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.

Racism, xenophobia, and discrimination: mapping pathways to health outcomes.

Despite being globally pervasive, racism, xenophobia, and discrimination are not universally recognised determinants of health. We challenge widespread beliefs related to the inevitability of increased mortality and morbidity associated with particular ethnicities and minoritised groups. In refuting that racial categories have a genetic basis and acknowledging that socioeconomic factors offer incomplete explanations in understanding these health disparities, we examine the pathways by which discrimination based on caste, ethnicity, Indigeneity, migratory status, race, religion, and skin colour affect health. Discrimination based on these categories, although having many unique historical and cultural contexts, operates in the same way, with overlapping pathways and health effects. We synthesise how such discrimination affects health systems, spatial determination, and communities, and how these processes manifest at the individual level, across the life course, and intergenerationally. We explore how individuals respond to and internalise these complex mechanisms psychologically, behaviourally, and physiologically. The evidence shows that racism, xenophobia, and discrimination affect a range of health outcomes across all ages around the world, and remain embedded within the universal challenges we face, from COVID-19 to the climate emergency.

Breaking free from tunnel vision for climate change and health.

Climate change is widely recognised as the greatest threat to public health this century, but 'climate change and health' often refers to a narrow and limited focus on emissions, and the impacts of the climate crisis, rather than a holistic assessment of economic structures and systems of oppression. This tunnel vision misses key aspects of the climate change and health intersection, such as the enforcers of planetary destruction such as the military, police, and trade, and can also lead down dangerous alleyways such as 'net' zero, overpopulation arguments and green extractivism. Tunnel vision also limits health to the absence of the disease at the individual level, rather than sickness or health within systems themselves. Conceptualising health as political, ecological, and collective is essential for tackling the root causes of health injustice. Alternative economic paradigms can offer possibilities for fairer ecological futures that prioritise health and wellbeing. Examples such as degrowth, doughnut economics and ecosocialism, and their relationship with health, are described. The importance of reparations in various forms, to repair previous and ongoing harm, are discussed. Breaking free from tunnel vision is not simply an intellectual endeavour, but a practice. Moving towards new paradigms requires movement building and cultivating radical imagination. The review highlights lessons which can be learnt from abolitionist movements and progressive political struggles across the world. This review provides ideas and examples of how to break free from tunnel vision for climate change and health by highlighting and analysing the work of multiple organisations who are working towards social and economic transformation. Key considerations for the health community are provided, including working in solidarity with others, prioritising community-led solutions, and using our voice, skills, and capacity to address the structural diagnosis-colonial capitalism.

Developing a guide to climate & health justice education: Process and content.

Climate justice and health education can address the disproportionate health impacts of climate change on minoritized communities by providing frameworks to build awareness and instigate action on climate-related health inequities. The Envisioning Environmental Equity Educator's Guide to Climate and Health Justice provides a framework for educators, activists and health professionals to lead lessons on health and climate justice that center the experiences of those Most Affected People and Areas (MAPA) by climate change. Collaborators in Brazil, the Philippines, and Uganda engaged in stakeholder meetings to assess priorities and needs about climate and health with policymakers, doctors, activists, and students. These meetings informed the product: An educator's guide to climate and health justice that explores their dynamics from an anti-racist, anti-colonial approach. The guide serves as a recommended lesson framework fit with concepts, examples, and activities for educators teaching in primary and secondary learning settings. It is an innovative climate and health justice educational resource that draws on principles of anti-colonialism, critical thinking and consciousness, and engaged pedagogy. It offers a strategy for climate justice communication that targets diverse audiences across climate, health and social contexts by promoting educational approaches that center MAPA experiences, fit for diverse audiences.