Climate change is a long-term change in the average weather patterns that have come to define Earth’s local, regional and global climates. Scientists attribute the global warming trend observed since the mid-20th century to the human expansion of the "greenhouse effect"— warming that results when the atmosphere traps heat radiating from Earth toward space. On Earth, human activities are changing the natural greenhouse. Over the last century the burning of fossil fuels like coal and oil has increased the concentration of atmospheric carbon dioxide (CO2). This happens because the coal or oil burning process combines carbon with oxygen in the air to make CO2. To a lesser extent, the clearing of land for agriculture, industry, and other human activities has increased concentrations of greenhouse gases. Gases that contribute to the greenhouse effect include: Water Vapor, Nitrous Oxide, Carbon Dioxide, Methane, Chlorofluorocarbons

Climate change has widespread current and potential health impacts on us. INCREASING TEMPERATURES: Heat stroke and heat-related illnesses Power outages during extreme hot and cold temperatures Increase frequency and distribution in vector-borne illnesses Increase in extreme weather events such as hurricanes, rain bombs, wildfires Increased droughts leading to poorer access to water and negative impacts on agriculture putting food supplies at risk and burdening farmers AIR POLLUTION: Exacerbation of multiple chronic illnesses including asthma, COPD, heart disease Lengthening allergy season Increased incidence of certain cancers, especially pulmonary FOOD AND WATER BORNE ILLNESSES: Diarrheal disease, including salmonellosis and campylobacteriosis, are more common in increasing temperatures and also in conjunction with both unusually high and low precipitation levels FOOD SECURITY: Shortages of key foods, especially in certain populations like Alaskan Natives Decrease nutrient content in foods - Elevated atmospheric CO2 is associated with decreased plant nitrogen concentration, and therefore decreased protein Increasing growth of pests and weeds will cause farmers to require increased use of herbicies and pesticides, exposing themselves initially then all consumers Livestock and fish production declines VECTOR BORNE ILLNESSES: Widening geographic distribution of diseases such as Lyme and Rocky Mountain Spotted Fever Longer seasons of many of these disease, increasing infection rates ALLERGIES: Climate change will potentially lead to shifts in precipitation patterns, more frost-free days, warmer seasonal air temperatures, and more carbon dioxide (CO2) in the atmosphere. This can lead to both higher pollen concentrations and longer pollen seasons.

1. What we're all meant to do... EDUCATE and ADVOCATE FOR our patients! You can educate your patients on the health consequences of climate change related to their disease(s). For instance, for patients with asthma and COPD, knowing to stay inside due to Ozone Action Days or teaching those patients about the Air Quality Index and how to use it to guide their outside activities https://www.airnow.gov/ For patients who enjoy outdoors activities such as hiking or camping, educate them about the potential increases in vector-borne illnesses and how to protect themselves. For patients with other chronic illnesses such as heart and kidney disease, educate them about the excaerbating effects of hotter temperatures and ensure to stay well hydrated, make plans on how to keep cool and avoid strenuous activities which can easily overtax these patients in hotter days. These are just a few examples. For further reading: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856872/ 2. Stay educated yourself about the frequently updated findings regarding climate change effects on health and specific diseases. 3. Start utilizing ICD 10 Codes that are specifically related to climate change and health.

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