  {"id":12252,"date":"2016-11-04T17:01:14","date_gmt":"2016-11-04T21:01:14","guid":{"rendered":"https:\/\/digital.hbs.edu\/platform-rctom\/submission\/going-out-of-pocket-for-climate-change\/"},"modified":"2016-11-04T17:01:14","modified_gmt":"2016-11-04T21:01:14","slug":"going-out-of-pocket-for-climate-change","status":"publish","type":"hck-submission","link":"https:\/\/d3.harvard.edu\/platform-rctom\/submission\/going-out-of-pocket-for-climate-change\/","title":{"rendered":"Going Out-of-Pocket for Climate Change"},"content":{"rendered":"<p>Spring is a wonderful season. Flowers begin to bloom, leaf buds appear on trees, temperatures start to become tolerable again, birds chirp around you \u2013 what\u2019s not to love?<\/p>\n<p>Well, if you\u2019re anything like me, the answer is easy: allergies. All that pollen in the air and I\u2019ve got itchy eyes and a great deal of sneezing. With global warming and climate change continuing to have widespread effects around the world, my allergies are about to get a lot worse.<\/p>\n<p><strong>Dust Is In the Air<\/strong><\/p>\n<p>As weather patterns continue to become more extreme, humans are going to become increasingly vulnerable to a myriad of health issues. Studies warn of increased risks of cancer, heart disease, mental health disorders, neurological diseases, respiratory disease, and infectious disease<sup>1<\/sup>.<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_12194\" aria-describedby=\"caption-attachment-12194\" style=\"width: 701px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/cc.png\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-12194 size-full\" src=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/cc.png\" alt=\"Health impact of climate change\" width=\"701\" height=\"447\" srcset=\"https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/cc.png 701w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/cc-300x191.png 300w, https:\/\/d3.harvard.edu\/platform-rctom\/wp-content\/uploads\/sites\/4\/2016\/11\/cc-600x383.png 600w\" sizes=\"auto, (max-width: 701px) 100vw, 701px\" \/><\/a><figcaption id=\"caption-attachment-12194\" class=\"wp-caption-text\">Source: National Institute of Environmental Health Sciences<sup>2<\/sup><\/figcaption><\/figure>\n<p>Let\u2019s focus on respiratory disease for a moment. Respiratory diseases are often caused by environmental factors that can either induce or aggravate certain conditions. For example, changes to the environment can significantly exacerbate asthma, trigger bronchitis or emphysema, and even lead to deep vein blood clots and chronic obstructive pulmonary disease<sup>3<\/sup>. As climate change worsens, the incidence of these illnesses is expected to grow significantly for a number of reasons<sup>4<\/sup>:<\/p>\n<ul>\n<li>Longer growing seasons, increased CO<sub>2<\/sub> levels, and higher temperatures can increase pollen production and lengthen or intensify allergies<\/li>\n<li>Mold spores can increase due to precipitation pattern changes<\/li>\n<li>Similarly, dust can increase due to drought pattern changes<\/li>\n<\/ul>\n<p><figure style=\"width: 556px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/static6.businessinsider.com\/image\/55955c87371d22a10e8b5587-881-725\/pollen%20chart.png\" alt=\"Source: Asthma and Allergy Foundation of America\" width=\"556\" height=\"463\" \/><figcaption class=\"wp-caption-text\">Source: Asthma and Allergy Foundation of America [5]<\/figcaption><\/figure>Communities are already seeing the effects. From 2005 to 2012, ER visits for asthma symptoms grew by 18% in California<sup>6<\/sup>. The White House has also released research showing that ozone-related ER visits for asthma in the NY-metro area will increase by 50 annual visits in the 2020s relative to the 1990s<sup>7<\/sup> and that in the past 30 years, the percentage of Americans with asthma has doubled<sup>8<\/sup>.