 Friends of the Dan and Carol Burak Distinguished Lecture Series. I welcome you. My name is Christine Vitovic. I am a member of the Rubenstein School of Environment and Natural Resources faculty and it is truly an honor for me to be able to introduce today's speaker, a mentor, a colleague and a friend from the University of Wisconsin, Dr. Jonathan Patz. Jonathan is a doctor of medicine and a master of public health. He occupies the distinguished John P. Holton Chair of Health and the Environment. He is a professor and director of the Global Health Institute, which he founded at the University of Wisconsin in Madison. He is a lead author for over 15 years of the IPCC reports, which was the group that won the Nobel Prize. If you Google Jonathan Patz, you will find much more and it is all very impressive. We are very fortunate that Jonathan accepted and our invitation and actually showed up despite our inability to provide superior conditions for his Nordic ski training. You see, Jonathan subjects himself annually to the tortures and rigor of the 35-mile Berkabiner ski race in Wisconsin. And he always finishes well up in his age group and worse, he claims he enjoys it. One year, he had a smile frozen upon his face as he blasted past me on the half-berky, the cordillofit. And I will never remember that moment. I will never forget that moment. I will always remember it. A fanatic when it comes to health benefits of human power transportation. Jonathan bicycles to work, putting his legs and lungs where his mouth is, and he does so even in the snowy and subzero Wisconsin winters, that rival those of Vermont legend. Even in his office, he uses a stationary bicycle for a desk, rather than the standing desks that have become so popular here on our own campus. Those are just some of his personal qualities. The professional endeavor you have all come here to share in today is Jonathan's work to address the health challenges brought on by climate change. A colleague once likened to the perils we face from climate change to those of the atomic bomb. These are the two greatest threats to all life our planet has faced. The millisecond flash in the New Mexico desert that ushered in the atomic age was utterly devoid of ambiguity. No one could ignore nor misrepresent it. In stark contrast, the crisis we face today has come upon us in a more insidious way, creeping up, obscured first, but increasingly insistent. And so we are very fortunate indeed to have Jonathan Pass, who somehow manages to think deeply and creatively about the seemingly intractable problem of climate change, while at the same time bringing optimism that sees in this crisis an opportunity for a healthier future for us all. And so friends and colleagues, I give you Dr. Jonathan Pass. Christine, that was a very, very kind introduction. When you said that you couldn't remember that moment, you were actually correct because there's no way that I would whiz past you in a ski race. She's a ski racer herself. Whoever has a chair right next to them, can you raise your hand and let folks that are standing come fill in the chairs? You don't have to stand up for this lecture. Only at the end. So the other thing that Christine did mention is that I was on her thesis committee, and that is one of my greatest honors because Christine is a rising superstar on campus. So stay tuned for her research, which is really cool. So today I want to talk about climate change and I want to talk about why confronting climate change could be the greatest opportunity for health that we've had in a very long time. And it really is a true honor to be the Burr-Rack Distinguished Lecturer this month. And I really, it's a pleasure to come back to UVM and meet faculty and students who are just doing wonderful things. I've been very stimulated by the engagement today and always a pleasure. Now you should, all of you should have seen these maps before. This is from the latest United Nations Intergovernmental Panel on Climate Change. I guess I'll use this pointer because maybe you can both, oh I won't. Anyway, these are the maps and on the left you can see the lightly shaded map of the world representing the sort of best case scenario of emissions into the future. If we ratchet down our emissions and we really get to renewable energy in a hurry, maybe we'll just warm up on average one degree centigrade by the end of the century. But if we continue to have energy consumption at business as usual levels, we're going to warm up to seven degrees centigrade on average. Now of course the earth is mostly water, so what that means for land areas where people live is that they may even be hotter. By the way, I see one, two, three, four seats. Raise your hand again if you have an open seat. Come and relax you guys in the back. There's seats up here if you want to sit down. Okay, pop quiz. Whoever is a student? Are we, right now, are we heading more to the left or the right? Who says left? Who says right? Actually right now we are heading worse. We're heading beyond that right, we're heading beyond worst case scenario with our energy consumption right now. So we are looking at a warmer future. Now I hope all of you have seen this slide too because I've been using this slide for, you know, since 1998 that sort of sums up the, you know, thinking about the physical attributes of climate change, rising temperatures, sea level rise from thermal expansion of salt water, and melting glaciers, land-based glaciers into the ocean, sea level rise, but also hydrologic extremes, extremes in the water cycle, more floods and more droughts. And these attributes cut across all sorts of health impacts. It's why I thought and started studying the health effects of climate change, thinking that this is the greatest public health threat that we face, thinking of all these exposure pathways, thinking about direct effects of heat waves, of air pollution, especially ground level, smog ozone, temperature sensitive, and aero allergens like ragweed pollen. Those are big health issues. But also there are so many climate sensitive infectious diseases, especially carried by insects, these vector-borne diseases, like malaria, West Nile virus, Zika virus. Now if we think about extremes of the water cycle, more flooding, that means more water contamination and more waterborne diseases. Thinking about water availability and droughts, that means pressure on our food supply. And the issue of malnutrition is a very big topic