When people hear the term “climate change,” the first thought that comes to mind may be of a polar bear on a melting iceberg somewhere in the Arctic Circle.

They may not realize that climate change is also having a local impact here in Massachusetts, from an increasing risk of heat exposure to outdoor workers to higher rates of pollen that can worsen asthma attacks and a greater risk of exposure to Lyme disease and other insect-borne illnesses.

Renee N. Salas, MD, MPH, MS wants to increase the awareness of how climate change impacts health locally, and to better define the economic costs and healthcare burden associated with rising temperatures and severe weather events.

“My ultimate goal is that when people think of climate change, they think about their child having asthma attacks because of increased pollen in the air, and not a polar bear on an iceberg,” she says. “A polar bear on an iceberg does not make climate change personal and does not provide nearly as much motivation to act.”

Dr. Salas is an emergency medicine physician and researcher at Massachusetts General Hospital and an affiliated faculty member and Burke Fellow at the Harvard Global Health Institute.

As a clinician, she is working to educate her patients on how climate change could be contributing to their health issues. In her research, she is connecting information from large health databases to climate change exposure pathways to better define how it impacts emergency department and hospital use, patient health outcomes, and the overall cost of care.

Local Impacts of Climate Change

Salas has seen the impact of climate change firsthand in cases of heat exposure in outdoor workers, patients who suffer repeated asthma attacks due to rising pollen levels related to a greater concentration of carbon dioxide in the air, and mental health issues that can be exacerbated during heatwaves.

She is also seeing more patients at risk for insect-borne diseases. “Lyme disease is a common one that we’ve seen spreading, especially in the Northeast. That’s a disease that I always keep in mind as an emergency medicine physician, because I don’t want to miss that diagnosis.”

Population displacement is another issue that has the potential to increase healthcare costs, Salas notes. As people migrate away from parts of the country affected by severe weather, they can put additional pressure on systems that are already stressed by the needs of the local population.

Impact on Providers, Hospitals and Healthcare Systems

At the hospital and system level, Salas hopes to identify the patient populations who are most at risk during severe weather events, and to help healthcare providers prepare for disruptions in supplies and resources that could occur at a time when care is needed most.

Patients may be unable to get to appointments or refill their medications if transportation or other services are disrupted during a storm, and hospitals may run short on supplies if they are unable to restock due to closed roads, structural damage or flooding.

“If you have a hospital that is open and can provide care, but you don’t have supplies, it’s going to severely limit its ability to provide life-saving care.”

A recent example of this occurred as a result of Hurricane Maria in Puerto Rico, which damaged the facilities that manufacture IV bags used to deliver drugs and fluids to patients across much of the United States.

Mass General and other hospitals had to convene task forces and develop new systems and processes to make sure the existing supply of bags made it to the patients who needed them most.

Severe weather events also create stress for the doctors and nurses who are relied on to provide care during emergencies. “They have their own families and homes that may be impacted,” Salas notes. “They are undergoing the same stresses their patients are, and it’s important to help them stay resilient as they provide care.”

Eco-Anxiety and the Power of Working Toward Change

Salas acknowledges that tackling a subject as far-reaching as climate change can be daunting at times, leading to a feeling that others have termed “eco-anxiety.” But it helps her to be working toward change. 

“While it is the greatest public health emergency and challenge of our time, it’s also the greatest opportunity,” she says.

“All of us happen to be alive at a point in history where we have a unique opportunity and obligation to act on climate change now, because what we do now will determine the health of our nations and our planet.”

“When I think about how I want to spend the hours of my day, and what work I want to dedicate my career to, I can’t think of a greater impact than to work on this challenge.”

About the Mass General Research Institute
Research at Massachusetts General Hospital is interwoven through more than 30 different departments, centers and institutes. Our research includes fundamental, lab-based science; clinical trials to test new drugs, devices and diagnostic tools; and community and population-based research to improve health outcomes across populations and eliminate disparities in care.
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