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“Climate change is a huge public health concern”

When Gaurab Basu saw the news about wildfire smoke from Canada hitting the U.S. earlier this month, one of the first things he did was check his patient chart.
“I was scanning my chart for pregnant patients and thinking about whether we could reschedule or maybe do a televisit and have them stay at home instead of taking a bus to come in,” said Basu, a physician in Boston and health equity fellow at the Harvard T.H. Chan School of Public Health.
It was a prescient concern: One of Basu’s patients who already suffered from asthma had to be hospitalized for an aggressive cough and low oxygen levels, which Basu suspects were related to the air quality. A few hundred miles south in New York City, which saw even worse pollution from the wildfires, there were more than 1,000 asthma-related emergency department visits over the weekend after the smoke event. “It’s been a hard few months for my patients with asthma. I had more conversations about air quality with my patients and colleagues than ever before,” Basu told me.
These conversations are becoming more and more common. Across the country, healthcare providers are watching in real time as climate change affects their patients’ health, from wildfire smoke to particularly bad allergy seasons, extreme heat, and vector-borne diseases like Lyme and dengue fever. In response, clinicians of all stripes are increasingly talking about climate change in their practice — and in effect becoming climate educators.
“Climate change is a huge public health concern, and part of my role as a physician is to highlight awareness,” said Neelu Tummala, an otolaryngologist (an ear, nose, and throat specialist, or what’s colloquially known as an ENT) and co-director of the Climate and Health Institute at George Washington University in Washington, D.C. “It’s not to scare people and say that global warming is going to be the end-all of society, but to make them conscientious of it and maybe inspire them to act on it.”
Healthcare providers occupy a rarefied space in American society. Nurses consistently rank as the most trusted profession in the country in an annual Gallup poll, followed closely by doctors and pharmacists (high school teachers were fourth in the 2023 poll; journalists are distrusted by a plurality of Americans). Patients tend to listen to what their clinicians have to say. That makes them uniquely placed to talk about climate change.
“We make it human,” Basu told me. “There’s a lot of translational work we can do, because emissions and pollutants are confusing and abstract and kind of invisible.”
As climate change increasingly moves from concept to lived reality, bringing it up in the doctor’s office is just a natural progression of the conversation a healthcare provider has with their patient. Take Tummala, whom I first met as a patient myself: I have a history of allergy-induced asthma, and before being taught how to calm my body down I would sneeze and wheeze my way through allergy season. So when I went to Tummala for a consultation this spring, it made sense that she mentioned, as our visit was wrapping up, that climate change was making allergy season worse.
Education has always been part of the job for healthcare providers; they routinely discuss medical science with their patients, whether when discussing individual diagnoses like diabetes or broader public health concerns like, say, COVID-19 or Mpox. But all of the clinicians I spoke with told me that for many patients, their conversation was the first time someone had drawn a connection between climate change and health, and in some instances the first time they’d heard of climate change at all.
The main difference between educating their patients about climate change and other public health concerns, Tummala pointed out, is that the solution to climate change lies not in medical research but in policy. There is no vaccine for climate change; the most a healthcare provider can do to address the problem within the confines of their clinic is give their patients tips for living with the impact of a global issue far beyond their control.
That also means this is new territory for clinicians, some of whom may not even know much about climate change themselves. As Karen Pennar wrote for STAT News in April, there’s a growing, student-led movement to incorporate climate change at medical schools across the country, and some programs, like those at George Washington University and Harvard Medical School, have begun adding climate change to their curricula. But there are already millions of clinicians at work across the country, and reaching them is just as important as training the next generation.
“It’s great to say we’re going to train the next generation of healthcare professionals, but the reality is climate impacts are here,” said Cecilia Sorensen, director of the Global Consortium on Climate and Health Education at Columbia University. “We can’t wait ten years for kids to grow up and start doing their own jobs. We have to train the existing health workforce.”
That means training not just doctors but also nurses and other clinicians who often spend more time with patients than doctors do. Academic initiatives like the Global Consortium are developing workshops, webinars, and other training programs to close the gap, and clinicians are also coming together on the local level: Tummala is on the steering committee for a group called Virginia Clinicians for Climate Action, or VCCA, which organizes educational events for clinicians at hospitals and clinics across the state of Virginia.
“Many of us in practice are figuring this out together and learning together,” said Samantha Ahdoot, a pediatrician and founder of VCCA. “It’s really a whole new field of medicine that’s developing quite quickly.”
