Human Health

The health sector in South Africa is identified as one of five key priorities of government and is prioritised in national climate change adaptation efforts. Aiming to adapt and address potential climate change risks to the sector, the National Department of Health has developed a Climate Change Health and Adaptation Plan 2014–2019, which aligns with implementing the Municipal Health Mandate in the National Health Amendment Act, 2013 of local government. Implementation of the plan will be guided by prevention; community participation; inter-sectoral collaboration and synergy between initiatives, equity and evidence-based planning.

Climate Change Impacts on Human Health

Climate change and its associated extreme weather events such as drought, floods and heat waves will pose numerous risks to the South African human health sector, and further exacerbate existing challenges.

The South African Long Term Adaptation Scenarios (LTAS) report highlights these potential climate change impacts.

  1. Increased temperatures may induce heat stress; increase the occurrence of respiratory, cardiovascular and general diseases and death.
  2. Increased temperatures, flooding and drought could increase the incidence, incubation and transmission of waterborne and associated communicable diseases.
  3. More areas may become favourable for vectors (malaria carrying mosquitos etc.) which are projected to spread within regions.
  4. Compromised food availability may lead to food insecurity, hunger and malnutrition.
  5. Health impacts from natural disasters (fires, floods) may result in increased drowning, injuries and population displacement impacts.
  6. Air pollution primarily resulting from the burning of fossil fuels may have serious health effects. 

Human Health Maps

Vulnerability Assessment in the Health Sector

Climate Change Vulnerability is assessed by identifying a set of climate change indicators or impacts and then assessing your exposure, sensitivity and adaptive capacity to these indicators. The following sections provide a summary on how to conduct this assessment specifically for the Human Health Sector.

Step 1: Develop Climate Change Indicators

The first step in a Climate Change Vulnerability Assessment is to develop a set of indicators. Indicators are a list of potential impacts that may take place in your area as a result of climate change. The LGCCS Vulnerability Assessment Toolkit has developed a draft range of indicators using the Long Term Adaptation Scenario Reports. The indicators have been grouped into sectors. This page deals specifically with the Human Health and the list of indicators are provided in the tables below.

Step 2: Assess your Exposure to the Indicators

The second step of a vulnerability assessment is to determine whether a particular indicator is relevant. This is termed “Exposure”. Exposure is whether or not a particular impact will take place in your area. The table below lists various indicators and links to materials to determine whether you are potentially at risk (exposed) to the impact. This is generally a “Yes/No” question.

