Climate change continues to accelerate, driving more frequent and severe weather events, particularly extreme heat. These environmental changes have broad adverse health effects, including increased all-cause mortality, cardiovascular and respiratory disease, mental health effects, and burden of vector-borne diseases. Air pollution from fossil fuel combustion, which is a major contributor to climate change, remains one of the leading global risk factors for death. Health burdens surrounding climate change fall disproportionately on vulnerable populations, including children, outdoor workers, people experiencing housing insecurity, and low-income communities. Physicians increasingly encounter and manage adverse effects from climate change in clinical care. During preventive care visits, physicians can counsel patients on environmental health risks, plant-forward diets, active transportation, and protection from heat and air pollution. In acute and disaster-related encounters, clinicians can assist patients in creating individualized action plans for disaster and heat preparedness and manage medical conditions exacerbated by climate change. Other strategies such as incorporating telehealth, practicing high-value care, and using sustainable prescribing can improve access, efficiency, and clinical outcomes while reducing pollution and emissions from health care systems. Physicians can advocate for policies that promote public health and support a more resilient and sustainable health care system.
Climate change caused by humans continues to accelerate.1 Mean global temperatures have increased by approximately 1.33°C compared with the late 1800s.1 The past 10 years were the hottest in human history on record, and the rate of warming in the past 50 years was nearly double that of the previous 50 years.1 Climate change is contributing to more severe weather events (eg, flooding, wildfires, drought) globally.2,3 Fossil fuel combustion is the largest driver of climate change, but methane from agriculture and fossil fuel industries, land-use change, and industrial processes that release potent greenhouse gases (eg, fluorochemicals) also contribute substantially.2,3 These drivers connect directly to clinical and public health interventions.3
SORT: KEY RECOMMENDATIONS FOR PRACTICE
| Clinical recommendation | Evidence rating | Comments |
|---|---|---|
| Encourage healthy plant-forward diets to improve health for all patients while reducing greenhouse gases emissions from agriculture.50–54 | B | Two meta-analyses of RCTs with disease-oriented outcomes and three meta-analyses of observational studies with patient-oriented outcomes |
| Counsel patients to reduce exposure to outdoor air pollution.21,43,46 | C | Expert opinion in the absence of high-quality trials |
| Counsel patients to proactively prepare for extreme weather events that are likely to occur more frequently in their region due to climate change.45 | C | Expert opinion in the absence of high-quality trials |
| Encourage modes of active transportation, specifically walking and cycling, when safe and accessible.55–57 | B | Three meta-analyses of observational studies |
| Educate high-risk patients on the recognition and prevention of heat-related illness.22,23 | B | Two RCTs conducted in Pakistan and Australia |
| Counsel patients with respiratory disease to reduce exposure to indoor air pollution.7,39,41,43 | B | Two RCTs, one large observational study, and a systematic review of mostly observational studies |
RCT = randomized controlled trial.
A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to https://www.aafp.org/afpsort.
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