Patient-Planetary Health Co-benefit Prescribing: Emerging Considerations for Health Policy and Health Professional Practice (original) (raw)
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Translating Planetary Health Principles Into Sustainable Primary Care Services
Frontiers in Public Health, 2022
Global anthropogenic environmental degradations such as climate change are increasingly recognized as critical public health issues, on which human beings should urgently act in order to preserve sustainable conditions of living on Earth. "Planetary Health" is a breakthrough concept and emerging research field based on the recognition of the interdependent relationships between living organisms-both human and non-human-and their ecosystems. In that regards, there have been numerous calls by healthcare professionals for a greater recognition and adoption of Planetary Health perspective. At the same time, current Western healthcare systems are facing their limits when it comes to providing affordable, equitable and sustainable healthcare services. Furthermore, while hospital-centrism remains the dominant model of Western health systems, primary care and public health continue to be largely undervalued by policy makers. While healthcare services will have to adapt to the sanitary impacts of environmental degradations, they should also ambition to accompany and accelerate the societal transformations required to re-inscribe the functioning of human societies within planetary boundaries. The entire health system requires profound transformations to achieve this, with obviously a key role for public health. But we argue that the first line of care represented by primary care might also have an important role to play, with its holistic, interdisciplinary, and longitudinal approach to patients, strongly grounded in their living environments and communities. This will require however to redefine the roles, activities and organization of primary care actors to better integrate socio-environmental determinants of health, strengthen interprofessional collaborations, including non-medical collaborations and more generally develop new, environmentally-centered models of care. Furthermore, a planetary health perspective translated in primary care will require the strengthening of synergies between institutions and actors in the field of health and sustainability.
Planetary health action framework: A case study SPECIAL ISSUE: PLANETARY HEALTH
Planetary health action framework: A case study, 2022
Planetary Health (PH) action is urgent to avoid the collapse of Earth's systems that sustain human health. PH care has been proposed as an approach to improve health equity and reduce healthcare´s ecological footprint. This paper presents the conceptual framework of patient-centered PH care as essential for PH action at the community level. We examine and reflect on one primary care clinical case through 8 lenses: 1) Actor-Network Theory, 2) Evidencebased medicine, 3) Patient-Centered Clinical Method; 4) Principles of Primary Care, 5) Proposed new primary care derivate principle of PH care, 6) the WONCA´s (World Organization of Family Doctors) core competencies tree, 7) WONCA´s curriculum, and 8) Sustainable Development Goal 3. This case offers insights into functions of primary care that mitigate, adapt and build resilience to the challenges of climate emergency and Anthropocene. It "connectsthe-dots" to propose a new identity of primary care, elaborate a blueprint for patient-centered PH care and a roadmap for PH action at the community level.
Medicine's Role in Mitigating the Effects of Climate Change
The virtual mentor : VM, 2009
Although philosophies connecting our health to nature go back to Hippocratic times, these early ideas stressed that harmony with and imitation of nature promoted health. Only recently have we begun to appreciate the reverse-that human medicine, as a result of its manufacturing processes, buildings, and waste disposal, has an unhealthy impact on the natural world [1]. The greening of health care has joined our general efforts to reduce the environmental impact of our homes, industries, campuses, transportation, and so on. Greening health care is challenging. Relative to homes, offices, and campuses, hospitals and clinics use materials and energy intensively-serving vulnerable patients and families in acute settings when those involved are too immersed in the crisis to embrace long-term environmental goals. The first wave of health care greening arose in the 1980s with attention to such practices as cleaner manufacturing methods and reduction in waste volume, toxicity of medical materials, and packaging. This movement is led by Health Care Without Harm (HCWH), which holds an annual CleanMed conference featuring green products. HCWH and others have tackled incinerator emissions, mercury in the waste stream, plastic materials that leach out environmental estrogens, disposal of electronics, and toxic hospital cleansers, among other targets. The second major wave has been driven by the movement to reduce the environmental footprint of buildings. The U.S. Green Building Council developed standards known as the LEED criteria to assess and rank the sustainability of all buildings, including those that house health care services. Boulder Community Foothills Hospital was the first U.S. hospital to be LEED certified. Many have been built since, and dozens are on the drawing boards. Climate Change A hospital is a high-energy enterprise-with its bright lights, refined air filtration, stable temperatures (intensive heating and air conditioning), heavy-duty imaging devices (with highly complex manufacturing histories), exotic chemicals, endless reusables and disposables, and the need to keep everything clean, disinfected, and purified. As continuing global exploitation of fossil fuels warms the Earth to an extent that bodes global natural and health disasters, health care is beginning to experience increasing pressure to reduce its use of energy-its carbon footprint.
