CLIMATE CHANGE MEDICAL ADVOCACY

Effective approaches to mitigating environmental health risks require policy-level interventions. Physician participation in such policymaking—as advisors to policymakers or in other capacities can be useful in bringing attention to short- and long-term health consequences that might otherwise be overlooked. Indeed, many physicians have chosen to learn about and work to change environmental conditions that can undermine health under climate change and to speak out about these issues in public. Many have detailed the health threats posed by climate change. Decades of evidence from diverse disciplines confirms that atmospheric accumulation of greenhouse gases are the primary drivers and that climate change is already causing adverse health effects through its impacts on agricultural production and food and water scarcity: respiratory illnesses (e.g., asthma), mental illnesses (e.g., depression), and novel infectious and zoonotic diseases such as Chikungunya and Zika that emerge or re-emerge in new locations.

A physician has a special obligation to advocate for actions that can reduce health threats related to climate change.

Physicians often have

(1) expertise in treating climate-related injuries, infections, and diseases that are increasingly prevalent and severe in diverse locations . They are often first responders

(2) proximity to those who need related care.

(3) Physicians are more likely than others to be effective in related advocacy aimed at health officials, the news media, local school boards, or the public, especially when their advocacy is based in scientific evidence and expertise and if they have been trained in advocacy skills.

(4) Such advocacy seldom poses unreasonable cost or risk to the physician, although advocates addressing politically charged issues often run the risk of being criticized for speaking up. Countering this risk, if physician advocacy helps reduce harmful impacts of climate change, then advocacy to address climate change might directly benefit physicians themselves as well as their families and communities.

(5) While physicians are not the only professional group with a special role to play in addressing climate change, physicians are unique among potential climate change advocates in having medical expertise and experience in treating the health effects of climate change and in their influence over the distribution of health care resources .

(6) The severity of the potential health consequences of climate change should concern all physicians, given realistic models suggesting more frequent extreme heat if current trends continue unabated .

(7) Finally, physicians’ silent acceptance of ongoing rates of greenhouse gas emissions risks undermining their ability to uphold public trust. In failing to speak out, physicians risk being seen as complicit or out of touch.

Addressing climate change is professionally appropriate for all physicians. It is obligatory for those with unique expertise (such as those specializing in pulmonary diseases, infectious diseases, and so on) practicing in affected regions (which, increasingly, are everywhere). In addition, climate change surely merits strong advocacy on the part of groups of physicians, such as professional societies, which might have a particularly effective voice in altering organizational practices to achieve reduced emissions, waste reduction, and energy conservation. Additional advocacy by individuals or groups could promote healthy, climate-friendly behaviors, such as walking or cycling rather than driving, and increasing consumption of fresh, unprocessed, and locally produced food. These behaviors have direct health benefits to those who practice them and indirect health benefits by reducing the carbon emissions that drive climate change.

Physicians as a group, and many individual physicians, have a professional responsibility to speak out about the health impacts of climate change and that including advocacy-related skills in medical curricula would better equip them to speak out constructively on this and other health threats.

Prominent climate change mitigation activities undertaken by health professions organizations and others include:

• Promoting public and legislative support for international, national, and regional policies to mitigate climate change ;
• Promoting a “co-benefits” approach, which promotes policy and lifestyle measures that improve public health while reducing carbon dioxide emissions ;
• Promoting the use of the social costs of carbon in decisions to estimate climate change costs ;
• Expanding medical school curricula on climate and global change ;
• Promoting climate awareness among health professionals;
• Greening health care facilities especially with regard to energy efficiency, and switching from fossil fuels to alternative energy sources at these facilities ;
• Preparing health care facilities to withstand extreme weather events .