HEALTH MATTERS I Global harming iritofamerica
Adobe advocates of certain interventions to tackle this issue. Previous public health wins such as banning smoking in public places are sources of optimism that public attitudes on health issues can change quickly, and with excellent evidence and advocacy, it is possible to reshape the public debate around climate change and health. The NHS struggles against an economic sys tem in which the full costs of climate change are not paid for by those who are responsible for the problem. These externalities need to be internalised, through eliminating subsidies to fossil fuels and introducing carbon pricing. There is a need for NHS trusts to identify ways in w hich success stories on climate-health initiatives can be shared, as well as the lessons from the work of the Sustainable Development Unit in the NHS (www.sduhealth.org. uk), which has had success in reducing the health sector’s greenhouse gas emissions despite rising activity. Outside of the remit of the NHS, public secto r interventions such as improving access to public green spaces can have significant benefits for health, while also tackling environmental issues such as air pollution and climate change. Environmental issues are synergistic in nature . Every time a field is mechanically tilled, 1% of the topsoil is lost. Accordingly, the impacts of climate change on agriculture and food yields also interact with the effects of soil erosion. Moreover, soil erosion is a driver of deforestation, which in turn impacts on climate change. Similarly, aquifer depletion due to intensive agriculture heightens our vulnerability to climate change’s effects on water resilience. The incentives in the agricultural system are perv erse, as they push towards the intensification of agriculture, leading to harm to biodiversity. Improving women’s rights, their access
Action on climate change can bring about dividends for public health.
adaptation; and only just over 1 in 3 countries have reported implementing activities to increase the climate resilience of their health infrastructure. Professor Sir Andy Haines spoke on the topic of mitigation actions and health co-benefits Mitigating climate change benefits health. For example, air pollution is a global health crisis. Some 71% of the 2971 cities in the World Health Organisation (WHO)’s database, and 87% of a random sample of cities do not satisfy WHO annual fine particulate matter exposure recommendations. The energy sector is the single largest source of humanmade air pollution, producing 85% of particulate matter. Progress on this so-called ‘coal phase-out’ has tangible benefits for air quality globally, and between 2016 and 2017, the amount of additional coal capacity planned for construction halved. Similarly, sustainable travel uptake, such as walking and cycling, can mitigate climate change, while encouraging healthier lifestyles and improving air quality. In these ways, mitigation tackles climate change and reduces the harm to health from air pollution.
Food and agriculture is also a sizeable contributor to climate change. The average dietary CO2 emissions per person in the UK are 5.6 kg per day—but if w e ate according to the WHO’s nutritional guidelines, this would fall by 17%. The dietary changes would also save almost 7 million life years over 30 years, mainly due to reductions in coronary heart disease, equivalent to an increase in life expectancy of just over 6 months. The audience and panellists reflected on the following themes:
The NHS is too financially challenged to have c limate change as one of its top concerns. On the frontline, however, NHS staff and health can serve as key
“Sustainable travel uptake, such as walking and cycling, can mitigate climate change, while encouraging healthier lifestyles and improving air quality. In these ways, mitigation tackles climate change and reduces the harm to health from air pollution”
May 2018 Vol 12 No 5 British Journal of Healthcare Assistants