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we recover from coronavirus. Can you
elaborate on that?
Coronavirus has been a tremendous
shock, an absolutely devastating infection
– particularly in parts of the world where
the infection has gone in an uncontrolled
manner. I absolutely acknowledge the
depth of human suffering. However, when
we look at climate change, rather than
an acute event where we’ve got rapid
dissemination of disease, like we see with
the pandemic, climate change is more of a
slow boiling situation.
What we can see from the climate
scientists, and what we’ve already seen
across the world, is that climate changemediated
events are affecting human lives.
There’s good research that shows that
climate change began to impact on human
health and wellbeing probably 20 years
ago. And that has increased in frequency.
There’s always debate about attributing
one particular extreme weather event to
climate change or not. But the climate
change footprint into the extreme weather
events is becoming larger and larger as the
CO 2 levels rise.
The modelling of the numbers of lives
that will be affected in some way – through
sea level rise or an increasingly hostile
hot environment – puts the figure in the
hundreds of millions. Potentially even
billions of people over the next 100 years.
That’s the difference to coronavirus.
Coronavirus has affected over five million
people around the world, and that’s an
extraordinary number. Obviously, the
effects from the pandemic have affected
almost every person living on the planet.
That’s also a really profound effect. And I
don’t think it’s always fair to compare one
crisis against the other, but the magnitude
of the numbers of people whose lives will
be affected by the increasingly warming
planet are immense.
Appreciating this dynamic between
the world we live on, the physical spaces
we enjoy and the increasing temperature
having an impact on our capacity to enjoy
living on earth, I think we better get an
understanding of this.
This new analysis has put Australia’s heatrelated
mortality at around 2 per cent. How
does that compare with other countries?
This is one of the issues: we haven’t looked
at it in great detail anywhere around the
world. What our analysis does is compare
the limited number of research papers
that have been done in Australia. There
was research out of Brisbane a few years
ago that showed a significant change in
mortality over summer periods that were
hotter. That’s not just the short-term heat
wave effect. If your summer is hotter
overall, then there’s a mortality effect for
your population of patients who are over
65 resonating into the years afterwards.
Our analysis fits in nicely to some of
the research that’s been done before, but
this disconnection between the natural
environment and health data is not just an
Australian issue, it’s dominant around the
world. We all need to understand more
about the dynamics of temperature.
It’s part of what our group is doing.
We’ve got some international collaboration
on board. We suspect that there’ll be
different mortality dynamics in different
climates – variables of humidity, overnight
temperatures, it’s a fairly complicated area.
We’re hoping that we can inform the risks
to do with very hot temperatures in the
Australian context in the next year or so.
Your research paper also recommends
that death certification needs to change to
include large-scale environmental events.
Can you elaborate on this?
I would like to see better acknowledgement
of environmental determinants of health in
our health data.
What do I mean by this? So, I’m living
here in Canberra and I lived through an
absolutely shocking summer, which started
around November and finished around
February, during which we had a very
protracted period of hazardous air pollution
from the bushfire smoke, during which we
had some of the hottest temperatures that
have ever been recorded.
Because I work in the hospitals here, I
know the health data we routinely gathered
over that period does not reflect the
environmental factors that were influencing
health and wellbeing. I was looking after
people in hospital, and I know that the
heat, bushfires and smoke all had an effect
on our psychological state, if not our
physical health.
What our group is advocating for is a
better understanding of the dynamics
between the environmental factors in our
human health.
Death certificates are complex. They
will always reflect the thing that’s actually
caused the loss of life. I’m a cardiologist.
The most common thing to write on a
death certificate is that someone’s died
from a cardiac arrest, or they’ve died
when their heart stopped. And so that’s
describing the biology of the actual
process of dying.
Death certificates also allow you to have
other causes – things like heart failure or
lung disease, and you can comment on
issues to do with tobacco use and alcohol
and other drugs. There’s not a lot of
space on a death certificate to talk about
the social determinants of health that
I mentioned.
I know there is going to be a population
of people, particularly on the south coast
and on the broader east coast of Australia,
who passed away over this January and
February period, whose deaths were made
so much more likely by their exposure to
air pollution from the bushfire smoke or to
direct exposure to bushfire. That health data
really needs to be captured.
It’s partly an acknowledgement to the
families and friends of those people who’ve
died, but also for us to then reflect in our
health services and health approach on
what the magnitude of the potential risks
There’s good research
that shows that climate change
began to impact on human
health and wellbeing probably
20 years ago. And that has
increased in frequency.
are with extreme weather events and,
potentially, with climate change.
We only know what we look for. What
we’re putting forward here is asking
doctors, healthcare professionals, health
services and policymakers to better
understand and appreciate this dynamic
which we all know.
If we think about this just on a human
level, we all know we’re influenced by
the weather and there are circumstances
around us. We know that air pollution
makes a difference to our quality of life.
There’s great data on that influencing our
longevity. We should get that into our
health data. We need to have that in our
health data as soon as we can, particularly
in the dynamics of climate change as the
world gets warmer. ■
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