Blooms in the spring cause allergies and asthma. Heat in the summer brings insect bites and vector-borne infections. Respiratory virus season begins as temperatures fall in winter.
Pediatricians are experts in the yearly cycle of child health. Throughout the history of modern pediatrics, this cycle has been constant. While weather is always changing, the climate, with its regional variations, has been a stable foundation.
That foundation is shifting. As heat-trapping gases in the atmosphere rise from the burning of fossil fuels and the Earth’s climate changes, pediatricians are witnessing corresponding shifts in child health.
An updated AAP policy statement and technical report describe current understanding of climate change and how changing conditions are affecting the health of U.S. children. Recommendations also are provided to help guide pediatricians in advocating for policies that protect children.
The policy statement and technical report, both titled Climate Change and Children’s Health: Building a Healthy Future for Every Child, are available at https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2023-065504/196647 and https://doi.org/10.1542/peds.2023-065505 and will be published in the March issue of Pediatrics. They are from the Council on Environmental Health and Climate Change, Council on Children and Disasters, Section on Pediatric Pulmonology and Sleep Medicine, and Section on Minority Health, Equity and Inclusion.
‘A thought leader in this space’
The AAP first published a policy statement and technical report on global climate change and children’s health in 2007 and revised the documents in 2015. The reports marked the first time a leading U.S. medical society recognized the need to care for patients by caring for the planet.
The latest policy and technical report will help guide a new AAP strategic initiative on environmental health and disaster readiness. The initiative is among four priorities outlined by the Board of Directors to shape the Academy’s work in 2024.
“Environmental health and disaster readiness is the newest strategic initiative, but it is in no way new work for the AAP,” said AAP CEO/Executive Vice President Mark Del Monte, J.D. “The Academy has been a thought leader in this space for many years, and through this strategic initiative, we have the opportunity to dig into the work, join with partners and accelerate change.”
Del Monte said a workplan for the strategic initiative will be developed in the coming months to help guide the Academy’s efforts in advocacy and provide guidance for members.
Effects of climate change on child health
The policy statement details the myriad ways climate change harms children’s physical and mental health.
Rising temperatures increase heat exposure with broad effects on children’s health. Adverse birth outcomes, heat-related illness and impaired learning are associated with exposure to extreme heat, affecting children from the prenatal period through young adulthood.
Extreme weather events such as floods and wildfires pose immediate health risks and represent potentially life-altering events in the lives of children, with significant harms to mental health and learning. Pediatricians witnessed the harmful effects of wildfire smoke on children’s respiratory health last summer, as wildfires burning tens of thousands of square miles in Canada caused regions in the eastern U.S to have the worst air quality on Earth.
Rising temperatures and atmospheric carbon dioxide (CO2) concentration have contributed to advancement of the North American pollen season by approximately 20 days since 1990. Higher concentrations of atmospheric CO2 influence not only the growth but also the composition of plants, reducing iron, protein and zinc content of wheat, rice and soybean. Warming temperatures and altered precipitation patterns affect infectious organisms and vectors of disease.
Economic welfare, education and health care delivery are at risk from sea level rise, extreme weather and ecosystem degradation, ultimately affecting the healthy development of children.
Addressing climate justice
Integrated throughout the report is the theme of environmental justice.
In the United States, across the world and between generations, those least responsible for climate change suffer most. Changes in Earth’s climate as a result of the extraction and combustion of fossil fuels cause disproportionate harm to families with limited means and those affected by decades of racism and discrimination, reaching centuries into the future.
A youth climate movement has grown in response to feelings of distress and betrayal by policies that inadequately protect the planet and the future of young people (see AAP News article “Pediatricians lending voice, expertise to climate lawsuits across the country”).
In response to these threats to child health and justice, and continuing a long history of advocacy for environmental protections, pediatricians across the country are advancing climate solutions as a framework for child health promotion.
Through collaboration with health systems, communities, corporations and governments, pediatricians are working to advance climate solutions at the local, state, national and international levels. Policies that reduce air pollution and carbon emissions, for example, simultaneously help address common child health conditions, including asthma, obesity and hypertension. Active transportation, plant-rich diets, and protection of and engagement with natural places present opportunities for pediatricians to promote climate solutions that also are core to their preventive care work with children and families.
Recommendations
The following recommendations in the policy can help guide pediatricians seeking to engage in hopeful climate solutions for children.
- Incorporate climate change counseling into practice. Assess for climate risks as social determinants of health, educate on regional protective strategies and use anticipatory guidance as a framework for discussing solutions.
- Incorporate climate, health and equity curricula within medical school, residency and continuing education.
- Seek ways to reduce the carbon emissions of health facilities, including hospitals, medical offices and transport services.
- Serve as a role model for practices that promote sustainability in your professional and personal community.
- Advocate for equitable climate policies at the local, state, national and international levels. Pediatricians are uniquely positioned to partner with and uplift youth and community voices working to advance zero-carbon energy policy and climate justice.
- Bring the child health voice to collaborations with health departments, universities and research facilities working to address climate change and health.
A healthy climate matters to every child. Policies that reduce reliance on fossil fuels and promote cleaner air create immediate gains in child health and equity and build a foundation for generations of children to thrive.
Dr. Ahdoot is a lead author of the policy statement and technical report and a member of the AAP Council on Environmental Health and Climate Change.
