By Caitlin Rublee, Caleb Dresser, and Cecilia Sorensen
Governments, nongovernmental organizations, and professional societies have called upon the health sector for increased engagement, collaboration and guidance to address the imminent health implications of climate change. To meet this demand, Jay Lemery, M.D., professor at the University of Colorado, teamed up with the Living Closer Foundation and National Institute of Environmental Health Sciences (NIEHS) to create the first postgraduate medical fellowship in climate and health science policy. The fellowship program’s goal is to provide physicians with a set of varied and robust scientific, leadership, and policy experiences that help increase fellows’ knowledge, as well as their connectivity, within the science policy community. According to Lemery, “Our aspiration is to train a new generation of clinicians facile in both domestic and international climate and health science policy, who are also outstanding communicators of risk assessment — to both the lay public and policymakers.” By allowing the fellows to be NIH Special Volunteers and engaging them in NIEHS, interagency, and global climate and health activities, NIEHS helps to provide the fellows with firsthand experience in science policy at the federal and international levels.
The first fellow, Cecilia Sorensen, M.D., completed the program in 2019. During her fellowship, she served as an author on the Fourth National Climate Assessment and helped to draft and finalize the NIEHS climate change and human health lesson plans for graduate and professional students. In addition, Sorensen served as a technical contributor to the Lancet Countdown U.S. Policy Brief, partnered with the Medical Society Consortium for Climate and Health and Practice GreenHealth on educational initiatives for physicians, and codirected a fourth year medical school elective on climate and health at the University of Colorado. She joined several research collaborations and published manuscripts on topics of climate change and women’s health, climate variability and Zika virus, and chronic kidney disease of unknown origin and heat stress. Her work was featured with interviews on National Public Radio as well as Colorado Public Radio. Additionally, she traveled to Lebanon, India, Guatemala, Puerto Rico, and Ecuador to complete field research and to meet with local health policy leaders. “There is no other opportunity quite like this for physicians who care deeply about environmental health,” says Sorensen.
This year, the fellowship consortium expanded with a new site at Beth Israel Deaconess Medical Center in Boston, in collaboration with the FXB Center for Health and Human Rights at the Harvard T.H. Chan School of Public Health and the Harvard Center for Climate, Health, and the Global Environment. “There is much we have to do — even in the United States — to make our communities and health systems more resilient to climate-related disasters,” says program director at Harvard, Satchit Balsari, M.D. “The impact of recent natural disasters on the morbidity and mortality of our medically vulnerable populations has been a key impetus for starting this fellowship,” he said, recounting the Hurricane Maria mortality study, authored by several members of this consortium. The first fellow in this new program, Caleb Dresser, M.D., brings a range of experience that includes health system capacity building in Uganda and sustainable agriculture research in India. During the fellowship, he hopes to focus on translating an understanding of population-level impacts from climate-related hazards into actionable approaches to adaptation.
Caitlin Rublee, M.D., is now the second fellow to enter the training program at the University of Colorado. She has a keen interest in the intersection of medicine and public health as it pertains to health equity and underserved populations. Her background in community health and ethics provides a foundation for current fellowship work, which is focused on building health care facility resilience and sustainability in health care.
Rublee and Dresser, both practicing emergency medicine physicians, have spent several weeks with John Balbus, M.D., at NIEHS gaining a more in-depth understanding of climate and health impacts and the role of governmental agencies in shaping environmental health, enhancing communication skills, and engaging across sectors. Work has included topics related to health care facility resilience, the health impacts of climate-related disasters, climate-sensitive diseases, seasonal and sub-seasonal forecasting, and integrating climate and health into education. The climate and health science policy fellowship has created a path for sustained transdisciplinary collaboration to improve population health at the intersection of academic medicine and government.
Both fellows feel their experience at NIEHS has broadened their understanding of both the subject matter and the process of policy generation and implementation. “My time so far with NIEHS has shaped my view of disease inside the emergency department and my role as a physician communicating the critical influence of environment and climate variability on health outside of the department”, Rublee shared. Dresser notes that, “My time at NIEHS has already played an important role in expanding my understanding of the role of governance and national-level policy in addressing issues related to climate and health.” Future work in collaboration with NIEHS will include involvement in literature review and management of the NIEHS Climate and Health Literature Portal, as well as further engagement in educational initiatives.