>> Laura: DR. JOANNA KATZMAN, WELCOME.

>> DR. KATZMAN: THANKS, LAURA, FOR HAVING ME.

>> Laura: THANKS FOR BEING HERE.

SO YOUR BACKGROUND IS IN CHRONIC PAIN AND OPIOID MANAGEMENT.

HOW DID YOU BECOME INTERESTED IN CLIMATE CHANGE FOR HEALTH CARE PROFESSIONALS?

>> DR. KATZMAN: RIGHT, LAURA, THAT'S A GREAT QUESTION.

PEOPLE ALWAYS ASK ME.

YOU KNOW, I HAVE ALWAYS BEEN INTERESTED IN PUBLIC HEALTH, AND I ACTUALLY GOT MY MASTERS DEGREE IN PUBLIC HEALTH BEFORE EVEN GOING TO MEDICAL SCHOOL.

AND THAT WAS MY PLAN, TO BE A PUBLIC HEALTH PRACTITIONER.

BUT I ALWAYS KNEW THAT I WANTED TO DO SOMETHING MORE IN MEDICINE, AND AFTER MEDICAL SCHOOL, I THEN BECAME INTERESTED IN NEUROLOGY AND PAIN MANAGEMENT.

BUT FOR MANY YEARS, FOR ABOUT A DECADE, MY GOAL WAS TO TIE-IN PUBLIC HEALTH EDUCATION INTO MEDICINE AND NEUROLOGY.

AND IT WAS IN THE EARLY 2000S WHEN I MET DR. ARORA AT PROJECT ECHO, AND HE SAID, JOIN ME IN HIS HEPATITIS C PROJECT ECHO AND LEARN WHAT I'M DOING.

I'M TRAINING PRIMARY CARE CLINICIANS ALL AROUND THE STATE OF NEW MEXICO AND TEACHING THEM HOW THEY CAN TAKE CARE OF THEIR PATIENTS WITH HEPATITIS C IN THIS VIRTUAL PLATFORM.

AND I UNDERSTOOD THAT HE COULD TRAIN CLINICIANS TO TAKE CARE OF THEIR PATIENTS WITHOUT NEEDING TO COME INTO THE UNIVERSITY, AND I THOUGHT, I COULD DO THIS FOR CHRONIC PAIN AND OPIOID MANAGEMENT.

AND THEN OVER THE YEARS, STAYING WITH PROJECT ECHO, IN ADDITION TO DIRECTING THE PAIN CENTER AT THE UNIVERSITY, I REALIZED I COULD ALSO BRANCH OUT AND DO THIS FOR OTHER PUBLIC HEALTH CRISES, LIKE FIRST RESPONDER RESILIENCY AND BORDER HEALTH.

AND THEN IN 2020, I TOOK A PUBLIC HEALTH CERTIFICATE AT YALE UNIVERSITY, VIRTUALLY, AND AFTER I TOOK THE SIX-MONTH COURSE, I HAD BEEN PASSIONATE ABOUT THE CLIMATE CRISIS IN NEW MEXICO BECAUSE OF OUR GROWING PROBLEMS WITH EXTREME DROUGHT AND EXTREME HEAT, AND AFTER TAKING THE YALE COURSE, I REALIZED WHAT BETTER VENUE THAN PROJECT ECHO TO REALLY, YOU KNOW, SHARE THIS KNOWLEDGE WITH CLINICIANS AND PUBLIC HEALTH PROVIDERS WHO REALLY DON'T GET THAT EDUCATION IN MEDICAL SCHOOL OR NURSING SCHOOL, THAN TO TEACH THIS TO THEM.

SO I VENTURED OUT AND STARTED THIS PROGRAM.

>> Laura: WHAT ARE SOME OF THE WAYS THAT CLIMATE CHANGE IS AFFECTING PEOPLE'S PHYSICAL AND MENTAL HEALTH IN THE SOUTHWEST?

>> DR. KATZMAN: RIGHT.

SO THERE'S JUST SO MANY AREAS THAT CLIMATE CHANGE IS AFFECTING THEIR HEALTH.

A COUPLE THAT I CAN THINK OF RIGHT OFF THE TOP ARE, SO MANY HEAT-RELATED EFFECTS.

I CAN THINK A CASE THAT WAS BROUGHT TO OUR CLIMATE CHANGE AND HUMAN HEALTH ECHO, AND WE PRESENTED THIS CASE A COUPLE OF TIMES.

YOU KNOW, NEW MEXICO HAS URBAN HEAT ISLANDS.

LAS CRUCES AND ALBUQUERQUE ARE FREQUENTLY FIVE AND SEVEN DEGREES WARMER FAHRENHEIT IN THE SPRING AND SUMMER MONTHS COMPARED TO OUR SUBURBAN AND RURAL COUNTIES IN NEW MEXICO.

