Former EPA Administrator Gina McCarthy Launches C-CHANGE: A New Climate Change Project at Harvard

Gina McCarthy - C - CHANGE

Moderator: Welcome to Conversations on Healthcare with Mark Masselli and Margaret
Flinter , a weekly s how where we speak to the top thought leaders in health
innovation, health policy, care delivery and the great minds who are shaping,
the healthcare of th e future. This week Mark and Margaret speak with
former administrator of the U.S. Department of Environmental Protection
under President Obama, Gina McCarthy, now Heads the Center for Climate,
Health and the Global Environment C - CHANGE at the Harvard T . H . Chan
School of Public Health, which seeks to promote a greater understanding of
the growing health risks associated with pollution and climate change.

Lori Robertson also checks in, the Managing Editor of FactCheck.org. She
looks at misstatements spoken ab out health policy in the public domain,
separating the fake from the facts. And we end with a bright idea that’s
improving health and wellbeing in everyday life. If you have comments please
email us at www.chcrad [email protected] or find us on Facebook or Twitter. We
love hearing from you. Y ou can also find us on iTunes or Stitcher or wherever
you listen to podcast. Please feel free to leave a review for us there. Now stay
tune for our interview with Gina McCarthy on C onversations on Healthcare.

Mark Masselli : We are speaking today with Gina McCarthy, Professor of the Practice of
Public Health at the Harvard T.H. Chan School of Public Health and Director of
C - CHANGE, the Center for Climate Health and Global Environment at
Harvard. She is the former administrator of the U.S. Environmental
Protection Agency under President Obama where she initiated a shift
towards linking environmental issues to global public health. Previously she
served as Assistant Administrator at the EPA’s Office of Air and Radiation. She
was Deputy Secretary of the Massachusetts Office of Commonwealth
Development, advising five Massachusetts governors on environmental
policy. She earned a Master of Science in Environmental Health Engineering,
Planning and Policy from Tufts University . Gina, welcome to Conversations on
Healthcare.

Gina McCarthy: It’s great to be here, thanks so much for having me.

Mark Masselli: W hen you served as EPA administrator, we saw some really significant steps
forward in addres sing the cause and effect of climate change, such as stricter
auto emission regulations , promoting growth of sustainable energy sources
and the signing of the Paris Climate Agreement in 2016 . S ince then
unfortunately we have seen a significant of outface u nder the current
administration. I am wondering if you could share with our listeners your
assessment of where we stand now having pulled out of the Paris Accord and
watching the rollback of many climate protections that are already in place.

Gina McCarthy : I know that many people are following a lot of the news clips on the
rollbacks of a lot of the steps we took, not just on climate change , but on real
core public health issues like clean water, clean air and I think people are
concerned and I am with the m . I am concerned but I need them to
understand one key thing. These rollbacks they have not been finalized, th ese
opportunities to submit public comments on many of them, these rules that

Gina McCarthy - C - CHANGE

are in place, the y are final rules which means you need to have a r ule to get
rid of a rule. W hat we did was follow the science, we followed the law, we
did great public process around it and I think we did a really good job at
showing you to continue to make progress environmentally, to preserve and
protect public health and our natural resources , b ut you could also at the
same time do them in very cost effective, reasonable ways and in fact,
enhance our economy and jobs.

And they can have a very hard time in this administration, trying to roll that
back , because they are doing them quickly, haphazardly, they are not really
following the procedures . A nd folk s should be worried for sure , l ot of it that I
worry about even more, really fundament al ways that they are attacking
science in terms of how EPA and other agencies do their business. That’s a
critical issue that I think people may be missing the forest for the trees if you
will.

Margaret Flinter: Gina, you have said that if we are going to bridge the divide over
climate change that we have really got to help people unde rstand this
inextricable link between the environment and the climate and public health.
Mark and I had Dr. Maria Ne i ra from th e World Health Organization, joining
us earlier this year. And she just was so compelling, talking about the
devastating impact o f pollution on global health, responsible maybe for 10
million deaths . M aybe you could help our listeners understand the depth of
harm to human health from pollution and climate change.

