Proposed SGIM Position Related to Health Effects of Climate Change

Approved by SGIM Council June 10, 2021

Prepared by William G. Weppner, Andrea Christopher, Matthew F. Hollon, Elizabeth Gillespie, Gaurab Basu, on behalf of the Environmental Health Interest Group and Health Policy Committee.

Climate change is among the major public health issues of this century, if not the most significant public health opportunity currently facing the Earth.1 Accordingly, SGIM, an organization of primary care clinicians, clinician educators, and health care & policy researchers should take an active role in educating patients, trainees, and the healthcare system about the health effects of climate change, and possible means to address underlying causes and attenuate expected effects.

  1. Climate change has wide-reaching effects on multiple disease processes and patterns through differing causal pathways including (but not limited to) heat waves, air pollution, extreme weather, vector-borne illness, nutrition, and water quality. These pathways have the potential to function as effect multipliers and cause consequential environmental and human catastrophe.2
  2. Climate change is a health equity and environmental justice issue. At-risk populations, including racial and ethnic minorities, those with co-morbid illness, the very young, the elderly, and those with limited resources are more vulnerable than others to the health effects of climate change. Physicians are well positioned to educate patients within these vulnerable populations about likely health consequences of climate change as well as to help prepare them to better withstand the effects.3-6
  3. The appropriate public health approach to addressing climate change is multi-faceted and requires collaboration across the disciplines of research, clinical care, education, and community partnership, a list which overlaps the Society of General Internal Medicine (SGIM) areas of interest.7-9
  4. Addressing climate change has significant return on investment including significant reductions in health expenditures from heat waves, air pollution, and other direct impacts on health. It also has secondary beneficial impacts on health including promoting active transportation and healthier eating.10-11

  5. SGIM recognizes that the general internal medicine community and hospital-based physicians are positioned to lead initiatives – both locally and nationally – which promote environmental sustainability, climate resiliency, and climate mitigation.12-14

Accordingly, SGIM supports the following actions:

  1. Physicians and healthcare professionals should work to prepare communities and healthcare facilities to better withstand both indolent health effects as well as weather-related disasters associated with climate change and should address climate mitigation efforts which, broadly speaking, help reduce human contributions currently contributing to global warming.
  2. SGIM believes that every medical trainee, both in medical school and as internal medicine residents, should be exposed to curricula addressing the public health impacts of climate change and supports members’ efforts to develop, disseminate, and evaluate such curricula. This includes commitment to inclusion of climate change content at every annual meeting for the next 10 years.
  3. SGIM encourages the medical community to become aware of and recommend “health co-benefit” methods to address the causes of climate change and provide associated health impacts; for example, encouraging human powered transportation, reducing food waste or recommending more plant-based diets.
  4. SGIM will continue to support virtual options at regional and national SGIM conferences, acknowledging the importance of opportunities for in-person collaboration and networking. In addition, SGIM will work to provide members with effective resources to facilitate carbon offsets for travel to in-person events.
  5. SGIM encourages its membership to pursue research projects to evaluate the impacts of climate change on human health, as well as interventions which reduce or attenuate such impacts.
  6. SGIM supports efforts to reduce the drivers of climate change, including Earth’s reliance on fossil fuels, a principal source of human contribution to climate change. SGIM calls for healthcare facilities to decarbonize with intent of reaching net zero emissions by 2050.

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References:

1. Watts N, Adger WN, et al. Health and climate change: policy responses to protect public health. Lancet. 2015; 386:1861-914.
2. Patz JA, Frumkin H, Holloway T, Vimont DJ , Haines A. Climate change: challenges and opportunities for global health. JAMA. 2014;312:1565-80.
3. Hunter DJ, Frumkin H, Jha A. Preventive Medicine for the Planet and Its Peoples. N Engl J Med. 2017; 376:1605- 107.
4. Di Q, Wang T, Zanobetti A, et al. Air Pollution and Mortality in the Medicare Population. N Engl J Med. 2017; 376:2513-2522
5. Blum LN, Bresolin LB, Williams MA. From the AMA Council on Scientific Affairs. Heat-related illness during extreme weather emergencies. JAMA. 1998;279:1514.
6. Liu JC, Pereira G, Uhl SA, Bravo MA, Bell ML. A systematic review of the physical health impacts from non-occupational exposure to wildfire smoke. Environ Res. 2015; 136:120-32.
7. Rice MB. Climate change at the bedside? Observations from an ATS membership survey. Ann Am Thorac Soc 2015;12:245-6.
8. American Medical Association’s H-135.938 Global Climate Change and Human Health. updated 2019. Available at: https://policysearch.ama-assn.org/policyfinder/detail/climate%20change?uri=%2FAMADoc%2FHOD.xml-0-309.xml Accessed August 16, 2019.
9. Crowley RA. Health and Public Policy Committee of the American College of Physicians. Climate change and health: a position paper of the American College of Physicians. Ann Intern Med. 2016: 164:608-10.
10. Haines A, McMichael AJ, Smith KR, Roberts I, Woodcock J, Markandya A. et al Public health benefits of strategies to reduce greenhouse-gas emissions: overview and implications for policy makers. Lancet 2009 374;2104-14
11. Younger M, Morrow-Almeida HR, Vindigni SM, Dannenberg AL. The built environment, climate change, and health: opportunities for co-benefits. Am J Prev Med 2008 35;517-26
12. Peters JL. Mitigating the impact of climate change on human health: the role of the medical community. AMA J Ethics. 2017;19:1153-1156.
13. Climate Action: A Playbook for Hospitals https://climatecouncil.noharm.org/ accessed August 16, 2019.
14. Haines A, Ebi K. The Imperative for Climate Action to Protect Health. N Engl J Med. 2019; 380: 263-273. 

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