Physician Action Needed in Face of Climate Change, ACP Says

Marcia Frellick

December 03, 2018

In response to recent reports warning of the threat of global warming to public health and the environment, the American College of Physicians (ACP) has issued a renewed call for individual physicians and healthcare organizations to step up and make changes.

Ana Maria López, MD, MPH, ACP president, told Medscape Medical News, "Ultimately, people are dying. We're not waiting for 2035. People are dying because of this impact now."

ACP and other healthcare groups have issued previous calls to action but "the alarming rapidity of the impact," she said, coupled with recent reports from the Lancet and US government, necessitated a renewed push.

Among the most troubling changes highlighted in the Lancet report, published online November 28, are the growth in diseases spread by insects, diseases that are more common in warmer climates occurring in cooler climates, changes to the food supply, and respiratory illnesses brought on by the trapping of greenhouse gasses, she said.

Nick Watts, MA, director of the UK Health Alliance on Climate Change, and colleagues, who authored the Lancet report, also point to other alarming trends:

  • "Vulnerability to heat has increased across all regions, exposures to heatwaves have risen further, vectorial capacity for disease vectors continues to increase, and terrestrial and marine food-security threats have grown."

  • In 2010-2016, air pollution worsened in almost 70% of cities globally, "particularly in low-income and middle-income countries."

  • Thirty countries are experiencing reductions in crop yields, reversing a decade-long trend of global improvement. Yield potential is estimated to be declining in every region.

  • 153 billion hours of labor were lost in 2017 because of rising temperatures, 62 billion hours more than in the year 2000; 80% of these losses were in the agricultural sector.

Hardest hit will be the elderly, children, and those without access to healthcare, López said.

"We need a concerted effort from the healthcare community to address the impact of greenhouse emissions," she said.

López said it's important for physicians individually and healthcare facilities to examine use of energy, water, and energy-efficient equipment and commitment to recycling.

Physicians and organizations are critical in advocacy efforts as well on all levels for reducing the effects of climate change, she said.

She added that physicians and organizations should also use and promote use of public transportation and carpooling, and advocate locally for better access to public transportation.

López pointed out that reducing energy use is not just good for the planet but for healthcare's bottom line.

According to the US Fourth National Climate Assessment, released on November 23, "With continued growth in emissions at historic rates, annual losses in some economic sectors are projected to reach hundreds of billions of dollars by the end of the century — more than the current gross domestic product of many US states."

The ACP has developed an action plan as part of a toolkit for physicians that includes a PowerPoint slide deck that can be used at chapter meetings and on grand rounds and talking points specific to each region of the United States.

Julie K. Wood, MD, senior vice president, health of the public and interprofessional activities of the American Academy of Family Physicians (AAFP), told Medscape Medical News that the increased air pollution in nearly 70% of cities and increased severity and frequency of extreme weather noted in the reports are "extremely concerning."

However, she said, AAFP "is encouraged by a reduction in cost of renewable energy sources and increase in employment opportunities in renewable energy. An increase in renewable, noncoal energy sources is crucial to mitigate the effects of climate change on health."

AAFP issued its first statement on the effect of climate change on health in 1969, she noted, and has since been promoting education and advocacy.

Both the AAFP and ACP are members of the national Medical Society Consortium on Climate and Health, which includes professional partner organizations representing more than 500,000 clinicians. Its mission is "organize, empower, and amplify the voice of America's doctors to convey how climate change is harming our health and how climate solutions will improve it."

Family physicians are uniquely positioned to notice links between certain exposures and threats to public health, Wood said, which makes their role in changing the trajectory critical.

"Climate change is negatively impacting the health of patients, families, and communities, and will continue to do so without action," she said.

Wood and Lopez have reported no relevant financial relationships.

Lancet. Published online November 28, 2018. Abstract

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