There’s a good chance your doctor is worried about climate change — and the health consequences it could have for patients. So a fellowship led by two Harvard doctors is training health care workers to take action.
Three-quarters of health professionals believe that climate change will harm patients, according to a survey published in the Lancet. Health care workers are also among the most trusted professionals in the U.S.
That combination of professional concern and public trust provides an opportunity for health care workers to speak up on climate change and organize in their communities, says Dr. Gaurab Basu, one of the creators of the fellowship. But many health professionals aren’t sure how to get started, because community organizing isn’t taught in medical school.
So Basu, a physician who holds several roles at Harvard, teamed up with colleague Pedja Stojicic to create the Climate Health Organizing Fellows Program. The free Zoom-based fellowship teaches participants how to build teams within their communities, and they’re coached through the process of planning and implementing a community-oriented project of their choice.
Yale Climate Connections spoke with Basu about the fellowship and why climate activism is a natural fit for health care professionals.
Yale Climate Connections: Where does your passion for climate change activism come from?
Dr. Gaurab Basu: I’ve really felt from the beginning of my career that it’s not enough for us, as health professionals, to just wait for bad things to happen to people’s health. Housing and poverty and racism and injustice are impacting my patients’ health. So I’ve had a real passion to explain how these structural issues impact my patients and to speak up about policy.
I had my thunderbolt moment [about climate change] when the UN’s IPCC report came out in 2018, and that really helped me wake up to how much climate change was impacting all the things I cared about in global health equity.
I went through a lot of grief, worry, and concern about climate change’s impacts and knew I needed to do something. It took me a lot of time to try to understand what the role of a primary care doctor could be. I came to really appreciate that health had to be at the center of the conversation about climate change because I think that doctors, nurses, social workers, and [other] health professionals can make this work very human.
So climate change advocacy really felt very natural to me — to speak up about how mitigating and adapting to climate change was critical and that we needed health professional voices in those structural and policy-oriented spaces to make changes for our patients.
YCC: What is the unique role of health care professionals in advocating for climate action?
Basu: Public health and climate change science is very confusing and complicated. And so you need experts who can understand what the research is saying and present it to the public with integrity — and to be a trusted voice in doing that. It’s my job to study this issue of how climate change impacts health, to read all the research, and be able to translate it and explain it. And so I take that responsibility really seriously.
I think it’s being a good doctor to go to my city council, to go to the state house, to be getting into the public forum and talking about why policy to end fossil fuel use, to end anthropogenic human-made greenhouse gas emissions matters, and explain the toll it is having on my patients. And so I feel pretty passionate that we need to be at the table in decision-making spaces so that we get the policy right.
YCC: So given all of that potential, what are some of the barriers that prevent more health care workers from getting involved in climate action?
Basu: I think one of the biggest barriers is that we’re operating in a pretty dysfunctional health care system that is taking a lot of our time and effort. So doctors, nurses, social workers, psychologists, we’re all working really hard — and with a lot of care and passion — to take care of our patients. And that is our core job. That’s the foundation of our work.
And so our experience was that health care professionals are very well-positioned to be messengers of climate action, but they were burnt out, overwhelmed, worried, and lacked a sense of community in their local institutions. So they felt very isolated and overwhelmed. My biggest goal for this fellowship was to create a learning space in which people would find community, a sense of purpose, a sense of inspiration, and self-efficacy — [to help] health professionals look at these huge challenges and not be daunted and paralyzed by them, but instead be able to find their place in this work.
YCC: How does the fellowship work?
Basu: Pedja Stojicic and I wanted to create a fellowship for health professionals who care about climate action but were never trained in the skill sets that would make them effective change agents. And so it’s a Zoom-based, six-month, online fellowship. People apply in groups of three. We wanted two health professionals and one non-health professional who is a climate advocate and leader because we want to build bridges. A real problem is that doctors and health professionals work in the clinic and the hospital so much that we lose our connection to the community. And this is a way of building a bridge right up front.
We then have monthly workshops where we teach about how to tell our personal stories, how to tell stories that will help people move to action, and how to use community organizing skills. We teach people how to build relationships and leadership structures and then get into the tactics of making change.
YCC: How does the fellowship format help address some of the issues that you raised about burnout and isolation?
