Doctors should take the lead in practical steps to reduce the carbon footprints associated with obesity, chronic disease and population growth, according to an article published in the Medical Journal of Australia and reported on the AMA website in May.

Doctors and other healthcare professionals must take the lead in raising climate change awareness.

Prof Robyn McDermott, Professor of Public Health at the University of South Australia, writes that ageing, obesity and associated conditions account for the greatest proportion of disability and accelerating health care use, and that the health sector itself has a significant and expanding carbon footprint.

“When we add the increasing costs of health care and the health industry’s carbon footprint to the entirely preventable loss of years of life and wellness caused by physical inactivity, we have a compelling case for specific action led by doctors in four health-related domains,” Prof McDermott said.

These four areas include reducing the adverse environmental impact of the health care industry; developing a comprehensive food and nutrition policy that addresses food quality, safety and security; upgrading urban planning rules to make climate change mitigation measures enforceable; and supporting more robust policies to protect the sexual health and reproductive rights of women globally to improve overall quality of life and indirectly slow population growth.

Climate change policies should be assessed for their impact on global health and equity.

In an accompanying editorial, Associate Prof Colin Butler, from the National Centre for Epidemiology and Population Health at the Australian National University, acknowledges that doctors are powerful role models, but says that the virtual absence of health as an agenda item for the recent climate change talks in Copenhagen underlines how far there is to go.

“It is … easy to call for “whole-of-government” approaches, whether to slow climate change, fix the obesogenic environment or to enhance equity. Easy to say, hard to achieve,” Prof Butler said.

“The law of increasing returns [how groups with influence are able to rig public opinion and legislate to benefit powerful minorities rather than the public good] is a powerful impediment, not only to whole-of-government reforms, but to the transition to sustainability more broadly.”

The Medical Journal of Australia is a publication of the Australian Medical Association.

Source: AMA

Image credit: flickr / wenzday01

Published on the AMA website 29 July 2010:

AMA President, Dr Andrew Pesce, said that Australia needs a National Strategy for Climate Change and Health to respond effectively to the health impacts of climate change.

Climate change will increase hurricane severity, causing mass casualties and other adverse health outcomes.

The 2009 State of the Climate report, released by the US National Oceanic and Atmospheric Administration, confirmed that the past decade was the warmest on record and that the Earth has been growing warmer in the past 50 years.

Dr Pesce said that climate change caused by global warming and greenhouse gas emissions poses significant challenges to the health and wellbeing of Australians.

“This report is further evidence that climate change is happening, that human activity is contributing to it, and that a coordinated health response is needed,” Dr Pesce said.

“Failure on the part of governments internationally to achieve significant reductions in greenhouse gas emissions is likely to result in significant public health problems.

“Extreme weather events caused by global warming, such as storms, floods, heatwaves and fires, will all have serious long-term health implications for Australians, including increased vector-borne diseases, possible chemical exposures, and fatalities and injuries from extreme weather events.

“These health impacts will place increasing demand on the health system over time.

“Australians of all ages need to be confident that they can continue to receive good quality timely access to their doctor, and other health and medical professionals,” Dr Pesce said.

A National Strategy for Climate Change and Health would assist Governments and the broader community to plan for increased demands on health service infrastructure from extreme events and emerging health conditions due to climate change, and must incorporate:

• Strong communication links between hospitals, major medical centres, and emergency response agencies to maximise the efficient use of health resources in extreme weather events;

• Localised disaster management plans for specific geographical locations that model potential adverse health outcomes in those areas;

• Nationally coordinated surveillance measures to prevent exotic disease vectors from becoming established in Australia; and

• Development of effective interventions to address mental health issues arising from extreme events, including those involving mass casualties, and from longer-term changes, including drought.

Source: AMA

Extreme Weather Events
The direct effects of extreme weather events include drowning from floods, injuries from floods, and structural collapse. Indirect effects outnumber the direct effects and likely will be more costly.

Climate change will increase the likelihood of extreme weather events like floods and increase the burden on human health.

Potential indirect effects include aggravation of chronic diseases due to interruptions in health care service, significant mental health concerns both from interrupted care and geographic displacement, and socioeconomic disruption resulting from population displacement and infrastructure loss.

Sea level rise increases the risk from extreme weather events in coastal areas, threatening critical infrastructure and worsening immediate and chronic health effects. Salt-water entering freshwater drinking supplies is also a concern for these regions, and increased salt content in soil can hinder agricultural activity in coastal areas.

Other indirect exposures and health effects
Climate change is a complex phenomenon and a range of unanticipated ecological effects will result. Many of these ecosystem effects could have indirect health effects.

Increased concentrations of ground-level carbon dioxide and longer growing seasons could result in higher pollen production, worsening allergic and respiratory disease.

Increased carbon dioxide concentrations in sea water are causing oceans to grow more acidic and are already causing adverse ecosystem changes in the world’s  oceans. This will have potentially dramatic implications for fisheries and the food supply in certain regions of the world.

Major regional ecosystem stresses may result in mass population movement and conflict, with significant health effects. Some of these concerns are low-probability high-impact events, and could have significant health impacts on a global scale.

Weather and climate have affected human health for millennia. Now, climate change is altering weather and climate patterns that previously have been relatively stable. Climate experts are particularly confident that climate change will bring increasingly frequent and severe heat waves and extreme weather events, as well as a rise in sea levels. These changes have the potential to affect human health in several direct and indirect ways, some of them severe.

Increased Temperatures
Heat exposure has a range of health effects, from mild heat rashes to deadly heat stroke. Heat exposure can also aggravate several chronic diseases, including cardiovascular and respiratory disease. The results can be severe and result in both increased illness and death. Heat also increases ground-level ozone concentrations, causing direct lung injury and increasing the severity of respiratory diseases such as asthma and chronic obstructive pulmonary disease.

Higher temperatures and heat waves increased demand for electricity and thus combustion of fossil fuels, generating airborne particulates and indirectly leading to increased respiratory disease.

Over a longer time period, increased temperatures have other effects ranging from drought to ecosystem changes that can affect health.  Drought may also strain agricultural productivity and could result in increased food prices and food shortages, worsening strain on those affected by hunger and food insecurity in the U.S. and elsewhere.

Droughts can result in shortages of clean water and may concentrate contaminants that negatively affect the chemistry of surface waters in some areas.

Ecosystem changes include migration of the vectors (organisms that do not cause disease but transmit infection by carrying pathogens from one host to another) and animal hosts that cause certain diseases prevalent in the U.S., such as Lyme disease and Hantavirus. The dynamics of disease migration are complex and temperature is just one factor affecting the distribution of these diseases.

Winters will also be warmer, which is likely to lead to a decrease in illness and death associated with exposure to cold. This may be one of the few positive health effects of global warming. In addition to this general warming trend, climate change will bring increased weather variability, the results of which are difficult to predict.