The Impact of Climate on Child Health – PediaCast 474

Show Notes

Description

  • Leyla McCurdy and Dr Perry Sheffield visit the studio as we explore climate and its impact on child health. We discuss the importance of environmental medicine and share ways pediatricians and parents can make a difference in the health and wellbeing of kids and families around the world. We hope you can join us!

Topics

  • Environmental Medicine
  • Children's Environmental Health Day
  • Climate and Child Health

Guests

Links

Transcription

Announcer 1: This is PediaCast.

[Music]

Announcer 2: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello, everyone, and welcome once again to PediaCast. It is a pediatric podcast for moms and dads. This is Dr. Mike coming to you from the campus of Nationwide Children's Hospital. We are in Columbus, Ohio. 

It's Episode 474 for October 1st, 2020. We're calling this one "The Impact of Climate on Child Health". I want to welcome all of you to the program.

So, we have made it through a very eventful spring and summer. And now, we stand at the beginning of October and a new season of life, the fall.

0:01:09

And I have to tell you, autumn is my favorite time of the year, at least here in the Midwest region of the United States. The air becomes crisp but not yet cold. It's time for jeans and sweatshirts. The leaves will soon turn brilliant colors before falling from the trees and creating a crunchy carpet beneath our feet.

Kids have returned to school. Baseball is wrapping up with the playoffs already underway and the World Series coming soon. College football has started despite its myriad of controversy. Pumpkin spice latte and other seasonal treats have made their debut and trick-or-treating will soon arrive in the neighborhood, all of which reminds us that the ebb and flow of life go on.

And even though these things are different this year, with physical distancing and face coverings and empty stadiums, the joys of life can and will go on. We must simply pivot in the just course as we hold the virtual hands of our family and friends and take life as it comes. Different this year, yes, but still the life that we know and love.

0:02:21

October also brings an important day as it turns out, October 8th, to be exact, so that's coming soon in the form of Children's Environmental Health Day. And it's an important day because the research is clear, the environment affects our health. It impacts the lives of our children and families. 

And so, in an effort to raise awareness about this relationship, we are going to explore the impact of climate on child health. And the folks who put Children's Environmental Healthy Day together, each year, they pick a focus that relates to environmental health, as that then relates to children and families. And this year, their focus is on climate and climate change.

0:03:07

To help us with the conversation, I have a couple of really terrific guests along for the ride. Leyla McCurdy is an Environmental Medicine and Public Health expert with the Children's Environmental Health Network. And Dr. Perry Sheffield is a pediatrician and associate professor of Environmental Medicine Public Health and Pediatrics at the Icahn School of Medicine at Mount Sinai in New York City. Really quite please to have them with us this week.

Before we get to them, I would like to mention an opportunity for the health professionals in the crowd, especially my fellow pediatricians. The American Academy of Pediatrics has put together a virtual course called Harnessing the Power of Traditional and Social Media in Health Care. And it's happening on November 14th and 15th on a computer screen near you. 

0:03:58

In a world of fake news, bias reports, misleading social and digital content, it's very important for child health experts to employ effective communication and engagement strategies on television, radio, podcasts, newspapers, magazines, blogpost, websites, social media channels like Facebook, Twitter, LinkedIn, and Instagram. However, this is not something that we are typically taught in medical school or residency training quite a bit like climate effects on health. We don't learn a lot about that either.

And in terms of communications, learning these skills takes time and lots of mistakes. So, here's what the American Academy Pediatric is offering. It's a virtual conference which you can attend from the comfort of your home while learning from healthcare communication experts who have made mistakes before you, and hopefully will be able to share their knowledge and prevent you for making similar mistakes they learned by doing. 

And they're ready to share what they know with you in live and recorded sessions on November 14th and 15th with recordings online and accessible to attendees even after that date.

0:05:06

Details and registration are available at the landing site for the course. And I will put a link to that in the show notes of this episode over at pediacast.org, Episode 474. Early bird registration is a $150 if you sign up by October 26th. And then, as a bonus, you can earn up to 17.5 hours of Category I Continuing Medical Education Credit and 10 points of MOC II credit for those who are maintaining their certification with the American Board of Pediatrics.

Again, links to details and the registration will be available in the show notes over at pediacast.org. I will be there, well, virtually and I hope to see you if you are a pediatric provider in the crowd. 

Couple of reminders, I want to remind you, you can find PediaCast wherever podcasts are found. We are in the Apple and Google podcast apps, also iHeart Radio, Spotify, SoundCloud, Amazon Music and most other podcast apps for iOS and Android.

