Medical journals around the world call climate change the world’s leading health risk

The world’s leading medical journals stepped into the climate change debate again with warnings of the dangers of climate change – grounded in health concerns but including concerns for equity, food security, and environmental destruction.  On September 4,  more than 220 leading medical, nursing and public health journals around the world published the same editorial, titled “Call for emergency action to limit global temperature increases, restore biodiversity, and protect health”.

An excerpt:

“Health is already being harmed by global temperature increases and the destruction of the natural world, a state of affairs health professionals have been bringing attention to for decades.  The science is unequivocal; a global increase of 1·5°C above the pre-industrial average and the continued loss of biodiversity risk catastrophic harm to health that will be impossible to reverse.

Despite the world’s necessary preoccupation with COVID-19, we cannot wait for the pandemic to pass to rapidly reduce emissions. Reflecting the severity of the moment, this Comment appears in health journals across the world. We are united in recognising that only fundamental and equitable changes to societies will reverse our current trajectory.”

The comment continues to state that “Targets are easy to set and hard to achieve”, and calls existing actions “insufficient”.  It calls on governments to  make “fundamental changes to how our societies and economies are organised and how we live. The current strategy of encouraging markets to swap dirty for cleaner technologies is not enough. Governments must intervene to support the redesign of transport systems, cities, production and distribution of food, markets for financial investments, health systems, and much more. Global coordination is needed to ensure that the rush for cleaner technologies does not come at the cost of more environmental destruction and human exploitation.” 

The editorial initiative was coordinated by the U.K. Health Alliance. The list of journals in which this statement appears is here, and includes The Lancet, the British Medical Journal,  the New England Journal of Medicine, Occupational and Environmental Medicine, The Journal of Climate Change and Health, and more than 200 other titles.  Canadian participants include the Canadian Journal of Respiratory Therapy and the Canadian Medical Association Journal.    The Canadian Association of Physicians for the Environment (CAPE) did not participate (not having its own journal), but on September 7 issued a echoed the same urgent concerns  in “A vote against fossil fuel subsidies is a vote for our health”.

2020 Lancet Countdown report on Health and Climate Change finds Canadians most at risk from extreme heat and air pollution

The Lancet Countdown Report on Health and Climate Change has been a landmark report since its first edition in 2015 (earlier reports are here ) .Compiled by an international team from more than 35 institutions including the World Health Organization and the World Bank, it documents the health impacts of climate change, and discusses the health and economic implications of climate policies. The global  2020 Countdown Report was released on December 2. Along with troubling statistics comes one core message:

“The COVID-19 pandemic and climate change represent converging crises. Wildfires and tropical storms in 2020 have tragically shown us that we don’t have the luxury of tackling one crisis alone. At the same time, climate change and infectious disease share common drivers. Responding to climate change today will bring about cleaner skies, healthier diets, and safer places to live–as well as reduce the risk factors of future infectious diseases.”

The Countdown project produces country-specific reports , with the Canada Briefing written by Drs. Claudel Pétrin-Desrosiers and Finola Hackett, and endorsed by the Canadian Medical Association.  The Canadian briefing presents updated information on two major issues: extreme heat and air pollution. Some highlights:

  • a record 2,700 heat-related deaths occurred among people over the age of 65 in Canada in 2018;
  • there were 7,200 premature deaths related to fine particulate air pollution from human-caused sources in Canada in 2018;
  • the work hours lost due to exposure to extreme heat was 81% higher in 2015-2019 than in 1990-1994 in Canada, with an average of 7.1 million extra work hours lost per year.

Although previous Canadian reports have called for carbon pricing, the 2020 report offers six recommendations which prioritize retrofitting and energy efficiency policies, along with funding for low-emissions transportation and active transportation.  The report also calls for: “…a recovery from COVID-19 that is aligned with a just transition to a carbon-neutral society, considering health and equity impacts of all proposed policies to address the climate and COVID-19 dual crises, directly including and prioritizing the disproportionately affected, including Indigenous peoples, older persons, women, racialized people, and those with low income.”

