SHA presentation on climate change and health
At the risk of sounding like a spokesman from the Department of the Bleeding Obvious, our climate is getting hotter. The ten hottest years ever recorded globally have all been since 2002 and seven of the ten hottest temperatures in UK history have been recorded since 2003. Climate scientists are telling us that if average global temperatures increase to 1.5°C above the pre-industrial average, there is a high likelihood the planet will tip into irreversible climate change, with catastrophic consequences for life on Earth. At current rates of warming, it’s estimated that we will hit that 1.5°C tipping point in or around 2033 and by the end of the century the IPPC has estimated that there could be an increase in temperatures of 2.7°C. At the launch of its latest report earlier this year, the IPCC’s Chair, Hoesung Lee, said “Any further delay in concerted global action will miss a brief and rapidly closing window to secure a livable future for all.”
The WHO has stated that “Climate change is the single biggest health threat facing humanity’”. It says that “climate change is already impacting health in a myriad of ways, including leading to death and illness from increasingly frequent extreme weather events, such as heatwaves, storms and floods, the disruption of food systems, increases in zoonoses and food-, water- and vector-borne diseases, and mental health issues. Furthermore, climate change is undermining many of the social determinants for good health, such as livelihoods, equality and access to health care and social support structures. These climate-sensitive health risks are disproportionately felt by the most vulnerable and disadvantaged, including women, children, ethnic minorities, poor communities, migrants or displaced persons, older populations, and those with underlying health conditions.”
Some facts and figures
The WHO estimates that, already, every year, environmental factors take the lives of around 13 million people. Over 90% of people breathe unhealthy levels of air pollution, largely resulting from burning the fossil fuels driving climate change.
Exposure to excessive heat has wide ranging physiological impacts for all humans, often amplifying existing conditions and resulting in premature death and disability. In 2015 alone, 175 million additional people were exposed to heat waves compared to average years. In 2003, 70,000 people in Europe died because of the June-August event, in 2010, 56,000 excess deaths occurred during a 44-day heatwave in the Russian Federation. Analysis by the BBC found that around the world the number of extremely hot days every year when the temperature reaches 50C has doubled since the 1980s, and now happen in more areas of the world than before, presenting unprecedented challenges to human health and to how we live.
Meeting the goals of the Paris Agreement could save about a million lives a year worldwide by 2050 through reductions in air pollution alone. Avoiding the worst climate impacts could help prevent 250,000 additional climate-related deaths per year from 2030 to 2050, mainly from malnutrition, malaria, diarrhoea and heat stress.
It is estimated that the production, processing, packaging, and distribution of food generate a third of greenhouse gas emissions. More sustainable production would mitigate climate impacts and support more nutritious diets that could prevent close to 11 million premature deaths a year.
But the increase in global temperatures is only one of the factors in the ecological crisis that we face. Human health and well-being are influenced by the health of local plant and animal communities and the integrity of the local ecosystems that they form, and climate change is only one of the factors that are contributing to the ecological crisis confronting us. Land use changes, pollution, poor water quality, chemical and waste contamination, and other ecosystem degradation are all contributing to biodiversity loss and are all posing considerable threats to human health – even in Wales. On 13 July, the Environment Agency issued an amber warning for the Wye, after its temperature passed 20C. It has called for a halt to trout and salmon fishing and warned of the danger of toxic algal blooms because of the high temperatures and the very high levels of phosphate pollution.
Infectious diseases cause over one billion human infections per year, and cause millions of deaths globally. Approximately two thirds of known human infectious diseases are shared with animals, and most recently emerging diseases – like SARS, Covid, Ebola and Monkey Pox, are associated with wildlife and increasing interactions between wild animals and humans, whether through increasing human encroachment on ‘wild’ environments or in the widespread demand for wild animals for food by urbanising populations.
And incidentally, human activity, through increasing mobility and globalisation, is creating feedback loops that are spreading diseases back into the wild environment as well as farmed animal populations. This year’s outbreak of bird flu has been the longest and largest ever experienced in the UK and much of the rest of Europe. The disease is not only infecting farmed birds but is also sweeping through wild populations including vulnerable populations of endangered birds. The disease is highly contagious in birds and started in commercial geese farms in Asia in 1996, eventually spreading across Asia to other poultry and then to wild birds, who in turn brought it to Europe.
