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Public health, energy & climate change: A survey of Maryland residents, 2014

Authors:
K. L. Akerlof
K. L. Akerlof
Edward W Maibach at George Mason University
Edward W Maibach
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Abstract and Figures

In 2013, George Mason University fielded the first survey of climate change, energy and public health in the state. We repeated some of the questions and added new measures in 2014. This report, focused on public health and climate change, is the last of four released from the 2014 data. Other reports highlight attitudes, behaviors, and policy preferences on sea‐level rise and adaptation, energy, and climate change generally.1 Below we highlight new findings regarding climate change and public health, and some of the most important changes that we found in the state over the past year.
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Public Health,
Energy & Climate Change
A Maryland Statewide Survey | 2014
Investigators:
KarenAkerlof,PhD
EdwardW.Maibach,MPH,PhD
GeorgeMasonUniversity
CenterforClimateChangeCommunication
4400UniversityDr.,MS6A8
Fairfax,VA22030
kakerlof@gmu.edu,(703)993‐6667
emaibach@gmu.edu,(703)993‐1587
ThissurveywasfundedbytheTownCreekFoundationofEaston,MD.WethanktheTown
CreekFoundationanditsExecutiveDirectorStuartClarkefortheirsupport.
Theprojectbenefittedfromtheexpertiseandhardworkofmanyindividuals.Membersofthe
ClimateCommunicationConsortiumofMaryland(climatemaryland.org)assistedinthe
developmentofthesurvey.KenAdamsandCharlesCoatsprovidedinvaluablehelpin
coordinatingitsfielding.They—withadditionalassistanceprovidedbyMasonundergraduate
andgraduatestudentsAiyaAl‐Beyati,RefkaAl‐Beyati,NatashaS.Taliferro,RebeccaLloyd,
DeannaKirby,StacyNelson,RoxanaKazemi,ClaudiaHarris,KellyHayden,PatrickGreenwalt,
BrittanyGrutter,AndySachs,VeraSolovyeva,DharaPatel,ElloiseL.Lotoc,DanielleKirby,
SuzanneHewitt,AileenS.DierigandSeanKelley—assembledthemailingsoveraseriesoflong
weekends.PaulWeissfromEmoryUniversityprovidedstatisticalsupportfortheweights.Any
errorsarethoseoftheauthors.
Credits,coverphoto:
Photoofachildwithasthmausinganebulizer.Longerperiodsofhightemperatures,suchas
anticipatedwithclimatechange,canresultinincreasesinairpollutionassociatedwithasthma.
Photofromistockphoto.comfromMarylandDepartmentoftheEnvironmentat
climatechange.maryland.gov.
Suggestedcitation:
Akerlof,K.,&Maibach,E.W.(2015).Publichealth,energy&climatechange:Asurveyof
Marylandresidents,2014.Fairfax,VA:CenterforClimateChangeCommunication,George
MasonUniversity.
TableofContents
ExecutiveSummary.........................................................................................................................1
1.MostMarylanderssayclimatechangeharmshumanhealth....................................................3
Breathingproblemsareseenasthemostlikelyharmtohealth;
infectiousdiseaselessso............................................................................................................3
Marylanderssayotherpeoplethanthemselvesandfuturegenerations
aremorevulnerable...................................................................................................................4
Peoplewithmedicalconditionsandtheelderlyareseenasvulnerable.................................5
Peoplewhoarevulnerableduetomedicalconditionsaremorelikelytounderstand
therisk......................................................................................................................................6
2.Doctorsandpublichealthexpertsaretrustedsourcesofinformationonclimatechange.......7
3.Theperceivedriskstohealthfromchemicalsandpollutionhavegrown..................................8
Healthrisksfromclimatechangeandfloodingareperceiveddifferentlyacrossregions.........8
Manyexperiencedlossofelectricityandwind‐orstorm‐relateddamageinthepastyear.....8
4.Environmentalhealthandhealthcareaccessarerankedamongtopstatepriorities............11
5.Coal,oil,andnuclearpowerareseenasharmfultohealth.....................................................12
Residentssaysolarandwindarenotatallharmfultohealth.................................................12
6.Studymethodology...................................................................................................................14
Appendices....................................................................................................................................17
Correlationtables.........................................................................................................18
Datatables....................................................................................................................20
Sampledemographics...................................................................................................44

1 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
ExecutiveSummary
In2013,GeorgeMasonUniversityfieldedthefirstsurveyofclimatechange,energyandpublic
healthinthestate.Werepeatedsomeofthequestionsandaddednewmeasuresin2014.This
report,focusedonpublichealthandclimatechange,isthelastoffourreleasedfromthe2014
data.Otherreportshighlightattitudes,behaviors,andpolicypreferencesonsea‐levelriseand
adaptation,energy,andclimatechangegenerally.1Belowwehighlightnewfindingsregarding
climatechangeandpublichealth,andsomeofthemostimportantchangesthatwefoundin
thestateoverthepastyear.
MostMarylandersunderstandthatclimatechangeharmshumanhealth
MorethanhalfofMarylanders(55%)saythattheyexpectthatpeople’shealthintheir
communitieswillbeaffectedbyclimatechangeinthenextseveralyears.
Stateresidentssaybreathingandrespiratoryproblems(72%),injuriesfromextreme
weather(61%),andheatstroke(55%)arelikelytobecomemorecommoninthestate
duetoclimatechange.
Infectiousdiseaseislesslikelytobecitedasanincreasingrisktohealthduetoclimate
change.Lessthanhalfofstateresidents(42%)saythatitwillbecomemorecommon,
eventhoughclimatechangeisprojectedtoaffectthespreadofdisease.
Doctorsandpublichealthexpertsaretrustedsourcesofclimatechangeinformation
Medicalauthoritiesareamongtheprofessionalstrustedthemostforinformationon
climatechange.Marylanderstrustdoctorsandpublichealthexpertsonclimatechange
onlyslightlylessstronglythanscientistsatMarylanduniversities(63%vs.70%).
MoreMarylandersperceivechemicalsandpollutionasarisktohealth
MorethanhalfofMarylanders(55%)saythatexposuretochemicals,including
pesticides,infoodandotherproductsisamajorrisktotheirpersonalhealth.This
representsasizeableshift—up23percentagepoints—sincespring2013.
Polluteddrinkingwater(52%),airpollution(47%)andsecond‐handsmoke(41%)also
showedconsiderableincreasesinpublicperceptionsasmajorriskswith19,16,and12
percentage‐pointgainsrespectively.
Sixty‐threepercentofMarylandersciteclimatechangeasamoderateormajorriskto
theirpersonalhealth—anincreaseof11percentagepointsfromspring2013.
EnvironmentalhealthandhealthcareaccessareamongMarylanders’toppolicypriorities
Three‐quartersofMarylanders(74%)saythatimprovingaccesstohealthcareshouldbe
ahighorveryhighpriorityforthestate’sGeneralAssemblyandgovernor.
1Seethereportsathttp://www.climatemaryland.org/survey/
2 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
Healthcareaccessranksaftercreatingjobs(89%)andreducingwaterpollution(81%)in
Marylanders’priorities,andisaboutthesamepercentageasgrowingthemiddleclass
andreducingairpollution.
Fossilfuelsandnuclearpowerareseenasharmfultohealth;solarandwindarenot
Almostthree‐quartersofMarylanders(72%)saythatcoalissomewhatorveryharmful
topeople’shealth.Oil(64%)andnuclearpower(58%)alsoraisehealthconcerns.
Overthepastyear,thenumberofpeoplewhosaythatcoalis“veryharmful”tohealth
increasedby10percentagepointsto41%.
Renewableenergysourcessuchaswindandsolarcontinuetobeviewedbymajorities
asnon‐harmful(solar,65%;offshorewind,57%;land‐basedwind,58%).In2014,there
wasanincreaseoffivepercentagepointsinthosepeoplewhosaythatsolarhasno
negativeeffectsonhealth.
