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61–639 2010

HEALTHY PLANET, HEALTHY PEOPLE: GLOBAL 

WARMING AND PUBLIC HEALTH 

HEARING 

BEFORE THE

SELECT COMMITTEE ON 

ENERGY INDEPENDENCE 

AND GLOBAL WARMING 

HOUSE OF REPRESENTATIVES 

ONE HUNDRED TENTH CONGRESS 

SECOND SESSION 

APRIL 9, 2008 

Serial No. 110–32 

( 

Printed for the use of the Select Committee on 

Energy Independence and Global Warming 

globalwarming.house.gov 


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SELECT COMMITTEE ON ENERGY INDEPENDENCE 

AND GLOBAL WARMING 

EDWARD J. MARKEY, Massachusetts, Chairman 

EARL BLUMENAUER, Oregon 

JAY INSLEE, Washington 

JOHN B. LARSON, Connecticut 

HILDA L. SOLIS, California 

STEPHANIE HERSETH SANDLIN, 

South Dakota 

EMANUEL CLEAVER, Missouri 

JOHN J. HALL, New York 

JERRY MCNERNEY, California 

F. JAMES SENSENBRENNER, JR., 

Wisconsin, Ranking Member 

JOHN B. SHADEGG, Arizona 

GREG WALDEN, Oregon 

CANDICE S. MILLER, Michigan 

JOHN SULLIVAN, Oklahoma 

MARSHA BLACKBURN, Tennessee 

PROFESSIONAL STAFF

GERARD A. WALDRON, Staff Director 

ALIYA BRODSKY, Chief Clerk 

THOMAS WEIMER, Minority Staff Director 


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C O N T E N T S 

Page 

Hon. Hilda Solis, a Representative in Congress from the State of California, 

opening statement ................................................................................................ 1 

Hon. Earl Blumenauer, a Representative in Congress from the State of Oregon, opening statement ...................................................................................... 3 

Prepared statement .......................................................................................... 5 

Hon. Edward J. Markey, a Representative in Congress from the Commonwealth of Massachusetts, prepared statement .................................................. 8 

Hon. Jerry McNerney, a Representative in Congress from the State of California, opening statement .................................................................................... 11 

Hon. Marsha Blackburn, a Representative in Congress from the State of 

Tennessee, prepared statement .......................................................................... 12 

WITNESSES

Dr. Howard Frumkin, Director, National Center, Environmental Health Center for Disease Control ......................................................................................... 14 

Prepared testimony .......................................................................................... 17 

Dr. Jonathan Patz, Professor and Director, Global Environmental Health, 

University of Wisconsin at Madison ................................................................... 33 

Prepared testimony .......................................................................................... 35 

Answers to submitted questions ...................................................................... 147 

Dr. Georges Benjamin, Executive Director, American Public Health Association ........................................................................................................................ 42

Prepared testimony .......................................................................................... 80 

Answers to submitted questions ...................................................................... 150 

Dr. Dana Best, American Academy of Pediatrics ................................................. 89 

Prepared testimony .......................................................................................... 92 

Answers to submitted questions ...................................................................... 152 

Mr. Mark Jacobson, Director Atmosphere Energy Program, Professor Environmental Engineering, Stanford University .................................................... 107 

Prepared testimony and supplemental materials .......................................... 110 

Answers to submitted questions ...................................................................... 157 

SUBMITTED MATERIALS

Frumkin, et al report entitled ‘‘Climate Change: The Public Health Response’’ 

from American Journal of Public Health in March 2008 (Vol. 98 No. 3) ........ 68 

American Public Health Association white paper on ‘‘Climate Change: Our 

Health in the Balance’’ from April 2008 ............................................................ 45 

American Public Health Association blueprint document entitled ‘‘Climate 

Change Is a Public Health Issue’’ ....................................................................... 66 

American Academy of Pediatrics policy statement entitled ‘‘Climate Change 

and Children’s Health’’ from November 2007 .................................................... 103 

American Academy of Pediatrics technical report entitled ‘‘Climate Change 

and Children’s Health’’ from November 2007 .................................................... 165 

Patz et al report on Climate Change 2007: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Fourth Assessment Report 

of the Intergovernmental Panel on Climate Change ........................................ 174 


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HEALTHY PLANETS, HEALTHY PEOPLE: 

GLOBAL WARMING AND PUBLIC HEALTH 

WEDNESDAY, APRIL 9, 2008 

HOUSE OF REPRESENTATIVES, SELECT COMMITTEE ON ENERGY INDEPENDENCE

AND GLOBAL WARMING, Washington, DC. 

The committee met, pursuant to call, at 10:04 a.m., in Room B– 

318, Rayburn House Office Building, Hon. Hilda Solis presiding. 

Present: Representatives Solis, Blumenauer, Inslee, Cleaver, 

McNerney, and Walden. 

Staff present: Ana Unruh-Cohen and Stephanie Herring. 

Ms. SOLIS [presiding]. Good morning. I would like to call the Select Committee on Energy Independence and Global Warming to 

order, and wanted to let our witnesses and everyone know that we 

are having some difficulty with timekeeping because these clocks 

are not working appropriately, but we will give you an indication 

when you begin to speak what the timing will be. I think most of 

you know what that procedure is like. 

Unfortunately, this morning Chairman Markey is not able to be 

with us; he had a—wrinkle. He is getting it taken care of. And I 

don’t mean it facially or figuratively speaking; he broke his wrist, 

so we hope that he will have a speedy recovery and come back to 

us very soon. 

But I am very delighted that this particular hearing is going to 

focus on healthy planet, healthy people, global warming, and public 

health, something that some of us here on the committee have been 

talking about for some time. And it just happens that this week is 

both National Public Health Week and World Health Day, and so 

we are focusing on the impact of climate change that will have on 

our communities and the health and well-being of our communities. 

Today’s hearing is an opportunity to address this important relationship. 

The World Health Organization reported that the effects of climate change may have caused over 150,000 deaths in the year 

2000, and predicts that these impacts are likely to increase in the 

future. According to the IPCC, the United States will be challenged 

by increased heat waves, air pollution, forest fires during the 

course of the century, with potential risks for adverse health impacts such as heat stress, increases in asthma, allergies, chronic 

and obstructive pulmonary disease. 

Last October, the director of the United States Center for Disease Control and Prevention, Dr. Julie Gerberding, testified that 

climate change is anticipated to have a broad range of impacts on 


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the health of Americans and the nation’s public health infrastructure. The World Health Organization found that the negative public health impacts of climate change will disproportionately impact 

communities that are already vulnerable. 

Children, the elderly, poor, and communities of color, as we 

know, are most vulnerable to the negative health impacts of climate change. More than 50 percent of 30 million people in the U.S. 

are impoverished and they currently live in urban areas; the majority of these communities are of color. And a recent report issued 

by the IPCC noted that these communities will have less capacity 

to deal with effects of climate change. 

Many of those communities are already suffering cumulative exposure. For example, 5.5 million Latinos and 68 percent of all African-Americans live within the range where health impacts from 

power plants are the most severe, and more than 70 percent of African-Americans and Latinos live in counties that violate federal 

air pollution standards. 

The EPA first recognized the possible impacts of climate change 

on public health over a decade ago, and in 1997, EPA’s publication, 

titled ‘‘Climate Change and Public Health,’’ the EPA wrote that, 

‘‘as climate changes, natural systems will be destabilized, which 

could pose a number of risks to human health.’’ And in 2001, the 

EPA sponsored a report for the Global Change Research Program 

entitled, ‘‘Climate Change and Human Health: The Potential Consequences of Climate Variability and Change.’’ The report stated 

that the assessment makes clear that the potential health impacts 

are diverse and demand improved health infrastructure and enhanced targeted research. 

As policymakers, we have a moral imperative to make sure that 

policy and regulations protect our most vulnerable population. Unfortunately, the health and welfare of minority and low-income 

communities continues to be put at risk by the administration’s 

failure to develop and implement and enforce environmental regulations, including the regulation of greenhouse gases public health; 

it is unnecessarily risking public health. Hurricane Katrina demonstrated to the world the direct effect that climate change is having on the health of our most vulnerable populations. These outcomes, as we know, will worsen unless there is action taken. 

Before we begin, I would also like to say that I am disappointed 

that we did not receive testimony from the administration prior to 

the start of this hearing. The failure of the administration to come 

to agreement on the CDC testimony is not only in violation of committee rules and courtesy, it is also a great disservice to my colleagues on this committee who deserve the opportunity to know in 

advance what a witness’ position is, and in this case the administration’s position. 

Frankly, this is yet another indication of the role of politics that 

is playing in science, and I hope in this case that the testimony reflects the science and not the politics. The administration must recognize our role in preventing impacts of climate change on vulnerable communities, including the need to improve health status and 

health equity, the inclusion of health policy in the development of 

climate response, and the need to prevent injustices such as those 

that resulted in Hurricane Katrina. 


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I look forward to hearing from all of our witnesses today, and I 

really want to thank our chairman, Ed Markey, for agreeing to 

have this very important hearing. He has been a longtime advocate 

in this area, and finally we see the day now where these issues 

that we have been talking about have come to the forefront. 

So I will yield back the balance of my time, and I will recognize 

Congressman Blumenauer, from Oregon, for 2 minutes. 

Mr. BLUMENAUER. Thank you, Madam Chair. Well, actually I 

may—since it is a little more relaxed, I may take a couple more, 

in part because, as you, I am in three places at once right now, for 

which I apologize, but we have got some ways and means stuff 

going forward. We are missing a caucus and I don’t even know 

where else I was supposed to be, but I wanted to be here to express 

my appreciation to the committee and staff for bringing us together 

and for the witnesses to join us. 

Not everybody is here. We have had a chance, however, to review 

some of the testimony that did get to us, and we will—the record 

that is being built, I think, is very, very important to be able to 

shape and inform what we are going to be doing with climate 

change. And being able to focus on the human health aspect here, 

I think, is perhaps the most important and under-appreciated area. 

Last week we had our state epidemiologist, Mel Kohn, give a 

presentation in Portland, where he outlined the public health 

issues that he is dealing with from climate change, from heat 

waves to vector-borne disease, asthma, allergy, air pollution, chronic—it was a pretty scary litany of items that they are considering 

with, from changes to physical activity to food insecurity, mental 

health. We need to be able to get the big picture together to be able 

to move forward on this. 

One particular area that I am hopeful that the witnesses can 

help us focus on and supplement the record, dealing with the problem of waterborne disease in particular. And this is an area that 

is an international initiative; it is something we have been working 

on with my associate, Ms. Benner, since the Johannesburg World 

Sustainable Development in 2002. We have got the Water for the 

Poor legislation, but it is not being funded. 

And candidly, the administration, as yet, has not even assembled 

the plan that was called for under that legislation. And this is only 

going to be compounded if global warming continues: an average 

global temperatures increase by just one degree, we are talking 

about a third of a billion cases of waterborne illness. Hundreds of 

thousands of people, potentially, that would be dying. 

There are opportunities with our assessment of global warming 

to actually deal—to fight climate change, to actually improve 

human health. We have got some legislation, Dr. Frumkin, dealing 

with recycling, and land-use, and transportation, that actually not 

only addresses climate change, but actually has the potential of 

helping the human physical activity and condition. We will be moving forward with that. 

One aspect I didn’t see, at least as we were reviewing last night 

the testimony that had been submitted, dealt with climate change’s 

impact on reduced biodiversity and missed opportunities for medical advancements, and I don’t know if that is going to find its way 

into the record now or later. The testimony had that iconic picture 


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of the polar bear. And some people are dismissing, you know, one 

more species, more or less, but just thinking about the amazing capacity of the polar bear to fast for 150 days, maintain a relatively 

normal body temperature, maintain bone mass, give birth, I mean, 

just basically stop the other processes—the impact that could have 

for long-term human health is something that I am hopeful we can 

get some help from you and others. 

I am going to stick around for as long as I can; I hope to get 

back. I appreciate your leading us through this and look forward 

to hearing our witnesses. 

