THe 1964 Civil Rights ActFederal funding recipients, including those who are covered by Medicare and Medicaid, are prohibited from discriminating against anyone. The Department of Health and Human Services Office for Civil RightsDespite the fact communities of color suffer unrelenting and innumerable climate-related health problems, the, which is responsible to enforce civil rights laws, has never addressed or recognized the climate crisis. This injustice is both institutional and environmental racism.
Currently, the U.S. accounts for approximately 14%of global carbon emissions each year, and is responsible to more than 40%of the total historical global carbon emissions. The country’s health-care industry, which receives More than a third of its revenuePublic health insurance programs account for approximately 8.5%About 25% of global health care emission and about 25% of total U.S. total emissions. This is due in part because of the high energy intensity of U.S. hospital, which is higher than DoubleThat of European hospitals.
The health risks caused by the emissions of the health care industry are greater than the number of preventable deaths from medical errors, which is upwards of 98,000 annually. This is not surprising. 58%Annual excess U.S. deaths 8 millionGlobal deaths due to fossil fuel use are on the rise.
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People of color, and those with low incomes, are particularly affected by the climate crisis. ResearchPublished in Science Advances last year, it was found that 12 of 14 sources (expressed as PM) are more likely to expose racial or ethnic minorities to higher levels of fine particulate pollution (expressed by PM).2.5This is the result of fossil fuel combustion. It is also known as the largest environmental causeHuman mortality.
Climate-related health problems also have adisproportionate impact on Medicare and Medicaid beneficiaries. A 2019 study shows that climate-related health harms also disproportionately affect Medicare and Medicaid beneficiaries. Study64% of the total health-care costs resulting from 10 climate-sensitive case studies events, including Hurricane Sandy, were borne by Medicare and Medicaid programs.
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Although Americans may not have Rights to life, liberty and the pursuit of happinessThey do not appear to have the right to a climate that is safe and healthy. The 9th Circuit Court of Appeals in Juliana v. United States ruled2020 will see the end of the American Constitution’s right to a climate that is safe and sustainable. The federal government and the courts accepted that Anthropocene warming had caused damage to the 21 plaintiffs, mainly minorities, and their psychological well-being.
The Lancets has been publishing since 2016. Countdown to Climate Change and HealthThis reality has been documented by, which quantitively documents in part climate-related health effects, exposures, as well as vulnerabilities. Its. SixthThe Countdown report was published in October 2021. It concluded that climate change’s health effects are inequitable and have disproportionate impacts on the most vulnerable populations in all societies, including those with low incomes, members from minority groups, women, children and older adults, as well as people with chronic illnesses and disabilities.
The Obama administration identified the exact same reality through the chapter Populations of Concern in their Encyclopedic 2016 report, The Effects of Climate Change on Human Health in America: A Scientific Assessment.
Philip Alston, professor at New York University School of Law and author of his 2019 assessment, made it clear that the climate penalty is particularly harsh on low-income persons. Climate Change and PovertyThe report was written by Alston while serving as UN Special Rapporteur for extreme poverty and human right. Alston concluded that climate changes will have devastating effects on people living in poverty, because governments have failed to address climate change seriously for decades. He concluded that climate change is threatening to undo the past 50 years of progress in global development, poverty reduction, and global health.
Alston referred to climate apartheid as a situation in which governments fail to mitigate Anthropocene heat gain, effectively committing an unconscionable attack on the poor.
OCRs responsibilities
Title VI, Section 601.The Civil Rights Act requires that federal funding recipients be prohibited from discriminating against anyone on the basis of race, color, national origin. The act does not specifically mention health care but its meaning was immediately recognized by federal health policymakers. The new Medicare program was created to force hospitals to desegregate in 1966, and Title VI was successfully exploited. Title VI, Section 602.Federal agencies are authorized to implement Section 601 through rule-making that would prohibit racially discriminate impacts or deny equal protection.
HSS and its Office of Civil Rights also have to comply with laws relating to environmental policy. The 1969 National Environmental Policy Act (NEPAAll federal agencies must identify and evaluate significant Federal actions that could adversely affect the quality of the environment. These actions require agencies to file an environmental impact statement. Courts have held that NEPA means agencies are required to file environmental impact statements. Take a hard look at the environmental consequencesBefore taking any final actions, they should consider other options and make their proposals public.
In 1994, the Clinton administration published NEPA with environmental justice in an effort to integrate it. Executive Order 12898. The order is still in force. It directs federal agencies, to the maximum extent permissible and allowed by law, to make environmental justice a part of their mission. This includes identifying and addressing, where appropriate, adverse human health and environmental effects of programs, policies, and activities that affect low-income and minority populations. The executive order requires agencies to develop strategies for environmental justice that promote the enforcement of all environmental statutes in areas populated by low- and minority-income people.
