Drishtikon: Impact of Climate Change on the Health of Persons with Disabilities

The article explores the impact of climate change on physical and mental health with specific reference to persons with disabilities. It also touches upon Suicide, Universal Health Coverage, and the way forward in this regard.

Introduction

The convergence of the ‘Three C’s’ — Covid, Climate Change, and Conflict — jeopardises global goals, including ‘Good Health and Well-Being’[1]. The culmination of climate change, biodiversity loss, and pollution have cascading and compounding impacts on the physical and mental health of persons with disabilities, among other vulnerable communities.[2] Billions around the globe are just one medical emergency (triggered by climate change and disasters) away from slipping into the vicious cycle of poverty.

Climate Change and Health

Climate crisis is a health crisis [3] in the global world order affected with troika of climate change, conflict, and covid (pandemic). The air we breathe, food we eat, water we drink, and environment we live in is a function of these factors that significantly affect one and all. Climate change and destruction of natural habitats are closely linked having serious health implications. Our health depends on the health of the ecosystems surrounding us, and these ecosystems are now threatened by deforestation, agriculture, and other changes in land use and rapid unplanned urban development. The rise in global temperature that has already occurred is leading to extreme weather conditions and events that bring intense heatwaves, cold waves, and droughts, devastating floods, and increasingly powerful cyclones, and hail storms. The combination of these factors means the impact on human health is increasing and is likely to accelerate and get intense.

1. Air Pollution: stroke, heart disease, chronic obstructive pulmonary disease (COPD), lung cancer, and pneumonia among others.
2. Drought: food insecurity, malnutrition, infectious diseases, pneumonia, and psycho-social stress.
3. Floods: infectious diseases, poisoning, and waterborne diseases.
4. Heat Waves: vomiting, exhaustion, dehydration, organ failure, hospitalization, and death.
5. Wild Fires: suffocation, burns, and cardiovascular & respiratory problems.

Dengue transmission is closely associated with three key factors — rainfall, humidity, and temperature. Climate change impacts the trajectory of dengue in India.[4] The World Bank’s ‘Climate Investment Opportunities in India’s Cooling Sector’ Report[5] came up with a serious warning that “soon India could become one of the first places in the world to experience heat waves that break the human survivability limit”.[6]

Severe heat waves, responsible for thousands of deaths across India over the last few decades, are increasing with alarming frequency. India is experiencing higher temperatures that arrive earlier and stay far longer (higher frequency and intensity). The Sixth Assessment Report of the Intergovernmental Panel on Climate Change (IPCC)[7] and the G20 Climate Risk Atlas[8] warned in 2021 that heat waves across India would likely last 25 times longer by 2036–65 if carbon emissions remain high, as in the IPCC’s worst case emission scenario.[9]

As per a 2021 study by the Lancet Planetary Health journal, researchers found that nearly 740,000 excess deaths in India annually can be attributed to abnormally hot and cold temperatures related to climate change.[10]

Climate change affect the disability-adjusted life years (DALYs) which represents the “loss of the equivalent of one year of full health. DALYs for a disease or health condition are the sum of the years of life lost to due to premature mortality (YLLs) and the years lived with a disability (YLDs) due to prevalent cases of the disease or health condition in a population.”

Climate Change and Mental Health

According to the World Health Organization, the climate crisis poses severe risks to people’s mental health and well-being.[11] Mental health is intrinsically related to planetary health. — euro-centricity and ableism of ‘eco-anxiety’.

The findings concur with a recent Intergovernmental Panel on Climate Change (IPCC) report published in February this year. The IPPC revealed that rapidly increasing climate change poses a rising threat to mental health and psychosocial well-being; from emotional distress to anxiety, depression, grief, and suicidal behavior.[12] According to the recent IPCC Climate Report, there’s increasing evidence that the impacts of climate change affect health and well-being, particularly mental health.

Further, “climate change has adversely affected the physical health of people globally and the mental health of people in the assessed regions”; ‘Mental health’ includes impacts from extreme weather events, cumulative events, and vicarious or anticipatory events.”; “Mental health challenges, including anxiety & stress, are expected to increase under further global warming in all assessed regions, particularly for children, adolescents, elderly, & those with underlying health conditions.”; “Some mental health challenges are associated with increasing temperatures, trauma from weather and climate extreme events, and loss of livelihoods and culture.”