[The prepared statement of Mr. Blumenauer follows:] 


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Ms. SOLIS. Great. Thank you very much, Mr. Blumenauer. 

I also would like, at this time, to ask for unanimous consent to 

insert Ed Markey, our chairman, his statement into the record. If 

there is no objection, then we will do that. 

[The statement of Chairman Markey follows:] 


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Ms. SOLIS. Next I would like to recognize the distinguished member from California, Mr. McNerney, for an opening statement. Feel 

free to take more than 2 minutes if you would like, but keep it—— 

Mr. MCNERNEY. Great. Well, I typically am a brief speaker, so 

I will, probably. Thank you, Madam Chairwoman, and this is a 

really important part of the question on the issue of global warming, is the health effects. We know there is going to be flooding effects and so on, but the sort of secondary effects, I think, are going 

to be actually more important in terms of the effect on our people. 

We have to adapt and mitigate; we all know that. But there is 

going to be things like problem plants growing that cause more allergies, more asthma, there will probably be an increase of ozone. 

The warmer temperatures—and I am sure we will hear about this 

from the experts—they will be increasing the rodent population, 

the insect population, which are vectors for diseases that we probably haven’t seen in our society for a long, long time. 

There will be droughts and floods, which have health impacts. 

There will be loss of habitat, which Mr. Blumenauer referred to a 

minute ago. We will lose tropical rainforests; we will lose costal 

areas. 

So we have a whole range of impacts that are going to be coming 

down the pipe from global warming. It is important for us right 

now to understand what those impacts are so that we can begin to 

plan, we can begin to mitigate, and we can begin to use that as an 

issue to further the public’s awareness and willingness to go along 

with steps that we are going to be needing to take to fight these 

coming issues. 

And one thing I always like to say is that if we make the right 

decisions here, we are not only going to be adapting and mitigating, but we are going to be creating opportunities. We are going 

to be creating a cooperation worldwide, so I think of it as a great 

opportunity as well as a threat. 

So what I want to do is listen to your testimony—hopefully I will 

be able to stay through most of it—and we will move forward with 

good legislation as a result. 

So thank you, Madam Chairwoman. 

Ms. SOLIS. Thank you. I thank the gentleman from California. 

[The prepared statement of Ms. Blackburn follows:] 


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Just for the sake of clarity here, each panelist will have a chance 

to give an opening statement for 5 minutes, and then from there 

we will go to question and answer. And I apologize if we don’t have 

all of our members here; we do have a series of other committee 

meetings and caucuses that are going on. 

So our first witness, I would like to thank Dr. Frumkin for coming here. Just a brief introduction: Dr. Howard Frumkin serves as 

the director of the National Center for Environmental Health and 

the Agency for Toxic Substances and Disease Registry. He received 

his M.D. from the University of Pennsylvania and his master’s and 

doctorate in public health from Harvard. 

Before joining the CDC in September 2005, he was professor and 

chair of the Department of Environmental and Occupational 

Health at Emory University, Rollins School of Public Health. He 

previously served as a member of EPA’s Children’s Health Protection Advisory Committee, where he chaired the Smart Growth and 

Climate Change workgroup. 

He currently serves on the Institute of Medicine roundtable on 

environmental health services, research, and medicine. He is the 

lead author on ‘‘Climate Change: The Public Health Response,’’ 

which was published in the American Journal of Public Health. 

This document outlines the CDC’s strategy to address climate 

change impacts on public health in the United States. 

Dr. Frumkin, welcome, and thank you, and you may begin. 

STATEMENTS OF DR. HOWARD FRUMKIN, DIRECTOR, NATIONAL CENTER, ENVIRONMENTAL HEALTH CENTER FOR 

DISEASE CONTROL; DR. JONATHAN PATZ, PROFESSOR AND 

DIRECTOR, GLOBAL ENVIRONMENTAL HEALTH, UNIVERSITY 

OF WISCONSIN AT MADISON; DR. GEORGES BENJAMIN, EXECUTIVE DIRECTOR, AMERICAN PUBLIC HEALTH ASSOCIATION; DR. DANA BEST, AMERICAN ACADEMY OF PEDIATRICS; 

MR. MARK JACOBSON, DIRECTOR ATMOSPHERE ENERGY 

PROGRAM, PROFESSOR ENVIRONMENTAL ENGINEERING, 

STANFORD UNIVERSITY 

STATEMENT OF HOWARD FRUMKIN 

Dr. FRUMKIN. Thank you very much, Madam Chair and other 

distinguished members of the committee. I am grateful to you for 

taking up this very important subject. 

As you said, I am Howard Frumkin, director of the National Center for Environmental Health and the Agency for Toxic Substances 

and Disease Registry at the Centers for Disease Control and Prevention. I am here to speak on our emerging understanding of climate change and its potential impact on health, and to discuss 

steps we are taking, as public health officials, regarding these potential consequences. 

I recognize that this topic remains controversial, and some of my 

testimony may not necessarily reflect broad consensus across the 

administration. In addition, CDC is not a regulatory agency and 

does not express any opinions on regulatory decisions pending before the Environmental Protection Agency. 

I would like to make three simple points. First, climate change 

is very much a public health concern. Some of the components of 


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that point were very well elucidated by members in their opening 

statements. Potential health impacts include heat waves, respiratory disease exacerbations, severe weather events, infectious 

disease risks, and others. For some of those, the science base is 

very well delineated; for others we have a lot to learn. 

Collectively, that science base is very well described in documents of the intergovernmental panel on climate change, in the 

U.S. climate change science program, and I won’t go into those in 

any more detail now. The bottom line is that climate change is a 

very serious public health concern. 

As the chair has pointed out on many occasions, it is particularly 

a concern that affects some of us more than others. Public health 

is very committed to addressing health disparities, and that commitment very much has to be a part of our steps to address climate 

change as well. 

The second point is that we need public health action to address 

the potential health consequences of climate change. Fortunately, 

the tools of public health—the tools in our toolbox—are very wellsuited to addressing climate change. 

Core functions of public health include surveillance and tracking; 

collecting data on environmental risk factors and on health outcomes; outbreak investigations, so that we better understand 

emerging or reemerging diseases that may be related to climate 

change; preparedness planning, such as heat wave preparedness 

plans, so that officials at the local level can better protect their 

populations from some of the consequences of climate change; research, because we need to understand much better the health implications of climate change. 

Communication is a core function of public health that is especially important because this is a broad and complex topic that the 

public needs to understand well, including its health consequences; 

we in public health have considerable experience at communicating 

complex health-related topics to the public. All of these and others 

are core public health functions, and they can very, very readily be 

deployed as we address climate change. 

With the permission of the chair, I would like to submit for the 

record an article entitled, ‘‘Climate Change: The Public Health Response,’’ that makes these points in considerably more detail. 

My third point is that CDC has a strong foundation for the work 

that we need to do going forward. We have ongoing activity, and 

have for a long time, in such functions as Vector-borne disease surveillance, heat wave epidemiology, strong working relationships 

with state and local health departments, preparedness planning, 

health communication. These are activities that are well-established at the CDC and form a strong foundation for moving forward 

as we address climate change. 

In closing, let me offer a good news aspect of the challenge that 

we face. As has been mentioned in the opening statements, many 

of the steps we need to take to address climate change offer a 

range of co-benefits that will benefit public health as well as environmental and other areas in diverse ways. For example, if people 

walk and bicycle more, not only is that part of the climate change 

response, but it helps to promote physical activity, it helps us 


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achieve clean air, it helps reduce the risk of car crashes, thereby 

offering a broad range of health benefits. 

We think there are many opportunities to benefit health in diverse ways as we address climate change. Part of our job at the 

CDC, and in public health more generally, is to document the 

science base for those co-benefits to bring them to the attention of 

the public and policymakers, so that together we can protect health 

as well as we possibly can as we move forward in addressing climate change. 

Thank you, again, for your interest in this subject and your commitment. I am pleased to answer any questions. 

[The statement of Dr. Frumkin follows:] 


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Ms. SOLIS. Thank you very much. 

Our next speaker is Dr. Jonathan Patz. Dr. Jonathan Patz is a 

professor and director of global environmental health at the University of Wisconsin in Madison. He co-chaired the health expert 

panel of the United States National Assessment on Climate 

Change, and was a convening lead author of the United Nations 

and World Bank Millennium Ecosystem Assessment. For the past 

14 years, he has been a lead author for the United Nations intergovernmental panel on climate change and shared the 2007 Nobel 

Peace Prize. 

Dr. Patz is president of the International Association for Ecology 

and Health, and has written over 75 peer-reviewed papers and a 

textbook addressing the health effects of global environmental 

change. He has served on several scientific committees of the National Academy of Sciences, and currently serves on the science advisory board of both the CDC and EPA. At the EPA he also serves 

on a committee investigating the health impacts of climate change 

on children. 

Welcome, Dr. Patz, and congratulations. 

STATEMENT OF JONATHAN PATZ 

Dr. PATZ. Thank you. And it is really an honor. I want to thank 

you for allowing me to present to this committee, and for a topic 

that I have worked on for about 15 years. As you mentioned, I did 

serve as co-chair for the U.S. National Assessment on Climate 

Change health expert panel and on the IPCC, and from your introductory comments it is quite clear that you understand that public 

health really is a core impact area of climate change, and that, in 

my view as a public health scientist, the health effects of climate 

change could be really one of the greatest challenges that we face 

in this century. 

The reason is that climate change is a unique and different type 

of health risk compared to others that we have dealt with in the 

past. We are used to dealing with single agents of disease, and trying to find a cure or a vaccine to toxic chemicals and trying to figure out ways to reduce exposure. But climate change can potentially affect our health through multiple pathways. 

Certainly we know about direct effects from heat waves, when 

more than 700 people died in the 1995 Chicago heat wave. And a 

new paper out just this year puts the number, as far as the European heat wave of 2003, up at approximately 70,000 people dying 

in less than a 2-week period. So we know that heat waves kill people. And the projections from the climatologists are that we are 

going to be having more frequent and more extreme heat waves. 

We have, in our sense, or our preliminary findings, at least for 

Wisconsin, showing that there will be a disproportionate increase 

in extreme heat waves compared to a decline in cold snaps. So we 

are worried about this. 

Dr. Jacobson will go further into detail looking at air pollution 

effects of climate change. I will just point out that accompanying 

heat waves are often stagnant air masses that exacerbate air pollutions, and according to the IPCC citing climate studies, there may 

be an increase in stagnant air masses, at least for the eastern 

United States. 


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One study that I want to point out that took a look at the relationship between climate and ozone air pollution—that is the 

ground-level photochemical smog pollution—finds that in the eastern United States, red ozone alert days, which are dangerous for 

asthmatics and other people with respiratory problems, that could 

increase by 68 percent. So warmer temperatures drive that chemical reaction that forms ground-level ozone smog pollution, and Dr. 

Jacobson will cover that further. 

Another air pollution issue is pollen. And ragweed pollen, according to one study, will increase by 50 percent under conditions of 

doubled CO2. So the issue of both ozone and allergens could be a 

problem as far as air quality. 

And Representative Blumenauer brought up the concern about 

water. Our group actually studied the—all waterborne disease outbreaks reported in the United States between the years 1948 and 

1994, and we found that the majority—actually, about 60—well, 

two-thirds, two-thirds—67 percent of reported waterborne disease 

outbreaks were preceded by extremely heavy rainfall months. 

So we see this issue of extremes of the hydrologic cycle—the 

water cycle—that climatologists tell us it is not just global warming, it is climate change. It is extremes, you know, more droughts 

and more flooding, that actually could present a challenge to our 

already challenged water quality. And in municipalities with rusting pipes and water systems, this could be an added pressure. 

So, can we adapt to these challenges? As Dr. Frumkin said, we 

do have many—we have means to adapt to many of these issues. 

However, I would argue that we need a multi-pronged approach 

that includes both preparedness and more upstream greenhouse 

gas mitigation. We do need to address specific issues of heat waves, 

air quality, water quality problems, but not lose sight of the root 

problem that is driving this, and that is climate change caused by 

greenhouse gas emissions. 