Studymethodology
Thesurveywasmailedto6,401householdsinthestateofMaryland,randomlyselectedfrom
withineachoffourregionsofthestate.2Wesampledattheregionalleveltoensurethefinal
datawasgeneralizabletothesedistinctlydifferentgeographicandculturalareasaswellasto
thestateasawhole,weightingthedataatboththestateandregionallevelsinaccordancewith
U.S.Censuspopulationdistributions.Householdsthatrespondedtothesurveyin2013were
notre‐contactedin2014.ThesurveywasfieldedfromMarch17toJune10,2014witha
responserateof35%.Theunweightedsamplemarginoferroris+/‐2percentagepointsatthe
95%confidenceintervalforthestateandlessthan+/‐5percentagepointsforeachregion.(See
studymethodology,page14).Thisreportincludessurveydatafrom2013asabasisfor
comparison;statisticalcomparisonsbetweenyearswereassessedforsignificance.Survey
reportsfrom2013canbefoundatclimatemaryland.organdincludeadescriptionofthesample
andmethodology.Bothwereconsistentacrossyears.
2WesternRegion–Allegany,Frederick,GarrettandWashingtoncounties;CentralRegion–Baltimore,Carroll,
Cecil,Harford,Howard,MontgomerycountiesandBaltimoreCity;SouthernRegion–AnneArundel,Calvert,
Charles,PrinceGeorge'sandSt.Mary'scounties;EasternRegion–Caroline,Dorchester,Kent,Queen
Anne's,Somerset,Talbot,WicomicoandWorcestercounties.
3 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
1.MostMarylanderssayclimatechangeharmshumanhealth
MorethanhalfofMarylanders(55%)saythattheyexpectthatpeople’shealthintheir
communitieswillbeaffectedbyclimatechangeinthenextseveralyears(seeAppendices,Table
1,p.21).Indeed,manystateresidentscontinuedin2014toseebreathingandrespiratory
problems(72%),injuriesfromextremeweather(61%),andheatstroke(55%)aslikelyto
becomemorecommoninthestateduetoclimatechange(seeFigure1).In2013,theywere
significantlylesslikely,however,tothinkthatsunburnswouldbeaconsequence,downby
sevenpercentagepointsto41%.Climatechangehaslongbeenconfusedwithozonedepletion,3
whichincreasestheamountofultravioletlightpassingthroughtheatmosphereandtheriskof
sunburnandskincancers.(Recently,somestudieshavesuggestedthatclimatechangeactually
mightaffectUVexposureandrelatedcancers.4)
Breathingproblemsareseenasthemostlikelyharmtohealth;infectiousdiseaselessso
Onaverage,72%ofMarylanderssaythatbreathingandrespiratoryproblemswillincreasewith
climatechange,butthosewholiveintheSouthernregionofthestate,stretchingfromAnne
ArundeltoSt.Mary’scounties,are10percentagepointsmorelikelytosaysothanthemore
Figure1|Heatstroke,injuriesandbreathingproblemsareexpectedtoincrease
3Read,D.,Bostrom,A.,Morgan,M.G.,Fischhoff,B.,&Smuts,T.(1994).WhatDoPeopleKnowAboutGlobal
ClimateChange?2.SurveyStudiesofEducatedLaypeople.RiskAnalysis,14(6),971–982.
4Hui,Y.,Thong,H.‐Y.,&Maibach,H.I.(2011).Globalwarminganditsdermatologicimpact.ExpertReviewof
Dermatology,6(5),521–523.
4 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
ruralEasternandWesternportionsofthestate(Southern,76%;Western,66%;Central,71%;
Eastern,66%)(seeAppendices,Table2,p.23).Infectiousdiseaseislesslikelytobethoughtof
asahealtheffectfromclimatechange(42%),withlittlevariationfromsurveyrespondents
acrossthestate’sregions(Western,40%;Central,41%;Southern,44%;Eastern,43%),even
thoughclimatechangeisprojectedtoaffectthespreadofdisease.5
Marylanderssayotherpeoplethanthemselvesandfuturegenerationsaremorevulnerable
Researchhasshownthatpeopletendtoseeclimatechangeassomethingthathappensto
peopleinplacesfarawayfromthem.6Inthissurveyweaskedrespondentswhotheybelieve
aremostvulnerabletopotentialhealthimpactsfromclimatechange—themselves,peoplein
theirhouseholds,peopleintheircommunities,Marylanders,orpeopleintheUnited
States—andthedegreetowhichtheywillbeharmed.Consistentwithpriorresearch,
MarylandersaremorelikelytosaythatpeopleintheU.S.generallyare“veryvulnerable”(31%)
orevenpeopleinMaryland(21%),thantheythemselves(11%)orthoseintheirhouseholds
(13%)(seeFigure2).Ofnote,fewpeoplesaythattheyorpeopleintheirhouseholdarenotat
allvulnerabletohealththreatsfromclimatechange(10%and12%respectively).
Figure2|PeopleintheU.S.areseenasmorevulnerablethanthosepeopleclosetohome
5Luber,G.,Knowlton,K.,Balbus,J.,Frumkin,H.,Hayden,M.,Hess,J.,McGeehin,M.,Sheats,N.,Backer,L.,
Beard,C.B.,Ebi,K.L.,Maibach,E.,Ostfeld,R.S.,Wiedinmyer,C.,Zielinski‐Gutiérrez,E.,&Ziska,L.(2014).Ch.9:
Humanhealth.ClimatechangeimpactsintheUnitedStates:ThethirdNationalClimateAssessment.U.S.Global
ChangeResearchProgram,p.220‐256.
6Leiserowitz,A.(2005).AmericanRiskPerceptions:IsClimateChangeDangerous?RiskAnalysis,25(6),1433‐1442.
5 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
MostMarylanders(65%)believethatfuturegenerationsofpeoplewillbeharmed“agreat
deal,”whileonlysmallminoritiesfeelthatpeopleinMaryland(28%)ortheythemselves(19%)
willbeharmedtothesameextent.Conversely,fewMarylanderssaythatthey(12%),other
Marylanders(7%)andfuturegenerationsofpeople(5%)willnotbeharmedatallbyclimate
change(seeFigure3).
Peoplewithmedicalconditionsandtheelderlyareseenasvulnerable
AmajorityofMarylanderssaythatpeoplewithmedicalconditions(59%)andtheelderly(55%)
areveryvulnerabletothepotentialhealthimpactsofclimatechange(seeFigure4).Theyare
lesslikelytoidentifyyoungchildrenandpeopleonlowincomesasveryvulnerable(42%and
36%,respectively).Inreality,asnotedinthekeymessagesofthehumanhealthchapterofthe
NationalClimateAssessment,“(c)ertainpeopleandcommunitiesareespeciallyvulnerable,
includingchildren,theelderly,thesick,thepoor,andsomecommunitiesofcolor.”7
Middle‐agedindividualsarenotconsideredaparticularlyvulnerablegroupunlesstheyhave
othercharacteristicsthatputthematrisk,suchasamedicalconditionorlowincome.
Figure3|Climatechangeisperceivedmoststronglyasathreattofuturegenerations
7Luber,G.,Knowlton,K.,Balbus,J.,Frumkin,H.,Hayden,M.,Hess,J.,McGeehin,M.,Sheats,N.,Backer,L.,
Beard,C.B.,Ebi,K.L.,Maibach,E.,Ostfeld,R.S.,Wiedinmyer,C.,Zielinski‐Gutiérrez,E.,&Ziska,L.(2014).Ch.9:
Humanhealth.ClimatechangeimpactsintheUnitedStates:ThethirdNationalClimateAssessment.U.S.Global
ChangeResearchProgram,p.220‐256.
6 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
Figure4|Youngchildrenandpeopleonlowincomesarelessfrequentlyidentifiedasathighrisk
Peoplewhoarevulnerableduetomedicalconditionsaremorelikelytounderstandtherisk
Marylanderswhosaythatthey—ormembersoftheirhousehold—havenotbeendiagnosed
withoneormoreoffivetypesofmedicalconditionsarelesslikelytounderstandthatpeople
withmedicalconditionsaremorevulnerabletohealththreatsfromclimatechange(see
Appendices,CorrelationTable1,p.18‐19).8Indeed,eachofthefivemedical
conditions—coronaryheartdisease,obesity,diabetes,respiratoryillness(asthma),aphysicalor
mentaldisability—arecorrelatedatthepersonaland/orhouseholdlevelwithincreased
understandingthatpeoplewithmedicalconditionsaremorevulnerabletoclimatechange.The
correlationsbetweenself‐reporteddiagnosesandrecognizingthatmedicalconditionsmake
peoplemorevulnerabletoclimatechangesuggestthatpeoplewhoarevulnerablearemore
likelytorealizeit,thoughtheeffectsizeisrelativelysmall.
