"Planetary health is deeply committed to equity"

 

Dr Howard Frumkin is an internist, an environmental and occupational medicine specialist and an epidemiologist. He is professor emeritus of Environmental and Occupational Health Sciences at the University of Washington School of Public Health and one of the founders of the planetary health concept. He is also senior vice president at Trust for Public Land, which creates parks and protects land for people, ensuring healthy, liveable communities for generations to come. Dr Frumkin is a member of the new master's degree in Planetary Health offered by the Universitat Oberta de Catalunya (UOC), the Pompeu Fabra University (UPF) and the Barcelona Institute for Global Health (ISGlobal). Recently, he took part in the presentation of the master's degree, which can be viewed online here.

 

Dr Howard Frumkin is an internist, an environmental and occupational medicine specialist and an epidemiologist. He is professor emeritus of Environmental and Occupational Health Sciences at the University of Washington School of Public Health and one of the founders of the planetary health concept. He is also senior vice president at Trust for Public Land, which creates parks and protects land for people, ensuring healthy, liveable communities for generations to come. Dr Frumkin is a member of the new master's degree in Planetary Health offered by the Universitat Oberta de Catalunya (UOC), the Pompeu Fabra University (UPF) and the Barcelona Institute for Global Health (ISGlobal). Recently, he took part in the presentation of the master's degree, which can be viewed online here.

This is an absolute pioneering programme that you are launching in Barcelona, and I am very honoured to be part of it. Many people think this is simply old wine in new bottles, but it's not: this is a revolutionary scientific approach. Planetary health is people-centred. That is why we greatly value the importance of the environment; we put people at the centre of this way of thinking. It is systems-based (everything is connected to everything), upstream-facing, looking at the root causes of the health and environmental challenges we face. It is also equity-committed, that is, deeply committed to equity, fairness and justice among people. It's future-oriented because we know that solutions that may be appropriate today may not be in 50 or 100 years. It's solutions-driven, aiming not only to characterize problems but to identify and test solutions. And we work hard to inspire hope.

I don't know of any scientific paradigm that combines all of these features, so for me, this is why planetary health is innovative and important.

Thank you for mentioning that book. One thing I have learned is that all of us were born and have lived our lives in the context of a big party, the party of fossil fuels and of seemingly endless supplies of energy and materials. We are so immersed in that high-consumption lifestyle that – like the proverbial fish, unaware that it exists in water – we don't even recognize how unusual this is. 

We need to take this planetary health perspective and apply it to each part of our lives: the way we harvest energy, the way we make our food, the way we travel, the way we build cities and buildings, the way we consume things. We need to be critical and analytical about each of those things. We need to be thinking not only about the biomedical aspects of health but about the broader determinants of happy and fulfilling lives. We know what matters to people to make good lives: not only health, but equity, time with friends and family, a sense of security and opportunity. This implies that we need much better ways to measure success than our typical economic indicators. We require indicators that actually capture the things that are important: happiness, fulfilment, environmental sustainability. Those are some of the main lessons I have learned in the last few years. 

We know from COVID-19 and from other pandemics that have occurred and will occur, that some of the risk factors are very explicitly addressed by planetary health: disrupting ecosystems, humans' incursions into ecosystems, our food system, meat and poultry farming, and the wet markets that exist in some parts of the world. These are practices that increase the risk of spillover.

We know about some protective factors against pandemics, which are important not only in avoiding pandemics but also in protecting us from other crises and challenges, for example, a strong sense of social solidarity. Countries with a strong sense of solidarity have done much better at fighting COVID-19, while countries that are deeply polarized – including my own – have had much more difficulty. 

A respect for science and a commitment to the equitable sharing of resources within and between countries are also important in controlling pandemic risk. We haven't really demonstrated these in terms of COVID-19 vaccination. 

So, keeping in mind that we will face further pandemics and further challenges over time, we need to learn to build social solidarity and centre science, equity and justice in our decision-making. I think these are lessons from the current pandemic.

As a society, we have to create a strong sense of social solidarity. People need to pull together, whether it is fighting a pandemic or fighting climate change or changing the way in which we build our cities. Building solidarity across divides is very important. And we need a commitment to justice, so that everybody can feel part of a collective solution, and that means shifting from a paradigm of competitiveness to a paradigm of cooperation, shifting to a paradigm of respect for nature and living within natural limits. This all implies specific changes in our food system, in transportation, in buildings, in energy and so on. As we make those changes to live within planetary limits, we will reduce the risk of future pandemics and other risks as well.

Young people are absolutely essential to tackling the challenges of planetary health: climate change, biodiversity loss, etc. We need their energy, their activism, their commitment. As students and as professionals, they should think as broadly as possible. If they love the physical sciences, good, but they could take some biomedical courses, for instance, and vice versa. If they love the hard sciences, good, but they might also take some courses in anthropology and ethics. 

I encourage them to be brave and get used to being outside their zone of comfort. And perhaps most importantly, have hope. We need hope to tackle the big challenges we face. We have bequeathed to them a world that is full of challenges, but I have confidence that they can tackle them.