The Important Role Doctors Can Play in the Climate Crisis

We know that human health is closely linked to the health of our planet and that everything that happens to the planet also affects us. The logical implication of this is that the climate crisis poses a threat to human health: climate change is exacerbating many direct and indirect risks and impacts that are already affecting the number of people who are getting sick and dying in the world today.

The creation and adoption of the 17 Sustainable Development Goals (SDG) of the 2030 Agenda by the United Nations in 2015 was largely motivated by this recognition that the climate crisis represents a health crisis.

The climate crisis poses a threat to human health: climate change is exacerbating many direct and indirect risks and impacts that are already affecting the number of people who are getting sick and dying in the world today

This relationship between human and planetary health has been highlighted by the COVID-19 pandemic because environmental degradation fosters the conditions that favour the emergence of new viruses. Experts warn that if we are to recover from the crisis caused by the pandemic, we must respond to the climate crisis.

What role can doctors play in this battle? That was the question posed by the three authors of a document entitled “The Health of the Planet is Our Health. Commitment by Catalan doctors regarding the climate emergency and its impact on people's health”: Josep Maria Antó, research professor and former scientific director at the Barcelona Institute for Global Health (ISGlobal), a doctor at Parc de Salut Mar and lecturer at the Pompeu Fabra University (UPF); Mònica Botta, medical director at Hospital de Granollers and member of the board of the Barcelona Medical Association (Col·legi de Metges de Barcelona [CoMB]); and Antoni Trilla, head of the Preventive Medicine and Epidemiology Department at Hospital Clínic de Barcelona, lecturer in the Faculty of Medicine and Health Sciences at the University of Barcelona (UB) and member of the CoMB Board. The position statement was published on September 2021 by the Council of Catalan Medical Associations (Consell de Col·legis de Metges de Catalunya [CCMC]) with the collaboration of ISGlobal.

Climate Change and Environmental Degradation Do Affect Our Health

The authors of the position statement cite a recent World Health Organisation (WHO) publication which estimates that, between 2030 and 2050, some 250,000 additional deaths per year will be caused by the direct effects of climate change, mainly due to malnutrition, malaria, diarrhoea and extreme temperatures.

The authors of the position statement cite a recent World Health Organisation (WHO) publication which estimates that, between 2030 and 2050, some 250,000 additional deaths per year will be caused by the direct effects of climate change, mainly due to malnutrition, malaria, diarrhoea and extreme temperatures

There is clear evidence that the global warming of the planet is the result of human activity, mainly our use of fossil fuels which produce greenhouse gases. The European Union has committed to the goal of reducing emissions by 50% by 2030. And the authors of the position statement are clear: no one should lose sight of the fact that what is at stake is the future of upcoming generations and the very survival of humanity.

Foto: Tri-Le / Pixabay

Human activities have other negative impacts on planetary health, including the pollution of the air, oceans, land and water, as well as the loss of biodiversity. This environmental degradation, at times so serious that it is irreversible, also has repercussions on human health.

Nor should we forget that all the risks associated with environmental degradation and the effects of climate change usually pose an even greater threat to disadvantaged people, in particular women and children, and especially those living in poverty and in low-income countries.

The risks associated with environmental degradation and the effects of climate change usually pose an even greater threat to disadvantaged people, in particular women and children, and especially those living in poverty and in low-income countries

How does planetary health affect our health? The CCMC document summarises the effect as follows:

1. Rising temperatures increase respiratory, cardiovascular and renal complications, and there is evidence that hot weather can even affect our reproductive capacity and the mental health of the population; this in a world in which heat waves are becoming increasingly frequent.
2. Current WHO estimates indicate that air pollution generated by human activities kills some 7 million people every year worldwide. Half of these deaths are caused by fine particulate matter (PM₅) suspended in the air we breathe. These particles not only cause respiratory disorders but are also small enough to pass through the alveoli in the lungs and enter our bloodstream. Numerous studies have found a link between air pollution levels and cardiovascular, cerebrovascular, oncological and neurological disease as well as cognitive impairment.
3. Reductions in rainfall and rising sea levels will affect the availability of fresh water and give rise to water shortages, which are associated with hygiene problems, the spread of disease and difficulties in food production. In many parts of the world, water quality has deteriorated due to contamination with chemical substances, pesticides, heavy metals, plastic waste and microplastics, among other pollutants.
4. The increase in drought conditions will have serious repercussions on agriculture and livestock production, resulting in food scarcity. The WHO predicts that climate change will cause some 95,000 additional deaths a year from malnutrition and undernutrition between 2030 and 2050.