8Nopersonalmedicalconditions,Pearson’scorrelation,r=‐.109,p<.001;nohouseholdmedicalconditions,r=
‐.107,p<.001.Foranexplanationofcorrelation,seep.21.
7 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
2.Doctorsandpublichealthexpertsaretrustedsourcesof
informationonclimatechange
Amongthe11groupsofprofessionalsandorganizationsassessedinthissurveyassourcesof
informationaboutclimatechange,medicalauthoritiesareamongthemosttrusted.
Marylanderstrustdoctorsandpublichealthexpertsassourcesofinformationaboutclimate
changeonlyslightlylessstronglythanscientistsatMarylanduniversities(63%vs.70%)(see
Figure5).Fewresidentsinthestatesaythattheydistrustdoctorsandpublichealthexpertson
climatechange(8%)orMaryland’sscientists(9%).Whileenvironmentalorganizations,
weathercastersandnewsmediaarealsoamongthetopfivemosttrustedsourcesof
informationonclimatechange,moreMarylanderssaythattheydistrustthem—aboutone‐fifth
toaquarterofthestate.
Figure5|Marylanderstrustdoctorsandpublichealthexpertsonclimatechange
8 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
3.Perceivedrisksfromchemicalsandpollutionhavegrown
MorethanhalfofMarylanders(55%)saythatexposuretochemicals,includingpesticides,in
foodandotherproductsisamajorrisktotheirhealth(seeFigure6).Thisrepresentsasizeable
shiftupward—23percentagepoints—sincespring2013.In2013,obesitywasconsideredthe
largestpersonalhealthriskamongMarylanders(majorrisk,37%).Thisyear,obesitydroppedto
fifthafterexposuretochemicalsinfoodandproducts,polluteddrinkingwater(52%),air
pollution(47%)andsecond‐handsmoke(41%).Publicperceptionsofobesitychangedlittleover
thepastyear(majorrisk,39%),butbeliefsaboutthepersonalhealthrisksposedbypolluted
drinkingwater,airpollutionandsecond‐handsmokeconsiderablyincreasedwithgainsof19,
16,and12percentagepointsrespectively.
Climatechangerankedeighthasa“major”personalhealthriskthatconcernsMarylanders.
Sixty‐threepercentofMarylanderscitedclimatechangeasamoderateormajorrisktotheir
personalhealth—anincreaseof11percentagepointsfromspring2013(seeFigure7).Almosta
quarter—23%—saythatitisamajorrisktotheirhealth,onparwithviolentstorms(23%).
Healthrisksfromfloodingandclimatechangeareperceiveddifferentlyacrossregions
Marylandersacrossthestate’sfourregionsgenerallymakesimilarjudgmentsaboutpersonal
healthrisks.Exposuretochemicalsinfoodandotherproducts,andairpollution,are
consistentlyrankedthetopmoderateormajorhealthrisksinallfourregions(Western,
82%/74%respectively;Central,85%/86%;Southern,81%/81%;Eastern,80%/75%)(see
Appendices,Table9,p.33).However,therearedifferences.Floodingisperceivedaslessofa
concerninthemountainousWesternregionandmoreofaconcernonthelow‐lyingEastern
Shore(Western,37%;Central,51%;Southern,52%;Eastern,60%).Climatechangeismostlikely
tobelistedasamoderateormajorpersonalhealthriskbythoseintheurbanCentralregionof
thestate(67%),whereitisranked6thof11risks,andleastlikelyintheEasternregion(49%),
whereitisrankedlowest(Southern,59%,ranked8th;Western,52%,ranked10th).
Manyexperiencedlossofelectricityandwind‐orstorm‐relateddamageinthepastyear
Morethanthree‐quartersofMarylanders(76%)saythattheyhaveexperiencedpoweroutages
atleastonceormoreinthelast12monthswithalmostanothertwo‐fifths(39%)sayingthat
theyhavehadwind‐orstorm‐relateddamageoverthesameperiod(seeFigure8).Power
outageswerereportedbylargemajoritiesregardlessofgeographiclocation(Western,83%;
Central,74%;Southern,79%;Eastern,72%)(seeAppendices,Table10,p.37).Windandstorm
damageafflictedbetween37%and45%ofresidentsacrosseachregionofthestate(Western,
42%;Central,38%;Southern,37%;Eastern,45%).Othertypesofstorm‐relatedexperiencesare
reportedlessfrequently:19%lostdrinkingwater,and9%sufferedflooddamage.Self‐reported
flooddamagesfortheprevious12monthsoverallarelowacrossmostofthestate,butshowa
9 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
Figure6|Marylandersbecamemoreconcernedabouthealthrisksinthepastyear
Figure7|Chemicals,pollutedwaterandairpollutionareperceivedasmajorhealththreats
10 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
similarpatternastheregionalperceptionsoffloodrisksreportedabovewith18%ofresidents
fromthelow‐lyingEasternShorereportingdamages,butjust5%oftheWesternregion
(Central,9%;Southern,9%).VeryfewMarylanderssaythattheyhaveexperiencedwildfire
damage(1%).
Personallyexperiencingharmorlosscaninfluencethewayinwhichpeopleweighfuturerisks,
andmotivatethemtotakeprotectiveactions.9Havingexperienceddifficultybreathingdueto
airpollutionduringthe12monthspriortothesurveyisassociatedwithperceiving11potential
healththreats—fromsecond‐handsmoketofluepidemics,obesity,andclimatechange—as
moresignificantpersonalrisks,10andismoststronglycorrelatedwithbelievingoneselftobeat
riskfromairpollutionandheatwaves,11althoughthecorrelationsarerelativelyweak(see
Appendices,CorrelationTable2,p.18‐19).Incidentsofrecentflooddamagearealso
associated—thoughnotstrongly—withhigherriskperceptionsregardingseventypesofhealth
threats,butparticularlyflooding.12Believingoneselftobebeingpersonallyatriskfromthe
healthimpactsofclimatechangeisalsoweaklycorrelatedwithpreviousexperiencesofflood
andwind‐orstorm‐relateddamage.
Figure8|LargemajorityofMarylandersexperiencedelectricpowerdisruptioninthepastyear
9Whitmarsh,L.(2008).Arefloodvictimsmoreconcernedaboutclimatechangethanotherpeople?Theroleof
directexperienceinriskperceptionandbehaviouralresponse.JournalofRiskResearch,11(3),351–374.
10 Pearson’scorrelation,r=.147,p<.001.Foranexplanationofcorrelation,seep.21.
11 Airpollution,r=.220,p<.001;heatwaves,r=.195,p<.001
12 r=.154,p<.001
11 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
4.Environmentalhealthandhealthcareaccessareranked
amongtopstatepriorities
Marylandresidentsrankhealthcareaccessandenvironmentalhealthalongwithjobsand
growingthemiddleclassatthetopoftheirlistforstatepolicymakerstoaddress.
Three‐quartersofMarylanders(74%)saythatimprovingaccesstohealthcareshouldbeahigh
orveryhighpriority,aboutthesamepercentageasgrowingthemiddleclassandreducingair
pollution.Thesethreeprioritiesfalljustaftercreatingjobs(89%)andreducingwaterpollution
(81%)(seeFigure9).TheCentralandSouthernregionsofthestate—thecorridorstretching
fromCecilCountytotheWashington,D.C.suburbsandSt.Mary’sCounty—aremostlikelyto
citeaccesstohealthcareasahighorveryhighpriorityissue(Westernregion,59%;Central,
75%;Southern,79%;Eastern,58%)(seeAppendices,Table11,p.38).

Reducingenvironmentalthreatssuchaswaterpollution(81%),airpollution(73%),andclimate
change(51%)alsoprovidesdirectpublichealthbenefits.Climatechangerankstowardthe
bottomofthelistofnineissuesthatMarylanderswereaskedtoprioritize,butevenso,halfof
thestate(51%)describesitasahighorveryhighpriorityforpolicymakers.
