After a slow start, hurricane season is here: A flurry of named storms formed within days during September. Fiona devastated Puerto Rico, and less than two weeks later, Ian battered the west coast of Florida before it and its remnants moved up and hit the Eastern Seaboard.
Extreme weather events like Ian and Fiona have become more intense because of climate change. That reality has implications for those of us in health care. We have a duty to protect and advance the health of our patients. Climate change is killing them, and we must change the way we practice medicine in response.
We can start by screening our patients for the impact of climate change as if it were a new vital sign.
We typically think of health as something doctors monitor, offering treatment such as prescription medications as needed. But in reality, only about 20% of a person’s health is attributable to the medical care they receive. The rest is determined by factors such as individual genetics, behaviors including dietary habits and smoking, and socioeconomic conditions.
Social determinants such as people’s neighborhood and socioeconomic status are actually responsible for 40% to 50% of a person’s health outcomes. It’s a sad truism that a ZIP code can be more predictive of a person’s health than his or her genetic code.
Consider how extreme weather events such as this summer’s heat waves affected communities unequally. Poor urban neighborhoods, with sparse tree cover but plenty of concrete and asphalt, absorb and retain the heat of the sun’s rays, while leafy, shaded suburbs just a few miles away stay much cooler. A University of California–San Diego study that measured land surface temperatures in over 1,000 counties across the United States found that neighborhoods with the lowest average education and income levels generally recorded higher temperatures.
A warmer globe will pose a host of less obvious health risks, too. Disease-carrying insects may spread well beyond their normal ranges. The Zika virus, discovered in East Africa in 1947, has moved in the Western Hemisphere in recent years, with local transmission as far north as Florida and Texas. Cases of the mosquito-borne chikungunya virus, once largely seen in Africa and Asia, have been found in the Caribbean and the U.S.
Extreme weather events can threaten people’s physical and mental health long after the waters recede. Almost 1 in 3 people in the Hurricane Katrina disaster area were estimated to have suffered from hurricane-related post-traumatic stress disorder in the months following the deadly storm.
Health care providers need to adapt to this unfortunate reality – and fast. That means increasing awareness of how climate change exacerbates health risks. From the first day of medical school, doctors ought to be trained to identify which patients are particularly vulnerable – and learn how to equip those patients with the knowledge they need to stay safe.
Physicians in regions at increased risk of natural disasters may need to be ready to deliver more mental health care. Doctors in drought-plagued areas may need to make water safety a part of their conversations with patients, because groundwater sources can become unsafe to drink without sufficient rainfall.
Hospitals and health systems also have a responsibility to reduce their own greenhouse gas emissions. The health care sector has accounted for 8.5% of U.S. carbon emissions. In fact, past data showed that if the American health care sector was a country, it would rank 13th in the world for greenhouse gas emissions. Simple changes like installing LED lights, more efficient air circulation units, newer elevators and even better vending machines can dramatically cut electricity consumption.
Every unit of carbon that health care providers put into the atmosphere exacerbates the impact of climate change on public health – and makes the task of delivering quality health care a little bit harder.
Climate change poses an immediate and dire health threat. Now is the time for health care providers to take collective action.