By Jasmin Abbott SfGH, Winner of the Earth Week Blog Competition

Addressing climate change offers us the opportunity to integrate respect for our planet and each other into every-day living, to tackle a huge health threat, and even go beyond this to improve health globally, perhaps beyond any recorded baseline. Integrated with this is the opportunity to approach decolonising global health and politics.

Climate change provides these opportunities because, as Katie Patrick (An environmental engineer who has dedicated her life to tackling climate change) argues, climate change will be overcome not by approaching it as an overwhelming problem to be solved, but when we come up with creative solutions that are better than the pre-existing state of things [1]. This requires a fundamentally optimistic and co-operative approach.

Climate change is a health emergency

For me, climate change is fundamentally about health (both human and non-human, but it is human health that I will speak to here). One only need glance over the 2019 Lancet Countdown Reports to see the impact human activities and climate change are having on the world’s disease burden and vulnerability to future disease. The report states 90% of children worldwide are exposed to particulate pollution above WHO guidelines, increasing the risk of asthma, COPD and other airway diseases. Food insecurity and drought are aggravating malnutrition worldwide. Infectious diseases, particularly those carried by insect vectors, are also finding more suitable areas and days for transmission [2]. It is crucial to recognise that climate change is having these effects now, and that any further rise in global average temperature, even if just to the maximum rise of 1.5˚C recommended in the IPCC report [3], will only worsen the situation.

What is just as concerning, is that our healthcare systems are not prepared for a future of increased disease burden, as the current COVID-19 pandemic has demonstrated. The Global South is disproportionately affected. Not only is the Global South affected more by droughts and crop failure, by air pollution, increased spread of transmissible diseases and other effects brought about by climate change, but people of the Global South are less likely to be able to access the healthcare they need. This is in part due to existing inequities in access, but also because healthcare infrastructure itself is at risk from climate change (for example, building destruction or the loss of reliable supply chains) [4]. People displaced as a result of climate change, who may be called climate refugees, currently have no guarantee that they will receive help [5].

Here is an opportunity to save lives – both the lives of people directly threatened by climate change, and those who would otherwise need to access health services. Climate change offers us the opportunity to evaluate the efficacy and security of our health services (their infrastructure, staffing, supply and sustainability), and in doing so to make global access to healthcare more equitable, with better outcomes.

The Greatest Health We’ve Ever Had?

The Lancet Countdown describes that climate change interventions can benefit human health, separate to stopping existing and predicted mal effects [2]. So why allow interventions to improve human health to occur only as a side effect? Once we have started producing creative responses to climate change, it increases options to purposefully improve human health through an integrated public health response.

Non-communicable diseases, such as cardiovascular diseases and mental health conditions, are a significant and rising global health issue, which in conjunction with climate change stand to decrease global quality of life and increase the strain on healthcare systems. But to tackle climate change, we need to evaluate our health systems, our food systems, and how we act locally in our environments. All these actions contain potential avenues that could enable the reduction of known modifiable risk factors for disease. For example, cardiovascular disease has lifestyle risk factors such as diet and exercise levels. But what if we redesigned our food systems so that healthy diets were the most accessible food choices? Or as we reduce the pollution in our cities, we redesign them so that they encourage daily activity and time spent in nature, such as cycling in our commutes?

Changes such as these, known as co-benefits, and the impact they can have, are already being researched (an example of this is the Centre for Diet and Activity Research in Cambridge, UK [6]). When we reconsider the fundamentals of how our societies function, as we are forced to do by climate change, we could make concurrent public health interventions with the backing and momentum of action on the climate crisis. Evidence-based interventions, spurred by creativity, could make it easier for people to take control of their health, and could modify risk factors outside of individual control. This is a huge opportunity not to be missed, and more people will benefit if we take a multidisciplinary, and locality-led, approach to climate change and health.

Students taking part in the National Conference titled 'Vital Signs: Our Planet, Out Health' 2019

Climate Justice and Decolonising Politics

Human environmental activity disproportionally impacts those in poorer countries and more vulnerable populations, such as women, people who are disabled, and children. Climate change is a political and structural issue, not a geographical one. In the current global political economy, richer peoples continue to benefit from power structures established in the colonial era.

The politics of climate change has shown that global politics can be different. The UN Climate Change Conferences are unique events because through this platform, all countries (in theory), have an equal right to speak, and an equal weight given to what they have to say [7]. The benefits of this are twofold. First, it is a crucial step to rectifying the imbalances that exist in our global community. Second, hearing traditionally ignored voices is itself a fuel for creativity. Without such a structure, I believe we will not be able to overcome climate change. The solutions to climate change do not lie only in the minds of the Global North, and poorer countries will only be able to implement solutions to the climate crisis if this is funded.

Despite the ideals of climate change negotiations, it is important to recognise that they are not isolated from global politics. Poorer countries do not get overall proportionally greater say, even though climate change impacts them more. Moreover, funding promises made in the climate agreements have fallen short of targets, and in 2017 President Trump withdrew the contribution of U.S. to the Green Climate Fund [8].

So, there is much to be done, but there is the opportunity to rectify the problems. When diverse voices speak and lead; rather than become co-opted, ignored or tokenised; the results are more likely to be suitable for the people who will be affected most. And again, I argue, why limit this alternate worldview to climate politics? Why not take this opportunity to embrace a world of true global cooperation and value of each other? Critically, this is an opportunity to address the unidirectional flows of resources, ideas and people between the Global North and South. Again, this would have positive impact on global health, where healthcare access could be more equitable, people of all backgrounds could be enabled to thrive through education and other means, and quality of health could be determined less by where people happen to be born.

Concluding Remarks

Climate change is a frightening truth, but I hope that readers of this article will take away the message that it is ok to dream about a different world. Rather than being naïve, it’s exactly what is needed. The impact of addressing climate change could be far beyond what anyone initially imagined, if we act on it together.


Jasmin Abbott is a medical student in her penultimate year at the University of Cambridge, and member of Students for Global Health Cambridge. You can find her on twitter @abbtt4

References

[1] Patrick, K (2019) ‘Why Creativity Will Save the World – A Talk’ Podcast episode from series ‘How to Save the World’ – Published 20 May 2019

[2] Watts, N et al. (2019) ‘The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate’ The Lancet Vol. 394 (10211)

[3] IPCC (2018). Global warming of 1·5°C. An IPCC Special Report on the impacts of global warming of 1·5°C above pre-industrial levels and related global greenhouse gas emission pathways, in the context of strengthening the global response to the threat of climate change. Geneva, Switzerland: World Meteorological Organization

[4] WHO (2018) Factsheet: Climate Change and Health Available at: https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health (Accessed April 2020)

[5] Long, O (2019) Climate Refugees: A Global Crisis Blog post for helprefugees.org Available at: https://helprefugees.org/news/the-plight-and-rise-of-climate-refugees/ (Accessed May 2020)

[6] Centre for Diet and Physical Activity Research Page: https://www.cedar.iph.cam.ac.uk/research/ (Accessed April 2020)

[7] Friends of the Earth (2019) “Dude, where’s my COP?” Podcast episode from series ‘How to Save the Planet’ – Published 9 April 2020

[8] Farand, C (2019) Green Climate Fund replenishment fails to fill hole left by Trump’s US.  Available at: https://www.climatechangenews.com/2019/10/25/green-climate-fund-replenishment-fails-fill-hole-left-trumps-us/ (Accessed May 2020)

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