A sense of social justice is what first drew me to the discipline of planetary health – that the poorest and most vulnerable communities, often those who have tread lightest on this earth, would be those most harmed by climate change; that future generations may be confronted by a natural world lacking in the stability and beauty enjoyed by mankind for centuries; that whole cultures, languages and even countries could be lost forever, diminishing our rich diversity and disproportionately compromising Indigenous peoples.
By Dr Julian Cassar
These realisations, slowly but surely, have prompted many changes in my personal life – in my consumption, diet, travel, waste management and banking. However, it has become increasingly clear to me that my responsibility extends beyond my personal life, and that I have a professional duty as a doctor to address climate change as a public health emergency.
This is because planetary health and human health are inextricably linked. We saw how the 2019-20 Australian bushfires ravaged both land and livelihood, causing physical and psychological injury in the short and long-term. We know that an increasing frequency and severity of heatwaves is associated not only with dangerous heat stroke, but also worsening psychological illness, violence and suicide. We are coming to understand that air pollution is just as powerful a risk factor as smoking, poor nutrition, harmful alcohol use and physical inactivity for global disease burden. We are also recognising that changes in temperature and rainfall can alter vector and pathogen survival, propagating the spread of infectious diseases to new locations and seasons. And as our patients grapple with these current and potential consequences of climate change, psychological distress – manifesting as eco-anxiety or ecological grief – will naturally become an increasingly common phenomenon, particularly in young people.
Fortunately, planetary health also represents one of our greatest opportunities, and GPs are perfectly suited to capitalise on this opportunity. As GPs, we are expert at making sense of a complex interplay of converging factors that exist within a wider context; we know how to deal with uncertainty, manage risk and utilise ethical and medicolegal frameworks to care for both the individual and the community; we deeply understand the importance of symptom management, treatment of an underlying cause and prevention of recurrence; and we are adept at translating difficult scientific concepts to lay people. These skills, developed to promote human health, are exactly those required to promote planetary health.
Dr Cassar gardening with his brother.
Ways to practically address planetary health in our work include:
- Building and sharing knowledge with our colleagues, patients and the wider community.
- Encouraging lifestyle therapies with environmental co-benefits such as plant-rich diets, using public transport or a bicycle for travel and spending time in nature.
- Optimising sustainability and waste management within our own general practices.
- Supporting planetary health research to build evidence for urgent action.
- Becoming advocates in this space, either individually or through groups such as Doctors for the Environment Australia and RACGP Climate and Environmental Medicine Specific Interest Group.
Like many others, I entered medicine with the idealistic desire to ‘help others’ and ‘make the world a better place.’ Never did I imagine that planetary health would be part of this work, yet I now feel that it is one of the most meaningful contributions that I can make as a doctor. Just as previous doctors pioneered significant breakthroughs in public health through advancements in sanitation, vaccination and screening, it is now our turn to transform the landscape of health – and what better way to achieve this than by learning to care for our home.