Extract from ABC News
By Catherine Taylor and Bridget Judd
For many Australians who have grown up in our "sunburnt country", last week's nation-wide heatwave may have felt like business as usual. It's almost summer, after all.
But if you dig into the statistics, the picture that emerges is deeply alarming, especially when considered in light of last year's devastating bushfires: We've just experienced Australia's warmest November on record.
The hottest year on record was 2019, and 2020 continues to track in the same direction. Back-to-back days of 40 degrees-plus in Sydney last week occurred for only the second time in 162 years.
But it's not just the environment that's suffering. Growing numbers of Australians are experiencing health problems, and even an increased risk of death, as a result of a rapidly changing climate.
The Medical Journal of Australia/Lancet Countdown on health and climate change this week argued urgent action is needed to prevent human health being further affected.
The health impact of climate change has already led to a 53.7 per cent global increase in heat-related mortality between 2010 and 2018, mainly affecting Japan, China, central Europe and northern India.
In Australia, in the same timeframe we've seen a 22 per cent increase in the annual average number of days of population exposure to bushfires, which killed 41 people last summer and exposed "much of Australia's population to hazardous air quality for a prolonged period of time".
Exposure to mosquito-born diseases including malaria and dengue fever has also increased along with the threat from zoonotic disease, graphically demonstrated by the COVID-19 pandemic. Food security took a hit, too, implying associated malnutrition.
So what is being done to improve the health outcomes of Australians in the face of accelerating climate change? And which foreign nations should Australia be looking to as leaders?
Who is responsible?
Australia's federal system makes healthcare a state responsibility — we have seen this play out during the coronavirus pandemic.
Because of this state-based approach, not all states and territories are on the same page when it comes to strategies linking health and climate.
Western Australia is preparing to release the results of its Climate Health WA Inquiry, which will emphasise connections between climate change and physical and mental health, vulnerability and resilience. Victoria and Queensland have similar documents.
But there are growing calls for Australia to develop a national plan of action that considers the widening impact of global warming on health as a problem in its own right, not tied to progress on climate change policy.
"I think a national approach is absolutely essential, particularly when we get to the emergency management of these things," says Andrew Gissing, a risk and resilience expert from Risk Frontiers.
Gissing argues the importance of a national approach is obvious in areas like warning systems for extreme heat, which can't be coordinated effectively with a state-by-state approach. Heatwave warning systems is an area the Bureau of Meteorology is working on.
Richard Yin, a Perth GP and member of Doctors for the Environment, has been arguing for a national health and climate change plan for years.
Australia does not have such a strategy, he says, and according to the MJA/Lancet report, only about 50 of 100 countries in the survey do, with less than 4 per cent of those that are in place considered effective.
"Australia needs to prepare for climate change impacts on health and that means actually mapping what's going on and being able to predict what's going on," Yin says. "There's a complexity to the task and a number of indicators that we're going to need to try to track."
Yin says that because he's in Perth, his patients seem to be avoiding the worst health affects of climate change. But he is seeing more patients coming to him with what he describes as "eco-anxiety".
Yin's colleagues working in regional WA are regularly treating patients for heat-related health conditions, he adds, and in some cases people have had to move because of the impact of smoke from bushfires.
"The health impacts from smoke can be can be horrific," Yin says, noting some people with asthma or lung disease have been in and out of hospital emergency departments until deciding to leave the place they're living, "because it's life threatening".
Georgia Behrens, Chair of the Australian Medical Students' Association's global health committee, agrees COVID-19 has proven how effectively Australia can manage national health emergencies by using a coordinated approach.
"With a shared set of goals and principles we can work consistently across the country," she says. "[The pandemic] has given us some early indications of a way that model could potentially work to tackle this shared health emergency."
Which countries are doing it best?
From cooling rooms in France to England's heatwave plan, addressing the health impacts of climate change is a rapidly developing sector.
But Yin struggles to single out one country he feels has achieved the right approach to this problem. He notes the UK has made progress, but he believes its strategy "doesn't really capture all of the issues and the planning was very general".
And even if another country did show leadership, he says, it wouldn't necessarily act as a blueprint for Australia because climate is so regionally specific. One area may be prone to extreme heat, but another faces flooding. Mosquito-borne diseases may be escalating in one place, while bushfire smoke affects another.
Gissing believes practical solutions can be a good first step — for instance, by providing localised information about neighbourhood temperatures and where to find "the coolest places" to spend time.
For Behrens, Germany is showing leadership with its strategy for establishing a dedicated department within the national health ministry that investigates health in the age of climate change — particularly in the way it has coordinated a national and regional plan — which could be relevant to Australia.
"I think this provides a really useful example of the way we could potentially proceed," she says, "acknowledging the shared challenge, and taking shared responsibility."
Changes we can make right now
Although it will take time to change the climate's warming trajectory and implement environmental policies at government level, there are discreet, piecemeal changes that can be put in place more quickly, Behrens says.
Urban planning can help cities plan to avoid becoming "heat traps", and develop spaces aimed at improving physical and mental health.
Gissing recommends increasing green spaces on both a large (parkland) and small scale (street planting) to offer shade or cooler zones throughout suburbs.
Even something as simple as retrofitting homes with heat-reflective roofing and reducing concrete and paving in backyards by increasing grassed areas can reduce what he calls "heat sinks around the home" and lower air temperatures.
When it comes to fighting fires, Gissing advocates investment in technology that can lead us to "the next generation of firefighting".
"How are we going to be fighting fires in 2040 or 2050 when the frequency of blazes is only going to increase because of climate change?" he says, pointing out that new technology which aims to rapidly detect and suppress fires could prevent catastrophic fire events in the future.
But we also need to improve people's access to zones Gissing calls "cooling refuges" — public swimming pools, air-conditioned shopping centres or even building links between neighbours who are able to help each other out.
"We will need community information about heatwaves, volunteers to manage transport, and shelters," Gissing adds, noting that vulnerable and elderly people may have trouble reaching these "cooling refuges" even if they exist.
"An integrated approach is the key."
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