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Cities Must Include Public Health Agencies in Planning Climate Change Adaptations to Equitably Face It

Cities Must Include Public Health Agencies in Planning Climate Change Adaptations to Equitably Face It

Aydali Campa

A recent study found that cities need to involve their public healthcare agencies in their plans to prepare for the effects of climate change. This will ensure that their adaptations are equitable to their citizens. PLOS Climate. Public health experts warn that increasing threats to the mental and physical health of urban residents are coming from both direct (like heat-related diseases and infectious diseases) and indirect (like disruptions to food supplies).

Barcelona is one of Europe’s most populated cities, with approximately 1.6million residents and an expected increase in population. Such growth, the urban heat island effect and large cities’ typical locations on coasts and rivers leave them disproportionately vulnerable to extreme weather brought on by climate change, with economically and socially marginalized communities hit the hardest. 

Barcelona and other big cities are at the forefront for climate change adaptation efforts. These efforts include decisions affecting housing, mobility, employment, and other areas. The drivers of global warming are also impacted by large metropolitan areas. While cities make up only a small fraction of the Earth’s land surface, they produce most of the world’s greenhouse gas emissions and consume the vast majority of the world’s energy. With many countries not meeting their Paris Agreement commitments, cities are increasingly taking on their own plans to reduce greenhouse gas emission and build resilience to the changing climate.

“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 of 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 focus of innovation.”

The authors say that municipal public health services can make an impact on that preparedness by taking preventative measures and providing data that can lead to better protection for those who most need it.The March PLOS Study was published. The review of 22 large cities’ climate adaptation plans found that, while almost all of the cities’ plans involved goals for human health and all of them reported heat as a health concern, many did not involve their public health agencies in the plans, despite such collaborations being crucial to making climate adaptations more equitable. The study also revealed that high-income cities were less likely to have their local public health agencies involved in addressing climate-related risks to their health than low- and mid-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 lead author of the study. “But paradoxically, we’ve seen that public health is often on the sidelines of climate planning.”

Growing Populations and Increasing Climate Risks

The Intergovernmental Panel on Climate Change’s report Adaptation to climate change is the focusAn earlier warning was issued about the adverse effects global warming is having on human health. According to the IPCC and other organizations, infectious diseases, mental health problems as well as displacement, heat stress, malnutrition, and other conditions, are all increasing with rising temperatures. 

Many of these effects are concentrated in cities. According to the WHO, extreme heat and rainfall have increased by at most 500 percent in the biggest cities around the world since 1980. This has directly impacted human health in urban areas across the globe. Another study was published last year. These weather events can also magnify the effects of growing disparities of income and access to healthcare. Cities need to be prepared for all these impacts, especially as cities grow, according to the authors.

These threats are more likely to be posed by increasing urbanization, particularly in low-income countries. According to the IPCC, urban populations worldwide grew by more 397 million people between 2015 and 2020. The majority of that growth was in less-developed countries. More than half the world’s population lives now in cities. That proportion is expected increase.By 2050, the number of people who are employed in this sector will be approximately two-thirds.

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

Barcelona Public Health Agency technicians stated that they consult with the city and other collaborating organizations about where and how to focus decisions on climate change adaptation and mitigation. Their role is to identify potential harms and help set preventative and protective measures, said Laura Oliveras Puig, one of the agency’s senior technicians. Opening  “climate shelters” in 11 schoolsOne of the ways they collaborated was to make it available for the public in the event of a heatwave. The shelters are made of green spaces and water features and were designed to be thermally comfortable so that people can use them during extreme climate conditions.

“We focus on what is the 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 is that it is all affected by climate change.”

According to the city’s adaptation plan, Barcelona’s biggest climate-driven health concerns are heat-related illnesses and the spread of infectious diseases that have migrated to the area as the climate warms. The city has had an average of one heatwave every four year, but it expects to experience between two and five each year by the end the century.

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Efforts to protect residents’ health during heat waves include developing climate shelters within walking distance of all Barcelona residents, improving the thermal comfort of homes and operating a 24-hour medical services helpline and protocols to protect outdoor workers.

The city was able to form a partnership with its local public health agency and other service agencies through this partnership Mapped the geographic distributionDifferent climate impacts, including heat-related deaths per neighborhood. They also looked at energy poverty in the city to identify neighborhoods and groups that might need interventions. Their climate action plan showed that the death rate for babies and elderly people increased by more than 25 percent during extremely hot days. These data will be used to prioritise interventions during future heatwaves, and to monitor the outcomes of those efforts.

Barcelona’s findings of disproportionate effects from heat are consistent with other large cities, where the consequences of higher temperatures are unevenly distributed across populations, with socioeconomically disadvantaged communities more likely to live in dwellings with less-efficient insulation in hotter parts of the cities. Evidence also shows that heat-related health risks are higher among the elderly and children. The vulnerability of children to heat is expected to worsen with growing urbanization and poor infrastructure, especially in South Asian and African cities, according to the IPCC’s findings.

The Barcelona Public Health Agency is also tasked with tracking 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. She explained that tracking vulnerability data can help to target the right actions to help those who are most in need. Her study was a pilot aimed at understanding the level of health agency involvement in cities’ climate adaptation planning. She plans to review a larger number of cities with more diverse incomes and regions by the end-of this summer.

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Despite the fact that there are limited resources available to public health agencies, especially as cities become wealthier, there is still a limit to what they can do.

Gentrification, which contributes to disparities in access to affordable housing and healthy food choices to put vulnerable communities’ health at risk, is one of the biggest barriers to sustainable climate change adaptation in Barcelona, according to Isabelle Anguelovski, director of the Barcelona Lab for Urban Environmental Justice and Sustainability. According to Anguelovski, reducing energy poverty, stabilizing rent prices, and expanding affordable housing can reduce the negative effects climate hazards have on already-burdened communities.

Mainstreaming public health across different city agencies as they work to adapt to a changing climate helps create awareness of warming’s impacts on public health, said City of Barcelona Sustainability Coordinator Irma Ventayol. She stated that the sustainability planning in the City includes 1,800 entities and agencies, including schools, that oversee food safety, nutrition, energy, housing, and energy. In order for everyone to collectively protect residents’ health from climate risks, “they have to believe that this problem exists,” she added.

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