Renee Salas

Renee N. Salas is an American medical doctor who is an attending physician in Emergency Medicine at Massachusetts General Hospital, Assistant Professor of Emergency Medicine at the Harvard Medical School, and the Yerby Fellow at the Harvard T.H. Chan School of Public Health.^[1][2] She was previously the Burke Fellow at the Harvard Global Health Institute, where she remains one of the Affiliated Faculty.^[3]

Renee Salas
Alma mater	Harvard T.H. Chan School of Public Health Cleveland Clinic Lerner College of Medicine Case Western Reserve University, Saint Mary’s College
Scientific career
Fields	Emergency Medicine, Climate change and the Health System
Institutions	Massachusetts General Hospital Harvard Medical School Harvard T.H. Chan School of Public Health

Salas leads efforts to make physicians and hospitals become more active in their response to climate change.^[4][5][6] She was senior author of the 2022 Lancet Countdown on Health and Climate Change U.S. Brief and lead author of previous U.S. Lancet Countdown briefs in 2021, 2020, 2019^[7][8][9] and 2018.^[10] She has worked with The New England Journal of Medicine both as a co-director for the first Climate Crisis and Clinical Practice Symposium, held in 2020, and as an NEJM guest editor on climate change and health.^[11][3]

Salas serves on the planning committee for the Climate Change and Human Health Initiative of the National Academy of Medicine, and has testified before Congress' House Committee on Oversight and Reform.^[12] In 2021 Salas was elected as a Member of the National Academy of Medicine (NAM) for her work on climate change, health and the health care system.^[13]

Early life and education

Salas attended Saint Mary's College in Notre Dame, Indiana from which she received a B.S. in biology in 2003 with minors in chemistry and psychology.^[12] She then attended the Cleveland Clinic Lerner College of Medicine (CCLCM), a program within the Case Western Reserve University School of Medicine in Cleveland, Ohio. Salas was one of the first group of students to be accepted by the Cleveland Clinic Lerner College of Medicine in its inaugural year in 2004.^[14] She earned both an MD and a Master's of Science in Clinical Research from Case Western Reserve University. After graduating, Salas held a residency at the University of Cincinnati, the first program in the country to offer an emergency medicine training program.^[15]

Salas started a two-year wilderness medicine fellowship at Massachusetts General Hospital (MGH)^[14] in 2013. As part of her fellowship she attended a lecture on climate change, where she first heard that climate change would be the next public health emergency. Up until that point she had never considered that climate change would impact her patients. This lecture made her reconsider her career, shifting her research focus to climate change and its impact on public health. She went on to also earn a master's degree in public health with a concentration in environmental health from the Harvard T.H. Chan School of Public Health^[16] in 2016.^[12]

In 2015 Salas was awarded a wilderness medicine fellowship and worked as a physician for the Himalayan Rescue Association in the Everest base camp.^[15] She was one of very few medical doctors in the vicinity when the 2016 Imphal earthquake struck Nepal, and worked to save the lives of the Sherpas and visiting climbers.^[15][17]

Research and career

In addition to practicing emergency medicine as a physician in the Department of Emergency Medicine at Massachusetts General Hospital and at Harvard Medical School, Salas studies the ways in which climate change is impacting both patients and the healthcare system. She works with health professionals to improve climate education, practice, research, and advocacy, to foster resilience, preparedness and effective leadership.^[11][18] When asked about the impact of climate change on the medical system, Salas remarked, "A climate lens must be added to every aspect of our practice. Speaking as an emergency medicine physician, that includes everything from ambulance and triage protocols to the screening tools we use. It also impacts how we treat patients, the discharge instructions we provide, and the follow-up plans".^[16]

Salas emphasizes that climate change is a "metaproblem" which underlies many others and a "threat multiplier" which broadly affects the practice of medicine and all facets of work in the medical profession.^[19] The many physical effects of climate change include increased heat, extreme weather, sea level rise, air pollution from CO₂, ozone, and wildfires. longer pollen seasons and higher levels of pollen in the air, wider dispersal of diseases, and food insecurity. The impacts on people's health include heat-related illness, increased cardiovascular and respiratory difficulties, problems in pregnancy, stress, anxiety, depression, poor nutrition, and increases in water- and vector-borne diseases such as Zika and Lyme.^[20][21] While those who are more vulnerable are more likely to suffer the effects initially (children, the elderly, the poor, those with chronic medical conditions, some racial groups), more and more individuals will be affected as climate change intensifies.^[16]

