Preparedness for the Health Consequences of Climate Change as a Potential Influence on Public Health Law and Policy
This Faculty Working Paper has been updated and posted within the Georgetown Law Faculty Publications series in the Scholarly Commons. It is currently available at http://scholarship.law.georgetown.edu/facpub/437/
Abstract
Because the health effects of climate change are likely to be significant and far-reaching, a key component of our ability to adapt will be our public health infrastructure. Perhaps counter-intuitively, recent emphasis in public health law on preparedness for extraordinary events may be to the detriment of our ability to cope with the health impacts of climate change. While existing emergency preparedness law will necessarily be an important backdrop for health-focused climate change adaptation efforts (especially with regard to natural disasters and infectious disease outbreaks), the focus on “emergency” preparedness in recent years does not necessarily situate us well for handling the substantial, but slowly emerging, intensification of more routine health threats that we expect to see as an impact of climate change. This paper examines the likely demands of climate change on public health infrastructure, law, and policy and evaluates weaknesses of the current public health legal framework.
Three case studies are used to illustrate the current public health law and policy response to the types of health threats that we are likely to see in the U.S. as a consequence of climate change: (1) the incompatibility of the strategic national stockpile of pharmaceutical and medical supplies with the needs of disaster victims following Hurricane Katrina; (2) privacy-based barriers to public health surveillance programs seeking to track trends in pediatric asthma; and (3) conflicts over the use of pesticides for vector control to fight West Nile Virus in the United States. Upon delving more deeply into these three examples, a picture emerges of the ways in which climate change weighs in on some of the key controversies of public health law: (1) how to draw the line between public and private responsibility for health in the context of rapidly widening health disparities; (2) striking the balance between individual rights and the common need for health protection; and (3) the challenge of setting health priorities democratically given that public perception of risk is frequently inconsistent with scientific evidence. The epidemiological transition and, more recently, terrorism and pandemic preparedness have played major roles in shaping the resolution of these issues through public health law. Climate change is poised to be the next major transition to fundamentally alter the balance on these important questions.