0:06:05

If you like what you hear, please remember to subscribe to our show so you don't miss an episode. Also, please consider leaving a review wherever you listen to podcasts, so that others who come along looking for evidence-based child health and parenting information will know what to expect.

We're also on social media and love connecting with you there. You'll find us on Facebook, Twitter, LinkedIn, and Instagram. Simply search for PediaCast. We also have a Contact link at the website if you like to leave a comment or suggest a topic for a future episode of the program. Oh, that, by the way, the Contact link is at pediacast.org

And then, got ahead of myself, I do want to remind you the information presented in every episode of PediaCast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. So if you have a concern about your child's health, be sure to call your healthcare provider. 

Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement which you can find at pediacast.org.

0:07:07

So let's take a quick break. We'll get our expert guests connected to the studio. And then we will be back to talk about climate and its impact on child health. It's coming up right after this.

[Music]

Dr. Mike Patrick: Leyla McCurdy is an environmental scientist and educator with the Children's Environmental Health Network and serves as chair of the Children's Environmental Health Committee for the American Public Health Association. She has shared her expertise with the Environmental Protection Agency, The National Institutes of Health, and the American Lung Association and she co-authored the book, Environmental Management of Pediatric Asthma: Guidelines for Healthcare Providers.

0:08:10

Dr. Perry Sheffield is a pediatrician and associate professor of Environmental Medicine and Public Health and Pediatrics at the Icahn School Medicine in Mount Sinai in New York City.

Both have a passion for raising awareness about the environment's impact on child health and promoting solutions and improve the health and well-being of children and families around the world.

That's what they're here to talk about, environmental medicine and the impact of climate on child health. So, let's give a warm PediaCast welcome to Leyla McCurdy and Dr. Perry Sheffield. Thank you both so much for being here today.

Dr. Perry Sheffield: Hi, Dr. Mike. It's nice to be here.

Leyla McCurdy: Hi, Dr. Mike. Thank you so much for giving us this opportunity to talk to parents about children's environmental health and climate change.

Dr. Mike Patrick: Really glad that both of you are able to stop by today. Leyla, I wanted to start with you. Tell us first about the American Public Health Association and its Children's Environmental Health Committee that you serve as chair. What exactly is that organization? What do they do?

0:09:08

Leyla McCurdy: Again, thank you, Dr. Mike. Children's Environmental Health Committee is a topic-focused committee under the Environment Section of the American Public Health Association led by volunteers who are all members of the American Public Health Association.

The goal of the Children's Environmental Health Committee is to increase awareness and promote collaborative efforts to reduce environmental health risk to children where they live, learn, and play. The American Public Health Association was established nearly 150 years ago and is dedicated to improving the health of the public and achieve equity in health status.

American Public Health Association also see this climate change a health emergency and has been working to inspire action, advance policy, and galvanize the field to address climate change for many years, and most recently established the Center for Climate Health and Equity.

0:10:12 

It's an honor to be here with Dr. Perry Sheffield, who is not only a leading pediatrician but she's also a valuable member of the American Public Health Association. And I'm delighted to serve with her on the Center for Climate Change and Health and Equities Advisory Board.

Dr. Mike Patrick: That's really great. And we're going to put links, so folks can find it more about the American Public Health Association. 

I also mentioned the Children's Environmental Health Network which really has lots of great educational information for parents and families and educators. Tell us a little bit more about that organization that you work with, the Children's Environmental Health Network.

Leyla McCurdy: Certainly. The Children's Environmental Health Network is a national organization established almost 30 years ago to protect the developing child from environmental health hazards and promote a healthier environment.

0:11:11

And climate change is a priority issue for Children's Environmental Health Network because children are particularly vulnerable to health impacts of climate change. We had many resources for parents on our website which is www.cehn.org.

Dr. Mike Patrick: Great. And we'll put a link to that in the show notes again for this episode, 474, over at pediacast.org.

Dr. Sheffield, tell us about your work with the Pediatric Environmental Health Specialty Unit and the New York State Children's Environmental Health Centers. You guys there in New York have really put a priority on climate and its effect on children's health, right?

Dr. Perry Sheffield: That's right. And like Leyla said, it's an honor to be here. And Leyla is one of my heroes. She's been a champion of children's environmental health for a long time. 

0:12:03

I remember her at a meeting over a decade ago when I was a newly-minted pediatrician just starting my specialty training in environmental health, going to a public health meeting and meeting Leyla who had been at it for a long time and still is. And just so clear about what we need to do as a community of concerned individuals in this country to, as you said, really improve environmental health for children.

And so, it was through that interest that I started working with a national group called the Pediatric Environmental Health Specialty Units. We call it the PEHSU. 

