Engagement with health in national climate change commitments under the Paris Agreement: a global mixed-methods analysis of the nationally determined contributions

Hilary Graham,Niheer Dasandi,Slava Jankin Mikhaylov,Pete Lampard

doi:10.1016/s2542-5196(20)30302-8

Abstract

SummaryBackgroundInstituted under the Paris Agreement, nationally determined contributions (NDCs) outline countries' plans for mitigating and adapting to climate change. They are the primary policy instrument for protecting people's health in the face of rising global temperatures. However, evidence on engagement with health in the NDCs is scarce. In this study, we aimed to examine how public health is incorporated in the NDCs, and how different patterns of engagement might be related to broader inequalities and tensions in global climate politics.MethodsWe analysed the NDCs in the UN Framework Convention on Climate Change registry submitted by 185 countries. Using content analysis and natural language processing (NLP) methods, we developed measures of health engagement. Multivariate regression analyses examined whether country-level factors (eg, population size, gross domestic product [GDP], and climate-related exposures) were associated with greater health engagement. Using NLP methods, we compared health engagement with other climate-related challenges (ie, economy, energy, and agriculture) and examined broader differences in the keyword terms used in countries with high and low health engagement in their NDCs.FindingsCountries that did not mention health in their NDCs were clustered in high-income countries, whereas greater health engagement was concentrated in low-income and middle-income countries. Having a low GDP per capita and being a small island developing state were associated with higher levels of health engagement. In addition, higher levels of population exposure to temperature change and ambient air pollution were associated with more health coverage included in a country's NDC. Variation in health engagement was greater than for other climate-related issues and reflected wider differences in countries' approaches to the NDCs.InterpretationA focus on health in the NDCs follows broader patterns of global inequalities. Poorer and climate-vulnerable countries that contribute least to climate change are more likely to engage with health in their NDCs, while richer countries focus on non-health sectors in their NDCs, such as energy and the economy.FundingThis work was in part funded through an unrestricted grant from the Wellcome Trust and supported by The Economic and Social Research Council.

Highlights

Climate change is threatening human health by irrevocably damaging the planetary systems on which life depends.[1,2,3] Addressing these threats is fundamental to the United Nations Framework Convention on Climate Change (UNFCCC), the global climate governance framework designed to protect current and future generations from “dangerous anthropogenic interference with the climate system”.4 In line with this ambition, the UNFCCC’s 2015 Paris Agreement seeks to hold the increase in global temperature to well below the critical 2°C threshold beyond which the climate system becomes increasingly inimical to public health.[2]
We examine how public health is incorporated in the nationally determined contributions (NDCs), and how different patterns of engagement might be related to broader inequalities and tensions in global climate politics
We identified keywords in the corpus of NDC documents associated with four themes, which were used in the keyword assisted topic model (keyATM) to produce six topics

Summary

Introduction

Climate change is threatening human health by irrevocably damaging the planetary systems on which life depends.[1,2,3] Addressing these threats is fundamental to the United Nations Framework Convention on Climate Change (UNFCCC), the global climate governance framework designed to protect current and future generations from “dangerous anthropogenic interference with the climate system”.4 In line with this ambition, the UNFCCC’s 2015 Paris Agreement seeks to hold the increase in global temperature to well below the critical 2°C threshold beyond which the climate system becomes increasingly inimical to public health.[2]. As of January, 2020, 185 nations had submitted their first NDCs. NDCs are voluntary and non-binding commitments to reduce emissions made by state parties to the Paris Agreement; they are encouraged, but not required, to include adaptation plans in their NDCs.[3] Because the NDC regime consolidates the position of state parties as the primary agents of climate action,[4] NDCs are the key global policy instrument for protecting the health of current and future populations. NDCs are voluntary and non-binding commitments to reduce emissions made by state parties to the Paris Agreement; they are encouraged, but not required, to include adaptation plans in their NDCs.[3] Because the NDC regime consolidates the position of state parties as the primary agents of climate action,[4] NDCs are the key global policy instrument for protecting the health of current and future populations Both mitigation and adaptation are essential to protect public health.[5,6]

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