University Place

The Global Climate Crisis and Human Health

– Welcome everyone to Wednesday Nite @ the Lab. I am Tom Zinnen. I work here at the UW-Madison Biotechnology Center. I also work for the Division of Extension, and on behalf of those folks and our other co-organizers, Wisconsin Public Television, Wisconsin Alumni Association, and the UW-Madison Science Alliance, thanks again for coming to Wednesday Nite @ the Lab. We do this every Wednesday night 50 times a year. Tonight, it’s my pleasure to welcome back to Wednesday Nite @ the Lab Jonathan Patz. He’s the director of the Global Health Institute. He was born in Baltimore, Maryland, and he went to high school there at the Friends School in Baltimore. Then he went to Colorado College, where he majored in biology, and then went to Case Western Reserve, where he got his MD degree. He got his master’s of public health at Johns Hopkins University, and he’s been here for a quite a while since then.

He’s board certified in occupational environmental medicine and in family medicine. Tonight, he’s going to talk with us about how might solving the global climate crisis also create the largest human health benefit of the century. This is, in my opinion, the greatest example of turning lemons into limoncello that I’ve ever seen. I’m looking forward to hearing what he has to say. Please join me in welcoming Jonathan Patz back to Wednesday Nite @ the Lab. (audience applauding) – Tom, it’s a real pleasure to be here, and it was great to– though we bumped into each other in that blizzard the other day and a little while back. I said I would only talk about climate change in the summer, not in the winter, so here I am. Thank you all for coming. You all know about climate change and the global climate crisis and how dangerous it is for human society, and I’ll talk about how climate change is a human health issue, but solving the problem, I will show evidence why this could be the greatest opportunity of our lifetimes. Now, of course, climate change is not fantasy.

It is real. It’s not your imagination that summers are getting hotter. I’m going to show you from James Hansen, this is surface temperature in the northern hemisphere, and looking at summertime, this is average summertime temperature for the year 1951 to 1980, and as you look at these years go forward, look especially at the extreme temperatures. Right here are very few, so here we go. Temperatures from 1951 to ’80, ’83 to ’93, ’94 to 2004, 2005 to 2015. It is not your imagination. It really is getting warmer. And there are consequences we’re seeing around the world. This is looking at Greenland’s ice is melting four times faster than was thought, and that would mean, as far as Greenland, if Greenland melts, that’s 23 feet or seven meters of sea level rise, but Greenland is a lot smaller than the Antarctic. If the Antarctic melts, that’s 57 meters, or 180 feet, of sea level rise, and the Antarctic is losing six times as much ice as it was four decades ago, so we’re seeing what is happening as the Earth is heating up.

But if you live in Wisconsin, as a little cautionary note, global climate change, it requires a global perspective. What impression do Wisconsin residents have about global warming after experiencing nearly three weeks of subzero temperatures throughout the region? And, of course, all of you now know about the term of the polar vortex. It’s because the jet stream slows down as the temperature difference between the Arctic and lower latitudes gets smaller. The Arctic is warming twice as fast as anywhere else on Earth, so as the Arctic is warming, there’s less temperature difference by latitude, and that’s what drives the jet stream. This is co-discovered by Dr. Steve Vavrus here at the University of Wisconsin in the Center for Climatic Research and the Nelson Institute so as the, as the jet stream slows down, it gets wavier, and you can see that y’know, this is what we saw. The Arctic temperatures dipping way south, but notice at either end of this extension of Arctic air, up here it’s really warm. They were canceling dog sled races in Alaska this past winter, so extremely hot temperatures where you don’t expect it here and extremely cold temperatures as the Arctic is disintegrating and the Arctic air is going further south. This past winter, I was lecturing out in Bozeman, Montana, which is farther north in latitude, and on Saturday, January 26th, I was on the other side of the polar vortex. It was plus 36 degrees Fahrenheit in Bozeman at the same time it was negative 24 in Madison.

