Supporting Military Readiness and Training through Environmental Conservation

Last week, the Obama Administration announced a new federal, local, and private sector collaboration that will preserve agricultural lands and restore and protect wildlife habitat, all while helping to sustain military readiness. 

Known as the “Sentinel Landscapes” partnership, the effort is kicking off with a pilot at Joint Base Lewis-McChord, an important training facility for our troops in the South Puget Sound region of Washington State, and home to some of the last remaining native prairie habitat for wildlife in the state. 

This unique convergence of landscapes comes with unique challenges. Namely, as development comes closer and closer to the base, at-risk species in the area take refuge in the only land that can’t be developed, the military base itself. The presence of these species can then bring restrictions to the base’s ability to engage in certain training activities.

In a unique collaboration, the U.S. Department of Agriculture, the U.S. Department of Interior, and the Department of Defense will work together and with private landowners and state and local partners, including the non-profit Center for Natural Lands Management, to preserve and restore habitat around the base to ensure at-risk species can survive, while also improving military readiness by ensuring training activities can proceed unimpeded.

Safeguarding our Environment for Health and Fighting Climate Change

Dr. William Rom is being honored as a Champion of Change for him work on the front lines to protect public health in a changing climate.

As author of Environmental Policy and Public Health: Air Pollution, Global Climate Change, and Wilderness and an instructor on environmental and global health at New York University for 25 years, I have reached dozens of policy students and medical residents and fellows.  I have been involved in air pollution policy for the past decade, leading the American Thoracic Society’s Environmental Health Policy Committee, presenting data to the Clean Air Scientific Advisory Committee and meeting with the EPA Administrator to encourage stricter standards ground level ozone and particulate matter to protect human health. I delivered Medical Grand Rounds on Climate Change and Global Public Health to international meetings and medical schools from New York to Addis Ababa, Ethiopia and Cape Town, South Africa. I traveled by dogsled with the Thule Inuit in northwestern Greenland in 2008, where I found that the ice was melting faster than ever before with four more months of open seawater compared to 30 years ago. I have canoed the major Arctic Rivers including the Albany, Churchill, Back and South Nahanni.  As a Fellow for two decades at The Explorer’s Club, I have been awarded four Flag expeditions, including travel with the Thule Inuit by dogsled in northern Greenland to obtain eyewitness accounts of the effects of global warming. To inform my professional colleagues, I have organized symposia on the topic for pulmonary doctors over the past decade. Currently, Dr. Kent Pinkerton and I are co-editing a textbook on Climate Change and Global Public Health. 

Climate change is projected to exacerbate heat waves and interactions with air pollutants to increase cardiorespiratory mortality. Hurricanes may become more frequent and intense, but most worrisome are potential storm surges that can cause widespread damage. New York University and Bellevue Hospitals, where I work, are still recovering from Hurricane Sandy’s 13-foot storm surge. The salt water damaged hospital electrical infrastructure in the basements of both hospitals, and we were forced to relocate for three months. This resulted in patient evacuations and required the salvage of many thousands of research samples.

As Director of NYU’s Division of Pulmonary, Critical Care, and Sleep Medicine and Bellevue Hospital’s Chest Service for 25 years, I have witnessed environmental medicine first hand. When air pollution particulates and ground-level ozone increase, we admit more asthma patients and chronic obstructive pulmonary disease patients in our Chest Service and ICU. 

I am also interested in the “smoky houses” problem from indoor biomass burning and have recently chronicled this challenge in photos from Ethiopia and Madagascar.  At Addis Ababa’s Black Lion Hospital I served as faculty, training their first two pulmonary fellows.  We observed lung disease, pneumonia, and lung cancer from indoor air pollution.

I served as a legislative fellow in health and environmental policy in the U.S. Senate for Senator Hillary Rodham Clinton.  For her, I wrote the Caribbean Wilderness Act (signed into law by President Bush), the Family Asthma Act, the Environmental Public Health Tracking Act, and the Electronic Medical Record and Health Quality Act.  I served on the Environmental Roundtable for Research and Education in the Environmental Health Sciences of the Institute of Medicine and am on CDC’s WTC Health Program Scientific/Technical Advisory Committee. 

Through all of my work, I’ve found it is critical to reach a larger stage on climate change and explain how its consequences affect our health.

Dr. William Rom is Director of the New York University Pulmonary Division and Bellevue Hospital Chest Service.

Healthy Air, Healthy Kids

Dr. Yadira Caraveo is being honored as a Champion of Change for her work on the front lines to protect public health in a changing climate.

Growing up in Colorado, you learn to appreciate clear blue skies and fresh mountain air – until the smog settles into the bowl-shaped Denver metro area, and suddenly the view isn’t so pretty.  During our training medical professionals like me don’t receive much education on the potential health effects of what humans put into the air.  We learn about bioterrorism, the negative effects of the food we put into our bodies, and the lung diseases affected by things as varied as keeping pigeons to popping too much popcorn.  But we never really learn about the cloud of “smog” sitting over Denver and how it will affect our patients. 

Upon graduating from medical school, I moved to Albuquerque, New Mexico to complete my training in pediatrics.  Albuquerque is another bowl-shaped city flanked by mountains, where bad air can settle and linger for days.  Living near the extinct volcanoes on the city’s west side, I could see the occasional cloud of smog settled over the city as I would drive into work.  On those days I knew what I would see all day at my shift in the emergency department, the children’s ward, or the urgent care clinic: asthma exacerbations.  On days where a brown blanket covered the desert city, I knew I’d be ordering a lot of albuterol, a medicine to help people breathe easier, putting kids on oxygen, and speaking to respiratory therapists.  It would be a day of seeing children struggle just to breathe. 

The focus on child advocacy drew me to residency in New Mexico.  I was interested in learning about how to interact with politicians and candidates, advocate for increased healthcare access in a poor state, and protect the public programs my patients relied on.  I was selected as a resident leader by the National Hispanic Medical Association and an intern in legislative affairs by the American Academy of Pediatrics.  I spent time in Washington with both groups and connected with members of the Union of Concerned Scientists (UCS) and Voces Verdes.  I participated in a conference on the public health concerns caused by emissions from coal-fired power plants and finally learned what I hadn’t been taught in medical school. 

As a Latina, I am naturally drawn to Latino health issues.  Nearly 50 percent of Latinos live in counties that regularly violate the ground level ozone, or smog, standards set by the Environmental Protection Agency, even though our standards for clean and safe air should be even stronger.  EPA estimated that further lowering the level of ozone considered safe would prevent thousands of asthma exacerbations, heart attacks, missed days of school, and hospital visits and deaths.  Obviously clean air affects everyone, but children are at a higher risk of these health effects than the adults who have the power to control pollution.  Due to young children’s size, faster heart rates, and immature systems, their lungs and brains are particularly vulnerable to toxins in our air, water, and environment.  Exposure at an early age could spell years of chronic illness and an impaired ability to learn, play, and work.  Through UCS and Voces Verdes, I advocated for tightening emission standards for coal-fired power plants, and I continue to raise awareness about the health effects of climate change and air pollution. 

Since leaving residency and starting private practice in Colorado, my advocacy efforts have shifted in part to local healthcare access issues in my hometown county and streamlining the referral system for children at risk of physical and cognitive delays due to various issues.  But every time I drive down the hill into Denver and see the brown cloud hanging over the city, I worry for my patients and think of what else we can do to ensure that our children are not just eating healthy, growing, and learning but breathing safe air. 

Dr. Yadira Caraveo is a General Pediatrician.