Although there was an effort to include diverse voices at the 2021 UN Climate Change Conference (COP26), many youths’ pleas for ambitious climate action were not met in the updated commitments, highlighting the reality that time at the podium does not necessarily influence the key policy and finance decisions that shape our climate-dependent future. Many of today's youth are already experiencing the worst impacts of our destabilising climate. Over half of the world's youth population live in countries that are deemed extremely high risk for climate disasters,1UNICEFThe climate crisis is a child rights crisis: introducing the children's climate risk index.http://data.unicef.org/resources/childrens-climate-risk-index-report/Date: 2021Date accessed: December 8, 2021Google Scholar and the mental health of countless more young people has been impacted by climate instability.2Marks E Hickman C Pihkala P et al.Young peoples voices on climate anxiety, government betrayal and moral injury: a global phenomenon.SSRN. 2021; (published online Sept 7.) (preprint).http://dx.doi.org/10.2139/ssrn.3918955Google Scholar Given the considerable stake and tenacity that young people have in addressing climate change, it is essential to platform their voices in high-level decision making. Youth activists, such as Greta Thunberg, have mobilised and demanded accelerated climate action from their leaders. Other young people have passionately taken to policy, technology, the arts, and advocacy as their tools for action. Vinisha Umashankar, the 15-year-old Indian student and entrepreneur who invented a solar-powered ironing cart to replace the charcoal-powered versions that are commonplace in India, addressed world leaders at COP26, saying, “we [the youth] will lead if you don’t”. However, despite being capable changemakers, youths face structural and institutional barriers to participating in the decision making processes that shape climate action. Reflecting on the successes of existing youth engagement approaches,3UNYouth2030: progress report 2021.http://www.unyouth2030.com/progressreportDate: 2021Date accessed: December 8, 2021Google Scholar we propose a four-pronged strategy—consisting of integration, education, climate health storytelling, and investment—by which governments, organisations, and the planetary health movement can champion youth leaders and foster intergenerational climate health leadership (figure). First, the strategic and meaningful integration of youth voices must become a pillar of planetary health. The mechanisms to achieve integration include: (1) consulting existing youth advocates, (2) developing longitudinal relationships with youth-led networks, (3) providing visibility to youth engagement initiatives, and (4) ensuring accountability for engaging young people.4Zeinali Z Bulc B Lal A et al.A roadmap for intergenerational leadership in planetary health.Lancet Planet Health. 2020; 4: e306-e308Summary Full Text Full Text PDF PubMed Scopus (7) Google Scholar An example of an effective model is YOUNGO: the children and youth constituency of the UN Framework Convention on Climate Change. This constituency forms a global network of youth activists ensuring that youth perspectives are included in decision making. In addition, the 2021 UN International Youth Day event on Aug 12, 2021, provided a platform for youth to engage in the theme of transforming food systems ahead of the food systems summit on Sept 23, 2021.5Sellars E Pavarini G Michelson D Creswell C Fazel M Young people's advisory groups in health research: scoping review and mapping of practices.Arch Dis Child. 2021; 106: 698-704Crossref PubMed Scopus (11) Google Scholar Youth collaboration with health institutions is essential. The Rhode Island Department of Health's Youth Advisory Council and the California Endowment are organisations that encourage youth to advise on multiple issues. Youth involvement within these organisations has allowed for the creation of policy and programmes that target the intersectionality of the climate crisis and public health. A comprehensive review of health studies found that, of 420 studies collecting data from youth (aged 18–24 years), just 21 incorporated youth in the research process.5Sellars E Pavarini G Michelson D Creswell C Fazel M Young people's advisory groups in health research: scoping review and mapping of practices.Arch Dis Child. 2021; 106: 698-704Crossref PubMed Scopus (11) Google Scholar There are too few opportunities for youth engagement in health research. Furthermore, journals should publish pieces championing the efficacy of youth participation in planetary health research and health research pieces to which youth have directly contributed.6Spajic L Behrens G Gralak S Moseley G Linholm D Beyond tokenism: meaningful youth engagement in planetary health.Lancet Planet Health. 