Envisioning environmental equity: climate change, health, and racial justice

Abstract

Climate change has a broad range of health impacts and tackling climate change could be the greatest opportunity for improving global health this century. Yet conversations on climate change and health are often incomplete, giving little attention to structural discrimination and the need for racial justice. Racism kills, and climate change kills. Together, racism and climate change interact and have disproportionate effects on the lives of minoritised people both within countries and between the Global North and the Global South. This paper has three main aims. First, to survey the literature on the unequal health impacts of climate change due to racism, xenophobia, and discrimination through a scoping review. We found that racially minoritised groups, migrants, and Indigenous communities face a disproportionate burden of illness and mortality due to climate change in different contexts. Second, this paper aims to highlight inequalities in responsibility for climate change and the effects thereof. A geographical visualisation of responsibility for climate change and projected mortality and disease risk attributable to climate change per 100 000 people in 2050 was conducted. These maps visualise the disproportionate burden of illness and mortality due to climate change faced by the Global South. Our third aim is to highlight the pathways through which climate change, discrimination, and health interact in most affected areas. Case studies, testimony, and policy analysis drawn from multidisciplinary perspectives are presented throughout the paper to elucidate these pathways. The health community must urgently examine and repair the structural discrimination that drives the unequal impacts of climate change to achieve rapid and equitable action.

Figure 1

Devakumar and colleagues' conceptual model on racism, xenophobia, discrimination, and health applied to climate change and health Reproduced with permission of Devakumar and colleagues.

Figure 2

Unequal responsibility for climate breakdown and unequal health outcomes between countries (A) Responsibility for climate breakdown across countries based on cumulative CO emissions from 1850–2015; countries in green were still within their fair share of the 350 ppm boundary as of 2015. (B) Projected climate-change attributable diarrhoeal mortality in people aged younger than 15 years; countries in light grey have mortality less than 0·01. (C) Projected climate-change attributable population at risk of malaria; countries in light grey have a risk of 0, the USA and Canada have a risk of 27. (D) Projected climate-change attributable heat-related mortality in people older than 65 years. (E) Projected climate-change attributable mortality due to undernutrition in children younger than 5 years; grey indicates no data. Projected climate change-attributable mortality and disease risk maps were created using Microsoft Excel and Datawrapper software to visually display mortality rates and population at risk per 100 000. Rates were calculated with the estimated number of deaths and population at risk per region in 2050 and medium population growth estimates for 2050 from the World Population Prospects 2010 revision., PPM=parts per million.

Figure 3

Research priorities at the nexus of climate change, health, and discrimination MAPA=most affected people and areas.