The Clinton executive order led to several guidance documents being produced. For example, the guidance documents in its 2016 reportThe Environmental Protection Agency, in Promising Practices to EJ Methodologies In NEPA Reviews, encouraged agencies to consider how the proposed regulatory action might potentially increase climate change-related dangers in low-income and minority populations. Although environmental justice is not defined by federal statute, the EPA has defined it as follows: fair treatmentThis means that no one group should be disproportionately affected by the negative environmental effects of industrial, governmental, and commercial policies.
Response to date
The Office for Civil Rights has not acknowledged or addressed thedisproportionate impact climate-related health risks have on people of color. One example is that none of its 50 QuestionsAddress the problem. Searching all the offices several hundred Bulletins and news releasesThe same results are obtained for climate and environment.
I asked Lisa Pino the director of the office for clarification, but she declined to interview me.
OCRs indifference is compatible with HHS more generally
The Centers for Medicare & Medicaid Services, which are part of HHS has not addressed climate-caused health problems. Although CMS included numerous climate-related health harms in its Medicare administrative rulemaking in 2021, Requests for information concerning health equity, none mentioned climate-crisis-related health effects. The climate crisis is not mentioned in any of the CMS’ current strategic visions for Medicare, Medicaid and the Childrens Health Insurance Program. These facts explain why a CMS search yields only one mention of climate change within a 2013 proposed rule regarding emergency preparedness.
Recent HHSs Climate Action PlanAnother dead end. The report states that the department is committed protecting the health and well-being of all Americans through integrating environmental justice, equity, and justice into our work, but it does not mention Medicare or Medicaid.
The climate crisis isn’t listed as one of the top 10. 15 priority topicsThe Assistant Secretary of Planning and Evaluation has not published a policy paper or planning paper on the subject. The climate crisis is not one. Five priorities were identifiedfor the Office of the Secretary General; is not identified under the fifth priority, emerging health threats; and isn’t the subject of any of the other Surgeon Generals 57 reports on public healthSince 2008 Xavier Becerra (HHS secretary) has yet to make a speech on Anthropocene heating, the greatest threat ever to human and planetary wellbeing in history.
The indifference of HHS to the climate crisis explains why the U.S. Government Accountability Office, in late January 2022, added HHS leadership to their organization. High-Risk ListGAO auditors doubted that HHS was prepared to respond to extreme weather events such as hurricanes, as stated by the GAO.
Biden’s administration has not lost sight of the Office for Civil Rights’ poor performance in relation to the climate crisis. The White House issued a statement on the climate crisis one week after Biden assumed office. Executive Order 14008The article, Tackling Climate Crisis at Home & Abroad, aims to update Clinton’s executive order. The Biden administration executive ordered HHS to create an Office of Climate Change and Health Equity in order to ensure environmental justice.
This office, which was officially set up in August 2021 is located in the HHS Office of the Assistant Secretary for Health. It is located in the HHS Office of the Assistant Secretary for Healthcare. Part taskedTo identify communities that are most vulnerable to climate hazards and to address health disparities caused by climate impacts. It does not appear to be able to enforce civil rights and has not been given any specific responsibilities.
Co-chairing, alongside the National Academy of Medicine, is the primary focus of the Office of Climate Change and Health Equity. Action Collaborative for Decarbonizing the U.S. Health SectorThe, which was launched September 2021. Although the collaborative includes policy workgroups, the Office of Civil Rights doesn’t participate. Also, relevant civil rights and equal protection issues will not be on the collaboratives agenda. Clinton’s executive order required agencies to Develop environmental justice strategiesThis responsibility is now held by the Office of Climate Change and Health Equity, although it may not be clear. It does not identifyAny environmental justice strategies
The United Nations Intergovernmental Panel on Climate Change released its most dire warning yet in February 2022. The 3,500-page document ReportIt was concluded that everywhere is affected by rising temperatures, increasing extreme weather, with no inhabited area escaping the devastating effects. Antnio Guerres, UN Secretary General, appropriately called it An atlas of human suffering.The Office for Civil rights published a memo about the IPCC Report on the same day it was released. Cybersecurity.
Consider the deadly and increasingly severe effects climate-related harms have on communities of color The danger of drowningIn a basement apartment) it is worth recalling that never-more prophetic 1966 quote Martin Luther King Jr.Health injustice is the most inhumane form of inequality. James Baldwins1955 observation, The Negro breathes what we don’t know about the past
David Introcaso, Vice President for Regulation Policy at Strategic Health Care, Washington, D.C., hosts The Healthcare Policy Podcast. His opinions do not necessarily reflect the views of his employer.
