Linking health justice, social justice, and climate justice

Comment Linking health justice, social justice, and climate justice Climate emergency is here. In 2019, many catastrophic climate events occurred, including huge cyclones in Mozambique and The Bahamas, protracted bushfires in Australia, and widespread flooding in Jakarta, Indonesia. Climate models predict further unprecedented and extreme weather events due to global heating. Unfortunately, there is still no unified political consensus regarding how to respond to the emergency. Individuals’ perceptions have a huge effect on how they respond to crisis. If something is not perceived as an emergency, people do not react quickly. If people recognise that there is an emergency, then those people act to prevent further harms, prepare for and mitigate against harm, adapt, and have emergency drills. This action is part of good safety planning and it saves lives. Yet, some individuals are sceptical about whether the global climate crisis is happening, and whether human activity is responsible. Political orientation and ideology might influence framing of climate change and shared perceptions of the problem.1 There is a range of responses to the climate emergency, which are shaped by power, privilege, and psychology. Psychology shapes how individuals perceive risk and whether they connect health, social, and environmental justice together as related issues that affect everyone. Some individuals claim that activists such as Greta Thunberg are engaged in fear mongering. Indeed, moral panics have historically been used as political tools, to implement antidemocratic policies—policies that would be rejected under stable circumstances. This use of moral panic has been termed the shock doctrine,2 and caution is needed to ensure that panics are not used to exploit vulnerable communities and reverse necessary environmental protections. Some individuals are confused about whether the climate is a cause for concern, perhaps thinking that those who are concerned are displaying a negativity bias—the tendency to focus on bad things.3 Other biases might affect perception: evolution has primed people to be vigilant to ancient risks (eg, spiders) but to be less aware of newer serious risks (eg, burning fossil fuels). Further psychological processes might also occur—eg, too much bad news can overwhelm people, reducing the motivation to act and leading to self-protection and inaction.4 www.thelancet.com/planetary-health Vol 4 April 2020 Some of the most politically powerful individuals seem to be in denial, wilful or otherwise. A failure to act might be linked to the psychology that comes with being insulated from the reality of what people affected by climate disaster face. The absence of action might also relate to the gradual nature of climate change, which allows events to be seen as isolated, occurring in the far future, and geographically distant.5 Individuals with vested interests also seem to be abusing their power by suppressing the true impact of industrialised exploitation of the planet. Parallels have been drawn with the tobacco industry, which relentlessly and knowingly marketed harmful products to the public. The psychological impacts of realising that there is a climate emergency are wide ranging. Environmental and climate changes have largely been accurately predicted.6 Some people who are newly aware of this reality have eco-anxiety, which is an adaptive response— if the perceived threat is real, then survival responses are needed. Many young people have grasped this reality and are turning anxiety into activism, galvanising global action. Young people are lobbying governments to respond in collaborative and coordinated ways to prevent collapse of the ecological system in which all people live. Some individuals who are already susceptible to mental distress could develop severe mental ill health (although anyone who is placed in traumatising or hostile environments is also susceptible). Individuals who are already seeing their homelands and infrastructures overwhelmed are physically and mentally vulnerable in the aftermath of destructive weather events. The hierarchies of social inequality and vulnerability are replicated in disasters. Individuals who are hardest hit by climate change are often already vulnerable and have the least resources. These individuals also tend to be the least responsible for the climate emergency because they consume fewer resources than people with an economic advantage. The attentional focus in the most economically developed countries in media coverage of disasters also shows inequality—there is often no or little coverage of disasters affecting poorer countries, where the people affected are Black, Asian, or from disadvantaged ethnic groups. Even affluent e131 Comment For more on psychology and global health see https://www. psychologyandglobalhealth.org For more on change to tobacco advertising see https:// scienceblog.cancerresearchuk. org/2017/05/19/this-is-the-endof-tobacco-advertising e132 countries such as Australia did not initially receive proportionate media coverage during the 2019–20 bushfires, given the scale of disaster. After the event itself, the media then moves on quickly. The aftermaths of disasters, such as hurricane Katrina, do not stay in the headlines; the evidence of the ongoing consequences is recorded by dedicated researchers.7 It is time to see the links between health, social, and climate justice, and to see them as deeply interconnected as part of a wider global health frame. Everyone who cares about their fellow human beings and fellow species now has a duty to act. For those people who are dedicated to human health and wellbeing, this duty to act is enshrined in ethical codes. Clinicians, researchers, employees, and citizens need to assert daily that there is a climate emergency, and to act accordingly.8 Support is especially needed for individuals who are already financially and physically vulnerable because of inequality, and who will struggle to access the help they need to keep safe and healthy.9 The frequency of extreme weather events is shifting discourse away from immediate recovery and resilience to a broadening recognition that transformative action is needed. For instance, in Australia, there are now widespread demands for the government to change course on climate policies.10 The importance of mass social action is clear: it has taken mass movements such as Me Too and Black Lives Matter to highlight injustices and demand better from those who have failed to act. Collaborative and coordinated interventions can change communities— eg, policy changes, campaigning, and health awareness have led to big reductions in smoking. Social connection, meaning, and hope, are essential for psychological wellbeing. Among other things, the psychology of how people live needs to change from focusing on the individual to a more collective stance (I to we), to differentiate want from need, and to recognise how advertising and social comparison are used to drive excessive consumption. Linking health, social, and climate justice can lead to the transformative activism that is needed for a better, healthier, and fairer world for everyone. The question now is, are you willing to help? We declare no competing interests. The views expressed are our own. Copyright © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Khadj Rouf, *Tony Wainwright t.w.wainwright@exeter.ac.uk Psychological Therapies, North and West Oxon Adult Mental Health Team, Oxford Health NHS Trust, Oxford, UK (KR) and Clinical Education Development and Research, University of Exeter, Exeter EX4 4QG, UK (TW) 1 2 3 4 5 6 7 8 9 10 Whitmarsh L, Corner A. Tools for a new climate conversation: a mixed-methods study of language for public engagement across the political spectrum. Glob Environ Change 2017; 42: 122–35. Klein N. The shock doctrine: the rise of disaster capitalism. 1st edn. New York: Metropolitan Books/Henry Holt and Company, 2007. Tierney J, Baumeister RF. The power of bad: how the negativity effect rules us and how we can rule it. New York, NY: Penguin Press, 2019. Gifford R. The dragons of inaction: psychological barriers that limit climate change mitigation and adaptation. Am Psychol 2011; 66: 290–302. Hayes K, Blashki G, Wiseman J, Burke S, Reifels L. 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