Opinion

Editorials represent the opinions of the authors and JAMA and not those of the American Medical Association.

EDITORIAL

Climate Change A Continuing Threat to the Health of the World’s Population Howard Bauchner, MD; Phil B. Fontanarosa, MD, MBA

Poverty and war are among the two greatest threats to health and well-being. In virtually every study, poverty emerges as a major risk factor for most diseases. The tragedies of 9/11 and the current conflicts in the Middle East are painful reminders of the human toll and societal cost of war. Yet poverty and war are seldom addressed by most national and international medical organizations. They have generally focused on the advancement of science, public and individual health, access to care, and more recently the importance of noncommunicable diseases. The great advances in health in the early part of the 20th century occurred because of improved sanitation, including the availability of clean water. During the latter half of the 20th century further gains in health occurred because of the “war on infectious diseases.” Antibiotics became widely Related article page 1565 available after World War II and vaccines followed shortly thereafter. Medicine became much more focused on individual health in the later part of the 20th century, with the HIV/AIDS epidemic emerging in the 1990s, but because of remarkable scientific progress this lethal disease has for many individuals become a chronic disease. Over the past 10 years, interest in global health has increased substantially with a greater recognition of the importance of universal access to care, noncommunicable diseases, and international transmission of serious infectious diseases. In this issue of JAMA, Patz and colleagues1 review the evidence on the health effects related to climate change. In 1996, Patz et al2 addressed the subject of climate change and emerging infections before the topic was well recognized by bio-medical scientists or extensively publicized by the popuARTICLE INFORMATION Author Affiliations: Editor in Chief, JAMA (Bauchner); Executive Editor, JAMA (Fontanarosa). Corresponding Author: Howard Bauchner, MD, JAMA, 330 N Wabash Ave, Chicago, IL 60611 ([email protected]).

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lar media. In the current report, Patz et al review the association of climate change with heat-related and respiratoryrelated disorders, infectious diseases, food security, and mental health. The authors also discuss the public perception of climate change and how society must adapt to climate change to mitigate some of its effects. Should physicians be concerned about climate change and its associated effects on health or is it outside the remit of medicine much like poverty and war? As physicians have come to recognize that many aspects of daily living affect health, such as working conditions, pollution, education, mental health, and psychosocial aspects of disease, medicine has broadened its research, clinical, and policy agendas. Many physicians are now involved in addressing these problems. But is climate change similar to poverty and war, best left to other scientists and politicians, or is it of such fundamental importance—like clean water, clean air, and adequate sanitation—that physicians should strive to further clarify the effects of climate change on health, educate themselves and the public, and mount a campaign to ensure that climate change does not lead to an epidemic of eroding health? The great gains in well-being in the 20th century occurred because of the concerted effort to improve the health of entire populations. Today, in the early part of the 21st century, it is critical to recognize that climate change poses the same threat to health as the lack of sanitation, clean water, and pollution did in the early 20th century. Understanding and characterizing this threat and educating the medical community, public, and policy makers are crucial if the health of the world’s population is to continue to improve during the latter half of the 21st century.

Published Online: September 22, 2014. doi:10.1001/jama.2014.13094.

opportunities for global health. JAMA. doi:10.1001 /jama.2014.13186.

REFERENCES

2. Patz JA, Epstein PR, Burke TA, Balbus JM. Global climate change and emerging infectious diseases. JAMA. 1996;275(3):217-223.

1. Patz JA, Frumkin H, Holloway T, Vimont DJ, Haines AP. Climate change: challenges and

JAMA October 15, 2014 Volume 312, Number 15

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Climate change: a continuing threat to the health of the world's population.

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