Blog

Climate change and health equity

By Pemma Muzumdar (she/her) on February 26, 2020

Pemma Muzumdar (she/her), MPH

Knowledge Translation Specialist

Pemma is racialized as Brown. Through various roles with the six National Collaborating Centres for Public Health, Pemma has worked at the nexus of public health, knowledge translation, and systems change for the past 12 years. She is passionate about public health system renewal, building a culture of equity in public health organizations, and supporting public health to address root causes of health inequities. At the National Collaborating Centre for Determinants of Health, her work and leadership is focused on: operationalizing values such as reciprocity, solidarity, and social justice through a range of program and policy approaches (e.g. those informed by critical race theory, intersectionality, decolonization); disrupting racism and White supremacy; analyzing opportunities for public health to respond to the inequitable climate crisis; and framing messages about the structural and social determinants of health. Pemma co-leads the Health Equity Collaborative Network (a group of health equity-focused public health staff from across Canada) and co-produces Mind the Disruption, a podcast about building a healthier world for everyone. She completed her Masters of Public Health at the University of Waterloo in 2010. 

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This is the first blog in a series that explores the connections between climate change, health equity and public health. Click here to read the second blog in this series.

We look forward to your responses. Feedback, comments or stories from the field can be sent to author Pemma Muzumdar, NCCDH Knowledge Translation Specialist, at [email protected].

What is climate change?

Climate change refers to a long-term change in weather conditions that is already under way.[1,2] The main causes of climate change include humans burning fossil fuels to power their everyday lives; destroying forests; and releasing methane into the atmosphere through animal agriculture, food waste and the extraction and use of natural gas.[1,2,3,4,5] As a result, unsustainable amounts of carbon dioxide and other heat-trapping gasses have accumulated in the earth’s atmosphere. This has caused polar ice caps to melt; sea levels to rise; precipitation patterns to change; and the number of extreme weather events such as heat waves, hurricanes, floods and forest fires to increase.

With further emissions and warming, the situation is predicted to worsen. Global temperatures have increased by approximately 1°C since preindustrial times.[4] Comparing average temperatures in 2016 to 1948 reveals that Canada’s average temperature has increased by 1.7 °C. [6] What’s more, Northern Canada is warming three times faster than the rest of the world, [1,6,7] which compounds the climate change impacts on northern Indigenous communities.

Related resources For a more comprehensive look at how Canada’s climate has changed, visit the website for Canada’s changing climate report. [6] The Frequently Asked Questions section of this report is a great place to start.     For an infographic (shown at right) that compares the scenarios of limiting warming to 1.5°C as compared to 2°C, visit the World Resources Institute. [8] For a summary of key findings from the 2018 Intergovernmental Panel Climate Change report, read the Summary for policymakers. [9] Image: World Resources Institute infographic [10] showing climate impacts at 1.5°C and 2°C average global temperature change

Climate change is a public health issue

Climate change is a public health issue because it threatens what we need to survive at a very basic level, including the air we breathe, the food we eat and the structures under which we find shelter. [11] A World Health Organization (WHO) assessment estimated that between 2030 and 2050, a changing climate would cause an additional 250,000 deaths per year due to heat stress, diarrhea, malaria and malnutrition. [12]

In Canada, air pollution, a major climate-related health impact, is linked to an estimated 14,600 premature deaths per year. [13] In a 2019 report, the Council of Canadian Academies listed health and human wellness as one of the six areas of climate risk due to the “adverse impacts on physical and mental health due to hazards accompanying extreme weather events, heatwaves, lower ambient air quality, and increasing ranges of vector-borne pathogens.” [14(pⅸ)]

Climate change and health equity: Multiple intersections

The risks and impacts of climate change affect everyone; however, not everyone is affected equally. Summarized below, the relationship between climate change and health equity is complex and multifaceted.

Climate change as a structural driver of inequity

Climate change and the effect it has on the natural environment is, in fact, structural; it shapes systems, the daily conditions of life and, ultimately, opportunities for health and a dignified life.

