of the U.S. population and economic activity formed the United States Climate Alliance to work at the state level to limit warming and meet the goals of the Paris Climate Accords.
States have also passed competing policies on the issue of zero emissions building standards that would ban natural gas in residential and/or commercial buildings, with at least four states and 104 local governments across the country establishing such standards while at least 20 states have passed legislation prohibiting localities from implementing a similar ban. Ohio in 2023 became the first state to define natural gas as a “green energy” source in state law despite its main component being the greenhouse gas methane, and proponents are working to pass similar legislation in other states.
In addition to supporting state chapters with climate-related policy issues, ACP has advocated with federal regulators in support of state climate action. In August 2022, ACP joined other health organizations in writing a letter to the EPA in support of granting waivers to approve California’s clean truck standards to regulate emissions from the heavy vehicle transportation sector.
- Environmental Health: A Position Paper of the American College of Physicians
- Climate Change and Health: A Position Paper of the American College of Physicians
- A Declaration on Climate Change and Health by ACP and 25 other health organizations
- ACP New Jersey: Sustainable Initatives to Guide Healthcare Transformation (SIGHT): Recommendations on Sustainable Healthcare in New JerseyUnited Nations Intergovernmental Panel on Climate Change: Synthesis Report for the Sixth Assessment Report
- United States Global Change Research Program. The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment
- Americares Climate Resilience Toolkit for Frontline Clinics
- “Climate Change and Health”, World Health Organization
- “Climate Change Policy and Mitigation Factsheet” University of Michigan Center for Sustainable Systems