60 degrees Fahrenheit difference in temperature on one side of the polar vortex, so this is, again, what we experience. And there were a few people that experienced the cold, especially in the United States, and you heard a few individuals say, “We could sure use some global warming, it’s so cold,” but if you look at this map, and this is the same thing happened two years ago, we had a polar vortex, which color is dominating the globe? The extreme cold blue? Or the extreme hot orange? And so this is why it’s so important that people understand it’s a global issue. The global climate crisis, you can’t look outside of your window and say, “Aha, it’s cold or it’s hot. I know what’s going on around the rest of the globe. ” It’s about global averages and why it’s so important that, when it’s a polar vortex in Wisconsin, ask yourself, “What’s the temperature in Alaska?” Or in Finland at the same time, and you’ll know you’ll get the answer. It’s probably extreme hot. So, what about the future? This is from the United Nations Intergovernmental Panel on Climate Change. I served on the UN IPCC for 15 years, which was really a great thing to be part of, and the United Nations IPCC is projecting that, best case scenario, if we have representative concentration pathways, RCPs, of not so much more greenhouse gas emissions, so we cut off fossil fuels and we calm down and we don’t burn so much dirty energy, well, we’ll still warm on average about one degree centigrade, but if we continue as business as usual, this is a higher representative concentration pathway of greenhouse gas emissions, the Earth will on average warm seven degrees centigrade by the end of the century. Seven degrees average warming for the globe is huge, and remember that the world is mostly ocean, so land surfaces, continents, will be warming even more. This is extremely, extremely rapid warming, and at the moment, it’s our fossil fuel emissions.

We are trending worse than this worst-case scenario, according to the United Nations Intergovernmental Panel on Climate Change. Now, you’re going to have some climate lectures at Wednesday Nite Labs, and things on sea level rise and flooding. I’m a health person, so I ask the question, climate change and what does that mean when you look at rising temperatures, sea level rise from thermal expansion of saltwater and also land-based glaciers sliding into the ocean, but also extremes of the water cycle, hydrologic extremes, more droughts, floods, and fires. Those are the physical attributes of climate change. For me, I say, “Well, so what?” And for me, the so what is that there are so many pathways through which climate affects our health, and every single one of these pathways has these health outcomes and multiple climate-sensitive diseases. It’s why I have studied this topic for more than two decades. I actually co-chaired the first US National Assessment to Congress, the health report of the National Assessment on Climate Change to Congress, because I think climate change represents the greatest public health challenge of our times, when you think about so many ways, be it from direct heatwaves that kill people to air pollution, stagnant air masses and heatwaves, and the effect of air quality on aero-allergens and ground-level smog ozone, to more biologically mediated impacts of climate change through infectious diseases especially carried by vectors, like mosquitoes and ticks, insect vectors that carry vector-borne diseases, and if we’re thinking of extremes of the water cycle, more flooding and contamination and waterborne diseases, and, of course, our health depends on adequate water resources and food supplies, so major climate-sensitive health outcomes and why climate change is absolutely a human health issue. Now on the bottom, I’ll talk briefly at the end about mental health and climate change, and this bottom issue, environmental refugees, may be one of the toughest things to understand. What was it, the extreme flood or drought that drove people out of their country, or the corrupt politics? Very hard to disentangle. Personally, I think this issue of environmental refugees and displaced populations will be the iceberg under the tip of the iceberg.

It will be a huge disruption to human civilization. One example, I don’t expect you guys to read these graphs, but I’ll just interpret that the top graph is looking at rainfall, falling rainfall, in Syria. This is a few months before their civil war. Falling rainfall, increasing temperatures, and the Drought Palmer Index showed that Syria experienced the most severe drought in its instrumental record, according to the study and the proceedings of the National Academy of Sciences, and it was documented that rural to urban migration was four to five times higher than normal. People are flooding into the cities because of the extreme drought. There were food price shocks, there were riots in the street. We will never know and be able to prove that that severe drought caused the civil war and hundreds of thousands of deaths and millions of refugees but it’s associations like this that are pretty strong associations that happen over and over again where we ask the question, such climate extremes and the stress on natural resources and how it disrupts civilizations could really be destabilizing and y’know, a very indirect effect, but maybe one of the largest effects of climate disrupting civilization. Let me just pause on the most common issue and the concern of temperatures, rising temperatures. You all know about that heatwaves kill people. The heatwave in Europe in 2003 estimated to have killed 70,000 people in 11 days, a public health disaster.