In approaching climate change, we must also look at this not in 

isolation of other environmental problems that could act in synergy 

with climate change. For example, a heat wave over a sprawling 

urban environment with lots of heat-retaining surfaces, the urban 

heat island effect. Or when a hurricane hits a city like New Orleans, and the fact that the coastal wetlands have been degraded 

makes that area much more vulnerable to a climate event. So we 

need to look at climate change with other issues. 

Finally, as Dr. Frumkin mentioned, there are great opportunities—co-benefits—if we reduce fossil fuel burning, and change our 

transportation system, and promote exercise, that is a great thing. 

And in this regard, I feel that energy policy becomes one and the 

same as public health policy. 

And currently there is very little funding to look at these issues 

of health, especially the CDC and NIH. There is no funding to protect the American public, and that needs to change. 

[The statement of Dr. Patz follows:] 


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Ms. SOLIS. Thank you very much. Sorry our time is short, but we 

will get back with you when we ask our questions. 

Our next speaker is Dr. Georges Benjamin. Dr. Georges Benjamin has been the executive director for the American Public 

Health Association, the nation’s oldest and largest organization of 

public health professionals, since 2002. This year, the APHA has 

dedicated National Public Health Week to climate change impacts 

on health in America. 

I am proud to have worked with APHA and Chairman Markey 

to introduce a resolution recognizing this week. We currently have 

104 cosponsors on the resolution. As an established administrator 

and author and orator, Dr. Benjamin started his medical career 

serving our military at the Madigan Army Medical Center. 

Later he moved to Washington, D.C., where he served as chief 

of emergency medicine at the Water Reed Army Medical Center. 

After leaving the Army, he directed one of the busiest ambulance 

services in the nation here in the District of Columbia Fire Department. Prior to joining APHA, he was chief executive of the State 

of Maryland’s Department of Health and Mental Hygiene, a cabinet-level agency. 

And we would like to welcome you, Dr. Benjamin. Thank you, 

and you have 5 minutes. 

STATEMENT OF GEORGES BENJAMIN 

Dr. BENJAMIN. Good morning, Madam Chair and members of the 

committee. Let me first of all thank you very much for that resolution. We think that is a very, very important statement of the engagement of Congress in this issue of climate change. 

You know, each year the American Public Health Association creates policies—public policy statements—that we think are important for the public’s health, and we actually put out our first public 

policy on climate change back in 1995. This past November we reaffirmed that policy, and many of the things in that policy are very 

consistent with both your statement, Madam Chair, as well as my 

colleagues—things my colleagues here at the table have said. 

Let me just point out four things, just in the interest of time. 

Number one, the fact that climate change is real and does affect 

our health, and most importantly, that there are certain populations that are more at risk—vulnerable populations. Number two, 

that we certainly support policies that are co-beneficial, meaning 

that public health has an opportunity here to get twofers and 

threefers and really leverage public health action to try to improve 

the climate as well as our own human health. 

Number three, that we don’t know a lot, or as much as we need 

to know, about the interrelationship between climate change and 

our health, and more importantly what we can do about it. And so 

there is really a need for an extraordinary research effort to find 

some of those things out. And then four, this requires enhancing 

the public health system with the skills, tools, and capacity to really address this very, very important role. 

Now, this week during National Public Health Week, what we 

are trying to do, of course, is to raise consciousness around this 

issue. We are asking all Americans to do five things. 


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Number one, be prepared, particularly for these extreme weather 

events. This is consistent with all of the other preparedness activity that is occurring for a variety of threats to human health. Secondly, to think about traveling differently, which means folks like 

me need to drive less and walk more, bicycle more, do what we can. 

Thirdly, eat differently; find ways in which we can certainly eat 

more locally, do things so that both it improves our health as well 

as address the issue of climate change. That means eating more 

fruits and vegetables and less meat, and that is always a challenge 

for a guy like me. 

Greening your work, recycling. Even at the American Public 

Health Association we had an event. We brought someone in yesterday to talk to our staff about things that we can do to green our 

work; we actually have a Green Team at our office, which is trying 

to lead by example. 

And green your home: all the things that we talk about in terms 

of insulating your home, changing the bulbs to the compact fluorescent bulbs, reducing your use of wasteful products, recycling, et 

cetera, and conserving water. 

These are things that we think all Americans can do, and we are 

trying to encourage, this week, for all Americans to focus on this 

effort. I think the communication that we are trying to put out is 

trying to tell the American people that there are things that they 

can certainly do to address this problem. 

We also think there are some things, certainly, that Congress 

can do. Number one, continue to play a leading role in this area. 

We think that Congress and the administration both have an opportunity to play a very important role here. That includes authorizing a program at the Center for Disease Control and Prevention—a very specific program to address this issue, including the 

funding to support that. 

Funding the National Institutes of Health, particularly NIEHS, 

to begin doing some of the basic science research that they do. Better funding and support for the EPA as well. Using some of the vehicles that you already have, such as the to-be-debated transportation bill, when it comes before you, the Farm bill, which is in 

front of you, and others. 

These are opportunities for you to leverage health into the discussion, and that way build capacity to do some of the things you 

heard Dr. Patz talk about to make this more of a holistic approach 

to improving our environment. And also provide funding for health 

impact assessments so that people are continually asking about, 

what is the health impact of the actions that we are going to do 

as a way of trying to both do adaptation and mitigation as we go 

forward? 

We think, in conclusion, that we certainly can’t wait. This is a 

very, very important time in our nation’s history. We think we 

ought to start now. 

I also, with your permission, would like to introduce a couple 

things for the record: both our white paper on climate change as 

well as a blueprint document that we have here. If we could possibly introduce those in the record. With that I will—— 

Ms. SOLIS. Thank you. Without objection, we will include that in 

your testimony. 


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[The information follows:] 


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Dr. BENJAMIN. Thank you very much. Madam Chair, I will pass 

the rest of my time. 

[The statement of Dr. Benjamin follows:] 


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Ms. SOLIS. Thank you. Thank you very much, Dr. Benjamin. It 

is a pleasure working with you. 

Our next speaker is Dr. Dana Best; she represents the American 

Academy of Pediatrics. This is a nonprofit professional organization 

of 60,000 primary care pediatricians, pediatric medical sub-specialists, and pediatric surgical specialists, dedicated to health, safety, 

and the well-being of infants, children, adolescents, and young 

adults. 

Dr. Best is an assistant professor of pediatrics at the George 

Washington University School of Medicine and an attending physician at Children’s National Medical Center in Washington, D.C. 

She serves also on the American Academy of Pediatrics Committee 

on Environmental Health, and in October 2007, the committee published their report, ‘‘Global Climate Change and Children’s 

Health.’’ 

Thank you, Dr. Best, for being here. You can begin your testimony. 

STATEMENT OF DANA BEST 

Dr. BEST. Thank you, Madam Chairwoman. 

Good morning to all of you. I appreciate this opportunity to testify today on the impact of climate change on child health, and I 

am proud to represent the American Academy of Pediatrics in this 

regard. 

Human health is affected by the physical environment. As the 

climate changes, environmental hazards will change and often increase, and children are likely to suffer disproportionately from 

these changes. Anticipated health threats from climate change include extreme weather events and weather disasters, increases of 

infectious disease, and air pollution. Within all of these categories, 

children have increased vulnerability compared to other groups. 

The health consequences associated with extreme weather events 

include death, injury, infectious disease, and post-traumatic mental 

health and behavior problems. Experiences with Hurricanes 

Katrina and Rita demonstrated the difficulties with tracking children’s whereabouts, keeping children and caregivers together, and 

the special needs of hospitalized infants and children during and 

after major natural disasters. 

Vector-borne infections are affected by climate change as well. 

Both the hosts—for example, rodents, insects, and snails—and the 

pathogens—such as bacteria, viruses, and parasites—are sensitive 

to climactic variables such as temperature, humidity, and rainfall. 

For example, malaria is a climate-sensitive vector-borne illness 

to which children are particularly vulnerable. Because they have 

naive immunity, children experience disproportionately high levels 

of both sickness and death from malaria. 

Climate change is expanding the range of mosquitoes to higher 

altitudes and latitudes, and warmer temperatures speed the development of the parasite within the mosquito itself. Small children 

will be most affected by the expansion of the malarial zones and 

the success or failure of our response to those changes. 

Children are especially vulnerable to both short-term illness and 

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oping and growing; they breathe faster than adults and they spend 

more time outdoors in vigorous physical activity. 

Formation of ozone, in particular, is known to increase with increasing temperatures. Children who are active in outdoor sports 

in communities with high ozone are at increased risk of developing 

asthma, which has been well documented. 

Rates of pre-term birth, low birth-weight, and infant mortality 

are increased in communities with high levels of particulate air 

pollution. Some investigators have argued that part of the global 

increase in childhood asthma can be explained by increased exposure to allergens in the air driven by climate change; those are allergens like pollen, as previously mentioned. 

For all organisms there exists a range of ideal temperatures, 

above and below which sickness and death increase. Humans are 

no exception. As temperatures increase, the frequency of heat 

waves increase. 

Children spend more time outside, often playing sports in the 

heat of the afternoon, which puts them at increased risk of heatstroke and heat exhaustion. Outdoor time during hot weather may 

also put children at increased risk of ultraviolet radiation-related 

skin damage, including skin cancer. 

Food availability may be affected and land and ocean food productivity patterns shift. Water availability may change and be reduced in some regions. 

Populations on the coasts may be forced to move because of rises 

in sea level, and massive migrations are conceivable, driven by abrupt climate change, natural disaster, or political instability, 

caused by increased demands for shrinking resources. 

World population is expected to grow by 50 percent, to 9 billion 

people, by 2050, which would place additional stress on ecosystems 

and increase demand for energy, fresh water, and food. As these 

changes evolve, social and political institutions will need to respond 

with aggressive mitigation and adaptation strategies to preserve 

and protect public health, particularly for children. 

In addition to its recommendations to pediatricians for reducing 

their own energy demands and incorporating sustainable practices 

into their personal and professional lives, the American Academy 

of Pediatrics calls upon government at all levels, from the smallest 

municipalities to the national and international levels, to implement aggressive policies to halt contributions to climate change 

caused by humans, and mitigate their impact on children’s health. 

First, policymakers should develop aggressive long-term policies 

to reduce the major contributing factors to global climate change. 

For example, the Environmental Protection Agency should set the 

national ambient air-quality standard for ozone at 0.060 parts per 

million. 

Our government should invest in prudent and vital preparations 

for our public health care systems, including immunization programs and disease prevalence reporting and tracking. And that 

means they have to be funded, too. 

Policymakers should give specific attention to the needs of children in emergency management and disaster response. Governments should support education and public awareness of the 

threats from climate change and their implications for public and 


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children’s health now and in the future. Governments should fund 

interdisciplinary research to develop, implement, and measure outcomes of innovative strategies to both mitigate and adapt to climate change, particularly those effects that have direct implications for children’s health. 

In order that members may have access to the full information 

on this topic that we have prepared, I would like to ask that our 

statement—the American Academy of Pediatrics’ policy statement 

and technical report, both called, ‘‘Climate Change and Children’s 

Health’’—be included in the hearing record. 

In conclusion, the American Academy of Pediatrics commends 

you, Madam Chairwoman, for holding this hearing today to call attention to the potential impacts of global climate change on children’s health. We look forward to working with Congress to prevent the adverse impacts on child health caused by global climate 

change, and plan for those we may be unable to avert. 

I appreciate this opportunity to testify. Thank you. 

[The statement of Dr. Best follows:] 


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Ms. SOLIS. Thank you, and without objection we will receive your 

additional report information. 

[The information follows:] 


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Ms. SOLIS. Our next speaker, and our last speaker, is Dr. Mark 

Jacobson. Dr. Mark Jacobson is director of the Atmosphere and Energy Program and professor of civil and environmental engineering 

at Stanford University. 

He has been at the forefront of developing models to better understand the effects of air pollutants on climate and air quality. In 

2000, he discovered that black carbon, the main component of soot, 

may be the second leading cause of global warming, after carbon 

dioxide. 