Salas connects these broad issues to the patients she sees in daily practice like the mother whose daughter's asthma worsened due to a combination of heat stress, pollen, and vehicular air pollution. She emphasizes that standard protocols must be adapted to take environmental conditions in which patients live into account during diagnosis and treatment. Some medications may be less effective depending on temperature. Patients who are dealing with extreme living conditions may be less able to respond to standard treatments. Hospitals themselves are increasingly at risk as physical conditions worsen, extreme weather events occur, supply chains are disrupted, and the demands and stresses facing medical personnel increase.^{[4][21][22][23]} For example, during a heat wave in 2018, the power failed at Mount Auburn Hospital. Firefighters had to be called to move patients from the hot rooms at the top of the building.^[22]

Despite the clear risks that global warming presents to human health,^[24][25] a survey conducted by the International Federation of Medical Students' Associations revealed that only 16% of medical schools included climate change on their curriculum.^[20] Salas founded and served as Chair of the Climate Change and Health special interest group of the Society for Academic Emergency Medicine.^[26][27]

Salas was the lead author of the U.S. Lancet Countdown briefs in 2018, 2019, 2020, and 2021 and the senior author of the 2022 Lancet Countdown on Health and Climate Change U.S. Brief.^{[7][8][9][28][29]} In February 2020 Salas was one of the co-directors and the keynote speaker of the Climate Crisis and Clinical Practice Symposium at Harvard Medical School, which encouraged clinicians and hospitals to take on a more active role in responding to climate change.^[21][30]

During the COVID-19 pandemic, Salas became concerned that the United States was unprepared to address both COVID-19 and climate change.^[31] In an opinion article for The BMJ in 2020 she emphasized three lessons from the COVID pandemic that needed to be applied to the climate crisis. She encouraged health professionals to use their position as trusted sources to promote action; to prioritize prevention; and to respond rapidly, globally, and in a coordinated fashion.^[32]

Awards

• 2022, Public Health Leadership Award, Society for Academic Emergency Medicine (SAEM)^[33]
• 2022, Early Career Alumnus Award, Alumni Association, Cleveland Clinic Lerner College of Medicine^[34]
• 2021, Member, National Academy of Medicine^[13]
• 2020, Shannon Scholar, St. Mary's College^[12]
• 2020, Early Career Leadership Award, Case Western Reserve University School of Medicine^[35][36]
• 2019, Yerby Fellowship, Harvard T.H. Chan School of Public Health^[37]
• 2018, Burke Fellowship, Harvard Global Health Institute^[38]
• 2018, Clinician-Teacher Development Award, Massachusetts General Hospital^[39]
• 2016, Eleanor and Miles Shore 50th Anniversary Fellowship Program for Scholars in Medicine, Harvard Medical School^[40]

Selected publications

• Salas, Renee N. (August 5, 2020). Written Testimony for the House Committee on Oversight and Reform Hearing: "The Devastating Health Impacts of Climate Change" August 5, 2020 Testimony of: Renee N. Salas, MD, MPH, MS..." (PDF). www.congress.gov.
• Salas, Renee N.; Slutzman, Jonathan E.; Sorensen, Cecilia; Lemery, Jay; Hess, Jeremy J. (July 2019). "Climate Change and Health: An Urgent Call to Academic Emergency Medicine". Academic Emergency Medicine. 26 (7): 837–840. doi:10.1111/acem.13657. ISSN 1069-6563. PMID 30408266. S2CID 53237339.
• Salas, Renee N.; Solomon, Caren G. (August 22, 2019). "The Climate Crisis — Health and Care Delivery". New England Journal of Medicine. 381 (8): e13. doi:10.1056/NEJMp1906035. ISSN 0028-4793. PMID 31433915. S2CID 201276100.^[41]
• Salas, Renee N. (July 16, 2015). "Humanity, Teamwork, and Art in Post-Earthquake Nepal". New England Journal of Medicine. 373 (3): 205–207. doi:10.1056/NEJMp1506643. ISSN 0028-4793. PMID 26083121.
• Rini, Brian I.; Tamaskar, Ila; Shaheen, Phillip; Salas, Renee; Garcia, Jorge; Wood, Laura; Reddy, Sethu; Dreicer, Robert; Bukowski, Ronald M. (January 3, 2007). "Hypothyroidism in Patients With Metastatic Renal Cell Carcinoma Treated With Sunitinib". JNCI: Journal of the National Cancer Institute. 99 (1): 81–83. doi:10.1093/jnci/djk008. ISSN 0027-8874. PMID 17202116.^[42]

