Challenges

Climate change, biodiversity loss, and other environmental changes are rapidly impacting the health of people worldwide, but many clinicians and other health professionals feel unprepared to deal with this burgeoning issue. During the Planetary Health Annual Meeting held in Boston in late 2022, the Clinicians for Planetary Health (C4PH) working group hosted a workshop that highlighted the latest findings of clinicians’ attitudes towards climate change, connections with the related fields of lifestyle medicine and integrative health, lessons learned from implementing “one minute for the planet” in a rural Brazilian clinic, and the benefits of clinicians prescribing time in nature for their patients. This article ends with a few suggestions for healthcare providers to begin implementing planetary health into their professional practice. Full article

The vast and growing challenges for human health and all life on Earth require urgent and deep structural changes to the way in which we live. Broken relationships with nature are at the core of both the modern health crisis and the erosion of planetary health. A declining connection to nature has been implicated in the exploitative attitudes that underpin the degradation of both physical and social environments and almost all aspects of personal physical, mental, and spiritual health. It is increasingly clear that the entwined challenges of biodiversity loss, climate change, and human health cannot be addressed without addressing selfishness, greed, apathy, and the value systems that created these global problems. Calls for a spiritual and cultural transformation recognize that “inner” development is important and necessary for meaningful “outward” transitions with a shared purpose for wiser, more sustainable societies. Many of these emotional and spiritual assets appear to be facilitated by a connection to nature, which is also strongly associated with community cohesion, prosocial attitudes, and pro-environmental actions. Restoring the human connection to nature may therefore provide a critical common pathway to promote the physical and spiritual wellbeing of individuals and communities as well as personal and social environmental responsibility. In this paper, we summarize and reflect on the discussions of the Nova Network planetary health community with respect to nature-based solutions as pathways to promote both personal and planetary health with a more mutualistic mindset. These discussions spanned biological to psychological interactions with nature—including the critical relationships with environmental microbes that influence the physical, emotional, and behavioral aspects of health. We consider the ways in which stronger relationships with nature promote “inner assets” to support “outward actions” for personal and planetary health. Full article

Burnout, a negative job-related psychological state common with health professionals, results in valuable healthcare research loss. Team mindfulness, promoting work engagement, represents an aspect effective in reducing burnout. In a series of diverse-membership academic meetings intended to reduce research burnout—employing writing prompts, doodling, and continuous developmental feedback—team mindfulness was demonstrated when conducted in person. Therefore, whether team mindfulness is evident when meetings are held online is relevant. During the first eighteen months of COVID-19 limitations requiring these meetings to be online, it was previously reported that team mindfulness was diminished. Question-asking, submitted doodles, and feedback responses were analyzed for the following year of the same group, both quantitively and qualitatively, and with respect to COR theory, to determine if the result persisted. Team mindfulness was also compromised in the second year with respect to the entire group but not regarding the individual relationship with the facilitator. For a diverse-membership group to demonstrate team mindfulness, it is suggested that creating and using avatars similar to those used in online games might be effective. To continue the successful aspect of team mindfulness found online for this group or similarly designed groups, a one-on-one meeting between participant and facilitator is recommended. Full article

Estimates of global population growth are often cited as a significant challenge for global food production. It is estimated that by 2050 there will be approximately two- billion additional people on earth, with the greatest proportion of that growth occurring in central Africa. To meet recommended future protein needs (60 g/d), approximately 120 million kg of protein must be produced daily. The production of ruminant meat (particularly beef cattle) offers the potential to aid in reaching increased global protein needs. However, advancements in beef cattle production are necessary to secure the industry’s future sustainability. This article draws attention to a subset of sustainable beef cattle production challenges, including the role of ruminant livestock in meeting global human protein needs, the environmental relationships of advanced beef cattle production, and big data and machine learning in beef cattle production. Considering the significant quantities of resources necessary to produce this form of protein, such advancements are not just a moral imperative but critical to developing advanced beef cattle production practices and predictive models that will reduce costs and liabilities and advance industry sustainability. Full article

Persistent organic pollutants (POPs) are toxic chemicals with demonstrable effects on pregnancy and neonatal outcomes. The associations of early pregnancy body mass index (BMI) and antenatal weight changes with circulating POP concentrations are poorly understood in the Canadian context. The aim of this study was to explore the relationship between maternal BMI in the first trimester, weight change from pre-pregnancy to 6–13 weeks of pregnancy, and first-trimester plasma POP concentrations among Canadian pregnant women. We analyzed data collected as part of the Maternal-Infant Research on Environmental Chemicals (MIREC) study and evaluated POP concentrations based on first-trimester BMI and early gestational weight change categories. We tested for overall differences using Kruskal-Wallis tests. The associations between first-trimester maternal BMI, weight change, and plasma concentrations of 41 POPs were evaluated using censored regression models. After controlling for potential confounders, first-trimester plasma levels of multiple POPs differed significantly across BMI categories, with the highest concentrations in underweight/normal-weight individuals and the lowest in class III obese individuals. Our findings provide preliminary evidence of higher circulating POP levels in individuals with obesity and align with previous findings of an inverse relationship between circulating POP concentrations and BMI in pregnancy. Future studies should prospectively evaluate the interplay between weight change and POP concentrations throughout pregnancy to inform gestational weight gain recommendations for pregnant individuals with obesity. Full article

