Evidence-Based Findings: Occupational Therapy & Climate Change

1. Foundational Theory & Occupational Science

The foundational evidence for our mission rests on the understanding that human occupation and the ecological environment share an inseparable connection, where human activity is crucial for replenishing the balance between people and the ecosystem. Research introduces the concept of the "occupational cycle" to explain how daily occupations transform ecosystem services into human health and well-being. However, many modern human occupations are currently impacting the planet to such an extent that they are reducing the environment's ability to support that very well-being.

To address this, scholars propose expanding the occupational therapy paradigm to incorporate a global perspective where "doing ecology" is recognized as a vital occupation that fosters a more sustainable planet. This transition toward "eco-social occupational therapy" connects ecology with occupational justice. It utilizes "ecopation"—the practice of a doer accounting for the environment—as a means to promote well-being at both the individual and population levels. Ultimately, by integrating sustainable development into its core paradigm, the profession can better address global well-being needs through daily "doing" that connects sustainability, glocalisation, and health.

2. Addressing Climate Change in Clinical Practice

The literature demonstrates that climate change is a clinical reality that can result in occupational deprivation, psychometric illness, and a direct threat to the participation in meaningful leisure occupations like gardening. Research specifically identifies that older adults must adapt their daily occupations during heat waves, supporting a clear role for occupational therapists in designing interventions and heat-adaptive strategies to manage the impact of extreme weather.

To address these challenges, clinical models such as "Modified Instrumentalism in Occupational Therapy" (MIOT) have proven effective in facilitating positive changes in occupational performance patterns, helping clients move from feelings of frustration and helplessness to empowerment through action. Furthermore, the evidence highlights "Environmentally Informed Occupational Therapy" (EIOT) and "Lifestyle Redesign" as effective approaches for linking sustainability with human health across various age groups.

In the realm of mental health, eco-social entrepreneurship models—such as community horticulture programs—offer adaptable, nature-based solutions that promote social and employment inclusion by focusing on a person’s capacities within their natural context. Ultimately, by framing climate change from a health perspective, practitioners can support global efforts to combat lifestyle diseases and environmental degradation through the promotion of sustainable, community-based occupations.

3. OTPs’ Ethical Responsibility: Advocacy for Environmental Justice

The evidence base for environmental action is deeply rooted in an ethical framework of intergenerational justice, which posits that the ability of future generations to exercise their occupational rights is directly dependent on the occupational duties we fulfill today. Scholars argue that the profession must transition from a consumerist, profit-driven health model toward a collectivist and altruistic vision of humanity to ensure true occupational justice.

Central to this transition is the concept of "occupational stewardship," which builds robust connections and systems that foster resilience during natural disasters and ecological stress. While research shows that practitioners feel an ethical obligation to use professional reasoning to create a sustainable future, significant institutional and political-economic barriers, such as neoliberalism and profit-maximizing health systems, often hinder these efforts.

Therefore, there is an urgent call for the profession to engage in political advocacy on both micro and macro levels, addressing the structural barriers that produce inequities for marginalized populations who are at the greatest risk of environmental disruption. By framing the occupational therapy practitioner as an essential stakeholder in planetary health, the literature reinforces that environmental degradation is not just an ecological issue, but a direct threat to health, well-being, and quality of life.

4. Education & Professional Development

Current research identifies an urgent need to incorporate concepts of sustainability, social equity, and environmental integrity into occupational therapy education and models of practice. Integrating sustainability into medical and our profession’s curricula is highlighted as a crucial step for reducing healthcare waste and greenhouse gas emissions, while humanistic principles help transform students into change agents.

The literature suggests that students can learn vital clinical reasoning skills through graded strategies that include "bidirectional questioning" to examine the ecological impacts of traditional, individual-centered care. Furthermore, environmental education is described as a powerful tool for training students with high ecological awareness, enhancing their understanding of eco-social occupational therapy and occupational ecology. Additionally, the United Nations Sustainable Development Goals provide essential targets that link the profession with a global interdisciplinary community, and evidence shows these goals are becoming increasingly visible within university curricula. By providing students with these "doing" skills and transferable advocacy strategies, the profession can effectively translate planetary health awareness into practical, clinical action.

Conclusion

What is good for the environment is good for human health. As vital stakeholders in the climate crisis, OTPs must lead the way in transitioning our daily occupations toward a more just and sustainable world.

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