Climate Change and Health Inequalities
Health and Care System Acknowledges it has a Role to Play
‘Climate change is the greatest global health threat facing the world in the 21st century’
The NHS has recognised both the health impact of the climate crisis and its responsibilities towards reducing carbon emissions. It has set up the Greener NHS programme primarily to deliver a net zero carbon health service. Given the current direct and indirect NHS carbon emission levels, this is an important and impactful ambition but this is not the only area of responsibility relating to the climate crisis in which the health and care system has a part to play.
Thrive by Design is part of the Yorkshire and Humber Climate Commission Adaptation and Resilience Panel and has been working with others to learn more about why the health and care system needs to also focus on adapting and growing resilience as an integral part of tackling health inequalities.
The Climate Crisis is Already Here
“The UK will face significant further changes in climate to 2050 and beyond, even if the world is on a Paris-aligned emissions trajectory. By 2050 the heatwave of 2018 will be a typical summer, summer rainfall could fall by as much as 24% and winter rainfall increase by as much as 16%, changes that will impact our wellbeing, the natural environment and the economy… But adaptation remains the Cinderella of climate change, still sitting in rags by the stove: under-resourced, underfunded and often ignored.”
We are already facing the impacts of the climate crisis in many direct and indirect ways, from extreme weather events to disrupted global food supplies. This is acknowledged in the recent government health paper ‘Climate and Health’.
This summer, we experienced unprecedented heat waves with ONS recording 3,271 excess deaths having been recorded in England and Wales. This is an average of 82 excess deaths per day and 6.2% higher than the five-year average. The excess rate was 2,803 for people aged 65 years and over which is the highest number since the introduction of the Heatwave plan for England in 2004.
In the UK, air pollution is the largest environmental risk to public health. The annual mortality of human-made air pollution in the UK is roughly equivalent to between 28,000 and 36,000 deaths every year. Greater air pollution and attributable mortality rates are found in areas of greater socio-economic deprivation in the UK.
A House of Commons inquiry into food insecurity concluded climate change and biodiversity loss were among the biggest medium to long term risks to UK domestic food production, alongside other factors, including soil degradation and water quality. UK Wheat yields dropped by 40% in 2020 as a result of heavy rainfall and droughts.
The Climate Crisis and Health Inequalities
In a recent report, The Longevity Science Panel describes how the effect is and will continue to be disproportionately felt by people and communities who are already likely to be living with higher health inequalities.
‘The most economically deprived and those who are already frail through age or having long-term health conditions will be the most vulnerable to high temperatures and shocks induced by adverse weather events such flooding and storms.’
When we overlay the impact of the climate crisis onto ‘vulnerability factors’ identified by WHO such as socio-economic, demographic and geographical, we can see that the climate crisis has a direct and indirect relationship with poverty, inequality and inequity and it will exacerbate pre-existing inequalities.
As the OECD articulates in it’s article on Climate Change and Health; whether we are talking about global or local contexts, people who are on low-incomes, high risk and insecure jobs, living in poor quality housing conditions and unsafe neighbourhoods with poor air quality, people from ethnic minority communities who are suffering from discrimination and social exclusion, people with limited access to good quality education and health care services and people who have higher risk of disease because of poor hygiene and unhealthy diets, will all suffer the greatest consequences.
Yorkshire and Humber Climate Commission
The Yorkshire and Humber Climate Commission, of which we are a partner, have articulated this intersection of health and care, inequality and adaptation and resilience as a top priority for our region in their action plan.
‘The Commission will work with health professionals to develop an outline strategy on how to address the climate and nature and health and wellbeing agendas in a joined-up way to make a tangible difference for the most vulnerable people in our society.’
We have been working with the Yorkshire and Humber Climate Commission adaptation and resilience panel to explore this question as a region. See the blog on their website for further information.
A recent related workshop highlighted the importance of the ‘deeply connected inequalities, deprivation and climate crisis’ and recommended the need to ‘shift the narrative to incorporate climate into health inequalities’. The workshop participants also discussed the lack of public and general discourse on adaptation and resilience with many saying that no-body in their organisation or networks is currently talking about this. The current cost of living crisis and level of poverty and hardship being felt by people presents a real barrier to those with existing lived experience of health inequalities getting involved in shaping how we grow more adaptive and resilient in the face of the climate crisis.
Taking Collective Action to Meet the Challenge
Adaptation and resilience is something we can tackle together. Whether it be at a macro level with the COP 27 Loss and Damage Fund or very micro level building sustainable drainage systems and rain gardens into urban places such as the Sheffield Grey to Green scheme we have some solutions already in play.
The IPCC Sixth Assessment report is hard to read but one positive note is that work on adaptation is beginning to emerge and there is a recognition that adaptation can improve the social, economic and environmental well-being in many different ways.
‘Adaptation can generate multiple additional benefits such as improving agricultural productivity, innovation, health and well-being, food security, livelihood, and biodiversity conservation as well as reduction of risks and damages’
In the emerging conversations around adaptation and resilience there are some key questions which we are keen to explore with others:
What is the relationship between the climate crisis and health inequalities?
What can the NHS and wider health and care partners do to adapt and build resilience into our health and care systems and local communities with a particular emphasis on protecting the members of our society who are most vulnerable to the climate crisis?
How do we lift barriers to ensure people with living experience are able to engage and co-design more adaptive and resilient communities, places and services?
How do we frame this challenge in a way that is accessible, meaningful and engaging to all?
And the big question for our health and care systems:
How do we, as a matter of urgency, move our whole health and care system approach to the climate crisis from chronic condition management to a blue light emergency?
If you are interested in collaborating with us on exploring these questions please get in touch email: roz.davies@nhs.net