Public health’s role in tackling climate change

The health risks from climate change are considerable, but directors of public health are ideally placed to ensure initiatives are implemented in the right way, to the right people.

At last month’s United Nations Climate Change Conference COP28, world leaders committed to ‘transition away’ from fossil fuels in a much-needed recognition of the mitigation and adaptation required to protect planetary and human health.

In the same week, the UK Health Security Agency’s fourth Health Effects of Climate Change report painted a sobering picture and, although health impacts were given more focus in Dubai than at previous COPs, the sheer scale of the threat to our health must be a key priority.

Heatwaves, wildfires, floods and hurricanes are increasing in scale, frequency and intensity and already stretching our hospitals, schools, and care systems to capacity. In 2022, when UK temperatures reached 40 degrees, an estimated 3,000 people died as a direct consequence of extreme heat.

The impact of biodiversity loss and environmental degradation are also taking hold, but although the situation is bleak, it is not too late.

We must do all we can to achieve net zero. We know if we do not, we will see more extreme weather, tropical diseases will become commonplace and our ability to grow crops will be compromised. At the same time, we need to mitigate health impacts by thinking through the implications of our decisions and adapting our approach accordingly.

To be effective, we must identify what works and share good practice. We also need to learn from other countries so we are prepared should diseases like dengue fever become endemic.

Directors of public health (DPHs) are uniquely placed to convene the right people at the right time because they already work in partnership to implement initiatives which, as well as improving and protecting residents’ health, have co-benefits to the environment. For example, how our spaces are built has an enormous impact on our health. By using insulation, smart meters and renewable-powered heating systems to improve energy efficiency, people’s quality of life will also improve, and our housing stock will be more resilient.

Similarly, buildings should be well ventilated, moisture-safe and have high levels of thermal efficiency to keep them warm in winter and cool in summer. Local planning should also ensure adequate green space and trees to provide shade and promote wellbeing.

East Sussex CC has a number of agreements and protocols in place between the public health team and other departments to address climate change. Its ‘healthy places’ team worked with planning to establish a ‘planning for health working memorandum of understanding’ which is supported by each of the district and borough councils, and the South Downs National Park.

Transport is another issue. Public health teams are working with partners to address this because only by developing an environment where access to alternative methods of transport is equitable, will people be able to use their cars less. Journeys up to 16km are responsible for 40% of emissions from vehicles – a distance where shifting to active travel and/or public transport is entirely possible. Electrified public transport needs to be expanded to cover the whole country and must be reliable, regular, safe, cheap, and efficient.

In Trafford, a scheme called ‘School Streets’ has been introduced where motorised traffic is restricted outside schools during peak times, creating pedestrian and cycle zones. As well as increasing physical activity and improving air quality, there is evidence of improved educational outcomes for children who are more physically active.

In Hastings, planning is under way for a development of pedestrian and cycle-friendly, climate-resistant garden routes connecting communities with the town centre.

The threat to UK biodiversity impacts present and future food security but through partnership and the adoption of sustainable farming practices, we can reduce greenhouse gas emissions and support a more nutritious plant-based diet for the population.

Climate change will exacerbate existing health inequalities, with older people, those in lower income groups, and those with underlying medical conditions at increased risk. It is therefore vital for everyone to have access to mitigations and adaptations, regardless of how much money they have or where they live.

DPHs are ideally placed to ensure initiatives are implemented in the right way, to the right people because they know their local communities, know where pockets of inequity are and have the relationships with community leaders to be able to address them.

Data about climate change, water and air quality needs to be available so they can respond effectively as well as support colleagues in areas including transport, planning, and environmental health.

Funding for reaching climate goals is not ringfenced. To build on existing, successful partnership programmes, adequate funding must be made available to allow DPHs to adapt their investment to local populations, ensuring effective interventions are implemented and longer-term, sustainable projects are created.

The outlook is bleak, but manageable – if we work together to find and implement solutions without bowing to industry or political pressure, without imposing boundaries and, crucially, without leaving anyone behind.

This article was originally published in the MJ.