Guidance

Climate and health: applying All Our Health

Published 18 May 2022

Introduction

This guide is part of All Our Health, a resource which helps health and care professionals prevent ill health and promote wellbeing as part of their everyday practice. The information below will help frontline health and care professionals use their trusted relationships with patients, families and communities to reduce the contribution of the health and care system to the climate crisis.

We also recommend important actions that managers and staff holding strategic roles can take.

Why it matters

Why act on the climate crisis in your professional practice

The health of the planet is inextricably linked to human health and wellbeing. A healthy planet provides us with our most basic needs:

• fertile land for food production
• safe water to drink
• clean air to breathe

The warming of the planet, known as climate change, is degrading our planet바카라 사이트檚 life-support system and threatens our ability to thrive and survive. Climate change is happening more quickly than previously feared and represents an urgent global crisis requiring a bold, united response.

Climate change has been identified as the most important health threat of the century, but it is also the . Everyone working in health and care needs to prepare for and be equipped to respond to the health impacts of the climate crisis.

The climate crisis has an important impact on health.

Global temperatures are rising at an unprecedented rate, driven by a build-up of greenhouse gases in the atmosphere. These gases, of which the most commonly known is carbon dioxide, are largely a result of burning fossil fuels. Global temperatures continue to rise and are expected to surpass the 1.5 to 2 degree threshold, triggering unprecedented changes to climate systems, with devastating impacts for human health and wellbeing.

The science is unequivocal; a global increase of 1.5掳C above the pre-industrial average and the continued loss of biodiversity risk catastrophic harm to health that will be impossible to reverse.

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In the UK, average surface temperature has already risen by 1.2掳C and the effects of climate change are already apparent. The UK is particularly at risk of drought, flooding and extreme weather events, all of which threaten the water, food, infrastructure and supply systems we depend on.

A warming climate affects health in 3 main ways:

1. Effects of extreme weather, such as heatwaves, flooding, wildfire, storms and drought on physical and mental health (for example injuries and trauma, heat-related illness). Such events are expected to increase in frequency and severity in coming years.
2. Effects on the planet바카라 사이트檚 life-support systems, such as rising sea levels and safe water availability, changing patterns of zoonotic and vector-borne disease (for example malaria, dengue fever), reduced pollination and crop failure leading to food shortages.
3. Effects mediated by social systems, such as livelihood loss, rising prices of food and fuel, supply chain disruption, pressure on health and care services, conflict or forced migration.

The climate crisis affects our efforts to safeguard the health of the population and therefore tackling it as a determinant of health is a crucial aspect of our role as health and care professionals.

Actions to prevent and prepare for the climate crisis will improve public health

Reducing our contribution to the climate crisis and creating resilience to respond to the worst impacts of a warming climate is an opportunity to protect health. Importantly, much of what can be done is a 바카라 사이트榳in-win바카라 사이트� for both the environment and for health.

The good news is that greenhouse gas emissions can be reduced in a way that addresses public health challenges; these are 바카라 사이트榳in-win바카라 사이트� opportunities. We know that increasing physical activity through active travel, making nutritious and sustainable food readily available and improving air quality and housing will reduce the risk of obesity, cardiovascular and respiratory disease, certain cancers and diabetes. These actions will also help achieve national commitments to reduce our contribution to the climate crisis.

Specific 바카라 사이트榳in-win바카라 사이트� opportunities for health and the climate crisis

Transport

Transport is the largest greenhouse gas-emitting sector in the UK, accounting for . Our transport system is largely road-travel dependent, and this has been a major factor in reducing physical activity through active travel and increasing obesity-related morbidity and mortality in the UK. Physical inactivity directly contributes to 1 in 6 deaths in the UK and costs wider society 拢7.4 billion a year.

Transport is also a major cause of air pollution. Burning fossil fuels for vehicles and industrial processes fills the air we breathe with greenhouse gases that warm the atmosphere and are released with pollutants that directly impact human health. In the UK, air pollution is responsible for an estimated 28,000 to 36,000 excess deaths a year, with the . Find out more about the health impacts of air pollution.

If we, as health and care professionals, can help people to increase the number of journeys taken on foot, by bicycle or public transport, we will see benefits for both health and the climate.

Housing

Homes that lack energy efficiency contribute to climate change and negatively impact our health. , with the vast majority of energy consumption from coal, oil and gas. Inefficient energy use in homes, as well as rising energy prices, increases the risk of fuel poverty and cold homes. Fuel poverty affects 13.4% of households in the UK. Improving the energy efficiency of homes is the most effective way of tackling fuel poverty in the long term. It reduces the amount of energy required to heat the home and can therefore contribute to reduced energy bills and a warmer, safer home.