And then, more recently, a state-based network that just got formed a few years ago called the New York State Children's Environmental Health Centers Network and we call that NYSCHECK. And those two groups are really to help train doctors and nurses to better address environmental health for children. 

0:13:06 

It's something that is not taught very much in our training and that was realized by some forward-thinking folks at the CDC many years ago. And this is their effort to try to fill that gap. And we hope that someday, there will be statewide networks all across the United States. 

But right now, the only one that exists in the country is in New York. But the national network of the PEHSU does have experts around the country that try to work for this effort.

Dr. Mike Patrick: And again, we'll put links to those organizations in the show notes so folks can find out more information. And then that leads us into Children's Environmental Health Day, which is coming up on October 8th, 2020. And this is really to help raise awareness and provide an opportunity to educate families, kids, parents about the environment and its impact on health. 

0:14:04

Leyla, tell us a little bit more about this special day and why it's important.

Leyla McCurdy: Thank you, Dr. Mike. Thanks for that great summary of what Children's Environmental Health Day is. Yeah, the day was established by the Children's Environmental Health Network as an annual event observed on the second Thursday in October. And as you said, this year falls on October 8th. 
And it's a day to raise awareness, mobilize society to take action on children's environmental health issues and involves many national network organizations across the country, like the network of the Pediatric Environmental Health Specialty Units. And, of course, Dr. Perry Sheffield already described that network to us, which is a leading member of the region, too.

0:15:01

And so, recognizing that climate change is the greatest public health threat to the physical and mental health of the children, the Children's Environmental Health Committee, in collaboration with the Children's Environmental Health Network, is focusing on climate change on Children's Environmental Health Day, this year specifically.

Parents have a critical role in protecting their children from the health impacts of climate change and educating their children about the issue. We encourage parents to get actively involved in this effort by participating in the Children's Environmental Health Day in October and making every day Children's Environmental Health Day. Our children deserve it.

Dr. Mike Patrick: Absolutely. And there's so many ways in which the environment can impact the health of kids and families. And as you mentioned, climate change is one of those ways. And in order to raise awareness and really help educate about this problem, this year, the Children's Environmental Health Day is really focusing on that.

0:16:08

And it's not just your organizations that are concerned about this. The American Academy of Pediatrics has lots of resources about climate change that I want to share with my listeners. Number one, How Climate Change Affects Children. Another link, Climate Change and Children's Health, Learn More About Climate Change, and A Call to Action: Climate Change and its Effects on Pediatric Global Health. Again, these are all resources from the American Academy of Pediatrics.

And one of the things that can really help parents understand what's going on with the climate and how it can impact children's health is the Climate Change Fact Sheet from the Children's Environmental Health Committee. Tell us a little bit more about that.

Leyla McCurdy: Certainly. We are delighted to release this new climate change and children's health fact sheet in conjunction with this PediaCast in celebrating the Children's Environmental Health Day. 

0:17:10 

It is a very appropriate tool to be used with all audiences. It summarizes some of the key facts about how children are impacted by climate change. And it is based on latest science on climate change and children's health. 

We based it on the policy statement that APHA adopted couple of years ago, Children's Environmental Health framework. And again, it's totally evidence-based and there are links provided to the articles. And everyone can use it with confidence with their audiences.

0:18:02

Dr. Mike Patrick: Great, great. Thanks. So Dr. Sheffield, I want to pull you in. Tell us how is it that climate and climate change impacts child health. Can you give us an overview of the problem?

Dr. Perry Sheffield: Sure. So, I couldn't agree with you more that climate change is real and that we know that humans have a role in creating the problem. But the good news is that we have a lot of healthy and safer solutions that can protect children's health now, while we're also doing things to prevent worsening climate change. And so, that's the good news part of the story that sometimes can feel overwhelming.

So, children have so many ways in which they are affected by our environment and specifically by the changes that the changing climate is bringing. One of the things that we talk about the most has to do with respiratory health or asthma, for example. And we can think of examples from all over the country.

0:19:08

So right now, a lot of people are thinking about the wildfires out west and we know that climate change has a role in those, both in causing long periods of drought, by causing invasive beetle species to move to higher altitudes and kill tress that then can set fire more easily when there's the right conditions. That's out west.

We know that closer to where you are in Ohio, there's been issues with algae blooms. And those actually can have respiratory effects and affect our ability to use and play in water, in recreational water bodies.

Here, closer to home, we think a lot about rainfall. We get a lot of rain in this part of the country all up and down the east coast, whether or not that's hurricane related or just big storms. And that can lead to flooding and mold. And the mold is a big driver of our respiratory health. Just annoying allergies are actually very potentially dangerous asthma attacks.

