Well established interdependence of health and society
Of the many lessons stemming from the ongoing pandemic, one is a greater appreciation of the true “interconnectedness” of health and the world. In health systems, this is both logical and well known—the capacity to treat one health condition overlaps greatly with the ability to treat another. However, the past two years have greatly reinforced and even expanded this connection; one example is the strong correlation found between non-communicable disease (NCD) management and covid-19 deaths in low-and middle-income countries (LMICs). This relationship goes beyond the traditional health ecosystem; our assessment of pandemic-response measures identifies the importance of not just the deployment of critical health-related resources but also the coordination between a wide range of actors.
This idea of interdependence can be taken to the next level, in how health and society are invariably interwoven in a multitude of areas. Improvements in population health have long proven to lead to greater economic growth; the magnitude of this impact is consistently demonstrated in our burden of disease models, where economic costs associated with lost productivity for illnesses such as diabetes and breast cancer dwarf direct healthcare expenditures. The mirror image of this relationship is how environments outside of health systems greatly affect health outcomes. Economist Impact’s recent publication on the topic of healthy workforces and economic vitality demonstrates the influence employers and the workplace have on individual wellbeing, particularly in regards to mental health.
The connection with planet health is clearer than ever
The focus of World Health Day 2022 applies this same notion by emphasising the relationship between a healthy planet and a healthy population. Again, this is not a new concept—the impact of chemicals in our food and water systems have long shown not just troubling environmental consequences but also negative impacts on critical health functions, it can even cause certain types of cancer. Conversely, consistent exposure to polluted air – both outdoors and indoors – has led to seven million premature deaths according to World Health Organisation (WHO) and the Institute for Health Metrics and Evaluation (IHME) estimates, though other studies suggest considerable higher figures.
Our understanding of this issue has expanded further through the urgency surrounding climate change and its intersection with human health. Heat-related illnesses, malnutrition, more widespread communicable diseases and injuries from severe weather are all realities stemming from a changing climate. A recent Economist Impact study detailed the concerning implications for lung health, with numerous drivers such as a greater amount of aeroallergens, ground-level ozone gas and fine particulate matter coming together to generate a potential for increased prevalence of asthma, chronic obstructive pulmonary disease (COPD) and respiratory infections.
Prioritizing levers that drive real, substantial change
The good news is a myriad of platforms exist that could immediately tackle climate change and improve health outcomes. Indeed, in our review of lung cancer policies in the European and Asia Pacific regions, the vast majority of countries have air quality strategies already in place. Building out a more nuanced set of pollution-related metrics and targeted policies for specific environments would be a natural place to focus efforts.
But as with other societal intersections, future success depends on ensuring public health is a key element in the climate-change agenda. This entails first and foremost having a seat at the table: too often the goals set and actions taken are siloed (or not even considered health ramifications), despite shared climate-health concerns and ‘win-win’ benefits. Adding in those quantifiable health benefits also justifies further investments: mitigating just a small portion of the health-related implications from air pollution in Europe would lower the estimated $1.6 trillion in annual economic costs. Lastly, such an approach would in turn foster much needed cross-sector efforts in the implementation of top priorities.
So how can the interconnectedness of people and planet health move from stated priority to measurable action, thus avoiding the challenges of other health areas deemed high risks like anti-microbial resistance (AMR)? One critical aspect to further explore and identify are the real levers of change, that one core focus initiates a positive ‘cascade effect’ through multiple elements of society, including improved population health. If for instance, tackling climate change generates better food security which then leads to better health for women and girls, which in turn produces an array of economic benefits, then the returns of a singular focus are immense. While the root driver and resulting impact(s) are likely much more complex than a linear relationship, this type of thinking and supporting evidence can guide a successful policy agenda and ensure maximum utility gained for society as a whole.
Does one factor play a larger role than them all?
It may simply come down to a common theme that consistently appears in our work: strong leadership. This is not just a cliché; the high correlation between the index of cancer preparedness and the EIU’s measure of political will reinforces a message that experts have stressed time and time again: setting proper foundations for success requires a long term, committed plan. Given past achievements in the health arena required similar fortitude and focus, having public health as a centrepiece in climate-change efforts could also bring valuable experiences and know-how in the effort to overcome this challenge and sustain the course over time.