Healthcare leadership for a climate resilient future
BMJ 2024; 387 doi: https://doi.org/10.1136/bmj.q2159 (Published 14 October 2024) Cite this as: BMJ 2024;387:q2159Over the past century, Earth’s average temperature has risen by more than 1.3°C, a clear sign that something is wrong. Ambient temperatures are increasing, extreme weather events are becoming stronger and more frequent, pollution is worsening, and disease patterns are shifting. Ignoring the problems will only make things worse. Intervention is vital, and the healthcare community has a critical role to play. Healthcare professionals, organisations, and insurers must understand the connection between climate and health and lead in implementing solutions at scale.
Research shows that healthcare workers are trusted authorities on the health impacts of a warming planet, from heat related illnesses to the spread of infectious diseases, and on the health benefits of personal and societal climate solutions.12 Medical professionals can conduct research that demonstrates the positive health outcomes of climate solutions, from showing that plant rich diets reduce both carbon emissions and risk of death from cardiovascular, respiratory, and neurodegenerative diseases,34 to quantifying how greening low income neighbourhoods reduces the impact of heatwaves and air pollution as well as reducing inflammation.5
To enable healthcare practitioners to speak confidently, new efforts are springing up. The University of Colorado Denver School of Medicine’s climate and health programme offers a diploma in climate medicine for healthcare professionals in any area of clinical practice. Harvard Medical School is among the institutions integrating climate concerns into their basic curriculum, and equipping future physicians to tackle the climate-health nexus.6 The Medical Society Consortium on Climate and Health7 and the Canadian Association of Physicians for the Environment8 aim to mobilise and equip healthcare professionals to make the connection between climate and health clearer to policy makers and the public. These efforts are critical in creating cultural shifts that present climate change not as an abstract matter, but as a direct and present threat to human health. When trusted professionals speak up, people listen—and that can drive change.
Professional medical societies can amplify the message that climate change is a health emergency both within and beyond healthcare. In 2022 the American Medical Association officially recognised climate change as a public health threat.9 The Lancet Countdown, which tracks the health impacts of climate across 47 indicators, has had a global impact, spurring national organisations to speak out on the risks of climate change. For example, the Canadian Medical Association, the Canadian Nurses Association, and the Canadian Public Health Association responded to the 2023 countdown with a policy brief that warns in plain language how “climate change will continue to have devastating impacts on health and human lives, further straining health systems and nullifying any possibility for adaptation, unless ambitious climate action is urgently undertaken.”10 The US National Academy of Medicine is several years into its grand challenge on climate change, human health, and equity.11 It has five strategic objectives, including communicating the climate crisis as a public health and equity crisis, and mobilising the health sector to reduce its carbon footprint.
Hospitals and healthcare organisations are already dealing with climate related health impacts, from rising cases of heat related illnesses to an uptick in gastrointestinal diseases in the aftermath of extreme weather events. They have a responsibility to lead by example. By investing in efficiency and clean energy and introducing healthy food systems, hospitals can reduce their direct emissions. For many hospitals, however, indirect emissions—those generated outside the hospital itself by, among other things, the production and transportation of the products and services it uses, the waste it generates, and the investments it makes—represent more than half the total footprint.12 This highlights the importance of sourcing supplies with a low carbon footprint (including disposables, equipment, and pharmaceuticals), divesting pension plans from fossil fuels, and advocating more broadly for climate solutions. In 2024, the Joint Commission launched a sustainable healthcare certification14 to provide a framework for healthcare organisations to monitor and report their emissions, while the Health Care Without Harm Climate Council lays out clear strategies for how hospitals can cut emissions and build climate resilience. Participants in their climate challenge represent more than 26 000 hospitals and health centres in 43 countries around the world.13
Finally, the health insurance industry has an essential role to play, particularly in countries without universal healthcare. As extreme weather events, new disease patterns, and mental health problems linked with climate change become more common, insurance companies must tackle these emerging challenges. A recent report identifies key steps for insurers, including building understanding of climate health impacts and developing new insurance products that respond to these risks.15 In Japan, insurance companies have created daily heatstroke insurance plans that people are increasingly opting for during deadly heatwaves.1617 In Australia, insurers have offered premium waivers during climate fuelled disasters such as the 2020 wildfires.18 In addition to helping people adapt to climate risks, the report advised that insurance companies can also widen their coverage to include climate influenced diseases such as dengue and mental health conditions exacerbated by extreme heat and pollution.
Research shows that climate scientists who see environmental stewardship as part of their duty are more likely to engage in relevant action—and the same can be true for healthcare professionals.19 As trusted messengers, healthcare leaders have a unique opportunity to educate their patients, their communities, and the public about the health risks posed by a warming world, as well as modelling and advocating for the changes needed to protect our shared future. Leadership in healthcare can, and must, be a catalyst for the change we so desperately need.
Footnotes
The BMJ has judged that there are no disqualifying financial ties to commercial companies. The authors declare the following other interests: BF is a co-founder and managing partner for Frist Cressey Ventures. KH serves on UBS’ global sustainability forum and Netflix’s sustainability advisory board, and is the sole proprietor of ATMOS Research, a non-publicly traded entity. She formerly served on the scientific advisory board of Engie.
Further details of The BMJ policy on financial interests are here: www.bmj.com/about-bmj/resources-authors/forms-policies-and-checklists/declaration-competing-interests
Commissioned; not externally peer reviewed.