Climate Change: What Is Our Role As Family Medicine Educators?

Colleen Fogarty,
MD, MSc

I coordinate and plan our annual community medicine rotation, a 3-week rotation for our interns at the very end of their year. This year, for our environmental health session, I invited a friend who has been making a film about the local effects of climate change. Kate Kressmann-Kehoe is a geologist by training, who literally suffered insomnia from worries about climate change. She successfully channeled her insomnia into the film, “Comfort Zone,” due for release this fall.

The film proved an excellent jumping off point for a multi-leveled discussion among our group of 13 residents. Some residents noted the regional economic effects of our very warm winter on our neighbors who clear snow or work in winter recreational activities. Others focused on the economic injustices of environmental change and noted that the large farmers — those with more economic resources — are more likely to adapt to a changing climate, while smaller farmers are at higher risk of total economic loss.

A startling piece of data that continues to haunt me is that if we do nothing to change our carbon footprint/CO2 emissions, Rochester, NY will experience a 10 degree F increase in temperature over the next century, and if we engage in some reduction of CO2 emissions, the temperature will increase by 5 degrees over that same time period. These changes would make the climate of Rochester like that of Georgia, or Virginia, respectively. While many local residents might enjoy a winter with less snow, the change in the climate will result in the loss of species and have an impact on the growing season and suitable crops.

Given the complexities of climate change, we centered much of our discussion on the public health threat of heat waves. The Chicago heat wave of 1995 resulted in the deaths of over 700 Chicagoans, the majority of whom were poor, elderly, and isolated. There were so many bodies that the city morgue needed to rent out a fleet of refrigerated semi-trucks in which to store the bodies. More recently, in 2003 a European heat wave killed an estimated 30,000.

Our discussion convinced me that heat waves, especially in urban areas, represent a growing threat. In fact, 2 weeks after our educational session, New York State Governor Andrew Cuomo announced the availability of air conditioning units to medically eligible low-income persons with written physician documentation that states that air conditioning assistance is “critical to prevent a heat emergency.”

Climate change warrants our awareness and involvement in planning. Family physicians can begin to assess patients for risk factors for heat-related morbidity and mortality and provide education about the importance of hydration and low exertion during heat waves.

How isolated are our patients? How mobile? How can our patients and their families access community resources, such as libraries, community centers, beaches, and spray parks? How many of our patients have air conditioning or easy access to family members with air conditioning? How about those with respiratory diseases? How can we work with our local public health and community officials to prevent the scale of death that occurred in Chicago in 1995?

Our community health curriculum must begin to raise our awareness as physicians of local effects of climate change and mobilize us to take action to prevent harm to our communities.

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