Climate Change and Health: past themes and future directions

Shuo Zhang

I recently attended Healthy Planet's panel discussion with Professors Hugh Montgomery, Ian Roberts, Anthony Costello and David Satterthwaite during the climate talks. They have all had long and varied careers, but their interests have converged in recent years by a deep motivation to advocate for urgent action on climate change. 

What really struck me during their presentations, and the subsequent question and answer session, is how far the climate change and health movement has come since the UCL-Lancet Commission in 2008, and also the diversity of perspectives, approaches and forms of engagement on the issues.  During these past four years, arguments have been redefined, emphasis redirected, and the movement has taken on board some important new evidence.

Past motivations

First, a quick history of how the climate change and health movement has gathered momentum.

In 2007 Climate and Health Council formed as ‘a meeting of doctors, nurses and other health professionals recognising the urgent need to address climate change to protect health’.  In 2008, Anthony Costello led The Lancet commission framed Climate Change as the ‘biggest health threat in the 21st century’  and set forth an interdisciplinary research directive to clarify and quantify the potential magnitude of climate change's direct and indirect health impacts. 

Impacts such as heat waves, changes in vector disease, air pollution and broader economic and geopolitical instability.  The Campaign for Greener Healthcare, now named the Centre for Sustainable Healthcare, was set up at the same time to develop a range of projects and programmes which focused on engagement, knowledge sharing, and transformation of the health system.  In April of the same year, the NHS Sustainable Development Unit was established to ‘help the NHS fulfil its potential as a leading sustainable and low carbon healthcare service'.  They state that they do this by 'developing organisations, people, tools, policy and research which will enable the NHS to promote sustainable development and mitigate climate change'.

These strands of global health, NHS sustainability and interest in transformative healthcare came together in 2009 with an organised and coherent health message at The Wave march before COP15 in Copenhagen – that 'what’s good for the climate is good for health'.

These strands still very much underlie and motivate the work that is being done, however both the political and economic landscape have changed.  There is a new urgency - since the initial Lancet Commission in 2008, new evidence now confirms some previously uncertain climate change impacts - however with the current economic recession, it seems there is less political will and public interest in the topic.

Why do we still care?

Perspective from the panel came from both personal and professional motivations. Prof Hugh Montgomery articulated the interconnected social, geopolitical and economic impacts on vulnerable populations in the developed and developing world of the indirect impacts of climate change today. This was most keenly illustrated through the impact of global weather on grain harvests, food prices and acting as a contributing factor to the Arab Spring.

Resource insecurity further compounds the pressures of future population growth on an already struggling planet. These themes of population, gender empowerment, new technologies, carbon-co benefits, have been consolidated within a development discourse and further, within an intergenerational justice discourse. Prof Anthony Costello presented updated research on the direct health impacts of climate change in terms of disease modelling.

It’s not just about future global impacts either. Prof Ian Roberts articulated the difference between demanding action to mitigate against the impacts of carbon on health, and demanding action on the negative health effects of carbon now.  Focusing on active travel in particular, he showed the potential benefits of reducing our reliance on the car and embedding active travel in our lifestyles, cities and communities.  And not just because it's healthier or lower carbon - but also because it can be more enjoyable.  This is applicable across the board: decarbonising our lifestyles re-emphasising meaning over consumption can help us to have healthier bodies and nicer places to live. 

Prof. Satterthwaite stressed that we mustn't forget that vast populations still live on the edges. They build homes and communities in the high risk peripheries of cities as cities are where today's economic opportunities lie. These incredibly vulnerable settlements need adaptation to the impacts of climate change now, but they are often the least able to vocalise their needs and participate in local governance.

So what is needed for the future?

Some questions that I feel still need to be answered: should emphasis be on top-down action and policies or bottom-up capacity building?  Can city and community level organisations be a new centre of power?  How do we make sure that money and support gets to the people who need it most?  And how can we ultimately make the most difference?

Fundamentally we all need to change what we are doing now, and to make better plans for the future.

I feel that healthcare professionals still have a lot to offer - we have a duty of care morally for our patients, and to minimise the impact of our healthcare systems on the planet, since it in turn sustains health.  Moreover, healthcare professionals interact with all sectors of society, have a global outreach and from the already existing healthcare partnerships and projects already set up, there is a pre-existing infrastructure there to disseminate information and create change.