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David Fidler, senior fellow for global health and cybersecurity at CFR, discusses the factors shaping U.S. health and climate policy included in his Council Special Report,\xa0A New U.S. Foreign Policy for Global Health.\xa0Penelope Overton, climate reporter at the\xa0Portland Press Herald, speaks about her experiences reporting on climate and environment stories in Maine and their intersection with public health outcomes. The host of the webinar is\xa0Carla Anne Robbins, senior fellow at CFR and former deputy editorial page editor at the\xa0New York Times.\xa0\n\nTRANSCRIPT\n\nFASKIANOS: Thank you. Welcome to the Council on Foreign Relations Local Journalists Webinar. I\u2019m Irina Faskianos, vice president for the National Program and Outreach here at CFR.\n\nCFR is an independent and nonpartisan membership organization, think tank, and publisher focused on U.S. foreign policy. CFR is also the publisher of Foreign Affairs magazine. As always, CFR takes no institutional positions on matters of policy.\n\nThis webinar is part of CFR\u2019s Local Journalists Initiative, created to help you draw connections between the local issues you cover and national and international dynamics. Our programming puts you in touch with CFR resources and expertise on international issues and provides a forum for sharing best practices. We\u2019re delighted to have over thirty-five participants from twenty-two states and U.S. territories with us today, so thank you for joining this discussion, which is on the record. The video and transcript will be posted on our website after the fact at CFR.org/localjournalists.\n\nSo we are pleased to have David Fidler, Penelope Overton, and host Carla Anne Robbins to lead today\u2019s discussion on \u201cClimate Change and Public Health Policy.\u201d\n\nDavid Fidler is a senior fellow for global health and cybersecurity at CFR. He is the author of the Council special report A New U.S. Foreign Policy for Global Health. Professor Fidler has served as an international legal consultant to the World Bank, the U.S. Department of Defense, the World Health Organization, and the U.S. Centers for Disease Control and Prevention. And his other publications include The Snowden Reader, Responding to National Security Letters: A Practical Guide for Legal Counsel, and Biosecurity in the Global Age: Biological Weapons, Public Health, and the Rule of Law.\n\nPenelope Overton is the Portland Press Herald\u2019s first climate reporter. She\u2019s written extensively on Maine\u2019s lobster and cannabis industries. She also covers Maine state politics and other health and environmental topics. In 2021, she spent a year as a spotlight fellow with the Boston Globe exploring the impact of climate change on the U.S. lobster fishery. And before moving to Maine, Ms. Overton covered politics, environment, casino gambling, and tribal issues in Florida, Connecticut, and Arizona.\n\nAnd, finally, Carla Anne Robbins is a senior fellow at CFR and cohost of the CFR podcast The World Next Week. She also serves as the faculty director of the Master of International Affairs Program and clinical professor of national security studies at Baruch College\u2019s Marxe School of Public and International Affairs. And previously, she was deputy editorial page editor at the New York Times and chief diplomatic correspondent at the Wall Street Journal.\n\nSo thank you all for being with us. I\u2019m going to turn the conversation over to Carla to run it, and then we\u2019re going to open up to all of you for your questions, which you can either write in the Q&A box but we would actually prefer you to raise your hand so we can hear your voice, and really open up this forum to share best practices and hear what you\u2019re doing in your communities. So with that, Carla, over to you.\n\nROBBINS: Thank you, Irina. And I\u2019m glad you\u2019re feeling better, although your voice still sounds scratchy. (Laughs.) Welcome back.\n\nSo, David and Penny, thank you for doing this. And thank you, everybody, for joining us here today.\n\nThis is\u2014Penny, at some point I want to get into the notion of covering cannabis and lobsters because they seem to go very well together, but\u2014(laughs)\u2014and how you got that beat. But, David, if we can start with you, can you talk about the relationship between the climate and public health threats like the COVID pandemic? I think people would tend to see these as somewhat separate. They\u2019re both global threats. But you know, why would rising temperatures increase, you know, the emergence or spread of pathogens? I mean, are they directly driving\u2014one driving the other?\n\nFIDLER: Yes. I\u2019ll just give a quick public health snapshot of climate change as an issue.\n\nIn public health, the most important thing you can do is to prevent disease threats or other types of threats to human health. In the climate world, that\u2019s mitigation of greenhouse gas emissions. That hasn\u2019t gone so well.\n\nThat creates, then, the second problem: If you have\u2014if you\u2019re not preventing problems from emerging, threatening human health and the infrastructure that supports human health, then you have to respond. And that\u2019s climate adaptation. And in climate adaptation, we deal\u2014public health officials and experts are going to have to deal with a range of issues. Close to if not at the top of the list is the way in which the changing nature of the global climate through global warming could increase\u2014and some experts would argue is increasing\u2014the threat of pathogenic infections and diseases within countries and then being transmitted internationally.\n\nAnd this leads to a concern about what\u2019s called a one health approach because you have to combine environmental health, animal health, and human health to be able to understand what threats are coming. And climate change plays\u2014is playing a role in that, and the fear is that it will play an even bigger role.\n\nComing out of the problems that we had with dealing with the COVID-19 pandemic, this also fills public health officials with alarm because we didn\u2019t do so well on that pathogenic threat. Are we ready to deal with potential pathogenic threats that global warming exacerbates in addition to all the other health threats that are going to come with climate change?\n\nROBBINS: So can we just drill down a little bit more on that, as well as a variety of other health threats from climate change? So, like, with malaria, like, more water; water, you know, pools; mosquitoes; malaria spreads itself. With COVID, there was this whole question about, you know, loss of jungles, and maybe animals come in closer to humans, and things spread that way. Can you talk some more about what changes happen to the world around us that\u2014with climate change that could increase the possibility of people getting sick, as well as other stresses on our bodies?