Health as the Central Driver for Action on Climate Change

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This article, initially published on the OECD Forum Network on June 4th 2021, is part of a series in which OECD experts and thought leaders — from around the world and all parts of society — address the COVID-19 crisis, discussing and developing solutions now and for the future. Aiming to foster the fruitful exchange of expertise and perspectives across fields to help us rise to this critical challenge, opinions expressed do not necessarily represent the views of the OECD.

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The COVID-19 pandemic has exposed—on an accelerated timeline—that health is critical for a functioning and thriving society. As a result, the pandemic has placed health at the forefront of global discourse in an unprecedented way in modern times. Leading up to the 26th Conference of the Parties to discuss the Paris Agreement, this central importance of health cannot fade into the background; the health crisis unfolding from climate change must be highlighted with the same urgency within the global halls of power.

As both a practicing emergency medicine doctor and public health expert on climate change, I see the diagnosis clearly. The health harms of climate change are worsening, as highlighted in the 2020 Lancet Countdown global report, and the climate headwinds that threaten the achievement of universal health coverage (UHC) are growing. Action on climate change is the treatment needed, and the prescription required to achieve improved health, health equity, and optimal UHC.

Climate change is a metaproblem, meaning that it underlies the other crises of our time, and a threat multiplier, meaning that it makes them worse. Thus, the fingerprints of climate change can be found nearly everywhere through both direct and indirect impacts, especially on our health. While certain vulnerable countries and populations disproportionately bear the brunt, no country or individual is left untouched.

Find out more about the OECD's International Programme for Action on Climate providing policy advice and sharing best practices to support countries’ efforts to achieve the objectives of the Paris Agreement

Find out more about the OECD's International Programme for Action on Climate supporting countries’ efforts to achieve the objectives of the Paris Agreement

Climate change already has a frighteningly broad range of health harms that impact every organ in the body, and research is continually discovering new connections. While direct exposures like severe heat and the intensification of extreme weather often capture the headlines, more insidious exposures have just as significant health harms: air quality degradation from wildfire smoke, heat-driven ground-level ozone, and intensified pollen; threats to food supply and safety and access to clean water; greater vector-borne disease burdens also cropping up in new areas. In addition, social factors—like forced displacement—lead to cascading failures that harm health.

Minimising these exposures will improve health for all, but especially for those most vulnerable. At the same time, the burning of fossil fuels—which drives climate change—also produces air pollution that broadly harms health. This shared root cause means there will also be both short- and long-term health benefits of reduced air pollution in a transition away from fossil fuels.

The implications for health expand beyond individual health harms: climate change also threatens the health system itself. A critical Sustainable Development Goal is the achievement of UHC, which strives to optimise factors like the accessibility, quality and affordability of health care. Yet, climate change threatens the achievement of UHC through key pathways like altering disease burdens, displacing populations, contributing to rising poverty, disrupting health care infrastructure and delivery, and leading to health care workforce disruptions and impairments. Countries with the highest vulnerability to climate change also have the most to overcome to achieve UHC.

Browse "The Climate Crisis —Health and Care Delivery" and find out more about how the consequences of climate change directly affect human health, the practice of medicine, and the stability of health care systems

Read "The Climate Crisis —Health and Care Delivery", by M.D., M.P.H., Renee N. Salas & Caren G. Solomon, and find out more about how the consequences of climate change directly affect human health, the practice of medicine, and the stability of health care systems

The health community is increasingly realising that climate change fundamentally threatens its very mission to improve health, prevent harm and save lives. To begin to understand both the implications to health systems and the interventions required, a climate lens must be applied to each component. A climate lens is, simply, understanding the implications of climate change on something today and its anticipated future impacts.

In the United States, applying a climate lens to health care policy will ultimately lead to a more resilient and equitable health care system. For example, the creation of a national surveillance system for climate-related health risks can drive evidence-based resiliency efforts and save lives. In addition, payer systems, such as federal health insurance programmes like Medicare, can incentivise climate-relevant efforts around clinical quality and the expansion of health-related social needs. There are countless opportunities both in the United States and globally, with far-reaching health benefits.

In medicine, we often prioritise a primary diagnosis while also recognising that other diagnoses are interconnected. Yet, by identifying their shared central driver and focusing treatments accordingly, it is possible to treat them all in full—often with additional health benefits. Similarly, the benefits to health, health systems and health equity can be the central driver for climate action, with wide-ranging, interconnected benefits to other sectors whether environmental, economic or national security.

In a world battling the ongoing COVID-19 pandemic, the true fragility of health has never felt so personal and its importance so vital. Thus, there has never been a better time to put health at the centre of action on climate change.

Read the report "The long-term environmental implications of COVID-19" and see the latest OECD data for #ClimateAction, recommendations and policy advice on the Green Recovery

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Renee N. Salas

Yerby Fellow, Center for Climate, Health, and the Global Environment, Harvard T.H. Chan School of Public Health

Dr. Renee N. Salas is a leading expert at the nexus of climate change, health, and health care. She is Affiliated Faculty and previous Burke Fellow at the Harvard Global Health Institute (HGHI),  a Yerby Fellow at the Center for Climate, Health, and the Global Environment (C-CHANGE) at the Harvard T.H. Chan School of Public Health, and a practicing emergency medicine physician in the Department of Emergency Medicine at Massachusetts General Hospital and Harvard Medical School. Dr. Salas has served as the lead author of the Lancet Countdown on Health and Climate Change U.S. Brief since 2018 and founded the Working Group of over 70 U.S. organizations, institutions, and centers.

She was a Co-Director for the first Climate Crisis and Clinical Practice Symposium - in partnership with The New England Journal of Medicine - and spearheads the broader Initiative. She serves on the planning committee for the National Academy of Medicine’s Climate Change and Human Health Grand Challenge and has testified before Congress. Dr. Salas engages in research on how climate change is impacting the healthcare system and developing evidence-based adaptation, lectures and serves on committees at the nexus of climate and health nationally and internationally, and advises and publishes in high impact medical journals. Her work and expertise are regularly featured in mainstream media outlets like the New York Times, NPR, Time, and the Associated Press.