Environmental health will become very personal


Raghu G. Mirmira, MD, Ph.D.

Earth Day 2022 has arrived – and gone. Gone, because the day is over, and for many, the message too. Earth Day is a call to action not just for one day but for a lifetime.

If you think about the terrible world events we’ve seen in recent years – cataclysmic floods, wildfires, extreme heat waves, melting polar ice – you probably think governments need to act, and I hope the Greta Thunbergs of this world or the Paris Agreement will eventually have an impact.

Beyond these more obvious consequences of climate change, there are environmental effects on our daily health. As healthcare providers, we see these effects daily in the course of our work, but perhaps we don’t recognize them, perhaps because we are often trained to see them as a consequence of the way we work. people’s lives, like genetic predispositions, or maybe just bad luck.

We are in the midst of a new era in health where we must consider more than just the biological determinants of disease. Our community, personal behaviors, psychological factors and environmental exposures are undoubtedly factors that weigh heavily on the risk of disease and accessibility to health care.

Environmental exposures that are difficult to quantify

At the University of Chicago Institute of Translational Medicine, these other determinants of health have collectively been referred to as the “sociome”. The problem with sociome – and environmental exposures in particular – is that, unlike the biological determinants of disease, it has no easily quantifiable measure, sometimes questionable contribution to disease, and can be so embedded in communities that it may not be obvious (think lead poisoning).

Unfortunately, even when we recognize a sociome contribution to a disease, we often dismiss it as hardly modifiable. The environment is particularly notorious because we view it as a fact of life and assume that there is not much a person can do about it. But when you think about any given disease, you realize that the data convincingly shows that personal health and the environment are closely linked.

Obesity and reduced physical activity affect the environment

Obesity is, by any measure, epidemic. According to Centers for Disaster Control and Prevention, obesity affects more than 40% of the American population. Consequences of obesity include diabetes, cardiovascular disease and cancers, as well as the worst outcomes of COVID-19.

In this context, there are health disparities among underserved populations, who face disproportionate burdens of obesity. In particular, the lack of availability of healthy foods in many underserved communities leads to the provision of cheap, high-calorie alternatives (and, yes, calories matter when it comes to obesity).

Farming practices focused on the production of highly processed foods represent a a third greenhouse gas emissions worldwide. The growing appetite for meat, for example, underpins global trends of deforestation to make way for cattle ranching and is unquestionably behind the current loss of the Amazon biome.

Of course, obesity is not driven solely by food consumption and food choices. The decrease in physical activity resulting from the use of motorized vehicles, in particular, reduces energy expenditure to the detriment of the increase in greenhouse gas emissions. In studycycling to work just one day a week has been shown to reduce an individual’s greenhouse gas emissions by more than 65% — and cycling to work can have the same effect as periods of exercises dedicated to weight loss and obesity. A win-win.

Environmental Disorders

Many other diseases are also closely linked to the environment. Particulate matter 2.5 microns or less (known as PM2.5) is often used as a quantitative measure of air pollution in the environment. Everyone may know that the exacerbation of lung diseases such as asthma is closely related to the prevalence of PM2.5 in the air.

But less valued are other disorders or impairments that we don’t normally associate with the environment. For example, vitamin D deficiency is closely linked in pm2.5 exposure. And, related to the ongoing pandemic, vitamin D deficiency is associated with more severe COVID-19[FEMININEOtherdisordersrelatedtoPM[FEMININEAutrestroublesliésauxPM2.5 include low birth weight (and did you know that low birth weight is a risk factor for obesity in adulthood?), thyroid disorders, infertility (think of the alarming situation decreasing world fertility rate), and certain types of cancer.

So where does this link between health and the environment lead us? The enormity of the health effects of the environment is enough to make you feel a personal sense of futility. It’s a justifiable feeling. As health-conscious individuals, imagine doing your part instead by reducing your own carbon footprint – for your own health, if not for the health of others.

If you’re a healthcare provider, spend a few minutes talking to your patients about the benefits of reducing their carbon footprint. It’s quite simple. How about walking or cycling to work 1 day a week, or just working from home once a week? We have already seen the global impact of work from home policies introduced during the pandemic – a stark global impact reduction in PM2.5 – so we know it works, but on a personal level you know you’re doing your part (not to mention the health benefits of walking or cycling).

Also, even if no one is telling you to go vegan, consider reducing your meat and dairy intake; it is believed that a diet that meets the recommendations of the World Health Organization reduce greenhouse gas emissions by 17%.

How about taking advantage non-traditional protein sources (cultured meats and insect-based supplements)? These alternatives may not seem acceptable today, but perceptions change over time. Some of these interventions are easier for some people than others, and we need to consider cultures and socio-economic status. But there is always common ground, and framing environmental issues around personal health often results in agreement. So as we reflect on Earth Day 2022, its theme of “investing in our planet” is as much about our health today as it is about the future of our planet.

Raghu Mirmira, MD, PhD, is a professor of medicine at the University of Chicago and director of the Center for Translational Research, which focuses on moving fundamental health concepts from the lab to the clinic. He is one of the leading NIH-funded diabetes and obesity researchers in the United States and has authored over 170 scientific papers on insulin production and its effects on organ systems. Follow Raghu on Twitter: @rmirmira

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