Interview: Dr. Aaron Bernstein

BIOGRAPHY 

Aaron Bernstein is the Interim Director of The Center for Climate, Health, and the Global Environment at the Harvard T.H. Chan School of Public Health (Harvard C-CHANGE), a pediatrician at Boston Children’s Hospital, and an Assistant Professor of Pediatrics at Harvard Medical School. Dr. Bernstein focuses on the health impacts of the climate crisis on children’s health and advancing solutions to address its causes to improve the health and wellbeing of children around the world.

Broadly speaking, how is climate change impacting the health and wellbeing of children worldwide?

Well, I think the first thing to recognize when it comes to climate change and children’s health is that climate change can really impact how a child grows and develops across their lifespan and pretty much any dimension of their health – whether it’s their mental health, their risk of getting infections, or their nutrition.

We have so many reasons to act on climate change, but the benefits of action are arguably the most pronounced for children.

One could point to just the nutritional benefits alone, which would result from having children eat more plant-based diets, including fruits and vegetables, grains, foods that are much less carbon-intensive. These kinds of diets benefit children’s health over their lifespan. At the same time, they reduce the chances that children will face food insecurity, and the nutritional consequences of that, which can really impair a child’s potential.

In your view, which groups of children are most vulnerable to the negative effects of climate change and what steps must be taken to help them?

That’s easy. It’s children who are raised in poverty and children who have not gotten their fair shake because they have a chronic medical problem or face adversity. I think one of the silver linings of climate action is that it speaks not only to the welfare of these children, to whom we owe a tremendous amount of our attention already, but also to the potential to direct resources to benefit them. These are resources we ought to be spending anyway, but would particularly benefit these children as climate change unfolds.

We also have endless examples in welfare countries and in low- and middle-income countries of how, for example, investment in young women and girls’ education results in huge dividends to all kinds of health outcomes. This is true in the context of climate change and it is also, of course, a pathway to lesser carbon use. There are so many opportunities for educating women, from lesser reliance on bio-fuel based cookstoves, and the environmental and health consequences that come with those cookstoves, to the risk of infectious disease spread.

For example, here’s one pathway we could trace. In many places around the world, when food becomes scarce, women are often those who are most likely to have to search harder and longer to get food for their homes. This increases their risk to infectious exposure (either because they’re going into the forest or into the wild) and increases their risk, in some places, for transactional sex, which can lead to the spread of HIV.

Measures that try to keep young women in school, that provide financial support that keeps food on the table so they’re not necessarily having to search harder for food, these measures are a good thing to be doing in general and are also a very good climate solution.

There are a number of these actions, which really point to foundations of health. They are even more important now that we face climate change and especially important when it comes to the world’s poor and the world’s children who haven’t been given a fair shake in terms of their health.

In the past couple of years, and especially in the past couple of months, we’ve seen an explosion of activism from young people regarding climate change. What role do you see young people having in helping to solve the climate crisis? What can they do that adults have not yet been able to achieve?

That’s a great question. I’ve described the events of last year as a watershed movement. The youth climate movement called for action among everyone on the planet to do more on climate. I think we’ll look back on last year as a potential turning point in how we as a human community act on climate change. I think that the most important thing that young people can do and continue to do is put this issue in the face of older people. It’s very hard for people, particularly when there’s a familial relationship there, to look at a child that is telling them, for example, your actions today are comprising our future, and not take them seriously.

When it comes to climate change, we don’t have a scientific problem. Which is to say, we don’t lack the science showing us the problem before us. We obviously could do more science to understand it better, but we fundamentally understand clearly that greenhouse gases, which are largely being put into the atmosphere through the burning of fossil fuels, are causing a transformation of the climate. We don’t have a problem when it comes to understanding what that means for our health. We already see the effects of this transformation of the climate on health. We see it in the heat waves, we see it in the migrations of people out of Syria, out of Central America, and other places around the world, which is partly happening as a consequence of extreme weather and which climate change is making evermore dangerous.

What we have with climate change is a problem of acceptance and understanding.

We live in a world that is increasingly vulnerable to blindness. This is true regardless of whether one sees climate change as a human-caused problem that deserves attention, or the opposite. But the reality is that the only way to have a conversation that is productive in this arena is to try and bring it down to size, to make it more personal and more immediate. There’s no better way to do that then to have someone who is young talking to someone who is older, and may see the world differently, and have that younger person say, You may not think this reality is reality, you may not see the world as I do, but as your daughter, as your son, as your student, whatever the relationship is, I want you to hear me on this because you know you need to recognize that this is my future. And there’s plenty of evidence around adults seeing this inter-generational equity part of climate change as a major place for progress to be made. It’s very hard to dismiss a young person or a child speaking to their future being stolen and ignore that. So I think that’s a critical piece, to continue to make these concerns visible to those who are older.