Figure9|HealthconcernsareamongtopprioritiesfortheGeneralAssemblyandGovernor

12 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
5.Coal,oil,andnuclearpowerareseenasharmfultohealth
AmajorityofMarylanderssaythatthefossilfuelscoalandoil,andnuclearpower,are
somewhatorveryharmfultopeople’shealth.Almostthree‐quartersofMarylanders(72%)say
thatcoalissomewhatorveryharmful,followedbyoil(64%)andnuclearpower(58%)(see
Figure10).Overthepastyear,thenumberofpeoplewhosaythatcoalis“veryharmful”to
healthincreasedby10percentagepointsto41%.Oilandnaturalgasextractedfromhydraulic
fracturingalsobecamemorestronglyviewedasahealthhazardinthelastyearwithincreases
ofsixpercentagepointsofthosewhosaytheyareveryharmful(respectively,26%and23%).Of
note,substantialpercentagesofMarylanders—14%to39%—reportthattheydonotknow
whetherornoteachof10namedsourcesofelectricalenergyinthesurveyarepotentially
harmfultopeople’shealth.Woodfuelorswitchgrassaretheleast‐wellknownbythepublic;
39%don’tknowwhethertheyareharmfulornottohealth.
Coalandnucleararerankedas“veryharmful”sourcesofenergybyapproximatelyone‐thirdof
residentsinthreeofthestate’sregions,andtherearegenerallyonlyslightregionaldifferences
(Western,nuclear/35%,coal/32%;Southern,coal/39%,nuclear/33%;Eastern,38%/nuclear,
33%/coal)(seeAppendices,Table12,p.40).IntheCentralregionofthestate,however,thereis
a16percentagepointdifferencebetweenthosewhosaythatcoalisveryharmfultohealth
(45%)andthosewhosaynuclearis(29%).Morethanaquarter(26%)ofCentralMaryland’s
residentsalsosaythattheydon’tknowwhatthehealthimplicationsofnuclearpowerare.This
comparesto19%inWesternandEasternMaryland,and17%intheSouthernregion.Calvert
Cliffs,thestate’sonlynuclearpowerplant,islocated40milessouthofAnnapolisinthe
Southernregion.
Marylanderssaysolarandwindarenotatallharmfultohealth
Renewableenergysourcessuchaswindandsolarcontinuetobeviewedasnon‐harmfulto
people’shealth.Largemajoritiessaysolar(65%)andwind(land‐based,58%;offshore,57%)are
notatallharmful.In2014,therewasanincreaseoffivepercentagepoints—upto65%from
60%thepreviousyear—inthosepeoplewhosaythatsolarhasnonegativeeffectsonhealth
(seeFigure11).
13 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
Figure10|Coal,oilandnuclearpowerareperceivedasharmfultohealth
Figure11|Majoritiessaywindandsolararenotharmfultopublichealth
14 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
6.Studymethodology
ThisstudywasconductedbyGeorgeMasonUniversity’sCenterforClimateChange
CommunicationtoexploreMarylanders’viewsonpublichealth,energyandtheenvironment.
ThesurveyinstrumentwasdevelopedatGeorgeMasonUniversity,partiallybasedonquestions
usedintheClimateChangeintheAmericanMindnationalsurveysrunbytheYaleProjecton
ClimateChangeCommunication(http://environment.yale.edu/climate‐communication/)and
GeorgeMason’sCenterforClimateChangeCommunication(http://climatechange
communication.org/).Themailsurveyconsistedof50questionsandtookapproximately20
minutestocomplete.
Forreportingpurposes,thedatahasbeenbrokenintofourseparatedocuments.Three
additionalreportsfocusonMarylanders’climatechangeattitudes,behaviorsandpolicy
preferencesregardingsea‐levelriseandadaptation,energy,andclimate.13Theunweighted
samplemarginoferroris+/‐2percentagepointsatthe95%confidenceintervalforthestate
andlessthan+/‐5percentagepointsforeachregion(seeTable1).
Samplingdesign;fielding
Thesurveywasmailedto6,401householdsinthestateofMaryland,randomlyselectedfrom
withineachoffourregionsofthestatefromSurveySamplingInternationalhouseholdaddress
databases,basedprimarilyonU.S.PostalServicedeliveryrouteinformation.Wesampledatthe
regionalleveltoensurethefinaldatawasgeneralizabletothesedistinctlydifferentgeographic
andculturalareasofthestate,aswellasthestateasawhole.ThesamplesizefortheCentral
regionofthestatewashigherrelativetotheotherthreeregionsbecauseitaccountsformore
thanhalfofthestate’spopulation(seeTable1).Householdsthatrespondedtothesurveyin
2013werenotre‐contactedin2014.
ThesurveywasfieldedfromMarch17toJune10,2014.Eachhouseholdwassentuptofour
mailings:anannouncementletterintroducingthesurvey(March17),acopyofthesurveywith
a$2billthankyou(March24),areminderpostcard(April7),andafollow‐upsurvey(April22).
(Asapointofcomparison,the2013surveywasfieldedfromMarch28toJune4.Methodology
forthe2013surveyisavailablewithinthosereportsatclimatemaryland.org.)Inorderto
achieverandomizationofrespondentswithineachhousehold,werequestedthattheperson
withthemostrecentbirthdaycompletethesurvey.Householdsthatcompletedandreturned
thesurveyweretakenoffofsubsequentmailinglists.
13 Seethereportsathttp://www.climatemaryland.org/survey/
15 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
Weighting
Thedatatablesreportpercentagesforthestateandeachregion.Statedatawereweightedfor
regionalrepresentation,gender,age,andeducationlevelbasedon3‐yearAmerican
CommunitySurveydatafromtheU.S.CensusBureau,followingthesameprocedureasin2013.
Eachregion’sdatawerealsoweightedforthesamedemographicvariables.Baseunweighted
samplesizesforeachquestionarereportedinadditiontotheweightedpercentages.
Respondentswhodidnotprovideregional,gender,ageoreducationleveldataweredropped
fromthedataset.Thisloweredthenumberofrespondentsby201cases.(Theoverallresponse
rateforthestudybeforethosecasesweredroppedwas38%.)Pleaseseethedemographics
sectionoftheappendixformoreinformationonthecharacteristicsofthesurveysamplepre‐
andpost‐weighting.
InstitutionalReviewBoard
ThestudywasreviewedbytheInstitutionalReviewBoardforGeorgeMasonUniversity
(Protocol#8508).
16 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
Table1|Regionalsamples,responseratesandmarginoferror
RegionCounties
Initial
sample Refusals
Undeliverable
addresses
Numberof
respondents*
Response
rate
Marginof
error
WesternAllegany,
Frederick,
Garrett,
Washington
1,4671410749536%+/‐4.40
%points
CentralBaltimore,
Carroll,Cecil,
Harford,
Howard,
Montgomery,
BaltimoreCity
2,0001613062933%+/‐3.91
%points
SouthernAnneArundel,
Calvert,
Charles,
Prince
George's,
St.Mary's
1,467118543531%+/‐4.70
%points
EasternCaroline,
Dorchester,
Kent,Queen
Anne's,
Somerset,
Talbot,
Wicomico,
Worcester
1,4671819047637%+/‐4.49
%points
StateAllcounties6,401705122,03535%+/‐2.2
%points

Investigators:
KarenAkerlof,PhD
EdwardW.Maibach,MPH,PhD
GeorgeMasonUniversity
CenterforClimateChangeCommunication
4400UniversityDr.,MS6A8
Fairfax,VA22030
kakerlof@gmu.edu,(703)993‐6667
emaibach@gmu.edu,(703)993‐1587
ThissurveywasfundedbytheTownCreekFoundationofEaston,MD.WethanktheTown
CreekFoundationanditsExecutiveDirectorStuartClarkefortheirsupport.