in climate change. Now the bottom one, looking at mental health and environmental refugees, I'll come to this later when we do a little case study on Syria. But this is one that's very difficult to quantify, but maybe the iceberg under the tip of the iceberg, as far as large problems, health and societal problems, when you have displaced populations. And we're learning more every day. At a recent conference in San Francisco I attended there's a new study in Asia, Southeast Asia, where they see preeclampsia in pregnant women, hypertension and preeclampsia, which is potentially fatal, very serious condition in pregnancy, because of sea level rise and salination of freshwater aquifers in coastal areas. The salt in the water was causing hypertension and preeclampsia. I'm going to give just a couple of examples of health impacts that we've studied and quantified and then dive into addressing climate change and look at climate change policy. We published this study a couple of years ago when we looked at the frequency of intense heat waves. Now we looked at all cities in the eastern U.S., and this is one just looking at New York City. Right now New York has about 18 days that are 90 degrees Fahrenheit or 32 degrees centigrade. I give this talk in various settings. So for you guys, 90 degrees Fahrenheit. So New York only has, I'm sorry, 13 days. 13 days on average for a summertime in New York, 13 days that are hotter than 90 degrees. Well by the middle of the century we've worked on climate downscaled models for this region and find that by mid-century that number could triple. So instead of 13 days hotter than 90 degrees, New York City will have 39 days hotter than 90 degrees. That's a concern for public health. The issue of infectious diseases is a big topic and this is why this little advertisement about global warming's greatest threat may be the smallest and the picture of a mosquito here. Okay for the students what's the difference between us mammals and a mosquito besides that we can't fly and Christine has guaranteed me she has told me with 51 percent certainty that you don't suck blood. So what's the big difference mammals and insects like a mosquito somebody quick you're not a student yeah they reproduce quickly yeah so and they're sensitive to environmental conditions okay so mammals and insects or reptiles exactly cold blooded so that means if they're cold blooded whatever the air temperature is around that cold blooded organism that's the body temperature so you know our body temperature stays the same more or less but whatever the air temperature is we'll determine the body temperature of that mosquito now what if that mosquito is carrying dangerous parasites or viruses like malaria these are two of them the two of the parasites types of malaria parasites the most dominant ones plasmodium falciparum mostly in Africa plasmodium vivax and this is a graph of what happens inside the mosquito rather than in people this is why this is called the extrinsic incubation period the development speed in the mosquito and notice that for the y-axis which is temperature as the temperature goes up the number of days that it takes that parasite to cross the stomach lining of the mosquito and develop into an infective sporozoite in the salivary glands so when she takes the next bite she transmits disease you can see that the warmer the temperature the fewer the days that that mosquito needs to be infectious so hotter temperatures mean more infectious mosquitoes or more quickly infectious now i want to warn you that you know climate is not everything with malaria there's human migration there's drug resistance there's governmental programs and pesticide or you know mosquito control and so i'll tell you that any very large epidemic of malaria however has an abnormal climate attached to it so there are a lot of things that you need you absolutely need the right amount of temperature and below a certain temperature you can't support the development of malaria below about 15 or 16 degrees centigrade you cannot have malaria it cannot develop in the mosquito that's why it's a tropical disease so what about another mosquito-borne disease that erupted last year in south america uh actually 2015 into 2016 so question about zika virus and the expo from from last year well we know a lot about this mosquito 80s egypti it's a carrier of a dengue fever yellow fever chicken gunya virus and zika virus and this mosquito has been studied very widely and the disease the most prevalent mosquito-borne virus in the world is dengue fever and this map shows you the range of where that mosquito occurs across the tropics and in southeast asia this mosquito has especially been studied the mosquito and the dengue virus system has been studied and it seems to be seasonal not a surprise many of these vector-borne diseases occur they peak at a certain month well it seems to be there's a synchrony a pattern of transmission which of course is seasonal but every now and then you get a massive epidemic and so this study published in the proceedings of the national academy of sciences two years ago looked at this synchrony of dengue fever in southeast asia and found these years that lit up in red being major epidemics more much more than normal and guess what those two years coincided with strong el nino years in fact 1997 right here is the strongest el nino year we have had in recent history until last year so the el nino of 2005 2016 was equal in strength to 1997 but lasted longer and if any climatologists are here i know you know you'll say well it depends where you measure it and you know it's probably the strongest whatever but let's say it's equal to 1997 so either the strongest or tied for the strongest el nino in history we've actually been studying the distribution of these temperatures over brazil and we're in the middle of sending off this paper that shows that the temperatures in brazil were four to five times standard four to five standard deviations hotter than a 30-year record normal temperature so the temperature was unprecedented and a couple of months ago also i'm picking on the picking out of the proceedings of the national academy of sciences this is a study that came out a few months ago and what it shows is the the vectorial capacity for zika virus or dengue fever from this mosquito so the because of the climate the probability of infection went up and basically if you look at this last bar right here you know