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Pediatrics October 5, 2023

Q&A on Climate Change and Pediatric Health: New Education from the American Board of Pediatrics

Heat waves. Wildfires. Superstorms. Floods. As climate change affects the frequency and intensity of extreme weather events, health risks increase, especially among vulnerable populations. The American Board of Pediatrics—a new addition to the AMA Ed Hub’s growing list of trusted content providers—seeks to educate pediatric clinicians on how children are adversely impacted by our quickly warming planet.

Adult and child holding hands while looking at large fire

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The ABP module “Impact of Climate Change on Pediatric Health Care,” now accessible on the AMA Ed Hub, is a Maintenance of Certification (MOC) Part 2 self-assessment with 20 questions linked to recent open-source articles. Authors Dr. Karina Maher and Dr. Lisa Patel spoke with the AMA Ed Hub about why it’s critical for pediatricians to deepen their knowledge of this urgent topic. The following Q&A has been lightly edited for length and clarity. If you are a pediatrician looking to claim MOC Part 2 credit and CME for this activity, please login to your ABP Portfolio to complete the activity there. Your username and password will be required.

  1. AMA Ed Hub: As you acknowledge in the module, climate change might not be the first thing that comes to mind when we think of pediatric health care. Why should pediatricians increase their competency on climate-related health issues and why is it a priority of the American Board of Pediatrics?

    Dr. Maher: There’s a big gap in knowledge among practicing pediatricians, which is to some extent being remediated in students and maybe even residents. But in terms of practicing pediatricians, it’s a very tiny minority that thinks about climate change, incorporates it into their practice, or even has the knowledge of what the health effects are. Because of this huge gap, we knew we had a role to play in using our knowledge to help educate our peers. The American Board of Pediatrics is the first U.S. board–certifying body to have recognized climate change as a foundational health issue—one that requires dedicated education. Hopefully, this inspires other medical boards.

  2. AMA Ed Hub: Articles in this module explore the troubling relationship between asthma rates and historical redlining, water-related weather events and waterborne disease, and extremely hot temperatures and infant mortality, to name a few. How does exploring such connections better equip physicians to provide quality care?

    Dr. Patel: It helps us respond to what we’re seeing in our clinics and hospitals. I’ve cared for a number of athletes, for example, who come in tipped over when it’s just a little bit hotter outside because their bodies aren’t adapted for it. They end up with heat illness and, in some cases, some amount of kidney damage from heat illness and dehydration. So, it’s important to talk to these athletes and their families about how the days are getting hotter and make sure that coaches and sports programs have plans in place. Or ensuring that when we’re counseling a family with an infant, for example, we know if they have access to air conditioning, particularly in months of extreme heat. We know that wildfire smoke is really dangerous for the entire population but particularly dangerous for kids under the age of five. For a child with asthma, we want to make sure we’re talking to families about wildfire as a possible threat to exacerbations.

    It’s unlikely an entire patient visit will be about climate change, but starting from the two-month visit, there are ways we can integrate nuggets of climate counseling to build awareness and people’s capacity to address the problem. As Dr. Maher mentioned, we’ve just now started thinking about all this, and we need to think faster and move faster to get people prepared.

  3. AMA Ed Hub: Thinking about climate change and its health impacts can engender feelings of helplessness, but what are some actions pediatricians can take to integrate climate counseling into their practice?

    Dr. Patel: I tell people to start with the easy places. Asthma is the number one chronic disease of childhood, and it’s a very good place to start working on your climate counseling because there are very clear links between hotter days, more polluted days, and asthma. So, start with the places that have the highest touchpoints and go from there, and use resources like those we’ve developed for the ABP to build your capacity. The other thing we need to do is talk about it—with our colleagues and the other people in our office or clinic. The more we talk about climate change, the more we can create a broader public awareness that this is something we’re all concerned about.

    Dr. Maher: By increasing their knowledge, pediatricians will feel more secure and confident when talking with patients—about, for example, allergies exacerbated by a warming climate and shifting seasons; more food insecurity and threats to children’s nutritional status due to climate change’s effect on crops; vector-borne disease from ticks and mosquitos that are in areas where they weren’t before; mental trauma related to climate-influenced weather events, and more. In our field, we’re used to taking on the responsibility of continuing our education, and this module is another opportunity to fill in any gaps learners might have.

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