Aging and Climate Change: Karl Pillemer, Leslie Wharton, & Ruth McDermott-Levy

Eric: Welcome to the GeriPal podcast. This is Eric Widera.

Alex: This is Alex Smith.

Eric: And Alex, who do we have with us today?

Alex: Today we’re delighted to welcome Karl Pillemer, who’s a sociologist and gerontologist. He’s Professor of Human Development at Cornell University and of Gerontology in Medicine at Weill Cornell Medicine. Karl, welcome to the GeriPal podcast.

Karl: Well, and thanks for having me looking forward to it.

Alex: And we’re delighted to welcome Leslie Wharton, who is 72-year-old retired attorney and leader of the grassroots organization, Elders Climate Action. Leslie, welcome to the GeriPal podcast.

Leslie: Thank you. I look forward to our conversation.

Alex: And we’re delighted to welcome Ruth McDermott-Levy, who is Professor in the College of Nursing at Villanova University and Co-Director of the Mid-Atlantic Center for Children’s Health and the Environment. Ruth, welcome to GeriPal.

Ruth: Thank you. It’s good to be here.

Eric: So we’re going to be talking about aging and climate change, but before we go into that, we always ask for a song request. Who is doing a song request for Alex?

Alex: That’s Ruth.

Eric: Ruth, you got a song request?

Ruth: Yeah, I would like to hear It’s the End of the World as We Know It.

Eric: I was going to ask, why did you pick this song? I’m going to ask why did you pick this song? Are you a neolist? Are we doomed, Ruth?

Ruth: Well, when you get into the climate change literature, it would seem we are, but believe it or not, I am an optimist and I also believe in the capacity of human ingenuity. So I think we can work our way out of this, but we have a lot of work to do.

Alex: And I love this song. I mean, I absolutely love this song. This takes me back to high school. There’s this high school band that used to play this song called Dog Odd, and we used to dance to it in the high school cafeteria at the high school parties at night. Love this song. So thank you for the opportunity to sing this one. See if I get these tongue twister lyrics correct.

(Singing).

Eric: Alex was going to take the whole podcast just singing that song. [laughter]

Ruth: Great job.

Eric: Well, Ruth, thanks for the song request. Maybe we can dive into this topic around aging and climate change. When we think about this, are we already seeing the effects in older adults on climate change and what are those health effects?

Ruth: The answer is yes. We are already seeing effects and they’re pretty much every body system. When we think about the older adult, most older adults have preexisting conditions or comorbidities. And so any additional stressor such as heat or an extreme weather event or having to move from your home because of a climate related disaster can really tax an older adult whose window of resilience is more limited. As we age, our body’s capacity to adapt to things becomes a little more challenge. And so we do see hospital admissions for heat exposure and certainly cardiovascular and respiratory problems related to air pollution with climate change and also cognitive problems. Because of the challenge of those stressors, we can get people with some confusion and delirium and those sort of issues can also be a problem. So it really affects everything.

Eric: And I’m just thinking, I read some stuff around climate related disasters in older adults, including, I didn’t know this before, but in Katrina, 75% of deaths were in people older the age of 60, despite them only making up about 15% of the total population. Big heat waves in England in 2020, 2,224 excess deaths in the obits over the age of 65. And of these about half were in those of older than age of 85, which was huge. And they accounted for older adults, 88% of all excess deaths from the heat wave.

Ruth: Right.

Karl: Sort of a follow-up question for Ruth and for you on that because if you look at the heat waves in Texas, as far as I can tell, the recent ones, a hundred percent of people who died were over the age of 60. But Ruth, I was wondering too, and you invited us to ask each other questions, so my golly I’m going to do it. I actually wonder though, since we’re on a GeriPal broadcast, I think that people are under emphasizing the special risk of older people. So if you look at government websites about heat for example, it’s got a line of buttons across the top with affected populations, outdoor workers, athletes and older people are in there. But this feels to me much more like Covid, where the most extreme effects of these climate change events and disasters and heat really are going to be the older population that we have a fundamentally and a legitimately geriatric problem in terms of vulnerability. And I feel like that’s downplayed how much more at risk older people are based on what Eric has just said.