We’ve done some modeling. This is with Dan Vimont of the Center for Climatic Research here at UW showing that, right now, New York City has, on average, 11 days that are 90 degrees Fahrenheit or 30 degrees centigrade or hotter, so 13 days right now, right here, this under the curve. 13 days over 90 degrees Fahrenheit. By mid-century, 40 years from now, New York will have a tripling in the number of hot days over 90, and we found this was true for all cities we looked at east of the Mississippi. Milwaukee will also see a near tripling of the number of days that are over 90 degrees, so it’s these extremes in temperature, the increased frequency of extreme events, that we’re really concerned about, and it shows up in the modeling. Now, this is a picture during the Chicago heatwave. Were any of you in Chicago in 1995 during the heatwave? It killed 700 people. Notice the air quality. We published this in the journal of Nature, and they subtitled, this was on the cover, and they subtitled this “The Wheezy City” because they thought our paper was on air pollution. Our paper was on heatwaves, and during a heatwave, you get stagnant air masses, and it’s estimated that a quarter to a third of the deaths during heatwaves are because of exacerbations in air quality.

We’ve done modeling studies of air pollution and climate. Ground-level smog ozone is very temperature-sensitive, so that brown haze smog is temperature-sensitive. There are models that show that that will increase with climate change. Now let’s look around the world, estimates for future summer temperatures, and the top map is mid-century. Let’s focus on the bottom map, which is by the end of the century. Everything in this dark red color will have a 90% probability or greater of having their hottest summer in history, and what’s concerning, especially in tropical regions, is that when you’re growing crops within a climatic envelope, so you don’t want it to be too cold or too hot to grow food, that these extreme temperatures will be devastating for crop yields, and this is published in the journal Science about 10 years ago, and similar studies are reinforcing these results that estimate that today’s 800 million people at risk for hunger could double by mid-century. That’s a public health crisis when you think about that effect, but I do have some good news, thinking about all these crop failures. There are some plants that will benefit from higher temperatures and more CO2. How many of you like ragweed and poison ivy? (audience laughing) So poison ivy does well, ragweed pollen does well with more CO2 and warmer temperatures, and this is a study from my hometown, sorry, I’m not from Wisconsin, my hometown of Baltimore where they planted ragweed plants on top of the Baltimore Science Center, that’s demonstrated right, here we are, right here, and then in the suburban area and a rural area, basically in the downtown urban core, it’s warmer, urban heat island effect, and there’s more CO2 from traffic, so ragweed plants produce much more pollen under those conditions of higher temperatures and more CO2 compared to the rural areas. So we were part of a study.

Wisconsin is monitoring ragweed pollen on top of the hospital, on top of the roof there, and if you look at ragweed season across the United States, notice that especially in the northern latitudes ragweed pollen season has increased two or three weeks, 24 days here, Wisconsin it’s increased 13 days, so ragweed pollen season is 13 days longer in Wisconsin, and we’ve seen, of course, the northern hemisphere, CO2 has increased 27%. Wisconsin has warmed since the 1950s by one degree Fahrenheit, so increases in ragweed pollen and that’s a problem for children who have asthma, but, of course, global warming’s greatest threat may also be the smallest. Now what is being conveyed in this slide? What is the difference between us mammals and that mosquito on the slide, besides the fact that we can’t fly? And Tom guaranteed me that at least 85% of you do not suck blood. (audience chuckling) So we are warm-blooded. Our body temperature’s always about the same, but mosquitoes are cold-blooded, so whatever the air temperature is around that mosquito, that’s her body temperature, and if she’s carrying dangerous parasites that cause malaria or all sorts of different diseases carried by mosquitoes, the temperature determines the development rate of the pathogen inside the mosquito. This is a particular mosquito species. Unlike the malaria mosquito, which is the genus Culex, I’m sorry, Anopheles, Culex carries West Nile virus. Anopheles mosquitoes carry malaria, Culex mosquitoes carry West Nile virus and equine encephalitis. This is Aedes aegypti mosquito, which carries yellow fever, dengue fever, and Zika virus. Dengue fever is the most prevalent mosquito-borne virus in the world, and it’s the same family as Zika virus.

