Global Climate Change and Women’s Health

By Duncan, Kirsty

For the first twenty years that climate change garnered international attention, gender issues were not on the agenda – although women (1) are generally poorer than men, and (2) are more dependent than men on primary resources (e.g. agriculture) that are threatened by changes in climate. Women often shoulder the responsibility for the household water supply and its purification; in Kenya, for example, carrying water may use up to 85% of a woman’s daily energy intake.

Because women collect water, manage its household use, and grow irrigated and rain-fed crops, they know water’s availability, quality, and reliability. Furthermore, as a result of this division of labour, women often come into contact with poor-quality water, and are more vulnerable to waterrelated diseases than are men. These dis eases kill between five and twelve million people per year, most of them women and children. Millions more are sickened with diarrhoea, hepatitis, and trachoma that would be preventable with access to clean water and health care information. Women then also bear the main burden of caring for those who are ill. Yet, women, in most parts of the world, remain almost invisible in decision-making about climate change.

The Conference of the Parties (COP-8) however, has, at last, recognized that women are extremely vulnerable to climate change and that they may bear an unreasonably large share of the burden of adaptation. Human health depends considerably on investing in the well-being of women, as their physical condition largely determines the health of their children who are the adults of tomorrow. Moreover, being female or male has a major impact on an individual’s health: the natural course of a disease may be different in women and men. Women and men may respond differently to illness, and society may respond differently to sick women and men.

DIRECT HEALTH IMPACTS

(1) Thermal Extremes

In a warmer world, heat waves are expected to become more frequent and severe. The young, the elderly, the poor, the frail, and those who live in the top floors of apartment buildings and lack access to air conditioning, especially in large urban areas are particularly vulnerable. Men and women differ in their response to extreme heat. Women sweat less, have a higher metabolic rate, and have thicker subcutaneous fat that prevents them from cooling themselves as efficiently as men. Women are therefore less able to tolerate heat stress. In 1984, average daily temperatures rose from 21.1 C to 28.9 C during a heat wave in New York. Elderly women were at highest risk of heat-associated death: among those aged 75-84 years, death rates rose 39% for men, and 66% for women; among those over 85 years old, increases were 13% for men and 55% for women. More recently, a heat wave struck France in August 2003. Excess mortality in August was 14 802; in all age groups female mortality was 15-20% higher than male mortality.

Fortunately, heat-related health impacts can be reduced through behavioural adaptations, such as the use of air conditioners, increased intake of fluids, the development of community-wide heat emergency plans, and improved heat-warning systems. Unfortunately, these measures are often unavailable to women in developing countries.

(2) Extreme Events

With increased temperatures, extreme weather events are likely to increase. Gender significantly affects the daily lives of women and men, before, during, and after an extreme event. Women who are battered, immigrants, indigenous, isolated, poor, refugee, and seniors are particularly vulnerable to such events. Gender-specific health impacts of extreme weather events include: mental stress as a result of providing emotional care during and after the crisis, and increased violence. Police reports of domestic violence following the 1980 Mt. St. Helen’s volcanic eruption increased by 46 %. Following the 1993 Missouri floods, the turn-away rate at shelters rose 111%, programmes sheltered 400% more flood-impacted women and children than anticipated and in 1998, a Montreal Police Chief reported that 25% of calls received during the 1997 ice storm were from abused women. Gender-based violence may lead to psychological distress. A recent study found that 30-40% of all battered women attempted to kill themselves at some point in their lives.

Women must be included in disaster prevention, mitigation, and recovery strategies. Specifically, women must be engaged in: family, household, and workplace preparation for extreme weather events; response and recovery; emergency site organization; physical and emotional care for children; and organizing kin and friendship networks.

INDIRECT HEALTH IMPACTS

(1) Nutritional Health

In developing countries, particularly in Africa and Asia where women farm cash crops and cultivate paddies, women are responsible for up to 80% of food production. Food production may be undermined, both directly and indirectly through plant or animal diseases and pests in regions vulnerable to climate change. Some studies indicate that the number of hungry and malnourished people in the world could increase by ~10% due to climate change. Consequently, women are likely to experience a decrease in nutritional health, as they are often the first to go hungry in an attempt to protect their families.