No
Indicator Title
Indicator Description
Exposure Question
Source of information
21Health impacts from increased storm eventsIncreased storms will result increased risk of drowning, injuries and population displacement impacts.Are you or will you experience increased storm events in your area?<a href="https://drive.google.com/open?id=0B88z-WjOEKIlZy0xcG1KTGthSlk&quot; target="_blank">LTAS Phase 1 - Technical Report - No 1 of 6 - Climate Trends And Scenarios For South Africa</a>
22Increased heat stressIncreases in average temperatures and extreme events (such as heat waves) are projected to induce heat stress, increase morbidity, and result in respiratory and cardiovascular diseases.Are you or will you experience increased heat waves in your area?<a href="https://drive.google.com/open?id=0B88z-WjOEKIlZy0xcG1KTGthSlk&quot; target="_blank">LTAS Phase 1 - Technical Report - No 1 of 6 - Climate Trends And Scenarios For South Africa</a>
23Increased vector borne diseases from spread of mosquitoes, ticks, sandflies, and blackfliesVector borne diseases such as malaria is projected to spread within regions bordering current malaria areas, which are presently too cold for transmission.Are vector borne diseases present or likely in your area?<a href="https://drive.google.com/open?id=0B88z-WjOEKIleGZVSVFVUnBuU1k&quot; target="_blank">LTAS Phase 1 - Technical Report - No 4 of 6 - Climate Change Implications For Human Health In South Africa</a>
24Increased water borne and communicable diseases (e.g. typhoid fever, cholera and hepatitis)Favourable conditions for the incubation and transmission of waterborne diseases may be created by increasing air and water temperatures.Are waterborne and communicable diseases present or likely in your area?<a href="https://drive.google.com/open?id=0B88z-WjOEKIleGZVSVFVUnBuU1k&quot; target="_blank">LTAS Phase 1 - Technical Report - No 4 of 6 - Climate Change Implications For Human Health In South Africa</a>
25Increased malnutrition and hunger as a result of food insecurityClimate Change will affect food systems, compromising food availability, access and utilisation, leading to food insecurity (particularly of subsistence farmers).Do you or will you have food insecurity in your area?<a href="http://www.agis.agric.za/agismap_atlas/AtlasViewer.jsp?MapService=agis_atlas2006&ProjectId=12&LId=0&OId=0&LayerIdVisList=none&quot; target="_blank">AGIS Food Security Atlas (Maize - Estimated yield (ISCW))</a>
26Increased air pollutionHealth impacts in resulting from exposure to air pollutants include eye irritation, acute respiratory infection, chronic respiratory diseases and TB, and sometimes death.Do you or will you have air pollution in your area?<a href="https://drive.google.com/open?id=0B88z-WjOEKIlU0EwSXhYcml3RVE&quot; target="_blank">LTAS Phase 1 - Technical Report - No 2 of 6 - Climate Change Implications For The Water Sector In South Africa</a>
27Increased Occupational health problemsTemperature is a common climatic factor that affects occupational health (for example, agricultural labourer’s productivity) by causing heat stress and dehydration.Do people work outside or are in conditions that cannot be cooled in your area?<a href="https://drive.google.com/open?id=0B88z-WjOEKIlU0EwSXhYcml3RVE&quot; target="_blank">LTAS Phase 1 - Technical Report - No 2 of 6 - Climate Change Implications For The Water Sector In South Africa</a>

Record your answers here and make note of any of the indicators above that you scored “Yes” to.

Step 3: Assess your Sensitivity to the Indicators

The third step of the vulnerability assessment asks the question, “if you are exposed, how important is the potential impact?” This is termed “sensitivity” and is generally assessed by a scale (e.g 1 to 5 or High, Medium, Low). For the purpose of the LGCCS Vulnerability Assessment Toolkit the Sensitivity Questions have been graded as High, Medium, Low.

The table below lists the same indicators as above but provides a column called “Sensitivity Considerations” to help assess how sensitive you are to particular impacts.

No
Indicator Title
Indicator Description
Sensitivity Question
Sensitivity Consideration
Source of information
21Health impacts from increased storm eventsIncreased storms will result increased risk of drowning, injuries and population displacement impacts.If it takes place how bad will it be (internal)?How populated are areas vulnerable to storms events (e.g. flood zones)?

Densely populated = High;
Partially populated = Medium;
Sparsely or not populated = Low
<a href="https://letsrespondtoolkit.org/resources/stakeholder-engagement-tool/&quot; target="_blank">To be determined through consultation with key stakeholders</a>
22Increased heat stressIncreases in average temperatures and extreme events (such as heat waves) are projected to induce heat stress, increase morbidity, and result in respiratory and cardiovascular diseases.If it takes place how bad will it be (internal)?Is there a high percentage of young and elderly in the area?

More than 20% = high;
Between 15% & 20% = Medium;
Less than 15% = low
<a href="https://goo.gl/MM4tK1&quot; target="_blank">LGCCSP Indicator List</a>
23Increased vector borne diseases from spread of mosquitoes, ticks, sandflies, and blackfliesVector borne diseases such as malaria is projected to spread within regions bordering current malaria areas, which are presently too cold for transmission.If it takes place how bad will it be (internal)?Are you in or neighbouring an area with vector borne diseases (e.g. malaria)?

