Intended for healthcare professionals

Opinion Climate 2024

Training health leaders to strengthen our response to the climate crisis

BMJ 2024; 387 doi: https://doi.org/10.1136/bmj.q2086 (Published 08 October 2024) Cite this as: BMJ 2024;387:q2086
  1. Cecilia Sorensen, director and associate professor1 2 3,
  2. James Hospedales, executive director and founder4
  1. 1Director, Global Consortium on Climate and Health Education, Mailman School of Public Health, Columbia University, New York, NY, USA
  2. 2Associate Professor, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
  3. 3Associate Professor, Department of Emergency Medicine, Columbia Irving Medical Center, New York, NY, USA
  4. 4EarthMedic/EarthNurse Foundation for Planetary Health

Our ability to ameliorate the adverse impacts of climate change on health is dependent on our ability to educate ourselves, and we must move faster.

The severity of climate related health risks is highly dependent on how well health systems can protect people.3 The chairman of the Intergovernmental Panel on Climate Change, Jim Skea says, “we have the technologies, the tools and the knowledge required to limit global warming.”1 We also have many of the tools and knowledge needed to enable health systems to identify, prevent, and respond to impacts related to climate on patients and communities, to increase the resilience of our health systems, and to mitigate its environmental impact. And yet, in 2022, deaths related to heat among people older than 65 increased by 85%, 127 million people had moderate to severe food insecurity due to extreme drought, many faced life threatening infectious diseases such as dengue malaria, vibriosis and West Nile virus, and our health systems contributed to nearly 5% of global greenhouse gas emissions.2 Health systems globally are yet to meaningfully confront the new and worsening realities of our 21st century climate.

A co-ordinated, interdisciplinary, and rapid transformation of the health sector is imperative to address climate threats and to seize the opportunity to improve population health and health services. Such a transformation will require broad institutionalization of climate and health within global, regional, and national policy agendas, and health organizations, and must be considered in the scope of health determining sectors. We currently lack the human capital to enable such a response. This gap may be attributed to a scarcity education and training among health professionals, policy makers, and affected communities—the very individuals that are needed to advocate for and enact local and national transformative policies and interventions.4 Education must occur at all levels of professional training, including at the undergraduate and graduate level, and continued professional education. Additionally, a focus should be on minimizing health effects on patients and communities while equipping professionals with the knowledge and skills to build climate resilient and sustainable health systems. Climate change education is slowly making its way into health professional curricula, however, institutions, professions, specialties, and countries vary, with the largest gaps in capacity found in low income and middle income countries.5 According to the World Health Organization, more than half of countries do not have the technical capacity to undertake climate and health work,6 gaps that are likely larger on subnational levels and among countries with fewer resources. Our ability to ameliorate the effects of climate change on health is dependent on our ability to educate ourselves, and we must move faster.

Climate education must permeate deeply into every niche of the healthcare and public health workforce. Education must also target health decision makers and leaders at all institutional and political levels, show casing the myriad opportunities to reap health co-benefits of evidence based policy and climate action. Merely providing knowledge will be insufficient to reach our goals: behavioural change and leadership are necessary to enact the require changes.

One approach to improve and disseminate education among health professionals is to upskill a global “coalition of the willing” to reach our health adaptation “tipping point.” Over the past 24 months, The Global Consortium on Climate and Health Education, based at Columbia University, has provided free, evidence based in-person and live-virtual climate and health courses on a regional basis, reaching over 25 000 health professionals in 168 countries. We partner with local institutions including academia, intergovernmental organizations, and non-governmental organizations to adapt our “core competencies for health professionals” to the region of focus.7 Working with regional partners, the consortium identifies local and regional experts in the core topics of focus to help promote regional expertise and provide real-world examples of successful adaptation and response. One region of focus has been the Caribbean.

The Caribbean islands comprise 30 countries and 40 million residents and is extremely susceptible to changes in climate because of their location in the hurricane belt, island nature, small size, and limited resources. Adverse climate impacts are ubiquitous and unrelenting and affect all sectors, including health and health services. Countries often do not have time to recover before experiencing another climate related event. These events often disproportionately affect people who have low incomes, older adults, women and children, and people with chronic health conditions. A recent survey of the views of Caribbean health professionals on climate change, showed that a perceived barrier to climate action was scarcity of training.8

A recent course based in the Caribbean joined EarthMedic/EarthNurse, the Pan American Health Organisation, and the Caribbean Institute for Meteorology and Hydrology in collaboration by participants from over 37 countries and 10 different health related fields. Participants provided feedback that showed improvements in health professional communication, in confidence to engage with local communities, and in application of climate and health knowledge and skills to their current scope of work.9

As we train health professionals in earnest, we must upskill communities in parallel. Resilience to the health impacts of climate change depends on a knowledgeable health workforce and a coordinated healthcare system, which result in an informed and empowered community. We believe that training and engaging community stakeholders and healthcare professionals will encourage the development of a sustainable and enduring partnership that can withstand and respond to a wide variety of climate related threats to health and improve local and national resilience. To this end, we are piloting scalable community and community health worker training in India, the Dominican Republic, and The Bahamas.10 We seek to inspire leadership, locally applicable solutions, and most importantly, hope.

Transforming the health sector to develop the capacity to protect health, while not exacerbating climate change, will require a monumental educational effort to affect leadership decisions and changes to clinical practice. As the climate crisis accelerates, the urgency and scale of our task cannot be understated.

Footnotes

  • Competing interests: CS and JH declare no competing interests.

  • Provenance and peer review: Commissioned, not externally peer reviewed.

References