Environmental degradation: climate change and health: sick earth, sick people

Climate change is making some patients even sicker, because rising temperatures can massively intensify existing diseases. In addition, new species of insects are immigrating, bringing certain pathogens with them. Climate change not only threatens the earth’s ecosystem, it also endangers human health. This health problem is primarily noticed by the public when heat deaths are reported on hot summer days.

As part of the Bayreuth Health Dialog event series, the topic was put on the agenda last week in order to advance the public debate. Initiated by the University of Bayreuth and the pharmaceutical manufacturer Lilly Germany, among others, and can be experienced on site at the Health Congress of the West, which in turn is supported by health insurance companies, regional panel doctors and industry.

Christian Schulz spoke at the beginning of several simultaneous crises that the topics of climate change and health could not be excluded: “That is too narrow a narrative.” Rather, he advocates the notion of planetary health. For Schulz, the global crises include food insecurity and water shortages, “but these can still be compensated for in Germany. Things are getting tight when it comes to energy security, the high costs will remain«. In addition, the earth’s load limits would be exceeded in many places: through excessive land use, new substances in the environment, increasing shortage of fresh water, the destruction of the biosphere, the acidification of the oceans and air pollution. “If the earth is sick, man cannot be healthy,” says the textbook “Planetary Health,” which Schulz co-edited in 2021.

The doctor also names responsibilities: The global North cannot wash itself clean. In 2030, the richest ten percent of humanity are expected to cause nine times more climate-damaging greenhouse gases than the rest of humanity. The line between the 10 percent and the rest of the people is at an annual income of $35,000, says Schulz. When it comes to the question of guilt, he comes back to the Exxon Mobil case. The oil company had been conducting its own climate impact research studies since the 1970s. The results, which according to today’s researchers are clear, were concealed by management.

Schulz sees toxic business models not only kept going by the fossil industries. Products that harm people, such as unhealthy food, tobacco or alcohol, are marketed just as ruthlessly.

The medical journal »Lancet« had just discussed the damage caused by such commercial health factors in March. How negative the effects of the products are can be seen at the end of the causes of death: From the 56 million deaths worldwide each year, 42 million died from noncommunicable diseases. The largest groups usually include chronic diseases of the heart and blood vessels, chronic respiratory diseases, cancer and diabetes.

To close the circle, Claudia Traidl-Hoffmann from the University of Augsburg names the five main risk factors for non-infectious diseases: poor diet with many animal products, smoking, risky alcohol consumption and too little exercise. Number five is air pollution – at the same time the only factor that cannot be influenced by individuals alone. “We breathe in climate change,” says environmental medicine specialist Traidl-Hoffmann.

Pollutants from combustion processes fuel air pollution. The amount of particles and substances carried in is currently increasing, among other things due to forest fires. Pollen is also in the air: due to warming, it flies for longer periods of the year, there is more and new pollen because new species are spreading in areas not previously inhabited by them. Heat stimuli make the pollen more aggressive and release more proteins. The bottom line is that more people suffer from allergies.

At the same time, the researcher and her colleagues are concerned that protective factors will be lost, such as contact with nature and biodiversity. And on top of that comes the heat: it aggravates the aforementioned non-contagious diseases. During the heat wave of 2003, around 9,500 people died in Germany. From 2018 to 2020, for the first time in three consecutive years, there was a significant excess mortality with a total of almost 20,000 deaths. According to estimates by the Robert Koch Institute, 4,500 people died from the heat in Germany in the summer of 2022. The problem: A heat register could provide more accuracy here, but it doesn’t exist.

Traidl-Hoffmann also regrets that the problem is often not recognized even on warm summer days. According to local reports, 20 schoolchildren in Bavaria suffered a circulatory collapse during a voluntary 800-meter run last July. The headline in the local press was “mysterious” and referred to data from the German Weather Service, which showed a maximum of 27 degrees. It was probably overlooked that the measurements are always carried out in the shade. The sports field, on the other hand, should have been in the sun. According to the environmental doctor from Augsburg, the topic of heat also shows the limits of human adaptability: At a body core temperature of over 42 degrees, the proteins change so much that our cells lose their function.

Researchers and doctors hope, however, that the problems can be overcome. To do this, they rely on the education of society as a whole. The Gummersbach family doctor Ralph Krolewski is one of 46 million health professionals worldwide. He sees himself as responsible and pleads for his climate consultation hour. He started doing this in 2015. The doctor starts with the situation of the patient. Among other things, opportunities for more exercise in everyday life are sought during the conversation. Krolewski, who enthusiastically rides his bike every day, also asks about the nutritional style. Lifestyle changes alone can reduce risks by up to 30 percent. “The non-medical procedures are well accepted by the patients because they achieve greater self-efficacy.” His approach can be used in 60 percent of all medical consultations. At the same time, the recommendations are stored in such a way that they also ethically correspond to the medical professional code: They also help to preserve the natural foundations of life.