1. "The UK Public health response to climate Department of Public Health
University of Oxford
change: What are we doing and what should we do?" Centre for Radiation Chemical and Environmental hazards
Abstract
Despite scientific consensus on changes in global climate and adverse impacts on health, the current public health knowledge and actions in addressing this issue are not well defined. An internet based survey was sent
to all public health departments in the UK (service public health, academic public health and the health protection units) to obtain baseline information on the current public health actions/activities already underway.
The response rate was 32%. The results demonstrate that respondents recognise climate change as an important health problem requiring a public health response. Nearly 50% of the responding departments had identi-
fied a lead for climate change and sustainability. Considering the importance and relevance of this agenda in the UK's current environmental and financial state, the results of this survey provide the best available evi-
dence of the current public health knowledge and action against climate change in the UK. It provides a snapshot of the attitudes, perception of the health effects of climate change, action and innovations already taken
and demonstrates a willingness to build a coordinated response. This will inform a public health programme of action to address the causes and health consequences of climate change.
Introduction of climate change response.
While there is a scientific consensus that the global climate is changing, with increasing climate vari- Figure 1: Essential components of public health climate change response specified by respondents
ability and extremes, rising temperatures and sea levels and increased frequency of natural disasters
100
resulting in substantial impacts on human health, the role of public health in the wider agenda for cli- 90
80
mate change is not clear and needs to be established. This is essential to enable an effective response 70
% of respondents
60
to one of the biggest threats facing human health in the twenty first century. 50
Since April 2010, NHS organisations have a legal responsibility to meet the government targets of 40
30
carbon reductions by 80 per cent by 2050, compared to 1990 levels. Alongside this is a growing evi- 20
10
dence in the field of climate change and environmental sustainability of substantial financial and 0
health benefits of low carbon business models. This means that the time to act is now. However, there
seems to be a huge gap between knowledge/evidence and public health action.
This poster presents a review undertaken to establish a UK wide picture of public health action/
activity already underway in order to allow an assessment of climate change as a public health prob-
lem, and the action/s being taken or planned by public health departments in the UK. The results will
help in the development of an effective public health response to the challenges of climate change.
Essential Components of
Aims and objectives climate change response
 To map the UK wide public health engagement and action/activity on climate change already
Perceived training needs
underway, the needs of the population and barriers to action;
Training was felt to be insufficient to non-existant and the following training needs were identified.
 To inform the Faculty of Public Health, Department of Health and thence the National Adapta-
-Understanding the science of climate change and current NHS policies
tion Sub-committee on Climate Change and its strategy; and
-Evidence based public health interventions and their practical implementation
 To develop and implement an effective public health programme for controlling the adverse
-Exemplars/examples of good practice
health impacts of climate change and linking this to sustainability projects already in place.
-Disease surveillance
-Advocacy
Methods
-Change management and leadership
A structured internet based questionnaire was developed for Directors of Public Health in the PCTs /
-Procurement
health boards and Directors of other Public Health departments (Academic departments and Health
-Disaster/emergency response planning
Protection Units) in the UK.
-Impact assessment
This online UK-wide survey was conducted in April 2010 and data collected using the online ques-
tionnaire was coded and fed into a spreadsheet for anonymised analysis using Excel. To encourage
Perceived resource needs
increased participation, one reminder was sent.
-Evidence based database of best practice
-Guidance (National, regional, local) e.g. commissioning guidelines
Results -Human resources (staff and time) and financial resources
Response rate -Sustainability standards and toolkits
The total response rate for this survey was 32% (after one reminder). However response rates varied
by the type of organisation surveyed. (See Table 1)
Recommendations
Table 1: Response rate by category of respondent
The following activities would form part of a public health programme of implementation developed with
Type of organisation Response rate key stakeholders (sustainability and climate change leads) identified in this study.
PCTs England 32% 1. An active special interest group/network on sustainability in public health to enable continued engage-
SHA/Region England 70% ment in this issue and allows sharing of emerging practice.
Scotland 14%
2. Continued advocacy to ensure that the issue remains a priority in the delivery of interventions.
Wales 19%
3. Education and training to enable the staff have the required knowledge and skills in implementing ef-
UK Academic Public Health 8%
fective public health interventions.
HPA England-National 29%
HPA England-Regional 30% 4. Research and development to enable the development of evidence base necessary to ensure interventions
HPA England-Local 30% are effective.
5. A resource of emerging practice to ensure that the necessary tools are available for the public health
Proportion of Public Health departments with a specific lead for climate change and/or sustain-
workforce to deliver on their sustainability objectives.
able development
Although respondents acknowledged the importance of this issue, only 48% of respondents have
Summary of conclusions
stated that their departments have a named lead for sustainability and climate change. And 56% of re-
Majority of respondents agree that climate change poses an important health threat and that public health
spondents have stated that their departments have discussed and debated within their department the
action is required. Respondents have described various training and resource needs to enable them to effec-
public health responsibilities for controlling the health effects of climate change. However, only 37%
tively implement public health interventions. Next steps include dissemination of the findings to various
of the departments have agreed action on or priority for its response to climate change.
stakeholders and developing a public health programme and an implementation plan. Funding and support
from other climate change groups will be sought and effective collaboration proposed nationally and inter-
Assessment of Public health responsibility/response
nationally.
Figure 1 shows the percentage of respondents that consider the following as the essential components
Poster by Dr Sucharita Yarlagadda, Specialty Registrar in Public health with thanks to Dr Elizabeth Haworth, Honorary Senior lecturer, Department of Public health, University of Oxford and the
rest of the team.