Champion Stories: Laalitha Surapaneni

Meet Laalitha Surapaneni.

Laalitha is a board-certified internal medicine physician at the East Bank campus of M Health Fairview University of Minnesota Medical Center and assistant professor at the University of Minnesota Medical School. With a master’s in public health and years of clinical experience, Laalitha aims to understand the health impacts of climate change and how physicians can promote clean climate policies that advance public health. As part of her climate advocacy work, Laalitha has testified in front of the Minnesota Legislature on the health impacts of climate change and has championed climate and health through a governor-appointed role on the Sustainable Transportation Advisory Council for the Minnesota Department of Transportation. She is also a member of Health Professionals for a Healthy Climate.

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

Laalitha: At the university, I'm a hospitalist, an internist taking care of hospitalized adult patients. Climate change is a social determinant of health, and so my clinical work involves counseling patients on how they can minimize environmental impacts on their health - much as I would counsel someone on a safe home environment to prevent falls, healthy lifestyle choices, or tobacco cessation. For example, if I have an elderly patient who comes in during the summer months (for any condition, not necessarily heat-related illness), I might ask if they have access to air conditioning or whether they live alone. I try to assess their risk of succumbing to extreme heat, while also discussing how they might protect themselves from heat-related illness. The conversation is similar for other relevant environmental health threats someone might face. For example, if a patient has COPD (Chronic Obstructive Pulmonary Disease), I might talk to them about poor air quality and how that impacts their health. In terms of how my work responds to climate change as we see it in Minnesota, healthcare institutions around the world, including Fairview, are recognizing the impact our systems and the way we provide care has on our environment. For instance, U.S. healthcare contributes to around 8% to 9 % of the country’s annual carbon footprint. As such, there’s a lot of momentum right now to decarbonize the U.S. healthcare sector and deliver healthcare sustainably.

How do you promote environmental justice and health equity?

Laalitha: From the data, we know that low-income communities and BIPOC communities suffer the brunt of environmental health impacts. In my work as a physician-advocate, I try to work towards long-term systemic change that promotes health equity and climate justice. As academics, we are at risk of falling prey to an ivory tower approach to climate action, which often results in inequitable and insufficient solutions. So, part of centering equity in my work involves recognizing community wisdom and working closely with frontline communities - communities who are closest to the issue. I find that those we deem “vulnerable” communities are the ones who are problem-solving and leading with action. Centering the work that these communities are doing, working in partnership with them, and lending my expertise when asked for are some of the ways I try to prioritize equity. In fact, as a physician-mentor for Twin Cities Medical Society (TCMS) public health advocacy fellowship, I recently helped author a paper on how to train medical students in community-centered advocacy. The paper includes principles applicable to climate and community-health advocacy, especially for those going into, or currently in, a health profession.

How has climate change impacted you personally?

Laalitha: I grew up in a coastal city in southern India. Throughout my childhood, I remember noticing that the summers were getting hotter, and the coastline was creeping closer. However, the thing I remember the most is the unfair distribution of climate impacts. This is something I could recognize even as a child. Growing up, I would read about mass farmer suicides as a result of drought. As a medical student, I would see patients who suffered from heat stroke after working outdoors in extreme heat without any respite. Now, halfway across the world, I still see these disproportionate impacts. It’s this need to address these injustices that drives my work around climate change.

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

Laalitha: The scientific literature recognizes that climate change is one of the biggest public health threats. Regardless of where we live or where we practice as health professionals, we’re all caring for patients who are suffering from climate-related health impacts. Whether that’s asthma attacks from wildfire smoke, hospitalizations due to extreme heat, or physicians not being able to provide care due to extreme weather events like hurricanes, climate change is here. It’s bringing patients to our clinics and our hospitals. In order to respond to this global health crisis, it is necessary that we educate ourselves. We also need to be thinking proactively about how we can work upstream to protect our communities and our patients from the worst health impacts and advocate for our health and the health of our planet.

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

Laalitha: Individual actions are no longer enough at this point in the climate crisis. Thinking about our role as academics and health professionals, I don’t think we can merely make personal changes in our lives (like buy an electric car and call it a day). We need system changes. As health professionals and scientists, we can play a critical role in the climate crisis storytelling. We must share the impacts we’re seeing in the clinic and in our communities. Even more importantly, we need to advocate for climate action that promotes public health. Climate action that promotes health includes advocating for emissions reduction within our hospital systems, working directly with communities to adapt to health impacts of climate change, and demanding clean climate policies from our legislators.

What can someone without public health or medical experience do to help highlight climate change as a public health issue?

Laalitha: One important thing we can all do when designing climate solutions is make sure our work is multi-sectoral. For people outside of the public health field, this means considering if your work will be strengthened by inviting either an impacted community member or someone with health expertise to the table. For many climate adaptation programs, it’s really great to have health professionals in the mix because we bear witness to our patient’s experiences and could be a part of creating impactful solutions. For instance, new bike paths should consider air quality, urban planning needs to consider increasing pollen from climate change, and cooling centers need to be accessible via public transit.

What are some of the biggest challenges for the climate and health space?

Laalitha: The despair and detachment people feel around climate change. News around climate change is often too overwhelming and, it’s easy to feel like not much can be done. I’ve personally felt the anxiety that our governments are not acting fast enough. However, whenever I feel despair creeping in, I try to refocus my thoughts and remind myself why I do what I do. I would encourage anyone who is feeling dejected to take a break and refocus from climate change in the abstract to climate justice. Frontline communities who are suffering the worst of climate impacts do not have the privilege to walk away. It's our moral responsibility, especially as health professionals, to engage in this work to promote community and planetary health.

On the flip side, is there anything or anyone that gives you hope for the climate and health space?

Laalitha: Personally, engaging in the work is what helps me stay hopeful. There was a time when I used to think that I would be able to take on this work if I could find some hopeful developments. But, I realized that in a crisis, just as we cannot let despair keep us down, we cannot wait for hope to inspire us into action. I now know that working in community with others towards a common goal helps me grow my hope every day.

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