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Blog 5 May 2021

How to win over health care professionals as champions for clean air

Healthcare professionals are vital in the fight against air pollution, but how do we encourage them to become clean air champions? Our new research, in partnership with Quantum and AHA outlines how healthcare professionals in Bangladesh, the UK, India, Ethiopia and Mexico perceive air pollution, and both barriers and opportunities to action.
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Air pollution is as much a health issue as it is an environmental issue. Air pollution impacts children’s lung and brain development, and it gives us respiratory illnesses. 90% of the people around the world breathe unhealthy air – and many communities live in acute air pollution areas close to major roadways, and industries. It is estimated that globally 7 million people lose their lives annually as a result of breathing unhealthy air – and millions more face long term health impacts.

In order for air pollution to get the attention in the public health discourse as it should, the role of health care professionals (HCPs) is crucial. HCPs of all levels, doctors, nurses, community health workers, can take greater action in advising their patients, pushing a clean air narrative in the countries they live in, as well as creating urgency for governments to take action.

To understand what motivates HCPs to take action and what barriers they face, the Clean Air Fund, in partnership with Quantum and Wellcome, embarked upon a five-country research to understand three key things:

  1. How do key health communities perceive air pollution?
  2. What kinds of communications and strategies would encourage them to act on the issue?
  3. What stops them from acting on air pollution today?

The research looked at the UK, India, Mexico, Bangladesh and Ethiopia to dig into what strategies air quality field could employ to mobilise HCPs to take on a greater role in addressing air pollution.

Our findings have given us insights that have the potential to spur greater participation from the health communities in these five countries – and learnings that can also be replicated in other geographies. For example, we found that a majority of the HCPs interviewed believe that they have the ability to influence across several spheres. 60% of HCPs in India and over 80% in Mexico believe they have influence over national governments’ health policies. In Bangladesh 91% of the HCPs have taken action on public health issues already and in India 92% of the HCPs have personally seen the impact of air pollution, with many observing health consequences on patients too. And crucially, in all the countries we looked at, HCPs themselves agree that they have the ability to do more on air pollution.

So what is stopping the health sector from increasing their action on air pollution?

Our research found a number of challenges faced by the health community in all of the countries. In particular, a country’s health culture  and  perceptions around air pollution stack up the challenges.

For example, in the UK where, despite understanding that bad air quality is a public health issue, only half of HCPs have advocated for clean air, taking a stand against air pollution is seen as a “left-wing” action by HCPs. Here, the cultural barriers for taking action hinder greater engagement by HCPs. Similarly in India, 71% of the HCPs we interviewed have advised their patients to mitigate air pollution impacts but have not engaged with policy or public health officials or in campaigns on air pollution. This may be due to a lack of prioritization, in some cases lack of access to information on long term impacts of air pollution, and the cultural barriers that promote beliefs that air pollution is an environmental issue.

In Mexico, the health system is under a lot of pressure already, and HCPs in the country do not have access to information on air pollution and health impacts, which restricts them from engaging more deeply on the issue with their patients and for public health interests. Similarly in Ethiopia, HCPs aren’t able to do more on air pollution due to a lack of information and other pressing health issues in the country. This is despite 57% of the HCPs interviewed recognizing air pollution as a key contributor to health issues in their patients.

How can the air quality movement engage HCPs in their cause then?

In light of these challenges, our research has identified opportunities to engage HCPs – these opportunities lie in recognizing where the motivation for action could be. We also analyzed what factors are in play when HCPs do act on air pollution and found that when HCPs have high levels of Agency and Issue Motivation they are more likely to act on an issue. Agency allows HCPs to feel empowered to take action and Issue Motivation describes when air quality is seen as a high priority (health) issue, both professionally and personally.

Doctor looks at x-ray of lungs.

These are two cues that the air quality field can take whilst building strategies to mobilize the health sector. To increase the agency for HCPs to act we must ensure air pollution remains prominent issue in the culture. This might be done through sustained media attention, and the highlighting and celebration of HCPs taking action.

In order to increase issue motivation, the clean air actors engaged in communications and campaigns have a greater role to play. Issue motivation requires tactics that humanise the impact of air pollution, ensure HCPs have access to credible data, facilitate connections between HCPs active on air quality and amplify their actions so they are celebrated as an example for others to follow. By using communications, we can provide tools and guidelines on how HCPs can take small and big actions and influence the broader public health discourse in their countries. Ultimately, the tools highlighted in the research have the potential to increase the power and influence of health care professionals to become strong leaders and advocates in clean air movements in their countries and globally.

You can read the summary report and country-specific insights here.