The fondest times of my childhood were the annual burst of flowers each spring. Not so for my kids, who sniffle and sneeze their way through pollen season.
With average temperatures growing warmer, trees here in Atlanta are flowering earlier in the year, blooming longer, and releasing more pollen than when I was a kid.
That’s led to what I have dubbed FOGO — “Fear of Going Outside” — for my children.
They live with weeks of nasal congestion, sleepless nights, tears, frustration, missed days of school, poor performance on spring tests, and this year, a refusal to go outside during school — almost an entire month of school recesses spent sitting inside alone with a teacher instead of playing outside with classmates.
When I discuss these experiences with other parents in my circle, many share the same sentiment. They, too, are feeling FOGO, along with a companion emotion I call “FOLGO” — Fear of Letting (them) Go Outside” during days of extreme heat or air quality alerts in a warming and traffic-congested Atlanta.
“They’re just more scared to go outside,” a friend told me recently amid record-high mid-spring heat and humidity in Georgia. “And quite honestly, a lot of times I don’t want to let them go play outside either.”
For friends in New York City, smoke from massive Canadian wildfires recently added yet another climate threat, with clearly visible evidence of risk from hazy air pollution.
And friends in Texas have been sweltering under a weekslong record heat wave, making outdoor time oppressive for their kids.
Why focus on children’s health?
In her recent book, “Children’s Health and the Peril of Climate Change,” Frederica Perera shares the scientific evidence behind the changing climate’s impacts on the physical and mental health of fetuses, infants, and children.
Perera, a professor of environmental health sciences at the Mailman School of Public Health and director of the Center for Children’s Environmental Health at Columbia University, notes that almost every child across the globe is already at risk from at least one climate change-related threat.
Extreme heat, compromised air quality and pollution, and the spread of disease-carrying mosquitoes and ticks to new regions are just a subset of threats that infants and children face over a lifetime.
But Perera doesn’t see parents as helpless. “I want people to understand that there’s much that they can do as individuals in their own lives to become advocates for children’s health,” she says. Parents can learn more about the risks to their children’s physical and mental health, take action to protect their local environments, and vote for climate-smart measures that will improve health in the short and long term.
Children are uniquely susceptible to the health impacts of climate change
From the earliest moments of life, climate change can have a major impact on health. Before a fetus is born, extreme temperatures increase the risk of premature birth. In later years, heat can affect a child’s ability to learn and increases the risk for mental health conditions.
Climate change degrades air quality through a variety of pathways — by lengthening and intensifying allergy seasons and increasing the frequency of wildfires with massive smoke plumes, for example.
And a host of factors increase the risk of climate-related environmental impacts on the health of children, Perera says.
In general, children are more likely to spend time outdoors and are more likely to be physically active when they are outside. Both can increase their exposure to high temperatures and polluted air.
Fetuses, infants, and children are also more vulnerable because of their rapidly developing bodies. Early development is a highly choreographed and critical window when toxic exposures can have long-lasting physical, mental, and cognitive health consequences. It is also a time when their bodies’ ability to metabolize toxic chemicals, regulate internal temperature, and mount a robust immune defense against infectious disease is still immature.
Children are also uniquely vulnerable because they are mostly dependent on the care of others. From ensuring hydration, making sure they cool off at regular intervals, keeping them away from toxic exposures, and taking measures to limit exposure to insect bites, caregivers play a big role in minimizing the risks to a child’s health.
Risks to children in marginalized and low-income communities are even higher and compounded by additional stressors like poverty, lack of access to healthy foods, and structural racism. In these communities, children often do not have the luxury of FOGO, with already disproportionate exposure to air pollution and heat and disproportionate rates of chronic illness that can also compromise the immune response.
How poor air quality harms health
Close to 20% of children in the United States suffer from hay fever, which makes longer and more intense allergy seasons fueled by climate change particularly brutal. High pollen counts can cause much more than merely nuisance symptoms like runny noses, congestion, and sneezing, with lack of sleep and declines in school performance a growing threat to well-being. For children with asthma, the risks from allergen exposure can lead to higher rates of emergency room visits.
Wildfires supercharged by climate change are increasingly compromising air quality across the globe. In the U.S., close to 7.4 million children breathed in air polluted by wildfire smoke every year between 2008 and 2012, according to a recent study. During pregnancy, these exposures have been associated with preterm birth and low birth weight. In children, studies have shown links between wildfire smoke exposure and asthma flares, pneumonia, and bronchitis.
Perera says that air pollutants such as nitrogen oxides and particulates are a parallel threat, caused mainly by the same fossil fuel combustion sources that causes climate change.
Many of the links to poor health are well documented but some risks are just emerging. Not only does air pollution trigger asthma flares, but we now know that certain types of air pollution can also cause asthma in the first place. Along with damage to the lungs, air pollution can increase the risk of infant death, preterm birth, and low birth weight, and harm to the developing brain, which can cause long-term impairment to immune function, health, and intellectual development.
Air pollution also affects the structure and function of the brain, with links to reduced cognitive abilities and attention deficit-hyperactivity disorder. New studies also suggest a link with mental health conditions like anxiety and depression in children and adolescents.
What parents can do
Kari Nadeau, a pediatrician and chair of environmental health at Harvard University, wants to counsel families about the climate risks to the health of their children, even before birth.
“If parents know the risks … we can prevent them in the child’s lifetime at an early stage by intervening early and by making an impact with some solutions,” Nadeau says.
She says that despite the risks, time spent outside is one of the most important investments parents can make in the physical and mental health of their children. Along with masking, timing outdoor activity appropriately and following public health guidance on poor air quality days or high pollen and high heat index days can make it possible for most children to enjoy the outdoors safely.
Nadeau urges parents to convert their children’s FOGO and, perhaps their own FOLGO, into action. “It’s important for us to know the risks because that should compel us and catalyze us to change them,” she says. “We don’t have to just be sitting around passively and waiting for the globe to warm.”
In her book, Perera describes numerous examples of successful local, state, and country-level interventions across the world that have helped to cut carbon emissions and toxic air pollution, made neighborhoods more bearable in the setting of extreme heat, and improved access to safe outdoor time.
One concrete step is to do all you can to make your local outdoor environment safer. Groups that engage in native tree plantings and advocate for equitable green space can help neighborhoods weather intense heat waves and decrease local air pollution to a certain extent.
Advocating for a shift to electric school bus fleets can also help clean up the local environment.
Considerations for “climate proofing” your home can also be very protective if you need to stay indoors. Transitioning to an induction stove can help lower indoor pollutant levels. If a stove change is not in the budget, stand-alone induction cooktops might be an economical choice. Sealing cracks and investing in a HEPA air filter can also be protective.
Finally, Nadeau encourages parents to strengthen their child’s physical and mental health. This means go outside, hike and play, eat healthy plant-based food, be physically active, encourage restorative sleep to build resilience in the face of escalating climate threats.
“I think that making sure that we role model … make sure they know that our beautiful planet is worth it and we need to make sure that we take care of it,” Nadeau says.