Annex 5. Climate change and health inequality

The detrimental health impacts of climate change are broad, cross-cutting and distributed unevenly across countries and within populations. Termed a “threat multiplier” by WHO, the effects of climate change on health and health determinants are mediated by social factors (1). Health issues such as pollution, poor water supply and sanitation, lack of access to clean energy sources, and unsafe homes and workplaces are associated with, and partially attributed to, low socioeconomic status; other demographic and geographic inequality dimensions also play a role (2). Thus, inequality monitoring is relevant in the context of climate change to identify and track the health effects of climate change and provide evidence to inform responses.

Climate change has grave implications, directly or indirectly, within contexts and populations such as low-resourced settings, rural and remote settings, refugee and migrant populations, and emergency contexts. The risks associated with climate change, and the ability to mitigate risks and adapt to changes, are mediated by social factors and have differential impacts on population subgroups. For example, the WHO Health and Climate Change Country Profiles, developed in collaboration with national governments, identified small island developing states as some of the countries facing the largest risks from climate change (3). Box A5.1 suggests some further reading on the health impacts of climate change with respect to gender and indigeneity.

BOX A5.1. Further reading on the health impacts of climate change with respect to gender and indigeneity

Brubacher LJ, Peach L, Chen TTW, Longboat S, Dodd W, Elliott SJ, et al. Climate change, biodiversity loss, and indigenous peoples’ health and wellbeing: a systematic umbrella review. PLOS Glob Public Health. 2024;4(3):e0002995. doi:10.1371/journal.pgph.0002995.

Sorensen C, Murray V, Lemery J, Balbus J. Climate change and women’s health: impacts and policy directions. PLoS Med. 2018;15(7):e1002603. doi:10.1371/journal.pmed.1002603.

Climate change. New York: United Nations Department of Economic and Social Affairs: Indigenous Peoples (https://www.un.org/development/desa/indigenouspeoples/climate-change.html, accessed 23 September 2024).

Gender, climate change and health. Geneva: World Health Organization; 2014 (https://iris.who.int/handle/10665/144781, accessed 23 September 2024).

The risks of climate change are evident across different health domains and require equity-oriented responses (4). For example, the effects of climate change threaten progress in advancing universal health coverage. The impacts of extreme weather events disproportionately impact people who already face financial barriers to health services and medicines, and put others who were previously able to afford payment at risk (5). Climate change is a key factor in promoting equity in nutrition (including food security and safety), and joint actions are required to address both climate and nutrition (6).

The Alliance for Transformative Action on Climate and Health, a WHO-hosted network, has convened working groups around themes including climate-resilient health systems, low-carbon sustainable health systems, supply chains, financing, and climate action and nutrition (7). In 2022, WHO compiled the Compendium of WHO and other UN guidance on health and environment as a resource for decision- and policy-makers working at various levels in health and environmental sectors. The resource aims to assist countries in taking actions to improve the health of people and the environment and reduce health inequities (8).

References

1. Climate change. Geneva: World Health Organization; 2023 (https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health, accessed 23 September 2024).

2. Environmental health inequalities. Geneva: World Health Organization; 2023 (https://www.who.int/europe/news-room/fact-sheets/item/environmental-health-inequalities, accessed 23 September 2024).

3. Health and climate change country profiles. Geneva: World Health Organization (https://www.who.int/teams/environment-climate-change-and-health/climate-change-and-health/evidence-monitoring/country-profiles, accessed 23 September 2024).

4. Khanal S, Ramadani L, Boeckmann M. Health equity in climate change policies and public health policies related to climate change: protocol for a systematic review. Int J Environ Res Public Health. 2022;19(15):9126. doi:10.3390/ijerph19159126.

5. Limaye VS. Reducing the inequitable health and financial burdens of climate change. One Earth. 2022;5(4):320–323. doi:10.1016/j.oneear.2022.03.016.

6. Climate action and nutrition: pathways to impact. Rome: Food and Agriculture Organization; 2022 (https://openknowledge.fao.org/items/8a9e30b9-aed2-42b1-b495-c7bd9f3be209, accessed 23 September 2024).

7. ATACH community of practice. Alliance for Transformative Action on Climate and Health (https://www.atachcommunity.com/, accessed 23 September 2024).

8. Compendium of WHO and other UN guidance on health and environment: 2022 update. Geneva: World Health Organization; 2022 (https://iris.who.int/handle/10665/352844, accessed 23 September 2024).