Fostering lung health for life by acting on climate change
The Health Policy Partnership
We transform the way people think about healthcare
This November marks the 29th?United Nations Climate Change Conference (COP29). As the conference’s second week gets underway, Dr Mary Johnson, Principal Research Scientist of Environmental Health from the Harvard T.H. Chan School of Public Health, has written about why it is so important to consider the health of our lungs when talking about the health of our planet, and the need for cross-sector collaboration to slow climate change and reduce the burden of chronic respiratory diseases. ?
Climate change has a role in every facet of our health
Climate change affects everyone’s health through rising levels of air pollution; long periods of extreme heat; catastrophic weather events such as floods, droughts and heatwaves; and the ensuing disruption to food systems and the availability of clean water. Its impact is insidious. It drives vulnerability to new diseases and exacerbates the severity of existing health conditions. It may also increase rates of water- and vector-borne diseases; poor mental health; respiratory, kidney and cardiovascular diseases; diabetes; and stroke.
The impact of climate change on the health of the most vulnerable is particularly alarming. Approximately 2 billion children worldwide are exposed to air that exceeds the World Health Organization’s (WHO’s) standards for pollution. Children are less able than adults to regulate their body temperature, and in 2020, 820 million children – that’s more than a third of all people under 18 – were exposed to heatwaves, which can lead to heat-related cramps, exhaustion, stroke, and even death. People over 65 are also vulnerable to the impact of climate change, with global heat-related deaths in the age group reaching 345,000 in 2019; that number is 80.6% higher than the 2000–2005 average.
This week marks the 29th United Nations Climate Change Conference – COP29 – where representatives from governments, academia, civic society and the private sector gather to discuss how to combat the worsening crisis of climate change, which has been called the?biggest threat to global public health?in the 21st century.
The first COP was held in 1995. But surprisingly, it was only in 2021 – thanks in great part to the tireless efforts of the WHO – that health became a central topic at the COP. The intersection of climate change and health is vitally important to understand, and so this is a prime opportunity to highlight one particular area of vulnerability: our lungs – specifically chronic respiratory diseases (CRDs).
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What are chronic respiratory diseases?
CRDs are a group of lung conditions that include chronic obstructive pulmonary disease (COPD, which is sometimes called emphysema or chronic bronchitis), asthma, occupational lung diseases and pulmonary hypertension. Unbeknown to most, CRDs were the third leading cause of death globally in 2019, affecting an estimated 455 million people and causing 4 million deaths.
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The price of climate change is paid by our lungs
There is evidence of the negative effects of climate change on CRDs – in fact, a headline from COP27 was ‘the price of climate change is paid by our lungs.’ Recent data suggest that air pollution was responsible for 8.1 million deaths around the world in 2021, becoming the second leading risk factor for death for all age groups, including children under five years. Although poor air quality has traditionally been generated by transport and energy-production emissions, climate change appears to be increasing the number of factors that drive air pollution. The warming environment is increasing the number of wildfires globally, and wildfire smoke releases hazardous pollutants such as PM2.5, which, in high doses, can exacerbate CRDs, trigger lung disease and lead to premature death, as well as increase emergency room visits and hospitalisations for those with asthma. Climate change is also causing shifts in the pollen season – increasing exposure to pollen and allergens which can lead to asthma and allergy-related illnesses – as well as extreme weather events, such as heatwaves, which have been shown to significantly increase morbidity and mortality in people with CRDs. Rising temperatures and precipitation levels due to climate change can also increase ground-level ozone and mould, which can affect people with respiratory diseases such as asthma.
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The need for intersectoral efforts
All of the data point to the fact that lowering the levels of harmful pollutants in the air can translate into better lung health – and there are some great examples of policies that have done just that:
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Raising awareness and driving action
These examples not only point to the problem but also demonstrate what can be done to address it. To drive meaningful change on CRDs, proactive policies supported by appropriate resourcing will be key. In the US, in 2020, CRDs were the most prevalent non-communicable disease (NCD); however, they received less public research funding than other NCDs. On the global stage as well, there are calls for clear and measurable national strategies aimed at tackling respiratory diseases and reducing respiratory mortality. It is important that those working in academia share and publicise their research findings and join forces with patient advocates and other stakeholders to raise awareness about CRDs; and galvanise policymakers to take concrete actions to address them.
This push for action was the goal of Lung health for life, a policy report which involved colleagues from around the world. This resource aims to promote understanding of CRDs and create a new sense of urgency among policymakers to finally give lung health, and CRDs in particular, the attention they deserve.