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Climate change and health: global issue, local responses.

Climate change affects health directly through changing frequency, intensity and duration of extreme heat events, floods, droughts and storms, and indirectly through adverse changes in air pollution, the spread of disease vectors, food insecurity and undernutrition, displacement and mental ill health.1,2 According to the latest Intergovernmental Panel on Climate Change report3, the impacts and costs of a 1.5°C rise in global average temperatures since pre-industrial times will be far greater than previously expected. This report also found that without major cuts in carbon dioxide emissions, a 1.5°C rise in global average temperatures could be reached in as little as 12 years, and almost certainly within 20 years. Internationally, climate change is now mainstream in health discourse.4 Research on health impacts of climate change suggests that health gains achieved over the past half century are being undermined by climate change.5 Given this, and the health co-benefits that accrue from actions for a sustainable economy, the 2015 Lancet Commission on Health and Climate Change concluded that tackling climate change could be the greatest global health opportunity of this century.2 In October 2016, the New South Wales (NSW) Government in Australia published the NSW Climate Change Policy Framework6, to respond to and mitigate the effects of climate change at a local level. Objectives of the framework include net-zero emissions by 2050 and for NSW to be more resilient to climate change. Within the framework, policy directions include reducing climate change impacts on health and wellbeing, and capturing co-benefits. One example of an initiative to arise from this framework is a multidisciplinary research group, the Human Health and Social Impacts Node, and some of the papers in this issue report findings of node research projects. The papers in this issue address selected climate change and health issues in NSW, Australian and regional contexts. Hime and colleagues7 report the findings of a climate change and health policy investigation in NSW and conclude that building adaptive capacity and resilience, and mitigating climate change, creates opportunities to promote health. Boylan and colleagues8 propose a conceptual framework for climate change, health and wellbeing in NSW, based on the World Health Organization’s Driving force, Pressure, State, Exposure, Effect and Action (DPSEEA) approach. Perkins-Kirkpatrick and Pitman9 provide a perspective on extreme events in the context of climate change, reporting the increase in heatwaves that is already occurring due to climate change, and uncertainty about how droughts and extreme rainfall Climate change and health: global issue, local responses