Many thanks to Dr Rosalie Schultz and Dr Peter Tait  from the Ecology and Environment special interest group of the Public Health Association of Australia, for this interesting take on two of Australia’s current health challenges. 

The looming health catastrophes of diabetes and climate change are competing for our concern. However, in a letter to the Medical Journal of Australia published this week we argue that these health catastrophes are linked. Both are predictable manifestations of 21st century human society.

Ironically we have been warned for decades about these two crises. Today, our daily experiences confirm both popular media and academic research: Australians are getting fatter, and the climate is changing as a result of human activities. As a result, complications of overweight, particularly diabetes, and extreme weather events which may be exacerbated by climate change,  are now in the news daily.

Catastrophes as manifestations of 21st century life

In our letter we point out that it is not useful to argue whether diabetes or climate change is a greater threat to health. In fact they are two manifestations of the modern world and how we live today.

Our everyday lives are surrounded by high energy, low nutrient foods. Even if your house is free of these products, they are on your TV and in every shop and many workplaces. Physical activity is almost entirely optional since most travel is motorised and most of us sit down to work. As a result Australians weigh more each year.

Production of almost everything is mechanised and driven by fossil fuels. Almost every industry is seeking to grow, to increase its throughput, production and profits. And our Prime Minister is urging his colleagues in other countries to prioritise growth, so this is an international phenomenon.

In this setting the catastrophes of diabetes and climate change are entirely predictable. Their co-occurrence is based on their “similar environmental aetiology, based in modern human lifestyles and their driving economic forces” as noted by Professor Gary Egger in Obesity Review in 2008.

Appropriate responses

If we think about controlling these two crises from an individual perspective, we will respond in an individual way. For example, to control diabetes we will encourage people to eat low-fat foods, to walk most days and to take medication as prescribed.  For climate change we will encourage people to turn off the light when they leave a room, to cycle or take public transport and buy a smaller car, and to make a considered choice about their electricity provider.

However, none of these responses are sufficient, nor do they heed the scope of the issues at hand. To effectively deal with the complete causal dimensions of diabetes and climate change will require societal change.

For example, we must move away from a food supply driven by profit. It is likely that we will need to revolutionise much of our food supply so that producers do not depend for their livelihoods on increasing sales and cutting costs. A local food supply based on small-scale production, and reduced food miles would cut to the core of both these crises. Re-designed cities and transport systems that promote walking, cycling and the use of public transport would profoundly increase physical activity and reduce fossil fuel consumpation, while enhancing our social interactions. This would prevent and manage diabetes while reducing our contribution to greenhouse gas emissions and climate change.

To stimulate such a shift in society will require a fundamental change in how we measure progress. We need to radically alter how we define and measure economic success, so that our daily goals are to improve our own and our national life satisfaction rather than our income, our wealth and national GDP.

The forces leading to weight gain and fossil fuel emissions are driven by powerful players who denyd the underlying problems and promoted piecemeal solutions. Blaming overweight people or their parents, like denying climate change, upholds the status quo and diverts attention from the major driver: our economic system, which  puts profit and growth ahead of a reasonable return on investment from providing the necessities of life.

The publication of our letter in the Medical Journal of Australia is starting point for conversations about the linked catastrophes of diabetes and climate change. We invite your contribution.