The Era of Climate Change Medicine—Challenges to Health Care Systems

Abstract

Editor's Note: With the Spring 2023 issue, we introduce a new recurring quarterly column in the Ochsner Journal. The column will focus on health care delivery and its impact on society. A particular emphasis will be placed on the role the environment, health equity, and social determinants play in health care delivery. A specific focus will be placed on the challenges of providing care to underserved populations and how health care systems are evolving to meet those needs. -R.A.An unprecedented joint editorial published simultaneously in 2021 in The Lancet, New England Journal of Medicine, and The BMJ stated that climate change will cause catastrophic harm to health that will be impossible to remediate unless action is taken. 1 The editorial reported that the science is unequivocal: a 1.5 °C expected rise in temperature above the preindustrial average will cause catastrophic harm to health. 1 A new era of climate change medicine is emerging. New diseases are being identified, existing ones are being exacerbated, and traditional health care delivery is being challenged. Climate, which has always been associated with health, is now one of the primary forces disrupting health care delivery.Climate change is impacting health in a myriad of ways, including the health impacts of increasingly frequent extreme weather events, such as heat waves, hurricanes, and floods. These events have led to the disruption of the food supply chain, increases in zoonoses, changing patterns of vectorborne diseases, and rising mental health issues. Without intervention, the crisis threatens to undo much of the progress made in global health and poverty reduction.Mesoamerican nephropathy, commonly called chronic kidney disease of unknown cause (CKDu), is a sentinel disease that has emerged and is directly related to exposure to increasing temperatures among field workers in Central America. 2,3 Hot spots for CKDu are in areas most impacted by rising temperatures. In Central America, CKD-driven in part by CKDu-has now become a significant cause of hospitalization and death. CKD is now the second leading cause of death in both Nicaragua and El Salvador. 4 The emergence of CKDu also demonstrates that marginalized populations, such as field workers, are the ones most impacted by climate change. 3,4 Infectious diseases are also evolving as a result of climate change. The 2022 Intergovernmental Panel on Climate Change reports that the prevalence of vector-borne diseases has increased in recent decades. 5 Warmer summers and milder temperatures have allowed pathogens to

Association Between Climate Change and Patient Health Outcomes: a Mixed-methods Systematic Review

“…Climate-related shocks such as temperature uctuations, precipitation changes, and rising sea levels degrade environmental and social factors that in uence health [3,42]. All aspects of health, from air and water quality to food systems, are impacted [3].…”

Assessment of Human Health Risk Indices Due to Metal Contamination in the Surface Water of the Negro River Sub-Basin, Áncash

“…The main GHGs are CO 2 (75%), CH 4 (16%), and N 2 O (2%), with their emissions largely due to the burning of fossil fuels [ 3 ]. The effects of climate change include the loss of glacial coverage, sea level rise, and an increase in the frequency and intensity of extreme weather events such as floods, storms, hurricanes, heatwaves, the loss of biodiversity, and deglaciation, among others [ 4 , 5 , 6 , 7 , 8 , 9 ]; these events impact human health, including the increase in zoonotic and vector-borne diseases, malnutrition and food insecurity, deaths related to natural disasters, and impact on mental health [ 10 , 11 , 12 ].…”

Editorial: Climate and health education: defining the needs of society in a changing climate

“…The changing climate also poses diffuse and deferred risks because of long-term societal changes, civil conflict, and disrupted livelihoods leading to mental or physical health effects and refugee displacement ( 10 , 11 ). Healthcare delivery is jeopardized either through barriers to community access or hospital operations via supply chain issues and extreme weather events ( 12 – 14 ). These impacts intertwine structural racism and environmental injustice that result in poor communities, communities of color, and communities in the global south being impacted disproportionately.…”