In the evolving landscape of modern medicine, one glaring omission persists across many medical education programs: the limited integration of environmental health. As the burden of disease increasingly correlates with environmental exposure ranging from air and water pollution to climate change and toxic chemicals, the need to embed environmental health into the foundation of medical training has never been more urgent.
Medical schools have traditionally emphasized pathophysiology, pharmacology, and patient-centered care. While these pillars remain essential, they often underrepresent the critical role that environmental factors play in disease etiology and prevention. Alice Chang, PhD, understands that failing to address environmental determinants of health limits the scope of medical education and, by extension, the capacity of future physicians to understand, diagnose, and prevent environmentally induced diseases.
The Environmental Determinants of Health: More Than a Backdrop
The World Health Organization estimates that nearly a quarter of all global deaths are attributable to environmental causes. From asthma exacerbated by urban air pollution to cancers linked to prolonged chemical exposure, the environment is not merely a background condition—it is a central player in human health outcomes.
Consider the rising prevalence of chronic respiratory diseases, many of which are aggravated or directly caused by air pollutants such as particulate matter (PM2.5), nitrogen dioxide, and ozone. Physicians trained to recognize symptoms and prescribe medication may offer temporary relief, but without an understanding of environmental triggers, they are less equipped to advocate for preventative measures or to counsel patients on minimizing exposure.
Similarly, climate change introduces new vectors for disease transmission, alters patterns of food and water security, and exacerbates heat-related illnesses. These are no longer future scenarios—they are current realities that demand clinical awareness. Physicians must be able to connect the dots between a patient’s illness and larger environmental trends, whether it’s the increased incidence of Lyme disease in expanding geographic areas or dehydration risks during unprecedented heatwaves.
Current Gaps in Medical Education
Despite the growing relevance of environmental health, it remains underrepresented in most medical school curricula. A 2020 survey published in Academic Medicine found that fewer than half of U.S. medical schools required any instruction on climate change and health. Even among those that did, the instruction was often brief, optional, or limited in scope.
This omission is not due to a lack of available knowledge. On the contrary, environmental health science is a well-established field with robust research and proven frameworks for education. What is missing is integration—a seamless inclusion of environmental health principles within existing courses and clinical training.
For example, when learning about cardiovascular disease, students could study the impact of air pollution and noise pollution on heart health. During infectious disease modules, discussions could include how climate change and deforestation influence the spread of zoonotic diseases. In pediatrics, curricula might highlight how early-life exposure to toxins like lead or endocrine disruptors can have lifelong consequences.
The integration of environmental health should not be confined to a single elective or guest lecture. Rather, it must be interwoven throughout the entirety of medical education to build a generation of physicians capable of approaching health with a comprehensive, systems-based mindset.
A Shift Toward Prevention and Advocacy
Medicine is increasingly shifting from a reactive model to a preventative one. Environmental health education complements this shift by encouraging upstream thinking—addressing the root causes of illness before symptoms emerge.
Training physicians to recognize environmental risks empowers them to become advocates for change. A doctor who understands the health implications of poor air quality is more likely to speak out in support of clean air policies. A pediatrician aware of lead contamination risks might push for stricter housing regulations or improved public health surveillance.
Medical professionals remain some of the most trusted voices in society. Their informed perspectives on environmental health can influence policy, shape public awareness, and guide communities toward healthier living environments. But this influence depends on foundational knowledge—something only possible through rigorous, comprehensive education.
Steps Toward Integration
Fortunately, the call to integrate environmental health into medical curricula is gaining traction. Leading institutions and professional organizations are beginning to respond. The American Medical Association (AMA), for instance, has passed resolutions urging the inclusion of climate and environmental health in medical education.
Innovative programs like the Climate and Health Curriculum Toolkit by the Global Consortium on Climate and Health Education (GCCHE) offer adaptable resources for schools seeking to introduce or expand environmental health content. Similarly, the Planetary Health Report Card—developed by medical students—evaluates how well medical schools address climate change and environmental issues, holding institutions accountable and driving competition for improvement.
To support long-term integration, medical education leaders must:
- Mandate environmental health instruction as a core component of accreditation and licensure requirements.
- Develop interdisciplinary teaching modules that link environmental exposures with clinical presentations.
- Invest in faculty development so instructors are equipped to teach environmental health topics accurately and effectively.
- Include environmental histories as standard practice in patient assessments, teaching students to ask about occupational exposure, housing conditions, and proximity to pollution sources.
- Foster community partnerships to expose students to real-world environmental health challenges and advocacy opportunities.
Looking Ahead: A Holistic Vision of Medicine
Integrating environmental health into medical curricula is not a luxury or a niche interest—it is a necessity for delivering effective, equitable, and future-ready healthcare. As environmental threats continue to shape public health outcomes, future physicians must be trained to recognize, address, and prevent environmentally-driven illness.
This integration calls for a holistic reimagining of what it means to be a doctor in the 21st century: not just a healer of individuals, but a guardian of community health, a steward of planetary well-being, and an advocate for environmental justice. By embedding environmental health into the heart of medical education, we equip tomorrow’s doctors with the tools they need to meet the complex challenges of a rapidly changing world.