 Dr. Lori Zoloff, she's a Margaret E. Burton Professor of Religion and Ethics and a senior advisor to the Provost for Programs on Social Ethics here at the University of Chicago. Professor Zoloff's interests focus on the intersection of bioethics and religion, particularly Jewish studies. She's a past president of the American Society for Bioethics and Humanities. Her work on bioethics and healthcare led her to serve on the NASA Advisory Council and the Space Agency's highest civilian advisory board and the International Planetary Protection Committee. Today, Professor Zoloff will give a talk entitled Global Warming, Healthcare and Chicago History. Please join me in giving a warm welcome to Professor Lori Zoloff. I do research on genetically modified organisms until the Golden Rise was the beginning of the most active and successful anti-GMO campaign based on almost no evidence. They mounted a campaign and they destroyed an intervention that could have saved millions of children in the world from blindness. So there you go. It was the first of that wave of anti-GMO. It's seen as an incredible tragedy by people who are using genetic technology to modify foods for the benefit of the poor because it set it back two decades. So but no, no adverse effects or essays at all in that trial, it was all about health concepts. Okay, back on to Global Warming. So I want to talk about the deadliest week in the city of Chicago and I want to say at the outset of this talk that I am a Californian, which will become important as this goes on. And if we go forward, we're not going forward this way. One block from where we're sitting today, July 1995, was the worst catastrophe in terms of heat waves, in terms of climate change, has yet in the United States. How many of you know this, the Chicagoans? But significant numbers don't. And I want to say I was off in California at the time. Okay, I had a one-year-old baby last of my five children, but still this did not make any national news. And when I teach this to children, to my students, war in fact children, they have no record, it's meaningless to them, they have no memory of this, there's no institutional memory of this. And when you ask them of the worst cases of climate change deaths, this just doesn't register whatsoever. Now, climate change is a serious public health issue. I'm going to try to convince you it's also a serious ethical issue in this talk. Obviously rising sea levels threaten coastal communities, New York, Mumbai, Shanghai, London, Los Angeles, my hometown. Increasing drought has led to horrible fires in the West we've just seen. Increasing storm activity threatens many parts of the country, but it's heat waves that can be the most fatal. And if you're feeling smug about California right now, like it looks so nice to live there, but oh, such a disaster area, don't, because the worst climate catastrophes have often been not hurricanes or fires, but heat waves because of urban density of course. And the worst one in U.S. history took place right here. Now in 1995, in three days in Chicago, 739 people are thought to have died. Now how to consider this, how to think about this relatively, is that the current occurrence is 1,500 heat-related deaths a year. This was in three days, half of the mobility mortality in a year, or the campfire in California, the fire last year, which is considered the worst wildfire death, was only 86 people, terrible for those 86 people, but nowhere near the death rate of the Chicago incident. Now, this is how it went here, is your statistical analysis. You can see the great jump in July. And who died? Well, it was bad to be a poor, black, elderly man in Chicago that week. Most of the apartments in the area were not air conditioned, and if they were, the units were often broken, they were too expensive to run, there were not units in public housing by and large. The brick buildings that surround the University of Chicago and most of South Chicago are built to contain heat because they're built for the winter months. Chicago is built to keep you warm, right, not to keep you cool. The way people thought about hot summers was, hmm, it's like, yeah, it was summer, it was hot, it wasn't a catastrophe, but most people died, even though the entire city was equally hot in just a few south and west side neighborhoods. And the issue becomes why, and that's where it becomes an ethical issue. This is the heat death map, and you can see just a few neighborhoods were affected in a city-wide event. Now, social economic factors, of course, determine the way that mortality and mobility were structured. The most important factor was if people loved you, if people were near you, if people checked on you. If you were isolated and you've had little social connection, you were at much more higher risk. Now, people stayed in their houses, and oftentimes people came to rescue and found that the doors were barred or the windows were barred, because they were afraid of crime. So younger people could go into the parks and off to the lake, but older people disproportionately feared the crime. An anomalous fact that many people have noticed and written about, very few deaths took place in the Hispanic neighborhoods with identical geographic and demographic and housing stock things. Something different happened in these tight-knit Hispanic communities where people did check on their elderly relatives. Here they are sleeping in the park and not just any old park, but of course that's the midway right outside there. You'll see it's almost all men and younger men. The city morgue actually ran out of space and had to put the bodies on the sidewalk outside of the morgue. Night-town temperature effect, we're familiar with this because this summer was a very hot one as well. People couldn't cool down. The critical temperature stayed in the upper 90s throughout these three days. But the city had no plan. The city had no plan to alert people. It had no plan to check on anyone. It didn't have cooling centers. And in fact, the weather broadcaster, the sainted Tom Skilling, told people that this was coming and he was largely ignored. The mayor, of course, was out of town. Now the heat-told death fought was to hold 300. It was more than twice as much as this. And they ran out of spaces to bury people to the state. There ended up being about 45 bodies who were never claimed. So I said that they were buried in a mass grave in Chicago. Now here's what the future looks like. Much hotter, much denser heat waves, much more urbanization. So all these effects, of course, are increasing. Heat waves, of course, only the most dramatic effect of global warming, there's pressure on food crops. And