This story is part of a series celebrating the work of women at the Columbia Climate School, in honor of International Women’s Day on March 8, 2022. Read more about the day and our related blog posts here.
When Dr. Linda P. Fried began her deanship at Columbia’s Mailman School of Public Health in 2008, she set out to find answers to a crucial question: What factors were going to profoundly affect human health in the 21st century? As a geriatrician and epidemiologist, she knew the issues that would confront humankind over the years would be of different dimensions than those of the previous century.
After she and her colleagues at the Mailman School carried out a lot of scenario modeling, it became glaringly evident that climate change would severely affect human health across the world in the near future. For instance, Fried pointed out that climate change has made hurricanes more dangerous during the last few decades. In addition, heavier precipitation events can lead to frequent flooding, which can cause a higher risk of contracting malaria and cholera in tropical countries such as Peru. And the increased frequency of major wildfires not only endangers people from the flames themselves, but also from the poor air quality that results.
The urgency of those preliminary findings galvanized Fried into action. A year later, she launched the nation’s first program on climate and health with her colleagues in the school’s Environmental Health Sciences department. “When we started this program in 2009, most people thought we were talking about science fiction,” said Fried.
Despite the lukewarm response and skepticism, Fried was determined. Under her leadership, she has been helping researchers, professors, and students to understand these issues on a deeper level and develop solutions to protect the public’s health in the face of climate change.
Fried started the Mailman School’s Climate and Health Program along with Joe Graziano, who was the chair of the Department of Environmental Health Sciences at Columbia. They recruited Patrick Kinney, an air pollution epidemiologist, who is now an associate professor at the public health school, to lead the program. Today, it is led by Jeff Shaman.
After 14 years of relentless hard work, Fried beams with pride about how the endeavor is thriving, with over 30 faculty members across the school who are delving into the intricate complexities of how climate change affects public health. But scaling up the program at a time when the climate crisis was still largely invisible to the masses was an arduous journey for Fried and her team.
Circumventing climate change apathy
While starting out in 2009, Fried said, “One huge challenge was that due to [the politicization of climate science], one of our most important funders, the National Institutes of Health, wouldn’t fund research work on the effects of climate change on health.”
“The inability to get grant funding has kept scientists from being able to work in this area in the past,” she added. “That makes philanthropic funding very critical.”
She observed that until recently, a vast majority of donors have been focusing mainly on mitigating climate change — or reducing and avoiding greenhouse gases emissions —and not as much on climate change adaptation, which includes minimizing the negative impacts of climate change. “It is vital to study adaptation measures for protecting human health and well-being. We have to move to a balanced portfolio of equally investigating mitigation and adaptation,” Fried explained.
It took time and painstaking efforts to secure adequate funding, which was not only frustrating for Fried and her team but also deeply concerning.
“These are urgent issues that we need to solve. We have the capabilities to solve them but we can’t do it without resources. But, the resources were not there back then. It’s taken a number of years — and primarily philanthropic support — to build this critical program,” Fried said.
Mainstreaming education about climate and health
Four years after establishing the Climate and Health Program, Fried went on to create another initiative that would ramp up the pace at which the entire health care system was being educated about the health impacts of climate change. This time, the idea came from former President Barack Obama’s special assistant, Alice Hill, who was leading policy development regarding climate change and national security.
In 2013, the Obama administration realized that the health impacts of climate change continued to be ignored but was critically needed. Hill approached Fried and suggested that there should be a program that would educate health care professionals about it.
The idea excited Fried and she decided to pitch it to global leaders at the global climate summit in Paris in 2015. After she presented the evidence on the public health impacts of climate change and the need for such an initiative, the World Health Organization announced that the concept was a critical health outcome of the Paris Climate Accords.
Yet, despite that response, no one volunteered to launch the education program. Again, Fried decided to kickstart the initiative at the Mailman School despite the fact that there continued to be very limited funding in the field of climate and health.
