Introduction by Croakey: The Federal and New South Wales Governments recently announced that each would each contribute $2.5 million (total $5 million) to support healthcare services recover from the floods in Lismore and the Northern Rivers region in NSW.
Grants of up to $150,000 will be available for general practices, allied health (including mental health), dental practices, pharmacies, private specialists, pathology providers, drug and alcohol treatment services and Aboriginal Community Controlled Health Services.
Health and Aged Care Minister Mark Butler said that out of 67 local primary care providers surveyed following the disaster, 58 practices, or close to 9 out of 10, reported some flood damage.
The Royal Australian College of General Practitioners welcomed the news, noting in a statement “that natural disasters, including floods and bushfires, will become not only more frequent but also more intense as climate change intensifies”.
Given the wide-ranging implications of intensifying climate disruption for the health and wellbeing of rural, regional and remote communities, Croakey readers may be interested in two related inquiries.
The Australian Competition & Consumer Commission is seeking contributions to a Regional Mobile Infrastructure Inquiry (deadline of 12 March), examining the provision of regional, rural, remote and peri-urban mobile telecommunications services and investigating the feasibility of providing temporary mobile roaming during natural disasters or other emergencies.
The Senate Select Committee on Australia’s Disaster Resilience is inquiring into preparedness, response and recovery workforce models, as well as alternative models to disaster recovery. It is considering the role of the Australian Defence Force, volunteer groups, not-for-profit organisations and state-based services, and the support required to improve Australia’s resilience and response to natural disasters.
To date, the health sector has made very few submissions to this inquiry, apart from the Department of Health and Aged Care. The Department’s submission says that the National Health and Climate Strategy now under development will consider the role of current preparedness, response and recovery workforce models in building health sector resilience.
The submission also stresses the importance of integrating mental health responses into disaster planning and ensuring “a proactive response to the short, medium and long-term mental health effects following natural disasters”.
The submission also includes a statement that some may contest, given the mismatch between demand and supply of mental healthcare: “People impacted by natural disasters are able to access a range of national, regional and localised mental health supports.”
Meanwhile, Susanne Tegen, Chief Executive of the National Rural Health Alliance, writes below that climate disruption is also affecting the health and wellbeing of communities through its impact on agricultural production and infrastructure.
She urges governments, support agencies and industries “to determine how best to ensure those members of society living in rural and remote Australia, and already struggling with inequitable access to healthcare, are not further disadvantaged by the health impacts of climate change”.
Susanne Tegen writes:
Heavy rain and floods in the eastern regions of Queensland and New South Wales last year, as well as Victoria and Tasmania were some of the worst Australia has seen in recent years – with loss of lives and livelihoods and damage to property, including farming land.
The disasters continued into the new year with floods in Queensland and the Kimberly region in Western Australia destroying crops, livestock and major infrastructure needed to support industries and communities, as well as impeding access to healthcare, and affecting Country and cultural sites.
Taking into account the property damage and impact on primary industry activities, and the increasing frequency and intensity of climate disasters, the National Rural Health Alliance (the Alliance) is deeply concerned about the cumulative financial and social impact of these disasters on rural communities.
The Alliance also acknowledges the economic impact on the nation as a whole, due to its strong reliance on exports and other contributions to the country’s wealth from rural, regional and remote Australia.
People in rural, regional and remote Australia make up 30 percent of the population and contribute two-thirds of Australia’s export earnings, including over $400 billion yearly in resource and agriculture exports (Rural Health in Australia Snapshot 2021). About 45 percent of the nation’s tourism income also comes from these regions (The little book of numbers).
Rural communities have helped keep Australia out of two global financial crises and kept us afloat when most countries experienced major economic downturns, further exacerbated by the COVID-19 pandemic. Metropolitan Australians are the beneficiaries of higher standards of living and wellbeing because of the contribution of rural industries such as agriculture, oil and gas extraction, mining, tourism, services and fishing.
However, the latest statistics on the production of principal agricultural commodities, released recently by the Australian Bureau of Statistics (ABS), have worrying implications for the health and wellbeing of Australians in both rural and urban areas. They indicate that the impact of inclement weather was not only felt among rural industries but also caused ripple effects on the larger Australian population.