Ruth: Yeah. No, I agree. And you’re liking it to Covid, some of the same vulnerabilities. So certainly aging, preexisting conditions or comorbidities, and then also lower socioeconomic groups. So our elders who are people of color, people who live in places that are already challenged by poor air quality and those things and access to healthcare, they also have greater risks. So I think you’re absolutely right. And I also do work with children, so there’s risks there, but the people that are, and that’s Eric mentioned about excess death, the people that succumb to this are older adults and we don’t want to lose them earlier than we need to. So it is an issue that we all need to take care of. And then I’m looking at Leslie, wondering, with your organization, are there things that you are doing to help bridge that gap?

Leslie: Well, yes, thank you, Ruth. Elders Climate Action, and let me just tell you a little bit about who we are, was created in 2014 as the project of a 501(c)(3), Elders Action Network. And we have gone from 250 members at the end of 2015 to about 26,000 right now across the United States and a number of chapters that have grown. Our focus is on advocating on policy at the national state, local level, educating on ways to mitigate, going all electric, getting heat pumps, things like that. And obviously the health impacts are one of the ways that we reach out to our membership to engage them, not so much I would say because of their concern about the impacts on them, but our mission is to create a livable planet for our children and grandchildren and all life. And you’ve got us who are in our later years looking down and asking ourselves, “What have we left to those people, to our children, to the kids who are four years old now? What are they going to grow up into?” And so the health impacts is a very important part of our messaging.

Alex: Sticking with that for a moment, Leslie. Well, Karl, tying back into your work, you have this wonderful website that I wanted to invite you to talk about Aging and Climate Change Clearinghouse. And on that, I found a link to this article by Rick Moody called Elders in Climate Change, No Excuses, in which he argues that elders are the group that benefited most from the massive consumption of fossil fuels in the post World War II eras. And that was a time of burgeoning wealth for today’s elders and that they bear a moral responsibility because they will not reap the burdens and harms to the greatest extent. It will be future generations. We just talked about how current generations of older adults are vulnerable to it, but in future it’s going to be worse and it won’t primarily be in the US. It’ll primarily be in low-lying areas, in countries that have less wealth and are less developed than the US. Thoughts about that? Is that a motivating factor, Leslie, for your organization?

Leslie: Well, let’s put it this way. As a former lawyer and other things, I do not find that forcing guilt on people is a good way to motivate them to take action. Are we responsible? Well, we grew up as children in the fifties and sixties. This was the world around us. It was a given. The vast economic expansion, the use of fossil fuels, we didn’t know no better. Yes, looking back now, we can see the effects of that world. And so we have a responsibility, now that we realize, to do everything that we can, but I think that responsibility should be out of love and concern for existing youth and future generations then out of slap you guilt, because I benefited. Yeah. No, we lived in a wonderful time of economic growth and expansion, but it had a lot of secondary impacts that we were unaware of and now we’re seeing it.

Karl: I get it. I think that really comes into the core of the issue. I think we’re touching on what strike me as the three main areas in this issue. And by the way, I bet that Ruth and Leslie and I have all had the same experience of giving talks to groups and people come up afterwards and say, “Oh, I never thought about that connection between aging and climate change”, as if it were something unusual to be talking about. But I think maybe all of us are touching on three areas that’s strike me as important. I mean, one is older people is vulnerable, and the only exception I might make is we know from environmental communication in general that public health messages are often more effective than some of the more like Love Your Mother Earth kind of messages. I think that’s an important one. But we also need to look at older people as contributors to climate change.

Older people in my parents’ generation were much more likely to be natural re-users and recyclers that traveled less. With the aging of the baby boom, but working, I can’t say they, I will say we are contributing much more. And then finally is what Leslie was talking about is older people as agents of change. And the other piece, which I think your question touches on, there have been studies, one thing that keeps some older people out of this is there are a lot of ageist messages in the climate change movement that old people don’t care about us. That this is a young person’s movement and that really needs to be addressed as well to get older people to mobilize as they’re doing.

Eric: So can I also… Go ahead, Leslie.

Leslie: I just wanted to pick up on Karl’s comment about the ageist attacks, the Hey, Boomers attacks of the youth and Elders Climate Action decided that yeah, we would be the boomers. We pick that mantle up right away and say, “Yeah, we’re the boomers and we’re working with you and we’re right behind you.” So stop Hey, Boomers as being a negative bad you and more like, “Okay, we’re with you.”

Ruth: Yeah. And to touch on… Oh, I’m sorry.

