Guardians of the Public's Health

AMA A19 House of Delegates Meeting Material

AAPHP is sponsoring one resolution - "The Climate Change lecture" for US Medical Schools and co-sponsoring a second - Health care accreditation of correctional, detention & juvenile facilities.  Details below: 

 “The Climate Change Lecture” for US Medical Schools

Resolution for AMA House of Delegates for June 2019 

Sponsor:  American Association of Public Health Physicians

 

Whereas,  AMA policy recognizes the grave and urgent risks to human health posed by global climate change and “supports educating the medical community on the potential adverse public health effects of global climate change and incorporating the health implications of climate change into the spectrum of medical education” (1); and

Whereas, experts have stated that, “climate change and health education should be rapidly integrated into U.S. health professional curricula and continuing medical education” but medical schools have been slow to proceed because there is not a broad consensus as to what information to include, how to add this to the curriculum, and what information might be displaced if climate change were added (2);  and

.

Whereas, The Global Consortium on Climate and Health Education published in March 2018 the paper “Climate and Health Core Competencies”, an institutional guide to climate change educational content for medical schools, which supports adding topics of climate change into medical school curricula  (3); and

Whereas, the AMA is uniquely positioned to influence accreditation bodies and medical schools to introduce quickly a minimum standard of climate change education for all medical students,

Therefore, be in resolved that:

1. The American Medical Association recommends that one hour of teaching on climate change, “The Climate Change Lecture”, be required for all medical students  before graduation with the M.D. or D.O. degree as a minimum standard, with more than one hour of teaching encouraged for medical schools that so choose, and

2. The goals of “The Climate Change Lecture” will be for medical students upon graduation to have a basic knowledge of the science of climate change, to be able to describe the risks that climate change poses to human health, and be prepared to advise patients how to protect themselves from the health risks posed by climate change, and

3. Medical schools will be exempted from the requirement of “The Climate Change Lecture” that have already implemented pedagogy  on this topic that amounts to an hour or more of required learning on climate change and health for medical students, and

4. The AMA will prepare a prototype PowerPoint slide presentation and lecture notes for “The Climate Change Lecture”, which could be used by medical schools, or schools may create their own lecture, video or online course  to fulfill the requirements of “The Climate Change Lecture”, and

5. The AMA will write to the Commission on Osteopathic College Accreditation (COCA) which is the accrediting organization for schools offering the D.O. degree in the United States; to the  Liaison Committee on Medical Education (LCME), which is the accrediting organization for schools offering the M.D. degree in the United States (including for the Uniformed Services University of the Health Sciences); and to the LCME representative from the AMA Medical Student Section, to recommend that “The Climate Change Lecture”, using AMA’s prototype PowerPoint presentation and notes, or other formats, become a requirement for all M.D. and D.O. degrees for United States medical schools beginning with 2021 graduates, and

6.  The AMA Delegation to the World Medical Association will present a similar resolution to the World Medical Association recommending the concept of the “The Climate Change Lecture” for medical schools worldwide.

 

Contact:  Todd L Sack MD, FACP

                 Member, American Association of Public Health Physicians,  tsack8@gmail.com,  904-403-6446

 

References:

(1)  H-135.938: Global Climate Change and Human Health (H-135.938)

Our AMA:
1. Supports the findings of the Intergovernmental Panel on Climate Change's fourth assessment report and concurs with the scientific consensus that the Earth is undergoing adverse global climate change and that anthropogenic contributions are significant. These climate changes will create conditions that affect public health, with disproportionate impacts on vulnerable populations, including children, the elderly, and the poor.

2. Supports educating the medical community on the potential adverse public health effects of global climate change and incorporating the health implications of climate change into the spectrum of medical education, including topics such as population displacement, heat waves and drought, flooding, infectious and vector-borne diseases, and potable water supplies.

3. (a) Recognizes the importance of physician involvement in policymaking at the state, national, and global level and supports efforts to search for novel, comprehensive, and economically sensitive approaches to mitigating climate change to protect the health of the public; and (b) recognizes that whatever the etiology of global climate change, policymakers should work to reduce human contributions to such changes.

4. Encourages physicians to assist in educating patients and the public on environmentally sustainable practices, and to serve as role models for promoting environmental sustainability.

5. Encourages physicians to work with local and state health departments to strengthen the public health infrastructure to ensure that the global health effects of climate change can be anticipated and responded to more efficiently, and that the AMA's Center for Public Health Preparedness and Disaster Response assist in this effort.

6. Supports epidemiological, translational, clinical and basic science research necessary for evidence-based global climate change policy decisions related to health care and treatment.

