‘The best time to plant a tree was 20 years ago …’ the old Chinese proverb goes. ‘… The second best time is now.’ I have recently been testing out this mantra as an antidote to climate change despair; psychologists call it cognitive dissonance, when the problem seems too vast and our agency as individuals too trivial. So we give up and bury our heads in the sand. To condemn such a response would be unfair; it is all too human. More human, however, is the ability to overcome challenges, solve problems, and come together in times of need. So why does this feel so hard and how can we make it easier?
THE CASE FOR CHANGE
In my mind, and I believe in the minds of many, dealing with the issue of climate change has always felt like a series of painful choices. Either we suffer now by reducing our reliance on fossil fuels and thus secure a sustainable future, or we carry on enjoying our current system and pay for it later. It appears that this is no longer the case. Decarbonising has become a win-win. The economic cost of unmitigated climate change is projected to run into the trillions.1 The global economy will be better off, flourish even, in a zero-carbon future. The cost of renewable energy generation is now cheaper than the fossil fuel equivalent and the industry is a huge source of employment globally. In this way, what were once tough choices are rapidly becoming no-brainers. The same principle applies to health. The Lancet Countdown update published in November 2018 suggests that tackling climate change will in turn provide:
‘… opportunities to improve breathing conditions for 90% of the global population exposed to polluted air, tackle the root causes of obesity, physical inactivity, and poor diet, alleviate social inequalities and promote social inclusion, improve workplace environments, and increase access to health care and other social services.’ 2
This, to me, is the fundamental idea at the core of Green Impact for Health. The online scheme, launched in 2015 by the Royal College of General Practitioners in conjunction with the National Union of Students, is free to join and simple to use. It takes a lot of the cognitive dissonance out of making health care sustainable: if you want to make your workplace greener, Green Impact for Health will have plenty of suggestions for you. Each action is small and achievable. Many you are probably already doing. You can focus on double-sided printing, promote inhaler recycling, or get your practice disposing of waste more efficiently. The sense of progress can be compelling and you can take it as far as you want. Renewable energy generation and structural energy efficiency improvements are all possible. Accrue enough points and you can win a bronze, silver, or gold award. I am hooked as are many of my colleagues. We are looking forward to a 2019 in which we continue to push forward positive change and enthuse others to do the same.
CLIMATE HEALTH
As with the Lancet Countdown, Green Impact for Health recognises the relationship between environmental sustainability and the health of the patient and of society. One of the big themes is social prescribing. The concept, promoted by the National Institute for Health and Care Excellence and the NHS, is relatively recent and as yet largely unproven.3 However, the idea is a good one and deserves our attention and research efforts. Walking and cycling to improve fitness can also help reduce journeys made by car. Making time to grow food and then eating it improves diet and reduces food miles and meat consumption. Time spent outdoors with others can foster greater care for the natural environment and communities. These are all things that healthcare workers can prescribe. What is more, they do not need to be seen as hard choices but truly are win-wins.
Perhaps we could even give in to the cliché and plant a tree. After all, the second best time is now.
- © British Journal of General Practice 2019