From immediate casualties to ongoing public health impacts, severe weather events serve as a tragic reminder that climate change is as catastrophic for our health as it is for our environment and economy.

The extreme, supposedly one-in-100-year weather events in Aotearoa in the last month have made it abundantly clear that the health effects of climate change can no longer be ignored. It is no longer an issue that affects them; it is affecting us and the livelihoods of communities here in Aotearoa.

By this point, you’ve probably heard, watched or read multiple articles linking climate change to the January floods in Tāmaki Makaurau and Cyclone Gabrielle, and the economic and environmental cost that the country will carry in the wake of these events. While climate change is often represented as an environmental and economic issue, climate change is also responsible for a global health emergency. 

Although the health impacts of climate change can be overwhelming, climate action like investment in clean energy systems, decarbonising transport systems and insulating homes can be a win-win for both the planet and public health. 

For those of you who are hearing about the health impacts of climate change for the first time, there are three general categories of impacts; direct (eg death and injury from severe weather), indirect (eg cardiovascular disease) and socially mediated (eg climate-induced anxiety and mouldy, damp homes), which will in turn exacerbate existing rates of noncommunicable diseases (these are diseases that are not spread through infection, like diabetes) and communicable diseases (disease which are spread through infection). The US Centre for Disease Control and Prevention has pulled together this map showing the range of impacts from climate change-induced weather events. 

Many communities in Aotearoa, in both small towns and our largest city, have experienced these effects. The combined death toll from the floods and Cyclone Gabrielle is 15, and is expected to rise. Tragically, this includes the lives of children who were swept away by rising flood waters. Hundreds of people have been injured, and we can expect this to grow as people participate in the clean-up –  just think of the sore backs caused by hastily lifting furniture, or climbing trees to get out of the path of rising water. Public health authorities have warned of outbreaks of water and soil-borne diseases like leptospirosis, as well as gastroenteritis, causing symptoms of vomiting and diarrhoea, from contaminated water supplies. Te Whatu Ora (Health New Zealand) also cautioned people to stay indoors to prevent respiratory illnesses arising from dust from dry, contaminated silt. There has been major contamination of food supplies and several communities remain cut off from food shops. We’ve seen the socially mediated health effects of climate change too. This includes the emotional cost of the floods, especially for whānau who have lost loved ones. Homes, possessions and taonga have been damaged and destroyed. Even for our own whānau in Ahuriri who live alone, the extreme weather events caused a lot of worry and stress, especially given that they had limited contact with the outside world due to broken telecommunication systems and prolonged power outages. 

The health impacts of climate change also extended to those who have not been able to access essential medical care, including dialysis treatment. Beyond the immediate effects we can anticipate that the water damage to houses will only worsen the challenges faced by already damp and mouldy homes, increasing risk associated with respiratory diseases. Combining all of these challenges, for many individuals and communities in Aotearoa, climate change is more than just an issue of concern; it is an issue of survival.

As in most crises, the adverse impacts of climate change on health are unequally spread among communities in Aotearoa. Due to persisting structural inequities, the impacts of climate change disproportionately affect the health of Māori, Pasifika, and the most socio-economically disadvantaged in our communities, and the floods in Tāmaki Mākaurau and Cyclone Gabrielle are no different. Already Māori are negatively overrepresented in most health and wellbeing statistics; in everything from access to affordable and adequate housing, to a higher burden of noncommunicable diseases like diabetes. 

However, these communities, who have borne the brunt of the floods, are the same communities who are the first to provide leadership, compassion and comfort to those in need. Throughout Tāmaki Makaurau, marae were quick to open their doors to those affected by the flooding; providing food, shelter and clothing. Local community organisations and clubs, like the Arc Collective Community Hub in Wesley and Piha Surf Life Saving Club, stood up emergency centres to distribute food and essential household items to affected whānau. And again in Hawke’s Bay, marae opened their doors and welcomed the community in to protect them from the impacts of the cyclone. 

In the wake of this flooding event, there are two learnings we can take away about the impact of climate change on our health. Firstly, we have to come to terms with the reality that climate change is driving a health crisis and if unattended to, we allow the adverse risks of climate change to widen existing health inequities in Aotearoa. If we reflect the urgency posed by this event, action on climate change not only has the potential to reduce the health impacts, but also improve public health and uplift the wellbeing of communities. 

Although the new health minister Dr Ayesha Verrall was quick to meet with health officials, far more political commitment will be needed; our health system has been far too slow to prepare for and respond to climate change. Not only is there no action, there are currently no plans in place either, despite Te Pae Tata, the interim plan of the newly transformed health system, signalling the creation of a climate response plan, which was echoed in the national adaptation plan on climate change. We need to accelerate the planning and preparedness of hospitals, health infrastructure and public health supply chains, so that health systems are resilient in the face of climate change. In times of crises, communities also need clear advice as to how they should manage health risks. 

Improving housing and transport infrastructure is also vital. This shouldn’t look like mass urban sprawl, and houses in reclaimed wetlands, but increasing the intensification of housing in the right places, accompanied by diversified and multi-modal transport networks. This will allow urban populations to move away from low-lying areas and return these parts to forest and wetlands that will double as water catchments during heavy rain events, as well as public parks and carbon sinks. 

It is critical that local communities are well-supported, through government resourcing and funding, to respond in times of (increasing) emergency. It is unjust to rely on the goodwill of community champions to protect communities as the scale, intensity and frequency of these crises build. Local communities need to be at the centre of decision-making and resource allocation for long-term adaptation and mitigation planning, including the climate response plan for the health system. This may look like an acceleration of investment in localised and community-driven resilience programmes and facilities to strengthen the preparedness of communities to respond during crises. 

As we move from one health emergency in Covid-19 to another in climate change, now is the time to enhance our plans and preparedness and invest in community resilience and action.