2019; 3: e373-e375Summary Full Text Full Text PDF PubMed Scopus (4) Google Scholar Second, integrating youth voices into the folds of planetary health cannot happen without an established foundation of knowledge on the subject. Numerous organisations provide educational resources for individuals to seek out. For instance, the Community Check-Up is a US environmental health organisation that builds youth climate health literacy. However, education must also extend into classrooms; in nations with free secondary education, the curriculum often fails to address environmental health and teach the communication skills required to effectively advocate. Across the world, achieving adequate access to learning, especially for the 62 million girls without educational access, is imperative. Furthermore, ensuring a minimum of 12–13 years of quality education for girls advances three crucial goals to improve planetary health: reproductive health, climate leadership empowerment, and workforce preparedness for roles that can further green practices.7Project DrawdownHealth and education.http://drawdown.org/solutions/health-and-educationDate: 2020Date accessed: December 8, 2021Google Scholar Institutions, and particularly those in academia and the policy sector, often fail to address the steep education barrier between school and higher education that delegitimises youth opinions and prevents them from engaging with sustainability decisions at a more influential level. For example, becoming a physician can take 11–16 years of training, and, with our opportunity to tackle climate change narrowing every day, youth cannot wait to climb the ladder of higher education. This education barrier partly explains why environmentally concerned institutions often adopt a silo mentality, in which an aversion to information sharing leads to reduced efficacy and morale; this manifests in isolated and tokenistic youth-centred programmes that are insufficient to allow young people to have a meaningful say in key decisions. Combining expertise from clinical specialists and planetary health experts with youth's ingenuity and passion is a promising solution. Third, in addition to integrating young people into all tiers of planetary health decision making, organisations and institutions should showcase and articulate the lived climate experiences of young people. Youth have a unique vantage point to share their experiences of being brought up in a climate-altered world, and this storytelling can tap into core human values, such as health, garnering empathy and understanding.8Health Care Without HarmVisual storytelling guide for health care professionals taking climate action.https://noharm-uscanada.org/documents/visual-storytelling-guide-health-care-professionals-taking-climate-actionDate: 2021Date accessed: December 8, 2021Google Scholar Prime case studies include the Nurses Climate Challenge initiative, which mobilises nurses to educate 50 000 health professionals on the health impacts of climate change, and the Climate Stories Collaborative, a university-led initiative showcasing the stories of those affected by, and those taking action against, climate change. Finally, sustainable implementation of education, integration, and climate health storytelling on the scale necessary requires multiple forms of investment—a key barrier to many initiatives that are youth-led and youth-focused. Monetary investments that enable youth to travel when needed and receive compensation for their work must become more accessible. Investment should also extend to non-monetary resources, like social media outreach to underserved youth communities and mentorship dedicated to youth advocacy. We must reframe our view of youth. Young people are more than victims of the climate crisis; they are individuals capable of positive change, who must be protected, consulted, and allowed to become full partners in the climate conversation.9Hart RA Innocenti essays no 4. Children's participation from tokenism to citizenship.https://www.unicef-irc.org/publications/100-childrens-participation-from-tokenism-to-citizenship.htmlDate: 1992Date accessed: December 8, 2021Google Scholar This essential reframing could garner the meaningful and measurable participation of youth in planetary health discussions. However, leaders must readdress the barriers limiting youth advocacy from reaching its full potential. The exclusion of young people from decision making delays progress worldwide in fighting the climate crisis. We call on global health leaders and institutions to make greater investments into the potential of the youth generation.10Bulc B Al-Wahdani B Bustreo F et al.Urgency for transformation: youth engagement in global health.Lancet Glob Health. 2019; 7: e839-e840Summary Full Text Full Text PDF PubMed Scopus (13) Google Scholar With this framework in mind, we can substantially improve our chances of securing a healthy and sustainable future. We declare no competing interests.
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