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Integrating Planetary Health in Health Guidelines (GRADE Guidance 46)

Urheber*innen

Piggott,  Thomas
External Organizations;

Saadat,  Pakeezah
External Organizations;

Herrmann,  Alina
External Organizations;

Tetelbom Stein,  Airton
External Organizations;

Darzi,  Andrea J.
External Organizations;

Haines,  Andy
External Organizations;

Bognanni,  Antonio
External Organizations;

Sousa-Pinto,  Bernardo
External Organizations;

Michels,  Charlotte
External Organizations;

Akl,  Elie A.
External Organizations;

Poluzzi,  Elisabetta
External Organizations;

Senerth,  Emily
External Organizations;

Madrid,  Eva
External Organizations;

Barbic,  Franca
External Organizations;

de’Donato,  Francesca
External Organizations;

Nonino,  Francesco
External Organizations;

Vist,  Gunn Elisabeth
External Organizations;

Neumann,  Ignacio
External Organizations;

Bracchiglione,  Javier
External Organizations;

Bousquet,  Jean
External Organizations;

Meerpohl,  Joerg J.
External Organizations;

Antó,  Josep M.
External Organizations;

Scahill,  Karolina A.
External Organizations;

Qiu,  Kavin
External Organizations;

Miersch,  Klaas
External Organizations;

Saif-Ur-Rahman,  KM
External Organizations;

Vasanthan Thinagaran,  Lenny
External Organizations;

Benton,  Lorna
External Organizations;

Schwingshackl,  Lukas
External Organizations;

Siedler,  Madelin R.
External Organizations;

Bala,  Malgorzata M.
External Organizations;

/persons/resource/maria-inti.metzendorf

Metzendorf,  Maria-Inti
Potsdam Institute for Climate Impact Research;

Aloosh,  Mehdi
External Organizations;

Cinquini,  Michela
External Organizations;

Cumpston,  Miranda
External Organizations;

Skoetz,  Nicole
External Organizations;

Oloyede,  Oyekola
External Organizations;

Alonso-Coello,  Pablo
External Organizations;

Dahm,  Philipp
External Organizations;

Wang,  Qi
External Organizations;

Vieira,  Rafael José
External Organizations;

Morgan,  Rebecca L.
External Organizations;

Murthy,  Srinivas
External Organizations;

Hofstede,  Stefanie
External Organizations;

Laot-Cabon,  Sylvie
External Organizations;

Thomander,  Tuuli
External Organizations;

Siebert,  Uwe
External Organizations;

Leontiadis,  Grigorios I.
External Organizations;

Schünemann,  Holger
External Organizations;

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Zitation

Piggott, T., Saadat, P., Herrmann, A., Tetelbom Stein, A., Darzi, A. J., Haines, A., Bognanni, A., Sousa-Pinto, B., Michels, C., Akl, E. A., Poluzzi, E., Senerth, E., Madrid, E., Barbic, F., de’Donato, F., Nonino, F., Vist, G. E., Neumann, I., Bracchiglione, J., Bousquet, J., Meerpohl, J. J., Antó, J. M., Scahill, K. A., Qiu, K., Miersch, K., Saif-Ur-Rahman, K., Vasanthan Thinagaran, L., Benton, L., Schwingshackl, L., Siedler, M. R., Bala, M. M., Metzendorf, M.-I., Aloosh, M., Cinquini, M., Cumpston, M., Skoetz, N., Oloyede, O., Alonso-Coello, P., Dahm, P., Wang, Q., Vieira, R. J., Morgan, R. L., Murthy, S., Hofstede, S., Laot-Cabon, S., Thomander, T., Siebert, U., Leontiadis, G. I., Schünemann, H. (2026 online): Integrating Planetary Health in Health Guidelines (GRADE Guidance 46). - Annals of Internal Medicine.
https://doi.org/10.7326/ANNALS-25-04761


Zitierlink: https://publications.pik-potsdam.de/pubman/item/item_34491
Zusammenfassung
Human health and natural systems are intrinsically linked—stable natural systems enable healthy human life. Health systems aim to promote, restore, and maintain health. Health systems may promote human health while having detrimental effects on natural systems, contributing to the transgression of planetary boundaries, such as biosphere integrity, climate change, and the introduction of new entities like microplastics. To date, the health guideline field lacks methods to assess the impacts of health interventions on planetary boundaries. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group established the Planetary Health Project Group in 2023 to develop formal GRADE guidance for integrating planetary health into guideline recommendations to address this gap.
Guided by the concepts of planetary health and planetary boundaries and following established methods for GRADE guidance development, the project group conducted iterative case study analyses, expert workshops, and a 2-round global Delphi consensus process. Four case studies were selected for application of this guidance before recommendations were finalized. The GRADE Working Group approved the official guidance.
The Planetary Health Project Group presents 7 domains of guidance for incorporating planetary health aspects into the guideline development process, including highly desirable items and optional items. Highly desirable items include formally addressing planetary health in public health and health system guidelines and explicitly justifying its exclusion where it is not addressed. Judgments within the evidence-to-decision (EtD) framework should systematically integrate included evidence across the prioritized planetary boundaries and equity. This guidance aims to support guideline developers and policymakers in making evidence-based, trustworthy recommendations to protect individual and planetary health, while maintaining thoroughness and feasibility for guideline developers within the GRADE approach.