Need for planetary health perspective in guidance for complex interventions for climate and health

Human activity has pushed Earth’s natural systems beyond safe and just planetary boundaries, creating threats to human health and survival (box 1).1 Evidence shows that six out of nine identified planetary boundaries have already been breached: climate change, novel entities (including synthetic chemicals), freshwater, biosphere integrity, land use, and biogeochemical (nitrogen and phosphorus) flows.3 Surpassing these thresholds will detrimentally alter environmental exposures that affect health outcomes through multiple pathways, both direct, such as changes to heat exposure or air pollution, and indirect, such as effects of population displacement.2

Net zero targets have incentivised widespread design of climate mitigation actions from local to national levels. Global action and commitment to reverse transgressions in planetary boundaries is increasing, with much effort focused on reducing greenhouse gas (GHG) emissions. But the scale of ambition and implementation is still not commensurate with the urgency needed to prevent catastrophic climate change. Counterarguments often focus on costs, uncertainty of effectiveness, or concerns about trade-offs, including for inequity.

Perceived public support may also inform which interventions are considered acceptable or feasible in any setting and is influenced by near term effects such as health outcomes. However, evidence on health is limited in implemented climate mitigation and adaptation policies.2 Identification of interventions for a given context may therefore rely on modelled evidence—for example, of the potential effect of carbon taxes on low income populations.4

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