In 2001, he developed the first global through urban scale air 

pollution weather climate model. His latest publication is titled, 

‘‘On the Causal Link Between Carbon Dioxide and Air Pollution 

Mortality.’’ 

Dr. Jacobson, welcome, and thank you for coming. You have 5 

minutes. 

STATEMENT OF MARK JACOBSON 

Mr. JACOBSON. Thank you, Madam Chair. I would like to thank 

the committee for inviting me to testify today. 

I will discuss scientific findings on the effects of carbon dioxide 

emitted during fossil fuel combustion on air pollution health in 

California, relative to the United States as a whole. I will then discuss how these findings compare with the two main assumptions 

made by Environmental Protection Agency administrator Stephen 

L. Johnson that formed the basis of his decision to deny California’s request for a waiver of Clean Air Act preemption. 

On March 6, 2008, EPA Administrator Johnson published a summary of his decision to deny the California Air Resources Board request for a waiver. The decision was made on two grounds. 

First ‘‘Greenhouse gas emissions from California cars are not a 

causal factor for local ozone levels any more than greenhouse gas 

emissions from other sources of greenhouse gas emissions in the 

world,’’ he says. And second, ‘‘While I find that the conditions related to global climate change in California are substantial, they 

are not sufficiently different from the conditions in the nation as 

a whole to justify separate state standards. These identified impacts are found to affect other parts of the United States, and 

therefore these effects are not sufficiently different compared to the 

nation as a whole.’’ 

These two issues are questions of scientific fact, which I will address here with results from a published study I performed, funded 

in part by the EPA, and subsequent analysis. The study began 

about 2 years ago, before the waiver issue became an issue, and before EPA funding commenced on the project. 

It was also the culmination of research on the effects of climate 

change on air pollution that I started 8 years ago and of research 

on the causes and effects of air pollution that I started 18 years 

ago. I first examined the effects of temperature alone, and separately, water vapor alone, on ozone using an exact solution to a set 

of several hundred chemical equations in isolation. 

The figure on the screen now shows the resulting ozone at low 

and high pollution levels. A comparison of the solid line, base temperature, with the dashed line, 1.8 degrees Fahrenheit or one degree Kelvin higher temperature, in the figure shows that the inVerDate Mar 15 2010 21:12 Nov 17, 2010 Jkt 061639 PO 00000 Frm 00111 Fmt 6633 Sfmt 6602 E:\HR\OC\A639.XXX A639

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crease in temperature increases ozone when ozone is already high 

at all water vapor levels, but has little or no effect on ozone when 

ozone is low. The figure also shows that water vapor, the horizontal 

axis, independently increases ozone when ozone is high, but can 

slightly decrease ozone when ozone is low. 

This result implies immediately that higher water vapor—sorry, 

higher temperatures and water vapor—should increase ozone 

where it is already high. It is also known that California has six 

of the 10 most polluted cities in the United States, with respect to 

ozone, including Los Angeles, Visalia, Bakersfield, Fresno, Merced, 

and Sacramento. So it is expected from this result alone that a 

warmer planet should increase ozone pollution in California more 

than in the U.S. as a whole. 

The next step was to evaluate whether carbon dioxide could trigger the temperature and water vapor changes sufficient to effect 

ozone when many other processes are considered simultaneously, 

and to evaluate effects in California. For this, a three-dimensional 

global model of the atmosphere that focused at high resolution over 

the United States was used. 

The next set of figures show differences in temperature, water 

vapor, and ozone over the United States due solely to historically 

emitted fossil fuel carbon dioxide from the simulation. Carbon dioxide increased near-surface temperatures and water vapor, and both 

sped back to increase near-surface ozone—the last figure shown— 

as expected from the previous analysis. 

Carbon dioxide similarly increased particles in populated areas 

for several reasons described in the written testimony. The changes 

in ozone particles and carcinogens were combined with population 

and health effects data to estimate that carbon dioxide increased 

the annual U.S. air pollution death rate by about 1,000 per 1.8 degree Fahrenheit, or one degree Kelvin, with about 40 percent of 

these increased deaths due to ozone. 

These annual additional deaths are occurring today, as historic 

temperatures are about 1.5 degrees Fahrenheit, or 0.85 Kelvin, 

higher than in pre-industrial times. Of the additional deaths, more 

than 30 percent occurred in California, which has only 12 percent 

of the U.S. population. As such, the death rate per capita in California was over 2.5 times the national average death rate per capita due to carbon dioxide-induced air pollution. 

A simple extrapolation from U.S. to world population gives about 

21,600—there is an error bar—deaths per year worldwide, per one 

degree Kelvin or 1.8 degree Fahrenheit, due to carbon dioxide. Carbon dioxide increased carcinogens as well, but the increase was relatively small. 

Next, let us examine the effects of controlling California’s carbon 

dioxide as if its local emissions instantaneously mixed globally, 

which it does not. In such a case, controlling local carbon dioxide 

in California still reduces the air pollution-related death and illness 

rate in California at a rate 2.5 times greater, per capita, than it 

reduces the death rate in the U.S. as a whole. 

However, carbon dioxide emissions do not immediately mix globally. Instead, carbon dioxide levels in polluted cities are much higher than in the global average, as shown with data in the figure now 

on the screen. This is from Salt Lake City, Utah. Although the 


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global background carbon dioxide is currently about 385 parts per 

million, the data indicate that a medium-sized city’s downtown 

area can have an average of 420 to 440 parts per million of carbon 

dioxide, and a peak over 500 parts per million of carbon dioxide. 

The figure now on the screen—this is almost done here—show 

computer simulations of carbon dioxide effects in California for a 

month of August, due solely to local carbon dioxide emissions. The 

elevated carbon dioxide over the urban areas is consistent with the 

expectations from the data. 

The increases in local carbon dioxide led to increases in water 

vapor and ozone over California. Since carbon dioxide emissions 

outside of the grids shown were not perturbed for the simulations, 

the simulations demonstrate that the effects on ozone found here 

were due solely to locally emitted carbon dioxide. In sum, locally 

emitted carbon dioxide is a fundamental causal factor of air pollution in California. 

The final slide here demonstrates compares modeled and measured parameters over each hour of a month and demonstrates the 

ability of the computer model used here to simulate the weather at 

specific times and locations. 

In conclusion, this analysis finds the following: 

Global warming due specifically to carbon dioxide currently increases the air pollution death rate of people in California more 

than it increases the death rate of people in the United States as 

a whole, relative to the respective population. The reason is that 

higher temperatures and water vapor due to carbon dioxide increased pollution the most where it is already high, and California 

has six of the 10 most polluted cities in the U.S. The deaths are 

currently occurring and will increase in the future. 

Controlling carbon dioxide from California will reduce the air 

pollution-related death rate and illness rate in California 2.5 times 

faster than it will reduce the death rate of the U.S. as a whole. 

And finally, carbon dioxide levels in cities are higher than in the 

global atmosphere. Such elevated levels of CO2 were found to increase ozone in California. As such, locally emitted carbon dioxide 

is a causal factor in increasing air pollution. 

These results contradict the main assumptions made by Mr. 

Johnson in his stated decision, namely, there is no difference in the 

impact of globally emitted carbon dioxide in California vs. the U.S. 

health, and locally emitted carbon dioxide does not affect California’s air pollution any more than carbon dioxide–than anywhere 

else in the world. I am unaware of any scientific publication that 

supports either assumption. 

Thank you. 

[The statement of Mr. Jacobson follows:] 


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Ms. SOLIS. Thank you very much. 

We will now begin questioning, and I will begin with myself for 

a 5-minute round of questioning. 

Dr. Jacobson, thank you very much for being here. According to 

your presentation, you were stating, or underscoring, that there is 

a correlation between urban cities and the high incidence of 

emittance of carbon dioxide and the negative effects it has in different cities in California. 

Now, Los Angeles is very different from, say, Bakersfield or the 

Central Valley. Can you just touch on that, what some of those— 

you know, how that is occurring with that process there? 

Mr. JACOBSON. Okay. In terms of carbon dioxide, well—one of the 

pollution in the Central Valley is due to particulate matter air pollution as well as ozone, and in Los Angeles it is also due to particulate matter and ozone, but sometimes different times of the year. 

Carbon dioxide is emitted more—there is more carbon dioxide emitted in Los Angeles, so the CO2 levels in Los Angeles will be higher. 

However, the Central Valley does receive—emit its own, and also 

receives a lot of carbon dioxide from the San Francisco Bay Area 

as well as coming from the south, from Los Angeles. And there are 

going to be—the Central Valley is more spread out, so you expect 

the ozone changes in particular will be over a larger area, but it 

has a quite lower population and concentration, in terms of its concentration compared to Los Angeles. 

The pollution in Los Angeles will be affected the most, I mean, 

the health impacts will be greater—expected to be greater—in Los 

Angeles because you have such a high population and the levels of 

ozone are generally higher in Los Angeles than in the Central Valley. And the pollution will get worse where the pollution is already 

bad. 

Ms. SOLIS. What will happen if we take no action? 

Mr. JACOBSON. Well, right now, historically, temperatures have 

already risen due to carbon dioxide, and this is currently causing 

about, I would say, estimate a medium value of about 800 additional deaths per year, compared to the background of about 50,000 

deaths per year due to air pollution. The background air pollution 

death rate in the U.S. is 50,000 to 100,000, and per one degree Celsius or 1.8 Fahrenheit increase in temperatures; that is estimated 

as about 1,000 additional deaths, with a range of 350 to 1,800 per 

year. 

So far, the temperatures have already risen about 80 percent of 

this, and so deaths are already occurring. In the future they are 

expected to occur more. So the problem is already here; the deaths 

are already occurring. 

Ms. SOLIS. Do you agree with the decision that EPA made? Do 

you have any comment on that? 

Mr. JACOBSON. No. I disagree with the decision for the reasons 

I cited in my testimony, that there is no basis in science that we 

know of right now for the two main reasons that were cited by Administrator Johnson. 

Those were assumptions that he made that—the two assumptions that he made were that first, CO2 just mixes globally, there 

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tion in California. Those assumptions were just those assumptions; 

they weren’t based on any science that I am aware of. 

Ms. SOLIS. Were you aware of—if there were any scientific evidence that was put out prior to what your research told you, was 

there any information from EPA that you may have seen? 

Mr. JACOBSON. No. I am sure there have been no studies, because the study I did, which was published on February 12, 2008, 

is the first study to look at the effects of carbon dioxide specifically 

on air pollution, ozone, and particulate matter and carcinogens in 

the United States as a whole, and on public health. There have 

been no previous public studies at all. 

Ms. SOLIS. All right. Thank you. 

My next question is for Dr. Frumkin, and I apologize if I can’t 

get to everyone. You all had very good testimony, and I want to 

thank you for that. 

But Dr. Frumkin, we have heard from your colleagues that there 

seems to be a need to increase funding in the area of global climate 

change and its relationship to health and children and the need to 

kind of fast-forward funding so that we can be prepared. In your 

opinion, what can we do to help provide more support for your particular office? 

Dr. FRUMKIN. We are doing what we can now, in terms of public 

health preparedness and prevention with respect to climate change. 

We have technical assistance underway, we have research programs in a very small way underway, we are building the science 

base, and so on. 

We recognize the possibility of doing more. Further public health 

activities would involve further research; we need to build our 

science base considerably. Technical assistance to state and local 

health departments would need to increase. 

Ms. SOLIS. Is your budget adequately funded to provide for these 

kinds of research developments that we need to undertake? 

Dr. FRUMKIN. As I said, we are doing everything we can within 

existing resources now. We do recognize the possibility and the opportunity of doing more. 

Ms. SOLIS. So you could use more financial support, funding for 

research, preparedness, yes or no? 

Dr. FRUMKIN. With further resources we would be able to do 

more. 

Ms. SOLIS. Okay. Very good. 

I think my time is up, but certainly we will come back and ask 

another round of questions so we can get to some more of you. 

I want to, at this time, recognize our next colleague here who has 

5 minutes for questioning, and that is the Congressman, Mr. Walden, from Oregon. 

