Mr Eddie Morris, RCOG President, writes…
Today, 7 April, marks World Health Day and the theme this year is ‘our planet, our health’. The World Health Organization (WHO) has called for global attention on urgent actions needed to keep humans and the planet healthy as well as create societies focused on the well-being of everyone.
The climate crisis and environmental exposure to pollutants are public health emergencies. As we begin to see more extremes of weather, biodiversity loss, and impact from pollution, it is clear that this threat is not experienced equally, but disproportionally affects already disadvantaged communities including those on low incomes, in the global south, women and girls, and disabled people (1).
Obstetricians and gynaecologists have a crucial role in advocating for the urgent changes necessary to address the climate crisis. We must advocate to ensure climate justice is central to all policies as healthcare professionals. We must also generate and interpret evidence of the impacts of climate change and exposure to pollutants wherever we can.
As obstetricians and gynaecologists we can and should do much more to educate policymakers, our colleagues and the people we care for, on the health risks and impacts of the climate crisis and environmental pollutants. We must also play a crucial role in building the capacity of the people we care for, our colleagues and policymakers to build resilient health systems that address health inequities rather than exacerbating them (1).
While women and girls globally have played little part in the creation of the climate crisis, their wellbeing and health, including sexual and reproductive health and rights (SRHR) are disproportionately affected. The effects are both indirect through impacts on livelihood, barriers to the provision of comprehensive health services and increased risks of violence and abuse due to social status; and direct through environmental disasters and exposure to pollutants that cause adverse health outcomes for women and their children.
The extent to which the climate crisis can affect women and girls can be seen across a range of areas:
- Climate change is resulting in the displacement of over 24 million people per year(2). Eighty percent of people displaced by climate change are women (3). Mass displacement in which women are at a higher risk of sexual violence, abuse and trafficking threatens their sexual and reproductive health and rights (1)
- Exposure to pollutants, including air pollution, which is a major driver of climate change, in pregnancy can affect the whole life course and has been linked to preterm birth, low birth weight, stillbirth, and neurodevelopmental disorders, contributing to intergenerational inequalities (1).
- Heat exposure has been linked to maternal and neonatal health risks including hypertension, placental abruption, low birth weight, and fetal anomalies (1). It has also been suggested that air pollution and heat exposure may create exponential risk.
- Flooding is an immediate risk to safety but in the days, weeks and months after floods the risks of infections, diseases transmitted by insects such as mosquitoes and malnutrition increase, all of which can have serious adverse effects on maternal and neonatal health (1).
This is happening now, and more action is needed to protect the health of women, and their children from long-term impacts. Governments must introduce ambitious policies to reverse the climate crisis. They must put in place ambitious targets for global reduction in air pollution emissions, end taxpayer-funded subsidies for fossil fuels, invest in green energy alternatives, promote active travel, subsidise public transport to discourage the use of personal cars, and apply the precautionary principle in relation to regulation of chemicals to prevent potentially harmful substances being released into the environment (1).
In response to the Lancet Countdown: Tracking Progress on Health and Climate Change report, the RCOG, RCPCH and UKHACC are calling on the UK government to adopt ambitious air quality standards which as a minimum adopt the 2005 WHO guideline by 2030. We are also calling for the UK government to develop heatwave plans across all nations of the UK, with evidence of the adverse impacts in pregnancy and in children explicitly considered and addressed (4).
The COVID-19 pandemic, has shown the ill effects of socio-economic disparities globally. Western government’s failure to create global equity in access to vaccines has failed to protect all people from the emergence of new variants. As we face these global health challenges we must continue to strive for a more just and fair society focused on well-being for all. Healthcare professionals can all play a role in being the medical voices advocating for action to protect our planet and our population’s health.
Notes:
The RCOG works in partnership with the UK Health Alliance on Climate Change to advocate for responses to climate change that protect and promote public health. You can sign up to join the UK Health Alliance on Climate Change network https://action.ukhealthalliance.org/page/69209/subscribe/1