\n\nFIDLER: Yes. In terms of vector-borne diseases such as malaria or dengue fever, the concern is that as global warming happens the area in which the vectors that carry these diseases will expand. So if you have malaria-carrying mosquitoes, if global warming is expanding the range of possibilities for those mosquitoes to inhabit, then there\u2019s a(n) increased public health threat from those vector-borne diseases. If you have a situation in which that global warming is also happening in connection with waterborne diseases, it\u2019s both the excess amount of water that you might have with flooding as well as potential shortages of water that you have could also increase the threat of waterborne diseases. So global warming has these effects on potential pathogenic threats.\n\nDeforestation is a concern in connection also with humans coming more into contact with pathogens that we haven\u2019t experienced before. Unfortunately, we still don\u2019t really know what the origin of the COVID-19 virus was, largely because of geopolitical problems. But also, as global warming affects forested areas or other types of ecosystems, the possibility for pathogens to emerge and effect public health increases.\n\nROBBINS: And then there are other effects, like loss of access to water, and rising heat, and all these other things which are part of\u2014because I would suppose that in a lot of places, you know, people would think, well, you know, I live in Kansas; I\u2019m not going to be really worried about loss of a jungle or something of that sort. So in the United States, if you\u2019re a public health official, and you haven\u2019t thought about climate change as a\u2014as a public health issue, and you want to go make the pitch, what would you say that\u2014how climate is already potentially affecting people\u2019s health?\n\nFIDLER: Yes, and this is one of the most interesting policy challenges about climate adaptation. Different areas of every country are going to experience climate change differently. So in some parts it might be wildfires. In another part it might be extreme heat. In another part it might be the spread of vector-borne diseases. And in other\u2014in coastal areas, you know, sea level rise. In other areas, shortage of water because of drought. And so for any given locality, right, there could be diverse and different effects of climate change on public health from even a neighboring state or certainly a state, you know, across the country.\n\nCity and county public health officials and state public health officials are already trying to start to get their head around the types of threats that their communities are going to face. And that\u2019s what\u2019s going to be interesting to me about today\u2019s conversation, is how those types of effects are being discussed at the local level. A critical principle that\u2019s usually put in\u2014on the table for any policy discussion, whether it\u2019s foreign policy or local policy, is that if you don\u2019t have community buy-in, you don\u2019t have community commitment to dealing with some of these problems, the policy solutions are going to be far more difficult.\n\nROBBINS: So, Penny, you are new\u2014reasonably new to this beat, and your newspaper created this beat, which is\u2014you know, which is a sort of extraordinary thing. I mean, how big is your newsroom?\n\nOVERTON: I think it\u2019s about fifty people\u2014\n\nROBBINS: And the notion\u2014\n\nOVERTON: \u2014if you include, you know, sports reporters and everybody.\n\nROBBINS: So the notion that they would\u2014maybe your newspaper\u2019s the rare local newspaper that\u2019s doing really well, but most local newspapers are, you know\u2014(laughs)\u2014are battling these days. Why did they decide that they wanted to create a climate beat?\n\nOVERTON: I think that our readers were asking for it. I mean, everybody\u2014I think you find that every newspaper is writing climate stories, you know, in some way, even if it\u2019s just running wire\u2014like, national wire stories. And of course, papers are and every news outlet is obsessed with metrics, and we know what readers are looking for. Sometimes the stories aren\u2019t necessarily labeled climate, but they are, you know, climate-related. And so in trying to sort out during a general newsroom kind of reshuffle about what readers, especially what our online readers\u2014since that\u2019s where everything is kind of moving towards\u2014what they were really looking for, climate was one of the topics that kind of rose to the top.\n\nAnd then also we\u2019re part of a newspaper family in Maine where there\u2019s a\u2014you know, every\u2014a lot of weeklies, several dailies that all belong under one ownership. It\u2019s actually a nonprofit ownership now, as of about a year ago. So I don\u2019t think it\u2019s a coincidence that it went nonprofit at the same time that they decided to do a climate beat. But one of the topics that unite all of the papers across a really, you know, far-flung state with the areas where you have really well-off people that live along the shore, people who aren\u2019t so well-off in the interior, there\u2019s not a lot that sometimes unites our state, but everybody was interested in this from the fishermen\u2014who may not want to call it climate change, but they know that things are changing and it\u2019s impacting their bottom line; to the loggers up north who can\u2019t get into their\u2014you know, their forest roads are now basically mud season for much longer than they used to be, they\u2019re not frozen anymore for as long as they were so they can\u2019t get in and harvest the way that they were; farmers. I mean, the three Fs in Maine\u2014forestry, farming, and fishing\u2014are, you know, pretty big, and they all care immensely about climate because they know it\u2019s affecting their bottom line. So I think that that really united all of our newsrooms.\n\nROBBINS: So can you talk a little bit more about that? Because I\u2014you know, you\u2019ve lived in places other than Maine, right? I mean, I used to live in Miami, and it\u2019s really hot in Miami these days. And the New York Times had this really interesting interactive a couple of years ago in which you could put in the year you were born and your hometown, and it would tell you how many more days of the year would be over 90 degrees. And it was just wild how many more days in Miami it would be. I mean, it\u2019s pretty hot in Miami, but many more days now than it was. And you\u2019ve seen already this spring how bad it is in Miami.