Hi Reader,
If your body temperature ran 1.5 degrees above normal, you'd call it a fever and take it seriously. Our planet is running about that hot right now, yet most of us still don't think of climate as a health problem.
At our recent health equity summit, I saw just how wide that gap is, even among people who work on health every day. In this essay I write about why the connection gets missed, who's left out of the climate conversation, and why the problems that fall between climate and health are some of the most important, and most overlooked, opportunities out there.
As always, I'd love your thoughts.
Shruti
A few weeks ago, we hosted our third annual health equity summit, and I had the honor of moderating a panel on climate and health. The connection between the two has been a focus for us at Symphonic for a while, so I assumed most people in the room saw it too. Then at the reception, person after person came up to me with some version of the same sentence: "When I saw this on the agenda, I thought it had nothing to do with healthcare." These were people who chose to spend a day at a health equity summit, many of whom have built their careers around this work.
That response stuck with me, because the science isn't really the problem. A Lancet commission called climate change the biggest global health threat of the 21st century back in 2009. The problem is that the climate and healthcare communities often aren't talking to each other, and when they do, they're speaking different languages. Part of that is translation. But part of it is structural. Climate conversations, especially in climate tech and investing, have tended to happen in whiter, more affluent rooms, while healthcare and health access work is more often led by the communities most affected. So the gap isn't only about what people understand. It's about who has access to which narratives, and who gets invited into which rooms. That's what I want to dig into here.
A planet with a fever
One of our panelists, Dr. Chethan Sarabu, offered an analogy that has stuck with me. Chethan trained in landscape architecture, then pediatrics, then clinical informatics, and today leads clinical innovation at Cornell Tech's Health Tech Hub, where he's helping build a new field called climate health informatics.
His analogy: think about the planet the way you'd think about your own body. A normal body temperature is about 37 degrees Celsius. The earth is now roughly 1.3 to 1.4 degrees warmer than before industrialization, and 2024 was the first full year above 1.5. If your temperature ran 1.5 degrees above normal, you'd be at 38.5. You would have a fever. When you have a fever, your heart works harder, you dehydrate faster, and whatever you were already managing gets harder. A warmer planet does the same thing to the systems we depend on, including our bodies.
Why we don't see it
My best guess is that a few things are working against us at once.
The first is how we categorize things. Most of us think of climate as an environmental issue, polar bears and melting ice caps, and health as something personal: me, my doctor, my family. Our institutions mirror that split. Foundations, government agencies, and venture firms tend to keep climate and health in separate buckets (even at Symphonic, where we invest across both, it's easy to do), so the overlap doesn't really belong to anybody.
The second is that the data hides it. A medical chart doesn't say "climate." When heat kills someone, the chart says kidney failure or a heart attack. Heat is the deadliest weather hazard in the United States, but it rarely gets named.
The third is distance and community. For a long time, climate was explained to us as something far off in time or place, happening to other people. That's changing as more of us live through heat waves, floods, and wildfire smoke. But who has access to the conversation hasn't caught up. Climate conversations still tend to feel academic and technical, held in rooms full of scientists, policy experts, and climate tech investors. Health feels personal and accessible: everyone has a body, a doctor, a family member who's been sick. So the people closest to the health effects of climate often aren't part of the climate conversation at all.
A storm in the Blue Ridge
I've been thinking a lot about an example from my own backyard. In September 2024, Hurricane Helene flooded a plant in Marion, North Carolina, that produced about 60 percent of the country's IV fluids. Within weeks, hospitals from Boston to Minnesota were rationing saline, postponing surgeries, and in some ERs handing patients Gatorade instead of an IV bag. That story is both a a climate story and a healthcare story, and it demonstrates how climate impacts our health through the supply chains, power grids, and buildings our health system depends on.
Who carries it
And of particular note: this doesn't land on everyone equally. A healthy adult with a cool bedroom and a flexible job can usually ride out a heat wave. An older person living alone without air conditioning, a kid with asthma who is spending an hour outside during recess in the heat, or someone working a double shift in a warehouse has a much harder time.
You can also see it on a map. In 94 percent of 108 American cities studied, neighborhoods once redlined by the federal government now run hotter in summer than their neighbors, about 2.6 degrees Celsius on average. In the 1930s, federal maps marked these neighborhoods as too risky for home loans, largely because of who lived there. Ninety years later, those streets have fewer trees and more pavement, and the people living on them are paying the price: a study of 11 Texas cities found higher rates of heat-related ER visits in more heavily redlined neighborhoods.
This is why climate belongs in a conversation about healthcare. Sir Michael Marmot, the epidemiologist who has spent decades studying the social determinants of health, asks a really important question: why treat people and then send them back to the conditions that made them sick? We tend to talk about resilience as a personal quality, but a lot of it comes down to infrastructure, and that infrastructure wasn't built equitably.
What I'm taking from it
I don't think more statistics will close this gap. What seems to work is making this more concrete with examples. A hospital that ran out of saline, a neighborhood that's hotter than the one across town, the grandmother whose blood pressure pill is a diuretic, so a few hot days can leave her dangerously dehydrated before she even feels thirsty, are all results of a warming climate that we haven't effectively figured out how to navigate.
As an investor, I think people like me should be paying a lot more attention here. Climate and health fall between foundation programs, government agencies, and most VC portfolios. Nobody really owns the problems in the middle, and the people who notice them first are usually the ones living with them, and they're rarely the ones we fund.
All of which brings me back to Chethan's fever analogy, the one I'm still thinking about. When you have a fever, nobody stops to debate whether it's a health problem. You take it seriously, you rest, and you call the doctor if it doesn't break. I'd love for us to start treating a warming planet the same way, as a health problem we act on now.
Sources
Shruti Shah is a General Partner at Symphonic Capital, an early-stage venture fund investing in AI as infrastructure across health, wealth, and climate resilience. She started her career as a public school teacher in Baltimore, went on to co-found a used furniture marketplace, and has spent the last few years helping founders through the hardest parts of building. She also teaches early-stage impact investing at UNC's Kenan-Flagler Business School and writes about tech, venture capital, entrepreneurship, marketplaces, and more.