Hostname: page-component-848d4c4894-nr4z6 Total loading time: 0 Render date: 2024-05-26T08:53:54.928Z Has data issue: false hasContentIssue false
  • English
  • Français

Using Precision Public Health to Manage Climate Change: Opportunities, Challenges, and Health Justice

Published online by Cambridge University Press:  27 January 2021

Walter G. Johnson
Get access Rights & Permissions [Opens in a new window]

Abstract

Amid public health concerns over climate change, “precision public health” (PPH) is emerging in next generation approaches to practice. These novel methods promise to augment public health operations by using ever larger and more robust health datasets combined with new tools for collecting and analyzing data. Precision strategies to protecting the public health could more effectively or efficiently address the systemic threats of climate change, but may also propagate or exacerbate health disparities for the populations most vulnerable in a changing climate. How PPH interventions collect and aggregate data, decide what to measure, and analyze data pose potential issues around privacy, neglecting social determinants of health, and introducing algorithmic bias into climate responses. Adopting a health justice framework, guided by broader social and climate justice tenets, can reveal principles and policy actions which may guide more responsible implementation of PPH in climate responses.

Type
Symposium Articles
Information
Journal of Law, Medicine & Ethics , Volume 48 , Issue 4: Climate Change and the Legal, Ethical, and Health Issues Facing Healthcare and Public Health Systems , Winter 2020 , pp. 681 - 693
Copyright
Copyright © American Society of Law, Medicine and Ethics 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

World Health Organization, “Quantitative Risk Assessment of the Effects of Climate Change on Selected Causes of Death, 2030s and 2050s,” 2014, available at <https://apps.who.int/iris/handle/10665/134014> (last visited March 8, 2020).+(last+visited+March+8,+2020).>Google Scholar
Kee, F. and Taylor-Robinson, D., “Scientific Challenges for Precision Public Health,” Journal of Epidemiology & Community Health 74, no. 4 (2020): 311–314.Google Scholar
Haines, A. and Ebi, K., “The Imperative for Climate Action to Protect Health,” New England Journal of Medicine 380, no. 3 (2019): 263–273.CrossRefGoogle Scholar
U.S. Global Change Research Program, “The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment,” April 2016, available at <https://health2016.globalchange.gov/> (last visited March 8, 2020).+(last+visited+March+8,+2020).>Google Scholar
Liu, C. et al., “Ambient Particulate Air Pollution and Daily Mortality in 652 Cities,” New England Journal of Medicine 381, no. 8 (2019): 705–715.CrossRefGoogle Scholar
World Health Organization, “Climate Change and Human Health: Risks and Responses,” 2003, available at <https://www.who.int/globalchange/publications/climchange.pdf> (last visited March 7, 2020).+(last+visited+March+7,+2020).>Google Scholar
Dangerdorf, S. et al., “Persistent Acceleration in Global Sea-Level Rise Since the 1960s,” Nature Climate Change 9 (2019): 705–710; Xu, C. et al., “Future of Human Climate Niche,” Proceedings of the National Academy of Sciences of the United States of America 117, no. 2 (2020): 11350–11355.CrossRefGoogle Scholar
World Health Organization, “Climate Change and Health,” February 1, 2018, available at <www.who.int/health-topics/climate-change> (last visited Jan. 29, 2020).+(last+visited+Jan.+29,+2020).>Google Scholar
Intergovernmental Panel on Climate Change, “Climate Change 2014: Impacts, Adaptation, and Vulnerability. Part A: Global and Sectoral Aspects,” 2014, available at <https://www.ipcc.ch/report/ar5/wg2/> (last visited Jan. 29, 2020).+(last+visited+Jan.+29,+2020).>Google Scholar
Wiley, L.F., “Adaptation to the Health Consequences of Climate Change as a Potential Influence on Public Health Law and Policy: From Preparedness to Resiliency,” Widener Law Review 15, no. 2 (2010): 483–519.Google Scholar
