Short Wave - The Climate Crisis Is A Public Health Crisis

Episode Date: June 30, 2021

A recent study published in Nature found that 37 percent of heat-related deaths are due to climate change. Dr. Renee Salas is seeing this in the emergency room of Massachusetts General Hospital. She's treating more and more patients for heat-related illnesses like heat stroke and intensified allergies. Today, she gives us a view into her work at the intersection of human health and climate change; plus, she envisions a new health care system that takes climate change into account.To read more on this, see our episode page for links.Reach the show by emailing [e-mail] pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences.NPR Privacy Policy

You're listening to Shortwave from NPR. Today, I want to introduce you to Renee Salas. She's an emergency medicine physician at Massachusetts General Hospital and Harvard Medical School. There was a patient I saw who was a young girl who came in with an asthma attack, and it was her third one that week. And her mom was just beside herself trying to figure out how to protect her daughter. For Dr. Salas, treating this girl meant seeing the problems through a lens that might surprise you.

Climate change. During the initial discussions, I hadn't really realized that pollen levels were higher because of climate change. And that's something that we've covered here on Shortwave before. The more carbon dioxide in the atmosphere, the more pollen that's produced. Towards the end of the visit, I recognized that and we talked through that. And I think by me making that diagnosis of recognizing that higher pollen levels were contributing to why her daughter wasn't able to keep her disease under control, It allowed us to develop a treatment plan directed at that.

And what did that look like? Well, Dr. Salas talked to the girl's mother about checking pollen levels online or through an app to decide whether her daughter should go and play outside. Or whether to install an air filtration system in order to keep pollen outside of the home. Or to make sure that the home is optimally weatherized. And I think also recognizing that these are treatments. And so we as doctors need to think about prescribing these for. our patients because not everyone can afford them. And so we have to make sure that everyone has these because this is how we protect health in the era of climate change. Today on the show,

more with Dr. Salas about her work at the intersection of climate change and health, and how she envisions a new healthcare system that takes climate change into account. I'm Reithu Chateji. You're listening to Shortwave, the Daily Science podcast from NPR. We're talking to Renee Salis, She's an emergency medicine physician and a fellow at Harvard School of Public Health's Center for Climate Health and the Global Environment. She says she and her colleagues see the impact of climate change in the emergency room. Take heat waves, for example, like the one sweeping through the country right now. Excessive heat raises the risk of heat-related illnesses. Yeah, so heat can cause heat stroke.

and I have a patient that I saw whose wife called 911 because he was acting confused. And the ambulance crew said that when they got to their apartment, they felt like they were hit by the Sahara Desert because it was so hot because they didn't have access to air conditioning and only had one window which was open. Now, when we checked his core temperature, it was 106 degrees Fahrenheit. So his body was literally cooking. And this is the most life-threatening form of heat illness. Now, heat actually kills more people than any other natural disaster. But it often escaped the headlines because it happens just like this patient, right? In isolation at home or it happens on sports fields.

And there was actually a recent study that attributed 37% of global deaths related to exposure to heat was actually due to climate change. Wow. So we know that it causes death and these really severe injuries, but it also can impact other organ systems and make other problems worse. So for example, heat's been associated with heart problems, worsening lung conditions. It can harm our kidneys and lead to kidney failure. It can actually worsen mental health conditions, worsen pregnancy outcomes. And we're learning more and more about what heat is doing. There was even one study that suggested that rising temperatures actually may make bacteria more resistant to antibiotics. Wow. And antibiotic resistance is already a problem, a huge

problem. Yeah, that already strikes fear in my heart as a clinician. So to combine these two together is something that definitely keeps me up at night. So is climate change making heat-related illnesses worse, or is it that heat's making these conditions more common? So it's a great question. question and I think we're really beginning to try to tease out exactly how climate change is contributing to disease. You know, sort of like tobacco smoking. We know that if you have smoked for 50 years and develop lung cancer, then there's a really high likelihood that the tobacco smoke contributed to you having lung cancer. And so as we advance our understanding, we're beginning to try to tease out exactly how different aspects of climate change are contributing to disease. But I think we do clearly know now that

climate change is increasing complications for people who have these conditions. And I think we'll increasingly see in certain conditions that it could be contributing to disease itself, but more research is needed. Now, he does just one way, of course, that climate change is affecting human health. Tell us about the other impacts. Yeah. So, you know, I often describe our current understanding of the implications for health as an iceberg. And trust me, I recognize the irony of that. But we just sort of see what's above the surface. And there is, I think, a giant mass underneath that we are just uncovering.

