Climate change is a healthcare emergency


Most of you have probably heard of the recent climate change rapport by the intergovernmental panel for climate change (IPCC), since its release it was at the forefront of public discourse on social media and in the news. However, like most stories these days, impact is short lived and we, the general public, move on with our lives as new stories are published that steal our attention. The IPCC have been releasing rapports like every couple of years since the early 1990’s, and every time they have been a bit more ominous. This time however, we cannot afford to simply wait until the next rapport, as the most recent one is also the most damning. 234 scientist read and used over 14 000 research papers to produce the rapport, making it an extensive piece of scientific literature by a significant group of diverse scientists from a varied disciplines.

To quote the authors; The report provides new estimates of the chances of crossing the global warming level of 1.5°C in the next decades, and finds that unless there are immediate, rapid and large-scale reductions in greenhouse gas emissions, limiting warming to close to 1.5°C or even 2°C will be beyond reach’.

To understand exactly what 1.5 to 2 degrees would look like, we can take a closer look at what impact the report predicts this temperature change will lead to:

Climate change is bringing multiple different changes in different regions – which will all increase with further warming. These include changes to wetness and dryness, to winds, snow and ice, coastal areas and oceans. For example:

  • Climate change is intensifying the water cycle. This brings more intense rainfall and associated flooding, as well as more intense drought in many regions.
  • Climate change is affecting rainfall patterns. In high latitudes, precipitation is likely to increase, while it is projected to decrease over large parts of the subtropics. Changes to monsoon precipitation are expected, which will vary by region.
  • Coastal areas will see continued sea level rise throughout the 21st century, contributing to more frequent and severe coastal flooding in low-lying areas and coastal erosion. Extreme sea level events that previously occurred once in 100 years could happen every year by the end of this century.
  • Further warming will amplify permafrost thawing, and the loss of seasonal snow cover, melting of glaciers and ice sheets, and loss of summer Arctic sea ice.
  • Changes to the ocean, including warming, more frequent marine heatwaves, ocean acidification, and reduced oxygen levels have been clearly linked to human influence. These changes affect both ocean ecosystems and the people that rely on them, and they will continue throughout at least the rest of this century.
  • For cities, some aspects of climate change may be amplified, including heat (since urban areas are usually warmer than their surroundings), flooding from heavy precipitation events and sea level rise in coastal cities.

However, this article specifically stated climate change is a health care emergency, so we are going to focus on the relationship between climate change and health.   

The world health organisation has an excellent piece on climate change and health we would highly recommend. There are some obvious side effects on health we can imagine from climate change – air pollution and poor air quality are likely to lead to and exacerbate existing respiratory conditions, particularly in vulnerable groups such as the elderly and children. Pollution combined with rising temperature are also likely to reduce the amounts of safe drinking water available and cause a reduction in food production in poor regions though soil that is no longer viable. Mal and under nutrition is already the cause of 3,1 million deaths annually.

Flooding and landslides

In the event of rising temperatures, more extreme weather events are expected with a more frequent occurrence of floods and landslides. If critical infrastructure such as roads, telephone connections and power supplies fail due to extreme weather, this poses an increased risk of death and injury. Changes in climate related to these events will not necessarily lead to major changes in mortality in every country. Extreme weather events may affect the availability and availability of health and care services, including home-based services. Even though these landslides might not affect all regions, we need to be mindful of the potential for mass migration from areas that have been destroyed due to extreme weather events and the risk this has to destabilise economies and regions if there isn’t a plan in place to get people shelter and security.


Heat and heatwaves:

Higher temperatures and more heat waves may increase health risks in the future, and chronically ill, elderly and socioeconomically weak groups are most at risk. Future buildings and urban planning will need to take care of good sunshade and facilitate outdoor areas with enough shade. At the same time, due to the increase in average temperatures, there could also be fewer deaths during winter season. There is more research needed on the effects of warmer climates in different areas and countries. Warmer climatic conditions are for instance likely to increase the risk of deadly water-borne and mosquito-borne diseases.


Increased temperature will change the growth conditions of trees and plants that produce pollen. It can for instance amplify and prolong the pollen season, expanding the areas where pollen causes health problems. It will exacerbate the ailments for those who already have allergies and can cause more people to develop allergies. Increased temperature and humidity, more precipitation and flood damage will also contribute in general to moisture problems indoors, in homes, schools and commercial buildings. Moisture can increase cause an increase in and prevalence of respiratory illness such as asthma due to better conditions for indoor mould formation and house dust mites.


