Climate change and the Canadian pediatric emergency medicine experience: an integrated mixed-methods study.

Abstract

Background: Climate change disproportionately impacts child health and is associated with an increase in certain pediatric emergency department (ED) presentations. This study examines how the climate crisis impacts the pediatric emergency medicine physician experience in Canada.

Methods: We conducted a convergent mixed-methods study of fully licensed attending or clinical associate physicians working in Canadian pediatric EDs. We developed and distributed an online survey to pediatric emergency physicians within the Pediatric Emergency Research Canada (PERC) database. We also conducted semi-structured interviews to delve further into their experiences and engaged in a 6-phase thematic analysis of transcripts.

Results: The survey was sent to 382 physicians and yielded a completion rate of 21%. Multiple stages of non-response bias analysis revealed no significant difference between survey respondents and non-respondents. Most (95%) respondents were at least moderately worried about the impact of climate change on health and 79% believed that their institutions were either minimally or not prepared for climate-related events. Four themes emerged from our thematic analysis: (i) feeling human in a time of crisis, (ii) climate change manifesting in the practice of pediatric emergency medicine, (iii) the role of pediatric emergency medicine during a climate crisis, and (iv) preparing pediatric emergency medicine for climate change. Integrative analysis suggests that (i) many pediatric emergency physicians are concerned about the health impacts of climate change; (ii) many pediatric emergency physicians see the impacts of climate change in the types of cases presenting to the pediatric ED; (iii) climate change may influence clinical practice; and (iv) pediatric EDs may not be prepared to respond to the impacts of climate change.

Conclusions: Climate change impacts the pediatric emergency physician experience in Canada. Further education on the health impacts of climate change could help the pediatric emergency community better prepare for the impending challenges.