With contributions from Dr. Aaron Bernstein.

Most major health organizations in the world have called climate change one of, if not, the foremost problem for health and that’s especially true for children. You can’t think about a child getting educated or living to their full potential in a world in which climate change goes unchecked.

The harms are overwhelmingly going to hit the children who are growing up in poverty and/or have been otherwise marginalized. This means that you can’t work on equity, justice, child welfare, or family welfare without addressing climate. We also know that these same disadvantaged children stand to benefit the most when we tackle climate change because they are much more likely to breathe polluted air, drink polluted water, and have less access to healthcare.

Because climate change touches everything we care about, it can feel overwhelming. We must bring the issue down to size and make it relevant to specific concerns that we can do something about– asthma, succeeding in school, having the financial resources to put dinner on the table – we can and must connect these to climate. The sooner we do this, the sooner we will see more progress on all fronts.

To be clear, I can already see the effects of climate in the children I care for. The allergy season is now three weeks longer than it was 3 decades ago. We’ve seen movement of infectious diseases, more damaging hurricanes, and more extreme wildfire seasons. No wonder so many describe the climate problem as a crisis.

Despite how much it already does to our lives and livelihoods, we have had a hard time taking needed actions. Climate change misses our brain’s motivation buttons. Our brains are designed to see danger happening immediately in front of our eyes. This problem in our sensorium is well known to psychologists who call it change blindness – the inability to perceive change when the rate of change is slow. This makes incorporating climate change into our decision making harder. We have a tendency to want to believe that we’ll figure it out tomorrow because we have more pressing problems today. This may be the most dangerous delusion humans have ever had– the idea that climate change isn’t relevant to human welfare right now. If you care about housing, education, or equity, let’s talk about how climate change interfaces with that.

Two climate-related health risks are air pollution and heat. 300,000 people are dying too soon every year because of air pollution created by burning fossil fuels. Black, Latinx, Asian, and poor Americans have been found to breathe more polluted air than the average American and are least responsible for its production. We can save more than half of the lives we’ve lost to COVID every year if we stop burning fossil fuels. Harms from fossil fuel sourced air pollution include specific harms to children. The pollution has been found to damage children’s developing brains, worsen (or even cause) asthma, and worsen pregnancy outcomes.

Heat exposure in the United States is already the single largest cause of death from natural disasters. We know that heat makes people die too soon, but it too has far reaching effects on our health and affects the people who can afford it least. Children in areas with high heat have trouble learning. It can cause birth defects, increases injuries at work, can lead to chronic medical problems like heart and lung diseases, and increases hospitalizations among both adults and children.

Yes. There is evidence that air pollution from burning fossil fuels or wildfires puts pregnancies at risk and can injure the brain, heart, and lungs of a developing fetus. After birth, air pollution likely contributes to infant mortality.

The brain’s development is enormously dependent on social and physical environments from before birth and continue through childhood. Pollutants such as lead, mercury, particulate matter, and polyaromatic hydrocarbons (PAH), all present in coal, are well known to damage developing brains. The harms of these chemical exposures can be compounded in a child who is growing up in a poor household or lacks buffers to adverse childhood events (ACEs). ACEs can result in toxic stress and toxic stress results in many, many health effects through childhood into adulthood. Climate change can be a source of ACEs, as natural disasters, food insecurity, and loss of homes are all ACEs.

It’s hard to think of a specific policy that climate change doesn’t bear upon. One recent prominent example is the infrastructure bill. It promises a greening of the economy and many jobs. At the same time, in the calculus around its price tag, we haven’t taken anywhere close to a full measure of the benefits that the proposed infrastructure improvements will have upon people’s health, and especially children. More mass transit, for instance, isn’t just about shortening commute times (which in and of itself is a health issue), it’s about air quality, environmental justice, and even ACEs as commute times have been tied to how much time parents can spend with children (the single largest buffer to toxic stress is a secure relationship with an adult).

The reason we are so concerned about the health of disadvantaged children right now is because they have lacked voice in the political process. This problem is magnified with climate risks as they will grow greater if we don’t act based upon the science. We must ask questions about whether children are being considered in policy and where the funds are being spent. Place-based funders have a real role here.

Funders need to figure out what they care passionately about, and then figure out how climate change may jeopardize all the hard work and funds they have invested into their passion. We can be more strategic and effective in our investments when the near and long-term effects of climate change are considered.

Air pollution. Air pollution comes from power plants, vehicles, and lots of other sources, like wood burning stoves. Several foundations have targeted specific sectors effectively. The Barr Foundation does this well in Boston. Their focus is on transportation, but also systemic ways to reduce pollution by connecting education strategies to the built environment.

Urban greening can be a huge part of the solution. We know communities of color and cities have less green space, are hotter, and have more traffic pollution. Putting in green space absorbs pollution and can cool things down. There is also evidence that green space around children can benefit their mental health. If you want to address air pollution, education, mental health, or energy security, then think about greening cities. And do it with plans on how to avoid green gentrification. Place based funders are especially important because you have to know the community, what it wants, and what will work.

Utility advocacy. In Massachusetts, as in many states, everyone who buys utilities pays into a fund that supports home weatherization and energy efficiency. In many states, these funds are not deployed based on need. At the same time, the fund is disproportionately paid into by the poor. Foundations can support campaigns to change that so the benefits go to the most inefficient homes producing the most pollution.

Air filtration supports. We spend approximately $4 trillion primarily on sick care in the United States and about a quarter of those dollars are fully preventable. If we had $1 trillion to spend, what could we do for families who live in high air pollution areas? Some pioneering examples come from Ohio and Vermont where healthcare dollars are being spent to weatherize homes and improve home indoor environmental quality. These actions can reduce utility bills, promote housing insecurity, and avoid illness while saving money.

Policy advocacy. We must keep focus on children and prevention. Healthcare can be an important part of the solution but right now the incentives and infrastructure aren’t in place to make it happen in most places. If we could find ways to use healthcare dollars for prevention and focus on children we will have compounding dividends for child health and, in many cases, provide for a liveable world for their future. Investments in better nutrition, transportation, housing, and electricity generation all can benefit child health today and combat climate change.

Get kids outside. Children (not to mention adults) need to be outside for all kinds of reasons. The past year couldn’t have made it any clearer. With children being couped up, we made our existing mental health and obesity epidemics far worse. At the same time, there is more and more evidence that being in nature can improve many aspects of child health.