By: Vincent Brinas, PT, DPT, Barnabas Health Ambulatory Care Center
Climate change is considered the biggest public health threat of the 21st century. There is scientific consensus that human activity is a major contributor for this global health problem. This is due to a rise in greenhouse gases (carbon dioxide, methane, and nitrous oxide), which trap heat causing increasing temperatures and a cascading effect of more severe climate disruptions. We are already witnessing these unprecedented weather conditions worldwide such as more intense hurricanes, devastating forest fires, rising sea levels, and longer periods of extreme frigid and hotter temperatures. All of these eminent threats pose greater health risks to larger numbers of people worldwide, making the health care sector at the forefront in combating climate change. Hospitals and health care systems are already responsible for 10% of greenhouse gas emissions especially when considering hospital care and power generation to buildings. The health care sector must lead by example through leadership of policy and outreach, mitigation of its carbon footprint, and resilience of its infrastructure against natural disasters and transition towards renewable energy. More information and solutions on health care's role in climate change can be found here: Climate Action: A Playbook for Hospitals
As a physical therapist, I strive in providing patient care with the importance of physical activity and functional independence; however, I realized I need to be more climate-conscious and recognize that certain areas of care may be disrupted due to the environment. One way the health care sector can address this public health crisis is through an environmental friendly approach within the workplace and patient care.
All health care workers can consider Greenhab when interacting with patients and making clinical decisions. Greenhab is having a climate-conscious mindset when treating or rehabilitating patients. The purpose is to adapt treatment plans and initiate dialogue towards addressing health problems with greater awareness on the environmental concerns that could be contributing factors. Here are some ways climate change may impact patient care and other considerations to be aware while interacting with patients:
Extreme Temperatures: Climate change has resulted in more frequent and longer periods of heatwaves and deep freezes in large parts of the globe. We need to recognize the health effects these prolong temperature changes have on our community. Higher temperatures mean greater incidences of heatwaves. These dangerous periods can lead to dehydration, sunburns, and heat exhaustion for the general population and can lead to heatstroke or more fatal conditions. Deaths and hospitalizations especially among the elderly, younger children, and those with chronic conditions can occur. Lifestyle changes must be recognized including demand for electricity and air-conditioning, staying indoors for longer periods, and reduced overall physical activity. The health care systems must be prepare for potential increase in hospitalizations and enact preventative measures including education towards at-risk populations including importance of hydration, adaptation to treatments such as limited exposure during the day or exercising at mornings/ nights, and developing cooling stations at hospitals and community/ senior centers.
Freezing temperatures can bring on frostbite, cold-related deaths, and increase risk of injury especially in icy conditions. Extreme cold can cause power outages, disrupt transportation, and damage water pipes. Healthcare workers need to protect themselves during these harsh conditions and educate the pubic regarding exposure to below freezing temperatures, proper clothing attire, and ensuring households and hospital systems can withstand elements that may impact heating and plumbing.
Natural Disasters: Warmer global temperatures have caused the melting of polar ice caps and a rise in sea levels. Climate change has also led to more intense and frequent hurricanes. The combination of these factors have expanded flood zones and placed coastal regions at risk either from lost of land or annually disruption to property and infrastructure. Healthcare sectors must recognize the health concerns during these periods, which include disaster-related injuries, water-related infections and disease, and the displacement of people due to destruction of homes. Healthcare providers near coastal regions or low-lying flood zones may need more preparation for hospitalizations during natural disasters, to address infrastructure resiliency and to educate the public on water-related disease and illnesses during recovery periods. They also need to recognize population migration as people move away from at-risk zones leading to socioeconomic impacts whether within the workplace or community.
Air Quality: Carbon emissions are experienced regularly especially during the daily rush hour as millions of cars expel these greenhouse gases into the atmosphere resulting in poor air quality. People living near road traffic are more likely to experience cardiopulmonary issues such as asthma, heart attacks and stroke due to chronic exposure to toxins. These areas also have less access to green spaces for physical activity and exercise. The health care sector must address air pollution especially in communities within proximity to freeways, factories, or refineries. Alternative forms of transportation such as biking and walking in addition to the trend of electric vehicles may be beneficial to reduce emissions and address health and wellness concerns.
Greenhab is an environmental approach to health care for both the clinician and the patient. We must reflect on the impact we can make within the health care setting, in the community that we serve, and our planet. Please click on the links below for more information and references.
Helpful Links
- Climate Action: A Playbook for Hospitals
- Environmental Impacts of the U.S. Health Care System and Effects of Public Health
- Globalization, Climate Change, and the Human Health
- Leading the global movement for environmentally responsible health care Health Care Without Harm (noharm.org)
- A call for a new environmental physiotherapy – An editorial
Vincent Brinas, PT, DPT
Doctor of Physical Therapy
E-mail: Vincent.Brinas@rwjbh.org
Vincent is a physical therapist at the Barnabas Health Ambulatory Care Center. He primarily treats general orthopedics and specializes in vestibular, concussion, and rehabilitation for runners. He completed his bachelor's degree in health sciences and his doctorate in physical therapy at the University of the Sciences in Philadelphia in 2016. He is an avid recreational runner, participating in races throughout the country such as the Norvo Nordisk New Jersey Marathon, Tunnel to Towers Tower Climb NYC at One World Observatory, and the Red Bull 400 in Utah, Michigan, and Whistler, Canada. On his days off, Vincent enjoys watching foreign and independent films, cooking cuisines from different countries, or hiking throughout the Tri-state area.
The Saint Barnabas Medical Center Rehabilitation centers are open and ready to help you achieve your goals. With four locations in West Orange, Millburn and Livingston, the experienced and compassionate staff at Saint Barnabas Rehabilitation offers adults and children the specialized care they need to resume an active life after surgery, injury or illness. They are committed to providing patients with the most advanced services in a safe, caring and soothing environment. For high-risk patients who are unable to visit in person, telehealth is an option. Patients do not need a prescription for physical therapy services.
https://hbr.org/2019/09/how-health-systems-are-meeting-the-challenge-of-climate-change