Already in a vector borne disease area = High;
Neighbouring a vector borne disease area = Medium;
Not near a vector borne disease area = Low
<a href="https://letsrespondtoolkit.org/resources/maps/malaria-risk/&quot; target="_blank">Malaria Risk Map for South Africa</a>
24Increased water borne and communicable diseases (e.g. typhoid fever, cholera and hepatitis)Favourable conditions for the incubation and transmission of waterborne diseases may be created by increasing air and water temperatures.If it takes place how bad will it be (internal)?Have you had an incidence of waterborne and communicable diseases (e.g. typhoid fever, cholera and hepatitis) in the past 3 years

Yes = High:
No = Low
<a href="https://letsrespondtoolkit.org/resources/stakeholder-engagement-tool/&quot; target="_blank">To be determined through consultation with key stakeholders</a>
25Increased malnutrition and hunger as a result of food insecurityClimate Change will affect food systems, compromising food availability, access and utilisation, leading to food insecurity (particularly of subsistence farmers).If it takes place how bad will it be (internal)?Child under 5 years severe acute malnutrition case fatality rate

More than 10% = high;
Between 5% & 10% = Medium;
Less than 5% = low
<a href="https://goo.gl/MM4tK1&quot; target="_blank">LGCCSP Indicator List</a>
26Increased air pollutionHealth impacts in resulting from exposure to air pollutants include eye irritation, acute respiratory infection, chronic respiratory diseases and TB, and sometimes death.If it takes place how bad will it be (internal)?Would you consider your area a high priority in terms of air pollution (e.g. SAAQIS Priority Areas)?

Yes = High;
Somewhat = Medium;
No = Low
<a href="https://letsrespondtoolkit.org/resources/maps/air-quality-priority-areas/&quot; target="_blank">LGCCSP Air Quality Priority Areas Map</a>
27Increased Occupational health problemsTemperature is a common climatic factor that affects occupational health (for example, agricultural labourer’s productivity) by causing heat stress and dehydration.If it takes place how bad will it be (internal)?Do a significant percentage of people work outside or are in conditions that cannot be cooled?

Significant = High;
Some = Medium;
Low/No = Low
<a href="https://letsrespondtoolkit.org/resources/stakeholder-engagement-tool/&quot; target="_blank">To be determined through consultation with key stakeholders</a>

Record your answers here and make a note of any of the indicators above that you scored “Medium or High” to.

Step 4: Assess your Adaptive Capacity to the Indicators

The forth step in the vulnerability assessment asks the question: “If there are going to be significant impacts due to climate change, do you have the systems (policy, resources, social capital) to respond to the change?”. The IPCC defines Adaptive Capacity as the “ability of a system to adjust to climate change to moderate potential damages, to take advantage of opportunities, or to cope with the consequences”. For the purpose of the LGCCS Vulnerability Assessment Toolkit the Adaptive Capacity Questions have been graded as High, Medium, Low.

The table below lists the same indicators as above but provides a column called “Adaptive Capacity Question” which is “Do you have high, medium or low adaptive capacity (policy, institutional, social and finance) to respond to the change?”.

