Dr. Andrew Lewandowski Seeks to Incorporate Climate Change Advocacy Into Pediatrics
In 2015, the American Academy of Pediatrics (AAP) released a revised Policy Statement on Global Climate Change and Children’s Health, in which it advised pediatricians to incorporate the effects of climate change on health into the existing anticipatory guidance framework. Since then, understanding of the health effects of climate change has grown, but there are still few accounts of pediatricians offering climate change counseling in a clinical setting. Due to this, there is no existing literature that evaluates the effectiveness of this practice, representing a significant gap in research.
One person seeking to address this gap is Dr. Andrew Lewandowski, a full-time pediatrician, member of the Wisconsin Environmental Health Network (WEHN) steering committee, and passionate climate change advocate. Dr. Lewandowski has always been interested in the outdoors and realized during his pediatrics residency that he could integrate this interest in the environment into his work. Although climate change is not a straightforward sub-specialty of healthcare, Lewandowski is passionate about calling attention to the impacts climate change has on human health. “Air quality, water quality, and climate change are probably the three areas that I found some of the biggest impacts on the health of people in general, but especially as a pediatrician, the effects on children,” Lewandowski said in an interview with WEHN. With the publication of the AAP’s 2015 Policy Statement recommending that pediatricians talk about climate change in clinic, Lewandowski was reminded that work to emphasize the intersections between climate change and health in pediatrics is well overdue. “If new ear infection guidelines came out, I’d expect that we would have all adjusted within a span of three years,” Lewandowski said. Now, six years since the AAP’s Policy Statement, climate change remains a rare topic of discussion in clinic.
In an attempt to put the AAP’s recommendations into practice, Dr. Lewandowski began including a forty-five second standardized message about the effects of climate change on children’s health in his patient visits. Patients who received this message were then asked to complete post-counseling surveys designed to assess patients’ knowledge gained as a result of the counseling, intentions to change their energy use behaviors, and degree of support for clean energy initiatives. Lastly, the surveys measured the influence of political orientation on these outcomes. After realizing that the data collected from these surveys could provide valuable insight into the effectiveness of pediatric climate change counseling, Lewandowski turned this project into a study published in The Journal of Climate Change and Health and co-authored by Drs. Perry Sheffield, Samantha Ahdoot, and Edward Maibach.
Dr. Lewandowski and his colleagues found that a large majority of participants learned more about the health effects of climate change during their clinic visit, and were likely to engage in energy-saving behaviors and support clean energy initiatives as a result of the counseling they received. Somewhat surprisingly, patient responses across various political identities were generally similar, despite the politically controversial nature of the topic of climate change. These results support Lewandowski’s notion that at the end of the day, “Everyone is in favor of doing the best they can to make sure that the health of their children is ensured.” Because of the unique trust that people have in their healthcare professionals, especially pediatricians, Lewandowski believes climate change shouldn’t be any different than the other politically controversial topics providers are obligated to talk about.
In addition to the controversial nature of climate change, its uniqueness compared to other topics related to health can serve as an obstacle to physicians talking about it in clinic. Unlike specialties such as cardiology and pulmonology, climate change advocacy as it relates to human health is not something Dr. Lewandowski gets paid for. As a full time pediatrician, father of three kids, and member of various boards and committees, it is a challenge for Lewandowski to fit climate change advocacy into his schedule, but the urgency of the crisis motivates him to continue this work. “[Climate change] is an environmental crisis, it’s an environmental emergency that is amplifying and accelerating human disease,” Lewandowski said. “So in many ways, not advocating for this, regardless of what sector of health you’re in, in my mind is a huge mistake.”
By demonstrating the effectiveness of climate change counseling by pediatricians, Dr. Lewandowski’s study has opened the door for other healthcare professionals to begin incorporating advocacy into their work. However, the study is not without limitations. Given the small size of the study, one of these limitations is the racial homogeneity of Lewandowski’s patient population, which primarily consists of white southern Wisconsin residents. “I would love to get a better sense of how this kind of messaging is received in clinic settings that would be very different from my own,” Lewandowski said. Additionally, he would like to see future research highlight climate justice by focusing more on the inequities in climate change impacts on different populations. Larger studies of the same nature as Lewandowski’s would have greater capability to assess the disproportionate effect of climate change on children, pregnant women, the elderly, people with chronic medical conditions, rural populations, and racial minorities. While small in scope, Dr. Lewandowski hopes that his study can serve as a stepping stone that gives physicians the confidence they need to talk about climate change in clinic.
Going forward, Lewandowski plans to continue advocating for the incorporation of climate change counseling into pediatrics. As part of this effort, he is currently working with a team of pediatricians to give pediatricians board certification credits to incorporate climate change into their daily practice. Dr. Lewandowski’s work exemplifies WEHN’s mission in action and serves as a reminder of the unique opportunity that physicians, and especially pediatricians, have to educate and advocate for climate action as highly trusted sources of information. As Dr. Lewandowski expressed, ”Having that trusted messenger, having someone who believes in what you say because they know that you have either their best interest or the best interest of their children at heart - That’s not replaceable.”
View clips from our interview with Dr. Andrew Lewandowski in this video on our YouTube channel. Video created by Erin Hastings with content creation from Bailey Griffin and Hannah Mortensen.
Read another study that Dr. Lewandowski recently co-authored on health impacts of climate change here.
This article and video are part of a project funded by the Energy Foundation with the aim of highlighting stories that illustrate the benefits of clean energy investments, climate action, emissions and air pollution reductions, and/or policies that make progress possible in Wisconsin.