To equitably address climate change, cities must include public health agencies in adaptation planning

According to a recent study published in PLOS Climate, cities must better involve their public health agencies in plans to prepare for the impacts of climate change if their adaptations are to equitably help their citizens. City officials must prepare for growing threats to the physical and mental health of the most vulnerable urban residents, both direct effects, such as heat-related illnesses and infectious diseases, and indirect effects, such as disruption of the food supply, warn public health experts.

Barcelona is one of the most densely populated cities in Europe, with around 1.6 million inhabitants and a population that is expected to continue growing. Such growth, the urban heat island effect, and the typical locations of large cities on coasts and rivers make them disproportionately vulnerable to extreme weather caused by climate change, with economically and socially marginalized communities bearing the brunt. affected.

This puts big cities like Barcelona at the forefront of climate change adaptation efforts that involve decisions affecting housing, mobility and employment. And metropolises also have a disproportionate impact on the drivers of global warming. While cities make up only a small fraction of Earth’s land surface, they produce most of the world’s greenhouse gas emissions and consume the vast majority of the world’s energy. As many countries fall behind in meeting their Paris Agreement commitments, cities are increasingly stepping up their own plans to reduce greenhouse gas emissions, as well as to respond to the impacts of climate change and strengthen their resilience.

“The future of the fight against climate change is being played out in our streets and squares,” Barcelona Mayor Ada Colau Ballano said in the introduction to the city’s 2018 Climate Action Plan. “We are where most of the population lives, the people most responsible for greenhouse gas emissions and the main center of innovation.”

Municipal public health departments can make a difference in this preparedness, by taking preventative measures and providing data that can lead to better protection for those who need it most, said the authors of the PLOS study published in March. The review of climate adaptation plans for 22 major cities found that while nearly all city plans included human health goals and all flagged heat as a health issue, many did not involve their public health agencies in the plans, despite these collaborations being crucial to making climate adaptations more equitable. The study also showed that higher-income cities had less involvement from their local public health agencies in addressing climate-related health risks compared to lower- and middle-income cities.

“We know as public health professionals that public health has data and tools that can help target the most vulnerable people,” said Mary Sheehan, the study’s lead author. “But paradoxically, we have seen that public health is often on the sidelines of climate planning.”

Growing populations and growing climate threats

The report of the Intergovernmental Panel on Climate Change, focusing on adaptation to climate change earlier this year, highlighted the widespread adverse effects that global warming is already having on human health. According to the IPCC, infectious diseases, mental health problems, displacement, heat stress, malnutrition and other conditions increase as temperatures rise.

Many of these impacts are concentrated in cities. Since 1980, extreme heat and rainfall have increased by at least 500% in the world’s largest cities, directly threatening human health in urban areas around the world, according to another study published last year. Such weather events also amplify the impacts of growing disparities in income and access to food and health care, and cities must prepare for all of these impacts, especially as urban populations grow, the authorities said. authors.

Growing urbanization will increase vulnerabilities to these threats, especially in low-income countries. Around the world, urban populations grew by more than 397 million people between 2015 and 2020, according to the IPCC report, with most of that growth occurring in less-developed regions. More than half of the world’s population now lives in cities, and this proportion is expected to reach around two-thirds by 2050.

Sheehan’s study suggests that a lack of public health involvement in urban planning about how to protect residents could put the health and safety of the most vulnerable at risk.

Technicians from Barcelona’s Public Health Agency said the city and collaborating organizations are consulting them on how and where to focus decisions on climate change mitigation and adaptation. Their role is to identify potential damage and help put in place prevention and protection measures, said Laura Oliveras Puig, one of the agency’s senior technicians. The opening of “weather shelters” in 11 schools for the general public in the event of a heat wave is one of the methods of their collaboration. The shelters consist of green spaces and water points, and the buildings have been adapted to be thermally comfortable so that people can use them during climatic emergencies.

“We focus on what is prevention, promotion and protection of health at the population level,” said Oliveras Puig. “And we find at the end of everything we do as a public health agency that everything is affected by climate change.”

According to the city’s adaptation plan, the biggest climate-related health problems in Barcelona are heat-related illnesses and the spread of infectious diseases that have migrated into the region as the climate warms. On average, the city has experienced a heat wave every four years, but expects about two to five per year by the end of the century.

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Efforts to protect the health of residents during heat waves include the development of climate shelters within walking distance of all Barcelona residents, improving the thermal comfort of homes and setting up a line of 24-hour medical assistance and protocols to protect outside workers.

Through a partnership between its public health agency and other local service agencies, the city mapped the geographic distribution of different climate impacts, including heat-related deaths by neighborhood. They also studied energy poverty across the city to identify neighborhoods and groups most likely to need interventions. According to their climate action plan, the death rate for the elderly and babies increased by more than 25% on extremely hot days. This data will be used to prioritize responses during future heat waves and to monitor the results of these efforts.

Barcelona’s findings on the disproportionate effects of heat are consistent with other major cities, where the consequences of higher temperatures are unevenly distributed across populations, with socio-economically disadvantaged communities more likely to live in housing with lower temperatures. less effective insulation in the hottest parts of cities. Evidence also points to higher heat-related health risks in the elderly and young children. Children’s vulnerability to heat is expected to worsen with increasing urbanization and poor infrastructure, especially in cities in South Asia and Africa, according to IPCC findings.

The Barcelona Public Health Agency is also responsible for monitoring the population’s access to food and water, the spread of infectious diseases and air pollution.

Less than half of the cities in Sheehan’s study engaged health agencies in their efforts to identify vulnerable populations. But tracking data to map vulnerability can enable more targeted actions to help those who need it most, she said. His study was a pilot project aimed at understanding the level of involvement of health agencies in cities’ climate adaptation planning. She plans to conduct a new review of a broader pool of cities that are more diverse across income classes and regions by the end of this summer.

Yet there is little public health agencies can do, especially as wealth gaps in cities grow.

According to Isabelle Anguelovski, director of the Barcelona Lab for Urban Environmental Justice and Sustainability. According to Anguelovski, eradicating energy poverty, stabilizing rental costs and expanding affordable housing and green spaces can lessen the negative impact of climate hazards on already burdened communities.

Integrating public health into various city agencies as they work to adapt to climate change helps raise awareness of the impacts of warming on public health, said Irma Ventayol, development coordinator sustainability of the city of Barcelona. City agencies that oversee food security and nutrition, energy and housing, as well as about 1,800 organizations and entities, including schools, are involved in sustainability planning in the city, he said. she stated. For everyone to collectively protect the health of inhabitants from climate risks, “they must believe that this problem exists”, she added.