Envisioning environmental equity: climate change, health, and racial justice.

Climate change has a broad range of health impacts and tackling climate change could be the greatest opportunity for improving global health this century. Yet conversations on climate change and health are often incomplete, giving little attention to structural discrimination and the need for racial justice. Racism kills, and climate change kills. Together, racism and climate change interact and have disproportionate effects on the lives of minoritised people both within countries and between the Global North and the Global South. This paper has three main aims. First, to survey the literature on the unequal health impacts of climate change due to racism, xenophobia, and discrimination through a scoping review. We found that racially minoritised groups, migrants, and Indigenous communities face a disproportionate burden of illness and mortality due to climate change in different contexts. Second, this paper aims to highlight inequalities in responsibility for climate change and the effects thereof. A geographical visualisation of responsibility for climate change and projected mortality and disease risk attributable to climate change per 100 000 people in 2050 was conducted. These maps visualise the disproportionate burden of illness and mortality due to climate change faced by the Global South. Our third aim is to highlight the pathways through which climate change, discrimination, and health interact in most affected areas. Case studies, testimony, and policy analysis drawn from multidisciplinary perspectives are presented throughout the paper to elucidate these pathways. The health community must urgently examine and repair the structural discrimination that drives the unequal impacts of climate change to achieve rapid and equitable action.

Unequal exchange of labour in the world economy.

Researchers have argued that wealthy nations rely on a large net appropriation of labour and resources from the rest of the world through unequal exchange in international trade and global commodity chains. Here we assess this empirically by measuring flows of embodied labour in the world economy from 1995-2021, accounting for skill levels, sectors and wages. We find that, in 2021, the economies of the global North net-appropriated 826 billion hours of embodied labour from the global South, across all skill levels and sectors. The wage value of this net-appropriated labour was equivalent to €16.9 trillion in Northern prices, accounting for skill level. This appropriation roughly doubles the labour that is available for Northern consumption but drains the South of productive capacity that could be used instead for local human needs and development. Unequal exchange is understood to be driven in part by systematic wage inequalities. We find Southern wages are 87-95% lower than Northern wages for work of equal skill. While Southern workers contribute 90% of the labour that powers the world economy, they receive only 21% of global income.

Is green growth happening? An empirical analysis of achieved versus Paris-compliant CO2-GDP decoupling in high-income countries.

BACKGROUND: Scientists have raised concerns about whether high-income countries, with their high per-capita CO2 emissions, can decarbonise fast enough to meet their obligations under the Paris Agreement if they continue to pursue aggregate economic growth. Over the past decade, some countries have reduced their CO2 emissions while increasing their gross domestic product (absolute decoupling). Politicians and media have hailed this as green growth. In this empirical study, we aimed to assess whether these achievements are consistent with the Paris Agreement, and whether Paris-compliant decoupling is within reach. METHODS: We developed and implemented a novel approach to assess whether decoupling achievements in high-income countries are consistent with the Paris climate and equity goals. We identified 11 high-income countries that achieved absolute decoupling between 2013 and 2019. We assessed the achieved consumption-based CO2 emission reductions and decoupling rates of these countries against Paris-compliant rates, defined here as rates consistent with national fair-shares of the remaining global carbon budgets for a 50% chance of limiting global warming to 1·5°C or 1·7°C (representing the lower [1·5°C] and upper [well below 2°C] bounds of the Paris target). FINDINGS: The emission reductions that high-income countries achieved through absolute decoupling fall far short of Paris-compliant rates. At the achieved rates, these countries would on average take more than 220 years to reduce their emissions by 95%, emitting 27 times their remaining 1·5°C fair-shares in the process. To meet their 1·5°C fair-shares alongside continued economic growth, decoupling rates would on average need to increase by a factor of ten by 2025. INTERPRETATION: The decoupling rates achieved in high-income countries are inadequate for meeting the climate and equity commitments of the Paris Agreement and cannot legitimately be considered green. If green is to be consistent with the Paris Agreement, then high-income countries have not achieved green growth, and are very unlikely to be able to achieve it in the future. To achieve Paris-compliant emission reductions, high-income countries will need to pursue post-growth demand-reduction strategies, reorienting the economy towards sufficiency, equity, and human wellbeing, while also accelerating technological change and efficiency improvements. FUNDING: None.

Existing climate mitigation scenarios perpetuate colonial inequalities.

The challenge of climate mitigation is made more difficult by high rates of energy use in wealthy countries, mostly in the Global North, which far exceed what is required to meet human needs. In contrast, more than 3 billion people in poorer countries live in energy poverty. A just transition requires energy convergence-reducing energy use in wealthy countries to achieve rapid emissions reductions, and ensuring sufficient energy for development in the rest of the world. However, existing climate mitigation scenarios reviewed by The Intergovernmental Panel on Climate Change do not explore such a transition. On average, existing scenarios maintain the Global North's energy privilege at a per capita level 2·3 times higher than in the Global South. Even the more equitable scenarios perpetuate large energy inequalities for the rest of the century. To reconcile the Global North's high energy use with the Paris Agreement targets, most scenarios rely heavily on bioenergy-based negative emissions technologies. This approach is risky, but it is also unjust. These scenarios tend to appropriate land in the Global South to maintain, and further increase, the Global North's energy privilege. There is an urgent need to develop scenarios that represent convergence to levels of energy that are sufficient for human wellbeing and compatible with rapid decarbonisation.

