2019 Colorado Hot Issues in Health Conference, Climate Session

Hosted by the nonpartisan Colorado Health Institute, the event has convened the state’s leading thinkers to discuss pressing issues related to health and health care for nearly 20 years.

The 2019 Hot Issues in Health Conference will take place on Thursday, December 5, 2019 and Friday, December 6, 2019 at the Hilton Denver Inverness in Englewood, Colorado

Moderator: Karam Ahmad, Policy Analyst, CO Health Institute, Ft. Collins, 28 years old

  • How to connect what we value for climate change?
  • CO is a hot place to live right now. 
    • CO temps have risen 2 F in the last 30 years
    • Denver is ranked #3 in the urban heat island effect (5 F warmer than surrounding areas).  Las Vegas and Albuquerque are first and second. Ft. Collins is 9th fastest warming.
    • Lamar – hottest record
    • Heat exhaustion takes a toll on the body

2018 was the second worst wildfire season on record.  The complexity, severity and number of fires are predicted to get worse

  • A majority of the state’s residents – nearly 3 million Coloradans – live in wildland-urban interface 
  • Extreme heat and more wildfires lead to worse AQ

Denver and NoCO fail ozone standards again. Metro Denver 12th worst for ozone pollution and among the worst in PM – Jim Crooks!


  • CO was drought-free earlier in 2019; now 23% of state living in drought
  • 1.144 million CO currently live in severe drought areas
  • Drought is a major stress for ranchers and farmers

Last year 12 bills passed related to climate change (a person later noted this was 2.5% of all bills and this is an existential threat – we should be doing more)

  • HB 1261 – first of its kind in the nation – emphasis on short and LT goals. Understand  disproportionate impacts
  • SB 181 – also first of its kind

How we are going to address and adapt to changes?

From Paris to Pueblo – a global issue creating local risk

What do we value?  We often get stuck in the weeds about

7 out of 10 CO take climate change seriously, though just 4 out of 10 believe it will personally harm them

What do you value? Health!  Health is everything.

If that’s not enough, beer prices could double because of climate change


Cleave Simpson – Alamosa, GM of Rio Grande Water Conservation District, rancher and farmer.  I talk about CC but about the quantity of water available. Challenged to think about this in a different perspective, but in the San Luis Valley, we see rural CO health impacts from climate change and are dealing with scarcity.  How this state deals with water scarcity will affect every aspect of our state. 

How are you communicating about these issues?  We’re so used to keeping up with quantity of water.  I watch, living and working in a basin that gets less than 7” of precipitation a year. We rely exclusively on snowpack from the San Juans.  It is not hard to present the change that is occurring. It’s not hard to show that on an annual basis the availability of water continues to diminish and over the last 20 years has become two of the driest years in the last 120 were in the last two decades: 2002 & 2018.

Our communities, economies, culturally in the Valley depend on aquifer systems and were all designed around a water supply that doesn’t exist any more.

Over the last 10 years have been working hard to come to terms with this.  Not easy. We see the consequences and there will be more. I’m an engineer.  It’s easy to focus on the quantitative impacts.  We routinely discuss and are addressing the quantities but not the impacts. Focusing on the larger impacts is a step I am taking.

I had more personal experience and exposure this summer – a farmer with 6 kids took his own life.  It causes one to take stock. Did some of our talk have influence on him?

Jennifer Gremmert – everyone deserves affordable access to energy – She raises funds to help vulnerable Coloradans.  Work with all the utility companies across the state, repair and replacement, PUC energy policy, families we serve have access to renewable energy, good indoor AQ.  Partner with Children’s Hospital, if home is exacerbating their condition, what can we do about efficiency and ventilation. Different strategies in resort communities.  Have good PPPs. As we think about Xcel closing coal plants and electrification have to think about how disruptive transitions happen, bring communities together for solutions.   How do you see needs of populations you serve evolving? Energy is evolving. Low energy costs and CO is a high production state. Nat gas is very affordable. RE is growing.

Broad sweeping energy saving tips, turn down your heat, but folks may live in a leaky house and have a health condition that needs them to stay warm.  Deliver savings from solar gardens right on their bills/payments. Doing lots of work with Housing Authorities and housing NGOs, non-profit housing efficiency programs.  For example, they worked with the Denver Rescue Mission and then they had enough hot water to provide hot showers to the people staying there. They work collaboratively.

Large programs often try to shove ideas.  Local partnerships really help meet people where they are.  How are different ways we can communicate with people and get programs to their households.  TOU rates with automated meters – what about those with medical equipment that needs to function all the time?