This is how climate change is depicted in a 2019 Pan American Health Organization conceptual framework. [22] Here, climate change is considered alongside other structural determinants of health inequities such as racism and colonization, as well as social, political and economic systems.

Image: The Pan American Health Organization conceptual framework names climate change as one of the structural drivers of inequity. [23]

Unequal vulnerability

Those who already experience structural inequities such as colonization, racism and low income are often most vulnerable to climate change risks and impacts. [5,24,25]

This concept is explored in a graphic published in a 2019 US policy brief. Here, unequal vulnerability in a heat wave is depicted as depending on multiple factors. These factors include what makes a person particularly susceptible to negative health outcomes (e.g., being a child with asthma), what a person is exposed to (e.g., living near sources of air pollution, and air pollution being worsened by heat), as well as what influences the ability to adapt to these circumstances (e.g., access to health care, income, and family support). [26,27]  

Image: Unequal health vulnerability in a heat wave [28]

Compounding existing inequity

The harsh impacts of a changing climate have the potential to worsen existing health inequities within countries. [24,29] Consider, for example, a low-income family without adequate insurance trying to recover after being displaced following a forest fire. Or think of an Inuit family increasingly unable to travel safely on melting ice to access traditional food sources.

Climate justice, climate debt

The concepts of climate justice and climate debt are also relevant to discussions about health equity and climate change.

Climate justice applies human rights and social justice perspectives [29] in recognition that those who are most affected by climate change (e.g., Indigenous peoples, people living in the Global South) are also least responsible for causing it. [29]

Moreover, the climate justice movement asserts that richer countries from the Global North have disproportionately emitted greenhouse gases and should therefore pay a climate debt. This means financing the cost for developing countries to adapt to global warming while also acting to prevent further climate change. [30,31] 

Photo credit: MI PHAM

References

[1] Canadian Public Health Association. Climate change and human health [Internet]. Ottawa (ON): CPHA; 2019 [cited 2020 Jan 12]. 12 p. Available from: https://www.cpha.ca/climate-change-and-human-health. 

[2] McGushin A. Climate change toolkit for health professionals: module 1 climate change – science drivers and communities [Internet]. Toronto (ON): Canadian Association of Physicians for the Environment; 2019 [cited 2020 Jan 21]. 15 p. Available from: https://cape.ca/wp-content/uploads/2019/04/Module-1-FINAL-TO-UPLOAD-SOLO-April-5-2019.pdf.

[3] Government of Canada. Causes of climate change [Internet]. Ottawa (ON): Gov of Canada; 2019 [cited 2020 Jan 21]; [about 6 screens]. Available from: https://www.canada.ca/en/environment-climate-change/services/climate-change/causes.html.

[4] Climate change Atlas of Canada. Climate change: the basics [Internet]. Winnipeg (MB); 2019 [cited 2020 Jan 21]; [about 11 screens]. Available from: https://climateatlas.ca/climate-change-basics.

[5] Rudolph L, Harrison C, Buckley L, North S. Climate change, health, and equity: a guide for local health departments [Internet]. Oakland (CA), Washington (DC): Public Health Institute and American Public Health Association; 2018 [cited 2020 Jan 12]. 370p. Available from: http://nccdh.ca/resources/entry/climate-change-health-and-equity-a-guide-for-local-health-departments.

[6] Bush E, Lemmen DS, editors. Canada’s changing climate report: advancing our knowledge for action [Internet]. Ottawa (ON): Government of Canada; 2019 [cited 2020 Jan 14]. 442 p. Available from: https://changingclimate.ca/CCCR2019/.

[7] Inuit Tapiriit Kanatami. National Inuit Climate Change Strategy [Internet]. Ottawa (ON): Inuit Tapiriit Kanatami; 2019 [cited 2020 Jan 14]. Available from: https://www.itk.ca/national-inuit-climate-change-strategy/resources/.

[8] Levin K. Half a degree and a world apart: the difference in climate impacts between 1.5˚c and 2˚c of warming [Internet]. Washington (DC): World Resources Institute; 2018 [cited 2020 Jan 21]; [about 12 screens]. Available from: https://www.wri.org/blog/2018/10/half-degree-and-world-apart-difference-climate-impacts-between-15-c-and-2-c-warming.

