When I started working with the Lancet Countdown in 2015, few people were discussing the connections between health and climate change. Since then, awareness of the health effects that we are seeing worldwide has made its way into the United Nations Framework Convention on Climate Change (UNFCCC) climate negotiations, the media and our public awareness, but there is still a long way to go. We need to make sure that we are prepared to tackle the health effects of climate change on a global level before they leave traces of devastating effects, or as my family doctor would say prevention is better than cure. Health cannot be separated from climate change, not in the long or short term.
Climate change is often placed as an issue to tackle in the future, but the health effects of these environmental shocks and stressors can be observed already today. We do not have time to waste – climate change is already here and it is killing us. According to our 2018 report, 157 million more vulnerable people were exposed to heatwaves in 2017 than in the year of 2000. The people suffering the most from these increased heatwaves are the elderly and those working outside, in particularly agricultural workers. In 2017, 3.2 billion weeks of labour were lost due to the heatwaves, with 80% of these losses taking place in the agricultural sector. Yet, we must not forget the most vulnerable, those who are too poor to afford to leave the fields and go back home as they need to feed their families. Policy-makers play a crucial role here in pushing for sustainable labour policies that protect these people financially while ensuring their health and safety.
Heat stress is the overarching term for illnesses that occur when the body’s defence mechanisms are unable to prevent the body’s temperature from rising. The most severe form of heat stress is known as Heat Stroke. This usually occurs when the body temperature is above 40 degrees Celsius and includes the failure of multiple organ systems that can lead to seizures, coma and ultimately death. Extreme heat can affect mental health, with studies showing increased admissions for bipolar disorder and schizophrenia, worsening dementia symptoms, as well as increased risk of suicide. Climate change aggravates risks to mental health and wellbeing when the frequency, duration, intensity, and unpredictability of weather-related hazards change. The resultant weather effects increase the number of people exposed or re-exposed to extreme events. The new IPCC special report on the impacts of global warming is therefore conveying a worrying message.
Mental health and wellbeing is a key area where more research is urgently required to better understand the connections to climate change impacts. Indirect effects of climate change may for example result from long causal pathways which makes them especially difficult to estimate. The effects may be short-term, long-term, direct or indirect, and sometimes have life-long impacts on people’s health and wellbeing. This can include mental ill-health after disasters, displacement, migration and loss of identity.
After hurricane Katrina for example, researchers were first astonished when realising that about half of the people diagnosed with PTSD had not faced any direct losses of financial assets or family members. It turned out that the loss people expressed having experienced was internal and related to the loss of safety and security in their own homes. Even though, these losses have been framed for some time now as Non-Economic Loss and Damages (NELDs) in a UNFCCC context we still have a lot of work left to do. When carrying out research in Bangladesh on how environmental stress and climatic changes influence people’s lives, a respondent told me when asked if he had sought medical attention after a recent cyclone strike. “I went to the clinic and told the doctor that something is broken, here, inside of me [pointing towards his chest]. He sent me home with some paracetamol and told me that they would ease the pain”. After people have experienced war and conflict a great part of the humanitarian aid includes medical expertise on how to heal trauma. It makes no sense that this still has not been properly included in post-disaster relief packages.
Our hope is that by using health to humanise the narratives around climate change we will move closer towards meeting our Paris Agreements goals. Meeting our climate change targets will reduce the burden of disease and enable people to live longer and healthier lives.
Dr. Sonja Ayeb-Karlsson researches (im)mobility decisions, health and wellbeing in the context of environmental stress and climatic changes at University of Sussex and IDS. She is also a senior researcher at UNU-EHS and a part of WG1 and WG2 in the Lancet Countdown that is tracking the connections between climate change and public health until 2030.