0:20:13

Dr. Mike Patrick: And really, not only respiratory illness as we think about climate but even heat-related stuff. So, as the temperatures go up, we worry about heat exhaustion, heat stroke, dehydration can really affect student athletes for sure and others too, right?

Dr. Perry Sheffield: That's a great example. Yeah, that's actually very near and dear to my heart. It's something I do research on, as I was a student athlete who experienced heat exhaustion, actually, as a teenager. I think that the foundation was laid very early for me to know that there was a serious risk.

There's also some really interesting evidence. So students, and student athletes, as you said, are probably one of the main ways that we think about increased heat waves or hotter days can affect children. And there are certain things that we can do to take precautions, whether that's changing practice times that some sports team are implementing or just making sure that there's very close attention to hydration status and making sure there's appropriate water breaks and things like that.

0:21:18

But heat, also, it turns out has insidious or less obvious effects. And some of that evidence is emerging around how children learn. And it turns out during hotter weather, learning is actually impaired. 

And then, also, how babies grow in utero, and so we're learning more and more how pregnancies are affected and how the outcomes of those are affected, either shorter pregnancies. And we know that prematurity is not only a big health cost, but also a health burden for families, but then also things like lower birth rates.

Dr. Mike Patrick: You had mentioned the migration of beetles and how that can impact the forest and then in turn impact wildfires. 

0:22:03 

Hearing them in the Midwest, one thing that we've seen that's also been insect-driven is the increase of Lyme disease, as we see more blacklegged ticks or deer ticks into this area. Does climate change impact the migration of those insects?

Dr. Perry Sheffield: Yeah, that's a great example and you have to pardon me because sometimes I geek out on this, because it is kind of amazing, how the ecology and how everything is connected to these webs of life. 

And so, climate is both lengthening the season in which ticks can do their thing and replicate. And then, also people are getting outside, and though it's winter, when it's warmer and then potentially being exposed. We had a case of Lyme disease from someone in Chicago in the winter, actually. 

And so, pediatricians are having to change their advice that they give families about when precautions are needed. And even raise our awareness of what we have to think about in terms of what might be the diagnosis when a child comes in with a rash or fever or symptoms that might line up with tick-borne illness.

0:23:14 

Not only is it lengthening season but the warming weather also affects how those little bugs inside the bugs, the things that cause us to get sick. Because it's actually that something that the tick carries that creates Lyme disease, how those things replicate or how fast. And so, it gets into those fascinating and really interesting entomology and pathology of infectious disease, but yes, you're right.

Dr. Mike Patrick: I used to be practicing in Ohio, that you'd really think about Lyme disease of someone had traveled to a place like Connecticut, your neck of the woods, and come back. But now in recent years, we're seeing many cases of Lyme disease that's contracted here in Ohio.

Dr. Perry Sheffield: And expanding range, I left that one out, but that's a critical one. Exactly.

0:24:05

Dr. Mike Patrick: Yeah. I mean, it really is a true change. And then, as you talk about floods, water-borne illnesses, you have stagnant water that's around. And, of course, flooding can also impact agriculture. And so this then affects food chains and food availability, correct?

Dr. Perry Sheffield: All of that right. There's actually some of the most interesting work, I think sometimes, with some of the climate health connections we think, somewhere not here, not in my city, for example. But it's actually there was some interesting work that showed that rates of diarrheal illness, not just in rural communities with wealth but in municipal water systems, when they were heavy rainfall events, there were more children that ended up coming to the emergency room for things like diarrhea. And so they were getting affected, too. 

And we know as you just said, there's runoff from either agricultural areas or in cities where many of our cities in America have combined sewers. So waste water coming out of homes and other buildings is getting mixed with the water that comes off the street, the rainwater.

0:25:13

And sometimes that overwhelms our wastewater treatment systems. And so that leads to water advisories and sometimes beaches getting closed. But it also can contaminate food sources. 

Dr. Mike Patrick: And really, as we think about some of the natural events especially the high impact ones as wildfires, hurricanes, bad floods, physical injuries are another thing we have to worry about with our kid and families, right?

Dr. Perry Sheffield: Right. And we think about that most commonly in related to things like high wind events and that's a concern. Interestingly, some of the heat research that we've done is actually showing that more children are getting injured during hot weather. And that's something that my team in Mount Sinai in New York is delving into more because we're not exactly sure why.

0:26:03 

We have some ideas, maybe children go in to a playground on a hot day and falling off the monkey bars. But we also know from studies that have worked with adults that heat can change sort of our mood, if you will. And sometimes there are incidence of increased aggression between adults. And so related to warmer weather. And so, we're wondering actually if children are affected by that, too.

