1) A medical director discusses a report released by the Medical Society Consortium on Climate and Health, which warns that climate change is harming public health. 2) The report aims to increase awareness that climate change poses immediate health risks to Americans from issues like extreme heat, weather events, declining air quality, and changing disease vectors. 3) It highlights stories from doctors who have seen increases in heat-related illnesses, mental health impacts from disasters, and tick-borne diseases - trends associated with a changing climate.

1. www.medsocietiesforclimatehealth.org
Medical Alert!
Climate Change is Harming
our Health
Mona Sarfaty, MD MPH, FAAFP, Director
Medical Society Consortium on Climate and Health
Fairfax, Virginia
www.medsocietiesforclimatehealth.org
Facebook: Medical Society Consortium
Twitter: @docsforclimate

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Disclosures

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Outline
• The science of climate change
• Medical Society Consortium on Climate & Health
(AAFP is a founding member)
• How climate change is affecting our health
• What the public and physicians think about this
• How family physicians and state chapters could be
involved

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Science of Climate Change: the
Composition of our Atmosphere
• Key Fact: The light from the Sun alone isn’t sufficient
to warm the earth; the atmosphere is needed to
retain warmth. It is the trace gases that are
responsible for retaining the warmth.
• Nitrogen accounts for 78% of the atmosphere, oxygen
21%, argon 0.9%.
• Gases like carbon dioxide, nitrous oxides, methane,
ozone, water vapor are trace gases.
• Without H2O & CO2, worldwide average surface
temperature would be –18oC (0⁰ F) not 15⁰C (59⁰ F).

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• 1824: Joseph Fourier established
existence of natural greenhouse effect
• 1859: John Tyndall confirmed heat-
trapping properties of greenhouse
gases
• 1890: Svante Arrhenius did first
estimate of global temperature
increase from fossil fuel use
• Today: 97% of climate scientists say
that we are experiencing global
warming
Scientists Have Known C02 Could Warm
the Climate for about 200 years

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Global Average Annual Temp
and CO2
NCA 2014

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Where did the C02 Come From?
• Scientists have detailed records of how much
coal, oil, and natural gas is burned each year and
how much CO2 is absorbed, on average, by the
oceans and the land surface.
• These analyses show that about 45% of the CO2
emitted by human activities remains in the
atmosphere.
• Also, a forensic-style analysis of the CO2 in the
atmosphere reveals the chemical “fingerprint” of
carbon from fossil fuels (Carbon 14 dating).

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Separating Human and Natural Causes
National Climate Assessment 2014

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Report Released March 15, 2017
• With the launch of the
Medical Society Consortium
on Climate and Health (19
societies/>550,000 doctors)
• Consortium mission is to
inform the public &
policymakers about the
harmful health effects of
climate change and the
benefits of climate solutions.
• Why did we release this?

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Why was this Report Released?
• Most Americans (70%) understand that climate change is
real and are concerned about it.
• But they see climate change as a faraway threat, in both
time and place, and as something that threatens the other
people or the environment and not them.
• Only a minority understand believe that climate change is a
threat to Americans or to them personally.
• The reality is climate change is already causing health
problems in communities in every region of our nation.
“Medical Alert!” fills that gap in awareness.

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Some Americans Face Greater Risk
The health of any American can be harmed by climate
change, but some face greater risk than others.
• Children
• Student who play sports
• Pregnant women
• Elderly individuals
• People with chronic illnesses and allergies
• People with limited resources

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Why Health Harms?
• Heat
• Extreme Weather
• Disease carrying vectors
• Threats to Mental Health
• Air Pollution (including pollen particles)
• Threats to nutrition, food security, potable water

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Isaac’s Story
Dr. Samantha Ahdoot
Pediatrician
Dr. Ahdoot’s 11 year old son, Isaac, was at band
camp when she got a call from the ER—Isaac had
collapsed while playing clarinet.
He experienced heat illness.
That day was part of a record-setting
heatwave in Washington, DC;
the heat index reached > 120⁰

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Focus on Heat and Children
Young children don’t
regulate their body
temperatures like adults
do and spend more time
outdoors.
Emergency room visits
for heat illnesses
increased by 133 percent
between 1997 and 2006.
Almost half of these
patients were children
and adolescents.

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Dr. Claude Tellis’ Story,
Retired Critical Care, Aug ‘ 16
• Baton Rouge was hit with a
“thousand year flood” event—
a storm that has only a one-
tenth of one percent chance of
occurring in any given year—it
rained in sheets for days.
• Worst natural disaster since
Hurricane Sandy
• 13 people died, the coast
guard rescued 30,000 people,
and 10,000 people ended up in
shelters.

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A Battered City
• Governor declared state of emergency:
homes/buildings damaged (230,000 people)
• Months later, homes still gutted, fridges,
washing machines, chairs piled on roadsides.
• This was a health crisis for many. Some fleeing their
flooding homes lost their medications for
hypertension, diabetes, and heart problems. Dr. Tellis
and others worked with pharmacies to get these re-
issued.
• Many people reported stress, depression and anxiety
in the weeks and months that followed.
• And long after the storm passed, some teachers
reported children who felt so anxious and afraid when
it rained that they needed counseling.

