A progress report on planetary health, environmental and sustainability education in physiotherapy – Editorial

We live in a world in which global warming, pollution, social injustice, inequity and population health fundamentally influence each other. As a result, health and health care can no longer be thought of and practiced in an isolated manner. All healthcare professions must educate their current and future colleagues with the necessary understanding and skills to develop and implement integrated responses to today’s inseparable social, environmental and health crises, and achieve the UN Agenda 2030 Sustainable Development Goals (SDGs) [1].

On 2nd March 2020, the Environmental Physiotherapy Agenda 2023 (EPT Agenda 2023) was launched as a global call to action urging physiotherapy (PT) education institutions to integrate planetary health, environmental and sustainability perspectives into their entry-level programs. To inspire the global PT profession to swiftly advance this urgent new imperative and lay a robust foundation for its further development, the EPT Agenda 2023 is also: a collaborative project aimed at developing and sharing emerging knowledge and experiences on relevant competencies, learning outcomes, content, methods, obstacles and solutions with the international PT profession [2].

Launched in a moment when COVID-19 had just reached its pandemic scale, the EPT Agenda 2023 appeared to slow in its tracks as energies rightfully concentrated on responding and adjusting to the pandemic across the globe, and within PT education programs. Fundamentally caused by humanity’s inadequate relationships with each other and our planet [3], however, the COVID-19 pandemic also provided further impetus to the imperative to integrate planetary health, environmental and sustainability perspectives into global PT education. It is encouraging that many have persisted through the difficulties presented by the ongoing pandemic and made notable progress towards the aims of the EPT Agenda 2023.

At the time of writing, over 300 people and 25 international healthcare organisations have signed the EPT Agenda 2023 to express and extend their support. In addition, over 26 PT educational institutions have formally joined the EPT Agenda 2023 as participating institutions, reaching across Africa, Oceania, Europe, Asia and the Americas. Supporting organisations include several student organisations, national professional associations from Sweden, Germany, New Zealand, Ireland and the USA, major interdisciplinary groups in Eco-Health and planetary health, and many more. While conversations with many more looking to join the project are ongoing, this collaborative effort and support clearly evidence existing recognition of the need for action and the extensive efforts already being made.

During quarterly meetings, representatives from participating institutions have discussed diverse ideas and approaches as they begin to integrate planetary health, environmental and sustainability elements into modules across their respective programs. Both by staying within and challenging existing competencies and learning outcomes frameworks these are some tangible changes being made:

• Global and public health modules are being adapted to integrate indigenous knowledge on and approaches to planetary health, the role of the natural environment in health and how these tie in with problems of colonialism, social justice and health equity.

• Outdoor exercise and greenspace exposure are being included in lifestyle health, exercise and activity prescription modules; experiential and theoretical approaches to learning about the links between environment, corporeality, social determinants of health and citizenship are being implemented on campus and via community visits.

• Reductions of the environmental footprint of clinical education environments, promotion of sustainable practice and environmental awareness are being trialled in clinical situations and passed on to students as key elements of professional practice.

• Pulmonary PT education increasingly includes teaching about air pollution and its significant toll on chronic obstructive pulmonary diseases and asthma; and climate change, its contribution to today’s migrant crisis, and relevant PT provision are being discussed with students, alongside the exploration of PTs other possible contributions to achieving the SDGs.

Though it is the largest international effort in international physiotherapy to date, the EPT Agenda 2023 and this exemplary list of educational initiatives do not capture all relevant developments in this field. Some PT programs that are not (yet) actively participating in the EPT Agenda 2023 are already engaging with diverse approaches to integrating the SDGs into their programs. Across the global healthcare professions, ever more healthcare professions are joining in these efforts as planetary health education frameworks and relevant evidence blossom [4,5]. Many students and individual educators in physiotherapy and other healthcare professions are integrating diverse relevant elements into their own learning and teaching and so advancing this urgent field and driving change from the bottom up.

Much is happening, yet so much more remains to be done. The complexity of today’s social, environmental, and health crises requires that we put outdated practices of siloed professional and academic leadership and competition, develop new ways to think and practice physiotherapy and increase our efforts to share and collaborate across any boundaries. Based on current positive efforts, we are hopeful and excited to see the global PT community continue to expand its involvement in meeting the largest health opportunities of the twenty-first century.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.