Frumkin, H. et al., “Climate Change: The Public Health Response,” American Journal of Public Health 98, no. 3 (2008): 435–445.Google Scholar
World Health Organization, “Operational Framework for Building Climate Resilient Health Systems,” 2015, available at <https://www.who.int/globalchange/publications/building-climate-resilient-health-systems/en/> (last visited March 9, 2020)+(last+visited+March+9,+2020)>Google Scholar
Ebi, K.L. et al., “Adaptation to Climate Variability and Change from a Public Health Perspective,” in Ebi, K.L., Smith, J. and Burton, I., eds., Integration of Public Health with Adaptation to Climate Change (Boca Raton: Taylor & Francis, 2005): at 1–15.Google Scholar
U.S. Department of Health and Human Services, “Primary Protection: Enhancing Health Care Resilience for a Changing Climate,” December 2014, available at <https://toolkit.climate.gov/topics/human-health/building-climate-resilience-health-sector> (last visited March 10, 2020).+(last+visited+March+10,+2020).>Google Scholar
Pascal, M. et al., “How Can a Climate Change Perspective Be Integrated into Public Health Surveillance?” Public Health 126, no. 8 (2012): 660–667.CrossRefGoogle Scholar
See, e.g., Ram, N. and Gray, D., “Mass Surveillance in the Age of COVID-19,” Journal of Law and the Biosciences 7, no. 1 (2020): doi: 10.1093/jlb/lsaa023; Ross, C., “Covid-19 Apps and Wearables Are Everywhere. Can They Actually Benefits Patients?” Stat News, August 4, 2020, available at <https://www.statnews.com/2020/08/04/covid19-wearables-apps-patient-care/> (last visited Aug. 10, 2020).CrossRefGoogle Scholar
Editorial, “Precision Global Health: Beyond Prevention and Control,” The Lancet Global Health 5, no. 1 (2017): e1.CrossRefGoogle Scholar
Chowkwanyun, M. et al., “‘Precision’ Public Health — Between Novelty and Hype,” New England Journal of Medicine 379, no. 15 (2018): 1398–1400; Taylor-Robinson, D. and Kee, F., “Precision Public Health — The Emperor’s New Clothes,” International Journal of Epidemiology 48, no. 1 (2019): 1–6.Google Scholar
Molster, C. M. et al., “The Evolution of Public Health Genomics: Exploring Its Past, Present, and Future,” Frontiers in Public Health 6, art. 247 (2018): 1–11.CrossRefGoogle Scholar
Weeramanthri, T.S. et al., “Editorial: Precision Public Health,” Frontiers in Public Health 6, art. 121 (2018): 1–3.CrossRefGoogle Scholar
Khoury, M.J., “Precision Public Health: What Is It?” US Centers for Disease Control and Prevention, May 15, 2018, available at <https://blogs.cdc.gov/genomics/2018/05/15/precision-public-health-2/> (last visited Jan. 28, 2020).+(last+visited+Jan.+28,+2020).>Google Scholar
See Topol, E.J., “Individualized Medicine from Prewomb to Tomb,” Cell 157, no. 1 (2014): 241–253.Google Scholar
Ginsburg, G.S. and Phillips, K.A., “Precision Medicine: From Science to Value,” Health Affairs 37, no. 5 (2018): 694–701.Google Scholar
Khoury, M.J. et al., “Precision Public Health for the Era of Precision Medicine,” American Journal of Preventative Medicine 50, no. 3 (2016): 398–401.Google Scholar
Stoeger, K. and Schmidhuber, M., “The Use of Data from Electronic Health Records in Times of Pandemic — A Legal and Ethical Assessment,” Journal of Law and the Biosciences 7 (2020): doi: 10.1093/jlb/lsaa041.Google Scholar
Bayer, R. and Galea, S., “Public Health in the Precision-Medicine Era,” New England Journal of Medicine 373, no. 6 (2018): 499–501.Google Scholar
Khoury, M.J. et al., “From Public Health Genomics to Precision Public Health: A 20-Year Journey,” Genetics in Medicine 20, no. 6 (2018): 574–582.CrossRefGoogle Scholar
Cooper, R. and Paneth, N., “Will Precision Medicine Lead to a Healthier Population?” Issues in Science and Technology 36, no. 2 (2020), available at <https://issues.org/precision-medicine/> (last visited September 28, 2020).Google Scholar
Horton, R., “Offline: In Defense of Precision Public Health,” The Lancet 392, no. 10157 (2018): 1504.Google Scholar