that's the highest risk level of that mosquito being able to transmit virus based on weather factors because this is a very this mosquito is very sensitive to extreme temperature so in the entomology the climate shows high very high risk for zika and again zika is a confusing story travel international travel is very much part of why zika arrived when it arrived but just like west nile virus in the united states in 1999 west nile came into the us from international travel came in likely they traced it back to a plane from the middle east uh you know the the strain the the sequence uh so probably came in from a flight from the middle east but when west nile emerged it happened to be the hottest july ever recorded in new york city's history so could this zika story be similar to west nile where this came in from international travel but the unprecedented temperatures could that have been a factor i don't know the answer but it sure is interesting and worth studying further now before i shift to policy just a quick reminder that climate change is not just about temperature it's also extremes of the water cycle and if you have you know if you have drought there are issues with with uh mount nutrition if you have flooding uh you have issues of water contamination and these are global projections from the us global change research program showing that the very heavy rainfall events you know the gully washers you know the two inches a day of rainfall equivalent to two feet of snow that the very heavy precipitation events that's what's going to be increasing and when we look at this type of rainfall intensity we did a study around chicago and found that by the middle of this century because of that increased rainfall intensity we'll see a doubling in these combined sewage overflow events which happened already because of heavy rainfall event so finally i want to get to that last issue about environmental refugees and while you probably cannot see these graphs i'll just summarize these graphs to say that you know they are they're soil moisture graphs they're you know winter rainfall surface temperature bottom line is those hydrologic values add up to the fact that right before the syrian civil war they had the most severe drought ever recorded in their instrumental record it's also known that because of this drought food prices went through the roof it's also known that rural to urban migration increased several fold and so there was a strain in cities and i don't know how responsible this drought is for leading up to the civil war and all of the hundreds of thousands of people that died and the millions of refugees but these types of difficult to study questions and observations you know make me worry that some of these indirect effects from climate change could have knock-on effects that are enormous and again something that i can't tell you with confidence that that drought caused the syrian civil war and everything that's erupted from it but i can just tell you that it was an unprecedented event and led to food price shocks and changes in migration patterns and stress in cities um someone else needs to you know it's a team of researchers that need to connect those dots further so i want to end this part of the lecture and mention how there are some parts of the world that will be more quickly affected than other parts and if you imagine sea level rise in a place like bangladesh versus sea level rise in a place like holland that already is below sea level and has all this engineering to hold the sea back there's a difference in vulnerability and there's also a difference in vulnerability when you think about where do we have diarrheal disease malnutrition and malaria those places are at risk first but in a globalized world increased disease anywhere affects all of us so i gave this presentation on the ethics of climate change the equity of climate change and i had a really an incredible audience five years ago a distinguished gentleman his holiness the dalai lama and i presented the ethics of climate change uh to him and he is a very smart man and he asked me he said jonathan if you know pollution kills your country is not showing much compassion right and i i had this i said listen your holiness it's not that simple you know when we built the steam engine and we started generating electricity from burning coal it was a wonderful advance in technology but we didn't know that uh that air pollution was dangerous until 1952 the london killer smog event that killed thousands of people and we said oh maybe burning coal and having factories you know in the middle of the city in the middle of london is not a good idea let's move the factories out of london let's put scrubbers on smokestacks it was only then that we learned about the dangers of air pollution we started doing something and i said it wasn't until you know like 1990 that we really understood that we're disrupting the earth's climate and that could have very disastrous impacts on populations oh he looked at me and he said jonathan it's 2011 it's 21 years later you know we know you know that you know you know this why is your country still burning all these fossil fuels so he got me thinking about that and i thought you know this issue of fossil fuels which is the cause the main cause of climate change and emitting greenhouse gases also emits other nasty pollutants like particulate pollution and i thought you know maybe just thinking about combating climate change is the wrong angle if you think about reducing fossil fuel emissions has enormous health benefits immediately forget about climate change if we get off of fossil fuels we can have immediate benefits and i'm not the only one thinking about this and there are lots of people that are realizing you know number one we've got to ramp ramp down on boss really ratchet down on fossil fuels quickly and we had just a year a year and a half ago the conference of the parties the 21st conference of the parties of the united nations framework convention on climate change and i was so pleased that not only were the impact scientists and the climatologists at this meeting but there were business leaders there there were 147 heads of state that attended this meeting not vice presidents but presidents and prime ministers that is more heads of state the highest number of heads of state ever gathered in one place for one event so that was unprecedented and most of the countries of the world had already