Amid smoky skies caused by Canadian wildfires, people walk on the jetty along the mouth of the Kennebunk River at Gooch’s Beach in Kennebunk on June 29, 2023. Gregory Rec/Staff Photographer, file

Most Maine doctors believe that climate change poses a health risk to their patients, with some saying they are already treating patients for problems tied to rising temperatures and extreme weather, such as asthma, allergies, heatstroke and Lyme disease. They also report an increase in climate-based anxiety and depression, especially among young patients.

This is what doctors told Colby College researchers in a 2020 survey of the climate perspectives of Maine Medical Association members. Survey findings, which include how doctors believe climate change is impacting their patients, were published this week in the Maine Policy Review.

“Health professionals are on the frontlines of the climate crisis and have important roles to play because they directly observe and respond to these health impacts,” wrote Gail Carlson, lead author of the report and assistant professor of environmental studies at Colby College.

The documented global health impacts of climate change include heat-related illnesses; diseases spread by ticks or mosquitos, such as Lyme disease or West Nile virus; respiratory illnesses, such as asthma and chronic obstructive pulmonary disease; food insecurity; and adverse mental health conditions.

The most direct link between climate change and public health in Maine can be found between warming temperatures and heat-related illnesses like heatstroke and diseases spread by the exploding population of ticks that no longer die off in the winter due to Maine’s mild seasonal weather.

When asked if climate change threatens their patients’ health, 78% of the 108 doctors who responded to the Colby survey said yes, 10% said maybe, 4% said not sure and 8% said no. Two-thirds reported being moderately or extremely concerned about current health impacts on their patients.

The risk of future patient impacts from climate change left 87% of respondents moderately or extremely concerned.

Thirty-eight percent of doctors surveyed said they were already observing the health impacts on patients.

Physicians identified a wide range of climate-related illnesses they had treated in their patients. The six most-cited illnesses were: asthma, tick-carried diseases such as Lyme disease, heat-related illnesses, allergies, COPD and mental health problems.

Some heat-related illnesses included: the exacerbation of lung and heart disease, heat stress for aging or sick patients who live in homes or facilities without air conditioning, and patients unable to exercise in extreme heat.

Doctors also cited a range of health risks posed by extreme weather, including families being forced out of their homes, patients missing doctor’s appointments for regular care because they cannot travel, and storm-related power outages that leave patients unable to charge their medical devices.

Respondents raised the issue of mental health impacts among current patients before the survey raised the issue, Carlson said.

“I see many children who have a great deal of anxiety,” one physician wrote. “In adolescents, they frequently verbalize worry specifically about climate change.”

More than half of those surveyed – 53% – answered “yes” when asked if climate change impacts patients’ mental health.

“The extreme weather issues and the unknowns associated with being a coastal state are creating significant distress,” one doctor wrote. “More worry about the future.”

While most think climate change threatens their patients’ health, an overwhelming majority of doctors surveyed, 85%, said they rarely, if ever, talked about climate change with their patients. Only 1% said they frequently raised the issue with patients, and 24% said they did sometimes.

In other studies, doctors have said they do not raise the health impacts of climate change with patients because they feel they don’t know enough about the topic to talk about it with authority and do not have enough time during appointments.

In 2019, the American Medical Association adopted a policy requiring medical educators to teach the health impacts of climate change. But a 2020 study found that only 15% of medical schools worldwide have incorporated climate change into their curricula.

Maine’s only medical school – the University of New England – does not offer climate change training.

In 2022, the American Medical Association adopted a policy calling upon its members to advocate for policies that limit global warming to 1.5 degrees Celsius, achieve carbon neutrality by 2050, support a rapid clean energy transition, and build climate resilience, especially among minorities.

Maine doctors and the MMA regularly testify on climate health and justice bills at legislative hearings.

As part of this work, the AMA will also develop strategies to decarbonize the health sector. In the U.S., the health industry contributes about 8.5% of all national greenhouse gas emissions. Only two of the Maine doctors surveyed suggested they should play a role in decarbonizing the health sector.

Carlson said she hopes to survey doctors again soon to update the results, noting that the climate field is a fast-changing one. Her next research paper, due out soon, will explore climate change’s mental health impacts on college students.