Climate change and Wales
In Wales over the coming decades, summers will become warmer and drier and winters milder and wetter. The Westminster Government’s Climate Change Risk Assessment (CCRA) reports predict that between the mid-1970s and mid-2010s, average annual temperature increased by 0.9C, rainfall by 2% and sunshine hours by 6.1%.
By 2050 it’s likely that we could get 6% more rain in winter in Wales, with as much as 13% more rain by the 2080s. And when it does pour down it could be more intense, leading to a greater likelihood of flooding, landslips, soil erosion and sedimentation of waterways. It’s also likely that storms like Ciara and Dennis in 2020, Dudley, Eunice, and Arwen in 2021 and Franklin in 2022 are going to increase in both frequency and ferocity. So, the flooding in the Rhondda and elsewhere over the last couple of years is a portent for the future.
According to climate change organisation, Climate Central, by 2050, sea-level rise will mean land now home to 300 million people will on average flood at least once a year. Previous estimates had put that figure at about 80 million. In the UK, 3.6 million people would face annual flooding by 2050 and up to 5.4 million by 2100 if emissions continue to rise. Cardiff is in the top 10 of capital cities at risk from rising sea levels.
There has been a 160mm rise in sea levels round the UK since 1900 and sea levels are continuing to rise. There are currently just under 12,000 homes and other buildings in Wales at high risk from coastal or river flooding but could increase by 260% by the 2080s.
According to the CCRA, warmer summers and more frequent heat waves are likely to spark an increase in heat-related mortality, heat stroke, and heat exhaustion. The heatwaves of 2020 led to an estimated total excess mortality of over 2,500 across the UK and even last year an estimated 1,600 people died. In Wales heat-related deaths could increase from a baseline of 2.4 per 100,000 people per year now to 6.5 per100,000 by the 2050s.
A few weeks ago, the Chief Medical Officer for Wales published his Annual Report for 2021, which included an entire chapter on climate risk and health. The CMO uses very neutral, even bland, language, but is clear that “the public health consequences of these climate related risks are not insignificant and add to a persistent and growing environmental burden of disease.” He goes on to say that “The public health argument to act now is strong…The public health benefits of effective mitigation interventions would far outweigh their costs.”
He quotes the WHO in saying that “strengthening community resilience and building system-wide adaptive capacity to climate change, can also lead to health benefits by protecting vulnerable populations from disease outbreaks and weather-related incidents, reducing health costs and promoting social equity.”
He points out that although a lot of research into the physical health risks posed by climate change has been undertaken, the toll on mental health is much less explored, and shouldn’t be underestimated. He gives as an example the ongoing anxiety, depression and PTSD experienced by people because of the floods in the valleys. He quotes from CCRA3 : “Flooding increased the risk of mental disorders (anxiety and depression) and post-traumatic stress disorder (PTSD) in people whose homes have been flooded and who experienced disruption as a result of flooding” and that “three years after flooding, the prevalence of negative mental health outcomes in affected persons is reduced but still significant”, and must be taken into consideration alongside plans to adapt to the physical health effects of climate change.”
In addition to this, the British Association of Counselling and Psychotherapy found that 55% of people felt climate change had impacted their mental well-being. People are reporting rising levels of fear and depression about their lives, the planet, and future generations. CCRA3 stated that “Young people are particularly vulnerable as they have fewer resources and strategies to cope with this challenge to their wellbeing, and patterns of mental health in children and teenagers is also an important determinant of mental health in adult life.”
Who is most at risk?
It’s depressingly easy to answer this – it is, in Wales as everywhere else, the poor, the old, the young and those with existing health problems. And of course, the population of Wales is older, poorer, and sicker than anywhere else in the UK.
What is to be done?
The Chief Medical Officer says, with masterful understatement, that “Health co-benefits will be gained across other sectors too, including in energy generation, transport, food and agriculture, housing and buildings, industry and water management.” He gives as an example the promotion and development of urban green spaces, which can not only help in mitigating climate change through acting as carbon sinks but can also offer health benefits such as reduced exposure to air pollution, reducing the heat island effect of cities, increasing space for physical activity and socialisation and contributing to stress relief.