Courtney Howard, past president  of the Canadian Association of Physicians for the Environment writes “COVID-19 recovery is an opportunity to tackle worsening climate crisis: New report”  (The Conversation, Dec. 3).  The Canadian Medical Association announcement of the report is here ; and the CMA also released a recent survey  of its members, showing that 95% of respondents recognized the impacts of climate change, and 89% felt that  health professionals have a responsibility to bring the health effects of climate change to the attention of policy-makers . The World Health Organization sponsored the survey as part of a global initiative –  the Canadian results will be included  in a global WHO report scheduled for release in January 2021.

Students benchmark the climate change content of curriculum in Canadian medical schools

The Health and Environment Adaptive Response Task Force (HEART)  is a group within the 8,000 member Canadian Federation of Medical Students . Its core purpose is to advocate for improvements in the medical curriculum to include the crucial links between health and climate and environmental change. In January 2020,   HEART released  Canada’s first-ever National Report on Planetary Health Education , meant to establish a benchmark on planetary health education in Canadian medical schools, and to provide schools with best practices and recommendations for improvements. Some of the practical examples cited: incorporating  “the effects of air pollution with respiratory health teaching, discussing climate-related displacement within teaching on refugee and migrant health, and exploring the increasing burden of heat stress on health-care systems. Furthermore, case-based sessions can highlight the effects on specific individuals. Examples could include considering isolated older people at risk of heat stroke or of being in extreme weather events, or discussing the effects of flooding or poor water quality on Indigenous communities.”

The HEART analysis identified the University of Alberta, the Northern Ontario School of Medicine and Dalhousie University as leaders, “where environmental issues are covered at greater length through lectures, assignments and extracurricular opportunities.”  The report is based on survey responses from  “nearly 50 students”  and 10 faculty members representing all 17 Canadian medical schools, and includes brief best practice examples.

The students also published a Commentary in Lancet Planetary Health on January 7   , “Training Canadian doctors for the health challenges of climate change”, which announces their report and aligns themselves with the Fridays for Future youth movement. It also puts their advocacy within the context of  global campaigns by medical students (for example, the International Federation of Medical Students Associations ) and the Call to Action on Climate Change and Health  in Summer 2019 by the Canadian health professionals’ associations, led by the Canadian Association of Physicians for the Environment.

 

Scientists, engineers, doctors protest the climate emergency

Scientists captured global attention with dire climate warnings in November when the mainstream media amplified their message contained in an article published in the academic  journal BioScience.  The article itself is clear and direct, beginning with:

“Scientists have a moral obligation to clearly warn humanity of any catastrophic threat and to “tell it like it is.” On the basis of this obligation and the graphical indicators presented below, we declare, with more than 11,000 scientist signatories from around the world, clearly and unequivocally that planet Earth is facing a climate emergency.”

On the issue of The Economy, the article states: “Excessive extraction of materials and overexploitation of ecosystems, driven by economic growth, must be quickly curtailed to maintain long-term sustainability of the biosphere. We need a carbon-free economy that explicitly addresses human dependence on the biosphere and policies that guide economic decisions accordingly. Our goals need to shift from GDP growth and the pursuit of affluence toward sustaining ecosystems and improving human well-being by prioritizing basic needs and reducing inequality.”

The Alliance of World Scientists invites scientists from around the world to sign on to the message. Summaries about the warnings appeared in The Guardian here  and in Common DreamsWarning of ‘Untold Human Suffering,’ Over 11,000 Scientists From Around the World Declare Climate Emergency” .   A Canadian viewpoint  appears in an article in the  Edmonton edition of the Toronto Star ,“5 Alberta scientists tell us why they joined 11,000 scientific colleagues in declaring a climate emergency” .

Engineers:

Like the scientists, other professionals recently spoke up about their “moral obligation” to do what they can to fight the climate emergency.  “Leading Australian engineers turn their backs on new fossil fuel projects” in The Guardian reports: “About 1,000 Australian engineers and 90 organisations – including large firms and respected industry figures who have worked with fossil fuel companies – have signed a declaration to “evaluate all new projects against the environmental necessity to mitigate climate change”.  The article focuses on  a new group, Australian Engineers Declare  , which issued an Open Letter in September 2019,  acknowledging that their professional organization, Engineers Australia, has a strong policy regarding climate change, but calling for faster action to address climate breakdown and biodiversity loss.  Engineers Declare states that engineers are connected to 65% of Australia’s greenhouse gas emissions, and that “engineering teams have a responsibility to actively support the transition of our economy towards a low carbon future. This begins with honestly and loudly declaring a climate and biodiversity emergency…we commit to strengthening our work practices to create systems, infrastructure, technology and products that have a positive impact on the world around us.” The declaration continues to list specific actions, including: “Learn from and collaborate with First Nations to adopt work practices that are respectful, culturally sensitive and regenerative.”

