~~ recommended by emil karpo ~~
Authors: Avery E. Emery, B.S., and Daniel G. Aaron, M.D., J.D. https://orcid.org/0000-
Climate change is a public health crisis. Communities are struggling to shoulder the costs of establishing critical public health infrastructure to mitigate the physical and mental health effects of rising temperatures, poor air quality, and extreme weather events. Meanwhile, the U.S. Supreme Court has limited the ability of federal regulators to implement public health measures, including those aimed at addressing climate change. In the absence of a comprehensive national approach to confronting the climate crisis, various states and local governments have sought to use litigation to pass many of the costs of addressing the public health effects of climate change on to the oil companies that they allege have contributed to this crisis. Although the progress of these lawsuits has repeatedly stalled, a recent settlement on the eve of a trial in a related case brought by Cameron Parish, Louisiana — seeking as much as $7 billion in damages from 26 companies in the oil and natural-gas industries — could be a bellwether for the efficacy of lawsuits against oil companies targeted at remediating the costs associated with climate change, including public health costs.
As global mean temperatures continue to rise because of emissions of greenhouse gases, severe weather events are expected to occur more often, cause greater damage, and kill, injure, or displace increasing numbers of people.1 Beyond exacerbating hurricanes, wildfires, and droughts, climate change will most likely make illness and deaths related to heat, air pollution, and undernutrition more common.1 Even according to conservative predictions, under which greenhouse-gas emissions peak around 2040, the United States will face an enormous burden of premature death and billions of dollars of health-related costs each year because of extreme temperatures, infectious diseases, and air pollution.2
The health effects of climate change in the United States won’t be evenly borne by all communities. Marginalized racial and ethnic communities and low-income communities have been disproportionately affected by climate change and air pollution.3 A long history of structural racism has resulted in marginalized groups, particularly Black people, being more likely than White people to live near major sources of pollution and in neighborhoods that have few green spaces and tend to be heat islands.3
Communities increasingly need to consider the effects of climate change when making decisions about public health infrastructure. The U.S. Global Change Research Program has highlighted the benefits associated with making health care infrastructure more resilient to the effects of climate change. For example, the Nicklaus Children’s Hospital in Miami spent $11.3 million to make critical updates, including building a shell intended to allow the hospital to withstand Category 4 hurricanes.2 To help mitigate the health effects of climate change, communities can also invest in heat-wave warning systems, cooling centers, green spaces with trees for shade, and updated power grids and water-management technologies.2
The case filed by Cameron Parish, which was settled in December 2023 for an undisclosed amount of money, was one of many that have targeted the oil industry. Louisiana communities have filed more than 40 lawsuits against oil companies over their dredging activities, alleging that the companies’ actions polluted local bodies of water and made the communities more susceptible to flooding. Meanwhile, states and local governments throughout the country have filed other lawsuits alleging that oil companies exacerbated the climate crisis by obfuscating their products’ role in contributing to climate change and the associated health harms and failing to pursue energy sources that result in lower greenhouse-gas emissions (see table).
Selected States and Local Governments with Pending Lawsuits against Oil Companies.
Although the settlement amount in the Cameron case is unknown, the companies’ willingness to settle, despite dozens of cases pending, suggests that litigation could be a promising way for states and local governments to adapt to a changing climate. Settlements or awards could be used by governments and public health officials to design and implement adaptations that could help reduce the public health harm caused by climate change and address the disproportionate effects on marginalized communities. One change could involve transitioning away from the use of fossil fuels in the medical field, since the health care sector is responsible for roughly 8.5% of U.S. greenhouse-gas emissions.4
Although Cameron’s settlement is encouraging and could allow the parish to implement critical adaptations, litigation may have drawbacks as a strategy for addressing the climate crisis. The slow pace of litigation (Cameron filed its lawsuit in early 2016) can spread litigation-related pressures over many years, which could result in such cases becoming a cost of doing business for the oil industry. One reason for this slow pace has been disagreement among parties over whether the cases should be litigated in state or federal courts. In 2023 and 2024, the Supreme Court repeatedly declined to review decisions that have sent the cases back to the various state courts. Although this development has been a victory for the states and local governments involved, which filed the cases in state courts and fought against their subsequent removal to federal courts, these procedural fights have substantially delayed resolution of the cases.
In addition, given their urgent public health needs in the face of climate change, governments may have an incentive to agree to settlements that are worth less than they could have been awarded in a jury trial. Such settlements, the terms of which may be kept confidential, could prevent the public from learning about the alleged disinformation campaigns by the oil companies named in the cases. Companies are also able to continue — and continue profiting from — the activities described in the lawsuits while litigation proceeds and potentially after the lawsuits are resolved. Moreover, this strategy doesn’t guarantee an equitable distribution of adaptation funds, since access to funds is dependent on a community’s willingness or ability to be involved in litigation that, even if successful, can take years to resolve.
Federal legislation could address these shortcomings by providing communities with the funds necessary to promote public health amid the climate crisis (and doing so faster than litigation could) and actively regulating greenhouse-gas emissions. But thus far, federal efforts to mitigate fossil-fuel pollution and implement lifesaving adaptations in the face of climate change have been lacking. The Inflation Reduction Act of 2022, for instance, is projected to reduce U.S. greenhouse-gas emissions, but many of its benefits are contingent on other necessary investments in energy infrastructure.5
Lawsuits brought by states and local governments, if broadly successful, could mark a turning point in efforts to protect public health from threats associated with climate change. Major adaptations are necessary, but the combined costs of such changes could overwhelm local governments. In the absence of federal legislation, the pending lawsuits offer an opportunity for the public to pass part of the financial burden associated with protecting public health on to companies that, according to the suits, profited from the use of fossil fuels and hid the dangers associated with emissions from the public for decades. Physicians and public health practitioners can support these lawsuits by joining amicus briefs in pending cases, helping to develop evidence-based plans for the use of litigation proceeds, amplifying conversations about climate change and health, and encouraging their cities, counties, and states to join the wave of litigation. Until there is a national approach to addressing the climate crisis, we believe lawsuits brought by governments can play an important role in holding companies accountable and rectifying problems that threaten individual and planetary health.
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