Gina McCarthy : Maria is fi ghting very hard to get people to understand the challenge
of pollution . And you are right, w e are talking about 9 to 10 million people
every year dying prematurely and hundreds and hundreds of asthma attacks
for our kids . W hat people need to understand is that climate change is really
about carbon pollution. I think we have talked about climate a s some big
planetary issue which of course it is, but in the end it’s all about whether or
not we can continue to live healthy and safe lives. And so the challenge of
climate change is that we have talked ab out it in such elusive terms that
people aren’t personalizing it.

O ne of the reasons why I am at the Harvard School of Public Health, directing
this new center called C - CHANGE, the Center for Climate Health and the
Global Environment, is to try to cut carb on pollution [inaudible 00:05:27] .
Let’s have people understand carbon pollution is directly impacting our
health. It is actually exacerbating the air pollution problem that we are
seeing. And people will be dying in larger numbers and they will have more
kids challenge, because of the wide sweeps in temperatures that we are
seeing, whether it’s the temperature is getting too hot or it’s because we are
driving too much , those challenges with transportation will need to be
addressed, but it’s all about putti ng carbon into the atmosphere from
burning fossil fuel a nd that is having a direct impact on our health today.

I am at C - CHANGE to try to personalize it. Harvard School of Public Health
was the place where air pollution was first identified in so many crit ically

Gina McCarthy - C - CHANGE

important scientific ways. The challenge that climate change poses to that is
also now well understood. I t’s all about now taking it out of a planetary realm
and really making it personal to individuals so they can understand that they
can do someth ing about it.

I think climate change was such a big issue that we made it so big that people
thought it was somebody else’s problem a nd we missed our opportunity to
talk about the direct public health, not just air pollution, but the way in which
we are se eing disease range s change. That when diseases are transmitted by
vectors , by ticks and mosquitoes you are seeing different types of outbreaks
of different diseases , you are seeing contagious disease on the rise in some
ways and infectious diseases, becaus e of changes in climate next to water,
either that’s too much or too little. And in both cases, you are going to have
contaminants getting in to your water systems that are creating a problem.

W e want to really at C - CHANGE not just bring it down to size, bu t we really
want to focus on kids, because I think everybody loves their kids, everybody
love s their family, this is about them and their families and their famil y’s
future. And that’s an important thing I think for us to get across now, when
we have an ad ministration that really is focused on, now you are shoving
science aside, we need to get it front and center in front of people , because
in this country, people matter.

Mark Masselli: I n addition to your many other attributes you are a great educator and really
focusing on making this understandable at the individual level. In spite of all
of these changes within the current administration we do see the impact on
climate change advancing in other countries, Germany is now generating
most of their energy th rough renewable. China well arguably the world’s
biggest polluter is really focusing on the push for solar energy. Y ou also say
the market forces here in the U.S. are driving the industry, I wonder if you
could tell our listeners how these marketing govern mental forces aimed at
reducing pollution and fossil fuel emission are impacting climate change.

Gina McCarthy: I think one of the most important things is that people are so focused
on the everyday news that they sort of lose the opportunity to sort of st ep
back and see what’s happening in the real world, because even here in the
United States the clean energy train has really left the station and it’s not
going back. It is remarkable how inexpensive renewable energy is in
particular solar and wind and how pervasive now people are looking at
geothermal, all these types of opportunities are now built into the market
place. It’s basically already built into the energy system and because
renewable energy in energy efficiency which remains a big driver of chang e.
All of these things are now the least expensive choices that utilities and their
customers can make, to both save money as well as reduce the air pollutants
that come along with the burning of fossil fuels.

So in the clean energy market today in United States, it’s really remarkable,
we have seen a tremendous shift into inexpensive natural gas and then
towards a renewable energy system , because that’s not only reduced the

Gina McCarthy - C - CHANGE

opportunity for pollutant that f uel climate change, but also reduced
traditional ai r pollutants like particulate matter, like ozone is no longer being
formed in as many places as it has been before. P eople will in watching and
talk about bringing back coal but frankly coal units, half of them have closed
since 2010. And that’s really not a direct result of EPA rules or rollbacks. It’s
really a result of clean energy being the cheapest, most inexpensive in the
result of terrific energy efficiency opportunities that we have had that have
kept that energy demand down.