Dr. Mike Patrick: That was the next topic on my list here was mental health. Climate really can affect mental health in many ways and Leyla had alluded to this as well. What sort of things can we expect the climate to do in terms of mental health in kids?

Dr. Perry Sheffield: Yeah, that's a great point. So, we are learning about how in those are subtle ways it might be affecting our mood and our mental health. 

We know there's great evidence that when there are extreme weather events, there are major disruptions in people's life routines. And we know that actually routine, routine, routine is probably one of the most important things for children's wellbeing. And so, every family in America has probably had a crash course in this in the last seven months here with the COVID epidemic.

0:27:20

So, climate can affect mental health in that way, that it can disrupt routines and it can either close schools and childcare centers, close places of work which has other effects on family, obviously. Or it can do things like displace families or close healthcare centers. So, all of those things are disrupt routines.

Leyla McCurdy: And good mental health aspects which is neglected mostly, right? And, Perry, thank you so much highlighting that. I mentioned in our fact sheet that the reference, a policy statement from American Public Health Association that's specifically focuses on children's environmental health. But they also referenced another policy statement from the APHA specifically focused on the mental health impacts of climate change.

0:28:18 

And again, those links are part of the fact sheet that Mike kindly offered to post, so those are really great resources for parents to use in whatever way they want to get involved with protecting their children from climate change.

Dr. Mike Patrick: And when we think about the things that families need, I mean, certainly housing, we've talked about water and food and we're seeing more and more insecurities of these things, even in suburbs. And climate has a role to play and these problems, too.

Dr. Perry Sheffield: You're right. There are things like food and nutrition insecurities that are happening. I guess I want to answer that question in two parts. One is sort of on a macro level, one on micro level because it's interesting and important.

0:29:15

So in the macro level, I would say that one of the most striking examples that I can think of had to do with after Hurricane Maria in 2017 that affected Puerto Rico and the Virgin Island so starkly. And we as a country had to take very big measures quickly because food and security was a real issue, partly because most of the foods that gets consumed in a place like Puerto Rico is imported. And when the harbors were full of debris and boats couldn't come in there quickly, we had to think of alternative solutions to make sure that that whole island, those three million people that live there didn't get cut off.

So that's a big example that took policy shifts and big emergency funding to sort of respond to an emergency and acute event.

0:30:06

The micro example is another really interesting science lesson that we are learning, that as our carbon dioxide levels go up and plants¸ particularly crop plants, get excited about that. They use carbon as a fertilizer, they tends to actually take in more carbon and they actually displace some of the things that are good for nutrition, more important for nutrition. Some of them micronutrients and some of them proteins.

And so, as a global health issue, thankfully in this country, micronutrient deficiency is not a huge health driver but certainly globally that is. And this is something that a lot of folk start to think about, how climate change particularly through this mechanism of the carbon dioxide fertilizing, basically being in the air and the plants taking it up, is changing the actual nutrient content of food, whether or not that's lower protein in a rice grain or lower zinc in another food crop. Those things have big impact on child's health both on how they grow and how their bodies are able to fight infections.

0:31:18

Dr. Mike Patrick:  And you mentioned that this is more of a concern at the present time in other areas of the world and not so much in developed countries like the United States. That can easily change, right?

Dr. Perry Sheffield: It could. Certainly, partly because we are a global system and particularly, I don't know if you meant to go this way, but I think immediately about migration. And if certain parts of the world are unable to support families and communities with the food that they need to grow and thrive, then the families do what families have been doing for thousands of years, is they move to try to find their places. And so, there's huge shifts in population that are being affected by climate change, partly driven by food insecurity.

0:32:04

Dr. Mike Patrick: And then that has impacts down the road. That's not an isolated event. And there's an impact on that movement both in terms of the cost financially, and also physically, mentally, on the families that are moving, and then also on the folks who have families moving in with them. It really does impact and affect all of us together as a global community.

You had mentioned COVID. It's hard not to do a podcast these days and not at least mention COVID. But I wanted to bring in this idea that climate also impacts our immune system. Tell us about that.

Dr. Perry Sheffield: There are a lot of potential ways. I'm going to go back to one example that we've talked about earlier when we're talking about mental health. We actually are learning that levels of stress, particularly chronic stress affect our immune system. And certainly, many things of the things that we're talking about related to climate change are stressors. So that's one mechanism.

0:33:07

But then, we're also learning, some of my work is focused on air pollution and not only I mentioned earlier, how respiratory health is affected by air pollution. But we also are learning that our immune system health is also affected by air pollution. So, there's a lot of different ways that climate change is affecting the immune system.