Alex: Oh, no, I was just going to say that’s like reclaiming or appropriating the term boomer and reinventing it in a positive sense rather than a pejorative sense. Yeah. Ruth, go ahead.

Ruth: But to touch on the elder as being responsible or that we benefited from fossil fuel use and all, but it was hidden from us or people older than myself. I mean, there’s evidence that the fossil fuel industry knew this was a problem and hid it. So I think we do need to move away from blame. And I am a public health person and I do know those messages don’t work. Smoking is bad for you. There’s other ways to be able to get those messages through. But I think it is really valuable that link between health and climate, because we all breathe, we all drink water, so it does get people’s attention. It’s interesting that two years ago in Glasgow, Scotland, I guess it was Cop26, that was the first time that WHO had a pavilion at the COP meetings and it took 26 Cops for them to be able, and that’s the UN Climate Change Meeting committee of the parties. It took that long for acknowledgement of a major health organization. So we all need to get up to speed.

Karl: I do wonder how we get geriatrics too to care because I think it’s no exaggeration that this is the greatest public health threat to older people.

Ruth: Oh, absolutely. Yeah.

Eric: Why? Why is this the greatest health threat to older adults?

Karl: Because of what we’ve just said, because of the weather related changes, increases in air pollution because of wildfires and heat domes. There’s so many public health threats that this is bringing about, increase in vector-borne diseases to which older people are especially vulnerable. The fact that older people have moved to the most climate sensitive regions of the country and evacuating them, especially if they have impairments, is often extremely difficult. And as you’ve mentioned for people in the developing world, older people. What studies show after these disasters, older people and especially minority older people are the least likely to be able to move or leave. So I think we also have to start talking about how do we make older people climate change resilient? What do we do to very concretely provide heat shelters and cool shelters? So it’s hard to know about individual practice when I think of geriatrics or geriatric nursing because a lot of the solutions are really broad scale public health initiatives are needed, don’t you think?

Ruth: Yeah. And Eric, to answer your question also, it affects every aspect of our life. So the things that Karl mentioned, but also access to healthcare during a disaster or even heat. I mean, there’s days… My mother passed away a year ago, but prior to that, there were days when it was so hot or the air quality was so poor in suburban Philadelphia, I couldn’t take her outside and she was a relatively healthy woman. And it is going to affect, if it hasn’t already, our food quality, the food that’s available, our medications. There’s an issue with an extreme heat, the medications may lose its efficacy, and there’s certain medications that make someone more vulnerable to heat emissions-

Eric: And the power outages that we see.

Ruth: Right. And so again, as we age, we do rely on more stuff to keep us healthy and to keep us active, whether it be home oxygen or a suction machine, or medications. I mean, many people in their mid to older years are on certain medications. And then access to those. We saw during Katrina, we couldn’t get IV fluids. So it’s just every single part of our life is affected and mental health issues. So we could go on.

Eric: I guess, Ruth, the question for you is what’s the role of the healthcare system in all of this? Why is it up to the healthcare system?

Ruth: Yeah. Okay. So if you’re talking about the system itself, that is a big emitter of greenhouse gases. I think it’s the second emitter.

Alex: Really?

Eric: It’s like 9% of all greenhouse gases come from the healthcare sector, I think.

Ruth: Yes.

Alex: Wait, what %? Say it again.

Eric: 9%.

Alex: 9%.

Ruth: We’re second to the restaurants-

Eric: 9% of all carbon emissions come from healthcare.

Ruth: Yes. So there are initiatives to green our healthcare system and reduce its carbon footprint. And actually at Cop26 in Glasgow, Scotland, there was an international initiative put forth by Healthcare Without Harm, which by the way, was founded by a nurse and a physician in the United States, but the United States signed on to it at that point. And so there is a push from the Department of Health and Human Services to get all healthcare systems on board to reduce carbon emissions. There’s a variety of ways to do that.

Eric: It really doesn’t feel like we’ve done that because the amount of waste that we see-

Ruth: Right. Right. So there’s waste, there’s the energy that’s used, it’s the food, it’s a whole-

Eric: There was just an article, I think it was in JAMA and New England Journal on the impact of clinical trials on global warming and suggestions on how to decrease that impact or at least include that impact when we’re writing for grants and publishing.

Ruth: And then to answer your question also about the different providers as far as nurses and physicians and respiratory therapists and pharmacists, most schools of medicine, nursing and all those other fields are including some climate change in their curriculum. For nursing education it is now a requirement for accreditation-

Eric: Really.

