Contagious Conversations / Episode 34: Young Leaders Take Action on Climate and Health
Transcript
Claire Stinson: Hello, and welcome to Contagious Conversations. I'm your host, Claire Stinson. Every episode we'll hear from inspiring leaders and innovators who make the world healthier and safer for us all. Contagious Conversations is brought to you by the CDC Foundation, an independent non-profit that builds partnerships to help the Centers for Disease Control and Prevention save and improve more lives.
Joining me today are Hazel Rogers and Ben Rabin. Hazel is the assistant director of patient experience and cultural transformation at Mount Sinai Morningside in New York City. Ben is a fifth-year medical student at Emory University in Atlanta, who is also studying to get his master's in public health. Hazel recently graduated from the Mount Sinai Health Systems Administrative Fellowship program, designed to provide developmental, administrative and managerial opportunities to advanced minority graduates of master's degree programs into health system leadership roles. Ben prioritized making the health risks and impacts of climate change a formal part of the Emory Medical School curriculum.
In this episode, we discuss the importance of taking action on the health impacts of climate change. We are working to engage the passion, ideas and enthusiasm of today's young adult leaders and innovators to help inform our climate and health approach. Welcome, Hazel and Ben.
Hazel Rogers: Hi, Claire. Thank you so much for having us.
Ben Rabin: Thanks for having us.
Hazel Rogers: It's very exciting.
Claire Stinson: Ben, let's start with you. As a medical student about to enter the medical profession, what prompted you personally to take action on the health impacts of climate change?
Ben Rabin: When I started medical school, I was curious to learn more about some of the intersections between climate change and health and how future climate change and some of the effects that we're already experiencing would affect individual and community health. And I was surprised as a first year student that this was a subject that rarely came up in our learning. I started to read more on the subject independently and then was connected with a peer of mine, Emmaline Laney, and one of the faculty members at Emory, Rebecca Philipsborn. And the three of us started to look further into this issue.
And basically what we saw was that the connections between climate change and health were already there in the scientific literature, but hadn't been translated to medical education on a large scale yet. The three of us put together a curriculum that we thought could address this gap in our training and hopefully eventually galvanize students and other medical professionals towards climate action.
Claire Stinson: That's really interesting. How quickly did that happen after you started medical school?
Ben Rabin: At the end of our first year, we put together an initial proposal that we shared with senior faculty members and deans. And their response was, this is a really cool idea and something that we could feasibly integrate into the curriculum, but you have to go through the regular processes that exist at the medical school. We put together our own little pitch that we shared with student committees and faculty committees, and it was eventually passed nine months later, which allowed us to explore the subject further and start working with other faculty members to integrate this.
Claire Stinson: That's really impressive. What training would help to better prepare medical students, who are the doctors of tomorrow as we know, for the health impacts of climate change?
Ben Rabin: I think there's several areas within climate change and health that are relevant to medical students and to most doctors. The first is I think healthcare providers should understand the consequences of environmental exposures like extreme heat for our patients, and they should be able to counsel patients to prevent these outcomes or manage them when they present to the clinic or to the hospital. For example, there's research that is now really emerging suggesting that repeated heat exposure for especially individuals like outdoor workers, construction workers may contribute to earlier onset of chronic kidney disease. And so we need more research in this area and we also need to be aware of this so that we're treating patients and giving them the guidance and counseling that they need to prevent this disease.
I also think another component that's important is that doctors need to learn how to effectively communicate some of the climate-associated health risks with their patients. And the nice thing about this is that many of the healthy behaviors that we already counsel our patients on–for example, eating less red meat, using active forms of transportation instead of driving–have a lot of co-benefits for our planetary health as well. And so I think there's an opportunity to make a more explicit link in the clinic with our patients.
Claire Stinson: It really sounds like it. It sounds like there was a need there. Congratulations to you on getting this going. It sounds like you and your student peers really enjoyed success in bringing climate change health issues into the medical training. Can you share what factors helped enable that success?
Ben Rabin: I think there were a few things. For one, we were really fortunate at Emory University to be working there because the university has a long legacy of working towards sustainability across the campus. That includes their office of sustainability initiatives, which was a huge support for us. And what this actually meant at the School of Medicine was that several of our senior faculty and even our deans were familiar with this area of health. And so they were receptive to introducing this content into a student curriculum that is already really jam packed with material.
Another important component was that we tried to put together a curriculum that would be logistically feasible for faculty members to introduce this material. Rather than blocking out two weeks of time to cram in this material for students, we asked that instead we'd interweave this material across subjects like cardiology, pulmonology, nephrology. That way we're sprinkling in climate science and environmental health into a lot of the courses that students are already learning about. And that helps them make the connection between heart disease and heat exposure, things like that.
And then I think the last thing that I would mention is that around the time that we were writing this proposal, there were several major declarations from leading health institutions like the WHO [and] the AMA calling for medical schools to teach students about climate change and health. And so we could point to these institutions and say, look, there's already a need for this that's established and recognized and so we are tapping into that.
