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Planetary Health in Health Guidelines and Health...
Journal article

Planetary Health in Health Guidelines and Health Technology Assessments: A Scoping Review

Abstract

ABSTRACT Introduction Individual human health is inextricably linked to planetary health, which refers to the health of human civilization and the natural systems on which it depends. These systems are captured by the nine planetary boundaries which together define a safe operating space for humanity. The health sector contributes to the transgression of these boundaries, thereby jeopardizing both individual and planetary health. However, there is a growing interest in the health sector in incorporating the preservation of planetary boundaries into health guidelines and health technology assessments (HTAs), which synthesize evidence and guide healthcare decisions. Methods This scoping review aims to describe methodological guidance and considerations for incorporating planetary health in health guidelines and HTAs. We conducted a scoping review adhering to the JBI methodology including articles from several databases since inception until September 2023. We used narrative synthesis and descriptive statistics to describe eligible studies. Results Of the 38 included studies, 14 (37%) were commentaries, six (16%) were methodological papers, and four (10·5%) were health guidelines. Included studies focused primarily on greenhouse gas emissions as an outcome. The included health guidelines were rated at a median of 52% (range: 16% to 67%) on AGREE II for methodological quality. Discussion Key findings pertain to the normative significance of planetary health in guidelines and HTAs, scope and quality of included studies, inconsistencies in methods, and challenges in implementation. These findings will inform future Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) guidance on planetary health. Registration A protocol of this scoping review was registered in Open Science Framework ( https://osf.io/3jmsa ) and published in the journal Systematic Reviews (10.1186/s13643‐024‐02577‐2). Summary Planetary Health is rarely integrated into health guidelines and HTAs; only four guidelines and no HTAs explicitly considered it during the guideline development process. Existing work focuses entirely on GHG emissions, with limited attention paid to other planetary boundary outcomes, such as pollution, freshwater change, and biodiversity. Methodological approaches are inconsistent; only one guideline used GRADE, and guideline panels rarely included planetary health or related field experts. There is an urgent need for standardized frameworks and guidance to systematically incorporate planetary health into future guidelines and HTAs.

Authors

Saadat P; Raja M; Darzi AJ; Michels CTJ; Herrmann A; Scahill KA; Jewell LM; Saif‐Ur‐Rahman KM; Napierala H; Heuer R

Journal

Clinical and Public Health Guidelines, Vol. 3, No. 1,

Publisher

Wiley

Publication Date

January 1, 2026

DOI

10.1002/gin2.70056

ISSN

2836-3973

Labels

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