Or another example – the promotion of active travel infrastructure, reducing the number of motor vehicles on our roads and enabling people to walk and cycle more, will not only reduce the amounts of greenhouse gases emitted but will also reduce the huge quantities of particulates generated from vehicle exhausts and from their brake pads and tires. The health benefits of such a policy are reduced rates of cardiovascular, respiratory and cancer diseases. At the same time, reducing how much we travel, and changing how we travel – much more use of public transport, walking, and cycling, switching to efficient electric vehicles and two thirds less flying – would reduce energy demand for transport by 78%.
One vitally important area the Chief Medical Officer doesn’t refer to are the potential benefits of one of the key elements in the Centre for Alternative Technology’s Zero Carbon Britain plan and one of the core proposals of Labour for a Green New Deal – a huge programme of building insulation and refurbishment for every home in Wales over the next ten years which could reduce energy demand for heating by around 50% – and reduce the dangers of overheating during our increasingly frequent heatwaves.
The Government defines households as being fuel poor if they spent more than 10% of their income on fuel to maintain a ‘satisfactory heating regime’ and any household having to spend more than 20% is defined as being in severe fuel poverty.
In October last year – so before the huge price rises for energy that hit us this year, the Welsh Government estimated that 196,000 households in Wales, equivalent to 14% of all households, were estimated to be living in fuel poverty, and another153,000 households or 11% of households, were at risk of fuel poverty. 59% of all low-income households were already in fuel poverty and another 26% were at risk. The Government’s estimates based on the price rises this April are that now, up to 614,000, or 45% of households in Wales could be in fuel poverty, with another 210,000 or 15% at risk.
32% of homes in Wales were built before 1919 and we have some of the oldest and least thermally efficient homes in Europe. While the Welsh Government has implemented several worthwhile initiatives to addressing these issues, including its Warm Homes Programme, the Welsh Housing Quality Standard and most recently the Optimised Retrofit Programme, these have largely involved social housing, not privately let or owner-occupied homes, though both of those sectors are on average in poorer condition. A major programme to retrofit all existing homes in Wales to at leastan EPC (energy performance certificate) ‘B’ rating within the next ten years would not only tackle both greenhouse gas emissions and fuel poverty, but would create several thousand new, well paid unionised jobs (10,000 FTE jobs a year over 15 years, according to the Institute of Welsh Affairs) as part of the creation of the one million green jobs outlined in the party’s 2019 Green New Deal strategy, now apparently largely abandoned by the party leadership.
But there is a growing recognition in all sorts of areas that action must be taken urgently. For example, while the climate emergency is a public health emergency, the healthcare sector itself currently contributes to the problem. NHS Cymru has the largest carbon footprint in the public sector – which is supposed to be zero carbon overall by 2030 – at currently a bit over1,000,000 tCO2e. In March last year the Government published an NHS Wales Decarbonisation Strategic Delivery Plan that includes 48 targets that the Government says are “ambitious, and in some areas will require a fundamental shift to our approach to healthcare but will contribute to reducing our impact on the Global Health Emergency.”
And there are some interesting and creative proposals coming out. For example, Cardiff & the Vale Health Board have multi-disciplinary teams working on how to reduce the consumption of nitrous oxide (which is 256 times potent the CO2 as a greenhouse gas) with a target of cutting consumption by 90%, which will prevent approximately 1 million litres of nitrous oxide emissions a year. If it is applied across all Health Boards, it will be the biggest single reduction in the NHS’s carbon footprint.
Conclusion
In a year when we have seen unprecedented levels of heat across these islands, and storms, floods, droughts, wildfires, and heatwaves have ravaged Australia, North America, Asia, Europe, and Siberia, we must recognise that the climate crisis is the greatest threat to human society that it has ever faced. And the prime driver of that crisis is the need for the capitalist system to endlessly expand and to endlessly exploit our planet’s finite and fragile resources. It’s clear what must be done – now – to avoid the very worst of what is to come; we must stop burning fossil fuel, we must stop the ongoing rape and poisoning of the natural world and we must undertake a dramatic redistribution of wealth and power. If humanity is going to survive this crisis we must argue for an entirely different social system, one (in George Monbiot’s words) of ‘private sufficiency and public luxury’ a society based on equality, solidarity, and faire shares for all, prefiguratively demonstrated in the principles of the NHS – and that system is socialism.
Sean Thompson SERA 19/7/2022