England’s National Health Service (NHS) is the country’s largest employer with 1.3 million staff, and its operations are responsible for approximately 4-5% of England’s carbon footprint. On January 25, the Chief executive officer of the NHS announced a new campaign to tackle the global climate change health emergency through a greener health care system. A website for the new campaign, “For a Greener NHS”, focuses on a goal of a net zero national health service, with an Expert Panel to compile experiences and make recommendations in an interim report due in summer 2020, and a final report scheduled for Fall 2020. In the meantime, the Greener NHS campaign will encourage such initiatives as switching from coal or oil-fired boilers to renewable heat sources for buildings; switching to less polluting anaesthetic gases and better asthma inhalers in treatment; and introducing technological solutions to reduce the number of patient visits and travel miles.
Another part of the initiative is a grassroots campaign for front-line workers, supported by the UK Health Alliance on Climate Change – which includes representative bodies covering over 650,000 NHS staff, including the union UNISON . The NHS press release quotes UNISON: “Involving staff is crucial if the NHS is to help the UK meet its emissions targets in good time. They know more than anyone how the health service ticks and so are best placed to make practical green suggestions to get the NHS to where it needs to be.” Examples of existing staff-oriented programs are described in case studies : reducing the use of disposable plastic gloves; an electric bike courier system for delivery of medical and laboratory samples; and a sustainable travel initiative to encourage staff use of transit, shuttle buses, bicycles and walking for journeys to work.
British medical associations and organizations are also acting at the societal level. In January, the prestigious British Medical Journal (BMJ) published an editorial: “Investing in humanity: The BMJ’s divestment campaign” , which calls on individuals and organizations to act immediately, stating: “Divestment offers health professionals and medical organisations, for the duty is both individual and collective, an opportunity to influence politicians and industry towards behaviours that are better for the planet and people’s health.” While urging divestment, the BMJ states: ” we will not accept advertising or research funded by companies that produce fossil fuels. We will also explore how else our business might be dependent on fossil fuel companies and take steps to end any such reliance. The BMA has no direct holdings in tobacco or fossil fuel companies.” (Note that The Guardian newspaper in the U.K. also announced in February 2020 that it will ban any fossil fuel advertising. ) According to a press release from the UK Health Alliance on Climate Change, six constituent groups of the Alliance have announced an intention, or are already divesting, from fossil fuels: the British Medical Association, the Royal College of General Practitioners, the Faculty of Public Health, the Royal College of Emergency Medicine and the Royal College of Paediatrics and Child Health, and in January 2020, the Royal College of Physicians . The Canadian Medical Association has also divested from fossil fuels.
A thoughtful new contribution to the “green jobs” debate comes in Re-defining Green Jobs for a Sustainable Economy , released by The Century Foundation, in cooperation with Data for Progress, on December 2. Co-author Greg Carlock is currently Senior Fellow and Research Director for Climate at Data for Progress, and was one of the authors of the original visioning document A Green New Deal , published in 2018 and leading to the current U.S. movement launched by Alexandria Ocasio-Cortez. Data for Progress continues to monitor public opinion and publish important contributions to the Green New Deal debate – in November, exploring the issue of a Green New Deal for Public Housing.
Re-defining Green Jobs for a Sustainable Economy outlines an interesting history of the “green jobs” definition and measurement in the U.S., but the main purpose of the report is to propose an expanded definition and framework of green jobs which would encompass the principles of equity and sustainability. Ultimately, the report recommends how an expanded definition can be integrated into U.S. public policy.
Perhaps most importantly, Re-defining Green Jobs for a Sustainable Economy focuses in detail on demonstrating why health care and educational workers should be considered as part of the green workforce, stating that including them in the green workforce definition “would go a long way toward gender and racial equity, and toward ensuring all workers green, family-sustaining jobs.”
An expanded definition of a green job, from the report:
“A green job should refer to any position that is part of the sustainability workforce: a job that contributes to preserving or enhancing the well-being, culture, and governance of both current and future generations, as well as regenerating the natural resources and ecosystems upon which they rely. And in order for green jobs themselves to be sustainable, they need to be good, living-wage jobs…. These green job occupations stand in contrast to work—even decent-paying work—in industries that result in the depletion or degradation of ecological systems and the social, cultural, and political institutions that support them.”
