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Health Professionals and the Climate Crisis: Trusted Voices, Essential Roles

  • University of Washington School of Public Health


Climate change has triggered a global public health emergency that, unless adequately addressed, is likely to become a multigenerational public health catastrophe. The policy actions needed to limit global warming deliver a wide range of public health benefits above and beyond those that will result from limiting climate change. Moreover, these health benefits are immediate and local, addressing one of the most vexing challenges of climate solutions: that the benefits of greenhouse gas reduction are seen as long‐term and global, which are remote from the concerns of many jurisdictions. In this commentary, we identify roles that health professionals and health organizations can play, individually and collectively, to advance equitable climate and health policies in their communities, health systems, states, and nations. Ultimately, health voices can work across national boundaries to influence the world's commitments to the Paris Agreement, arguably the world's most important public health goal.
doi: 10.1002/wmh3.421
© 2021 The Authors. World Medical & Health Policy
published by Wiley Periodicals LLC on behalf of Policy Studies Organization
Health Professionals and the Climate Crisis: Trusted
Voices, Essential Roles
Edward Maibach , Howard Frumkin , and Samantha Ahdoot
Climate change has triggered a global public health emergency that, unless adequately addressed, is likely to
become a multigenerational public health catastrophe. The policy actions needed to limit global warming
deliver a wide range of public health benefits above and beyond those that will result from limiting climate
change. Moreover, these health benefits are immediate and local, addressing one of the most vexing challenges
of climate solutions: that the benefits of greenhouse gas reduction are seen as longterm and global, which are
remote from the concerns of many jurisdictions. In this commentary, we identify roles that health pro-
fessionals and health organizations can play, individually and collectively, to advance equitable climate and
health policies in their communities, health systems, states, and nations. Ultimately, health voices can work
across national boundaries to influence the world's commitments to the Paris Agreement, arguably the
world's most important public health goal.
KEY WORDS: climate change, global health, public health, advocacy, public policy
A stable climate is arguably the most fundamental determinant of human
health (McMichael, 2017). Earth's climate, however, is currently changing at an
unprecedented rate (World Meteorologic Organization, 2019). This rapid climate
change has triggered a global public health emergency that, unless adequately
addressed, is likely to become a sustained public health catastrophe that will last
many generations (IPCC, 2018; Harmer, 2020).
Serious direct health harms of climate change result from increasingly extreme
weatherincluding more frequent and severe heatwaves, storms, floods, and
droughts. Indirect health harms resulting from secondary consequences of climate
change are even more insidiousair pollution, vectorborne illness, contaminated
water and food, crop and livestock loss and reduced nutrient value, damaged and
destroyed housing and farmlands, mental health impacts, and increases in conflict
and forced migration. All of these impacts are magnified by socioeconomic and
This is an open access article under the terms of the Creative Commons AttributionNonCommercial License, which
permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used
for commercial purposes.
biological factorsincluding age, gender, poverty and income inequality, under-
lying health problems, racism, and discriminationsuch that the health of more
vulnerable, marginalized, and disempowered people tends to be harmed first and
worst (Ebi et al., 2018; Watts et al., 2015).
Currently, the world's stated goalas ratified in the Paris Climate Agreement
in 2015is to limit global warming to no more than 2°C. Subsequently, however,
the Intergovernmental Panel on Climate Change has warned that warming of 2°C
should not be considered safe; they suggested 1.5° as a more prudent global goal
(IPCC, 2018). Regrettably, global efforts to date are falling far short of what is
necessary to limit the warming to 2°, much less 1.5°, with models currently pro-
jecting 3° of warming as a more likely outcome (Watts et al., 2020). Planetary health
rescue will require farreaching transformations across the global economy; while
many of the needed technologies are now available, neither effective political
leadership nor widespread public buyin has yet emerged.
A Focus on Health May Help Untie the Gordian Knot
There is a bright silver lining to this dire situation. The policy actions that are
most needed to limit global warming to levels that could be considered safe for
public health and wellbeing also deliver a wide range of additional public health
benefits above and beyond those that will result from limiting climate change. In a
very real sense, climate solutions are health solutions.
Many of the public health benefits of climate policies begin accruing almost
immediately upon implementing the policy actions. Furthermore, the primary
beneficiaries of these policy actions are the people in the jurisdictions that imple-
ment them. In other words, the health benefits of climate solutions are proximal in
both time and space. This helps to solve one of the most vexing challenges asso-
ciated with climate solutionsthat their climate change benefits accrue primarily in
the distant future, and are globally distributed, undermining many jurisdictions
willingness to undertake them.