When Zika virus erupted in Brazil and Colombia, the climatic conditions were very unusual. In fact, just prior to the Zika virus epidemic, which coincided with one of the largest dengue fever epidemics, you can see El Nino, El Nino of 2015 brought historic high temperatures into the regions. Temperatures, according to our analysis, were two standard deviations higher than a constructed 50 year average, so it was really hot, and the ability of that mosquito to carry dengue fever and Zika virus was at its highest level, as far as a biological transmissibility of these viruses, was at its highest level because of these hot temperatures. Now, the temperatures are not everything. There’s international travel and how did Zika get to South America in the first place? Probably from international travel, but the extreme climate, we think, had something to do with the emergence of Zika in South America. Quick reminder, it’s not just about temperatures. Climate change is about extremes of the water cycle. We have noticed that in Wisconsin, and I notice your next Wednesday night lecture is on flooding. This is the Kickapoo River last year. Big problems, big flooding problems for Wisconsin, and this is not new.

We know that we have problems when we have extreme heavy rainfall, but with climate change, the issue is that it’s not necessarily going to rain more or less in a particular time. Because hot air holds more moisture, when it rains, it can rain really hard, so this is showing that future projections with climate change, it’s the type of rainfall that is going to be increasing. The heavy downpour events will be increasing, and this is looking modeling across the globe, and when it rains it will pour. We’ve studied what the effect is for water quality, and right now in Chicago, you get these combined sewage overflow events. When it rains too hard, there is contamination. We modeled the Chicago water basin and found that there would be, by the middle of the century, because of more extreme heavy rainfall, a doubling in the number of these combined sewage overflow events. So strains on water contamination, and if you any of you are from Milwaukee, you know the problems when it rains too hard and you get the rainfall and runoff that goes out into Lake Michigan into the bay there. My colleague, Dr. Sandra McLellan at UWM, she goes out and dips for bacteria, for E. coli bacteria, after every rainstorm that Milwaukee has, and if you can notice these flaming blue hot colors are right here at South Shore Beach and flaming red hot high counts of E.

coli bacteria on Bradford Beach. Don’t go swimming at these beaches after a heavy rainstorm because there’s risk of recreational exposure, so it’s not surprising that increases in heavy rainfall are going to threaten our water and, in this case, recreational safety with water. So when we think about climate change, too often we think of climate change as an environmental risk, and you see the picture of the polar bear. I would argue that really these are the new faces of climate change. Climate change absolutely is a human health crisis, looking at asthma, diarrheal disease, refugees, but also mental health. Not only do climate disasters cause post-traumatic stress disorder, PTSD, but there is now evidence of pre-traumatic stress disorder. People are becoming very anxious about the looming crisis. So I’ll shift gears and take a sip of water, ’cause I get choked up about this. So, there’s another element here, and this is an ethical challenge. We wrote a paper 12 years ago calling climate change and health the greatest ethical dilemma of our times.

If you look at these data-driven cartogram maps, on the bottom what we see are climate-sensitive diseases, malnutrition, diarrheal disease, malaria, those three in particular. What countries are already experiencing increases in these climate-sensitive diseases? It’s these poor countries in sub-Saharan Africa, India, but then the question is who’s actually causing climate change? Who’s emitting the most greenhouse gases in the world that’s causing the problem? And you can see that’s the top map. This is a 50 year aggregate of CO2 emissions. Africa’s not causing the problem. The United States is the number one contributor historically to greenhouse gas emissions, and so for today’s climate change, the United States is the number one most responsible country. Now, China is out-polluting us now, and in a few decades, they may become number one, although they’re also number one in solar energy investment and technology, so they’re sort of hedging their bets, but right now, per capita Americans are very responsible for this problem that we have globally. On average, we emit six times more CO2 per person than an average global citizen because of our energy consumption. So after publishing this, this got a lot of visibility, and I found myself in front of His Holiness, the Dalai Lama, showing him that exact map and explaining to him how climate change is a health issue, and that people are dying from climate change for all sorts of things, all sorts of health outcomes, that I just showed you, and he’s a very smart man and he said, “Jonathan, if you know that pollution kills, your country is not showing much compassion, correct?” At which point I got choked up a little bit, and I said, “You know. ” I started to say it’s complicated, but I decided not to say that, and I started to say, “We are a fossil fuel-based economy and we didn’t know that air pollution was bad. ” Actually, you know what, I think I did say this, because I said, “We didn’t know “that air pollution was harmful “until after the killer London smog episode of 1952, and then we got smart about it.

