Andy Haines was formerly a family doctor and Professor of Primary Health Care at UCL. He developed an interest in climate change and health in the 1990’s and was a member of the Intergovernmental Panel on Climate Change for the 2nd and 3rd assessment exercises and review editor for the health chapter in the 5th assessment. He was Director (formerly Dean) of the London School of Hygiene & Tropical Medicine from 2001- October 2010. He chaired the Scientific Advisory Panel for the 2013 WHO World Health Report, the Rockefeller /Lancet Commission on Planetary Health (2014-15) and the European Academies Science Advisory Council working group on climate change and health (2018-19). He currently co-chairs the InterAcademy Partnership (140 science academies worldwide) working group on climate change and health and is also co-chairing the Lancet Pathfinder Commission on health in the zero-carbon economy.  He has published many papers on topics such as the effects of environmental change on health and the health co-benefits of low carbon policies. His current research focuses on climate change mitigation, sustainable healthy food systems and complex urban systems for sustainability. He was awarded the Tyler Prize for Environmental Achievement in 2022.

THE CREATIVE PROCESS · ONE PLANET PODCAST

You were one of the first people to publicly identify climate change as a serious health, public health crisis. During your lifetime, you've seen the future unfolding before your eyes from the biodiversity loss, species loss crop failures, eight million people dying each year from air pollution… Climate change, planetary health and human health is now seen as intertwined. What are some of your more compelling findings? And what kind of indications do they give us and how to effectively move forward?

SIR ANDY HAINES

In terms of the impacts of climate change on health when we started 30 years ago, because there was very little data then, so we made suggestions as to what we thought the health outcomes we thought would be affected like vector-borne diseases, crop failures, water availability, sea level rise, increasing disasters related to climatic extreme events, and obviously the effects of extreme heat on vulnerable populations. In particular, elderly people, but not just elderly people. So we suggested a whole range of different health impacts that could occur. And I think, in general, those ideas have stood the test of time, but of course, as the situation has moved on, we've also become much more preoccupied with what kind of action we need to take.

So when we started, we were mainly talking about the effects of extreme heat without being able to attribute them to climate change because obviously heat waves have occurred throughout history, and populations are more or less adapted to different climates. But now I think the science has moved on, and we can be much more competent about attributing either some extreme events or trends in extreme heat exposure, for example, to human-induced climate change. So it isn't just natural fluctuation. So that's a change. And as the evidence becomes stronger, of course, it also strengthens the case for climate action, which sadly, as we know at the moment, is not sufficient to really have the desired effect.

So our knowledge has advanced, but the actions that we need to put into practice have not gone at the same speed. And so we're really facing an increasing climate emergency. And we don't know quite where it's going to end up, but it could end up 2.5%, 3% hotter than pre-industrial times on global average as we reach the end of the century.

THE CREATIVE PROCESS · ONE PLANET PODCAST

And so as you think about the future and the wonderful collaborators and teachers that you've had, what gives you reason for hope?

HAINES

So I'm given a great deal of hope by the kind of people I meet, the people I work with. We have to hope that vision is also translated into a political reality, and I think that's where it becomes more difficult because politicians are driven by the short-term imperative of being reelected. And sometimes you have to take decisions that may not be vastly popular initially. They may over time become more popular. And we know that probably younger people perhaps are prepared to accept policies that middle-aged and older people may not be prepared to accept and so on. So there are differences within society, sometimes quite deep divisions, which need to be addressed and overcome.

THE CREATIVE PROCESS · ONE PLANET PODCAST

In addition to your work as Chairman of the Lancet Commission on Planetary Health, you also work on creating in healthy, sustainable cities. We are living in the century of the city living in a decade of transformation. So cities really are being recognized now as one of the main drivers of creativity and innovation, as well as consuming 75% of the world's natural resources and accounting for around 70% of global carbon dioxide emissions. What do you think the cities of the future are going to look like?

