Better public health starts with effective climate policy

The Albanese Government now has a chance to act on climate change, resulting in better public health for all Australians, writes Dr David Shearman.

OUR NATION is beset by a need to reform age care, general practice, crowded hospitals and the management of epidemics. The poor care of the aged and the gross underpayment of their carers is a national disgrace. Chaos reigns because of the Morrison Government’s incompetence and failure to grasp the much wider need for good health.

One of these needs was recently illustrated by the heart rendering east coast floods and the lack of urgency to prepare for the inevitable environmental changes due to climate change which will have an increasing number of health impacts.

Human health and the environment are indivisible

Forty years ago, a study of patients recovering from gall bladder surgery in hospital rooms that viewed trees showed they were able to be discharged one day earlier than those in rooms looking onto a brick wall. The rooms were otherwise identical.

This should give joy to treasurers with their eyes fixed firmly on reducing costs of patient hospital stay. Nevertheless, the design of public and private hospitals often fails to use this psychological gift from nature. Immediate budgetary need outweighs long term efficiency and health gains.

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Indeed, we know that introducing green nature into large hospitals can humanise the institutional environment and reduce the stress of patients, visitors and staff.

The psychological benefits of nature are conferred on us throughout our lives — if we embrace them and cease plundering them. Studies from the University of Michigan highlighted by the American Psychological Society demonstrate mental functioning, social relationships and even physical well-being benefit from green natural environments.

These environments are known medically as “restorative”. We know that the green of woodland has a profound psychological impact of calming using mechanisms probably inherent in our brains which recognise places for shelter and food during our evolution.

Our existence and health on this planet depend on the life support systems of the natural environment, stable climate, water, clean air, biodiversity and the ecological services they provide for land to grow food; all are under increasing threat.

“Disease services” and “health services”

Let us think about health differently. In reality, we have a “disease service” which treats disease and costs more than $100 billion a year, and a “health service”, called Public Health, which receives a pittance of $2 billion to prevent disease.

As indicated by the Public Health Association of Australia, we have one of the lowest rates of preventive health spending of any OECD nation. Investment in preventive health was less than 2% of health expenditure for at least the past ten years and only 1.5% in 2018-19 and in 2019-20. Canada, New Zealand and the United Kingdom – nations with comparable health systems to Australia’s in many ways – are around 5% of total health spending.

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The focus of Public Health is on prevention, promotion and protection rather than on treatment, on populations rather than on individuals and on the factors and behaviours that cause illness and injury rather than the illness and injury.

This public “health service” aims to keep us healthy with education and programs on tobacco, alcohol, addictions, poor diets, sugar in foods and related obesity, all of which cause chronic illness costing $47 billion per year. It also covers vaccination and closing the gap in life expectancy for Aboriginal and Torres Strait Islander people.

But the task is even more difficult because the rhetoric of Australian governments in search of economic growth often exposes Australia to decisions that may threaten the public’s health. Unhealthy commodity industries – alcohol, gambling and junk food – urge governments to adopt policies friendly to their economic interests and governments have been very accommodating as appropriately illustrated by the Preventative Health Taskforce in the Heart Attack Grill.

An example of the dangerous offerings on the menu at the Heart Attack Grill (Image via Private Healthcare Australia)

The health issues of climate change and environmental loss

This “health service” now has two huge new tasks. Firstly, in protecting health from accelerating climate change which the leading medical journal, The Lancet, regards as the greatest health threat facing the world, a warning now endorsed by medical organisations but still viewed sceptically by many in government despite two decades of secure science.

And secondly, in protecting health which is threatened by the demise of our natural environment, its biodiversity and its ecological services.

Unfortunately, our governments display great ignorance about the health impacts of the loss of ecological services which become casualties of everyday decisions to promote economic growth. These services have been destroyed by continuing land clearing, reflecting our appalling record of threatened species extinction.

The decline of farmland soils, a living ecological system, is partly due to climate change but also caused by many other factors related to land management and pollution. Indeed, as with climate change, tipping points are now recognised for ecosystems; those in soil become overwhelmed and useless for growing crops. World food production is declining.

Each day the media describes “economic progress” from government decisions that fail to address the potential health impacts due to environmental damage. Hopefully, this will change if the Albanese Government creates a secure and scientific, national environmental protection agency.

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The Victorian Government logs pristine forests for the construction industry, endangering Melbourne’s water catchment. The security of long term sustainable drinking water is swapped for short term budgetary gain.

The previous Environment Minister, Sussan Ley, said the revised Environment Protection and Biodiversity Conservation Act 1999 (EPBC Act) “will allow projects to be fast-tracked”. This prioritises lucrative resource projects ahead of our health needs for productive land, clean air and unpolluted water upon which our long term future depends.

We continue to put aside the need to green all urban streets and to provide green space for new housing developments because developments are cheaper without it. Governments have yet to realise that the provision of social housing would reduce the burden of chronic disease.

The natural environment has no monetary value in current economic thinking except for money-making tourism. Those who claw their way to leadership positions must surely have graphs of GDP on their bedroom walls and dream of consumable booms instead of the birds and the bees.

So the tasks of the true health service (Public Health) must be to protect all our life support systems. Currently, our medical organisations have recognised the health consequences of climate change and demand action, but this must now extend with urgency to leadership on health and the natural environment.

The community, elected representatives and our new national government need to understand that health and the natural environment are indivisible. The environment and its services must be protected and not plundered.