AAP Montana Chapter members are taking an innovative approach to environmental justice and climate change advocacy. Their practical solutions, legal advocacy and community engagement demonstrate how medical professionals can advocate effectively for children’s health in the face of growing environmental challenges.
AAP Chapter and District Engagement staff recently discussed the role of pediatricians in addressing climate change with Lori G. Byron, M.D., M.S., FAAP, a member of the AAP Council on Environmental Health and Climate Change Executive Committee and former Montana Chapter president. A longtime environmental advocate, Dr. Byron helped draft a statement adopted by the chapter on the effects of climate change on the pediatric population and the state. Following is a summary of the conversation.
Vulnerable population
When discussing environmental justice in health care, the focus often turns to children, fetuses and pregnant mothers as particularly vulnerable populations, Dr. Byron said.
“Kids are affected more (than adults) by exposure to chemicals or pollutants, either in the air or what they eat and drink,” she said. “They’re reliant on other people to care for them, which makes them more vulnerable during extreme weather events. They’re also outside more, so they’re really exposed to more, especially poor air or extreme heat like we’re seeing nowadays with climate change.”
Practical solutions to unique challenges
Montana’s rural landscape creates unique environmental justice challenges that differ from the industrial zoning and inner-city pollution typically associated with urban areas.
The state’s populations, particularly Indigenous communities, face disproportionate impacts from environmental issues, said Dr. Byron, who practiced pediatrics for 27 years on the Crow Indian Reservation. In response, the Montana Chapter implemented several innovative programs to address these challenges.
One successful initiative involved partnering with rural nurse practitioners to distribute box fan filters — homemade high efficiency particulate air (HEPA) filters — to families who couldn’t afford air purifiers, particularly during wildfire season.
The chapter also implemented the Air Quality Flag Program in schools and clinics to raise community awareness about air quality conditions. Colored flags that correspond to the Environmental Protection Agency’s Air Quality Index are raised each day.
“We’ve gotten 60 schools and clinics to start flying the flags,” Dr. Byron said.
The Montana High School Sports Association also uses air quality indices when making decisions about practices and games.
The flag program has received a positive community response, with health care providers reporting that patients regularly consider air quality when planning outdoor activities.
Legal advocacy and youth engagement
In 2023, the Montana Chapter supported a groundbreaking constitutional climate case, Held v. Montana, which became the first such case to go to trial in the U.S. Led by 16 youth plaintiffs, the case successfully challenged Montana’s preference for fossil fuels and its failure to consider climate impacts. In December 2024, the state Supreme Court upheld the ruling revoking two Montana statutes.
Dr. Byron was the medical expert for the case, and members of the chapter’s Climate Committee supported the youth during the trial.
“The kids won the case, hands down!” Dr. Byron said.
Building for the future
The chapter has expanded its impact through various initiatives, including:
- an annual “Ride for Their Lives” bike event drawing international attention to the impact of climate change on children,
- Montana’s first Youth Climate Summit, bringing together young people from across the state,
- collaboration with Boys and Girls Clubs to provide climate education and resources,
- regular climate change and health conferences, and
- webinar series focusing on how climate change affects at-risk populations.
The Montana chapter’s success has provided a model for other AAP chapters. Twenty chapters now include energy policy in their legislative blueprints, demonstrating how local initiatives can grow into systemic change.
The Montana Chapter’s approach emphasizes the importance of meeting people where they are and building community partnerships.
“Pediatricians are natural advocates,” Dr. Byron said, and their work in environmental justice continues to evolve and adapt to meet the changing needs of their communities.
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