of course, we can't use golden rice anymore or modified food. So, you know, this was a very wet year in the state of Illinois in the Midwest. There was enormous floods. And so there's going to be a pressure on food crops we're going to see in the coming season. If there's fire, like it is in California, it raises prices on agricultural goods, mostly affected in wine, but it can happen in other places. The increase in particulates because of increasing dust and fire residue, my whole family has their little masks fitted for them. The children have little printed masks with little smiley faces on them, but they're wearing them because of the increased particulates in the Bay Area and Southern California. As well increasing the respiratory rate, increasing cardiac stress. Mental health issues, of course, exacerbated as temperatures increase, fear storms mean more homelessness and loss of place. There's a worldwide care to this problem. Now we see dramatic shifts in populations. Much of the pressure on the southern border of the United States is because of an earlier massive drought in the Guatemalan highlands. That unprecedented drought forced millions of people out of their farms into cities and, of course, walking north. There's increases in emergency room visits in chronic conditions. Of course, metabolic diseases affected by heat, cardiovascular disease affected by heat, workplace risk for outside workers, increases for construction, and any outdoor trade. But the thing that I'm interested in is vector-borne diseases. Infectious and vector-borne diseases, where's my ID person over there? As you know, the range of everything is changing. Dengue fever is now the fastest growing disease worldwide, and it's nearly impossible to eradicate the Dengue. The mosquitoes are very clever. They can overwinter. Zika, of course, spread highlights our vulnerabilities. Djibben Gaia also spreading tick-borne disease, increasing dramatically. Pawasan disease just killed Kay Hagan, a Democrat from North Carolina, a wonderful liberal, progressive voice, just was bitten by a tick, apparently, on a hiking trip and died of this Pawasan disease, increasing in numbers every year. Tick-borne stuff, a lot of this, of course, Lyme disease. We know what he meant by the fever. And I'm particularly interested in malaria because, as you know, from last year's talk, malaria was a very important disease in the United States, and the efforts to combat it have stalled. There are no effective countermeasures to the malaria burden right now. Mosquitoes have outwitted human beings once again, and we're faced with the possibility of a widely spreading malaria outbreak. It's a serious and sometimes fatal parasitic infection in 100 countries worldwide, and it's been the same 100 countries. Coma and death that can occur, it's not a mild disease at all. It disproportionately affects people, particularly children, in the lowest and poorest countries of the world, particularly in sub-Saharan Africa, South Asia, and South America. And about between 400,000 and 500,000 deaths a year, which is about a child every two minutes, so we can count up how many children will die during this very talk, for instance. In 1870, this was the malaria map, it was the most important disease in the United States, the leading cause of death in the U.S. You can see it now closely at Chicago on that map, this was a terribly malaria area, a swampy malaria area. And in fact, the entire Mississippi Valley was a wonderful place to stay if you were malaria mosquito. How did this falciparin malaria got there because of the slave trade, of course? Malaria began to retreat over time because agricultural practices changed and because people moved out of malaria areas, but not out of the American South, so it was very persistent in the southern states. The death rates fell dramatically just because this was before DDT was invented, it was just using quinine and drainage of swamps and education campaigns. This is WPA, Roosevelt sent workers into the south to begin clearing swamps and, of course, the Tennessee Valley Authority controversially drained some areas, flooded some others, and if you're like pop culture, like me, you know, this Ozark has a whole subplot about the Tennessee Valley Authority submerging farmers, but they did get rid of the malaria in the south. But it was not eradicated until 1951 and so DDT became widely available and was used in aerial spring and aerial crop spring in 1951. I was already born, what can I say? Now, why is this an ethical question? Sad tragic story of Chicago, scary ideas about malaria and vector spreading, but why ethical? And this is because it's driven by climate change and climate change is an ethical problem because it is due to the release of certain carbon and methane in the atmosphere, which, of course, you know, but it's also true it's potentially by our very participation in a global economy that needs our enthusiastic participation to continue because of our country's decisions about budgets, about how much is spent, about legislation, about healthcare spending, about inspections, research, et cetera. I have a brother-in-law who works on the docks in first the Bay Area and then in Los Angeles and he said the dock workers that inspect for false supreme mosquitoes which used to be done on a regular basis have all been cut by the current administration and now one ship a year is checked for invasive mosquitoes. Now, this is a well-characterized and data-divided science reality. Since 1870, we know about the greenhouse effect, the most profligate users of carbon are Americans per capita and especially the wealthiest Americans and the populations most at risk of the people that have contributed at least to the disease. That is the heart of the ethical problem of climate change which we all know but the second part is this, that we do know but we still don't act and the longer we don't act to radically change our lives, it continues in a deepening of unjust relationships. This lack of response to the plight of the poor is linked to the mortality of climate change. The ethical issue of climate change is thus a public health problem, not only a social justice problem but a public health problem, a problem for physicians in particular. And second to last person on the thing I want to say, a little something about the classic philosophy, I teach Emmanuel Levinas here at the University of Chicago and for Levinas, when the stranger approaches you, when the stranger known to you approaches you, the poorest of the poor in Chicago, the most isolated of the poor in Chicago, the poorest of the poor of our planet who live in Sub-Saharan Africa, when they