When most people think about climate change — if they do at all — what usually comes to mind is melting glaciers, starving polar bears and flood waters lapping at the doors of Miami Beach condo buildings.
The popular thought is that the future impacts of a warming globe are just that, problems for the future.
But doctors in Florida say the changing climate is a public health risk, one they already see evidence of in their waiting rooms right now. Now, some clinicians have formed a new group to sound the alarm.
They want to educate people and policymakers about the dangers of a hotter, more humid world, and the risks to their most vulnerable patients, patients like the one Dr. Cheryl Holder, president of the Florida State Medical Association, met one suffocatingly hot Miami summer day.
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The elderly woman arrived at Holder’s clinic with two requests — more medicine and her doctor’s signature on a form for her power company.
She had asthma, worsened by the heat wave stifling South Florida, so she burned through her prescription earlier than expected. She cranked the air conditioning down in her Opa-locka home to cope, but when her bill came at the end of the month she was shocked. On a fixed income, it wasn’t an expense she could afford.
She asked Holder to sign a form from Florida Power & Light certifying that she had lifesaving equipment in her house — like a ventilator or a nebulizer — that would earn her a discount on her bill, even though she didn’t own any of the approved equipment. So Holder didn’t sign the form, but she did give her patient a second medication to help keep her asthma in check.
Long after she left, Holder still worries about that patient. She worries that as climate change makes the world warmer and sends deadly heat waves to Florida and beyond, there will be a lot more patients like this woman in the future.
“Being in Florida especially, you can’t not realize what’s happening to our climate,” she said. “I see it right now on a day-to-day basis.”
She’s not alone. Doctors across the state are worried too, and some have banded together to form Florida Clinicians for Climate Action. The group is so new it doesn’t have a leadership structure or a set agenda yet, but members said they want to make sure people know how climate change is already affecting public health.
The data on short-term effects of global warming are sparse — likely because the process is so slow moving and the changes are, for now, minor — but doctors said they know what they see and they’re ready to act.
Heat worsens asthma, heart and lung disorders and even mental illnesses. Rising seas push floodwater polluted by leaky sewage pipes into neighborhoods. A changing climate helps spread mosquito-borne diseases (think Zika), and research shows it makes hurricanes stronger and more common.
And who’s most vulnerable? The same people that always are, doctors say: low-income populations, the elderly and people of color.
“Low-income people have less opportunity to get out of the path of health impacts of climate change,” said Dr. Mark Mitchell, co-chair of the National Medical Association Commission on Environmental Health.
The same group that’s already underinsured, overexposed to risk and financially unequipped to deal with it isn’t prepared for a far-reaching issue like climate change, he said. That’s where clinicians want to come in.
They want to make sure everyone knows about the impacts of climate change and how to protect themselves, all the way from making sure high school coaches know how to teach their athletes the warning signs of heat exhaustion to explaining the benefit of community cooling centers in low-income neighborhoods to politicians.
Florida Clinicians on Climate Action was officially formed last month, said Dr. Mona Sarfaty, director of the Medical Society Consortium on Climate and Health. One of the group’s goals, she said, was to bridge the gap between Floridians who know climate change is happening (70 percent, according to a Yale survey) and those who think it will affect them personally (41 percent).
Clinicians are just the ones to do it, she said. They have access to patients throughout their lives, and polls show that nurses, doctors and pharmacists consistently top lists of most trustworthy professions.
“Not that many people know a climate scientist, but everyone knows or has contact with a doctor,” Sarfaty said.
Florida Clinicians for Climate Action joins an uncrowded (and underfunded) field in Florida, with a single state level program dedicated to coming up with solutions for Floridians.
The state’s program is the Centers for Disease Control-funded BRACE project, an acronym for Building Resilience Against Climate Effects. The program started under Florida’s Department of Health in 2012 but shifted to Florida State University in 2016.
Chris Uejio, the project lead, said the project gives out $1 million in grants over five years to county health departments to help them prepare for the health effects of climate change. Those grants can fund anything from tree planting to helping officials streamline their hurricane preparedness plan.
“The county health departments really are the front lines for seeing how climate change affects human health,” Uejio said.
But it’s the sole state-level program in recent years dedicated to directly addressing the link between climate change and human health, even as the Sunshine State consistently tops lists of most vulnerable regions in the country. That leaves doctors like Roderick King, the head of Florida’s Institute for Health Innovation and the assistant dean for public health education at the University of Miami, frustrated.
“The state is not doing anything,” King said.
His group works on research related to climate change and human health, including a 2016 report on the health impacts of sea level rise. Next, he said, he’s looking for funding to research the connection between heat waves and hospital admittances for heart failure, something he and his colleagues have noticed anecdotally.
King was one of the speakers at the Tampa-based conference where Florida Clinicians for Climate Action was formed. He said it was the first conference in Florida to focus wholly on climate change and the health impact on poor and vulnerable communities.
“I think a page has turned,” he said. “This gives us hope and is starting to build some attention and visibility on this issue.”
Dr. Lynn Ringenberg, who co-founded another Florida medical group focused on the topic in 2008, Physicians for Social Responsibility, said she’s glad to see the topic finally getting the attention it deserves, especially from healthcare providers.
“If we can just start the conversation at a pretty simple level, as you go through your life with your clinician and they keep talking about it you’ll realize how important it is,” she said. “And then it kind of snowballs, doesn’t it?”