Opinion

Health professionals have a role to play in ‘Our Planet, Our Health’

The theme for today’s World Health Day is Our Planet, Our Health. So, what can Canadian health professionals do to protect and restore the health of the planet, which is after all the ultimate determinant of the health of the population?

A World Health Organization campaign urges people, communities, governments and organizations around the world to share their stories about the steps they are taking to protect their health and that of the planet. As a group of physicians and other health professionals in British Columbia actively engaged in planetary health, we encourage health professionals to examine their role in planetary health.

The starting point is that health professionals are never only health practitioners; they are also part of the health-care system, and they are citizens in their own communities and in the province, Canada and globally. So, we have ideas, examples and suggestions in all those areas.

But we begin by urging you to take the Planetary Health Pledge (listed at the end of the article) – and doing so in a public way that will help to spread the word and build momentum.

This is a shorter version of the Pledge published in The Lancet, adapted by Doctors for Planetary Health – West Coast (D4PH). In the buildup to World Health Day, it has been taken up by other Canadian groups concerned with planetary health such as the Canadian Association of Physicians for the Environment (CAPE), the Canadian Association of Nurses for the Environment (CANE), the Canadian Coalition for Green Health Care and the new Réseau d’action pour la santé durable du Québec.

Together, they have launched a campaign, also promoted by the Planetary Health Alliance, to have health professionals video themselves taking the pledge – on their own or with their colleagues, at home, at work or out in nature. Then post the video to your social media network. Here is a potential message to go with it, with hashtags that will link your video to the Planetary Health Alliance (#PlanetaryHealthPledge) and the WHO’s World Health Day campaign (#HealthierTomorrow):

I’m one of a growing number of physicians/ nurses /other health professionals across the globe who is pledging to protect the health of people, our communities, & the planet. Follow us to support our efforts. @WCDrs4PH  #PlanetaryHealthPledge  #HealthierTomorrow 

The same five national and regional organizations, supported by a number of other national and regional health-focused organizations, have also created an open letter to Canada’s First Ministers urging them to put the health of people and the planet at the heart of all their decision-making and to take a number of key strategic steps toward creating a well-being society, as the WHO is urging.

Besides taking the pledge, the first thing to do, as has been the case for many of our members, is to tune in to climate-related health problems. The obvious ones are those linked to dramatic extreme events such as heat deaths, respiratory problems linked to wildfires, injuries from storms, hurricanes or tornadoes and health problems related to flooding – things we have seen in 2021 throughout B.C., across Canada and around the world.

Practitioners must also be tuned in to the growing reports of mental health problems related to climate change and other forms of global ecological change. There is a growing awareness of climate stress and anxiety, especially among young people. Then there is the phenomenon called solastalgia – “the pain or sickness caused by the loss of, or inability to derive solace from, the present state of one’s home environment.” While this certainly applies to people displaced by fires and floods, in Canada it has been particularly noted among Indigenous people whose links to the land are strong, and whose environments – particularly in the Arctic – are changing rapidly and in ways they can’t prevent.

There is much you can do for your patients to help prevent health problems, both at a personal level and at the planetary level.

There are other less dramatic but nonetheless important health impacts of global ecological change that you should keep an eye open for. These include an increase in insect-borne diseases such as Lyme disease and the health impacts of pollution – not just the more dramatic and obvious forms of air and water pollution, but the more subtle impacts of lifelong exposure to persistent organic pollutants, many of which are teratogens, carcinogens or endocrine disruptors.

You might also want to be aware of the broader health impacts related to disruption of agri-food systems, resulting in food supply problems. In Canada, farmers on the Prairies and other food producers elsewhere, including fishers, may experience crop losses and failures, with resultant social and health impacts; in addition, we can expect to see growing numbers of eco-refugees. Our intrusion into and disruption of natural ecosystems as well as the loss of biodiversity is a major health concern.

Obviously, you will also want to help your patients deal with these looming ecological crises and their health impacts. Some of that help will be in the form or treating their immediate medical and psychological needs, of course. But there is also much you can do with and for your patients that can help to prevent health problems, both at a personal level and at the planetary level.

There are numerous health co-benefits to a more sustainable, low-carbon way of life, so look at this as prevention and health promotion not just for your patients but at the same time for the planet. One major benefit is diet; there is clear evidence that a diet based on low levels of animal foods and high levels of plant foods is not only good for health, but for the environment. In fact, the new Canada Food Guide recommends exactly that sort of diet.

Combine that with exercise. A good place to start is PaRx Canada’s first national, evidence-based nature prescription program. In addition to the health benefits of exercise, this has the added benefit of contact with nature, with all its mental health benefits, while at the same time helping to instill a sense of respect for nature, which we all need if we are to make peace with nature, as the United Nations urges.

Then there are the well-documented health co-benefits of active transportation and public transit, not only in terms of physical exercise, but reduced emissions of carbon dioxide and other air pollutants, as well as fewer traffic-related injuries. And, of course, a switch away from fossil fuels in vehicles, home heating and elsewhere has many health benefits from reductions in pollution and global warming.

In addition to noticing and treating health problems related to climate change and other ecological problems, draw attention to them among your colleagues, in your professional meetings and journals, even in the local media; we all need to know what’s going on. You might also consider teaching about planetary health and its link to human health to your medical, nursing or other trainees.

If you want to learn more, regularly review The Lancet Planetary Health, consider attending conferences specific to these issues (perhaps remotely), and ask that this topic be addressed in conferences, rounds or other CME/professional development activities in your department or discipline.

Photo: Helen Boyd, a nurse with the Canadian Association of Nurses for the Environment, speaks at a rally.

Photo credit: Melissa Lem

 

The Planetary Health Pledge

I, as a physician (nurse/other health professional category), solemnly pledge to work to protect the health of people, their communities, and the planet.

I pledge to maintain the utmost respect for human life and the diversity of life on Earth, and for the natural systems which support all life.

I pledge to advocate for equity and justice by actively addressing environmental, social and structural determinants of health, envisioning a transition to a society that places the wellbeing of all persons, in balance with nature, at its heart.

I pledge to address the climate and ecological crisis in my actions at home, in my community, and in my profession, to protect the planet and all of its life forms for current and future generations.

Adapted from the Pledge in the Lancet (2020), by Doctors for Planetary Health – West Coast

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We are a grassroots group of activist physicians working with our communities to grow an intersectional, decolonial and anti-racist movement on the climate and ecologic emergency. We use a long-term approach to address the complex interconnected issues and structural problems contributing to this emergency, and stand in solidarity with Indigenous land and water protectors. We use our health lens and evidence-informed approach to bring light to structural injustices that impact the earth we share.

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