The decarbonization of electrical and transportation systems provides a useful
example. Although these are actions that must soon be taken worldwide in order to
achieve the goal of the Paris Agreement, any city, or state, or nation that shifts to
renewable electricity will immediately realize benefits from cleaner air and water,
healthier people, and reduced health costs. Moreover, these transitions are
employmentintensive (Georgeson & Maslin, 2019). The jobs and other forms of
economic prosperity that are created will also further enhance public health and
wellbeing in that jurisdiction because secure employment and economic prosperity
are important social determinants of health.
The U.S. state of Wisconsin provides an excellent example. A University of
Wisconsin research team modeled the health and economic impacts that would
accrue if the state meets 100 percent of its energy needs with clean energy (e.g.,
wind, solar)produced instate (Abel & Spear, 2019). Achieving that goal would
create 161,100 net jobs (more than doubling the current number of energy jobs in
the state), increase state GDP by nearly 5 percent, increase state tax revenue by
2 World Medical & Health Policy
more than $500 M per year, and avoid human health damages that cost more than
$21B annually.
In addition to the rapid decarbonization of energy and transportation systems,
a wide variety of other policies that are necessary to achieve the goal of limiting
global warming to 2°C or less will also deliver shortand longterm health benefits.
These include improving food systems, the built environment, landuse practices,
access to family planning services, and education of women and girls. These ben-
efits have been described in detail, and in most cases quantified (Gao
et al., 2018; Milner et al., 2020; Shindell, Faluvegi, Seltzer, & Shindell, 2018).
Health Professionals Can Play Many Important Roles
Another silver lining to the climate crisis is that physicians and other health pro-
fessionals increasingly understand the human health relevance of climate change
(Hathaway & Maibach, 2018). In large numbers, they believe the organizations that
represent them should engage in both public and policymaker education about the
climate crisis, as well as in advocacy to ensure that appropriate policy measures are
adopted to protect health (Kotcheretal.,2021;Sarfaty, Mitchell, Bloodhart, & Mai-
bach, 2014; Sarfaty et al., 2015; Sarfaty, Kreslake, Casale, & Maibach, 2016).
Research shows that physicians and other health professionals are highly
trusted sources of information around the world (Chen, Vasudev, Szeto, &
Cheung, 2018; Clemence, 2020; Reinhart, 2020; Ipsos, 2019), and that presenting
information about the health harms of climate change is an effective communica-
tion strategy that leads to enhanced issue engagement (Maibach, Sarfaty, Mitchell,
& Gould, 2019). Moreover, many health professionals are personally inclined to get
involved in relevant education and advocacy activities (Hubbert, Ahmed, Kotcher,
Maibach, & Sarfaty, 2020; Kotcher et al., 2021; Sarfaty et al., 2014, 2015).
Every physician and nurse fulfills multiple rolesas a family member, a
community member, a professional, and a citizen. Grounded in these roles, they
can, and we argue should help achieve the goal of limiting global warming to no
more than 2°C.
At the most basic level, change begins at home. Health professionals can take steps
to decarbonize their own personal lives, for example by powering their homes with
clean energy (e.g., solar), reducing their home energy use (e.g., heat pumps), embracing
lowcarbon forms of transportation (e.g., active and mass transportation, electric ve-
hicles), avoiding unnecessary air travel (e.g., vacationing closer to home), and embracing
a healthy, sustainable diet (e.g., eating less red meat and more grains, fruits, and veg-
etables). They can multiply the impact of these actions by explaining to otherstheir
family members, friends, neighbors, coworkers, members of their faith community
why they are taking these actions. Such modeling is effective; for example, people who
know somebody who gave up flying because of climate change are more likely to
change their own attitudes toward flying less (Westlake, 2017). Leading by example can
enhance health professionalsmotivations to take further actions (Gifford, Kormos, &
McIntyre, 2011; Stankuniene, Streimikiene, & Kyriakopoulos, 2020)and makes their
leadership more credible in the eyes of others (Attari, Krantz, & Weber, 2016).
Maibach/Frumkin/Ahdoot: Health Professionals and the Climate Crisis 3
Change can also begin at work. Many of the actions noted above are equally
applicable to health professionalswork lives as they are to their personal lives. The
trusted voices of health professionals, as noted above, can be compelling for
patients. Seeing a bicycle in a physician's office sends an important message to
patients. Clinicians can and should advise patients to reduce dietary meat and walk
more, simply for the sake of the patientshealth; if appropriate, they can explain
that such behavioral choices also benefit the larger community and the planet.
