13/05/2018

Turning Climate Change Legislation Into Public Health Policy

The Lancet

Macduff Everton/Getty Image
SUMMARY
The effects of climate change are inextricably entwined with health:
  • WHO estimates 7 million deaths from breathing polluted air indoors and outdoors;
  • Impact of weather-related natural disasters;
  • Negative effects on crop yields and food security;
  • Changing patterns of vector-borne diseases;
  • The shaping of social and environmental determinants of health.
2018 marks 10 years of the UK's 2008 Climate Change Act, which mandated reduction of UK carbon dioxide emissions by 80% by 2050 to 1990 levels, and legislated an independent Committee on Climate Change.
The effects of climate change are inextricably entwined with health: ranging from the WHO estimate of 7 million deaths from breathing polluted air indoors and outdoors; through the impact of weather-related natural disasters; negative effects on crop yields and food security; and changing patterns of vector-borne diseases; to the shaping of social and environmental determinants of health.
2018 marks 10 years of the UK's 2008 Climate Change Act, which mandated reduction of UK carbon dioxide emissions by 80% by 2050 to 1990 levels, and legislated an independent Committee on Climate Change.
Internationally, this past decade saw completion of the first phase of the Kyoto Protocol, the establishment of the 2010 Green Climate Fund, and the adoption of the 2015 Paris Agreement within the UN Framework Convention on Climate Change, collectively setting national and international targets towards mitigating the effects of climate change.
Building on local, national, and international progress to turn climate change policy into public health actions maximises cobenefits for health.
Local authorities and health professionals have already cooperated for many years in the UK: climate change legislation is a common and shared interest, but these groups must engage in stronger partnerships and dialogue.
There is bureaucratic complexity in national government cross-departmental sharing of policy—including key players from the Departments of Environment, Food, & Rural Affairs, Transport, Health, Business, and Energy & Industrial Strategy—but such sharing is essential for effective results.
The Climate Change Act and accompanying committees facilitate this, and there is support from health professionals, seen in the work of the Lancet Countdown and the UK Health Alliance on Climate Change.
Pressing challenges for UK policy makers exist around the interlinked policies of travel and air pollution.
From the lack of joined up infrastructure to quantifying the impact of health-related travel in the UK, health needs to be better embedded into decision making.
For example, although individual-level public health advice has long been to undertake more active travel through walking and cycling, urban planning and rural infrastructures are widely variable, traffic safety is frequently poor, and levels of outdoor air pollution are dangerous.
Air pollution policy is at a crossroads.
The UK Government is in the final stages of developing a new draft clean air strategy that would bring the 1956 and 1968 Clean Air Acts up to date.
An environment act, which is yet to be drafted, is also being precipitated by the UK's 2019 departure from the European Union, and has the potential to influence local and national land use, industry output, agriculture, and urban planning.
 Government departments need the support of the health community to link these initiatives and to keep health firmly on cross-departmental agendas.
Internationally, new data published on May 2 by WHO reporting the air pollution levels in 4300 cities found that nine of ten people globally are breathing polluted air (defined by WHO as exposure to small particulate matter of 2·5 μm or less in diameter [PM2·5], in concentrations higher than an average mean of 40 μg/m3).
WHO data should be used to inform policy to support cross-sectoral solutions for transport, land use, urban housing, and energy infrastructure.
Against this backdrop, WHO has called for health to be the top priority for urban planners—with more than half of the world's population already living in cities.
In China, the urban population is expected to reach 71% by 2030, bringing a host of urban health implications.
The Tsinghua-Lancet Commission on Healthy Cities in China: unlocking the power of cities for a healthy China recommends addressing urban planning, calling for better integration of health into all civic policies, and the integration of multisectoral policies.
The recommendations have universal importance and should be read and acted on by all those with responsibility for urban health, and are not limited to China.
Cooperation and sharing of goals, targets, and measurements across diverse sectors will support effective action on climate change—especially environmental pollution.
Climate change legislation is a central concern across government at all levels, and is not solely about the changing climate, but is embedded in public health policies.
The Climate Change Act plays an important part in the UK, and can continue to act as a beacon to inform other countries' national approaches within the Paris Agreement framework.
 Health professionals have a responsibility to influence and contribute to policies at local and national levels that demonstrate commitment to public health, as this will define how future societies take shape around our world.

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