The Cribsiders podcast

#101: Tiny Patients, Big Planet: Pediatric Prescriptions for a Changing Climate

January 17, 2024 | By



Join us on this eye-opening episode as we explore the predicament of pediatric health in the face of a changing climate. From global changes to the impacts on tiny bodies, we’ll delve into the health effects of climate change and opportunities to mitigate its impact. Get ready for a ‘temperature checkup’ on our planet and discover how we can create a healthier, greener future for the next generation.

Climate Change Pearls

  1. Climate change can impact every medical specialty. Consider climate-related factors when taking medical histories and developing treatment plans for all patients.
  2. Counsel families to prepare for climate-related health issues including reviewing air quality, looking at pollution indices, and creating disaster plans for medical needs. 
  3. Climate change can have a profound impact on childrens’ mental health. Screen for symptoms of PTSD, depression, and anxiety in the wake of extreme weather events. 
  4. Healthcare providers are trusted voices on the issue of climate change. Families look to us to provide guidance on anticipated health effects, and we can leverage our expertise to advocate for measures that mitigate these impacts. 
  5. Hospitals account for nearly 8.5% of greenhouse gas emissions in the United States and are an important area for improvements towards greater sustainability.

Climate Change Notes 

Health Impacts of Climate Change

Climate change due to “trapped” green house gasses causes shifting weather patterns leading to episodes of extreme heat, altered precipitation, extreme weather events, worsening air quality, warming of oceans, shifts in agriculture, and loss of biodiversity. Health impacts include but are not limited to: 

  • Heat-related illnesses: Increased rates of dehydration, heat stroke, and heat exhaustion
  • Injury and illness directly caused by extreme weather events: In addition to causing injury, extreme weather events often reduce access to clean drinking water. 
  • Allergies: Allergy “seasons” change and can become prolonged as temperatures increase. Increases in carbon dioxide levels can lead to higher counts of pollen and ragweed. 
  • Lung disease: Increased wildfires leading to general deterioration in air quality.
  • Mental health disorders: Disruptions to society as a result of extreme weather events has been linked to mental health problems including PTSD, anxiety, and depression. In studies, more than ⅓ of children exposed to these events have new mental health diagnosis in the aftermath of the event, and more than 10% have persistent symptoms 1+ year later. Children are also exhibiting signs of eco-anxiety (i.e., fear of environmental doom and catastrophe), which increases with exposure to related stories in the news and experiences in their own lives. 
  • Malnutrition: Food insecurity due to disrupted food supplies and distribution networks

Practical Advice & Impact Mitigation Strategies

  • Counsel families to avoid peak times of heat/sun exposure. Review age-specific signs of heat-related illness and strategies to reduce risk (e.g., hydration and taking frequent breaks)
  • Consider environmental exposures screening for patients with asthma (there is a pilot for this at Boston Children’s Hospital). Provide guidance and resources based on exposure risk.
  • Discuss environmental metrics, including Air Quality Index and pollen indices, with vulnerable families. Consider advising children with asthma to have rescue medications more readily available on poor air quality days
  • Provide information about cooling centers, if available.
  • Make sure that children with complex medical conditions that require equipment have plans in place for extreme weather events.
  • Recognize that climate impacts every specialty! When reviewing medical history and medication list, think about what role climate plays and any necessary adaptions. (E.g., patients on nephrotoxic meds may have issues with thermoregulation or be at higher risk for adverse effects). Apply “climate layer” to daily work. 
  • Discuss use of insect repellants and light colored clothing to reduce risk of vector-borne diseases. Discuss tick checks and clinical manifestations of lyme disease, if present in your area.
  • Consider recommending a plant-forward diet, given it is healthier for both patients and the planet! 

Environmental Justice Issues

  • In many ways, climate change is “The Covid we can see coming.” It is an impending public health crisis that is impacting communities in significant and disproportionate ways 
  • Populations contributing the least emissions are often the most affected by the impacts of climate change. Vulnerable populations often have both increased exposure to adverse environmental conditions and reduced resources to mitigate health effects. (E.g., urban heat islands disproportionately affect communities of color, which can be linked to historical practices of redlining.)
  • The Justice40 Initiative aims to ensure that at least 40% of government investments to address climate change are allocated to communities that are “marginalized, underserved, and overburdened by pollution.”

Opportunities for Health Professionals

  • Primary care providers are very much trusted professionals when it comes to speaking up about climate issues. The public trusts us to be messengers on the topic and to translate the scientific findings into actions to protect health.
  • Healthcare is a significant contributor to global emissions (the sector accounts for 4.6% of emissions globally, and the U.S. contribution is approximately 8.5%). Providers have the opportunity to become knowledgeable and push our institutions to increase sustainability. The organization Healthcare without Harm has many resources for this. We can also push our organizations to invest in research and divest from fossil fuels.
  • Identify your state’s AAP climate advocate and ask to support, or become an advocate yourself. 
  • Be aware of your local Pediatric Environmental Health Specialty Unit (PEHSU), which works to integrate environmental health into clinical care and public health



Listeners will explain the effects of climate change on pediatric health and be able to discuss strategies to mitigate adverse health impacts. 

Learning objectives

After listening to this episode listeners will…  

  1. Identify five ways in which climate change can effect pediatric health
  2. Recognize key manifestations of climate-related health issues in pediatric patients
  3. Describe mitigation strategies and practical interventions that healthcare professionals can implement to minimize the health impacts of climate change on pediatric populations
  4. Recognize the importance of climate-informed healthcare policies and guidelines
  5. Discuss disparities in the health impacts of climate change 



Dr. Shah reports no relevant financial disclosures. The Cribsiders report no relevant financial disclosures. 


Engel S, Shah S, Masur S, Berk J. “#101: Tiny Patients, Big Planet: Pediatric Prescriptions for a Changing Climate”. The Cribsiders Pediatric Podcast. https:/ January 17, 2024.


Episode Credits

Producer, Writer, & Infographic: Sydney Engel FNP
Showrunner: Sam Masur MD
Cover Art: Chris Chiu MD
Hosts: Justin Berk MD & Sydney Engel FNP
Editor: Clair Morgan of
Guest: Shalini Shah DO, FAAP

CME Partner


The Cribsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit and search for this episode to claim credit.

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