Health professionals can achieve an even greater impact by influencing the policies
of the health systems in which they work. Providing health care is energyintensive.
Power is currently produced predominantly with fossil fuels. Health professionals, in-
dividually and collectively, can implement policy changes in their clinic, hospital, hos-
pital system, or national health service aimed at increasing energy efficiency, de-
carbonizing energy sources through purchasing and/or onsite production of clean
energy, eliminating the use of super heattrapping pollutants that are needlessly used in
inhalants and anesthetics, and sourcing lowcarbonfootprint supplies and equipment.
As the health sector has considerable market power, such practices can help propel
market transformation across many industries. And because hospitals and clinics are
anchor institutions and leading employers in their communities, such practices can set
an example for other businesses, amplifying their impact.
Health professionals who are teachers also have opportunities to teach their stu-
dents about the relevance of climate change to human health, and the opportunities to
advance health through climate solutions, thereby helping to ensure readiness and
leadership among the next generation of health professionals. Health professionals who
conduct research can contribute in two additionalways:byaskingandansweringim-
portant questions at the nexus of climate and health, and by modifying their research
methods to reduce needless waste of energy and materials.
Arguably, health professionalsindividually and collectivelycan achieve
their greatest impact by advocating with the public and policymakers for policies
that will help stabilize the climate and improve health. Equitable climate and health
policies can and should be implemented at all levels of government (cities and
counties, states and provinces, as well as nations). Health professionals have a
unique and necessary role to play in explaining the need for such policies and in
advocating for their adoption. Beyond public policies, health professionals can also
use their influence, their trusted place in society, to encourage, if not demand, that
their nation's and the world's largest corporations also adopt policies that will help
stabilize the climate and promote human health and wellbeing.
Health professionals can also promote decarbonization in the private sector, using
their voices as university faculty members, pension fund stakeholders, and shareholders
in public companies, to call for disinvestment from fossil fuel companies
(Bergman, 2018; Law, Duff, Saunders, Middleton, & McCoy, 2018).Althoughcon-
troversial, divestment is widely recognized as an important tool in propelling the
transition to a postcarbon economy (Hunt and Weber, 2018; McKibben, 2018).
Nor do health professionals have to limit themselves to informing and per-
suading decisionmakers regarding the climate emergency; they can themselves
aspire to political office. Perhaps the bestknown example of a health professional
4 World Medical & Health Policy
leading on climate change is a physician and former Norwegian Prime Minister
Gro Harlem Brundtland, but other physician and nurse elected officials from the
global (e.g., Bhutan's Prime Minister Lotay Tshering)to the national (e.g., U.S.
Representatives Jim McDermott, Lois Capps, Lauren Underwood, Raul Ruiz, Ami
Bera, and Kim Schrier), to the state and local (e.g., California Assembly member
Joaquin Arambula), have taken strong positions on climate change. Bringing the
trusted voices of health professionals into executive and legislative branches of
government is a powerful way to advance climate action.
Health professionals daily encounter the ravages of racism and poverty; they
know that these injustices are leading causes of preventable suffering and
premature death. They are wellpositioned to bring that awareness to climate
solutionsprotecting vulnerable communities in adapting to climaterelated
hazards, and assuring that the benefits of decarbonization strategies are
distributed equitably (Ebi & Hess, 2020; Rouf & Wainwright, 2020; Shue, 2014).
More Powerful Together
As individuals, health professionals can achieve only so much. By working
together, health professionals can maximize their impact.
Joining an organization that focuses specifically on climate and health is per-
haps the easiest way for health professionals to align themselves with others
seeking to advance climate and health solutions. Examples of such organizations
include Alliance of Nurses for a Healthy Environment; Global Climate and Health
Alliance; Medical Society Consortium for Climate and Health; and Physicians for
Social Responsibility.
Another natural opportunity for physicians and other health professionals to
work together is to influence the professional societies to which they already be-
long. Health professional societies should develop strong climate and health res-
olutions and policies and should advocate actively for equitable, healthpromoting
climate policies in state and federal governments. They are more likely to do so
when their members initiate these actions.