Claire Stinson: Absolutely. Well, it sounds like you've had quite an impact on the future of medical training. Thank you for sharing the story of this success. And Hazel, let's turn to you. Tell us a bit about your role at Mount Sinai.
Hazel Rogers: Yes, of course. I am an assistant director of patient experience and cultural transformation. It's a really long title, but what does it actually mean? I would say that my main focus is to serve as an advocate for the voice of our patients and our employees. And I can achieve this through various diversity, equity and inclusion as well as people strategies. I like to say that my role is unique because I not only ensure that my local hospital, Mount Sinai Morningside, meets the psychological and physical safety of our patients and employees, but I also work closely at the system level where I can push these initiatives forward and really help drive change for the entire health system, which serves around 42,000 employees. It's a really exciting job, very fast paced, but I'm just happy to really serve and contribute to Mount Sinai Health System overall.
Claire Stinson: Thank you for sharing that. That sounds like a really important role. Hazel, we talk about the importance of community quite a bit on this podcast. What do you see as the biggest climate health threat facing the communities you work with?
Hazel Rogers: I would start by saying that unfortunately we've all witnessed across America that your zip code can define your health as well as even predict your life expectancy. And although New York City is diverse, there are still zip codes that struggle with environmental racism.
I would say realistically, severe weather is one of the biggest climate health threats that we have for the communities that we serve. And this all stems back to our lack of resources that underserved communities have compared to affluent neighborhoods. And I just read this article within the New York Times and it mentions that New York City's heat is distributed unequally and that low income residents and people of color receive the highest heat burden. This means that deaths from heat strokes and heat exposure are more likely to occur within Black and Latinx communities due to the poor air quality and inadequate access to cooling and air conditioning.
Claire Stinson: That's really important to note. Thank you for sharing that. We also talk quite a bit about COVID-19 on this podcast. Did the pandemic bring to light particular disparities in the communities Mount Sinai serves? And do you see parallels between the health impacts of climate change and equity?
Hazel Rogers: Oh, absolutely. As you all know, New York City was the global epicenter of COVID-19. And although we knew that there were health disparities between affluent and underserved communities, I really strongly would just say that COVID-19 and climate change really exasperated these preexisting problems like socioeconomic, political, demographic and cultural conditions. And these factors led to vulnerabilities and the collapse of healthcare systems, communities and livelihoods.
To your point, Claire, I do see the parallels between climate change and equity. And Ben also brought up a really good point about having the physicians really share those health associated problems with environmental change. And just to add to that, I really want to talk about air pollution. Dirty air is preventing people of color and low -ncome communities from even having a chance to fight against the COVID-19 pandemic. And I also read in the American Lung Association that minorities who were more exposed to air pollution contributed to a higher risk of becoming seriously ill from coronavirus.
But although equity not only played a role in contracting COVID-19, I really just want to highlight that there were also disparities with regards to equity in terms of those who wanted to receive the vaccine.
As an administrative fellow, I along with the director of operations at Mount Sinai Morningside, we managed the COVID vaccine pods, which was an opportunity for us to really allocate vaccines to over 750 residents a day. And I noticed that while we were scheduling these patient appointments, we were only tapping into specific zip codes. And now I know that it was not intentional at all, but just from a public health background and just from what we focus on here at Morningside, really focusing on equity and people, I wanted to make a change. And that's why I really love the fact that Mount Sinai Morningside advocates for people to speak up and come up with different ideas of how they could impact and change the communities.
Because I was able to say to my director of operations leader that I believe we should go into the communities and connect with the residents that we're not tapping into to schedule these vaccine appointments, that's exactly what we did. The director of operations and I, we went to grocery stores, we went to Spanish Harlem, we went to restaurants, we went to pharmacies on 125th Street because we really wanted to ensure that everyone had a fair chance to receive the vaccine if they wanted to. And it was a really rewarding experience because I felt as though Mount Sinai Morningside really likes to find resources and to really want to better serve the communities that we tend to focus on. It was really a rewarding experience, Claire.
Claire Stinson: Climate change is the greatest health threat of the 21st century. The CDC Foundation is focused on bringing together young people to raise awareness about the linkage between climate and health, and to engage them in their communities to better prepare for the growing health impacts from climate change. Visit cdcfoundation.org to learn more.
Ben, turning to you, how do we align the public health and clinical care systems to tackle the health impacts of climate change together?
Ben Rabin: I just want to piggyback off of what Hazel was saying because I think her work really speaks to the intersection of clinical medicine and public health in this space. I think there are a few opportunities. One is in disease prevention and health promotion. And this could be community level or individual level interventions where we're improving our health and also reducing our carbon emissions at the same time. One example is encouraging individuals to eat more plant-based diets. We know that eating red meat is a risk factor for high cholesterol, and also eating red meat has an enormous environmental impact because of the way that cows are raised and things like that. And so encouraging patients to modify their diet could have both individual and planetary co-benefits.
Exactly as Hazel was describing, this is a real opportunity to reduce health disparities across race, sex and socioeconomic status. It's important that we're reducing some of the disparate impacts that are experienced by people as a result of climate change and natural disasters. I think that's another area where we can bridge these two fields.
