Harnessing determinants, data science and decision-making to tackle the climate and health crises across the Americas – and globally

Authors: Georges C. Benjamin, Laura Magaña, Jeanette Vega*

Climate change has a profound impact on people’s health. From extreme weather to heat waves, ice and snowstorms, flash rainstorms with massive floods, and even droughts — all bring many kinds of dangers and heightened health risks that extend well beyond the immediate threat of physical injury and death. The changing climate also alters the ecosystem in ways that impact the nutritional quality of the food we eat and the infectious diseases to which we are exposed. Climate change also has long-term, far-reaching repercussions to critical health and social systems by depleting essential resources, displacing populations, and exacerbating existing vulnerabilities and inequities. Many of the adverse health effects related to climate change stem from their socioeconomic impacts as well as their direct health effects: for example, a hurricane that injures or kills people also destroys homes and livelihoods, leaving families struggling to find food, clean water and safe shelter for days, weeks or even months. In many cases the societal impact on whole communities can span years for recovery if they ever really do so.

“It is clear what we must do. The data demonstrate the degree of interconnectivity between our future health and that of our planet. Investments and policies related to climate change mitigation and population health should reflect the inextricability of these challenges.”

In the Americas, among other effects, sea level rise is projected to increase along most coasts contributing to increased coastal flooding in low-lying areas and shoreline retreat along most sandy coasts. Ocean acidification and marine heatwaves are projected to increase, and strong declines in glaciers, permafrost, and snow cover will continue. Many countries in the region are among the least equipped to withstand climate-related shocks. Geography is a big factor. So is widespread poverty. To build more resilient systems, adapt to new climate realities, and mitigate harm to individuals and populations, we need more cohesive action globally, across governments, sectors and disciplines. We need to leverage the latest advances in data science in policy and decision-making to drive effective, lasting solutions that address the impact on social determinants of our health.

This is the crux of a newly published report by the Commission on Health Determinants, Data and Decision-making (3-D Commission), an initiative by the Rockefeller Foundation and Boston University School of Public Health. Over the past two years, the 3-D Commission has delved into the key social and economic drivers that influence health outcomes and illustrates how data science and the social determinants of health should be integrated into decision-making processes. The findings of the 3-D Commission’s final report are centered on the need to consider the full spectrum of societal factors, barriers and opportunities for using data on determinants, and to use those data more systematically to inform policies and practices aimed at improving health. The Commission’s report provides a useful roadmap for scholars, practitioners and policymakers alike, with recommendations focused on six core principles for action in three key areas — political will, technical capacity and community engagement – to drive results and improve population health outcomes. The six principles offer useful guidance to address the challenges of climate change and population health.

Six principles for action for harnessing determinants, data science and decision-making

1. Evidence-informed decision-making to promote healthy societies needs to go beyond healthcare and incorporate data on the broader determinants of health.

2. All decisions about investments in any sector need to be made with health as a consideration.

3. Decision-making that affects population health needs to embrace health equity — while also acknowledging potential tradeoffs between short- and long-term costs and benefits.

4. All available data resources on the determinants of health should be used to inform decision-making about health.

5. Data on the social determinants of health should contribute to better, more transparent and more accountable governance.

6. Evidence-informed decision-making to promote healthy societies needs to be participatory and inclusive of multiple and diverse perspectives.

Climate-driven health impacts will vary by age, gender, income, livelihoods and ability to deal with the challenge. Human health risks and widening social and health inequities related to poor living environments could be reduced — or perhaps prevented — if the drivers and consequences of climate change on socio-ecological systems were addressed through policy and planning. For example, while COVID-19 may not be directly linked to climate change, the risk of its transmission and severity of disease are related to social determinants that depend directly on climate. These include increasing mobility and migration, overcrowding in cities with poor sanitation, and comorbidities from air pollution exposure. The same socioeconomic factors and health factors that contribute to COVID-19 disease risk also increase a population’s vulnerability to the adverse health effects of climate change.

The UN’s latest scientific assessment concludes that, while there is no way to stop global warming from intensifying over the next 30 years, there is still time and opportunity — a “short window” — in which to act and prevent the worst. According to the WHO, meeting the Paris Agreement goals would save about a million lives every year by 2050 through reductions in air pollution alone. Avoiding the worst climate impacts could help prevent 250,000 additional climate-related deaths per year between 2030 and 2050, mainly from malnutrition, malaria, diarrhea, and heat stress. And the value of health gains from reducing carbon emissions would be approximately double the global cost of implementing carbon mitigation measures.

At the national level, most countries list adverse health effects from climate change as a priority policy and population health issue. Yet less than 2 percent of multilateral climate finance goes toward health projects. This reflects the lack of coordination – and broader disconnect – between decisions being made about population health versus environmental sustainability and has limited global progress against our greatest public health challenges.

It is clear what we must do. The data demonstrate the degree of interconnectivity between our future health and that of our planet. Investments and policies related to climate change mitigation and population health should reflect the inextricability of these challenges: for the good of the planet and for the good of humanity, for the Americas and the world.

*Georges C. Benjamin, MD is Executive Director of the American Public Health Association; Laura Magaña is President and Chief Executive Officer of the Association of Schools and Programs of Public Health; and Jeanette Vega is the CEO of Pronova Technologies, a Company focused in Digital Health in Chile.