Latest blog post:Human and planetary health
I became interested in the links between climate change and health as a first year medical student. I’d always been vaguely concerned about climate change after learning about it at school, but in truth I’d never done much about beyond recycling. The extreme heat I experienced in India before I went to medical school – and more importantly the vulnerability and inequality I saw around me – made it feel much more real: something that was already affecting people around the world, now.
A few months after starting at medical school, I received an email inviting students to apply for a 2-day training programme on climate change, health and sustainable healthcare. Suddenly, the connections between these two previously separate interests started to become apparent. I applied, attended, and my course in life changed – definitely for the better overall, I think.
Through reports such as the 2009 UCL-Lancet Commission on the health effects of climate change, I learnt how climate change affects food, water and air – the very fundamentals of health – and how health is affected by heat, floods, storms and droughts. I learnt about the injustices at the centre of discussions about climate change: that those who are least responsible are most vulnerable to its effects, between and within countries, and across generations. I came to realise how strangely society makes – or fails to make – decisions about the future. And how short-term vested interests often have far more influence in shaping policy than is ever mentioned at medical school.
Just yesterday, the Intergovernmental Panel on Climate Change published Working Group II’s report, on ‘Impacts, Vulnerability and Adaptation’. The report, like the previous one on climate science, makes for very depressing reading. It highlights the risks from changing patterns of infectious diseases, food insecurity and malnutrition and the mental and physical health caused by extreme weather events.
The higher-end warming scenarios are particularly concerning - though scientific understanding of just how concerning is limited. The headline message, though, is very bad indeed. Whilst emphasising that current models are inherently conservative, the report states that ‘extrapolation from current models nevertheless suggests that the global risk to food security becomes very severe under an increase … of 4-6°C or higher'. The thing is, under business-as-usual, this is pretty much where we’re headed.
The IPCC provides very strong evidence that climate change is likely to exacerbate poverty and inequality and act as a driver of displacement and conflict. My take is that these indirect impacts are likely to affect health far more dramatically during my lifetime than the more obvious ones: the heat deaths, the rise in cases of dengue, the injuries in storms or bushfires.
There is a good news story too, even in the face of such serious threats. I learnt how polluted air, diets high in red and processed meat, and places that make walking and cycle unappealing all help to explain why so many patients who come to hospital are either overweight, unfit, unhappy or some combination of the above. And, therefore, how tackling such problems creates an unparalleled opportunity to realise the ‘health co-benefits’ of sustainability. This is what the Global Climate and Health Alliance (GCHA) seeking to show in their report and film about what the IPCC report means for health, released this Thursday.
What can you, as a student, do? You can read and share the GCHA report (and some of the rather longer IPCC one if you can), sign the Lancet’s manifesto for planetary health, and be political. If your medical school is not teaching you about these issues, find allies, show people who design your curriculum some of the evidence, and work with them to change that. The student organisation I am part of will soon be launching a campaign to call on UK medical institutions to divest from fossil fuels; to get involved you can find out more here and sign up here, or for those abroad, why not think about starting a similar campaign in your country?
In the words of Rudolf Virchow, ‘politics is nothing else but medicine on a larger scale’. Since planetary and human health are impossible to separate, we must learn how to look after health on this second scale too.