SPECIAL ON CLIMATE CONFERENCE 2011
Climate change and NCDs
The modern world has brought boons in our life and also many curses. We reduced the rate of infant and maternal deaths but the burden of having non communicable diseases (NCDs) in younger age is increasing. We have cooled our homes with ACs but heated up the world with global warming. In addition to this, without lessening the rates of diseases, the multiplier effects of climate change on health may greatly exacerbate existing health inequities between and within countries, posing a major supplementary dispute obstructing global development. There is a conventional assessment that suggests that the extent of climate change that had already occurred by the year 2000 was directly responsible for the loss of at least 5.5 million disability adjusted life years (DALYs)
However, keeping the conventional consequences infectious diseases and injury of climate change on the sidelines, NCDs will likely be affected by climate change in two ways. First, climate change itself may directly and indirectly increase the incidence of many major NCDs and secondly, policy responses to climate change both adaptation and mitigation is will likely have both positive and negative implications for NCDs.
There is still a dilemma over how climate change affects the risk of having cardiovascular disease (CVD), respiratory diseases and cancer. The heat-related mortality and morbidity arise from overloading the cardiovascular and respiratory systems. Another way of having CVDs through climate change is the additional changes in ambient temperature, precipitation, and cloud coverage that would alter sun exposure behaviour. Climate change has the potential to change the risk of UV-related health outcomes, including cancers. The last but not the least risk of having a NCD through climate change is mainly a non conventional NCD mental health and injury. Increasing frequency and intensity of extreme temperatures and weather events, and increased antagonism for inadequate natural resources, on top of existing social inequities, are likely to affect interpersonal and intergroup behaviour and may result in increased stress and anxiety, leading to mental health problems.
This currently slightly unrecognized relationship of NCDs and climate change actually gives a food for thought that there are NCD risks from climate change mitigation and adaptation responses. The underlying determinants of NCDs and of climate change overlap substantially. Policy responses that aim to address common determinants may reduce NCD levels, could help avoid further climate change, and may assist in the management of existing climate change impact. The two key mitigation policy areas associated with the energy sector are likely to provide benefits to NCDs: energy generation and domestic energy use. One of the main pathways linking electricity generation to climate change and human health is through the fine particle air pollution arising from the fuel cycles for fossil fuels. These emissions not only cause climate change but also increase the risks of CVD, lung cancer, and acute respiratory infections. On the other hand indoor smoke from inefficient burning of biomass fuels contributes not only to climate change but to lung cancer, lower respiratory infections and pulmonary disease, low birth weight, cataracts, and possibly asthma and heart disease, a total of some two million deaths per year. Thus policies to address energy generation and domestic energy use can actually benefit the NCD risk behaviors.
The world is increasingly becoming urban. Most of the future urban growth will take place in cities in low- and middle-income countries. A key challenge, and opportunity, is to ensure that current and future urban development is done in such a way that prevents NCDs, reduces poverty, and builds societies that live within environmental limits. Urban design that supports greater street connectivity and balanced land use mix with more residential density mitigates better than nonresidential density through the incentives that people and organizations are given to pursue low carbon emission activities. Such designs have implications for NCDs. Climate change mitigation and NCD prevention can be achieved through urban design that incorporates green spaces within communities. The presence of green space also has indirect benefits for NCDs by encouraging physical activity, improving air quality, and reducing urban heat island (UHI) effects.
Addressing the environmental and social determinants of NCDs will improve global health which will also make inroads in poverty eradication and meeting out social equity. This will ensure people, communities, and nations to cope with the fallouts of climate change and combat it effectively.
The writers are public health researchers from Eminence (www.eminence-bd.org).
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