Dr. Mike Patrick: This is really an evolving area of study, I feel. And there was a NIH study that, as a twin study, looked at the environment's impact on their immune system. So you have kids, they have the some genetics. These are identical twins but then they're separated, they live in different environments.

And I'm going to put a link. It's such a fascinating study and I'll put a link to it, immune system shaped by environment more than genes.

And then, there is an article that was really written for students that really breaks this down. It's called Immunity: Environment Can Have a Big Impact. It's based on these twin's study and explains it in terms of really easy to understand. I'm going to put links to both of those in the show notes for folks to check out over at pediacast.org, Episode 474.

0:34:19

Do you think climate has impacted the COVID pandemic?

Dr. Perry Sheffield: Yes. Where to begin, right? Something that we have talked a lot about in the last seven months are frontline communities. 

But something we were talking about in the climate and health world before COVID was frontline or sometimes called fence line or communities that are disproportionately affected by the impacts of climate change. Whether or not that's literally frontline on a coast or frontline in terms of, as you said, the families that are affected by the spreading tick populations or the pollution that's coming from things like wildfires, or the families that were previously in inadequate housing that then really suffer the brunt of an extreme weather event.

0:35:14

So all of those things, we already were very acutely aware of the frontline communities. And it turns out there's a lot of overlap between the two. And so many of the communities that have been most affected by COVID particularly Black and Brown communities and lower income communities in this country have also, have been, are, and are expected to be the most impacted by climate change.

Dr. Mike Patrick: So, we've talked about climate and how it can impact kid's health. What can parents do? What are the action plans that the folks should really take home away from this conversation?

Leyla McCurdy: Again, Mike, thanks so much for giving us the opportunity to check to parents about this most important issue. And, obviously, parents are extremely critical in the well-being of children. And there are many, many things parents can do.

0:36:12

It depends what you want to choose to do at what level. One way is very simple. If you have not been engaged in any of the activities before in your community, you may want to check out the Children's Environmental Health Day website, which I'll come back to later. But again, you could just get involved in a community activity in your own neighborhood.

And one of the critical ways that parents can actually help your children is to talk to them about this issue because children are very aware, as we all know as parents. Children do not miss a thing. They know what's going on and they are impacted by it.

0:37:13

They may not know how to talk about it and it falls on us as parents to talk to them gently and to probe them to understand where they are and bring them along slowly. And if they are interested, of course, age appropriately, we can engage them actually to do certain things to help protect the environment, to protect themselves. 

And so, those are things that can be done very easily. There are a lot of resources online which will be posted as part of this PediaCast. One of the things that we have done as the Children's Environmental Health Committee is to create a toolkit for parents and teachers. 

0:38:07

And, of course, with many schools being close right now, I think it has become more of a parent toolkit than teacher toolkit but there are resources in that toolkit grouped by age that talk about climate change. And this is also another opportunity to explore other environmental health issues which many of them tie to climate change, but still.

There's a spectrum of what parents can do. Again, it depends on what you choose to do. There are great opportunity for efficacy both in your own community and at the state level and even federal level. 

So, I'll just close with that. I'm sure I left out some things but hopefully those spark some ideas.

0:39:08

Dr. Mike Patrick: Yeah. We're going to have a ton of resources in the show notes. And I think you make a really great point that even just beginning with educating ourselves, talking about these things with our kids and what they're concerned about. But I also think on the community level, it not only impact with awareness and education surrounding the effects of climate and change. But then, looking at the disparities of how climate affects different members of our communities in different ways. 

When you think about families who may not have air conditioning in the summer time, who do have food insecurities. And so how can we really as neighbors and as fellow community members come together and help other families who maybe in less fortunate situations than ourselves and really getting our kids involved on that level can also be important. What other ideas do you have, Perry?

0:40:02

Dr. Perry Sheffield: Yeah, I agree. I think that there are so many benefits from coming together as a community. We know both in just improving our health and sense of connectedness on a day-to-day basis. And then we know that having a strong community networks after big events like storms or other disasters are critical for our community resilience.

When I think about what parents can do, the first thing I think about is what parents are already doing. Parents are doing so much to nurture their child's mind and body. So in that same vein, it's thinking just doubling down on some of those things. 

We talked about the importance of routines earlier. And they've had a whole other PediaCast on sleep and how important that is. So the routine is what helps support the sleep routine, too. And we know that sleep is critical for being in a state that we can fight infections, that we can learn well in school, all of those things. 

0:41:05

Making space for children's big feelings. As Leyla said, children are aware that the adults are talking about something big trends, boundary, many-year problem like climate change. And so talking about that and giving space for children's feelings, but then being able to reassure them with a plan. 

