Planetary Health: Educating the Current and Future Health Workforce
- 1 Citations
- 109 Downloads
Abstract
Human health and well-being are inextricably linked to the environment, but human development in Western countries has been at the expense of the natural environment, largely through our reliance on fossil fuels. As we may have already reached “tipping points” in terms of some global environmental changes (e.g., climate change, biodiversity loss, air pollution), threatening human health and well-being, health professionals must respond urgently through mitigation, adaptation, and advocacy. Many are, however, not sufficiently informed to feel confident to do so. There is thus an imperative to upskill and educate practicing health professionals and current health professional students to practice environmentally sustainable health care and to take action to protect the environment to ensure human health. This chapter sets the scene in terms of the importance of the environmental determinants of health for individuals and for populations. It also provides health professionals and health professions educators with a resource list and case studies to guide the integration of planetary health and sustainable health care into the curriculum.
Keywords
Environmental determinants of health Planetary health Climate change Global environmental changes Environmentally sustainable health care Health professions educationReferences
- Alvarez NC, Richardson J, Parra-Anguita G, Linares-Abad M, Huss N, Grande Gascón ML, et al. Developing digital educational materials for nursing and sustainability: the results of an observational study. Nurse Educ Today. 2018;60:139–46.CrossRefGoogle Scholar
- Australian Government. National medicines policy. Department of Health and Ageing. 2000. https://www.health.gov.au/internet/main/publishing.nsf/Content/National%20Medicines%20Policy-1. Accessed 16 Apr 2019.
- Barton H, Grant M. A health map for the local human habitat. J Royal Soc Prom Health. 2006;126(6):252–3.CrossRefGoogle Scholar
- Behrens G, Zhang Y, Beggs P. Lancet countdown 2018 report: briefing for Australian policymakers. http://www.lancetcountdown.org/media/1394/2018-lancet-countdown-australia-policy-brief-final-for-upload.pdf. Accessed 20 Apr 2019.
- Boelen C, Pearson D, Kaufman A, Rouke J, Woollard R, Marsh D, Gibbs T. Producing a socially accountable medical school: AMEE Guide No. 109. Med Teach. 2016;38(11):1078–91.CrossRefGoogle Scholar
- Capon T, Talley NJ, Horton R. Planetary health: what is it and what should doctors do? MJA. 2018;208(7):296–7.Google Scholar
- Charlesworth KE, Jamieson M. New sources of value for health and care in a carbon-constrained world. J Pub Health. 2017;39(4):691–7. https://academic.oup.com/jpubhealth/article/39/4/691/2918119?searchresult=1Google Scholar
- Charlesworth KE, Jamieson M. Healthcare in a carbon-constrained world. Aust Health Rev. 2018;43(3):241–5. https://www.publish.csiro.au/AH/AH17184CrossRefGoogle Scholar
- Charlesworth KE, Ray S, Head F, Pencheon D. Developing an environmentally sustainable NHS: outcomes of implementing an educational intervention on sustainable health care with UK public health registrars. NSW Pub Health Bull. 2012;23:1–2. https://doi.org/10.1071/NB11018.CrossRefGoogle Scholar
- Clark C Sustainable nursing: putting environmental stewardship to practice. 2019. https://nursing.wisc.edu/sustainable-nursing-putting-environmental-stewardship-to-practice/. Accessed 23 June 2019.
- Cohen AJ, Brauer M, Burnett R, Anderson HR, Frostad J, Estep K, et al. Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015. Lancet. 2017;389:1907–18.CrossRefGoogle Scholar
- Costello M, Abbas A, Allen S, et al. Managing the health effects of climate change. Lancet. 2009;373:1693–733.CrossRefGoogle Scholar
- Coughlin S, Roberts D, O'Neill K, Brooks P. Looking to tomorrow’s healthcare today: a participatory perspective. Intern Med J. 2018;48:92–6.CrossRefGoogle Scholar
- Dahlgren G, Whitehead M. “The main determinants of health” model. 1991. In: Dahlgren G, Whitehead M, editors. European strategies for tackling social inequities in health: levelling up Part 2. Copenhagen: WHO Regional Office for Europe; 2007. http://www.euro.who.int/__data/assets/pdf_file/0018/103824/E89384.pdf.