Theprojectbenefittedfromtheexpertiseandhardworkofmanyindividuals.Membersofthe
ClimateCommunicationConsortiumofMaryland(climatemaryland.org)assistedinthe
developmentofthesurvey.KenAdamsandCharlesCoatsprovidedinvaluablehelpin
coordinatingitsfielding.They—withadditionalassistanceprovidedbyMasonundergraduate
andgraduatestudentsAiyaAl‐Beyati,RefkaAl‐Beyati,NatashaS.Taliferro,RebeccaLloyd,
DeannaKirby,StacyNelson,RoxanaKazemi,ClaudiaHarris,KellyHayden,PatrickGreenwalt,
BrittanyGrutter,AndySachs,VeraSolovyeva,DharaPatel,ElloiseL.Lotoc,DanielleKirby,
SuzanneHewitt,AileenS.DierigandSeanKelley—assembledthemailingsoveraseriesoflong
weekends.PaulWeissfromEmoryUniversityprovidedstatisticalsupportfortheweights.Any
errorsarethoseoftheauthors.
Credits,coverphoto:
Photoofachildwithasthmausinganebulizer.Longerperiodsofhightemperatures,suchas
anticipatedwithclimatechange,canresultinincreasesinairpollutionassociatedwithasthma.
Photofromistockphoto.comfromMarylandDepartmentoftheEnvironmentat
climatechange.maryland.gov.
Suggestedcitation:
Akerlof,K.,&Maibach,E.W.(2015).Publichealth,energy&climatechange:Asurveyof
Marylandresidents,2014.Fairfax,VA:CenterforClimateChangeCommunication,George
MasonUniversity.
TableofContents
ExecutiveSummary.........................................................................................................................1
1.MostMarylanderssayclimatechangeharmshumanhealth....................................................3
Breathingproblemsareseenasthemostlikelyharmtohealth;
infectiousdiseaselessso............................................................................................................3
Marylanderssayotherpeoplethanthemselvesandfuturegenerations
aremorevulnerable...................................................................................................................4
Peoplewithmedicalconditionsandtheelderlyareseenasvulnerable.................................5
Peoplewhoarevulnerableduetomedicalconditionsaremorelikelytounderstand
therisk......................................................................................................................................6
2.Doctorsandpublichealthexpertsaretrustedsourcesofinformationonclimatechange.......7
3.Theperceivedriskstohealthfromchemicalsandpollutionhavegrown..................................8
Healthrisksfromclimatechangeandfloodingareperceiveddifferentlyacrossregions.........8
Manyexperiencedlossofelectricityandwind‐orstorm‐relateddamageinthepastyear.....8
4.Environmentalhealthandhealthcareaccessarerankedamongtopstatepriorities............11
5.Coal,oil,andnuclearpowerareseenasharmfultohealth.....................................................12
Residentssaysolarandwindarenotatallharmfultohealth.................................................12
6.Studymethodology...................................................................................................................14
Appendices....................................................................................................................................17
Correlationtables.........................................................................................................18
Datatables....................................................................................................................20
Sampledemographics...................................................................................................44

1 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
ExecutiveSummary
In2013,GeorgeMasonUniversityfieldedthefirstsurveyofclimatechange,energyandpublic
healthinthestate.Werepeatedsomeofthequestionsandaddednewmeasuresin2014.This
report,focusedonpublichealthandclimatechange,isthelastoffourreleasedfromthe2014
data.Otherreportshighlightattitudes,behaviors,andpolicypreferencesonsea‐levelriseand
adaptation,energy,andclimatechangegenerally.1Belowwehighlightnewfindingsregarding
climatechangeandpublichealth,andsomeofthemostimportantchangesthatwefoundin
thestateoverthepastyear.
MostMarylandersunderstandthatclimatechangeharmshumanhealth
MorethanhalfofMarylanders(55%)saythattheyexpectthatpeople’shealthintheir
communitieswillbeaffectedbyclimatechangeinthenextseveralyears.
Stateresidentssaybreathingandrespiratoryproblems(72%),injuriesfromextreme
weather(61%),andheatstroke(55%)arelikelytobecomemorecommoninthestate
duetoclimatechange.
Infectiousdiseaseislesslikelytobecitedasanincreasingrisktohealthduetoclimate
change.Lessthanhalfofstateresidents(42%)saythatitwillbecomemorecommon,
eventhoughclimatechangeisprojectedtoaffectthespreadofdisease.
Doctorsandpublichealthexpertsaretrustedsourcesofclimatechangeinformation
Medicalauthoritiesareamongtheprofessionalstrustedthemostforinformationon
climatechange.Marylanderstrustdoctorsandpublichealthexpertsonclimatechange
onlyslightlylessstronglythanscientistsatMarylanduniversities(63%vs.70%).
MoreMarylandersperceivechemicalsandpollutionasarisktohealth
MorethanhalfofMarylanders(55%)saythatexposuretochemicals,including
pesticides,infoodandotherproductsisamajorrisktotheirpersonalhealth.This
representsasizeableshift—up23percentagepoints—sincespring2013.
Polluteddrinkingwater(52%),airpollution(47%)andsecond‐handsmoke(41%)also
showedconsiderableincreasesinpublicperceptionsasmajorriskswith19,16,and12
percentage‐pointgainsrespectively.
Sixty‐threepercentofMarylandersciteclimatechangeasamoderateormajorriskto
theirpersonalhealth—anincreaseof11percentagepointsfromspring2013.
EnvironmentalhealthandhealthcareaccessareamongMarylanders’toppolicypriorities
Three‐quartersofMarylanders(74%)saythatimprovingaccesstohealthcareshouldbe
ahighorveryhighpriorityforthestate’sGeneralAssemblyandgovernor.
1Seethereportsathttp://www.climatemaryland.org/survey/
2 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
Healthcareaccessranksaftercreatingjobs(89%)andreducingwaterpollution(81%)in
Marylanders’priorities,andisaboutthesamepercentageasgrowingthemiddleclass
andreducingairpollution.
Fossilfuelsandnuclearpowerareseenasharmfultohealth;solarandwindarenot
Almostthree‐quartersofMarylanders(72%)saythatcoalissomewhatorveryharmful
topeople’shealth.Oil(64%)andnuclearpower(58%)alsoraisehealthconcerns.
Overthepastyear,thenumberofpeoplewhosaythatcoalis“veryharmful”tohealth
increasedby10percentagepointsto41%.
Renewableenergysourcessuchaswindandsolarcontinuetobeviewedbymajorities
asnon‐harmful(solar,65%;offshorewind,57%;land‐basedwind,58%).In2014,there
wasanincreaseoffivepercentagepointsinthosepeoplewhosaythatsolarhasno
negativeeffectsonhealth.
Studymethodology
Thesurveywasmailedto6,401householdsinthestateofMaryland,randomlyselectedfrom
withineachoffourregionsofthestate.2Wesampledattheregionalleveltoensurethefinal
datawasgeneralizabletothesedistinctlydifferentgeographicandculturalareasaswellasto
thestateasawhole,weightingthedataatboththestateandregionallevelsinaccordancewith
U.S.Censuspopulationdistributions.Householdsthatrespondedtothesurveyin2013were
notre‐contactedin2014.ThesurveywasfieldedfromMarch17toJune10,2014witha
responserateof35%.Theunweightedsamplemarginoferroris+/‐2percentagepointsatthe
95%confidenceintervalforthestateandlessthan+/‐5percentagepointsforeachregion.(See
studymethodology,page14).Thisreportincludessurveydatafrom2013asabasisfor
comparison;statisticalcomparisonsbetweenyearswereassessedforsignificance.Survey
reportsfrom2013canbefoundatclimatemaryland.organdincludeadescriptionofthesample
andmethodology.Bothwereconsistentacrossyears.
2WesternRegion–Allegany,Frederick,GarrettandWashingtoncounties;CentralRegion–Baltimore,Carroll,
Cecil,Harford,Howard,MontgomerycountiesandBaltimoreCity;SouthernRegion–AnneArundel,Calvert,
Charles,PrinceGeorge'sandSt.Mary'scounties;EasternRegion–Caroline,Dorchester,Kent,Queen
Anne's,Somerset,Talbot,WicomicoandWorcestercounties.