” And then he looked at me, he said, “Yeah, well, how long have you known about climate change?” And I said, “Well, just about 25 years ago. ” And he said, “25 years ago, you guys should be doing something by now. ” Well, I told him I would get back to him. (audience laughing) And so I thought about his challenge. It’s such a devastating crisis and you’re killing people. Why aren’t we doing something? What’s so hard about it? So I went to the 2015 21st Conference of the Parties of the United Nations Framework Convention on Climate Change, the big Paris summit on climate, and it was really exciting because countries came in with big pledges. They pledged, I’ll just show you, these are these intended nationally determined commitments, the INDCs, intended nationally determined commitments to reduce greenhouse gases. Now, business as usual takes us, no action takes us up to eight degrees Fahrenheit, four and a half degrees centigrade warming, or actually more now, but these big commitments, 40% reduction by the EU, 28% reductions by the US and Australia. Big reductions. Saying we promise in the next 15 years to cut our emissions tremendously, that still, even if everyone lived up to their bargain, that still only gets us to this reduction down to three and a half degrees centigrade warming, and all the impact scientists that I’ve been working with with the United Nations Intergovernmental Panel on Climate Change have pretty much set two degrees, two degrees centigrade, as a level above which there will be dangerous impacts.

Ecosystems will fall apart. If the Earth warms above two degrees warming, it’s going to get nasty, so please stay below two degrees centigrade. Nothing magic about two degrees, but these assessments have been going on and on every five years and they get better and better. The assessments are it gets nasty above two degrees warming. So how do we ratchet, how do we get down there? And here’s my bias because I’m a health guy, right? To get immediate and substantial action, I feel really strongly, and I’ve felt this way for 20 years, and keep feeling stronger about it, that climate change is a health issue and it’s really important to talk about it with the health frame. I think there’s more common ground when you talk about the health effects of climate change, and there’ll be more incentive to go faster further on solving the problem. From the Paris Agreement, the Intergovernmental Panel on Climate Change was asked a follow-up question. Well, what would it take to stay below two degrees centigrade? What do we have to do with our energy policies to stay below two degrees centigrade warming, and, if possible, what would it take to stay below one and a half degrees centigrade warming, and what might the difference be? So, this report just came out in October, and this is a report, you all have heard this in the news. Once I get to the punchline, I’ll show you. So, the report is called Global Warming of 1.

5 Degrees Centigrade and an assessment of that and what does it take to stay that. To stabilize at one and a half degrees warming, this is what you’ve heard in the news, that we will have to cut emissions mostly burning fossil fuels but also cutting rainforests is a problem, but we have to cut emissions 45% by the year 2030 and be net carbon zero by 2050. So you have heard, now it’s 2019, so by 2030, that’s 11 years. Last year you heard the big news, we have 12 years. You’ve heard Fridays for the Future, the children protesting, saying, “Why should we go to school? “What’s our future? “If you guys don’t do something about climate change “and we only have 11 years left, “we have no future. You are spending our future. ” So, you saw this news, you’ve heard about it. This is the idea we have 11 years to get our act together and really go be serious about cutting emissions. Challenging. Maybe.

I argue that cutting climate change could be free. Even a net gain. Remember the title of my talk? Golden Opportunity in Solving the Climate Crisis? We’ve started publishing on this, golden opportunities, solving the global climate crisis, the greatest health opportunity of our times. Why? Well, look at the energy sector. From dirty energy, and this is something you all probably know already, air pollution kills seven million people every year prematurely according to the World Health Organization and the Global Burden of Disease Report. Air pollution kills a lot of people, especially burning coal and oil and dirty energy. Food systems. Chronic diseases from y’know, cardiovascular disease, heart attacks, and strokes and diabetes, having an unhealthy diet is also environmentally unfriendly. A high red meat diet is environmentally unfriendly and not great for our cardiovascular systems. In poor countries, I don’t advocate no meat.

