Dr Misha Rosenbach on the Relationship Between Climate Change and Medicine

Climate change and health care are important topics, because a changing climate impacts every organ system of the body, individual patients, and population-based health, noted Misha Rosenbach, MD, associate professor of dermatology and internal medicine at the University of Pennsylvania and program director of the dermatology residency training program, in an interview ahead of this year’s American Academy of Dermatology Virtual Meeting Experience (AAD VMX).

Rosenbach will be presenting the session “Climate Change & Dermatology” on the final day of AAD VMX.

Transcript

How are climate change and medicine related?

Climate change is a crisis that society should be grappling with. There is scientific consensus that man-made changes in the environment are leading to changes in our climate right now and in the future. This is primarily from burning of fossil fuels leading to CO₂ in the air; also other products like methane, which are heat-trapping gases that lead to global warming. Some of that warmth is absorbed by the ocean, some of that CO₂ is absorbed by the ocean, and this leads to a lot of changes across the globe that have disproportionate effects in different places.

We're already witnessing those changes, and they are already having significant impacts on society, individual people, population as a whole, and certainly on politics and how both individual choices are made in terms of mitigating things and trying to be better, but also societally—how countries, organizations, companies are going to take steps to transition from what has been the status quo toward more sustainability to sort of mitigate the effects that scientists have shown us are coming.

Climate change and health care are important topics. So the New England Journal of Medicine has a section dedicated to the climate crisis, Lancet has a dedicated journal focused on planetary health, JAMA has published a number of articles about climate change. And I think the effects of a changing climate have impacts on every organ system of the body, individual patients, and population-based health.

For a US-based audience focused on health care, what we know is if you rank countries by their greenhouse gas emissions, the US health care industry would be a top 10 emitter on its own. And it really is imperative that health organizations recognize that and talk about that. The AMA [American Medical Association] and the ACP [American College of Physicians] both have position statements saying that physicians should engage in discussing climate change, learning about climate change, teaching about climate change, and take efforts to move toward sustainability in health care and identifying ways to reduce the carbon footprint of the practice of medicine and care in general.

Why are you excited about this year's meeting?

First of all, a big development is that there are vaccines and we are being vaccinated, and there's a chance that next year's meeting will be in person. So let's just talk about the miracles of modern science and the amazing fact that we have so many effective vaccines so quickly. That's wonderful.

Two, we're able to host a virtual meeting. So as bad as this pandemic has been, imagine this 20 years ago when we didn't have smartphones, we didn't have Zoom, or we didn't have all the technology we have. And so one of the benefits, kind of tying this in to the climate change in dermatology topic, is we are having a virtual meeting. So if you think about one of the big sources of carbon footprints for people in health care or academic medicine, or in most people who are probably listening to this or attending this sort of meeting’s bracket, a lot of that is air travel. And so I think many of us are realizing that many of the trips we would go on for business actually can be conducted virtually.

One of the things that that means is, normally when I put together something like the climate change and dermatology symposium, I have to identify speakers who are going to be able to physically be at the meeting. But now we're able to extend invitations to people in Europe or Australia or Asia or kind of like all over the world who might not physically be present at the American Academy of Dermatology meeting but are able to virtually link in and then provide their expertise to our audience.

Air emissions are a huge source of CO₂, and it's one of these disproportionate things where the people who fly the most lead to most emissions, but then climate change impacts disproportionately more people who have never even been on an airplane. And it's one of these sort of injustice-type things that hopefully having access to virtual education, virtual formats, virtual platforms like this will mean that everyone is at least able to make the decision to fly less without impacting their profession, their career, or continuing medical education.