HEALTH LEADERS SHOULD SPEAK OUT FOR PROPOSED CARBON EMISSION REGULATION

This is an opportunity to fulfill commitments to our patients and the climate

Lisa Patel, MD, MESc

Earlier this month, the Environmental Protection Agency (EPA) released a new proposed regulation to limit the release of carbon pollution from power plants, opening a period of time for the public to voice their opinion through the "public comment." I believe the oath that healthcare providers take to care for patients obligates us to speak out enthusiastically in support of this standard to protect health.

As a pediatrician, I know that health professionals want to make sure that our patients, friends, family, and neighbors are healthy and thriving. As a field, health professionals have clearly moved to recognize that factors outside of healthcare—the social determinants of health—are major drivers of health outcomes, and increasingly climate change is recognized as a social determinant of health and one of the greatest threats to public health and safety. Its impact on our health is only growing in significance.

As the executive director of the Medical Society Consortium on Climate & Health—which represents 70% (700,000) of U.S. doctors represented by our 48 member societies—I know climate change threatens my patients' health. More poor air quality days and heat waves mean more children in the emergency room from asthma and more expectant mothers in preterm labor, to name just a few examples of the health harms of climate change.

This new proposed standard, known as the Greenhouse Gas Standards and Guidelines for Fossil Fuel-Fired Power Plants, is part of the Biden administration's effort to achieve the goal of reducing greenhouse gases by 50% by 2030. The Inflation Reduction Act, the largest climate investment in U.S. history, is expected to reduce these emissions by 40%, but it is a suite of robust standards (of which this new proposal is a critical component) that will get us the rest of the way to this ambitious goal. For public health, it is a critical goal we must achieve.

We know we can avoid the worst of the harms brought on by climate change and enjoy rapid improvements in our health if we move quickly toward cleaner, more reliable, and more affordable energy. We can help realize this vision by submitting public comments for this standard to be as strong as possible. The more com- ments the EPA receives in support of cleaning up pollution for a healthier today and a healthier future, the more likely the EPA will pass a rule with ambitious standards.

Our voice is critical because fossil fuel CEOs and lobbyists are going to once again quickly mount an offensive to weaken these safeguards as much as possible. History has shown us as much. Fossil fuel CEOs and lobbyists continue to follow the playbook of Big Tobacco, which delayed regulation for decades while our patients died from tobacco-related illness. Like tobacco companies today, fossil fuel companies fight regulation behind the scenes while spending millions to make false claims that they are part of the solution. We must counter misinformation campaigns with the truth that our patients' health—not to mention efforts to respond to the threat of climate change—are at stake.

As health leaders, we should also make it clear to healthcare systems and hospitals that have pledged to reduce their greenhouse gas emissions that this change is an easy step to help them reach their climate commitments.

The fact is that this standard, if implemented effectively, will be a boon for healthcare systems that have pledged to reduce greenhouse gas emissions. Healthcare system emissions arise from three main areas: through the activities that take place within their buildings and campuses (think on-site heating or anesthetic gases, which have a very high global warming potential, and vehicles on the grounds); through the purchase of electricity to power their operations; and through the emissions associated with their supply chain, which includes things like the production and transportation of food and medical supplies to their facilities as well as business travel.

Healthcare systems can most easily control what happens in their buildings. But hospitals and health systems also consume a significant amount of electricity, and sourcing electricity through new means can be complicated. Some have made significant reductions in their electricity emissions by installing solar panels at their facilities or by purchasing clean renewable electricity, but for most these have not been viable options. Sector-wide strides to reduce greenhouse gas emissions from power plants will help move systems toward their goals without needing to make any direct financial investment.

In addition to realizing our commitments to climate action, a strong limit on carbon pollution also helps us meet our commitment to protect our most vulnerable patients. Babies and children, pregnant people, older adults, those with chronic health conditions, people with lower incomes, and communities of color feel the health harms of climate change most intensely. And polluting power plants are often closest—and thus most directly harming —families with low incomes and families of color.

The EPA's new proposed standard is an opportunity to live up to our climate commitments as a country and as a health sector. It is a moment to make our voice loud and clear, so it is not drowned out by companies who would prioritize the size or their wallets over public health and the health of our planet.

Lisa Patel, MD, MESc, is a pediatric hospitalist and the executive director of the Medical Society Consortium on Climate and Health. She trained at Stanford, Yale, and UCSF.