I think the other piece, and this is more geared towards finding solutions to the problems we face, is that we underestimate the value that young people have when it comes to solutions. Experience always counts in figuring out how to do stuff, but experience is a double-edged sword. Experience hones our ability to execute things based upon what we have learned in the past. Yet the pathways that experience show us are potentially excluding other pathways that may be as good, if not better. The younger you are, the fewer of these encumbrances on your thinking you are subject to.

And so for those of us who are a little bit older, who are more set in our ways because of our experience, we would be wise to listen to how people who are younger than us think about solving some of the challenges ahead. This is not to say that everyone younger than I am has better ideas than I do, or vice versa. But I do think we need as much creative thinking around this as possible. Acknowledging that, in many cases, folks who are decades younger than I am have had more formal education about climate change than I’ll ever have because it’s been a part of their grounding in education from very early on. That transforms how someone would understand the problem. I think there’s a fair amount of humility that needs to be put into adults about how little we were taught about this issue in our formal education and how folks that are younger than us may have learned a lot more.

When it comes to education, if you had to develop a primary school curriculum related to climate change, what elements would you emphasize?

I think at the earliest point, the emphasis needs to mostly be on the solutions. We need to present the problem, but I wouldn’t dally on that too much. These are opportunities to underscore what is needed and what’s possible and also frankly to cultivate an understanding among children that our welfare is not independent of others.

It’s interesting. When you talk to children, they will not tell you that their ability to do well in the world is on their own. Obviously, most children will hopefully have supportive adults in their lives who give them reason to believe that. Only later in life do people tend to have mindsets that are increasingly narrow about our need for the input of others and the assistance of others in our lives.

But you know, there’s a reason for that. It’s not that it’s completely without cause, but issues like the current pandemic or climate change underscore how critical it is for us to operate on the basis that we are 1) in this together and 2) that we’re not going to fix this in isolation. That sounds silly on its surface. Yet, if one looks out at the world, we can easily argue that we need much more collaboration and much more partnership, particularly North to South and rich to poor, than we have now.

Even in that overly collective view of human existence, it is ultimately self-interest that drives this collaboration – if you want to look at it that way. Ultimately, there’s no world in which the currently rich folks make it, and in which climate change ravages the poor, that works out for anybody.

So I think for early childhood education, it’s critical to focus on solutions. Where will the talents of future adults be needed to give them a sense of what they will need to think about moving forward?

I think it’s critical to help children grasp that there are certain problems that we simply cannot deal with in isolation. That is a good lesson not just in the climate arena, of course, but in any number of challenges we face.

Moving forward, is there a dream project you would like to do with UNICEF? 

I’ve seen a number of wonderful UNICEF projects over the years. I think one of the most powerful is putting human faces on issues like climate change. I think that a project that showed how children’s lives were connected through this issue around the world, that brought this issue across national lines would be especially powerful, particularly among countries that are largely responsible, but also those that are enormously vulnerable.

For example, in the United States there’s a huge number of people who would say we shouldn’t do anything about this because China’s the big problem and if we do everything and China does nothing, it still is game over. That kind of thinking suggests that we have essentially no moral responsibility to anybody and, for that matter, that there is no opportunity in us leading on climate change – which is insane because there is enormous opportunity!

However, you could imagine that those same voices, when confronted by Chinese children and American children about what they see as their nation’s responsibility and the risk to their welfare, might be jarring to those who would take dismissive views about the need for our countries to engage. For that matter, pointing to those same children’s concerns about their own countries, not just the other, but themselves, could be really moving. As I pointed out, the voices of younger people in this conversation are immensely powerful and I think UNICEF is really well positioned to capture some of those voices.

To learn more about Dr. Bernstein's work, check out these two programs he runs at Harvard C-Change. Kids and Climate shows how transitioning to clean energy protects children from dangerous pollutants and allows them to live healthier lives. ClimateMD engages and empowers medical professionals to bring awareness to the health threats posed by climate change and  to turn this awareness into actions that improve health today.

Photo Credit: John Wilcox for Coverage, a BCBS of MA news service.