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2020 Lancet Countdown on Health and Climate Change: U.S. Policy Report

12/03/2020 | 2020 Lancet Countdown

COVID-19 shows how no one is immune from converging health crises and that millions of lives can be saved with climate action, according to new research published in The Lancet. The 2020 Lancet Countdown on Health and Climate Change is a comprehensive yearly analysis tracking the impact of climate change on human health across 41 indicators around the world.  

The U.S. Policy Brief, which accompanies the global report, summarizes how climate change, air quality, and COVID-19 worsen Black, Indigenous, and people of color (BIPOC) racial health inequities, and that these challenges can’t be treated in isolation. Report authors advocate for a holistic response to these converging crises, stressing that integrated solutions can deliver better public health, a sustainable economy, environmental protection and a more equitable society.

Air pollution effects illustration
Exposure to air pollution increases the risk of disease and death. Since air pollution and GHGs come from the same sources, climate action will reduce illness and death from air pollution and climate change.

“This past year, we have seen the harms of our converging crises—COVID-19, climate disasters, and systemic racism,” said Dr. Renee Salas, lead author of the U.S. Brief and leader of the Harvard Chan C-CHANGE Climate MD program. “It’s been a preview of what lies ahead if we fail to urgently make the necessary investments to protect health. Just like in my emergency department, I can’t take one health problem and place it in isolation because one insult on the body creates new problems and worsens old ones. We must take an integrated approach when tackling these challenges. Climate action is the prescription we need for better health and equity as we emerge from this pandemic.”

The report was launched virtually on December 3, 2020, with climate and health leaders including our Advisory Board Chair Gina McCarthy and the 14th Assistant Secretary for Health Dr. Howard Koh who discussed climate action in the Biden administration, as well as Property Brothers’ Drew Scott who discussed the real-world implications of the findings as part of our Reel Science program.

“The very prescription we need for dealing with the climate crisis—getting off fossil fuels, moving to more plant based diets, and tackling deforestation—will also address current and massive health risks, from emerging infections and obesity, to asthma and other disease burdens from air pollution that causes millions of deaths every year,” said Dr. Aaron Bernstein, director of Harvard Chan C-CHANGE about the report.

Top findings on the converging crises from the 2020 U.S. Policy Brief include:

    • Air pollution is killing Americans. More than 68,000 people died prematurely in the U.S. from air pollution in 2018. Nearly 25,000 of those deaths are from particulate (PM 2.5) pollution generated by agriculture and transportation.
    • Your zip code determines your health. Climate change further exacerbates existing racial health inequalities that exist because of ongoing discriminatory practices. Early research suggests that exposure to air pollution may make people more susceptible to severe cases of COVID-19, and thus could be part of the reason more BIPOC people are dying from the virus than white people.
    • In addition to air pollution, heat also creates deadly conditions: In 2019, the U.S. experienced over 102 million more days of heatwave exposure (compared with a 1986-2005 baseline) affecting older persons (adults over 65). In the past two decades, heat has killed twice as many older people, reaching a record high 19,000 deaths in 2018. The U.S. saw 2 billion potential hours of labor lost due to extreme heat across the service, manufacturing, agricultural, and construction sectors in 2019.
    • Wildfire risk is increasing. Individuals in the U.S. experienced 1.85 billion more person-days (one person experiencing one day) of exposure to high wildfire risk in 2016-2019 compared to 2001-2004.
    • Life-threatening bacteria is increasing in coastal waters. The suitability of coastal waters for growth of Vibrio bacteria has increased by as much as 99% in the Northeast over the past five years.

The U.S. should rapidly and urgently implement the following recommendations in an equitable and just fashion so that every person can live with dignity and in good health:

    • Transition to healthy, sustainable agricultural practices: Implement agriculture policies and invest in programs that can foster improved health from a reduction in particulate air pollution and GHG emissions, such as reducing the need for nitrogen fertilizers.
    • Remove U.S. fossil fuel subsidies: Eliminate fossil fuel subsidies and reduce investments in new fossil fuel exploration and production.
    • Shift to zero-carbon electricity: Urgently transition to zero-carbon electricity generation by 2035 that is affordable for all.
    • Increase access to healthy transport options: Rapidly invest in enhanced active transport infrastructure and affordable, accessible zero-carbon public transportation, electric vehicles, and charging stations.
    • Strengthen the public health system: Increase and sustain investments in public health to protect against the accelerating health threats of climate change.
    • Invest in a healthy recovery from the COVID-19 pandemic: Implement a ‘quadruple benefit’ COVID-19 recovery plan that works toward a stable climate, protects public health, promotes a sustainable economy, and creates an equitable society.


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Dr. Renee Salas

Renee N. Salas MD, MPH, MS

Renee's work focuses on the intersection of the climate crisis, health, and healthcare delivery.

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