ACP recommends actions to mitigate climate change's impact on health

More must be done to address the serious health consequences from climate change, according to the ACP.

Recent research suggests that climate change is progressing faster than expected. In June, the AMA declared it a public health crisis.

In a position paper published in Annals of Internal Medicine, Ryan Crowley, BSJ, senior associate for health policy at ACP, and colleagues wrote that the organization “recognizes that human and planetary health are interconnected, and that climate change is a global human and environmental health crisis.”

“ACP believes health equity and justice must be at the core of efforts to address climate change and that sufficient investment should be dedicated to vulnerable communities and populations that are disproportionately affected by climate change,” the authors wrote.

The quality of the air we breathe, water we drink and climate change directly affect human health, they wrote. Environmental quality can also “contribute to common diseases” like asthma, heart disease, stroke and cancer.

“Interventions such as reducing air pollution and water contamination, providing protection from ultraviolet radiation, and mitigating climate change can improve health outcomes for persons with communicable and noncommunicable diseases,” the authors wrote.

They noted that people from low-income and underrepresented racial and ethnic populations are “disproportionately likely to reside in areas with higher levels of air, water, and other types of pollution.” Further, 92% of global pollution-associated deaths happen in low- and middle-income countries.

“ACP affirms the need to achieve environmental justice and emphasizes that all communities, including people of color, people with low income and marginalized populations, deserve to live, work, learn and play in a safe and healthy environment,” they wrote.

The ACP offered several recommendations in this effort, the first being “immediate action to limit global temperature rise to 1.5 degrees Celsius above preindustrial levels.” This should include, according to ACP, “interventions that provide health-related co-benefits,” like adopting sustainable agricultural and food consumption practice, zero-emissions energy sources, accelerating the transition from fossil fuels to clean and more.

The other specifics of this recommendation include the ACP’s support of:

• offering cooling centers during heat waves and installing systems to warn communities of these events early;
• integrating climate change and health into internal medicine curricula; and
• physicians collaborating with their community’s public health agencies to prevent, track and adapt to climate change-related health effects.

The ACP also said there is a need for:

• “comprehensive action to achieve environmental justice,” emphasizing that all communities, including people from underrepresented populations, “deserve to live, work, learn, and play in a safe, healthy environment;”
• efforts to reduce air pollution, like the EPA setting “robust air quality standards for ozone, particulate matter, nitrogen dioxide, carbon monoxide, and other pollutants to protect public health and welfare;”
• improvements to laws and regulations that support access to clean water, like the Clean Water Act, Safe Drinking Water Act and Lead and Copper Rule;
• “action to protect the public from harmful exposures to toxic substances,” which include both existing and new chemicals, “with particular attention to children, pregnant people, and other susceptible populations;” and
• sufficient and sustainable funding for federal agencies with a mission of environmental health.

In a related editorial, Emily Senay, MD, MPH, of the Icahn School of Medicine, and Andrew Hantel, MD, of the Harvard Medical School Center for Bioethics, wrote that “the ACP’s recommendations cannot be implemented soon enough.”

“Internists, medical subspecialists, and the entire health care community are already caring for those harmed by climate and environmental causes,” Senay and Hantel wrote.

They also noted that “pollution- and climate- mediated pathogenesis has been linked to virtually every organ and body system,” and has been known to worsen cancer risk, trauma, mental health, neurologic conditions, infectious diseases, maternal fetal outcomes and more.

“All of this increases demand for care from stressed delivery systems still struggling with the COVID-19 pandemic,” they wrote. “Improving clinical care will require a greater understanding of the role of environmental exposures in disease processes and advocacy for rapid reductions in dangerous exposures. Even small actions can provide significant benefit — a 10% reduction in air pollutants could prevent 66,000 deaths annually in the United States.”

References:

• Crowley, R, et al. Ann Intern Med. 2022;doi:10.7326/M22-1864.
• Senay, E, et al. Ann Intern Med. 2022;doi:10.7326/M22-2808.
• Yaguang, W, et al. Environ Health. 2021;doi:10.1186/s12940-021-00742-x.