Public health epistemological perspective

Peter Coventry shares with us his epistemological perspectives of emergency and crisis in public health in the third blog in this series based on the IGDC/YESI Webinar event ‘Emergencies, wellbeing and social justice in the Anthropocene.’

Peter Coventry’s work examines the relationship between green and blue spaces and health and wellbeing. Peter joined us in this webinar to discuss epistemological perspectives specifically in relation to emergency and crisis in public health.

Climate change is a public health emergency

Climate emergency is increasingly conceived as a health emergency and the evidence for this is stark. We know that nine out of the 10 hottest years on record have occurred in the last decade, with devastating health consequences. Heat-related mortality among older adults has increased by more than 50% over the past 20 years with 900 people in England alone killed by heat waves in 2019. Our own research here at York shows that populations exposed to flooding have higher prevalence of mental health problems.

Evidence such as this suggests the health impacts of extreme weather events are both immediate and long-term. In this sense, emergency framing is used to stimulate accelerated responses to protect and improve public health. Just as the World Health Organization declared COVID19 to be a public health emergency, there is an argument that it should now also declare climate change as a public health emergency. This approach links to the idea of grouping emergencies together and recognises the intersection between climate and health.

‘Emergency’ as reaction and ‘Emergency’ as avoiding future impacts

I think this helps to draw out the difference between ‘emergency’ as reaction (which focuses on responses to threats that have occurred, such as floods and wildfire) and ‘emergency’ as strategy (which focuses on emergency framing to stimulate action to avoid future impacts of climate change in the absence of immediate danger).

Because emergency level reactions to events like floods and heatwaves are so disruptive there might be increased willingness amongst governments to put in place long-term strategic responses that prevent future, but as yet unseen, impacts of climate change on health.

To illustrate this further we can point to the response of COVID19 which did include the use of very disruptive lockdowns, which are an example of emergency as reaction, and while these lockdowns were very effective, they have led to mental health problems and economic hardship. Going forward governments might therefore be incentivized to deliver health policy interventions that increase pandemic preparedness to minimise threats in the future.

Linking the climate and health emergencies can be problematic

However, the narrative about catastrophic events like floods, fires, hurricanes melting ice caps and so on can be at odds with the observable and lived reality of climate change. These events can be easily ‘othered’; they happen elsewhere and to other people and they can be perceived as abstract and intangible.

Furthermore, invoking fear and crisis can be counter productive if the dramatic effects of climate change are not immediately apparent. The concept of emergency is associated with a threat to our survival and our health and often triggers a psychological and physiological response that we typically experience as fear and anxiety.

We can become overwhelmed by fear and paralysis, and an inability to act, and people might withdraw from climate action. Furthermore, motivation for collective action might wane over time in the face of sustained messaging about climate crisis and emergency. In the case of COVID19 commitment to restrictions during the pandemic were not universal and lockdowns were increasingly contested despite continued framing of COVID as a public health emergency.

Climate change viewed as a health problem makes it tangible

So, I think there probably is a call for more sustainable approaches to the framing of climate change that can stimulate rapid but durable action to mitigate the impacts of environmental challenges to health. Framing climate change as a health issue is critical to this. 

Climate change as climate health can divorce climate change policy from ideological and contested contexts and support novel social and ecological perspectives, such as ‘planetary health’, that recognised climate as a key determinant of health.

And lastly, framing climate change as a health problem, makes it personal, it makes it local and relevant to today, rather than an abstract event that will affect future generations.

Global scientific initiatives such as the Lancet countdown can play a key role in explaining and monitoring the world’s response to the health effects of climate change, but we are still faced with a difficult challenge about how best to mobilise such knowledge into action without invoking emergency framing.

Check out the full version of Pete’s talk:

About the author

Peter’s research focuses on using epidemiological methods to understand the relationship between green and blue spaces and health and well being, and developing applied methodologies to test the impact of nature-based activities on mental health.

He has particular interests in understanding the role of nature-based solutions for promoting health and wellbeing among people with mental health problems and long-term physical conditions. His work on environment and health is underpinned by a planetary health perspective which seeks to connect public health with ecological science to preserve and enhance population health.