The New Social Determinant of Health: The Climate

From Patient Charts to Climate Charts: Should Doctors Be Climate Advocates?

The Stethoscope Meets the Thermometer: When Health and Heat Collide
It’s 2 AM in the emergency department. A middle-aged man comes in with heat stroke. The city just had its third record-breaking heatwave this month. Dehydration, exacerbated COPD, worsening heart failure, asthma flares — it’s not even flu season, but the hospital is packed. While you're writing admission notes, a thought hits: “Is this the new normal?” Should we just adapt, or is there a role for us — as doctors — to help prevent this?

Doctors and Climate: A Relationship Already in Progress
This isn’t a hypothetical. According to The Lancet’s annual Countdown on Health and Climate Change, climate change is already affecting clinical outcomes globally. Rising air pollution levels worsen respiratory disease. Extreme weather events disrupt healthcare delivery. Changing patterns in vector-borne diseases are throwing off established diagnostic norms. Even mental health is impacted by ecological disasters.

Yet, despite this data, the medical profession has traditionally stayed silent on environmental matters. Until now.

The Hippocratic Oath in a Warming World
“First, do no harm” — but what if our silence is part of the harm? Healthcare contributes about 5% of global greenhouse gas emissions. If the global healthcare sector were a country, it would be the fifth-largest emitter. Ironically, the industry meant to protect health is also complicit in threatening it.

So the question becomes: Can we afford not to engage?

The Rise of Medical Climate Advocacy
The British Medical Journal (BMJ) and The Lancet have recently amplified this conversation. In 2021, over 200 medical journals, including The BMJ, The Lancet, NEJM, and JAMA, issued a joint editorial urging world leaders to take climate action to protect public health. That’s not fringe activism — that’s mainstream medicine stepping into the public arena.

In tandem, organizations like the Global Climate and Health Alliance and Health Care Without Harm are mobilizing physicians to push for greener hospitals, decarbonization, and sustainable practice.

What Climate Advocacy Looks Like in a White Coat
Let’s get real. No one expects an intensivist to also be a part-time climate scientist. But climate advocacy doesn’t require marching on Capitol Hill (although you can if you want). It can be as simple — and as powerful — as the following:

1. Greening the Clinic

• Choose renewable energy for hospital power sources
  
  
• Advocate for reusable medical equipment when safe
  
  
• Reduce unnecessary lab tests to cut energy-intensive diagnostics
  
  
• Push for green procurement policies in your facility
  

2. Educating Patients
Imagine counseling a COPD patient on minimizing outdoor exposure during high smog alerts — you're already doing climate-informed medicine. Extend this by:

• Discussing the health benefits of plant-rich diets
  
  
• Encouraging active transport (walking, biking)
  
  
• Highlighting how energy efficiency at home can reduce respiratory flare-ups
  

3. Speaking Up at Work
Hospitals have sustainability committees. If yours doesn’t, form one. Lobby for bike racks, less plastic in the cafeteria, or better recycling systems. Get pharmacy departments to consider climate-friendly inhaler prescriptions (such as switching from MDIs to DPIs when clinically appropriate).

4. Getting Political (Professionally)
Many medical associations are now lobbying governments for climate-health policy. Doctors who write op-eds, testify in hearings, or sign letters to policymakers can move the needle. A white coat lends credibility.

5. Research and Curriculum Reform
Push for the inclusion of planetary health in medical education. Publish studies showing the health impacts of climate change in your region. Create CME modules about eco-anxiety and disaster medicine preparedness.

“But I’m Already Burnt Out. Isn’t This Extra Work?”
Valid point. Physician burnout is real — so why add more to your plate?

Because climate change is already making your job harder. More patients. More unpredictability. More system strain. And the biggest burnout trigger of all? Powerlessness. Becoming a climate advocate isn’t a burden — it’s a way to reclaim control.

Doctors are among the most trusted professionals globally. When we speak, people listen. That voice carries beyond the walls of our clinics — into schools, governments, and media.

Stories from the Frontlines of Climate-Health Advocacy

• A pediatrician in Bangladesh integrates flood preparation into rural child health programs.
  
  
• An allergist in California includes pollen maps and AQI apps in routine counseling.
  
  
• A UK-based respiratory physician helped switch an entire NHS Trust to low-carbon inhalers — reducing CO₂ emissions by thousands of tons.
  

None of them were trained as climate scientists. All of them used their clinical insight to protect health in the real world.

Is This Really Our Role? A Counterpoint Worth Addressing
Some argue that doctors should “stay in their lane.” But what is the scope of our lane? Do we stop at diagnosis and prescription, or do we engage with the root causes of illness? We screen for domestic violence, educate about food insecurity, and ask about mental health stressors.

The climate crisis is a health crisis. That is our lane.

The Ethical Imperative
Silence, in this context, is consent. As physicians, we swore to protect life. The climate emergency endangers billions of lives. This is a textbook public health issue — just on a planetary scale.

Even the AMA, the Canadian Medical Association, and the World Medical Association now frame climate change as a critical health threat. The ethics are clear: if we have the platform, the knowledge, and the opportunity, we have the responsibility.

How to Start — Without Burning Out

1. Start small. Join or start a green team at your institution.
   
   
2. Leverage your expertise. Focus on issues tied to your specialty (e.g., allergists and pollution, cardiologists and heat).
   
   
3. Join a network. Groups like “Doctors for XR,” “Climate Code Blue,” or “My Green Doctor” provide structure and support.
   
   
4. Use social media wisely. A single post debunking a myth or sharing a heatwave health tip can go far.
   
   
5. Make your patients part of the solution. Empower them to protect both their health and the planet.
   

This Isn’t About Being Perfect — It’s About Participating
You don’t have to be a “climate doctor.” You just have to be a doctor who cares. And you already are.
The same empathy that compels us to stay late after rounds or hold a patient’s hand during bad news — that same force — is the foundation of climate advocacy.

When our patient charts begin to reflect the heatwaves, floods, smoke, and displacement affecting communities worldwide, it’s no longer a separate issue. It’s a medical emergency. And it’s time we started treating it like one.