Canadian medical schools have made significant strides in recent years toward incorporating principles of Planetary Health into their curricula. However, more work must be done to enrich future physicians’ understanding of climate justice as a medical, social and moral imperative.
Planetary Health is a multidisciplinary field and social movement focused on addressing the impacts of climate change and environmental degradation on human health. The Canadian Federation of Medical Students Health and Environment Adaptive Response Task Force (CFMS HEART) has been, at the student level, one of the pioneers in advocating for Planetary Health to become an indispensable component of undergraduate medical curricula in Canada.
Increasingly, Canadian physicians and learners demonstrate a strong understanding that:
- Climate change has direct and indirect consequences for health;
- Physicians are fundamental in responding to those consequences;
- Physician-led advocacy toward better climate policy and more sustainable health systems is essential.
Encouragingly, HEART’s most recent evaluation indicated that 16 of 17 Canadian medical schools have responded by integrating some Planetary Health competencies into their curricula. This growing understanding is also reflected by the Medical Council of Canada’s adoption of a Health and the Climate Crisis learning objective, as well as the integration of Planetary Health into national curriculum work undertaken by the Association of Faculties of Medicine of Canada.
Simultaneously, medical schools across Canada are embracing movements to integrate other core tenants of social justice into medical education. This includes calls for a standard Canadian curriculum on 2SLGBTQIA+ health; a national research collaboration on tackling anti-Black racism in medical education; a student-led curriculum framework on homelessness and vulnerable housing; and the AFMC Joint Commitment to Action on Indigenous Health.
However, these efforts are not always integrated to reflect the intersectionality of these issues and to approach teaching and learning in a way that is multidimensional and synergistic.
The case for integration
The introduction of Planetary Health curricula into Canadian medical education will never be complete unless it is thoroughly integrated at every level with anti-oppression approaches to social and community justice. This is, in essence, because the root causes of climate and environmental change are intimately linked to other root causes of oppression: extractive capitalism, colonialism and white supremacy. The outcomes of these links are seen, for example, in the disproportionate impacts of climate change on Indigenous health in Canada.
These issues are deeply and historically enmeshed, and any approach to Planetary Health that fails to acknowledge its social and political complexity will not only be inadequate to address the challenges of the future, but will perpetuate inequities through the exclusion of vital perspectives. Moreover, marginalized communities have often led the way in taking community action to address climate-related emergencies; failing to include their voices would mean missing out on crucial solutions to increasingly pressing challenges.
To address this issue, HEART’s most recent set of Planetary Health curricular competencies is built around a framework of Planetary Health Justice, which seeks to recognize the central relationship between all aspects of Planetary Health work and other social and structural determinants of health.
Calls to action
While the issue of Planetary Health is complex and requires solution seekers at all levels of the health care system and beyond, we write from the perspective of medical students. As a result, we propose steps to break down silos between Planetary Health and other anti-oppression work that medical learners, educators and their allies can pursue in collaboration:
- Centre principles of justice in advocacy for Planetary Health curricula. Whether drawing from the CFMS HEART curricular competencies or from the growing wealth of other Planetary Health educational frameworks, learners and educators should ensure that advocacy is built around equity-oriented and anti-oppression approaches.
- Collaborate with medical learners and educators working on other social justice issues to find areas of synergy. When looking to add teaching on how climate change affects northern and remote communities, for example, identify areas of overlapping content with your local Indigenous Health curriculum and highlight links to Planetary Health. Likewise, look for opportunities in reproductive and women’s health teaching to address impacts of the climate crisis on women and gender minorities, such as the relationship between environmental exploitation and violence against Indigenous women and girls. This not only increases the number of voices advocating for these issues to be addressed in medical curricula but helps streamline curriculum additions in an era where there are ever more demands on the time and energy of students and faculty alike.
- Recognize that social justice issues extend far outside medicine, and work to include multidisciplinary and community voices in Planetary Health education. For example, look to nursing educators who have created brilliant frameworks for critical environmental justice education, grassroots organizations like Indigenous Climate Action, artists and film-makers working to decolonize Planetary Health, and student, youth and community organizations addressing climate justice in your local community. This could mean inviting speakers from other faculties or organizations, screening documentaries or assigning readings and case studies drawn from other disciplines when planning Planetary Health educational activities.
Medical learners and educators must think broadly and draw on the multitude of diverse voices that comprise the climate movement to ensure Planetary Health education is inclusive, intersectional and justice oriented.
Emma McDermott and Kabisha Velauthapillai, the 2021-2022 co-chairs of CFMS HEART, contributed to this article.
