Climate change and human health: what can GPs do?

In recent months articles in the most respected peer reviewed medical journals in Australia, the USA and Britain have called for urgent action to reduce climate change.1–4 The chief scientist of the United Kingdom has described climate change as ‘the most severe problem that we are facing today – more serious even than the threat of terrorism’.5 Yet, many of you will wonder if this is really such an urgent issue, and – even if it is – what on earth has it got to do with general practice?

Action on climate change : the health risks of procrastinating

Objective: The world's climate will continue to change because of human influence. This is expected to affect health, mostly adversely. We need to compare the projected health effects in Australia arising from differing climate change scenarios to inform greenhouse gas emission (mitigation) policy.

Methods: We estimated health effects in Australia (heatwave mortality, dengue transmission regions) around 2100 under various greenhouse gas scenarios: "strong policy action" (efforts made now to reduce emissions) and "no policy action" (emissions continue at present high levels with no climate change-specific policies).

Results: Compared with no policy action, mitigation could reduce the number of deaths caused by hot temperatures among older Australians by 4,000–7,000 a year (range reflects likely population size at 2100). Under a scenario of "no action", the zone of potential transmission of dengue fever expands 1,800 kilometres (km) south, as far as Sydney. In contrast, by markedly constraining greenhouse gas emissions now, this southward extension could be limited to 600 km (to Rockhampton). The number of displaced people within the Asia-Pacific region could increase (by orders of magnitude) under the "no action" scenario because of adverse socioecological circumstances aggravated by climate change.

Conclusions: Additional health effects will accrue as a result of the projected climate change throughout this century, and individuals and health systems should be prepared for some level of adaptation. However, timely and strong policy action to reduce greenhouse gas emissions would diminish the extent and severity of estimated future health effects.

Be the Change You Wish to See: National Attiudes and Climate Change Policy

A multitude of views characterize what should or should not be done about climate change, and in the past decades, nations have acted very differently in the face of climate change. This study explores factors that affect individuals' attitudes and concerns towards the environment and how those attitudes ultimately affect climate change policy. One model investigates the link between individual attitudes and countries' actions on climate change, and the results show that attitudes indeed matter in the implementation of policy. Different measures of democracy such as freedom of the press also prove to be important as channels for these attitudes. A second model identifies a number of political, socioeconomic and demographic characteristics that matter for people's attitudes towards climate change.

Physical environmental conditions, spawning and early-life stages of an estuarine fish : climate change implications for recruitment in intermittently open estuaries

Significant variation in the egg and larval survival and juvenile recruitment of estuarine fishes has been linked to fluctuating environmental conditions. This present study compared the distribution and abundance of black bream (Acanthopagrus butcheri) eggs and yolk-sac larvae between two microtidal estuaries of different flow regimes, where the riverine flow into the Glenelg estuary was around eight times the flow volume into the Hopkins estuary. Samples were collected monthly from September to November at sites along each estuary where vertical profiles of temperature, salinity and dissolved oxygen (DO) were measured, and vertically stratified sampling of black bream eggs and yolk-sac larvae was conducted using a Schindler sampler. Salt wedge formation was apparent in both estuaries, with significant de-oxygenation of deeper, saline waters. Eggs occurred in a wide range of DO levels but yolk-sac larvae were less common at the lowest levels. Most eggs and yolk-sac larvae were collected in salinities greater than 10. Results suggested that egg mortality was higher in the Hopkins than the Glenelg estuary, which may be associated with the hypoxic conditions characteristic of low-flow conditions. The results have significant implications in terms of climate change that is predicted to lead to warmer, drier conditions in south-eastern Australia, potentially increasing stratification and subsequent hypoxic zones.

Climate change and social inclusion: opportunities for justice and empowerment

...the greatest untapped resource at our disposal lies in the disadvantaged Australians living in our most excluded communities. (Nicholson 2007 p. 4)

The commons are where justice and sustainability converge, where ecology and equity meet. (Shiva 2005 p. 50)

Since 1990, the Intergovernmental Panel on Climate Change (IPCC) has recognised human induced climate change to be primarily a result of burning fossil fuels and land clearing (Lee 2007). Changes to the world's climate patterns have been occurring for decades, but only in recent times has climate change arrived in our collective conscious. An onslaught of extreme weather events, destruction and failure of crops, increasing levels of water restrictions, government announcement of desalination plants. proposed increase in prices for utilities such as power and water - have ushered climate change into the Australian lexicon.