HAINES

So when we think about cities of the future, we need to think about systems change because you can't just change one thing in isolation. You need to rethink how we can create cities that are both resilient to environmental change, they can withstand environmental shocks better. So, for example, reducing the urban heat island. We know that cities are hotter than the surrounding rural areas and within cities, there is often wide temperature variation depending on whether you're near a park or whether you are in a very built-up area without any natural shading or green space. And that can cause a massive variation, really substantial variation in the temperature. And we know also that some of that's related to inequities. So in many cities, it's certainly true in many US cities, the poorer neighborhoods are much less likely to have green space, and they're much more likely to suffer exposure to extreme heat.

So one issue is redesigning cities to withstand these climatic shocks, reducing the inequities in the prospects for living that many people have. And thinking about how to minimize the potential impact of climate change by increasing inequities, which could happen unless we forestall that.

So that's one issue. The other is how we recreate the transport systems. Now in many industrialized countries, of course, we depend very much on the private car, and that leads to congestion, traffic, traffic injuries, and deaths on a global scale, about 1.3 million people a year die of traffic injuries. I won't call them accidents because I think many of them can actually be can be factored out with appropriate policies. So we need to think about win-win policies, which will make cities more pleasant places to live and reduce their environmental footprint. And one of the approaches, of course, is by creating more active opportunities for active travel, walking and cycling, safer walking, and cycling, but also better public transport systems. So reducing our dependence on a private car and then emphasizing more when we do need to use a car. Shared ownership, for example, is one option. So a number of things can be done. But of course, in order to change people's travel patterns, you need to make active travel, and public transport, both affordable, safe, and pleasant. And, and that's, I think a challenge for urban planners that we need to focus much more on that. And also, this has led to the rise of the concept of the 15-minute city, in which basically all basic services are within 15 minutes walking or cycling. Whether it be the clinic to see your primary care doctor or whoever you want to go to the local library or supermarket. And so that I think is certainly an important approach. I know there's been a bit of pushback on that recently. Some people see it as a potential infringement of liberties, but I think that's a mistaken view. I think actually it could increase people's freedom because it increases their ability to access key services near their homes in a safe and healthy fashion.

THE CREATIVE PROCESS · ONE PLANET PODCAST

It's not just a matter of planetary or human health when we are thinking about scarcity of water. It also contributed to the war in Syria because of water shortages and how that affects crops and availability of food. So just help us consider the geopolitical elements of climate change.

HAINES

We've been doing some work recently, particularly on the vulnerable group that is pregnant women's farmers in West Africa and documenting that they are already exposed to really very extreme levels of heat, much more than I would have thought before we did this work. And it already appears to be having an adverse effect on the fetus. So at the end of a shift, you can show that the fetal heart rate increases in proportion to heat exposure. And we believe that that's having an effect on the well-being of the fetus now. And probably because women are trying to adjust their core body temperature, trying to keep it within physiological range, diverts more blood to the skin. And it diverts blood away from the placenta growing. 

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People sometimes ask me if I'm optimistic, and sometimes they ask me if I've got hope. And I think there is a difference between the two. I mean, optimism is the kind of feeling that the probability is it's all going to be fine. And hope is the feeling that there's still a good chance that things could work out well. And I think I'm more at the kind of hope that the optimism that, you know, we have so much knowledge within our grasp. And we have so much technology that we could use. But it isn't just about technology, it's also about values. What kind of values, and what kind of society do we want to live in? What kind of values do we have collectively as a community, and as a society? And that's a much more contested field. I do think that we do need to really raise that as an issue in society. What kind of society do we want to live in? And what kind of future do we want for ourselves? But also for those that will come after us? And I think that's a crucial debate that we should be having now. I think this big issue is what are the values that drive our society? What kind of a future do we want? And I'd like to see much more of a debate in public discussion about that.

This interview was conducted by Mia Funk and Alexa Potter with the participation of collaborating universities and students. Associate Interviews Producer on this episode was Alexa Potter.

Mia Funk is an artist, interviewer and founder of The Creative Process & One Planet Podcast (Conversations about Climate Change & Environmental Solutions).