Physicians:

doctors DXR-logo-webOn November 1, the editor-in-chief of The Lancet, one of the world’s most prestigious  medical journals which has published a Countdown Report on Climate Change and Health since 2016.  As reported in “Protesting climate change is a doctor’s duty” ,  the most recent remarks were made in a video  which calls for health professionals to engage in nonviolent social protest to address climate change. The video cites the British professional standard, Duties of a Doctor, and lauds  Doctors for Extinction Rebellion , four of whom have been arrested in London. The website of Doctors for Extinction Rebellion chronicles recent activities including that on October 17th 2019, the Royal College of Physicians committed to Divest from Fossil Fuels.

Climate change and health: a new call to action for doctors

Two new articles appeared in the January issue of the New England Journal of Medicine, recognizing the health impacts of climate change and the gap in environmental justice. Most frequently cited, sometimes with alarmist headlines, is  “The Imperative for Climate Action to Protect Health” (Jan. 17)  (registration required). The authors state that the World Health Organization may have underestimated the health effects of climate cop24_health_climate_change_reportchange when it predicted in a 2018 report that climate change will kill 250,000 people per year between 2030 and 2050.  The NEJM authors Haines and Ebi state: “We think the impact is more difficult to quantify because there is also population displacement and a range of additional factors like food production and crop yields, and the increase in heat that will limit labour productivity from farmers in tropical regions that wasn’t taken into account, among other factors. ”  They point to the need for investment and policies to promote adaptation to reduce health risks.

The other article in January’s New England Journal of Medicine is an overview of the issue and a more direct call to action for doctors.  ” Climate Change: A health emergency ”   by Drs. Caren G. Solomon and Regina C. LaRocque states:    “Disruption of our climate system, once a theoretical concern, is now occurring in plain view — with a growing human toll brought by powerful storms, flooding, droughts, wildfires, and rising numbers of insect borne diseases. Psychological stress, political instability, forced migration, and conflict are other unsettling consequences. In addition, particulate air pollutants released by burning fossil fuels are shortening human life in many regions of the world. These effects of climate disruption are fundamentally health issues, and they pose existential risks to all of us. People who are sick or poor will suffer the most….As physicians, we have a special responsibility to safeguard health and alleviate suffering. Working to rapidly curtail greenhouse gas emissions is now essential to our healing mission….  The authors’ call to action includes: “working with medical students on climate action, supporting the undergraduate divestment movement, joining forces with like-minded health professionals, and speaking with our legislators. “

In Canada, the Canadian Association for Physicians and the Environment (CAPE)   is leading the way on such education and advocacy – a compilation of their press releases  reveals the broad range of their actions. Most recently, on January 15, CAPE announced  that the Ontario Court of Appeal has granted intervenor status to the Intergenerational Climate Coalition, of which  CAPE is a member, to defend the constitutionality of the federal pricing of climate emissions, challenged by the Ontario provincial government in a case to be heard in April 2019.  Other members of the Intergenerational Climate Coalition are Generation Squeeze,  Saskatchewan Public Health Association, the Public Health Association of BC, the Canadian Coalition for the Rights of Children , and the Youth Climate Lab.  The same group announced in December 2018  that it has intervenor status in the Saskatchewan government’s challenge to the federal carbon tax plan.

UPDATE: 

A February 5 press release states: “Together, representatives from the Canadian Association of Physicians for the Environment (CAPE) , the Canadian Medical Association (CMA)  , the Canadian Nurses Association (CNA), the Canadian Public Health Association (CPHA) and the Urban Public Health Network (UPHN) are calling for action: asking federal parties to recognize that climate change is the greatest public health challenge of the 21st century, and to make climate solutions a priority in the 2019 federal election.”

Dr. Gigi Osler, President of the Canadian Medical Association (CMA) is quoted  : “Climate change is no longer some abstract idea that may harm future generations or people on the other side of the globe; it’s a reality that’s already harming the physical and mental health of Canadians. We cannot afford to treat climate change as a wedge issue. We must treat it as the public health crisis that it is.”