[9] Allen M, Babiker M, Chen Y, et al. Summary for policymakers [Internet]. In: Special report: global Warming of 1.5°C. Masson-Delmotte V, Zhai P, Pörtner HO, et al, editors. 2018, in press [cited 2020 Jan 21]. 24 p. Available from: https://www.ipcc.ch/site/assets/uploads/sites/2/2019/05/SR15_SPM_version_report_LR.pdf.

[10] Levin K. Half a degree and a world apart: the difference in climate impacts between 1.5˚c and 2˚c of warming [Internet]. Washington (DC): World Resources Institute; 2018. [Figure], Half a degree of warming makes a big difference; [cited 2020 Jan 21]; [about 12 screens]. Available from: https://www.wri.org/blog/2018/10/half-degree-and-world-apart-difference-climate-impacts-between-15-c-and-2-c-warming.

[11] World Health Organization. COP24 Special report: health and climate change Geneva:WHO; 2018 [cited 2020 Jan 21]. 74 p. Available from: https://www.who.int/globalchange/publications/COP24-report-health-climate-change/en/.

[12] World Health Organization. Climate change and health [Internet]. Geneva: WHO; c2020 [cited 2020 Jan 21]; [about 10 screens]. Available from: https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health.

[13] Health Canada. Health impacts of air pollution in Canada: estimates of morbidity and premature mortality outcomes, 2019 report [Internet]. Ottawa (ON): Government of Canada, Health Canada; c2019 [cited 2020 Jan 21]. 36 p. Available from: http://publications.gc.ca/site/eng/9.874080/publication.html.

[14] Council of Canadian Academies. Canada’s top climate change risks: the expert panel on climate change risks and adaption potential [Internet]. Ottawa (ON): CCA; 2019 [cited 2020 Jan 21]. 70 p. Available from: https://cca-reports.ca/wp-content/uploads/2019/07/Report-Canada-top-climate-change-risks.pdf.

[15] Howard C, Buse C, Rose C, MacNeill A, Parkes M. The Lancet countdown on health and climate change: policy brief for Canada [Internet]. Lancet Countdown, CMA, CPHA: 2019 [cited 2020 Jan 12]. 8 p. Available from: https://storage.googleapis.com/lancet-countdown/2019/11/Lancet-Countdown_Policy-brief-for-Canada_FINAL.pdf.

[16] American Public Health Association. How climate change affects your health [Internet]. [location unknown]: APHA; c2020 [date unknown, cited 2020 Jan 21]; [about 6 screens]. Available from: https://www.apha.org/news-and-media/multimedia/infographics/how-climate-change-affects-your-health.

[17] American Public Health Association. How climate change affects your health [Internet]. [location unknown]: APHA; c2020. [Figure], How climate change affects your health; [cited 2020 Jan 21]; [about 6 screens]. Available from: https://www.apha.org/news-and-media/multimedia/infographics/how-climate-change-affects-your-health.

[18] Martin W, Vold L. Climate change and health: it’s time for nurses to act. A discussion paper [Internet]. Ottawa (ON): Canadian Federation of Nurses Unions; 2019 [cited 2020 Jan 12]. Available from: https://nursesunions.ca/wp-content/uploads/2019/05/CFNU_climatechange-web.pdf.

[19] Canadian Medical Association. Climate change and health [Internet]. : CMA; c2020 [date unknown, cited 2020 Jan 21]. Available from: https://www.cma.ca/climate-change-and-health.

[20] Canadian Nurses Association. Climate change and health position statement [Internet]. [location unknown]: CNA; 2017 [cited 2020 Jan 12]. Available from: https://www.cna-aiic.ca/-/media/cna/page-content/pdf-en/climate-change-and-health-position-statement.pdf.

[21] Perrotta K, Howard C, Canadian Medical Association, Canadian Nurses Association, Urban Public Health Network, Canadian Public Health Association. Call to action on climate change and health [Internet]. Toronto (ON): Canadian Association of Physicians for the Environment; 2019 [cited 2020 Jan 21]. 5 p. Available from: https://cape.ca/wp-content/uploads/2019/12/Call-to-Action-ENGLISH-Dec-2019.pdf.

