Measures to combat climate change could have appreciable direct as well as indirect benefits for public health, say authors of a series of six papers and four comments in The Lancet Online First.
In the first comment, authors from the London School of Hygiene and Tropical Medicine say that many policies to reduce greenhouse gas emissions can also have a range of ancillary effects, including effects on health. The authors of the first paper in the series looked at the effects of two hypothetical interventions: to improve the energy efficiency of UK housing stock (combined fabric, ventilation, fuel switching and behavioural changes); and to introduce 150 million low-emission household cookstoves in India. The UK housing changes were estimated to cut disability-adjusted life years (DALYs) by 850 and to save 0.6 megatonnes of carbon dioxide per million population in one year. Introducing cookstoves was calculated to result in substantial reductions in acute lower respiratory tract infection in children, chronic obstructive pulmonary disease and ischaemic heart disease resulting in 12,500 fewer DALYs and a saving of 0.1-0.2 megatonnes of carbon dioxide per million population per year.
A further paper modelled the health and environmental effects of changes to urban land transport in Delhi and London, which included lower-carbon-emission motor vehicles and a higher level of active travel. Increasing active travel – in either city – gave rise to more health as well as environmental benefits than increasing use of lower-emission motor vehicles. Much of the benefit arose from a reduction in the number of years of life lost from ischaemic heart disease, by 10-19% in London and 11-25% in Delhi. Other papers looked at the health effects of strategies linked to low-carbon electricity generation, short-lived greenhouse pollutants, and food and agriculture. In his own comment, Richard Horton, editor of The Lancet, points out how this research could help combat the public’s negative perception of initiatives to combat climate change: “The overwhelming impression among the public is that any response to global warming will be negative … We will have to drive less, fly less, eat differently, change the way we generate energy, and alter our lifestyles in ways that will limit our freedom to do as we please … Not surprisingly, this political message is hard to sell to a public already struggling during a time of global financial insecurity.” “Health is likely to become an increasingly important concern, not only for a public anxious about the impact of climate-change mitigation policies on their lives, but also for politicians eager to sweeten the climate-change policy pill. This latest report aims to accelerate political and public assent for large cuts in greenhouse-gas emissions.”
Professor Vivienne Nathanson, head of science and ethics at the British Medical Association, said of The Lancet’s papers: “Climate change not only contributes to disease and premature death but exacerbates existing health inequalities in the UK and globally. Today’s research shows that a reduction in emissions will have a positive effect on health in both high and low-income settings, and that lifestyle changes made by all us will have direct health benefits.”
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