EVs won’t be available to low income families unless we make them available.  Beneficial electrification may be the same.

Local partners in local communities is the best way to do this communication.

A lot of families have to make choices, pay their utility bills or have money for medicine or healthy food.

Jill Ryan – ED of CDPHE, 2 decades of experience in public health, Eagle County, Exec. Colo Communities 4 Climate Action.  CDPHE put out a public health improvement plan every 5 years, based on local PHAgencies – they do theirs first.  So many this time said CC is one of their top priorities, so it is one of ours as well. We have a climate cabinet, CDOT dir, Will Toor, Wildly Important Goals, increase the number of Climate Action Plans and resilience plans.  DOLA has some funds for this. The Adaptation plans are a good tool is they allow local communities to look at most vulnerable populations and address vulnerabilities.

Climate change amplifies other risks and disasters.  Eagle, low snow pack low, seasonal workers weren’t able to work on the mountain.  Und the vulnerabilities of your community and how those who will be most vulnerable will be most impact.

What can county commissioners and local level policymakers do?  So glad you asked. Mentioned climate adaptation plans. DOLA also funds climate action plans – set targets to reduce emissions community wide.  In Eagle County – several benefits to reducing carbon footprint as a local govt, save a ton of taxpayer dollars, get local govts prepared for new energy economy, and you are a great model then locally.  We purchased a solar farm and saved $300K per year. Purchasing EVs, amount saved in fuel costs and oil changes was used. Fixing leaky buildings, changing LEDs, swapping out boilers, there are a lot of things you can do that reduce GHGs and save money.  If you want more info, glad to provide info. Right now we are doing rulemakings, particularly the AQ Division and working with COGCC, mission changed to protect public health and environment. There will be additional regulation of the O&G industry and additional AQ regulation.  We’re even having meetings about how to engage in the rulemaking process. We’ll have two years of rulemakings. Ozone standard – going to serious non-attainment for long-term nonattainment, increased regulation of industry. The challenge is our AQ Control Division has been severely underfunded for decades.  Our DBs are from the 1990s. We have very little equipment to monitor AQ. We’re hiring inspectors. AQ is one of the Gov’s top goals. We’re trying to do our work and engage the public and address what is having real health impacts on folks.

Jim Crooks, National Jewish, leads a research group, health impacts of climate pollution, worked formerly at EPA, env epidemiologist, ozone, smoke, dust, heat, pollen – quantifying those impacts, better support DMs in incorporating health impacts into energy DM. CBA of different options. Not that hard to do but communities don’t talk to each other much.  Also teaches at CO School of Public Health, get CC message out. Absolutely a responsibility to go out and talk about the intersection of health and CC.

Heat – heat stroke, number of days above 90 and 95 degrees has gone up, people who exert themselves outside are at risk. Heat is also a factor in generating ozone.  It’s going to become harder to control as things get warmer.

Ozone is a respiratory irritant and also makes people more prone to allergies.  Ozone also gets into the body and causes inflammation in other organ systems, such as the heart (heart attacks and heart disease).

Warm air also has the capacity to hold more moisture. With all that extra CO2 (more than 50% more in the atmosphere now than all of human development up to the past 150 years) and heating of the atmosphere from fossil fuel use, we now have more days with no precipitation and with extreme precipitation. Also the risk of drought goes up. The predictions for the Eastern Plains for drought after 2050 fall off a cliff. The Dustbowl will come back this century. High dust levels will contribute to heart attacks and heart disease, in addition to other problems. With the extra CO2 there are also more allergenic pollens, more pollen, with more allergenic proteins in the pollen too.

Rising CO2 drives plant growth and a lot of those have allergenic pollens – more pollen – with more allergenic proteins on it.  The future is not a fun place for those with allergies.

What should Colorado do to protect what you value?

Cleave:  4th gen of my family to farm and ranch in the San Luis Valley.  My son would like to continue with that legacy. We try to keep up with irrigated ag and cows.  Son has a college degree and doesn’t have to be there doing this. Am I heading him in the right direction?  Is the water supply in the future going to be enough for him to carry on? Causes me some sleepless nights. Make it snow, would be great!  I recognize we are transitioning to an era of even more water scarcity. Being thoughtful about it. Not making rural areas carry the burden for growing demand on the Front Range.  Irrigated ag offers open spaces, secure food supply, even wildlife habitat.

