As wildfires increase the likelihood of respiratory illnesses for residents in California and Queensland, Australia, a new report from The Lancet warns that such health risks will become increasingly common without action to address climate change. But, the authors stress, it's still possible to prevent some health effects and mitigate others.
Given the magnitude of the issue, lead author Nick Watts, MBBS, MA, framed the issue in terms of what an individual child born today will face in his or her future. If the world continues on its current trajectory, such a child will eventually live in a world at least 4ºC above average preindustrial temperatures.
"We roughly know what that looks like from a climate perspective," said Watts, executive director of The Lancet Countdown: Tracking Progress on Health and Climate Change, during a telebriefing on the report.
"We have no idea of what that looks like from a public health perspective, but we know it is catastrophic," he continued. "We know that it has the potential to undermine the last 50 years of gains in public health and overwhelm the health systems that we rely on."
Health Sector a Significant, Growing Contributor
The report describes the changes to which climate change has already contributed and addresses both the health threats and the way institutions and states are currently responding to those threats. It also includes policy briefs specific to individual countries and an extensive appendix with projections data.
The authors note that progress in mitigating fossil fuel combustion — the biggest driver of rising temperatures — is "intermittent at best," with carbon dioxide emissions continuing to rise in 2018. The past decade has included eight of the 10 hottest years on record. "Many of the indicators contained in this report suggest the world is following this 'business as usual' pathway," the authors write.
In fact, the trend of coal-produced energy that had been declining actually increased 1.7% between 2016 and 2018. Perhaps ironically, given the focus of the report, "the healthcare sector is responsible for about 4.6% of global emissions, a value which is steadily rising across most major economies," Watts and colleagues report.
The potential health risks from climate change range from increased chronic illness, such as asthma and cardiovascular disease, to the increased spread of infectious diseases, especially vector-borne diseases, including dengue fever, malaria, and chikungunya. Increases in the frequency and intensity of severe weather events can lead to increased acute and longer-term morbidity and mortality.
Though children will suffer the brunt of negative health impact from climate change, the effects will touch people at every stage of life, from in-utero development through old age, the authors emphasize.
"Downward trends in global yield potential for all major crops tracked since 1960 threaten food production and food security, with infants often the worst affected by the potentially permanent effects of undernutrition," the authors report. Children are also most susceptible to diarrheal disease and infectious diseases, particularly dengue.
Mitigating Actions Available
But the report focuses as much on solutions and mitigation strategies as it does on the worst-case scenario without action. Speakers during the telebriefing emphasized the responsibility of all people, including physicians and other healthcare providers, to play a role in countering the public health disaster that could result from inaction on climate.
"Thankfully, here we have the treatment for climate change, solutions to shift away from the carbon pollution and towards clean energy and working to find the best way to protect ourselves and each other from climate change," Renee N. Salas, MD, MPH, lead author of the 2019 Lancet Countdown US Policy Brief and a Harvard C-CHANGE Fellow, said during the press briefing. "All we need is political will."
Salas compared the present moment to that period when a physician still has the ability to save a critically ill patient's life with fast action.
"If I don't act quickly, the patient may still die even though that treatment would have saved their life earlier," she said. "We are in that narrow window."
Physicians have a responsibility to speak to patients and families frankly about not only specific conditions, such as asthma, but the climate-related causes of those conditions, such as increasing air pollution, said Gina McCarthy, director of the Harvard Center for Climate, Health and the Global Environment and the 13th US EPA Administrator. Physicians are trusted advisors and therefore need to speak up because climate change is "about the health and wellbeing and the future of children," she said.
Political polarization is one of the biggest challenges to addressing climate change and stymies efforts to take action, according to Richard Carmona, MD, who served as the 17th US Surgeon General.
"The thing that frustrated me as a surgeon general and continues to frustrate me today is that these very scientifically vetted issues are reduced to political currency that creates divisiveness, and things don't get done," he said during the briefing.
"We have to move beyond that and elevate this discussion to one of the survival of our civilization and the health and safety and security of all nations in the world," continued Carmona, who is also a professor of public health at the University of Arizona in Tucson.
The report notes that the warming is already "occurring faster than governments are able, or willing, to respond," likely contributing to the increased outcry across the world from youth about the need to act.
And anyone can take some kind of action, McCarthy said. Her aim is to make the reality of climate change effects personal so that people understand its impact on them as well as what they can do.
"The report provides a list of actions that policymakers can take today to reduce the threat of climate change" as well as information on "how we can adapt and be more resilient as communities" while facing climate change's challenges, she said.
McCarthy encouraged people to pay particular attention to the report's mitigation and adaptation recommendations "because I want them to know that climate change isn't a lost cause," she said. The actions people can demand of policymakers will not only avoid the worst-case health scenario but can also improve health today, she added.
"We can do better than to dwell on the problem," McCarthy said. "We need people now to be hopeful about climate change, to do as others have suggested and demand action and take action in their own lives. We can use that to really drive solutions."
Annual Report Assesses Numerous Indicators
The Lancet Countdown is an annual report supported by the Wellcome Trust that pulls together research from 35 academic institutions and United Nations agencies across the world to provide an update on what the authors describe as "41 health indicators across five key domains:
Climate change impacts, exposures and vulnerability
Adaptation, planning and resilience for health
Mitigation action and health co-benefits
Economics and finance
Public and political engagement."
Given the complexity of the issue of climate change and the wide range of possible effects and preventive measures, contributing researchers included not just climate scientists but also ecologists, mathematicians, engineers, hydrologists, social and political scientists, physicians and other public health professionals, and experts in energy, food, and transportation.
The research was supported by the Wellcome Trust. Multiple authors also received support from a range of government institutions and public and private foundations and fellowships. No relevant financial relationships were noted.
Tara Haelle is an independent health and science journalist and book author. She specializes in reporting on vaccines, pediatrics, women's health, mental health and medical research with articles in NPR, Scientific American, New York Times, Forbes, Politico, and elsewhere.
Lancet. Published online November 13, 2019. doi: 10.1016/ S0140-6736(19)32596-6. Full text
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Cite this: Without Action, Every Child Will Be Affected by Climate Change - Medscape - Nov 13, 2019.