[22] Pan American Health Organization. Just societies: health equity and dignified lives. executive summary of the report of the Commission of the Pan American Health Organization on equity and health inequalities in the Americas [Internet]. Washington (DC): PAHO; 2018 [cited 2020 Jan 21]. 285 p. Available from: http://iris.paho.org/xmlui/handle/123456789/51571.

[23] Pan American Health Organization. Just societies: health equity and dignified lives. executive summary of the report of the Commission of the Pan American Health Organization on equity and health inequalities in the Americas [Internet]. Washington (DC): PAHO; 2018. Figure 1.1, Conceptual framework; [cited 2020 Jan 21]. p. 6. Available from: http://iris.paho.org/xmlui/handle/123456789/51571.

[24] Buse CG. Health equity, population health, and climate change adaptation in Ontario, Canada [Internet]. Health Tomorrow. 2015;3(1):26-51 [cited 2020 Jan 12]. Available from: https://ht.journals.yorku.ca/index.php/ht/article/view/40177.

[25] Kumar N. Cities, climate change, and health equity [Internet]. Toronto (ON): Wellesley Institute; 2018 [cited 2020 Jan 12]. 12 p. Available from: https://www.wellesleyinstitute.com/wp-content/uploads/2018/06/Cities-Climate-Change-Health-Equity-WIJune-2018-fv.pdf.

[26] Islam SN, Winkel J. Climate change and social inequality [Internet]. New York (NY): United Nations, Department of Economic and Social Affairs; 2017 [cited 2020 Jan 12]. 30 p. Available from: https://www.un.org/esa/desa/papers/2017/wp152_2017.pdf.

[27] Salas RN, Knappenberger P, Hess JJ. Lancet countdown 2019: 2019 Lancet countdown on health and climate change policy brief for the United States of America [Internet]. London (UK): American Public Health Association; 2019 [cited 2020 Jan 12]. 11 p. Available from: https://www.lancetcountdownus.org/2019-lancet-countdown-us-brief.

[28] Salas RN, Knappenberger P, Hess JJ. Lancet countdown 2019: 2019 Lancet countdown on health and climate change policy brief for the United States of America [Internet]. London (UK): American Public Health Association; 2019. Figure 1, Unequal health vulnerability in a heatwave; [cited 2020 Jan 12]. p. 5. Available from: https://www.lancetcountdownus.org/2019-lancet-countdown-us-brief.

[29] United Nations. Sustainable development goals: climate justice [Internet]. UN; 2019 [cited 2020 Jan 21]. [about 3 screens]. Available from: https://www.un.org/sustainabledevelopment/blog/2019/05/climate-justice/. 

[30] Warlenius R. Decolonizing the atmosphere: the climate justice movement on climate debt. J Environ Dev. 2017;27(2):131-55.

[31] Saraswat C, Kumar P. Climate justice in lieu of climate change: a sustainable approach to respond to the climate change injustice and an awakening of the environmental movement. Energy Ecol Environ. 2016;1(2):67–74.

[32] National Collaborating Centre for Determinants of Health. Climate change, health equity and public health responses: a curated list [Internet]. Antigonish (NS): NCCDH, St Francis Xavier University; 2020 [in press]. Available from: http://nccdh.ca/resources/entry/climate-change-health-equity-and-public-health-responses-a-curated-lis.

[33] National Collaborating Centre for Determinants of Health. Climate change, public health and equity [video on the internet]. Antigonish (NS): NCCDH, St Francis Xavier University; 2019 [cited 2020 Jan 21]. Available from: http://nccdh.ca/workshops-events/entry/webinar-climate-change-public-health-and-equity.

[34] Muzumdar P. Centring equity in emerging public health responses to climate change [blog on the internet]. Antigonish (NS): National Collaborating Centre for Determinants of Health, St Francis Xavier University; 2020 [cited 2020 Jan 21]. Available from: http://nccdh.ca/fr/blog/entry/centring-equity-in-emerging-public-health-responses-to-climate-change

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