Assessing Perception and Knowledge of the Medical Community About Environmental Health

Abstract

Purpose: A stable climate has been an essential feature in sustaining our species over the last 12,000 years. Since the Agricultural Revolution, the consequences of humankind’s excessive carbon footprint on the global climate is a growing threat to human welfare. Anthropogenic climate change has already been implicated in health risks associated with air pollutants and other toxic exposures, spread of infectious diseases, particularly vector-borne diseases, and heat-related diseases such as heat stroke and renal failure. Climate change also poses substantial risks to the delivery of health care as it increases the risk of extreme weather events such as floods and hurricanes that can impair both access to care and medical supplies. Many medical educators argued that medical schools must teach students about the clinical relevance of climate change1 and environmental health issues more broadly so students can be informed advocates for their future patients and vulnerable populations they will be caring for. Methods: This research project surveyed current Harvard medical and dental students via an online survey and conducted one-on-one interviews with Harvard teaching faculty. Analysis included Likert scales with statistical measures and qualitative analysis with NVivo software. Results: 128 out of ~800 students (16%) provided survey responses. 20 Harvard teaching faculty who either teach in the core curriculum or are involved in curriculum design were contacted and 16 were interviewed. Students reported that they understood environmental health slightly to moderately well (mean 2.43, Std. Dev. 0.82). Relatively few students demonstrated knowledge of environmental health risks in comparison to other risks for disease. Students mostly stated that they felt not at all to a little prepared to address environmental health issues (mean 2.02, Std. Dev. 0.92). Students endorsed the idea that new curriculum should be introduced in the pre-clinical years either in the Essentials courses or integration over several curricula and taught in small groups along with short videos. Faculty reported that successful implementation of a robust environmental health curriculum required: a faculty advocate, alignment with Harvard Medical School’s learning objectives, relevance to the practice of medicine, and would help foster well-rounded physicians. Conclusions: This study identified both a student and faculty perceived gap in education around environmental health. Responses from both students and faculty highlight several methods in which environmental health curriculum could be implemented and that there could be benefit to the inclusion of such content at Harvard Medical School.