3 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
1.MostMarylanderssayclimatechangeharmshumanhealth
MorethanhalfofMarylanders(55%)saythattheyexpectthatpeople’shealthintheir
communitieswillbeaffectedbyclimatechangeinthenextseveralyears(seeAppendices,Table
1,p.21).Indeed,manystateresidentscontinuedin2014toseebreathingandrespiratory
problems(72%),injuriesfromextremeweather(61%),andheatstroke(55%)aslikelyto
becomemorecommoninthestateduetoclimatechange(seeFigure1).In2013,theywere
significantlylesslikely,however,tothinkthatsunburnswouldbeaconsequence,downby
sevenpercentagepointsto41%.Climatechangehaslongbeenconfusedwithozonedepletion,3
whichincreasestheamountofultravioletlightpassingthroughtheatmosphereandtheriskof
sunburnandskincancers.(Recently,somestudieshavesuggestedthatclimatechangeactually
mightaffectUVexposureandrelatedcancers.4)
Breathingproblemsareseenasthemostlikelyharmtohealth;infectiousdiseaselessso
Onaverage,72%ofMarylanderssaythatbreathingandrespiratoryproblemswillincreasewith
climatechange,butthosewholiveintheSouthernregionofthestate,stretchingfromAnne
ArundeltoSt.Mary’scounties,are10percentagepointsmorelikelytosaysothanthemore
Figure1|Heatstroke,injuriesandbreathingproblemsareexpectedtoincrease
3Read,D.,Bostrom,A.,Morgan,M.G.,Fischhoff,B.,&Smuts,T.(1994).WhatDoPeopleKnowAboutGlobal
ClimateChange?2.SurveyStudiesofEducatedLaypeople.RiskAnalysis,14(6),971–982.
4Hui,Y.,Thong,H.‐Y.,&Maibach,H.I.(2011).Globalwarminganditsdermatologicimpact.ExpertReviewof
Dermatology,6(5),521–523.
4 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
ruralEasternandWesternportionsofthestate(Southern,76%;Western,66%;Central,71%;
Eastern,66%)(seeAppendices,Table2,p.23).Infectiousdiseaseislesslikelytobethoughtof
asahealtheffectfromclimatechange(42%),withlittlevariationfromsurveyrespondents
acrossthestate’sregions(Western,40%;Central,41%;Southern,44%;Eastern,43%),even
thoughclimatechangeisprojectedtoaffectthespreadofdisease.5
Marylanderssayotherpeoplethanthemselvesandfuturegenerationsaremorevulnerable
Researchhasshownthatpeopletendtoseeclimatechangeassomethingthathappensto
peopleinplacesfarawayfromthem.6Inthissurveyweaskedrespondentswhotheybelieve
aremostvulnerabletopotentialhealthimpactsfromclimatechange—themselves,peoplein
theirhouseholds,peopleintheircommunities,Marylanders,orpeopleintheUnited
States—andthedegreetowhichtheywillbeharmed.Consistentwithpriorresearch,
MarylandersaremorelikelytosaythatpeopleintheU.S.generallyare“veryvulnerable”(31%)
orevenpeopleinMaryland(21%),thantheythemselves(11%)orthoseintheirhouseholds
(13%)(seeFigure2).Ofnote,fewpeoplesaythattheyorpeopleintheirhouseholdarenotat
allvulnerabletohealththreatsfromclimatechange(10%and12%respectively).
Figure2|PeopleintheU.S.areseenasmorevulnerablethanthosepeopleclosetohome
5Luber,G.,Knowlton,K.,Balbus,J.,Frumkin,H.,Hayden,M.,Hess,J.,McGeehin,M.,Sheats,N.,Backer,L.,
Beard,C.B.,Ebi,K.L.,Maibach,E.,Ostfeld,R.S.,Wiedinmyer,C.,Zielinski‐Gutiérrez,E.,&Ziska,L.(2014).Ch.9:
Humanhealth.ClimatechangeimpactsintheUnitedStates:ThethirdNationalClimateAssessment.U.S.Global
ChangeResearchProgram,p.220‐256.
6Leiserowitz,A.(2005).AmericanRiskPerceptions:IsClimateChangeDangerous?RiskAnalysis,25(6),1433‐1442.
5 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
MostMarylanders(65%)believethatfuturegenerationsofpeoplewillbeharmed“agreat
deal,”whileonlysmallminoritiesfeelthatpeopleinMaryland(28%)ortheythemselves(19%)
willbeharmedtothesameextent.Conversely,fewMarylanderssaythatthey(12%),other
Marylanders(7%)andfuturegenerationsofpeople(5%)willnotbeharmedatallbyclimate
change(seeFigure3).
Peoplewithmedicalconditionsandtheelderlyareseenasvulnerable
AmajorityofMarylanderssaythatpeoplewithmedicalconditions(59%)andtheelderly(55%)
areveryvulnerabletothepotentialhealthimpactsofclimatechange(seeFigure4).Theyare
lesslikelytoidentifyyoungchildrenandpeopleonlowincomesasveryvulnerable(42%and
36%,respectively).Inreality,asnotedinthekeymessagesofthehumanhealthchapterofthe
NationalClimateAssessment,“(c)ertainpeopleandcommunitiesareespeciallyvulnerable,
includingchildren,theelderly,thesick,thepoor,andsomecommunitiesofcolor.”7
Middle‐agedindividualsarenotconsideredaparticularlyvulnerablegroupunlesstheyhave
othercharacteristicsthatputthematrisk,suchasamedicalconditionorlowincome.
Figure3|Climatechangeisperceivedmoststronglyasathreattofuturegenerations
7Luber,G.,Knowlton,K.,Balbus,J.,Frumkin,H.,Hayden,M.,Hess,J.,McGeehin,M.,Sheats,N.,Backer,L.,
Beard,C.B.,Ebi,K.L.,Maibach,E.,Ostfeld,R.S.,Wiedinmyer,C.,Zielinski‐Gutiérrez,E.,&Ziska,L.(2014).Ch.9:
Humanhealth.ClimatechangeimpactsintheUnitedStates:ThethirdNationalClimateAssessment.U.S.Global
ChangeResearchProgram,p.220‐256.
6 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
Figure4|Youngchildrenandpeopleonlowincomesarelessfrequentlyidentifiedasathighrisk
Peoplewhoarevulnerableduetomedicalconditionsaremorelikelytounderstandtherisk
Marylanderswhosaythatthey—ormembersoftheirhousehold—havenotbeendiagnosed
withoneormoreoffivetypesofmedicalconditionsarelesslikelytounderstandthatpeople
withmedicalconditionsaremorevulnerabletohealththreatsfromclimatechange(see
Appendices,CorrelationTable1,p.18‐19).8Indeed,eachofthefivemedical
conditions—coronaryheartdisease,obesity,diabetes,respiratoryillness(asthma),aphysicalor
mentaldisability—arecorrelatedatthepersonaland/orhouseholdlevelwithincreased
understandingthatpeoplewithmedicalconditionsaremorevulnerabletoclimatechange.The
correlationsbetweenself‐reporteddiagnosesandrecognizingthatmedicalconditionsmake
peoplemorevulnerabletoclimatechangesuggestthatpeoplewhoarevulnerablearemore
likelytorealizeit,thoughtheeffectsizeisrelativelysmall.
8Nopersonalmedicalconditions,Pearson’scorrelation,r=‐.109,p<.001;nohouseholdmedicalconditions,r=
‐.107,p<.001.Foranexplanationofcorrelation,seep.21.
7 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
2.Doctorsandpublichealthexpertsaretrustedsourcesof
informationonclimatechange
Amongthe11groupsofprofessionalsandorganizationsassessedinthissurveyassourcesof
informationaboutclimatechange,medicalauthoritiesareamongthemosttrusted.
Marylanderstrustdoctorsandpublichealthexpertsassourcesofinformationaboutclimate
changeonlyslightlylessstronglythanscientistsatMarylanduniversities(63%vs.70%)(see
Figure5).Fewresidentsinthestatesaythattheydistrustdoctorsandpublichealthexpertson
climatechange(8%)orMaryland’sscientists(9%).Whileenvironmentalorganizations,
weathercastersandnewsmediaarealsoamongthetopfivemosttrustedsourcesof
informationonclimatechange,moreMarylanderssaythattheydistrustthem—aboutone‐fifth
toaquarterofthestate.
