Lung Health in a Changing Climate: AstraZeneca’s Commitment to Equity and Action

By NanaEfua Afoh-Manin MD, MPH, MPA

It has been three weeks since Climate Week NYC 2024, hosted by the Climate Group, which marked a turning point in addressing this global public health crisis by featuring, for the first time, the integration of climate and health on the main stage. With a forward-looking approach, AstraZeneca led the informative week with a critical, thought-provoking discourse on climate change and lung health, health equity and inclusive actions with its inaugural Health Equity Roundtable titled Lung Health: A Climate Conversation. The gathering brought together a powerhouse group of research experts and thought leaders to grapple with important nuances in the sector as it relates health disparities and conservation. Held at The New York Times building, the experts spoke candidly about the social and environmental drivers of health and evoked a solution-driven discussion about the challenges of early access to screening and diagnostics while reaffirming a commitment to evidence-based action in ensuring no community would be left behind.

Dan Wygal, VP of Corporate & Government Affairs at AstraZeneca set the tone as the moderator sharing shocking statistics on the impact of environmental pollutants known to cause and exacerbate lung diseases. According to the American Lung Association’s 2024 report, State of Air, over 131 million people in the US live in areas with dangerous levels of air pollution.² After progress from decades of interventions designed to reduce emissions, “State of the Air” shows that climate change is degrading air quality in much of the country. An overwhelming number of people are living in communities with failing grades in ozone air pollution. The increase in toxic particulate matter is reported to be driven by wildfires. Spikes in these particulates lead to increased illness, hospitalizations, and premature deaths (State of Air, 2024). Extreme heat and environmental degradation add to the air pollution burden.

Dr. Joan Schiller, who sits on the Board of the Lung Cancer Research Foundation, is Chair and Co-founder of Oncology Advocates United for Climate and Health – International (OUCH – International), an adjunct professor at the University of Virginia, and the former Deputy Director of UT Southwestern Cancer Center, remarked that air pollution caused by the burning of fossil fuels and smoke from wildfires is responsible for 13-14% of lung cancer cases worldwide³ Dr. Schiller’s sobering review of the effects of climate change on cancer care, cancer outcomes, and cancer incidence underscore the urgency for critical action to reduce CO2 levels in the atmosphere, whether produced by the burning of fossil fuels, or smoke from wildfires and burning of other sources of biomass.

“The climate crisis and the increasing threat to lung health sits at the intersection of genetics and environment,” asserted Chief Scientific Officer at GO2 for Lung Cancer, Dr. Courtney Granville. For more than 30 years, GO2 has been at the forefront of everything that’s happening in lung cancer. Founded by patients and survivors, the organization is dedicated to increasing survival for those at risk, diagnosed, and living with lung cancer. As climate conditions and air quality change, it’s not only about the production of particulate matter but also about how long these particulates “stick around,” she explained. The World Health Organization (WHO) identified air pollution as the second leading cause of death globally, emphasizing the urgent need for action.³ Research has revealed that these toxic materials change the environment and biodiversity, which leads to chronic conditions like asthma and COPD worsening over time, particularly in underserved communities where access to healthcare remains limited.⁴

Biodiversity: The Elephant in the Room

Many of the experts agreed that biodiversity loss is “the elephant in the room—an existential threat that is seldom discussed but critical to solving the climate and health crisis.” The impassioned statement by Dr. Neil Vora, senior advisor for One Health at Conservation International and Executive Director of the Preventing Pandemics at the One Source Coalition, underscored the moral imperative to preserve biodiversity. He recognized that from fossil fuel use, these reductions are not happening fast enough to mitigate the crisis.⁵ Dr. Vora emphasized that “without addressing biodiversity, we will not be able to meet climate or health equity goals.”

According to the WHO, COVID-19 was the fifth leading cause of death related to communicable diseases prior to 2021. Since then, deaths from other noncommunicable diseases were also on the rise. Trachea, bronchus, and lung cancers deaths have risen from 1.2 million in 2000 to 1.9 million in 2021 and are now ranked sixth among the leading causes of death.⁶ Worldwide, air pollution is estimated to cause 29% of lung cancer deaths. According to Dr. Upal Basu Roy, Executive Director of Research at LUNGevity Foundation, the number one way to reduce the disease burden is to reduce air pollution through reduced emissions and through integrated prevention and early detection efforts.

LUNGevity is the nation’s leading lung cancer organization transforming what it means to be diagnosed with and live with lung cancer. AstraZeneca, a proud sponsor of Lung Health and Climate Change, also partners with LUNGevity in advancing our shared commitment to decrease the burden of lung cancer. LUNGevity seeks to make an immediate impact on quality of life and survivorship for everyone touched by the disease while addressing disparities throughout the care continuum.⁸

Improving Access to Screening and Early Detection

A major pain point presented at the roundtable was the need for more equitable access to early detection and lung health screenings. Randy Rutta, CEO of the National Health Council (NHC), points to the fact that the burden of climate change and health inequities fall disproportionately on low socioeconomic communities. These communities already have difficulty accessing baseline health services and health literacy. Climate action solutions aimed at targeting vulnerable populations must recognize that the legacy systems that are operating are insufficient and biased. According to the NHC, legacy systems continue to bolster discriminatory practices and have replaced the language of segregation with new discriminators. Randy emphasized that “piecemeal solutions are problematic in addressing discrimination and health disparities.” A complete transformation of the healthcare system to promote unbiased tools and structures—like those embedded in some of our AI tools—is necessary in order to advance equitable access to quality healthcare for all.⁷

Rutta also affirmed that “tapping into the assets of the community to build strong collaborations in outreach, education and a real investment in community buy-in is an effective asset-based mindset needed to do this work long term.” Dr. Basu Roy agreed and cited that many communities, especially in states that have not expanded Medicaid, are experiencing rising rates of lung cancer without the necessary infrastructure for timely screening and early detection. More advocacy and resources need to be directed to communities like these, which are falling out of the safety net and subject to state policies that exacerbate health disparities.  

