It’s time to start talking to our patients about climate change and the structural causes of disease. Hurricane Harvey has devastated Texas, leaving many dead, thousands with homes destroyed and billions in damage to infrastructure. Hurricane Irma pummeled the Caribbean and Florida at the same time that Hurricanes Katia and Jose were picking up strength in the Atlantic and threatening Mexico and the Eastern Caribbean. Forest fires are destroying regions of the Pacific Northwest. Meanwhile, in Nigeria, over 100,000 people have been forced to leave their homes because of widespread flooding, and in Southeast Asia over 1,200 have died due to historic flooding, which has left over one-third of Bangladesh under water.
These disasters did not come out of the blue, though. They are just a few examples of what results from an economic system that knows no limits. If the medical community wants to start addressing the systemic causes of illness, instead of just addressing the results that manifest themselves in various degrees of illness for suffering patients, we will have to make addressing the structural aspects of disease central to everyday medical practice.
The System’s Toxic Effect
In medicine, we are often told not to “politicize” health care issues, not to be “too controversial” because “X” residency may not want to accept you, or “Y” employment opportunity may not want to hire you. Frankly, there is no more time for that, especially as we will continue to see more and more patients coming to our offices, clinics and hospitals damaged by this system. To take Texas as an example, in addition to the immediate physical risks associated with widespread flooding and infrastructure destruction, communities will be at risk for a number of health issues, ranging from inadequate access to medical care and prescriptions to an increased risk of mosquito-borne diseases to an increased toll of mental illness from psychological stress.