Champion Stories: Micah Niermann

Meet Micah Niermann.

Micah is the Chief Medical Officer at Gillette Children’s. Prior to his current position, Micah practiced internal medicine and pediatrics and served as the Director of Medical-Surgical Services at Children’s Minnesota as well as the Internal Medicine-Pediatrics Hospitalist Lead at Abbott Northwestern Hospital. As a practicing physician, Micah realized that to be an effective health professional, he also needed to have a full understanding and appreciation for climate health. Aside from his administrative and clinical work, Micah serves on the Governor’s Advisory Council for Climate Change where he uses his health expertise to inform Minnesota climate policy and helped craft Minnesota's Climate Action Plan.

How does your work deal with climate and health, specifically as we see it occur in Minnesota?

Micah: My work deals with climate and health on several levels. On the patient care level, climate change will have a profound effect on the patients I serve because of their medical complexity and support needs. For example, a lot of our patients are on ventilators or feeding pumps, or in wheelchairs. How would they evacuate during extreme weather conditions? You don’t have to look far to see a real-world example. For instance, there was enormous chaos that ensued with Hurricane Katrina. How prepared are we as health systems to be able to endure large scale weather events, especially as they occur more frequently? Apart from evacuation capability, I also have to think about worsening air quality. Many of our patients have significant lung disease. Due to muscular or skeletal defects, they may have difficulty breathing or be unable to take deep breaths. These patients are at a greater risk for severe lung issues, including inability to breathe, due to wildfire smoke or other climate-related events. On the administrative level, I can help work with other leaders within Gillette to reduce our own greenhouse gases and work with leaders from other health systems to accelerate climate action. Finally, I can utilize my leadership position to advocate for vulnerable populations in conjunction with Gillette’s advocacy team at state and federal levels.

How do you promote environmental justice and health equity in your work?

Micah: Given the mission and the types of conditions we treat at Gillette, our care is naturally suited to focus on health equity and environmental justice. For instance, Gillette is committed to ensuring that the voices of patients within the disability community are heard and recognized through state and federal policy debates on healthcare and climate issues. Gillette is also devoted to making sure that all communities outside of our own healthcare system, especially those most adversely affected and historically discriminated against, are being heard. Part of the foundation of this work occurs with building stronger partnerships with providers in underserved communities as well as fostering mentorship programs with youth.

How has climate change impacted you, or your community, personally?

Micah: You cannot mistake the effects of climate change in Minnesota. Spring is arriving sooner, winters are warmer, the summers are hotter and at times are downright tropical. There have been days this summer when Minneapolis has been hotter than parts of Texas. Algae blooms fueled by warm weather and nutrient rich run-off are more common. Where do I stop?

I cannot underscore this statement enough: There is no greater threat to human health than climate change. We are products of our environment, and climate change is going to affect every aspect of our lives and destabilize current systems that provide our necessities such as food, water, and electricity. From just the healthcare lens, we already have seen patients with chronic illnesses experience exacerbations of underlying conditions due to climate related events like heat waves. We have flooding and droughts, the spread of vector-borne diseases, and rising food prices.

What keeps me up at night are the climate related changes we will see within the next decade if we don’t act now. And I want to be part of the solutions that aim to mitigate many of these changes.

Why do you think it’s important for physicians to integrate climate change into their work?

Micah: As health care providers, we are committed to do no harm—it's part of our Hippocratic Oath that we take when we first enter medicine. This needs to include harm from climate change. Climate change is going to affect everyone. It is our ethical and moral obligation to our patients to address issues that are going to adversely affect their health. We’ve addressed the health implications of tobacco use and not wearing seat belts. Climate change is just on a massive scale. We have to recognize climate change for what it is: a health crisis.

What is something impactful that physicians can do to protect people’s health in the face of climate change?

Micah: When I was a first-year med student, a community physician I followed asked me: what is the most important thing a physician does? The answer was to educate. We educate in all of our interactions with patients and families. We talk to them about their conditions and treatments. We help to educate them so that together we can help them make the best decision possible. Part of this education includes understanding the many factors that influence health such as employment, nutrition, housing and now climate change. As health care providers, it is our responsibility to educate ourselves and our patients on the impacts of climate change.

What are some of the biggest climate and health challenges right now?

Micah: I think there are two large ones. First, I worry that our health care infrastructure isn’t equipped to handle repeated mass weather events, spreading infectious diseases, and exacerbations of chronic conditions. The COVID-19 pandemic laid bare numerous weaknesses in our health care system. Our health care system needs to be changed, not only in how we are structured to manage health, but also in how health care is incentivized. Ultimately, we have a health care system that is based on short-term rewards when it needs to be focused on creating resiliency to long-term repeated threats.

The other big challenge is making sure that we as a community recognize that climate change is real and that we must do something about it. This recognition will only come about through more conversations—through reaching out and talking with people who think otherwise. It’s important to understand why people feel the way they do and help them understand that climate change is a significant problem that also affects them. We are all in this together, and we have to figure it out together.

On the flip side, is there anything giving you hope for the future of climate and health?

Micah: There’s always hope. As a history major, what I really took away from my studies is that people are capable of incredible damage, but also amazing creativity. Even during the bleakest of times, human beings have risen to the challenge through perseverance and innovative thinking. We are fully capable of mitigating climate change.

I read articles daily about advancements in science and technology that can reduce our greenhouse gas emissions through better efficiencies, lower cost, and easier access. In addition to our capacity to create solutions, there is also a spirit of change I sense now through stronger calls for action across many communities.

What can someone not in public health do to protect people’s health in the face of climate change?

Micah: What it comes down to are the two biggest challenges I mentioned previously. It’s critical to have conversations with people who don’t recognize climate change as a real and significant threat. We must be open to listening and understanding their values. Meaningful change is built on relationships. This starts with having small conversations, whether that’s among family, friends, or neighbors. These relationships are the most significant way to make a direct impact. If we don’t talk about it, nothing will happen.

The opinions expressed in these stories are the interviewees and do not necessarily reflect the opinions of MDH.