National responsibility for ecological breakdown: a fair-shares assessment of resource use, 1970-2017.

BACKGROUND: Human impacts on earth-system processes are overshooting several planetary boundaries, driving a crisis of ecological breakdown. This crisis is being caused in large part by global resource extraction, which has increased dramatically over the past half century. We propose a novel method for quantifying national responsibility for ecological breakdown by assessing nations' cumulative material use in excess of equitable and sustainable boundaries. METHODS: For this analysis, we derived national fair shares of a sustainable resource corridor. These fair shares were then subtracted from countries' actual resource use to determine the extent to which each country has overshot its fair share over the period 1970-2017. Through this approach, each country's share of responsibility for global excess resource use was calculated. FINDINGS: High-income nations are responsible for 74% of global excess material use, driven primarily by the USA (27%) and the EU-28 high-income countries (25%). China is responsible for 15% of global excess material use, and the rest of the Global South (ie, the low-income and middle-income countries of Latin America and the Caribbean, Africa, the Middle East, and Asia) is responsible for only 8%. Overshoot in higher-income nations is driven disproportionately by the use of abiotic materials, whereas in lower-income nations it is driven disproportionately by the use of biomass. INTERPRETATION: These results show that high-income nations are the primary drivers of global ecological breakdown and they need to urgently reduce their resource use to fair and sustainable levels. Achieving sufficient reductions will likely require high-income nations to adopt transformative post-growth and degrowth approaches. FUNDING: None.

Quantifying national responsibility for climate breakdown: an equality-based attribution approach for carbon dioxide emissions in excess of the planetary boundary.

BACKGROUND: This analysis proposes a novel method for quantifying national responsibility for damages related to climate change by looking at national contributions to cumulative CO2 emissions in excess of the planetary boundary of 350 ppm atmospheric CO2 concentration. This approach is rooted in the principle of equal per capita access to atmospheric commons. METHODS: For this analysis, national fair shares of a safe global carbon budget consistent with the planetary boundary of 350 ppm were derived. These fair shares were then subtracted from countries' actual historical emissions (territorial emissions from 1850 to 1969, and consumption-based emissions from 1970 to 2015) to determine the extent to which each country has overshot or undershot its fair share. Through this approach, each country's share of responsibility for global emissions in excess of the planetary boundary was calculated. FINDINGS: As of 2015, the USA was responsible for 40% of excess global CO2 emissions. The European Union (EU-28) was responsible for 29%. The G8 nations (the USA, EU-28, Russia, Japan, and Canada) were together responsible for 85%. Countries classified by the UN Framework Convention on Climate Change as Annex I nations (ie, most industrialised countries) were responsible for 90% of excess emissions. The Global North was responsible for 92%. By contrast, most countries in the Global South were within their boundary fair shares, including India and China (although China will overshoot soon). INTERPRETATION: These figures indicate that high-income countries have a greater degree of responsibility for climate damages than previous methods have implied. These results offer a just framework for attributing national responsibility for excess emissions, and a guide for determining national liability for damages related to climate change, consistent with the principles of planetary boundaries and equal access to atmospheric commons. FUNDING: None.

Duration and effect of single-dose atropine: paralysis of accommodation in penalization treatment of functional amblyopia.

BACKGROUND AND PURPOSE: Atropine dilates the pupil and paralyzes the ciliary muscle accommodation, blurring vision, and therefore is an effective penalization of the sound eye in the treatment of functional amblyopia of the other eye. The degree of blur induced is a function of the amount of the patient's uncorrected hyperopia and the distance from the eye of the viewed material or object. Another factor determining effectiveness of atropine penalization is the duration of the effect of the atropine. It is the purpose of this study to investigate these factors. METHODS: Six normal children underwent complete eye exam with cycloplegic refraction several days before deliberate instillation of atropine 1% in the sound, or right eye. Distance and near acuity was then tested after 30 minutes, and on subsequent days. Additional data points were derived by placing known minus lenses in front of the tested eye. In addition, we also studied one successfully treated amblyopic patient when he terminated chronic daily atropine in his normal, sound eye. RESULTS: Atropine initially produced a linear reduction in logMAR acuity (blur) at distance of about 0.2 logMAR lines per diopters of uncorrected hyperopia. The magnitude of the blur was greater for near, but the effect of increased hyperopia was slightly greater for distance measurements. This blurring of acuity lasted just less than 48 hours for normal subjects, and just over 48 hours following prompt cessation of chronic daily atropine in that one subject. Regression formulae were derived relating uncorrected hyperopia and time interval following atropine cessation on distance and near acuity in children of amblyopic age range. CONCLUSION: The degree of penalization is highly dependent on the uncorrected hyperopic refractive error. A significant penalization effect is present only for one day or so. Daily atropine is therefore indicated for penalization. To better tailor penalization therapy to target sound eye acuity blur, these formulae and graphs can be used, specifically, in addition, to determine the amount of deliberate spectacle hyperopic undercorrection to maximize the penalization effect.