According to a recent study, cities should better include their health facilities in plans to prepare for the effects of climate change if their adaptation is to fairly help its citizens. PLOS climate. City authorities must prepare to increase threats to the physical and mental health of the most vulnerable urban dwellers, both from direct consequences such as heat and infectious diseases and indirect consequences such as malnutrition, health experts warn.

Barcelona is one of the most populous cities in Europe, with about 1.6 million inhabitants and a population that is expected to continue to grow. Such growth, the urban heat island effect, and the typical location of large cities on coasts and rivers make them disproportionately vulnerable to extreme weather caused by climate change, with economically and socially marginalized communities suffering the most.

This puts big cities, such as Barcelona, ​​at the forefront of efforts to adapt to climate change, which include solutions that affect housing, mobility and employment. And metropolises also have a huge impact on global warming factors. While cities make up only a small fraction of the earth’s surface, they produce most of the world’s greenhouse gas emissions and consume the vast majority of the world’s energy. As many countries fail to meet their commitments under the Paris Agreement, cities are increasingly implementing their own plans to reduce greenhouse gas emissions, as well as respond to the changing climate and strengthen their resilience.

“The future of the fight against climate change is taking place in our streets and squares,” said Barcelona Mayor Ada Kolau Bolyana, presenting the city’s Climate Action Plan for 2018. “We are where most of the population lives, the people who are most responsible for greenhouse gas emissions, and the main focus of innovation.”

Municipal health services can make a difference in this preparedness by taking preventive action and providing data that can lead to better protection for those who need it most, the authors say a PLOS study published in March. A review of 22 major cities ’climate adaptation plans found that although almost all urban plans provided for human health goals and all reported heat as a health issue, many did not include their health facilities in their plans, despite Such cooperation is crucial in order to make climate adaptation fairer. The study also found that high-income cities had less involvement of local health authorities in addressing climate issues compared to low- and middle-income cities.

“We, as health professionals, know that public health has data and tools that can help target the most vulnerable people,” said Mary Sheehan, lead author of the study. “But, paradoxically, we’ve seen that public health is often on the sidelines of climate planning.”

Population growth and increasing climate threats

Report of the Intergovernmental Panel on Climate Change focused on adapting to climate change earlier this year highlighted the widespread adverse effects of global warming on human health. Infectious diseases, mental health problems, movement, heat stress, malnutrition and other conditions increase with increasing temperature, according to the IPCC.

Many of these impacts are concentrated in cities. Since 1980, extreme heat and rainfall have increased by at least 500 percent in the world’s largest cities, directly threatening the health of people in urban areas around the world. another study published last year. Such weather events also exacerbate the effects of growing income disparities and access to food and health care, and cities need to prepare for all these impacts, especially as urban populations grow, the authors say.

Rising urbanization will increase vulnerability to such threats, especially in low-income countries. From 2015 to 2020, the world’s urban population grew by more than 397 million people, according to the IPCC report, with most of this growth coming from less developed regions. More than half of the planet’s population now lives in cities, and that share is expected to be grow to about two-thirds by 2050.

Sheehan’s study suggests that a lack of public health involvement in urban planning to protect residents can threaten the health and safety of the most vulnerable.

Technicians from the Barcelona Health Agency said the city and its collaborating organizations are consulting with them on how and where to focus solutions on climate change mitigation and adaptation. Their role is to identify potential harm and assist in taking preventive and protective measures, said Laura Oliveras Puig, one of the agency’s senior technical staff. Discovery “Climate shelters” in 11 schools For the general public in case of heat one way to cooperate. The shelters consist of greenery and water bodies, and the buildings have been adapted to the thermal comfort of people during climatic emergencies.

“We are focusing on what is prevention, strengthening and health care at the population level,” Oliveras Puig said. “And we believe that at the end of everything we do as a health agency, it’s all affected by climate change.”

According to the city’s adaptation plan, Barcelona’s biggest health concerns are heat-related diseases, and the spread of infectious diseases that have migrated to the area as the climate warms. On average, the city experienced one wave of heat every four years, but by the end of the century is expected to be two to five a year.

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Efforts to protect the health of residents during the heat include the creation of climate shelters within walking distance of all Barcelona residents, improving thermal comfort in homes and the operation of round-the-clock telephone help and protocols to protect workers outdoors.

Thanks to a partnership between its health agency and other local services, the city mapped geographical distribution various climate impacts, including mortality associated with neighborhood heat. They also studied energy poverty across the city to identify neighborhoods and groups that are most likely to need activities. According to their climate action plan, the death rate of the elderly and infants has risen by more than 25 percent on extremely hot days. This data will be used to prioritize interventions during future heats and to monitor the results of these efforts.

Barcelona’s findings on disproportionate heat exposure are consistent with other large cities, where the effects of higher temperatures are unevenly distributed across the population, and vulnerable communities are more likely to live in houses with less effective insulation in hot urban areas. The data also point to higher health risks for the elderly and young children. Children’s vulnerability to heat is expected to worsen with increasing urbanization and poor infrastructure, especially in cities in South Asia and Africa, according to the IPCC.

The Barcelona Health Agency is also tasked with monitoring public access to food and water, the spread of infectious diseases and air pollution.

Less than half of the cities in Shihan’s study involved health facilities in their efforts to identify vulnerable populations. But tracking data to reflect vulnerabilities could allow for more targeted action to help people who need it most, she said. Her study was a pilot aimed at understanding the level of involvement of health agencies in urban climate planning. By the end of this summer, she plans to conduct a new survey of a wider pool of cities, more diverse in terms of income categories and regions.

However, public health facilities can only do so much, especially if the urban gap is growing in wealth.

Gentrification, which contributes to disparities in access to affordable housing and healthy food choices to threaten the health of vulnerable communities, is one of the biggest barriers to sustainable adaptation to climate change in Barcelona, ​​says Isabel Anguelowski, director of Barcelona. laboratories on urban issues. Environmental justice and sustainability. Eradicating energy poverty, stabilizing the cost of rent and expanding affordable housing and green spaces can reduce the negative impact of climate hazards on already aggravated communities, Angelovsky said.

The inclusion of public health in various urban agencies working to adapt to changing climates is helping to realize the impact of warming on public health, said Barcelona’s sustainable development coordinator Irma Ventayol. The city’s institutions overseeing food and food security, energy and housing, as well as about 1,800 organizations and organizations, including schools, are involved in sustainable development planning in the city, she said. In order for everyone to collectively protect the health of residents from climate risks, “they need to believe that this problem exists,” she added.

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