For more than 15 years public health academics have been advocating for greater attention to the impact of climate change on health, the disproportionate affect that climate change will have on particular people and groups across society and the need for health promotion to focus on environmental and ecological health challenges.
Over time the risks that climate change poses to health have not reduced, but increased, and we need new conversations to connect the environmental risks of climate to health and the social determinants of health.
Connecting climate change to health and the local environment where people live
In 1986 the Ottawa Charter for Health Promotion (https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference) was developed by the World Health organisation with the aim of enabling people to increase control over their lives and improve health.
Later this knowledge would be expanded and health inequities linked to social determinants of health Commission on Social Determinants of Health, 2008 that describe where people are born, live, work, play, age and their influence on long term health outcomes. This includes local factors that people might not necessarily associate with health such as access to and quality of housing, with daily living conditions influenced by where people live, family wealth, gender, race and ethnicity.
The commission included climate change as a risk factor of ongoing health inequities back in 2008. It wasn’t a big leap of faith. Airconditioning, well insulated housing, leafy green suburbs, and air purifiers cost money and people who are poor, older, have disabilities or long-term health conditions have fewer resources to adapt to hotter climates or increasing frequency and intensity of bushfires and floods. Climate change provides another example of double disadvantage or area level deprivation amplification because the disadvantage experienced by people is amplified by the area level or environmental disadvantage where people live.
Alignment of health planning and climate adaptation agendas
Ultimately, health planning and climate adaptation agendas converge around the recognition that socio-economic processes drive inequity. Area level disadvantage and marginalisation are complex and intersecting processes with no singular cause. Good adaptation planning requires intersectoral policies, interventions, public education and partnership across government portfolios.
Health and adaptation agendas also agree that inequities are not inevitable. If inequities are the outcomes of our socio-economic processes, they provide potential points of intervention and improvement. These interventions can range from small adjustments, through to more fundamental shifts in our socio-economic process, or “transformation”.
Planning for climate change or planning for health: why they have remained disconnected in planning practice?
There has been limited research available on the impact of climate on health and noted difficulties surrounding the measurement and assessment of climate impacts on complex systems using modelled data.
Limited interdisciplinary academic research also means there are fewer opportunities for research knowledge translation, with flow on implications for planning practitioners. And although health planners might be confident in their expertise to identify areas or populations vulnerable to health inequities, they appear to have less confidence in defining areas or populations vulnerable to climate change, despite the similarities.
For many local governments across Victoria, planning also often remains siloed within separate teams with focus on public health/social planning, environment, sustainability, transport and public open spaces.
Local government staff within sustainability, transport, public health, statutory and strategic planning departments within local governments need to work together to respond to the challenges posed by the social and environmental determinants of health.
A key task in connecting climate change to health in planning practice requires that we build integrated climate change and health literacy across health professionals, local and state governments, and communities more broadly.
Positive steps, and the potential of bringing these agendas together
in Victoria, councils must address climate change as a public health priority in their four year current municipal public health and wellbeing planning cycle (2021-2025) through the Victorian Public Health and Wellbeing Act 2008.
Guidance released by the Department of Health and Human Services has been designed to assist councils to meet their legislative obligations. All steps outlined in this guidance necessitate a whole of council approach and importantly facilitate conversations across departments who may not necessarily consider climate change central to their work.
The wider health and human services sector also plays a critical role in planning for climate change adaptation at the local level. This again demands competencies and skills to undertake place-based risk and vulnerability assessments of climate change impacts affecting patient and community health as well as impacts on assets, workforce and services.These are all things we are currently investigating in a partnership project with local governments in Victoria.
These assessments ultimately point to a range of interventions needed to address the drivers of vulnerability including poverty reduction, improved access to housing and housing quality, access to open space, and improved social infrastructure. Taking a broad view of both the direct and indirect impacts of climate change on health and well-being highlight the co-benefits that emerge across a range of planning areas.
This approach also highlights the uneven social and spatial differentiation of impacts and interventions. From the perspective of climate change adaptation, taking a health and well-being lens reminds us how important it is to move beyond a focus on reactive coping mechanisms to stresses and shocks (i.e. bushfires, increasing heat related illness, thunderstorm asthma) and move into a long term more transformative approach to health and climate adaptation meeting the needs of diverse populations and places.
Assoc/Professor Melanie Davern is director of the Australian Urban Observatory at the Centre for Urban Research, RMIT University
Dr Susie Moloney is executive director of the Jesuit Social Services‘ Centre for Just Places
Katrina Dunn is climate change and community resilience project coordinator at the Jesuit Social Services‘ Centre for Just Places