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11 - The Role of Health Professionals in Fostering Planetary Health

Published online by Cambridge University Press:  01 July 2021

Andy Haines  and
Howard Frumkin
Andy Haines
Affiliation:
London School of Hygiene and Tropical Medicine
Howard Frumkin
Affiliation:
University of Washington
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Summary

Environmental change will pose numerous challenges to health systems, as described in earlier chapters. They will need to become more resilient to shocks, including extreme events, and be able to detect and respond to changing patterns of disease (see Chapter 5). This chapter describes four major ways in which health professionals can catalyse rapid decarbonization of the economy and support moves to live within planetary boundaries while protecting health: reducing the burden of preventable ill-health; reducing the environmental impact of health care; contributing to slowing population growth; and providing broader societal leadership.

Type
Chapter
Information
Planetary Health
Safeguarding Human Health and the Environment in the Anthropocene
 , pp. 360 - 378
Publisher: Cambridge University Press
Print publication year: 2021

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References

Marmot, M. The Health Gap: The Challenge of an Unequal World. New York and London: Bloomsbury Press; 2015.Google Scholar
Fries, JF, Koop, CE, Beadle, CE, et al. Reducing health care costs by reducing the need and demand for medical services. New England Journal of Medicine. 1993;329(5):321–5. doi: 10.1056/nejm199307293290506.Google Scholar
WHO. Declaration of Alma-Ata International Conference on Primary Health Care, Alma-Ata, USSR, 6–12 September 1978.Google Scholar
Walsh, JA, Warren, KS. Selective primary health care: an interim strategy for disease control in developing countries. New England Journal of Medicine. 1979;301(18):967–74. doi: 10.1056/nejm197911013011804.Google Scholar
Sanders, D, Nandi, S, Labonté, R, Vance, C, Van Damme, W. From primary health care to universal health coverage – one step forward and two steps back. The Lancet. 2019;394(10199):619–21. doi: 10.1016/s0140-6736(19)31831-8.Google Scholar
Xie, E, de Barros, EF, Abelsohn, A, Stein, AT, Haines, A. Challenges and opportunities in planetary health for primary care providers. The Lancet Planetary Health. 2018;2(5):e185–7. doi: 10.1016/s2542-5196(18)30055-x.Google Scholar
Ebrahim, S, Taylor, F, Ward, K, et al. Multiple risk factor interventions for primary prevention of coronary heart disease. Cochrane Database of Systematic Reviews. 2011(1). doi: 10.1002/14651858.CD001561.pub3.Google Scholar
Lobelo, F, Young, DR, Sallis, R, et al. Routine assessment and promotion of physical activity in healthcare settings: a scientific statement from the American Heart Association. Circulation. 2018;137(18):e495–522. doi:10.1161/CIR.0000000000000559.Google Scholar
Lobelo, F, de Quevedo, IG. The evidence in support of physicians and health care providers as physical activity role models. American Journal of Lifestyle Medicine. 2016;10(1):36–52. doi: 10.1177/1559827613520120.Google Scholar
Frank, E, Dresner, Y, Shani, M, Vinker, S. The association between physicians’ and patients’ preventive health practices. Canadian Medical Association Journal/Journal de l’Association medicale canadienne. 2013;185(8):649–53. doi: 10.1503/cmaj.121028.Google Scholar
Hedin, B, Katzeff, C, Eriksson, E, Pargman, D. A systematic review of digital behaviour change interventions for more sustainable food consumption. Sustainability. 2019;11(9):2638. Available from www.mdpi.com/2071-1050/11/9/2638.Google Scholar
Laverack, G. The challenge of behaviour change and health promotion. Challenges. 2017;8(2):25. Available from www.mdpi.com/2078-1547/8/2/25.CrossRefGoogle Scholar
Sackett, DL, Haynes, RB, Tugwell, P. Clinical Epidemiology: A Basic Science for Clinical Medicine, 2nd ed. Boston: Little, Brown; 1991.Google Scholar