Dowell, S.F. et al., “Four Steps to Precision Public Health,” Nature 540, no. 7632 (2016): 189–191.Google Scholar
Dolley, S., “Big Data’s Role in Precision Public Health,” Frontiers in Public Health 6, art. 68 (2018): 1–12.Google Scholar
Burstein, R. et al., “Mapping 123 Million Neonatal, Infant and Child Deaths Between 2000 and 2017,” Nature 574, no. 7778 (2019): 353–358.Google Scholar
See Chowkwanyun et al., supra note 18.Google Scholar
See Ram and Gray, supra note 16.Google Scholar
Hodge, G.A. et al., “Nanotechnology: Rhetoric, Risk and Regulation,” Science and Public Policy 41, no. 1 (2014): 1–14.CrossRefGoogle Scholar
Hansen, A. and Bi, P., “Climate Change Adaptation: No One Size Fits All,” The Lancet Planetary Health 1, no. 9 (2017): e353–e354.CrossRefGoogle Scholar
See Dowell et al., supra note 30.Google Scholar
Clark, J., “Big Data, Pollution and the IoT,” IBM Internet of Things Blog, November 7, 2017, available at <https://www.ibm.com/blogs/internet-of-things/iot-pollution-initiatives/> (last visited Mar. 22, 2020).+(last+visited+Mar.+22,+2020).>Google Scholar
Loftis, D., “StormSense: A New Integrated Network of IoT Water Level Sensors in the Smart Cities of Hampton Roads, VA,” Marine Technology Society Journal 52, no. 2 (2018): 56–67.CrossRefGoogle Scholar
Ting, D.S.W. et al., “Digital Technology and COVID-19,” Nature Medicine 26, no. 4 (2020): 459–461.CrossRefGoogle Scholar
Ross, C., “In Coronavirus Response, AI Is Becoming a Useful Tool in Global Outbreak, Data Experts Say,” Stat News, January 29, 2020, available at <https://www.statnews.com/2020/01/29/coronavirus-response-artificial-intelligence-becoming-useful/> (last visited Jan. 29, 2020).+(last+visited+Jan.+29,+2020).>Google Scholar
McGovern, A. et al., “Using Artificial Intelligence to Improve Real-Time Decision-Making for High Impact Weather,” Bulletin of the American Meteorological Society 98, no. 10 (2017): 2073–2090.CrossRefGoogle Scholar
See Palmer, T., “Build High-Resolution Global Climate Models,” Nature 515, no. 7527 (2014): 338–339.CrossRefGoogle Scholar
See Editorial, The Lancet Global Health, supra note 17.Google Scholar
See Kee and Taylor-Robinson, supra note 2.Google Scholar
Lazer, D. et al., “The Parable of Google Flu: Traps in Big Data Analysis,” Science 343, no. 6176 (2014): 1203–1205.CrossRefGoogle Scholar
Parmet, W.E., Populations, Public Health, and the Law (Washington, DC: Georgetown University Press, 2009): at 13–19.Google Scholar
Kennedy, M. and Mamo, L., “The Imaginary of Precision Public Health,” Medical Humanities 46, no. 3 (2019): 192–203.Google Scholar
GSMA, “Connected Women: The Mobile Gender Gap Report 2019,” February 2019, available at <https://www.gsma.com/mobilefordevelopment/wp-content/uploads/2019/02/GSMAThe-Mobile-Gender-Gap-Report-2019.pdf> (last visited March 13, 2020).+(last+visited+March+13,+2020).>Google Scholar
Hu, J.C., “So About That Thermometer Data That Says Fevers Are on the Decline…,” Slate: Future Tense, April 6, 2020, available at <https://slate.com/technology/2020/04/kinsa-smart-thermometer-data-fevers-covid19.html> (last visited April 7, 2020).+(last+visited+April+7,+2020).>Google Scholar
Egede, L.E. and Walker, R.J., “Structural Racism, Social Risk Factors, and Covid-19 — A Dangerous Convergence for Black Americans,” New England Journal of Medicine (2020): doi: 10.1056/NEJMp2023616.CrossRefGoogle Scholar
Ellis, E.G., “For Homeless People, Coivd-19 Is Horror on Top of Horror,” Wired, April 2, 2020, available at <https://www.wired.com/story/coronavirus-covid-19-homeless/> (last visited April 3, 2020).+(last+visited+April+3,+2020).>Google Scholar
See World Health Organization, supra note 8.Google Scholar
See Dowell et al., supra note 30.Google Scholar
Solove, D.J., “A Taxonomy of Privacy,” University of Pennsylvania Law Review 154, no. 3 (2006): 447–560.CrossRefGoogle Scholar
