Planetary health and sustainable primary care: what does this mean for a GP curriculum?

[摘要] ‘Wherever we deliver care, in our hospitals, clinics and communities around the world, we are already responding to the health harms caused by climate change.’ (The healthy climate prescription letter delivered to COP26 and COP27 Presidencies, 2021).1In January the roses bloomed. In July, smoke billowed from scorched urban grasslands and homes. The global climate emergency — of which the untimely unfurling of flower buds and extreme heat are just two tell-tale signs — has roused a call to action from the global health community.2 It is claimed, though, that doctors have remained relatively inactive in this conversation and that this is linked to gaps in their training, including a ‘dearth of curricular space.’ 3,4For tomorrow’s doctors to be able to successfully navigate climate-related health threats, in partnership with their patients, medical curricula must shape teaching and learning now. To address this need, the Royal College of General Practitioners (RCGP) has collaborated with experts and other stakeholders to develop a curriculum topic guide5 that embeds planetary health into UK postgraduate family medicine training.WHAT IS PLANETARY HEALTH AND WHY DO GPs NEED TO KNOW ABOUT IT? The health of individuals is deeply interconnected with the health of populations and the planet. Planetary health can be defined as ‘the health of human civilization and the state of the natural systems on which it depends.’ 6 As a field, it aims to understand and address the human health impacts of human-caused disruptions to the earth’s natural systems.7 Disruption of these natural systems through, for example, climate change and biodiversity loss, profoundly affects the social and environmental determinants of human health. We harm the planet, which harms our health. The health impacts of climate change on individuals are well documented and include rises in infectious diseases, food insecurity, and the effects of pollution and severe weather.8 In a landmark ruling in the UK in 2021, air pollution was for the first time listed as a medical cause of death.9 At the same time, healthcare services, including primary care, are a major contributor to environmental damage; addressing this is also part of planetary health. Simply put, what this means in general practice is understanding how the health of the planet is affecting the health of our patients, how their clinical care is affecting the planet, and what we can do about it.

[学科分类] 卫生学