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The coronavirus pandemic highlights the important link between human health and the environment; it draws attention to structural inequalities and the need to address social, environmental and health justice.
Planetary health is conceptualised as the health of human civilisation and the state of the natural systems on which it depends, reflecting the interconnectedness we have as humans with the planet. Our planet is sick, and that sickness impacts significantly on its inhabitants; for example, it is estimated that 4.2 million deaths globally are linked to ambient air quality, further enhancing social and health inequalities.
Nurses need to understand the connections between the health of the planet and human health, to adapt to and mitigate for climate change. If we increase our knowledge about climate change, and practise sustainable healthcare, we can model best practice, and educate and influence colleagues, patients and their families.
Policy change is required to ensure nursing education includes core competencies for sustainability and climate change. Research has demonstrated changes in knowledge and attitudes following sustainability sessions focused on the application to clinical practice. When exposed to sustainability issues, student nurses can act as advocates and make changes in their own lives as well as in practice.
“Time is running out and we cannot afford to be complacent”
Covid-19 has also exposed the fragile nature of supply chains through shortages of personal protective equipment and other essential items for healthcare delivery. This is not a new problem, concern about the potential interruption to healthcare supplies has received significant attention. Many items used in clinical practice are based on scarce natural resources, the extraction and production of which contribute to climate change.
Furthermore, the excessive manufacture, use and disposal of single-use items negatively impacts the environment. Nurses are leaders in managing resources used in healthcare, they can make a difference if they have appropriate knowledge. One thing that the pandemic has highlighted, particularly in ‘lockdown’, is the need for human contact. Many people started to appreciate the value of companionship, and re-evaluate their contact with nature. As humans we are embedded within an ecosystem that we rely on for our health and survival. Cycling, walking, connecting with the outdoors and listening to bird song can lead to a re-appraisal of what is valued. We need to move away from consumerism, where the model of ‘wealth’ is financial. This consumerist model, and our need for more and cheaper stuff, is not only destroying the planet but perpetuates social inequalities.
Nurses can be environmental activists – see, for example, the excellent campaigning work of the Alliance of Nurses for Healthy Environments. And in 2018, the International Council of Nurses called for nursing leadership to combat the effects of climate change on health. Universities will need to act on future planetary health challenges by using a social equity lens and embedding programmes in curricula that support healthcare practitioners. Nurses are many things – leaders, activists, educators, clinicians, carers. With knowledge and awareness of the fragility of our planet, the impact we have on a complex ecosystem, and how planetary health is integral to human health, we can meet the challenges of climate change. Time is running out and we cannot afford to be complacent.
Janet Richardson is emeritus professor, University of Plymouth