Health professionals as activists: tackling threats to public health

In this short article, Katie Burns considers the role of healthcare professionals in light of the greatest global threat to public health: climate change.

The change in our climate is inescapable and affects the air we breathe, the water we drink, how much food we have to eat and whether we have safe places to live¹ – these all being social and environmental determinants of health. Despite frequent warnings from meteorologists and other scientists, public attitudes and government policies in the northern hemisphere have been slow to change. Yet over the last few years, heat waves have been the cause of shortages of certain types of food,² and in the last year especially wildfires have destroyed homes, businesses and people’s lives.³ Furthermore, the health of the public is in danger of deteriorating rapidly over the coming decades. It has recently been found that 58% of human-affecting pathogenic diseases are exacerbated by climate-related changes.⁴ This is before we even begin to consider the psychological effects of climate change and its effect on long-term conditions or the sourcing of treatments. The WHO predicts that before the first half of the century is over, the world will see 250,000 additional deaths per year due to malnutrition, vector-borne diseases and heat stress.¹ But many more people, while not dying, will be living in poor health due to changes in climate, and the majority of these will be among the poorest nations. With 90 scientific authors from 51 institutions around the world, the most recent Lancet countdown report presents data indicating these widespread changes in the environmental, social and economic determinants of health. The report indicates the increasing impact climate change is having on both physical and mental health through the world’s populations. These changes are often happening simultaneously, further accelerating exposure to health threats.⁵ What role is there for public health professionals in the face of such dire warnings?

A Time for Action

Healthcare professions are among the most trusted individuals in society,⁶ and the time has come for significant radical change to what we consider as normal health promotion. It is therefore a moral imperative for healthcare workers to become more active in warning of the threats of global warming and to call governments to account for inaction. There hasn’t previously been such a strong need for healthcare professionals to become activists to promote the health of the public and help prevent suffering and deaths in the future. A recent article in Nature Climate Change⁷ suggests that adding the voices of scientists and healthcare workers strengthens the argument for policy-makers to hear. The authors also advocate for civil disobedience to strengthen the messaging. Groups such as Doctors for Extinction Rebellion cite the General Medical Council (GMC) code of conduct as their reason for speaking out about the need for greater action from governments:

Our code of conduct compels us to act where we notice unacceptable risks to current and future patient health, and act promptly. We have noted that traditional techniques of writing academic papers and journal articles have not produced sufficient meaningful results to continue with them alone.⁸

For those of us who genuinely care about global inequalities, the case for action is unequivocal as there is much evidence to indicate that those in the poorest countries will continue to suffer the most. This emerging fact was identified by the Intergovernmental Panel on Climate Change over 20 years ago.⁹ In the intervening period, little has changed for the plight of millions of people. Never before has there been such an urgent moment for healthcare workers to be involved in promoting health and preventing disease and death, before it is too late. In short, healthcare workers have a responsibility to become activists to help bring about lasting change, and the sooner, the better.

Photo credit: Gareth Morris.