Lastly, where there is a need, health professionalsand health organizations
can work together to create new organizations. For example, in 2016, several
medical societies recognized the value of working together to unify and amplify the
voice of medicine as a strategy to influence U.S. federal policy on the issue of
climate and health. Together they launched the Medical Society Consortium on
Climate and Health, which currently has 32 national medical societies as members,
and more than 50 additional health organizations as affiliates and partners. With a
coalition of aligned health organizations, the Consortium helped develop a Policy
Action Agenda on Climate, Health, and Equity which guides the Consortium's
advocacy activities, and has subsequently been endorsed by nearly 200 health or-
ganizations. After the 2020 U.S. election, with a coalition of health organizations
that developed the Policy Action Agenda, the Consortium developed a compre-
hensive, allofgovernment,set of climate, health, and equity recommendations
Maibach/Frumkin/Ahdoot: Health Professionals and the Climate Crisis 5
for the incoming Biden Administration and the new Congress to use in protect
[ing] our nation's health in the face of the climate health emergency.
As an outgrowth of the Medical Society Consortium on Climate and Health, in
2017 several physicians in Virginia organized the Virginia Clinicians for Climate
Action to advocate for equitable climate and health policies in their state. Their
collective actions have already had a significant demonstrable impact on enacting
important climate and health legislation (see Box 1). Their success has inspired
BOX 1 Health Professionals Advancing Climate and Health Policy in Virginia
The voice of the health community was historically absent from the climate policy discussion
in Virginia. Virginia Clinicians for Climate Action (VCCA)was formed in 2017 to fill this void.
Since its inception, VCCA has helped build a network of health partners and over 450 clinician
advocates for climate solutions. VCCA doctors, nurses, and allied health professionals write
opinion pieces, attend hearings, issue statements, and positions, collaborate with medical so-
cieties on climate and health programs, meet with legislators, hold monthly educational we-
binars, and partner with hospital systems to hold climate and health conferences and lectures.
VCCA's experience in Virginia demonstrates the power of unified a health voice to overcome
barriers blocking the necessary transition to a clean energy economy. Health professionals and
health organizations are becoming a powerful voice in climate and energy policymaking in the
state. Having heard from VCCA members across Virginia, State Health Commissioner
Dr. Norman Oliver established a Climate Change Committee at the Virginia Department of
Health in 2019. In 2020, a circuit court overturned and vacated the permit for a proposed
Atlantic Coast Pipeline compressor station, citing the healthbased impacts on the local, ma-
jority AfricanAmerican community. The pipeline was ultimately canceled, successfully con-
cluding years of campaigning by impacted communities and environmental justice advocates.
Subsequently, VCCA was joined by Healthcare Without Harm, Kaiser Permanente, Bon Se-
cours Mercy Health, and the Virginia Chapter of the American Academy of Pediatrics, in
support of landmark climate legislation, the Virginia Clean Economy Act (VCEA). This bill
passed in 2020, making Virginia the first southern state to commit to 100 percent clean elec-
tricity by 2050. Furthermore, Virginia joined the Regional Greenhouse Gas Initiative (RGGI)in
2021. These policies will be enacted with a focus on equity50 percent of the revenue gen-
erated by participating in RGGI will be allocated toward energy efficiency programs for low
income communities. RGGI was the first climate legislation ever supported by a Virginia
medical society, the Virginia Chapter of the American Academy of Pediatrics, in 2015.
In 2021, VCCA joined partners to address transportation, the leading source of carbon pollu-
tion in the state. VCCA developed a report, webpage, and videos on the health effects of
vehicle pollution in Virginia, and the health benefits of stronger vehicle emission standards.
This report was recently cited in a press release from nine Virginia cities and counties sup-
porting clean transportation. A unified health voice is proving its value in advancing climate
policy in Virginia.
6 World Medical & Health Policy
health professionals in over a dozen additional U.S. states to create statefocused
climate and health.
The goal of the Paris Climate Agreement is arguably the world's most im-
portant public health goal. Successfully addressing the climate crisis requires high
level policy actionambitious Nationally Determined Contributions through the
U.N. Framework Convention on Climate Change, reversal of perverse economic
subsidies at the international and national level, transformative changes in agri-
culture, transportation, urban planning, energy, and manufacturing policies. It also
requires farreaching behavioral changesin the choices people make regarding
how they eat, how they travel, how they consume goods, and how they use energy.
And it requires bold privatesector action across the economy, from manufacturing
firms to healthcare organizations. For each of these, the voices of health pro-
fessionals can play a highly influential role.
All authors contributed to the conceptualization and writing of this com-
Conflicts of interest: None declared.