And it comes right back to what you said Dr. Mike about being connected to other people in the community. They're working together because this is a problem that's bigger than any of us.

And then in environmental health, particularly in pediatric environmental health, we try to be very careful to not the burden on already burdened individuals. We are all managing a lot to just keep our families running. So binding together with other community members is really what help us be able to do that.

And then, the other thing that I would say is thinking about healthy diets. We know that plant-based diets, yeah, probably all of us could shift. If you're not already vegetarian or vegan, we probably could all make some healthy shifts toward more plants, which we know is good for our body. And we know it's actually good for the planet too because it takes less resources to grow those grains and vegetables and fruits than it does to raise animals that we consume.

0:42:21

Dr. Mike Patrick: As we expand our thoughts on community schools and, of course, schools look a lot different these days than it did just a year ago but there many ways in which schools can also raise awareness and educate families on the threats that climate can bring. 

Dr. Perry Sheffield: Yeah. Leyla mentioned the toolkits that have been developed at the National Institute of Health. Their Environmental Health Institute has a curriculum that they've developed. So there's a lot of great tools that are coming out that teachers can use that are already compliant with all of the many requirements that teachers have to meet but then can also teach children about this. And then, children in turn can drive not only their parents to make changes, but probably the questions they even ask their pediatricians that can drive changes.

0:43:16

And so, there's lot of learning opportunities as you heard in this PediaCast. I get excited about the myriad and the really interesting ways that weather is related to bugs and is related to human health. And all of those amazing interconnected is really a very cool science lesson, too.

Leyla McCurdy: Perry, thanks for mentioning the National Institute of Environmental Health Science Curriculum. That's a K-12 curriculum. It was specifically designed for high schools but can be adapted for earlier ages. And it is a part of the toolkit that Children's Environmental Health Committee put together. 

0:44:01

So, you can look at the link of the toolkit and you will be able to pull that up. And I'm very supportive of the use of that by teachers at schools. It's a terrific curriculum.

Dr. Mike Patrick: Yep. And we will definitely put a link to that in the show notes as well. What about the medical home? As you practice pediatrics and you engage with young patients and families, what sort of topics do you bring up in the exam room as it relates to climate?

Dr. Perry Sheffield: We at the New York State Children's Environmental Health Network that you mentioned has landing page about climate change. And we have some specific tools because as we have said several times, these conversations are important ones to be having. And so parents can start the conversation if the pediatrician, or whoever the practitioner and the medical home is, isn't initiating the conversation or making those connections. 

0:45:03

So whether or not it's talking about the importance of being vigilant about ticks for a new parts of the country or longer seasons, or whether or not it's talking about how to identify leaks and humid condition that are promoting mold growth and how to safely treat those, how to safely get rid of pests through something called integrated pest management. So we know that roaches are trigger for asthma, but we know sometimes that the way we have treated them in the past with big aerosol pesticides actually can cause asthma problems, too.

So there's all these interconnections that we know that humid conditions can lead to more roaches and that's a type of climate change, for example. But there are safer ways that we need to address those issues to not create other problems.

0:46:00

Dr. Mike Patrick: And as we think about do we sort of started this off talking about respiratory illnesses and allergies and asthma. And just even making some changes in your own local climate inside your house can make a big difference. And that's one other ways that pediatricians can really help advise families on what are ways to allow your kids to breathe cleaner air. 

Dr. Perry Sheffield: Exactly. Never been more, a friend of mine this year was thinking about ventilation related to COVID and now dreams of clean air related to the wildfires out west. And we have families, I have numerous consults about families trying to figure how to get their indoor air quality improved. 

And if they don't already have fancy air filters, then they are jerry rigging one with furnace, filters, and box fans. And it turns out that that actually can make improvements, too.

And then some of the things that it might be changes in some of our habits, the way how much fragrance-containing cleaners we're using or whether or not we're choosing to burn incense. All those things affect, as you said, indoor air quality and your microenvironment. It's in our power to change them.

0:47:15

Dr. Mike Patrick: Absolutely. What I really hope, my ultimate goal for this episode of PediaCast is really for this to be a jumping off point, sort of launch points for parents, to really delve into climate and climate change and its impact on your family, on your child's health, and your community. 

And we're just going to have so many resources in the show notes this week. I mentioned some of them from American Academy of Pediatrics. We're going to have stuff from the Children's Environmental Health Network. We talked about a parent and educator information and advocacy kit.

There are so many things that we're going to have in the show notes that you can explore. I mention the show notes a lot. But this week, there's really going to be some great resources and that fact sheet that we talked about from Children's Environmental Health Committee.

