Prioritizing Health in a Changing Climate

Originally published on August 22, 2019 by Renee N. Salas, M.D., M.P.H., Debra Malina, Ph.D., and Caren G. Solomon, M.D., M.P.H. in The New England Journal of Medicine

As medical professionals navigate busy days in temperature-controlled hospitals and seemingly indestructible health care systems, it can be easy to lose sight of the environmental chaos unfolding outside. The stark reality is that high levels of greenhouse gases caused by the combustion of fossil fuels — and the resulting rise in temperature and sea levels and intensification of extreme weather – are having profound consequences for human health and health systems.

The negative effects of climate change are frighteningly broad: they touch every human organ system, while challenging health organizations by interrupting supply chains and damaging public health infrastructure. Whereas some consequences – such as heat-related illnesses caused by longer and more frequent heat waves and hospital flooding from extreme weather events – are obvious, many effects of climate change on daily clinical practice are still generally unrecognized; examples include pollen increases leading to more allergies and asthma exacerbations and expanded range and activity of insect vectors leading to more cases of vectorborne diseases. As climate change continues to alter disease patterns and disrupt health systems, its effects on human health will become harder to ignore.

The consequences are greatest for the most vulnerable patients (such as the poor, the young, and the elderly), but we all will face far more widespread harm in the future. Globally, the countries that have contributed the least to carbon pollution bear its greatest health harms. Meanwhile, we must acknowledge both the fragility of our health care systems and health care’s own large carbon footprint.