Corresponding author: Edward Maibach,
Edward Maibach, MPH, PhD, is a distinguished university professor of George
Mason University, Fairfax, VA.
Howard Frumkin, MD, DrPH, is a professor emeritus at the University of
Washington School of Public Health, Seattle, WA.
Samantha Ahdoot, MD, is an assistant professor of Pediatrics at the Virginia
Commonwealth University School of Medicine, Arlington, VA.
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Maibach/Frumkin/Ahdoot: Health Professionals and the Climate Crisis 9
... Demirbilek and Cetin (2021) (15) study's finding mentioned that managers who adopt sustainable management behaviors acted on raising staff awareness about sustainability initiatives and leading teams that implement them. Bianchi, et al. (2018) (43) and Maibach, et al. (2021) (44) confirmed that nursing management can intentionally support awareness building to enhance nursing practice so that it is in arrangement with a healthy planet. In this scene, Peterlin, et al. (2015) (45) stated that servant and sustainable leadership as contemporary leaders encouraged sustainability at individual, organizational and social levels, as well as emphasizing the individualized influence on current followers and the future needs of generations to come. ...
... Demirbilek and Cetin (2021) (15) study's finding mentioned that managers who adopt sustainable management behaviors acted on raising staff awareness about sustainability initiatives and leading teams that implement them. Bianchi, et al. (2018) (43) and Maibach, et al. (2021) (44) confirmed that nursing management can intentionally support awareness building to enhance nursing practice so that it is in arrangement with a healthy planet. In this scene, Peterlin, et al. (2015) (45) stated that servant and sustainable leadership as contemporary leaders encouraged sustainability at individual, organizational and social levels, as well as emphasizing the individualized influence on current followers and the future needs of generations to come. ...
... Nurses and physicians, who have important roles within the health care sector, regularly rank first in relevant international surveys in regard to society's trust in them and their recommendations (6)(7)(8)(9). Since the climate crisis has numerous consequences for health, health professionals nowadays have a great opportunity and responsibility to make appropriate use of the trust placed in them to promote climate-sensitive societies (10). In their daily work routine, health professionals have a lot of opportunities to address climate change and health. ...
Full-text available
Background Health professionals such as physicians and nurses may play an important role in the transformation process towards a healthy, sustainable and climate-sensitive society. However, little is known about their climate-specific health literacy. This study aimed to assess knowledge regarding climate change and its impacts on health and climate-specific health literacy in health professionals. Methods In July/August 2022, a cross-sectional, questionnaire-based study was carried out at the University Hospital Regensburg, Germany, to assess climate-specific health literacy in nurses and physicians from various clinical specialties. Descriptive and exploratory statistical analyses were performed. Results The study population consisted of 142 participants (57.7% women; response rate: 24,7%). Most participants (93%) considered climate change to be highly relevant. However, only 12% of respondents stated to be very well informed regarding the general consequences of climate change. Although 57% of all participants had never mentioned climate change in relation to health to their patients, participants with higher levels of knowledge regarding the effects of climate change were more likely to mention it compared to those with lower levels of knowledge. The most frequently stated obstacle to integrate the topic of climate change in clinical work was lack of time during work (79%), not enough information (42%) and lacking materials (39%). Differences between health professions were apparent. Conclusion The results of our survey suggest that the current state of climate-specific health literacy differs between different groups of health professionals. There is a need to improve health professionals’ levels of climate-specific health literacy and to increase the potential in interprofessional cooperation regarding planetary health.
... The leading global professional organizations for physicians, nursing and public health have declared the climate crisis to be a public health emergency [6]. Additionally, most medical societies have recommended, or even mandated, the development of curricula to train their learners [7]. ...
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Climate Change is the most serious planetary emergency of our time. Carbon emissions secondary to the healthcare industry account for about ten percent of all emissions in the United States. Health professionals, therefore, need to understand how they can make a difference in their profession, by understanding the health-related impacts of climate change and the importance of healthcare sustainability. An 8-week telementoring Climate Change Healthcare Sustainability ECHO series was developed to educate healthcare professionals in these topics such as the health-related effects of climate change, healthcare sustainability, quality healthcare and carbon accounting. A total of 376 participants from throughout the US and 16 other countries- completed this 8-week series and received no-cost continuing medical education credits. The evaluation consisted of pre and post Zoom polls, weekly post-session surveys and the registration demographics. Participants were primarily physicians and public health professionals who significantly improved their knowledge and communication skills after the course as compared to starting the training.