Meat is important in many places in the world, but in very rich countries, overabundance of red meat is a problem with chronic disease, and, finally, transportation. It’s estimated now that physical inactivity, mostly because of automobile overdependence, is killing more than five million people every year from sedentary lifestyles. So if you look at these big health problems, a low carbon economy could be a huge boon, a huge benefit for health. Here’s an analysis published in Nature Climate Change. Came out of MIT. They looked at a systems approach of a clean energy system for the United States, and it’s complicated what it means to have this clean energy system, but basically a clean energy economy in the United States, and, with that, what would the air quality change be? Cleaner air from cleaner energy? And this is straight from their abstract that the health benefits could offset the investment cost of that clean energy anywhere between 26% and 1050% of the US carbon investment, trying to get to low carbon. So the health benefit from clean air could be anywhere from a quarter to 10 times greater in value than investing in the clean energy. This study was derived from a University of Wisconsin study done a little bit earlier where we only looked at the US, this is now looking globally, that the investment cost of not emitting one ton of CO2, so having clean energy so that you avoid emitting one ton of CO2, which is the most abundant greenhouse gas, might cost $30 in clean energy technology. It might cost $30. Well, what happens when you don’t burn coal and oil that creates greenhouse gas emissions like CO2? You also don’t emit dangerous fine particles, PM2.

5, sulfur dioxide, nitrogen dioxide, the nasty pollutants that we know kill people. So for every ton of CO2 you don’t emit, you’re also not emitting all those nasty, harmful air pollutants, so much so that the clean air benefit from just looking at reduced fine particles, PM2. 5, would be equivalent, would be $200 in avoided mortality and hospitalization from that improvement in air quality. So when I’m in the state legislature, I’ve asked ’em, I’ve said, “Okay. “I want you to take a deep breath. “I’m going to ask you a really tough question based on this. “Look at the $200 and look at the $30, and ask yourself which number is bigger. ” (audience laughing) And the answer I got was, “Well, we were only thinking about “the investment side on the left. “We didn’t know, we weren’t thinking about, well, the health benefit from clean air would be enormous. ” And I was happy that they said that, that they admitted that we really hadn’t thought of that, but it’s a much bigger number, so the health benefits from clean energy are enormous, and even much higher in places like India and China where you have really more serious air pollution.

But looking at that $30, I question if it’s that expensive. Look at the cost of solar energy. It’s dropped 99% in several decades, and solar and wind have dropped 80% and 30% respectively in the last seven years. My colleague, Greg Nemet, just came out with a book. He got a grant to write a book on why on Earth solar energy dropped way faster than anyone ever imagined, and he’s a professor here who’s analyzed that, you know what, we have been shocked by how fast the price of solar has dropped. So we’re not waiting for solutions. We’re not waiting for cheap energy solutions. So renewables are here, they’re cheap, but there’s always an argument, right? What about jobs? Hey, what about the fossil fuel jobs? Well, this is from the 2017 US Energy and Employment Report showing one million US jobs in renewable energy. That’s five times more employment compared to jobs in coal, oil, and gas combined, as far as energy, and, for me, jobs and income is health. So the job story.

Now, I have an MD behind my name, and so we would be really stupid if we don’t show serious compassion for coal miners and coal mining communities. They will become a– They’re now a vulnerable population in this energy transition. We absolutely cannot burn anymore coal, but we better take care of those communities that depend on coal and be serious about investing in and helping those people, ’cause they are now a vulnerable population. Absolutely have to take care of coal miners, but we cannot be burning more coal. One of our superstar graduate students did this report. When asked y’know, can Wisconsin create all of its energy from in-state sources? Right now, we spend 14 billion out of state. We send 14 billion out of state to bring in coal-fired electricity, dirty electricity that we’re shipping money out of state. Can we create all that energy from inside Wisconsin? And the analysis was, number one, switching to an entirely electric economy from 100% in-state clean power. Is it possible? The answer was yes. The answer was yes and it was about 35% wind, 30% solar, conservation measures, and about 6% nuclear.

