Climate Change, Human Health, and Academic Medicine

In the past century, the temperature of the earth has risen; her oceans have warmed; and the planet’s ice, snow sheets, and glaciers at both poles have begun to melt. ¹ Atmospheric carbon dioxide levels, now over 400 parts per million, are significantly higher than at any point in the past 3,000,000 years. ² These levels are more than twice those of the last Ice Age, which ended nearly 12,000 years ago, and the concentration of carbon dioxide in the atmosphere is 25% greater today than in 1950. ^3,4

Evidence drawn from ice cores, ocean sediment, ancient tree rings, and layers of deep rock indicate that the current rate of warming is approximately 10 times faster than during previous major temperature cycles on earth. These and other data suggest that carbon dioxide generated by human activity—not small variations in the earth’s orbit responsible for climate change in the past, as some posit—is the likely cause of global warming. ^5,6

The consequences of rapid climate change, irrespective of origins, are dramatic. The frequencies of intense rainfall, record-high temperatures, and extreme weather events around the globe have increased. ⁷ The sea level is rising, and the oceans have become more acidic. ^8,9 Ecosystems in saltwater, freshwater, and on land are changing and biodiversity is diminishing. ^10–12

People in every country have begun to experience the health repercussions of rapid climate change. Extreme heat, poor air quality, reduced availability of food and safe water, and infectious diseases will continue to lead to displacements of populations, physical illness, mental health disorders, disability, and death. ^13–17The health of humanity and the state of our planet are linked—and it is for this reason that the field of academic medicine must concern itself with climate change.

Two articles in this issue of Academic Medicine contribute to our awareness of the impact of climate change on human health and offer guidance for climate science, the practice of medicine, and medical education. Goshua et al ¹⁸ issue a call to action for medical schools, asking that the next generation of physicians be “prepared to address the many implications of climate change on the mental and physical health of their patients and society.” Current efforts to address climate change in medical education are insufficient, they state, and “should not mirror” the slow response of leaders and countries throughout the world to this existential threat.

Focusing specifically on graduate medical education, Philipsborn et al ¹⁹ lament the lack of widely used evidence-based curricular resources for teaching residents about the effects of climate change. Such resources should cover, for example, the increased risk of heat-related illness, infections, asthma, mental health conditions, negative perinatal outcomes, and adverse experiences from trauma and displacement. The authors propose a framework for curricular content, including material on how climate change negatively affects health and health care delivery and necessitates adaptation in clinical practice. In the appendix to this article, the authors thoughtfully tie their curricular framework and learning objectives to the core competencies of the Accreditation Council for Graduate Medical Education and provide examples of teaching and assessment approaches.

Several articles on global health and medical education also appear in this issue of the journal. ^20–29 Taken together, they further reinforce the importance of international collaboration in health policy, science, education, and clinical practice efforts to support human health in all corners of our world. Like Goshua et al and Philipsborn et al, some of these authors implore all of us in academic medicine to engage in sincere self-critique and to take on new thinking. The authors opine that antiquated and elitist attitudes, nonequitable partnerships, and inadequate commitment to building infrastructure, systems, and resources have hampered health professions education and other efforts to advance human health. Climate change represents but one example of the many consequential issues in global health that should inspire both reflection and innovation.

Our journal endeavors to elevate and consider topics of significance for academic medicine. Some of these topics, Dear Reader, may be newly, poorly, or differently understood. Our journal welcomes the opportunity to address such hard issues and to explore broad concerns that the missions of academic medicine may help to address, with the goal of making a salutary difference in the world. In this instance, views of climate change and its origins, consequences, and remedies diverge in our society. That said, the fact, the verity, of global warming itself is well established, as is its connection to human health and, thus, to us.