Immediate action is needed to reduce carbon emissions and protect Americans from the growing effects of climate change, according to the most recent policy brief from The Lancet Countdown. Without it, people across the nation will increasingly be exposed to threats to their health and well-being, said the report, which was co-launched by APHA on Nov. 15.

The Nation’s Health spoke with Renee Salas, MD, MPH, MS, the brief’s co-author, about the health impact of climate change, policy recommendations and what individuals can do to protect their health. Salas is an emergency medicine physician and affiliated faculty at Harvard University’s Center for Climate, Health and the Global Environment.


In a nutshell, what do people need to know from this report? 
This report covers a broad range of findings, from quantifying how the burning of fossil fuels — which is the main driver of climate change and contributes to premature death due to particulate air pollution — to how the fossil fuel sector is financed. 

It also quantifies how the health of those in the United States are harmed by climate change. We stress, as we have every year, that these harms are not equally distributed, and that those who have existing health disparities from economic injustice and structural racism are impacted more. 


How is the US doing on greenhouse gas emissions? Salas portrait
The U.S. remains a leading contributor to greenhouse gas and air pollution emissions. We have among the highest per capita carbon emissions in the world, even surpassing China.

While we didn't cover this in the brief, there are new reports that have come out that show that 2023 will have had about a 3% reduction in carbon dioxide emissions in the U.S., and that has been driven primarily by a decline in coal-related carbon emissions. There’s hopeful signs that we're on the right track, but we have significant work to do.


The report mentions using green space in urban centers to mitigate rising U.S. temperatures. How does that work?
When we build cities, we use a lot of man-made material, like pavement or concrete, and anyone who has stood in a parking lot versus standing in the shade of a tree in a park knows that there is a substantial difference between those two environments.

These nature-oriented strategies of creating more green space, like trees and parks, can help reduce temperatures in what are called urban heat islands. This not only helps to lower temperatures, but also has a multitude of other benefits for health, like improving physical activity and mental health. 


What will sea rise from global warming mean for the 2 million people in the US who live less than 3 feet above sea level? 
As sea levels rise, that can accelerate flooding, which contaminates drinking water and soil with waterborne pathogens from septic systems and from toxic substances from industrial facilities.

Saltwater and flooding can also make it harder for people to access medical care. Even if the hospital or medical facility itself is open, it can flood the roads and prevent people (from being transported) to hospitals. 

There's also significant mental health impacts, which can be especially long-lasting, thinking about the devastating economic losses and how flooding can impact cultural heritage sites, particularly in Indigenous communities or others who rely on coastal resources for economic, social and cultural practices.


What can individuals do to protect themselves? 
After educating yourself and your community on the ways in which fossil fuel pollution and climate change harm health, tell your elected representatives and other decisionmakers why you care about healthy, equitable and sustainable communities, and what the health benefits are of quickly moving toward renewable energy like solar and wind and electric transportation. Small actions matter too, and we can all think about how we contribute to our own carbon footprint, like choosing renewable energy to power your home, riding your bike to work instead of driving, or consuming less goods. 

Worker sweeps flooding water in business

Lastly, it's critical that we learn how to protect ourselves and our family and those around us from the harms happening now. For example, it's important to improve the air you breathe by minimizing how much air pollution you're exposed to from burning of coal and climate-intensified wildfire smoke, and this can include accessing resources from your public health department or speaking to your medical professionals about interventions like checking the air quality alerts or weatherizing your home to keep unhealthy air out or installing air filtration systems. 

Another example is coming up with a disaster plan for how to keep accessing your medications or power generated medical devices during a power outage.


What can policymakers do to slow climate change and protect health?
We have four recommendations that we put forth in the brief that are all centered around the idea that a rapid transition from fossil fuels is essential to save lives, protect health and well-being, avoid the worst impacts of climate change, and maintain a healthy environment. 

Recommendation one is to take action to reduce air pollution, which will simultaneously reduce the health risks from fossil fuels today. The second recommendation is we must protect health from future climate change by ending fossil fuel exploration and extraction and we have to rapidly phase out fossil fuel use and end fossil fuel subsidies. 

Our third recommendation is to ensure that protecting and enhancing human health is a central consideration as we have a societal-wide transition to renewable non-combustion energy.

And lastly, we have to invest in adaptation to protect people's health from the harms of climate change today.

For more information on the “2023 Lancet Countdown on Health and Climate Change U.S.,” and to watch a recording of the launch event with APHA, visit 

Bottom photo: A worker sweeps flood water at Alley Restaurant in Scituate, Massachusetts, in January following heavy rains. (Photo by John Tlumacki, courtesy The Boston Globe/Getty Images)