Climate transformation: the next revolution in public health?

Abstract

Commentary on Hanlon, P. and Carlisle, S.: Do we face a third revolution in human history? If so how will public health respond? Journal of Public Health 2008, vol. 30. Is climate change driving the human species into the vortex of a third global revolution on the scale of the agricultural and industrial revolutions? If this is the case—what will be the implications for human health and wellbeing and for the discipline and profession of public health? These are the key questions raised in this provocative and timely article. The transformational periods of human civilization have, as the authors rightly suggest, been marked by the convergence of complex demographic, technologic, economic, political and ecological drivers and crises. In many cases the resulting challenges have triggered adaptive social and economic innovation. Public health concerns, understandings and interventions have often played a key role in these processes. There are, of course, also numerous salutary examples of failed adaptation and societal collapse. The first point to note about the population health challenges of the early 21st century is the extent to which they are globalized and interconnected. Although global flows of trade, finance, information and migration continue to be contested and uneven, the dominant trend is towards a world in which no civilization can be an island. No society can make itself fully immune from the spread of disease, financial speculation, political violence or changing weather patterns. The tension between globalizing interconnectedness and resurgent support for diverse cultural religious and political identities and values gives rise to a second key challenge for population health. Hanlon and Carlisle speculate that ‘we could see a re-prioritization of society towards values which promote wellbeing, health and equity, whilst reducing inequalities and over-consumption’. If so, how should we understand and measure progress, health and wellbeing? As the OECDSecretary General, Angel Gurria recently noted ‘if we agree that progress encompasses many elements, we also have to agree that its measurement cannot be reduced to growth in GDP per capita . . . it is time to call for a global effort to find better measurements of progress that will consider the multidimensional features of societal wellbeing.’ Or, as the recently elected Prime Minister of Bhutan, Jigmi Thinley reminds us, ‘we have to think of human wellbeing in broader terms. Material wellbeing is only one component. That doesn’t ensure that you’re at peace with your environment and in harmony with each other.’ The third and greatest population health challenge is climate change. The rapidity of the Arctic ice melt is now showing us ever more clearly what the climate modelers have been warning: the speed and extent of climate change is likely to be at the most serious end of the predicted range. There is also now increasing understanding that the health implications of climate change extend well beyond the effects of extreme weather events, heat waves and vector born diseases. A hotter and more volatile climate combined with the actions needed to reduce carbon emissions and adapt to rapidly changing ecologies will have important consequences for the full range of social, economic and environmental determinants of physical and mental health. Public health researchers, policy makers and practitioners have the capacity and the responsibility to play a crucial role in shaping public debate about climate change. As Hanlon and Carlisle rightly note, this responsibility extends beyond identifying specific epidemiological consequences and technical fixes to broader questions about ‘the new social structures, cultures and psychologies’, needed to envisage and