<\/p>\n<p>What does this mean for hospitals and insurers? You can expect future costs from increased doctor visits and disease treatments to rise dramatically, and hospitals and insurance plans need to be ready to handle these population health changes.<\/p>\n<p><strong>Kaiser Permanente Takes the Stage<\/strong><\/p>\n<p>Insurers today are largely focused on reducing emissions, lowering energy consumption, and becoming more sustainable<sup>9,10<\/sup>. While these efforts are a great first step, they are limited to making organizations more environmentally friendly and don\u2019t address the future health risks to their populations discussed above.<\/p>\n<p>Luckily, Kaiser Permanente is taking a hard look at all aspects of climate change. Kaiser is a unique managed care organization that, unlike most other large insurers, also operates its own network of hospitals.<\/p>\n<p>Kathy Gerwig, Kaiser\u2019s Environmental Stewardship Officer, understands what\u2019s at stake. In 2008, Kaiser formalized its efforts to mitigate the effects of climate change and adopted a new statement:<\/p>\n<p><em>\u201cClimate change will cause health effects that will directly impact Kaiser Permanente\u2019s ability to fulfill our promise of quality affordable care.\u201d<sup>11<\/sup><\/em><\/p>\n<figure style=\"width: 368px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"http:\/\/climateforhealth.org\/sites\/climateforhealth.org\/files\/styles\/home_slider\/public\/photos\/feature-gerwig-millettecredit.jpg?itok=hrDWhhRo\" alt=\"Kathy Gerwig\" width=\"368\" height=\"181\" \/><figcaption class=\"wp-caption-text\">Kathy Gerwig<\/figcaption><\/figure>\n<p>Since then, Kaiser has successfully undertaken a number of initiatives to become more sustainable<sup>12<\/sup>:<\/p>\n<ul>\n<li>Reduced water use by 10%<\/li>\n<li>Reduced waste by 41%<\/li>\n<li>Decreased the amount of meat per patient meal by 18%<\/li>\n<li>Increased the amount of locally grown ingredients in patient meals to 50%<\/li>\n<li>Increased reliance on renewable energy<\/li>\n<li>Promoted the recycling and reusing of sterile medical equipment<\/li>\n<\/ul>\n<p>Most importantly, however, Kaiser has developed an \u201cepidemiological database to study the relationship between adverse climate events, [e.g., increased CO<sub>2<\/sub> levels], and disease.\u201d This program, called Research Program on Genes, Environment, and Health, is tasked with understanding the impact of the environment on specific diseases<sup>13<\/sup>. The organization has been analyzing data collected from over 10 million member health records in 7 geographic regions across the U.S., a unique benefit of Kaiser having its own hospital system<sup>14<\/sup>.<\/p>\n<p><strong>What\u2019s Next?<\/strong><\/p>\n<p>Already within its industry, Kaiser is recognized as a leader in preparing itself for climate change, both by reducing its own impact on the environment and launching initiatives to analyze the health risks of climate change. Despite the many awards Kaiser has already won, there\u2019s more work to be done.<\/p>\n<p>Kaiser can build deeper relationships with other data owners, such as EPIC and athenahealth (electronic health records firms) and invest more heavily in population health data analytics. Partnerships with data owners can broaden the geographic coverage of the database, and heavier investment in analytics can better uncover environmental disease patterns across the country. Kaiser can also serve as a knowledge center within the industry and share best practices with other plans and hospitals regarding both its sustainability efforts and analytics efforts. Hopefully, Kaiser\u2019s current efforts are simply the start of an industry-wide push to understand and plan for the unfortunate but very real health risks of climate change.