And then last, I think creating or updating guidelines to train clinicians in disaster preparedness is another increasingly important thing. We saw examples of this after Hurricane Katrina and most recently, Hurricane Ian. It's important that healthcare workers are really prepared for events like this that can disrupt healthcare delivery.
Claire Stinson: Absolutely. And there really are so many small things we can all do every day to impact climate change. Thank you for sharing that. And Ben, how do you reframe the climate change conversation from one of economics to one of health? Because we know it normally comes from that economics angle and how can we make the health related messages resonate more?
Ben Rabin: Yeah, this is, I think, a challenging question. For one, we've been able to make a lot of progress with the economic message, and that has helped us accomplish things on the federal level, for example, in passing the Inflation Reduction Act. But moving forward, I do agree that it's important that we're talking more and more about some of the health consequences. I think one way that we can do this is by really illustrating or mapping out to people how climate solutions have benefits for our health. Hazel was talking earlier about air pollution, and I think this is one of the most salient examples. When we use electric bikes and buses instead of diesel or gas powered cars, we end up with cleaner neighborhood air.
And what that means for our health is fewer asthma exacerbations in our kids, fewer COPD exacerbations, fewer acute cardiac events. And so it's really important that we're making that connection for our patients and also for our communities on a broader level. And I think it's also really crucial that the benefits that our communities are experiencing are distributed equitably so that the communities who face the greatest risks related to climate change should also experience the greatest benefit as a result of mitigation or adaptation strategies.
Claire Stinson: Absolutely agree, really important points. Thank you for sharing that. Hazel, if I could go back to you bringing this back to community, how do we better bring community health into the current healthcare structure?
Hazel Rogers: From my experience, I would say the most important way to bring community health into the healthcare structure is first gaining the community's trust. Building and sustaining the trust within these communities is needed for sincere and effective outcomes. Coming from a masters of public health background, I noticed two things. Public health really focuses on the mission–the mission of health, the mission of people–but healthcare has the money. I really think it's important to align our mission with the money, so you can easily really achieve this through strategic planning, community engagement, as well as providing resources that the community needs.
I really like the fact that Ben touched on clinicians providing instructions on healthy eating as well as updating the clinicians to prepare for events that could disrupt the healthcare system. In addition to that, I think it's also very important to conduct community health needs assessments. We can partner and create programs with our community members. We can join forces with other community organizations. But I think really to incorporate community health into healthcare structures, we need to start investing in them. And we need to show up for all communities equally, no matter the zip code.
Claire Stinson: Absolutely. Really important points. Thank you. Thank you for sharing all of that. And let me ask you a question that is more about the future. What or who gives you the most hope about effectively addressing the climate change and health issues that we face today?
Hazel Rogers: I would say today's people really give me the most hope about addressing climate change and the issues that we face. Claire, to be honest, I'm still not an expert in this field, but it's people like you and the platforms that you have allowed me to join so that I can learn more about what's happening in the world and how we can best support and institute change.
I think it's also very inspiring and just tying this back to people to see leaders that I work with bring about these issues across the table within my current health system. For example, the vice president of diversity, equity and inclusion, she's been a huge resource for me because she's always open to sharing her knowledge and her insight with myself and other colleagues across the health system, which has been really helpful.
And lastly, I would just really say today's generation of young adults really give me hope. Millennials and Gen Zs, I believe they are great activists with regards to climate change. Their engagement on social media is really impressive, and they just continue to spread awareness about this issue. And it's really inspiring. It's just a beautiful thing to just witness so many people really involved with climate change and really wanting to make an impact for the future.
Claire Stinson: Well, I think we're in good hands with you for our future as well. Thank you so much for sharing that. Ben, let me ask you the same question. What or who gives you the most hope about effectively addressing the climate change and health issues that we face?
Ben Rabin: I have to give credit to my peers among the medical students who I've been working with over the last four years now. And a couple of people who I would shout out are Emmaline Laney, who I've worked with for four years while she was a student at Emory. She's now graduated and is an internal medicine resident at Brigham and Women's Hospital in Boston. And she's brought so much passion and knowledge to the work that we did at Emory and really building this curriculum from the ground up. My mentor, Dr. Philipsborn, who has really shown me that being a climate change advocate as well as a practicing clinician is possible and that it's really necessary and gratifying work.
And then outside of Emory, there's a network of medical students called Medical Students for a Sustainable Future, which has really inspired and pushed forward a lot of incredible projects both in the curricular space, but also around advocacy and healthcare sustainability. And two of the leaders in that group are Natasha Sood and Karly Hampshire. They've both done really great work. I feel really fortunate to have been able to work directly and indirectly with these folks in the climate and health space, and they push me to keep working.
Claire Stinson: Well, thank you for sharing that. And you guys have done such a good job outlining the importance of taking action on the health impacts of climate change. And let me just say, Ben and Hazel, you two give me hope for our future on this topic. And I'm so grateful that you've been a part of Contagious Conversations.
Hazel Rogers: Thank you so much, Claire, for having us. This has just been a really exciting opportunity. I'm happy that I'm here speaking with you both.
Ben Rabin: Thank you for having us.
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