Chris Hanley of the National Academy of Medicine and Director of the Grand Challenge on Climate Change, Human Health, and Equity advised ensuring co-development and collaboration with the community throughout the entire lifecycle of the process. “Partnership has to start from minute one, and be a sincere effort throughout.” Echoing this is Dr. Alexander Azan, Assistant Professor at NYU Langone Health, Department of Population Health and Family Health Centers, who reiterated how communities have reasonable distrust in the health system and may be skeptic to screening. “This is a barrier we as health professionals need to be innovative at overcoming.” Mobilizing trusted networks and practitioners is a great opportunity to partner with patient advocates.⁸

AstraZeneca’s Commitment to Health Equity

At the heart of the roundtable discussion was AstraZeneca’s dedication to advancing health equity through its US Health Equity Roadmap. This strategy is guided by four foundational pillars: Science, Delivery, Community, and People, each serving to guide efforts to close the gap in lung health disparities. AstraZeneca’s efforts focus on increasing diversity in clinical trials, expanding access to life-saving treatments, and building meaningful partnerships with community organizations.

To the point of enhanced understanding at the community level, AstraZeneca is investing in data smart systems and AI to predict at-risk populations to support efficient allocation of resources, especially in regions with limited healthcare infrastructure. The company is advancing insight beyond only behavioral risk factors, such as smoking, and modeling environmental risk factors along with wider socio-economic factors like poverty, underinsurance, and educational attainment. In many populations, these risk factors often overlap and have a compound effect. A prime example of this commitment is the Rural Appalachian Lung Cancer Screening Initiative. In collaboration with the Association of Community Cancer Centers, AstraZeneca has made significant strides in addressing the needs of some of the most economically disadvantaged regions in the US. This initiative has driven lung cancer screenings in the rural Appalachian counties, transforming Kentucky’s screening rates into some of the best in the nation. As Dan Wygal put it, “We are not just discussing solutions; we are engaging cross-sectors.”

Public-Private Partnerships: A Collaborative Approach to Innovation

Complementing its Health Equity Roadmap, AstraZeneca recognizes that creating sustainable healthcare systems requires both reliable data and strong partnerships. Public-private collaborations play a pivotal role in accelerating innovation worldwide, with no single entity—government, organization, or institution—able to achieve these ambitious goals alone. This collaborative ethos was a recurring theme at the roundtable.

Community Health Workers (CHWs) were also highlighted as essential partners in these collaborations, especially in underserved regions. Often the most trusted members of their communities, CHWs play a critical role in educating and disseminating resources to vulnerable populations. Yet, despite their impact, CHWs remain an underutilized resource. As Laura Kate Bender aptly remarked, “A successful program is ultimately one that is customized for the population it serves,” underscoring the need for greater investment in CHWs initiatives, particularly in rural areas hardest hit by environmental degradation.

The Takeaway: What does the climate crisis have to do with lung health?

The evidence is clear, climate change is not just an environmental issue, it is a public health crisis that demands immediate, inclusive, and intentional action. It has a lot to do with rising rates of lung cancer and other respiratory ailments. The experts emphasized the need for stronger policies that focus on preserving biodiversity and promoting prevention, particularly in air quality regulation and early screening for lung disease. Dr. Azan called for more robust federal and local policies to support lung health, stressing that “prevention is key to reducing the lung health burden in the face of climate change.”

As AstraZeneca continues its response to the White House’s PREPARE Action Plan, the company aims to strengthen community and healthcare system resilience to climate change through strategic public-private partnerships, the integration of cutting-edge technologies like AI, and the application of Social Drivers of Health (SDoH) indices. By utilizing these evidence-based approaches, AstraZeneca is well-positioned to introduce more informed and impactful solutions. The roundtable concluded with several actionable takeaways and an optimistic outlook on future initiatives. Stay tuned for The Health Innovation Summit (THIS) for Lungs, a two-day event exploring lung health, sponsored by AstraZeneca, taking place in Philadelphia, PA, on November 1-2, 2024.

Through strategic partnerships, technological innovations, and a commitment to health equity, AstraZeneca’s continued engagement will be vital to scaling up lung health interventions and addressing the broader health equity challenges posed by climate change.

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1. Economist Impact: https://impact.economist.com/sustainability/ny-climate-week-what-does-this-mean-for-cop28
2. American Lung Association: State of the Air Report 2024 (2024)
3. WHO Air Pollution report: https://www.who.int/health-topics/air-pollution#tab=tab_1
4. Granville, C., Health inequities across the lung cancer care continuum in ten marginalized populations: a narrative review
5. Vora, N., The Lancet: PPATS Commission on Prevention of Viral Spillover: reducing the risk of pandemics through primary prevention (2024)
6. World Health Organization: The top 10 causes of death (2024)
7. National Health Council - https://nationalhealthcouncil.org/staff/randall-l-rutta/
8. Azan, A., Primary care needs to rise to the challenge of caring for patients during climate disasters (2023)