Ruth: So that’s a big win.

Eric: That’s great.

Ruth: Yeah. Yeah, it’s really good. And then for medical education, I know they are doing a lot as well. They’re trying to get it into their licensing exam. Nursing’s had a problem getting it there, and we may get there at some point, but medicine is working on that, and there’s an organization called Global Consortium for Climate and Health Education that is really leading the way for all healthcare providers for information on how to do that.

Eric: So as we start talking about things that we can do about it, maybe we can just start off with this thing of including it in the curriculum for healthcare professionals. Ruth, you’re involved in including it in the nursing curriculum. What does that actually look like?

Ruth: Well, again, I’m an optimist. I don’t see it as that hard. I mean, really, if we’re teaching somebody about respiratory disease, then we can add, “Well, we need to check the air quality and what does that mean?” And there’s so many great tools to do that. One is AirNow from the EPA that you can have on your smartphone. And that’s a good thing to share with an older patient or client that making decisions about your activity. So you can just get it in there. I think it’s important to teach students, all healthcare students and probably all students, what climate change is and how we got to this point. But then after that, as far as the health piece, you can just infuse it into whatever body system you’re talking about or however you’re teaching that it’s not that difficult.

Karl: Yeah, I think it’s also just spinning off what Ruth said there, there is this interconnection between aging and climate change and more generally older people in disasters. And so if we think of that relationship though, as these kinds of disasters increasing, so flooding, hurricanes, extreme heat and extreme cold, there are system level things to do. One really promising thing, and Ruth, you may know more about this, but in the VA system, in some of the regional VAs, they have great now plans to make sure that everybody who’s on a medical device that requires electricity is kept track of. Because in some of these disasters, people, as has been noted, die because there’s no electricity to power, whatever it is, they need to make sure that they can get medications. So different kinds of networking, cell phone reminders, ability to keep in touch of very vulnerable older people is something that’s less on the practice level. But it’s really important on the health systems level. And I think really the VA’s pioneering some of that, and I think other people could use it as well.

Alex: How about Leslie, what are you encouraging, hearing from your members, older adults to do combat climate change?

Leslie: Well, what we are doing is we’re offering a home, a platform for folks who haven’t retired yet or are retired. I got involved five years before I retired, but a place for purpose, because a lot of the problems for elders is they step out of the structured work environment where they were part of a pyramid structure, they had their colleagues, they had their instructions, they knew what to do. And the old myth that, “Oh, now you’re going to get an extended vacation and play golf in pinochle or something”, well, that lasts for a very short period of time before elders can start really finding themselves at loose ends. And in the old days, the elders lived in the communities they grew up with, their kids were there, the grandkids were there, it was all part of their ecosystem. But now one kid’s off this side of the planet, the other one’s over there, this one’s here, and the elders are not part of a family community, what is more even a community, local community.

So what we have been doing is offering elders, and we’ve got members up into their eighties and early nineties, the opportunity to learn, to take action, engage locally, build chapters, be part of chapters where there is either in person or with Covid on Zoom, but here are the folks in your county and engage. And there are so many things that can be done to address climate change. A lot of them are obviously adopting the right policies, implementing the policies, things at the individual level. The Inflation Reduction Act provides enormous tax benefits to people who get heat pumps or put solar on their roofs. And a lot of people don’t know about it because it’s sort of distant out there, complex. But by educating folks, they can actually invest in things they maybe couldn’t afford on their own.

But with the rebates and other things, they can get reducing, one, their costs because these are much more efficient. Two, reducing greenhouse gas pollution so that they’re contributing in that way. Three, being a model to the neighbors who look and say, “Oh, you got solar panels? Yeah, we can do it.” Or, “Oh yeah, I got a heat pump and it really works well and it’s much more efficient, blah, blah, blah, blah.” But the point is we are a universe of elders who’ve come together as volunteers who bring our backgrounds, our interests, and coalesce, and we form committees. I don’t want to take away the whole show. I could do that, but-

Alex: Well, I wonder, Leslie, how much of the emphasis is on, you said policies upfront and making sure they’re implemented, how much of the emphasis on political action, because in order to… Individual change will only take us so far and that what we really need is big systematic change within the US and globally. Somebody mentioned it’s the first day of the Global Climate Summit as we’re recording.