Figure5|Marylanderstrustdoctorsandpublichealthexpertsonclimatechange
8 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
3.Perceivedrisksfromchemicalsandpollutionhavegrown
MorethanhalfofMarylanders(55%)saythatexposuretochemicals,includingpesticides,in
foodandotherproductsisamajorrisktotheirhealth(seeFigure6).Thisrepresentsasizeable
shiftupward—23percentagepoints—sincespring2013.In2013,obesitywasconsideredthe
largestpersonalhealthriskamongMarylanders(majorrisk,37%).Thisyear,obesitydroppedto
fifthafterexposuretochemicalsinfoodandproducts,polluteddrinkingwater(52%),air
pollution(47%)andsecond‐handsmoke(41%).Publicperceptionsofobesitychangedlittleover
thepastyear(majorrisk,39%),butbeliefsaboutthepersonalhealthrisksposedbypolluted
drinkingwater,airpollutionandsecond‐handsmokeconsiderablyincreasedwithgainsof19,
16,and12percentagepointsrespectively.
Climatechangerankedeighthasa“major”personalhealthriskthatconcernsMarylanders.
Sixty‐threepercentofMarylanderscitedclimatechangeasamoderateormajorrisktotheir
personalhealth—anincreaseof11percentagepointsfromspring2013(seeFigure7).Almosta
quarter—23%—saythatitisamajorrisktotheirhealth,onparwithviolentstorms(23%).
Healthrisksfromfloodingandclimatechangeareperceiveddifferentlyacrossregions
Marylandersacrossthestate’sfourregionsgenerallymakesimilarjudgmentsaboutpersonal
healthrisks.Exposuretochemicalsinfoodandotherproducts,andairpollution,are
consistentlyrankedthetopmoderateormajorhealthrisksinallfourregions(Western,
82%/74%respectively;Central,85%/86%;Southern,81%/81%;Eastern,80%/75%)(see
Appendices,Table9,p.33).However,therearedifferences.Floodingisperceivedaslessofa
concerninthemountainousWesternregionandmoreofaconcernonthelow‐lyingEastern
Shore(Western,37%;Central,51%;Southern,52%;Eastern,60%).Climatechangeismostlikely
tobelistedasamoderateormajorpersonalhealthriskbythoseintheurbanCentralregionof
thestate(67%),whereitisranked6thof11risks,andleastlikelyintheEasternregion(49%),
whereitisrankedlowest(Southern,59%,ranked8th;Western,52%,ranked10th).
Manyexperiencedlossofelectricityandwind‐orstorm‐relateddamageinthepastyear
Morethanthree‐quartersofMarylanders(76%)saythattheyhaveexperiencedpoweroutages
atleastonceormoreinthelast12monthswithalmostanothertwo‐fifths(39%)sayingthat
theyhavehadwind‐orstorm‐relateddamageoverthesameperiod(seeFigure8).Power
outageswerereportedbylargemajoritiesregardlessofgeographiclocation(Western,83%;
Central,74%;Southern,79%;Eastern,72%)(seeAppendices,Table10,p.37).Windandstorm
damageafflictedbetween37%and45%ofresidentsacrosseachregionofthestate(Western,
42%;Central,38%;Southern,37%;Eastern,45%).Othertypesofstorm‐relatedexperiencesare
reportedlessfrequently:19%lostdrinkingwater,and9%sufferedflooddamage.Self‐reported
flooddamagesfortheprevious12monthsoverallarelowacrossmostofthestate,butshowa
9 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
Figure6|Marylandersbecamemoreconcernedabouthealthrisksinthepastyear
Figure7|Chemicals,pollutedwaterandairpollutionareperceivedasmajorhealththreats
10 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
similarpatternastheregionalperceptionsoffloodrisksreportedabovewith18%ofresidents
fromthelow‐lyingEasternShorereportingdamages,butjust5%oftheWesternregion
(Central,9%;Southern,9%).VeryfewMarylanderssaythattheyhaveexperiencedwildfire
damage(1%).
Personallyexperiencingharmorlosscaninfluencethewayinwhichpeopleweighfuturerisks,
andmotivatethemtotakeprotectiveactions.9Havingexperienceddifficultybreathingdueto
airpollutionduringthe12monthspriortothesurveyisassociatedwithperceiving11potential
healththreats—fromsecond‐handsmoketofluepidemics,obesity,andclimatechange—as
moresignificantpersonalrisks,10andismoststronglycorrelatedwithbelievingoneselftobeat
riskfromairpollutionandheatwaves,11althoughthecorrelationsarerelativelyweak(see
Appendices,CorrelationTable2,p.18‐19).Incidentsofrecentflooddamagearealso
associated—thoughnotstrongly—withhigherriskperceptionsregardingseventypesofhealth
threats,butparticularlyflooding.12Believingoneselftobebeingpersonallyatriskfromthe
healthimpactsofclimatechangeisalsoweaklycorrelatedwithpreviousexperiencesofflood
andwind‐orstorm‐relateddamage.
Figure8|LargemajorityofMarylandersexperiencedelectricpowerdisruptioninthepastyear
9Whitmarsh,L.(2008).Arefloodvictimsmoreconcernedaboutclimatechangethanotherpeople?Theroleof
directexperienceinriskperceptionandbehaviouralresponse.JournalofRiskResearch,11(3),351–374.
10 Pearson’scorrelation,r=.147,p<.001.Foranexplanationofcorrelation,seep.21.
11 Airpollution,r=.220,p<.001;heatwaves,r=.195,p<.001
12 r=.154,p<.001
11 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
4.Environmentalhealthandhealthcareaccessareranked
amongtopstatepriorities
Marylandresidentsrankhealthcareaccessandenvironmentalhealthalongwithjobsand
growingthemiddleclassatthetopoftheirlistforstatepolicymakerstoaddress.
Three‐quartersofMarylanders(74%)saythatimprovingaccesstohealthcareshouldbeahigh
orveryhighpriority,aboutthesamepercentageasgrowingthemiddleclassandreducingair
pollution.Thesethreeprioritiesfalljustaftercreatingjobs(89%)andreducingwaterpollution
(81%)(seeFigure9).TheCentralandSouthernregionsofthestate—thecorridorstretching
fromCecilCountytotheWashington,D.C.suburbsandSt.Mary’sCounty—aremostlikelyto
citeaccesstohealthcareasahighorveryhighpriorityissue(Westernregion,59%;Central,
75%;Southern,79%;Eastern,58%)(seeAppendices,Table11,p.38).

Reducingenvironmentalthreatssuchaswaterpollution(81%),airpollution(73%),andclimate
change(51%)alsoprovidesdirectpublichealthbenefits.Climatechangerankstowardthe
bottomofthelistofnineissuesthatMarylanderswereaskedtoprioritize,butevenso,halfof
thestate(51%)describesitasahighorveryhighpriorityforpolicymakers.
Figure9|HealthconcernsareamongtopprioritiesfortheGeneralAssemblyandGovernor

12 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
5.Coal,oil,andnuclearpowerareseenasharmfultohealth
AmajorityofMarylanderssaythatthefossilfuelscoalandoil,andnuclearpower,are
somewhatorveryharmfultopeople’shealth.Almostthree‐quartersofMarylanders(72%)say
thatcoalissomewhatorveryharmful,followedbyoil(64%)andnuclearpower(58%)(see
Figure10).Overthepastyear,thenumberofpeoplewhosaythatcoalis“veryharmful”to
healthincreasedby10percentagepointsto41%.Oilandnaturalgasextractedfromhydraulic
fracturingalsobecamemorestronglyviewedasahealthhazardinthelastyearwithincreases
ofsixpercentagepointsofthosewhosaytheyareveryharmful(respectively,26%and23%).Of
note,substantialpercentagesofMarylanders—14%to39%—reportthattheydonotknow
whetherornoteachof10namedsourcesofelectricalenergyinthesurveyarepotentially
harmfultopeople’shealth.Woodfuelorswitchgrassaretheleast‐wellknownbythepublic;
39%don’tknowwhethertheyareharmfulornottohealth.
