Ecological Bodies and Relational Anatomies: Toward a Transversal Foundation for Planetary Health Education

As planetary health education enters medical and health professional training, transversal implementation across curricula is critical in developing its full potential and enabling future health professionals to meet the social, environmental, and health challenges of current and future generations in an integrated manner. To advance the transversal implementation of planetary health education, our study proceeded through: (1) a sequence analysis of documents framing physiotherapy education to identify relevant nexus points; (2) an explorative implementation of planetary health into foundational anatomy and physiology modules identified as critical nexus points; (3) practical implementation during the 2021 autumn semester. Implementation in the operative foundations of healthcare education—anatomy and physiology—enables the emphasis of the ecological nature of human bodies and interconnection with our planetary environment. Musculoskeletal joints accentuate the relational nature of bodies highlighted across current research and traditional knowledges, as dynamically pervaded and in interaction with culture, technology, objects, ideas, plants, planets, etc. Teaching relational anatomies thus highlights planetary health as the transversal foundation of medical and healthcare education. Making this foundation more explicit will be critical for the transversal implementation of planetary health education and subsequent practice, as well as the fundamental shifts in our understanding of human lives and health they require

Environmental physiotherapy and the case for multispecies justice in planetary health

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

Physiopunk Vol 1

Physiopunk emerged out of an introductory public health module for first-year students in the Bachelor program in physiotherapy at UiT The Arctic University of Norway. Throughout the module, students gradually expanded their view of physiotherapy, from its past and present individual and physical health focus toward the integration of social and ecological issues as fundamental determinants of health. Because considering and addressing social and ecological issues is still a novelty in physiotherapy that will require considerable innovation and transformation, students were finally invited to conclude their learning by writing fictional stories about diverse futures for physiotherapy

The role of physiotherapy in a more sustainable health care system

Context: Population health and environmental crisis are intimately linked. The health care community has an important responsibility to integrate environmental issues into its actions. Objective: This article proposes approaches to integrate environmental and sustainability issues into physiotherapy practice. Development: Actions aiming at promoting high-value care, communicating about environmental issues with patients to encourage active mobility, and developing self-management and group treatments can produce positive effects on the climate while guaranteeing high-quality care. Nevertheless, systemic actions would bring broader benefits. Favoring conservative treatments over surgical ones, promoting interdisciplinarity, and developing prevention and health promotion roles at the community level would have a much greater impact on health and climate. Discussion: Numerous opportunities for action toward a more sustainable health care system exist for physiotherapists. However, the actions that would have the greatest impact require changes in the role of physiotherapists in the health care system. These changes require significant efforts in education and lobbying from professional associations. Conclusion: The promotion of physiotherapy as a key player in a sustainable health care system is an important opportunity for the development of the profession. This goes hand in hand with the development of new roles for the profession that incorporate the importance of environmental and social components of health.Contexte: La santé des populations et la crise environnementale sont intimement liées. Le monde de la santé a la responsabilité d’inclure la problématique environnementale dans ses actions. Objectif: L’objectif de cet article est de proposer des pistes de réflexion pour intégrer les questions environnementales et de durabilité dans la pratique de la physiothérapie. Développement: Des actions visant à promouvoir des soins à haute efficacité, communiquer sur la problématique environnementale avec les patients afin de favoriser les moyens de déplacement actifs, développer leurs compétences (self-management) et les traitements en groupe peuvent amener des effets positifs sur le climat, tout en garantissant la qualité des thérapies. Néanmoins, des actions systémiques permettraient des bénéfices plus larges. Favoriser les traitements conservateurs au détriment de traitements chirurgicaux, promouvoir l’interdisciplinarité et développer les rôles de prévention et de promotion de la santé au niveau communautaire auraient un impact beaucoup plus important sur la santé et le climat. Discussion: De nombreuses possibilités d’agir en faveur d’un système de santé plus durable existent pour les physiothérapeutes. Les actions qui auraient le plus d’effet nécessitent cependant des changements au niveau du rôle des physiothérapeutes dans le système de soins. Ces changements passent par des efforts importants au niveau de la formation, du lobbying et des associations professionnelles. Conclusion: La promotion de la physiothérapie comme un acteur essentiel d’un système de santé durable est une opportunité importante de développement de la profession. Cela va de pair avec le développement de nouveaux rôles pour la profession qui intègrent l’importance des composantes environnementales et sociales pour la santé

Education for the anthropocene : planetary health, sustainable health care, and the health workforce

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 wellbeing 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

South African Healthcare Professionals’ Knowledge, Attitudes, and Practices Regarding Environmental Sustainability in Healthcare: A Mixed-Methods Study

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