October 15, 2017


Donald A. Holzworth, MS
Executive in Residence at the Gillings School
Adjunct professor of health policy and management


There is no greater public health threat than a dying planet. The implications for public health professionals’ not addressing climate change as a public health threat are profound, but so is the potential for entrepreneurial thinking.

Entrepreneurs typically can distinguish between what people think they need in the present versus what they may want or need in the future. In other words, they create a demand for a product or solution that does not yet exist – or at least anticipate those demands. Consider the rapid rise of alternative energy solutions in the face of decades of resistance from special interests such as electric utilities and the fossil fuel industry. Now, solar and wind energy are more cost-effective than any other source of fuel, and economic forces have begun to drive changes that cannot be stopped. Witness how the introduction of the iPhone changed the ways people work and communicate.

Governments, on the other hand, typically respond to immediate problems or perceived threats after the fact, in ways that are driven by political expediency. The responses to recent hurricanes serve as an example. A majority of Americans understand that climate change is real – just as cancer and heart disease are real – but different from the way they perceive those other chronic problems, people do not have a clear sense of climate change’s impact on them personally. They are therefore not moved to complain to their representatives, and nothing happens.

Meanwhile, entrepreneurs – along with some enlightened corporate, state and local officials – see this challenge as a business opportunity and recognize that market forces, unless impeded by restrictive regulation, ultimately will drive meaningful positive change. Can this happen soon enough to avert environmental and human catastrophe? That’s the question.

Q: Why is public health a perfect background to inform and drive this kind of work?

A: The threat of climate change is difficult to communicate because the changes are gradual and pose no immediate apparent threat – until now. At this writing, we have witnessed Hurricane Harvey, a 1,000-year flood event in Houston and its surrounding communities. Harvey was preceded immediately by two 100-year flood events in the same area in 2015 and 2016. Florida stared down the barrel of Irma, the strongest hurricane ever recorded in the Atlantic. Then, the state was hit hard by Hurricane Maria, which also devastated Puerto Rico. Data clearly show that the magnitude and frequency of such storms has been increasing. We also know that ocean temperatures are rising, which leads to more moisture being pumped into our atmosphere. While other factors also play a role, increased moisture in the atmosphere coming from warmer oceans is the “fuel” that hurricanes need to intensify.

While the media generally focus on property destruction and family dislocation, public health professionals play a critical role in monitoring and addressing both the potential and real spread of disease through contaminated water and crowding. They work to solve issues related to people’s mental and physical health needs. Over the years, public health entrepreneurs have played a significant role in inventing technologically driven rapid data collection, analysis and communication tools that can be used in the field to speed response to health emergencies.

Q: What training is needed to better prepare public health students and practitioners to become environmental entrepreneurs?

A: Consider the critical role played by public health professionals in responding to the threat of infectious diseases, such a smallpox, polio, malaria and HIV – or their fight against cancer and heart disease. These threats were apparent. Virtually everyone could name a family member, friend or acquaintance on whom these diseases had a direct impact. The public outcry initiated the political will to address these problems.

Except for the possibility of nuclear war, we have not previously faced a real and ever-present threat to the public’s health and the planet we live on. People understand and respond to health threats. Therefore, public health professionals, including environmental scientists, must be trained as “communication entrepreneurs” to better communicate the immediate public health threat posed by climate change.

As with all great entrepreneurs, public health professionals must see beyond immediate threats by literally “looking into the eye of the hurricane.” I call upon them to deliver effective messages that lead to a public outcry for resources and policy responses. We have witnessed the outcry and response for past and present global diseases. How much more adamantly should we demand solutions for climate change, which endangers all of us?


Return to Table of Contents

Carolina Public Health is a publication of the University of North Carolina at Chapel Hill Gillings School of Global Public Health. To view previous issues, please visit sph.unc.edu/cph.