... 74 International co-operation between health professionals was identified as vital to addressing global equity in climate change related health policy. 75 This is an area that warrants further exploration, including in relation to the need to de-carbonise health services globally. ...
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Anthropogenic climate change is unequivocal, and many of its physical health impacts have been identified, although further research is required into the mental health and wellbeing effects of climate change. There is a lack of understanding of the importance of ethics in policy-responses to health and climate change which is also linked to the lack of specific action-guiding ethical resources for researchers and practitioners. There is a marked paucity of ethically-informed health input into economic policy-responses to climate change—an area of important future work. The interaction between health, climate change and ethics is technically and theoretically complex and work in this area is fragmentary, unfocussed, and underdeveloped. Research and reflection on climate and health is fragmented and plagued by disciplinary silos and exponentially increasing literature means that the field cannot be synthesised using conventional methods. Reviewing the literature in these fields is therefore methodologically challenging. Although many of the normative challenges in responding to climate change have been identified, available theoretical approaches are insufficiently robust, and this may be linked to the lack of action-guiding support for practitioners. There is a lack of ethical reflection on research into climate change responses. Low-HDI (Human Development Index) countries are under-represented in research and publication both in the health-impacts of climate change, and normative reflection on health and climate change policy. There is a noticeable lack of ethical commentary on a range of key topics in the environmental health literature including population, pollution, transport, energy, food, and water use. Serious work is required to synthesise the principles governing policy responses to health and climate change, particularly in relation to value conflicts between the human and non-human world and the challenges presented by questions of intergenerational justice.
... This implies that the education of health professionals needs to be adapted so that they become equipped with the knowledge and skills they need to address these health impacts. Additionally, it has been suggested that health professionals can play an important role as change agents in driving the transformative societal changes needed to mitigate the climate and ecological crises (13,14). Health professionals belong to the most trusted of all professional groups in society (15) and the medical professional ethos demands care for individual and population health, including that of future generations (16). ...
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Aim: The climate and ecological crises are considered fundamental threats to human health. Healthcare workers in general and doctors in particular can contribute as change agents in mitigation and adaptation. Planetary health education (PHE) aims to harness this potential. This study explores perspectives among stakeholders involved in PHE at German medical schools on the characteristics of high-quality PHE and compares them to existing PHE frameworks. Methods: In 2021, we conducted a qualitative interview study with stakeholders from German medical schools involved in PHE. Three different groups were eligible: faculty members, medical students actively involved in PHE, and study deans of medical schools. Recruitment was performed through national PHE networks and snowball sampling. Thematic qualitative text analysis according to Kuckartz was used for the analysis. Results were systematically compared to three existing PHE frameworks. Results: A total of 20 participants (13 female) from 15 different medical schools were interviewed. Participants covered a wide range of professional backgrounds and experience in PHE education. The analysis revealed ten key themes: (1) Complexity and systems thinking, (2) inter- and transdisciplinarity, (3) ethical dimension, (4) responsibility of health professionals, (5) transformative competencies including practical skills, (6) space for reflection and resilience building, (7) special role of students, (8) need for curricular integration, (9) innovative and proven didactic methods, and (10) education as a driver of innovation. Six of our themes showed substantial overlap with existing PHE frameworks. Two of our themes were only mentioned in one of the frameworks, and two others were not explicitly mentioned. Few important elements of the frameworks did not emerge from our data. Conclusions: In the light of increased attention regarding the connections of the climate and ecological crises and health, our results can be useful for anyone working toward the integration of planetary health into medical schools' and any health professions' curricula and should be considered when designing and implementing new educational activities.
Health professional societies and researchers call for the integration of climate change into health counselling. However, the scientific evidence and conceptual grounding of such climate-sensitive health counselling (CSHC) remains unclear. We conducted a scoping review identifying scientific articles on the integration of climate change into communication between health professionals and patients in health-care settings. Scientific databases (Web of Science, PubMed, and Google Scholar) were searched from inception until Nov 30, 2022. 97 articles were included, of which 33 represented empirical research, and only two evaluated the effects of CSHC. More than half of the articles originated from the USA and addressed physicians. We introduce a conceptual framework for CSHC, which elaborates on aims, content areas, and communication strategies, and establishes the guiding principle of integrating CSHC into routine activities of health care. This framework supports health professionals in implementing CSHC and enables researchers to conceptualise intervention studies investigating how CSHC can contribute to the health of patients and the planet.
