We owe it to our patients to lead and support climate change action


After months of negotiations, the Conference of Parties 21 (COP21) adopted a historic and unprecedented climate change agreement in Paris recently. The Paris Agreement reflects nearly universal recognition among parties that climate change demands an urgent, coordinated response. This agreement includes cutting greenhouse gas emissions to curtail the average global temperature rise to “well below 2ºC above pre-industrial levels and to pursue efforts to limit the temperature increase to 1.5ºC above pre-industrial levels.” (Art. 2)


The Paris Agreement specifically recognizes the climate/health nexus, reflecting the numerous direct and indirect impacts that affect our patients, from heat stress and heat strokes, non-communicable diseases, crop reduction and food shortages, droughts and water shortages, polluted resources and infectious disease, and the ensuing violence, war, and terrorism that combat for control of scarce resources (see graphic above).

Health professionals from organizations all over the world have heralded the Paris Agreement as “an unprecedented victory for people and planet.” Dr. Xavier Deau, general practitioner and former president of the World Medical Association, noted, “We the physicians have the ethical duty to stand for the health of the population … and are now looking forward and calling on their governments to get to work protecting the health of their populations.” It is in this context that health sector support for climate change mitigation and adaptation is critical — whether advocating for reductions in greenhouse gas emissions or building stronger and more resilient health systems.

A Lancet Commission report issued earlier this year on Climate Change and Health identified tackling climate change could be “the greatest health opportunity of the 21st century.” An international group of health organizations working to tackle climate change and promote public health called the Global Climate & Health Alliance was formed at COP17 and praised the progress made at COP21: “Here in the U.S., it is critical that we must capitalize and build on the success of the Paris agreement, continuing to lead by supporting stronger policies that speed the transition to a clean energy economy, putting America back in control of our own energy situation.”

Dirty energy, such as coal, gas, fracking, and nuclear power pose severe health risks to those in the vicinity of their extraction and use. Clean energy, such as solar and wind, are far less detrimental to public health, and have the potential to create millions of new jobs in our country. Keeping the oil in the soil seems to be a rallying cry, but also a matter of prudence. Ending fossil fuel subsidies, establishing a carbon pricing mechanism, and investing in clean energy research are critical steps to transition away from a carbon-intensive economy and reduce greenhouse gas emissions — ultimately curbing climate change and protecting our patients’ health.

As thousands of Americans die every year from air pollution, we, as physicians, would be complicit if we did not speak out against the injustices that occur at disproportionately high levels in areas affected by poor air quality. Where I live in Baltimore, Maryland, there are twice as many children affected by asthma than the national average, with asthma-related emergency room visit rates nearly three times higher in Baltimore than for the state of Maryland. Two months ago, the EPA enacted a new ozone standard, limiting emissions to 70 parts per billion, which is predicted to prevent over 230,000 asthma attacks in the US over the next ten years, avoiding tens of thousands of days of missed school and almost 700 premature deaths.

The Paris Agreement provides the foundation for the stronger action we need in the years ahead. It is essential in ensuring the viability of our hospitals and the health of our communities.‎ Drawing on this momentum, physicians can be active on this issue by signing on to the WHO’s Our Climate, Our Health campaign Call to Action, and learning more about how climate change affects patients’ health and strategies physicians can employ to address these threats. The Global Climate & Health Alliance also offers additional resources and information about climate change and health. In addition, Health Care Without Harm offers specific resources and recommendations for environmentally responsible health care.

In the months and years to come, it is critical that physicians and the health sector engage in Paris Agreement implementation. We owe it to our patients to lead and support climate change action now.

Richard Bruno is a family medicine resident and can be reached on Twitter @richardbrunomd.  Elizabeth Wiley is a family medicine resident and can be reached on Twitter @elizabeth_wiley.

Image credit: Intergovernmental Panel on Climate Change, Shutterstock.com


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