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Planetary Health: What should doctors do? An open MJA edition due to overwhelming demand

The latest edition of the Medical Journal of Australia is focused on climate health, under the title Planetary Health: What should doctors do?

The MJA said via Twitter that “due to overwhelming demand” all the planetary health/climate change content in the issue has been made open access until midnight on Friday 27 April 2018.

You can access it here: https://www.mja.com.au/journal/2018/208/7 …

Its editorial is written by Professor Tony Capon from Sydney University, the world’s first Professor of Planetary Health, MJA Editor-in-Chief Nick Talley, and Richard Horton, Editor-in-Chief of The Lancet, which last year launched the Lancet Countdown: Tracking Progress on Health and Climate Change.

They say Australia is well regarded for research on planetary health — not least because of the exemplary leadership of the late environmental epidemiologist Professor Tony McMichael, whose work first shone a spotlight on the health impacts of climate change.

They ask:

But what more can and should doctors do?

Declaring that planetary health “is the business of the medical profession because the health of our patients is at risk”, they call on the profession to lead by example, warning that as doctors remain highly trusted members of the community, “if we take no action, this speaks louder than words.

They provide suggestions for bringing planetary health perspectives more sharply into focus in medicine that include:

  • ensuring that the health impacts of pollution, deforestation, biodiversity loss and climate change are included in medical training;
  • carefully considering the medical model of care and the ways that health professionals (and the institutions they work for or belong to) might be able to reduce their carbon footprint
  • talking to patients about relevant environmental health matters “as, indeed, Hippocrates was doing more than 2000 years ago when he wrote his thesis On airs, waters and places”
  • encouraging and supporting further research on health impacts of environmental change and options for transitions to sustainable ways of living
  • educating the community about planetary health issues when appropriate opportunities arise
  • reflecting on personal behaviour – “the way we live at home and our recreational pursuits” – with the need for all of us to “tread lightly on the Earth”.

Another article – Preparing medical graduates for the health effects of climate change – looks more closely at the need for health professionals, including doctors, to “understand the impact of climate change on health and be competent to take action and advocate for change”.

“Otherwise it will be a missed opportunity when an urgent and scaled response to mitigate and adapt to climate change is required if society is to avoid the most harmful consequences,” say the authors, Professor Lyn Madden from the University of Notre Dame Australia and President of the Australasian Faculty of Public Health Medicine (AFPHM) of the Royal Australasian College of Physicians (RACP), Professor Michelle McLean from Bond University and Dr Graeme Horton from the University of Newcastle.

Despite the risks and issues involved, they say there are still few examples in the literature where climate change and health has been integrated into medical curricula though medical students have been attempting to fill the breach, including the Australian Medical Students Association which has developed a short online court on climate change.

They welcome the “timely” work of the  Medical Deans of Australia and New Zealand (MDANZ), which has formed a working group, representing medical schools and medical student associations across both countries, to develop curricula and resources to address the health threats posed by climate change within primary medical programs.

There are lessons also for Australia’s health system from the steps taken over the past 10 years by the NHS in England to consider environmental sustainability as part of good health and care, writes David Pencheon, from the University of Exeter in the UK. Those lessons include that:

  1. Robust and regular engagement with health care staff elicits the best practical ideas that protect health and the most effective mandate from trusted professionals to implement them.
  2. Governance, regulatory and reporting mechanisms need to be understood in order to remove barriers to improvement and ensure the rapid spread of effective innovation in health and care.
  3. Traditional medical research that identifies health threats requires complementary interdisciplinary research focused on solutions — such as models of care that balance hospital treatment with care closer to home and community prevention strategies.

The edition includes a collection of peer-reviewed articles on various aspects of planetary health:

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