Remote sensing monitoring of crop growth began from airborne photography to assist in crop pest management and has evolved into monitoring from satellites, manned aircraft, unmanned aerial vehicles (UAVs), and ground-based systems for crop production process modeling, optimization, and control. In recent years, for crop growth remote sensing monitoring, apart from satellites, manned aircrafts, and ground-based systems, UAVs have been developed and widely used for low-altitude remote sensing of crop fields to uniquely provide a cost-effective, flexible tool for field crop growth remote sensing. Additionally, their data create a critical layer between all other remote sensing platforms. This paper overviews the use of remote sensing from difference sources, especially airborne remote sensing from manned aircraft and UAVs, to monitor crop growth in the area of the lower northern Mississippi from the Mississippi Delta to the Black Prairie, one of the most important agricultural areas in the U.S. In this paper, three sites typical in the area are demonstrated for remote sensing monitoring of crop growth, and the issues and challenges are identified and discussed for future opportunities to integrate remote sensing data from different sources to improve crop monitoring in this area and surrounding areas. Full article

Grŵp Cynefin, a social housing association in North Wales, United Kingdom (UK) with other partner organisations, had a vision to create a community Hub in the Nantlle Valley to strengthen and support the health and well-being of the local community through the provision of a range of traditional and preventative services. Social prescribing (SP), which is a non-medical support using community assets, would be a part of this new innovative Hub. SP activities would be co-designed and co-produced by current community members. Drawing on the principles of citizens’ assembly deliberations and Future Design, four focus groups (n = 16) were conducted to develop sustainable strategies for SP activities as part of the proposed Hub. Deliberations on the perspectives of future generations were considered along with current community needs. Findings from the focus groups imply that current members of society are open to the concept of taking an inter-generational approach when designing SP activities to address the social and economic needs of the community along with integration of traditional and preventative community health services. Deliberations highlighted that the proposed Hub could strengthen communities and support community health and well-being, by providing a place to socialise and acting as a single point of access for community services, which could promote social cohesion in line with the Well-being for Future Generations (Wales) Act. Applying a long-term thinking approach to citizens’ assembly deliberation design offers a voice to the interests of future generations, providing inter-generational equity. Full article

Most people know the fabled story of the elephant and the “six blind men”, with each of them separately examining a different portion of the mysterious object before them and drawing a different conclusion without awareness of the whole picture—which could have been gleaned by sharing information with their neighbours (Figure 1) [...] Full article

We are in the midst of an unprecedented public and planetary health crisis. A major driver of this crisis is the current nutrition transition—a product of globalization and powerful multinational food corporations promoting industrial agriculture and the consumption of environmentally destructive and unhealthy ultra-processed and other foods. This has led to unhealthy food environments and a pandemic of diet-related noncommunicable diseases, as well as negative impacts on the biophysical environment, biodiversity, climate, and economic equity. Among migrants from the global south to the global north, this nutrition transition is often visible as dietary acculturation. Yet some communities are defying the transition through selective resistance to globalization by recreating their traditional foods in their new home, and seeking crop species and varieties customarily used in their preparation. These communities include Zapotec migrants from the Central Valleys of the southern Mexican state of Oaxaca living in greater Los Angeles, California. Focusing on the traditional and culturally emblematic beverage tejate, we review data from our research and the literature to outline key questions about the role of traditional foods in addressing the public and planetary health crisis. We conclude that to answer these questions, a transnational collaborative research partnership between community members and scientists is needed. This could reorient public and planetary health work to be more equitable, participatory, and effective by supporting a positive role for traditional foods and minimizing their harms. Full article

Arbovirus control depends on accurate projections of likely changes in the arthropod vector species, essential to inform local and global public health authorities. According to the WHO Assembly and the Global Vector Control Response (GVCR), by 2030, the burden of vector-borne diseases, particularly arbovirus infections, is expected to be greatly decreased. However, anthropogenic drivers, including climate change, insecticide resistance, and a lack of operational local databases for risk management of emerging and re-emerging arboviruses, hinders effective implementation plans. This article presents a statistical, mechanistic, integrated surveillance, thermal biology, and holistic framework (termed SMITH) to discuss how temperature variations affect the biological transmission, replication, extrinsic incubation period, nutritional behavior, distribution, and survival (TRENDS) of arboviruses. Future transdisciplinary research that involves knowledge translation between local and global communities is required for early detection and risk management of the growing threat posed by arboviruses for human, animal, and planetary health. Full article

