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Ten practical actions for doctors to combat climate change

BMJ 2008; 336 doi: (Published 26 June 2008) Cite this as: BMJ 2008;336:1507
  1. Jenny Griffiths, Alison Hill, Jackie Spiby,
  2. Mike Gill, Robin Stott
  1. 1Health and Sustainability Network (
  2. 2Climate and Health Council (

The effects of climate change on health are already here, from increasing food prices to floods. Doctors led the charge on tobacco—we must do the same for climate change.

It is the defining issue for health in the 21st century. By reducing our greenhouse gas emissions as health professionals, as well as citizens, we will also prevent disease.

The world is close to the critical thresholds of two degrees of global warming and 450 ppm (parts per million) of carbon dioxide equivalent emissions. We have 5-10 years to stabilise emissions to prevent catastrophic climate change. This requires action now.

Each person in the UK is directly responsible for about 10 tonnes of carbon emissions a year, divided evenly between energy consumed in buildings; transport (including one tonne on air travel); food production, distribution, and retailing; and consumption of goods and services other than food. About half of these emissions come from the home, and half from work and community infrastructure.

Our priorities require little money. Most mean that we, and our patients, will spend less, and they have the additional merit of improving wellbeing. Here are 10 practical actions.

  • 1. Inform ourselves about the basic science of climate change, the health benefits of taking action, and the urgency of doing so.

  • 2. Advise our patients. Better diet and more walking and cycling will improve their health and reduce their carbon emissions.

  • 3. Use less energy ourselves (and reduce costs) by more insulation in the roof, walls, and floors; turning off appliances and lights; and, where possible, reducing use of goods and services.

  • 4. Drive the car less; fly less; walk or cycle more; use public transport; drive an efficient car; share cars; hold meetings by teleconference, videoconference, or webcasting; attend fewer international conferences.

  • 5. Influence food menus wherever we go—ask for local food, less meat, and less processed food; a low carbon diet is a healthy diet. Drink tap water.

  • 6. Advocate locally, especially in primary care, to maximise home insulation and uptake of relevant grants.

  • 7. Advocate for personal carbon entitlements within an equitable, fair shares global framework, such as Contraction and Convergence.

  • 8. Advocate to stabilise population—by promoting literacy and promoting women’s access to birth control, through the International Planned Parenthood Federation ( or Marie Stopes International (

  • 9. Be a champion: put climate change on the agenda of all meetings—clinical teams, committees, professional networks. Doctors can tip opinion with chairs and chief executives.

  • 10. Gear up your own influence and that of all health professionals by joining the Climate and Health Council ( or the Health and Sustainability Network (, or both.

We have calculated, using modest assumptions, that the medical profession collectively

could reduce carbon emissions by 5 million tonnes a year by acting on these suggestions. This is equivalent to the annual carbon emissions of half a million people in the UK.

Advising patients on lower-carbon diets and walking and cycling instead of car travel would have a large impact. If three patients a week reduced their carbon emissions from food or car travel by just 5% as a result of information from general practitioners, each GP could save 15 tonnes of carbon per year, and also benefit health. Doctors are still the professionals that the public trusts most. And the impact year on year would be cumulative.

Globally 22% of greenhouse gas emissions are caused by livestock production.

Meat consumption in high income countries is four times higher than in low income countries. Halving meat consumption to 90 g/day/person would benefit health. In the UK, one third of food is wasted.

Every doctor could reduce their own carbon emissions by 5-10% by driving 5000 miles per year in a car with a fuel economy of 60 mpg (rather than the average of 10 000 miles with a fuel economy of 30 mpg). Reducing air travel by half would save another 5% of average personal carbon emissions. Across the population, these four changes would do much to stabilise carbon dioxide equivalent emissions below the critical 450 ppm threshold.

The medical profession could help to prevent perhaps 100 000 tonnes of carbon emissions by advocating successfully for home insulation in just 10 local households, which would also help reduce excess winter deaths. Authoritative international advice emphasises the cost-effectiveness of insulation. The insulation and heating improvements schemes promoted through UK councils have variable uptake, despite rapidly rising fuel poverty.

The world population was 2.5 billion in 1953, is 6.7 billion now, and is projected as 8 billion in 2028 and 9 billion in 2050. Feeding 9 billion people adequately could require a massive increase in food production.

The global framework of Contraction and Convergence starts with a science based calculation of the carbon we can emit in order to keep CO2 levels below 450 ppm, and an equal entitlement of this to each adult. The framework enables development and health improvement for the world’s poorest people (

Doctors must advocate for stabilising world population and for an equitable global framework for carbon control.

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