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Associate Professor Rae Walker
        School of Public Health
            La Trobe University
   Primary Health Care:
    ◦ is community based
    ◦ promotes, protects and develops health
    ◦ in a defined community (DHS 2009:16)

   Service values in Declaration of Alma Ata.
    ◦   Address physical, social and mental wellbeing
    ◦   Put people at the centre of health care
    ◦   Promote health
    ◦   Value social justice, community participation and
        social inclusion
The levels are interdependent




 Environment Society      Individual
Port Phillip and Westernport region the likely impacts of climate
  change are:
  Rising temperatures. Average temperatures have already increased
    0.4C above pre-1990 averages and this is likely to at least double
    by 2030. By 2070 Melbourne’s average temperatures are likely to
    be similar to those currently found in Echuca. There will be more
    hot days and more extreme fire danger days.

  Declining rainfall. Rainfall has already decreased by 14% below pre-
   1990 averages. By 2070 Melbourne’s rainfall is likely to be similar
   to that of present day Seymour. Less rainfall and drier soils will
   lead to changes in agricultural practices and production.

  The weather will become more variable with more heavy rain, more
    dry spells, and more storms.

  Sea levels will rise producing coastal flooding enhanced by more
    major storm events (Department of Sustainability and Environment
    2008).
   71% said level of concern about CC had increased
    over last 2 years
   78% said that if nothing is done CC will have very
    serious or somewhat serious consequences
   45% consider CC a serious problem now
   Knowledge of the science of CC poor
   The most common perception of CC consequences
    are natural disasters and extreme weather events
   37% reported personal experience of natural
    disasters
   59% thought their locality vulnerable
   We may perceive risk:
    ◦ Through feelings – fast, intuitive, instinctive
      reaction to danger
    ◦ Through analysis – logic, reason, knowledge of
      evidence assessment of danger

   The risk apprehension continuum:

    ◦ Feelings ………………X…………………. Analysis

    ◦ The best spot is in the middle
   Climate change itself – eg changes in
    temperature, rainfall, vegetation and habitat
   Climate change adaptation/mitigation
    strategies – eg carbon pricing(Chapman &
    Boston 2007)
   Health impacts of extreme            Diminished food production:
    weather events (floods, storms,       yields, costs/affordability,
    cyclones, bushfires etc)              nutritional consequences
   Health impacts of temperature        Increases in urban air pollution
    extremes, including heat              (e.g. ozone)
    waves                                Increased production of
   Vector-borne infectious               aeroallergens (spores, pollens)
    diseases (e.g. mosquito-borne        Mental health consequences of
    dengue fever, Ross River virus        social, economic and
   Food borne infectious diseases        demographic dislocations
    (including from Salmonella,          Emotional stresses and mental
    Campylobacter and many other          health problems in children, in
    microbes)                             response to perceptions/fears
   Water-borne infectious                of climate change and to
    diseases and risks from poor          family stresses
    water quality
   Health impacts will vary across ‘regions,
    communities and demographic subgroups’
    reflecting
    ◦   Differences in location (geographic)
    ◦   Socio Economic Status
    ◦   Preparedness
    ◦   Infrastructure
    ◦   Institutional resources
    ◦   Local adaptive strategies
        (Garnaut 2008:139)
People impacted most will be:
 ◦   People who are old or sick
 ◦   On low incomes
 ◦   In outer suburbs
 ◦   In rental housing
 ◦   People in poor quality housing (Garnaut 2008:139)
 ◦   Speak a language other than English at home
 ◦   Children (UNICEF)
 ◦   Indigenous Australians
   Mitigation – reduction in the source of,
    enhancement of sinks for, greenhouse gases
    (adapted from Garnaut 2008:612)
   Adaptation – adjustment of natural or human
    systems to moderate harm or exploit
    opportunities (adapted from Garnaut 2008:608)
   Coping – short term responses to situations
    that are threatening (adapted from Berkes & jolly 2001:2)
Chain of effects                    Potential responses
Heavy rain and flooding of an
urban area
Vulnerable groups:
•People living in low lying areas   •Assessment of risk
•People without communication       •Activation of response plans

Effects on individuals:
•Injury                             •Medical/nursing services
•Shortage of food and water         •Coordination of supplies
•Stress                             •Community peer support
•Loss of property                   •Material aid

Effects on community:
•Economic disruption                •Emergency relief payments
•Damage to infrastructure           •Repair based on need
•Social stress                      •Community organisation
   Social model of health
   Variability in health impacts across
    populations and localities
   Multiple scales of intervention – individual,
    household, community, region, etc.
   Multiple social responses to climate change
    – mitigation, adaptation and coping
   Joined-up change strategies