Coalandnucleararerankedas“veryharmful”sourcesofenergybyapproximatelyone‐thirdof
residentsinthreeofthestate’sregions,andtherearegenerallyonlyslightregionaldifferences
(Western,nuclear/35%,coal/32%;Southern,coal/39%,nuclear/33%;Eastern,38%/nuclear,
33%/coal)(seeAppendices,Table12,p.40).IntheCentralregionofthestate,however,thereis
a16percentagepointdifferencebetweenthosewhosaythatcoalisveryharmfultohealth
(45%)andthosewhosaynuclearis(29%).Morethanaquarter(26%)ofCentralMaryland’s
residentsalsosaythattheydon’tknowwhatthehealthimplicationsofnuclearpowerare.This
comparesto19%inWesternandEasternMaryland,and17%intheSouthernregion.Calvert
Cliffs,thestate’sonlynuclearpowerplant,islocated40milessouthofAnnapolisinthe
Southernregion.
Marylanderssaysolarandwindarenotatallharmfultohealth
Renewableenergysourcessuchaswindandsolarcontinuetobeviewedasnon‐harmfulto
people’shealth.Largemajoritiessaysolar(65%)andwind(land‐based,58%;offshore,57%)are
notatallharmful.In2014,therewasanincreaseoffivepercentagepoints—upto65%from
60%thepreviousyear—inthosepeoplewhosaythatsolarhasnonegativeeffectsonhealth
(seeFigure11).
13 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
Figure10|Coal,oilandnuclearpowerareperceivedasharmfultohealth
Figure11|Majoritiessaywindandsolararenotharmfultopublichealth
14 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
6.Studymethodology
ThisstudywasconductedbyGeorgeMasonUniversity’sCenterforClimateChange
CommunicationtoexploreMarylanders’viewsonpublichealth,energyandtheenvironment.
ThesurveyinstrumentwasdevelopedatGeorgeMasonUniversity,partiallybasedonquestions
usedintheClimateChangeintheAmericanMindnationalsurveysrunbytheYaleProjecton
ClimateChangeCommunication(http://environment.yale.edu/climate‐communication/)and
GeorgeMason’sCenterforClimateChangeCommunication(http://climatechange
communication.org/).Themailsurveyconsistedof50questionsandtookapproximately20
minutestocomplete.
Forreportingpurposes,thedatahasbeenbrokenintofourseparatedocuments.Three
additionalreportsfocusonMarylanders’climatechangeattitudes,behaviorsandpolicy
preferencesregardingsea‐levelriseandadaptation,energy,andclimate.13Theunweighted
samplemarginoferroris+/‐2percentagepointsatthe95%confidenceintervalforthestate
andlessthan+/‐5percentagepointsforeachregion(seeTable1).
Samplingdesign;fielding
Thesurveywasmailedto6,401householdsinthestateofMaryland,randomlyselectedfrom
withineachoffourregionsofthestatefromSurveySamplingInternationalhouseholdaddress
databases,basedprimarilyonU.S.PostalServicedeliveryrouteinformation.Wesampledatthe
regionalleveltoensurethefinaldatawasgeneralizabletothesedistinctlydifferentgeographic
andculturalareasofthestate,aswellasthestateasawhole.ThesamplesizefortheCentral
regionofthestatewashigherrelativetotheotherthreeregionsbecauseitaccountsformore
thanhalfofthestate’spopulation(seeTable1).Householdsthatrespondedtothesurveyin
2013werenotre‐contactedin2014.
ThesurveywasfieldedfromMarch17toJune10,2014.Eachhouseholdwassentuptofour
mailings:anannouncementletterintroducingthesurvey(March17),acopyofthesurveywith
a$2billthankyou(March24),areminderpostcard(April7),andafollow‐upsurvey(April22).
(Asapointofcomparison,the2013surveywasfieldedfromMarch28toJune4.Methodology
forthe2013surveyisavailablewithinthosereportsatclimatemaryland.org.)Inorderto
achieverandomizationofrespondentswithineachhousehold,werequestedthattheperson
withthemostrecentbirthdaycompletethesurvey.Householdsthatcompletedandreturned
thesurveyweretakenoffofsubsequentmailinglists.
13 Seethereportsathttp://www.climatemaryland.org/survey/
15 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
Weighting
Thedatatablesreportpercentagesforthestateandeachregion.Statedatawereweightedfor
regionalrepresentation,gender,age,andeducationlevelbasedon3‐yearAmerican
CommunitySurveydatafromtheU.S.CensusBureau,followingthesameprocedureasin2013.
Eachregion’sdatawerealsoweightedforthesamedemographicvariables.Baseunweighted
samplesizesforeachquestionarereportedinadditiontotheweightedpercentages.
Respondentswhodidnotprovideregional,gender,ageoreducationleveldataweredropped
fromthedataset.Thisloweredthenumberofrespondentsby201cases.(Theoverallresponse
rateforthestudybeforethosecasesweredroppedwas38%.)Pleaseseethedemographics
sectionoftheappendixformoreinformationonthecharacteristicsofthesurveysamplepre‐
andpost‐weighting.
InstitutionalReviewBoard
ThestudywasreviewedbytheInstitutionalReviewBoardforGeorgeMasonUniversity
(Protocol#8508).
16 | Public Health, Energy & Climate Change, 2014 | A Maryland Statewide Survey
Table1|Regionalsamples,responseratesandmarginoferror
RegionCounties
Initial
sample Refusals
Undeliverable
addresses
Numberof
respondents*
Response
rate
Marginof
error
WesternAllegany,
Frederick,
Garrett,
Washington
1,4671410749536%+/‐4.40
%points
CentralBaltimore,
Carroll,Cecil,
Harford,
Howard,
Montgomery,
BaltimoreCity
2,0001613062933%+/‐3.91
%points
SouthernAnneArundel,
Calvert,
Charles,
Prince
George's,
St.Mary's
1,467118543531%+/‐4.70
%points
EasternCaroline,
Dorchester,
Kent,Queen
Anne's,
Somerset,
Talbot,
Wicomico,
Worcester
1,4671819047637%+/‐4.49
%points
StateAllcounties6,401705122,03535%+/‐2.2
%points

... In 2014, a majority of Marylanders recognized that people with medical conditions (59%) and the elderly (55%) are very vulnerable to the potential health impacts of climate change; they were less likely to identify young children and people with low incomes as very vulnerable (42% and 36%, respectively) [11]. Moreover, Marylanders were more likely to say that people in the United States generally are "very vulnerable" to the health effects of climate change (31%) or even people in Maryland (21%), than they themselves (11%) or those in their households (13%). ...
Vulnerable Populations Perceive Their Health as at Risk from Climate Change
Article
Full-text available
Climate change is already taking a toll on human health, a toll that is likely to increase in coming decades. The relationship between risk perceptions and vulnerability to climate change’s health threats has received little attention, even though an understanding of the dynamics of adaptation among particularly susceptible populations is becoming increasingly important. We demonstrate that some people whose health will suffer the greatest harms from climate change—due to social vulnerability, health susceptibility, and exposure to hazards—already feel they are at risk. In a 2013 survey we measured Maryland residents’ climate beliefs, health risk perceptions, and household social vulnerability characteristics, including medical conditions (n = 2126). We paired survey responses with secondary data sources for residence in a floodplain and/or urban heat island to predict perceptions of personal and household climate health risk. General health risk perceptions, political ideology, and climate beliefs are the strongest predictors. Yet, people in households with the following characteristics also see themselves at higher risk: members with one or more medical conditions or disabilities; low income; racial/ethnic minorities; and residence in a floodplain. In light of these results, climate health communication among vulnerable populations should emphasize protective actions instead of risk messages.
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Wind and storm damage afflicted between 37% and 45% of residents across each region of the state (Western, 42%; Central, 38%; Southern, 37%; Eastern, 45%)
  • 37
  • Central
  • Southern
  • Eastern
Central, 74%; Southern, 79%; Eastern, 72%) (see Appendices, Table 10, p. 37). Wind and storm damage afflicted between 37% and 45% of residents across each region of the state (Western, 42%; Central, 38%; Southern, 37%; Eastern, 45%). Other types of storm-related experiences are reported less frequently: 19% lost drinking water, and 9% suffered flood damage. Self-reported flood damages for the previous 12 months overall are low across most of the state, but show a