Abstract
Since its inception, the field of wilderness medicine has undergone significant evolution, expanding its scope to incorporate environmental health as a fundamental aspect of its mission. Initially characterized by its focus on remote settings and resourcefulness, wilderness medicine has evolved to recognize the critical link between environmental exposures and human health. The establishment of the Journal of Wilderness Medicine in 1990 marked a key milestone, eventually transforming into Wilderness & Environmental Medicine—a transition that underscores the importance of environmental factors in wilderness-oriented healthcare. Paul Auerbach wrote that the change in the journal's name “clarifies the interrelationship between the forces which shape our natural environment and those which impact on the physiology and health of human beings.” 1
As global warming increases the frequency and severity of natural disasters and magnifies exposure to environmental hazards, the relevance of wilderness medicine is poised to grow even further. Beyond training medical professionals to respond to emergencies in remote areas, wilderness medicine enhances our understanding of the broader implications of environmental health. It challenges the traditional notion of healthcare confined to indoor hospital settings by emphasizing the necessity of providing care in remote locations and promoting resourcefulness in resource-limited situations. These skills of ingenuity and resourcefulness, applied to the rising challenge of the health hazards posed by climate change, are solutions unto themselves.
The relationship between wilderness medicine and adaptation to the hazards posed by climate change is clear, with wilderness medicine practitioners ideally positioned to provide crucial support in humanitarian and disaster medical responses following climate-sensitive weather events. Equipped with specialized training, resourcefulness, and improvisation skills—and embedded in every community around the country—these practitioners are adept at navigating dynamic and challenging healthcare environments, making these practitioners indispensable in delivering lifesaving care in the aftermath of natural disasters exacerbated by climate change. Their ability to operate effectively in austere conditions and improvise to provide high-value care underscores the vital role wilderness medicine plays in supporting health systems in adapting to the impacts of climate-induced emergencies and safeguarding human health in the face of environmental challenges.
Driven by a concern for both patient welfare and environmental preservation, wilderness medicine practitioners recognize the direct link between environmental wellness and human health. Yet, the extent to which we can leverage this connection to advocate for sustainable healthcare practices remains unclear, emphasizing the need for concerted efforts to define and amplify our role in this vital endeavor. As Jay Lemery—a past president of the Wilderness Medical Society and one of the staunchest advocates for the application of an environmental lens in healthcare—reminds us, “There is no better argument to convince people to advocate for environmental wellness than to educate on the direct link to human health.” 2 Given that we are concerned with the welfare of both patients and the wilderness, our role in both sustainability efforts within the healthcare sector and advocacy for planetary health more broadly would seem self-evident.
This special topic section of Wilderness & Environmental Medicine delves into various topics that illuminate the intricate connections between climate change, environmental health, and wilderness medicine. Covering diverse subjects from geriatric care to mental health and tropical diseases, these articles underscore the journal's broad reach. However, they only scratch the surface of the multifaceted interactions between humans and environments currently undergoing flux due to climate change, highlighting the pressing need for further research and action.
Paul Auerbach wrote that “we must muster the courage and energy to learn, teach, and urgently speak out in defense of all life on Earth. It is time for the medical profession to walk tall and, once again, accept responsibility for the greater good. We have done so many times before in the face of pandemics, wars, and major socioeconomic deficiencies. It is essential now and we must act.” 3 The often-cited father of wilderness medicine poignantly reminds us of the inextricable relationship between our own health and the health of the environment. The Wilderness Medical Society's inclusion in the Medical Society Consortium on Climate and Health further underscores the urgency of addressing climate change's exacerbation of health hazards, from respiratory risks in wildfires to alterations in marine toxicology.
As practitioners of wilderness medicine, we hold fundamental values that resonate deeply with the human experience and serve as a source of connection with diverse communities. Armed with compassionate communication skills, we have a unique opportunity to contribute to mitigating greenhouse gas emissions and aiding communities in adapting to climate change's impacts. As guardians of public health, it is incumbent upon the medical profession to heed Dr Auerbach's call and rise to the challenge, championing the ethos of wilderness medicine in confronting the climate crisis head on.
