That familiar spring and summer buzz seems quieter this year. Even compared to last year, there seem to be fewer bees and other flying insects in my small town-garden and the birdsong feels more reserved.

And where is all the rain? My lawn makes a dry crunch underfoot and has the brownish tinge you would expect to see in Mediterranean countries. The clover, dandelions and buttercups don’t seem as bright or prolific. When it does rain, we have extremes between rapidly evaporating droplets and torrential downpours with lightning and hailstones.

The biodiversity crisis is insidious. A lack of wildlife is harder to notice than its abundance, much like the absence of a wheeze in someone with acute asthma, which might be reassuring until you suddenly appreciate the dearth of breath sounds. British nature has been wheezing for years and it is only now as it becomes silent we are noticing how critical the situation it is. (1)

Despite the UK becoming one of the world’s most nature-depleted countries, biodiversity is often forgotten from our climate-crisis conversations. The focus is on decarbonisation, electric cars or dreams of large-scale technological carbon capture and storage. Yet it is perhaps the most important indicator for humanity’s future; our canary in our climate coalmine. We have lost 97% of our wildflower meadows since 1930, 2% of native UK species are already extinct and a further 15% are threatened or endangered, including our beloved hedgehogs. (1)

Sadly, humanity is the primary destroyer of wildlife. Our roads have carved up our landscape, restricting nature’s freedom to roam and stacking roadkill numbers into the thousands. Our ‘tidy’ gardens leave invertebrates and small mammals homeless. Many of our green and pleasant lands are barren of biodiversity, due to pesticides killing insects in their millions and monoculture plantations providing little sustenance to wildlife. Coupled with the mass-felling of city trees and swathes of roadside wildflowers mown down to a fine stubble, nature has been under a sustained attack and is at breaking point.

As doctors busy in wards, clinics and surgeries, we can easily fail to appreciate the impact our butterflies, buzzards and badgers have on our health. Therefore, campaigning for the restoration of nature might initially seem unrelated to patient care or our clinical leadership roles, particularly with numerous pressing issues facing our healthcare system. The reality, however, is that the healthier our planet is, the healthier we as humans are. A biodiverse world provides fresh water, food, shade and resilience against droughts, floods and wildfires. Ultimately, if nature dies, we die.

The positive health impacts of restoring biodiversity are wide-ranging and far reaching. For instance, those who feel closer to nature report higher levels of psychological wellbeing whilst insect diversity sustains our food production. (2) Urban forests can even reduce the surrounding land surface temperature by up to 12°C, potentially reducing some of the worst health effects of our future heatwaves. (3)

Critically, nature is our most effective carbon-capture mechanism. From wildflower fields to seagrass meadows, thousands of species intricately interact, ultimately trapping carbon in fossil fuels. Rewilding projects can accelerate this process; recently introduced beavers and bison are reshaping our landscape, restoring floodplain forests and wildflower meadows whilst reducing the impacts of drought and flooding. Reintroducing apex predators, such as the Lynx, would accelerate the rewilding process, as demonstrated by the reintroduction of wolves to Yellowstone National Park.

In April 2023 Doctors’ Association UK (DAUK) presented an open letter, signed by organisations representing hundreds of thousands of health professionals, to the Department of Health and Social Care (DHSC) calling for the Health Secretary to support the Climate and Ecology Bill. This cross-party Bill aims to reverse the biodiversity loss by 2030, setting nature on the road to recovery. It commits the UK to taking responsibility for its share of overseas emissions, including shipping and aviation, and to prioritise nature and decarbonisation in policy decision-making. (4) Whilst DAUK is not an environmental organisation, it has been leading healthcare groups in support of this legislation. Non-environmental charities such as Parkinson’s UK and Street Doctors offered support without hesitation, demonstrating anyone who cares about health and inequality could be strong, vocal allies to the environmental groups facilitating change.

Crucially, the public would assist in developing the legislative action plan through Citizens’ Assemblies, an example of powerful collective leadership. The assemblies would provide unique opportunities to regenerate areas of deprivation alongside nature, tackling poverty and the associated health inequalities. Despite this currently being the only parliamentary legislation with the power to truly tackle the biodiversity crisis, it does not have majority support in the House.  DAUK still awaits a response from the DHSC.