- Ebi K, Campbell-Lendrum D, Wyns A. The 1.5 health report. Climate Tracker. 2018. IPCC Report. https://www.who.int/globalchange/181008_the_1_5_healthreport.pdf
- Eckelman MJ, Sherman J. Environmental impacts of the U.S. health care system and effects on public health. PLoS One. 2016;11(6):e0157014. https://doi.org/10.1371/journal.pone.0157014.CrossRefGoogle Scholar
- Frumkin H, Haines A. Global environmental change and noncommunicable disease risks. Ann Rev Public Health. 2019;40:261–82.CrossRefGoogle Scholar
- General Medical Council (United Kingdom). 2018. Tomorrow’s Doctor. https://www.gmc-uk.org/-/media/documents/dc11326-outcomes-for-graduates-2018_pdf-75040796.pdf. Accessed 28 Apr 2019.
- Gómez A, Balsari S, Nusbaum J, Heerboth A, Lemery J. Environment, biodiversity, and the education of the physician of the future. Acad Med. 2013;88:168–72.CrossRefGoogle Scholar
- Grose J, Doman M, Kelsey J, Richardson J, Woods M. Integrating sustainability education into nursing using an interdisciplinary approach. Local Econ. 2017;30(3):342–51.CrossRefGoogle Scholar
- Gupta J, Hurley F, Grobick A, et al. Communicating the health of the planet and its links to human health. Lancet Planet Health. 2019;3(5):e204–6.CrossRefGoogle Scholar
- Hackett F, Got T, Kitching GT, MacQueen K, Cohen A. Training Canadian doctors for the health challenges of climate change. Lancet Planet Health. 2020; early online https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196%2819%2930242-6/fulltext
- Haines A, Ebi K. The imperative for climate action to protect health. NEJM. 2019;380:263–73.CrossRefGoogle Scholar
- Hathaway J, Maibach EW. Health implications of climate change: a review of the literature about the perception of the public and health professionals. Curr Environ Health Rep. 2018;5:197–214.CrossRefGoogle Scholar
- Health Care Without Harm/ARUP. Health care’s climate footprint. Green Paper Number 1. 2019. https://noharm-global.org/content/global/reducing-healthcares-environmental-footprint. Accessed 4 Oct 2019.
- Health Effects Institute. State of global air. 2019. https://www.stateofglobalair.org/. Accessed 6 May 2019.
- Horton R. Offline: planetary health – gains and challenges. Lancet. 2016;388:2462.CrossRefGoogle Scholar
- Horton R, Lo S. Planetary health: a new science for exceptional action. Lancet. 2015;386:1921–2.CrossRefGoogle Scholar
- Horton R, Beaglehole R, Bonita R, Raeburn J, McKee M, Wall S. From public to planetary health: a manifesto. Lancet. 2014;383:847.CrossRefGoogle Scholar
- Intergovernmental Panel on Climate Change (IPCC). Global warming of 1.5 °C. 2018. https://www.ipcc.ch/sr15/. Accessed 5 May 2019.
- International Pharmaceutical Federation (FIP). FIP statement of policy: environmentally sustainable pharmacy practice: green pharmacy. 2015. https://www.fip.org/www/uploads/database_file.php?id=376&table_id=. Accessed 27 Apr 2019.
