Health of the Planet, Health of the Public

Karen Chui

Climate change is at the forefront of political discussions around the world. The social movement Extinction Rebellion brought the subject to UK and global headlines in May 2019. The movement protested for climate change and environmental protection, in order to minimize the risks of human extinction and ecological collapse. In recent years, many renowned scientific organizations and academic groups have also spoken out about the detrimental impact of climate change on human health. Health care professionals should be aware of the health risks of climate change and understand that advocating for climate change is synonymous to advocating for the health of the public.

Extinction Rebellion protesters blockade North Bridge, one of the main routes into Edinburgh city centre. Photograph: Jeff J Mitchell/Getty Images

The European Academies Science Advisory Council published “The imperative of climate action to protect human health in Europe” on 3rd June 2019. In the report, the EASAC describes how the extent of climate change is threatening the global health gains that we have made in the past few decades.

The direct effects of rising global temperature include increasing heatwaves, droughts, storms, flooding and wildfires. The largest wildfire recorded in California hit in November 2018, which claimed 85 lives and 14000 homes, and led to a large admission of burn patients to hospitals in the area. In March 2019, Cyclone Idai destroyed the landscape of Mozambique, Zimbabwe and Malawi, killing more than 1000 people and displacing more than 3 million people.

An aerial view of Mozambique’s Sofala province, once of the hardest hit by Cyclone Idai. Copyright 2019 Photo courtersy of National Institute of Disaster Management, Mozambique.

Climate change indirectly affects our ecosystems and socioeconomic systems. There is an increased risk of infectious disease transmission, injuries, mental illness and reduced water availability and food security. Powerful and destructive weather conditions lead to displacement and forced migration of communities, as well as damage to infrastructure of existing health services. Such humanitarian crises leads to a decline of economic activity and threats of conflict. The most vulnerable groups to these effects are children, the elderly, disabled and marginalised populations.

Pakistan Floods, 2010 Dadu district, Sindh province, Pakistan People in a flooded Pakistani village scramble for food rations as they battle the downwash from an army helicopter delivering aid. These unprecedented floods affected approximately 20 million people and destroyed homes, crops and infrastructure, leaving millions vulnerable to malnutrition and waterborne disease such as cholera. Estimates of the total number of people killed range from 1,200 to 2,200, while an estimated 14 million people were left homeless. Image credit: Daniel Berehulak, Getty Images / Wellcome Photography Prize 2019

The Lancet published “The Lancet Countdown: Tracking Progress on Health and Climate Change” in 2018. The annual report is an international research collaboration tracking the world’s response to climate change and the effects on health. It tracks 41 indicators across five domains: the health impacts of climate change; health resilience and adaptation; health co-benefits of mitigation; finance and economics associated with health and climate change; and political and broader engagement. The report builds on the 2015 Lancet Commission on health and climate change, which provided ten global recommendations in response to the public health emergency of climate change.

In the domain of climate change impacts, exposures and vulnerability, the report found that in 2017 at least 157 million more people were exposed to heatwave events and 153 billion hours of labour were lost since 2000. Changes in temperatures may also result in increases in transmission of vector-borne and water-borne diseases. In 2016, the Baltic coastline saw a 24% increase of suitability for epidemics for vibrio cholerae and the highlands of sub-Saharan Africa saw a 27.6% increase in vectorial capacity for transmission of malaria, from the 1950 baseline.

Response to climate change remains slow, with mixed responses from national governments since signing the Paris Agreement in 2015. FInancial contributions around the world for climate change adaptation is well below the $100 billion per year commitment made under the Paris Agreement. Efforts to implement change and decarbonize nations have also been insufficient. Over 90% of people living in cities breathe polluted air that is toxic to their cardiovascular and respiratory health. Low and middle income countries observed a 70% increase in air pollution concentration from 2010 to 2016.

Image: REUTERS/Jason Lee

Although the development of mitigation interventions is slow, we can be optimistic about the progress that has already been made and is ongoing. Globally 157 GW of renewable energy was installed in 2017, which is twice as much as the fossil fuel capacity that was installed in the same year. In 2017, more than 2 million electric vehicles were on the road, with global per-capita electricity consumption for road transport increasing by 13% from 2013 to 2015. The number of people employed in renewable energy in 2017 increased to 10.3 million around the world. Global leadership in response to climate change and health is currently fronted by China, the EU and many countries most vulnerable to climate change.

Credit: Joe Brusky/Flickr

The EASAC report stressed the urgency to stabilise climate and increase efforts to limit greenhouse gas emissions to protect human health. It recommends implementing health in all policies, such as reforming the EU Adaptation Strategy to increase focus on health consequences of climate change and linking climate change and health objectives into all EU domestic policies. The Lancet Countdown emphasized the importance of a wider understanding of climate change as a central public health issue. Increased engagement of the media and scientific community in this subject promotes an accelerated response to combating health effects of climate change and prioritisation of mitigation interventions. Health care professionals have a responsibility to promote the health of the public and prevent suffering. Working to curtail greenhouse gas emissions and rising global temperatures, in order to avoid the catastrophic effects of climate change on health and the environment, must now be part of our mission.

Author: Karen Chui

References

https://www.nejm.org/doi/full/10.1056/NEJMp1817067

http://www.lancetcountdown.org/the-report/

https://easac.eu/fileadmin/PDF_s/reports_statements/Climate_Change_and_Health/EASAC_Report_No_38_Climate_Change_and_Health.pdf​

https://planetaryhealthalliance.org/clinicians-for-planetary-health

https://twitter.com/LancetCountdown