submitted their commitments to reduce fossil fuel consumption so i felt very positive going to this meeting and and seeing the outcome this is bill gates and there were other prominent and influential investors and as of november of this past year november fourth enough countries representing a majority of greenhouse gas emissions around the world have signed on so the paris climate agreement went into effect in november so i think at that time i was you know i'm feeling like you know we are really we've got inertia that you know we are coasting and so i i've had the benefit of talking to some students today and somebody of course said to what about the elephant in the room right so i just you know and updating my slides this is from today 20 uh january 26th um reaction to the new u.s administration the doomsday clock was set 30 seconds closer to midnight uh with two and a half minutes to go and you know we we are at a time where we're at an unprecedented we are really um we've made so many gains in the science and in the in the global leadership the paris meeting was incredible the commitments are incredible as far as looking at 30 to 40 reduction in greenhouse gases over the next 30 years across many countries um but we have a new administration um and so it's it's we we need to sort of think about okay where are we with the science and the policy um i you know there are some positive things you know this is one about Ivanka trump uh interested and you know whatever uh our president has said in the campaign you know there are a lot of there's a lot of momentum around the world at different levels we don't need to just think about the national governments or the international treaties um us mayors urged trump to recognize the urgent climate threat to cities so changing the frame about climate as a threat to cities president obama talked about climate threat on national security so the idea that climate change it's not just about polar bears and it's not just about ice cover or ecosystems which are really you know that's important impact but there are different frames to view climate change and when you think about what is necessary that came out of the paris agreement as far as projections for getting to a certain level of warming and the the ideal climate impact assessment scientists has said is that we want to stay below two degrees centigrade above two degrees centigrade average you know ecosystems and and agriculture and other things start to break down we want to stay below this threshold level of two degrees well the paris agreement with you know lots you know commitments of a third to half reduction in co2 emissions in the next couple of decades enormous commitments will still only get us um halfway it will only get us to the commitments on the table the big commitments still only get us to a warming of 3.5 degrees centigrade by the end of the century so that's great you know right now that's where we're heading we're heading to eight degrees fahrenheit or 4.5 centigrade if we don't do anything if we make these big steps from the paris agreement we'll get to 3.5 but that's not enough to get us down below a threshold of two degrees centigrade so we need to urgently get that down and this is where the health frame comes in I think that you know to get these immediate actions adding the focus of environment and economic damages I think that the health frame can get us there quicker because health is a non-partisan issue if you think about you know I don't you know I my opinion my opinion is that health is far less partisan than environment how about that is that fair there we go okay so and this is where I think we have a great message and a message that all of you I hope will will scream out loud and clear and I think that policies to combat climate change could be free or looking at public health co-benefits you know side benefits from greenhouse gas emission policy from climate mitigation policy the health co-benefits could be a net gain and so I'm going to show you the evidence for that and I I think the main opportunities are across these three big sectors energy sector especially electric power generation the transportation sector transportation and urban planning and food systems I think there are other sectors and other benefits but these three are are huge and directly beneficial to human health let's look at the first one energy is related to air pollution air quality today according to the world health organization um whoops sorry um almost four million people die every year from outdoor air pollution and a little more than four million people die every year from indoor pollution from cook stoves and things like that so how we generate power whether whether it's indoors or outdoors for electric power that is a huge burden and kills more than seven million people every year we have obvious examples like the olympics that came to atlanta in 1996 and the city officials said hey the athletes are coming the olympics are here we really want to clean up the city clean up our air let's reduce traffic let's mandate some temporary laws and reduce traffic and so they reduce traffic by uh 23 percent and that you know reduced pollution they saw 28 percent decrease in ground level ozone small ozone which is very uh is triggers asthma in children if there's too much ozone and no surprise asthma related emergency room visits declined by 42 percent now how many of you are here in the public health at the mph program and how many of you are budding epidemiologists of course you guys that say wait a second you know less traffic maybe there are less people driving to the emergency room right you got a control for that and these guys these are epidemiologists and they found that well children's er visits for non asthma cases didn't change so it wasn't just less so anyway so we have a a good epi study that shows less traffic less pollution less asthma so we know we know that pollution has a direct effect on on health now looking systematically across the united states asking the question what would it take to get to a low carbon society if we took our us energy system and we invested in renewable energy and and greener technology and i don't have all the the details are in the in the paper this is a paper in nature climate change from a couple years ago but you know the green technology you know there's an upfront investment to get to greener technology but if we look at the result if you were