The Fourth Clinical Climate Change Conference, held virtually on January 7, 2022, provided a path forward for the health care community to address the health effects of the climate crisis and improve patient care through state-of-the-science research and practical, evidence-based tools. This annual continuing medical education conference at the Icahn School of Medicine at Mount Sinai was attended by more than 250 physicians, medical students, researchers, and allied community leaders from across the United States.
Assistant Secretary for Health Admiral Rachel Levine, MD, highlighted in her keynote address the importance of focusing on equity in climate and health policy as communities of color suffer disproportionately and are more likely to face other crises, such as poverty.
Vulnerable groups that experience poverty and lack access to health-promoting community infrastructure, housing, and clinical care are often also at a heightened risk of climate-related exposures such as increased temperature, air pollution, and extreme weather events. Dr. Levine emphasized the critical role the health care community must play in addressing social determinants of health through partnership with stakeholders outside of medicine, particularly in areas such as housing, food access, environmental protection, environmental justice, employment and economic opportunity, and transportation.
“Health equity is central to our discussions of climate change, and climate change is not the first threat that these communities have to face. It is one of many,” said Dr. Levine, who completed her residency in pediatrics and adolescent medicine at Mount Sinai and stayed on as a faculty member from 1988 to 1993. “There are other crises that people face, including poverty, that we need to understand as clinicians to provide the best care possible to individuals. We need to explore new ways to understand and to address the social determinants of health if we are going to have meaningful progress.”
She added, “While everyone will have some form of mental health response to climate change, there are populations that are uniquely vulnerable…We need to take a health equity lens to this. For some communities, climate change is not a concern of the future…It’s a concern of today.”
J. Marshall Shepherd, PhD, an international expert on climate and health at the University of Georgia, noted that citizens must move beyond the perspective that climate change is a future concern. Extreme weather is happening now and will continue to increase in frequency and scale.
Robert Wright, MD, MPH, co-director of the Mount Sinai Institute for Exposomic Research, the convening organization, emphasized that climate change affects virtually all aspects of the environment, which in turn affects health. Because of this complexity, understanding the impact of climate on health requires measuring the environment on a grand scale repeatedly over time, he said.
Age, poverty, where you live, and pre-existing health conditions compound the impacts of climate-related environmental exposures. With sophisticated new technologies, we are now able to collect rich exposure data on diverse parameters of our environment, such as air pollution, weather, and temperature in geospatial time, according to Dr. Wright, who is Ethel H. Wise Chair of the Department of Environmental Medicine and Public Health.
This year’s conference theme focused on mental health, and a major takeaway was that clinicians must prioritize their own well-being to be effective. It is well documented that clinicians are experiencing increased stress due to both the climate crisis and job-related pressures, leading to increased burnout and exodus from clinical care.
“Clinicians are also personally impacted by climate change. We also can feel anxious about the future, feel anger, frustration about the world and what future generations are inheriting from us. We must develop our own resiliency, our own practices, to notice how climate change impacts our own mental well-being and seek assistance as needed,” said Dr. Levine. “We need to consider the pressures that climate change can also put on our provider community. This is of concern of myself and the Surgeon General. We need to think of the supports that clinicians need to continue to provide care during the climate crisis.”
‘Eco-anxiety,’ a term used to describe climate-related stress, coupled with the ongoing stressors of the pandemic and social inequities, must be recognized and managed to protect the health of both providers and patients, experts say.
Young people are also affected by eco-anxiety, and they identify the future of the planet’s health as a key concern. A recent survey of thousands of teenagers and young adults in 10 countries found that more than half were extremely or very worried about climate change and felt sad, anxious, angry, or powerless. That highlights the need for increased supports to improve resiliency and coping in young people, who are often at the forefront of climate change advocacy.
Health providers can take action in both their professional and personal lives by being environmentally conscious and connecting with others to build community to affect positive change. As trusted messengers, they are well positioned to educate patients on the health consequences of climate change and to advocate for solutions that protect and promote the health of all people.
The 2022 conference was organized by the Mount Sinai Institute for Exposomic Research. Conference supporters included the American Lung Association, the American Public Health Association, the New England Journal of Medicine, the Center for Earth Ethics at the Union Theological Seminary, Columbia’s Global Consortium on Climate in Health Education, the Yale Program on Health Care Environmental Sustainability, the Center for Health Equity, Education and Advocacy at the Cambridge Health Alliance and the Medical Society Consortium on Climate and Health.