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Walker health social climate change

  • 1. Associate Professor Rae Walker School of Public Health La Trobe University
  • 2. Primary Health Care: ◦ is community based ◦ promotes, protects and develops health ◦ in a defined community (DHS 2009:16)  Service values in Declaration of Alma Ata. ◦ Address physical, social and mental wellbeing ◦ Put people at the centre of health care ◦ Promote health ◦ Value social justice, community participation and social inclusion
  • 3. The levels are interdependent Environment Society Individual
  • 4. Port Phillip and Westernport region the likely impacts of climate change are: Rising temperatures. Average temperatures have already increased 0.4C above pre-1990 averages and this is likely to at least double by 2030. By 2070 Melbourne’s average temperatures are likely to be similar to those currently found in Echuca. There will be more hot days and more extreme fire danger days. Declining rainfall. Rainfall has already decreased by 14% below pre- 1990 averages. By 2070 Melbourne’s rainfall is likely to be similar to that of present day Seymour. Less rainfall and drier soils will lead to changes in agricultural practices and production. The weather will become more variable with more heavy rain, more dry spells, and more storms. Sea levels will rise producing coastal flooding enhanced by more major storm events (Department of Sustainability and Environment 2008).
  • 5. 71% said level of concern about CC had increased over last 2 years  78% said that if nothing is done CC will have very serious or somewhat serious consequences  45% consider CC a serious problem now  Knowledge of the science of CC poor  The most common perception of CC consequences are natural disasters and extreme weather events  37% reported personal experience of natural disasters  59% thought their locality vulnerable
  • 6. We may perceive risk: ◦ Through feelings – fast, intuitive, instinctive reaction to danger ◦ Through analysis – logic, reason, knowledge of evidence assessment of danger  The risk apprehension continuum: ◦ Feelings ………………X…………………. Analysis ◦ The best spot is in the middle
  • 7. Climate change itself – eg changes in temperature, rainfall, vegetation and habitat  Climate change adaptation/mitigation strategies – eg carbon pricing(Chapman & Boston 2007)
  • 8. Health impacts of extreme  Diminished food production: weather events (floods, storms, yields, costs/affordability, cyclones, bushfires etc) nutritional consequences  Health impacts of temperature  Increases in urban air pollution extremes, including heat (e.g. ozone) waves  Increased production of  Vector-borne infectious aeroallergens (spores, pollens) diseases (e.g. mosquito-borne  Mental health consequences of dengue fever, Ross River virus social, economic and  Food borne infectious diseases demographic dislocations (including from Salmonella,  Emotional stresses and mental Campylobacter and many other health problems in children, in microbes) response to perceptions/fears  Water-borne infectious of climate change and to diseases and risks from poor family stresses water quality
  • 9. Health impacts will vary across ‘regions, communities and demographic subgroups’ reflecting ◦ Differences in location (geographic) ◦ Socio Economic Status ◦ Preparedness ◦ Infrastructure ◦ Institutional resources ◦ Local adaptive strategies (Garnaut 2008:139)
  • 10. People impacted most will be: ◦ People who are old or sick ◦ On low incomes ◦ In outer suburbs ◦ In rental housing ◦ People in poor quality housing (Garnaut 2008:139) ◦ Speak a language other than English at home ◦ Children (UNICEF) ◦ Indigenous Australians
  • 11. Mitigation – reduction in the source of, enhancement of sinks for, greenhouse gases (adapted from Garnaut 2008:612)  Adaptation – adjustment of natural or human systems to moderate harm or exploit opportunities (adapted from Garnaut 2008:608)  Coping – short term responses to situations that are threatening (adapted from Berkes & jolly 2001:2)
  • 12. Chain of effects Potential responses Heavy rain and flooding of an urban area Vulnerable groups: •People living in low lying areas •Assessment of risk •People without communication •Activation of response plans Effects on individuals: •Injury •Medical/nursing services •Shortage of food and water •Coordination of supplies •Stress •Community peer support •Loss of property •Material aid Effects on community: •Economic disruption •Emergency relief payments •Damage to infrastructure •Repair based on need •Social stress •Community organisation
  • 13. Social model of health  Variability in health impacts across populations and localities  Multiple scales of intervention – individual, household, community, region, etc.  Multiple social responses to climate change – mitigation, adaptation and coping  Joined-up change strategies