to get to cleaner energy because not only do you reduce carbon emissions but you reduce all those nasty you know nitrogen dioxide and sulfur dioxide and pm 2.5 the fine particles that kill the most that's the most dangerous component of air air pollution the health benefits if you were to reduce you know clean up the energy system the benefits from less mortality and from hospitalization could offset the investments the upfront investments anywhere between 26 and 1050 percent now that's a big range so a lot of air a lot of you know but still we're talking about the health benefits being between a quarter to 10 times in value to the upfront investment costs of clean energy our group is looking at this in china we're modeling you know if you were to reduce fossil fuel emissions reduce burning coal what would that mean for health because of reduction in pm 2.5 and if you were to reduce 32 percent of emission pm 2.5 from coal in china you would save more than a hundred million years of life so that's how dirty china is if you were to reduce 32 percent of the emissions you save a hundred million life years and if you got rid of all of the pm 2.5 emissions we're talking about 400 million years of life saved per year this is like in the year 2030 this is not up to this is in the year 2030 that's how many years of life could be saved from getting rid of pm 2.5 which is why yesterday or the day before i saw on twitter that at the davos world economic forum the head of china saying uh you know stepping up and defending the paris agreement because china knows it's not just climate change we got to get off of fossil fuels we would love to save 400 million years of life and get away from this dirty energy and they've they've uh they just they were about to build 140 new coal fire power plants they said no we're not doing that so you know there are health reasons if you just forget climate mitigation there are health reasons and china knows this to get off of burning coal and burning oil so i'm going to show a slide that i think is really important for policymakers you think about you know it it does cost some money to get to cleaner energy and maybe for every ton of co2 that you pull out of the atmosphere uh it could cost 30 dollars for cleaner energy but remember you know we're getting rid of that greenhouse gas emission the co2 you also get rid of all the other nasty pollutants and so every for every ton of co2 that you pull out of the atmosphere the pm 2.5 that you remove is so much that you would save 200 dollars in health benefits so you know i i presented this to the state legislature in wisconsin and when i did this they they said you know we've only been thinking about the cost of energy and we admit we hadn't thought about that side of the equation and so i asked them well here's a tough question you know which number is bigger and right now you know most politicians and decision makers are only focused on the left side of the equation what do we have to pay for for cleaner energy and not thinking about the enormous health benefit we would have and if you live in other parts of the world you have even have greater benefits like in india and china where you really have bad pollution problems so this is something that is extremely important to convey that it's not we're not talking just about energy and mitigating climate change we're talking about a golden opportunity for health and and health health cost savings and maybe it's not even that expensive anymore the this is looking at the cost at the cost of solar since the 1970s the price of solar has dropped 99 percent so i've seen a lot of solar on campus i've seen solar in vermont so you know this is getting very realistic you know we can have a solar solar and wind power is getting competitive so when you see charts a a diagram like this that shows you how much known oil reserve we have in the ground and for the case of climate change mitigation to stabilize and stay below two degrees centigrade that's all we can burn and the argument is hey to stabilize at two degrees centigrade we can't really burn much more oil you know we have you know five times as much known oil reserve as we should be allowed to burn you know before we get above this you know this threshold of two degrees it's thought to be more catastrophic once you go above that so on top of this argument we can add the health argument and say it's not just about stabilizing climate it's a great idea if you just ignore climate change altogether and say burning less fossil fuels is a wonderful health benefit so i want to shift gears and just talk about two other quick things besides energy i want to talk about trends in chronic disease this is a study that came out across 200 countries looking at 19 million people and the bottom line is that all across the world rates of obesity are increasing and we know how important that is for health and the all the diseases the chronic diseases related to that so one opportunity here is to if we can increase physical fitness and tackle that problem we have a group in my research program that's studying using this integrated transport and health impact model iThym and it's looking at very well documented relationships between exercise and thinking about metabolic equivalent per task for walking for biking you know that we know that if you can increase just minutes minutes of per week of physical activity you see a relative risk reduction in cardiovascular disease in diabetes dementia depression colon cancer breast cancer and and uh so we see these some of these major chronic diseases unbelievable opportunity if we can just crank up a little more exercise and if you look at you know if you just in my state of wisconsin added 10 minutes per week you know that's two minutes a day in a in a work week two minutes per day at two minutes more exercise per day you would see you know a reduction of 24 you know annually 24 less breast cancer patients 27 colon cancer more than 300 less heart attacks dementia depression 99 fewer diabetics per year by increasing exercise by two minutes per day in a work week and there are big costs to these chronic diseases you know you can you can have cost savings uh across these chronic diseases and if you were to monetize the the value of you know what if now nationally according to the national transportation survey the national average commuting active commute time so walking or biking this is actually this is just for