Moreover, “Effective adaptation options for reducing mental health risks under climate change include improving surveillance, access to mental health care, and monitoring of psychosocial impacts from extreme weather events.”; “Health and well-being would benefit from integrated adaptation approaches that mainstream health into food, livelihoods, social protection, infrastructure, water, & sanitation policies requiring collaboration and coordination at all scales of governance.”

The best way to protect people from Climate Chaos is by tackling “inequities such as those based on gender, ethnicity, disability, age, location, and income”[13] and thus, we need to take necessary measures to counter disproportionate impact of climate change on physical and mental health of historically marginalised communities including persons with disabilities.

Suicide and Disability

Suicide is a serious public health challenge being the fourth leading cause of death among youth (15–29 years of age). Suicide and mental disorders are closely linked, although suicides also happen impulsively in moments of crisis with a breakdown in the ability to deal with life stresses, such as financial problems, family and relationship crises, or chronic pain and illness.[14]

In addition, experiencing conflict, disaster, violence, abuse, or loss and a sense of isolation are strongly associated with suicidal behavior. Suicide rates are disproportionately high amongst vulnerable groups who experience abuse and discrimination, such as persons with disabilities, children, and old adults among others.

The Disability Discourse

Capability Approach provides the perspective how climate change disproportionately puts health of persons with disabilities at hig risk of loss and damage.[15] Taboo associated with disablity also have cascading and compounding on mental health of persons with disabilities.

“Indian women are at a higher risk for infections due to their frequent contact with unsanitary water. Trachoma, a water-washed disease that can lead to blindness, is transmitted through contaminated water where women gather. Women and girls collecting water are also susceptible to diarrhea, hepatitis A, and leptospirosis, a bacterial infection from water that is tainted by animal urine.”[16]

The Global report on health equity for persons with disabilities states that because of the systemic and persistent health inequities, persons with disabilities face the disproportionate risk of dying much earlier — as much as 20 years earlier.

Climate action and justice is intrinsically related to human health and especially that of vulnerable communities and have first, second, and third order impacts like that on one’s capability, livelihood, education, and beyond.

Concluding Remarks

Universal health coverage[17] lifts people out of poverty, promotes the well-being of families and communities, protects against public health crises, and moves us toward. — all put human health at risk and vulnerable communities even further by having disproportionate impacts. Inclusive Medical/Health Insurance Policies are integral to ensure Universal Health Coverage. However, the grim reality is that our insurance policies aren’t inclusive of persons with disabilities among other marginalized groups despite the circular by the Insurance Regulatory and Development Authority of India dated 2nd June 2020 mandate.

Delhi High Court in Saurabh Shukla vs Max Bupa Insurance & Anr., dated 13th December 2022, ordered the Insurance Regulatory and Development Authority of India to ensure insurance policies are designed for persons with disability. The court remarked that “it is the settled position in law that the right to life includes the right to health and healthcare is an integral part of the same.”[18]

In that respect, there is a need to provide universal health care for the negative and disproportionate impacts of climate change on vulnerable communities especially persons with disabilities, among other measures to mitigate and adapt to impact of climate change on human and planetary health.

Bibliography

• IPCC Sixth Assessment Report — Climate Change 2022: Climate Change 2022: Impacts, Adaptation, and Vulnerability, February 2022.
• Mental health and Climate Change: Policy Brief, World Health Organization, 3 June 2022.
• WHO Global report on health equity for persons with disabilities, 2022
• World Bank’s ‘Climate Investment Opportunities in India’s Cooling Sector’ Report, 2022.

References

[1] Ensure Healthy Lives and Promote Well-Being for All at All Ages, The Global Goals, Available at <https://www.globalgoals.org/goals/3-good-health-and-well-being/> Accessed on 26th November 2022.

[2] Abhisek Kumar, Climate Change, Disability, and the Capability Approach, The Sangyan, Available at <https://sangyan.medium.com/climate-change-disability-and-the-capability-approach-916a2fdfae41> Accessed on 03rd December 2022.