As the name would suggest, VCCA goes beyond education. Its members directly advocate for climate policy at the state level, from an annual lobby day in Richmond to testifying on the health impacts of climate change at public hearings. This kind of political organizing is a tricky line to walk: Doctors are pressed for time and energy already, and their involvement in advocacy of any sort is sometimes frowned upon — as illustrated by the recent case of Indiana doctor Caitlin Bernard, who was reprimanded after speaking publicly about an abortion she provided for a 10-year-old girl.
Climate change is just as embroiled in the culture war as COVID-19 and abortion are, and the clinicians I spoke with told me they’re careful to separate any advocacy work they do from their conversations with their patients. Instead, they focus on the patient’s experience of the changing world, as Tummala did with me. That grounds those conversations in the health impacts and makes clear she’s speaking from a perspective of transparent, science-driven healthcare rather than advocacy.
“We have the ability to depoliticize this. We can talk about this as a health issue, not a political issue,” Tummala told me. “You have to meet people where they’re at. If you, for example, try talking to a patient about losing weight, they may think you’re judging them. But if you bring it up in a way that shows it could help their sleep apnea or heart disease, they may be more willing to listen. I think it’s the same with climate change.”
In Cheryl Holder’s experience, those health realities are harder to deny than the high-level concept of climate change. “I get pushback from folks who are not experiencing it like my patients experience it,” said Holder, founder of Florida Clinicians for Climate Action (FCCA) and a physician who primarily treated members of lower-income communities until she retired last December. As part of her advocacy mission with FCCA, she started using Instagram and TikTok to talk about the connection between climate change and health — and she would inevitably see comments from climate deniers.
Her conversations with patients, however, were a different story. Most of them worked outdoors, where they could tell things were changing. “If you work outdoors and you feel the heat, see the grass growing faster and the trees flowering earlier, you know something is happening,” Holder told me. “When I tell them it’s because of pollution from humans, they accept it.”
But just as a patient may decide not to follow a doctor’s advice for treating a medical condition, Basu accepts that sometimes the climate conversation just won’t land. That doesn’t make him any less likely to bring it up, however.
“Hopefully, the patient can trust in a pattern of me making good decisions about their care enough that they believe in [the climate connection],” Basu told me. “I think that’s a critical moment to bring people into the conversation, and to do it with care.”
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Amarillo-area residents successfully beat back a $600 million project from Xcel Energy that would have provided useful tax revenue.
Power giant Xcel Energy just suffered a major public relations flap in the Texas Panhandle, scrubbing plans for a solar project amidst harsh backlash from local residents.
On Friday, Xcel Energy withdrew plans to build a $600 million solar project right outside of Rolling Hills, a small, relatively isolated residential neighborhood just north of the city of Amarillo, Texas. The project was part of several solar farms it had proposed to the Texas Public Utilities Commission to meet the load growth created by the state’s AI data center boom. As we’ve covered in The Fight, Texas should’ve been an easier place to do this, and there were few if any legal obstacles standing in the way of the project, dubbed Oneida 2. It was sited on private lands, and Texas counties lack the sort of authority to veto projects you’re used to seeing in, say, Ohio or California.
But a full-on revolt from homeowners and realtors apparently created a public relations crisis.
Mere weeks ago, shortly after word of the project made its way through the small community that is Rolling Hills, more than 60 complaints were filed to the Texas Public Utilities Commission in protest. When Xcel organized a public forum to try and educate the public about the project’s potential benefits, at least 150 residents turned out, overwhelmingly to oppose its construction. This led the Minnesota-based power company to say it would scrap the project entirely.
Xcel has tried to put a happy face on the situation. “We are grateful that so many people from the Rolling Hills neighborhood shared their concerns about this project because it gives us an opportunity to better serve our communities,” the company said in a statement to me. “Moving forward, we will ask for regulatory approval to build more generation sources to meet the needs of our growing economy, but we are taking the lessons from this project seriously.”
But what lessons, exactly, could Xcel have learned? What seems to have happened is that it simply tried to put a solar project in the wrong place, prizing convenience and proximity to an existing electrical grid over the risk of backlash in an area with a conservative, older population that is resistant to change.
Just ask John Coffee, one of the commissioners for Potter County, which includes Amarillo, Rolling Hills, and a lot of characteristically barren Texas landscape. As he told me over the phone this week, this solar farm would’ve been the first utility-scale project in the county. For years, he said, renewable energy developers have explored potentially building a project in the area. He’s entertained those conversations for two big reasons – the potential tax revenue benefits he’s seen elsewhere in Texas; and because ordinarily, a project like Oneida 2 would’ve been welcomed in any of the pockets of brush and plain where people don’t actually live.
