Examining Climate Change as a Social Determinant of Health and Strategies to Address It
An article published in 2020, “Climate Change as a Social Determinant of Health” by Maya I. Ragavan, MD, MPH, MS; Lucy E. Marcil, MD, MPH; and Arvin Garg, MD, MPH, highlights the urgent and critical need to define climate change as a social determinant of health to effectively promote child health equity and well-being. A changing climate has a widespread impact on the social and environmental circumstances in which people live, although not everyone is affected equally. The consequences of climate change are disproportionately felt by children, people of color, and communities of lower socioeconomic status, resulting in worsened health outcomes and limited resources to address the challenges of climate change.
Neither the National Academy of Medicine nor the American Academy of Pediatrics (AAP) includes climate change in their comprehensive reports on tackling child poverty, despite its profound impact on child poverty and health. Framing climate change as a social determinant of health provides a unique opportunity for multidisciplinary collaborative efforts to address its effects on both health and other social determinants of health.
The authors offer strategies that pediatric healthcare communities can use to integrate climate change work into their professional practices. These recommendations have the potential to reduce healthcare costs and carbon emissions, support families affected by climate change, and improve child health throughout the life course.
The strategies include:
Medical Education –Existing social determinants of health curricula have been proven effective in enhancing medical trainees’ knowledge about social determinants of health, their ability to recognize patients experiencing social needs, and understanding of appropriate resources to support families. The authors suggest incorporating climate change education into existing social determinants of health curricula to inform pediatricians about climate change, its impact on child health, and methods to alleviate families’ concerns.
Addressing Climate Change in Clinical Practice – In addition to the AAP encouraging pediatricians to talk to parents about climate change during pediatric visits, data pertaining to parental attitudes toward schools teaching climate change suggests that many parents may want their pediatricians to discuss climate change during appointments. However, no data exists on addressing climate change during pediatric visits. The authors propose that future research investigate both the provider’s and parents’ perspectives on the importance of having discussions related to climate change and which topics are most meaningful to address, as well as the barriers and facilitators to such conversations.
Given the challenges of providing climate change resources in the clinical setting, pediatricians should concentrate their efforts on helping families learn about disaster preparedness and reducing carbon emissions, providing referrals to families affected by climate change, and providing parents with developmentally appropriate climate change information to assist them with educating their children.
Community and Scientific Partnerships – To holistically address social determinants of health, pediatric providers have assembled interdisciplinary teams. Similarly, addressing climate change as a social determinant of health will require multidisciplinary collaboration and effort. The authors advise the pediatric community to work alongside climate scientists, leaders in clean energy, community-based organizations, and behavioral health specialists with expertise in environmental-related mental health. In addition, pediatricians should prioritize working with policymakers to advocate for legislative policies aimed at reducing carbon emissions.
Professional Responsibilities – With the U.S. healthcare system contributing 10% of greenhouse gas emissions and hospitals’ status as the second most energy-intensive commercial buildings in the nation, the pediatric field has a responsibility to reduce its climate impact. The authors suggest transitioning to climate-friendly alternatives (e.g., patient-centered medical homes), professionals being more mindful about individual choices (e.g., joining a conference virtually versus traveling by air), and working together to reduce carbon emissions.
About the Author
Angela Magardino, MPH, is a recent graduate from Boston University School of Public Health where she earned certificates in Environmental Health and Maternal and Child Health. She is currently a Research Assistant for the WE CARE Study. Her research interests focus on how physical and social environments influence disparities in pediatric health and well-being. She is passionate about advocating for environmental, climate, and child health justice as well as transforming the structures underlying racial and health inequities.