Resolution 420: A Golden Opportunity for Sustainable Care

The 2021 Intergovernmental Panel on Climate Change (IPCC) annual report made clear the staggering degree to which summer heat, wildfires, droughts, and other impacts of the climate crisis are challenging human well-being.¹ In response to its release, 200 medical journal editors responded, calling on “world leaders to keep the global temperature rise below 1.5° Celsius to prevent catastrophic and irreversible harms to public and global health.”²

Now the American Medical Association (AMA) has joined their call to greater action toward rapid decarbonization. Building on a number of policies intended to limit the harmful impacts of climate change on American patients, the AMA has passed Resolution 420, which declares climate change a “public health crisis that threatens the health and well-being of all individuals” and calls for legislative advocacy for the AMA to protect patients by “advocating for policies that: (1) limit global warming to no more than 1.5° Celsius, (2) reduce US greenhouse gas emissions aimed at carbon neutrality by 2050, and (3) support rapid implementation and incentivization of clean energy solutions and significant investments in climate resilience through a climate justice lens.”³

Resolution 420 represents a sweeping and resolute commitment to political advocacy and action, its bold scope opening the door for further initiatives from medical associations of all kinds. The American Psychiatric Association (APA) has already committed to divest from direct investment in fossil fuel assets⁴ and to reduce the carbon footprint of its meetings,⁵ but Resolution 420 offers the opportunity to go further, by acting politically to support clean energy and decarbonization policies to reach the 1.5° Celsius target, and by changing psychiatric practice, priorities, and asset management actively to reach these goals. Following this lead, other medical associations can be encouraged to join the APA and AMA’s commitments to divest from fossil fuel-linked portfolios and to advocate for and enact policies that address the disproportionate impact of climate change on social determinants of health for disadvantaged populations.

Resolution 420 has particular importance in its pursuit of the aggressive goal of limiting global warming to 1.5° Celsius, a key and more ambitious threshold identified by the IPCC’s thousands of global scientists as critical to minimizing the health-related harm from climate change, particularly for those in less wealthy and resourced countries in the global south.

With Resolution 420, the AMA also issued a commitment to decarbonize the practice of medicine. The American health care industry produces nearly 10% of the nation’s total greenhouse gasses, indirectly contributing to more than 600,000 disability-adjusted life years lost annually.⁶ These health care emissions represent a clear violation of our Hippocratic Oath to do no harm. No other nation on Earth has as great an imbalance in the ratio of pollution and emissions to national health care access and quality.

The climate crisis is upon us right now, but most physicians and practices are currently unprepared to decarbonize at the scale of emerging national goals and regulations. The necessary changes are systemic—beyond the capabilities of any one clinician or practice. Properly addressing this public health crisis will require a cohesive approach among all physician groups, with core elements of our strategic approach guided by well-informed medical societies. As the AMA develops its strategic plan to protect our patients, the APA has an opportunity to follow it closely, leading our organization into an ethical and sustainable future.

Dr Lee is chief fellow at the University of Hawai'i Child and Adolescent Psychiatry Fellowship Training Program. He also sits on the American Psychiatric Association (APA) Committee on Climate Change and Mental Health, and is a frequent collaborator with the Climate Psychiatry Alliance. Dr Haase is medical director of psychiatry for Carson Tahoe Regional Center and chairs the climate committees for the APA and the Group for the Advancement of Psychiatry.

References

1. Climate change widespread, rapid, and intensifying—IPCC. Intergovernmental Panel on Climate Change. Press release. August 9, 2021. Accessed June 27, 2022. https://www.ipcc.ch/2021/08/09/ar6-wg1-20210809-pr/

2. Atwoli L, Baqui AH, Benfield T, et al. Call for emergency action to limit global temperature increases, restore biodiversity, and protect health. BMJ. 2021;374:n1734.

3. AMA adopts new policy declaring climate change a public health crisis. American Medical Association. Press release. June 13, 2022. Accessed June 21, 2022. https://www.ama-assn.org/press-center/press-releases/ama-adopts-new-policy-declaring-climate-change-public-health-crisis

4. Protecting public mental health from the adverse effects of climate change by ending APA investments in fossil fuel companies. American Psychiatric Association. Accessed June 21, 2022. https://www.psychiatry.org/about-apa/Meet-Our-Organization/Assembly/Action-Item-Tracking-System

5. Towards making the carbon footprint of the APA meeting carbon neutral. American Psychiatric Association. Accessed June 21, 2022. https://www.psychiatry.org/about-apa/Meet-Our-Organization/Assembly/Action-Item-Tracking-System

6. Eckelman MJ, Sherman J. Environmental impacts of the U.S. health care system and effects on public health. PLoS One. 2016;11(6):e0157014.