Ruth: COP28.

Alex: And so how much of your organization is focused on that political action, or do you steer clear of it because it’s a little bit of a sensitive topic in some places and there’s some pushback?

Leslie: Let me, I don’t want to use the word correct, but that’s the one coming to mind your language, right?

Alex: Please.

Leslie: Because it’s not political. That is, we’re not partisan. It is not, “Oh, yes, Democrats or yes, Republicans.” Legislation, regulatory actions, those are things that don’t have to be political in the sense of parties. We’re a 501(c)(3), a nonprofit. We can’t engage in political action, but we can certainly do letters to members of Congress. I have appeared at virtual Environmental Protection Agency rulemaking meetings and testified over Zoom or I could go in person. So we really are focused on the policies and the implementation that are needed to be adopted to move us from spouting greenhouse gases, to reducing them and to a sustainable world that can support the lifestyle that we grew up with, albeit one, creating a world devastating pollution.

So yeah, we’re very focused on that. But part of that is also educating our members and educating people on what they can do and helping bring them together into virtual communities or forming local communities. And health is not my area of focus, but for elder people, for those in the sixties, seventies, and eighties, and who are retired and who may be in their apartments, condos, and homes, this is enormous mental health benefit to feel that you are engaged with others on something positive, that you are ensuring each other up. When the climate depression strikes, you’re in a conversation with your elder friends who …

Eric: Helps mitigate social isolation too.

Leslie: Helps with social isolation, gives you something to engage with others outside. So it is an enormous mental, physical health benefit because we feel we’re still part of the world and we’re making a difference, and we are learning and we’re engaged. And when I was born, people didn’t live past their sixties. And now it’s like you keep seeing the Obits, 103 years old, 104 years old. And so the point is we’re crafting a new way of being in the elders.

Karl: If I could insert a little research nugget, we and others have done research showing that we know that volunteering is very good for older people and they volunteer in large numbers. But the view of labor statistics, only around 1% of older people have environmental volunteerism as their main role. However, volunteering in environmental activities turns out to be even better than other kinds of volunteering. It involves nature exposure, it allows older people to express generativity, sort of building a world that they won’t live to see. So it’s kind of win-win-win if we could move the vast numbers of baby boomers more into this area. It’s not just Leslie saying people’s impressions. There’s good research showing that activities around environmental sustainability and conservation that’d be good to prescribe to your patients. And I really think we don’t have research on it, but we certainly know that at the end of life, nature exposure is really positive as is a sense of purpose. So I would think there might even be more towards the end of life intervention in there somewhere to get people engaged in these kinds of generative environmental activities.

Eric: Great. I also wonder, because I’m hearing from Leslie, there’s an individual focus, there’s a focus on the policies out there. I wonder if we can focus again on the 10% that the healthcare sector is contributing to carbon emissions in the US. What’s our role in changing the healthcare system, in our own healthcare system. We’re that middle area where whether it be our clinics, in the operating rooms-

Leslie: You are talking about a network of corporations, of manufacturers, of suppliers, of scientific research groups. I mean, you are talking about a huge, huge network. So I can’t speak to how you can start insinuating yourself into that process to get change. But a lot of it would come from regulatory work, from pressure to reduce plastics, to reduce a… That is to find ways of producing the things that are being produced now and getting them around to the people who need them at lower climate cost.

Eric: Well, I’m also just thinking about, we talking about Covid. If there’s one thing I saw with Covid is the amount of waste we produced increased dramatically. And I’m wondering from you, Ruth, is this part of your curriculum? Is leadership, in your own institution, do we just, these one-off things that we just throw away every time we use it? Or how do we teach nurses and doctors to actually pay attention when we’re thinking about creating policies to maybe include impact on global warming and climate?

Ruth: There’s a lot of things that are coming up here. So I’m going to back up because I’m a public health person. What we need to do as a nation is be more preventative and so that if we walk more, we ride bikes to places and things like that, we’re not creating the emissions and we’re becoming healthier and our mental health is better and we lose weight and all of those great things. And so we do have a life, a longer life. And so that’s one thing, better food, all of that kind of stuff we need to really concentrate on as a nation ’cause we don’t do very well in that department. The other thing is, as far as the health system, yes, I totally agree that we need policies, but we’re talking about 50 states and what a mess that’s going to be with states’ rights, but there’s opportunity for the health system to save money if they don’t generate as much waste, because healthcare waste is really expensive.