Medicine, Health Care and Philosophy
The article critically responds to "A Planetary Health Pledge for Health Professionals in the Anthropocene" which was published by Wabnitz et al. in The Lancet in November 2020. It focuses on the different roles and responsibilities of a physician. The pledge is criticised because it neglects the different roles, gives no answers in case of conflicting goals, and contains numerous inconsistencies. The relationship between the Planetary Health Pledge and the Declaration of Geneva is examined. It is argued that the Planetary Health Pledge should have supplemented the Declaration of Geneva instead of changing it.
Clinical Ecology—Transforming 21st-Century Medicine with Planetary Health in Mind
Challenges, 2019
Four decades ago, several health movements were sprouting in isolation. In 1980, the environmental group Friends of the Earth expanded the World Health Organization definition of health, reminding citizenry that, “health is a state of complete physical, mental, social and ecological well-being and not merely the absence of disease—personal health involves planetary health”. At the same time, a small group of medical clinicians were voicing the concept of “clinical ecology”—that is, a perspective that sees illness, especially chronic illness, as a response to the totaled lived experience and the surroundings in which “exposures” accumulate. In parallel, other groups advanced the concept of holistic medicine. In 1977, the progressive physician-scientist Jonas Salk started that “we are entering into a new Epoch in which holistic medicine will be the dominant model”. However, only recently have the primary messages of these mostly isolated movements merged into a unified interdisciplinary discourse. The grand, interconnected challenges of ourtime—an epidemic of non-communicable diseases, global socioeconomic inequalities, biodiversity losses, climate change, disconnect from the natural environment—demands that all of medicine be viewed from an ecological perspective. Aided by advances in ‘omics’ technology, it is increasingly clear that each person maintains complex, biologically-relevant microbial ecosystems, and those ecosystems are, in turn, a product of the lived experiences within larger social, political, and economic ecosystems. Recognizing that 21st-century medicine is, in fact, clinical ecology can help clear an additional path as we attempt to exit the Anthropocene.
The Value of Global Indigenous Knowledge in Planetary Health
Challenges , 2018
In order to fulfill a broader vision of health and wellness, the World Health Organization (WHO) 2014-2023 strategy for global health has outlined a culturally sensitive blending of conventional biomedicine with traditional forms of healing. At the same time, scientists working in various fields-from anthropology and ecology to biology and climatology-are validating and demonstrating the utility of Indigenous knowledge. There is a misperception that Indigenous peoples are in need of Westernized science in order to "legitimize" our knowledge systems. The Lancet Planetary Health Commission report calls for the "training of indigenous and other local community members" in order to "help protect health and biodiversity" (p. 2007). Such calls have merit but appear authoritarian when they sit (unbalanced) without equally loud calls for the training of (socially dominant) westernized in-groups by Indigenous groups "in order to help protect health and biodiversity." The problems of planetary health are both profound and complex; solutions can be found in a greater understanding of the self and the universe and the land as a medicine place. The following message was delivered as part of a keynote at the inVIVO Planetary Health Conference in Canmore, Alberta, Canada-20 points of consideration for a planetary health science in its pure, raw form, on behalf of the Indigenous elders.
Planetary Health and Family Medicine
Planetary Health and Family Medicine, 2023
Many family physicians and other medical professionals are really worried about the ecological and climate crises. But they frequently have trouble coming up with practical solutions to deal with it in their work. In order to address this issue, this session will provide a response to the question, "What can I do in my practice?" Fortunately, there is already existing advice. Some of the family practice guidelines that have been created by various nations will be shared and debated during this session. This toolkit acts as a mechanism for continuous quality improvement by defining the justification for each step, offering advice on how to execute it, and showing the way to a practice with net-zero carbon emissions. Lifestyle Medicine (LM) is evidence-based, clinical care that supports behaviour change through person-centered techniques to improve mental wellbeing, social connection, healthy eating, physical activity, sleep and minimisation of harmful substances. This is highly relevant in the context of family medicine and the current non-communicable disease pandemic.