A hotter planet is causing further damage to human health

Shortly after the new year, Washington Mail He published a story with a title that would have seemed inexplicable, even runic, to most readers just a few years earlier: “The blazing future of the world is etched in the crippled kidneys of the Nepalese workers.” But we’re so used to the idea that the climate crisis, in the words of Naomi Klein, “changes everything,” so why not change the internal organs of Nepalese? Jerry Shih’s remarkable reporting tells a series of unbearably poignant tales: young Nepalese struggling to make ends meet in their impoverished homeland head to the Gulf states to do construction work in the sweltering heat, some with little access to water, some even breaking down. (Other reports also show that some Nepalese working abroad are turning to the black market for a transplant that might keep them — and families who depend on the money they earn — alive.) The piece ends with a man back in his care. His sister, who donates her kidney to save him. The costs of medical procedures require that he sell his half-built house, and give up his life’s dream, which is to get married.

the Mail He was right: the future of the world he It is likely encapsulated in this story. The planet is steadily warming, and large swathes of it are moving past the point where it’s safe to do heavy work outside in the middle of the day. A 2022 study estimated that six hundred and seventy-seven billion man-hours a year are actually lost because it’s too hot to go out and build things or farm. Researchers have estimated the cost at more than $2 trillion annually, but, of course, it can also be measured in other units—in vital organs, or dreams.

But it is not only the future that such studies illuminate; It’s also the past. Unless you keep up with your problems from Current opinion in renal disease and hypertension, you may have missed a recent article titled, “Redlining leads to increased rates of nephrolithiasis in small population groups: a hypothesis.” I only saw it because one of the medical experts who wrote it—David Goldfarb, who runs a dialysis unit at Virginia Hospital in New York and teaches at New York University School of Medicine—is an old family friend. He sent it to me, and it somewhat blew my mind.

“Nephrolithiasis” is the technical term for kidney stones, those small formations that can cause severe pain when they pass. (I’ve never had it, but I know more than one man who said he came away from the experience with a new appreciation for what his wife went through during labor.) Doctors have long known that higher temperatures lead to more sweat, which reduces the volume of urine and thus increases the “saturation of the insoluble salts that cause kidney stones.” During heat waves in the United States, it only takes three days before emergency room visits start to spike with kidney stones.

For reasons that are still unclear, kidney stones used to be more common among white people, but in recent years, doctors have noticed huge increases among black Americans and a significant rise in Latino communities. The authors of the new article looked to the past for a possible explanation—particularly to the 1930s, when a federal agency, the Home Owners Loan Corporation, rated all of America’s neighborhoods and deemed some “dangerous” for investment, because they were home to large minority communities. This grading system (from A for “best” and B for “still desirable” to C for “low” and D for “hazardous”) is based on what has come to be known as redlining. The grading system has led to a chronic “disinvestment withdrawal” in lower-rated neighborhoods, which, over time, has reduced everything from parks and green spaces to street trees and air conditioning in homes.

Now the results can be measured with a thermometer: In Portland, Oregon, the authors report, neighborhoods rated Class A in the 1930s are “about 8 degrees Fahrenheit cooler than the city average, while the average Temperatures in D-rated neighborhoods are 4.8 degrees Fahrenheit warmer. Actually, you don’t need a thermometer—that’s a 13-degree gap a person can feel just by walking around town. No one has thoroughly studied the occurrence of kidney stones between these different neighborhoods, but the authors, in their hypothesis, point to ongoing research. Now, similar work on asthma, another heat-related illness, showed that emergency room visits were 2.4 times higher in red-lined areas.

In fact, Ben Goldfarb – an environmental journalist who will publish this year a book called Crossings on the environmental impact of roads – writes that its yours The degree program produced all kinds of adverse health effects. In Syracuse, Miami, Minneapolis and other cities, large portions of the agency’s red-lined neighborhoods—whose residents were mostly black—were demolished to make way for interstate highways. He told me: “Today minorities live disproportionately near the urban highways that displaced them and suffer as a result. Air pollution causes asthma and cancer. Noise pollution increases the risk of heart disease and stroke; and the physical fragmentation that highways cause is devastating local economies. It is heartbreaking, though not surprising, that disastrous political decisions made decades ago continue to ravage bodies and societies today.”

It is true that everyone will pay some price while the planet cooks. The authors of the Nephrology Study projected a potential additional cost to the US health care system of at least $1 billion annually. But some people will be hurt more than others by history. Doing justice in the present requires taking that past seriously—understanding how we ended up where we are, and why we should put those who have the least first, while trying to grapple with the future. But we are at a moment in this country where the idea of ​​historical responsibility is increasingly seen not as logical and obvious but as a kind of unsavory political correctness.

In April 2022, Florida Governor Ron DeSantis signed the Stop Mistakes for Our Children and Employees Act, or stop wok Represent. (Introducing the bill, he said, “In Florida we take a stand against state sanctioned racism that is a critical racist theory,” adding that “we will not allow Florida tax money to be spent teaching children to hate our country or each other.”) A preliminary injunction was issued. Against the act, which includes a statement against any school teaching that “a person, by virtue of his race, color, sex, or national origin, has a personal responsibility and should feel guilt, anguish, or other psychological distress for acts in which the person played no part, and which he committed In the past other members of the same race, color, national origin, or sex.” But, even if you can silence teachers, legislation cannot silence the effects of history. On a hot summer day in Jacksonville, Florida, where DeSantis was born, the temperature in A neighborhoods was 5.5 degrees below average, and 4.4 degrees above average in D-rated communities. ♦

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