walking on average americans commute 35 minutes per week so that's seven minutes per day is the average exercise for commuting now people can have non-commuting exercise but if you look at the average us population who might not be in a university and have access to a gym or not be able to afford a gym you know there's a lot of inactivity in this country and cities have been built for the automobile rather than for people but if we were to take the average of 35 minutes per week and if we were to double that to 70 minutes per week we would save you know just across looking at depression diabetes and heart disease we would save uh 10 billion dollars a year in avoided health costs if we were to get to the minimum level of recommended exercise that's 30 minutes five days a week is the minimum recommended level of exercise so that's 150 minutes 30 minutes times five 150 minutes we would save 27 billion dollars in avoided health costs so you know these are these are important and then my cousin asked me uh well how would those health costs translate to insurance premiums so these are some important messages to say you know this is why our insurance is high Debra Lopez was saying we have unhealthy habits we have a golden opportunity here to improve health and reduce the cost of health care so I want to end because we do have a little reception uh I don't know drinks and food or just drinks a little bit of food okay so I want to just end with the last area of health co-benefits from climate change policy food and agriculture you can probably read this in the front but maybe not in the back this uh Cal banner says uh I am full of greenhouse gas do you have a stake in it and I took that picture when I was walking with my then 89 year old mother um walking for three hours in the climate uh you know the people's climate march in new york city this is a graph that probably all of you know that if we eat lower on the food chain you know less red meat in the diet it's better for the environment and better for our health this is a high meat diet this is a medium meat diet a low meat diet this is a fish diet vegetarian and vegan and this is looking at the carbon dioxide equivalents you know tractors and diesel and fertilizers and water and everything the carbon the environmental you know the carbon dioxide equivalent as far as what it takes to produce protein from from these different sources so that's an obvious one and I think you guys know that here in in vermont um we're looking at uh something else uh I don't know what you're serving christine and susan but um I have a an incredible student who's working on a study of insects as a sustainable protein source and you know I'm not going to necessarily uh tell you that that's what we're having or is it I don't know I don't know we'll see uh there is a grab a grab bag a pot of something right but think about it you know when you compare the amount of feed that it takes to raise protein from cattle from pigs from chickens from a cricket that's a cricket you know insects are more sustainable you know and think about the amount of of that animal that you eat you know you only eat a portion of the cow and you can see that you know you eat more of the cricket right now I'm still not convincing you I'm sure but I mean we have to be thinking about food systems because how we eat you know it really dictates how much water land and energy emissions we're using depending on where we get our protein from and the kilogram of protein derived from legume vegetables is far more sustainable environmentally than from these other sources and uh comparing um you know looking at uh percent of protein by weight looking at cows chickens and mealworms that was her study looking at mealworms um you know it's dramatic advantage and other benefits as far as uh b12 and iron look at this is actually from crickets so we're looking into that and um you know this idea it's called entomophagy eating insects and we're studying the the safety of micro livestock I think it's called uh mini livestock now uh but anyway um and looking at food safety issues you know I this is not far fetched but this is something to think about you know our food system really determines uh a lot with the environment and our own health but I don't want to open a whole can of worms on this one the next time Christine invites me back I'm going to bring Valerie and we're going to show you some really cool research so I want to end by just uh reminding you of the many um unhealthy exposures that climate change poses I really do think that climate change is one of our toughest challenges it's one of our biggest environmental public health challenges of of these times but that actions to mitigate climate change to get to a low carbon economy a healthy energy society they are enormous benefits especially when you think about um changes in energy production transportation urban planning and in food systems and with that I want to thank you very much for your attention and if you want you can follow me on twitter anytime thank you Jonathan for a very provocative talk I think that many people will probably have questions I know I have a few myself especially about the insects we have an insect grower here in Vermont I don't know yeah we'll introduce you when Valerie when you come back but in the meantime um if you do have a question please raise your hand and we will get the microphone right to you go right back here so thanks for a great talk 30 40 years ago smoking was very accepted we now live on our campus where not only is tobacco free but I think if you see someone smoking right it provokes a reaction but yet despite that all of us here buy into climate change driving your signal occupancy vehicle to campus is socially accepted right and those of us that buy commute are sort of these real outliers so how do you change people that actually buy into climate change and get them to change their their culture obviously you've adopted it but but you're probably a rarity on your campus as well among people that buy into climate change so that's what my question is so changing the culture changing the social norms um great question you know and I said this to at lunch to the students people will not do what they should do if it's inconvenient uh I tell a story you know I bicycle because it's selfish it's the fastest way for me to get to work I I once had to testify in the state legislature and pick someone up at the