Keep nuclear, don’t get rid of it, but don’t expand it. So those were some of the main energy sources. Yes, we can produce all of our power in-state, and it would create 162,000 net new jobs. You would save the $14 billion and actually generate another $13 billion for the state GDP, and as far as health, the clean air quality, we’re talking about avoided health damages, and a lot of this is mortality, of $21 billion a year. So, oh my God, why don’t we do this? Why don’t we save money in Wisconsin, create jobs, have healthier environment and let’s go! There’s no reason not to do that. Okay, food sector, food systems. Can you read that in the back? “I am full of greenhouse gas, do you have a steak in it?” (audience laughing) This is from the People’s Climate March in New York a few years ago. So this is something you all know, that a high-meat diet, this is looking at a high-meat diet here, is very harmful for the environment. This is looking at CO2 equivalence, as far as water, energy, fertilizer, feed, all the stuff that goes into producing a gram of protein from a high-meat diet is very hard on the environment. This is a low-meat diet, fish, vegetarian, vegan.

So eating lower on the food chain is healthier for the environment and for our cardiovascular systems. There’s studies showing less meat in the diet, less saturated fat, reduce heart attacks, a bunch of studies like that. We also have to think outside of the box. Thinking about food sources, I know the Impossible Burger is here, y’know, plant-based, plant-based food, but something else. I’ve got a student who’s been, actually she’s a postdoc now working on entomophagy. Did any of you come to our Swarm to Table event? (audience murmuring) You know, Farm to Table? Swarm to Table, we had an expert in edible insects, a chef come from New York and then the World Authority from Holland came over, so we have to be thinking outside of the box. Think about, y’know, look at this comparison in looking at red meat, so red meat and pork, chickens, and crickets. (audience chuckling) Comparing the feed conversion, how much food you have to put into this, and water and land use. Cutting rainforests for pastures, that’s terrible, right? So crickets for and insects for feed for chickens, or grinding up cricket powder, which is a really amazing protein, and putting it into things. People don’t have to eat insects, and there is the yuck factor in this country, and many, but two billion people around the world eat insects by choice, not because of poverty.

So we have to be thinking this way about possible futures. Okay, another one of my postdocs, Jason Vargo, came up with this term, Metro sapiens. Since 2006, there are now more people for the first time in history that live in cities compared to the countryside, so more of us are urban dwellers, right, so we are Metro sapiens. I want to ask you another tough question. I want you to look at the next picture, and I want you to ask yourself, “What’s wrong with this picture?” (audience laughing) And many people would argue that we have designed our cities especially in the United States, we’ve designed our cities to, we’ve designed out routine exercise. Now, if you’re in a wheelchair, of course, you take the elevator around the back. You don’t take an escalator. So we’ve designed cities like this, and US transportation, which is very automobile-dependent, has contributed to sedentary lifestyles. In our country, there are 60% of Americans that do not even meet the minimum level of physical activity. So that’s a crisis, that’s a problem.

And y’know, we have terrible y’know, rates of obesity in adults and children are very significant. 600,000 people die of heart attacks every year, but here’s the golden opportunity. Almost half of car trips are really short trips. I have a car. Now, I bike because it’s more convenient in Madison, and luckily we live in a city that’s very bikeable. It’s platinum-ranked for bikeability, but most people in America live in cities that are not like Madison, and it’s really, it’s criminal that people do not have a choice in their transportation. I can choose to bike. Well, when I lived in Baltimore, when I was working– when I was at Johns Hopkins School of Public Health, I rode my bike into work twice, and I said, “Wow, is that too dangerous. ” No way, that physical fitness, forget it. By design, I’d be taking my life in my hands.

