Climate change affects healthcare systems — and vice-versa

Climate change is affecting health globally: Deadly heatwaves have become more frequent and prolonged, weather catastrophes more common and intense, and climate-related diseases, particularly vector-borne infections, more widespread.

In the Pacific Northwest, a 2021 heatwave led to the deaths more of than 600 people in Washington and Oregon. For weeks in 2021 and 2022, wildfire smoke gave Seattle the worst air quality in the world.

The U.S. healthcare sector is a significant contributor to climate change, too. It is responsible for an estimated 8.5% of the country’s greenhouse-gas emissions. These emissions arise from sources such as power generation for hospitals and clinics, drug and device manufacturing, and the use of anesthetics, inhaler propellants and other potent gases.

To raise awareness of the impacts climate change is having on health, as well how clinicians and healthcare professionals can address these issues, the University of Washington hosted a daylong symposium March 28 at the Center for Urban Horticulture. 

UW Medicine, the UW School of Medicine, UW Center for Health and Global Environment, UW EarthLab and UW Sustainability sponsored the symposium.

In the event’s first session, Dr. Catherine Karr, professor of pediatrics, discussed the deterioration of air quality due to wildfire smoke. Karr has been researching the effects of air pollution on children. It not only causes acute illnesses but might also predispose them to chronic illnesses. 

“We know air pollution makes asthma worse if you’ve got it, but the important question is whether air pollution causes children to develop asthma in the first place,” she said. Karr is leading research in the Yakima Valley to examine the effects of wildfire smoke and other pollutants on fetal and child health.

Dr. Indi Trehan, an associate professor of pediatrics and emergency medicine who has done extensive work in the developing world, noted that climate change is affecting almost every type of infectious disease. It has enlarged the geographic range of mosquito-borne infections such as malaria, dengue, yellow fever, chikungunya and Zika virus. Heavy rains and flooding have contributed to cholera outbreaks in Africa and the Eastern Mediterranean. Fungal infections are flourishing as ambient temperatures rise. Most concerning in Washington state is the arrival of the highly drug-resistant fungus Candida auris, he said.

“Virtually every infectious disease will get worse due to climate change,” he said.

Climate change takes a psychological toll, as well, said McKenna Parnes, a postdoctoral fellow in psychiatry and behavioral sciences. She is studying the psychological impact of climate change on young people. She expressed concern about the rising prevalence of clinical depression and generalized anxiety in that population due to climate change.

“They are bearing a significant burden, and we need to be thinking about how we can support them,” she said.

In a panel discussion, participants considered efforts to reduce healthcare’s ramifications on climate change. 

Dr. Elizabeth Hansen, a UW Medicine anesthesiologist who practices at Seattle Children’s, described how Children’s was able to reduce its greenhouse emissions. Initiatives included halting use of the anesthetic desflurane, a gas whose effect is 2,500 times more potent than carbon dioxide, and slashing the leakage of nitrous oxide, another potent greenhouse gas. 

“We were able to reduce our measured emissions from inhaled anesthetics about tenfold, saving our hospital hundreds of thousands of dollars by reducing our waste and improving our efficiency and still taking great care of our patients,” she said.

Dr. Christopher Chen, medical director for Medicaid at the Washington State Health Care Authority, to suggested healthcare emissions could be cut by eliminating unnecessary, resource-intense specialty care, increasing investments in primary care and addressing the social determinants of health.

Deans from three UW schools — Allison Webel in Nursing, Hillary Godwin in Public Health, and Dr. Timothy Dellit in Medicine — emphasized the importance of collaboration across UW institutions to achieve meaningful change.

While progress is happening, Dellit said, more must be done to integrate climate initiatives undertaken by individual departments and clinical services. 

“We’re in our infancy around these efforts,” he said. “It’s been largely fragmented. So one of my goals is to bring these activities together in a coordinated fashion, across the school, across the clinical environment and really make a difference.”

Organizers of the conference included Dr. Jeremy Hess, professor of environmental and occupational health sciences, global health and emergency medicine; Dr. Stefan Wheat, acting instructor, emergency medicine; Dr. Mollie Grow, professor of pediatrics; and Dr. Robert Yates, clinical associate professor of surgery.

– Written by Michael McCarthy 

Please see photos from and a written summary of the conference on the Department of Emergency Medicine website. Video by Karly Tinsley.

For details about UW Medicine, please visit http://uwmedicine.org/about.