Individually and combined, all of these factors will trigger the forced migration of millions of people, particularly from tropical and subtropical regions of the planet, where the effects of climate change will be particularly severe. Just in relation to the problem of rising sea levels alone, the WHO reminds us that over half of the world’s population lives less than 60 kilometres from a coastline. The care of migrants in destination countries will pose many challenges, particularly for health care systems, because of the high levels of poverty associated with migration, making this population susceptible to the diseases associated with poverty, including mental health disorders.

Nord de Darfur (Sudan). Foto: Albert González Farran / ONU

The Response of Catalan Doctors

This is a global problem with global implications and one that demands an immediate response. In the opinion of the authors of the position document, doctors bear a special responsibility in this situation. Recognising this, Catalan doctors have made a commitment to provide a response to the threat to human health and well-being posed by global warming and the alteration of the planet’s natural systems. They have committed to doing everything possible to prevent the effects of these changes where possible and to mitigate and adapt to those that are inevitable.

Catalan doctors have made a commitment to provide a response to the threat to human health and well-being posed by global warming and the alteration of the planet’s natural systems

Accordingly, the Council of Medical Associations of Catalonia (CCMC) has published this position statement to publicly express its commitment to promoting and supporting actions that seek to make global health and the fight against the climate crisis a public health priority.

The CCMC document states that:

• The time has come to redefine our concept of health and to recognise that human health can never be separated from the health of the planet’s natural resources.
• It is now vital to improve training for doctors on global health issues and the implications of climate change for public and individual health.
• People look to doctors for leadership on health-related issues and, consequently, doctors have a responsibility to help educate the population about good habits related to both their own health and planetary health.
• Since the primary mission of the medical profession is to protect health, the doctors urge local, regional and national government bodies and international organisms to immediately start legislating, forging agreements and implementing measures designed to combat climate change and to take effective steps to remedy the climate crisis.
• Doctors’ position as leaders in questions of health allows them to become a model for civil society (citizens, companies, organisations, etc.) by monitoring and reducing their own emissions and carbon footprint.
• The effects of the climate crisis force us to adapt our health infrastructures and resources to new needs and emergency situations. For example, doctors will have to treat more patients with rare and little-known diseases, respond to epidemic outbreaks and care for more migrants arriving in our country in very precarious conditions. Public healthcare systems, already under strain, will have to be prepared to deal with these new challenges. And new public health strategies will be needed.
• Doctors have a responsibility to safeguard the right to health of the most disadvantaged individuals and communities—the people who are most vulnerable to the health effects of climate change, which tends to accentuate social inequalities.
• It is essential to prioritise and support research in order to assess the risks and find global solutions to emerging health needs and responses to emergency situations, which will often require knowledge sharing.
• Doctors can play a leading role in medical facilities by promoting policies focussed on reducing greenhouse gas emissions and other waste generation and encouraging more environmentally sustainable practices.
• As prescribers, doctors have a duty to promote and ensure the responsible consumption of drugs and other medical resources. In a scenario in which the prevalence of infectious diseases is expected to increase it is imperative to reduce the inappropriate use of antibiotics, with the dual benefit of combatting the emergence of new resistant strains and of reducing the negative impact of antibiotic abuse on the environment.

What is clear, therefore, is that medical associations, doctors and other health professionals must play a key role in protecting people’s health from the effects of the climate crisis. For this reason, the CCMC document concludes with a call to all of these stakeholders around the world to collaborate and establish global alliances to deal with this global crisis. The time to act is now.