(2) Respiratory Health

Climate change is likely to increase acid precipitation, particulates, and smog. Current health effects of air pollution range from severe, uncommon events (e.g. death) to mild, common events (e.g. throat irritation). Air pollution currently harms more than 1.1 billion people each year, and kills three million annually. Ninety percent of these deaths occur in developing countries, where air pollution is at its worst. Women and children do most of the cooking in developing countries. About 2.5 million women and children die each year from respiratory infections due to indoor air pollution. Traditional cook stoves produce carbon monoxide, hydrocarbons, pollutants, and smoke that affect the health of those who tend the stoves. (More than two-thirds of deaths are associated with indoor air pollution, which affects mostly women and children.

In South Africa, children living in homes with wood stoves are almost five times more likely than others to develop respiratory infections severe enough to require hospitalization. In rural Mexico, coal smoke exposure can increase lung cancer risks by a factor of nine. Air pollution may affect females more than males: females may inhale particles deeper into their lungs, and since they have fewer red blood cells, they may be more susceptible to the toxicological influences of air pollutants. Worsening air quality due to climate change will therefore further impair the health of women and children who already suffer from indoor air pollution. Improved biomass cook stoves, such as the Upesi stove developed in Kenya, conserve biomass resources, decrease the time and energy needed for collecting fuel and cooking, and emit 60% less smoke.

(3) Vector-borne Disease

An estimated 20% of the world’s population is at risk of contracting malaria. The disease causes more than 300 million acute illnesses and kills at least one million people every year. Malaria kills an African child every 30 seconds, and remains one of the most important threats to the health of pregnant women and their newborns. Malaria is particularly sensitive to weather and climate. Precipitation, for example, determines the presence or absence of mosquito breeding sites.

All models predict increases in transmission of malaria in a warmer world. Pregnant women are particularly vulnerable to malaria because they are twice as attractive to malaria-carrying mosquitoes as non-pregnant women. Moreover, pregnancy reduces a woman’s immunity to malaria, making her more susceptible to malaria infection, and increasing her risk of illness, severe anaemia and death. Maternal malaria increases the risk of spontaneous abortion, premature delivery, stillbirth, and low birth weight – a leading cause of child mortality.

Fortunately, insecticide treated nets (ITNs) offer substantial protection against malaria; the proper use of ITNs combined with treatment for malaria can reduce malaria transmission by as much as 60% and the overall young-child death rate by one-fifth.

(4) Water-related Diseases

Schistosomiasis is a water-based infectious disease caused by five species of the fluke (parasitic worm) Schistoma. Symptoms vary but include bloody urine and liver disorders. The occurrence of schistosomiasis is particularly linked to agricultural, and water- development schemes. High-risk groups for schistosomiasis are school- age children and specific occupational groups such as irrigation workers and women who use infected water for their domestic purposes.

Climate change could expand the range of the disease, or create greater need for irrigation, particularly in arid regions. Potential increased transmission of schistosomiasis could be reduced by constructing irrigation systems that are not conducive to snails which are necessary for the disease.

ADAPTATION

Regrettably, those with the least resources have the least capacity to adapt and are the most vulnerable. Vulnerability is likely to be differentiated by gender.

According to Amartya Sen, "The voice of womenis critically important for the world’s future – not just for women’s future." The equal participation of women is absolutely necessary to meet changing climatic conditions.

Further Reading and Resources:

Duncan, K., Guidotti, T., Cheng, W. et al. 1998. Health Sector. In The Canada Country Study: Climate Impacts and Adaptation. Koshida, G. and Avis, W. Environment Canada:Ottawa. pp. 501-590.

Duncan, K. 2006. Climate change, health, and women. Climate Change and Health Impacts Atlantic Conference 2006. St. John’s, Newfoundland and Labrador, March 23-24, 2006.

World Health Organization. 2003. Climate Change and Human Health – Risks and Responses. WHO: Geneva.

Dr. Kirsty Duncan is an Adjunct Professor at the University of Toronto, an Author, and an international speaker. She previously served as Canada’s health representative to the Intergovernmental Panel on Climate Change (IPCC).

Copyright WEED Foundation Spring 2007