Health Sector Challenges to Climate Change Adaptation in Australia

Health Sector Challenges to Climate Change Adaptation in Australia

Redwan RahmanResearch Fellow Urban Research ProgramGriffith University

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Brief overview of climate change impacts on healthChallenges for Health Sector Suggested Adaptation MeasuresPolicy Directions

Main Focus

Since 1960 Australias mean temperature has about 0.70C. By 2030 Queenslands annual average temperature 0.40C-20CBy 2030, SEQ annual average temperature 0.20C- 1.60CSea level rise, annual average precipitation changes

Australias C C Scenario

Name of CitiesPresent203020702100Melbourne 9122227Sydney3.34.4914Brisbane .91.7821Adelaide 17223444Perth 27355672Canberra 582132

Present and Projected Hot Days

AreasFloodsSevere stormsCyclonesBushfiresAustralia 31428426677Queensland 111379004

Average Annual Cost of Natural Disasters in Australia (Figures in millions in 1999 prices)

Health concernsHealth vulnerabilitiesHeatwaveHeat stroke, heat stress, heat crampsCardiovascular & respiratory illness185 death in February 2004 in Brisbane Flood, Cyclone , StormsInjury, illness and death (10) will increase 4-138% by 2020 in QLDSocial & mental stress, more visits to health practitionersDisplacement of population Damage to health infrastructureNatural disaster costs 1.4 billion/year

Health Sector Vulnerabilities

Food-borne disease Diarrhoea, nausea, vomiting, abdominal cramps, fever, headache4 million/r year Costs exceed $ 2.5 billion/yearWater-borne Diarrhoea, cholera, Gastroenteritis 5-18% increase by 2050

Vector-borne disease Malaria 750 /year, Dengue 260 /year RRV 4300/year, BFV 454/year (only in QLD)Illness, death, arthritis, rashDengue management in North Queensland 300-400,000 /year

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Socio-Economic disruption & Human vulnerabilities Elderly, children, Chronically ill, Indigenous & disabled people, single householdLoss of income & productivity, Low incomeSocial disruption, diminished quality of life, & number of homeless people increaseingIncreased costs of health care

UV radiationSkin damage and skin cancerCataracts, Disturbed immune system1700 death due to skin cancer /year1000 people treated /dayCosts $300 million/yearAir pollution Asthma, Respiratory, Cardiovascular diseases, birth defects4,000 death /year

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Growing population-internal & External migration, growth rate higher than national average By 2051, 1 in 4 will be 65 years old which is almost 7-9 million QLD is facing growing prevalence of chronic and complex diseasesMedical workforce participation decreasing Consumers knowledge & expectations for quality health care is increasingPreparedness of the health system is not adequate

QLD Health System

ServicesQueensland AustraliaInpatient services604767Out-patient and community services351375Population and preventive health6668Mental health services89100Dental Health3122Indigenous health24002749Doctor per 100,000333381

QLD Health System per capita expenses

Political Will & StewardshipUncertainty & Lack of requisite Health DataMonitoring & Surveillance SystemHealth WorkforceMental Health Communication & Empowerment

Health Sector Challenges

Partnership Building Institutional Challenges Infrastructure Preparation Stakeholders Engagement Local, State & Commonwealth

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Lack of consensusRole of political parties Policy makers need to support public health approachesHealth & Hospital Reform CommissionHealth Workforce Report

Political Will & Stewardship

Uncertainties about projectionsUncertainty about severity & intensity of future CCWhat changes will emerge between Health & CC are not clearDisease distribution & their magnitude, relation with CC are uncertain Lack of historical & longitudinal data

Uncertainties and Lack of Data

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Lack of comprehensive monitoring & surveillance system Limited monitoring, reporting & surveillance of climate variablesData collection of risks, vulnerability & disease are generally collected at different spatial scales & through different methods. Integration & harmonisation of data Monitoring & Surveillance