So the fact that we have so many short car trips that could be bikeable, we need better mass transit. Not everybody can bike, people are injured, People have– not everybody can get around on a bike or walking, so we have to have really effective transit, mass transit, and options for active transportation, walking and biking. When you look at these 60% of Americans don’t even meet the minimum levels of exercise. Let me compare a couple places in the US. Looking at how driving drives obesity, in Washington, D. C. , they ranked number one for leaving their car behind, taking mass transit, either walking or biking, they are ranked number one for active travel, and as far as disease, they would rank number one, but there’s too much stress in Washington, so they rank number three, versus Alabama, they are dead last for driving, they have terrible mass transit, they don’t take mass transit, they don’t walk, they don’t bike because they can’t. It’s not personal choice, and because of the incredible obesity rates in Alabama, well, part of it is food, yes, food is part of it, but I would argue this is an ethical challenge that they don’t even have access if they wanted to be able to commute in an active way, and Wisconsin, we’re in the middle somewhere. So this is where urban design, what a golden opportunity for improving our health. So we’ve done studies looking at what if you shifted transportation? What if you had more biking? Comparing cities around the United States, the cities with the highest rates of walking and biking have obesity rates and diabetes rates 20% and 23% lower than the cities that have the lowest rates of active travel.

And, of course, exercise has many other benefits. Heart disease reduction, cancer reduction, dementia, depression, all these things. Exercise is really great. One of my students, Maggie Grabow, did this study where we the headline was Swapping Tail Pipes for Pedals: Small Changes Could Pay Huge Dividends For Public Health And The Economy. We found that if we could get those short car trips off the roads in the 11 largest cities in the Midwest, just in the metropolitan area, and turn half of those car trips only in the summertime, you don’t need the studded tires, just summertime biking half the time for those short car trips, we would save 1300 lives every year and billions of dollars in avoided mortality and hospitalization, so golden opportunity. And, finally, how we design our cities not only for active travel but for green space, and that there are studies, this is a study out of Milwaukee showing that green space reduces depression, stress, and anxiety very significantly, almost like moving and divorce, big numbers as far as mental health effects of green space. So designing cities for people, for mental health, for physical fitness, golden opportunity. This is a brand new study this year out of Denmark showing the association between the relative risk of developing any psychiatric disorder in children, comparing the level of green space across the urban environment, the suburban environment, any place they went, they saw the more green space led to less psychiatric disorders, so mental health benefit. So I’ll wrap up by talking about attitudes on climate change. This is a colleague of mine, Ed Maibach.

He’s one of these really smart guys that looks at climate change communication and attitudes. He and his colleague at Yale, Tony Leiserowitz, have published something called The Six Americas showing people that are alarmed, alarmed, concerned, cautious, disengaged, what does that say? – [Audience] Doubtful. – Yeah, and then dismissive, right? Right. So never before in the United States, and this is from 2018 the most recent survey across America, never before in the US has a public been more ready to hear about actions on the global climate crisis. Right now, almost 60% of people are alarmed or concerned. That’s the highest it’s been. Forget about the politics in Washington. If you poll Americans, we’re at a very high level of concern for doing something and, of course, there’s now the Citizens Climate Lobby has been working through this bipartisan climate coalition in Congress, so in the House, there’s this climate solution, this Energy Innovation and Carbon Dividend Act, the idea that it’s not a carbon tax, but it’s money back to people putting a carbon dividend, and, for my background in public health, I’d say, “What do we know about preventive measures about one of the biggest killers that we know, smoking?” Youth smoking dropped precipitously when cigarette prices rose, so I argue that, like tobacco, it’s time for a real price on carbon, but parallel to the tobacco companies, the fossil fuel companies are putting tons of climate change disinformation campaigns around that climate change, it’s not real, don’t believe it, but here’s my argument. Regardless of one’s views on climate change science, we can all agree on safe routes to school, physically fit children and adults from cities designed for people, not just for cars, clean air from low carbon energy, green jobs and lots of them, reduced stress and depression and anxiety from green cities. So even if you don’t believe in climate, climate change, it’s real, it’s now, it’s serious, but even if you don’t believe it, I mean, what a golden opportunity.

A low-carbon economy gives us all these amazing health opportunities. So with that, I want to reinforce that climate change is absolutely a health issue, and clean energy, a clean energy economy, offers health opportunities, and because it’s all about communication and talking more about the global climate crisis, not less, to talk more about it, you can take a 19-minute version of this talk that you just heard ’cause I did a TEDx at Oshkosh, so you can spread this to all your networks. I see some young people here. You have bigger networks, right? So spread this, help this go viral. You can just Google my name and TEDx and take my 19-minute TEDx talk and send it to all your friends, so, with that, I thank you very much for your attention. (audience applauding)