Smoke and mirrors

As it stands, Australia’s healthcare system is not prepared for climate change. Policymakers must recognise this very real threat to the health of Australians and make significant changes to prepare for the future, Arnagretta Hunter writes.

Before this summer, many Australians may have asked if climate change was really a health issue. It is now obvious, however, that climate change is the most significant health threat the nation faces. It is also clear that the health system was caught underprepared for the health crisis of smoke, fire, and heat, and little has been done to adapt to or mitigate these threats. This must change if the Australian health system is to survive a changing climate.

Bushfires have burned in all states and territories of Australia this summer, with a large area of New South Wales and Victoria now devastated by fires. The loss of human life, homes, forest, and biodiversity is hard to describe and imagine in its magnitude: more than 15 million acres of land have been burned, and more than a billion animals killed by fire.

Along with this, bushfire smoke across Canberra, NSW, and Victoria has exposed more than 10 million Australians to hazardous air pollution. People have experienced smoke exposure with intensity and duration not previously seen from a bushfire anywhere in the world.

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The health impacts of this are somewhat uncertain, given the unprecedented nature of the fires, but most people exposed to smoke have at least experienced sore eyes and throats. Coughing and breathlessness have not been uncommon, but usually minor in severity.

Vulnerable populations, however, are at increased risk of more serious effects from smoke exposure, particularly older people and those with pre-existing lung and heart disease.

Pregnant women have been advised to minimise exposure to smoke, and very young children are also likely to be vulnerable to both short and long-term effects from hazardous air pollution.

Affected populations are likely be followed for years to come to allow policymakers to better understand these risks. However, the risks are sufficiently understood at this stage to attribute significant mortality over this summer to both the heatwave events and the bushfire smoke.

Australia’s healthcare system has not been prepared for climate change. Australia’s Long Term National Health Plan, produced by Health Minister Greg Hunt in 2019, makes no reference to climate change or to extreme weather events. The Productivity Commission Draft Report into Mental Health produced in 2019 also fails to mention or recognise the likely effect of climate change on mental health and wellbeing.

The National Health and Medical Research Council has not funded research on climate change and health in the past decade. At the end of 2019, only $10 million was allocated nationally to climate change research, in contrast to a five billion dollar investment into the Medical Research Futures Fund, a system that has little room for climate change researchers to access funding in health.

More on this: Live blog: Bushfire analysis and opinion

The Medical Journal of Australa and Lancet’s report, Global Countdown 2019, comments that there is only one national health and climate change strategy, and it was developed in 2017 by a not-for-profit advocacy group, not the government.

Even as the summer of 2019-20 loomed, with forecasts suggesting a high likelihood of extreme weather, the healthcare system did not respond in a coordinated manner.

Before the events, health risks including extreme heat and heat waves, water shortages, and bushfires were all recognised.

Community, advocacy, and disaster response groups called for a federal government response, and health groups were no exception in joining the call for early preparation and action.

Many organisations, such as the Australian Medical Association, Royal Australian College of Physicians, Royal Australian College of General Practitioners, and the Australian College of Emergency Medicine called for a climate emergency to be declared.

Like in other aspects of the federal government’s preparation for the summer, strong medical advocacy and dire health warnings were not heeded. The toxicity around the politics of climate change in the federal government that prevented action is extraordinary, particularly in light of the events of this summer.

Climate change is a significant threat to the health and wellbeing of Australians. It affects the physical environment in which we live, the air we breathe, the water we drink, and the food we enjoy. Its health effects have the potential to be insidious. Few if any, death certificates this summer will mention climate change, and yet we know that many Australians will suffer, and some will die, as a result of fire, smoke, and heat.

Its impacts are wide-ranging in scope. Many have seen serious disruptions affect everyday life, and mental health effects from smoke and fire are common, with most people experiencing at least a short period of anxiety, if not a taste of significant existential dread. Climate change will also affect healthy ageing through its impact on our exercise routines.

2020 must represent a turning point in the Australian response to climate change. Events like these bushfires hurt communities, relationships, work, hope, and futures. The healthcare sector can lead on this, by providing policymakers and the public with a better understanding of the health risks of continued climate change.

After a devastating summer of fire and heat, the urgency needed in pursuing global decarbonisation is clear. There is much work to be done across the Australian landscape, both physically in the environment, and in the policy context. Australia must better understand and mitigate this existential threat.

Placing health and wellbeing in the centre of these discussions is crucial. It can reinforce both the significant benefits of action, and the serious risks of continuing to ignore the dominant issue of our time.