As our planet faces more frequent and severe environmental threats due to climate change (including threats to biodiversity), environmental justice will be essential to ensure that the costs and burdens of combating these threats are shared equally, borne by all people worldwide in a fair and equitable manner. If the past is any indicator, however, environmental problems—and their “solutions”—disproportionately affect poor communities and communities of color, including Indigenous communities. Despite these past injustices, Indigenous lands, which make up only 20 percent of the Earth’s territory, contain 80 percent of the world’s remaining biodiversity—evidence that Indigenous peoples are among the most effective stewards of the environment. A primary reason for this remarkable statistic is the use and practice of Indigenous Traditional Ecological Knowledge; ecological wisdom which has been passed down for generations and has been shown to strengthen community resilience in response to the multiple stressors of global environmental change. While the United States government has been slow to acknowledge the value of Traditional Ecological Knowledge, it has recently begun to incorporate that knowledge into environmental policy in response to the worldwide climate crisis. Continuing the integration of Traditional Ecological Knowledge into government environmental policy will ensure that such policies will be more effective at the federal, state, and local levels and more equitable in their application. Western scientists, government officials, and global leaders need to build trusting and co-equal relationships with Indigenous communities by actively listening to all cultures and respecting the many kinds of knowledge systems required to conserve the natural world and all living beings. This paper will address how incorporating Traditional Ecological Knowledge into U.S. policy would help safeguard the environment from further biodiversity loss and other ecological destruction, and advance environmental justice to ensure the fair treatment of all. Full article

Researchers and practitioners increasingly emphasise the need to complement dominant external, technological approaches with an internal focus to support transformation toward sustainability. However, knowledge on how this internal human dimension can support transformation across individual, collective, and systems levels is limited. Our study addresses this gap. We examined the narratives of participants in the sustainability course “One Year in Transition”, using micro-phenomenology and thematic analysis. Our results shed light on the dynamics of inner–outer change and action and the necessary capacities to support them. This related to changes regarding participants’ perspectives, which became more relational and interconnected. We also showed that participants increasingly seek an inner space that provides direction and freedom to act. The data suggested that this, over time, leads to increasing internalisation, and the embodiment of a personal identity as a courageous and principled change agent for sustainability. Our results complement extant quantitative research in the field by offering a nuanced picture of the entangled nature of inner–outer transformation processes and associated influencing factors. In addition, they point towards ways in which inner dimensions can be leveraged to achieve change, thus filling existing knowledge gaps for reaching sustainability and associated goals across all levels. Full article

Bangladesh, one of the most disaster-prone countries in the world is also severely exposed to climate change (CC) impacts with a multitude of health complexities. Health adaptation to CC is thus a serious issue in Bangladesh, but not explored properly from a health system and policy environment perspective. In order to address this gap and provide a holistic picture of the overall scenario, this scoping review explores CC impacts on the population health in Bangladesh and discusses the policy environment and health system preparedness against such climatic challenges. A total of 28 articles were reviewed following Arksey and O’Malley’s scoping review framework. A “5-point scale” was devised to assess CC integration in the health sector Operational Plans (OPs). Though the country made significant progress in different health indicators, poverty and income inequality have kept marginal communities out of many health provisions. There are four major stakeholders in the health system. The government sector is handicapped by poor governance, bureaucratic processes, and staff shortages; and primarily focuses on the public sector only. National Health Policy (NHP) governs the health system through 29 sectoral OPs, that put CC as a major cross-cutting issue. About 25% of the OPs have fully integrated CC and other OPs have significant CC co-benefits. In Bangladesh CC was linked to increased morbidity and mortality, diarrhea, cholera, skin problems, respiratory infections, malaria, dengue, kala azar, pre-eclampsia, and hypertension. Significant research gaps exist on child health, migrant health, and mental health. Integration of research evidence into policy, planning and program design is largely absent. However, prioritizing health for the National Adaptation Plan is an essential step towards establishing a climate-resilient health system. Full article