- Jackman-Murphy KP, Uznanski W, McDermott-Levy R, Cook C. Climate change: preparing the nurses of the future. Deans Notes. 2018;39(2):1–3.Google Scholar
- Kreslake JM, Sarfaty M, Roser-Renouf C, Leiserowitz AA, Maibach EW. The critical role of health professionals in climate change prevention and preparedness. Am J Public Health. 2018;108(S2):S68–9. https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2017.304044CrossRefGoogle Scholar
- Madden DL, McLean M, Horton G. Preparing medical graduates for the health effects of climate change: an Australasian collaboration. MJA. 2018;208(7):291–2. https://www.mja.com.au/journal/2018/208/7/preparing-medical-graduates-health-effects-climate-change-australasianGoogle Scholar
- Malik A, Lenzen M, McAlister S, McGain F. The carbon footprint of Australian health care. Lancet Planet Health. 2018;2:e27–35.CrossRefGoogle Scholar
- Maxwell J, Blashki G. Teaching about climate change in medical education: an opportunity. J Pub Health Res. 2016;5(1):673. https://www.jphres.org/index.php/jphres/article/view/673Google Scholar
- McGain F, Naylor C. Environmental sustainability in hospitals – a systematic review and research agenda. J Health Serv Res Policy. 2014;19(4):245–52.CrossRefGoogle Scholar
- Mortimer F. The sustainable physician. Clin Med. 2010;10(2):110–1.CrossRefGoogle Scholar
- Mukonoweshuro R, Richardson J, Grose J, Tauringana V, Suchanging C. Accounting undergraduates’ attitudes towards sustainability and climate change through using a sustainability scenario-based intervention within curriculum to enhance employability attributes. Int J Bus Res. 2018;18(4):81–90.CrossRefGoogle Scholar
- Myers SS. Planetary health: protecting human health on a rapidly changing planet. Lancet. 2017;390:2860–8.CrossRefGoogle Scholar
- Pencheon D. Developing a sustainable health care system: the United Kingdom experience. MJA. 2018;2018(5):284–5. https://www.mja.com.au/system/files/issues/208_07/10.5694mja17.01134.pdfGoogle Scholar
- Pichler P-P, Jaccard IS, Weisz U, Weisz H. International comparison of health care carbon footprints. Environ Res Lett. 2019;14:064004. https://doi.org/10.1088/1748-9326/ab19el.CrossRefGoogle Scholar
- Prescott SL, Logan AC, Albrecht G, et al. The Canmore declaration: statement of principles for planetary health. Challenges. 2018;9:31. https://www.mdpi.com/2078-1547/9/2/31CrossRefGoogle Scholar
- Prüss-Ustün A, Wolf J, Corvalán C, Bos R, Neira M. Preventing disease through healthy environments. A global assessment of the burden of disease from environmental risks. 2016. World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/204585/9789241565196_eng.pdf;jsessionid=B0C830DB53BDC6660A1A55BDAAE071CD?sequence=1. Accessed 27 Apr 2019.
- Purcell R, McGirr J. Preparing rural general practitioners and health services for climate change and extreme weather. Aust J Rural Health. 2014;22:8–14.CrossRefGoogle Scholar
- Purcell R, McGirr J. Rural health service managers’ perspectives on preparing rural health services for climate change. Aust J Rural Health. 2018;26:20–5.CrossRefGoogle Scholar
- Ramanathan V, Haines A. Healthcare professionals must lead on climate change. BMJ. 2016;355:i5245. https://doi.org/10.1136/bmj.i5245.CrossRefGoogle Scholar
- Richardson J, Grose J, Allum P. Can a health and sustainability scenario session change undergraduate paramedic students’ attitudes towards sustainability and climate change? J Paramed Pract. 2016;8(3):130–6.CrossRefGoogle Scholar
- Rockström J, Steffen W, Noone K, Persson A, et al. A safe operating space for humanity. Nature. 2009;461(7263):462–75. https://doi.org/10.1038/461472a.CrossRefGoogle Scholar
- Schwerdtle PN, Maxwell J, Horton G, Bonnamy J. 12 tips for teaching environmental sustainability to health professionals. Med Teach 2019. https://doi.org/10.1080/0142159X.2018.1551994. (early online).
- Shelton CL, McBain SC, Mortimer F, White SM. A new role for anaesthetists in environmentally-sustainable healthcare. Anaesthesia. 2019;74:1091–4. https://doi.org/10.1111/anae.14647.CrossRefGoogle Scholar
- Singleton JA. On our watch: It is time for the profession to take responsibility for its environmental impact. Pharmacy GRIT, 2019;Autumn:4–6. https://eprints.qut.edu.au/129484/
- Smith KR. Introduction: mitigating, adapting, and suffering: how much of each? Ann Rev Pub Health. 2008;29(32). https://www.annualreviews.org/doi/full/10.1146/annurev.pu.29.031708.100011
- Stone SB, Myers SS, Golden CD, et al. Cross-cutting principles for planetary health education. Lancet Planet Health. 2018;2:192–3.CrossRefGoogle Scholar
- Sustainable Development Unit, UK National Health Service. Sustainable development in the health and care system e Health Check 2018. Cambridge: SDU; 2018. https://www.sduhealth.org.uk/policy-strategy/reporting/sustainable-development-in-health-and-care-report-2018.aspx. Accessed 20 Feb 2019.
