Dokumen

Climate change impacts on health across the life course

Climate change is transforming all aspects of life on earth, including human life. This issue of the journal includes three articles summarising the available reviews on the impact of climate change on maternal and newborn health, child and adolescent health, and older people, which together take a life course approach to optimal development and healthy ageing [13]. Reflecting evidence reviews, these articles explain that climate change has diverse and detrimental impacts on health and well-being across all life stages, from infancy to older age.

Climate change directly impacts health, such as the effects of extreme or sustained heat on susceptible sub-populations, including pregnant women, newborns, infants, children, vulnerable adults and older persons. It can also indirectly negatively affect health through multiple pathways by negatively affecting the underlying determinants of health. Examples include reduced crop outputs leading to food shortages, reduced nutritional intake, and decreased vitality (e.g. strength and metabolic balance). Climate change can increase the geographic range of disease vectors, such as mosquito species found at higher altitudes, leading to an increased incidence of malaria, West Nile fever, and Zika, among others, in new locations [4]. An increasing number of climate-induced disasters are experienced worldwide, including in small island states [5].

These and other direct and indirect effects are cumulative and occur across the life course. The effects of climate change can either be exacerbated by existing inequalities and the interaction with other crises or be mitigated through good governance, which draws on collective intelligence for the common good, evidence-based policies, the engagement of people, and the involvement of all sectors [6,7].

Good governance and health in all policies draw on the fundamental principle that all people have the right to health as part of human rights [8]. Moreover, all governments have committed themselves to achieving the Sustainable Development Goals [9], and most have signed the Paris Agreement [10]. These international policy instruments broadly underline that a) everyone’s basic needs, such as food, shelter and health services, must be met without discrimination, b) climate change and health are inextricably linked, and impacts are not confined to national borders, and c) importantly, policy choices can make a difference to anticipate, mitigate and adapt to climate change, if implemented at national, regional and global levels. Furthermore, evidence indicates that policies and actions will also need to address the social, economic, commercial and political determinants of climate change [11,12].

Pathways describing climate change’s negative impact on the health of people at each life stage and across the life course

The articles in this special issue identify climate hazards and their differential impacts on health for three distinct life stages, discuss exposure pathways, and consider vulnerabilities at individual and population levels that put people at a higher risk. A framework for action must recognise the following key findings. A person’s context, genetic inheritance and social position will shape an individual’s vulnerability and resilience to climate change impacts. The accumulation of these risks identifies the most vulnerable life stages, including pregnant and postpartum women, children and adolescents, and older people, particularly those living in settings that do not provide protection from the vagaries of the changing climate.

Each life stage has common hazards such as extreme temperatures, wildfires, droughts, floods, storms and sea level rise; climate-sensitive infections; and poor air quality. Exposure pathways include food and water insecurity, displacement and migration, health and social systems impacts, and other critical services.

Measurable impacts are noted on all domains of health (e.g. physical, cognitive, psychological, sensory, vitality) across the life course. For example, psychological impacts include increased anxiety, depression, posttraumatic stress disorder and an increase in associated substance abuse disorders; air pollution can lead to reduced cognitive capacity, whether preventing optimal development for children or accelerating declines among older persons. Moreover, negative effects of climate change that occur during one stage of life impact subsequent life stages

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