Ingrid Johnston
The connections between climate and health, and the importance of systemic changes in Australia to recognise and address them, have been highlighted in 4 important reports released in the past week – the Lancet Countdown report 2020, the MJA-Lancet Countdown report 2020, the Climate Health WA Inquiry, and the climate and health report from the Grattan Institute.
Between them, these reports make it clear that the health impacts from climate change are happening now and accelerating – we haven’t been doing enough and are running out of time to turn the tide.
The Paris Agreement seeks to limit global warming to well below 2oC, and ideally to 1.5oC, but we have already reached an average of 1.2oC globally, and 1.5oC in Australia. The impacts here are significant – 22% increase in exposure to fire in the past 15 years; averaged across Australia, there were more days over 39oC in 2019 than in the rest of the period since 1960 combined; more intense heatwaves are resulting in excess ambulance demand, hospital admissions, and mortality; changing patterns of infectious disease; rising food insecurity; and the impacts on mental health will continue to increase and unfold as time goes on. Health costs associated with mortality due to air pollution are estimated at $5.3 billion per year.
Globally, the hottest 5 years on record have occurred since 2015, and the past 20 years have seen a 54% increase in heat-related mortality among people older than 65. This is having direct financial impacts, with more than 300 billion hours of potential labour capacity lost in 2019 – equivalent to about 5% of GDP in both India and Indonesia.
Many sectors are affected. The climate suitability for infectious disease transmission is growing rapidly, with a 15% increase in environmental conditions suitable for dengue fever in 2018. Up to 565 million people face potential inundation from rising sea levels. Emissions from livestock grew 16% from 2000 to 2017 – the same year in which excess red meat consumption contributed to almost 1 million deaths.
The good news is that globally there are lots of areas of action. Low carbon electricity made up 28% of capacity in China in 2017 (compared with 17% in Australia), and from 2010-2017 the annual growth rate in renewable energy globally averaged 21%. Health services are connected with meteorological services in 86 countries, to assist with health adaptation planning. Almost three quarters of countries mention health and wellbeing in their Nationally Determined Contributions for the Paris Agreement, and in the UK, the National Health Service, which has been actively and successfully decreasing emissions for over a decade, recently declared the ambition to deliver net-zero health services as soon as possible.
As has too often been the way in climate change policy here though, Australia continues to defy the science and be left behind. We are the only OECD country to have worsened the carbon intensity of our energy supplies over the last 3 decades and are now 36% worse than the global average. We also defy the financial logic. Compared with current commitments, limiting warming to 1.5oC by 2100 would generate a global accumulated net benefit of at least USD265 trillion, or more than 3 times the 2018 global economy.
And the will to make the changes exists in Australia. The Cities Power Partnership, a network of local government councils leading the response to climate change now covers more than 50% of the population.
But the longer we delay serious action, the harder the proposition becomes. Right now, the global effort required is a reduction of 7.6% annually. If we wait another 5 years though, this will rise to 15.4% annually to meet the Paris Target. And the impacts are making the task all the more difficult. The emissions from the 2019-20 fires in NSW and Victoria alone were more than equivalent to a year’s worth of Australia’s annual emissions.
Recommendations from both the Climate Health WA Inquiry and the Grattan Institute report centre around the need for governance and system structures which recognise the links between climate change and health, and leadership at a national level to complement the work being done predominately in the States and Territories so far. Prioritising climate change within national plans and strategies; establishing Sustainable Development Units, incentivising change and planning targets to deliver net-zero health services; strengthening adaptation and resilience of the health systems; monitoring risk and responses, developing early warning systems and communication strategies for specific extreme weather events and climate-related disasters; and strategic long-term thinking will all be required as the health sector mitigates and adapts to climate change, to cope with the impacts, and protect the health of Australians.
Many carbon intensive practices lead to poor air quality, poor food quality and poor housing quality, which disproportionately impact the health of the most disadvantaged populations. These direct links with broader injustices and inequalities can’t be ignored, and they are what underpin the climate justice movement. A healthy environment is essential to ensuring a healthy and egalitarian society, and therefore policies addressing health, social issues and climate must now deal with all of these interconnected issues in a cohesive way. We know what we have to do – we just need the will to do it.
Dr Ingrid Johnston is a senior policy officer at PHAA with a diverse background in public health both in Australia and overseas, including with government (State and Federal), academic, and community sector organisations. After many years working across forensic mental health, family violence, youth justice and prison health, Ingrid completed a PhD on adaptation of disaster response to climate change on remote Pacific islands and is on the Board of Australia’s Climate and Health Alliance.