In conversation with Abi Deivanayagam, Race & Health Collective
Written by Jessica Kleczka
Climate change is the biggest threat to public health in the UK and globally. Its impacts are now undeniably felt across the world and increasingly, scientific emphasis is put on the present and future impacts of climate breakdown, as was evident in the recent chapter of the IPCC analysing vulnerability and adaptation. Human health, often neglected in the past, is now becoming an essential focus point of how we understand the changes happening to our world. The new IPCC report made progress in acknowledging both physical and mental health impacts, which decrease resilience and could potentially derail much of the progress our societies have made - economically, socially, and culturally.
The health impacts of climate change are not equal: the poorest and most marginalised communities are disproportionately affected worldwide, both by direct and indirect health effects of climate change. Inequalities in climate impacts already exist presently, but are thought to intensify in the future, especially in the absence of meaningful action both on mitigation and adaptation*. The UK has one of the worst health inequalities in Europe, and has seen declining health even before the Covid-19 pandemic. Climate change will only exacerbate and accelerate those existing health disparities. Under a business as usual scenario, over 800 million people worldwide will face food insecurity, and 140 million could be displaced by 2050.
We spoke to Abi Deivanayagam from Race & Health Collective and Health for a Green New Deal, who is a doctor training to specialise in public health, and an activist at the intersection of climate, health and racial justice. Abi is passionate about a public health that is abolitionist, rooted in compassion and freedom. On climate change and health inequality, she says: “Whilst the climate crisis affects all of us, it doesn’t affect us all equally. And people who are disadvantaged due to poverty, racial minoritisation, gender inequality or disabilities, bear a much greater burden of the health impacts of the climate crisis. There’s also unequal responsibility for the cause of this crisis: Those who contribute the most suffer the least, and those who contribute the least suffer the most. That is injustice, and that is violence.
A lot of these injuries aren’t new. They’re merely salt which is poured on our existing wounds. And those are due to our political and economic systems that have been causing violence for centuries. The climate crisis is merely a symptom of a much deeper disease that is making our planet and everyone on it sick. So we need to be very bold and ambitious to tackle this issue.”
Last month, an open letter signed by the UK’s leading medical institutions with a combined membership of over 250,000 health workers was delivered to 10 Downing Street. With signatories including the British Medical Association, it is an authoritative initiative calling for an immediate end to new fossil fuel licences and a categorical rejection of the Cambo oil field, which is still up in the air.
“There are many ways in which climate can impact health in the UK”, Abi says in our interview. “Mainly heat and cold related illnesses; the impacts of flooding and disasters; infectious diseases that are likely to increase in the future as the planet warms; but also more volatile weather which means we’ll have to deal with food insecurity. We also can’t ignore the energy crisis we’re in and how that’s related to the climate crisis: A lot of preventable deaths happen in the UK because of cold weather - this is because of our reliance on fossil fuels which are extremely volatile and lead to price hikes which sadly the most vulnerable are hit with the most, because people are not able to afford heating. People can also die acutely from storms as we've seen recently. It is devastating that in a rich country like the UK we don’t have systems in place to deal with this.”
The health letter also calls for an end to oil and gas subsidies, which have exceeded £14 billion since the UK signed the Paris Agreement. A considerable share of those subsidies has been shouldered by the taxpayer, but in light of the recent energy crisis the government has yet to announce adequate emergency support for the most vulnerable households. The UK’s current policy of Maximum Economic Recovery effectively forces the government to extract every last drop of oil in the North Sea, although the only party that truly profits are oil and gas companies - most of whom are not even based in the UK.
On the consequences of new fossil fuels, Abi says: “More oil and gas exploration anywhere has huge negative implications for public health and worsens health inequalities. Over the last couple of months, our reliance on fossil fuels has shown us that we have an energy system that doesn't serve those who need it. While more people are experiencing fuel poverty, the rich are growing richer and fossil fuel giants like Shell are reporting sky-high profits that could be used to help us out of this situation.”
Worldwide, around 8 million people are thought to die from air pollution caused by fossil fuels every year, making up a fifth of total deaths. In the UK, this figure is estimated at up to 40,000 a year. “Air pollution is an important determinant of health”, Abi stresses. “It can cause death directly, but also chronic illness - especially a particle called PM2.5 which can get lodged in people's lungs throughout their life and result in illness. This, again, happens unequally because the poorest people live in areas with bad air quality.”
A prominent example of this has been the case of Ella Kissi-Debrah, a nine year old black girl from south-east London who died from an asthma attack in 2013. After a year-long legal battle, an inquest ruled that air pollution had made a “material contribution” to her death, and experts are now calling for law changes reflecting that there is no safe level of particulate matter. But despite the Environment Act now being enshrined in law, we have yet to see governmental action on reducing maximum levels of particulate matter.
Fossil fuel pollution is thought to contribute to falling fertility rates, too: Childbirth has steadily decreased over the last 50 years, and the start of this trend seems to have correlated with the start of the industrial revolution. Fossil fuels and their byproducts have been found in people's blood, urine, placenta, breast milk, and even newborn babies. They interfere with the body’s hormonal systems and negatively affect reproductive health. Counter to unscientific claims of “overpopulation”, experts are now concerned that we may be facing unbalanced demographics in our lifetime, with too few younger people to support an ageing population.
All of this makes it unacceptable for rich countries like the UK to explore for more oil and gas, Abi says. “Countries in the Global North are historically responsible for 92% of global CO2 emissions. This is a process of atmospheric colonisation, as Jason Hickel calls it. Any more new oil and gas fields will directly lead to death and suffering. And any oil and gas field we stop means saving lives.”
The concept of environmental racism - racial discrimination in environmental policy and enforcement - may have its origins in the US, but there are now a number of studies showing that racialised groups in the UK are disproportionately exposed to pollution. “My recent research looked at environmental racism against children in the UK”, Abi shares with us, “I used the Millennium Cohort Study where 18,000 children from the UK born in 2000 have been followed throughout their lives. I found that non-white children are 19 times more likely to live in areas of high air pollution compared to white children. That’s accounting for social status, so it’s just based on ethnicity.”
“There’s also research which shows that single parent households - which are majority racialised women who are more likely to experience financial stress and social isolation - have worse health outcomes as a result of where they live. These are the households that suffer the most from heat and pollution.”
Environmental justice has now arrived in the medical vocabulary, with organisations like Medact calling for action on land justice and climate reparations. Abi echoes this increased politicisation of public health: “Whether we’re health professionals or campaigners, we need to ensure we see the climate crisis as a result of colonial capitalism, white supremacy, ableism, and the cishetero-patriarchy*.”
Medact’s Public health case for a green new deal is a groundbreaking report making a strong argument for a rapid transition away from fossil fuels. In its six point plan, it calls for
By tackling these six key areas, Medact argues, we would successfully address the upstream determinants of illness and mortality and increase overall public health. The economy, environment and our health are inextricably linked, the authors stress, and global justice must be at the heart of our approach.
“It’s time that we reclaim sustainability as a social justice issue”, Abi says, “so we can stop seeing the climate crisis as an abstract thing but something that affects everybody living on this planet. If we are going to prioritise public health, it needs to start with the UK saying “no” to new oil and gas, push companies to pay their tax and reparations for the damage the industry has done to people in the UK and globally. And we need to do it with ambition. The health community is ready.”
Healing Justice London
Land In Our Names