Amnesty International, “COVID-19, Surveillance and the Threat to Your Rights,” April 3, 2020, available at <https://www.amnesty.org/en/latest/news/2020/04/covid-19-surveil-lance-threat-to-your-rights/> (last visited Aug. 3, 2020).+(last+visited+Aug.+3,+2020).>Google Scholar
Gostin, L.O., Hodge, J.G. Jr., and Valdiserri, R.O., “Information Privacy and the Public’s Health: The Model State Public Health Privacy Act,” American Journal of Public Health 91, no. 9 (2001): 1388–1392.Google Scholar
Kshetri, N., “Big Data’s Impact on Privacy, Security and Consumer Welfare,” Telecommunications Policy 38, no. 11 (2014): 1134–1145.Google Scholar
Karp, P., “Government Refuses Police Request for Access to Australian Coronavirus Contact Tracing App,” The Guardian, April 23, 2020, available at <https://www.theguardian.com/australia-news/2020/apr/23/government-rules-out-police-having-any-access-to-australian-coronavirus-contact-tracing-app> (last visited April 27, 2020).+(last+visited+April+27,+2020).>Google Scholar
Kobie, N., “Everyone Should Be Worried by Big Tech’s Huge NHS Data Grab,” Wired, December 16, 2019, available at <https://www.wired.co.uk/article/google-apple-amazon-nhs-health-data> (April 6, 2020).+(April+6,+2020).>Google Scholar
U.S. National Science & Technology Council, “Artificial Intelligence and Cybersecurity: Opportunities and Challenges,” March 2020, available at <https://www.nitrd.gov/pubs/AICS-Tech-Summary-2020.pdf> (last visited Aug. 3, 2020).+(last+visited+Aug.+3,+2020).>Google Scholar
Thrope, J.H. and Gray, E.A., “Big Data and Public Health: Navigating Privacy Laws to Maximize Potential,” Public Health Reports 130, no. 2 (2015): 171–175.CrossRefGoogle Scholar
Chan, T. et al., “The UK National Data Guardian for Health and Care’s Review of Data Security, Consent and Opt-Outs: Leadership in Balancing Public Health with Rights to Privacy?” BMJ Health & Care Informatics 23, no. 3 (2016): 627–632.Google Scholar
Cohen, I.G. and Mello, M.M., “Big Data, Big Tech, and Protecting Patient Privacy,” JAMA 322, no. 12 (2019): 1141–1142.CrossRefGoogle Scholar
LeCun, Y. et al., “Deep Learning,” Nature 521, no. 7553 (2015): 436–444.Google Scholar
Benjamin, R., Race After Technology: Abolitionist Tools for the New Jim Code (Cambridge, UK: Polity Press, 2019): at 40–48.Google Scholar
Vyas, D.A., Eisenstein, L.G., and Jones, D.S., “Hidden in Plain Sight — Reconsidering the Use of Race Correction in Clinical Algorithms,” New England Journal of Medicine 383, no. 9 (2020): 874–882.CrossRefGoogle Scholar
Id.Google Scholar
Obermeyer, Z. et al., “Dissecting Racial Bias in an Algorithm Used to Manage the Health of Populations,” Science 366, no. 6464 (2019): 447–453.Google Scholar
Benjamin, R., “Assessing Risk, Automating Racism,” Science 366, no. 6464 (2019): 421–422.CrossRefGoogle Scholar
Janeja, V., “Predicting the Coronavirus Outbreak: How AI Connects the Dots to Warn About Disease Threats,” The Conversation, March 3, 2020, available at <https://theconversation.com/predicting-the-coronavirus-outbreak-how-ai-connects-the-dots-to-warn-about-disease-threats-130772> (last visited March 3, 2020).+(last+visited+March+3,+2020).>Google Scholar
Council of Europe, “Algorithms and Human Rights: Study on the Human Rights Dimensions of Automated Data Processing Techniques and Possible Regulatory Implications,” March 2018, available at <https://rm.coe.int/algorithms-and-human-rights-en-rev/16807956b5> (last visited Apr. 3, 2020).+(last+visited+Apr.+3,+2020).>Google Scholar
Katyal, S.K., “Private Accountability in the Age of Artificial Intelligence,” UCLA Law Review 66, no. 1 (2019): 54–141.Google Scholar
Hodge, J.G. Jr., “Revisiting the Renaissance in Public Health Law,” Journal of Law, Medicine & Ethics 46, no. 4 (2018): 1031–1033.Google Scholar
Venkatapuram, S., Health Justice: An Argument from the Capabilities Approach (Cambridge, UK: Polity Press, 2011): at 4–5, 16.Google Scholar
Wiley, L.F., “Health Law as Social Justice,” Cornell Journal of Law and Public Policy 24, no. 1 (2014): 47–105.Google Scholar