“We’re struggling with tax rates and increases and stuff. In the proper location, it would be well-received,” he told me. “The issue is, it’s right next to a residential area.”
Indeed, Oneida 2 would’ve been smack dab up against Rolling Hills, occupying what project maps show would be the land surrounding the neighborhood’s southeast perimeter – truly the sort of encompassing adjacency that anti-solar advocates like to describe as a bogeyman.
Cotton also told me he wasn’t notified about the project’s existence until a few weeks ago, at the same time resident complaints began to reach a fever pitch. He recalled hearing from homeowners who were worried that they’d no longer be able to sell their properties. When I asked him if there was any data backing up the solar farm’s potential damage to home prices, he said he didn’t have hard numbers, but that the concerns he heard directly from the head of Amarillo’s Realtors Association should be evidence enough.
Many of the complaints against Oneida 2 were the sort of stuff we’re used to at The Fight, including fears of fires and stormwater runoff. But Cotton said it really boiled down to property values – and the likelihood that the solar farm would change the cultural fabric in Rolling Hills.
“This is a rural area. There are about 300 homes out there. Everybody sitting out there has half an acre, an acre, two acres, and they like to enjoy the quiet, look out their windows and doors, and see some distance,” he said.
Ironically, Cotton opposed the project on the urging of his constituents, but is now publicly asking Xcel to continue to develop solar in the county. “Hopefully they’ll look at other areas in Potter County,” he told me, adding that at least one resident has already come to him with potential properties the company could acquire. “We could really use the tax money from it. But you just can’t harm a community for tax dollars. That’s not what I’m about.”
I asked Xcel how all this happened and what their plans are next. A spokesperson repeatedly denied my requests to discuss Oneida 2 in any capacity. In a statement, the company told me it “will provide updates if the project is moved to another site,” and that “the company will continue to evaluate whether there is another location within Potter County, or elsewhere, to locate the solar project.”
Meanwhile, Amarillo may be about to welcome data center development because of course, and there’s speculation the first AI Stargate facility may be sited near Amarillo, as well.
City officials will decide in the coming weeks on whether to finalize a key water agreement with a 5,600-acre private “hypergrid” project from Fermi America, a new company cofounded by former Texas governor Rick Perry, says will provide upwards of 11 gigawatts to help fuel artificial intelligence services. Fermi claims that at least 1 gigawatt of power will be available by the end of next year – a lot of power.
The company promises that its “hypergrid” AI campus will use on-site gas and nuclear generation, as well as contracted gas and solar capacity. One thing’s for sure – it definitely won’t be benefiting from a large solar farm nearby anytime soon.
And more of the most important news about renewable projects fighting it out this week.
1. Racine County, Wisconsin – Microsoft is scrapping plans for a data center after fierce opposition from a host community in Wisconsin.
2. Rockingham County, Virginia – Another day, another chokepoint in Dominion Energy’s effort to build more solar energy to power surging load growth in the state, this time in the quaint town of Timberville.
3. Clark County, Ohio – This county is one step closer to its first utility-scale solar project, despite the local government restricting development of new projects.
4. Coles County, Illinois – Speaking of good news, this county reaffirmed the special use permit for Earthrise Energy’s Glacier Moraine solar project, rebuffing loud criticisms from surrounding households.
5. Lee County, Mississippi – It’s full steam ahead for the Jugfork solar project in Mississippi, a Competitive Power Ventures proposal that is expected to feed electricity to the Tennessee Valley Authority.
A conversation with Enchanted Rock’s Joel Yu.
This week’s chat was with Joel Yu, senior vice president for policy and external affairs at the data center micro-grid services company Enchanted Rock. Now, Enchanted Rock does work I usually don’t elevate in The Fight – gas-power tracking – but I wanted to talk to him about how conflicts over renewable energy are affecting his business, too. You see, when you talk to solar or wind developers about the potential downsides in this difficult economic environment, they’re willing to be candid … but only to a certain extent. As I expected, someone like Yu who is separated enough from the heartburn that is the Trump administration’s anti-renewables agenda was able to give me a sober truth: Land use and conflicts over siting are going to advantage fossil fuels in at least some cases.
The following conversation was lightly edited for clarity.
Help me understand where, from your perspective, the generation for new data centers is going to come from. I know there are gas turbine shortages, but also that solar and wind are dealing with headwinds in the United States given cuts to the Inflation Reduction Act.
