This presentation covers three key messages: Climate justice (rechtvaardigheid) is a concept that should be at the heart of the climate change discourse, and is tied to the causes, consequences and interventions Climate change results in inequitable (onrechtvaardige) health outcomes: case study of the Netherlands Twitter & social media is a great way to tap into the climate justice conversation and hear the lived experience of people

1. Climate justice and
health equity
T: @JoyceBrowne | E: J.L.Browne@umcutrecht.nl |
W: www.globalhealth.eu
Joyce Browne, MD PhD
Assistant Professor Epidemiology/Global Health

2. (potentiële) belangenverstrengeling Geen
Voor bijeenkomst mogelijk relevante
relaties met bedrijven
Geen
 Sponsoring of onderzoeksgeld
 Honorarium of andere (financiële)
vergoeding
 Aandeelhouder
 Andere relatie, namelijk …
Contractonderzoek voor:
• PATH
• Nederlandse Vereniging voor
Tropengeneeskunde & Internationale
Gezondheidszorg (NVTG)
• Porticus
Externe onderzoeksfinanciering ontvangen
van:
• The Bill and Melinda Gates Foundation
• NWO
Disclosure belangen spreker

3. Key messages
• Climate justice (rechtvaardigheid) is a concept that should be at the
heart of the climate change discourse, and is tied to the causes,
consequences and interventions
• Climate change results in inequitable (onrechtvaardige) health
outcomes: case study of the Netherlands
• Twitter & social media is a great way to tap into the climate justice
conversation and hear the lived experience of people
3

4. Climate change & 3 essential moral questions
4

5. Climate change & 3 essential moral questions
1. Do we have a duty to do anything at all in
the face of climate change?
2. Assuming that we are obliged to do
something, how much should we do?
3. How should these duties be distributed?
5

6. Why climate justice is a special type of global
challenge: it is intergenerational
6

7. Why climate justice is a special type of global
challenge: it is intergenerational
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8. Why climate justice is a special type of global
challenge: it is transnational
8

9. Why it is important deliberately include climate
justice into the climate change conversation?
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10. Why it is important deliberately include climate
justice into the climate change conversation?
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11. Why it is important deliberately include climate justice?
• All (in)actions related to climate change impose burdens on some and
confer benefits to others
• ‘Value neutrality’ does not exist, in fact: it favors those voices who are
heard and represented in the decision-making process
• Including a climate justice lens can (partially) mitigate these biases, and
ensures the interests of those most vulnerable are deliberately invited
into the conversation, considered and protected
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Dooley et al. 2021

12. Climate justice principles
Overarching: Protect the vulnerable against deprivation
Three examples:
1. Distinguish “the ‘survival emissions’ of the poor” from “the ‘luxury
emissions’ of the rich”
12
Dooley et al. 2021

13. Climate justice principles
Overarching: Protect the vulnerable against deprivation
Three examples:
1. Distinguish “the ‘survival emissions’ of the poor” from “the ‘luxury
emissions’ of the rich”
2. Commitment to right to and promotion of sustainable development
(UNFCCC, article 3.4)
13
Dooley et al. 2021

14. Climate justice principles
Overarching: Protect the vulnerable against deprivation
Three examples:
1. Distinguish “the ‘survival emissions’ of the poor” from “the ‘luxury
emissions’ of the rich”
2. Commitment to right to and promotion of sustainable development
(UNFCCC, article 3.4)
3. Acknowledge that not all countries can afford to be equally ambitious,
and therefore responsibilities can differ (UNFCCC, article 3.1)
14
Dooley et al. 2021

15. Climate justice (rechtvaardige) & health equity
(gelijke/eerlijke gezondheidskansen)
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‘Equity is the absence of avoidable, unfair, or
remediable differences among groups of people (..).
Health equity implies that ideally everyone should
have a fair opportunity to attain their full health
potential and that no one should be disadvantaged
from achieving this potential.
WHO, https://www.who.int/healthsystems/topics/equity/en/

16. How do justice (rechtvaardigheid) and health
equity (eerlijke kansen op gezondheid) relate to
planetary health and climate change: a case study
Causes, consequences, intervention strategies

17. Case study: energy poverty in the Netherlands
Energy poverty: “when, in a wealthy
country as the Netherlands, a
household has inadequate access to
good energy services and utilities.”
(TNO)
• Connected to poverty, but not
interchangable
• 2021: 550.000 households (7%)
• 2022: projections of >2.5 million
https://www.tno.nl/nl/aandachtsgebieden/energietransitie/roadmaps/systeemtransitie/de-sociale-aspecten-
van-de-energietransitie/energiearmoede/

18. There are people behind the energy poverty numbers:
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https://twitter.com/overlistener/status/1562168715722035200?s=20&t=nMl
drtvFHsIDMrOrPVfH9Q

19. Tackling energy poverty = social justice promotion
Remember the 3 ethical questions:
1. Do we have a duty to do anything
at all in the face of climate
change?
2. Assuming that we are obliged to
do something, how much should
we do?
3. How should these duties be
distributed?
19

20. 1. Do we have a duty? The health consequences of energy poverty
Health consequences of energy poverty:
• Physical and mental health consequences of
poorly isolated and ventillated houses and rising
costs of energy:
• Extreme heat (summer)
• Cold and draft (winter)
• Poverty-related stress
• Out-of-pocket medical expenses not affordable
anymore
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21. Who is at risk?
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22. Who is at risk?
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23. Who is at risk? Energy poverty as a social
determinant of health
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24. The social determinants of
health are the circumstances
in which people are born,
grow up, live, work and age,
and the systems put in place
to deal with illness. These
circumstances are in turn
shaped by a wider set of
forces: economics, social
policies, and politics.
Energy poverty as a social determinant of
health
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Whitehead & Dahlgren; https://www.who.int/health-topics/social-determinants-of-health

25. Its time to integrate the
social and environmental
determinants of health
(RISE model)
25
Melis & et al, forthcoming

26. Climate change adaptation/mitigation responsibility and
costs should be fairly distributed
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27. Climate change adaptation/mitigation responsibility and
costs should be fairly distributed
Principles
1. Distinguish “the ‘survival emissions’ of
the poor” from “the ‘luxury emissions’ of
the rich”
2. Commitment to right to and promotion of
sustainable development (UNFCCC, article
3.4)
3. Acknowledge that not all countries can
afford to be equally ambitious, and
therefore responsibilities can differ
(UNFCCC, article 3.1)
Operationalization
1. Energy is basic need, ensure basic needs
are covered
2. Energy transition of houses should also be
possible for those at lower income scales
3. Countries -> individuals & role of industry.
Fair taxing and fair prices/?
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28. • We see and know the
consequences
• We understand the social and
environmental determinants
of health
• We can be a voice and
advocate
Finally: why should we care as a health community?

29. Key messages
• Climate justice (rechtvaardigheid) is a concept that should be at the
heart of the climate change discourse, and is tied to the causes,
consequences and interventions
• Climate change results in inequitable (onrechtvaardige) health
outcomes: case study of the Netherlands
• Twitter & social media is a great way to tap into the climate justice
conversation and hear the lived experience of people – for example:
• https://www.linkedin.com/in/michelle-van-tongerloo-0a708982/
29
T: @JoyceBrowne | E: J.L.Browne@umcutrecht.nl | W: www.globalhealth.eu