Kassirer, JP. On the Take: How Medicine’s Complicity with Big Business Can Endanger Your Health. Oxford and New York: Oxford University Press; 2005.Google Scholar
Doran, T, Maurer, KA, Ryan, AM. Impact of provider incentives on quality and value of health care. Annual Review of Public Health. 2017;38(1):449–65. doi: 10.1146/annurev-publhealth-032315-021457.Google Scholar
Gray, BH. For-Profit Enterprise in Health Care. Washington, DC: Institute of Medicine Committee on Implications of For-Profit Enterprise in Health Care; 1986.Google ScholarPubMed
Marik, PE. The cost of inappropriate care at the end of life: implications for an aging population. American Journal of Hospice and Palliative Medicine. 2015;32(7):703–8. doi: 10.1177/1049909114537399.Google Scholar
Smith, S, Brick, A, O’Hara, S, Normand, C. Evidence on the cost and cost-effectiveness of palliative care: a literature review. Palliative Medicine. 2014;28(2):130–50. doi: 10.1177/0269216313493466.CrossRefGoogle ScholarPubMed
Karliner, J, Slotterback, S, Boyd, R, Ashby, B, Steele, K. Health Care’s Carbon Footprint: How the Health Sector Contributes to the Global Climate Crisis and Opportunities for Action. Health Care Without Harm and Arup; 2019. Available from www.arup.com/perspectives/publications/research/section/healthcares-climate-footprint.Google Scholar
Wiedmann, T. A review of recent multi-region input–output models used for consumption-based emission and resource accounting. Ecological Economics. 2009;69(2):211–22. https://doi.org/10.1016/j.ecolecon.2009.08.026.Google Scholar
Lenzen, M, Malik, A, Li, M, et al. The environmental footprint of health care: a global assessment. The Lancet Planetary Health. 2020;4(7):e271–9. doi: 10.1016/S2542-5196(20)30121-2.Google Scholar
Eckelman, MJ, Sherman, JD, MacNeill, AJ. Life cycle environmental emissions and health damages from the Canadian healthcare system: an economic-environmental-epidemiological analysis. PLoS Medicine. 2018;15(7):e1002623. doi: 10.1371/journal.pmed.1002623.CrossRefGoogle ScholarPubMed
Ranganathan, J, Corbier, L, Bhatia, P, et al. The Greenhouse Gas Protocol: A Corporate Accounting and Reporting Standard (Revised Edition). Geneva and Washington, DC: World Business Council on Sustainable Development (WBCSD) and World Resources Institute (WRI); 2004. Available from https://ghgprotocol.org/corporate-standard.Google Scholar
Pichler, P-P, Jaccard, IS, Weisz, U, Weisz, H. International comparison of health care carbon footprints. Environmental Research Letters. 2019;14(6):064004. doi: 10.1088/1748-9326/ab19e1.CrossRefGoogle Scholar
Vollmer, MK, Rhee, TS, Rigby, M, et al. Modern inhalation anesthetics: potent greenhouse gases in the global atmosphere. Geophysical Research Letters. 2015;42(5):1606–11. doi: 10.1002/2014gl062785.Google Scholar
Ryan, SM, Nielsen, CJ. Global warming potential of inhaled anesthetics: application to clinical use. Anesthesia and Analgesia. 2010;111(1):92–8. doi: 10.1213/ANE.0b013e3181e058d7.CrossRefGoogle ScholarPubMed
Parker, NW, Behringer, EC. Nitrous oxide: a global toxicological effect to consider. Anesthesiology. 2009;110(5):1195; author reply 6. doi: 10.1097/ALN.0b013e31819faca9.Google Scholar
Janson, C, Henderson, R, Löfdahl, M, et al. Carbon footprint impact of the choice of inhalers for asthma and COPD. Thorax. 2020;75(1):82–4. doi: 10.1136/thoraxjnl-2019-213744.Google Scholar
Bawaneh, K, Nezami, FG, Rasheduzzaman, M, Deken, B. Energy consumption analysis and characterization of healthcare facilities in the United States. Energies. 2019;12(19). https://doi.org/10.3390/en12193775.Google Scholar
MacNeill, AJ, Lillywhite, R, Brown, CJ. The impact of surgery on global climate: a carbon footprinting study of operating theatres in three health systems. The Lancet Planetary Health. 2017;1(9):e381–8. doi: 10.1016/S2542-5196(17)30162-6.Google Scholar
NHS. Reducing the Use of Natural Resources in Health and Social Care. Cambridge, UK: National Health Service Sustainable Development Unit; 2018. Available from www.sduhealth.org.uk/policy-strategy/reporting/natural-resource-footprint-2018.aspx.Google Scholar