The burden of ill health from cold homes remains significant in the UK. Living in a cold home represents a considerable risk to health, wellbeing and inequalities. Cold homes are recognised as a source of both physical and mental ill health, increasing the risk of heart attack and stroke, respiratory illness, falls and accidents. Equally, with increasingly warmer temperatures due to global warming, there is also a significant risk to health, particularly for older people, very young children, and those with chronic health conditions of living in a home that is too hot. Ensuring homes are well ventilated can not only help to reduce temperatures on hot days but can also benefit health by improving indoor air quality.

If we, as health and care professionals, can help to encourage efficient energy usage in homes, as well as ensure that homes are not too hot or too cold, we will see benefits for both health and the climate.

Food

Our is a major contributor to global temperature rise, deforestation, biodiversity loss, freshwater overextraction, as well as air and plastic pollution. At the same time, the way we eat is causing significant morbidity and mortality, with poor diets increasing the risk of heart disease, high blood pressure, type 2 diabetes, obesity and certain cancers. , having a higher impact on the NHS budget than smoking, alcohol consumption and physical inactivity.

The are often those with the highest emissions, pollution, land and water use. A diet rich in plant-based foods, and lower in animal source foods which have a significant environmental impact, has benefits for health and the environment. Adherence to the Eatwell Guide which encourages a high consumption of fruits, vegetables, wholegrains and plant-based protein, could contribute to a .

If we, as health and care professionals, can encourage people to adopt a balanced, sustainable diet and promote wider changes to our food system, we would reduce the environmental impact of food production and supply, as well as reduce the risk of diet-related disease.

Green space

Our interaction with natural places can have a significant impact on our health. Protecting nature and biodiversity safeguards health and wellbeing. People who live in greener neighbourhoods have has been shown to improve mood, reduce anxiety, and reduce the risk of type 2 diabetes and cardiovascular disease. , or taking physical activity in green or natural environments, may also provide additional benefits to people바카라 사이트檚 overall wellbeing. It is estimated that 拢2.1 billion per year could be saved in health costs if everyone in England had good access to green space, due to the increased physical activity in these spaces.

Green spaces can also bring communities together, reduce loneliness and mitigate the negative effects of air pollution, excessive noise, heat and flooding. However, green space access is closely linked to health and social inequalities. The most affluent wards in England have 5 times the amount of parks and green space compared to the most deprived 10% (Public Health England, 2020).

If we, as health and care professionals, can promote the protection of green spaces, and implement nature-based interventions for health, such as for mental health or , we can improve the health of people and the planet, while reducing health inequalities.

Social and health inequalities

The climate crisis and the social justice crisis are closely related. Those have contributed the least to it. Deprived areas have the while producing a much lower proportion of housing and travel emissions. The political and economic systems which drive the climate crisis also drive social injustice.

The climate crisis impacts people differently depending on their susceptibility, risk and ability to cope. For example, elderly populations, people living in care homes and those with underlying health conditions are more likely to suffer from the effects of extreme heat and cold. Fuel poverty and poor housing can exacerbate these effects.

People from deprived areas face disproportionately higher flood risk than those in wealthy areas, particularly in coastal and rural zones, which could mean they are more vulnerable to flood-related financial and livelihood loss.

If we, as health and care professionals, act on the climate crisis in a way that addresses social inequalities, we can ensure that the costs of climate action are not unfairly borne by those with lower incomes or other social disadvantages.

The health sector is committed to action

Policies and commitments at international and national levels require the health sector to take action on the climate crisis. At a global level, the UK has signed the , a legal commitment to keep global temperatures below 2 degrees Celsius and reduce carbon emissions by 45% by 2030. Commitments made at the in 2021 put us on track for 2.5 degrees of warming.

At a national level, the requires the government to undertake 5-yearly assessments of climate risks and produce a National Adaptation Plan for responding to the identified risks, including the risks to health and wellbeing as a priority.

Within the health and care sector, the NHS in England became the first healthcare system in the world to commit to reduce the carbon emissions it can directly influence (for example, the amount of electricity used by hospitals) to . Carbon emissions it cannot control but can influence (for example, emissions from manufacturers within the supply chain) will be reduced to net zero by 2045.

