Changing Planet, Changing Health by Paul R. Epstein and Dan Ferber

June 1, 2011

Changing Planet, Changing Health
Changing Planet, Changing Health: How the Climate
Crisis Threatens Our Health and What We Can Do
about It
by Paul R. Epstein and Dan Ferber ’84.
University of California Press, 2011. 368 pages. $29.95

Among many arresting images in this new book by Paul Epstein and Dan Ferber, one stands out: Africa’s upwardly mobile mosquitoes.

An increase in average global temperatures has warmed the East African highlands that until recently were too cold for malaria-carrying mosquitoes to survive. So the insects are moving up, from their historical home in the tropical lowlands to the highlands, where residents used to feel safe from a disease that kills more than one million people each year. And now highland Africans are dying, too.

In Changing Planet, Changing Health: How the Climate Crisis Threatens Our Health and What We Can Do about It, it’s not only the polar bears on their shrinking ice floes who should be worried. Epstein, a medical doctor trained in tropical public health, and Ferber, a science journalist, make the case that climate change’s one-two punch—a warming planet and more extreme weather events—are harming humans now.

Drawing on Epstein’s substantial work in the climate-health field and other peer-reviewed research, the authors show that the impacts of climate change—warming seas, drought, species decline, etc.—don’t end there. Each trend is already exacting a price on people, through the resurgence of infectious, potentially fatal diseases such as malaria and cholera in Africa and South America; record-shattering heat, most notably the 2003 heat wave that killed more than 52,000 in Europe; and stifling air in U.S. cities that worsens the plight of allergy and asthma sufferers, especially children.

Yet when Epstein and another physician attended the Earth Summit in Rio de Janeiro in 1992, a milestone meeting of world leaders and top researchers, they were stunned by the blank stares. “We attended many research presentations on climate change, trade and endangered species but could find no one talking about human health consequences,” Epstein writes. “What are you doing at an environmental meeting?” the other delegates asked. “You’re doctors.”

But Epstein had a hunch.

He knew that weather fluctuations could trigger epidemics. Longer warm and rainy seasons give disease-carrying mosquitoes more opportunity to breed and infect victims. Drought gives way to poor hygiene, raising the risk for waterborne illness. Hurricanes and floods can cripple water supplies and sanitation, prompting outbreaks of gastrointestinal viruses.

Epstein, now associate director of the Center for Health and the Global Environment at Harvard Medical School, spent almost two decades as a physician in low-income communities, mostly around Boston. But a stint in Mozambique, treating cholera victims in a 1978 outbreak, planted the seed for more global pursuits and his growing suspicion: If weather patterns affect the spread of disease, and climate change is linked to warmer oceans and mountains, more wildfires, stronger hurricanes, and so on, would climate change lead to more disease? Had it already?

From Bangladesh, Epstein reviews research that shows warming seawater can awaken dormant cholera bacteria within, a clue to how the disease resurfaced in South America in 1991 after more than a century of latency. In Kenya, he documents how malaria-carrying mosquitoes have widened their territory to infect people never before exposed.

In congested U.S. cities, rising carbon dioxide—aside from its impact on the global climate—will make it harder for Americans with asthma, allergies, and other respiratory ailments to breathe, Epstein and Ferber write. Culprits include familiar soot and smog but also ragweed, which thrives in high CO2 conditions, pumping out many times the amount of pollen in the city than it does in the country.

The authors conjure vivid images—beetles that invade Wyoming’s venerable whitebark pines are causing the “rooftop of the Rockies” to crumble; snails and clams that have trouble building shells are suffering from “oceanic osteoporosis,” the result of increasingly acidic oceans.

In other sections, attempts to weave an exciting narrative where none exists can try a reader’s patience (“Githeko…stopped at a blue wooden gate. He honked his horn. There was no answer, so he opened the gate himself. He parked on a small lawn …”). An overly detailed detour through the anatomy of financial markets slows a final section already packed with solutions. Those culminate in a “new international financial architecture” to address the root causes of environmental damage, including a tax on currency speculation that the authors estimate would raise an estimated $5 billion per year for efforts to curb global warming.

The cholera victims, wasting trees, and dying oysters provide compelling evidence that our fates are inextricably linked to the natural world, but Epstein is ultimately hopeful that humanity can and will make healthier choices. We better get to it, he and Ferber argue. Climate change surely is ailing the world—and has the potential to make us all sick.

The Oregonian.