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Mental Health and Climate Change
People exposed to the worst extreme weather events also
experience serious mental health consequences including, post-
traumatic stress disorder (PTSD), increases in suicidal thoughts
and behavior, substance abuse.

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Another Extreme……Drought
• Decreased food crops
• Water shortages
• Wildfires
 Increased 60% so far in 2017
2014 Lake Erie Algae bloom

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Story of Dr. John Meredith
Emergency Physician
Eastern Carolina University
June 2008, a wildfire devastated eastern North Carolina.
Starting in the midst of the state’s worst drought, the Evans Road
Wildfire burned more than 45,000 acres and cost $20 million to
battle.
Fire burned three long months that summer and plumes of smoke
carrying dangerous particles covered the eastern side of the state
and beyond.
Researchers saw this fire as an opportunity to learn more about the
harms to our health from air pollution resulting from wildfires.
They studied two sets of counties in North Carolina: those that
were affected by the smoke and those that were not. They tallied
emergency room visits for respiratory conditions, including asthma,
pneumonia, and common respiratory infections, as well heart
attacks and other cardiac conditions.

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The Comparison of Counties
• People living in counties affected by the plume had
a 50 percent increase in the trips to emergency
rooms from respiratory illness like Chronic
Obstructive Pulmonary Disease (COPD),
pneumonia, bronchitis.
• The smoke caused a spike in emergency
department visits for heart disease.

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Map shows for how
long ragweed
pollen season has
changed from 1995
to 2005. Many
people are
allergic to Ragweed.
http://www.ars.usda.gov/ &
U.S. National Climate Assessment

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Health Effect: Spread of Disease by
Ticks and Mosquitos

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Story of Dr. Nitin Damle, Internist,
President, American College of
Physicians
“It’s not a surprise that over the past five years, my Rhode
Island internal medicine practice has seen a rise in the
incidence of tick-borne diseases, including Lyme disease and
other infections.
My physician colleagues used to treat two or three cases a
month during tick season; now each of us sees 40 to 50 new
cases during each tick season.”
The blacklegged ticks, the carriers of Lyme disease, thrive in
warm, muggy weather. In Rhode Island, winters are now
warmer and shorter, the tiny, sesame seed-sized insects have
more time to bite humans and spread Lyme disease.
Tick season used to be relegated to summer; it now spans
spring and autumn. And this isn’t limited to the typical tick
hotspot states.

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What Do Doctors Think?
• Surveys of medical societies produced similar
results
• They know that climate change is occurring and
that humans are mostly causing it
• They think it’s directly relevant to patient care;
85% think it’s harming their own
• They feel that physicians should be involved

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What do physicians want?
• They wanted their societies to speak out
• They indicated that doctors have a responsibility
to educate the public about the health impacts of
climate change….and have a responsibility to
educate their patients
• Want CME for themselves and med students!
• Doctors should lead on environmental
sustainability in their workplaces.
• The Consortium was founded to enable these.

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What is the solution: clean energy
• Embrace clean renewable energy that does not
produce carbon dioxide or methane as a
byproduct at home and at work.
 Energy production: solar, wind, geothermal are all
cleaner…They don’t pollute the air or the water. This
can be purchased from suppliers in many areas.
 “Green your office” [MyGreenDoc.org]
• Pursue energy efficiency.
 Right now we could reduce
energy use by 25-40% !!

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What You Can Do in Practice
to Offer Health Benefits
• Diets with more vegetables and less meat are healthier
and produce less methane (if organic, they even
sequester carbon)
• Active transportation (walking, biking, public transit) is
better for your health and leaves the air cleaner
• Protect or plant forests as quickly as possible. This
helps sequester carbon. Also, cities with more trees &
cooling greenery protect people from dangerous heat.
• Tell your patients how to protect themselves from the
increases in dangerous heat, longer allergy seasons,
extreme weather, diseases carried by ticks/mosquitos

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What You Can Do in your State AFP
Chapter or in the AAFP
• Support the formation of an AAFP Member Interest
Group (form is on the table with the evaluations)
• Include a climate change presentation in your
chapter’s CME meeting (Mattdotburke@gmail.com)
• Put the Medical Alert! report on your website
• Write/publish a piece in your state Family Physician
magazine
• Adopt a climate change policy for your AFP chapter
• Pursue a relevant issue at the state level

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What about legislative work?
• Ask candidates for governor in 36 states in the
upcoming election about their plan for addressing
climate change
• Be like Virginia: ask your friendliest legislators for
a bill requiring a plan to protect health
infrastructure & people from climate change
• Watch out & oppose anti-competitive efforts to
squash renewable energy growth in your state
• Support efforts to create greater energy efficiency

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What do your
colleagues have to say?
https://youtu.be/6UzubShRYAI

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More Clean Renewable Energy is Available
So are routes to Energy Efficiency

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Low Fossil Fuel Transportation is Healthy

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Mediterranean Diets are Healthier
All of these become more scarce in an extreme climate.

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Thank You
www.medsocietiesforclimatehealth.org
Facebook: Medical Society Consortium
Twitter: @docsforclimate
#climateandhealth