AND THAT MEANS THAT PEOPLE WHO LIVE IN THESE URBAN AREAS ARE MORE AFFECTED BY EXTREME HEAT.

SO IF YOU'RE WORKING IN THESE CITIES, OR IF YOU'RE HOMELESS, OR IF YOU'RE A VULNERABLE PATIENT, SOMEONE WHO MIGHT HAVE A SUBSTANCE USE DISORDER, OR IF YOU DON'T HAVE AIR CONDITIONING, OR IF YOU'RE IMPOVERISHED, YOU MIGHT BE MUCH MORE SUSCEPTIBLE TO EXTREME HEAT.

SO A CASE I CAN THINK OF THAT COMES TO TOP OF MIND IS A POSTAL WORKER, FOR INSTANCE, WHO MIGHT BE OUT IN THE SUN ALL DAY, LET'S SAY IN LAS CRUCES, MAYBE FROM 8:00 A.M. TO 5:00 P.M.

THEY MIGHT BE WORKING, THEY MIGHT BE WALKING DURING THEIR SHIFT, THEY MIGHT BE WALKING SEVERAL MILES A DAY, MAYBE NOT HAVING ENOUGH WATER WITH THEM.

THEY MIGHT NOT BE WEARING A WIDE-BRIMMED HAT, SO NOT HAVING ENOUGH PROTECTIVE SHADE.

AND ONE CASE I REMEMBER IS THEM COMING HOME TO THEIR DAUGHTER, WHO THEY LIVED WITH, AND THEY'RE CONFUSED AND THEY'RE NOT REMEMBERING KIND OF THEIR DAY, WHERE THEY ARE.

THEIR DAUGHTER TAKES THEM TO THE EMERGENCY ROOM, AND THEY'RE ACTUALLY HAVING HEAT EXHAUSTION AND ALMOST HEAT STROKE.

AND WHEN THEY GET TO THE EMERGENCY ROOM, THE DOCTOR CHECKS THEM FOR THEIR LABS, WORRIED ABOUT RENAL FAILURE, PUTS THEM UP IMMEDIATELY TO INTRAVENOUS FLUID, AND ON OUR CLIMATE CHANGE ECHO, THIS IS ONE OF THE THINGS THAT WE TEACH ABOUT, IS THAT EXTREME HEAT CAN REALLY PUT SOMEONE AT RISK FOR HEAT EXHAUSTION, HEAT STROKE.

AND SO WE EDUCATE ON THINGS LIKE THAT, LAURA.

>> Laura: I REMEMBER FROM PARTICIPATING IN ONE OF THE WEBINARS THE IMPACT THAT HEAT WAVES CAN HAVE ON PEOPLE WHO HAVE MENTAL HEALTH CHALLENGES OR ON CERTAIN TYPES OF MEDICATIONS.

WHAT SHOULD NEW MEXICO HEALTH CARE PROFESSIONALS BE ALSO WATCHING OUT FOR WHEN WE HAVE THESE LONG DAYS AND DAYS AND WEEKS OF HOT TEMPERATURES?

>> DR. KATZMAN: RIGHT.

IT WOULD BE REALLY NICE IF NEW MEXICO COULD PUT OUT MORE PUBLIC SERVICE ANNOUNCEMENTS ABOUT THE PROLONGED HEAT WAVES, PROLONGED IMPACTS.

MANY PATIENTS WHO HAVE DEPRESSION, WHO HAVE PSYCHOTIC DISORDERS LIKE SCHIZOPHRENIA, ARE ON DOPAMINERGIC MEDICATIONS THAT, ALONG WITH COMBINED EXTREME HEAT, THERE ARE INTERACTIONS THAT CAN ADVERSELY AFFECT THE PATIENT AND CAUSE THEM TO HAVE INCREASED CONFUSION IT MIGHT CAUSE THEM TO HAVE BECAUSE OF THE NATURE OF THE MEDICATIONS.

ALSO ONE THING WE KNOW, LAURA, IS THAT WHEN THE HEAT AT NIGHT DOES NOT FALL BELOW A CERTAIN POINT -- FOR INSTANCE, IF IT REMAINS ABOVE 95 FOR A WEEK OR TWO AT A TIME AND THAT TEMPERATURE DOES NOT DROP, FOR INSTANCE, IF THE TEMPERATURE DOES NOT DROP BELOW 90, BUT IT STAYS HIGH, THERE'S INCREASE IRRITABILITY IN SOMEONE WHO DOESN'T NORMALLY GET ANXIOUS OR IRRITABLE OR KIND OF ARGUMENTATIVE.

