Transcript Slide 1

Sustainability
and
Inequalities
David Pencheon
NHS Sustainable Development Unit, England
21st May 2010
RCP
ADPH Conference
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sustainable development
“development that meets our own needs…
…without compromising the ability of people
in the future and elsewhere to meet their
needs”
- adapted from the Brundtland Commission
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sustainable development
=
social justice
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• Food and obesity
• Physical activity
• Travel related
trauma and death
• Access to green
space and health
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• All based on an
unsustainable
economic model
• consumerism
• status
• trust
• social cohesion
• Unequal
societies are
less sustainable
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myths
• The credit crunch means we have to delay
investing in a sustainable future
• My wealth depends on someone else’s
poverty
• Inequality drives innovation and creativity
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The least empowered and the
most vulnerable are MUCH
more sensitive to change
- economic
- environmental
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The time is now
At least 15,000
people died
prematurely as a
result of Europe’s
heat wave in
2003 in France1
1. Unprecedented heat-related deaths during the 2003 heat
wave in Paris: consequences on emergency departments
Jean-François Dhainaut, Yann - Erick Claessens, Christine
Ginsburg, and Bruno Riou.
Crit Care. 2004; 8(1): 1–2.
Published online 2003 December 4. doi: 10.1186/cc2404.
and Bhattacharya, S. (October 2003), ‘European heat wave
caused 35,000 deaths’, The New Scientist.
http://www.newscientist.com/article/dn4259
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The 1995
Chicago heat
wave led to
approximately
700 heatrelated
deaths in
Chicago over
a period of
five days
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Unfair resource use causes illness
and death directly...
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…there are MUCH greater health
risks for the least empowered through:
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Health co-benefits
1. Traditional person focussed benefit
– Physical activity, diet, mental health, trauma, air
pollution…
2. Benefits for health care system
– Congruent with policy direction for many health care
systems: care closer to home, empowered, self
care, better use of drugs, better use of ICT,
prevention
3. Benefits for international (health) inequity
– Cost effective leap frogging from pre-industrial, precarbon to post carbon, missing out high carbon step
in the middle
– Justice: Contraction and convergence
– Energy: Concentrated solar power (CSP), much
from warmer and poorer countries
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Fairer and
more sustainable
global health…
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Who produces the greenhouse gases?
The world map reflecting production related to climate change.
“Climate Change presents the biggest threat to health in the 21st Century” The Lancet (373;9697 pp 16591734, May 16-22 2009).
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Who bears the burden?
The world map reflecting mortality related to climate change.
“Climate Change presents the biggest threat to health in the 21st Century” The Lancet (373;9697 pp 16591734, May 16-22 2009).
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Within 6 hours, deserts receive more energy than the world uses in a year.
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References
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Climate and Health Council (www.climateandhealth.org)
Collapse, Jared Diamond.
Global health, global warming, personal and professional
responsibility, Cambridge Medicine, Pencheon D, Vol 2, No 22, 2008
Stott R, Healthy response to climate change, BMJ 2006;332;1385-1387
Gill M, Why should doctors be interested in climate change?
BMJ Jun 2008; 336: 1506
Griffiths J, Alison Hill, Jackie Spiby and Mike Gill, Robin Stott Ten
practical actions for doctors to combat climate change, BMJ
2008;336;1507
Sustaining a healthy future: www.fph.org.uk
Griffiths J et al, The Health Practitioner's Guide to Climate Change,
Earthscan 2009
Pencheon D, Health services and climate change: what can be done?
J Health Serv Res Policy. Editorial Jan 2009
UCL Health Commission/Lancet: Managing the Health effects of
Climate Change. May 2009
The health benefits of tackling climate change, Wellcome/LSHTM, Nov
2009
Sustainable Development Commission: http://www.sdcommission.org.uk/pages/health.html
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Action now…
1. SDC Good Corporate Citizenship
toolkit
–
www.corporatecitizen.nhs.uk/
2. NHS Carbon Trust Management
Programme
–
http://www.carbontrust.co.uk/
carbon/publicsector/nhs/
3. Sustaining a Healthy Future
–
www.fph.org.uk
4. NHS Confederation briefings
–
http://www.nhsconfed.org/Publications/
briefings/Pages/Briefings.aspx
5. NHS Carbon Reduction Strategy
and 2030 health care scenarios
–
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See notes of this slides for some of the most important specific actions
Never waste a crisis...
...our watch, our legacy
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