Australian Government Department of Health and Aged Care National Health and Climate Strategy consultation

24 July 2023

Introduction

Rural and remote Australian communities are, for numerous reasons, particularly prone to the health-related impact of climate change. The geographic location of rural and remote communities renders them at risk of extreme weather events such as heatwaves, extended periods of low rainfall or drought, flood and more recently bushfires.

Rural community demographics have higher proportions of older Australians and Aboriginal and Torres Strait Islander peoples, greater incidence of chronic disease, comorbidities, and poor mental health mean that already susceptible groups experience greater health challenges. Furthermore, rural and remote communities face socioeconomic disadvantage including higher rates of unemployment, poverty, welfare dependency, digital exclusion, lower rates of educational attainment and reduced access to appropriate health services. In some communities, infrastructure such as housing, telecommunications, transport, and sanitation is also lacking. Climate change has been described as a risk multiplier, exacerbating existing health challenges and other disadvantage.

The effects of climate change are high across rural Australian communities, who have high vulnerability and low resilience to disasters. Natural disasters (drought, floods, storms, animal and insect plagues) have a flow on health impact to both physical and mental health. Rural Australians are more likely to have been affected by flooding at least once since 2019 (61%) than people living in urban areas (38%), and significantly more likely to have been affected by bushfires (49%) than people in urban areas (36%).

Currently climate impacts are imposing economic costs of around $38 billion per year and projected to increase with population growth even with global action to reduce emissions. Therefore, it is important that healthcare clinics in rural and remote regions of Australia with workforce shortages including emergency services are supported to care those communities affected by extreme weather events such as heatwaves, bushfires, and drought.

About 7 million people (28 percent of the population) live in rural Australia. Broadly, rural Australian industries, including agricultural industries and mining, contribute almost $400 billion per year to the value of the economy. Agriculture, fisheries and forestry, rural industries and resources generate at least 80 per cent of the country’s exports per year. Furthermore, 46 per cent ($107 billion) of the nation’s annual tourism expenditure occurs in regional Australia with half a million people directly employed in rural tourism-related industries. This is a significant economic contribution and key to sustenance of international trade, stimulating economic wealth and facilitating employment. Climate change could impact the productivity and competitiveness to these industries and employers. The health and wellbeing of people living in rural Australia is essential to the broader economic productivity and development of the nation. Furthermore, it is important to encourage other businesses and families to relocate to rural Australia, to invest and take up employment to maintain our nation’s wealth.

There are severe health inequities for rural and Australia. Currently there is a $6.5 billion annual shortfall in health expenditure in Australia’s regional and remote communities which equates to each person in rural Australia missing out on nearly $850 a year of healthcare access. This shortfall presents unique challenges and requires the Australian Government to allocate more spending to healthcare for rural and remote Australians. Rural and remote communities need access to multidisciplinary healthcare services and health workers to support their physical and mental wellbeing, more so in times of disaster (flood, drought, bushfire).

The Alliance acknowledges the accumulation of social, economic, and environmental burden from climate change leaves many communities in rural and remote Australia highly vulnerable to the health risks associated with climate change. Furthermore, the Alliance supports the development of National Climate Change and Health Strategy to facilitate planning for future climate health impacts to rural and remote Australia. Access to high-quality health care is essential to enhance overall health and wellbeing and facilitate improved health equity for rural Australians. Improving access to health services for those living in rural and remote Australia is also fundamental to the generation and further development of the economy.

The National Rural Health Alliance has a Position paper: Rural health policy in a changing climate – three key issues which also form part of background and input to this submission process.

Some of our members have noted that the consultation paper does not mention ‘air’. Air quality should at least be highlighted in the built environment section as a specific action area. Given that the encroachment of the built environment on the natural environment accelerates climate change due to deforestation etc, and increases the likelihood of zoonoses such as COVID-19 being introduced into the human population, and with several pandemics of respiratory viruses in the last 20 years, much has been learnt about the importance of breathing clean air, indoors and outdoors. Air pollution is usually thought of as outdoor air, ie pollution from the built environment and from natural occurrences such as fire. With all that we've learned in the mitigation of the airborne COVID‑19 virus, the indoor and outdoor air quality's impact on health should be described as a part of the Strategy.

The outcome of the strategy must be that all levels of government to take immediate action to reduce the impact of climate change. Rural communities need assistance to plan and mitigate against health impacts and to be provided with the resources required to respond to the impacts of climate change to enjoy good health across their lifespan. Below is a broad scope of recommendations for policy action to address the health implications of climate change. The following recommendations are referenced within the National Health and Climate Strategy Consultation Paper responses.

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