Connecting planetary boundaries and planetary health: A resilient and stable earth system is crucial for human health
The Lancet comment argues that integrating planetary boundaries and planetary health frameworks is essential to protect human health. It outlines health risks from Earth system destabilisation, stresses justice and equity, and calls for coordinated research, policy alignment, and improved monitoring and communication.
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OVERVIEW
Connecting planetary boundaries and planetary health: A resilient and stable earth system is crucial for human health
The report examines the relationship between the planetary boundaries framework and planetary health, arguing that closer integration is required to better assess and manage risks to human health. Planetary boundaries define safe operating limits for nine Earth system processes. Six of these boundaries have already been transgressed, with trends indicating further deterioration. The authors link these transgressions to growing risks for population health and wellbeing globally.
Destabilising the earth system threatens human health
The report finds strong evidence that changes across all planetary boundaries affect human health, including impacts on non-communicable diseases, infectious diseases, nutrition, maternal and child health, and mental health. Health impacts can occur even before boundaries are exceeded, while crossing them may trigger irreversible tipping points that amplify risks. Although the total disease burden has not been comprehensively quantified, existing evidence suggests substantial global impacts over coming decades.
The authors propose systematic health risk assessments for each planetary boundary, including assessments of tipping elements. They recommend creating a regularly updated monitoring dashboard that links Earth system change with health outcomes and aligns with annual planetary boundary assessments. Addressing methodological gaps between Earth system science and environmental epidemiology is identified as a priority.
Justice is central for safeguarding health within planetary boundaries
Health impacts from Earth system change disproportionately affect future generations, Indigenous peoples, low-income regions, and marginalised groups, despite these populations contributing least to environmental degradation. The report highlights the need to ensure universal access to essential resources such as food and water without increasing pressure on Earth systems, alongside addressing overconsumption in high-income contexts.
The authors reference the “safe and just Earth system boundaries” framework, which adjusts boundary thresholds to avoid severe or irreversible harm to communities and individuals. Earth system justice is presented as a normative foundation, incorporating intergenerational, intragenerational, and interspecies equity. Policy responses should ensure that both benefits and burdens of environmental action are distributed fairly.
The true benefits and costs of policies should be considered
The report argues that environmental policies often underestimate health benefits and fail to account for the health costs of ecosystem degradation. Integrated assessment across planetary boundaries and planetary health would allow better internalisation of health impacts historically excluded from economic decision-making.
Examples cited include renewable energy systems, which reduce CO₂ emissions while lowering air pollution linked to an estimated 5.1 million excess deaths annually, and peatland restoration in Indonesia, which delivers climate and health benefits by reducing fire-related emissions. Active transport and plant-forward diets are highlighted as interventions with dual environmental and health benefits. The authors note that transforming the global food system would cost substantially less than the hidden health and environmental costs of the current system.
A “planetary health in all policies” approach is recommended to improve policy coherence, manage trade-offs, and align environmental, health, and socioeconomic objectives, including the Sustainable Development Goals. Broader economic indicators beyond GDP, such as wellbeing-based measures, are encouraged.
Integrated science communication to enable transformative change
The report concludes that coordinated communication between planetary boundaries and planetary health communities is necessary to build public and political support for structural change across food, energy, health, and urban systems. Messaging should centre health and justice as core rationales for environmental action.
The authors stress transparency, open access, and long-term funding for a combined monitoring dashboard linking Earth system change and health impacts. Engagement with Indigenous knowledge systems, the arts, and humanities is encouraged to reinforce understanding of human–nature interdependence and counter misinformation.