[3] Climate crisis is a health crisis, World Health Organization, Available at <https://www.instagram.com/p/CkvKqyzjq9n/> Accessed on 16th November 2022.

[4] Taran Deol, Is it climate change that impacts trajectory of dengue in India?, Down To Earth, Available at <https://www.downtoearth.org.in/news/climate-change/is-it-climate-change-that-impacts-trajectory-of-dengue-in-india--85930> Accessed on 16th November 2022.

[5] Climate Investment Opportunities in India’s Cooling Sector, International Bank for Reconstruction and Development / The World Bank, 2022, Available at <https://documents1.worldbank.org/curated/en/099920011222212474/pdf/P15743300f4cc10380b9f6051f8e7ed1147.pdf> Accessed on 26th November 2022.

[6] Abhishek Kumar, India Under Heat, The Sangyan, Available at <https://www.instagram.com/p/Cl54OuOSD0l/> Accessed on 26th November 2022.

[7] The Working Group II, Climate Change 2022: Impacts, Adaptation and Vulnerability, 28th February 2022. Available at <https://www.ipcc.ch/report/sixth-assessment-report-working-group-ii/> Accessed on 29th November 2022.

[8] G20 Climate Risk Atlas, Available at <https://www.g20climaterisks.org/india/> Accessed on 03rd December 2022.

[9] Climate Investment Opportunities in India’s Cooling Sector, International Bank for Reconstruction and Development / The World Bank, 2022, Available at <https://documents1.worldbank.org/curated/en/099920011222212474/pdf/P15743300f4cc10380b9f6051f8e7ed1147.pdf> Accessed on 26th November 2022.

[10] Climate Investment Opportunities in India’s Cooling Sector, International Bank for Reconstruction and Development / The World Bank, 2022, Available at <https://documents1.worldbank.org/curated/en/099920011222212474/pdf/P15743300f4cc10380b9f6051f8e7ed1147.pdf> Accessed on 26th November 2022.

[11] Mental health and Climate Change: Policy Brief, World Health Organization, Available at <https://www.who.int/publications/i/item/9789240045125> Accessed on 16th November 2022.

[12] Why mental health is a priority for action on climate change, World Health Organization, Available at <https://www.who.int/news/item/03-06-2022-why-mental-health-is-a-priority-for-action-on-climate-change#:~:text=The%20IPPC%20revealed%20that%20rapidly,%2C%20grief%2C%20and%20suicidal%20behavior.> Accessed on 16th November 2022.

[13] Damian Carrington, This climate crisis report asks: what is at stake? In short, everything, The Guardian, Available at <https://www.theguardian.com/environment/2022/feb/28/what-at-stake-climate-crisis-report-everything> Accessed on 13th December 2022.

[14] Suicide, Fact sheets, World Health Organization, Available at <https://www.who.int/news-room/fact-sheets/detail/suicide> Accessed on 6th December 2022.

[15] Abhishek Kumar, Climate Change, Disability, and the Capability Approach, The Sangyan, Available at <https://sangyan.medium.com/climate-change-disability-and-the-capability-approach-916a2fdfae41> Accessed on 17th December 2022.

[16] Alexandra Barton, Water in Crisis — Women in India, The Water Project, Available at <https://thewaterproject.org/water-crisis/water-in-crisis-india-women> Accessed on 16th November 2022.

[17] Universal health coverage, World Health Coverage, Available at <https://www.who.int/health-topics/universal-health-coverage#tab=tab_1> Accessed on 02nd December 2022.

[18] Nupur Thapliyal, Hold Meeting With Insurance Companies, Ensure Products Are Designed For Persons With Disabilities: Delhi High Court To IRDAI, Live Law, Available at <https://www.livelaw.in/news-updates/conduct-meeting-insurance-companies-designing-products-persons-with-disabilities-delhi-high-court-irdai-216617> Accessed on 15th December 2022.

About the Author

Abhishek Kumar, NCPEDP-Javed Abidi Fellow on Disability.
The author can be reached at: abhishek.ncpedp@gmail.com