The Prairie Climate Centre at the University of Winnipeg maintains the Climate Atlas of Canada, and on November 20 launched a new section of their website devoted to climate change and health in Canada. So far, the webpages provide a general overview of the issues of air quality, diseases, extreme heat, and mental health – supported by more detailed articles – for example, Climate Change, Air Quality, and Public Health ; Wildfire Smoke and Health ; and a new 4-minutes video about wildfires, with impactful images which highlight the links between wildfires and mental health, especially relating to first responders and medical providers. The Prairie Climate Centre also published the Heat Waves and Health report, released in August 2019, and now part of the new section.
Since 2016, the prestigious medical journal The Lancet has published an annual report, Countdown on Health and Climate Change . The 2018 Countdown report focused on work-related health impacts of climate change, especially heat effects, as summarized in the WCR here . The 2019 edition just released in early November focuses on the impacts of climate change on the health of children, with this key message: it is possible to limit the global average temperature rise to well below 2ºC, a situation which “would transform the health of a child born today for the better, throughout their lives. Placing health at the centre of the coming transition will yield enormous dividends for the public and the economy, with cleaner air, safer cities, and healthier diets.”
In addition to the global report, the Lancet also publishes country-specific Policy Briefing reports. The Policy Briefing for Canada (in French here ) is written in cooperation with the Canadian Medical Association and the Canadian Public Health Association. The four highlighted results for Canada are:
- “Exposure to wildfires is increasing in Canada, with more than half of the 448,444 Canadians evacuated due to wildfires between 1980 and 2017 displaced in the last decade;
- The percentage of fossil fuels powering transport in Canada remains high, though electricity and biofuels are gaining ground. Fine particulate air pollution generated by transportation killed 1063 Canadians in 2015, resulting in a loss of economic welfare for Canadians valued at approximately $8 billion dollars;
- Canada has the third-highest per capita greenhouse gas emissions from healthcare in the world, with healthcare accounting for approximately 4% of the country’s total emissions;
- The health of Canadians is at risk due to multiple and varied risks of climate change…… An ongoing, coordinated, consistent and pan-Canadian effort to track, report, and create healthy change is required.”
For each of the four problems, broad policy recommendations are made.
Some of the other countries for which Policy Briefs are available: Australia ; European Union ; the United Kingdom ; and the United States . Each one reflects the unique challenges of the country concerned. The full menu of all Country Briefs is here.
Nurses’ Unions, Climate Change and Health: A Global Agenda for Action was written by Sean Sweeney, Irene Shen and John Treat of Trade Unions for Energy Democracy (TUED). ( A summary appears in the September 2019 Bulletin 90 of the TUED ). The report provides a brief overview of climate change issues, and an extensive chapter about the human health impacts of climate change. It concludes by outlining six key areas where nurses and their unions “can make use of their expertise and political strength in the fight against the climate and health emergency, and for climate and health justice.” The agenda for action includes: Resist new fossil fuel projects; Make Emergency Response and Recovery Services “Climate Ready”; Work with Allies at the Global Level on Preparedness; Fight Poverty and Racism. Defend Worker Rights and Protections; Articulate and Advocate for a Pro-Public Shift in Policy; and Extend Public Control Over Energy Generation and Use through Energy Democracy. Although the report was written for nurses’ unions, the authors express the hope is that it can be useful for the labor movement more generally, “to wage the struggle for climate protection and climate justice with a clearer understanding of the challenges that must be faced in order to achieve it.”
The report was written for Global Nurses United , a federation of the nurse and health care worker unions which has grown to represent 27 nations since its founding in 2016. The Canadian Federation of Nurses Unions and Fédération interprofessionnelle de la santé du Québec are members from Canada; National Nurses United is the member from the United States. The purpose of GNU is to fight against austerity, privatization, and attacks on public health, as well as to work for nurses’ and workers’ rights and improved patient care for all.
The Canadian Federation of Nurses released its own publication in June 2019, Climate Change and Health: It’s Time for Nurses to Act , “as a starting point for for advocacy and leadership”. It shares some content with the Global report, but focuses on Canadian examples, and outlines its own six recommendations for action. A summary appears here .