Pollution as a Public Health Crisis

To the Editor: A harried plane ride in the middle of the night from Hawaii to Maryland landed a mother and her child in our dimly lit pediatrics office. The mother’s voice wavered as she recounted the acrid smell of gasoline in their water, strange symptoms of shaking, nausea, and migraines, and finally learning that a jet fuel leak had been polluting their water supply for months. Their friends and neighbors had gone to doctors, most of whom were baffled by the strange constellation of symptoms. I was equal parts shocked and ashamed to know so little of this event that was decimating the health and safety of an entire community. As health care professionals, we have a duty to understand how environmental health factors affect the day-to-day lives of our patients. Our role does not end with providing treatment but must extend to taking action as community members, voters, and advocates. The biopsychosocial models of wellness and human flourishing emphasize how each of our interactions with patients is embedded in a richer context. As environmental public health crises are often deeply entrenched in structural racism and poverty that exacerbate health disparities, it is imperative for health care professionals to promote the voices of affected communities and use our power to invoke policy change without commandeering the conversation. 1 My lack of knowledge about this mother’s experience was incendiary. While I cannot hope to understand the complex mechanisms of every world event, I have a responsibility to learn more about the conditions that contribute to my patients’ health concerns. Our electronic health record note prescribed further blood testing, symptomatic treatments, and social support. Yet, my night was spent poring over articles and writing emails to state and federal officials about the connection between pollution and public health and the need to intervene to protect the communities in Hawaii that have been affected by this fuel leak. As we explained that treating her family might be a lengthy and ever-changing process as their symptoms evolved, the mother looked at me earnestly and nodded, “I trust you.” Even when her trust had been broken by the structures meant to protect her family, she chose to place her trust in us. I will make sure it is worth her while

Health care · Political science · Public health · Public relations · Air Quality and Health Impacts · Climate Change and Health Impacts · Environmental Justice and Health Disparities · History · Law · Medicine · Nursing · Psychology

• An Overview of This Year’s Trainee-Authored Letters to the Editor

  Open Access•Lala L Forrest, Laura Blyton•Academic Medicine•2023

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