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Public health and climate change are interconnected. As climate-related diseases continue to rise around the world, healthcare systems across the globe are facing unprecedented challenges. The problems in Hong Kong’s collapsing healthcare system today serve as a perfect lesson for the world; not only do we need to put more effort into building up the resilience of citizens, but we also need to go beyond resilience to change the very social and climate conditions that affect our public health. This article argues that governments must place health at center of climate and social action.
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The overwhelming scientific evidence pointing to the health effects of climate change on human health is causing health policy agendas across the globe to begin to recognize the serious threat to public health that climate change poses to humanity. It is therefore understandable that health was a major topic at the COP26 discussions. The COP26 Health Programme was established to “prioritise health and equity in the international climate movement and sustainable development agenda.” Within the programme, an Adaptation Research Alliance was created to “catalyse and scale investment in action-oriented research and innovation for adaptation that strengthens resilience in communities most vulnerable to climate change.”
Research also shows that climate change has worsened the health of people. Countries in development. This has however unhelpfully reinforced a type of “developed-country complacency syndrome”Developed countries are not able to evade the worst effects climate change has on them.
This syndrome is also prevalent in Hong Kong. This syndrome has a remarkable score of 0.949 on Human Development Index., Hong Kong’s standard of living is ranked 4th in the world. Many Hongkongers don’t have to worry about the impacts of climate change on their city. However, Hong Kong is experiencing stronger typhoons Record-breaking temperatures have been setNearly everyone is relatively unaffected almost every year.
To feel the effects of climate change on your health, you don’t have to experience something as severe as the destruction or destruction of your home. They have a subtly but significant impact on our daily lives.
The Everyday Effects of Climate Change On Hong Kong’s Public Health
Hong Kong: For every increase of 1C over 29C, Hospitalization rates rise by almost 55% Deaths by almost 2% – which amounts to approximately 1,000 more deaths per year. This is because temperature increase indicates rising temperatures greenhouse gas emissionsThese gases have significant health effects on the heart, lungs, and skin. Many people feel dizzy during hot summers.
Climate change is also facilitating Spread of infectious diseases (infectious)Hong Kong. Changes in rainfall patterns have made it easier to transmit vector-borne diseases like Dengue fever, Hand, foot and Mouth Disease (HFMD)., and malaria.
Mental health can also be affected by rising temperatures. According to a Study, they can be “direct or indirect, short-term or long-term, … or even transmitted to later generations”. Consequences also vary in severity, ranging from “milder” symptoms of distress to more serious clinical disorders such as depression or even suicide. In fact, haze eventsThe effects of smog days (such as smoggy day) can already increase mortality risk by almost 3% in Hong Kong. For those with mental disorders, the consequences are much worse.
While everyone is affected, some social groups are more affected than others.
The Health Inequalities in Climate Change in Hong Kong
A report published by the Institute of Health Equity of the Chinese University of Hong Kong IHE (CUHK IHE), reveals that there are a number of factors that influence health equity. Hong Kong’s economic inequality is a major determinant of health inequalities. Hong Kong’s Gini coefficient is a remarkable 0.539. This makes it one of the top 10 countries in terms of income inequality. As Hong Kong’s temperatures rise, the city ’s poorest suffer the most. Many people live in terrible conditions because they cannot afford quality housing. Flats that are subdividedWith Poor air quality, hygiene, and suffocating temperature are all factors that contribute to poor air quality.. These living spaces can also be breeding grounds for disease. mosquitoesThey can be found constantly swarming them.
More than 30% of Hong Kong’s elderly live in povertyThis is likely to have risen with the pandemic still in effect. Without a stable source of income and surging house prices, many have become “cardboard Grandpas and grandnies” with nowhere but a cardboard box to live in. They are without a decent environment to live in, and without anyone to care for them. most vulnerable.
These health inequalities are only half of the story. While hospitalisation rates can be useful indicators of the severity of health issues, they do not account for the fact there are people with health problems who are unable to go to the hospital. This is evident within Ethnic minority communitiesAs Cultural and linguistic barriersThey may not be able to access local healthcare services due to financial constraints.
Image by: Hong Kong Hospital Authority
A Collapsing Hong Kong Healthcare System
Despite ranking 8th globally on the World Index of Healthcare Innovation, Hong Kong’s healthcare measurement in the “Quality” category has been labelled “poor”, as it suffers from OvercrowdingAnd a serious Deficit of healthcare workers. According to the local think tank Our Hong Kong Foundation, there are less than two doctors for every 1000 people. This statistic is significantly lower than the Organisation for Economic Co-operation and Development’s (OECD) average figure of 3.5 and far behind regional rival Singapore (2.5). Hong Kong’s healthcare expenditure levels are also low in comparison with OECD countries: total health expenditure as a percentage of GDP is around 7% (2% points below OECD average).
