By Karen McElfish, MD

As temperatures rise due to climate change, what effects does this have on children? Because of their
immature physiology and metabolism, incomplete development, greater minute ventilation, greater
surface-area-to-body-mass ratio, unique behavior patterns including play and time spent outdoors, and
dependence on caregivers, children are more vulnerable to the consequences of climate change than
adults. It is estimated by the World Health Organization that almost 90% of the existing global burden of
disease attributed to climate change occurs in children under the age of five.

The combustion of fossil fuels emits particulate matter and ground-level ozone. Higher surface
temperatures cause greater ozone formation, which contributes to increased asthma. Children are most
vulnerable to ozone, because they have developing lungs, breathe faster, and spend more time
outdoors. Asthma is the most common pediatric chronic disease, affecting almost 10% of American

The increased number of wildfires as a result of climate change also increases asthma attacks, as well as
emergency room visits and hospital admissions with exposure to wildfire smoke and ozone. Add to that
the risk of injury or death from the actual fires.

Allergy seasons are prolonged by as much as 2 to 4 weeks with rising temperatures, with greater
lengthening in more northern latitudes. This leads to increased production of allergens such as ragweed.
Nearly 10% of American children suffer from seasonal allergies. The elevated pollen counts lead to
greater numbers of allergy-related asthma attacks.

As temperatures rise, so do the number of excessive heat days, with increased incidences of death and
disability due to heat exhaustion and heatstroke. Children under the age of one are especially
vulnerable to heat-related deaths, because of their immature thermoregulatory systems. Student
athletes, such as high school football players, are another high-risk group. Additionally, the more than
120,000 child farm workers in the United States are adversely affected.

Diarrheal illnesses are a leading cause of childhood deaths worldwide, with more than 1.6 million
deaths annually in children under the age of 5 years. Bacterial infections such as E coli, salmonella, and
cholera increase with rising temperatures. Changes in precipitation, both drought and heavy rain events,
disrupt and contaminate water systems, leading to more outbreaks of gastroenteritis. Climate change is
predicted to increase the burden of illness, especially to low-income areas already experiencing greater
risk of disease.

Vector borne diseases, such as those carried by mosquitoes and ticks, increase with the expanding
range for both vectors and the disease-transmitting organisms, due to warmer climates. Cases of Lyme
disease, West Nile virus, Dengue fever, and Malaria rise. Diseases once primarily seen in the tropics are
now found in more northern latitudes. Again, children are more at risk, due in part to more time spent

The increasing number of extreme weather events disproportionately impact lower-income
communities. Children and their families are displaced, often separating children from their caregivers.
After Hurricane Katrina, children experienced on average three moves per child. Education is disrupted,
leading to poorer academic performance, absenteeism, and behavioral and mental health issues.

Food insecurity becomes an issue with extreme heat, increased water demands, drought, sea-level rise,
and flooding. Food production is decreased and the nutritional value of foods change, for example with
lower zinc and iron in grains. These nutrients are important for growth and development. Food safety
becomes compromised, with increasing contamination from bacteria and fungi, and subsequent use of
more pesticides. With climate change childhood undernutrition increases, currently at more than 3
million deaths in children under the age of five and projected to increase by as much as 20% by 2030.

Children are at risk. Climate change is arguably the greatest public health threat they face. While more
research and education on the effects on children continues to be needed, advocacy for strong policies
and legislation to combat climate change is a must and something we United Methodists can do. Now is
the time
to combat climate change, to protect children and their future.

Dr. Karen McElfish is a retired pediatrician and a member of the United Methodist Women Program
Advisory Group and the United Methodist Creation Justice Movement.