N ow in transportation w e are seeing the same kind of revolution, even
though they are talking about roll ing back some of the car standards. Because
we are seeing that the young people today aren’t as in love with their cars
and it’s a good thing. We need new transportation syste ms and there is
tremendous investment now, part of its thanks to the Volkswagen settlement
when they made a mistake, basically saying they were selling really fuel
efficient diesel engine vehicles when they weren’t a s a result there is more
than two billio n that have been distributed across the U.S. states that are
supporting the shift to building, charging station, proactive vehicles and bring
in some great electric boxes .

W hen we make that shift in public transportation , y ou tend to be able to help
the in dividuals and communities that are most vulnerable, because it’s the
low income minority communities and it’s the young people that are most at -
risk to air pollution. I f you can get clean transportation systems, you are
looking at tremendous opportunities to improve public health . So while the
U.S. companies maybe barking that they don’t want to do a standards and
meet standards overtime that they actually help to negotiate, it’s important
before this administration. They are doing very well in the marketpl ace, we
are seeing renewable energy jobs are growing in the fastest in any sector, we
are seeing twice as many folks working in solar and wind than we ever have
seen in our coal industry. It’s not just the faculty at Harvard that I hang
around with that ar e very smart students get it. They want a different way of
doing business . G ood things are happening in the real world.

Margaret Flinter: Gina, you have spent almost four decades working on environmental
policy and I want to go back to this C - CHANGE, the C enter for Climate, Health
and the Global Environment at Harvard which just sounds like a tremendous
partnership. And I understand it’s between Harvard and Google and that part
of your focus and your opportunity there is you have got a level of data and
kno wledge in the form of that data that you may never have had access to
before, even you know back at EPA. So tell us about the initiative?

Gina McCarthy: Businesses by Google are realizing that they have to really invest in
their business. But they also hav e to think about the reputation and t hey
have to be part of these broader solutions. Google has been working with
Harvard University, because we have a great program on healthy buildings.
Green buildings are great but the tighter you make a building the mo re you
hold the air within it. An individual spend an exorbitant amount of their time

Gina McCarthy - C - CHANGE

indoors. S o the quality of the air indoors is extremely important . A s Harvard
was building new buildings and thinking about how to make their students
healthier, they wo uld have been thinking about how they not just build them
tighter, but also what does it mean for air quality within and for the
performance of those students and their health.

S o we have had a big program that’s now run at C - CHANGE, in addition to
working with the sustainability folks at Harvard to take a look at indoor air
quality. Google has been helping because there are new monitoring
technologies that can tell you what the quality of the air is. They are using
modern technology to tell you what a heal thy building is, so they can talk to
the HVAC system and make it all work together and provide an atmosphere
for your students that keep them just as smart and perform ing just as well as
the day they came in, if not better. We are developing building stand ards and
standards for products so that others can learn and we are doing all kinds of
research and buildings across the world.

W e are doing a variety of t asks at C - CHANGE. I want businesses to
understand why it’s a real benefit to go to green healthy buil dings. We want
to work with cities to tell them if you are buying electric buses , put them in
the places where the air quality is worse and need the m most. We are talking
about how you connect kids and climate and do research on connections that
we s ee bet ween kids and autism or seniors in dementia. We are looking at
women’s health issues and kid ’ s health issues and for those of the areas in
which we are trying to fill all the gaps, bring science to the table that will
inform more, but also that make it ver y personal and actionable for
individuals and families and businesses. I t’s just like the 60s, when I grew up
man, information is power. I want people to have that information and that’s
what C - CHANGE is all about.

Mark Masselli: We are speaking today with Gina McCarthy, Professor of the Practice of
Public Health at the Harvard T.H. Chan School of Public Health, and Director
of C - CHANGE, the Center for Climate, Health and Global Environment at
Harvard. She is the former administrator of the U.S. Environment al
Protection Agency under President Obama.