\n\nSo I think to myself, Maine. I mean, Maine\u2014I went to school in Massachusetts; I know what Maine is like. So I would think that Maine would be\u2014it\u2019s going to take a while for\u2014you know, for it to come to Maine, but what you\u2019re saying is it\u2019s already in Maine. So can you talk about how\u2014you know, how it is? And, obviously, it\u2019s affecting Maine for them to create a beat like that. So what sort of stories are you writing?\n\nOVERTON: Well, I mean, Maine is definitely\u2014you know, its impacts are going to be different. The actual climate threats are different in Maine than they are, say, like in Arizona where I used to live and report. You know, but contrary to what you might think, we actually do have heatwaves\u2014(laughs)\u2014and we have marine heatwaves. The Gulf of Maine is warming faster than 99 percent of the, you know, world\u2019s ocean bodies, and so the warming is definitely occurring here.\n\nBut what we\u2019re seeing is that just because it\u2019s not\u2014the summer highs are not as high as, like, you know, Nevada, Arizona, Southern California, the Midwest, we also are completely unprepared for what\u2019s actually happening because nobody here has ever really had to worry about it. Our temperate climate just didn\u2019t make air conditioning a big, you know, high-level priority. So the increasing temperatures that are occurring even now are\u2014we don\u2019t have the same ability to roll with it. Warming stations in the winter? Yes, we have those. Cooling stations in the summer? No, we don\u2019t have those. And I mean, there are a few cities that are now developing that, but if you don\u2019t have a large homeless population in your city in Maine you probably don\u2019t have a public cooling station. It\u2019s really just the public library is your cooling station.\n\nSo some of those\u2014that kind of illustrates how sometimes it\u2019s not the public health threat; it\u2019s actually the public health vulnerability that a local reporter might want to be focusing in on. So you can go to the National Climate Assessment and you can pull up, like, exactly what, you know\u2014even if you don\u2019t have a state climate office or a climate action plan, you can go to one of those National Climate Assessments, drill down, and you can get the data on how, you know, the projected temperature increases, and precipitation increases, and the extreme weather that\u2019s projected for 2050 and 2100 in your area. And those might not be, you know, nightmare stuff the way that it would be for other parts of the country, but then you\u2019d want to be focusing in on how\u2014what the infrastructure in your state is like. Are you prepared for what will be happening?\n\nAnd I think the air conditioning thing is a really good example. Maine also happens to be, you know\u2014Florida will love this, but Maine\u2019s actually the oldest state as far as demographics go. And so you have a lot of seniors here that have been identified as a vulnerable population, and so with the combination of a lot of seniors, with housing stock that\u2019s old and doesn\u2019t have air conditioning, and that they\u2019re a long distance from hospitals, you know, don\u2019t always\u2014they don\u2019t have a lot of emergency responder capability, that\u2019s kind of a recipe for disaster when you start talking to your local public health officers who are going to start focusing in on what happens when we have extreme weather, and the power goes out, and these people who need\u2014are reliant on electricity-fed medical devices, they don\u2019t have access, they can\u2019t get into the hospital. You can see kind of where I\u2019m going with the vulnerability issue.\n\nROBBINS: David, Penny has just identified the sort of things that one hopes a public health official on a state, or county, or local town or city level is thinking about. But in your report, it says the United States faces a domestic climate adaptation crisis. And when we think about climate and adaptation, and when we look at the COP meetings, the international climate change meetings, the Paris meetings, we usually think about adaptation as something that we\u2019re going to pay for for other countries to deal with, or something of the sort. But can you talk about the concerns of our, you know, adaptation policies, and particularly state-level weaknesses?\n\nFIDLER: Yes, and I think Penny gave a nice overview of what, you know, the jurisdiction in Maine, you know, faces, and public health officials and experts are beginning to think about how do we respond to these new types of threats, which for most public health agencies and authorities across the United States is a new issue.\n\nThe data is getting better, the research is getting better. The problems that public health agencies face sort of a across the United States are, one, they were never really built to deal with this problem. Some of it overlaps, so for example, if you have increased ferocity of, you know, extreme weather events\u2014tornados, hurricanes\u2014public health officials in those jurisdictions that are vulnerable know how to respond to those. They work with emergency management. As the scale of those types of events increases, however, there is a stress on their capabilities and their resources. Other things are new\u2014air pollution from wildfire, the extreme heat of that; sea level rise, salination of drinking water from that; or even sinking in places where groundwater is being drawn out because of a lack of rainfall.\n\nPart of the problem that we have, that I talk about in my report coming out of COVID, is that among many issues today, the authority that public health agencies have at the federal and state level is polarized. We don\u2019t have national consensus about public health as an issue. So unfortunately, coming out of COVID, we\u2019re even less prepared for a pandemic as well as climate change adaptation. And that\u2019s something that we need to have better federal, state, local cooperation and coordination on going forward.\n\nAgain, it\u2019s going to be very different from dealing with a pandemic, or even dealing with a non-communicable disease like tobacco consumption or, you know, hypertension because of the diversity\u2014geographic\u2014as well as the particular problem itself. So this is going to be a real challenge for federal and public health agencies, which at the moment are in some of the weakest conditions that I\u2019ve seen in decades.\n\nROBBINS: Penny, how much do you have to deal with your local public health, state public health agencies? And do they have a climate action plan? How developed are they on this? You talked about going to a particular website. Do you want to talk a little bit about that, as well? The assessments that you are making, is that information that you\u2019ve gotten from your local public health agencies or from your state, or is this something that you yourself have come up with?