Climate policy needs a new lens: health and well-being

As the new Australian parliament takes the reins, health groups are moving to ensure that health minister Sussan Ley addresses a major health threat in this term of government: climate change.

Largely ignored by successive federal governments, the health risks from climate change are increasingly urgent. One or two degrees of warming at a global level may not sound like much, but if you take many organisms (including humans) too far outside their comfort zone, the consequences are deadly.

The Climate and Health Alliance – a coalition of concerned health groups, researchers, academics and professional associations – is calling on the Australian government to develop a national strategy for climate, health and well-being.

How climate change affects health

Major increases in ill-health are anticipated from continued climate change. These include:

• greater rates of injuries, disease and deaths associated with more intense heatwaves, fires and other extreme weather events;

• increased risks of infectious and food- and water-borne diseases;

• health consequences arising from lost work capacity because of extreme weather;

• harmful effects on community mental health; and

• increasing air pollution.

In February 2009, by which time global average temperatures had increased by less than one degree, Victoria experienced temperatures between 12-15 degrees above the average. That single heatwave caused the devastating Black Saturday bushfires. It was also responsible for a 62% increase in deaths, from both direct heat-related illnesses and the exacerbation of other chronic medical conditions.

During this five-day event, ambulances had a 46% increase in demand. Emergency departments experienced an eightfold increase in heat-related presentations, a 2.8-fold increase in cardiac arrests, and a threefold increase in patients dead on arrival.

Heat doesn’t just affect the very old and very young. A recent international report shows that a billion workers globally are being exposed to extreme heat. This reduces productivity and puts lives at risk.

Global warming is also causing dramatic ecosystem collapse, such as the loss of corals on the Great Barrier Reef, and the recent death of thousands of hectares of mangroves in northern Australia. These will impact on fish stocks and food supply – and therefore, adequate nutrition – for communities that depend on these resources.

Preparing the health sector for climate change

Federal policymakers in Australia have failed recognise the health threat of climate change or offer robust and effective national policy solutions to tackle it. Governments in the United Kingdom and the United States, in contrast, are helping communities prepare for climate change. They are also investing in measures to promote climate resilience in the healthcare sector.

Like all services, the health sector is vulnerable to the direct consequences of extreme weather events such as fires, floods, heatwaves, and storms. These events can disrupt supply chains, electricity services, and water supplies; compromise the safety and quality of food services; suddenly and dramatically increase service demand; and interfere with service delivery through adverse impacts on personnel.

When Hurricane Sandy hit New York in 2012, many hospitals were forced to evacuate because of flooding; others were unable to function. Many lost electrical power, and some had back-up generators that failed due to flooding. Subsequent investigations reveal a lack of climate preparedness in the healthcare system.

A case study of multiple hospital evacuations during the event revealed that the health system experienced prolonged increased patient volume, displaced staff, and disrupted telecommunications. This created chaos as evacuated patients were transferred with little accompanying information about their diagnosis or required care.

The Climate and Health Alliance has proposed a national healthcare standard for “climate resilience”, to ensure the Australian healthcare sector and its workforce are adequately prepared for climate-related health threats.

Time for policy commitment

As well as the obvious national interest, there is now an obligation under the Paris climate agreement for nations to consider their citizens' “right to health” in the context of climate policy. There is also an obligation to ensure that the health benefits from climate mitigation are reflected in climate policy choices.

These benefits are potentially huge. A recent US study estimated the savings on healthcare spending from carbon-reduction policies can be more than ten times the cost of policy implementation.

While there is strong evidence emerging in the international literature about the health benefits from strategies to cut emissions, that work is yet to be done in Australia.

As a signatory of the Paris Agreement, the Australian government must now apply a “health lens” to all of its climate policies. The Climate and Health Alliance is today calling for Australia to develop a national strategy for climate, health and well-being, which would allow Australia to:

• adequately respond to the risks to health from climate change;

• support the health sector to build climate resilience and transition to low-carbon operations;

• promote education and awareness about climate change and health among the health professions and the wider community, so both can be better prepared;

• strengthen climate and health research to identify population groups and communities particularly vulnerable to health risks from climate change and develop strategies to reduce those risks; and

• invest in research to quantify the health benefits of different emissions-reduction scenarios to guide climate policy choices.

Current Australian carbon reduction commitments are inadequate to limit global warming to a safe level, and climate policies do not reflect the risks or opportunities for health. Lives are being put at risk.

We need a coordinated national response, with leadership from the health minister, but involving all portfolios, to protect the health of all people in Australia from climate change.

Fiona Armstrong is the Executive Director of the Climate and Health Alliance which receives funding for its sustainable healthcare program from its international partner, Health Care Without Harm.

Peter C. Doherty receives funding from the NHMRC to work on immunity to the influenza A viruses. He is in his final year as chair of the advisory board for the ARC Centre of Excellence for Climate Systems Science and serves on the board for the Melbourne Sustainable Society Institute. He is a Board Member of The Conversation.