Mr. WALDEN. Thank you. Thank you, Madam Chair, and I appreciate the witnesses and your testimony, and I have been on this select committee—Congress, and I think you all provided some really 

superior testimony, especially compared to some we have had. I appreciate the detail that you have offered. 

Dr. Jacobson, I am curious: Aren’t there already communities in 

California that have not met the clean air standards under federal 

law today, that are out of attainment? 

Mr. JACOBSON. Yes, that is correct. 


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Mr. WALDEN. And what effect does that have on public health? 

Have you studied that? 

Mr. JACOBSON. Well, that is pretty well known to be a serious 

effect on public health, so I mentioned there are about 50,000 to 

100,000 people die each year in the United States due to air pollution, and a good portion die in California—prematurely, that is— 

due to air pollution. And that is due to existing health problems 

due to mostly fossil fuel combustion. 

Mr. WALDEN. And have you studied what the health outcomes 

would be if California just met the existing clean air requirements 

and got those cities into attainment status? 

Mr. JACOBSON. I can’t say I can give you the—I haven’t studied 

that specifically in terms of provide numbers for it. But I should 

point out that even if California were in attainment there would 

still be premature deaths, because with 0.08 parts per million 

standard, that is still way above the health threshold for ozone pollution health effects, which is about 0.035 parts per million, or 35 

parts per billion. So, the standard is 80 parts per billion, and the 

health effect threshold is 35 parts per billion. So even if you met 

the standard, you would still have health problems. 

Mr. WALDEN. What level are those cities at now that are not in 

attainment? 

Mr. JACOBSON. Los Angeles can get up to 150, I think in the— 

right now, I mean, it used to, in the 1950s it would get up to 560 

parts per billion, but that doesn’t happen anymore. 

Mr. WALDEN. So 150 for L.A. right now, parts per—— 

Mr. JACOBSON. Parts per billion of ozone. And, well, I think it 

may even, some days it gets up to 200 parts per billion, which is 

a stage one—— 

Mr. WALDEN. And the federal limit is supposed to be 80? 

Mr. JACOBSON. Well, that is for 8 hours. The 1-hour standard is 

120 parts per billion. These high levels are generally for a shorter 

period of time, so they might just be exceeding the 1-hour standard 

rather than the 8-hour standard. 

Mr. WALDEN. Okay. I wonder, as we look at the balance, how 

long would it take to get temperatures in the globe to actually come 

down? I mean, that depends on what all we may or may not do 

here, but I look at Europe—they have got a cap and trade system, 

and yet their carbon dioxide emissions actually went up 1.1 percent 

last year, even with their framework in place. 

I am trying to figure out—I have read some data that it would 

be at least 50 to 100 years where you would see a trend line go 

the other direction. Is that what you are finding in your data? 

Mr. JACOBSON. With carbon dioxide, the lifetime of carbon dioxide, which is the time it decreases to about 38 percent of the original value, is about 35 to 50 years, and so you can imagine over 35 

years you will start to get some feedback. You will get down to— 

you will get a reduction of two-thirds, almost, not quite two-thirds, 

60 percent. 

However, there are other chemicals that cause, like black carbon, 

for example—which is the main component of soot—which has a 

much shorter lifetime of a few weeks. So if you control that, you 

can actually get the feedbacks within one to 4 or 5 years. And so 

if you control soot, that is kind of the fastest way to slow global 


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warming; controlling methane is probably—that has a faster feedback than carbon dioxide, and carbon dioxide is one of the longerlived greenhouse gases, if not the longest. 

Mr. WALDEN. So, what could we do that would control soot most 

effectively? 

Mr. JACOBSON. Well, aside, I mean, the shortest-term is diesel 

particle filters and off-road vehicles, construction equipment— 

equipment, but the next step is really to convert all the diesel to 

clean electric-type vehicles eventually, or hydrogen fuel cell vehicles powered by clean, renewable—— 

Mr. WALDEN. So, I understand that in Europe they have always 

used more diesel—— 

Mr. JACOBSON. Yes. 

Mr. WALDEN [continuing]. In their vehicles than we do, which is 

part of why they get higher mileage. But they have also, subsequently, ended up with more premature deaths because of the 

added pollution in the air. Is that because of the soot? 

Mr. JACOBSON. Correct. That is one of the reasons. Their death 

rate—while the U.S. is 50,000 to 100,000, Europe is maybe 300,000 

to 350,000 per year, and a lot of that is due to the fact that they 

have, like 40 or 50 percent of their cars are diesel, putting out particles. So there is a lot more particle pollution in Europe, and particles are the main component of air pollution health problems. 

Mr. WALDEN. One final question for each of you, perhaps, if there 

is time. My understanding is that under some of the cap and trade 

provisions like the Warner-Lieberman bill—I have talked to some 

power companies that rely a lot on coal for production of electricity, 

and they indicate that their cost of power would go 4.8 percent to 

11.5 percent, or more than double. 

When we think about health issues, I think about heating for elderly in the winter and cooling in the summer in the hotter climates. Have any of you studied the effects of increased energy 

prices on health care, especially among either the young or the elderly, if you more than doubled the electricity cost in the country? 

Fifty-two percent of our power comes from coal, if that is what 

the model shows when you run it through, that it is a two and a 

half times increase in electricity. I am wondering, have we looked 

at that, too, as we look long range? 

Dr. Frumkin. 

Dr. FRUMKIN. We haven’t looked at that question at the CDC, 

but I would be happy to look for information on that and get back 

to you. 

Mr. WALDEN. Would you? 

Dr. FRUMKIN. Yes, sir. 

Mr. WALDEN. That would be helpful. 

Dr. Benjamin, anything from—— 

Dr. BENJAMIN. No, we haven’t, although if we are simply looking 

at cost, I think the thing we would want to put in the equation is 

the cost of health care, which would offset some of the fiscal dollars. 

Mr. WALDEN. Yes. I want to look at all the costs and the effects. 

Because I know we hear anecdotally when there is a huge heat 

wave the number of people that die in their homes because they 

don’t have adequate air conditioning. And then when it is really 


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cold, we hear about those who freeze and are—you see the pictures 

on television every winter of people bundled up, especially seniors. 

So I am just trying to figure out all of these input costs, and certainly the tradeoffs—— 

Dr. BENJAMIN. We would love to look at the health care costs—— 

Mr. WALDEN. Yes. 

Dr. BENJAMIN [continuing]. Not just the deaths, but the people—— 

Mr. WALDEN. Sure. 

Dr. Best or—— 

Dr. BEST. The impacts of these extreme temperatures are very 

real for children. In terms of cost, that is not a calculation that the 

Academy has a stand on, nor do we do research. But we do know 

that there are groups who have done this, and we will be happy 

to report on that. 

Mr. WALDEN. Thank you. 

Dr. PATZ. I work with energy policy experts in our Center, and 

a couple points that they have told me is that the competitive price 

of renewables is coming way down; wind power is becoming competitive. But moreover, I would like to point out, too, historically 

the arguments against the Clean Air Act, where the argument was, 

‘‘This is way too expensive. It is going to cost our economy; it is 

going to hurt us.’’ And there were major concerns. 

And once the Clean Air Act was implemented, there were some 

analyses conducted that found that, by far, the benefits, especially 

health benefits and environmental benefits—but especially health 

benefits—made the Clean Air Act much favorable. In fact, the concern of the cost was unwarranted. 

Mr. WALDEN. So you don’t think there is any concern with a, perhaps, two and a half-fold increase in cost of electricity produced 

from coal? That that won’t have any health effect or any effect on 

the economy? 

Dr. PATZ. Well, I think that is a great research question. 

Mr. WALDEN. Right. 

Dr. PATZ. I think that the argument about economy versus environmental protection is a false argument. 

Mr. WALDEN. I am not making that argument; I am trying to 

find out—— 

Ms. SOLIS. Time is way over, and I thank you. But we will have 

another round of questioning. I am going to excuse myself; I have 

to go vote in another subcommittee, and I am going to turn the 

gavel over to Congressman Inslee for his 5 minutes of questioning. 

Mr. INSLEE [presiding]. Thank you. Dr. Jacobson I think has 

been too modest here. I think he is actually the author of a paper 

called, ‘‘A Renewable Energy Solution to Global Warming,’’ which 

talks about the electrification of our transportation system, and it 

causes significant optimism. I will share that with Mr. Walden; he 

might find it interesting. 

Mr. WALDEN. I would love to see it. 

Mr. INSLEE. I will do that. Do you want to make any comments 

about that at all? 

Mr. JACOBSON. Sure. I am happy to. So, we have looked at, what 

is the possibility of converting the entire vehicle fleet in the United 

States to electric vehicles powered by renewable energy, primarily 


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wind and solar—a combination, actually, of wind, solar, geothermal, hydroelectric, and tidal wave power. And, well, one analysis we focused primarily on wind and looked at, well, how many 

wind turbines would we need to power the entire vehicle fleet? 

And it turned out to be, with infused 5-megawatt, which are 

large turbines that are currently existing in Europe—they are not 

in the United States right now, but they are manufactured by a 

company—if you put them in locations where the wind speed is between seven and a half and eight and a half meters per second on 

the annual average, then it turns out you would need between 

70,000 and 120,000 5-megawatt wind turbines to power the entire 

U.S. vehicle fleet with electric vehicles. And part of this is because 

electric vehicles are so efficient—compared to internal combustion 

they are about four to five times more efficient—so you need less 

energy, basically, to run them. 

But there is plenty of wind to actually do this. By the way, this 

number—70,000 to 120,000—that is less than the 300,000 airplanes that were produced in World War II over a period of 7 

years, most of those in the last 3 years. And the space you need 

for this is not that great. It turns out, well, just for the turbine 

spacing—you need to separate them by a certain distance so they 

don’t interfere with each other—but for this it is about 0.5 percent 

of the United States; it could be a lot of it offshore. 

But that compares to, if you wanted to do the same thing with 

ethanol-fueled vehicles you would need about 15 percent of the entire United States, which is 30 times more land area, or even cellulosic ethanol would be 20 times more land area for that than doing 

it with wind. And the actual land area you would need for the turbine spacing touching the ground is really only two square kilometers, because they can use—for all these turbines, because they 

are just poles in the ground—you could use all the land underneath 

for farming and ranching and open space. And a lot of this could 

also go offshore, so it doesn’t actually have to go over land. 

Mr. INSLEE. Doctor, I have got to make sure—I have got another 

question. I was really heartened by your research, because it confirms sort of what I believed, and there are a couple books that talk 

about that theory out there, one called, ‘‘Earth: The Sequel,’’ which 

is the typical—another one is called, ‘‘Apollo’s Fire.’’ And they both 

are optimistic visions, and I appreciate your research on that, and 

I will try to share with my colleagues. 

Dr. Frumkin, the U.S. Supreme Court decision in Massachusetts 

v. EPA required the EPA to determine whether greenhouse gas 

emissions can be reasonably anticipated to endanger public health 

and welfare. Despite, apparently, EPA’s staff’s finding that it did, 

the administration refused to sign off on that endangerment decision. I just want to ask you, based on your considerable expertise 

in public health, do you believe that greenhouse gas emissions 

cause or contribute to air pollution, which may reasonably be anticipated to endanger public health? 

Dr. FRUMKIN. Thank you for the question. I recognize that there 

are legal and regulatory dimensions to the question. CDC doesn’t 

have a position on those issues, nor does it have a position on any 

of EPA’s regulatory decisions. What I can do is speak to the public 

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tribute to climate change, and as I and others have testified here 

today, climate change does pose a number of public health challenges. 

Mr. INSLEE. I kind of take that as a yes, that it does have the 

capacity to endanger public health, but, you know, is that a fair 

statement? 

Dr. FRUMKIN. I think I would let my words speak for themselves. 

Mr. INSLEE. I think we get the message; I wish the White House 

did. 

I wanted to read a quote, actually, which was one of the—if you 

believe in irony, this is one of the great ironies. In turning down 

California’s request for regulation of greenhouse gases, the administrator of the EPA said ‘‘Severe heat waves are projected to intensify in magnitude and duration over the portions of the United 

States where these events already occur, with likely increases in 

mortality and morbidity, especially among elderly, young, and frail. 

