Health and Social Justice in a Changing Climate
RACISM AS A PUBLIC HEALTH CRISIS
By Hanna Linstadt MD, Rachel Dahl MS, and Caitlin Rublee MD, MPH, on behalf of the SAEM Climate Change and Health Interest Group
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Our knowledge and understanding of history inform our actions in the present. The teachings and foundation of medical education build critical thinking skills that apply to clinical practice. In emergency medicine, atypical disease presentations influence future management plans and an ever-expanding differential diagnosis. The most up-to-date literature informs evidence-based practices that define high quality, timely emergency care year after year. One of the challenges of COVID-19 has been the on-the-go learning and development of evidence; yet, even in a global pandemic, we can look to history to inspire and lend key lessons on public health and social justice. The Pandemic of 1918, or the Spanish Flu, transformed public health in the United States (U.S.). It claimed the lives of approximately 675,000 Americans and decreased the average life expectancy in the U.S. by 12 years. The similarities to COVID-19 include strain on health care systems,
“Effects of climate change exacerbate existing social and environmental conditions, thereby increasing exposure of at-risk populations to conditions that contribute to adverse health outcomes.” ill practitioners, rapid spread, altered medical education, specific populations at increased risk, limited gatherings, misinformation, masks and restrictions. Following the Pandemic of 1918, public health, evidence-based medicine, and health care systems developed with a new-found purpose. There was a renewed interest in science and data to inform prevention and treatment, and groundbreaking achievements in modern medicine were accomplished. Population-level surveys were created and implemented, governments created
health plans, vaccines were created, and laboratories formed networks to test for diseases. Out of a devastating pandemic came an era of modern medicine which set the foundation for scientific, evidence-based medical discovery and practice. As medical education and research matured, so did recognition of the social and environmental determinants of health. Specifically, a new threat to health was identified: environmental injustice. Environmental justice is “the fair treatment and meaningful