The OHKF has described Hong Kong’s healthcare system as “hanging on a rope stretched too thin”. The reasons for this claim are clear:
- Undesirable work environment
There are several options. Attrition is on the riseIn recent years, the rate of doctors and nurses has increased partly due to Emigration is on the riseOut of the city. As the perceptions of job uncertainty grow (for work-related and economic reasons), the healthcare sector faces greater uncertainty.
- Hong Kong’s rapidly ageing population
This is one side of the testimony to the fact Hong Kong has the world’s longest life expectancy85 years. On the other hand, it is expected that Hong Kong’s older citizens will reach 65. 27%A staggering 2033 and 37%By 2066. Co-Director of PolyU’s Institute of Active Ageing under the Faculty of Health and Social Sciences Professor Teresa Tsien believes that, as people live longer, “the chances of dependency on medical, welfare and other services will be greater.”
The climate change will make it more difficult. Young and old alike are more likely to need medical attention. Even though the number of medical professionals continues to rise, it may struggle to keep pace with the increase in vulnerable people in Hong Kong.
- Healthcare disparities between the public and private sector: A vicious cycle
Hong Kong has a dual system of public-private health care. Their differences are however great. The number of doctors in private and public hospitals is approximately the same – but 90% of Hong Kong’s inpatients receive services at public hospitals. It is predicted that more doctors in the public sector will “defect” to the private sector because of better pay, working hours, and conditions. The workload of those in the public sector will continue to increase, which will result in longer waiting times and a decrease in manpower. This creates a vicious circle.
- Hong Kong: Primary care over curative
Hong Kong’s public healthcare focus is weighted significantly towards curative careThis is the main concern of the rehabilitating and curing patients. In the case of climate health, curative approaches are certainly important, but they only cure the “symptoms” and not the “disease”, i.e. Climate change is a serious problem.
Although the WHO describes primary care as being “the first level of contact of individuals, the family and the community with the national health system” and therefore fundamental to any healthcare system, Hong Kong’s primary care remains inadequately provided. The majority of providers are private (70% market share) and can only be accessed by the wealthy. Contrary to this, there are only 73 public hospitalsThey provide primary care for a population of 7.5million; they also Often, they are underfunded. To support access, vouchers were introduced. Lack of publicityThe programme was deemed quite satisfactory by the author. Ineffective.
It is no surprise that Hong Kong’s curative-oriented healthcare system is collapsing. What can we do?
Mentality Shifts Needed for Hong Kong’s Healthcare System
Today, global health policy discourses are realising the need to build “Climate-resilient Health Systems” that can “Climate-related trends and hazards can be anticipated, prepared for, and responded to.”.
Hong Kong’s health policy discourses have recognized the need for more than curative approaches to promote preventive and promotional approaches. For example, public health academic Emily Chan argues that the government should devote more resources to enhancing Hong Kong’s risk reduction, preparedness response and recovery abilities, which involves Training and promotion of public health literacy in the workforceIn light of the increasing climate-induced weather events that are occurring in Hong Kong.
Non-governmental and government bodies have also intensified their efforts to foster resilience. The Hong Kong Observatory’s “MyObservatory”For example, citizens can access live weather information via a mobile app so they are better prepared for any weather event. Another example is the Hong Kong Air Quality Health Index app (HK AQHI), developed by the Environment Protection Department. This app provides citizens with real-time information about the air quality while they travel.
But Hong Kong’s healthcare challenges are not simply issues of manpower and literacy. Even though the government encourages a lot more Public-private partnerships (PPPs). to improve quality and efficiency, they only upgrade Hong Kong’s “defensive capabilities”. Professor Veronika Schoeb at the Department of Rehabilitation Sciences at PolyU argues, “healthcare practitioners have only Control over health-related social problems is very limited such as education, work environment, or housing.” As a result, the underlying social determinants of public health remain unconsidered. In framing action only in terms of keeping pace with the rate of climate change (which is common around the world), it seems as if we are only trying to “delay the inevitable”.
Healthcare systems must also be more active in other areas. Public policy is key for Hong Kong. Health should be at the center of all forms of social justice – which includes climate justice.
Image by GovHK
A Climate-Sensitive Healthcare System
The COP26 Special report on Climate Change and HealthThis article provides useful suggestions on how to develop within-sector or cross-sector initiatives that may be suitable for Hong Kong.
