During the most recent conference of my professional organization, my colleague Amanda Dilger and I encouraged our fellow clinicians in attendance to offset the carbon cost of their travel. This was in addition to a panel in which we explained to a small crowd of surgeons that climate change is a health issue. Amanda and I are otolaryngologists, but we are also climate activists.
Before starting the panel, I was unsure about how it would be received by my fellow surgeons, as climate change had rarely been discussed at these meetings. But my colleagues who walked up to the mic after our talk asked the kinds of questions that told me they understood this environmental health issue and the need for hospitals to be more sustainable. As for offsetting the carbon cost of their travel, which admittedly has its own limitations as a climate mitigating action, the responses were more varied. Most of the people gave us a smile or thumbs-up as they walked away. We took that as passive support for climate action. A few gave encouraging verbal responses of “we need more of this,” while some just said the word “no” and quickly escaped.
While climate change poses an urgent threat to public health, this variable response by the health care community is pretty standard. There is a small, but dedicated, group of us who are keenly aware of the importance of environmental health, a group that understands that children, in part because of their smaller anatomy, are extremely vulnerable to the health risks of climate change and air pollution. But there is a much larger group of health professionals who easily walk away from the role of climate change in health, at least in their professional practice.
World leaders gathered in Egypt last week for COP27 to address ways to reduce climate change, and while some aspects of climate change as a health issue were addressed, much more needs to be done. Climate change is fueling a public health crisis, from worsening heat extremes to intensified weather events, and the people impacted—with heat stroke, breathing complications, mental health disorders—are showing up in emergency departments and exam rooms.
It’s time for doctors to recognize, and policy makers to plan for, the effect of climate change on people’s health. My colleagues and I are working at George Washington University on this issue. In the most recent Lancet Countdown, an annual report on health and climate, researchers describe how health is at the mercy of fossil fuels. We saw this over the summer, when levels of carbon dioxide, a heat-trapping pollutant, hit a record high at the same time that schools were sending children home in response to extreme heat, which over recent decades has been the deadliest weather-related disaster in the U.S.
Climate change is the story of a growing generation. The past seven years on Earth have been the hottest seven years on record. Too many children are growing up in a world where weather extremes and air pollution are making them sick. But, as doctors, we never code it in our reports that way.
For example, my colleague treated a six-year-old boy in the ER who had trouble breathing when higher levels of ground level ozone exacerbated his asthma attacks. This is simply coded as having an asthma attack, J45.901. Where do ground level ozone and particulate matter fit in? Another example from another colleague is a teenager in a new city who was experiencing symptoms of post-traumatic stress disorder after being displaced from her home as a result of an “above-normal” Atlantic hurricane; that teen was diagnosed as having PTSD. Where do climate-related weather extremes fit in? Whether coded or not, air pollution and climate change are driving many acute and chronic illnesses, and this rarely factors into our records or our treatment plans.
Climate change is not a novel virus that is taking the science community by surprise, although a warming planet means viruses, such as the Aedes-transmitted arbovirusthat transmits dengue, are surviving in places they never could before. We have the knowledge and power to transition away from an economy that is dependent on fossil fuel combustion. Legislative changes to lower heat-trapping pollutants will avoid many of the harmful effects of global warming on the environment and our health. Climate action works, and health care providers at all levels can and need to advocate for this.
We do this at the Climate and Health Institute at GWU, where we work via a cross-disciplinary approach with members from schools such as business, law and international affairs to mitigate climate change by advocating for climate legislation and mobilizing sustainability initiatives on campus and in the community. Health touches every discipline, and our shared goal of advancing equitable climate solutions, through education, policy-relevant research and advocacy, is best achieved by working together.
Thankfully, there is substantial opportunity to take meaningful action. The Inflation Reduction Act is the largest U.S. climate bill to date. It puts us back on path to reduce harmful emissions by 40 percent by 2030, which brings the United States significantly closer to the goal of cutting emissions measured in 2005 in half by 2030. We now need to build upon this framework with equitable legislation that both achieves this goal and addresses the needs of frontline communities who have suffered the most environmental harm from a legacy of pollution and racism domestically and globally. By advocating and pushing for equitable climate legislation, we can ensure that the people elected into office during midterms will prioritize this.
In addition, leaders in health care need to look at emissions from the health care sector and consider what harms are being done to the communities they are entrusted to heal. The health care industry contributes upwards of 10 percent of heat-trapping pollutants in the United States. Health sector decarbonization is a substantial area of climate action that can cut back on harmful pollutants. Just switching the type of anesthetic gas we use for procedures can have major implications on health care pollution.
Climate change is happening right now. I chose to talk about planetary health with that small group of surgeons at our annual conference knowing that the solutions to reducing emissions would be more than any single person could provide. But if, in medicine, our goals are to improve health and well-being, and to reduce suffering, then we must come together to address climate change and reduce its harmful effect on life.
This is an opinion and analysis article, and the views expressed by the author or authors are not necessarily those of Scientific American.