\n\nOVERTON: Well, the state is\u2014I think that the state of Maine is actually pretty far down the road for its size. It\u2019s like punching above its weight, I guess, when it comes to climate. They have\u2014they published their first climate action plan in 2020, and they updated it with a\u2014kind of like how close are we coming to our goals in 2022, and then they\u2019re in the process of developing the next four-year kind of installment, which will be due out in December.\n\nSo the first one was kind of like\u2014to me as an outsider, it felt like a \u201cclimate change is happening, folks\u201d kind of report. In Maine we definitely\u2014we have a split. We have an urban, you know, core that\u2019s kind of\u2014it\u2019s liberal, and you don\u2019t have to convince those people. We have a lot of rural parts of the state where, if you ask, you know, is climate change real, you\u2019re still going to get a pretty good discussion, if not an outright fight. (Laughs.)\n\nBut one of the things that I\u2019ve found in this latest update is that, as they are focusing in on impacts, you get a different discussion. You don\u2019t have to discuss with people about why the change is happening; you can just agree to discuss the changes, and that pulls in more communities that might have not applied for any type of, you know, federal ARPA funds or even\u2014Maine makes a lot of state grants available for communities that want to do adaptation. So if you can get away from talking about, you know, the man-made contributions, which, I mean, I still include in every one of my stories because it\u2019s just\u2014you know, that\u2019s actually not really debatable, but as far as the policy viewpoint goes, if you can just focus in on the impact that\u2019s already occurring in Maine, you get a lot of people pulled into the process, and they actually want to participate.\n\nAnd I also have found that the two\u2014the two impacts in Maine of climate change that are most successful at pulling in readers\u2014(laughs)\u2014as well as communities into planning processes are public health and extreme weather. I don\u2019t know if it\u2019s, you know, all the Mainers love their Farmers\u2019 Almanacs\u2014I\u2019m not sure. I mean, I\u2019m originally from West Virginia. I still have a Farmers\u2019 Almanac every year, but I just kind of feel like extreme weather has been a wakeup call in Maine.\n\nWe got hammered with three bad storms in December and January that washed a lot of our coastal infrastructure away. And, I mean, privately owned docks that fishermen rely on in order to bring in the lobster catch every year, and that\u2019s a $1.5 billion industry in Maine. Maine is small\u20141.5 billion (dollars), that dwarves everything, so anything the messes with the lobster industry is going to have people\u2014even in interior Maine\u2014very concerned. And everybody could agree that the extreme storms, the not just sea level rise, but sea level rise and storm surge, nobody was prepared for that, even in places like Maine, where I think that they are ahead of a lot of other states.\n\nSo you start pulling people in around the resiliency discussion. I think you kind of have them at that point. You\u2019ve got their attention and they are willing to talk, and they\u2019re willing to accept adaptations that they might not be if you were sitting there still debating whether or not climate change is real.\n\nThe public health has been something that has really helped bring interior Maine into the discussion. Everybody does care. Nobody wants to lose the lobster industry because that\u2019s an income, like a tax revenue that you just wouldn\u2019t be able to make up any other way, even if you are in a Rumford or a Lewiston that have nothing to do with the shoreline. But public health, that unites\u2014that\u2019s everybody\u2019s problem, and asthma, and, you know, all of our natural resource employees who are out working in the forests, and the blueberry fields, and whatnot, extreme heat and heat stroke\u2014those things really do matter to them. They may disagree with you about what\u2019s causing them, but they want to make sure that they are taking steps to adapt and prepare for them. So I just have found public health to be a real rallying point.\n\nAnd I also think that, for local reporters, if you don\u2019t have a state action plan\u2014because even though Maine has one\u2014we\u2019re a lean government state\u2014they don\u2019t\u2014you know, they\u2019re still gathering data, and it can be pretty slim pickings. But you can go to certain things like the U.S. Climate Vulnerability Index, and you can start looking for\u2014drilling down into your local Census tract even. So you don\u2019t need something at your state. Even if you\u2019re in a state that, say, politically doesn\u2019t want to touch climate change with a ten-foot pole, you can still use those national tools to drill down and find out where your community is both vulnerable to climate threats, but then also the areas that are least prepared to deal with it. And then you can start reporting on what nobody else wants to write about or talk about even. And isn\u2019t that the best kind of reporting\u2014is you kind of get the discussion going?\n\nSo I think public health is a real opportunity for reporters to do that, and also your medical\u2014the medical associations. If you talk to doctors here at the Maine Medical Association, they may not want to talk about humanity\u2019s contribution to climate change, but they already know that climate change is posing an existing health risks to their patients, whether that be, you know, asthma, allergies, heat stroke, Lyme disease, or just mental health issues; whether you\u2019re a lobsterman worried that you\u2019re not going to be able to pay off that million-dollar boat because the lobsters are moving north, or if you are a young person who has climate fatigue. We don\u2019t have enough mental health providers as it is. Anything that\u2019s going to exacerbate a mental health issue in Maine, I mean, we don\u2019t have the tools to deal with what\u2019s already here. That\u2019s a gap that reporters feast on, right? We write about those gaps to try and point them out, and hopefully somebody steps in to resolve them.