As medical students who will inherit and treat the health consequences of climate change, we are witnessing how it reshapes the physical and emotional landscapes of our generation. These fears are actively shaping how an entire generation plans its future, from whether to have children to where to live and work. Across the country, young people are experiencing what researchers have termed eco-anxiety: chronic stress, fear for the future, and even symptoms of depression and insomnia, all stemming from awareness of the planet’s deteriorating health. Many of us aim to practice at the intersection of medicine, public health, and policy, and we therefore recognize our responsibility to confront the upstream forces that shape health long before patients enter the clinic. Climate health is patient health.
Recent research has shown that younger generations are increasingly distressed by the climate crisis, especially given a perception of governmental failures to act on this issue. Public policy both reflects and shapes this anxiety. Under the current administration, executive orders have moved to dismantle key federal climate protections, including directing the Environmental Protection Agency (EPA) to review or rescind the Clean Power Plan, weakening emissions standards for new power plants, rolling back methane regulations for oil and gas operations, eliminating the federal use of the social cost of carbon, and removing climate considerations from environmental reviews under the National Environmental Policy Act (NEPA). Recently, the United States also withdrew from the Paris Climate Agreement, signaling a retreat from global climate leadership. Together, these actions signal a deprioritization of climate mitigation at the federal level.
From a public health perspective, this rollback can be extremely consequential: Increased greenhouse gas emissions can cause worsened air quality, extreme heat exposure, respiratory disease, and mental health stressors. For young people, the implications extend beyond physical health. When institutions retreat from climate action, the signal received by many is that the risks they fear are not being meaningfully addressed. Over time, that disconnect between lived concern and institutional response can deepen feelings of uncertainty and erode trust in the systems meant to safeguard public health.
Climate anxiety is also deeply intertwined with issues of equity. Low-income communities and communities of color face disproportionate exposure to extreme heat, poor air quality, and climate-related disasters, increasing risks for a wide range of health harms. For young people growing up in these environments, these exposures can carry additional psychological consequences, as climate threats intersect with uncertainty about their future. Yet these same communities often face structural barriers to climate education, mental health care, and institutional acknowledgment of environmental harm, meaning the burden of climate change is not only heavier but also less frequently validated or addressed.
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Medical students are not climate scientists or policymakers, but our training offers a distinct perspective. Medicine teaches us to recognize how upstream determinants shape downstream disease and to intervene before harm escalates. Climate change is increasingly emerging as one of those upstream drivers, influencing not only respiratory and cardiovascular illness but also the mental health of young people confronting an uncertain future. Responding to eco-anxiety, therefore, requires more than reassurance. Health care systems should incorporate climate-related stress into adolescent and young adult mental health assessments, recognizing it as a legitimate contributor to distress. For example, clinicians might ask patients about climate-related worries during routine screenings, much as they already screen for social determinants of health, and provide counseling or coping strategies when those concerns interfere with daily life. Medical education and public health training must also prepare clinicians to discuss climate impacts thoughtfully, without dismissing or pathologizing concern. This includes training physicians to validate patients’ fears about extreme heat, wildfire smoke, or future family planning decisions in a warming world.
At the policy level, climate legislation should be understood not only as environmental policy but also as preventive public health policy. Investments in clean energy, urban heat mitigation, and disaster preparedness reduce not only emissions but also the uncertainty and chronic stress experienced by communities facing worsening climate threats. In this way, physicians can help bridge prevention and care by treating climate-related distress while also advocating for the conditions that prevent it.
Climate anxiety is a current, measurable public health crisis and should not be brushed off as young people overreacting. It is a rational response to a credible threat. The question is whether that anxiety will be allowed to harden into paralysis or be met with institutional action that restores agency and hope.
The health of our youth and communities depends on interventions in the present. We owe our next generations the respect of acting decisively, communicating transparently, and creating a future where young people can dream, grow, and thrive, without carrying the weight of existential fear over the planet they will inherit.
Gauri Gurumurthy, Preston Dang, and Rohini Kambhampati are medical students.
