Will Patients Listen If Health Care Providers Talk Climate Change?

Recently I had the chance to join @chcradio, the Conversations on Health Care radio show that features in-depth discussions on health policy, co-hosted by Mark Masselli and Margaret Flinter and produced by Adam Shapiro. Our episode, Will Patients Listen If Health Care Providers Talk Climate Change? is live here

One of the big insights I’ve learned and shared on the podcast is the role of healthcare professionals in educating their patients about the effects of climate change on health. Andrew Lewandowski, a private practice pediatrician in Madison, Wisconsin, did this in over 200 well-child visits and published his results in this journal article.

In his private practice, Dr. Lewandowski followed the American Academy of Pediatrics recommendations (more on these below) and read the following 45 sec script during over 200 well-child visits in late 2020:

"In the last two years, the American Academy of Pediatrics and 100 other health organizations declared climate change a health emergency. Air pollution alone caused over 64,000 premature deaths in the United States in 2016, and worsening air quality is only 1 out of 9 ways that climate change is harming people, disproportionately harming children. So just like I want your children to eat healthy foods and be in the right car seat for their health and safety, we now know that decreasing our energy use, increasing energy efficiency, and supporting clean energy initiatives are also important for improving our children's health. Any questions?”

Then he surveyed his patients afterwards. This 45 sec script seem to have made a strong impression. Here are his results:

First he asked what they knew before the visit. Of the 133 who responded, 82% reported prior awareness of health harms from climate change (90% of self-reported liberals and 57% of self-reported conservatives). When asked if they learned more about health harms from climate change during the clinic visit, 89% said yes (88% of liberals, 86% of conservatives). Additionally, Dr. Lewandowski asked about the likelihood of changing energy use behaviors and reported that 89% said they were likely or very likely (93% of liberals, 79% of conservatives) to do so, and 91% were likely or very likely to support clean energy initiatives (95% liberals, 72% of conservatives).

On the Zoom call I joined, Dr. Lewandowski pointed out that none of his patients complained about his use of time in the appointment to talk about this topic, and none of his patients have left his practice.

This experiment and practice of discussing climate change during a doctor-patient visit may strike you as bold, and possibly even beyond the scope of routine care, if you didn’t know that the American Academy of Pediatrics (representing 67,000 pediatricians) began recommending as early as November 2007 (and updated in 2015 policy statement) that pediatric healthcare professionals play a vital role in integrating sustainability into their thinking about health. Many professional associations have followed suit, including the American Medical Association. The National Academy of Medicine, of which I’m a proud member, has taken a leadership role in bringing together an Action Collaborative on Decarbonizing the U.S. Health Sector.

This role of health care professionals, especially doctors, coincides with a high degree of trust that the public tends to put in us. Above is yet another poll that reaffirms that public confidence. Regardless of our political positions, we all want the air that we and our families breathe to be clean, the water to be drinkable, and to take special care of our more vulnerable seniors, pregnant mothers, and babies, and others. Making sure that people understand the relationship between the environment and their health is a vital responsibility of all physicians, in the clinic, and as members of our communities.

I learned about Dr. Lewandowski’s work at an online meeting of the New Hampshire Healthcare Workers for Climate Action meeting, which was co-sponsored by the Medical Society Consortium, a collection of professional medical associations working at the national and state level on the environmental impacts on health and of health care.

If you’re a physician and want to get involved, check out the Consortium website and consider signing up! If nothing else, it’s a great opportunity to learn more and get to know some great people who feel passionately about making healthcare healthier.