The Heat Is Online

Paul Epstein Connected Warming to Human Health Impacts

Dr. Paul Epstein, Expert in Public Health, Is Dead at 67

The New York Times, Nov. 14, 2011

Dr. Paul Epstein, a public health expert who was among the first to warn of a link between the spread of infectious disease and extreme weather events, adding a new dimension to research into the potential impact of global climate change, died on Sunday at his home in Boston. He was 67.

The cause was lymphoma, said his wife, Andy.

Dr. Epstein, a physician and associate director of the Center for Health and the Global Environment at Harvard Medical School, published widely in scientific journals beginning in the early 1990s about what were then some of the less obvious potential effects of excessive carbon dioxide in the atmosphere.

He wrote about ocean warming-spiked algae blooms, and how they might be the source of recent cholera outbreaks, how milder winters and hotter summers favored mosquito breeding in areas where there had been outbreaks of encephalitis, how the same conditions accelerated the growth of ragweed, and how some particulate matter from coal-burning plants was particularly good at carrying pollen and other allergens deep into the lungs, possibly explaining a worldwide asthma epidemic since 1980.

His views provoked arguments. Within the politically contentious climate-change debate, it has been especially hard to prove direct links between climate events and the outbreak of disease.

But Dr. Epstein’s prolific writing and his championing of others’ research broadened the terms of the debate — initially focused on long-term threats facing coastal populations and Arctic polar bears, for instance — to include questions about potentially sudden, unforeseeable public health catastrophes.

Former Vice President Al Gore, who tapped Dr. Epstein as a science adviser in conceiving the slide show about global warming that became the basis of the Academy Award-winning 2006 documentary  "An Inconvenient Truth,"  praised him not only for his research but also for “his rare ability to communicate the subtleties and complexities of his field.”

“Paul was truly a pioneer in the area of climate change and infectious disease,” Mr. Gore said in an e-mail on Monday.

Dr. Epstein’s initial interest in the field was sparked by observations he made as a volunteer physician in East Africa, beginning in the late 1970s in Mozambique. He saw outbreaks of disease that had not been recorded before — “malaria high up in the mountains of Kenya, tick-borne diseases that were hard to explain,” said his wife, a public health nurse who lived in Mozambique with Dr. Epstein and their two children from 1978 to 1980.

But it was a seminal 1989 article in The New England Journal of Medicine — “Potential Health Effects of Global Climatic and Environmental Changes,” by Dr. Alex Leaf, a Harvard Medical School professor and chief of medicine at Massachusetts General Hospital — that suggested the possibility that those unusual outbreaks among the poorest people in Africa might be related to climate change.

“Dr. Leaf’s article gave us a new insight,” said Dr. Eric Chivian, director of the Center for Health and the Global Environment at Harvard and a longtime friend and colleague of Dr. Epstein.

“We realized our responsibility as physicians was to educate people that climate change was not just about whales, wolves and polar bears,” Dr. Chivian added.

Paul Robert Epstein was born on Nov. 16, 1943, in Manhattan, the older of two children of Nathan Epstein, a physician, and Edith Hillman Boxill, a music therapist. He was a graduate of the Little Red School House, a progressive private school, where his classmates included figures active in the ’60s antiwar movement like Angela Davis and Kathy Boudin. He graduated from Stuyvesant High School, Cornell University and the Albert Einstein College of Medicine.

Besides his wife, he is survived by a son, Benjamin; a daughter, Jesse; and a sister, Emily Duby.

Dr. Epstein worked throughout his life as a primary care physician in poor communities, mainly in Boston, and also did stints of volunteer service in several East African countries.

Soon after attending a United Nations Earth Summit in Rio de Janeiro with Dr. Chivian, where the topic of human disease was barely mentioned, he helped frame the idea for the Harvard Center for Health and the Global Environment, which was established in 1993.

With Dr. Chivian, a professor of clinical psychiatry, he taught a course at Harvard Medical School, “Human Health and Global Environmental Change,” that became a template for similar courses now taught at more than 65 medical and graduate schools around the country, Dr. Chivian said.

In an interview with The New York Times in 1998 about that year’s outbreak of cholera and malaria in South America in the wake of El Niño flooding, and simultaneous outbreaks of cholera, malaria and Rift Valley Fever in Africa after heavy rains and flooding, Dr. Epstein made the case for linkage.

“If extreme weather events are part of a changing climate,” he said, “we’ve seen lots of evidence of the profound health effects associated with climate change this year.”