It is important to view climate medicine through a structural lens, not a narrowly focused one that focuses on climate-health knowledge. This does not connect this existential danger to the larger socio-political system in which we operate.
Climate negotiations (COP26These November meetings in Glasgow, Scotland were some the most significant in human history. They determined our collective path to a livable planet. This could be achieved through aggressive climate action, or through incremental climate policy solutions that are underwhelming. Unfortunately, more of the latter was the case. Regardless, we must continue to look inward as well as outward to find entry points for climate actions within our fields, such as public health and clinical medicine — both of which are complementary to each other. This is crucial because the climate crisis, a serious threat to human, animal and global health, is inextricably tied to these fields. This is ubiquitously highlighted in many of the recent reports and calls to action ahead of COP26, such as the World Health Organization’s COP26 Special Report on Climate Change and Health, #HealthyClimate PrescriptionBy the Global Climate & Health Alliance, and the 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future by the LancetAmongst many others.
Climate change and structural racism are also inextricably connected, just as the climate and health connection. Both have their roots in colonization and capitalism. This results in climate change having a different effect on different populations depending on a variety of factors, such as racism, class and social status. Inequalities have been a result of the long history of systematic oppression, structural racism, and other forms of oppression. social determinants of healthspectrum, which leads to poor health outcomes for those at the margins of society. The confluence between current inequities and climate change, structural racismThis will only exacerbate existing social, racial and health inequalities among socially vulnerable groups. Climate injustices will continue to be perpetuated by historically marginalized and systematically disadvantage communities that have a limited adaptive capacity and resilience to adverse effects of climate change on their health.
This complex sociopolitical phenomenon directly impacts public health and the allied field of clinicalmedicine. Patients will seek medical attention if they are exposed to climate change and suffer from the resulting illnesses. Physicians who fail to consider the impact of climate change on their patients, particularly historically marginalized populations, are doing a disservice. Heat-related illnesses, vector-borne diseases, water-related illnesses, asthma, and mental healthThese are just some of the many health issues that will continue growing as temperatures rise and the environment changes. This will require climate adaptation in clinical practice.
Fortunately, this has finally led to an increased interest in climate change from physicians’ perspectives, vibrant discourses on the emerging field of climate medicineThere has been an explosion of commentary linking climate change with clinical practice. These developments should be lauded because they provide a pathway for equitable patient care. We must be cautious as the field of climate medicine develops and coheres. Current and future physicians must develop new competencies and frameworks for clinical care in the face of climate change. This is important for both clinical care and because physicians are health educators for patients. Physicians are in a unique position to advocate on behalf of their patients in a broader legislative capacity. climate advocacy. It is important to view climate medicine from a structural perspective, rather than a narrowly focused one that focuses on climate-health information and does not consider the wider socio-political environment in which we operate.
Climate medicine should be treated as a structure competency that crosses all specialty silos. Our research team is developing a simple, global-level training framework for climate medicine. It builds on the extremely well-done and comprehensive work of others. existing literatureFrameworks for physician training. We believe physicians need to be trained as climate competent care providers by having skills in (a) climate-informed clinical practice; (b) climate advocacy at the interpersonal, institutional, and societal level (c) climate communications — with patients as well as the broader public given physicians are a trusted voice (d) climate equity and political economy — focusing on teaching physicians the intersection of structural racism and climate change as it relates to political economy; and (e) self-reflexive leadership — to ensure an equitable, non-white supremacist, decolonial approach towards climate competent care. A method that allows physicians to be humble and helps them lead by following others who have a better understanding about the social and structural determinants and health. It is important to lead with humility when it is climate medicine. Although clinical medicine has a limited scope of training, physicians are often questioned about their leadership on issues that they don’t know much about.
Climate medicine is a vital part of clinical medicine and cannot be ignored. Clinical medicine will repeat its arrogant past mistakes by ignoring the unavoidable interplay of climate change, structural racism and politics. These mistakes include a lack of advocacy for universal health care (which is itself a form of structural violence) to reverence for murderous, violent racists such as Marion Sims to ‘proto-eugenics’,All the while pretending to not be political. This is a chance for medicine to show humility and train future climate medicine leaders to be more competently address this crisis and lead society towards justice.
- Ans Irfan Kelly Maloney Roger Pattani
Ans Irfan is a professor, researcher, and critical public-health scholar at George Washington University’s Milken Institute School of Public Health. He is the Director of Climate & Health Equity Practice Fellowship, an international fellowship focused on training the next generation of climate medicine leaders in the Global South. He also is a Robert Wood Johnson Foundation’s Health Policy Research Scholar fellow. He is currently based in Harvard Divinity School. His research focuses on the intersection between religion and public health policies, particularly as it relates to climate change. [email protected] and Twitter: @PHScientist can be reached.
Kelly Maloney, PharmD, is a Florida retail pharmacist. She graduated from the University of Wisconsin with a Doctor of Pharmacy. Dr. Maloney currently is completing a Master of Public Health with an emphasis in climate change and epidemiology at the Milken Institute of Public Health. She can be contacted at [email protected]. Twitter: @KellyCancelsCO2
Roger (Tanay) Pattani, a public health scientist, is currently pursuing advanced training at the Milken Institute of Public Health (George Washington University). Contact him at [email protected]