WE ALSO KNOW THAT VIOLENCE IN THE COMMUNITY INCREASES IN THE SUMMER MONTHS, AND HEAT CERTAINLY EXACERBATES THIS.

THIS HAS BEEN STUDIED OVER AND OVER AGAIN IN MANY KIND OF PEER-REVIEWED JOURNALS.

SO IT'S THE FALLING OF THE TEMPERATURE AT NIGHT THAT IS REALLY PROTECTIVE.

>> Laura: SO I'M CURIOUS IF THERE ARE THINGS THAT HEALTH CARE PROFESSIONALS HAVE BEEN LEARNING THROUGH THIS TRAINING THAT MIGHT APPLY TO SOMEONE LIKE ME OR OUR AUDIENCE MEMBERS.

LIKE, HOW DO WE BATTLE THAT FEAR ABOUT CLIMATE CHANGE?

HOW DO WE BATTLE THAT FEAR AND HOPELESSNESS?

>> DR. KATZMAN: RIGHT.

SO THIS IS -- I CONTINUALLY LEARN FROM THE EXPERTS THAT COME ON THE CLIMATE ECHO.

I FEEL, LAURA, LIKE A NOVICE MYSELF.

I FEEL LIKE I HAVE SO MUCH TO LEARN.

BUT WHAT I HAVE LEARNED FROM THE EXPERTS THAT HAVE COME ON TO THE CLIMATE CHANGE AND HUMAN HEALTH ECHO IS THAT WE NEED TO BALANCE THE GRAVITY OF THE SITUATION, AND WHAT I THINK IS SO HARD FOR SO MANY PEOPLE WHO ARE STILL NOT BOUGHT INTO THE DATA OF THE CLIMATE SITUATION IS THAT, YES, THE FACTS ARE TRUE, THE SCIENCE DOES HOLD UP, IS THAT THERE IS HOPE, THAT WE HAVE A LOT OF HOPE, AND THERE'S A LOT OF THINGS WE CAN DO AS AN INDIVIDUAL AND AS A COLLECTIVE.

AND AS A COMMUNITY, THERE ARE SO MANY THINGS WE CAN DO TOGETHER.

THERE ARE SO MANY NATURE-BASED SOLUTIONS TO REDUCE OUR CARBON FOOTPRINT.

THE GROWING OF TREES HAS NEVER BEEN GREATER IN THE UNITED STATES AND IN THE AMERICAS, FOR INSTANCE.

THERE ARE SO MANY NATURE-BASED SOLUTIONS.

WHETHER IT IS GROWING FOOD LOCALLY, SOURCING YOUR FOOD LOCALLY, GROWING TREES.

THE WHITE HOUSE HAS PUT OUT MOST RECENTLY NEW INCENTIVES FOR HEALTH CARE ORGANIZATIONS ALL AROUND THE COUNTRY, INCENTIVES TO DECREASE THEIR CARBON FOOTPRINT.

FOR INSTANCE, OUT OF ALL THE CARBON EMISSIONS IN THE COUNTRY, HOSPITALS EMIT 7% TO 10% OF CARBON EMISSIONS.

SO AS HEALTH CARE PROVIDERS, WE CAN HELP TO PUSH ON OUR ADMINISTRATORS AND, YOU KNOW, CEOs TO WORK ON THINGS TO DECREASE THE CARBON FOOTPRINT.

JOINING ORGANIZATIONS LIKE THE MEDICAL SOCIETY CONSORTIUM FOR CLIMATE CHANGE AND BECOMING A COMMUNITY AND FEELING LESS ISOLATED CAN PROVIDE US HOPE.

MAYBE BIKING TO WORK JUST ONE DAY A WEEK, OR TAKING PUBLIC TRANSPORTATION, THINGS LIKE THAT.

>> Laura: WELL, I REALLY APPRECIATED KIND OF ZOOMING INTO THE PROJECT ECHO, AND IT REALLY WAS YET ANOTHER REMINDER FOR ME THAT WHETHER YOU BELIEVE THE DATA OR WHETHER YOU ARE, YOU KNOW, ACTIVELY PAYING ATTENTION TO CLIMATE CHANGE, LIKE CLIMATE CHANGE IS HAVING AN INCREDIBLE NUMBER OF IMPACTS ON OUR DAILY LIVES.

SO THANK YOU FOR A REALLY AMAZING SERIES, AND I HOPE THAT ALL THE HEALTH CARE PROFESSIONALS WHO HAVE BEEN PARTICIPATING ARE REALLY APPRECIATING IT.

SO THANK YOU.

>> DR. KATZMAN: WELL, THANK YOU, LAURA, FOR EVERYTHING YOU'RE DOING TO REALLY SHOWCASE THE ENVIRONMENT.