BEIS. 2018 UK Greenhouse Gas Emissions, Provisional Figures. London: UK Department for Business, Energy & Industrial Strategy; 2019.Google Scholar
Zander, A, Niggebrugge, A, Pencheon, D, Lyratzopoulos, G. Changes in travel-related carbon emissions associated with modernization of services for patients with acute myocardial infarction: a case study. Journal of Public Health. 2011;33(2):272–9. doi: 10.1093/pubmed/fdq048.CrossRefGoogle ScholarPubMed
Salas, RN, Maibach, E, Pencheon, D, Watts, N, Frumkin, H. A pathway to net zero emissions for healthcare. BMJ. 2020;371:m3785. doi: 10.1136/bmj.m3785.Google Scholar
Alexander, R, Poznikoff, A, Malherbe, S. Greenhouse gases: the choice of volatile anesthetic does matter. Canadian Journal of Anesthesia/Journal canadien d’anesthésie. 2018;65(2):221–2. doi: 10.1007/s12630-017-1006-x.Google Scholar
Charlesworth, M, Swinton, F. Anaesthetic gases, climate change, and sustainable practice. The Lancet Planetary Health. 2017;1(6):e216–17. doi: 10.1016/s2542-5196(17)30040-2.Google Scholar
Wilkinson, AJK, Braggins, R, Steinbach, I, Smith, J. Costs of switching to low global warming potential inhalers. An economic and carbon footprint analysis of NHS prescription data in England. BMJ Open. 2019;9(10):e028763. doi: 10.1136/bmjopen-2018-028763.Google Scholar
Sustainability West Midlands. ‘Saving Lives with Solar’ Community Energy Scheme 2017. Available from www.sustainabilitywestmidlands.org.uk/resources/saving-lives-with-solar-community-energy-scheme/.Google Scholar
Wootton, R, Tait, A, Croft, A. Environmental aspects of health care in the Grampian NHS region and the place of telehealth. Journal of Telemedicine and Telecare. 2010;16(4):215–20. doi: 10.1258/jtt.2010.004015.Google Scholar
Holmner, A, Ebi, KL, Lazuardi, L, Nilsson, M. Carbon footprint of telemedicine solutions – unexplored opportunity for reducing carbon emissions in the health sector. PLoS One. 2014;9(9):e105040. doi: 10.1371/journal.pone.0105040.Google Scholar
Yellowlees, PM, Chorba, K, Burke Parish, M, Wynn-Jones, H, Nafiz, N. Telemedicine can make healthcare greener. Telemedicine and e-Health. 2010;16(2):229–32. doi: 10.1089/tmj.2009.0105.Google Scholar
Masino, C, Rubinstein, E, Lem, L, Purdy, B, Rossos, PG. The impact of telemedicine on greenhouse gas emissions at an academic health science center in Canada. Telemedicine and e-Health. 2010;16(9):973–6. doi: 10.1089/tmj.2010.0057.Google Scholar
Vidal-Alaball, J, Franch-Parella, J, Lopez Seguí, F, et al. Impact of a telemedicine program on the reduction in the emission of atmospheric pollutants and journeys by road. International Journal of Environmental Research and Public Health. 2019;16(22):4366. Available from www.mdpi.com/1660-4601/16/22/4366.CrossRefGoogle Scholar
Dorrian, C, Ferguson, J, Ah-See, K, et al. Head and neck cancer assessment by flexible endoscopy and telemedicine. Journal of Telemedicine and Telecare. 2009;15(3):118–21. doi: 10.1258/jtt.2009.003004.Google Scholar
WHO. Towards Environmentally Sustainable Health Systems in Europe: A Review of the Evidence. Copenhagen: WHO Regional Office for Europe; 2016. Available from www.euro.who.int/en/health-topics/environment-and-health/Climate-change/publications/2016/towards-environmentally-sustainable-health-systems-in-europe.-a-review-of-the-evidence-2016.Google Scholar
NHS. Securing Healthy Returns: Realising the Financial Value of Sustainable Development. Cambridge, UK: National Health Service Sustainable Development Unit; 2016.Google Scholar
Marsh, K, Ganz, ML, Hsu, J, Strandberg-Larsen, M, Gonzalez, RP, Lund, N. Expanding health technology assessments to include effects on the environment. Value in Health. 2016;19(2):249–54. doi: 10.1016/j.jval.2015.11.008.CrossRefGoogle ScholarPubMed
Sustainable Trials Study G. Towards sustainable clinical trials. BMJ. 2007;334(7595):671–3. doi: 10.1136/bmj.39140.623137.BE.Google Scholar
Subaiya, S, Hogg, E, Roberts, I. Reducing the environmental impact of trials: a comparison of the carbon footprint of the CRASH-1 and CRASH-2 clinical trials. Trials. 2011;12:31. doi: 10.1186/1745-6215-12-31.Google Scholar