Multiplier effect
Climate disasters have a multiplier effect on the challenges already experienced by rural communities, while they continue to be relied on to provide for Australians’ wellbeing.
ABS data shows that 369 million hectares of agricultural land are down five percent from 2020-21. Flooding across areas of New South Wales and Queensland in the latter part of 2021 affected the growth and harvesting of many winter crops. South Australian and Victorian producers experienced destructive hailstorms in January 2022. In addition, flooding across areas of New South Wales and Queensland from November into December 2021 resulted in significant livestock losses.
Given such repercussions, we should also expect serious consequences from recent disastrous floods in the Kimberley region. Already the death toll among livestock is feared to be well into the tens of thousands, according to Western Australia Today. As such, meat production in the region will be severely affected and could be felt across Australia in the months to come.
The Alliance calls on the Federal Government and other levels of government to work with industry for targeted and proactive measures that take rural realities into account, when drawing up policies and implementing strategies to minimise climate impact.
The Alliance believes that climate change is a significant and enduring threat to health and that the risks to wellbeing and livelihoods are greater in rural and remote communities. Our position paper on climate change, Rural health policy in a changing climate: three key issues, released in January 2021, highlights that extreme weather events, food security and vector-borne disease are areas of particular relevance for rural and remote Australia.
Natural disasters like bushfires, floods and storms can result in psychological trauma and this can contribute to the development of mental illness. This is especially true for primary producers, who struggle to make ends meet while grappling with climate-related losses to their crops and livestock.
Farmers and farm workers are considered a high-risk group for mental ill health. They are more likely to face stigma and are often reluctant to receive mental health care, and have less access to mental health services. Data indicates that at least one farmer dies by suicide every 10 days and extreme climate events are a contributing factor to this statistic.
Flooding can also impact health through increased risk of contaminated food and water or infection from vector-borne diseases such as Ross River virus, Barmah Forest virus and dengue.
Food security matters
Rural populations already facing food insecurity will become more precarious as a result of increasing extreme weather events. Australia produces over 90 percent of its own food and is a significant global food provider. Therefore, the effects of climate change on food security will not only be felt within Australia, but well beyond its borders too.
Older Australians and Aboriginal and Torres Strait Islander peoples living in rural communities have greater incidence of chronic disease, comorbidities and poor mental health. They experience greater health challenges due to reduced access to appropriate healthcare services and also face socioeconomic disadvantage including higher rates of unemployment, poverty, welfare dependency, digital exclusion and lower rates of educational attainment compared to urban communities.
The effects of turbulent and unpredictable weather patterns and natural disasters will further exacerbate the health challenges experienced by these groups, and increase health inequalities.
In its position paper, the Alliance highlights several key areas that urgently require rural emphasis, since one approach does not suit all when it comes to healthcare. It also maintains that governments should act immediately to introduce policies and incentives to reduce the nation’s greenhouse gas emissions.
The Alliance is a supporter of the Framework for a national strategy on climate, health and well-being for Australia launched by the Climate and Health Alliance (CAHA). The CAHA Framework also identifies key areas of policy action needed to address climate change impact.
Governments must ensure that the transition to a sustainable economy is managed and planned to support those regions and sectors of the economy most affected by these turbulent weather trends. This should be done through the development of regionally specific transition plans that support the viability and sustainability of communities and businesses.
Priority and support must also be committed to rural research. Solutions to adapt to and mitigate the direct and indirect effects of climate change on health are crucial for the whole of Australia. This includes the impact of extreme weather events, risks to agriculture and food security, and the potential threat of vector-borne diseases.
The Alliance calls on governments to address these implications in their rural health strategies and healthcare planning for prevention and early intervention; primary, secondary and tertiary care; crisis and trauma management; mental health service provision; and healthcare workforce education and training. This planning will also need to incorporate additional direct and indirect costs to healthcare.
Governments and other support agencies, as well as industries, have a social contract to determine how best to ensure those members of society living in rural and remote Australia, and already struggling with inequitable access to health care, are not further disadvantaged by the health impacts of climate change. Funding of appropriate programs will be an important investment for all Australians.
• Susanne Tegen is Chief Executive of the National Rural Health Alliance
See Croakey’s archive of articles on the health of rural, regional and remote communities
