Protecting the Health and Well-Being of Communities in a Changing Climate Proceedings of a Workshop (2018) / Chapter Skim
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6 Regional Perspectives from the West
6 Regional Perspectives from the West
Pages 89-108
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From page 89... ...
Key points made by the panelists are presented in Box 6-1. In the open panel discussion with the workshop audience, topics covered included working with vulnerable communities, incentives for innovative approaches to agriculture, Kaiser Permanente and the political climate in California, the challenges of communicating about climate change with the agricultural sector and with legislature, learning from tribes, measuring greenhouse gas emissions in terms of health, and reasons for hope.
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From page 90... ...
CLIMATE + COMMUNITY HEALTH + HEALTH CARE IN THE WEST2 Gerwig began by remarking that she would be providing a perspective from Kaiser Permanente, a large integrated health system with medical centers, Permanente Medical Groups, and an insurance plan. Kaiser 2 This section summarizes information presented by Kathy Gerwig, vice president of em ployee safety, health, and wellness and environmental stewardship officer, Kaiser Permanente, Oakland, California.
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From page 91... ...
Additionally, all of Kaiser Permanente's western states have Democratic governors (California, Hawaii, Oregon, Washington) -- an important consideration as Kaiser Permanente's engagements in climate action are "a key pillar of its environmental stewardship." Health Care Organizations Are Powerful Community Forces Health care organizations "wear a lot of different hats," Gerwig continued.
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From page 92... ...
Reiterating that hospitals are big purchasers, she explained that more purchasing from local sources has positive effects both on economic security of a community and the climate. Greater use of local sources increases local jobs, and local jobs mean shorter commutes, which, in turn, reduce fossil fuel use and greenhouse gas emissions.
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From page 93... ...
She quoted a community member who participated in the Community Health Needs Assessment: "If you suffer from asthma then you may not go outside and be active and then you are gaining weight and you're not eating healthy food." As a second example, Gerwig cited youth physical inactivity levels in Moreno Valley, located in southern California. The percentage of Moreno Valley youth who are physically inactive is 45.01 percent, compared to 35.92 percent across California.
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From page 94... ...
Kaiser Permanente's Greenhouse Gas Emissions Gerwig noted that when discussing Kaiser Permanente's efforts to address climate, she always starts by being transparent about what Kaiser Permanente is emitting. In 2015, the organization's total greenhouse gas emissions amounted to nearly 800,000 metric tons of CO2e.3 The vast majority of these emissions (91 percent)
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From page 95... ...
Next, Gerwig referred to earlier discussions on equity and added that Kaiser Permanente appreciates that those who will suffer the most are those who are least able to be resilient against what she described as "the onslaught of climate change." Finally, as big greenhouse gas emitters, with 8 percent of greenhouse gas emissions in the United States coming from health care, Gerwig said, "[w] e have an obligation." Summary In summary, Gerwig called for several community health actions around climate change.
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From page 96... ...
She recognized that having many of Kaiser Permanente's operations located in California gives her what she described as a "bubble perspective," but she stated there are opportunities in many other parts of the country as well. Third, she encouraged workshop participants to ask their health care partners to publicly report their greenhouse gas emissions.
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From page 97... ...
The current state mandate is to reduce greenhouse gas emissions to 40 percent below 1990 levels by 2030, a new target that just passed in August 2016 as part of SB (Senate Bill)
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From page 98... ...
Using some of the Greenhouse Gas Reduction Fund monies, California has recently established four "climate smart" agricultural programs to give grants to farmers for various activities and projects that reduce greenhouse gases: (1) the Sustainable Agricultural Lands Conservation (SALC)
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From page 99... ...
She described methane as a "very potent greenhouse gas." Thus far, $12 million has been spent on anaerobic digesters on a few of the largest concentrated animal feeding operations in the Central Valley to capture methane and convert it into a bio-gas, and another $50 million has been allocated for this current budget year to be split between anaerobic digesters and alternative manure management practices. CalCAN has been focusing a tremendous amount of energy on the latter, she said, and has been a leading advocate because they would like to see some of the state funding be allocated toward practices that have other benefits in addition to reduced greenhouse gas emissions.
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From page 100... ...
It also attempts to address the fact that communities are located in the places where the biggest pollutants are being produced. AB 197, which passed in August 2016, takes SB 535 one step further, requiring that the state do a better job linking its greenhouse gas reduction efforts with the actual air quality problems created by the same greenhouse gas-emitting industries.
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From page 101... ...
ITEP has held 30 of these trainings thus far, including one just completed in Anchorage, Alaska; one was scheduled for Spokane later that week, and another four to five were planned for later in the year. In addition to the trainings, ITEP helps tribes build the capacity to address climate change impacts by maintaining a website with a host of information that tribes can use, such as profiles of other tribes that are working with climate change and examples of tribal adaptation plans that already have been implemented.
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From page 102... ...
For example, sagebrush is very important to the Navajo, who use it for ceremonies and a whole host of other purposes. The potential loss of that resource, Wilkinson said, "could be devastating to the culture." At the adaptation plan stage, again, Wilkinson said, tribal planning is different, with the main difference being tribal reliance on traditional ecological knowledge, or TEK.
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From page 103... ...
Traditional ecological knowledge is one of those strengths, as are tribes' strong cultural and community bonds. He mentioned a program in the Hopi Tribe to teach Hopi farmers new ways to farm their corn, which is becoming a serious challenge on the reservation because of drought.
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From page 104... ...
Gerwig reiterated what she described as the "incredibly useful" platform that Community Health Needs Assessments provide because they draw on listening to the community. Health care providers may think they know what their community's health needs are, but, she said, "we all have our lenses." It is only when they invite conversation and transparency that they see what these needs really are.
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From page 105... ...
Unless it can be shown that a new approach is going to reduce greenhouse gas emissions, she said, "there is nothing" that will fund that approach. The quantitative models being used to project future emissions reductions per practice are based on available science.
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From page 106... ...
"You base it on what the community members want." The assessments identify specific community issues, such as violence, food scarcity, or something else. In addition to that community-level work, Kaiser Permanente also pursues priorities for the environmental program overall.
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From page 107... ...
An unidentified audience member recalled visiting a Shoalwater Bay Tribe site on the southern peninsula of Washington state, where the tribe has been measuring climate impact for many years. The audience member commented on the impressiveness of the tribe's extensive planning for rising sea water and relocation inland and referred other workshop participants to the Robert Wood Johnson Foundation (RWJF)
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From page 108... ...
. Gerwig was unaware of any efforts in that arena, but thought the idea "striking." More broadly, she said, the question explores how more mainstream health care measures can be used in ways that will attract the attention of people working in health care.
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