Zak, JD, Wallace, J, Murthy, VN. How neuroscience labs can limit their environmental impact. Nature Reviews Neuroscience. 2020;21(7):347–8. doi: 10.1038/s41583-020-0311-5.Google Scholar
Zotova, O, Pétrin-Desrosiers, C, Gopfert, A, Van Hove, M. Carbon-neutral medical conferences should be the norm. The Lancet Planetary Health. 2020;4(2):e48–50. doi: 10.1016/S2542-5196(20)30003-6.Google Scholar
Coroama, VC, Hilty, LM, Birtel, M. Effects of Internet-based multiple-site conferences on greenhouse gas emissions. Telematics and Informatics. 2012;29(4):362–74. https://doi.org/10.1016/j.tele.2011.11.006.Google Scholar
Tarrass, F, Benjelloun, M, Benjelloun, O. Recycling wastewater after hemodialysis: an environmental analysis for alternative water sources in arid regions. American Journal of Kidney Diseases. 2008;52(1):154–8. doi: 10.1053/j.ajkd.2008.03.022.Google Scholar
Jones, EE. Water use in the surgical scrub: surgeons can reduce their environmental footprint. ANZ Journal of Surgery. 2009;79(5):319–20. doi: 10.1111/j.1445-2197.2009.04881.x.Google Scholar
Somner, JE, Stone, N, Koukkoulli, A, et al. Surgical scrubbing: can we clean up our carbon footprints by washing our hands? Journal of Hospital Infection. 2008;70(3):212–15. doi: 10.1016/j.jhin.2008.06.004.Google Scholar
Stephenson, J, Crane, SF, Levy, C, Maslin, M. Population, development, and climate change: links and effects on human health. The Lancet. 2013;382(9905):1665–73. doi: 10.1016/s0140-6736(13)61460-9.CrossRefGoogle ScholarPubMed
O’Neill, BC, Liddle, B, Jiang, L, et al. Demographic change and carbon dioxide emissions. The Lancet. 2012;380(9837):157–64. http://dx.doi.org/10.1016/S0140-6736(12)60958-1.Google Scholar
Bologna, M, Aquino, G. Deforestation and world population sustainability: a quantitative analysis. Scientific Reports. 2020;10(1):7631. doi: 10.1038/s41598-020-63657-6.Google Scholar
Cincotta, RP, Wisnewski, J, Engelman, R. Human population in the biodiversity hotspots. Nature. 2000;404(6781):990–2. doi: 10.1038/35010105.Google Scholar
Cohen, JE. How Many People Can the Earth Support? New York: W.W. Norton; 1995.Google Scholar
Dasgupta, A, Dasgupta, P. Population overshoot. In Bykvist, K, Campbell, T, editors. Oxford Handbook of Population Ethics. Oxford: Oxford University Press; forthcoming.Google Scholar
Bongaarts, J, O’Neill, BC. Global warming policy: is population left out in the cold? Science. 2018;361(6403):650–2. doi: 10.1126/science.aat8680.Google Scholar
O’Sullivan, JN. The social and environmental influences of population growth rate and demographic pressure deserve greater attention in ecological economics. Ecological Economics. 2020;172:106648. https://doi.org/10.1016/j.ecolecon.2020.106648.Google Scholar
Murtaugh, PA, Schlax, MG. Reproduction and the carbon legacies of individuals. Global Environmental Change. 2009;19(1):14–20. https://doi.org/10.1016/j.gloenvcha.2008.10.007.Google Scholar
Ramesh, R. Leave population out of climate talks, Indian minister says. Guardian. 28 August 2009.Google Scholar
UNFPA. Programme of Action. Adopted at the International Conference on Population and Development, Cairo, 5–13 September 1994. New York: UNFPA; 1994.Google Scholar
UN Secretary-General. Progress towards the Sustainable Development Goals. Report of the Secretary-General. New York: United Nations Economic and Social Council; 2019. Contract No. E/2019/68. Available from https://unstats.un.org/sdgs.Google Scholar
Guttmacher Institute. Adding It Up: Investing in Contraception and Maternal and Newborn Health, 2017. New York: Guttmacher Institute; 2017. Available from www.guttmacher.org/fact-sheet/adding-it-up-contraception-mnh-2017.Google Scholar
Bhutta, ZA, Das, JK, Bahl, R, et al. Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? The Lancet. 2014;384(9940):347–70. doi: 10.1016/S0140-6736(14)60792-3.Google Scholar
