Opinion

A green approach to public health

A range of new AMA policies underscores the impact of global climate change on health and urge physician action to address it.

Posted Dec. 22, 2008.

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The push to go green has become more than a hip cause. It has become a matter of protecting the public health.

Green momentum can be seen on a range of levels -- from government policy to decisions made by everyday people about heating their homes, buying their cars, putting food on their tables and even changing their lightbulbs.

And it is certainly evident within the practice of medicine. The health care sector has been an active player in developing green initiatives. These projects have demonstrated progress in reducing pollution and increasing energy conservation. And frequently the endeavors have been copied in other medical, and nonmedical, settings.

A recent report by the American Medical Association Council on Science and Public Health loosely defines such "green initiatives" as practices or programs that are believed to benefit the environment.

Some are intended to mitigate the effects of global climate change by reducing greenhouse gas emissions, others aim to improve efficiency and resource conservation.

In general, these efforts involve responsible waste management policies; the use of ecologically sustainable products, foods and materials; the development of nontoxic, sustainable and ecologically sound products; and building practices that help conserve resources and contribute to a healthy environment.

But the accomplishments so far must be viewed as prologue to an even greater level of focus and activity. And applying this expectation to the practices and procedures within the medical enterprise is especially timely now, as the scientific evidence strengthens the concept that global climate change brings with it very serious health implications.

In an effort to respond to this emerging public health threat -- which can take the forms of increases in heat-related illnesses, infectious and vector-borne diseases, and a multitude of respiratory problems -- the AMA adopted a range of noteworthy policies at its November Interim Meeting.

For instance, the AMA, which is not new to the concept of environmental stewardship and working to safeguard the public health by reducing environmental hazards, called for more educational efforts within the medical community regarding the adverse health effects of global climate change. It offered its support for the findings of the latest report by the Intergovernmental Panel on Climate Change, which delineates this very dire course, and for efforts to search for novel, comprehensive approaches to mitigating climate change to protect the health of the public.

The AMA also recognized the importance of physician involvement in policymaking at state, national and global levels, and called on physicians to become role models for patients and communities by using environmentally friendly practices and promoting resource conservation.

But it is critical to understand that the to-do list does not begin and end with the big picture. The AMA urged physicians in the trenches to increase their understanding of the health implications that could present as very real issues in their practices -- to think locally, as well as globally.

Specifically, the new policy encourages doctors to work with local and state health departments to ensure that such negative health effects are anticipated and that plans are in place to facilitate efficient responses.

The AMA is taking a leading role in educating physicians on these very real issues, effects and opportunities.

The more doctors get involved, the better they will serve their patients by protecting them from environmental harm.

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