Where Is Climate Change in Population Health Education?

Climate change is considered by many people to be the greatest threat to humankind.  Changes to the natural world are coming faster and more furiously than previously predicted: the planet is experiencing the hottest month on record, rain “bombs,” catastrophic hurricanes, and polar vortexes, among other significant events. 

The health impacts from climate change are numerous and can affect a wide variety of populations.  Extreme heat triggers wildfires that influence outdoor air quality, increasing ozone and particulate matter, thereby aggravating cardiovascular and respiratory illnesses, like heat stroke or asthma.  Increases in precipitation can cause water-borne illnesses, like E. coli.  Increased exposure to damaging UV rays increases risks of skin cancer and dehydration. Health practitioners often need to respond to patients affected by these extreme weather and temperature events.  With all of these areas ripe for health interventions, how are we preparing the next generation of health practitioners to address these threats, specifically those who work in population health?

While several articles and reports call for more training of health professionals to include climate change, little has changed inside classrooms.  For example, when we looked at the Council for Education for Public Health (CePH) accredited master-level programmatic websites (MPH), two key aspects were considered: 1) was there a concentration in climate change? and 2) how many courses were taught specifically in climate change?  None of the programs had a concentration in climate change. Two programs had certificates in climate change, but these were additional to the master’s degree. Three programs had specific courses in climate change through global health. Yet 46% of the institutions that housed these programs had graduate courses in climate change in other disciplines.  These courses were not cross listed as courses that MPH students could take as part of their public health program. Climate change is taught as part of the introductory environmental health course (though in most cases, it is limited to a lecture or two) and in 13% of programs, it is incorporated into global health courses. Three courses that mentioned climate were listed in environmental health concentrations, but not as part of the general public health track. 

…how are we preparing the next generation of health practitioners to address these threats, specifically those who work in population health?

One possible explanation for the dearth of climate change education in master’s level public health programs may include accreditation.  Climate change is not included in the CePH accreditation document as a subject to be taught by an accredited program. These findings suggest that climate change is not required for accreditation of public health programs, nor is it included as part of public health curricula with specific courses or modules. 

Public health curricula are not unique in their lack of attention to climate change. Medical, nursing, pharmacy, and other allied health professional schools also largely exclude climate change as part of their curricula, despite calls for its inclusion.  Primarily, these calls are coming from healthcare providers (doctors and nurses) and health organizations, but some organizations, like the American Medical Association and the American Nursing Association, recommend via their policy statements that  climate change be included. Columbia University Mailman School of Public Health has launched an initiative entitled “Global Consortium on Climate and Health Education.”  More than 180 schools/organizations have joined this group to share resources and include climate change as part of their curriculum.  But when examining many of the United States public health programs, we find a disconnect between their aspirations and the curricula on their websites, which do not reflect a focus or concentration on climate change.

If “climate changes everything,” then we need to change how we teach health professionals about the impacts of climate change, especially to address the pressing needs of population health.

If “climate changes everything,” then we need to change how we teach health professionals about the impacts of climate change, especially to address the pressing needs of population health.  In the second post of this two-part series, we will consider steps to address this disconnect, how we can adopt a solutions-based approach, and how accreditation can help foster learning about climate change and health impacts.  It is essential for schools and programs to resolve this disconnect by taking action to train the current and next generation of practitioners for climate change readiness in a variety of populations.  

Check back soon for part 2 in this series.