de Onis, M, Dewey, KG, Borghi, E, et al. The World Health Organization’s global target for reducing childhood stunting by 2025: rationale and proposed actions. Maternal and Child Nutrition. 2013;9(Suppl. 2):6–26. doi: 10.1111/mcn.12075.Google Scholar
Pratley, P. Associations between quantitative measures of women’s empowerment and access to care and health status for mothers and their children: a systematic review of evidence from the developing world. Social Science & Medicine. 2016;169:119–31. doi: 10.1016/j.socscimed.2016.08.001.Google Scholar
Varkey, P, Kureshi, S, Lesnick, T. Empowerment of women and its association with the health of the community. Journal of Women’s Health. 2010;19(1):71–6. doi: 10.1089/jwh.2009.1444.Google Scholar
Afshar, H, editor. Women and Empowerment: Illustrations from the Third World. New York: St. Martin’s Press; 1998.Google Scholar
National Research Council. Population Growth and Economic Development: Policy Questions. Washington, DC: The National Academies Press; 1986.Google Scholar
Lutz, W, Crespo Cuaresma, J, Kebede, E, et al. Education rather than age structure brings demographic dividend. Proceedings of the National Academy of Sciences. 2019;116(26):12798–803. doi: 10.1073/pnas.1820362116.Google Scholar
Rentería, E, Souto, G, Mejía-Guevara, I, Patxot, C. The effect of education on the demographic dividend. Population and Development Review. 2016;42(4):651–71. doi: 10.1111/padr.12017.Google Scholar
Vollset, SE, Goren, E, Yuan, C-W, et al. Fertility, mortality, migration, and population scenarios for 195 countries and territories from 2017 to 2100: a forecasting analysis for the Global Burden of Disease Study. The Lancet. 2020;396(10258):1285–306. doi: 10.1016/S0140-6736(20)30677-2.Google Scholar
Sobotka, T, Skirbekk, V, Philipov, D. Economic recession and fertility in the developed world. Population and Development Review. 2011;37(2):267–306. doi: 10.1111/j.1728-4457.2011.00411.x.Google Scholar
Bradshaw, CJA, Brook, BW. Human population reduction is not a quick fix for environmental problems. Proceedings of the National Academy of Sciences. 2014;111(46):16610–15. doi: 10.1073/pnas.1410465111.Google Scholar
Maibach, E. Increasing public awareness and facilitating behavior change: two guiding heuristics. In Hannah, L, Lovejoy, T, editors. Climate Change and Biodiversity, 2nd ed. New Haven, CT: Yale University Press; 2019. pp. 336–46.Google Scholar
Vosoughi, S, Roy, D, Aral, S. The spread of true and false news online. Science. 2018;359(6380):1146–51. doi: 10.1126/science.aap9559.Google Scholar
Nusbaumer, MR, DiIorio, JA. The medicalization of nuclear disarmament claims. Peace & Change. 1985;11(1):63–73. doi: 10.1111/j.1468-0130.1985.tb00073.x.Google Scholar
Williamson, J. Nuclear war, climate change, and medical activism. The Lancet Planetary Health. 2020;4(6):e221–2. doi: 10.1016/S2542-5196(20)30127-3.Google Scholar
Haines, A, Hartog, M. Doctors and the test ban: 25 years on. BMJ. 1988;297(6645):408–11. doi: 10.1136/bmj.297.6645.408.Google Scholar
McCally, M, Cassel, CK. Medical responsibility and global environmental change. Annals of Internal Medicine. 1990;113(6):467–73.Google Scholar
Schwartz, BS, Parker, C, Glass, TA, Hu, H. Global environmental change: what can health care providers and the environmental health community do about it now? Environmental Health Perspectives. 2006;114(12):1807–12. doi: 10.1289/ehp.9313.Google Scholar
Jameton, A. The importance of physician climate advocacy in the face of political denial. AMA Journal of Ethics. 2017;19(12):1222–37. doi: 10.1001/journalofethics.2017.19.12.sect1-1712.Google Scholar
Parker, CL. Slowing global warming: benefits for patients and the planet. American Family Physician. 2011;84(3):271–8. Available from www.aafp.org/afp/2011/0801/p271.pdf.Google ScholarPubMed
WONCA. WONCA Statement on Planetary Health and Sustainable Development Goals. World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians; 2017. Available from www.globalfamilydoctor.com/News/PlanetaryHealthandSustainableDevelopmentGoals.aspx.Google Scholar

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