Did you know that 24% of all global deaths are linked to the environment, which is about 13.7 million deaths a year, according to the World Health Organization [1]?
Climate change is the greatest global health threat of the 21st century [2]. As such, the human and planetary health is going to be increasingly tested by the ecological affliction associated with greenhouse gas emissions. The Intergovernmental Panel on Climate Change (IPCC) is the United Nations body for assessing the science related to climate change [3]. The IPCC has estimated that human activities are projected to have caused approximately 1°C of global warming above preindustrial levels. The Paris Agreement goal of limiting global warming to below 2°C may be more difficult to achieve if it continues to increase at the current rate [3]. While we move ever deeper into the Anthropocene (viewed as the period characterized by human impact on climate and environment), and if we do not do anything about it, we will face the threat of a world in which warming reaches 4°C above preindustrial levels by the end of the century [3].
There is emerging evidence on climate-sensitive health risks. The health of a community is vital to the state of wellness of its people. As public awareness of climate crisis and its critical impact increases, a significant proportion of individuals have experienced increasing rates of anxiety and depressive symptoms, and even post-traumatic stress symptoms [4]. While we try to mitigate some of the global warming effects, adaptation to climate change requires collective action to strengthen the environmental wellness of communities. Consequently, there is a need for innovative tools and interventions to help healthcare professionals and communities adapt to and mitigate these consequences.
Environmental wellness is a process that involves establishing a sustainable living by attempting to reduce the use of natural resources (i.e., the resources that exist without any actions of humankind, such as oil, coal, natural gas, and metals) and to master one’s personal resources (i.e., the within-person capacities of self-efficacy and resilience). Sustainable living is simply a method of reducing one’s carbon footprint by altering methods of energy consumption, reducing waste, and eliminating pollutants, among others. Ensuring environmental wellness enhances our personal health and the health of our communities. Promoting good health and wellbeing at all ages is essential to a sustainable development and is one of the United Nations Sustainable Development Goals [5].
Let us discuss now the concept of personal environmental health. One’s personal environment refers to the person, home, and office space. “Person-environment fit” (PE fit) theory refers to the relationship of compatibility or incompatibility that may exist between a person and the environment [6]. The basic rationale of this theory is simple: it is generally assumed that PE fit leads to positive outcomes, such as increased satisfaction, performance, and overall wellbeing. In other words, a positive association is to be expected between an optimally compatible environment and improved work attitude, performance, and stress level. Therefore, health and safety are essential in personal environments. Both home and work environments have impact on our health.
As healthcare providers, to support the environmental wellness of our patients, the following environmental attributes/components described below must be incorporated in treatment settings. We can further encourage our patients to consider these key components in their own home environments and work settings (see below the acronym ABC).
A: Ensure an environment that is accessible - make a physically and emotionally accessible space that is culturally competent and trauma-informed for service delivery;
B: Cultivate a benevolent environment (i.e., meaning a concern for the wellbeing of people other than oneself) - create supportive environments that are inclusive and supportive of all abilities;
C: Keep the environment clean - organized work and home spaces can promote good health and can improve stress, anxiety, and mood. It is known that chronically elevated levels of cortisol (often called the “stress hormone”) can lead to anxiety and depression.
In Practice
Imagine what you are going to do in the year 2022. We believe that a successful healthcare is a sustainable healthcare, which keeps a focus of environmental impacts on the healthcare system. For physicians, committing to sustainability of medicine can be seen as part of the Hippocratic Oath, a promise to protect the wellness of people. As a clinician, what do you wish for yourself, your family, peers, and your patients? The following is a simple 3-step exercise to help us explore our readiness and preparedness for climate action.
Practice self-care
To take care of others, as clinicians, we need to start by taking good care of ourselves. Riddell and Hategan [7] have outlined some strategies for clinicians to help optimize one’s own wellbeing, which can be employed prophylactically when well or as an acute intervention when psychologically injured.
Start the healing
As clinicians, we have a responsibility which extends beyond the individual patient to the health and wellness of community, society, and the world as a whole. It is our responsibility to help educate patients and the public alike on the climate-sensitive risks to health and how to try to mitigate those, one of the first steps to a healing process in the Anthropocene.
Take action
Make a list of everything you are worrying about, and divide it into what you do and do not have control over. In the process, ask yourself: What are the most important things for me right now? What are the main threats to the things I value most? If climate change is not on your worry list, you may need to do more studying on climate change. Then, ask yourself some more: What am I doing to safeguard what I value most? If we are not doing anything now, we may suffer in the future.
As a final refection, think, again, the ABC: Act Now + Be Bold + Be Creative and do something that works for you to combat climate change and improve resilience in the face of profound changes ahead.
References
1. World Health Organization. Preventing disease through healthy environments: a global assessment of the burden of disease from environmental risks. September 13, 2018. https://www.who.int/publications/i/item/9789241565196. Accessed January 4, 2022.
2. Watts N, Amann M, Arnell N, et al. The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come. Lancet. 2018;392(10163): 2479-2514. doi: 10.1016/S0140-6736(18)32594-7. Erratum in: Lancet. 2020 Jun 6;395(10239):1762. PMID: 30503045.
3. The 2021 Intergovernmental Panel on Climate Change (IPCC). https://www.ipcc.ch/. Accessed January 4, 2022.
4. Clayton S. Climate change and mental health. Curr Environ Health Rep. 2021;8(1):1-6. doi: 10.1007/s40572-020-00303-3. PMID: 33389625.
5. United Nations. Sustainable Develtps://www.un.org/sustainabledevelopment/health/. Accessed January 4, 2022.
6. Pasca R. Person-environment fit theory. In: Michalos A.C. (eds) Encyclopedia of Quality of Life and Well-Being Research. Springer, Dordrecht, 2014. https://doi.org/10.1007/978-94-007-0753-5_2155.
7. Riddell T, Hategan A. Physician Health and Wellness. McMaster Textbook of Internal Medicine. Kraków: Medycyna Praktyczna. https://empendium.com/mcmtextbook/chapter/B31.II.21.26 Accessed January 4, 2022.
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