- About HHR
Human rights are universal, and greenhouse gasses (ghg) and climate change are global. However, most of the changes needed to reduce ghg emissions immediately are local. The realisation (or loss) of rights, including from climate change, is particular and local—although our actions can affect the rights of people in other countries.
The good news is, as the health community increasingly turns our attention to ghg reduction, we are discovering that tackling climate change locally could be the greatest global health opportunity of this century for all people to enjoy their right to the highest attainable standard of health.1
Here is a climate story of hope from New Zealand.
New Zealand proudly tops the list for respecting some human rights, such as votes for women. But our more recent record shows big gaps in the conditions to enable the right to health (and other rights) to be fulfilled for many of our children, indigenous Māori, or Pacific ethnic groups.2 There is too little progressive improvement and at times there is retrogression.3 Climate change will worsen the picture, with the impacts most felt by indigenous Māori and by groups whose health is already most compromised.4 Many Pacific neighbouring States face obliteration from sea level rise.
Climate change is very challenging for New Zealand as we have one of the highest per capita ghg emissions. Where can we get co-benefits, that is, benefits both for immediate health gain and for ghg reduction? Commuter transport and warm housing are two areas that have been closely studied.
We can halve the ghg emissions from car commuting even before we improve public transport or put a single electric car on the road.5 The fear of injury from motor vehicles has fed the steady decline in people cycling to work. Modifying local streets to reduce speeds and creating dedicated cycleways will encourage people back to bikes. This would lead to a substantial drop in all-cause mortality, mostly from increased physical activity. The financial savings from health costs and mortality would yield benefits 10-25 times greater than the costs of implementing the changes.
Globally, improving health from reducing fossil fuel transport emissions is a big win-win for health and climate.6 Even in New Zealand, air pollution is associated with all-cause and respiratory mortality.7 Here we could easily electrify our many urban short cars trips. Our rail network is already fully electric and could replace long-distance fossil fuel freight haulage. Achieving fully renewable electricity generation for ghg reductions (New Zealand is already at 80% ) would give us the health co-benefits of reduced air pollution deaths. It is estimated over 900 deaths each year (about 3% total) were premature from air pollution generated by either motor vehicles or dirty, inefficient home heating—despite NZ being a population of only 4.6 million, low-air-pollution country).8
New Zealand houses are notoriously cold and damp, particularly in winter. A programme of retrofitting insulation reduced mortality and resulted in fewer hospitalisations and lower health service costs.9 There were also small reductions in household electricity use. The overall programme had a benefit cost ratio of about 4:1. Fossil fuel is used to supplement renewable electricity production, especially at times of peak demand, such as domestic heating in winter. Until all electricity generation is renewable, any electricity reductions will contribute to ghg reductions.
Agriculture, mostly meat and dairy, is more problematic. It’s New Zealand’s top ghg emission sector. A healthier diet than New Zealand’s current red-meat heavy one would be substantially lower in ghg emissions and is both feasible and affordable.10 But agriculture is our main economic activity and we export most of our production.
High levels of breast feeding globally would enhance human rights for women and children everywhere. One of our biggest exports is milk powder, much of it as breast milk substitute. Drastically dropping the demand for New Zealand breast milk substitutes would drop ghg emissions both from reduced agricultural emissions and from reduced coal-fired dehydration to produce milk powder.11 This would be another win-win for health and climate.
Reorienting New Zealand’s agricultural economy will have many complex interactions for the right to health locally and may take some time as we work to ensure that all business respect rights.12 This is all the more reason to act immediately where there are unequivocal health and human rights co-benefits with climate action—transport, housing and breastfeeding.
This good-news story for achieving ghg reductions and realising the right to health is one of hope. Other countries have good potential to achieve climate and health co-benefits from options as diverse as clean indoor cooking and lighting and nutrition.13 To reach that potential we need local, national and global commitments at Paris far greater than we are seeing to date. And we need to ensure that international trade and investment agreements respect rights and do not handcuff governments from making healthy decisions.14
Gay Keating is a public health specialist and researcher, currently based at Te Rōpū Rangahau Hauora a Eru Pōmare, University of Otago, Wellington.
