Twenty-five percent of the global burden of disease is linked to an environmental risk factor. According to Dr Maria Neira, Director of Public Health and the Environment at WHO, that is 12.6 million preventable deaths directly attributable to climate change. Dr Neira spoke of the links between climate change and primary health care in the PHC Webinar Series on 25 July 2019.
Dr Neira began by addressing the question that many people have, which is –why climate change and health? Why should health care professionals keep themselves informed on environmental issues?
Climate change is putting at risk the three fundamental pillars of health - nutrition, shelter, and access to water. As just one example, natural disasters destroy crops, destroy people’s homes and can contaminate safe sources of water. This can lead to malnutrition, water-borne diseases, and other health issues. It can also lead to massive migration Another example is air pollution – of the 12.6 million preventable deaths linked to climate change each year, 7 million of them are the result of exposure to air pollution.
Whether it is an Increase in the incidence of asthma, increased mental illness resulting from migration, increases in vector-borne diseases – all of these are having a direct impact on health care providers. As a result, there is a greater need for health services at the same time that the health care infrastructure needed to provide those services is being severely impacted.
So what should PHC professionals do in the face of such challenges? Dr Neira spoke of two separate avenues of action: climate change adaptation and climate change mitigation.
Climate change adaptation is a term used by the environmental community to describe actions that, in public health, are known as secondary prevention. In other words, prepare and take steps to cope. It is about building the resilience of health care facilities and developing their abilities to cope with the changes in disease burden, such as increased cases of malaria or asthma, greater burden of mental illness resulting from forced migration, etc.
It means also putting in place increased surveillance to monitor and report on changing disease burdens, and creating a linkage between public health governance and meteorological authorities to be able to better understand the overall impact on the population.
What is important is to not just adapt to the effects of climate change, but to tackle the root causes as well. Or, in public health terms, to put in place primary prevention. Health care providers have an important leadership role to play in terms of mitigating climate change. In a recent survey on climate change, participants were asked which sectors had the most credibility in terms of influencing environmental policy, and health professionals were at the top of the list.
Health professionals have an opportunity to influence such key factors as the choice of energy, which has a huge impact on health, or urban planning, which again, by influencing people’s day-to-day lives and activities, can contribute significantly to reductions in preventable deaths. Decision-makers can also work to reduce the carbon footprint of hospitals and other health care facilities, thus leading by example.
Climate change will impact every aspect of health care, particularly at the community level, which means that PHC professionals will have a key role to play in both adapting to and mitigating climate change.