Environmental Health

Environmental Health — LGBTQ+ Community and Climate Change

Everyone’s lives will be impacted by climate change. But what about the people and communities already disproportionately experiencing the effects of inequitable systems?

Those who contribute the least to climate change are suffering its greatest impacts. Both nationally and globally people of Black, Indigenous, people of color (BIPOC) and the poor, will experience an unduly high level of some of the most damaging and dramatic effects of climate change. 1 Less discussed when assessing the impact of the climate crisis, however, is the LGBTQ+ community. They are disproportionately more vulnerable to the harmful impacts of a warming planet. They are more likely to be living on lower incomes, to experience homelessness, and have limited access to health care. 2 BIPOC members of the LBGTQ+ community face multiple overlapping structure disadvantages. People on lower incomes have fewer financial alternatives with less access to capital. They face increased risk under the same set of circumstances as those with more privilege. The LGBTQ+ community in particular tends to face financial challenges that stem from discrimination and intolerance. Unemployment puts LGBTQ+ populations at greater risk of poverty and homelessness, making them more vulnerable to the effects of climate change. Trans folks also can face barriers and discrimination in the healthcare system: one in four transgender people report

By Anna Johnson and Mike Menzel, MD having avoided medical care out of fear of being disrespected or mistreated. Their socioeconomic status increases exposure to the effects of climate change because they tend to live in areas with higher levels of air pollution and aren’t able to seek medical care for the secondary health impacts. Forty percent of homeless youth identify as LGBTQ+. Those who are without a safe place to live are more exposed to extreme weather events that are more common due to climate change. As we adapt to

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a changing climate, we need to address equitable solutions to those more affected by climate change.

References: 1. IPCC, Climate Change: Impacts, Adaptation and Vulnerability, Chapter 14, p841, March 2014. 2. UCLA School of Law, Homelessness Among

LGBTQ Adults in the US, May 2020.

Anna Johnson, Policy and Public Affairs, Fresh Energy, and Mike Menzel, MD, TCMS Environmental Health Task Force.

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By Marvin S. Segal, MD

FRANK S. RHAME, MD

It is indeed rare for one of our Luminaries to be featured at the pinnacle of their profound professional activity, but that seems to be the case here. Let’s follow along his career and determine whether that’s a true statement.

Dr. Frank Rhame, though born in Pennsylvania, had many early life home travels—finally and thankfully ending up in the Twin Cities in 1979 with a U of M medical faculty position. His BS degree was from Cal Tech and his MD was earned at Columbia in New York City. There followed internal medicine and infectious disease (ID) post graduate specialty and fellowship certifications at Columbia, the University of Michigan and Stanford University. The discipline of ID incorporates the study of disorders caused by organisms such as bacteria, fungi and parasites—the relevance of viral diseases perhaps taking on a less important clinical prominence until the emergence of the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). Frank’s senior college year interest in “phase genetics” stoked his later involvement with the pathogenic activity of viruses—those submicroscopic particles of genetic material that invade host cells and therein perform their replicating “dirty work.” Dr. Rhame’s initial clinical and epidemiological activity was in the area of nosocomial infection prevention. That interest subtly evolved into clinical virology involvement when, in the early ’80s, he—and medicine in general—was challenged by a baffling and virulent condition of very sick young patients with pancytopenia and multisystemic disease who succumbed to their illness in frightening numbers. When asked how those early AIDS patients were initially diagnosed and treated, his response honestly stated, “We hadn’t a clue!” As he and other dedicated physicians empathetically plodded forward with few therapeutic tools to help those patients, valuable strides were being taken to better understand the disease’s public health and sexual medicine implications and the eventual antiviral agents that would prolong and save their lives. Frank, and “the wonderful circle of like-minded scientists with whom I had the honor of working,” played pivotal roles through the years in each of those meaningful advancements with AIDS via clinical research, education and direct patient engagement. Those preceding experiences stood him in good stead for what was to come about much later—thusly preparing him for the more current virus induced pandemic of COVID-19. Along the way, Dr. Frank participated in >200 clinical studies for pharma, NIH and the CDC, authored >100 journal articles and essays, advanced to professorships in epidemiology and ID at our U of M, held numerous editorial positions in peer reviewed publications, and became a local expert in travel advice and international medicine. His numerous commendations and honors include “Clinician of the Year” from the ID Society of America and “First a Physician” from our own TCMS. The good doctor Rhame is presently “as busy as I’ve ever been” with research and advisory capacities related to COVID-19. His work with Remdesivir and convalescent serum plasma administration has attracted international attention and is certain to result in more well-deserved plaudits. Expressions of his current concerns and optimistic thoughts are easily extracted from some of his recent quotations: “This virus has exposed and exploited weaknesses in our public health approach;” “Other countries were better prepared in their approach to this viral pandemic and we should and will learn and modify from them;” “Eventual immunization will be of huge help to our populations and old people in particular.”

So . . . early on we asked if Dr. Rhame—our modest Luminary, proud father, grandfather and husband of his professionally accomplished wife—was now at the height of his splendid career? Answer: A resounding YES!—and he has been “right-up-there” for decades, and, has every intention of continuing along that same successfully productive path.

This last page series is intended to honor esteemed colleagues who have contributed significantly to Twin Cities medicine. Please forward names of physicians you would like considered for this recognition to Nancy Bauer, Managing Editor, nbauer@metrodoctors.com.