A pediatrician wrote the book on how climate change is making kids sick

By Zahra Hirji

Debra Hendrickson used to avoid bringing up climate change at work. A pediatrician in Reno, Nevada, she treated kids for everything from asthma to depression without pulling their parents aside to explain how rising global temperatures are compromising human health. At least not until 2018.

That summer, Hendrickson was treating a boy for exposure to wildfire smoke from California, in a hospital room he shared with another boy also struggling to breathe. Looking out at the hazy sky, one of the kids’ fathers asked what was happening. Hendrickson, who has a background in forestry and environmental science, decided to be blunt: “It’s climate change,” she said. To her relief, no one scoffed, stormed out or demanded a new doctor.

“People are not denying the evidence really that’s right in front of them,” Hendrickson says. “They may have different explanations for what’s going on, but they understand that this is happening and it’s right outside the window.”

Six years later, Hendrickson brings up climate change with patients and their parents on the regular — so much so that in July she released her first book. In The Air They Breathe: A Pediatrician on the Frontlines of Climate Change, she shares anecdotes and explains all the ways climate change is making kids sick, sometimes fatally so.

“I really wrote this because I wanted parents to understand the urgency of the moment we’re in,” Hendrickson says.

As kids head back to school, Bloomberg Green spoke with Hendrickson about her book and how parents and teachers can keep kids safe in a warming world.

This interview has been edited and condensed for clarity.

Kids across the US are returning to school this month. What do you wish teachers and parents knew about how climate change is impacting them?

In schools, one of the biggest issues is that the higher temperatures we’re seeing are associated with more difficulty learning and behavior problems in classrooms. Schools in areas that have in the past been more temperate, like Seattle and Reno, if the air conditioning goes out, if they don’t have air conditioning because they’ve never needed it before at the time kids go back to school — those kids are more at risk of being affected.

Here in the West, smoke becomes a big hazard this time of year. Typically we’ve gone through a hot, dry summer, and the fires will often start in late summer or early fall. The main pollutant in smoke is particulate pollution and the particulates are often bound to heavy metals and toxic chemicals that are really bad for kids’ lungs and other organs. We see increased rates of wheezing, coughing [and] visits to the pediatrician when this kind of air hits down here.

But it also influences kids over time because their lungs and brains are still growing and developing. We know that kids who are raised in heavily polluted areas that have high rates of particle pollution, the kids are much more likely to have stunted, stiffer lungs. And those particles don’t stop at the lungs, they invade the bloodstream and affect every organ in the body.

What is it about kids that makes them more at risk of getting sick from the heat?

Pediatricians often say children are not just small adults. It’s because their physiology is very different from adults, and so you can’t use the same calculations and assumptions when you’re figuring out how much fluid to give them or that kind of thing. They have immature judgment and they depend on adults to tell them when it’s too hot, or when they are showing signs of heat illness, which a child may not recognize. The other reason that kids in general are more at risk from environmental hazards is that their organs are still developing and growing.

Beyond the physical impacts, climate change is also a source of anxiety and stress for kids. Have you seen this with your patients?

I tell the story in the book of this girl — I was just asking about her future and she suddenly brought this up. She wanted to work with kids because she wasn’t sure she wanted to have any on her own. She’d done some research with a local university on climate change and was feeling so down about what she was seeing in the models this scientist showed her. She didn’t want to talk to her mom about it because she didn’t want to upset her mom.

But at the end of that story, they were both getting involved and doing something about it. They went to a climate march downtown before the pandemic and that girl went on to be involved with some environmental projects to reduce her school’s carbon emissions.

The anecdote is to get kids involved in some kind of action, especially action to reduce carbon emissions in some way and have them join together with other kids. [The anxiety is] just below the surface for a lot of teens. I’ve had to tell some kids that you need to take a break from the news and just try to do something outdoors.

Speaking with families about climate change can be tricky because the issue is so politicized. What have you learned about how to do this effectively?

There’s often something going on outside or in the news that makes it easier to bring up. Throughout the summer, I give warnings about the heat and I’ll say, “Temperatures are rising.” No matter where the parents are coming from, they’ll usually go, “Yeah, I know.” People are not denying the evidence really that’s right in front of them. They may have different explanations for what’s going on, but they understand that this is happening and it’s right outside the window.

Then we talk about how to keep kids safe. I have brochures in the rooms about how they could decarbonize their homes or lives to help protect the air quality that kids are breathing. So focusing on immediate health benefits is a less political topic. Everybody loves for their kids to have clean air and clean water. Everybody here loves the outdoors.

Have you gotten any pushback from parents?

I don’t push the issue to the point of an argument. I think the best way to approach any conflict like that is to ask questions about where they are coming from, like: Do you have any concerns about this? What are your thoughts about this? Do you want ideas for how to deal with this? Then it’s really up to them. It never works well to really lecture people. They’ve looked at what techniques work for talking to vaccine-resistant parents; often the more you talk at them, the more resistant they get. It’s sometimes better just to create a little space and ask a question and see where they go.

What have your patients taught you about climate change?

I’ve learned that it’s affecting them. Summer used to be the time that you were off school and everything was carefree. Now you have to worry about smoke and heat. It makes me upset and angry. It’s a crime against them that’s being committed that we are all sitting back and watching. It’s not just a crime, it’s probably the biggest crime that has ever been committed. It’s going to affect every child who ever lives from now on.