Ranges of vector-borne and tick-borne diseases in North America 

may expand both modulation by public health measures and other 

factors.’’ 

Would anyone disagree with the position that if you conclude 

that, by necessity you have concluded that carbon dioxide has the 

capacity or capability to endanger public health? Does anybody disagree with that on this panel? If you were—that, I will take that 

no one disagrees with that. 

Next question: As public health experts, we have been struggling 

with how we get America to move on global warming. You have 

seen the federal government largely acting, in the last 7 years 

under this administration, much more the ostrich with the head in 

the sand and the tail feathers in the air rather than the American 

eagle, and we need to change that. 

As public health experts, can you help us on what you think the 

best messaging is to the American people on trying to tackle this 

beast? You know, you have been successful in seatbelts, in changing behaviors, and you have had some success with tobacco usage. 

What messaging works to help move America in that direction? 

Dr. BENJAMIN. Mr. Inslee, I think, just from the American public 

health perspective, we need to change the message from, ‘‘The end 

of the world, there is nothing we can do,’’ to, ‘‘This is a very significant problem, and every one of us can do something and implement 

a way to make a big difference.’’ 

I think that what often happens with a big problem like this, 

people get overwhelmed. And so, my perspective of simply telling 

people again, you know, travel differently, do some things differently at home, do some things differently at work, and letting 

them know that every little bit helps, will make a big difference. 

Mr. INSLEE. Dr. Patz. 

Dr. PATZ. Yes. If I could just add, I think that the issue of cobenefits, that in fact this could be a great opportunity if we think 

about changing some of our energy policies, especially in the area 

of transportation—60 percent of Americans do not meet the minimum recommended level of exercise, and this is one where we 

have sort of designed unhealthy cities. And this is a great opportunity when we think about greening cities, reducing greenhouse 


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gases and automobile traffic. We have a great opportunity to enhance personal fitness. 

Another point that I think is both locally, as Dr. Jacobson pointed out, regarding CO2 emission affecting California, but also that, 

in fact, our CO2 emissions do affect the world. And just like the argument of secondhand tobacco smoke, where what one individual 

does when he lights up a cigarette and that smoke affects someone 

else, this is actually a global problem as well, and that our energy 

emissions are, in fact, hurting other countries, not only our own. 

So I think that is a message as far as an ethical issue. 

Mr. INSLEE. I appreciate it. 

Dr. Frumkin, did you have something? 

Dr. FRUMKIN. Yes, sir, just to let you know that the CDC has 

been holding a series of expert workshops on various aspects of climate change, and the most recent one was on health communication regarding climate change, precisely because we recognize the 

question that you just posed, that public health communication has 

been very successful in many domains; what can we learn from 

that to apply to climate change communication? 

We know, for example, that bad or threatening news is difficult 

for people to take, but if it is coupled with constructive recommendations about what you can do, it is much easier for people 

to accept that news. 

Mr. INSLEE. Well, some of us believe—and I appreciate Dr. Benjamin’s comment—that we need to switch from doom and gloom to 

a sense of a can-do, innovative, optimistic spirit of America. That 

is an American message, I believe, that will succeed here. 

I will now hear 5 minutes from Representative Cleaver. 

Mr. CLEAVER. Thank you, Mr. Chairman. I apologize for being 

late. Like everybody, we are all running between several hearings, 

but I didn’t want to miss this for a number of reasons. And the primary reason is the panel; those of you here offer—great perspective 

on this issue. And I grew up in an all black neighborhood in Texas, 

and we lived a few yards away from the waste treatment—well, actually, it did not get the anticipated name of waste treatment plant 

until a few years ago. [Laughter.] 

But, you know, I also realize that the incidence of some diseases, 

most particularly asthma, is highest among African-Americans. 

And when you look at where the waste treatment plant was, and 

also where the city dump was located, you see that that has got 

a 99.9 percent African-American community. And I know specifically Dr. Patz, you used the term ‘‘disproportional vulnerability,’’ 

and it caught my attention earlier. 

And is the climate change and environment placing at risk the 

poorest people, the people of color who live in areas where we have 

chosen, with some great intentionality, to locate these facilities 

that emit, I think at the least, unpleasant odors and maybe even 

some other particles that would be damaging? 

Dr. PATZ. This is a very good point regarding the different portions of the population that would be most vulnerable to climate 

change. And what we are dealing with when we talk about climate 

change are extreme and environmental conditions, be it a heat 

wave, a flood, a drought, or severe storm. 


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Certainly we know that it is the poor that are most at risk in 

heat waves, especially the poor elderly. As far as flooding, you 

know, people that live in flood plains would be more at risk. And 

when you deal with ozone pollution, it is true that African-Americans do have a higher rate of asthma. 

So there are certainly—when you, you know, when you look at 

Hurricane Katrina, which, you know, simply was a—you know, we 

don’t know—I won’t make any judgments about why it occurred, 

but when Hurricane Katrina hit, it really was the poor, and most 

African-Americans in New Orleans that simply did not have the 

means or the ability to get out of town and avoid that disaster. 

So I think to the extent, in this country, absolutely there are populations at risk that are primarily the poor; and if you look globally, it is the same situation. Compare a sea-level rise in Holland 

versus Bangladesh, and you can see that a population with very little capability to react is at more risk. 

Mr. CLEAVER. Thank you. 

Dr. Benjamin, would you say that there are things in landfills 

that could become airborne that would do damage—medical damage—to people who live nearby? 

Dr. BENJAMIN. Absolutely. Obviously there are lots of things 

dumped in landfills that are toxic. If you really look at it, there are 

probably four raw areas that disproportionately affect vulnerable 

communities, particularly minorities. One, more vulnerable to extreme weather events, much more lower baseline health status. 

Then you place people near toxic environments like that, and 

then they, as a community, the community capacity to recover is 

diminished. So all four of those things, including the toxic issue 

that you are concerned about, are measures that need to be—— 

Mr. CLEAVER. I have gone down to New Orleans twice—we have 

held hearings down there. The flood was one issue that was terrible and devastating; I had a son down there in college—— 

The issue that I am concerned about more now than the flood is, 

when we went down there we all had to wear masks when we went 

into the Ninth Ward. There is a—I grew up in public housing— 

there is a stench down in New Orleans like nothing I have ever experienced in my life, and of course the landfill was washed into the 

Ninth Ward. 

And my fear is that we don’t know the damage of Katrina right 

now, that it may not come into fruition for a few years down the 

road, but I cannot imagine that we are not going to have some prolonged damage to lungs and probably much more in the years to 

come. Do any of you have any comments on—my time is expired, 

but do any of you have any comments? 

Dr. BEST. I second your concern, and I also want to emphasize 

that it is children who are having—reaping the permanent harm 

from these exposures, and because they have a longer shelf life, 

they will suffer those harms for longer periods of time than an 

adult who was exposed to the same event. So we need to consider 

children, especially, when we think about these kinds of disasters 

and environmental harm. 

Ms. SOLIS [presiding]. Thank you very much. 

We can go for another round of questioning if you would like, and 

I certainly would like to ask some questions. 


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But I would like to go back to Dr. Frumkin, and just a basic 

question here: Do you believe that greenhouse gases do have an impact on health—an adverse effect on health? 

Dr. FRUMKIN. I think that was a question we addressed while 

you were out of the room, Madam Chair. What I mentioned was 

that that is a complex question with regulatory and legal dimensions, and the CDC doesn’t have a position on the regulatory and 

legal dimensions of that question. As for the science, there is strong 

evidence that carbon dioxide is a greenhouse gas that contributes 

to climate change, and there is strong evidence that climate change 

threatens health in a number of ways. 

Ms. SOLIS. Have any studies in your department that you have 

been involved in indicated that? 

Dr. FRUMKIN. I am sorry, indicate—— 

Ms. SOLIS. That there is a correlation, and in fact this is evidence. 

Dr. FRUMKIN. One example of research that we have done would 

be looking at heat waves, and characterizing the epidemiology of 

heat waves, identifying who is the most vulnerable and how the 

deaths and illnesses occur from heat waves. Heat waves are expected to become more common with climate change. 

Ms. SOLIS. So that is a yes. Okay. You had mentioned something 

earlier as well, in your opening statement and your testimony, alluding to differing views within the administration, and I wanted 

to ask you if you could, kind of, at least give me an idea what that 

means, what the difference is between your agency, OMB, and the 

administration. What differing views were you talking about? 

Dr. FRUMKIN. What I was referring to is that we have a considerable amount of work going on on climate change at the CDC; it is 

extensive. It is well represented on our Web site and in our publications, but I don’t know that all of that work has been carefully 

vetted across the administration, so it isn’t necessarily the case 

that all of our work has—represents a consensus across the administration. 

Ms. SOLIS. But they are given all that information from you, 

OMB, and the administration? 

Dr. FRUMKIN. I don’t know and can’t speak to the level of attention that all of our work has had. 

Ms. SOLIS. Okay. All right. Thank you. Thank you, Dr. Frumkin. 

I wanted to ask, Dr. Best, you talked extensively about children 

and public health prevention and preparedness, and you mentioned 

that we should really have more of an organized method here of 

preparing children for these negative health effects that are going 

on. Can you be specific and give me some idea of what we could 

do that currently isn’t in existence that can help us prepare for 

that? 

Dr. BEST. Well, we have talked in broad generalizations about 

some of the issues today. A good public health infrastructure that 

is supported and funded appropriately is key. 

In terms of children’s health, we also need health insurance for 

children. We need to make sure that children have access to health 

care through appropriate placement of workforce. 

We also need to think about children when we think about costbenefit calculations. The cost of an immediate—you know, the costs 


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incurred by improving the quality of our air are not just borne by 

the industry that pollutes the air; they are also borne by the children throughout their lives. 

Ms. SOLIS. Have you seen any differences—we talked a little bit 

about disparities that exist between communities of color and the 

general population. Are you seeing any of that with respect to how 

negative health—— 

Dr. BEST. I see it every day. With my—— 

Ms. SOLIS [continuing]. With respect to air pollution—— 

Dr. BEST. Yes. Yes, ma’am. 

Ms. SOLIS. And can you elaborate? 

Dr. BEST. I serve the low-income minority population of Washington, DC every day in my clinical practice; those are the children 

that I care for. And they suffer asthma, adverse permanent harm 

to their lung function because of the air pollution effects in the city. 

And they have poor access to care because of the fact that Washington, DC is yet another example of an urban island where children aren’t treated as well. 

Ms. SOLIS. Right. Okay. 

Dr. Patz, do you want to chime in? 

Dr. PATZ. Yes. I would just like to make a comment about, you 

know, about the research and what is available, what is out there, 

what do we know, and what do we need to do. You know, Dr. 

Frumkin mentioned that the CDC is doing everything that it can 

because they understand how climate change is a very important 

public health issue. 

I have been doing climate change health research for about 14 

years, and have received some grants from the EPA, NOAA; these 

are not large programs. To date, I really don’t think there has been 

much funding at CDC for preventing some of the health effects of 

climate change. 

There is an intention; they understand the problem. They are 

holding workshops. They want to do something, but I don’t see 

funding at the CDC. I think their hands are tied when it really 

comes to serious protection of the American public from the health 

effects of climate change. 

Likewise, NIH has really not been funding climate change health 

research. They are now talking—they are actually meeting next 

week, and hopefully they will have some mandate to actually allocate funding to public health research. 

But I think that we really—you know, I have been applying for 

these grants, and—the CDC really has hardly any funding to support their efforts to protect us from climate change, and I think 

that is a huge need. 

Ms. SOLIS. Thank you very much. 

