Healthcare professionals see firsthand the debilitating effects of dirty air and pollution-related diseases right here in Washington—from forest fire smoke, increasingly severe and prolonged heat waves, and longer, more potent allergy seasons. These impacts affect us all, but they disproportionately harm vulnerable populations like the young, the elderly, the poor, and communities of color. 1-2117 would rollback major progress to mitigate that impact. by Dr. Ken Lans Did you hear the one about the hedge fund millionaire who moves up from California and spends millions of dollars to get a bunch of his right-wing initiatives on Washington’s November 2024 ballot? Turns out it’s not a joke. All four initiatives on the November ballot would, if passed, be awful for the health of people here in Washington. But Initiative-2117, stands out for just how far-reaching its bad health consequences would be. The initiative would repeal Washington's Climate Commitment Act (CCA) and prohibit any policies involving carbon pricing in the future. In the service of a self-interested extremist, it dangerously and ridiculously halts and reverses important progress finally being made to combat air pollution and climate change. These dangers are fully detailed in a Washington Physicians for Social Responsibility (WPSR) report, ‘A Risk to our Health: An Analysis of the Threats to Health Posed by I-2117’.  Healthcare professionals see firsthand the debilitating effects of dirty air and pollution-related diseases. We’re also beginning to see, right here in Washington, more and more direct health impacts of climate change—from forest fire smoke, increasingly severe and prolonged heat waves, and longer, more potent allergy seasons. These impacts affect us all, but they disproportionately harm vulnerable populations like the young, the elderly, the poor, and communities of color. The CCA is a cap-and-invest program which passed in 2021 and just took effect last year. It employs a form of carbon pricing where the maximum amount of total permissible CO2 is established and decreases each year, and permits to pollute up to that limit are sold at auction. The program is already beginning to have significant and beneficial impacts on our health through meaningful reductions in air pollution.  And as more revenue is collected in future auctions, those benefits will grow. But all health gains—existing and potential—are threatened if I-2117 passes. Addressing our Climate and our Health Combustion of fossil fuels—gasoline, diesel, and natural gas—is the primary source of greenhouse gasses (primarily CO2) and air pollution (PM2.5 small particulate matter, sulfur dioxide and nitrogen dioxide). The World Health Organization (WHO) states, “Air pollution, primarily the result of burning fossil fuels, which also drives climate change, causes 13 deaths per minute worldwide.” Around the world, exposure to polluted air is the second highest risk of death for children 5 and under. Major health-related impacts from air pollution include increased morbidity (illness) and mortality (death) from asthma and other respiratory illnesses, cardiovascular disease and stroke, cancer, and diabetes. We’re also concerned about mental health impacts, as PM2.5 can enter the brain via the olfactory nerve and bloodstream. Medical studies make it clear that there is no safe level of PM2.5, no threshold point where harm starts. The more air pollution a person is exposed to, even starting at low doses, the more harm that can result (and the lower the exposure, the less harm). So all reductions in air pollution levels are good for health.  Supporters of I-2117 emphasize the dollars you could save, but we also need to recognize the increased costs we already pay, both in terms of actual dollars spent on healthcare and, maybe even more importantly, in terms of damage to our very health and well-being, from exposure to pollution and from the impacts climate change is already having. These same emissions that release health-harming gasses also release climate-change causing CO2.  The resulting environmental changes brought about by these dramatically increasing levels of CO2 in the atmosphere include more extreme weather events, more frequent, more severe, and longer lasting heat waves, and an increase in the number and severity of wildfires and their accompanying smoke — all of which put increasing burdens on the health of people throughout the state. Air pollution and climate-related risks are cumulative. Added to the health impacts resulting from air pollution, direct impacts we’re seeing from climate change include, heat-related illnesses and deaths; asthma, lung cancer and other respiratory illnesses; cardiovascular disease, including heart attack and stroke; infectious diseases such as Lyme disease and encephalitis; mental health conditions, including increased depression and suicidality; violent behavior, including intimate partner violence; and lowered birth weight in infants. Climate Change and Pollution Do Not Impact All People Equally All these health conditions that are exacerbated by climate change and air pollution are experienced more frequently and with greater impact by vulnerable, marginalized, and