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Objective: According to the WHO, anthropogenic climate change poses the greatest threat to human health in the 21st century. However, the link between climate change and human health is not an integral part of medical education in Germany. Within a student-led project, an elective clinical course was designed and successfully implemented, which has been made accessible to undergraduate medical students at the Universities of Giessen and Marburg. The implementation and didactic concept are explained in this article. Methodology: In a participatory format, knowledge is imparted using an action-based, transformative approach. Topics discussed are, amongst others, interactions of climate change and health, transformative action, and health behavior, as well as "green hospital" and the simulation of a "climate-sensitive health counselling". Lecturers from different disciplines within and beyond medicine are invited as speakers. Results: Overall, the elective was evaluated positively by the participants. The fact that there is a high demand among students for participation in the elective, as well as for the transfer of concepts underlines the need for including this topic into medical education. The implementation and further development of the concept at two universities with different study regulations demonstrates its adaptability. Conclusion: Medical education can raise awareness of the multiple health consequences of the climate crisis, can have a sensitizing and transformative effect on various levels, and can promote climate-sensitive action ability in patient care. In the long term, however, these positive consequences can only be guaranteed by including mandatory education on climate change and health in medical curricula.
Objectives: This study's primary objective was to assess pharmacists' knowledge and beliefs regarding climate change and health. Secondary objectives included assessing perceptions of its relevance to pharmacists and pharmacy practice as well as potential roles in mitigating climate change. Methods: An 18-question, anonymous survey was developed using questions adapted from previously-published surveys that evaluated the general public's views of international issues and health professionals' perceptions of climate change and health, with additions specific to the midwestern United States and Ohio. It was sent electronically to a random sample of 500 registered pharmacists living and working in Ohio. Data were analyzed using descriptive and non-parametric statistics. Results: Seventy pharmacists participated in the study. The majority of respondents (78.3%) believed climate change is happening. More recognized climate change to be a great or moderate threat to human health worldwide (72.7%) than to patients in their community (45.4%, p<0.001). A little more than half (54.5%) thought climate change was relevant to pharmacy practice. Perceived barriers that reduced willingness to communicate with the public about this topic included lack of time (73.4%) or knowledge (49.2%) and feeling that it would not make a difference (46.1%) or it is too controversial (35.4%). Respondents believed pharmacists could have the greatest impact through increasing sustainability in the healthcare system (48.5%). Conclusion: Most respondents recognized climate change is happening, is a threat to human health worldwide, and is relevant to pharmacy. However, many did not recognize its potential impact on their own patients or their role in climate action, showing a need for more education on this topic. As these are the first data collected among pharmacists in the United States, additional studies should be performed in other parts of the country as opinions may vary based on personal experience with or exposure to impacts of climate change.
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Climate change arguably represents one of the greatest global health threats of our time. Health professionals can advocate for global efforts to reduce emissions and protect people from climate change; however, evidence of their willingness to do so remains scarce. In this Viewpoint, we report findings from a large, multinational survey of health professionals (n=4654) that examined their views of climate change as a human health issue. Consistent with previous research, participants in this survey largely understood that climate change is happening and is caused by humans, viewed climate change as an important and growing cause of health harm in their country, and felt a responsibility to educate the public and policymakers about the problem. Despite their high levels of commitment to engaging in education and advocacy on the issue, many survey participants indicated that a range of personal, professional, and societal barriers impede them from doing so, with time constraints being the most widely reported barrier. However, participants say various resources—continuing professional education, communication training, patient education materials, policy statements, action alerts, and guidance on how to make health-care workplaces sustainable—can help to address those barriers. We offer recommendations on how to strengthen and support health professional education and advocacy activities to address the human health challenges of climate change.
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Climate change has altered global to local weather patterns and increased sea levels, and it will continue to do so. Average temperatures, precipitation amounts, and other variables such as humidity levels are all rising. In addition, weather variability is increasing, causing, for example, a greater number of heat waves, many of which are more intense and last longer, and more floods and droughts. These changes are collectively increasing the number of injuries, illnesses, and deaths from a wide range of climate-sensitive health outcomes. Future health risks will be determined not just by the hazards created by a changing climate but also by the sensitivity of individuals and communities exposed to these hazards and the capacity of health systems to prepare for and effectively manage the attendant risks. These risks include deaths and injuries from extreme events (for example, heat waves, storms, and floods), infectious diseases (including food-, water-, and vectorborne illnesses), and food and water insecurity. These risks are unevenly distributed and both create new inequities and exacerbate those that already exist. Most of these risks are projected to increase with each additional unit of warming. Using an equity lens to move beyond incremental to transformational resilience would reduce vulnerability and improve sustainability for all, but substantial additional funding is required for proactive and effective actions by the health system.
