Refocusing Our Science on the Planetary Health Crisis and Sustainable Cancer Care

Few nurse scientists today feel adequately prepared to respond to the planetary health crisis. Experts from nursing and other disciplines who specialize in this domain frequently share a key truth. Science relevant to this unprecedented crisis is evolving so rapidly that we are all now students of it, pacing ourselves to keep up and comparing notes with each other. Knowing that pinning down the state of the science is difficult helps build our confidence. But answering the question “What can I do in my program of science right now?” remains elusive. I’ve got some ideas and examples to help—my 6 R’s of our response to the planetary health crisis.

First, (re)educate. Doing research typically ties back to our love of learning. There’s no better time to learn about the planetary health crisis. The Planetary Health Alliance (https://www.planetaryhealthalliance.org/ph-education-materials), Climate Resources for Health Education (https://climatehealthed.org), Lancet Countdown (https://www.lancetcountdown.org), and the Alliance of Nurses for Healthy Environments (https://envirn.org) are good places to start. Sustainable healthcare is integral to an effective response to this crisis. Practice Greenhealth (https://practicegreenhealth.org) and Health Care Without Harm (https://noharm-global.org) offer terrific resources for scientists and clinicians alike. You’ll soon see that developing sustainable cancer care is part of how our science can address the planetary health crisis.

Second, reframe. Everything occurs in an environment even if we call it setting or context. Look at environment in your research. Are you a health services researcher looking at reducing overuse of acute cancer care, for example? That means you are already doing sustainable healthcare research. Acute care is the sector with the largest carbon impact and greatest waste. Reducing waste in and reliance on acute care positively influences planetary health. Consider including carbon impact and waste lifecycle analysis as you advance your program of research.

Third, (re)connect. We’ve long acknowledged that science relies on teams. Take time to connect or reconnect with colleagues whose science is complementary to yours to explore addressing aspects of the planetary health crisis together. For example, consider collaborating with experts in design and communication in developing virtual cancer nursing. Or explore collaborating with climate scientists and bioengineers to redesign treatment administration to reduce plastic waste while improving patient experience.

Fourth, (re)engage. Return to the people who are the focus of your research. Engage or reengage with your participants and members of your population of interest to gain their perspectives on the planetary health crisis and sustainable healthcare. Undoubtedly, you will learn that they too are concerned about the planet and worry about their cancer and healthcare in that context. Whether or not you use community-based participatory research, seeking out patient and community representatives or creating advisory boards will strengthen how you address the planetary health crisis and support development of sustainable cancer care.

Fifth, reevaluate. The planetary health crisis and sustainable healthcare touch all that we study in distinctive ways. Take time to review your phenomena of interest to identify specific influences. For example, cancer nursing research has a strong tradition of studying the experience of loss and grief. Today, everyone on the planet endures a daily experience of loss and grief, often termed eco-grief. News and social media surround us with information about what we are losing in biodiversity, safety, and health. Loss and grief from cancer are then overlaid on that baseline. We need to examine the interaction of eco-grief with that arising in the experience of living with and after cancer.

Finally, reflect. Realigning our programs of research is not easy, but returning to what anchors us will help. The excitement of discovery and our joy in learning have sustained each of us in difficult moments. Finding community and the solace of fellowship have carried us forward when scientific success temporarily eluded us. Such experiences can inform our next steps.

Inaction is antithetical to good science. Avoiding the planetary health crisis in our science is akin to thinking about cancer treatment without acknowledging precision therapeutics. Believing that we cannot redirect our science to respond to the planetary crisis and to help develop more sustainable cancer care depletes us and undermines the strength of our science. Remembering why we love science and value being part of our international communities of scientists and nurses allows us to recenter the promise and the power of our science. Through that science, we must help support development of sustainable cancer care and healthcare and make our planet resilient. Everyone, especially those living with and after cancer, is counting on us.

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