There is growing acceptance that human-induced global warming and unsustainable patterns of living are implicated in a health threat to individuals and populations, says Benny Goodman.
Health care professionals are becoming more interested and more aware of the relationship between the environment and health. Of course, ever since the early pioneering days of public health, when Dr John Snow famously investigated cholera in London and its links to the Broad street pump, there has been interest in this linkage.
However it might be fair to suggest that since about 2007 when the IPCC published its 4th assessment report on climate change, and included a chapter on human health in its working group II report, there has been renewed interest and focus on these challenging issues.
So, there is growing acceptance, but not an uncontested acceptance , that human-induced, i.e. ‘anthropogenic’, global warming and unsustainable patterns of living, such as the overuse of fossil fuels for personal transport, are implicated in a health threat to individuals and populations.
Climate change: The 'biggest threat to public health this century'?
Costello et al(2009) in a paper in the Lancet argued that ‘climate change is the biggest threat to public health this century’, although this particular claim is disputed by some authors such as Indur Goklany who argues that the WHO’s Global Health Risks ranks climate change among 24 global health risks, and indeed ranks it pretty low, and in a 2012 report suggests Global Warming Policies might be Bad for your Health. There is still much to learn about the nature of the health threats to populations both current and future.
Nonetheless, on December 4th 2011, the first Global Climate and Health Summit brought together over 200 participants from more than 30 countries and concluded with the adoption of the Durban Declaration on Climate and Health and the Health Sector Call to Action.
The delegates called for a ‘fair, ambitious and binding global treaty, and urged all countries to commit to immediate strong climate action to protect and promote health’. This follows previous suggestions by organisations such as the Climate and Health Council and the BMJ that health professionals should take a leadership role in putting health at the core of sustainability and in addressing the health and security aspects of climate change. The Sustainable Healthcare Education (SHE) network is currently engaging in a national consultation on ‘priority learning outcomes’ (PLOs) for medical education.
This work has been carried out in collaboration with and prompted by the General Medical Council. This is an exciting development and carries forward sustainability into medical education as an explicit theme for ‘Tomorrow’s Doctors’.
Various international health and nursing organisations have also published position statements on climate change: The American Nurses Association 2008 House of Delegates (2008), International Council of Nurses (2008), the Royal College of Nursing Australia (RCNA) and Australian College of Nursing (2012).
More education is needed
Thus, many in the health professions globally and especially those working in Public Health have accepted sustainability and climate change as hugely important areas for education and practice. However this is not just about climate change.
The issues around sustainability, e.g. biodiversity loss, desertification and soil erosion, do not require that climate change is an established fact or even that the health impacts will be as they are predicted. There are many other sustainability and environmental issues resulting from current human practices that negatively impact on the health of populations and, if not addressed, through for example Agenda 21, could seriously threaten the health of the global population in the future. This has been recognised for over three decades and has a much longer history even than that. Many know the history but I have also learned that many do not, so in summary:
During the 1980s the United Nations General Assembly established the Brundtland Commission which published in 1987 a report: ‘Our Common Future’. This was a global initiative to unite countries around sustainability principles. During the World Summit on Sustainable Development (WSSD) in Johannesburg in 2002, the International Association of Universities (IAU), the Association of University Leaders for a Sustainable Future (ULSF), Copernicus Campus, and UNESCO launched the Global Higher Education for Sustainability Partnership (GHESP) to promote education for sustainable development in particular among higher education institutions.
Again, in 2002, the United Nations General Assembly proclaimed the years from 2005 to 2014 as the Decade of Education for Sustainable Development (DESD). Responses by governments around the world include ‘Caring for Our Future’ (2006) which is the Australian Government’s Strategy. The United States’ response to DESD includes a partnership of several hundred individuals, organizations, and institutions dedicated to the overall aim of seeing sustainable development fully integrated into education and learning.
In the UK the Higher Education Academy (HEA) has a ‘thematic area’ of education for sustainable development with a purpose to help institutions develop curricula and pedagogy. We now have curricula guidance such as the HEA’s ‘Future Fit Framework’ (Sterling 2012) which is designed for educators interested in sustainability education applied to their discipline, to assist them with developing their ‘sustainability lens’.
Support from the NHS and universities
Finally the UK’s National Health Service recognises its sustainability responsibilities, especially as a high net contributor to carbon emissions, and has provided resources and a carbon reduction strategy to address sustainability in everyday healthcare practice. The sustainability ambitions of Plymouth University are well established and underlined in its new corporate strategy.
Other UK universities such as Nottingham, Brighton and Gloucester also recognise the importance of this agenda. Sustainability cuts across academic disciplines and can apply in all. Many students cite sustainability as an important aspect of both choosing their University and for their future careers. Health care professionals have a very important role to play in both addressing health impacts and in supporting the NHS in its sustainability ambitions. Health care education can play a key part in promoting the sustainability literacy of the professionals of the future.
This then sets the scene for why health care professionals should be engaging in the issues. I hope in future posts that we can explore what this agenda means for us personally and professionally as we address the health impacts of climate change and the sustainability issues that arise from our lifestyles.