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Achieving climate change mitigation goals requires the mobilization of all levels of society. The potential for reducing greenhouse gas (GHG) emissions from households has not yet been fully realized. Given the complex climate change situation around the world, the importance of behavioral economic insights is already understood. Changing household behavior in mitigating climate change is seen as an inexpensive and rapid intervention measure. In this paper, we review barriers of changing household behavior and systematize policies and measures that could help to overcome these barriers. A systematic literature review provided in this paper allows to define future research pathways and could be important for policy-makers to develop measures to help households contribute to climate change mitigation.
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James Milner and colleagues argue that carefully considered policies to lower carbon emissions can also improve health, and we should use these benefits to push for strong climate action © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to.
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Rapid and potentially irreversible climate change poses a direct threat to global public health. Andrew Harmer and colleagues argue that WHO should recognise this in the same way as global threats from specific diseases
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The green economy has previously been defined and measured in various, but limited, ways. This article presents an estimation of the scale of and employment in the US Green Economy using a data triangulation approach that uses many sources of data and multiple types of data. This can give a suggestion of the green economy’s role in economic development and employment at the country level. It also makes it possible to compare the scale of ‘green jobs’ to employment in fossil fuel-related sectors, and to compare the US green economy to other economies. Through the Low Carbon and Environmental Goods and Services Sector (LCEGSS) dataset, the US green economy is estimated to represent $1.3 trillion in annual sales revenue and to employ nearly 9.5 million workers; both of which have grown by over 20% between 2012/13 and 2015/16. Comparison with China, OECD members and the G20 countries suggests that the US is estimated to have a greater proportion of the working age population employed (4%) and higher sales revenue per capita in the green economy. Estimated values for other countries suggests that they too have significant production and consumption in the green economy and the US should consider, as other economies are, developing energy, environmental and educational policies relevant to the green economy to remain competitive in these areas. Given the shortcomings of other data sources, this information can contribute to understanding the potential impact of changes to federal-level policies on economic sectors that are vital to combating climate change and protecting the environment.
When we think of "climate change," we think of man-made global warming, caused by greenhouse gas emissions. But natural climate change has occurred throughout human history, and populations have had to adapt to the climate's vicissitudes. Anthony J. McMichael, a renowned epidemiologist and a pioneer in the field of how human health relates to climate change, is the ideal person to tell this story. Climate Change and the Health of Nations shows how the natural environment has vast direct and indirect repercussions for human health and welfare. McMichael takes us on a tour of human history through the lens of major transformations in climate. From the very beginning of our species some five million years ago, human biology has evolved in response to cooling temperatures, new food sources, and changing geography. As societies began to form, they too adapted in relation to their environments, most notably with the development of agriculture eleven thousand years ago. Agricultural civilization was a Faustian bargain, however: the prosperity and comfort that an agrarian society provides relies on the assumption that the environment will largely remain stable. Indeed, for agriculture to succeed, environmental conditions must be just right, which McMichael refers to as the "Goldilocks phenomenon." Global warming is disrupting this balance, just as other climate-related upheavals have tested human societies throughout history. As McMichael shows, the break-up of the Roman Empire, the bubonic Plague of Justinian, and the mysterious collapse of Mayan civilization all have roots in climate change. Why devote so much analysis to the past, when the daunting future of climate change is already here? Because the story of mankindâs previous survival in the face of an unpredictable and unstable climate, and of the terrible toll that climate change can take, could not be more important as we face the realities of a warming planet. This sweeping magnum opus is not only a rigorous, innovative, and fascinating exploration of how the climate affects the human condition, but also an urgent call to recognize our species' utter reliance on the earth as it is.
The Lancet Countdown is an international collaboration established to provide an independent, global monitoring system dedicated to tracking the emerging health profile of the changing climate. The 2020 report presents 43 indicators across five sections: climate change impacts, exposures, and vulnerabilities; adaptation, planning, and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. This report represents the findings and consensus of the 35 leading academic institutions and UN agencies that make up The Lancet Countdown, and draws on the expertise of climate scientists, geographers, engineers, experts in energy, food, and transport, economists, social, and political scientists, data scientists, public health professionals, and doctors.