References

1. "Renee Salas, MD, MS, MPH - Department of Emergency Medicine". Massachusetts General Hospital. Retrieved January 10, 2023.
2. Johnson, Steven Ross (June 24, 2022). "The Demographics of Disaster". U.S. News & World Report - The Report. pp. C21–C25. Retrieved January 10, 2023.
3. "Renee N. Salas". Harvard T.H. Chan School of Public Health. September 5, 2019. Retrieved January 10, 2023.
4. Boyle, Patrick (November 14, 2022). "Sicker patients serve as clarion call for doctors to take on climate change". AAMC News. Association of American Medical Colleges. Retrieved January 10, 2023.
5. "Renee Salas, MD, MPH, MS, on intersection of health and the climate crisis". AMA Moving Medicine Video Series. American Medical Association. January 20, 2022. Retrieved January 10, 2023.
6. . The Healthcare Policy Podcast. June 19, 2019. Archived from the original on August 8, 2019. Retrieved May 7, 2020.
7. "Lancet Countdown on Health and Climate Change: Policy Brief for the U.S." Harvard Global Health Institute. Retrieved January 10, 2023.
8. Miller, Naseem S. (October 27, 2021). "Finding local stories in The Lancet's health and climate change report". The Journalist's Resource. Retrieved January 11, 2023.
9. "The Lancet Countdown on health and climate change". The Lancet. Retrieved January 10, 2023.
10. Salas, Renee N.; Knappenberger, Paige; Hess, Jeremy (November 28, 2018). 2018 Lancet Countdown on Health and Climate Change Brief for the United States of America. London, United Kingdom: American Public Health Association.
11. "Renee Salas, MD, MS, MPH: NEHI Innovator in Health". Network for Excellence in Health Innovation (NEHI). December 2, 2022. Retrieved January 10, 2023.
12. "Saint Mary's Hosts 2021 Spring Shannon Scholar | Saint Mary's College, Notre Dame, IN". Saint Mary’s College. Retrieved January 10, 2023.
13. "Renee Salas, Howie Frumkin elected to the National Academy of Medicine for climate work". C-CHANGE | Harvard T.H. Chan School of Public Health. October 18, 2021. Retrieved January 10, 2023.
14. "2016 Mid-Atlantic Student Wilderness Medicine Conference: Renee Salas, MD, MS". Wilderness and Disaster Medicine Interest Group, Thomas Jefferson University. 2016. Retrieved July 13, 2020.
15. "Emergency Physician Dr. Renee Salas Treats Injured in Nepal Earthquake". ACEP Now. July 15, 2015. Retrieved May 7, 2020.
16. Powell, Alvin (February 10, 2020). "Heatwave = heat stroke = ER visit". Harvard Gazette. Retrieved May 7, 2020.
17. Powell, Alvin (April 28, 2015). "'I felt as if I was on a boat at sea'". Harvard Gazette. Retrieved January 10, 2023.
18. Healthy Food Team (September 25, 2018). "Climate and emergency medicine resources". Health Care Without Harm. Retrieved January 10, 2023.
19. Scott, Sophia C. (June 5, 2022). "Climate Change as a Public Health Crisis: A Conversation With Dr. Renee N. Salas". Harvard Health Policy Review. Retrieved January 10, 2023.
20. Earls, Maya (December 27, 2019). "Despite Climate Change Health Threats, Few Medical Schools Teach It". Scientific American, E&E News. Retrieved May 7, 2020.
21. Feldscher, Karen (February 19, 2020). "Climate in the clinic". Harvard College. Retrieved May 7, 2020.