\n\nSo I rambled a bit, but there\u2019s\u2014I feel like this bee\u2014\n\nROBBINS: No, no, no, you\u2014\n\nOVERTON: \u2014it\u2019s like never like what stories\u2014boy, what stories can I write; it\u2019s more like how am I going to get to them all, you know, because I feel like everybody out there, even if you are not a climate reporter, I guarantee you there is a climate aspect to your beat, and there is probably a public health climate aspect to your beat. I mean, if you are a crime reporter, are your prisons\u2014(laughs)\u2014I mean, most prisons aren\u2019t air conditioned. Just think about the amount of money that\u2019s being spent to deal with heat stroke, and think about the amount of\u2014I mean, I\u2019m making this up as you go, but I guarantee you if you are a prison reporter, that you\u2019re going to find, if you drill down, you\u2019re going to see disciplinary issues go through the roof when you have a heat wave. That\u2019s what I mean by, like, you can find a climate story in any beat at a newsroom.\n\nROBBINS: That\u2019s great. I always loved the editors who had story ideas if they gave me the time to do them.\n\nDavid, can we go back to this\u2014the United States faces a domestic climate adaptation crisis? If I wanted to assess the level of preparation in my state to deal with some of the problems that Penny is doing, how do I do that? What do I look for\u2014climate action plans? Where do I start?\n\nFIDLER: Well, I think you would start at the\u2014you\u2019ve got to start both at the federal level, so what is the federal government willing to do to help jurisdictions\u2014local, county, state\u2014deal with the different kinds of climate adaptation problems that they\u2019re facing. And even as a domestic policy issue, this is relatively new. I think Penny gave a great description of how that has unfolded in one state. This is happening also in other jurisdictions. But again, because of the polarization about climate change, as well as fiscal constraints on any federal spending, how the federal government is going to interface with the jurisdictions that are going to handle adaptation on the ground is important\u2014state government planning, thinking, how they talk about it, how they frame the issue, do they have a plan, is it integrated with emergency management, is it part of the authority that public health officials are supposed to have, how is that drilling down to the county, municipal, and local level.\n\nAgain, it\u2019s going to be different if it\u2019s a big urban area or if it\u2019s a rural community, and so, as the impacts\u2014and Penny is right about it\u2014it\u2019s the impacts on human lives, direct and indirect, including damage to economic infrastructure, which supports jobs, supports economic well-being. That\u2019s a social determinant of health.\n\nAnd as I indicated, there are efforts underway, not only in individual states, but also in terms of networks of county and city health officials, tribal health officials, as well, for Native American areas\u2014that they\u2019re beginning to pool best practices. They\u2019re beginning to share information. So I would look not only at those governmental levels, but I would look at the networks that are developing to try to create coordination, cooperation and sharing of best practices for how to deal with different issues. So if you have a situation where you are like Penny described in Maine, you know, you really haven\u2019t had to have air conditioning before; now you\u2019ve got a problem. What are the most efficient and effective ways of dealing with that problem? Share information. Research, I think, is also ongoing in that context. And so there is a level of activism and excitement about this as a new, emerging area in public health.\n\nAgain, there are lots of constraints on that that have to be taken seriously. At some point, it\u2019s just also a core principle of public health and epidemiology that you need to address the cause of these problems. And if we still can\u2019t talk about climate change and causes for that, this problem is only going to metastasize in our country as well as the rest of the world. And there are not enough public health officials at the state, county, local level, and there\u2019s not enough money if we don\u2019t try to bring this more under control. That\u2019s mitigation. We\u2019ve squandered four decades on this issue. We have no consensus nationally about that question, and so that just darkens the shadow in, you know, looking forward in terms of what public health officials are going to have to handle.\n\nROBBINS: So I want to throw it open to our group, and if you could raise your hand. We do have a question already from Aparna Zalani. Do you want to ask your question yourself, or shall I read it?\n\nQ: Can you guys hear?\n\nROBBINS: I will\u2014I\u2019m sorry. Yes, please.\n\nQ: OK, yeah, basically I just wanted to know if you guys know if anybody is collecting good heat-related death data\u2014data on heat-related deaths.\n\nROBBINS: And Aparna, where do you work?\n\nQ: I work for CBS News.\n\nROBBINS: Thank you.\n\nOVERTON: I\u2019m just looking through my bookmarks because, yes\u2014(laughs)\u2014there are. I know that those are factored into Maine\u2019s climate action plan, and I can guarantee you that is not a Maine-only stat. That would be coming from a federal\u2014there\u2019s just not enough\u2014the government here is not big enough to be tracking that on its own. It is definitely pulling that down from a federal database. And I\u2019m just trying to see if I can find the right bookmark for you. If you\u2014and I\u2019m not going to because, of course, I\u2019m on the spot\u2014but if you add your contact information to the chat, or you can send it, you know, to me somehow, I will\u2014I\u2019ll send that to you because there is, and it\u2019s a great\u2014there\u2019s emergency room visits, and there are other ways. They actually break it down to heatstroke versus exacerbating other existing problems. It\u2019s not necessarily just\u2014you don\u2019t have to have heatstroke to have, like, say, a pregnancy complication related to heat illness, or an asthma situation that\u2019s made far worse. So they do have, even broken down to that level.\n\nFIDLER: And when I\u2019m often looking for aggregate data that gives me a picture of what\u2019s happening in the United States, I often turn to the U.S. Centers for Disease Control and Prevention, CDC. And so they\u2019re often collecting that kind of data to build into their own models and their research, also in terms of the assistance that provide state and local governments on all sorts of issues. And because adaptation is now on the radar screen of the federal public health enterprise, there might be data on the CDC website.\n\nAnd then you can identify where they are getting their sources of information, and then build out a constellation of possible sources. Again, it\u2019s something\u2014there\u2019s the National Association of City and County Health Officers\u2014NACCHO is the acronym\u2014that, again, it\u2019s one of those networks where you could probably see those health officers that are having to deal with extreme heat and the morbidity and mortality associated with that. There could be data that they are generating and sharing through that sort of network.