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BMC Global and Public Health volume 2, Article number: 73 (2024) Cite this article
Climate change is regarded as a threat to global health and health systems around the world.Nonetheless, health data are seldom gathered in a manner that enables analysis with climate data. This comment argues for a climate-health data infrastructure to increase climate resiliency and to protect public health.
Background
Climate change is now widely considered to pose one of the most significant threats to global health in the twenty-first century [1]. All aspects of human health are affected by climate change, increasing the risk of deaths, noncommunicable diseases, the emergence and spread of infectious diseases, and health emergencies [2]. There are also a wide range of indirect effects caused by changes in air quality, food and water security, and biodiversity [3]. These risks are only expected to increase with further warming of the climate [4] and are an increasing area of interest in climate epidemiology.
An unprepared health system
In addition to individual health outcomes, climate change is expected to place enormous strains on global health systems with more frequent and severe climate and weather events, impacting the robustness and reliability of healthcare services [5]. Climate change is already a threat to the health infrastructure and most healthcare systems are not prepared to handle an increase of climate-sensitive health risks. Among other things, climate hazards have the potential to increase the demand for emergency health and ambulatory services, as well as emergency admission and hospitalization. Healthcare infrastructure can be physically damaged during major climate hazards that can disrupt access to medical services [6]. Furthermore, potential impacts on healthcare workers may also prevent them from accessing their workplaces. This highlights the importance of strengthening healthcare systems to make them resilient enough to withstand the effects of climate change [6].
The climate-health nexus
Lately, the connection between climate and health has been gaining traction as crucial for climate resiliency and an interest in the climate-health nexus has grown on the global climate and health policy agenda [7]. A problem however is that climate and health data are rarely collected in a way that facilitates analysis, and datasets can often be found in different locations and held by different organizations [8] that usually do not cooperate. Climate data exist in different places and in different formats, for instance, temperature and precipitation as direct measurements, but also through networks of weather stations and advanced climate models. Health data can be found in a variety of study designs, including cohorts, panel surveys and biobanks and morbidity indicators such as hospitalizations, emergency department (ED) visits and ambulance transports, calls to healthcare advice lines or internet searches for climate-related health symptoms, among others.
To address climate-health priorities, the health sector needs to form an active partnership with meteorological agencies to propose and acquire climate data and develop the services needed to increase awareness and build capacity. As an example, the UK Health Security Agency work in partnership with the national meteorological service Met Office to provide specific weather health alerts as an early warning system to the health and social care sector, when adverse temperatures are likely to impact on the health and wellbeing of the population. Today, we know that extreme temperatures can affect people with a whole spectrum of diseases, including myocardial infarction, unintentional injuries, and mental disorders and that some medications become a risk for the user in combination with heat. A closer collaboration between the weather and climate sector and the health care sector is therefore something that should be further developed. On a global level, the World Meteorological Organization (WMO) and the World Health Organization (WHO) have a Joint Office for Climate and Health (https://climahealth.info), which promotes the coordinated development and use of climate, weather, and environmental services to improve public health.
A climate and health data infrastructure
Despite public health adaptation to climate change being imperative, there has been little discussion of how to increase adaptive capacity and resilience. Building up a climate and health data infrastructure could change that. Understanding the connections between climate change and health is crucial for forecasting climate risk to societies and human health. It is therefore important to build healthcare systems that are resilient enough to withstand the hazardous effects of climate change, but also to enable effective public health policies. By using climate and health data, health practitioners can improve diagnosing, routine planning and surveillance. This includes training staff to quickly recognize and respond to conditions like heatstroke during a heatwave to save lives, or novel vector-borne diseases such as West Nile virus to start screening blood donors to prevent spread via blood transfusion.
Research further suggests a substantial under-reporting of for instance heat-related mortality, where some studies indicate that official records underestimate the association by at least 50-fold [9]. For example, Australia’s official health data estimated that about 300 people died due to heat between 2006 and 2017, while researchers concluded that it was closer to 36,000 deaths [10]. This underreporting could be due to the fact that impacts from heatwaves are not always immediately visible, and patients are often treated by doctors who do not recognize symptoms of heat-related illness, and instead list these as complications that accompany heat-related illnesses, such as dehydration, tachycardia, dizziness or syncope.
The National Institutes of Health’s climate change and health initiative (NIH CCHI) have launched a website (https://climateandhealth.nih.gov/) to support the growing need for transdisciplinary research to address health risks related to climate change. Another NIH resource, the Climate and Health Outcomes Research Data Systems (CHORDS), has launched a web-based catalog of resources on climate and health, which includes data, tools, educational resources, engagement opportunities, and more (https://www.niehs.nih.gov/research/programs/chords). The WHO, WMO, Wellcome Trust and the Rockefeller Foundation also recently brought together technical partners to advance the technical and policy agenda for the use of weather and climate information for health decision-making.
Conclusions
Climate change is a complex problem, without a clear cause-effect relationship, that often spans several areas and cuts across time and space. It is a global, regional and local problem all at once, making it difficult to fit into existing decision-making structures. Linking health care data to climate data can facilitate a whole-system approach and acknowledge the role of climate change as a driver of health outcomes. However, without appropriate data, this is difficult to accomplish. By merging climate and health data, one important step for cross-sector collaboration can be made towards a whole-system understanding to better protect or promote health in a changing climate, both for the health problems we are facing today and those we may face in the future.