Jill Hunsaker Ryan still lives in Eagle County, Vail and Beaver Creek.  CC is a threat to ski industry. Ski season is getting shorter.  Need 100 days to maintain a good ski industry. (Jeannie McQueenie, partner in

Back of my head, Colorado is the headwaters for 18 other states.  Local communities – get involved with CC4CA.  It’s going to take some large systemic changes to tackle this.

CDPHE – we let folks telecommute, buy everyone bus passes, encourage bicycling.  I take the bus from Eagle County. Many ride e-bikes. We are the leaders.  Anything you can impact, you should impact.

Jennifer Grammert. I value affordability and fairness.  Alice Jackson of Xcel says 8th graders today will figure it out.  We can invest in innovation and research.

Jim Crooks, I have children ages 11 and 14. They are going to experience a lot more climate disruption.  A child born today may be celebrating New Year’s in 2100. I would like to raise up the voices of younger people.  It would be nice to wait for 8th graders to innovate but we need to do it now.  We’ve already saddled our youngsters. This is their WWII and we’re the ones who bombed Pearl Harbor.  From a policy perspective: accounting for avoided health care costs in making decisions. It’s not that hard to do on the air pollution side and I don’t see it being done.  There should be more communication between climate, policy, and health people.

Ft. Collins, health researcher: 

  • Change is something we can watch go by.  This is not “change” but a climate crisis, collapse, catastrophe, suicide.  This is an existential crisis. It it was 12 bills, that’s 2.5% of bills.  If this is truly the crisis we say it is.
  • EJ – hasn’t been a lot of talk.  They suffer first and the most – needs to be talked about more.
  • I lived in NYC before this in a small apt with family of 5.  Before that I lived overseas in Europe.
  • It seems to be the American thing to have 2 cars, over 2K sf house, a green lawn.  I don’t see a measurable change happening.

PRPA is amazing.  Local communities putting in mandates, thresholds, boundaries. When I started in this work 20 years ago, the env community said it wanted the price of energy as high as possible. I didn’t see any conversation about marijuana use.  We have a public health issue relating to vaping. Our teens are going to be really sick.  National Jewish is addressing issues.

CDPHE? Jill: for those of us in public health, there have been really successful policies put in place around tobacco use and smoking.  We worked for decades to understand those and put them in place. Not every public health issue has such elegant solutions, tobacco taxes. Obesity, . A lot of the strategies we used on tobacco we need to use on vaping.

Jim: MJ – volatile ogranics, some carcinogenic, also precursor for ozone.

Jennifer: Marijuana – 4-5% of electric use in Colorado

Dr. John Douglas, public health, Tri-County health, public sentiment is everything (Lincoln). This room is the choir. Wisdom: how do we communicate to get the urgency? How does this look like to explain this in a compelling, non-pollarizing way.

Cleave: from ag community, I don’t believe it is as polarizing as on the Front Range.  We’re not in a drought. We’re in the aridification of the West. The supply needed to make our living is just not there.  We’ve come to the realization that we have a lesser supply of water to continue to do what we’re doing.  It’s actually not possible. We’re on the margins. Incrementally, if we are thoughtful and get some help from Mother Nature, we can make it, otherwise we have fundamental change that impacts the health and well-being of my community.

Accountable health communities

Social determinants of health

Jennifer G: Access to people and how do you get people to apply? A navigator at a hospital?  We’ve got to really start using the resources.  Trusted: our doctors, faith communities, schools.

Steve Child, Pitkin County.  During Lake Christine fire, Basalt, we came within one power poll of burning through the Upper Roaring Valley, power would have been out for a week, vulnerable food and electric supply, this matters for public health.  What CC is doing to us. Pitkin County passed a declaration of CC emergency a couple months ago. It’s so hugely important to us, the country, the state, and the world.

Karan: Best way to activate people is to use a health frame. It’s up to us to emphasize that CC is a threat multiplier. Center this conversation around health is pivotal moving forward.

Joe Hanel, Colorado Health Institute Shark-nado – a tornado full of sharks (6 sharknado movies).  #3 “Oh Hell No!” We’ve all been the guy suddenly hit by sharks. The economy – more sharks – record long boom in CO and the US, longest economic expansion on record. Likely ending in the next year or two though. The boom has been good for the state budget and restore cuts, add full day kindergarten. The state budget really rises and falls with the economy. Health Policy – ACA still law of the land.  Sharks still circling. Under threat in courts and by exec action.  Dem primary, M4All. 30% for M4All, 30% in favor of keeping ACA, 30% for Trump.

Politics – entering an election year, even an impeachment year.