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1 Question, 5 Answers: What’s the Biggest Climate-Related Health Concern?

1 Question, 5 Answers is a column where we ask different types of healthcare pros to weigh in on the same issue.

A warmer climate doesn’t just mean hotter days and longer summers. Direct effects of climate change, namely rising sea levels, more frequent, extreme storms and increased air pollution, can lead to major health issues — and the World Health Organization predicts that if global temperatures continue to rise, so will the associated health risks.

But which global warming–related illnesses will have the greatest impact, and who’s most at risk? Here’s what five healthcare experts had to say.

Megan Christenson, MS, MPH

Epidemiologist at the University of Wisconsin–Madison, population health sciences
Madison, Wisconsin

One of the biggest challenges with climate change-related health concerns in Wisconsin is the wide range of impacts that are involved. Heat extremes can lead to heat-related illnesses and deaths. Air quality degradation due to heat may also exacerbate problems for those with respiratory conditions such as asthma. Flooding can cause flood-related food and waterborne illnesses, injuries and drowning. Drought conditions can lead to reduced drinking water availability. Furthermore, the stress related to flood damage, drought impacts and economic losses may lead to mental health impacts.  

Attributing health effects to climate change can be challenging. While some effects are fairly direct (e.g., high temperatures leading to heat illnesses), some relationships between climate change and health are indirect and more difficult to quantify. For example, climate change can influence vector-borne diseases such as Lyme disease by extending the season of transmission, but other factors such as changes in land use can also influence Lyme disease rates. Other conditions like mental health impacts can be difficult to directly attribute to climate change.  Better understanding the complex relationships between climate and health impacts is a major goal of researchers and the public health community.

The health impacts of climate change are not experienced equally by populations. Some groups are more likely to be affected by climate change than others. Those most affected include low- income populations, communities of color, immigrant groups, indigenous peoples, children and pregnant women, older adults, vulnerable occupational groups, people living with disabilities and people with chronic diseases. It’s important for us to consider these populations when developing climate change adaptation strategies.

Andrew Bryant, MPH, LICSW

Therapist at North Seattle Therapy and Counseling

Not surprisingly, the prospect of a disrupted climate has an impact on how people feel and behave. Some have called this pre-traumatic stress, and it is showing up in therapy offices more frequently. And as news continues to demonstrate the real-world impacts of climate change — not in the distant future, but now — people will be more directly affected by stress around climate change.

People react differently to climate-related stress and fear, using various coping mechanisms. Many respond by denying the consequences of what is happening or making small, personal lifestyle choices that alleviate their worries. These are common ways to cope when feeling overwhelmed, helpless or scared. They work in a limited way, but tend not to address the underlying feelings of fear, grief and anger about what is happening. Other responses I’ve seen as a psychotherapist include hopelessness, depression, anxiety, sleeplessness, a compulsive focus on climate-related news and social media, anger and rage, a sense of powerlessness or confusion, isolation and grief. Many parents and grandparents are scared for their children and grandchildren; younger adults are afraid to have kids.

These feelings are likely to increase if we as a society fail to take action. Mental health is frequently ignored or stigmatized in our society, and expression of feelings like sadness, fear and anxiety are often discouraged. But talking about our emotional responses to climate change is essential, because those feelings shape how we as individuals and communities respond to the crisis at hand.

Dr. Susan E. Pacheco, MD

Associate professor of pediatrics with McGovern Medical School at UTHealth, and a pediatric immunologist/allergist with UT Physicians Pediatric Specialists — Texas Medical Center

It’s sobering what climate is doing to children. I’ve made my platform about climate change and health in the context of the pediatric population. 

When it comes to the effects of climate change, kids are more vulnerable than anyone else, not only because they depend on us, but also because their brains and bodies are still developing. Climate change–associated environmental problems, like major weather events, extreme heat and air pollution, can affect children even in the womb.

Air pollution specifically is linked with many adverse health outcomes in children. Because of air pollution related to climate change, we’re seeing more kids with congenital heart disease, asthma, allergies, eczema and behavioral problems. There’s also data associating increased incidence of autistic spectrum disorders in children whose mothers were exposed to some air pollutants before the child was born.

We have clear evidence that climate and environment can wreak havoc on children’s developing brains. One doctor conducted a study on children who grew up in Mexico City and died of causes unrelated to climate change or air pollution. When she looked at their brains, she found evidence of inflammation, including pre-Alzheimer’s and pre-Parkinson’s tissue changes. While we have clear information that air pollution can cause these things, and that pollution can affect children’s brains even before they are born, so many people don’t know their kids’ brains are being affected. It’s alarming, and we need to do something about it.

Dr. Sharon Chinthrajah, MD

Clinical associate professor at Stanford University and director of the Clinical Translational Research Unit at the Sean N. Parker Center for Allergy & Asthma Research at Stanford University
Stanford, California

We are seeing more intense and more catastrophic wildfires raging across the U.S. In California especially, wildfires have significantly increased in frequency and duration during the drought season. With cities and towns blanketed with wildfire smoke, the pollutants pose serious threats to the health of tens of thousands of people. There are more than 70 medical and health organizations, including the American Lung Association, the American Medical Association and the American Heart Association, that recognize climate change as a health emergency.

Whether the wildfires burn in your community or miles away, the smoke may reach your area and put the people who have chronic heart or lung diseases at great risk. Wildfires, extreme heat and air pollution create poor air quality that puts everyone at risk, especially the young and the elderly. Smoke in the air contains fine particles and mixed gasses from burning forests and buildings. Exposure to these pollutants can irritate your eyes, nose, throat and lungs. Poor air quality can worsen asthma or COPD [chronic obstructive pulmonary disease] symptoms by causing chest pain or wheezing or bringing on an asthma attack. It can also lead to increased heart attacks and strokes.

Rising temperatures can contribute to shifts in flowering times and increased pollen counts, affecting millions who suffer from allergies and respiratory problems. This combined with air pollution can severely affect those with lung diseases and may lead to decreased productivity and missed days from school and work.

Dr. Rebecca Pass Philipsborn, MD

Assistant professor of pediatrics at the Emory University School of Medicine

Continued use of polluting energy and amassing greenhouse gas emissions pose risks to the health and well-being of us all. But some groups, especially our children, who have contributed least to this problem, are especially vulnerable.

Climate change already causes harm to children. In my clinic, I see the links between heat and air pollution and asthma attacks, between increased pollen production from warmer temperatures and problematic allergies, between more powerful natural disasters, displacement and upheaval of children’s lives. I’ve seen pregnant women forced from their homes and support networks by hurricane evacuations navigating childbirth. 

Globally, children experience climate impacts in scarcity of food and water, infectious exposures, and injury and losses in floods, disasters, migration and conflict.  

Children are especially at risk because childhood is a period of rapid physical and psychological development. Adverse environmental exposures — like climate-related extreme heat, malnutrition and pollution—interfere with growing bodies and minds, blunting a child’s long-term developmental potential. 

As just one example, extreme heat exposure while a baby is developing during pregnancy is associated with more birth defects and preterm births. Young children also rely on those around them to care for them and to shield them from danger. Climate change undermines this protective buffer of communities and caregivers. Patients and doctors alike have seen how climate change disrupts access to healthcare and threatens healthcare delivery.

Responses have been condensed and lightly edited.

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The Paper Gown, a Zocdoc-powered blog, strives to tell stories that help patients feel informed, empowered and understood. Views and opinions expressed on The Paper Gown do not necessarily reflect those of Zocdoc, Inc. Learn more.