People’s health and well-being are affected by various factors, including behaviour, genetic make-up, demographic elements such as age, gender and population sub-group, and increasingly by the environment and changing climate. Reducing Europe’s greenhouse gas emissions by 20% by 2020 would lead to health savings worth €52 billion annually, according to estimates by the Health and Environment Alliance and Health Care Without Harm Europe. Thus not only are there personal reasons to value and promote health as a key component of well-being, it is also in the interests of the public purse and authorities. However, when we look at the inter-linkages between the environment, climate and health, it is obvious that much more should be done to reduce and prepare for unwanted health consequences.
Disruptions to our environment, often as a result of our own actions, are affecting basic elements of our well-being. Air pollution is a good example. European Environment Agency (EEA) data shows that 12 EU member states exceeded national emission levels in 2010. This is mainly due to road transport, which is a significant source of air pollutants, namely nitrogen oxides. Not only do emissions contribute to climate change, but they also have more short-term consequences: causing people respiratory problems, contributing to acidification of soil and surface water, and damaging vegetation.
Add to the picture potential environmental and climatic risks deriving from climate change such as floods, droughts, storms, changes in local air quality, heat waves, fires and increased UV radiation, and it becomes clear that the impact on people’s health will only grow. Extreme heat increases levels of air pollution, which causes cardiovascular and respiratory diseases that can be deadly especially among elderly people, as seen in Europe during heat waves in 2003. Extreme weather events damage homes and medical facilities, and may put unbearable strain on health systems. Global warming is expected to affect distribution of infectious diseases such as malaria. Changing rainfall patterns affect agriculture and freshwater supplies, and thus affect the key elements of our well-being: food and water.
We can no longer close our eyes to the fact that our surrounding environment and climatic changes have an enormous impact on our well-being. To stay healthy, promote health and well-being, prevent diseases, and treat and care for people, we need healthier environments and we need to prepare for current and future effects of climate change. We need to mitigate our impact on the environment by reducing our greenhouse gas emissions and adapting our societies, including infrastructures and health systems, to extreme weather events, environmental disasters and changing weather and environmental conditions.
The EU recognises the importance of mitigation efforts and has set itself ambitious energy and climate change objectives for 2020, known as the 20/20/20 targets. These are reducing greenhouse gas emissions by 20%, improving energy efficiency by 20% and increasing the share of renewable energy in the EU’s energy mix to 20%. These goals have been incorporated into the ‘Europe 2020’ strategy for smart, sustainable and inclusive growth and its flagship initiative ‘Resource-efficient Europe’.
However, the EU is not set to meet these targets. To boost member states’ interest in meeting these targets, more discussion on the direct and indirect short- and medium-term benefits for Europe is clearly necessary. Health benefits are a perfect example. In addition to the direct health savings from reducing greenhouse gas emissions and air pollution, mentioned earlier, indirect health-related benefits can be seen across society. Designing greener cities that support more active lifestyles and promote new attitudes to transport would encourage healthier lifestyles and reduce cardiovascular and other chronic diseases. Healthier environments can increase the number of healthy life years, reduce hospital admissions and use of medication, and thus make enormous savings in public health expenditure. With ageing populations and the economic crisis pressuring public budgets, it is in Europe’s self-interest to promote health and healthier environments. Triggering public debate on the health-related costs of environmental and climatic change in Europe would help to make health considerations an integral part of the rationale for creating greener and more sustainable economies.
Health services themselves must also ‘green’ their services. As major employers, landowners and consumers, health services can play a significant role in reducing their own greenhouse gas emissions. Managing energy, buildings, transport and waste, and developing green environments, would have a positive impact on the environment and climate, and help to save money and promote health.
However, not even the best mitigation efforts can prevent the heat waves or floods which already affect us today and which are likely to increase due to climate change. Europe must do more to reduce such damage to society, including its health effects. EU work on adaptation has begun, albeit slowly. The European Commission’s White Paper on ‘Adapting to climate change: towards a European framework for action’, and a sectoral paper on health, were published in 2009. These will be followed by an Adaptation Strategy, expected to be published in 2013.
To prepare and protect Europeans from new infectious diseases and increased respiratory diseases, cancers and other climate change-related health effects, action will be needed across borders and at different levels of society. It is useful to bear in mind that adaptation measures often do not require significant investment. Running awareness campaigns, training medical staff and putting in place warning systems and preparedness plans would represent a significant and cost-effective basis for action.
As health systems play a central role in dealing with the health-related consequences of extreme weather events, environmental disasters and changing weather and environmental conditions, the systems must improve their preparedness and response capacity. They should conduct risk assessments and outline priorities for action should climate-related health problems threaten populations or the health facilities themselves. Ensuring that health systems continue to deliver without disruptions to supplies of clean water, energy and food must be the basis of any preparedness plan.
Planning ahead rather than paying for consequences later also makes sense in other sectors and policy areas. This means improving urban planning, together with energy and transport systems, so that they not only promote low-carbon, environmentally-friendly and healthier economies, but also take into account projected climatic and environmental changes for health. Examples of action range from energy-efficient cooling facilities and solar shading to flood defences and grey water storage for recycling water.
While member states and regions will be responsible for adaptation measures, the EU can play an important role with regard to protecting health by sharing knowledge, experiences and lessons learned; promoting cross-border co-operation on research, infrastructure projects and developing preparedness plans; assessing the impact of climate change on health, and ensuring that both its mitigation and adaptation policies help to promote public health.
Despite being central to our well-being, health considerations are often treated as a separate policy issue. This is no longer sustainable. Our surrounding environment and climate change can affect people’s health, and consequently society and the economy as a whole. Thus the EU and its member states must take seriously the inter-linkages between the environment, the climate and health. Europe must promote healthier environments by reducing greenhouse gas emissions and adapting to current and potential impacts of climate change. By protecting and promoting health, Europe can take a major step towards tackling the economic and ecological crises it is facing.
Annika Ahtonen is a Policy Analyst in the Europe’s Political Economy Programme of the European Policy Centre.
This commentary builds on the EPC Issue Paper ‘Green growth: making eco-efficiency a driver for growth’ and on the work of the EPC-KBF Climate Change Adaptation Task Force, the results of which will be published in the summer of 2012. It was published on the occasion of the conference ‘Human health and the impact of environmental and climatic factors’, held in Copenhagen on 25 April 2012.