0:48:07

So, Leyla, tell us once again about Children's Environmental Health Day and the work of the Children's Environmental Health Network. Just give us one more reason to go and check out those resources.

Leyla McCurdy: Thanks, again, Mike. And I really appreciate the opportunity to talk to parents about this issue. And they are so critical for the wellbeing of our children and, of course, they care deeply. 
And sometimes, as parents, we don't know where to turn. And I think this PediaCast is a good way for parents to start exploring, no matter where they are in terms of their knowledge and awareness about climate change.

0:48:55

And so, I think Children's Environmental Health Day is a really good starting point of getting engaged. Even if you just go on the web and go to Children's Environmental Health Network's website, cehn.org and check out Children's Environmental Health Day, you will see lots of activities. 

And many of them are in local communities. And so you could connect with an activity in your own community. And also, you could just look at the resources. And again, if you're so willing to get engaged in advocacy activities, there's activity resources link that will be provided to you.

And so, again, let me repeat the date. It is on Thursday, October 8th, but don't wait. Any time, you can get on. All these resources are available for you to do this work any time, any day. 

0:50:16

And also, I will remind everyone that October is Children's Health Month. And so, every day in October, we can think about Children's Environmental Health issues and climate change and take these tools and resources we try to share with you and start your own thinking and activities in this area.

And, of course, you know we have resources to you any time through the APHA website or through Children's Environmental Health Network website. You will be able to reach some staff that can help you with these activities.

And again, I want to thank Dr. Mike for starting this conversation. I'm looking forward to more. And, Perry, it's been a great honor to be on this wonderful PediaCast with you.

0:51:17

Dr. Perry Sheffield: Thanks, Leyla.

Leyla McCurdy: Thank you for participating.

Dr. Mike Patrick: Yeah. I really just appreciate both of you stopping by and talking about this. And again, be sure to check out all of those resources in the show notes over at pediacast.org for this episode. 

And so, we will close then with Leyla McCurdy, Children's Environmental Health Network and Dr. Perry Sheffield, Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai. Once again, thank you both so much for stopping by today.

Dr. Perry Sheffield: It's been a pleasure. We all want clean air, clean water for our children where they live, learn, sleep, eat, play, pray. We have a lot of common ground on this.

Leyla McCurdy: Yes. Our children deserve it.

[Music]

0:52:25

Dr. Mike Patrick: We are back with just enough time to say thanks once again to all of you for taking time out of your day and making PediaCast a part of it. Really do appreciate that.

Also, thanks once again to our guests this week, Leyla McCurdy with the Children's Environmental Health Network and Dr. Perry Sheffield, Environmental Medicine and Public Health expert from the Icahn School of Medicine at Mount Sinai in New York City.

Don't forget, you can find PediaCast wherever podcasts are found. We are in the Apple and Google podcast apps, iHeart Radio, Spotify, SoundCloud, Amazon Music, and most other podcast apps for iOS and Android. Please subscribe to the show wherever. And in any of those places that you listen, if you subscribe, you will be notified when new episodes are available. 

0:53:07

And then, don't forget that landing site, pediacast.org. You'll find our entire archive of past programs, all 474 of them. Also, show notes for each of the episode, our Terms of Use Agreement, and the handy Contact page if you would like to suggest a topic for a future episode of the program.

Reviews are helpful wherever you get your podcast. We always appreciate when you share your thoughts about the show, and we love connecting with you on social media. You'll find us on Facebook, Twitter, LinkedIn, and Instagram. Simply Search for PediaCast.

At the beginning of the program, I mentioned that American Academy of Pediatrics media course for healthcare providers. And we do have a lot of pediatric provider who listen to this podcast. But I want let all of you know, if you are a pediatric provider, so you take care of kids in a health setting, we have another podcast that's made just for you called PediaCast CME. 

That stands for Continuing Medical Education. It's similar to this program. We do turn the science up a couple notches and offer free Continuing Medical Education Credit for those who listen. 

0:54:13

And that includes, by the way, not only doctors but also nurse practitioners, physician assistants, nurses, pharmacists, psychologists, social workers, even dentists. And that's because Nationwide Children's is jointly accredited by many professional organizations, and so it's likely we offer the exact credits you need to fulfill your states Continuing Education requirements. 

Shows and details are available at the landing site for that program, pediacastcme.org. You can also listen wherever podcasts are found. Simply search for PediaCast CME. 

Thanks again for stopping by and until next time, this is Dr. Mike saying stay safe, stay healthy and stay involved with your kids. So long, everybody.

[Music]

0:55:09

Announcer 2: This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.

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