These commitments are essential because the health and care system in England accounts for approximately 5% of the country바카라 사이트檚 national greenhouse gas emissions. Particular carbon 바카라 사이트榟otspots바카라 사이트� include supply-chain derived items such as pharmaceuticals and medical equipment, as well as certain anaesthetic gases and patient or staff travel (see graph below). The health system also contributes to plastic and air pollution:

• in catering alone, the NHS bought at least 163 million plastic cups, 16 million pieces of plastic cutlery, 15 million straws and 2 million plastic stirrers in 2018
• one in 20 cars on the road are related to the NHS

For a sector based on the principle of 바카라 사이트淔irst, do no harm,바카라 사이트� the health and care sector must act quickly and collectively to mitigate its own climate damage.

Figure 1: Sources of carbon emissions by proportion of NHS Carbon Footprint Plus

Medicines, medical equipment and other supply chain:

• medicines and chemicals: 20%
• medical equipment: 10%
• non-medical equipment: 8%
• other supply chain: 24%

NHS carbon footprint:

• building energy: 10%
• water and waste: 5%
• anaesthetic gases and metered does inhalers: 5%
• business travel and NHS fleet: 4%

Personal travel:

• patient travel: 5%
• staff commute: 4%
• visitor travel: 1%

Commissioned health services outside NHS: 4%

Source: NHS, .

What you can do to help

Reducing the impact of healthcare on the climate crisis

Health and care professionals have an integral role to play in reducing the contribution of the health and care system to the climate crisis. Patient-facing health workers have a particularly important role given they are able to influence how many resources are used and how much healthcare activity is undertaken. Clinical care is responsible for the high-emitting consumption of pharmaceuticals, equipment and consumables, while , for example whether they are admitted to hospital, or how often they need to make a journey to an outpatient clinic.

Reaching NHS Net Zero demands that the health and care system becomes environmental, socially and economically sustainable. This will require leadership and innovation from NHS staff.

A sustainable health system will:

• help prevent illness

• give greater control to patients in managing their health

• be leaner by streamlining care systems to minimise wasteful activities

• prioritise treatments and technologies with a lower carbon footprint

Core principles for health and care professionals

This All Our Health climate crisis information has been created to help all health and care professionals understand that the climate crisis is a problem for health, and how healthcare professionals need to prepare for and respond to it.

Health and care professionals are highly trusted and therefore well placed to advocate for action on the climate crisis and the health impacts it has. By acting on the climate crisis, we can safeguard population health against the worst effects of a warming climate.

Health and care professionals should recognise the climate crisis as a health crisis, and therefore climate action as a core part of their professional responsibilities. Delivering on this, they can:

• take everyday opportunities to talk with colleagues, management and patients or clients about the link between climate and health and the importance of taking action now
• incorporate 바카라 사이트檞in-win바카라 사이트� interventions which improve health while taking climate action
• reduce the contribution that health and care has on the climate crisis

Taking action

Frontline health and care professionals

Health and care professionals can implement these core principles by:

• educating themselves and others about the climate crisis and health
• promoting and protecting public health
• reducing the environmental impact of healthcare

Educate yourself and others about the climate crisis and health

Ask colleagues whether they are willing to make positive changes together. See .

Check whether your organisation has a Sustainability Action Plan or for .

Encourage your professional networks and regulatory bodies to as a commitment to climate action.

Become a or , join or start a team. Find out how to join climate action and sustainability initiatives at work.

Promoting and protecting public health

Using the approach 바카라 사이트� use every opportunity to talk to patients and their families about ways they can improve their health which also have a positive impact on the environment.

Encourage patients and staff to use active travel when appropriate for them, especially for short journeys.

Help patients and staff reduce their exposure to air pollution, and to the risk associated with high pollution episodes.

Identify patients most vulnerable to cold or hot weather (children, the elderly, those with chronic conditions), and ensure they know how to keep their homes at a reasonable temperature. Use this .

Encourage patients and staff to increase their consumption of whole grains, nuts, seeds, plant-based protein, fruits and vegetables, whilst reducing red meat and processed food consumption.

Encourage patients and staff to increase their use of green spaces for both physical and mental health. You can make this part of your management plan using these .

Reducing the environmental impact of healthcare

Opt for low-carbon treatments and technologies where appropriate.

Use this to help you to discuss with your patient the benefits of switching to a lower-carbon inhaler for their respiratory disease.

Anaesthetists, A&E and maternity services staff can reduce the use of highly .

Reduce unnecessary resource use.

Replace single-use with recyclable or multi-use consumables where appropriate.

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Actively travel to or at work, using public transport where available, and avoid air travel wherever possible.

Use communication technology when appropriate to reduce staff and patient travel.

Switch off lights and computers when not in use, reduce paper use and optimise recycling.

