Taking action to tackle the climate crisis, health and inequality

The climate crisis is a health crisis

The climate crisis is a health crisis.¹ But taking action to tackle the climate crisis offers us a huge opportunity to improve health and reduce inequality.²

Indeed we cannot tackle inequality without tackling the climate crisis, and vice versa.³

Some GPs and surgeries are already leading the way by making changes to how they travel, prescribe, and use resources.

It is great to hear about practices like Whitfield in Dundee where they are using e-bikes for commutes and home visits.

Green impact for health toolkit

Most GPs I speak to are passionate about the climate and the environment, but are looking for a bit of guidance, rather than another complex topic to research.

If you are interested in action but would benefit from a framework to follow, there is a toolkit which has just had its 7th edition launched.

The Green Impact for Health Toolkit is structured to guide practices through actions that will eventually lead to them becoming carbon net zero.

Greener Practice is the other best place to look. It is a site made by GPs full of resources and links to inform and support you towards... well... greener practice.

There are some GPs who want to get COVID-19 out of the way before they deal with another crisis, or perhaps are working at capacity already.

If the climate crisis isn’t on your radar, perhaps start by having a look at this short video which outlines the problem and offers a solution.

If you could be tempted by a little more detail on the problem but also on opportunities in the context of COVID-19, then take a look at the grand rounds from July in Tayside with Nick Watts, lead on Lancet Countdown Commission on Climate and Health, and new lead for NHS England’s Net Zero strategy.

Unfortunately, pandemics are increasingly likely due to our relationship with the environment, and the later we leave changes the more work we will have to do to reverse the damage being done.

Climate crisis and COVID-19

There have been two recent publications of interest: the Scottish Sustainability Network Strategy (external PDF file) was launched in September and offers a broad vision of how the public sector can work together to meet net zero targets.

It discusses the opportunity with the disruption from COVID-19, but also the obligation that comes with the urgency of the climate crisis, to ensure our recovery is green.

The other paper is from NHS England on Delivering a 'Net Zero' health service.

This is a more detailed and NHS specific strategy on what needs to happen to get to net zero. Although it doesn’t include NHS Scotland, there is a huge amount of useful data which can be used to drive the necessary urgent change.

Both of these papers, and the Marmot review, illustrate how crises like COVID-19 and the climate crisis are disproportionately affecting minorities and the most vulnerable, and we know that business as usual will further exacerbate disparity.

In fact, the World Bank predicts that by 2030 climate change will reverse recent improvements in public health, put 100 million people back into poverty and cause a minimum of 250,000 additional deaths each year globally.⁴

Air pollution is already causing over 4 million deaths a year.

The mitigation needed to tackle climate change such as reducing pollution, renewable energy provision, increased energy efficiency in housing, active travel, changing diets, and access to green-space can on the other hand reduce poverty, unemployment, inequality, improve health and reduce premature deaths.

The obvious place to get this right first is within the NHS. We need to stop doing harm.

Practical steps that you can take for a more sustainable future

So, a couple of things to get started on (if you haven’t already):

1. Switch your energy provider to renewable sources (if you haven’t switched for a while it will likely be cheaper).
2. Avoid printing where possible, print double sided when unavoidable.
3. Switch off equipment and lights when not in use – these last two steps will save thousands of pounds a year.
4. Look at reducing the emissions from your travel and the pollution we are causing in our local areas.

If you are interested in shifting your commute and your home visits to e-bike or e-cargo bike, get in touch with cyclingfriendly@cycling.scot who can advise on grants on facilities like showers and racks, bicycles, e-bikes and e-cargo bikes, as well as discounts for bikes such as cycle to work schemes.

This won’t just reduce your emissions; it will save you money, improve your health and set a good example too.

If an e-bicycle is not suitable, then the energy savings trust does have information on grants and loans available for electric cars, which of course are also tax deductible, and have no vehicle emissions tax.

It would be better to vehicle share and unless you have very high mileage or very poor fuel consumption it is best to keep your old car going as long as possible due to the 11+ tonnes of CO2 from building a new electric car.⁵

With many new electric cars having a range of over 250 miles, even rural GPs should however consider one, if they need to replace an existing vehicle.

About the writer

Dr Munro Stewart

Dr Munro Stewart currently works as a locum GP in Tayside. Dr Stewart has been an active member of RCGP since he was a trainee and currently sits on East Scotland Faculty Board as well as sitting on the RCGP Climate Emergency Advisory Group.

Additionally, Dr Stewart sits on the NHS Tayside Sustainability Group and tutors undergraduate medical students at Dundee University.

1. Jennings et al. Mapping the co-benefits of climate change action to issues of public concern in the UK: a narrative review. The Lancet. Sep 2020. Vol 4, ISS 9 E424-433. https://doi.org/10.1016/S2542-5196(20)30167-4
2. Watts et el. The Lancet Commission Countdown on Health and Climate. https://doi.org/10.1016/S0140-6736(19)32596-6
3. Munro et al. Sustainable Health Equity: achieving a net-zero UK. The Lancet. Nov 2020. https://doi.org/10.1016/S2542-5196(20)30270-9
4. Stephane H et al. (2016). Shock Waves: Managing the Impacts of Climate Change on Poverty. World Bank Group. https://openknowledge.worldbank.org/handle/10986/22787
5. How Bad Are Bananas? Carbon footprinting by Mike Berners-Lee, University of Lancaster. 2020. Profile Books.