Original 2008, reaffirmed 2014)

(2)   http://www.lancetcountdown.org/media/1426/2018-lancet-countdown-policy-brief-usa.pdf  (Accessed Feb. 17, 2019)

(3)  Columbia University Mailman School of Public Health: Global Consortium on Climate and Health Education. GCCHE Core Climate & Health Competencies for Health Professionals [Internet]. 2018. Available from:   https://www.mailman.columbia.edu/research/global-consortium-climate-and-health-education/mission

Accessed February 23, 2019

 

Other Resources:

1. “My Patients’ Health Depends on Addressing Climate Change”  By Autumn Vogel  (4th Year medical school student Penn State Med School)  February 6, 2019

https://otherwords.org/im-a-future-physician-my-patients-health-depends-on-addressing-climate-change/ Accessed February 17, 2019.

2. Preparing Medical Students for a Warmer World”    By Christian Cayon (medical student at Mt. Sinai School of Medicine)  January 03, 2019

https://www.truthdig.com/articles/the-looming-health-crisis-we-arent-preparing-for/   Accessed February 17, 2019.

AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES


Resolution: 401

(A-19)


Introduced by: Minority Affairs Section

Subject: Health care accreditation of correctional, detention & juvenile facilities

Referred to: Reference Committee D

(___________, Chair)


Whereas, In 1976, the Supreme Court of the United States 1 ruled that all persons

incarcerated in the United States have a constitutional right to appropriate health care; and

Whereas, There are organizations that created standards of correctional health care and

regularly survey and accredit facilities; and

Whereas, At the present time, only approximately 15% 2 of the nearly 7,000 3 penal facilities in

the United States are accredited, resulting in only 1 in 5 (20%) of inmates in an accredited

facility 4 ; and

Whereas, The Federal government has enacted the First Step Act (Formerly Incarcerated

Reenter Society Transformed Safely Transitioning Every Person Act) in recognition of their

concerns of those incarcerated; and

Whereas, An accredited facility has advantages including: 1) ensuring proper health care is

provided, 2) promoting the health of a vulnerable segment of society and 3) contributing to

the welfare of society by lessening its financial health care burden; therefore be it

RESOLVED, That our AMA work with an accrediting organization, such as the National

Commission on Correctional Health Care (NCCHC) and others, with accreditation expertise

utilizing physicians surveyors, to develop a strategy to accredit all correctional, detention &

juvenile facilities; and be it further

RESOLVED, That all correctional, detention &; juvenile facilities be accredited by such a

national accrediting organization no later than 2025.


References:

1 Estelle v. Gamble, 429 U.S. 97 (1976).

2 Less than 1000 facilities are presently accredited by primary accrediting organizations.

(Personnel communications with ACA & NCCHC

3 Prison Policy Initiative statistics (https://www.prisonpolicy.org)

4 Rold, W J (2008). Thirty Years After Estelle v. Gamble: A Legal Retrospective. Journal of Correctional Health

Care, 14(1) 11-20


Relevant RFS & AMA Policies:

Existing Related Policies:

H-430.986-Health Care While Incarcerated (CMS Rep. 02, I-16)

D-430.997-Support for Health Care to Incarcerated Persons (Res. 440, A-04 Amended: BOT

Action in response to referred for decision Res. 602, A-00 Reaffirmation I-09 Reaffirmation

A-11 Reaffirmed: CSAPH Rep. 08, A-16 Reaffirmed: CMS Rep, 02, I-16)

H-430.989-Disease Prevention &; Health Promotion in Correctional Institutions (CSA Rep. 4,

A-03 Modified: CSAPH Rep. 1, A-13

H-60.986-Health Status of Detained & Incarcerated Youth (CSA Rep. C, A-89 Reaffirmed:

Sunset Report, A-00 Appended: Res. 401, A-01 Reaffirmed: CSAPH Rep. 1, A-11

Reaffirmed: CSAPH Rep. 08, A-16 Reaffirmed: Res. 917, I-16

Addendum:

NCCHC Survey Procedures:

NCCHC sends at least 2-3, or more surveyors, one of which is a physician, to the facility, for

2-4 days depending the size and ADP. The physician reviews medical records for quality of

care, selected at random, and interviews inmate/patients, medical staff & officers. The other

surveyor(s), usually nurse, or correctional medical administrator, reviews P&P’s, medication

processes and also does interviews. A comprehensive report is sent to the facility (Attn:

warden and health services administer), which grants accreditation, recommends corrective

action or denies accreditation.

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