But in addition to heat-related illness, we know that there's a series of exposures that harm health in multiple ways. And it's actually frighteningly broad. So there's air quality harms, which can happen like wildfire smoke or heat can increase ground-level ozone, which can cause problems with heart and lung conditions, pollen, like we talked about, it can actually impair both food supply and safety. So, for example, actually crops are less nutritious because of climate change, which is really of concern in places that are already on nutritional issues and on the margin of nutrition. Yeah, I mean, this reminds me that climate change affects some communities more than others.

And I'm wondering, how does this play out with all the other health impacts? Yeah, unfortunately, oftentimes those that contribute the least are actually harmed the most, and that's true globally, but also here in the U.S. And so this climate change is not an equal opportunity harmer, and there are certain populations that disproportionately bear the brunt. And that can be because of age, so children and the elderly can be more impacted, can be those with preexisting health conditions like we've talked about. But I think more importantly, people who are. lack the resources to be able to optimally protect themselves are going to be at greater risk. Give you an example. Yeah. So like the elderly man with heat stroke, I mean, he lived in lower income housing in Boston in a top floor apartment. So he did not have access to air conditioning.

And that's really a key thing when we think about it, because not only is it just buying the air conditioning unit, but you have to be able to afford the electricity to run the air conditioner. Exactly. Many communities have decided that subsidizing heat during the winter is a critical thing in order to protect those who are less fortunate and have less resources. Right. But we need to begin to switch our framing and recognize that should we subsidize electricity for cooling because with these unprecedented temperatures that we are facing and will

increasingly face, we have to protect these individuals who are most vulnerable. Yeah. So how aware are most doctors really about this link between climate change and health? I mean, did you learn about this in medical school and start your practice well aware of this connection? Well, I wish I could say I did. But I was actually in attending. So I already had gone through medical school and residency and was a full-fledged practicing doctor when I learned about climate change. And for me, it's a moment that will forever be crystallized in my mind because I just, I sat there and was listening actually to the Lancet Commission report calling climate change the greatest health threat of our time, but also the greatest opportunity. And I just felt a

calling then and there that I wanted to direct my career towards this. And so we are increasingly working to educate health professionals about this. And it's becoming much more mainstream, but it needs to accelerate. And we need to really increase the connections for health professionals so that we can best serve our patients. Yeah. So say in five years from now, in an ideal world, what would you like to see in terms of both doctors and health systems taking into account factoring in climate change when they see patients? Well, it sounds like I have a magic wand here, so I will use it.

And I will paint a picture where we have made the ambitious sweeping reforms and commitments that we need to decarbonize our globe. So address climate change. Yes, address climate change. Because there's nothing harder for me as a doctor. and having a patient in front of me that I don't have a treatment for. Right. But the reality is we have the solutions we need to move away from fossil fuels

and to intervene on climate change and get us on the track to keep our temperatures such that it will minimize human suffering. So first and foremost, you know, in five years, I think we could well be on our way to that. So I'm going to throw that in as number one because getting to the root cause always is the best way to improve health. And then, you know, secondly, I would love to see where climate change has been really disseminated throughout the medical community in the sense that we are educating our patients for their specific risks, that it has just become a part of our daily practice and our screening systems, and that it has been integrated into the medical education curriculums for doctors and other health professionals in training. So they can actually proceed forward in their path with this just as a part of one of many tools and issues that we need to address as health professionals. And third, that we have created resilient health care systems that we've recognized that our infrastructure and our supply chains and power outages are all vulnerabilities we have to deliver the high quality care that we all want to give our patients. And so we have addressed those vulnerabilities and found them and are on a path to ensure that not only can our hospital systems give care to our communities when they need it most, but also that they aren't contributing to climate change and that we have achieved net zero within our health care systems.

Thank you so much, Renee, for taking the time to tell us more about your work and just how climate change is affecting health and health systems. We really appreciate it. Well, it was an honor and privilege to do it, so thank you for reaching out, and thank you for highlighting this topic. Today's episode was produced by Rebecca Ramirez, edited by Viet Le, and fact-tracked by Indy Kera. Josh Newell was the audio engineer. I'm Ritu Chateji. Thanks for listening to Shortwave, the Daily Science podcast from NPR.