come to you and you're aware of their face, that moment of the approach of the stranger is the ethical moment, Park Vance, in Levinas's French. Understanding that your moral agency, your capacity to act as a moral agent beyond the four principles is encountered at that moment, is formed at that moment and in fact it's an ontic moment as well for yourself comes into being in a substantially different way when you are the one who in Levinas's terms have to come up with the goods, when you are taken hostage by the stranger, when you are the first on the scene for the stranger and I would argue for physicians in particular, being the first on the scene has a resonant call to you and should be and this is true for Emmanuel Levinas, even if you feel yourself to be innocent, the gaze of the stranger should remind you that you are not innocent and here of course we're not at all innocent, we're very culpable in this problem and we know it, we don't even need this existential guilt to motivate us, we have actual real-time guilt. Global warming is happening, it's as long predicted, the only changes in the predictions are that everything is much, much worse than we thought. It's unclear what's happening to the lake, 50% of NOAA scientists who work on the lake say it's gonna keep getting, now it's 11 inches above the highest point it's ever been, maybe it'll keep going up, the other half say it'll dry up, so it's unclear what's happening to our very own lake but the only thing that's changed is that things are worse and they're happening faster. Now local and regional and national changes, we still can mitigate some effects but the practice of ethics should include paying attention to this scientific reality I would argue before anything else, before anything else. Chicago in particular have a responsibility to need to remember our most recent history. After the disaster in 1995, daily did act and his administration released an adorable report it had a city disaster plan with a snowstorm on the cover just to obfuscate the issue. A plan is now in place in fact to check on people, cooling stations are advertised widely, we all see the slimes and there are many media outlets, everyone knows you can go to a cooling center and the police are supposed to knock on doors and get people out and of course the weatherman, especially Tom Skilling, no yes brother of that other one is read in Chicago as canonical texts and you always need to trust Tom Skilling. So I want to say thank you. Target Malaria has taught me a lot about this spread of malaria and the spread of dengue WHO is working hard on this but the mosquitoes as I said are winning and are accidentally coming north as the range is spreading. The Anopheles mosquitoes are still here, they didn't disappear just the parasite did so they're ready as they were in 1776. The University of Chicago Divinity School gave me a whole year to think about this and the University of Cambridge Clair Hall and the Boucher Foundation who allowed me to come there and read lots of books to think about climate change and to think about our obligations and responsibilities and of course Mark, you've given so much to all of us and to me as well and I just want to thank you, you've just been terrific, a leader in our field, a leader in our discipline and a leader at the University of Chicago so thank you very much and thank you of course always to my students. Thank you and questions. An agreeing audience, it's okay. It was a sobering talk but I'm so inspiring. Okay. One is you have to act like scientists and if you're not a scientist like me, you have to act like you believe scientists, right? Which we do in many other arenas but then our behavior is inconstant with our belief systems so really, really understanding it means you cannot admit anymore. You really can't drive a car very much anymore and you should really limit how much you fly, right? So I was also president of the American Academy of Religion and I proposed that the AAR, which is 10,000 members, radically change its behaviors and act like climate change is real and take a sabbatical year every seven years. Big ideas, spectacular failure, no one wanted to give up the least little bit of their meeting time. So that's one thing. Every institution in every organization say, here are the things we know that reduces carbon burden. It's eating meat, it's transportation, it's how we hear our institutions. There's things we know, you know, plastic water bottles. I mean, we know exactly how much everything costs us in terms of carbon, figure it out and in your institution, in your office, in your school, act as if you believe it, as if you care about science. So that's one thing. The second thing is we have to, this is an election year, need I say more, right? We have to get our country back into the Paris. A climate accord, it's the only hope for a reduction to two percent, to two degrees and it's a failing hope as it is, but we have to act both locally, as city level, Chicago is by itself on the accord like many mayors, but we have to really think politically why it's so important this year to express our concern about this issue, insist that this issue be debated and discussed. And also, we have to look at our personal practices. Everything you do is a moral gesture. Everything is a moral gesture and you have to act like you, like now, it's very time to act like I work for BP, right? To get on the plane and act as if I'm, I should burn as much carbon as I possibly can, but we have to really think about it. How we live in our homes, how we feed our families, what we share with our students, I actually recommended that you tithe 10% of your time to think about climate change. So in every class you teach, right? One week in a quarter system, it can be about climate change and why it's important. Not that your entire life is taken over by it, because God knows if we don't do anything it will, but like in California, but to give some percentage of your time and your energy and your brilliant attention to the catastrophe that really does await us as if we walk forward not doing anything. If we do do that, if we just walk forward like it doesn't matter, it is gonna be the kind of catastrophe we see all the time. As a Californian, my 99 year old mother has been evacuated twice already, right? And this fragility is really going to concern all of us. We are fragile in a way that we've never thought about before. And the 1995 heat wave is just the smallest indicators with a terrible death rate that should alert us to how important this is and how we should stop thinking it's not gonna happen. It's happening, it's happening now. So those are my three ideas.