Dr. Jacobson, I want to thank you for your testimony, first of all, 

and just tell you that the area that I represent in California is one 

of the heavier-polluted communities. We have freeways that just 

transfer us across our communities there, and I have often wondered also, as my colleague Mr. Cleaver asked, about ambient air 

pollution and the cause and effect for our children, as was mentioned earlier, having so much activity outside and not being properly—or the folks that should be—the gatekeepers should be someVerDate Mar 15 2010 21:12 Nov 17, 2010 Jkt 061639 PO 00000 Frm 00141 Fmt 6633 Sfmt 6602 E:\HR\OC\A639.XXX A639

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how helping to try to provide more information in terms of safety 

for our children. 

Can you maybe touch on that? 

Mr. JACOBSON. I assume it is Los Angeles? 

Ms. SOLIS. Yes. Los Angeles. East Los Angeles. 

Mr. JACOBSON. Okay. Yes, living near a freeway is a dangerous 

place to live, because you have particles coming right from the tailpipe, and that is when the concentrations are the highest. Particles, by the way, are the most damaging component of air pollution and there is no threshold to the health problems due to particles. You can go down to almost zero, and you get health problems due to particles. 

And vehicles are emitting particles even though they are a lot— 

the emissions are much lower than they used to be. They are still 

emitting these particles, and they are pretty concentrated as they 

go downwind of the freeway, even, like 100 meters, 500 meters, you 

know, even a kilometer down, you know, they will get diluted, but 

the concentrations are going to be highest near the freeway. 

And these particles—these are the ones emitted. Now, that 

doesn’t mean other people aren’t affected downwind, so there is 

this local air pollution right near the freeway. But then there are 

other types of particles that form in the atmosphere due to chemical reactions involving the sun and gases, and converting gases to 

particles, and there are also gases that—although ozone isn’t emitted from a tailpipe, it is formed in the atmosphere. 

So actually, downwind in Los Angeles, particularly on the east 

side of Los Angeles because most of the emissions are on the west 

side—although there are a lot on the east side, but most of them 

are on the west side—and these emissions get transformed and 

moved by the wind to the east side, where the concentrations of the 

chemicals formed in the atmosphere build up the most. So people 

far downwind actually also have a big—are affected by the air pollution significantly. 

So there is this local effect, where people near freeways have bad 

health effects—— 

Ms. SOLIS. So it is compounded? 

Mr. JACOBSON. Yes. Well, it is not—well, I would say if you are 

on the west side you are not getting so much of the secondary pollution—— 

Ms. SOLIS. Right. 

Mr. JACOBSON [continuing]. You are getting more of the primary 

pollution. If you are on the east side you get more of the secondary 

pollution, so it is—— 

Ms. SOLIS. Where lower-income people tend to be living or working—— 

Mr. JACOBSON. Near the freeways, probably. So yes. So you are 

getting more of the primary pollution, but all populations are getting the secondary pollution, really, depending on—because it just 

spreads out all over Los Angeles. 

Ms. SOLIS. And just a last comment on soot. Something that you 

didn’t mention was marine vessels, and that is something that we 

are looking into. Have you done any research on that? 

Mr. JACOBSON. Yes. It includes marine vessels and aircrafts in 

terms of their—because aircraft is another unregulated source of 


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soot emissions, and marine vessels are, I guess I am not sure what 

the status of the regulation is, but they are pretty much unregulated on the global scale. And that is an area where you can get— 

especially in ports. 

I mean, when you are out to sea there is going to be some impact, but it is not going to affect the health as much as right near 

ports, if marine vessels are idling. I think in California there have 

been some recent laws to have them plug in—so that kind of stuff 

is a really good idea. 

Ms. SOLIS. Okay. My time is up, so we will go next to Mr. Walden for questioning. 

Mr. WALDEN. Thank you. Thank you, Madam Chair. I appreciate 

that. 

Dr. Jacobson, I am going to go back on this issue of wind turbines. I represent a 70,000 square mile district in eastern Oregon, 

home for the northwest, probably, to some of the most wind turbines in the area, with many more coming up online. And I know 

that it works well there because of the dams that allow us to have 

hydropower. 

There are some—even some on this committee—who would like 

to tear out some of those dams, and I don’t know what the replacement power is, but it is going to have a bigger carbon footprint 

than hydro. But because the wind isn’t firm energy, that becomes 

a bit of a problem. And I know the Bonneville Power Administration has told me there is a capacity to how much wind they can 

actually put on the grid. 

Are you aware of studies that give us some ideas, regionally, 

where we can put the wind? My understanding is in the Dakotas, 

actually, there is much more wind potential than other places. 

Have you looked at those infrastructure issues? 

Mr. JACOBSON. Yes. So, two points. One, we did produce a world 

wind map, and it is actually the only map of the world’s winds at 

80 meters, which is the height of modern turbines. And that is publicly available; I would be happy to send it to you. 

Second, we have looked at combining different renewables together to firm the capacity, and having—the west coast is really 

well-suited for this because it has a lot of hydro, and the hydro is 

excellent for, yes, dealing with the intermittency and filling in gaps 

because you can turn it off within 15 or 20 seconds in spinning reserve mode. 

But you can actually combine also solar, because a lot of places 

wind peaks at night and solar peaks during the day, so you can 

even combine wind and solar and balance the load better there, 

and use the hydro to fill in all the gaps from that. So we did a 

study for California—it was kind of a rough study; we are doing 

some more detailed study now—but we found that for 2020, if we 

actually looked hour by hour, that if we combined these renewables 

together—solar, wind, hydroelectric, geothermal, those are the ones 

we looked at—you can get an exactly smooth output of supply without anything else. 

Mr. WALDEN. Wow. 

Mr. JACOBSON. But, I mean, that was in California, and I assume 

it is the same in Oregon, too, and Washington. 


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Mr. WALDEN. Yes, I would think so. The Geo-Heat Center at the 

Oregon Institute of Technology in Klamath Falls—they have spent 

a lot of time looking at geothermal potential and told me that there 

is enough in Oregon to produce two-thirds of our electricity 

needs—— 

Mr. JACOBSON. Yes. 

Mr. WALDEN [continuing]. With geothermal, because these new 

advances in the last year and a half—being able to produce electricity at a lower allows the delta between the cold water and the 

hot at lower, and we have got a 10-meg geothermal plant just sited 

in my district. 

So, the key that we will have out west is we have the potential; 

a lot of it rests on federal land. And there are few on this committee, or on the committees in charge of this Congress today, who 

will allow us to access those resources. And it seems to me if we 

are serious about dealing with some of these energy issues, you 

have to be able to site the wind where it is needed, where it can 

produce with wind turbines, within boundaries, I understand. 

We are starting to get pushback on that visual impact. You mentioned offshore. You know, Massachusetts, they didn’t want it 

where they could see it. Nobody wants any of this stuff where they 

can see it, by the way. 

And in terms of geothermal, I think we are going to face some 

challenges to accessing that. I mean, have you looked at that? 

Mr. JACOBSON. Yes. Well, geothermal is a baseload, so it doesn’t 

really have the intermittency issues—— 

Mr. WALDEN. That is great. 

Mr. JACOBSON. Yes. It is a great baseload. I haven’t looked at 

that with a lot of detail, but it is a good source. 

In terms of siting the wind turbines, keep in mind that the total 

area if you really want to solve this problem is pretty—it is not a 

large amount of area you would need. 

Mr. WALDEN. Right. 

Mr. JACOBSON. So the question is, do you want to look at the 

wind turbines, or would you rather look at a coal fire power plant? 

I mean, it is not really a—nobody wants to add anything; it is really a question of what you are replacing. 

Mr. WALDEN. Right. 

Mr. JACOBSON. And so if you have a coal fire power plant that 

is, you know, emitting stuff that is hurting your children downwind, you know, you would think people would rather look at the 

wind turbines. There are about, I think it is like 20 or 25 offshore 

wind proposals in the United States right now; and the only one 

you ever hear about is the one in Massachusetts, but in fact, all 

the other ones, they don’t have this same problem—— 

Mr. WALDEN. Good. 

Mr. JACOBSON [continuing]. In terms of—well, I am not saying 

they don’t have problems, but in terms of actually getting implemented. But they don’t have as much public controversy as that 

one. 

Mr. WALDEN. Well, and I am real interested, too, in the notion 

of plug-in hybrids. I bought a Prius last July that will more than 

double my gas mileage here in Washington, and last month I 

bought a Ford Escape hybrid, and getting 66 percent better mileage 


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than the SUV I used to have. I would love to be able to charge it 

up at night on the grid, but you can’t do that yet. 

In terms of battery development and domestic investment, we 

have done that in various energy bills; we have put money out 

there to invest in new technology for battery life. What are you seeing on the scientific side of things? How far away are we from really making a leap forward on batteries? 

Mr. JACOBSON. Well, Tesla rolled out their first pure electric vehicle on lithium-ion laptop batteries, and so they are starting to 

produce them. So they exist now; there are a very small number. 

I think they put out one—one of them is actually on the road now, 

and I think there are another—— 

Mr. WALDEN. (OFF MIKE) 

Mr. JACOBSON. So they do exist, and there are many electric vehicle companies following in the wings. And from what Tesla says, 

you know, these batteries a while. I mean, I have a Prius myself. 

I got it in 2001 or 2002, and I haven’t had to change the battery. 

And that is not with these lithium-ion batteries; that is with the 

older version. 

So they last pretty long. The older ones even last pretty long, 

from my own personal experience. And the lithium-ion, from what 

they say, should also last quite a while as well. So I don’t know 

a lot about the details of the battery industry, but I can say that 

I am pretty optimistic about it. 

But that is the idea, is to plug in your own home; so you have, 

maybe, solar panels on your roof, you have smart meters that control when you get the electricity, so that is another way to smooth 

out the supply of intermittent renewable energy. And in California, 

PG&E is doing that; they are developing smart meters so that they 

can control when you get your power if you plug in your car at 

night. 

So it is really a combination of all these renewables with a smart 

electric grid, and actually organizing the grid in such a way in the 

United States so that we can not only have—we know where the 

wind farms should go—but we have the transmission between 

them, because that is really the limiting factor in the expansion of 

wind, is transmission, and we need an organized transmission grid. 

And also, that reduces the intermittency too, if we connect two 

wind farms that are far apart enough, then you smooth out the 

supply, too. So there is a benefit—a financial and a wind benefit. 

Ms. SOLIS. Thank you, Dr. Jacobson. Thank you. 

Mr. WALDEN. Thank you, Dr. Jacobson. I appreciate it. 

Ms. SOLIS. Now I would like to recognize Mr. Cleaver for another 

round of questioning. 

Mr. CLEAVER. Thank you, Madam Chair. Could I ask, if people 

leave the room and risk intellectual damage by not hearing everything that goes on here, if you would hold the door when you go 

out. It is creating sound pollution. 

The question that I would like each of you to answer is, we know 

the issues of challenge. 

We will start with you, Mr. Jacobson. What would you do if you 

were a member of Congress, in terms of legislation, that would 

have the greatest impact in reducing the health risks of the American public, particularly its children, as a result of climate change? 


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Mr. JACOBSON. I would do two things. One relates to providing 

better renewable energy sources, and the other relates to—if we go 

back to the issue I was discussing, which is the waiver issue, being 

able to allow states to actually control their emissions, and then 

that also is effectively the same thing, which allows them to try to 

find ways to reduce their carbon and cars, be it by a low fuel standard or some more renewable energy. 

But more specifically, having a national program, as I mentioned, 

for expanding renewable energy on a large scale—because if you 

look at the individual states’ portfolio standards, they are, you 

know, they have expansion of renewables to 20 percent, let us say, 

of their total electricity. But that is not enough; you need an 80 

percent reduction in carbon to address climate change. 

So you need a huge infrastructure change that is much larger 

than anybody is proposing at state levels. And so to do this, you 

really need this kind of national, sort of Apollo-like, program to go 

to true renewables, which are wind, solar, geothermal, hydroelectric, tidal wave powers. But in order for that to work, you need 

a better transmission system to interconnect these. 

So having kind of an organized transmission system with a largescale renewable energy program would make a lot of these problems go away because—especially if you start using battery-electric 

vehicles instead of the, you know, fossil fuel vehicles, then you 

make a lot of these air pollution problems go away automatically 

with better technologies. But in the meantime, allowing states like 

California to control their own CO2 has a similar effect, because 

other states then follow. 

