A planetary health-organ system map to integrate climate change and health content into medical curricula Health professionals must be prepared to address the health risks and impacts of climate change PerspectivesCompeting interests: No relevant disclosures.

ObjectiveThe lifelong risks of cardiovascular disease following hypertensive disorders of pregnancy are well described. Awareness of these risks and associated health-seeking behaviours among affected individuals remains unclear. We aimed to assess participants’ knowledge of their cardiovascular disease risk and relevant health-seeking behaviours following a pregnancy affected by preeclampsia or gestational hypertension.MethodsWe undertook a single-site, cross-sectional cohort study. The target population included individuals who birthed at a large tertiary referral centre in Melbourne, Australia, between 2016 and 2020, and were diagnosed with gestational hypertension or pre-eclampsia. Participants completed a survey assessing pregnancy details, medical comorbidities, knowledge of future risks and health-seeking behaviours post-pregnancy.Results1526 individuals met inclusion criteria and 438 (28.6%) completed the survey. Of these, 62.6% (n=237) were unaware of their increased risk of cardiovascular disease following a hypertensive disorder of pregnancy. Participants who reported awareness of their increased risk were more likely to have annual blood pressure monitoring (54.6% vs 38.1%, p<0.01), and at least one assessment of blood cholesterol (p<0.01), blood glucose (p=0.03) and renal function (p=0.01). Participants who were aware were more likely to be taking antihypertensive medication (24.5% vs 6.6%, p<0.01) since pregnancy, compared with those who were unaware. There were no differences between groups in diet, exercise or smoking habits.ConclusionAmong our study cohort, risk awareness was associated with increased health-seeking behaviours. Participants who were aware of their increased risk of cardiovascular disease were more likely to have regular cardiovascular risk factor assessments. They were also more likely to be taking antihypertensive medication.

PurposeWithin the context of a review of a Doctor of Medicine graduate curriculum, medical students partnered with faculty staff to co-develop a novel curriculum resource exemplifying the integration of planetary determinants of health into existing medical curricula.MethodWe undertook qualitative methodologies involving a planetary health literature review and curriculum mapping exercise in three parts between April 2018 - May 2021. In part one, a student focus group sought students’ perceptions on opportunities for climate-change related teaching. Part two involved two 5-hour workshops that mapped planetary health principles to classical organ systems-based teaching areas. Part three consisted of curriculum mapping expert review.ResultsParticipatory workshops involved 26 students and positioned students as leaders and partners in curriculum development alongside academics and clinicians. Final synthesis produced a comprehensive infographic rich document covering seven organ systems plus healthcare’s ecological footprint, the role of medical students and opportunities for applied skills and behaviours.ConclusionsThe student-staff co-production method adopted here promotes higher order relational and extended abstract reasoning by students, the ultimate task of any higher education. This approach, and the open access resource generated, provides an integrated and novel planetary health framework, supporting students to be leaders for a sustainable future.Practice Points[1]This project provides a methodology to overcome barriers to curriculum-wide integration of planetary determinants of health and a template to move beyond stand-alone planetary health workshops or population health case studies.[2]Student and educator co-development of planetary health teaching and learning resources promotes higher order relational and extended abstract reasoning by students, the ultimate task of any higher education.[3]Integrating planetary health supports emerging clinicians in all areas of medicine to be leaders for a sustainable future.