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Worse is coming and that's why for the past 20 years, the health and medical community has tried to raise public awareness of this issue. Unfortunately, the clearly documented and growing health effects aren't often spoken about in Australia. In part, this is due to scarce funding, a hostile political environment and the formidable size and scope of the "modelling exercise" required to begin to describe what will happen if pollution continues at current rates.
However, whilst climate change and health research in Australia is limited we only need to look to our recent history as a portent of things to come.
During the 2009 heatwaves that preceded the Black Saturday bushfires in Victoria there were double the number of deaths from heat related illness as there were from the bushfires. Those most at risk are the very old, very young, people with chronic disease and those on illicit or prescribed medications that mask heat-related stress, as well as those working outdoors or already exposed to high temperatures. It's been documented that asthma presentations to hospitals also increase on such days as well as in dust storms. This is without taking into account the smoke haze created by prescribed burns which are used to prevent bushfires from raging out of control.
When a cyclone or (as occurred recently in Adelaide and Brisbane) a wild storm hits, the health effects are widespread, severe and difficult to deal with. Nor are they confined to the day itself. In disaster preparation an event that cripples health infrastructure is referred to as a "complex disaster". This might mean there are hospitals without power, or people with chronic disease unable to access medications. Hurricane Katrina in New Orleans is one example.
While Australia has one of the best disaster response systems in the world, it is dependant on states and territories backing each other up to cope. It is unclear whether even our systems are robust enough to manage as these extreme weather events become more intense and occur more often.
Even without factoring in climate change we know more and more patients will add to the strain on our hospital system as the population increases and ages. We might find new, innovative ways of treating more patients but ultimately we – the health workforce – is a limited resource. It's not difficult to envisage our health system capacity (compounded by staff absenteeism) becoming overwhelmed.
By nature, the medical profession is conservative and doesn't like conflict or making a fuss. We like to be absolutely sure before we do. While you might find varying opinions within the health and medical community about their personal responsibility and action on climate change everyone is uniform in accepting the evidence that shows this problem is only getting worse. Notably, many medical and nursing colleges (and the Australian Medical Association) have formal position statements on climate change.
So where is the urgency - particularly given the less than ten year timeframe towards a "positive feedback loop" situation? This refers to certain tipping points that - once reached – mean exponential and potentially irreversible change. This also happens in serious illness, where even the fittest and healthiest bodies can fail when the primary "insult" (ie trauma, infection) is so large it overwhelms you.
This is where some uncertainty exists about possible changes in the climate system ie what will it look like when the complex web of interactions occurs. The only thing that's certain is it will be everyone's problem.
So, what must be done? Even the most cynical health professional agrees that prevention is better than cure, and while we still have a chance we must try to avoid disaster.
There is much to learn from other countries. For example, the National Health Service in the UK has a sustainability unit that's dramatically cut emissions from health care. Some local private hospital networks have already seen fit to take this pathway. A global network with strong connections in Australia, the Global Green and Healthy Hospitals initiative features many examples of healthcare services leading by example by cutting emissions, and improving population health at the same time.
In national climate policy, Australia lag behinds many wealthy and not so wealthy countries. This is an opportunity missed! Just think of the health benefits of leafy, pedestrian- and cycle-friendly towns and cities, where people are more active and breathing cleaner air.
Health care professionals want to see rapid change, and that's why many of us are advocating for a national strategy on climate change and health in Australia – exemplified by the attendance of many health and medical leaders at a recent roundtable in Parliament House.
This approach offers us the opportunity to co-design policies with government and political parties that ensure health implications are considered when deciding how to tackle climate change – and imbuing such talks with the sense of urgency that the science dictates. We are worried not only for our patients, but also for ourselves and our families.
The cure is known – it's time to act.
*Dr Marianne Cannon and Dr Joseph Ting are emergency physicians based in Brisbane.
Links
- Climate-endangered nations sign up to 100 per cent renewable energy
- The North Pole is an insane 20C warmer than normal as winter descends
- The Exceptional Heatwave of January-February 2009 in South-Eastern Australia
- Planetary Boundaries: Exploring the Safe Operating Space for Humanity
- St Vincent’s Health to install 2.7MW solar across 16 sites
- Australians left critically vulnerable to climate change: health experts warn
