The changing climate of public health

Dr Maria Neira is exactly the type of role model young girls should aspire to be. Accomplished, poised and highly intelligent, Dr Neira has the rare type of charisma that is able to command a room yet she make you feel as if she is speaking directly to you, and for your benefit.

Dr Neira’s resume is equally as impressive; Director of Public Health, Environmental and Social Determinants of Health at the World Health Organization, previous president of the Spanish Food Safety Agency, and Vice Minister of Health and Consumer Affairs in Spain.  

In 1990, she was appointed as Director of the Department of Control and Eradication at WHO and has previously worked as the Coordinator of the Global Task Force on Cholera Control. She is also a medical specialist in endocrinology.

After her speech at the recent Doctors for Environment Conference in Melbourne, the Doctus Project was privileged to speak to Dr Neira about her views on climate change, the future of public health, and what can be done about the obesity epidemic.

Please note, the following interview has been lightly edited for clarity and length.

2017-07-16 Changing Climate of Public Health Featured Photo

Yael Lefkovits: What is the relationship between public health and the environment, and why should an organisation like WHO, which aims to improve health and wellbeing, be concerned with issues such as climate change?

Dr Maria Neira: When it comes down to it, the same factors that are often intricately linked to climate change are also some of the most important social determinants of health. By improving our sustainable development goals, we will be able to benefit both the environmental sector and the health sector.

For example, improving access to clean energy, will not only benefit the environment, but can also improve the physical health of the people who are no longer breathing polluted air. Over 3.3 million deaths can be attributed to the air we are breathing today, and polluted air has been linked to chronic diseases and cardiovascular disease complications.

And although it is easy to overlook the implications of pollution in countries like Australia, it is important to remember that this is actually a universal problem that also affects many low-income nations which use solid fuels or fire wood.

Of course, this is a simplistic overview. Clean air is not the only goal we should be looking to for environmental reform. However, this example highlights why public health and the environment are actually interlinked; one relies on the other. It is fundamentally important for people who believe in promoting health and wellbeing to understand that a part of this is improving the way we treat our environment.

YL: How should we be aiming to convey the message to the public that taking care of the environment is of utmost importance?

MN: It is important to communicate with the public in a way that will resonate with them. In-depth explanations of methodology of particular studies, which highlight necessary public health interventions, are not necessarily effective.

There are two necessary components to effectively conveying this message. Firstly, people need to understand the benefits of conserving the environment from a health perspective. And once this has been established, as it has been, people need practical steps to understand what they themselves can do about it.

For example, when I was working on the Cholera Task Force, I couldn’t simply take to the streets and say ‘there is a cholera outbreak.’ Instead, you tell people that as there is a cholera outbreak, they need to be stringent about washing their hands, and if they feel these symptoms, they should seek medical attention. It is not enough to educate the public about climate change and leave it as that. Policy makers need to come to people with tangible and practical points, which can be easily implemented.

YL: Do you believe there is a relationship between obesity and the environment?

MN: Without a doubt, yes. The interesting factor to consider is that some of the same strategies we can use to tackle the obesity epidemic are often the same ones that should be implemented to fight climate change.

Consider an architectural shift towards ‘healthy’ urban planning. In an attempt to fight sedentary life, a predisposing factor for obesity, it would be wise to improve the design for our cities necessitating less transport by car, and improving people’s abilities to be transported via walking and bike riding. We need cities that will allow us to move. And consequently, we will also be reducing our carbon footprint by encouraging more environmentally sustainable modes of transport. In Paris, for example, we have seen the health benefits of their promotion of city bikes and limitations of city traffic.

Of course urban planning is not the entire solution. The obesity epidemic is complex and multifaceted. There are certainly genetic factors at play, and ultimately, even increasing someone’s physical exercise cannot offset a large caloric intake. However what remains clear is that many of the large scale public health interventions that should be implanted to tackle climate change will also have a positive effect on the obesity epidemic and vice versa.

YL: What advice do you have for any women looking to follow in your footsteps and pursue leadership roles in the public health sphere?

MN: I guess it’s important for young women to understand that should not need to feel like victims. All too often I have seen women in the medical sphere try to act like men because they believe this is what will help them progress in their career. Being a woman is a gift and strength, and there is no need to try and be anything different.

It is easy to see how a woman of Dr Neira’s calibre rose to the top of the public health sphere. It is comforting to know that despite the frighteningly large scope of the environmental crisis, we have intelligent and visionary leaders.

After all, in the words of Dr Neira herself, ‘if you love public health, there are no limits.’

The views and opinions expressed in this article are those of the author and do not necessarily represent those of the Doctus Project.