This definition is intentionally broad, intended to encompass the multitude of ways that the environment can affect health, including climate change, pollution, biodiversity shifts, reconfiguration of biogeochemical cycles, land use changes, and resource scarcity, with health consequences including expanding ranges of vector-borne diseases, mental illness, and excessive mortality due to heat and air pollution. The World Health Organization states that climate change is “the greatest threat to global health in the 21st century,” and now attributes almost a quarter of deaths and global disease burden to environmental degradation. Paradoxically, healthcare delivery has an adverse impact on the environment, and therefore health. If the healthcare system were a country, it would be the fifth largest carbon emitter in the world.

As future health professionals, we must be prepared to address the impacts of human-caused environmental changes on our patients’ health, and to understand and mitigate the environmental impact of clinical care. It is imperative that we hold our institutions accountable for educating health students on planetary health and education for sustainable healthcare, generating research to better understand health impacts and solutions, supporting related student initiatives, embracing sustainable practices on our campuses and in our hospitals, and engaging with surrounding communities that are most affected by environmental threats. Because climate change and environmental threats disproportionately affect marginalized populations, these issues are inherently ones of equity and justice. 

With the purpose of increasing planetary health awareness and accountability among medical schools, the Planetary Health Report Card (PHRC) was developed as an institutional advocacy tool in 2019 by a group of medical students at the University of California, San Francisco School of Medicine. The PHRC is a student-driven metric-based tool that aims to evaluate health professional schools on discrete metrics in five main category areas: 1) Curriculum, 2) Interdisciplinary research in health and environment, 3) Community outreach and advocacy 4) Support for student-led initiatives and 5) Campus sustainability. Since its founding just three years ago, the PHRC community has grown to encompass 15 countries and over 105 medical schools. As it has spread across the world, it has left many examples of institutional change in its wake. Though initially developed by medical students to evaluate medical schools, the report card is now being adapted for and piloted in nursing and pharmacy training programs, catalyzing interprofessional collaboration.