Climate protection is child protection: but what can physicians do?

Global warming, extreme weather events and air pollution are making children sick. What can physicians do now to ensure a better future?

"There are many of us in the medical professions and we have power. We just have to use it properly."

Translated from the original German version.

esanum: Dr. Auer, climate change has now reached the "global north". What does that mean for the health of our children, how will they grow up with the changing climate?

We are only just beginning to feel the consequences of climate change in Germany. For a long time, it took place somewhere else, in the global south. At the latest since the flooding in the Ahr valley (western Germany), which cost so many people their lives, we have realised that we cannot escape the climate crisis and its effects. Of course, our children will suffer even more because they still have such a long lifespan ahead of them, and they are also much more vulnerable than we adults and dependent on the conditions in which they grow up.

What does this mean? First of all, there are direct consequences: Global warming, rising temperatures, heat waves are increasing and becoming more extreme. Babies and children especially vulnerable and dependent on adults to recognise their needs at higher temperatures and protect them. We need to be prepared to deal with inadequate amounts of water: We will have more droughts on the one hand, but also extreme weather events such as heavy rains, which are the cause of floods, and forest fires. This destroys ecosystems, there is a biodiversity crisis, species extinction threatens us, we have new potentially disease-carrying species like ticks or mosquitoes, we have an increase in allergies, new, more aggressive types of pollen are emerging, and we have air pollution, which goes hand in hand with climate change, and environmental toxins. All this has an impact on many other systems.

esanum: That sounds like a dystopia that has become reality. How do you cope psychologically with that, it's scary, isn't it?

Yes, it is frightening. We also talk about "eco-anxiety", the fear of the consequences of climate change, and also solastalgia, a feeling of grief over the loss of one's home or living space. You have to try to redirect and use the energy that is created. If I see that this makes me sad or angry, then I can either fall into helplessness or get involved, try to change something even within the family. You have to think about what measures you can implement on a small scale. Parents are responsible for this, but often the impulses come from children and young people themselves.

esanum: Do you expect mental illness among children and adolescents to continue to increase, and then in the long term also in society as a whole?

Yes, that is to be expected. The more children are affected by extreme weather events, the greater the danger that they will also suffer from disorders. When a child experiences something like this, for example, that their own home suddenly no longer exists, the kindergarten is washed away or they have to move and reorient themselves, then of course this does something to the children. We know that depression and post-traumatic stress disorders increase in such cases, especially when the child is directly affected and perhaps relatives have been injured. But research is still in its infancy, we don't yet know exactly what to expect.

esanum: How can physicians support children in this process of processing and of course already in the area of prevention? 

Prevention is the key word here. I think, first of all, it is important that we set a good example. As parents, but also as physicians, we have to take climate change seriously. There are two major fields of action. One is climate protection, where we have to be careful that everything doesn't get worse, and the other is adaptation, that is, adapting to the consequences of climate change. By showing that climate protection is also child protection and child health protection, we are already doing a lot for children's mental health.

The health sector has a huge responsibility, because it is itself responsible for emitting 5% of all greenhouse gases worldwide. This is an incredible figure when you consider that the health sector is actually responsible for maintaining and restoring health. When you then consider that it is a major contributor to health hazards, it is completely absurd. We have to take that into account in our workplace design, in the practices, but also in the clinics, you have to address that. There are great programmes to make the workplace climate neutral, like Klik Green or from KLUG (German languange only), the German Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection (BMUV) and the German Environment Agency (Umweltbundesamt – UBA). But we also have to address this in families and see what can be done there to protect the climate and what are the co-benefits. Energy, nutrition, mobility, these are all things that have a direct impact on climate change and children's health.

esanum: That means the task is to reach out to the parents and make them partners, to create awareness and to educate? 

Yes, absolutely. And we are predestined for this because we are very close to the families. Paediatricians in particular have the unique opportunity to accompany families so closely and for such a long time. This creates a relationship of trust, and we physicians are listened to. That is a huge responsibility, but also a huge opportunity. And even if you can't convince them with the topic of climate change, you can certainly convince them with the topic of health, because all parents want healthy children. There is a lot you can do in education, change your lifestyle, take the bike more often, pay attention to healthy nutrition. Growing up healthy benefits health and the climate.

esanum: What else is particularly important to you? What do physicians need to know?

What can be said is that with our lifestyle in the global north, we are largely responsible for the situation in the global South being the way it is. People there live under much more difficult conditions than we do. We have a responsibility to ensure that the consequences of the climate crisis are not borne solely by people in countries that have contributed almost nothing to its creation. That is a moral-ethical responsibility, but of course it also protects our own security and health and freedom. And if you don't do it for ethical reasons, you can still do it for reasons of self-preservation. We are called upon to ensure that the structures in the countries of the global South are changed, that access to health systems is made possible for all, that education is made possible even under difficult conditions and that food security is given. That we invest in infrastructures and pass on technologies, for example in the field of renewable energies.

We in the health professions have a special responsibility, we have to make sure that we use the room for manoeuvre that we have. This is the workplace we have, where we can appeal to our employers or also become active ourselves within the clinic or practice. Be it in relation to energy, how we heat, or also the organisation of the ways to the workplace or the waste, which is also a big factor.

This is also true in private life and in politics. We can influence a lot through our voting behaviour, we can consider where we have invested our money and whether we are perhaps unintentionally continuing to promote fossil fuels. There are so many levers that can be used. We all need to get into dialogue and keep giving each other good examples and talk about what we can implement. Of course, we have to communicate how serious the situation is, but it is also very important that we orient ourselves towards positive visions for the future, because that motivates us to act. And health is a very central aspect here. Especially as physicians, we have to turn to preventive tasks instead of just treating the disease. We have to understand the connections and educate about them. There are many of us in the health professions and we have power. We just have to use it properly.