Benfer, E.A. et al., “Health Justice Strategies to Combat the Pandemic: Eliminating Discrimination, Poverty, and Health Inequity During and After COVID-19,” Yale Journal of Health Policy, Law, and Ethics (forthcoming), available at <https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3636975> (last visited Aug. 10, 2020); Benfer, E.A., “Health Justice: A Framework (and Call to Action) for the Elimination of Health Inequity and Social Injustice,” American University Law Review 65, no. 2 (2015): 275–351.Google Scholar
Schlosberg, D. and Collins, L.B., “From Environmental Justice to Climate Justice: Climate Change and the Discourse of Environmental Justice,” WIREs Climate Change 5, no. 3 (2014): 359–374.CrossRefGoogle Scholar
Gostin, L.O., Global Health Law (Cambridge, MA: Harvard University Press, 2014): at 19–20.Google Scholar
See, e.g., Gates, M., “Sexist and Incomplete Data Hold Back the World’s COVID-19 Response,” Stat News, July 30, 2020, available at <https://www.statnews.com/2020/07/30/sexist-and-incomplete-data-hold-back-the-worlds-covid-19-response/> (last visited Aug. 3, 2020).+(last+visited+Aug.+3,+2020).>Google Scholar
Rudolph, L. et al., “Health in All Policies: A Guide for State and Local Governments,” available at <https://www.apha.org/topics-and-issues/health-in-all-policies> (last visited May 7, 2020).+(last+visited+May+7,+2020).>Google Scholar
Ienca, M. and Vayena, E., “On the Responsible Use of Digital Data to Tackle the COVID-19 Pandemic,” Nature Medicine 26, no. 4 (2020): 463–464.CrossRefGoogle Scholar
Warzel, C., “Privacy Is Not your Responsibility,” New York Times, Sept. 17, 2019, available at <https://www.nytimes.com/2019/09/17/opinion/alabama-app-privacy.html> (last visited May 7, 2020).+(last+visited+May+7,+2020).>Google Scholar
Wiley, L.F., “From Patient Rights to Health Justice: Securing the Public’s Interest in Affordable, High-Quality Care,” Cardozo Law Review 37, no. 3 (2016): 833–890.Google Scholar
Sell, S.K., “21st-Century Capitalism: Structural Challenges for Universal Health Care,” Globalization and Health 15 (Suppl. 1), art. no. 76 (2019): 1–9.CrossRefGoogle Scholar
Hodge, J.G. Jr. et al., “Constitutional Cohesion and the Right to Public Health,” University of Michigan Journal of Law Reform 53, no. 1 (2019): 173–225.CrossRefGoogle Scholar
See Liptak, A., “Sent to Prison by a Software Program’s Secret Algorithms,” New York Times, May 1, 2017, available at <https://www.nytimes.com/2017/05/01/us/politics/sent-to-prison-by-a-software-programs-secret-algorithms.html> (last visited May 11, 2020).+(last+visited+May+11,+2020).>Google Scholar
Adadi, A. and Berrada, M., “Peeking Inside the Black-Box: A Survey on Explainable Artificial Intelligence (XAI),” IEEE Access 6 (2018): 52138–52160.CrossRefGoogle Scholar
U.K. Royal Society, “Explainable AI: The Basics,” November 2019, available at <https://royalsociety.org/-/media/policy/projects/explainable-ai/AI-and-interpretability-policy-briefing.pdf> (last visited Aug. 10, 2020).+(last+visited+Aug.+10,+2020).>Google Scholar
Miller, T., “Explanation in Artificial Intelligence,” Artificial Intelligence 267 (2019): 1–38.Google Scholar
Crawford, K. et al., “AI Now 2019 Report,” AI Now Institute, December 2019, available at <https://ainowinstitute.org/AI_Now_2019_Report.pdf> (last visited May 9, 2020).+(last+visited+May+9,+2020).>Google Scholar
Erikson, S.L., “Cell-Phones ≠ Self and Other Problems with Big Data Detection and Containment During Epidemics,” Medical Anthropology Quarterly 32, no. 3 (2018): 315–339.CrossRefGoogle Scholar
Johnson, K.N., “Automating the Risk of Bias,” George Washington Law Review 87, no. 5 (2019): 1214–1271.Google Scholar
See Leach, M., Scoones, I., and Wynne, B., eds., “Introduction: Science, Citizenship and Globalization,” in Leach, M., Scoones, I. and Wynne, B., eds., Science and Citizens: Globalization and the Challenge of Engagement (New York, NY: Zed Books, 2005): 3–14.CrossRefGoogle Scholar