\n\nAnd on the\u2014\n\nOVERTON: And one thing I would add\u2014\n\nFIDLER: Sorry. Drilling at the global level, WHO would be another place to think about looking if you wanted a global snapshot at data.\n\nOVERTON: I was going to add that will probably be underreported, as well, because in talking to, like, say\u2014because, I mean, we\u2019re just ultra-local, right\u2014talking to the emergency room directors at our hospitals, there are\u2014the number of cases that might come in and really should be classified as heatstroke, but then end up being listed instead in the data, you know, in the documentation as, like, a cardiac problem. You know, it\u2019s\u2014I think you are limited to how quickly someone on the ground might identify what\u2019s coming in as actually being heat-related versus like just whatever the underlying problem was. They might list that instead.\n\nAnd the other thing, too, is to make sure that\u2014this is the hardest part about climate reporting is the correlation aspect versus causation. You\u2019re going to mostly be finding, look, heat waves are\u2014when we have heat waves, you see this spike. You have to be really careful because it could be that the spike that\u2019s coming in emergency rooms is actually because there was also a power outage.\n\nNow I would argue extreme weather still adds that\u2014you know, makes that linked, but you have to be careful about making sure you don\u2019t jump from correlation to causation. I\u2019m sure you know this, but it\u2019s the same thing with every statistic, but sometimes my first draft of a story I\u2019m like, oh, look at that. I just made climate change responsible for everything. (Laughter.) And I have to go back and like, you know, really check myself because the minute you overstep in any way is the minute that you, like, lose all credibility with the people out there who are already skeptical.\n\nFIDLER: And this is sort of\u2014it\u2019s often where adaptation becomes a much more complicated problem for public health officials because there are underlying health problems that have nothing to do with climate change, that when you meet, you know, warming, extreme temperatures or even, you know, problems with, you know, sanitation, or water, or jobs, it can manifest itself in very dangerous diseases or health conditions that then lead to hospitalization and to biased statistics.\n\nSo what Penny is saying is absolutely right, and there needs to be care here, but from a public health point of view, this is why this is going to be a monster problem.\n\nROBBINS: Can we just\u2014because we have other questions, but talking about bookmarks, Penny, you had\u2014when you were talking before, you went through some other places that you go to for data and information. Can you just repeat some of those you were talking about?\n\nOVERTON: Yeah, the National Climate Assessment, the U.S. Climate Vulnerability Index, good old Census Bureau. (Laughs.) I mean, there are a couple of\u2014the other thing, too, I would say that if you are in a state that doesn\u2019t have\u2014say that public health officers are under intense pressure not to talk about climate change, still go to your local university because I guarantee you that there are grad students, you know, coming in from the blue states someplace that might be going to school in a red state, but they\u2019re going to be studying those topics, and they are going to be collecting data. I, you know\u2014geez, countless stories based on grad student work. So I would keep those folks in mind, as well.\n\nAnd the other thing is that, if we\u2019re talking about public health, I always think of public health and climate in three ways. It\u2019s the threat, you know, the actual increase, something like tick-borne illness if you are Mainer because we never had ticks here really before because our winters were so awful, and the ticks couldn\u2019t last. Well, now they\u2019re here, and Lyme disease has gone through the roof. So I think about it\u2014that\u2019s like a threat.\n\nAnd then there\u2019s the vulnerability issue that I was mentioning. But there\u2019s also the accountability issue\u2014is that you want to make sure as a reporter that you are following the infrastructure money that\u2019s coming through, and that they are actually going to the places that need it the most. And public health is something that I think is a good lens to look at that. If all your money is going into the shoreline communities in Maine because they\u2019re the ones with grant officers that are writing the grant applications to get the infrastructure money, do they really need it, or is it that town in the middle of the state with no grant officer, and huge public health needs and vulnerabilities that really need it.\n\nSo I would think about public health as being an important accountability tool, as well, because if you\u2019ve got public health data, you can easily point out the communities that need that money the most, and then find out who is actually getting the cash.\n\nROBBINS: So Debra Krol from the\u2014environmental reporter from the Arizona Republic, you had your hand up.\n\nOVERTON: I love your stories, Deb.\n\nQ: Thank you very much. Just a brief aside before I ask the question because I know we\u2019re running short on time.\n\nWe did a story here a few months ago about a nonprofit group that\u2019s helping these underserved communities obtain grants and do the grant reporting, and I remembered something that we learned at a local journalist get-together at CFR, so that\u2019s what influenced me to do that. So kudos to our friends over there.\n\nBut my question is, is data sharing between agencies\u2014you know, we\u2019re always trying to get statistics out of the Indian Health Service, and every other state that has tribal communities or tribal health has the same problem. So how much of these stats do you think are actually coming from tribal health departments?\n\nOVERTON: I know in Maine they are coming. In fact, Maine\u2019s five federally recognized tribes are kind of blazing a path as far as looking for grant applications. And of course, once they apply for a grant, you could go through all that data when they\u2019re looking to justify the need, right? And that will help you in just getting the, you know, situation on the ground.