Blair Wylie
The medical profession is paying closer attention to the environment's impact on women's health because of growing awareness of climate change and high-profile media stories about the impact of lead exposure and contaminated water, says Blair Wylie, founding director of the Collaborative for Women's Environmental Health in the Department of Obstetrics & Gynecology at Columbia University Vagelos College of Physicians and Surgeons.
She joined Columbia in 2022 to lead the new collaborative. "Ob/Gyn is a few steps behind pediatrics in thinking about environmental contributors to disease," Wylie says. "Health issues related to the environment can start before birth. I see my goal as helping to amplify this, helping researchers in the department think about the various environmental contributors."
A big part of her role is increasing literacy among Columbia's clinicians and patients around environmental health concerns. More patients now ask about the effects of such things as mold growing in their homes, summer heat waves, and smoke from wildfires. "And, oftentimes clinicians throw up their hands because they don't know what to do," Wylie says.
Advocacy and community engagement are important, too. Partnerships with community-based organizations can help promote policy change around environmental problems that contribute to poor health. For example, Columbia physicians have partnered with organizations pushing for New York City buses to stop idling.
"We, as clinicians, have powerful voices when it comes to influencing policy and legislation," says Wylie.
A focus on the environment is critical to see real change in health outcomes, she adds. Moving the needle on decreasing preterm birth rates, for example, may require a close look at air quality and air pollution and subsequent legislation to help. It's the same with prenatal lead exposure affecting development and endocrine-disrupting chemicals, such as phthalates in personal care products, that impact fertility and menopause.
Part of the collaborative's mission is sustainability, recognizing that climate change is an existential threat and helping Columbia reduce its carbon footprint and carry out effective disaster planning for its patient population ahead of events like heat waves and floods.
"The overall thought is to elevate the environment as a contributor to disease and to health care disparities," says Wylie. "We're trying to create these bridges both within our department and also with other parts of Columbia that are focused on the environment-law school, public health school-where we're bringing obstetricians and gynecologists to the table."
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Blair Wylie, MD, is the Virgil G. Damon Professor of Obstetrics and Gynecology at Columbia University Vagelos College of Physicians and Surgeons.
This is an excerpt from an article, "The State of Care: Women's Health," that appeared in the Winter 2023 issue of Columbia Medicine.
