Why health matters for climate justice: reflections on low- and middle-income countries

Why it is critical to put health at the centre of climate action and the pathways to a health-centred climate justice.
Flooded health clinic in Vietnam

A local district-level clinic in Vietnam’s central region was flooded.

The climate crisis is a health crisis and the single biggest health threat facing humanity. Reports and statements issued by the IPCC and the World Health Organisation (WHO) signal the urgency of climate action to avert catastrophic health impacts and prevent millions of climate change-related health deaths. Human-induced climate change is causing widespread disruption in socio-ecological systems, adversely affecting the physical and mental health of populations across the globe. It is also leading to a deterioration in many of the social determinants for good health such as sustainable livelihoods, equality and access to health care and social support structures. However, not everyone is affected equally. We know that the populations whose health is being harmed first and worst by the climate crisis are those who contribute least to climate change. Marginalized people within affected communities are exposed to the risks of climate change while also being disempowered from organising transformation in ways that will reduce their vulnerability.

At NatCen International, we are working with Newcastle University to address knowledge gaps in the current understanding of the damage to human health caused by the impacts of climate change on water-based ecosystems in South and South-East Asia (SSEA). This is an important body of work because there is limited evidence on the evolving complexity of the health-climate change nexus, especially in the SSEA, an under-researched region, where populations and communities are at high exposure to intersecting vulnerabilities and health impacts of climate change.

In this article, we outline two key reasons why it is critical to put health at the centre of climate action and we propose pathways to a health-centred climate justice. Bringing both agendas together can help increase momentum around the global sustainability agenda and generate stronger political will to support health equity and climate justice together.

Climate change is a public health challenge in low- and middle-income countries

The health effects of climate change continue to worsen and are being felt on every continent, but low- and middle-income countries (LMICs) suffer the most. According to the WHO, climate change is expected to cause 250,000 deaths per year as a result of heat stress, diarrhoea, malaria and childhood malnutrition. Moreover, research shows that the effects of global warming such as droughts and soil dry-out have stressed out rural areas facing difficulties in farming, starvation, and forced migration. The consequent overcrowding of coastal and delta areas could also lead to physical illness by vector-borne disease. In the Mekong delta, the effects of climate change on freshwater ecosystems are having a significant and far-reaching impact on human health. The negative effects of long drought periods on water availability and quality are forcing local communities in the region to rely on contaminated water sources, increasing their risk of waterborne diseases.

Climate change has adverse (and under-researched) effects on mental health

In many LMICs, climate change-accelerated water stress is disrupting agricultural production, compromising food security and livelihoods, all of which adversely impact mental health. Affected communities that have to evacuate due to events such as hurricanes, flooding, or wildfires can be put at extreme risk to mental health when the evacuation or displacement takes place for a long period. Habitat loss, the loss of spatial and cultural parameters, or landscape changes brought about by, for example, deforestation, desertification, or river disappearance, can cause emotional distress and anxiety to local communities for the changes in way of life they might undergo. In these countries, these mental health challenges become dire when the existing services, infrastructure, and funding to address these are severely inadequate, where fewer than 20% of people with mental disorders report receiving adequate services. The WHO reports that of the estimated 1 billion people living with mental health conditions globally, three quarters of those suffering in LMICs do not have access to necessary mental health services.

An additional challenge is that there is also a lack of data on the mental health impact of climate change in those countries. Although those most at risk of climate change are least able to access mental health support, there is still lack of attention to mental health and psychosocial well-being in climate change research and action.

A joined-up approach, however, will need more investments in good data

The health effects of climate change are still invisible to many. Robust data on the scale and impact of many climate-sensitive health risks remain scarce. This is troubling because the limitations in data or poor data have direct implications for both policy and programming. Very little, for instance, is understood about the waterborne diseases and other water-related health impacts exacerbated by climate change in the Mekong delta. There exists a significant lacuna of knowledge on the relationships between climate conditions, water quality, and water-related diseases in the region. It is therefore critical to reinforce the national data infrastructure especially in LMICs, and to improve the data that is used by health workers and policymakers to protect communities most at risk.

Way forward: A health-centred approach to climate justice

Climate justice and improving health outcomes are inextricably bound. We propose two pathways to achieving a health-centred approach to climate justice. First, by embedding health in climate actions and negotiations. At the national and regional levels, this means building improved health outcomes into countries’ National Adaptation Plans and Nationally Determined Contributions and other climate change policy commitments. At the global level, there is significant scope to underpin the health objectives in the sustainability agendas such as the Sustainable Development Goals, the on-going discussions of the UN Framework on Climate Change and the UN Convention on Biological Diversity. COP27 featured activities in this space and there is hope that COP 28 will embed a focus on health equity and outcomes in discussions on just transition, food security, early warnings and adaptation, among others.

Moreover, to inform policies that tackle the adverse effects of climate change on health, transformative multidisciplinary research is needed to generate robust data and evidence. New questions need to be asked, and sometimes different data collected. This field of work will reveal who the most affected groups and societies are, in what way climate hazards and shocks have affected human health, and how these effects take place and accumulate over time. It is also necessary to build and reinforce research networks involving transdisciplinary and innovative thinking and actions that have the potential to lead to significant shifts in the understanding of the relationships between climate change and human health.

This blog was originally published on the Asia Development Alliance (ADA) website. 

About ADA

A groundbreaking regional network, the Asia Development Alliance (ADA), empowers civil society and is a catalyst for social change. It brings together 30 national CSO platforms representing over 10,000 organisations from South, South East, North East and Central Asia.