The New Deal for Our Health and our Children’s Health

Although the news is currently dominated by Ebola, many health advocacy organizations, including ours, believe that the real, enduring health crisis is the menace of climate change. We’re in good company. Joining others in a recent British Medical Journal article on climate change, World Health Organization (WHO) Director General Dr. Margaret Chan called for urgent action to protect health. “Climate change, and all of its dire consequences for health, should be at centre-stage… whenever talk turns to the future of human civilizations. After all, that’s what’s at stake.”

The last few months have seen a boom in activity by doctors and nurses and other health professionals on climate and health. They have taken part in huge demonstrations for climate justice that have taken place all over the world. Many have provided evidence for the first UN Climate Summit called by Secretary General Ban Ki-Moon in New York in September 2014, and more than 400 health representatives from 96 countries took part in the first-ever WHO Climate and Health Summit in Geneva in August 2014. The civil society network, Global Climate and Health Alliance, in which HEAL is a founding member, released a “Call to action” urging WHO DG Dr Chan to declare climate change as a global public health emergency and to take urgent measures to address it.

This article aims to show why this boom in the involvement of the health community in climate and health must maintain its force and grow. Full engagement of medical professionals and the health community is an imperative for our climate and for our health. We describe the health impacts of climate change and show why, if advocacy by health professionals helps clinch a legally-binding and properly resourced agreement on climate, it could be the best public health deal ever achieved.

The facts

At a global level, the latest figures from the World Health Organization show that climate change is expected to cause approximately 250,000 additional deaths annually from 2030-2050. Of those deaths, 38,000 are due to heat exposure in elderly people, 48,000 result from diarrhoea, 60,000 are caused by malaria, and 95,000 are due to childhood malnutrition.

But climate change is already impacting public and community health in far greater ways as evidenced by the US National Climate Assessment, the IPPC assessment published earlier this year, and other recent studies.

Most at risk are the most vulnerable, such as children. According to WHO, more than 80% of the current health burden due to the changing climate occurs in children younger than five years old.

This is primarily because of physiological and developmental factors. They will disproportionately suffer from the effects of heat waves, air pollution, infectious illness, and trauma resulting from extreme weather events.

Allergy and asthma are a special concern for children’s health in the US and Europe. More frost-free days and warmer seasonal air temperatures can contribute to shifts in flowering time and pollen initiation from allergenic plant species, and increased CO2 by itself can elevate production of plant-based allergens. Higher pollen concentrations and longer pollen seasons can increase allergic sensitizations and asthma episodes, and diminish productive work and school days.

Air pollution has also been linked to other health conditions affecting children, and is increasingly recognised as a source of behavioural problems in children. An article published in Pediatrics in October 2014 shows that prenatal exposure to air pollution and maternal psychological distress jointly affect child behaviour. The study in Krakow, Poland and New York City shows the greatest effects among children with high levels of prenatal exposure to exposure to the air pollutants, such as polycyclic aromatic hydrocarbons (PAH) resulting from combustion sources such as motor vehicles, coal-fired power plants, residential heating and tobacco smoke.

The good news

Fortunately, strong action to address the climate challenge will be a very positive force for health.

This is why success at the international UNFCCC climate talks in Paris in December 2015 would mean revolutionary changes in the promotion of good health.

A growing body of scientific work shows that many of the policies that will reduce greenhouse gas emissions will also benefit health. For example, a fall in greenhouse gases is associated with a rise in air quality. As the levels of harmful gases and pollutants in the air fall, major improvements in cardiopulmonary health, including asthma, bronchitis and stroke, take place. City policies that encourage “active transport” highlight how extending opportunities to walk and cycle can produce significant physical and mental health benefits, as well as reducing air pollution.

Evidence is now available to show that ending our dependency on fossil fuels, the cause of climate change, can help tackle both climate change and the rise in non-communicable diseases such as diabetes, obesity, cancer, heart disease, stroke, and asthma.