Basu: There’s a lot of deep work. What are moments in their lives that push them to this call to serve? Who are the people who are influential in their lives? What were moments in their lives that made them take this calling of protecting our planet and [by] doing so, protecting [their] patients? So we do that deep work of thinking of those deeper core values, and then we help them tell stories about that — of why they were called to serve. That’s called the story of self.
Then we help them articulate and craft a story about us — how they can tell a story of the community in which they are working and the constituency they are working with. What is the story of that group of people? That can really help [the fellows] feel connections and community and feel less isolated, that they have shared values with people who are doing this hard work together.
The story of now is the story of action and urgency. What issue matters so much, and why do we need to take action?
A lot of that story-based work helps people find, [or] unveil, a sense of purpose. They all have it, but I think doing that deep story-based work really helps them understand where their place is in this work and how they want to spend their time to build community, have a sense of purpose, and feel like they can take some action.
The whole idea of community organizing is that you work with people to find your people power, and you use that power to make policy changes at your institutions or your local community. [So we ask] what is the power analysis in your local community? What are the barriers? Who are your allies? Who are your adversaries? How can you create power among a group of people who may not think they have power?
We do intensive workshops on that, and then we help them develop a project over the course of the fellowship. [Each group] applied to the fellowship with a project in mind. These projects look like decarbonizing hospitals, increasing tree canopies in heat islands, sustainable food systems, increasing biodiversity in their local community. So these are pretty inspiring folks who have organized themselves in their local community, understand the connections between climate and health, and want to take action, and want to learn concrete skill sets in community organizing and in storytelling so they can be more effective to make that change.
YCC: Do you have any favorite projects that you could talk a little bit more about?
Basu: A group of our fellows [from the University of Pittsburgh Medical Center] wanted to decarbonize their hospital. The city of Pittsburgh is not an easy place to decarbonize. There are a lot of fossil fuel interests. But three people [from a group of five] came into our fellowship and they built organizational power. They brought people into their movement and were able to use that power to get the University of Pittsburgh Medical Center to commit to the [Health and Human Services Health Sector Climate Pledge] to decarbonize their hospital: to decrease their emissions by 50%, to have an executive who is in charge of that work, and to end their emissions by midcentury. By the end of their fellowship year, they had convinced their hospital, from the CEO down, to make those commitments, which was a big, big change.
There’s an organization in Chicago that’s working on creating tree canopies in urban heat islands by creating Miyawaki forests all around heat islands in the greater Chicago area and really explaining the health benefits of mitigation against heat and all the biodiversity benefits that increased tree canopies benefit with a real focus on equity.
So we really push the fellows to get out into the community, to build partnerships, to understand what has already been done. I think there’s a lot of humility that needs to come in this work also, where we learn from community organizations that have done really powerful work already and what the voice of health professionals can add in making some of those outcomes come to fruition.
YCC: Have you heard from participants about how this also impacts their work as clinicians?
Basu: I think those of us in this climate and health space who provide clinical care want to communicate the way that climate change is impacting heat waves and air pollution and things like allergies and infectious diseases. And so it helps with that identity of “Hey, I’m a clinician, I really care about taking my care of my patients. And I also know that there are these bigger issues impacting my patients, and I have a sense of responsibility to protect my patients from those harms, both in the clinic and at a policy and community-based level.” So it all feeds into itself.
For me, when I’m a primary care doctor in a community health center, my patients are really my teachers. And when I have the privilege of hearing about their lives and about their health and how things are playing out in their lives, I have moments of insight, of understanding the human face of climate change. And so that really influences the kind of policy I want to work on, the kind of projects I want to work on. And so what I would argue is that it suddenly becomes a body of work in which the big stuff — working in the community, working on policy — feeds into the work in the clinics. And the work in the clinics feeds into what we want to do at the policy level. And that can feel really fulfilling.
YCC: What is your hope for the impacts of this fellowship long term?
Basu: We want to build a long-term community, and we want health professionals to understand their power as effective agents of change. Our approach in this fellowship is to help people find their voice, find their community, and realize that they can be very impactful in making change. That is really inspiring. It can give us a lot of energy and vision and can keep us going when this work feels so hard.
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