Pediatricians believe conversations about the weather should be part of any doctor’s visit

This story was originally published by Grinding and appears here as part of the Climatic desk collaboration.

The reality of climate change hit Dr. Samantha Ahdoot home one summer day in 2011, when her son was nine years old.

Ahdoot, an assistant professor at the University of Virginia School of Medicine, and her family were living in Alexandria when there was a heat wave. Morning temperatures were in the 80s and her son had to climb a steep hill to get to her day camp.

About an hour after he left for camp, he received a call from a nearby emergency room. His son had collapsed from the heat and needed intravenous fluids to recover.

“It was after that event that I realized I had to do something,” he said. “That, as a pediatrician and a mother, this was something I had to learn about and get involved in.”

Dr. Ahdoot kept that promise. She is the lead author of the American Academy of Pediatrics’ recently updated report. policy statement on climate change, which appeared earlier this year. The statement urges pediatricians to talk about climate change with their patients. But investigation suggests that that’s not happening much yet and that there are practical barriers in the way.

In 2007, the AAP was the first national group of doctors to make a public statement about climate change. The updated statement covers the growing research about the many ways climate disproportionately affects children. Heat increases risk of premature birth birth; Babies are among the most likely die in heat waves. Because their bodies cool less efficiently than adults, children are still more susceptible to heat-related illnesses as they grow. Children breathe more air per pound of body weight, causing their breathing to be up to 10 times greater. more affected by toxins in the smoke of forest fires. Excess heat harms children’s performance in school, especially those with low incomes and less access to education. air-conditioning. And research suggests that teens and young adults feel more climate anxiety than older adults.

The number one recommendation in the new policy statement is that its members “incorporate climate change counseling into clinical practice.” This may seem like a difficult task, considering the average visit to the pediatrician It’s 15 minutes. A 2021 study found that 80 percent of parents agreed that the impact of global warming on their children’s health should be discussed during their well-child visits. But only four percent said it had actually happened in the past year.

“How do you talk about climate change in a visit where you have to talk about X, Y, Z, all the vaccines, respond to all the concerns?” said Dr. Charles Moon, chief resident at Montefiore Children’s Hospital in New York. A member of the AAP Council on Environmental Health and Climate Change, he has been working to create a curriculum at his hospital to begin teaching pediatricians and other doctors about this topic.

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“I don’t think we have all the answers yet,” he said. “I do a lot of work teaching other pediatricians and that requires a bit of a mindset shift.”

Dr. Moon sees patients in the South Bronx, nicknamed “Asthma Alley” because of air pollution. Part of his challenge is to put environmental threats into perspective for families who face many different obstacles in their lives in a way that does not lead to despair or disempowerment.

Or, as he put it: “If you can’t put food on the table, who wants to hear about climate change?”

In Oakland, California, Dr. Cierra Gromoff has a lot of experience with families receiving Medicaid and says the pressure on them and their health care providers is real. “There are incredibly marginalized groups of children who face other insurmountable things,” she said. “These providers are so short on time that they have to focus on the biggest fire: whatever systemic issues are occurring.”

Gromoff, a clinical child psychologist, has been concerned about the environment since her childhood as an Alaska Native in the remote Aleutian Islands. She thinks that to overcome these obstacles, state and federal insurance providers should require or reward doctors for taking the time to include environmental health in their evaluations.

She is the co-founder of a telehealth startup, Kismet Health, which is creating a tool that could show local environmental threats indexed to a patient’s home or school address.

The tool could help doctors recognize climate risks by showing whether a patient lives near a green space, an urban heat island or a polluting chemical plant.

Gromoff said she would like to see free resources that pediatricians can provide to families on everything from signs of heat stroke in a baby to eco-anxiety.

“We should have a screening question,” he said. “‘Are you worried about what’s happening to our Earth?’ And if they say yes, we should be able to provide them with some kind of handout: What they feel is real. These are small steps you can take.”

The good news, Moon and Ahdoot say, is that interest in the topic is increasing in the medical community. On half of medical schools They are covering climate change in the curriculum, a number that has more than doubled since 2019. And there are state climate and health research consortia in 24 states, Ahdoot said. The American Academy of Pediatrics has been creating continuing education materials also on the subject.

Incorporating climate change into clinical practice is not about adding another item to an already long checklist, Ahdoot said. Nor is it about transforming pediatricians into activists or talking about factors about which families can do nothing.

“Pediatricians never want to proselytize,” he added. “It always has to be valuable to the individual patient.”

The goal of the new climate policy for pediatricians is to help doctors translate their climate knowledge into useful solutions and advice for their patients. Some examples from Ahdoot include: testing patients for Lyme disease in Maine, where it used to be too cold for ticks; start allergy medications in February because pollen arrives earlier in the year; or teaching athletes the warning signs of heat exhaustion.

For Ahdoot, it’s also important to be aware of how the weather affects a child’s mental health. Part of the answer, she said, is to talk about actions families can take that benefit both people’s health and the planet, such as eating more plant-based diets and walking or biking instead of driving.

“What’s good for the climate,” he said, “is generally good for kids.”

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