Public discussion about climate change rarely links environmental changes and disasters to their impacts on human health, even as the lengthening tally of droughts, wildfires, heatwaves, and hurricanes exert increasing costs on communities throughout the United States. As with the COVID-19 pandemic, these events disproportionately affect the most vulnerable, particularly in communities of color.
An increasing sense of urgency spurred three Geisel students, Maya DeGroote ’21, Tala Radejko ’21, and Kali Smolen ’25, Guarini ’25 to join hundreds of their medical student colleagues in creating a local chapter of Medical Students for a Sustainable Future (MS4SF).
“No matter what specialty we go into, climate change is already affecting the health of our patients and communities,” says Radejko. “COVID-19 is just one example.” The World Health Organization estimates climate change contributes to nearly 150,000 deaths annually, and a recent study from Harvard University indicates that 8 million deaths (1 in 5) in 2018 could be attributed to fossil fuel pollution.
Add to that the billions of pounds of medical waste generated by healthcare in the U.S. With an estimated 8.5 percent of annual carbon emissions, America’s healthcare system is the highest emitter globally.
MS4SF is a national student organization that recognizes climate change as an urgent threat to human health and social justice. At Geisel, the chapter aims to improve understanding of how climate change affects community health and wellbeing and to collaborate with faculty, staff, and students across Geisel, Dartmouth-Hitchcock Medical Center (DHMC), and Dartmouth College.
DeGroote says an ultimate goal is to integrate climate change competencies into the medical education curriculum. “Climate change and air pollution directly impact pulmonary and cardiovascular health,” she stresses. “In coastal regions catastrophic flooding results in traumatic injuries. Heatwaves and droughts disrupt growing conditions and its effect on the food supply and nutrition affect population health. And our region is experiencing a northern expansion of Lyme disease.” Geisel students rotating in California have also seen how worsening fire seasons impact their patients’ physical and mental health.
Rima Itani Al-Nimr, MS, RDN, LD, a lecturer in medical education and medicine, and the Nutrition in Medicine longitudinal curriculum director, also sees clear links between nutrition science and sustainability.
“It’s impossible to discuss sustainability without acknowledging its link with nutrition science. Our food supply—what we grow, the livestock we raise, along with how and where we process, distribute, prepare, and consume food, both as a nation and globally—has a clear and significant impact on planetary health,” says Al-Nimr, who serves as the group's advisor and mentor.
A Planetary Health Report Card (PHRC), an audit of how the medical school is doing in terms of curriculum and sustainability efforts, is the group’s first big project. “In regard to the curriculum, the report card addresses efforts educating medical students about the health impacts of climate change and how to make our school more sustainable in terms of goals and initiatives—such as reaching carbon neutrality or supporting sustainable change on a broader scale.” Smolen adds.
This year, more than 50 medical schools are using this assessment tool. Due this spring, the report card will be shared with Geisel deans and faculty to gather further input.
Al-Nimr says the medical students have already begun the process of recommending sustainability and equity curriculum content and have reached out to DHMC to discuss sustainability practices in clinical care. “Our healthcare system is a long way from being sustainable or equitable, and discussions about planetary health can also be opportunities to talk about racial justice in medicine,” DeGroote, Radejko, and Smolen emphasize. Another of the group’s goals is to make sure any curriculum or practical reforms to come out of the PHRC support ongoing student efforts to address race and equity at Geisel.
Sarah Crockett, MD, an assistant professor of emergency medicine and director of the Wilderness and Austere Medicine Program at Dartmouth, says, “This is not a future concern, but something that is now affecting human disease on both an individual and global level.” She notes many physicians in the wilderness medicine community are taking the lead as advocates for planetary health. Crockett, who leads sustainability initiatives at DHMC, shares Al-Nimr’s conviction that human health and planetary health are inseparable.
“Numerous schools nationwide are now ensuring courses on human health and climate change are part of their core education—we hope to be able to do so here at Dartmouth as well,” says Crockett.
DeGroote, Radejko, and Smolen agree: “This is not a project for the few, but for everyone.”
Anyone interested in joining MS4SF may contact: firstname.lastname@example.org.