Grants from the Rockefeller Foundation enabled her to launch what would become a leading organization called the Global Consortium on Climate and Health Education (GCCHE) in 2017. GCCHE creates curriculum for climate and health courses with the help of experts all over the world. The courses are available free of cost for health professions schools that commit to educating their students on these issues.
Today, more than 240 public health, medical, nursing, and other health professionals’ schools are members of the consortium’s global network. All thanks to the GCCHE’s efforts, each one of them has committed to adding education on the health impacts of climate change to their curriculum.
While the dean of the Mailman School continues to diligently challenge the way people think about public health, her journey towards becoming a distinguished geriatrician also began with the same curiosity and growth mindset.
Venturing into geriatrics
A native New Yorker, Fried earned a bachelor’s degree in history from the University of Wisconsin in 1970. She then spent five years working in different jobs as a social worker and paralegal, according to a profile story about her in the New York Times. She went on to pursue an MD degree at the Rush Medical College in Chicago and trained in internal medicine at Rush-Presbyterian-St. Luke’s Medical Center.
“I didn’t plan on going into geriatrics,” she said. As someone who was trained as a general internist and epidemiologist, she wanted to focus on how to prevent chronic diseases when she started a faculty position at Johns Hopkins University in 1985.
At the time, she was delving into the role of physical activity in preventing cardiovascular diseases. That’s when she met Dr. William R. Hazzard, who had joined Johns Hopkins to work in the field of geriatric medicine. “He said to me one day that I should be a geriatrician,” said Fried. “I told him that, quite frankly, I wasn’t interested because I was excited about the research project I was already working on.”
“But when I looked at the data on aging and life expectancy, it took my breath away,” exclaimed Fried. “In the 20th century, we had done the inconceivable by increasing life expectancy by 30 years — all thanks to public health measures and social investments. It’s unbelievable.”
She further realized that it was important for researchers to understand whether it was possible for the masses to not only live longer but also lead healthy lives. “That was a very compelling question that most people weren’t working on at the time. So, two days later, I changed my career and got into geriatric medicine,” recalled Fried.
Since then, she has authored over 500 peer-reviewed articles and chapters. Before her research, frailty as a medical term was vague. It was considered to be synonymous with disability and comorbidity even though it is highly prevalent in old age. By defining frailty as a clinical syndrome, Fried developed a robust assessment tool for identifying, preventing, and treating frailty among older adults.
Fried doesn’t see her work in geriatrics as separate from her work on climate change. “Some of the work that I’ve done in defining frailty in aging is now related to how older adults who are frail have diminished abilities to handle extreme weather events,” she explained.
“During heat waves associated with climate change, it is frail older adults who are particularly vulnerable, along with infants. The longer lives that people all over the world are now experiencing require new expertise as to how to keep people healthy throughout their longer lives,” added Fried.
Enhancing collaboration between climate scientists and epidemiologists
Fried further pointed out that there is an interaction between infectious diseases like COVID-19, frailty and aging, and climate change. In public health, the term “syndemic” is used to define different epidemics or health consequences that mutually exacerbate each other.
For instance, there is compelling evidence that climate change is worsening the air pollution crisis globally. Exposure to air pollutants compromises individuals’ hearts, lungs, brains and immune systems and makes them more prone to severe COVID infections. Older adults are already highly susceptible to severe COVID infections that result in higher rates of hospitalizations and fatalities, so the additional impacts of air pollution are potentially very serious for older people.
“There are many other possible threats from climate change in terms of affecting life expectancy. It has not been modeled yet but it is still an important potential effect that we need to understand,” she said.
Fried’s future plans are to continue highlighting how climate change is wreaking havoc on people’s lives. This includes working out the details on new research projects that faculty from the Mailman School and Columbia Climate School could work on together.
In the past, the faculty of the Mailman School of Public Health has been deeply involved with the Earth Institute — now a part of the Columbia Climate School — in studying environmental issues across faculties, Fried reflected. “There is a lot of wonderful history for both the schools to build on,” she said. “It is my anticipation and hope that we can offer strengths to the Columbia Climate School on the health dimensions of climate change, which I think would round out the Climate School quite well.”