- Teherani A, Nishimura H, Apatira L, Newman T, Ryan S. Identification of core objectives for teaching sustainable healthcare education. Med Educ Online. 2017;22:1. https://doi.org/10.1080/10872981.2017.1386042.CrossRefGoogle Scholar
- Tong S, Ebi K. Preventing and mitigating health risks of climate change. Environ Res. 2019;174:9–13.CrossRefGoogle Scholar
- Tun MS. Fulfilling a new obligation: teaching and learning of sustainable healthcare in medical education curriculum. Med Teach. 2019;41(10):1168–77. https://doi.org/10.1080/0142159X.2019.1623870.CrossRefGoogle Scholar
- United Nations Climate Change. The Paris Agreement. https://unfccc.int/process-and-meetings/the-paris-agreement/the-paris-agreement. Accessed 5 May 2019.
- United Nations Environment Programme. GEO-6: summary for policymakers. 2019. https://wedocs.unep.org/bitstream/handle/20.500.11822/27652/GEO6SPM_EN.pdf?sequence=1&isAllowed=y. Accessed 5 May 2109.
- Walpole SC, Pearson D, Coad J, Barna S. What do tomorrow’s doctors need to learn about ecosystems? – A BEME systematic review: BEME Guide No. 36. Med Teach. 2016;38(4):338–52.CrossRefGoogle Scholar
- Walpole SC, Vyas A, Maxwell J, Canny BJ, Woollard R, Wellbery C, et al. Building an environmentally accountable medical curriculum through international collaboration. Med Teach. 2017;39(10):1040–50.CrossRefGoogle Scholar
- Walpole SC, Barna S, Richardson J, Rother H-A. Sustainable healthcare education: integrating planetary health into clinical education. Lancet Planet Health. 2019;3:e6–7.CrossRefGoogle Scholar
- Watts N, Amann M, Arnell N, Ayeb-Karlsson S, Belesova K, Bery H, et al. The 2018 report of the Lancet countdown on health and climate change: shaping the health of nations for centuries. Lancet. 2018;392:2479–514.CrossRefGoogle Scholar
- Watts N, Amann M, Arnell N, Ayeb-Karlsson S, Belesova K, et al. The 2019 report of the Lancet countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate. Lancet. 2019;394:1836–78.CrossRefGoogle Scholar
- Wellbery C, Sheffield P, Timmireddy K, Sarfaty M, Teherani A, Fallar R. It’s time for medical schools to introduce climate change into their curricula. Acad Med. 2018;93:1774–7.CrossRefGoogle Scholar
- Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, de Souza Diaz BF, Ezeh A, et al. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation-Lancet Commission on planetary health. Lancet. 2015;386:1973–2028.CrossRefGoogle Scholar
- World Health Organization (WHO). An estimated 12.6 million deaths each year are attributable to unhealthy environments. 2016. https://www.who.int/news-room/detail/15-03-2016-an-estimated-12-6-million-deaths-each-year-are-attributable-to-unhealthy-environments. Accessed 5 May 2019.
- World Health Organization (WHO). COP24 special report. Health & climate change. Geneva: WHO; 2018. https://www.who.int/globalchange/publications/COP24-report-health-climate-change/en/. Accessed 27 Apr 2019.
- World Health Organization (WHO). Ten threats to global health in 2019. https://www.who.int/emergencies/ten-threats-to-global-health-in-2019. Accessed 20 Apr 2019.
- Zaidi AA. The “Buy One, Get One Free” ethics of investing public and philanthropic funds in health and climate. AMA J Ethics. 2017;19(12):1193–201.CrossRefGoogle Scholar