AS LONG AS WE'RE CARING ABOUT PUBLIC HEALTH...:

The astounding impact of pollution on health was confirmed this year by a study published in the New England Journal of Medicine that examined particulate air pollution in 652 cities across the globe. It found that particulate pollution was associated with increases in cardiovascular and respiratory mortality and in overall mortality. Other studies have linked pollution to ailments ranging from diabetes to kidney dysfunction. Not only is pollution the leading environmental cause of disease, it is also connected to climate change and the health of the planet. The Lancet Commission estimated that the annual economic costs of pollution are $4.6 trillion globally.

New research also suggests that people living in areas with poorer air quality may be more susceptible to the impacts of Covid-19, the disease caused by the novel coronavirus.

Yet the pollution problem largely remains neglected by policymakers, funding organizations, and the media. Globally, the pollution agenda draws only a fraction of the hundreds of millions of dollars of annual funding that goes towards other public health threats like HIV/AIDS and malaria, pointed out Richard Fuller, a co-author of the Lancet report and president of the pollution-focused nonprofit Pure Earth. Why isn't pollution on our radar?

Part of the answer is that environmental regulations in the U.S. and other wealthy nations have already led to some progress. Following publication of the Lancet report, Philip Landrigan, a co-author and physician-epidemiologist at Mount Sinai School of Medicine in New York, explained, "I was a medical intern at Cleveland Metropolitan General Hospital in the late 1960s. You couldn't see down the length of the corridor from the steel mills' air pollution. You don't see pollution like that in Cleveland anymore. But you see it in New Delhi."

Another factor is that the pollution problem is complicated and insidious. We tend to pay attention to it only in a crisis, such as when drinking water in Flint, Michigan was discovered to be tainted with lead and other pollutants. "The Flint water crisis captured people's attention as something that was important and unacceptable," said Gary Adamkiewicz, an assistant professor at the Harvard T.H. Chan School of Public Health. "It showed gaps in public policy, revealed which communities had power and a voice, and how these things can go unnoticed without proper testing."

The Lancet Commission estimated that the annual economic costs of pollution are $4.6 trillion globally.

But even when no health emergency dominates local and national headlines, pollution continues to threaten our well-being. Polluted water leads to diarrheal diseases and other infections in the gastrointestinal tract. Soil polluted with toxic chemicals leads to heart disease, stroke, and brain injury in developing children. Polluted air leads not only to asthma, lung cancer, and diabetes, but also to low birthweight in infants. There are even cognitive effects: Recent studies have found that chess players make more mistakes in more polluted environments and that high levels of air pollution are linked to higher rates of attention deficit hyperactivity disorder and dementia.

A September 2019 study published in Nature Communications examined the placentas of 28 new mothers and found that soot-like black carbon had accumulated on the fetal side of the placental walls, suggesting that particulate air pollution can directly affect a developing fetus. A recent study of expectant mothers in Boston showed that women exposed to higher levels of air pollution during pregnancy birthed newborns with lower fetal heart rate variability, indicating poorer cardiovascular health.

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