Higher temperatures may also result in increased levels of ground-level ozone. This could also impair lung function, causing higher rates of bronchitis and asthma, an increased risk of respiratory infections and increased mortality from lung and cardiovascular diseases. The heat wave in Europe in 2003 demonstrated there was a correlation between temperature rise and ground-level ozone that contributed to increased mortality; in Paris, mortality more than doubled during the heat wave (up to six times higher than normal on the worst day). Across Europe it accounted for maybe as many as 70,000 additional deaths, especially from respiratory and cardiovascular causes.

 

Fossil fuels such as oil, gas and coal are not only the main drivers of CO₂ emissions and climate change, but also the most dominant sources of air pollution globally. Climate measures that reduce the use of fossil fuels could lead to a significant reduction in death and disease in parallel through a reduction in air pollution. One precondition, however, is that fossil fuels are not replaced with other polluting energy sources.


Mental health:

It is easy to forget the effects these significant changes can have on our mental health as well. Climate change can affect mental health either directly or indirectly. An increased incidence of post-traumatic stress disorder, depression and anxiety has been demonstrated in the aftermath of natural disasters such as floods, droughts, heat waves and extreme weather events. Natural disasters will more often affect vulnerable parts of the population who are also those who often have poorer access to services and treatments for mental health.

 

Climate change affects our health and health system both directly and indirectly. Increased conflicts, changing mass migration flows, poverty, disturbances in the production of medicines, changes in access to foreign labour along with other more local changes will together place an additional burden on the provision of good health services. It will be important to protect vulnerable groups in the event of greater burdens on the health system, including that vulnerable groups are followed up with adapted measures and that these groups are included in contingency plans.

 

Both climate adaptation and cuts in greenhouse gases in other sectors can have positive effects on public health. A robust infrastructure that enables the delivery of health services, promoting the safe use of public transportation and active movement - such as biking or walking as alternatives to using private vehicles - reduces carbon dioxide emissions and air pollution. It can also reduce traffic injuries and increase levels of physical activity which helps prevent diseases like diabetes, heart disease and cancer.

 

Access to large and freely available green areas are important for local quality of life as well as public health and can at the same time help to manage stormwater in case of heavy precipitation. It is therefore important that health effects are assessed in relevant planning processes in other sectors both in terms of climate adaptation and reducing emissions and pollution – such as in the case with stormwater (water that originates from rain, including snow and ice melt). Stormwater is highly pollutant, as it effectively meets and blends with whatever pollutant is on the surface it passes through such as road salts, garbage, oil, heavy metals, toxic chemicals from cars, pesticides and fertilizers from gardens and other waste products such as virus and bacteria from animals. As an alternative to traditional water management systems, some companies have developed new climate positive models such as green infrastructure (GI). GI refers to water management practices such as vegetated roofs, planting by roadsides, growing absorbent gardens and other options to capture and reduce stormwater runoff and pollution. GI mimics natural hydrological processes and uses natural elements such as soil and plants to turn rainfall into a resource instead of a waste. It also increases the quality and quantity of local water supplies and provides myriad other environmental, economic, and health benefits—often in nature-starved urban areas.

Meeting the goals of the Paris Agreement could save about a million lives a year worldwide by 2050 through reductions in air pollution alone. Over 90% of the urban population of the world breathes air that exceeds WHO’s guideline levels for outdoor air pollution. The health benefits far outweigh the costs of meeting climate change goals.

In conclusion we are facing an incredible challenge in the health sector. During the pandemic most people experienced for the first time in their careers being redeployed into other areas and disciplines in order to triage, damage control and manage workload as a result of rapid rising covid infections and mortality rates spreading through the entire health sector. If we continue our current climate path, it is highly likely we will experience similar situations in the relatively near future.

As it stands, Europe will miss its 2030 climate goal by at least 21 years… Closer collaboration between members states and their partners will be essential, and the financial benefits are potentially massive – whilst an estimated investment of around €3.6 trillion is needed, there is a potential impact on economic growth of more than €8 trillion, thats this many euro 1 000 000 000 000 000 000. For more information on climate and health we can also recommend WHO Europe, health topics; environment and health.