Q uestion comes to mind around battery storage, it seems to be the next
disruptive technology in the power sector and low cost storage could
transform the power landscape and there are lot of folks thinking about it .
W hat excites you in this world where we are trying to move to renewables
but we know what of the big issues that we have to overcome are really
focusing on the whole issue around technologies around batteries.

Gina McCarthy: You are absolutely right ; b atteries have become the place where it
can stop pro gress from happening but also the incredible place where it
opens up tremendous new opportunities. When I left the administration I
joined as an advisor to a private equity firm in New York City called Pe gasus
Capital Advisors. I really had never worked in the business sector before and I
think investment is where it’s at, companies like Pegasus focused on

Gina McCarthy - C - CHANGE

sustainability and wellness. For new technologies to blossom, if we can shift
our investment there an d businesses are really jumping into this, because
they understand the world is not just is changing, but needs to change a nd
that a low carbon future is really where its at, and they would love to attract
the best students and the best employees ever, to go to their firm and to do
that they have to really be understand the equities and the issue that
surround us.

O ne of the things I know about now that I never did before is the Bloomberg
New Energy Outlook, who to figure that I would ever be reading or thi nking
about things like this. But it just happens to speak to this very issue because it
talks about not just cheap renewable generation making a huge impact, but
falling battery cost. T here is opportunity is huge, $500 billion or more is
plan ned to be inv ested in battery capacity by the middle of this century
globally. And that’s going to make a huge difference in the world because it
allows more renewable energy to be where you need it empowering where
you want it.

With the EPA and the Department of Envi ronmental Protection that I have
worked on, they are all about public health. We love birds and bunnies, but
they are not our measure of success. And I think energy because of it’s
connection with fossil fuels and its potential huge impact not on the plane t
but on our public health, energy matters, just like clean air matters. And if
you can think about both at the same time then you can actually look to a
public health lens to identify most important benefits that we can provide to
public health and that w ill not only keep people healthy, but it will raise our
ability to give people an opportunity to live healthy lives. You began with
Maria’s understanding that 9 million people at least die every year from poor
air quality, what you may not realize is that over 90% of that damage
happens in middle and low income countries. We know that we have to do
better.

Mar garet Flinter : We have been speaking today with Gina McCarthy, Professor of the
Practice of Public Health at the Harvard T.H. Chan School of Public He alth and
Director of C - CHANGE, the Center for Climate, Health and the Global
Environment at Harvard. You can learn more about their work by going to
www.harvard.edu/c - change or follow her on Twitter @HarvardC CHANGE .
G ina, thank you so much for your commitment to making a better world and
thank you so much for joining us on Conversations on Healthcare, today.

Gina McCarthy : Thank you so much.

[Music]

Mark Masselli: At Conversations on Healthcare, we want our au dience to be truly in the
know, when it comes to the facts about healthcare reform and policy . Lori
Robertson is an award - winning journalist and Managing Editor of
FactCheck.org, a non - partisan, nonprofit consumer advocate for voters that
aim to reduce the level of deception in U.S. politics. Lori, what have you got

Gina McCarthy - C - CHANGE

for us this week?

Lori Robertson: We have recently published our second quarterly update for 2018 for
a feature we called Trump’s Numbers. One measure we examined is the
number of people without health insurance, the number of the uninsured
went up only somewhat under Trump but millions are expected to drop or
lose coverage next year and in subsequent years. The most recent report
from the National Health Interview Survey estimates that 29.3 mill ion people
were uninsured during 2017. That’s an increase of 700,000 people from 2016.
But it’s still 19.3 million fewer that were uninsured in 2010, the year
President Obama signed the Affordable Care Act.

