Climate change remains the eminent global public health threat of our time.
Many , patients, and alike are certainly interested in learning more about climate change. But reports suggest there is a and frameworks for mitigation and knowledge dissemination to fulfill this goal.
The physician-patient relationship is a crucial one in helping to about climate change and health. Patients have a in their family medicine physicians regarding environmental issues, and the American College of Emergency Physicians (ACEP) has of emergency physicians in both educating and treating patients with disease manifestations and exacerbations related to extreme weather events and other effects of climate change.
It is increasingly evident that a to provide resources to key players -- individually and in partnership -- will be necessary to curb the effects of climate change on public health. This can include investing in relevant research initiatives and fostering health education.
There are several opportunities across the spectrum of healthcare delivery -- known as "" -- for clinicians to communicate with patients about climate impacts on health. In order for clinicians to begin these conversations, it's important for them to first fully recognize certain truths, delineated here as the CAVEATS of climate change education and resolution:
- Climate change affects physical, emotional, and financial health
- All are susceptible to the impacts of climate change
- Vulnerable populations experience the brunt of climate change
- Equitable solutions to climate change take policy and practice change
- Assessment of individual community voices is required to deliver the greatest impact where it is most needed
- The physician voice is a necessary and proper employ within the arena to affect policy change, practice improvement, and rid society of environmental injustices that threaten public and individual health
- Strategically partnering takes a multi-systemic, multi-tiered approach to foster and improve critical understanding of how climate and health are interdependent
As follows, I present a strategic framework to serve as a roadmap, which can be used by physicians who are interested in engaging in this work in their own practices and health systems:
Identify the Passion. This is where this work begins, and it is required to effectively execute the steps that follow. This could simply mean the identification of a problem. For me, I'm passionate about patient education, and found nothing about climate when I searched my health system's electronic health record (EHR) database of patient education handouts. Let your passion be your impetus as a physician working to improve climate change knowledge for your patients.
Incorporate the Data. In such a process, we have to gather a basic understanding of where current medical knowledge stands on the topic -- so a literature search is necessary. Climate and health is a relatively novel field, but the knowledge base is exponentially expanding.
Initiate the Conversation. The physician voice is a trusted and powerful voice, and is necessary in this work. I met with my health system's medical informatics team after I learned they were interested in my goals, and they welcomed my input and the work I had already done. They were willing to develop a plan at the system-wide level to meet, evaluate, and assess the efficacy of patient education handouts on climate change and health.
At the national level, my voice was welcomed in meeting with Epic representatives who shared an enthusiasm for this work. They told me about their efforts within their EHR corporate structure to combat climate change. As I did with Epic, it is crucial to encourage your EHR partners to take on this essential work long-term.
Invite Key Players. Meeting key players often involves networking and building connections. I was connected with Healthy Climate Wisconsin representatives by my fellowship program leaders; through this, I was connected with Epic leaders in this space. This opened up a huge window of additional conversations, engagements, and opportunities to further present my concerns surrounding climate change education.
Institute the Action. As conversations progressed, my project reached across multiple levels. There was a component at the individual practice level, the health system-wide level, and at the national level with the potential to impact patients and practices around the country. This all started because I created education . I was more than willing to share these handouts with Epic representatives, Wellstar representatives, and WebMD Ignite (our health system's third-party patient handout vendor).
Individual Voices Matter. Never forget the patient voice. I've had patients with new-onset adult asthma due to air pollution. I've had patients who have been impacted by respiratory disease due to buying homes close to interstates. More personally, my uncle, who was an outdoor worker, died from cardiovascular collapse as a result of extreme heat. Individual voices of those impacted by the ravages of climate change continue to inspire and should be at the forefront of this work.
Iterate the Process. No good work is complete without the ability to extrapolate the findings to other relevant populations. Repeat and extend this work from practice to practice, health system to health system, and have conversations and partner with other EHR companies to affect positive change.
My journey has been just one example of what I hope will be many climate-related projects, with the goal of reaching a larger swath of the population and extending this work from one EHR system to all. Even more, I hope this framework will help physicians understand that, though our formal training on climate change and health is often limited, we have the practical skills and basic expertise to get started.
Our planet is worth it. Our patients depend on it.
Earl Stewart, Jr., MD, is an internal medicine physician in Atlanta, and a 2023 climate and health equity fellow with the Medical Society Consortium on Climate and Health.