According to the World Health Organization (WHO), only 10 percent of the world’s population is less than five-years-old and they will bear 90 percent of the economic and health burden of climate change. We have a very limited amount of time remaining in which to decide whether we will take responsibility to address climate change and the disproportionately devastating effects it will have on our children.

If we do not address this issue, post-millenials will have to deal with the steadily worsening environmental erosion largely because we — the current voting age population — acted irresponsibly.

Whether one believes that climate change is the consequence of “environmental abuse” or some natural recurring weather fluctuation — we have to confront this problem in the interests of Generation Z and those that may (or may not) follow. Politicians are now suggesting that parents consider whether or not to have children in the face of this global thermal crisis.

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The current administration is “hardening its attack on climate science” and working to undermine research demonstrating the dire effects of inaction. However, the disproportionate “dire” impact of climate change on adverse birth outcomes, impairment of cognitive and behavioral development, respiratory illness and potentially childhood cancer is already evident.

As recently reported, the administration is avoiding the opportunity to leave a beneficial health legacy to the next generation of voters by denying or dismissing the existence of climate change.

Scientists project an increase in global temperature 1.5-5.8 degree Celsius (2.7-10.4 degrees Fahrenheit) by the year 2100. This is more than sufficient to affect our children at all ages. Increased temperature in the first trimester of pregnancy is associated with a significant increase in congenital heart disease in the U.S.

A heat wave in the second trimester of pregnancy increases the risk pre-term delivery (less than 34 weeks gestation) by almost 20 percent, plus the care and co-morbidities associated with prematurity add significant health care costs.

These numbers presume that the baby survives to term. A 1 degree Celsius increase in the mean temperature during the week before delivery is associated with a 6 percent increase in the risk of stillbirth.

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A 5.5 degree Celsius increase in the average weekly apparent temperature (similar to the commonly used “real feel temperature”) is correlated with an almost 9 percent increased risk of stillbirth. These numbers are even more alarming in other countries with naturally higher temperatures, less available air conditioning, more frequent heat waves and worse air pollution.

Our children will disproportionately bear the brunt of climate change throughout childhood. They sweat less and acclimatize (adjust to temperature changes) slower than adults while losing more water and absorbing more heat per pound. They are more prone to dehydration, electrolyte imbalance, kidney failure and heat stroke.

In 2014 the CDC reported that heat-related death rates per million people in children less than 1 year of age were 5-8 times greater than those for adults under the age of 35 (the age of most of their parents) and were only exceeded by adults over the age of 65 (the age of many of their grandparents).

Children’s underdeveloped respiratory system, smaller airways and higher respiratory rates make them more susceptible to asthma, pneumonia and other respiratory diseases that are made worse by heat, allergens and air pollution. Children are also more vulnerable to vector-borne (ticks, mosquitoes, etc.,) and water-borne diseases all of which are projected to increase many fold with global warming.

Of course our children are not the only age group adversely affected by climate change. Elder individuals are equally, if not more, vulnerable and should not be ignored. Unlike our children though, this population has the ability to speak out, vote, support efforts to reduce global warming and take some responsibility for our neglect of this issue.

Of course, Robert Mendelsohn and others have suggested that global warming will actually benefit already wealthy investors in certain U.S. industries (forestry, agriculture and commercial fishing for example) while adversely affecting the poor. Each person can decide whether furthering these economic disparities justifies ignoring climate change.

There is ample evidence that we can make a difference. Simply closing coal and oil burning plants in areas in California reduced the incidence of pre-term births by 20-25 percent. Projections of the health benefits of cutting greenhouse gas emissions indicate that cost-effective measures would reduce the overall premature death rate by 0.5-2.2 million people per year. Recent polls suggest that most parents and teachers would like children to learn more about climate change, but most of them don’t talk about it. This is our opportunity to lead, learn and educate by example.

Evaluations by the World Health Organization and multiple independent scientists confirm that climate change is the biggest health threat of this century, especially to our children. In Charles Dickens “A Christmas Carol” Ebenezer Scrooge sees his own death approaching and asks the Ghost of Christmas future whether “these are shadows of things that will be or are they the shadows of things that may be only?”

We are fast approaching the end of the “may be” phase and are now seeing the transformation of shadows and hints into reality. The emergent question now is whether we will change or just leave this problem for our children to deal with.

Dr. Michael Rosenbaum is a professor of Pediatrics and Medicine at Columbia University Irving Medical Center. Dr. Lawrence Stanberry is the associate dean for International Programs and Director of the Programs in Global Health at Columbia University’s Vagelos College of Physicians and Surgeons with particular emphasis on global preparedness and pediatric infectious diseases.