Friday, January 11, 2008

The medical effects of climate change: Do physicians know?

While climate change is a problem with vast implications for human well-being, the medical impact of climate change has received limited attention from physicians or the medical care system. There has been minimal coverage of the health effects of climate change in either the media or the clinical literature. Thus, it is likely that most doctors are not familiar with the health consequences of climate change. But they should be.

Medical scientists of the Intergovernmental Panel on Climate Change (IPCC) have reported that conditions known to be attributed to climate change include heat-related cardiovascular events, worsening of asthma and chronic pulmonary disease, outbreaks of vector borne and waterborne infectious diseases, injuries from extreme weather events and the mental problems that result from catastrophic events. At this time, these effects are not on the radar screen of many practitioners of medicine. And if they are, they are not perceived as a threat to residents of the United States.

Physicians are not aware of what to expect as the climate changes. While it is difficult to predict the exact nature or the extent of medical effects from climate change, specific types of outcomes — like those mentioned above — are predictable. Models developed by the IPCC scientists have accurately predicted increases in vector borne diseases in the countries of Central America. Vulnerability is increased if people are not aware of and prepared for the conditions we are likely to face.

Clearly awareness by medical professionals is needed so we may rise to meet the health challenges of climate change. Physicians must be prepared to advise their vulnerable patients of the dangers they may face, and be ready to recognize and treat conditions that will develop when flooding, drought and/or heat bring increased cardiac stress, deterioration of air quality, or vector borne and waterborne infectious diseases. Physicians must be knowledgeable so they report the medical conditions that are critical to public health surveillance systems. It will be more difficult for health and public health systems to respond to climate-related health effects if surveillance is ineffective.

The infrastructure for health and public health communication should be utilized now to disseminate this information and strengthened to prepare the medical care system for future challenges.

-Mona Sarfaty, MD, FAAFP, CPH
2008 National Public Health Week Advisory Committee member and research assistant professor, Thomas Jefferson University, Jefferson Medical College

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