Comment Log Display

HEALTH NETWORK FOR CLEAN AIR


August 15, 2008

Dear Chair Nichols and Members of the California Air Resources
Board:

As health and medical organizations, we are extremely concerned
about the crisis of global warming and the reality that global
warming will lead to serious public health problems and increase
rates of illness, hospitalizations and premature death.  Our
health professionals are on the front lines dealing with the
direct effects of global warming in daily interactions with the
affected public and patients in hospitals and emergency rooms.  We
are especially concerned about impacts to vulnerable individuals
including seniors, people with heart or lung disease, children and
infants. We greatly appreciate the hard work of CARB staff in
developing the draft-scoping plan to implement AB 32 and address
these problems, but believe the plan needs substantial
strengthening.

Air pollution already drives high mortality and morbidity numbers
and global warming will only make this situation worse.  The state
is currently experiencing up to 24,000 premature deaths, 350,000
asthma attacks, thousands of hospitalizations and emergency room
visits, and millions of missed school and work days from
respiratory and cardiac illnesses caused by pollution.  In
addition, research shows that children in polluted areas of the
state are growing up with reduced lung capacity due to pollution
exposures that slow and stunt lung growth and development.  

Global warming will pose a range of other health challenges to our
communities at the same time we are dealing with the severe air
pollution problems.  Global warming is expected to increase
sickness and death from heat waves and weather extremes, water
pollution, increased and more widely distributed vector
populations, increased potential for food-borne illness and other
environmental challenges.  

Clearly, public health must be a key consideration in the
development of the scoping plan and other AB 32 related
implementation activities.  In order to make this happen, there
needs to be a much higher level of engagement with the public
health community, through both public health agencies and
organizations.  While we appreciate that CARB has committed to do
a public health analysis of individual scoping plan measures, we
are concerned that this is only a beginning. We urge the board to
take the following actions:  

1)	Establish a broader role for the public health community in the
development of the scoping plan and broader implementation of AB
32.   State and local public health agencies and organizations
should have a formal and ongoing role in reviewing plans and
strategies for greenhouse gas reduction and provide input on both
the broader public health impacts of the mix of proposed measures
(including gaps where additional measures could improve public
health benefits) and the specific health benefits and concerns
related to individual measures.  Public health input is needed at
every step in the process of developing mitigation measures and
strategies to reduce global warming, both prior to and after the
adoption of the scoping plan.  When implementation begins, public
health support can facilitate the public and community support
needed for the local and regional changes.

2)	Change the priorities and commitments in the scoping plan to
better reflect public health concerns and provide a higher level
of public health protection:

•	Elevate the priority of significant shifts in transportation and
land use in the scoping plan.  

Given that 40% of greenhouse gases emanate from vehicles and
vehicles are also a strong source of smog precursors, contributing
to respiratory and heart disease, the state should place a much
higher priority on efforts to reduce personal driving and
commercial transportation.  Promoting use of transportation
alternatives such as walking, biking and public transit will lead
to healthier lifestyles, less obesity and less chronic illness and
injury.  

•	Establish measures to promote healthier communities including a
stronger focus on reduction of vehicle miles traveled.
The scoping plan must include a stronger statewide goal for
reducing vehicle emissions and stronger measures to promote
transit and changes in land use and transportation patterns that
reduce personal driving.

•	Set strong regional goals for greenhouse gas reduction
As part of the push toward healthier communities, the state should
establish strong regional goals to spur local action backed up by
increased state resources to revise local and regional plans to
support AB 32 goals.

•	Take a cautious approach toward cap and trade
CARB should approach market-based measures cautiously, limit their
use and apply appropriate safeguards to ensure emission reductions
are real, verifiable, surplus and permanent.  In addition, CARB
should ensure that pollution sources pay for emission allocations
rather than allow free distribution.  Cap and trade must not lead
to further adverse impacts on communities already
disproportionately impacted by the regulated industries and
sectors, chronic disease and injury, and little or no access to
health care.

•	Focus on local health benefits of scoping plan measures,
especially with regard to environmental justice communities.
The plan must not only prevent creation of pollution “hot spots”
and real “heat islands”, but should also demonstrate that measures
will improve air quality and health conditions in local
communities.  Communities especially affected include those near
ports, goods movement, power plants, agricultural and other
industrial pollution sources.

•	Direct revenues to assist community-level mitigation efforts.
CARB should ensure that additional state revenues raised through
greenhouse gas fees or cap and trade programs are directed to
assist local community global warming mitigation and adaptation
efforts, especially in environmental justice communities.

3)	Engage the public health community in development of strategies
for public outreach and messaging on global warming and mitigation
strategies.  Building public support for mitigation strategies
will be critical to the success of the state’s efforts.  Public
health forces have considerable expertise and experience in
reaching out to and educating diverse communities, as well as
helping structure the policies and environments to motivate and
support healthy behavior change.

The CARB scoping plan currently estimates health benefits valued
at $2 billion, including reductions of premature deaths, asthma
attacks and respiratory symptoms. While these numbers are
significant, we believe these health benefits could be increased
significantly by strengthening the plan as discussed above and
focusing on measures with large air quality co-benefits.

Californians are in the middle of a public health crisis as
evidenced by high levels of air pollution related illness, chronic
disease associated with obesity and physical inactivity, and other
health issues.  The serious environmental challenges brought on by
global warming will quickly overwhelm health service systems,
particularly for low-income communities. Reducing global warming
is a vital strategy that will help Californians breathe easier and
prevent suffering from lung and heart disease, as well as promote
community and transportation design change that can reduce the
risk of chronic disease and injury. 

We look forward to working with you toward the development of a
strong, health protective, greenhouse gas reduction plan.

Sincerely, 

Bonnie Holmes-Gen, Senior Policy Director
American Lung Association of California

Donna Gerber, Director, Government Relations
California Nurses Association/National Nurses Organizing
Committee

David Claman, M.D., President
California Thoracic Society

Bruce Pomer, Executive Director
Health officers Association of California

Michael DeLollis, M.D., Chair, Community Health Committee
Fresno-Madera Medical Society

Elina Green, MPH
Long Beach Alliance for Children with Asthma

Kevin Hamilton, RRT, RCP, Co-Director
Medical Advocates for Healthy Air (Fresno)

Allyson Holman, Chair
Merced-Mairposa County Asthma Coalition

Evan Krasner, M.D., Executive Director
Physicians for Social Responsibility, San Francisco

Marice Ashe, JD, MPH, Director
Public Health Law & Policy

Joel Ervice, Associate Director
RAMP (Regional Asthma Management and Prevention)

William S. Sandberg, Executive Director
Sierra Sacramento Valley Medical Society

Steve Heilig, MPH, Director Public Health & Education
San Francisco Medical Society