It goes into a whole bunch of different categories. They can save a lot of money. And actually, we worked with a hospital on a project like that to demonstrate we don’t need to wear gloves for every time we touch a patient. We really do not. And so we need to get away from some of that craziness in our system. And my mother was a nurse back in the day when they reused and sterilize things. And so we don’t need to waste as much. I was just in Kenya visiting hospitals, and one of the things they did in ICU and in the surgical units, they wear these little footy things. They’re paper things to cover your feet so you don’t track in bacteria and other pathogens. They take their shoes off and wear Crocs that stay in there, and then they’re just washed. So again, it was like a brilliant thing. And so we can learn from our colleagues in the developing world, so we really do need to think about what we’re doing.

Alex: Yeah.

Karl: The other thing I think that we forget though too, is that healthcare is 20% of our gross domestic products. So it is the polluting in the same way others do. Ruth, I wonder if you agree. I think there’s been some helpful movement in this area. The joint commission either was going to or did offer new accreditation standards addressing climate impacts. And I think they’re also, they’re trying to revise national construction and safety codes for hospitals that will make them more environmentally efficient. I think a lot of things are still voluntary, which of course means that a lot of people won’t comply. But I feel like slowly the healthcare industry is addressing the degree to which it has this enormous impact. And the Biden administration slowly also seems to be trying to move some of these things forward. I’m just not sure where they stand now, but they’re all good ideas.

Ruth: Yeah, Rachel Levine has been a real advocate of that too in HHS. So yeah, we do have federal advocates and then as I mentioned, Healthcare Without Harm. And then there’s also Practice Green Health, which are organizations that are trying to do that, and our elders rely on those services. So we want to have good services, but we want to keep them out of the hospital too and have a healthy lifestyle for them and everyone else.

Karl: I just want to say that the National Academy of Medicine has an action collaborative on decarbonizing the US health sector. And that would be an interesting thing for people to take a look at if they’re concerned about this.

Alex: That’s great. And it ties into what I was going to say. I was in the East Coast last spring, we’re college touring because my oldest son’s senior in high school this year, and every college we went to had a big banner, Net Carbon-neutral by, and they all had a different date, 2030, 2045, whatever it was. They took pride in it. They know their students care about it and that their applicants want to go to a school that cares deeply about it. Wouldn’t it be great if our hospitals and healthcare systems also have that same incentive and we are people who work in those systems and we can encourage our systems to move in that direction.

Ruth: Absolutely. Absolutely. And that’s another opportunity, again for older adults to engage with their grandchildren who are high school and college age that are really interested in this. So again, thinking of the work Leslie does.

Alex: I wanted to also say Rick Moody has this wonderful quote from the Talmud at the end of his article, “Do not be daunted by the enormity of the world’s grief. You’re not obligated to complete the work, but neither are you free to abandon it.” And again, I found that from Karl’s site, Aging in Climate Change, Clearinghouse. Karl, do you want to say more about that site? I know it was relatively recently launched and what your hopes are for it?

Karl: Sure. Yeah, I’m very excited about that and we’ve tried to make there be something in it for everybody. Its major goal is to try to pull together information on aging and climate change for three groups. One is researchers, so folks who might want to do work in this. Many of us who work in the field and social science and climate change, were doing something else before. And in other fields we’ve seen it as moving our personal interests and agenda into our work. And so there are a lot of resources for them.

There’s a searchable database on aging and climate change that’s kept up to date, annotated bibliographies. And then there’s also information that links older people themselves to possible opportunities and one for environmental organizations. And I’ll say one thing, and I’m not sure if Leslie hasn’t thought, when we were starting this work, we surveyed local environmental organizations and found that they aren’t particularly elder friendly, very few modify activities, so people with some level of disability might be able to do them, and they don’t specifically try to attract these 75 million boomers who are a huge resource. So we also try to provide guidance for them as well, how they can attract older volunteers, how they can work with them. So we would love people to come here, Aging Climate Change Clearinghouse. So we finally have enough hits that it comes up on a Google search. And I wanted to say, I hope your son is considering Cornell. [laughter]

Ruth: Or Villanova.

Alex: Very small liberal arts colleges only.

