A report on the impact of climate change on health has revealed a widening in health inequalities. Those most disadvantaged such as women, all adults over 65, children and those with medical conditions are most vulnerable.
Existing inequalities
The health inequalities between different ethnicities, neighbourhoods and social classes are already stark, with millions of women in the most deprived areas in England dying almost eight years earlier than those from wealthier areas.
According to the UK Health Security Agency’s (UKHSA) report, these disparities will worsen as the impact the climate crisis has on health is disproportionately negative to the most disadvantaged groups. These particular groups also include people with disabilities, homeless people and people living in local authorities with high levels of deprivation. Moreover, the report said that children and young people will experience increasingly severe weather into their retirement, with effects persisting or increasing for their children.
The report looks at a “worst-case” where global temperatures increase to 4 degrees or more above pre-industrial levels by the end of the century. It does not imply that this is the likely scenario but independent scientists said governments should still prepare for the worst rather than underestimate the risk – as occurred during the Covid pandemic.
Food prices are also likely to become more volatile as much of what the UK imports is from regions sensitive to climate impacts such as drought. Wildfires producing toxic smoke are also expected to occur more frequently during the hotter, drier summers. The elderly, young children and those with pre-existing health conditions are most vulnerable to these threats.
The Earth has already warmed by 1.2°C above pre-industrial levels and the amount of carbon in the atmosphere means further warming is already locked in even if emissions start declining overnight. This means some adaption is necessary alongside the reduction in emissions and making improvements to housing, flood defences and extreme temperature warnings will help mitigate some of these growing dangers, the UKHSA said.
Rising temperatures
In particular, the report notes that heat-related deaths could soar over the next few decades. Last summer, the United Kingdom saw temperatures reach above 40°C for the first time on record, with nearly 3,000 excess deaths recorded across the period, while many other countries have experienced. The UK Health Security Agency (UKHSA) has said that deaths due to extreme heat would increase by one-and-a-half times in the 2030s and by 12 times by 2070.
Flooding will also increase with knock-on effects for mental health: people who experience flooding are at higher risk of depression, anxiety and post-traumatic stress disorder.
Under the same high emissions scenario, cold-related deaths are also forecast to rise for a period before declining, with deaths from extreme cold declining by the mid-century, and deaths from moderate cold peaking around the same time and seeing a decline by the 2070s. Despite rising temperatures, deaths due to cold will therefore continue to be substantial.
Warmer temperatures will also pave the way for infectious diseases from tropical islands to arrive in the UK. Asian tiger mosquitos carrying dengue fever could become established in England by mid-century because of climate change, the Government health experts said. Warmer conditions have allowed the biting insect to spread across much of Europe in recent years, travelling alongside humans.
Dengue fever could be transmitted in London by 2060 while the mosquito itself could become widely established across England in the 2040s, the report concluded. Officials also said other infectious diseases spread through food or water could become more prevalent with the risk of more pandemics increasing.
Responses
Sir Michael Marmot, the director of the Institute of Health Equity and the author of the landmark Marmot review into health inequalities in 2010, said that climate breakdown can make health inequalities worse. “Extremes of heat and cold associated with climate change increase mortality of vulnerable groups,” Marmot said. “In the UK, excess winter mortality is particularly high – higher than in colder Nordic countries. [This is] probably the result of cold homes which, in turn, is linked to fuel poverty.”
Marmot added that the effect the climate crisis has on health inequalities is global and that the livelihood and health of people in low- and middle-income countries will be affected to a greater degree than those in high-income countries. He said “Action to reduce greenhouse gas emissions should include housing, transport, work and food. Done with regard to equity, actions in these domains can reduce health inequalities. Clean transport, for example, will reduce air pollution at the same time as it contributes to net zero, with the effect of reducing health inequalities. Without regard to equity, climate-change action could make inequalities worse.”
Prof Lea Berrang Ford, the head of the Centre for Climate and Health Security at the UKHSA, made it clear that the negative health effects of climate breakdown will not be distributed equally across the UK, social determinants or generations. Ford said: “The distribution of the impacts of climate change do not just differ across geographic regions, but also across different socio-demographic groups. Climate change is well recognised as likely to exacerbate existing health inequalities, and across a range of health impacts the most vulnerable groups are adults over 65 years old, children and those with pre-existing medical conditions.”
Andrew Haines, a professor of environmental change and public health at the London School of Hygiene & Tropical Medicine, said that multiple threats to health from climate change will “amplify existing inequities in health”. There will also be geographic variation in impacts. For example, heat exposure is higher in urban areas and the risks of flooding are higher for populations living in low-lying areas and coastal regions.”
For Prof Kristie L Ebi, of the Center for Health and the Global Environment at the University of Washington, the projections the report made are “concerning, compelling, and policy-relevant”, while “demonstrating the magnitude and pattern of health risks in the UK” in a changing climate. Even with timely and effective adaptation, and rapid reductions in greenhouse emissions, there will be residual risks that health systems will need to manage. Filling the research gaps will help ensure that interventions to address the health risks will further identify vulnerable populations and interventions to protect and promote health while decreasing inequities. The results of the negotiations at Cop28 will be critical for determining the future health risks of climate change.”
UKHSA chief executive Professor Dame Jenny Harries said: “Things that when I trained many years ago were called tropical diseases will actually become national domestic diseases. In the summer of 2022, UK temperatures reached above 40°C for the first time on record. We had nearly 3,000 excess deaths recorded across that extended heat period while many other countries have experienced bouts of intense and prolonged heat in recent months. Using a high emission scenario, UK health-related deaths are estimated to increase by over 100 per cent in the 2030s, over 500 per cent in the 2050s, and over 1,000 per cent by 2070.”
Curia’s NHS and Life Sciences Commission
Independent, cross-party, and not-for-profit, as a policy institute Curia turns policy into practice as the UK’s first “do tank”. Curia hosts four commissions including NHS Innovation and Life Sciences, Levelling Up, ED&I and Education. Curia provides evidence-based consultancy services, due diligence, and socio-economic and environmental analysis. Commissions share best practice through partner publishing and broadcasting agency Chamber UK.