This paper presents data and analyses from our Planetary Health Film Lab (PHFL) and its sister project the Youth Climate Report. Qualitative data include semi-structured interviews with youth and their educators and content analysis of films produced by young people (ages 19–25) from six countries (Australia, Columbia, Ecuador, Italy, India, Canada). The educative processes designed for the Planetary Health Film Lab are illustrative of our work to build the field of planetary health education that is with/for young people whose educative projects are mobilized in turn to educate wider audiences and for policy change. The analyses show how youth document and record planetary health concerns alongside responsive projects that are embedded in awareness of climate justice and their interconnected ecological systems. The qualitative content analyses of selected films resulted in three themes: (1) Anthropogenic footprints, (2) Ecological and climate justice, and (3) Collective local/global solutions. Data also illustrates how young people’s participation in educative film projects contribute to the education of others and address related intergenerational justice issues. Implications for the knowledge, ethics and practices of youth-centred planetary health education are discussed as they augment the Framework for Planetary Health. Youth are crucial but overlooked collaborators in redressing planetary health education, an error we begin to correct through transdisciplinary approaches with/for young people who could help define the field. Full article

The Finnish Kalevala epic contains a world-creation myth that exemplifies the essential cooperation between humans and the nature spirits that inhabit the land. These stories not only reflect the culture’s animistic worldview, they also contain a remarkable awareness of how humans depend on the wisdom of nature to survive and illustrate how that coexistence benefits both humans and nature—a perspective that can be increasingly valuable in the modern era. Full article

Bitcoin critics have argued that energy-intensive Bitcoin production and adoption will exacerbate global warming. Conversely, Bitcoin advocates have been dismayed by critics’ apparent lack of willingness to scrutinize Bitcoin’s potential role in helping to improve the economics of renewable energy investments, reduce net emissions from methane venting and flaring, increase electricity grid efficiency, and provide higher-order environmental, social, and governance (ESG) benefits. Given the disparate views, there is a pressing need to identify key knowledge needs regarding Bitcoin’s net energy use, carbon emissions, and direct and indirect ESG impacts. I used a variation on the ‘key questions’ horizon scanning approach to identify 100 questions that, if answered, could help provide credible evidence to support policymakers’, investors’, and research funders’ decision-making on issues relating to the impact of Bitcoin production and adoption. The questions are distributed across 13 themes (ranging from energy use to social impacts). The breadth of knowledge required to answer key questions highlights the need to build research capacity, encourage collaborative cross-sectoral and -disciplinary research, and develop a prioritized research agenda. Defensible evidence for investors, regulators, and policymakers needs to consider Bitcoin’s complex net impacts on energy use and environmental, social, and governance benefits. Full article

Background: Climate change is one of the largest threats to human health and well-being globally. The healthcare industry itself currently contributes to fueling the climate crisis with its emissions and material consumption. There has been much research on decarbonising hospitals ecological/carbon footprints but very limited study on ways to assist healthcare clinics in transitioning to a low-carbon healthcare system. Methods: A structured literature review was conducted, and the results analysed. Results: The literature review revealed four important areas to act upon to decarbonise a healthcare clinic most efficiently. These are: energy use, waste minimisation/management, the behaviors/attitudes of staff, and decarbonising the supply chain. Conclusions: The pooled literature reveals an evidence-based set of recommendations or guiding principles to decarbonise healthcare clinics the most effectively. To maximise operational effectiveness, how this is achieved will differ between clinics. Although this research is written with reference to Australia, these identified ini-tiatives are likely to be relatable to many other countries healthcare systems. Decarbonising health clinics will contribute to a sector-wide transition to more sustainable healthcare that will lead to improved environmental, social, economic and health outcomes. Full article

Background: The use of face masks was a significant part of the WHO COVID-19 preventive protocols. While their usage has been effective, lack of adherence by individuals has been associated with discomfort and adverse side effects. This might facilitate unnecessary exposure to the SARS-CoV-2 virus, thereby increasing the incidence of COVID-19. This study assessed the side effects of prolonged mask-wearing and offers recommendations for present and future pandemics. Methods: Adverse side effects of face masks were evaluated from November 2021 to February 2022 with a structured Google Forms online questionnaire. The survey targeted regular and occasional face mask users around the world. All responders anonymously completed the survey, which included ten structured questions with a sub-section on the effects of the continuous use of face masks. The information obtained was analyzed using descriptive statistics, and the data were presented in graphs. Results: Almost 60% (1243) of the 2136 participants indicated discomfort while using face masks. Breathing difficulties and pain around the ears were cited as major causes of discomfort, accounting for 32% and 22%, respectively, of responses. Headaches were reported by 26.8% (572) of the respondents, with 44.6% experiencing one within 1 h of wearing a mask. Nine hundred and eight (908) respondents experienced nasal discomfort, while 412 individuals reported various skin-related discomfort, including excessive sweating around the mouth and acne. Conclusions: This study provides baseline data as to why there was less adherence to face mask use which includes headaches, skin irritation, ear pains, breathing difficulties, sore throat, dry eyes, and increased sweating around the mouth. As a result, this may contribute to an increased risk of infection. While COVID-19 lingers and the management of its undesirable effects persists into the future, it is vital that a superior mask design, concentrating on safety, comfort, and tolerability, be developed. Full article