Karl: But yeah, thanks a lot and we really hope it’s a good vehicle for the work that all of us are doing. Thank you for asking-

Eric: Sure. I wonder, I want to be mindful of the time we’re running close to the hour. We’re going to have links to all these sites on our show notes. I wonder if I can hear from each of you. Let’s go to the brass tack, the people who are listening to this podcast, hopefully you’ve convinced them that this is an important issue that they should also take up. What are you hoping that they do after listening to this podcast? Karl, I want to start with you.

Karl: I hope they’ll be aware of it. I hope they’ll prioritize it. I hope they’ll educate themselves. I also hope that everybody involved, and since we’re talking maybe to more medical and health professionals, that they keep two things in mind. One is we still need to do everything we can do to prevent the effects of climate change. But for your sake, for the sake of your practice or your patients, you have to think about mitigation and resilience. So how are your patients going to deal with extreme heat and cold? How are they going to deal with power failures or increasing air pollution? I think that we need a climate change lens, and it’s like staring at the sun. It’s easier for everybody not to think about it, but I think it’s really critical to both be involved in reducing the sources of climate change in your healthcare setting or practice, but also be really thinking about how your vulnerable patients are going to be affected by these changes.

Eric: Wonderful. How about you, Ruth?

Ruth: Yeah, I agree with what Karl said. Also, it can be really overwhelming, and I have some friends that actually are very intelligent and say, “I can’t deal with it”, and walk away.

Eric: It’s too big of a problem.

Ruth: But I’ve been in this for a while. And you start small. And so if you’re talking about healthcare providers and healthcare systems, start with waste and do an education with people of how to manage the waste. And your health system will love you for it because you’re going to save them money. And once that gets going, then you can go, “Okay, well let’s look at our food waste. Let’s look at where our food is coming from.” And you can just keep ticking it away. There is, what’s it called, Project Draw Down, which has some really great evidence-based examples of how to get things done.

Also, little shout out, I mean, I have some publications about how to deal with discharge planning in the area of climate change, really practical guidelines for healthcare providers. And the other thing, we just did a survey with senior centers for healthy adults who are out in the community and their preparation for climate change adaptation. And they’re not prepared either, and they’re not thinking about health effects. So again, for providers, that may be a place to do some outreach and trying to keep people as healthy as they can so they don’t end up in the hospital.

Eric: Yeah. Well, if you also send me the discharge planning paper, I’ll include it in the show notes. Love thinking about this. And again, of meshes with the geriatric approach too, which includes minimizing things that don’t work, whether it be multi-day, nighttime lab checks in the hospital, or keeping people in the hospital or just avoiding the hospital, if at all possible. De-prescribing a really important part of waste in the healthcare system. Leslie, what’s your focus?

Leslie: Well, I think that it bridges with Karl and Ruth. Obviously we’re not gerontologists, we’re not dealing with the sick. But for everyone who’s engaging with elder people, they’re either suffering the impacts of climate change or they’re trying to adapt to avoid them, and they’re having some emotional and mental impacts, even if it’s just from the news. And I think that learning about things like Elders Climate Action, Third Act, which is Bill McKibben’s group of over 60 people, but learning about the opportunities that elders have to engage and make a difference.

And yes, climate change is global. It’s overwhelming, it’s got multiple sources. You need to touch base in all these places. But by engaging in organizations, you can take a slice of the pie, focus on it, own it, feel good about it, and know that you are contributing to something and that you are working for your kids, the grandkids, grandnieces and nephews, the kids you see running down the street to go to school. So I think that engaging on climate change with others is an enormous opening for elders. And I don’t think doctors often think about, what’s your social engagement? How are you finding purpose in life? How many times are you just clicking the dial on your TV to see if you can find a more entertaining program? There are ways.

Eric: And I love the idea of a bigger view of prevention too. We think about prevention like colonoscopies, mammograms, like bigger views of what does it mean to do prevention for older adults?

Ruth: That’s not prevention, that’s screening. [laughter]

Eric: Well, I love all of this and I want to thank you all, but before we end, I think Alex is going to give, It’s the End of the World one more try. It’s a lot of lyric all at once.

Karl: That’s so exciting.

Alex: We’re just going to do a little bit of the end here.

(Singing).

Eric: Ruth, Leslie, Karl, thanks for joining us on this podcast.

Leslie: Thank you.

Ruth: Thank you.

Karl: Thank you. It’s great.

Eric: And thank you for the amazing work that you do. And thank you to all of our listeners for your continued support.