Europe was one of the first regions of the world to promote the so-called “co-benefits” of climate action in policy discussions. In 2010, HEAL published its first major report on climate and health, Acting NOW for better health, showing the health benefits that Europeans could expect from stronger climate action by the European Union. The estimates of health costs avoided covered both respiratory and heart problems. The report also showed that the sooner action was taken, the sooner the benefits for health.

Recognition of health co-benefits has helped reshape thinking climate policy. Once economic assessment of the health benefits became available, it provided European policymakers with a persuasive new argument in favour of climate action. Today, research shows that the short and long-term benefits for health can offset – partly or sometimes wholly – the costs of climate policies. The most recent example is New Climate Economy’s groundbreaking report, “Better Climate, Better Growth” which includes figures on the potential health gains and their associated cost savings resulting from climate action.

In September 2014, at the UN Climate Summit, the positive message on climate action and health came over loud and clear. The health community spoke about the concrete examples of a range of investments that would mitigate climate change and benefit health. One of the main approaches is to support a move away from coal to help avoid millions of early deaths through improved air quality. Coal is the dirtiest of all fossil fuels and burning is a major contributor to climate change worldwide.

HEAL’s coal report published last year shows that in the European Union emissions from coal power plants are responsible for more than 18,200 premature deaths, 8,500 new cases of bronchitis and over 4 million lost working days. The associated costs of up to €43 billion per year fall on individuals, families, health services and governments in Europe and represent what HEAL calls an “unpaid health bill”.

The impact of the findings has not only reverberated in Brussels, home of the European Union institutions, but also in many European countries, including Poland, Germany, Romania and the UK. The US and Chinese governments have already embraced the message of better health in their support of recent actions against pollution from coal power plants. But we believe that with the help of health professionals, the health co-benefits model can be used more extensively to drive up national climate targets in all regions of the world.

Why the health community voice in climate matters

Physicians, healthcare professionals and other health advocates can make a powerful and compelling case for a strong agreement on climate action on public health grounds. They have already proved their strength in relation to the international tobacco convention. This climate change agreement offers much higher stakes and arguably the best ever new deal for global and national health.

In Europe, HEAL has worked with the UK Climate and Health Alliance to help formulate a public health warning message that “Climate change may be hazardous to your health”, and a second message, that climate action could actually promote health, as well as create substantial fiscal savings, “What’s good for the climate is good for health, + the economy”. The European Respiratory Society, the European Lung Foundation and the Standing Committee of European doctors as well as national asthma groups from the European Federation of Allergy & Airways Diseases Patients´ Association have used this positive frame in their communications while speaking to the media to multiply and extend the impact of these messages to their communities.

The health community voice matters because they can speak with experience and authority; many are already on the front line and witnessing the impact of climate change on health outcomes. Some European networks are already involved in sharing information with their patients and associations. For example, tens of thousands of fact sheets for children on climate change and health in different languages have been distributed in respiratory and asthma clinics in Europe.

“Climate and Health” road to Paris

In just over a year, leaders will meet in Paris at the COP21 international climate talks, there are a few things that we all can do to bring the health message and the health messenger to the climate table. We can become ambassadors for a move out of fossil fuels and towards a clean, sustainable energy pathway. These investment choices benefit public health. What this requires is the removal of subsidies for certain types of agriculture and for coal and all other fossil fuels while supporting investment in renewable energy sources, including reinforcing health services. These and other recommendations are spelt out by the Global Climate and Health Alliance call to action.

We can respond positively to the plea of Christiana Figueras, Chair of the UN Framework Convention on Climate Change, urging health ministries and the wider public health and advocacy community to gear up for climate discussions in 2015, and be ready to provide expertise to their national climate negotiators, and make the case for a strong global agreement.

The health community can lead by example and turn this climate problem, identified as the greatest public health challenge of the 21st century, into a massive public health opportunity. A strong and well-resourced agreement will be a great asset for public health. It can help create resilient, low carbon, health promoting cities, economies and communities, in which everyone has access to clean air and water and healthy food.

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