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    Preparing Physicians to Address the Health Consequences of Climate Change


    Editor’s note: The opinions expressed by the author do not necessarily reflect the opinions of the AAMC or its members.

    Over the past several years, I have seen climate change emerge as a major public health issue. At first glance, this topic seems far removed from the day-to-day work of physicians. But a closer look reveals serious and widespread health consequences.

    In my work as an occupational and environmental medicine physician and epidemiologist, I have seen how climate change can affect health—both directly and indirectly. Temperatures are rising. Almost every year is warmer than the previous one. Heat waves are hotter, longer, and more frequent. Going forward, we will see more heat-related disorders, such as heat stress and heat stroke, and more heat-related exacerbations of chronic diseases, such as diabetes and coronary artery disease.

    As the academic medicine community learns more about the relationship between climate change and health, we also need to help prepare future physicians to recognize and respond to these health consequences.

    Understanding health effects of climate change

    As an educator, I have included climate change in the environmental and occupational health course that I direct at Tufts University School of Medicine.

    As people become more aware of the consequences climate change can have on health—their health—public concern is likely to increase.

    Patterns of some diseases transmitted by mosquitoes, ticks, and other vectors are changing as a result of climate change. In the United States, these vector-borne diseases include West Nile virus and Lyme disease. In tropical countries, we will see more malaria and dengue fever. Waterborne diseases will occur more frequently, partly because of sewage contamination of water after heavy downpours and flooding. These changes are already happening in some parts of the world.

    As precipitation patterns change, we will see consequences of heavy downpours and flooding in some areas and the effects of decreased rainfall in others. These effects will be more severe in low-income countries. A study in India, for example, reported an increase in gastrointestinal illness after a heavy rainfall.

    Floods and droughts will reduce agricultural output, too, leading to more malnutrition and decreased access to safe drinking water. Scarce food and water will cause many people to leave their homes and communities, escalating the numbers of internally displaced persons and “climate refugees,” who will be more vulnerable to illness, injury, and premature death. In addition, scarcity of food, water, and other essential resources will lead to heightened socioeconomic instability and increased risk of collective violence. A severe drought in Syria from 2006 to 2010 led to mass migration of farmers to cities, creating more socioeconomic instability and contributing to the start of the civil war there.

    Many of these conditions are linked to mental health problems. Already, research has found that people who are displaced or are unable to continue farming, for example, are at risk for anxiety, depression, worsening addictions, and suicide.

    Roles for physicians

    Many public health challenges are invisible until a crisis comes along. Climate change is a global crisis. We need to act to address it. We need to be prepared, even for the unexpected. Medical schools and teaching hospitals have an opportunity to lessen the negative effects of climate-related illnesses by training future physicians to recognize and treat them. Physicians can help communities develop preparedness plans to address diseases that will increase as a result of climate change. The Centers for Disease Control and Prevention provides preparedness guidance to communities through its Building Resilience Against Climate Effects (BRACE) framework.

    Finally, we can serve as role models—using sources of renewable energy, eating plant-based diets, promoting public transportation whenever possible, and educating patients about potential health consequences. As people become more aware of the consequences that climate change can have on health—their health—public concern is likely to increase. The academic medicine community must set an example and prepare future physicians to increase awareness and to address these health consequences.