\n\nBut I\u2014yes, I mean, I don\u2019t know about whether there may be certain parts of the country where that\u2019s not leading the way, but also\u2014I would also urge you to look at\u2014go through the Veterans Administration, as well, just because I\u2019m sure that, you know, that there\u2019s a large overlap between Indian Health Services, BIA, and the VA. And it\u2019s the way the VA provides public health care and the outcomes they get when they are serving indigenous veterans are far different than what Indian Health Services and BIA sometimes get. And they are more forthcoming with their data.\n\nFIDLER: I know that one of the issues that\u2019s on my list to do some more research for my foreign policy analysis is to look at the way the federal governments, state governments, and tribal authorities interact on climate adaptation. And that comes loaded with lots of complicated problems\u2014just the history of relations between tribes and the federal government, the concerns that the Indian Health Service has about problems that have been around for decades, layering on top of that adaptation. So some of it, I think, gets involved in just political disputes between tribes and the federal government. Some of the data-sharing problems I think relate to a lack of capabilities to assess, process, and share the data.\n\nThe tribal authorities are on the list, at least, of the federal government\u2019s radar screen for improving how they do adaptation. I personally think that how that jurisdictional tension is resolved could be a very valuable model for thinking about U.S. foreign policy and how we help other countries in adaptation.\n\nI also think there is variable experiences between tribal authorities and the federal government. A lot of activity is happening in Alaska with adaptation that I think is more advanced than it is with some of the tribal authorities\u2019 relations with the federal government in the continental United States. So we just also need to start looking, you know, beyond for best practices, principles, ways of making this work better as adaptation becomes a bigger problem.\n\nROBBINS: Debra is\u2014Debra Krol is offering to speak with you offline. She has some recommendations on research. Debra, thank you for that.\n\nQ: You are welcome.\n\nROBBINS: And for the shoutout.\n\nGarrick Moritz, an editor of a small town newspaper in South Dakota. Can you tell us the name of your paper and ask your question?\n\nQ: Yeah, I am the Garretson Gazette. Hello, if you can hear me.\n\nROBBINS: Absolutely.\n\nQ: Oh, yeah, we just get frequent\u2014we get frequent notifications from the state health department about, you know, like West Nile and several other, you know, vector diseases, and it mostly comes from mosquitos, and mosquito populations are a real problem in a lot of places. And it\u2019s definitely one here.\n\nAnd so, I guess, in my own reporting and in basically reporting from people across the country, how can\u2014what are practical tips that we can give to people, and things we can recommend to our city, state or county officials?\n\nROBBINS: To protect themselves.\n\nOVERTON: You know, I think that if you were to go to the, you know, U.S. CDC, you\u2019re going to see that there\u2019s a lot of, you know, straight up PSAs about how to handle, you know, even right down to the degree of, like, you know, the kinds of mosquito repellent you can use that doesn\u2019t have DEET in it, you know, like it gets pretty specific. I think that that\u2019s\u2014you could probably\u2014and in fact I think they even have infographics that, you know, are public domain that you are able to just lift, as long as you credit the U.S. CDC. So it\u2019s almost like\u2014and also Climate Central. And there\u2019s a couple of\u2014I would say a couple of kind of groups out there that basically serve it up for reporters. I mean, I love Climate Central. I love Inside Climate News. These are some places that specifically work with reporters, and for smaller markets, they even do the graphic work. And it\u2019s a great resource. I would urge you to look there, too.\n\nROBBINS: Can we talk a little bit more about other\u2014\n\nFIDLER: And I think one of the\u2014\n\nROBBINS: Yeah, David, can you also talk about other resources, as well as answering\u2014whatever answer to your question. What should we be reading and looking to for information?\n\nFIDLER: Well, in terms of vector-borne diseases, many states and the federal government has vast experience dealing with these. There\u2019s a fundamental problem\u2014is that as the geographic range of vector-borne diseases begins to expand into areas where the history of that type of vector control just really hasn\u2019t been, you know, part of what public health officials have had to worry about, so the infrastructure, the capabilities. And then, also importantly, how you communicate with the public about those kinds of threats: what the government is doing, what they can do to protect themselves. We\u2019re sort of present at the creation in many ways, and some of these places have a whole new way of doing public health.\n\nOne of the things that worries people the most in our polarized society is the disinformation and misinformation that gets in the way of accurate public health communication\u2014whether it\u2019s COVID-19, or whether it\u2019s climate change, or whether it\u2019s something else. So that communication piece is going to be vital to making sure that people can take the measures to protect themselves, and they understand what the state governments and the local governments are doing to try to control vectors.\n\nROBBINS: And Inside Climate News\u2014where else do you get your information that you would recommend for our\u2014\n\nOVERTON: Well, I just\u2014\n\nFIDLER: Sorry, go ahead, Penny.\n\nOVERTON: Oh, no. You can go ahead. I\u2019m actually pulling some up right now that I can put in the chat.\n\nFIDLER: Again, my go-to source is the CDC, and the CDC then also has its own information sources that you can track in terms of how, you know, public health authorities, public health policies, practices, implementation plans can be put together for all kinds of different public health threats. And the spread of vector-borne diseases has been near the top of the list longer, I think, than some of these other health threats from climate change. So that\u2019s a little bit more advanced, I think, based on the history of controlling vectors as well as the identification of that being an ongoing threat.\n\nThere are synergies with what we\u2019ve done in the past. With some of these other problems we don\u2019t have those synergies. We\u2019re having to create it from scratch.\n\nROBBINS: Penny, you were talking about places that actually\u2014smaller, you know, that newspapers can\u2014or other news organizations can get info, can actually, you know, get graphics gratis, or something of the sort. Does Poynter also have help on climate or are there other reporting centers where people are focusing on climate that provide resources for news organizations?