California has been an example for 50 years, basically, since 

1948, when the Los Angeles Air Pollution Control District started 

making regulations, and it is actually—the very first motor vehicle 

control act in the world was a California 1959 Motor Vehicle Control Act from California. So you really need to have states control 

their pollution, and also to scan renewable energy. 

Mr. CLEAVER. Thank you. 

I am going to ask that each of you would do a short response, 

because my time is running out. 

Thank you very much, Dr. Jacobson. 

Dr. FRUMKIN. Well, Dr. Jacobson spoke to energy and transportation policy. I am going to speak to public health actions that we 

need to take. 

These are the standard public health protection steps: We need 

surveillance and tracking, good data collection, so that we have a 

sense of where we are both on environmental risk factors and on 

health. We need public health preparedness planning, so that 

states and localities can forecast the problems that they may face 

and take steps to protect the public. 

We need research so that we better understand the health implications of climate change. We need good communication so that 

people understand the issue and the steps they can take. 

All of those are the standard tools in the public health toolbox 

and the steps—what we can do to promote those actions would go 

a long way toward helping us protect public health. 

Mr. CLEAVER. Thank you. 

Dr. Benjamin. 


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Dr. BENJAMIN. Let me concur with my former colleagues on what 

they said, particularly the comments from Dr. Frumkin about investing more in the public health infrastructure. Let me talk about 

two very specific things as well. 

One, I would like to see a program actually officially authorized 

within the Center for Disease Control and Prevention around climate change. And obviously, also, funded as well. 

Secondly, really paying a lot of attention to policy. There are a 

lot of things that often aren’t thought of as health policy. Again, 

the farm bill, the transportation bill, lots of things that we do 

around adult environments that have huge health implications, 

and for Congress to think about health impact assessments in all 

of those pieces of legislation. And obviously we would be eager to 

help you as you think through that. 

Mr. CLEAVER. Thank you. 

Dr. BEST. And I would second all of my colleagues’ comments. I 

would also urge a long-term force perspective, rather than shortterm immediate gain. 

When we think about children, again, we think about how long 

they are going to be on the Earth, and we need to think about how 

an exposure or a catastrophe that they experience during childhood 

affects the rest of their lives. We also need to think in the microlevel as well, and think about how we, as individuals, can reduce, 

reuse, recycle, and think about how we, as employees and coworkers and patients in hospitals, how we can make sure that those 

principles are part of our daily lives. 

Dr. PATZ. Yes. That is a great question. I think that climate 

change can influence so many different risks to health that have 

been outlined throughout the hearing. I think it is very important 

to Congress’ understanding to integrate the nature of the health 

risks of climate change. 

So that will demand a concerted effort across both the public and 

private sector. Addressing climate change policy should include aspects of self-preparedness, as Dr. Frumkin has mentioned, and Dr. 

Georges Benjamin has mentioned, that we need to have specific 

targeted funding for CDC to address climate change. 

Urban planning is part of this issue. Natural resource utilization, 

as far as actual vulnerability to a population when experiencing extreme climates. So natural resources and energy policy; energy policy and public policy really should be linked. 

So it is a truly new type of challenge, and it is going to demand 

serious legislative measures, unlike many of the other health effects that we have studied in the past. I think this is truly one of 

the most, you know, serious broad-reaching issues that cannot just 

be put in a box and focused in isolation. Climate change touches 

on so many of these other areas that ultimately affect the health 

of our population. 

Mr. CLEAVER. Thank you, Madam Chair. 

Ms. SOLIS. Thank you very much. 

I wanted to personally thank all of you for coming and providing 

us with your testimony, and for speaking before the select committee. It means a great deal to us that are working on this issue, 

and especially this topic for some of us is just so important. 


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It is a priority for many of us, and as a member of the Energy 

and Commerce Committee that I sit on, and Health Subcommittee, 

this is something that I have been longing to see more discussion 

about. So, we don’t just have to have it in the select committee, but 

it should be in other committees of similar jurisdictions. 

But I wanted to make one comment, and then I will go to each 

of you and ask you to give me a 1-minute kind of wrap-up of what 

we should take away from your discussion today. And one is, for 

me right now, I am often confounded that we are not able to get 

the research data that indicates that we are having adverse effects, 

chronic illnesses, and how that, then, is contiguous with many of 

the environmental—the particulate matter, the smog, the ozone— 

and where that is easily accessible for the public. 

It is great that we have the science and the research, but if it 

is not correlated or brought together in some format, the public and 

the voting public is not fully aware of what those implications are. 

We see it manifested years out, especially with children and our elderly. We talk about asthma; this is one example. 

But that is something that I know that I have been frustrated 

over for a number of years, given the proximity of where I live, in 

a part of southern California where the ozone, smog, water contaminants, many, many adverse contaminants that are affecting 

our population, that will have an impact for years to come. And we 

don’t have a good thermometer, or gauge, on what we should be 

doing to turn that around. 

So anyway, that is my one cent, for what it is worth. And then 

I will go to Dr. Patz and give you each a minute to kind of give 

us something here on the committee that we can take away, that 

we should be thinking about. 

Dr. PATZ. So we really, you know, we do understand that climate 

change does pose these risks, and we need to be prepared. We do 

need more research; we do need to understand the nature of these 

risks more. 

We are beginning to make some headway as far as looking at 

place-based, you know, location-based problems. And I think that 

that is where, you know, where climate will actually have an impact and where we can really look at one place and look at the vulnerability based on its natural resources, or be it Los Angeles, the 

basin, and there have been studies showing that heat waves may 

even triple in California, so these types of analysis. 

But I also think that we have brought in this issue of health impact assessment, which is more than just looking at adverse risks 

that we are used to studying, but to look at both the negative effects and potential positive effects from changes in policy. And this 

is where I think we really need to get a better handle of—that will 

get a better quantification of the true story when you change policy 

and you reduce greenhouse gases, for example, in an urban population. 

You know, the multiple co-benefits to air pollution reduction, increased fitness, and reduced greenhouse gases, it has got to be a 

comprehensive-type analysis to really get an understanding of assessing that policy intervention for climate change. 

Dr. BEST. As a pediatrician—and as you know, I am here to represent children—I would urge you to consider children and chilVerDate Mar 15 2010 21:12 Nov 17, 2010 Jkt 061639 PO 00000 Frm 00148 Fmt 6633 Sfmt 6602 E:\HR\OC\A639.XXX A639

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dren’s health every time you make a decision, because what is good 

for children is good for the rest of us, it is good for the environment, it is good for our education system, it is good for business. 

We need to remember that children are here for longer than I 

am, or at least their potential life is longer than mine, and that everything we do that improves the climate, that improves our education system, that improves our health care system has a manyfold impact on their lives. And that includes public health infrastructure as well. 

Ms. SOLIS. Thank you. Thank you. 

Dr. Benjamin. 

Dr. BENJAMIN. Let me just state uncategorically that climate 

change is here and it has health effects. Number two, we can and 

should address it now. And number three, let me just focus very 

specifically on the area of vulnerable populations, because I know 

others will talk about the broader public health issues. 

And one, we need to begin looking at, very specifically, the 

science around how this affects these vulnerable populations. Number two, trying to engage them now in the conversation, and I use 

the word conversation very specifically so that we don’t just talk 

to people, or talk at people, we actually engage in a two-way dialogue. 

And number three, engage them now so that we can begin to 

craft solutions that make sense for their world. Their world is different than the world that I may live in, the world that you may 

live in, depending on socioeconomic status, et cetera, or other capacities, and we need to very specifically engage them in their 

world for solutions. 

Ms. SOLIS. Thank you. 

Dr. Frumkin. 

Dr. FRUMKIN. Representative Solis, thank you very much, and 

thank your colleagues as well, on this committee, for shining a 

spotlight on this very important problem. Climate change is a 

major public health challenge. There is a lot we in the public 

health sector can do to tackle it. 

The conventional terms mitigation and adaptation correspond to 

what we in public health call prevention and preparedness, and 

those are standard public health efforts. We need better research 

so we understand the science better. We need preparedness planning, so that we can take steps to protect public health. 

We need to communicate effectively the things we learn and the 

recommendations we develop. As we do all of that, we need to focus 

on the most vulnerable among us: poor communities, communities 

of color, those with particular vulnerabilities, so that we can take 

special steps to be sure those communities are protected. 

We at CDC stand ready to work with other agencies, with state 

and local public health, with organizations across the health sector, 

and with partners in transportation, energy, and other sectors so 

that we can do the very best we can to protect public health. 

Thank you. 

Ms. SOLIS. Thank you. Thank you. 

Dr. Jacobson. 

Mr. JACOBSON. Well, I think we—thank you very much for inviting me, again—I think we know that climate change is going to inVerDate Mar 15 2010 21:12 Nov 17, 2010 Jkt 061639 PO 00000 Frm 00149 Fmt 6633 Sfmt 6602 E:\HR\OC\A639.XXX A639

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crease, and it does currently increase air pollution the most where 

the pollution is already the highest. And right now the pollution is 

highest in California, and so that would give a reason for California to be able to control its own air pollution. 

If we look more broadly at what are some solutions to climate 

change, then there are these large-scale renewable energy solutions 

that are feasible in terms of the resources available, if we just put 

our mind to it. I think it really requires kind of a focus on that 

issue, and part of the problem I have seen—the reason there hasn’t 

been more of a focus on renewable energy solutions—is that a lot 

of the, not only the funding, but also the, just the talk, is really 

on solutions that are really less than official, from a climate or air 

pollution point of view. 

I speak specifically of, for example, bio-fuels, which there is really no demonstration that it actually improves climate or air pollution. There is this carbon sequestration, there is, you know, clean 

coal, other technologies that have been pushed by industries, which 

the science hasn’t shown that these are actually proven benefits. So 

I think there is a good change of focus. 

Ms. SOLIS. Right. Thank you so much. 

That will conclude our hearing, and I want to thank the members that came this morning, and also our witnesses and to the audience. Hopefully this will be the first in a series of discussions we 

will have on the environment, climate change, and health care. 

So thank you very much. Thank you. This meeting is adjourned. 

[Whereupon, at 11:53 a.m., the committee was adjourned.] 


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srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 210 here 61639A.116
159 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 211 here 61639A.117
160 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 212 here 61639A.118
161 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 213 here 61639A.119
162 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 214 here 61639A.120
163 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 215 here 61639A.121
164 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 216 here 61639A.122
165 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 217 here 61639A.123
166 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 218 here 61639A.124
167 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 219 here 61639A.125
168 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 220 here 61639A.126
169 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 221 here 61639A.127
170 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 222 here 61639A.128
171 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 223 here 61639A.129
172 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 224 here 61639A.130
173 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 225 here 61639A.131
174 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 226 here 61639A.132
175 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 227 here 61639A.133
176 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 228 here 61639A.134
177 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 229 here 61639A.135
178 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 230 here 61639A.136
179 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 231 here 61639A.137
180 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 232 here 61639A.138
181 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 233 here 61639A.139
182 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 234 here 61639A.140
183 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 235 here 61639A.141
184 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 236 here 61639A.142
185 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 237 here 61639A.143
186 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 238 here 61639A.144
187 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 239 here 61639A.145
188 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 240 here 61639A.146
189 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 241 here 61639A.147
190 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 242 here 61639A.148
191 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 243 here 61639A.149
192 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 244 here 61639A.150
193 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 245 here 61639A.151
194 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 246 here 61639A.152
195 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 247 here 61639A.153
196 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 248 here 61639A.154
197 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 249 here 61639A.155
198 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 250 here 61639A.156
199 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 251 here 61639A.157
200 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 252 here 61639A.158
201 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 253 here 61639A.159
202 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 254 here 61639A.160
203 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 255 here 61639A.161
204 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 256 here 61639A.162
205 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 257 here 61639A.163
206 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 258 here 61639A.164
207 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 259 here 61639A.165
208 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 260 here 61639A.166
209 


srobinson on DSKHWCL6B1PROD with HEARINGInsert offset folio 261/400 here 61639A.167