The challenges for all of us are many and varied and perhaps even unimaginable. as many propose a global reduction in annual C02 emissions of between 60-80% (compared to 1990 levels) by 2050.

We are not talking just about the re-construction of our world, but about its re-invention. Ryan (2007)

How will climate change affect us? Who is most vulnerable? What will be the features of policies and strategies to combat climate change that ensure an equitable and just response across our entire society? Are our present social-cultural justice paradigms of social exclusion and inclusion adequate in addressing the impending health consequences that are likely to result from climate change, and in supporting an equitable. harmonious and fruitful life for all population groups in the future?

This paper, written in the spirit of solution-oriented research. focusing on the causes of positive health rather than the causes of disease and other problems (Robinson & Sirard 2005). explores the possibility of a paradigm shift which imagines the social inclusion of specific population groups, not as an appended extra, but integral to the design of an equitable, sustainable low carbon society of the future.

Future landscapes in South-eastern Australia : the role of protected areas and biolinks in adaptation to climate change

The extent and rapidity of global climate change is the major novel threatening process to biodiversity in the 21 st century. Globally, numerous studies suggest movement of biota to higher latitudes and altitudes with increasing empirical -evidence emerging. As biota responds to the direct and consequent effects of climate change the potential to profoundly affect natural systems (including the reserve system) of south-eastern Australia is becoming evident. Climate change is projected to accelerate major environmental drivers such as drought, fire and flood regimes. Is the reserve system sufficient for biodiversity conservation under a changing climate? Australia is topographically flat, biologically mega-diverse with high species endemism, and has the driest and most variable climate of any inhabited continent. Whilst the north-south orientation and aftitude gradient of eastern Australia's forests and woodlands provides some resilience to projected climatic change, this has been eroded since European settlement, particularly in the cool-moist Bassian zone of the south-east. Following settlement, massive land-use change for agriculture and forestry caused widespread loss and fragmentation of habitats; becoming geriatric in agricultural landscapes and artificially young in forests. The reserve system persists as an archipelago of ecological islands surrounded by land uses of varying compatibility with conservation and vulnerable to global warming. The capacity for biota to adapt is limited by habitat availability. The extinction risk is exacerbated. Re-examination of earlier analysis of ecological connectivity through biolink zones confirms biolinks as an appropriate risk management response within a broader suite of measures. Areas not currently in the reserve system may be critical to the value and ecological function of biological assets of the reserve system as these assets change. Ecological need and the rise of ecosystem services, combined with changing socio-economic drivers of land-use and social values that supported the expansion of the reserve system, all suggest biolink zones represent a new, necessary and viable multi-functional landscape. This paper explores some of the key ecological elements for restoration within biolink zones (and landscapes at large) particularly through currently agricultural landscapes.

Climate change and community response in the Borough of Queenscliffe

The Borough of Queenscliffe (BoQ) occupies a unique place among coastal Victorian locations. Situated at the tip of the Bellarine Peninsula, the Borough has approximately 3000 permanent residents, one third of who are over 60 years old. The Borough is also the smallest in Victoria, covering a total area of 13 square kilometres. BoQ is also unique because of its location. The Borough is almost totally surrounded by water and much of this is classified as maritime national park. The Swan Bay Marine Reserve is a Ramsar site and is therefore a wetland of international significance. The Borough relies heavily on tourism for its economic livelihood.

This paper begins with an overview of the BoQ in geographic, demographic and economic terms and then discusses the possible effects and impacts of climate change, as they relate to this small community. These sections are viewed from environmental, economic and social perspectives. Environmental impacts include the erosion of the coastal sand dune system and the loss of habitat for the orange-bellied parrot. Social impacts include the health effects and dangers of flooding for low-lying housing. Various indicators of community response are described, particularly the activities of the local climate change action group. Their strategy can essentially be described as a ‘push upward and downward’ approach. Innovative actions to implement this strategy are described in the paper.