disenfranchised populations. Not by chance, but due in large part to the long-term policies of “redlining” and zoning laws and other historical forms of discriminatory public policy and ongoing bias, poorer communities, tribal communities, and communities of color are far more likely to be located in close proximity to the sources of pollution, such as industrial sites, oil and gas refineries, ports, rail yards, and busy highways. They are also less likely to have adequate infrastructure and tree canopy to help mitigate the effects of extreme heat. Disadvantaged groups also include migrant workers, people with limited English proficiency, displaced persons, indigenous tribes, and those with pre-existing medical conditions, chronic illness, and disabilities. The CCA is designed specifically to place environmental justice and equity at the center of climate policy. It implements and funds the HEAL (Healthy Environment for All) Act of 2021 that requires the State “to identify and address environmental health disparities in overburdened communities and for vulnerable populations.” Because industries participating in the CCA will take some time to substantially reduce their pollution, especially in already overburdened communities, and will likely pass on as much of their increased costs as they can to the consumer, any equitable carbon pricing regimen must include investments in overburdened communities and energy subsidies to low income households. The CCA does just that. Of monies spent, 35-40% must benefit vulnerable populations in overburdened communities; 10% must be formally supported by Tribal resolution. Indeed, as of late spring, the Office of Financial Management estimated that, of total CCA investments made to that time, nearly $924 million, or 43%, were directed to overburdened communities and $155 million, or 7.3%, specifically to benefit Tribes. Improving the Health and Well-being of Children Children with developing lungs are particularly vulnerable to air pollution, and can experience lifelong effects from inhaled particulates. In the home, CCA funds programs such as an expansion of weatherization and projects that improve indoor air quality through the replacement of gas stoves and gas and oil furnaces. Studies show that diesel-emitting school buses expose children to harmful exposures both on and outside the buses—exposures that can decrease cognitive function, increase cardiovascular risks, and worsen respiratory health. The CCA is funding electric school buses to minimize these risks. It also funds free bus, ferry, and train rides for everyone under 18 and expands sidewalks and crosswalks so that children can safely access schools, parks and the outdoor environment.  CCA-funded expansion of our regional air quality monitoring network—a critical system for equipping parents of a child with asthma with real-time health information so they can make critical decisions around medication and exposure—would also be ended if I-2117 passes. Finally, carbon emission reduction projects funded by the CCA, though admittedly small compared to worldwide emissions, still matter as all these reductions add up. Combined, they will help to reduce extreme weather events worldwide, including flooding — such as we’ve just seen from hurricane Helene — and heat waves. Such interventions are critical, as increased child and infant mortality have been associated with extreme heat events, as well as decreased cognitive abilities in children exposed to high heat. Even those still in the womb can experience negative health impacts from extreme heat. Climate resilience projects for schools, funded through the CCA, such as HVAC improvements and electrification, will directly help keep the children of Washington learning and growing through extreme heat. My Prescription: Vote No on I-2117 To sum up why is it so urgent and important to defeat I-2117:   Because climate change and air pollution have such dire and far-reaching consequences for the health of the residents of Washington (and in fact to every living being on our planet) and we’re already paying, often dearly, with our health;   Because Washington is seen as a model of climate action and passage of I-2117 here would likely severely chill climate action in other states (and, adding insult to injury — which I mean literally — I-2117 would prohibit any future climate pricing in our state);   Because the Climate Commitment Act is already showing what a crucial role it can play in reducing pollution, addressing the impacts of climate change, and improving health for so many. Voting ‘no’ becomes one of the most vital health decisions that you can make. So join me, my colleagues at WPSR, and concerned health professionals throughout the state (including the Washington State Medical Association, the Washington State Nursing Association, the Washington State Public Health Association, and the American Lung Association in Washington) in casting a critical vote to protect your health, your children’s health, and everyone’s health. Dr. Ken Lans is a retired General Practice Physician and a founder and current Board President of Washington Physicians for Social Responsibility (WPSR).