‘You start somewhere’: Raising awareness of planetary health

Amanda Lyons

4/03/2019 11:13:21 AM

An RACGP program led to Dr Tammra Warby’s role in creating an international educational document on planetary health.

Dr Tammra Warby wanted to provide GPs a concise document about planetary health and its impact on general practice.
Dr Tammra Warby wanted to provide GPs a concise document about planetary health and its impact on general practice.

It was while she was working on her project for the RACGP’s Future Leaders Program – designed to help new Fellows develop their skills as GP leaders – that Dr Tammra Warby came up with her idea.
‘For that program, we had to develop a project, then learn about leadership skills while putting it into practice with a project plan,’ she explained to newsGP.
‘I had too many ideas at first, but I had just started to get interested in the effect of climate change on health. And then I was matched with my mentor, Dr Tim Senior, who used to be the Chair of the Environmental Impacts in General Practice RACGP Specific Interests network.’
The Future Leaders Program helped Dr Warby solidify her ideas, with a particular focus on the concept of planetary health.
‘Planetary health is an emerging field in which we look at the fact that humans are causing disruptions of the earth’s support system, and that has a loop-back effect on our own public health,’ she said.
‘A lot of emerging threats are related to the fact that the earth’s support systems are a finite resource – there are not endless supplies of land or fresh water – and our exploding population.

‘Some people are experiencing under-nourishment, others over-consumption. And then we’ve got excess air pollution, which affects cardiac disease, COPD, lung disease, and is responsible for about 7.1 million deaths per annum, globally.
‘There are other emerging issues, such as the loss of biodiversity, which means that declining pollinator populations are making it harder to grow crops. Separate to that, you’ve got direct and indirect effects of climate change, which can then increase potential disasters, floods, fires and infectious diseases.’

Climate change has been considered a factor in Australia’s summer bushfires. (Image: Rob Blakers)
As Dr Warby worked on her project, combining her interest in planetary health with medical education and contacting professional organisations with similar interests, she saw a gap in educational materials for GPs on her chosen topic.
‘I thought, “Okay, I could do that”’, she said.
Dr Warby approached the Planetary Health Alliance (PHA), which in turn put her in touch with the World Organization of Family Doctors, or WONCA, and their Working Party on the Environment. She put her idea – the production of a concise educational document for GPs and family doctors about planetary health – to the PHA and WONCA, and it was accepted.   
Dr Warby was appointed as co-leader of the declaration project.
‘It’s important to recognise that GPs especially are overburdened with lots of information all the time,’ Dr Warby said.
‘We thought it was a nice opportunity to make something succinct that gave a bit of a header of knowledge for GPs who either already know this sort of stuff, or those who maybe are not putting together the linkages between the whole-of-planet environment and how it relates to the individual patient.
‘For example, to get right down to the person in front of you, then you’re talking, how does the person with cardiovascular disease respond in a hotter environment? We’ve got rising temperatures and of course just hit another heat record for January.
‘Then you’ve got heat-related mortality, but you also have increased morbidity and effect on functioning, so you might see a lot more health effects for people who are exposed in the outdoors.’
Dr Warby believes that education for GPs on planetary health is extremely important because of their integral role in community health.
‘GPs and family doctors are frontline with the health effects, so we have great opportunity to help patients to understand the linkages themselves,’ she said.
‘And also, role-modelling can be important. For example, we have family doctors around the world who have started up food gardens with their communities or their practices. So there’s that opportunity for leadership within their communities, about responding to it.’
The educational document, Declaration Calling for Family Doctors of the World to Act on Planetary Health, was released on Friday 1 March and shared by WONCA to all its members.
‘Globally, people have the power,’ Dr Warby said. ‘We can all make little changes; we can all cut down our consumption, we can be more careful with our food wastage and food choices.
‘We can understand that, if we buy food that’s grown in the USA or somewhere else, bringing it to Australia uses a lot of resources. Just being aware of the wastage – buying local, at farmers’ markets and such places, reduces the resource consumption that goes into getting whatever we’re consuming to us.
‘It’s a big challenge, but I think just remembering we can all start with something ourselves is important. We have that question, where do we begin with something like this? You start somewhere – you start with yourself.’

climate change environmental health planetary health WONCA

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Dr Virginia Reid   5/03/2019 3:27:00 PM

Great article . Can't believe however that there is no reference here to the EAT-Lancet commission report. There are many people who've already well and truly started and are up and running. The EAT forum is a really good place to start as they have a diet, recipes and a lot of resources. Hope you enjoy! The other really hopeful shift in mitigating climate change is regenerative agriculture and I think it would be good if doctors could urge government to support these suppliers in the food chain. Amsterdam is doing a fantastic job by these means and of tackling child adolescent obesity ie banning fast food ads, nothing but water and milk is allowed in schools etc. We need to get behind the notion that climate change is one of the greatest public health challenges of our time. Please feel free to get back to me for more information/references/articles and would be happy to help.

Tammra Warby   5/03/2019 8:41:49 PM

Hi Virginia great comments thank you. Eat lancet is covered in the declaration - it was an exciting innovation that came out as we were working on it .