- Within-sector developments
- a. Access to primary care is increased
A strong primary healthcare infrastructure is essential for the best healthcare systems worldwide. Hong Kong must diversify its healthcare service beyond curative care. It can learn from Finland and Canada regarding the expansion and strengthening of primary care services. These benefits are substantial, as the OECD argues (in a 2020 report). Realizing the Potential Of Primary Care, “[p]rimary health care can save lives and money while levelling the playing field to achieve more equal access to medical treatment”.
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- b. Increase professional engagement within the community
Community engagement is essential for healthcare services to be effective. In recent years, quite poorThis is important because of politics and the pandemic. Today, the majority of community engagement is organized by non-governmental organizations. The government has been slow to respond to these programs and failed to provide the necessary support. This might also explain Hong Kong’s poor health literacy.
Engagement can be encouraged by increasing the involvement of health professionals. You will be more respected by the public (than the government) “to communicate the health risks of climate change, and to promote policies that protect public health from climate impacts”. It is possible to simply give education materials to patients and visit vulnerable households. Health talks and forums can also be organized within communities on a larger scale.
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- c. Improve coordination between health services
Hong Kong’s healthcare sector is often also criticised for its Lack of coordinationServices are often created only in a reactive manner, leading to a lot more redundancy. Communication is essential to improve governance in the healthcare sector. One way to begin is to create health data harmonisationThis involves data sharing among health departments. This can increase efficiency and quality of services and make the process easier for both the patient and staff.
- Cross-sector developments
While changes within the sector are important, these are not enough. (Climate) health is heavily socially determined, as we have seen. This is why the COP26 Special Report resolutely argues that we need to “include health inAll policies”. Hence, in the words of IHE CUHK, “[t]In order to reduce the social determinants, the government should collaborate with all sectors, including academia and social care and health, business, charities and voluntary organizations, and work with them to develop policies across the board. [climate] health inequalities.”
Hong Kong must take a positive approach to climate-related public health issues. How can we make our city more green and liveable, in addition to increasing health resilience?
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- a. Urban planning and transportation
It is encouraging to see that the concepts of livingability are being recognized in Hong Kong’s newest Clean Air Plan 2035These are becoming more closely linked to health and well-being. For example, the government has been trying. Promote a low-carbon transportation infrastructureInstalling roadside air quality sensors and financially rewarding the use of electric vehicles and public transportation.
Housing has been left out of the plans. We have seen that the government must improve the living conditions in public housing by updating or installing cooling and ventilation systems. Assessment tools such the The are necessary to ensure accountability. Hong Kong Green Building Council’s BEAM Plus New Buildings should be actively employed to crucially ensure that future construction projects are “human-centric”, green, and practical.
According to a Report by Civic Exchange, a local think tank, urban development is not just about infrastructural improvement but also about discovering their “vibrancy”. This is difficult in a densely populated place like Hong Kong. The authors Carine Lai, Antonio Da Roza, show that vibrancy doesn’t have to be about building extravagant spaces like shopping malls. These are also energy-intensive. But it can be achieved through creating accessible, green and open spaces for public activities such street hawking, performance, and other such activities. As such, they can be enjoyable spaces – as the evidence shows, they are also opportunities for Enhancing mental and physical health – without necessarily being environmentally damaging.
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- b. The power sector must consult the medical sector more
Talk of sustainability is part of the global discourses. Green and sustainable transitions to renewable energyThere has been a significant increase in Hong Kong. Discussions have focused on decarbonisation and energy diversification in economic terms only, with little concern for public health.
Hong Kong’s climate action needs to be “people-centred”. The medical sector should be a bigger stakeholder in Hong Kong’s power discussions, so that future decisions and investments can be improved: they should consider not only the scarcity of natural resources – that humans can only exploit so much of – but also the potential health ramifications of such initiatives.
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- c. Transform climate education
To sustain climate action, Climate education must be transformed. The education system should not only educate people about the negative effects of climate change on their health, but also encourage sustainable lifestyles and mindsets that will allow future generations to envision different paths to a healthier Hong Kong.
Overcoming Hong Kong’s Healthcare Crisis: Lessons for the World
Hong Kong has all the expertise and resources it needs to make those changes possible – it has access to a remarkable pool of professional talent that not every country can boast of. However, Hong Kong’s poor management of the healthcare sector and its failure to situate health issues within climate discussions (and vice versa) are lessons that healthcare systems around the world can draw on.
The 1992 creation of the COP was motivated by the noble goal of creating a global coordinated strategy to address climate change. Governments around the globe will continue to keep this in mind and use the COP26 opportunities to strengthen cross-regional collaborations for improved public health worldwide.
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