\n\nOVERTON: Yes, I mean, Climate Central has\u2014I should have just like made them like the co-beat, you know, reporters for me in the first six months when I was starting this because anything that I needed to\u2014you know, every day it was something new. OK, geez, today I\u2019ve got to know everything there is to know about extreme weather and climate, you know, in such a way that I can bulletproof myself when the troll inevitably calls me and says, you know, this isn\u2019t true. And I need to have, you know, a little bit of armor prepared, right down to I need graphics, and I don\u2019t have\u2014we don\u2019t have a graphics person, but\u2014so Climate Central is a great place for a reporter in a small market to start.\n\nThey actually, like just this past week, came out with what they call a summer package, and it basically has an overarching umbrella viewpoint of, like, here\u2019s like the climate topics that are going to brought up this summer. Inevitably it\u2019s going to be heat waves, it\u2019s going to be drought, or extreme rainfall. It\u2019s going to be, you know, summer nights getting warmer and what that means\u2014the benefits, the longer growing seasons than some areas that, like in Maine, for example, climate change will not be all bad for Maine. It\u2019s going to mean that we have longer growing seasons in a place that has been pretty limited by the\u2014you know, the temperature and by the amount of time that we could actually grow a crop.\n\nAnd then, also, I mean, we\u2019re going to have\u2014we\u2019re going to have migration in because, like I was saying earlier, we are not going to be dealing with the extreme heat of like the Southwest, so people who are escaping like the California wildfires\u2014we\u2019re already seeing groups of people moving to Maine because it is more temperate, and you do have a longer horizon line before you\u2014you know, you get miserable here. And I think that if you look at those issues and you figure out how do I even start, going to Climate Central where they can actually\u2014not only do they have the infographics, but you can type in, like, the major city in your state, you know. I can\u2019t tell you the number of times I\u2019ve typed in Portland, Maine, and I get some amazing number, and it's, oh, wait, this is Portland, Oregon. So you could pull, like, your individual state, and even Maine has three states that Climate Central\u2014or excuse me, three cities that Climate Central lists. I guarantee you that your state will probably have many more. So it will be probably a place pretty close to where you are located. And you can have the infographic actually detailed, without doing anything besides entering in the city. It will be information that\u2019s detailed to your location. That\u2019s an incredible asset for a small market reporter who doesn\u2019t have a graphics person or the ability to, like, download data sets and crunch a lot of numbers.\n\nAlso\u2014\n\nROBBINS: That\u2019s great.\n\nOVERTON: \u2014I would urge you to look at the National Climate Assessment. There is a data explorer that comes out with those, and that allows you to drill down to the local level. That\u2019s the way that I found out that there\u2019s a small place in Aroostook County, Maine, which is like potato country, that\u2019s going to see the greatest increase in high precipitation days in the next\u2014I think it\u2019s in the next 50 years. I can\u2019t think of many things that aren\u2019t potato related that Aroostook County stands out for, but the fact that you play around with the data enough, and you see, look, there\u2019s a small place here in Maine that\u2019s going to be the number one greatest increase. That\u2019s why I think the climate assessment and the data explorer is so important.\n\nROBBINS: So we\u2019re almost done, David. I wanted to throw the last question to you.\n\nI\u2019m a real believer in comparison. I always say that to my students: Comparison is your friend. Is there any city or state in the United States, or perhaps someplace overseas that has a really good state plan for dealing with the health impacts of climate change that we could look at and say, this is really what we should be doing here?\n\nFIDLER: I mean, given that I\u2019m a foreign policy person, I\u2019m probably not the best person to inquire about that, but as I began to do my research to see how this is happening in the United States, I\u2019ve been surprised at the number of cities, counties, state governments that have really begun to dig into the data, develop plans, you know, for whatever problem that they\u2019re going, you know, to face.\n\nI live in the\u2014you know, the Chicagoland area. The city of Chicago has been working on adaptation for a while. The problems that it faces are going to be different than the problems that Miami faces. There\u2019s also, again, networks of cities that are starting to talk to each other about what they are doing in regards to these issues. The data is becoming better, more accessible, data visualization tools. Penny just described those sorts of things.\n\nMy recommendation to those working in local journalism is to begin to probe what your jurisdictions are doing, where they are getting their information. How are they implementing and turning that information into actionable intelligence and actionable programs? And I think that local journalism will help fill out our understanding of who is taking the lead, where should we look, what are the best practices and principles around the country.\n\nROBBINS: Well, I want to thank David Fidler, and I want to thank Penny Overton for this. And I want to turn you back to Irina. This has been a great conversation.\n\nFASKIANOS: It really has been a fantastic conversation. Again, we will send out the video, and transcript, and links to resources that were mentioned during this conversation. Thank you for your comments. We will connect people that want to be connected, as well, so thank you very much to David and Penny for sharing your expertise, and to Carla for moderating.\n\nYou can follow everybody on X at @D_P_fidler, Penny Overton at @plovertonpph, and at @robbinscarla. And as always, we encourage you to go to CFR.org, ForeignAffairs.com, and ThinkGlobalHealth.org for the latest developments and analysis on international trends and how they are affecting the United States.\n\nAgain, please do share your suggestions for future webinars by emailing us at localjournalists@CFR.org.\n\nSo again, thank you to you all for today\u2019s conversation, and enjoy the rest of the day.\n\nROBBINS: Thanks, everybody.\n\n(END)