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OpinionJan 17, 2024

Why should physiotherapists act on the climate and nature crisis and what should they do?

Most physiotherapists know about the seriousness of the climate and nature crisis and some have taken actions, perhaps reducing the amount of meat they eat. But most have not acted. Physiotherapists are by no means alone: most people know about the crisis, but most have not taken any action. I, for example, have known about the crisis since the early 1990s but did nothing apart from write about it (which is not action) until about four years ago when I became the chair of the UK Health Alliance on Climate Change (UKHACC).

Simon Kuper, the Financial Times journalist, described the commonest form of ’climate denial’ in a recent column [subscription needed]: ‘I was chatting with my teenage daughter the other day when she mentioned climate change. Inevitably, it causes her anxiety. She will probably live to see many coastal cities go under, countries become too hot to inhabit and rich havens shut out climate refugees. My instinctive response was to change the subject. I was exhibiting the new, mainstream form of climate denial: a refusal to think about climate change because it’s too painful.’

Physiotherapists know about pain and that exercise is often the best response to pain. Similarly, action is the best response to mental pain and we know that action begets action as well as better mental health.

Photo Credit: I A McMillan
No fly zone: a single return flight will make up most of our annual carbon footprints

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Health services are 'part of the problem'

The main reason why physiotherapists should take action on climate change is because it’s the major threat to global health, as the World Health Organization has declared. The crisis is harming health now through air pollution, heatwaves, wildfires, floods, droughts, extreme storms, extension of the range of infectious diseases, forced migration, and harm to mental health, particularly among the young who see their future taken away. Importantly, the poor and marginalised are the ones who suffer the most. All of these harms from the crisis are set to become exponentially worse if we cannot drastically reduce our emissions of greenhouse gases and stop destroying nature – neither of which we have managed to do so far.

Probably the best reason for physiotherapists to take action on the climate and nature crisis is that they can make a difference. Mounting a serious response to the crisis will require change at every level 

If we cannot respond adequately, the biggest harm to health will come from shortages of water, food, habitable land and shelter, and will result in conflict as people fight for those diminishing resources.

Another reason for physiotherapists to take action on the crisis is that health services are part of the problem as well as the solution. If health services were a country, they would be the fifth biggest emitter of greenhouse gases, and they are a huge source of waste with their culture of disposable equipment, much of it plastic.

Probably the best reason for physiotherapists to take action on the climate and nature crisis is that they can make a difference. Mounting a serious response to the crisis will require change at every level: global, national, regional, within the health system – professionally and personally. Without global change, personal change cannot make a difference – but personal change is the easiest to achieve.

What is the 'good news'?

The good news, something that health professionals need to emphasise, is that the personal changes we need to make for the planet are good for us as individuals. Walking and cycling more and driving less are good for almost every system in or body, as physiotherapists know. Similarly eating more plant-based and less animal-based foods reduces our chances of developing cardiovascular systems, diabetes and cancer. Visiting green spaces regularly benefits our mental health and can reduce the need for pharmaceutical treatments.

As individuals we can also stop flying (a single return flight will make up the most of our annual carbon footprint), turn down the heating at home, abandon wood-burning stoves (which are terrible for air pollution), buy less and repair more, and change to a climate-friendly bank. It’s a small step from these actions to more political acts like writing to an MP or local council, joining an organisation like Friends of the Earth, going on a march (always an uplifting experience), and committing to voting primarily on how serious parties and candidates are about countering the climate and nature crisis.

We at the UKHACC hope that the Chartered Society of Physiotherapy will join the Alliance, which currently has 46 member organisations representing nurses, paramedics, pharmacists, dentists, vets, doctors and others

Call to action

In their professional role physiotherapists need to contribute to the UK’s ‘four NHSs’ reaching carbon net zero (meaning that whatever carbon the NHS does produce will be offset in some way). The NHSs are committed to getting to net zero by 2040-2045, which will mean big changes in clinical practice. The best people to get clinical practice to net-zero are clinicians themselves, and some groups – for example, surgical teams and mental health professionals – have made a start. Physiotherapists must be part of these programmes of work.

An adequate response to the climate and nature crisis will come only with global and national action, and politicians have been reluctant to make the changes necessary. It will be easier for politicians to act once the electorate demands they do so. We at the UKHACC hope that the Chartered Society of Physiotherapy will join the Alliance, which currently has 46 member organisations representing nurses, paramedics, pharmacists, dentists, vets, doctors and others. Our members’ members number over a million – most of the NHS workforce. We work to mitigate the effects of climate change, promote adaptation, and explain the benefits to health of the actions we need to take. We look forward to working with physiotherapists.

Richard Smith is chair of the UK Health Alliance on Climate Change and was editor of the BMJ from 1991-2004.

 To follow UKHACC on X (formerly Twitter): @UKHealthClimate

Author: Richard Smith
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