Polling by the Gallup organization found a larger increase estimating that 3.2
million Americans entered the ranks of the uninsured in 2017. Trump failed
to repeal and replace the Affordable Care Act as he promise d to do. But in
December he signed a tax bill that will end Obamacare tax penalty for people
who failed to obtain coverage. At that point Trump told reporters that
“Obamacare is finished, it’s dead, it’s gone” but that’s not so, the mandate
penalty remains in effect until 2019. The number of people signing up in
December through the ACA exchanges for coverage in 2018 dropped only
slightly to 11.8 million, that’s down from 12.2 million in 2017 and 12.7 million
in 2016. That’s according to the government’s final enrolment report
rd
released April 3 , according to an estimate by the nonpartisan Congres sional
Budget Office, the end of the mandate penalty next year will cause 4 million
people to lose or drop coverage in 2019 rising to 12 million, 2 years later and
13 million in 2025.

CBO said that ending the mandate would cause average policy premiums for
those buying individual market policies to rise 10% in most years. That’s
because healthier people would be less likely to buy insurance causing overall
premiums to rise and then more people to not get insurance. And that’s my
factcheck for this week ; I a m Lori Robertson, Managing Editor of
FactCheck.org.

Margaret Flinter: FactCheck.org is committed to factual accuracy from the country’s
major political players and is a project of the Annenberg Public Policy Center
at the University of Pennsylvania. If you have a fact that you would like
checked, email us at www.chcradio.com , we will have FactCheck.org’s Lori
Robertson, check it out for you, here on Conversations on Healthcare.

[Music]

M ark Masselli : Each week C onvers ations highlights a bright idea about how to make
wellness a part of our communities and everyday lives. In the emergency
room or the ICU clinicians are confronted with a myriad of unpredictable
medical crisis that sometimes can be challenging to diagnose -- .

Male: Especially if you are in a busy Tertiary care hospital and it’s 04:00 in the
morning and there is almost nobody else to talk to, and that’s the existential

Gina McCarthy - C - CHANGE

dread of medicine, to be able to stand next to a patient and know that you
need to help th em but you can’t because you don’t have the knowledge you
need in the moments you need it .

Mark Masselli: ICU physician Dr. Joshua Landy was noticing a growing trend of image sharing
via smartphones to crowdsource second opinions from friends and
colleague s across the country. But he also was concerned about the potential
violation of HIPAA regulations. So he developed an app for that, he created
Figure 1, a sort of Instagram for doctors in which images can be shared across
a dedicated social media platform that would allow input from clinicians
within their network.

Joshua Landy: And what the network does is it lets you take a picture of a case and submit it
for conversation for learning, for teaching. I f it’s something you have never
seen before and you wa nt to record it, you take a picture of it something you
need help with, you take a picture.

Mark Masselli: Doctors are using the app to communicate not only with colleagues within
their hospital settings but around the world where someone might have
superi or expertise with a certain condition.

Joshua Landy: A nurse in Haiti put up a picture of a little baby. So once baby was born with
unusual skin condition, she didn’t know what it was and if it was safe to let
the baby live. So she put up a picture of an o ld Figure 1 and within a few
hours, 16,000 people like logged hundreds of responses and the one that was
wrote at the top and agreed upon was from a pediatric resident in
Vancouver. And what that means is we can change what is the traditional
way of a pati ent accessing medical care.

Mark Masselli: Dr. Landy sees the potential for this platform only growing as more young
digital natives enter the medical workforce.

Joshua Landy: It’s not just the workflow that we design for in healthcare but also thinking
ab out the way we learned. We are learning every time we see a new case,
right education and clinical practice are meaningfully connected.

Mark Masselli: A free downloadable app offering secure HIPAA complain t image sharing
among clinicians around the world, tapping the collective expert instantly.
Now that is a bright idea.

[Music]

Mark Masselli: You have been listening to Conversations on Healthcare. I am Mark Masselli.

Margaret Flinter: And I am Margaret Flinter.

Mark Masselli: Peace and health.

Moderator: Conversations on Healthcare is recorded at WESU at Wesleyan University,
streaming live at www. chcradio.com , iTunes or wh er ever you listen to
podcast. If you have comments please email us at [email protected]

Gina McCarthy - C - CHANGE
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