Global health equity and climate stabilisation: the need for a common agenda Sharon Friel The Australian National University & University College London IUHPE, Geneva July 2010

Disruption to the Earth system

Greenhouse gas emitters Patz et al, 2007 Density-equalling cartogram. Billion tonnes of carbon equivalent, 2002 the carbon footprint of the poorest 1 billion people on the planet is around 3 percent of the worlds total footprint. (HDR, 2007)

Dangerous climate change On current trends, average global temperatures could rise by 2 - 3°C within the next fifty years or so, leading to many severe impacts, often mediated by water, including more frequent droughts and floods (Stern, 2006)

Current and future climate related injustices We do not inherit the Earth from our ancestors, we borrow it from our children American Indian proverb cited in UNDP Human Development Report 2008

The rich will find their world to be more expensive, inconvenient, uncomfortable, disrupted and colourless – in general, more unpleasant and unpredictable, perhaps greatly so. The poor will die. Smith 2008 Adaptation apartheid

Deaths attributable to climate change between 1970s and 2000 Patz et al, 2007 Density-equalling cartogram. 4 health outcomes – malaria, malnutrition, diarrhea, inland flooding fatalities

Adapted McMichael et al, 2008 Human Society - governance - norms & values - economic policy - trade - urbanisation - demography Daily Exposures & Vulnerabilities - livelihoods - economic production - social cohesion - physical environment - air quality - energy supply - food yields - microbes Climate Changes - temperature - water: flooding - water: drought Health & Health Inequities - infectious disease - mental health - heat stress - malnutrition - respiratory

1.Poor housing conditions – higher risk of heat stress; injury 2.Poor working conditions – heat stress 3.Impaired food yields and price effects - food insecurity 4.Poor housing and sanitation – higher risk infectious disease Added stress of climate change

Common causes – common solutions

AJ Houweling, 2008 Climate Change Urbanisation Health Inequity

Balk et al 2008, in UNHABITAT State of the Worlds Cities 2009 Levels of Urbanisation, 2000 (by Ecosystem)

Urban population in the Low Elevation Coastal Zone McGranahan et al 2007

Transport, Energy and Urban Dwellers Worldwatch Institute, 2007

Distance travelled by mode, UK Sustainable Development Commission, 2010

reducing CO 2 emissions through an increase in urban active travel and use of lower-emission motor vehicles could achieve a 10–19% reduction in London 11–25% reduction in Delhi in the number of years of life lost from ischaemic heart disease Woodcock et al 2009 CC mitigation and health co-benefits: transport and planning sectors AJ Houweling, 2008

A bi-directional relationship Climate Change Diet-related Health and Health Inequities The Food System

Climate change impact on agricultural yields World Development Report, World Bank 2010

Global Hunger Index billion undernourished people in the developing world Hunger in the rich world In the last 12 months were there any times that you ran out of food and couldnt afford to buy more? - unemployed (23%) - single parent households (23%) - second lowest income quintile (20%) - young people (15%) Burns 2004 Food insecurity

Quiggan 2009 based on ABS CPI data 2007 Consumer price impact of drought and other severe weather events, Australia

Grain and dairy export subsidies and import restrictions are creating an imbalance in food availability and livelihoods between countries Fair and sustainable trade arrangements?

The food and agriculture sector contributes 16-29% of total global GHG emissions ~ 80% of agricultures GHG emissions arise directly from the livestock sector Smith et al 2007, FAO 2006

Animal produce intake Kcal per person per day Adapted from FAO (2006)

Technological change plus 30% reduction in production in livestock Resulting decrease in burden of Ischaemic Heart Disease: 15% DALYs, 17% premature deaths in UK 16% DALYs, 17% premature deaths in São Paulo (Brazil) Friel et al. (2009). "Public health benefits of strategies to reduce greenhouse-gas emissions: food and agriculture." The Lancet 374(9706):

Coherence across the system? Food and agriculture Social Urban planning Health