airport I said I have to drive today you know I'm working on my power point I look at my watch and I said oh my god I'm going to be late for the test testimony so I said I don't have time to drive and park and whatever you know so it and so I live in Madison Wisconsin gold rank for bike ability so it has to be by design you have to really go upstream and talk to urban planners and talk to um dietary you know whoever is putting the default menu that it's a vegetarian rather than the meat and potatoes it's got to be by design up front design so this is what's going to take a cross-sectoral approach in planning and design so that you know the single occupancy vehicle uh it's going to it's not it's it's going to be inconvenient especially when you think about traffic if you have great mass transit or better bike lanes or better inter interconnectedness of of different alternative modes of transportation you know when it becomes inconvenient you know then people say I don't want to drive this happened in Bogota Columbia and they they started the bus rapid transit system and people didn't want to be stuck in traffic for hours and they started taking it and so it's a matter of intentional design for sustainability um and and being very aware that you can't just ask people to do stuff because they should but this is where there are great opportunities for urban planning and and there are win-wins when they did this um or tactical urban experiment in New York and they blocked off Broadway you know the shop owners were screaming at first saying whoa we're gonna have less traffic less business it was the opposite that happened you know they had people said well pedestrian mall we love it business so it's those types of opportunities to take advantage of great question hi um well i have two things the first thing i wanted to ask you was about the natural gas in china um how are they getting that gas are they fracking and does fracking also put the pm 2.5 into the atmosphere and if they are fracking why not just skip the natural gas and go right to renewables because you're not helping the climate by fracking and then i'm going to put in a little plug um i'm part of the pipeline coalition here in vermont we have a week of um action coming up february 4 through the 11th i've hit some of you up with our little flyers i'll leave more out front we are trying to stop the vermont gas pipeline going through but i do want to have that your answer to the question about why go to natural gas because once you're hooked on natural gas right you know what's the incentive to go to renewables so it's a great question and i'm not qualified to fully answer it so i'll just tell you that uh you know the issues that i know about fracking are that with all the methane leakage it's not beneficial to the climate but let's pretend let's pretend that wasn't an issue that the methane wasn't leaking let's pretend they fix that the idea that natural gas as a bridge um people debate that say you know yes we got to get away from it's an opportunity cost you invest in fracking and natural gas it's better immediately if we solve the methane issue which we haven't but it does take away from other renewable you know real renewable energy investment so i would defer to the energy experts there are some benefits to natural gas if the methane if the methane can be controlled but the fracking you know the fracking fluids is still an issue the frack sand they're they're huge issues with fracking so i don't promote fracking but um and i sort of agree with you but i'm not the expert in it uh hi so it seems like from like a national level it might be pretty difficult to or international level to mitigate the public health effects of climate change so i guess like to what extent do you think these can be mitigated through trying to regulate microclimate and like urban cleaning and stuff like that at like more of a local level excuse me i'm glad you asked that question um i think that um this is where it's exciting because it's at the urban it's at the city level and these subnational levels that we're getting incredible progress um the c40 cities program you know mayor bloomberg michael bloomberg and some others you know these are mega cities around the world more than 40 now and they are committed to climate change mitigation and and getting you know having all sorts of you know activities at the urban level um making huge progress and you've heard california you've heard um you know jerry brown saying whatever the nation does we're still committed to reducing greenhouse gas emissions we don't care what the feds do and this is where there's a an r20 initiative that's international which is regional subnational um you know state level and region level groups coming together saying you know there is slow movement at national levels and international agreements hopefully they'll do something but we're not going to wait around and so there are you know innovations and progress getting to a green society green energy society all over the place and especially at the local level so i think the cities and states are going to be driving the the the agenda and so as i have to say you know i'm you know all scientists climate scientists and climate impact scientists are watching we're on alert you know we're a little bit you know we we're watching what's going on with the new administration we have some concerns we don't know what they mean really but we're watching a little more vigilantly vigilantly um and so at the same time i have huge optimism at the local level you know what's going on there so hi great talk two questions for you uh the first is as a physician i'm wondering how you've been able to harness your uh credibility to help move legislatures and the second question i have is you seem very optimistic and um which which is very refreshing especially given our current political climate um and it's interesting when i reflect on a talk that bill mckibbing gave at the hospital a while back um it was it was a much more pessimistic talk and i think a lot of us feel somewhat pessimistic and i'm wondering how you uh maintain your optimism in in light of the fact that we're 2.5 minutes away from doomsday well i think that i think the medical community has a very important role you know i think that looking at the the narrative and the communication that has to be out there uh you know we need the actual you know personal impact and you know when you