The climate crisis dominates so much of daily life and work globally. Foreboding messages from the Intergovernmental Panel on Climate Change (https://www.ipcc.ch) and other sources abound. Science on global heating, the climate crisis, and health is exploding with new information. Trying to make sense of it all feels extremely overwhelming. The result, then, is that we cancer nurse researchers typically suffer a combination of a general overload and being specifically overwhelmed by climate concerns without knowing where to turn. The consequent inertia is often profound. We all end up saying, “Who me, put climate into my research? I'm not expert enough…” while hopelessly listing obstacles that limit our action. Bringing obstacles into sharper focus and realistic scale helps reduce inertia.
Finding a way to address climate and sustainability in our research is akin to education we undertake across our careers, like delving into a new method or shifting phenomena. The difference here is the dire existential nature of the climate crisis. We typically conduct research with some sense of existential security enabling us to see a future. The climate crisis strips away such surety. Turning back toward what we know seems preferable to thinking about how to make some scientific contribution that limits this, the ultimate existential crisis. But we cannot allow ourselves to turn away from this crisis. Such scientific stagnation goes against our values as nurses, scientists, and people. As human beings, we hope for planetary security, an end to the climate crisis and restoring healthy climate. We must act on that shared hope.
Let us begin by acknowledging the climate crisis results partly from healthcare. Healthcare contributes significantly to global heating, through greenhouse gas emissions and other pollutants, accounting for as much as 5% of global impact.1 Concomitantly, radical shifts in our climate affect all aspects of health and well-being, as well as affect healthcare delivery. Effects on health are better known, especially by those of us who study cancer and its impact on human health, function, and experience across the cancer trajectory. From carcinogenesis to health inequities, the scope of climate effects on health is vast with evidence accruing rapidly.
Many resources help us integrate climate into our research, offering added benefits of informing education, practice, and policy development. Let's start learning and transform our science for the climate and health!
First, go beyond basics available in the lay press. The Alliance of Nurses for Healthy Environments (https://envirn.org) has a new edition of their textbook (https://envirn.org/e-textbook/) available and free to read. The Lancet Planetary Health journal (https://www.thelancet.com/journals/lanplh/home) often publishes key papers. Second, look at home and abroad for potential cross-disciplinary collaborators. Some disciplines offer greater likelihood than others for making connections. But know that like-minded colleagues are everywhere—I recently met someone in our German department! Read up and reach out for a chat. Third, assay institutional resources in academic, clinical, and educational sectors. Globally, institutions are realigning priorities to reflect urgent need for climate response. Investigate and, again, start a conversation. Finally, look at current and planned projects. Every aspect of health and well-being is affected by the climate crisis, directly or indirectly. Map out implications and then design secondary analyses where possible and prioritize including at least one dimension of climate in every new study. Here are examples to get your scientific creativity flowing: ○ Avoiding unnecessary healthcare encounters is a priority metric. A decrease in unnecessary encounters represents less fossil-fueled transportation. Incorporate calculated carbon savings into healthcare utilization research. ○ Investigation of sustainable policy and practice changes in cancer care lags significantly behind need. Target sustainability in practice improvement and health services research. ○ Social discrimination and inequity mean greater harm from the climate crisis. Always include climate in health equity studies. ○ Mental health and well-being are desirable targets in many studies. Solastalgia may occur with or exacerbate cancer-related existential distress. Include solastalgia assessment and interventions such as nature-based social prescribing and virtual nature experiences when studying well-being.The prospect that acting on my own hope leaves you with tangible resources, new directions, and a sense that you too can act bolsters my faith that we can limit global heating and restore healthy climate globally. I look forward to reading about your scientific success contributing to our healthy climate!
1. Lenzen M, Malik A, Li M, et al. The environmental footprint of health care: a global assessment. Lancet Planet Health. 2020;4(7):e271–e279.
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