<\/p>\n<p>&nbsp;<\/p>\n<p><em>Word Count: 785<\/em><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Sources:<\/strong><\/p>\n<ol>\n<li>\u201cA Human Health Perspective on Climate Change,\u201d National Institute of Environmental Health Sciences, 2010, p. 7, [http:\/\/www.niehs.nih.gov\/health\/materials\/a_human_health_perspective_on_climate_change_full_report_508.pdf], accessed November 2016.<\/li>\n<li>Ibid., p. 5<\/li>\n<li>Ibid., p. 13.<\/li>\n<li>\u201cAsthma, Respiratory Allergies and Airway Diseases,\u201d NIH, 2016, [http:\/\/www.niehs.nih.gov\/research\/programs\/geh\/climatechange\/health_impacts\/asthma\/index.cfm], accessed November 2016.<\/li>\n<li>Cody Sullivan, \u201cThe global pollen problem is getting worse,\u201d <em>Business Insider<\/em>, July 13, 2015, [http:\/\/www.businessinsider.com\/pollen-season-gets-worse-each-year-2015-6], accessed November 2016.<\/li>\n<li>Kathy Gerwig, \u201cClimate change is a lifestyle disease,\u201d <em>San Francisco Chronicle<\/em>, August 26, 2015, [http:\/\/www.sfchronicle.com\/opinion\/openforum\/article\/Climate-change-is-a-lifestyle-disease-6467749.php], accessed November 2016.<\/li>\n<li>\u201cThe Health Impacts of Climate Change on Americans,\u201d The White House, 2014, p. 1, [https:\/\/www.whitehouse.gov\/sites\/default\/files\/docs\/the_health_impacts_of_climate_change_on_americans_final.pdf], accessed November 2016.<\/li>\n<li>\u201cFACT SHEET: Administration Announces Actions To Protect Communities From The Impacts Of Climate Change,\u201d The White House, April 7, 2015, [https:\/\/www.whitehouse.gov\/the-press-office\/2015\/04\/07\/fact-sheet-administration-announces-actions-protect-communities-impacts-], accessed November 2016.<\/li>\n<li>\u201cAetna\u2019s Commitment to a Healthy Environment,\u201d Aetna Corporate Website, [https:\/\/www.aetna.com\/about-us\/corporate-responsibility\/aetnas-commitment-healthy-environment.html], accessed November 2016<\/li>\n<li>\u201cHealthy Planet,\u201d Humana Corporate Website, [https:\/\/www.humana.com\/about\/corporate\/healthy-planet], accessed November 2016.<\/li>\n<li>Barbara Grady, \u201cDiagnosing the link between health and climate change,\u201d <em>GreenBiz<\/em>, April 14, 2015, [https:\/\/www.greenbiz.com\/article\/link-between-health-and-climate-change-even-potus-says-take-note], accessed November 2016.<\/li>\n<li>\u201cKaiser Permanente Brings Health Focus to 2015 Paris Climate Summit,\u201d Kaiser Permanente, January 6, 2016, [https:\/\/share.kaiserpermanente.org\/article\/kaiser-permanente-brings-health-focus-to-2015-paris-climate-summit\/], accessed November 2016.<\/li>\n<li>Martin Sipkoff, \u201cHealth Plans Prepare to Meet Challenges of Climate Change,\u201d <em>Managed Care Magazine<\/em>, August 2010, [http:\/\/www.managedcaremag.com\/archives\/2010\/8\/health-plans-prepare-meet-challenges-climate-change], accessed November 2016.<\/li>\n<li>Kaiser Permanente RPGEH website, [https:\/\/www.dor.kaiser.org\/external\/DORExternal\/rpgeh\/index.aspx], accessed November 2016.<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>How does a health system begin to prepare for the health effects of climate change on its patient population?<\/p>\n","protected":false},"author":1816,"featured_media":12797,"comment_status":"open","ping_status":"closed","template":"","categories":[1218,41,1801],"class_list":["post-12252","hck-submission","type-hck-submission","status-publish","has-post-thumbnail","hentry","category-climate-change","category-healthcare","category-kaiser-permanente"],"connected_submission_link":"https:\/\/d3.harvard.edu\/platform-rctom\/assignment\/climate-change-challenge-2016\/","yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - 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