That being said, healthcare leadership in the climate crisis doesn’t begin with the grandeur of parliamentary presentations, it starts with a simple conversation between colleagues, friends or family. In the workplace this may become a climate and health teaching session, a patient interaction explaining the carcinogenicity of red meat or discussing lower-carbon inhaler choices. Environmentalism is no longer taboo and anyone from any profession can take that first step, ensuring no-one is left behind.

We are seeing the destruction of millions of livelihoods worldwide because of climate change, with over one billion climate refugees predicted by 2050. (5) Healthcare professionals are at the forefront of managing the injuries, illnesses and health consequences of inequality caused by the mass displacement of people and extreme weather events. Nature can limit this damage. A diverse natural world, much like a diverse workforce, creates a resilient environment in which species are more resistant to disease and external stressors, such as the changing climate. This protects humanity from zoonotic pathogens, pandemics, crop failures and extreme weather events.

A united NHS has a powerful voice. Healthcare professionals have a duty to speak for nature as we do with all who are vulnerable. There can be no doubt that, for the sake of our patients and ourselves, we must advocate and lead for our natural world, so it can be our strongest ally against the monumental challenges we face.

References:

1. Hayhow DB, Eaton MA, Stanbury AJ, Burns F, Kirby WB, Bailey N, Beckmann B, Bedford J, Boersch-Supan PH, Coomber F, Dennis EB, Dolman SJ, Dunn E, Hall J, Harrower C, Hatfield JH, Hawley J, Haysom K, Hughes J, Johns DG, Mathews F, McQuatters-Gollop A, Noble DG, Outhwaite CL, Pearce-Higgins JW, Pescott OL, Powney GD and Symes N (2019) The State of Nature 2019. The State of Nature partnership. Available at: https://nbn.org.uk/wp-content/uploads/2019/09/State-of-Nature-2019-UK-full-report.pdf
2. Pritchard A, Richardson M, Sheffield D, McEwan K. The relationship between nature connectedness and eudaimonic well-being: A meta-analysis. Journal of Happiness Studies. 2019;21(3):1145–67. doi:10.1007/s10902-019-00118-6. Available at: https://link.springer.com/article/10.1007/s10902-019-00118-6
3. Schwaab J, Meier R, Mussetti G, Seneviratne S, Bürgi C, Davin EL. The role of urban trees in reducing land surface temperatures in European cities. Nature Communications. 2021;12(1). doi:10.1038/s41467-021-26768-w. Available at: https://www.nature.com/articles/s41467-021-26768-w
4. Lee M, McDonnell A. We’re in an Environmental & Health emergency – CE bill [Internet]. https://www.zerohour.uk/health-letter/; 2023 [cited 2023 Jun 23]. Available from: https://www.zerohour.uk/health-letter/
5. Institute for Economics & Peace. Ecological Threat Register 2020: Understanding Ecological Threats, Resilience and Peace, Sydney, September 2020. Available from: http://visionofhumanity.org/reports

Author

Dr Matthew Lee

Matthew is a doctor currently working in North Wales, both clinically and in ‘Sustainable Healthcare’. He graduated from Cardiff University Medical School in 2021 and completed an intercalated BSc in Medical Education during his time there. Matthew has always had a passion for nature and the outdoors, joining his University’s Wilderness and Expedition Medicine Society. Through his interest in the natural world, he became more aware of the critical state of the planet and the effects of the climate crisis on human health.

He joined the Doctors’ Association UK (DAUK) committee in 2021 and became the organisation’s Sustainability Lead in 2022, aiming to use the voice of health professionals to raise awareness of the impact of climate change on the NHS. He has since represented DAUK at the Planetary Health Hub at Extinction Rebellion’s non-disruptive protests in April, and has attended Parliament to discuss the Climate and Ecology Bill with cross-party MPs.

He aims to combine his love of nature with clinical work in the future, working to promote both planetary and human health. In his spare time he enjoys a variety of outdoor activities, playing squash and joining his local brass band on the bandstand playing the trombone

Declaration of interests

I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: Committee member of the Doctor’s Association UK. I do not believe I have any personal of financial conflicts of interest.