Public understanding of CC is not yet clear, incomplete & lack of confidence. Knowledge of health risks in regards to climate change is also either poor or non-existentLack of targeted communication: state agencies have not yet developed any targeted communication mechanisms to specific groups, emphasising different levels of understanding, ethnic & cultural differences about vulnerability Education and Communication

Education & Training-reforming Interdisciplinary knowledgeable health workforceClinically relevant advise to manage effects of CCKnowledge deficiency of PHC providersEvidence based research to support public health actions on CC Lack of leadership & Advocacy Preparedness & Action plan at various levelsPolitical leverage & influence to government Poor communication Health Workforce

Public health responsibility to identify, investigate & explain health problems New diseases, changes in incidence, range & seasonality existing diseasesInstitutional capacity to collect quick informationRapid diagnosis & dissemination of alertsCapacity under strain2009 swine flue -36991cases, 186 death

Health System

Emergency 5000/m, Youth 750,000/year, of total health burden, Disruptions determinants of healthEmotional distress & anxiety about future CC Acute traumatic stress, post-traumatic stress disorder, depression, anxietyClinical management Therapeutic approaches will vary depending on clinical presentation, health professional background, training as well as individuals understanding of & conceptualisation of climatic effects

Mental Heath

We need to develop integrated, interdisciplinary & multilevel adaptation mechanisms Develop partnerships among Commonwealth, State and local government agencies, universities, research organisations, NGOs, community organisations & private sectorStrengthening collaboration, promoting common goals & sharing good practices across sectors & building teamwork between health & other professionals & community groupsPartnership Building

Horizontal coordination among the sectorsVertical coordination among local, regional, state & national levels of governmentGap between scientific analysis of threat of climate change, economic analysis of costs, benefits of adaptation & mitigation, political perception of feasible climate policy Inclusion of social, cultural, economic and political value of the society needs to be considered in adaptation planning

Institutional Challenge

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Location & accessibility to health facilityInfrastructure design, development & usesPerceived threat to natural disastersThermal insulation, heating and cooling system, electric power availabilityEnergy intensive-double consumption than commercial offices & 6 time water NSW 53 % of total government buildingsQLD 30 % of total state occupied facilities Health Infrastructure

Various groups Different interests Narrow economism Checks & balances between traditional public institutions & (newly))empowered of non-traditional stakeholdersPublic health interventions, designing and implementing adaptation plan in conjunction with these groups and facilitating climatic justiceBuilding neighbourhood support system Stakeholders Engagement

Surveillance & Monitoring Communication & EducationMedical InterventionLegislative & Regulatory MeasuresEngineering & TechnologyInfrastructure DevelopmentEcosystem Intervention

Possible adaptation measures

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Surveillance and Monitoring Heatwave Extreme Weather Events Prepare registries for vulnerable individuals Early surveillance of impacted populationCollect morbidity and hospitalisation data Collect mortality dataPrepare registries for vulnerable individuals Early surveillance on impacted populationMonitor health outcomesCollect quantitative data on short and long term health impacts

Education and CommunicationHeatwave Extreme weather events Declare early warning system, Inform & educate about health risks of heat wave and the potential measures to be taken to reduce risks, Guidelines for school attendance, sports events and outside work practicesEarly warning system, Provide information about possible risks of disaster and actions to be taken to reduce risks, Educate the community about disaster preparation

Policy Measures Improvement SectorsLegislative and regulatory initiativesHeat event response plan Identification of vulnerable population, Extend state emergency plan to include heat event, consider energy limits in times of emergency, Health, Emergency , Local government Housing, EnergyUrban design to reduce heat island effectsStreet orientation, shading design, material use Extend to existing homes and offices, shading existing car parksArchitects, Landscape planning. Landscape Architects, Planning

Policy Directions

Policy & decision makers need creditable informationPartnership building Stakeholders engagementConfidence of affected communities & groupsEnhance state capacityBuilding social & human capital

Conclusion

Med. intervention, Eng, Tech.Partnership building Responsive & deliberative engagement of stakeholders Enhance state capacity & social capitalPolitical support & Resources