The Current Climate for Health
As we prepare for the 26th UN Climate Change Conference of the Parties (COP26) in Glasgow, we have been inundated with suggestions for how to improve the health of our planet and tackle climate change.
The health of the planet is inextricably linked to the health of its population, and we have already begun to see the measurable impact that global warming is having on individual health (as described in the 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future). While it is difficult to attribute singular episodes to an increasing global temperature, there is broad agreement that changes to our environment are having a severe impact on human health.
During COP26, as parties discuss these challenges, it is worth considering that rather than climate change being the biggest challenge to health, in fact, health is the biggest challenge to climate change. If we make progress in supporting individuals to realise their health potential, to prolong their health span, and avoid becoming patients, this will have a momentous impact on the climate and the health of our planet. Healthcare systems, and the support of patients within the community, has significant implications for the world we live in. If healthcare systems were a country they would be the 5th biggest carbon emitter in the world. Decisions we make related to health have long-term implications, for example medication seeping into waste water, either through excretion from the body, or as a result of being flushed away if not used, has profound implications for water quality, and the ecosystems it supports. On the other hand, the growing trend for blue and green prescribing, where patients are encouraged to spend time by water or in green spaces, has the potential to improve the environment, if it leads to more emphasis being placed on making these spaces accessible and maintaining them as a health resource.
There is significant opportunity to target chronic diseases and in doing so improve sustainability. For example, encouraging hypertension patients to adopt a plant-based diet has implications for the farming industry that could lead to more sustainable agriculture; facilitating workers to actively commute (i.e., incorporating cycling, walking or running into their daily commute to work) reduces the use of cars, and therefore lowers emissions, whilst tackling lifestyle diseases. This is particularly important when the same people that are most influenced by the social determinants of health, are going to be most impacted by climate change.
As the pandemic demonstrated, there are still significant disparities between different populations, with health inequalities and the social determinants of health being specifically emphasised (as outlined in the Marmot report ‘Build back fairer’) – many of which have important implications for the future of the planet, for example the role of public transport in reducing emissions, the need for more energy efficient housing, air quality and pollution, working conditions, and work-life balance. Many aspects of modern society that need to be improved to better protect the environment, could also improve individual- and population-level health in the process, which provides even greater incentive to make strong decisions about how to plan for a future which prioritises planetary health.
When considering how best to make progress in these closely aligned areas, considering how to provide healthcare to support future needs while at the same protecting the environment, it is worth remembering that we should not just improve health because we can. It is an imperative. Health is the most important societal and personal pillar for fairness, equity & equality, progress, prosperity and sustainability, as addressed by the WHO One Health approach. Climate change is not the biggest threat to health, the lack of access to a healthy life and health services are the biggest threat for individuals, families, communities and countries to have the bandwidth to work with climate change.
While COP26 shows how society-wide defence policies against climate change are ramping up, building a more sustainable healthcare system still awaits transformative ideas.
The challenge for policy makers, is how to position good health as the biggest opportunity, to ensure that policies to improve and prolong health are part of the sustainability solution (as this paper describes). This presents an opportunity for COP26 discussion, to address questions such as how do we prioritise decisions that are both beneficial for health and positive for the environment? How do we reorganise the health system to focus on a preventative rather than curative approach?
Ensuring global health means ensuring health for individuals as well as the planet.
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