1 Watts N, Adger WN, Agnolucci P, Blackstock J, Byass P, Cai W, et al. Health and climate change: policy responses to protect public health. Lancet [Internet]. 2015 [cited 2015 Jul 23];6736(15). Available from: http://linkinghub.elsevier.com/retrieve/pii/S0140673615608546
2 Craig E, Anderson P, Jackson G, Jackson C. Measuring potentially avoidable and ambulatory care sensitive hospitalisations in New Zealand children using a newly developed tool. N Z Med J [Internet]. 2012 [cited 2014 Jul 14];125(1366):38–50. Available from: http://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2012/vol-125-no-1366/article-craig; Robson B, Harris R. Hauora: Māori Standards of Health IV. A study of the years 2000-2005 [Internet]. Robson B, Harris R, editors. Wellington: Te Rōpū Rangahau Hauora a Eru Pōmare; 2007 [cited 2015 Oct 13]. Available from: http://www.hauora.maori.nz/hauora/#publication; S Ajwani, Blakely T, Robson B, Tobias M, Bonne M. Decades of Disparity III: Ethnic and socioeconomic inequalities in mortality, New Zealand 1981-1999 [Internet]. Wellington: Ministry of Health New Zealand; 2006. Available from: http://www.wnmeds.ac.nz/nzcms-info.html
3 Baker MG, Barnard LT, Kvalsvig A, Verrall A, Zhang J, Keall M, et al. Increasing incidence of serious infectious diseases and inequalities in New Zealand: A national epidemiological study. Lancet [Internet]. Elsevier Ltd; 2012;379(9821):1112–9. Available from: http://dx.doi.org/10.1016/S0140-6736(11)61780-7
4 Bennett H, Jones R, Keating G, Woodward A, Hales S, Metcalfe S. Health and equity impacts of climate change in Aotearoa-New Zealand, and health gains from climate action [Special Article]. N Z Med J [Internet]. 2014;127(1406):16–31. Available from: http://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2014/vol-127-no-1406/6366
5 Macmillan A, Connor J, Witten K, Kearns R, Rees D, Woodward A. The Societal Costs and Benefits of Commuter Bicycling: Simulating the Effects of Specific Policies Using System Dynamics Modelling. Environ Health Perspect [Internet]. 2014;(February):1–26. Available from: http://ehp.niehs.nih.gov/1307250/
6 Höhne N, Day T, Fekete H, Gonzales S. Assessing the missed benefits of countries’ national contributions: Quantifying potential co-benefits [Internet]. Cologne; 2015. Available from: https://newclimateinstitute.files.wordpress.com/2015/06/cobenefits-of-indcs-june-2015.pdf
7 Hales S, Blakely T, Woodward A. Air pollution and mortality in New Zealand: cohort study. J Epidemiol Community Heal [Internet]. 2012 May [cited 2015 Oct 13];66(5):468–73. Available from: http://www.otago.ac.nz/wellington/otago024003.pdf; Hales S, Salmond C, Town GI, Kjellstrom T, Woodward A. Daily mortality in relation to weather and air pollution in Christchurch, New Zealand. Aust N Z J Public Health [Internet]. 2000 Mar;24(1):89–91. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10777987
8 Kuschel G, Metcalfe J, Wilton E, Guria J, Hales S, Rolfe K, et al. Updated Health and Air Pollution in New Zealand Study – Volume 1: Summary Report. 2012. http://www.hapinz.org.nz/HAPINZ Update_Vol 1 Summary Report.pdf
9 Grimes A, Denne T, Howden-Chapman P, Arnold R, Telfar-Barnard L, Preval N, et al. Cost Benefit Analysis of the Warm Up New Zealand: Heat Smart Programme Revised 2012 [Internet]. Wellington; 2011. Available from: http://www.healthyhousing.org.nz/wp-content/uploads/2012/05/NZIF_CBA_report-Final-Revised-0612.pdf
10 Wilson N, Nghiem N, Ni Mhurchu C, Eyles H, Baker MG, Blakely T. Foods and dietary patterns that are healthy, low-cost, and environmentally sustainable: a case study of optimization modeling for New Zealand. PLoS One [Internet]. 2013 Jan [cited 2014 May 5];8(3):e59648. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3609827&tool=pmcentrez&rendertype=abstract
11 Galtry JA. Improving the New Zealand dairy industry’s contribution to local and global wellbeing: the case of infant formula exports. N Z Med J [Internet]. 2013;126(1386):82–9. Available from: https://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2013/vol-126-no-1386/galtry
12 Ruggie J. Guiding Principles on Business and Human Rights: Implementing the United Nations “Protect, Respect and Remedy” Framework. [Internet]. 2011. Available from: http://www.ohchr.org/Documents/Issues/Business/A-HRC-17-31_AEV.pdf
13 WHO Media centre. Household air pollution and health: Fact sheet [Internet]. World Health Organization; 2014 [cited 2015 Oct 13]. p. 3–7. Available from: http://www.who.int/mediacentre/factsheets/fs292/en/
14 UN Human rights experts. UN experts voice concern over adverse impact of free trade and investment agreements on human rights [Internet]. 2015. Available from: http://www.ohchr.org/FR/NewsEvents/Pages/DisplayNews.aspx?NewsID=16031&LangID=E; Chan M. Health has an obligatory place on any post – 2015 agenda [Internet]. Geneva: WHO; 2014. Available from: http://www.who.int/dg/speeches/2014/wha-19052014/en/ Previous publications in HHRJ by Gay Keating Climate Change and the Right to Health for Māori in Aotearoa/New Zealand, June 2014
Previous publications in HHRJ by Gay Keating
Letter to the Editor: The Rule of Law as a Social Determinant of Health
O.B. K. Dingake
Letter to the Editor: Refusal to Treat Patients Does Not Work in Any Country – Even if Misleadingly Labelled Conscientious Objection
Christian Fiala and Joyce H. Arthur
Letter to the Editor Response: Much to Debate about Conscientious Objection
Wendy Chavkin, Laurel Swerdlow, and Jocelyn Fifield
Papers in Press
The Cholera Epidemic in Zimbabwe, 2008-2009; A Review and Critique of the Evidence
C. Nicholas Cuneo, Richard Sollom, and Chris Beyrer
Letter to the Editor: Human Rights, TB, Legislation and Jurisprudence
O. B. K. Dingake
UNstoppable: How Advocates Persevered in the Fight for Justice for Haitian Cholera Victims
HIV Criminalization Laws and the Right to Health
Canada’s Mining Industry in Guatemala and the Right to Health of Indigenous Peoples