Academic health institutions, including medical schools in Canada are agreeing that while caring for human health is a priority, it’s equally important to “do no harm” to the health of the planet.
Building on Western’s commitment to sustainability, Schulich School of Medicine & Dentistry has joined several other institutions in signing the Academic Health Institutions’ Declaration on Planetary Health recently launched by the Association of Faculties of Medicine of Canada (AFMC).
“Our planet and our health-care systems are stressed. We are witnessing environmental devastation that impacts the lives and health of some of the most marginalized and underserved populations globally. Health-care professionals and health systems need to be prepared for this,” said Western professor Nicole Redvers, co-chair of AFMC’s Committee on Planetary and Global Health.
Redvers is director of Indigenous Planetary Health and associate professor in the department of epidemiology and biostatistics at Schulich Medicine & Dentistry. A member of the Deninu K’ue First Nation (NWT), Redvers has extensive experience with Indigenous patients, as well as scholars and communities around the globe, and has leveraged her research and experience to provide a clear co-direction to the declaration on planetary health.
Redvers said the declaration underlines the critical role of medical schools in building climate-resilient health systems.
“When it comes to adopting a planetary health approach, there’s a scarcity of clear clinical recommendations for health-care providers, educational training efforts and policy guidelines across the globe,” said Redvers. The declaration calls upon academic health institutions to fill these gaps.
The declaration states the activities of global health systems, which encompass networks of health and medical organizations, institutions, policies and resources contribute to almost five per cent of global greenhouse emissions, which is twice as much as the greenhouse emissions produced by the aviation industry.
“Medical schools need to train health-care professionals who will take into account the health of the planet in their practice and research,” said Schulich Medicine & Dentistry Dean Dr. John Yoo.
“Schulich Medicine & Dentistry is working to ensure our students and community are exposed to planetary health perspectives through curriculum learning and practical global health experiences. As a signatory of the declaration, we seal our commitment to lead the planetary health movement in Canada.”
The declaration calls for institutions to implement an action plan that incorporates equity and justice into planetary health education and research. It emphasizes the need to focus on communities most affected by climate change, the respectful integration of Indigenous traditional knowledges and position the work within existing quality improvement frameworks.
Academic health institutions are also encouraged to allocate resources for planetary health research, formally recognize such research and collaborate across disciplines.
Adopting the patient–planetary co-benefit framework
A fine balance between the needs of patients and the planet through initiatives like sustainable medical care is at the core of the planetary health declaration. One of the approaches that address this need is patient-planetary (P-PH) co-benefit prescribing – an approach in health care where physicians consider both the patient’s health and the health of the planet when making prescribing decisions.
“Clinic-oriented efforts and activities related to sustainable medical care currently focus on waste reduction and recycling and the promotion of planet-friendly diets, among other things,” said Redvers. “These are all urgently needed changes. However, physicians are not adopting such measures at the rate that is needed. This is again because of a lack of knowledge, guidelines, support and resources and absence of environmental context and proper social and cultural influences.”
Co-authored by Redvers, a review recently published in the Lancet recommends the need for clear clinical recommendations, guidelines and training efforts to support healthcare professionals in implementing P-PH co-benefit prescribing. It emphasizes the importance of developing standards of practice that have co-benefits for patients and the planet and calls for more research and evidence-based literature in this area.
“To get more physicians and healthcare providers on board, we need to implement targeted systems-level behavioural change measures. We need to educate, motivate and support our health-care professionals – and the health systems in which they operate – towards clear and decisive action,” said Redvers.