No
Indicator Title
Indicator Description
Adaptive Capacity Question
Source of information
21Health impacts from increased storm eventsIncreased storms will result increased risk of drowning, injuries and population displacement impacts.Do you have high, medium or low adaptive capacity to respond to Health impacts from increased storm events?<a href="https://letsrespondtoolkit.org/resources/stakeholder-engagement-tool/&quot; target="_blank">To be determined through consultation with key stakeholders</a>
22Increased heat stressIncreases in average temperatures and extreme events (such as heat waves) are projected to induce heat stress, increase morbidity, and result in respiratory and cardiovascular diseases.Do you have high, medium or low adaptive capacity to respond to Increased heat stress?<a href="https://letsrespondtoolkit.org/resources/stakeholder-engagement-tool/&quot; target="_blank">To be determined through consultation with key stakeholders</a>
23Increased vector borne diseases from spread of mosquitoes, ticks, sandflies, and blackfliesVector borne diseases such as malaria is projected to spread within regions bordering current malaria areas, which are presently too cold for transmission.Do you have high, medium or low adaptive capacity to respond to Increased vector borne diseases from spread of mosquitoes, ticks, sandflies, and blackflies?<a href="https://letsrespondtoolkit.org/resources/stakeholder-engagement-tool/&quot; target="_blank">To be determined through consultation with key stakeholders</a>
24Increased water borne and communicable diseases (e.g. typhoid fever, cholera and hepatitis)Favourable conditions for the incubation and transmission of waterborne diseases may be created by increasing air and water temperatures.Do you have high, medium or low adaptive capacity to respond to Increased water borne and communicable diseases (e.g. typhoid fever, cholera and hepatitis)?<a href="https://letsrespondtoolkit.org/resources/stakeholder-engagement-tool/&quot; target="_blank">To be determined through consultation with key stakeholders</a>
25Increased malnutrition and hunger as a result of food insecurityClimate Change will affect food systems, compromising food availability, access and utilisation, leading to food insecurity (particularly of subsistence farmers).Do you have high, medium or low adaptive capacity to respond to Increased malnutrition and hunger as a result of food insecurity?<a href="https://letsrespondtoolkit.org/resources/stakeholder-engagement-tool/&quot; target="_blank">To be determined through consultation with key stakeholders</a>
26Increased air pollutionHealth impacts in resulting from exposure to air pollutants include eye irritation, acute respiratory infection, chronic respiratory diseases and TB, and sometimes death.Do you have high, medium or low adaptive capacity to respond to Increased air pollution?<a href="https://letsrespondtoolkit.org/resources/stakeholder-engagement-tool/&quot; target="_blank">To be determined through consultation with key stakeholders</a>
27Increased Occupational health problemsTemperature is a common climatic factor that affects occupational health (for example, agricultural labourer’s productivity) by causing heat stress and dehydration.Do you have high, medium or low adaptive capacity to respond to Increased Occupational health problems?<a href="https://letsrespondtoolkit.org/resources/stakeholder-engagement-tool/&quot; target="_blank">To be determined through consultation with key stakeholders</a>

Record your answers here and make a note of any of the indicators above that you scored “Low or Medium” to.

Step 5: Develop Response Plans for Priority Indicators

Once you have completed the exposure, sensitivity and adaptive capacity assessments, short-list the indicators that you have the following answers for:
  • Exposure – Yes
  • Sensitivity – High or Medium
  • Adaptive Capacity – Low or Medium
These short-listed indicators are the indicators that you are most vulnerable to. You will now need to develop a response plan to deal with these vulnerabilities. The LGCCS Vulnerability Assessment Toolkit includes generic responses plan for each sector (here). You can use these templates as a starting point for developing your own sector response plan.

Key Responses to Climate Change in the Human Health Sector

Municipalities are often actively involved in providing health services and child care facilities, however capacity and resources to effectively manage these systems is often limited at the municipal level. Within this context, recommended municipal responses to increased climate change impacts on human health could therefore focus on the following:

Role of Councillors

  • Support and promote the improvement of existing health systems to deal with current and projected impacts on health in the municipality 
  • Spearhead climate change awareness raising linked to health risks. 
  • Ensure climate change health responses are considered during project planning and the IDP Review process 
  • Advocate for budget allocation to climate change program 

Role of Individuals

  • Work together with the municipality to support initiatives that address health risks. 
  • Exercise precaution on very hot or very cold days to minimize impacts. 
  • Avoid lighting uncovered in-door fires emitting excessive smoke. 
  • Refrain from drinking untreated water from any open natural water source. 
  • Opt for nutritious food options and where possible practice all-year-round home gardening. 
  • Exercise and promote disease preventive measure as communicated by the Department of Health 

Role of Municipal Administration

  • Develop and integrate municipal health adaptation strategies and policies addressing nutrition and food security. 
  • Implement the Air Quality Management Act Mandates and develop and implement greenhouse gas emission reduction plans for other sectors (inter alia transport, waste.) 
  • Review and Develop environmental health by-laws to include climate change. 
  • Develop awareness campaigns on the health risks of extreme events (heat waves), and appropriate responses. 
  • Strengthen awareness programme focused on waterborne diseases and outbreaks. 
  • Strengthen existing disease prevention programmes. 
  • Strengthen information and the knowledge of how climate change is linked to disease occurrence through research efforts. 
  • Work with provincial and national government to develop efficient data-capturing systems. 
  • Strengthen awareness programmes on the impacts of indoor burning of traditional fuel sources, and open fires