Physicians have a moral imperative to persuade their patients, their family members and friends — and especially their health system leaders — that climate change is real, with global health impacts already visible and certain to get exponentially worse. And the U.S. will not be excepted.
That was the message given to delegates at the American Medical Association’s interim meeting here during a session on climate change.
“We are the most trusted profession in America,” said Mona Sarfaty, MD, MPH, founding director of the Medical Society Consortium on Climate and Health at George Mason University in Fairfax, Virginia.
“Personal physicians, it turns out, are specifically trusted on the topic of climate change,” she continued, “and we can help patients get health smart, help them protect themselves from the harms of climate changes from heat, from allergy season, from mosquitoes, ticks and storms.”
And, she added, “if you don’t have time in our individual visits, you can put materials in our waiting rooms so that they’re easily accessible.”
Sarfaty said physician surveys show that nearly half of those responding in the U.S. don’t think people here are being harmed now by climate change. “But we know differently… and they need to hear from us, and as they learn more they will become more concerned.”
Sarfaty’s remarks came after Emily Senay, MD, MPH, of the Icahn School of Medicine at Mount Sinai in New York City, quantified the enormous amounts of pollution that the healthcare industry itself produces from its operations and waste.
Healthcare “harm due to combined greenhouse gas and non-greenhouse gas pollution has been calculated at more than 600,000 disability-adjusted life years lost, making it on par with lives lost annually to preventable medical errors” as estimated in the landmark 1999 Institute of Medicine report, To Err Is Human, Senay said.
“That makes healthcare pollution a patient safety issue,” she said, slowly repeating the words for emphasis. Leaders of American healthcare systems need to act fast to reduce their carbon footprint by finding ways to reduce waste and their reliance on fossil fuels, even as they brace themselves and their infrastructure for physical damage from increasing weather-related events.
“Healthcare facilities are energy, water, and resource intensive,” she said. “They use two and a half times the energy and more water than other equally sized commercial buildings” and waste 85% of what they procure to run their operations. Hospitals and related facilities also are major consumers of hazardous products and chemicals.
Of all greenhouse gas emissions in the U.S., she said, the health sector is responsible for 10%, a number that increased by 30% from 2003 to 2013.
Climate expert Nitin S. Damle, MD, MS, MACP, former president of the American College of Physicians and an internist at Alpert Medical School of Brown University in Providence, Rhode Island, talked about the death toll from temperature warming of just a few degrees. “You may think, ‘what’s two or four or five degrees of rise? It’s really not that much.'”
But the human impact of increasing numbers of days over 95 °F, especially along the U.S. eastern seaboard, will be enormous, he said. In one emergency department in the northeast, “every day that it was 95 degrees or higher, there was a 6.6% increase during the following seven days in ER visits. And the number of heat-related visits went up by almost 90%.” And there were more deaths, from myocardial infarction, stroke, kidney injury, and suicide, he said.
Mortality from the impact of heat is expected to increase from two per 100,000 in 2000 to four to six per 100,000 by 2050, “and by the end of the century, we’re talking about 15 to 20 deaths per 100,000.”
More air pollution not only leads to greater mortality, but some evidence also links particulate matter to neurodegenerative diseases, allergies, and asthma, Damle said.
He also pointed to climate warming’s expansion of disease-bearing vector habitats.
“This is alarming, and we may see a resurgence of malaria over the course of less than a century,” he said.
“Forest fires, droughts, heat waves, and extremes of weather – we’ve seen a 4%-6% increase in all since 1980.” And in a few years, “Every part of the country will be affected one way or the other by climate change.”
Another aspect of climate change and health is the effect on food production and distribution: increased spoilage and contamination, as well as agriculture’s carbon footprint, particularly for beef, poultry, and dairy products versus plant based foods.
“It’s a pretty significant difference in terms of greenhouse gas emissions,” Damle said.
Lastly, he said, we can expect mass migration due to climate change. “Over one billion people will need to migrate within the 21st century due to rising sea level,” Damle said.
“And if all that doesn’t make you depressed, I am not sure what will.”
All speakers urged physicians to become advocates for change, in their institutions, among their patients, and as leaders in their communities. They need to think of their organizations not just as healers, but also as contributors to a looming catastrophe that only massive amounts of concerted action taken now can mitigate.