There are a lot of stories out there about certain technologies coming out to the forefront to solve the problem, whether it’s gas generation or something else. But the scale and the scope of this stuff … I don’t think there is a silver bullet where it’s all going to come from one place.
The Energy Department put out a request for information looking for ways to get to 3 gigawatts quickly, but I don’t think there is any way to do that quickly in the United States. It’s going to take work from generation developers, batteries, thermal generation, emerging storage technologies, and transmission. Reality is, whether it is supply chain issues or technology readiness or the grid’s readiness to accept that load generation profile, none of it is ready. We need investment and innovation on all fronts.
How do conflicts over siting play into solving the data center power problem? Like, how much of the generation that we need for data center development is being held back by those fights?
I do have an intuitive sense that the local siting and permitting concerns around data centers are expanding in scope from the normal noise and water considerations to include impacts to energy affordability and reliability, as well as the selection of certain generation technologies. We’ve seen diesel generation, for example, come into the spotlight. It’s had to do with data center permitting in certain jurisdictions, in places like Maryland and Minnesota. Folks are realizing that a data center comes with a big power plant – their diesel generation. When other power sources fall short, they’ll rely on their diesel more frequently, so folks are raising red flags there. Then, with respect to gas turbines or large cycle units, there’s concerns about viewsheds, noise and cooling requirements, on top of water usage.
How many data center projects are getting their generation on-site versus through the grid today?
Very few are using on-site generation today. There’s a lot of talk about it and interest, but in order to serve our traditional cloud services data center or AI-type loads, they’re looking for really high availability rates. That’s really costly and really difficult to do if you’re off the grid and being serviced by on-site generation.
In the context of policy discussions, co-location has primarily meant baseload resources on sites that are serving the data centers 24/7 – the big stories behind Three Mile Island and the Susquehanna nuclear plant. But to be fair, most data centers operational today have on-site generation. That’s their diesel backup, what backstops the grid reliability.
I think where you’re seeing innovation is modular gas storage technologies and battery storage technologies that try to come in and take the space of the diesel generation that is the standard today, increasing the capability of data centers in terms of on-site power relative to status quo. Renewable power for data centers at scale – talking about hundreds of megawatts at a time – I think land is constraining.
If a data center is looking to scale up and play a balancing act of competing capacity versus land for energy production, the competing capacity is extremely valuable. They’re going to prioritize that first and pack as much as they can into whatever land they have to develop. Data centers trying to procure zero-carbon energy are primarily focused on getting that energy over wires. Grid connection, transmission service for large-scale renewables that can match the scale of natural gas, there’s still very strong demand to stay connected to the grid for reliability and sustainability.
Have you seen the state of conflict around renewable energy development impact data center development?
Not necessarily. There is an opportunity for data center development to coincide with renewable project development from a siting perspective, if they’re going to be co-located or near to each other in remote areas. For some of these multi-gigawatt data centers, the reason they’re out in the middle of nowhere is a combination of favorable permitting and siting conditions for thousands of acres of data center building, substations and transmission –
Sorry, but even for projects not siting generation, if megawatts – if not gigawatts – are held up from coming to the grid over local conflicts, do you think that’s going to impact data center development at all? The affordability conversions? The environmental ones?
Oh yeah, I think so. In the big picture, the concern is if you can integrate large loads reliably and affordably. Governors, state lawmakers are thinking about this, and it’s bubbling up to the federal level. You need a broad set of resources on the grid to provide that adequacy. To the extent you hold up any grid resources, renewable or otherwise, you’re going to be staring down some serious challenges in serving the load. Virginia’s a good example, where local groups have held up large-scale renewable projects in the state, and Dominion’s trying to build a gas peaker plant that’s being debated, too. But in the meantime, it is Data Center Alley, and there are gigawatts of data centers that continue to want to get in and get online as quickly as possible. But the resources to serve that load are not coming online in time.
The push toward co-location probably does favor thermal generation and battery storage technologies over straight renewable energy resources. But a battery can’t cover 24/7 use cases for a data center, and neither will our unit. We’re positioned to be a bridge resource for 24/7 use for a few years until they can get more power to the market, and then we can be a flexible backup resource – not a replacement for the large-scale and transmission-connected baseload power resources, like solar and wind. Texas has benefited from huge deployments of solar and wind. That has trickled down to lower electricity costs. Those resources can’t do it alone, and there’s thermal to balance the system, but you need it all to meet the load growth.