Developing a climate change inequality health impact assessment for health services

Fiona Haigh; Alana Crimeen; Liz Green; Holger Moeller; Stephen Conaty; Jason Prior; Ben Harris-Roxas

doi:10.1071/phrp3342336

RESEARCH ARTICLE (Open Access)

Developing a climate change inequality health impact assessment for health services

Fiona Haigh ^A ^B ^* , Alana Crimeen ^C , Liz Green ^D , Holger Moeller ^E ^F , Stephen Conaty ^G , Jason Prior ^H ^I and Ben Harris-Roxas ^E ^I

+ Author Affiliations

- Author Affiliations

^A Health Equity Research and Development Unit, UNSW Sydney, Australia

^B Sydney Local Health District, NSW, Australia

^C School of Built Environment, UNSW Sydney, Australia

^D Wales Health Impact Assessment Support Unit, Public Health Wales, Cardiff, UK

^E School of Population Health, UNSW Sydney, Australia

^F George Institute for Global Health, Sydney, NSW, Australia

^G Public Health Unit, South Western Sydney Local Health District, Liverpool, NSW, Australia

^H Institute for Sustainable Futures, University of Technology Sydney, NSW, Australia

^I Healthy Populations and Environments Platform, Maridulu Budyari Gumal (SPHERE), Sydney, NSW, Australia

^* Correspondence to: f.haigh@unsw.edu.au

Public Health Research and Practice 33, e3342336 https://doi.org/10.17061/phrp3342336

Published: 6 December 2023

2023 © Haigh et al. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, which allows others to redistribute, adapt and share this work non-commercially provided they attribute the work and any adapted version of it is distributed under the same Creative Commons licence terms.

Abstract

Objectives:To develop a Climate Change Inequality Health Impact Assessment (CCIHIA) framework for health services; to provide a systematic process for assessing potential unequal health impacts of climate change on vulnerable and marginalised populations and places; to support effective planning to address these impacts; and to develop contextually appropriate local strategies. Type of program: A collaborative interdisciplinary scoping research project involving two universities and two local health districts (LHDs) in New South Wales (NSW) to develop a CCIHIA framework. This work builds upon the health impact assessment (HIA) approach, which systematically assesses proposals’ potential health and equity impacts by involving stakeholders in developing responses. Methods: The project involved four main activities: understanding stakeholder requirements; conceptualising climate change vulnerability; considering the role of health services; and integrating findings into a conceptual framework. Results: Stakeholders identified key functions that should be addressed across the framing, process and utility of the CCIHIA framework. The resulting conceptual framework outlines contexts and social stratification, the differential impacts of climate change (including factors influencing unequal impacts) and the health system’s position, and also identifies key potential points of intervention. Lessons learnt: The challenge of addressing the complexity of factors and resulting health impacts is reflected within the CCIHIA framework. While there are many intervention points within this framework for health services to address, many factors influencing unequal impacts are created outside the health sector’s direct control. The framework’s development process reflected the focus on collaboration and the interdisciplinary nature of climate change response. Ultimately, the CCIHIA framework is an assessment tool and an approach for prioritising inclusive, cross-cutting, multisector working, and problem-solving.