Monday, November 27, 2017

The Existential Challenges of Climate Change and Health Equity

Climate change was the focus of the 2017 American Public Health Association (APHA) annual meeting. Dozens of sessions and hundreds of papers described and catalogued the impact of rising global temperatures on the health of people, animals, plants, and the physical environment. Beyond that, many presentations described how climate change is already destroying vulnerable communities, cultures, and societies along with the history, wisdom, knowledge, customs, traditions, and social order that they embody. There is a growing realization that the threat of climate change is an existential one – one that could irreversibly alter our existence, as we know it.

What wasn’t acknowledged is that equity is also an existential challenge – one that if not addressed in a responsive and inclusive fashion, could lead to conflict, social disruption, and the dissolution of the values and hopes that bind us together as a society. Inequities in opportunities, discrimination against minority populations, and the growing disparities in wealth and power are the forces that stress social and political structures and threaten to fracture them.

The existential challenges of climate change and equity are reciprocally related – climate change impacts equity and equity influences climate change. Climate change disproportionately affects indigenous peoples, populations of color, and the poor; making climate change a major force in worsening health and societal inequities. Conversely, the economic and social policies and systems that create and perpetuate health and social inequities also embody a disregard for the health of the environment. These policies and systems are the reason why climate change and health inequities exist. 

The APHA meeting convinced me that the tack MDH is taking to address health equity is also what is needed to prevent and mitigate the disastrous consequences of climate change. Advancing health equity also advances the creation of a livable planet for everyone. The Triple Aim of Health Equity provides the framework for essential actions .

Expand our understanding about what creates (a healthy planet). We need to expand the narrative about the causes of climate change – that it is not just about uncontrolled economic development and the burning of fossil fuels but how all of us live our lives and how we interact with each other and our environment. It is recognizing how the dominant public narrative of individual responsibility and free market economy shapes our economic and social policies in ways that are not climate friendly.

Implement a (climate) health in all policies approach with (health) equity as the goal. We must recognize that, like health equity, climate change is not the responsibility of just one sector of the economy, one governmental agency, or one country. Climate change prevention and mitigation require all sectors and all countries to be involved. Equity must be the goal of those actions otherwise, there will be climate winners and losers, which will perpetuate climate change and negatively affect all of us.

Strengthen the capacity of communities to create their own healthy future. We must acknowledge that having the authentic voice of communities in discussions of policies that affect climate is essential. Policies made without community involvement will not be effective or sustainable. Policy makers and public officials must also be accountable to the communities they serve which will facilitating the development of policies and systems that create healthy people and healthy environments everywhere for everyone.

At the core of the Triple Aim of Health Equity is social cohesion – the set of shared vision, values, and hopes that keep a society functioning in harmony. The breakdown in social cohesion is at the core of most of today’s problems and the barriers to solving them. Health is not about individual actions but about relationships – to one’s family, community, culture, society, and environment. Health – be it personal, community, or climate health – is dependent on relationships that build and support social cohesion. Moreover, social cohesion can only be achieved on a platform of social justice – the core value of public health.

Climate change and health equity are linked and, if we are successful in achieving health equity, we will be effective in preventing and mitigating the negative effects of climate change. The continued existence of our society is dependent upon our work to advance health equity.