Over the past few centuries, human activity has wrought dramatic changes in the natural systems that support human life. Planetary health is a useful concept for health profession education (HPE) teaching and practice because it situates health within a broader understanding of the interdependent socio-ecological drivers of human and planetary health. It facilitates novel ways of protecting both population health and the natural environment on which human health and well-being depends. This paper focuses on the climate crisis as an example of the relationship between environmental change, healthcare, and education. We analyze how HPE can help decarbonize the healthcare sector to address both climate change and inequity in health outcomes. Based on the healthcare practitioner’s mandate of beneficence, we propose simple learning objectives to equip HPE graduates with the knowledge, skills, and values to create a sustainable health system, using carbon emission reductions as an example. These learning objectives can be integrated into HPE without adding unduly to the curriculum load.

Climate change, biodiversity loss and large-scale environmental degradation are widely recognized as the biggest health threats of the 21st century, with the African continent already amongst the most severely affected and vulnerable to their further progression. The healthcare system’s contribution to climate change and environmental degradation requires healthcare professionals to address environmental issues urgently. However, the foundation for context-relevant interventions across research, practice, and education is not readily available. Therefore, we conducted a convergent mixed-methods study to investigate South African healthcare professionals’ knowledge, attitudes, practices, and barriers to environmental sustainability. Healthcare professionals participated in a cross-sectional questionnaire (n = 100) and in-depth semi-structured focus group discussions (n = 18). Data were analyzed using descriptive statistics and thematic analysis, respectively, and integrated to provide holistic findings. Our results confirm overwhelmingly positive attitudes and a high degree of interest in education, implementation, and taking on more corresponding responsibility, but a lack of substantial knowledge of the subject matter, and only tentative implementation of practices. Identified barriers include a lack of knowledge, resources, and policies. Further research, education, and policy development on overcoming these barriers is required. This will facilitate harnessing the extant enthusiasm and advance environmental sustainability in South Africa’s healthcare practice.

Background:Global environmental change is fundamentally altering the composition and functioning of our planetary ecosystem. Effectively presenting the largest threat to the health of present and future generations, these changes and their health impacts are forcing us to think and practice healthcare in much broader terms than ever before. Objective:In this article, we provide an early outline for a radically otherwise, yet strangely familiar, environmental physiotherapy developed through a succession of carefully developed arguments. Discussion:We show how an underpinning belief in human exceptionalism has engendered an exploitative relationship with our natural planetary environment that has both shaped Western science and healthcare and led to our current environmental health crisis. Building on the dependence of human health on our planetary ecosystem, approaches like planetary health hold great promise for a corresponding, paradigmatic turn in healthcare. They fall short of this however, where they perpetuate anthropocentric interests and interventionist practices that have underpinned healthcare to date. Drawing on ethical and post-human philosophies we argue against human exceptionalism and for a solidarity that includes other-than-humans as the primary characteristic of planetary existence. Conclusion:Building on this foundation, we provide an early outline for a radically otherwise, yet strangely familiar, environmental physiotherapy, grounded in ecological awareness, multispecies justice, and a range of consonant practices of passivity and accompaniment, conceived as an alternative to the commonplace interventionism of healthcare.

We live in a world in which global warming, pollution, social injustice, inequity and population health fundamentally influence each other. As a result, health and health care can no longer be thou...

A high proportion of people are insufficiently physically active. The reasons for this are complex and in part relate to social determinants of health, lifestyle choices, and deleterious environmental conditions like climate change, loss of green and outdoor environments and a concomitant loss of biodiversity. Physiotherapists, and other health professionals, may have a positive impact on these global issues, through the encouragement of active transport, and advocacy to reduce barriers to its uptake and optimize exposure to health-giving outdoor spaces. In this paper, we demonstrate how physiotherapists can promote active transport as a planetary health intervention, and provide insight into the benefits and challenges of this planetary health intervention, with direct implications to physiotherapy practice.

Non-steroidal anti-inflammatory drugs (NSAIDs) continue to be amongst the most frequently used pharmaceutical treatments for mild to moderate musculoskeletal pain globally. In this short communication, we continue to expand the growing field of environmental physiotherapy by tracing NSAIDs journey through aquatic ecosystems, and the potential of physiotherapy to mitigate these negative environmental impacts and so contribute to achieving a range of UN Agenda 2030 Sustainable Development Goals and the aspirations of One Health. Through metabolic excretion into waterways, NSAIDs negatively impact the health and survival of various aquatic lifeforms, which, in turn, has consequences for human health. By reducing and delaying the need for pharmacotherapy for mild to moderate musculoskeletal pain, physiotherapy presents an important sustainable healthcare solution. Beyond this, however, the ecological persistence of NSAIDs also underscores the need for transformative change in healthcare and physiotherapy, towards the full recognition of the interconnected nature of human, animal, and ecosystems health and the complex questions and responsibilities this raises. For this, we need to increase our understanding of the entangled nature of health and its negotiation with human and non-human others and develop approaches to include them in our thinking, pursuit, and practice of health and care.