The world’s climate crisis has spared no one. Science tells us that the harms of climate change will worsen with time if we fail to take substantial actions now to reduce carbon pollution. In the United States, the growing burden of atmospheric carbon pollution has already fueled searing heat waves that have triggered bouts of asthma, heart attacks, and kidney failure. It has unleashed unprecedented rains in the Midwest that have jeopardized health for thousands of people. It has stoked wildfires in the West that have taken lives, razed homes and hospitals, and sent toxic plumes of smoke across the continent. And it has fueled powerful hurricanes, like Maria and Harvey, that have enfeebled hospitals and clinics and forced rationing of critical medical supplies such as IV fluids nationwide.

Burning fossil fuels generates roughly 80% of our country’s carbon pollution and the bulk of other air pollutants known to cause or exacerbate a host of ailments, including everything from chronic obstructive pulmonary disease, myocardial infarction, and stroke to lung cancer, type 2 diabetes, pneumonia, and possibly even dementia. Actions that reduce carbon pollution often offer important opportunities to reduce conventional air pollution and save lives and health care costs, with benefits that tend to accrue in greater shares to the poor and people of color, because they bear the brunt of air pollution from fossil fuels.

Yet while scientists tell us we have little time to wait if we hope to avoid the most devastating effects of climate change, leaders in Washington, D.C., are attacking science and rolling back Obama-era rules from the Environmental Protection Agency (EPA), as detailed by the Harvard Law School Environmental and Energy Law Program (https://eelp.law.harvard.edu/epa-mission-tracker). The EPA is now working to weaken fuel-efficiency standards for cars, relax rules on methane emissions, stop regulating mercury emissions, and implement other changes related to power plants that all lead to increased air pollution. Such efforts deprecate climate science and advance the interests of the fossil-fuel industries while exacerbating harm to human health.

The EPA’s most recent target is the Clean Power Plan (CPP), a policy finalized by the Obama administration in 2015. The CPP established the country’s first-ever carbon-pollution limits for coal- and gas-fired power plants, requiring emission reductions beginning in 2022 that were scheduled to ramp up over time. It would have led to a 32% reduction in carbon emissions from power plants below 2005 levels by 2030 — enough to offset all the carbon emissions from the U.S. health care sector. It would also have saved thousands of lives each year while providing states the flexibility to design their own compliance plans.

But the CPP was scuttled this June by the Trump administration’s Affordable Clean Energy (ACE) rule, which is neither affordable nor clean. Unlike the CPP, ACE takes credit for all the reductions already projected to happen between now and 2030 but doesn’t actually lock in those reductions. Instead, it allows states to decide whether they will require installation of a few technologies that could improve the efficiency of the electric generating units at power plants. But these technologies may also lead to the units running more, resulting in more emissions. So though the EPA projects that ACE could result in a 1% improvement in carbon emissions over “business as usual” by 2030, analysis by our center and our partners suggests that it could end up offering no carbon-reduction benefit at all. In other words, the rule would do little to nothing to address our climate crisis and would cost, rather than save, lives.1

If these EPA rollbacks are successful, they will diminish our ability to mitigate health effects and diseases related to the burning of fossil fuels and the immense toll they take on our families. If we stop supporting and listening to the best available science, if we allow more pollution to be emitted, and if we start limiting the EPA’s ability to monitor and enforce pollution standards, then we put at risk everyone’s health — and especially the health and future of our children.

Many health care systems, including Kaiser Permanente, Gundersen Health System, and Partners HealthCare, have been responding to the climate crisis. Recognizing that climate change is already harming patients, they are reducing their own greenhouse-gas emissions from hospitals and clinics to ensure that their facilities are not part of the problem. Some are also making their facilities and operations more resilient to the impact of climate change so that they can continue to function if disaster strikes.2

But the health care sector can do so much more to protect patients. Research could explain the vulnerability of critical medical supply chains to climate disruptions and help us adapt the care we provide, including the drugs we prescribe, given changing risks. Since some types of patients are especially vulnerable to health effects of heat waves and other climate-related extreme weather, we can make concerted efforts both to advise them, before disaster strikes, about how to stay safe and to put in place better systems for locating them and getting them access to lifesaving care afterward.

We can also use our roles as trusted advisors to inform and motivate actions that are increasingly necessary to protect the health of the communities we serve. For example, on July 8, 2019, the American Lung Association and the American Public Health Association filed a lawsuit against the EPA claiming that the ACE rule abandons the agency’s legal responsibility to protect health under the Clean Air Act. Although many more lawsuits will follow and the rule may not withstand court challenges, the EPA will already have wasted precious time and meaningful opportunities to reduce carbon emissions — and related health problems — in the time frame that climate change demands.

Other groups are endorsing broader opportunities for increased engagement by health care professionals in the fight against climate change, such as the recently released U.S. Call to Action on Climate, Health, and Equity, signed by 74 health care organizations, including the American Medical Association, the American Academy of Pediatrics, and the American Academy of Nursing.3

This call to action states unequivocally that climate change is a health emergency. It calls out 10 actions to accelerate a just transition to cleaner and safer energy, food, and transportation systems, arguing that we must take these actions to meet our legal obligations and to protect the health and safety of American families, especially those most vulnerable to climate effects. And it makes the case that we must take climate action to protect health care workers’ ability to do our jobs: climate action is as much a medical imperative as a moral one.

Fortunately, some states and cities are working hard to fill the void left by the current administration’s inaction on climate. The Rocky Mountain Institute estimated that the more than 3000 existing climate commitments from cities, states, and businesses could get the United States about two thirds of the way toward our goals set under the Paris Agreement.4 Five states and Puerto Rico, as well as 130 cities, including many of the most populous ones, have committed to shifting to 100% renewable or clean energy in coming decades. Six or more additional states may follow suit in the next year. Even more encouraging is news that many politically conservative states, including Kansas, Texas, and Oklahoma, have the greatest use of renewables.

The medical community can help advance these climate actions. We can demand that proposed climate policies come with a credible accounting of their health effects. We can prioritize research evaluating the health effects of carbon-reduction strategies. We can discuss climate action in ways that make it personal, telling stories about the people we see in our clinics, hospital beds, and emergency departments whose health has been compromised by climate change, in an effort to educate and influence the media, decision makers, and parents.5 Together, we can transform climate change from a politicized problem for polar bears into an opportunity to improve human health — and act to create a healthier, more just, and sustainable world.