Help transition towards low-carbon models of healthcare.

Use a approach to redesign pathways, processes and services, by embedding sustainability into quality improvement projects.

Join a .

If you바카라 사이트檙e an allied health professional (AHP), see this for information and ideas on how your profession can contribute to NHS Net Zero.

Team leaders and managers

If you바카라 사이트檙e a team leader or manager:

• direct team members to information on the climate crisis and health and give them permission to take action on climate change as a core part of their work
• collaborate with other departments (for example, sustainability officers, catering managers, estates managers) to lead on initiatives that address the climate crisis
• contact your area바카라 사이트檚 lead or sustainability manager and help develop or implement ambitions.
• use the to shape your team바카라 사이트檚 work

Senior or strategic leaders

If you바카라 사이트檙e a senior or strategic leader:

• in your department or organisation (see ) as a commitment to climate action, and publicise what actions will be taken as part of a declared climate action strategy
• organise media training for key personnel so they can explain to partners and the public what your organisation is doing and how other organisations can help
• identify the in your NHS organisation, and help develop or implementing it (see )
• establish or join Green Champion networks and Green Impact teams
• improve green space access for patients and staff at your organisation (see )
• use the NHS바카라 사이트檚 role as an to engage in cross-sector working to influence public services and local businesses to reduce their climate impact
• work with local authorities and other partners to bring a Health in All Policies approach to cross-sector discussions about key issues (for example, transport, food systems, urban planning), emphasising the benefits to population health of policies that reduce negative environmental impacts
• take a system-wide approach to
• decarbonise procurement in buildings, infrastructure, catering and equipment
• implement recommendations from existing climate change response plans:
  • Heatwave plan for England
  • Cold weather plan for England
• co-ordinate local action across sectors for resilience in the health and care sector (such as hospital preparedness for extreme weather events such as flooding or storms), drawing on

Understanding local needs

Take action on the climate crisis while improving health and reducing social inequalities at a local level:

• work with your local authority to find out and identify suitable interventions
• review the or the
• support health and wellbeing boards to build adaptation actions into local
• understand local climate risks such as flooding and

Measuring impact

Measuring the impact of your work demonstrates its value and enables its spread:

• design, measure and report changes to clinical practice using
• find more information about sustainability reporting guidelines for public sector organisations
• share good practice ideas through , the and

Further reading, resources and good practice

Education about the climate crisis for health professionals

This , highlights how climate change is a critical public health issue.

Free e-learning modules on Environmentally Sustainable Healthcare .

UK government report on the health effects of climate change in the UK.

WHO special report: .

A with lectures on climate change, COVID-19 and sustainability.

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This and is an argument for social and economic structure changes to tackle climate change and social injustice.

바카라 사이트榃in-win바카라 사이트� strategies for improving public health and acting on the climate crisis

Transport

This guide from the Clean Air Fund can be used to communicate the .

Use these resources to promote physical activity among patients:

• physical activity frameworks
• UK Chief Medical Officers바카라 사이트� physical activity guidelines

Housing

This Citizens Advice resource can be provided to patients to .

Food

This brief for healthcare professionals outlines .

The Association of British Dieticians has published a toolkit to help you .

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Green space

Nature-based interventions, including , and .

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Social inequalities

on how to consider at-risk populations.

Reducing the impact of health and care

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The can be used to reduce the air pollution at hospital sites for the benefit of patients, staff and the wider community.

A list of .

to help local authorities prepare for the impacts of climate events on organisations and services.

using this guide developed by Greener Practice.

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: resources and ideas for improving the sustainability of primary care services.

Good practice examples

Case studies from the : these projects embedded sustainability into quality improvement to reduce waste, inappropriate prescribing and unnecessary cannulation across departments.

Sussex Community NHS Trust chose to support and promote active travel investing in e-bikes and electric and hybrid pool cares. See the scheme in action.

The at Great Ormond Street Hospital shows how simple changes to the way non-sterile gloves are used can significantly reduce the environmental impact of care while improving patient outcomes and experience.

The NHS Sheffield Clinical Commissioning Group shows how and improve wellbeing.

(2019 to 2024), improving the sustainability of their service and providing care in a way that both protects and recognises the health benefits of nature and the environment. They have made particular progress on leading a whole systems approach to increasing physical activity, a key component of increasing active travel and reducing transport-related climate impacts and ill health.

The uses the health voice to support a transport system which makes active travel the easy and accessible choice.

The brings public, private and third sector organisations together to prevent and prepare for the worst impacts of climate change whilst improving population wellbeing.