IHP Interview with Suellen Breakey from the Center for Climate Change and Health Equity

The MGH Institute’s Center for Climate Change and Health Equity is a nurse-led initiative focused on exposing and educating all health professionals on how they can respond to the impacts of climate change through education, practice, adaption, and resiliency. The Center’s work was recently recognized with a Friends of the Earth award from Salem State University. To recognize that today is Earth Day, Suellen Breakey, the director of the Center, who spoke with the OSC’s Lisa McEvoy for this month's IHP Interview about the history of the Center, how it has contributed to education and scholarship at the MGH Institute and beyond, and some of the Center’s newest initiatives. 

How did the Climate Center begin?

Patrice Nicholas and I had written a global health text that was published in 2015. We were finishing up the book when I thought about including a chapter on climate change. There was an editorial in Health and Human Rights by Paul Farmer, Jay Lemery, and Carmel Williams that highlighted climate justice, which is the idea that those who contribute least to greenhouse gas emissions bear a disproportionate burden. That got us interested in it and Patrice took the lead on the chapter and that’s how we started to understand about climate change and health. That started our work in this area.  

The dean who was here at the time, Inez Tuck, encouraged us to move this idea forward. With a small group of interested faculty, we created the Center in 2017, with Patrice as our inaugural director. We just began by getting out there. We participated in a lot of nursing grand rounds at hospitals within the Mass General Brigham system. By word of mouth, we got invited to speak in different places in the community. We were really focused on scholarship and disseminating work through publications and presentations. We were also focused on educating students about the connection between climate change and health and have guest lectured in several courses within the nursing program and co-hosted several student events. 

Our steering committee grew to include staff and people from other disciplines such as PA, OT, and healthcare leadership. The work has continued to evolve and grow. In 2017, people were not really talking about climate change. Now it has become something people are much more familiar with. Not everybody believes it is caused by humans; but it is hard to deny that it is happening. 

A lot of work has gone on nationally and internationally to think about how healthcare providers can address this issue, particularly since it is inextricably tied to health.  From the beginning, we have been able to connect with people who are also interested in climate change and health. We got involved with some national initiatives like the Nurses Climate Challenge where the goal was to educate 50,000 healthcare providers, and have had a strong relationship with the Alliance and Nurses for Healthy Environments for several years. I just finished a two-year term as the co-chair of their Global Climate Change Committee and still sit on their steering committee. 

Around the same time, the Global Consortium for Climate and Health Education out of the Columbia University Mailman School of Public Health started a global nurses working group that I got involved in. The global nurse working group work has been working on creating learning resources for faculty — learning objectives, case studies, and slides that can be found on the Climate Resources for Health Education website. The work was initiated by a group of medical students and faculty and has expanded to include the nursing group as well as public health and pharmacy among others.  These resources are free and available to faculty and students globally. 

How much are climate change issues integrated into the curriculum at the MGH Institute?

We just submitted an application to be a National League of Nursing Center for Excellence around Climate and Planetary Health. The application process included a deep dive into what people are doing so we have seen that it is extensively integrated across the School of Nursing curriculum. We would be happy to work with faculty from other schools if they have questions or are looking for resources or ideas. 

Within the School of Nursing, we have done two or three faculty development workshops where we introduced the faculty to some great resources like the Global Consortium for Climate and Health Education, as well as provided faculty with ideas and tips about how they can integrate climate change information into their curriculum. It has been integrated into several courses at all levels. Pre-licensure faculty have it in some of their courses and advanced practice faculty are using case studies and lectures on climate change topics in their courses 

Currently, we are in the process of creating a module that all the advanced practice students complete to ensure they get the information on the health aspects of climate change as well as advocacy and policy knowledge around climate change efforts. Addressing climate advocacy and policy is really what is needed to see tangible outcomes; and there is a more clear understanding and a call nationally for nurses to get involved with policy and advocacy at all levels. 

A couple of years ago, we published the results of a survey we did with faculty and students at the IHP across all professions about what they think we should be addressing about climate change. Do they think it's something that's within their professional responsibility? We included open-ended questions asking about barriers to curricular integration and the resources needed.

We got so much rich data from these open-ended questions and created a tentative model of what successful integration should look like. As a result of this publication, I was invited to speak at the American Association of Colleges of Nursing national conference in December to talk specifically about how people can start to think about integrating this into the nursing curriculum. This was the first time that this annual conference for Baccalaureate and Advanced Practice faculty addressed the importance of addressing climate change and health in the curriculum and was well-received by participants.

How did the Center’s early work evolve and where do you see it going next?

When Ken White became dean in 2021, he brought in a consulting company to help us develop our strategic plan. It was a great process that led us to focus on four areas — scholarship and thought leadership, education, community engagement and advocacy, and sustainability of the Center.

While we maintain productivity in disseminating scholarship and curricular integration, we are now focused on engaging with surrounding communities. Kathy Sabo, who is principal investigator on a $3 million HRSA grant, which is specifically focused on addressing health-related climate impacts and social and environmental determinants of health, is a member of the steering committee. I am a co-investigator on the grant along with steering committee members Eleonor Pusey-Reid and Tominsin Olayinka. The grant has been helpful in getting students and the climate center into the community  where are doing work with GreenRoots, an organization in Chelsea and different schools in the area. The students are facilitating workshops for people around heat, air quality and emergency preparedness, helping them to think about what how to plan for the next extreme weather emergency.  

We have also started to forge relationships with Kim Truong and Callie Watkins Liu in the Mission, Values, and Community Excellence Office. We hosted walking tours in Roxbury and Chinatown that were really eye-opening. We met with a nonprofit group from Roxbury called Alternatives for Community Engagement, or ACE, and we are hoping to collaborate further on some projects that will happen within the community around heat and air pollution. 

Lastly, we have a nascent relationship with Mothers Out Front, a grassroots national organization. Last year, we invited someone from the East Boston chapter come and do a lunch and learn with students and faculty. They host monthly action calls — the most recent call was about the important role libraries play as climate-resilient hubs, which is being threatened by cuts to their federal funding. The proposed actions for this call included small ways to support your library and writing to your legislators to oppose funding cuts. Their work is practical, yet powerful at the same time and something anyone can get involved in. It seems like a small way to get involved but every action makes a difference.  

What can people do on Earth Day?

This is the 55th year of Earth Day and the theme this year is Our Power, Our Planet with the goal of increasing renewable energy. Two great sites include Earth Day Boston and the larger national Earth Day site that both have really great ideas of what people can do. On the Earth Day Boston site, you can calculate your individual carbon footprint and look at ways to decrease your impact on the environment. There are political action strategies and really simple ways that you can get involved, even if it is just going out for a walk in the woods to acknowledge Earth Day or eating meat one less day a week, for example. Just visiting Earthday.org and learning about the origins of Earth Day and the historical significance of the work that’s been done and how that movement has contributed in so many important ways to protecting the environment and improving public health would be a simple way to acknowledge the day.