talk about the children with asthma uh because of increased ragweed seasons and and you know when you get to the you know the actual health dimension and look at you know patients i think that's very a very important part of climate change communication um you know we want to be as as honest and objective as possible uh but built not but but and built into that is that you know population studies and relative risks translate to people and when you when you look at the clinical situation uh and you see you know more ozone you know red alert ozone days and you've got children they're coming in with asthma you know that's a problem i mean we did some modeling about the number of red ozone alert days that would happen just from temperature alone it goes way up and those red ozone alert days red ozone alert days mean kids with asthma having problems so i think it's very important there is a a a rising effort there's of course physicians responsible for psr physicians for social responsibility has been doing this for a while there's a new group that's even more international that includes psr um called the climate and health um alliance there's an international one and there's a u.s climate and health alliance it's where um it's an entry for the medical profession to come in and of course the green hospitals the health care without harm and the green hospital movement uh is very strong uh kaiser permanenti has been pushing this pretty hard uh gary cohen is the director of this so the health profession is saying you know we want to take care of our patients and today's population without burdening the next generation so if we are you know treating people and yet we are pumping out a lot of pm 2.5 and harming populations downwind from our hospital we don't want to do that i mean so hospitals are becoming much more aware of that so that health care without harm and the green hospitals movement is a really important one hi i was wondering what the decrease in biodiversity how that's going to affect the amount of diseases going on with animals and insects hmm uh well i bumped into a student uh who's an expert in disease models that could probably answer that more than me i it's um that's it's a tricky question um we've done some studies looking at changing ecosystems in the amazon and showing that if you reduce biodiversity especially you change the landscape and change the biodiversity of mosquitoes in the peruvian amazon disrupting that that network that um you know that biodiversity changes in a negative way and the malaria-carrying mosquito anopheles darling eye in that region dominates when you disrupt the ecosystem so there are some other cases where it can go the other way you know the amount of biodiversity including pathogen biodiversity in the jungle means there are more pathogens out there so it's a tricky dynamic i can't tell you you disrupt an ecosystem you change biodiversity you will always get worse disease i don't know that but um generally a lot of these species are held in check and that includes pathogens and if you disrupt that ecosystem and the biodiversity there's potential for one of these to emerge but that's a tricky question good question but hard to answer we have time for just one more question so uh my question is uh there's two questions one is that the county just north of here and the county just south of here uh are heavily agriculture areas and how do you uh suppose that state like vermont which really values agricultural heritage balance that with your recommendations for moving away from traditional agriculture and also most of vermont is not as urban as where we are right now where i come from it's a 15 mile commute to uh where i work over the summer and my question there is how do you put those urban planning and transportation models into effect there to try to receive those same benefits yeah now a good question i'll just say two things i think that depending where you live you'll have different strategies so in an urban environment having you know alternative transportation and it really equitable equitable transportation the opportunity for people to commute how they want to commute from good mass transit or from walking or from biking and mass transit whatever that works in an urban environment now since 2006 the world is more urban than rural and where you know the trajectory is in a few decades 75 of the world will live in cities so i think we have a golden opportunity to do work in cities and have a major impact however you know especially vermont mostly rural and i think that you know transportation in rural areas it's probably not it's it's not practical to bike unless you uh you know you know and you have great distance it's probably not practical there you know having a fuel efficient or electric vehicle that's hopefully electricity from renewables you know let you know better technology for the vehicles might be the answer for transportation in the rural setting as far as agriculture i'm not the expert um but i can tell you that from the experts that i talked to there are huge opportunities in in more you know more organic not not that organic farming is everything but integrated systems where you know let's say you don't eat the mealworms like my student is studying but you feed the mealworms to chickens or and then you know or you've got a few cows that are you know creating manure and then you've got your own maggots and feed chickens i mean there are so many ways of of better more sustainable farming practices that is probably at least a dozen people in this room know far better than me and and vermont is probably i think you're a leader in in that type of smart agriculture so um you know i i can't say more than that other than to you know look at many different solutions and where you know that agricultural practices can be improved upon and made more sustainable pursue those diverse approaches uh and not think about needing to have the same transportation in rural versus urban they're two different to two different populations so be very um flexible and diverse in approaches to solving the problem i'd like to just take a moment and thank you all for sharing your time with us and engaging in this very important topic we want to continue the conversation we have some refreshments back there Jonathan will be with us for a little bit longer so please feel free to come up and continue the conversation and please join me in thanking dr pass thank you