22. Bailey, Melissa (April 20, 2020). "How climate change is putting doctors in the hot seat". Kaiser Health News. Retrieved May 7, 2020.
23. Hodgson, Camilla (January 15, 2020). "Hottest decade ever recorded 'driven by man-made climate change'". Financial Times. Retrieved May 7, 2020.
24. Suran, Melissa (June 21, 2022). "UN Reports New Insights on Link Between Climate Change and Human Health". JAMA. 327 (23): 2276–2277. doi:10.1001/jama.2022.9240. PMID 35648449. S2CID 249237059.
25. Kluger, Jeffrey (November 25, 2019). "How Climate Change is Clobbering Kids' Health". TIME Magazine. Vol. 194, no. 22/23. Retrieved January 10, 2023.
26. "SAEM Committee & Academy Handbook April 2019" (PDF). Society for Academic Emergency Medicine. Retrieved January 10, 2023.
27. Salas, Renee N.; Slutzman, Jonathan E.; Sorensen, Cecilia; Lemery, Jay; Hess, Jeremy J. (July 2019). "Climate Change and Health: An Urgent Call to Academic Emergency Medicine". Academic Emergency Medicine. 26 (7): 837–840. doi:10.1111/acem.13657. ISSN 1069-6563. PMID 30408266. S2CID 53237339.
28. "2019 Report". Lancet Countdown. Retrieved May 7, 2020.
29. Chandler, Ashlie (November 28, 2018). "Global climate report warns of serious threats to health, productivity and livelihoods | UW School of Public Health". University of Washington School of Public Health. Retrieved January 10, 2023.
30. "The Climate Crisis and Clinical Practice Symposium" (PDF). Beth Israel Deaconess Medical Center. Retrieved January 11, 2023.
31. "Climate Change and Health: Learning from COVID-19 | SPH | Boston University". School of Public Health. May 14, 2020. Retrieved January 10, 2023.
32. "Renee N. Salas: Lessons from the covid-19 pandemic provide a blueprint for the climate emergency". The BMJ. April 23, 2020. Retrieved May 7, 2020.
33. "Past Award Winners". Public Health Leadership Award. Retrieved January 10, 2023.
34. "Dr. Renee Salas is First to Receive Early Career Alumnus Award". Cleveland Clinic. October 18, 2022. Retrieved January 10, 2023.
35. "Renee Salas". Harvard Catalyst. Retrieved January 10, 2023.
36. "Early Leader" (PDF). Case Western. Retrieved January 10, 2023.
37. Williams, Michelle A. (2020). End-of-Year Report to the Harvard Chan School Community (PDF). Harvard T.H. Chan School of Public Health. p. 30. Retrieved January 11, 2023.
38. "Current and Past Fellows". Harvard Global Health Institute. Retrieved January 11, 2023.
39. "Clinician-Teacher Development Award". Massachusetts General Hospital. Retrieved January 10, 2023.
40. "Eleanor and Miles Shore 50th Anniversary Fellowship Program for Scholars in Medicine 2016 Annual Reception" (PDF). Harvard Medical School. Retrieved January 10, 2023.
41. Salas, Renee N.; Solomon, Caren G. (August 22, 2019). "The Climate Crisis — Health and Care Delivery". New England Journal of Medicine. 381 (8): e13. doi:10.1056/NEJMp1906035. ISSN 0028-4793. PMID 31433915.
42. Rini, Brian I.; Tamaskar, Ila; Shaheen, Phillip; Salas, Renee; Garcia, Jorge; Wood, Laura; Reddy, Sethu; Dreicer, Robert; Bukowski, Ronald M. (January 3, 2007). "Hypothyroidism in Patients With Metastatic Renal Cell Carcinoma Treated With Sunitinib". JNCI: Journal of the National Cancer Institute. 99 (1): 81–83. doi:10.1093/jnci/djk008. ISSN 0027-8874. PMID 17202116.