Implementing a Health in All Policies Approach in Australia

The direct and indirect impacts of climate change on human health in Australia are substantial. For example, during the 2019–20 summer bushfire season, 33 people lost their lives as a direct cause of the fires and thousands were hospitalised due to smoke inhalation (AIHW, 2020). Immediately after the fires, there was an increase in mental health distress with estimations that approximately half of Australian adults felt anxious or worried (AIHW, 2020). In 2021, almost 50,000 Australians were displaced by weather-related disasters (Beggs et al., 2023). There are also climatic drivers that affect people’s health. For example, increasing global average surface temperatures increase air pollution levels, particularly ozone, which can increase the occurrence of heart and lung diseases (Akritidis et al., 2024).

To address these impacts, the Australian Government’s Department of Health and Aged Care (DHAC) has committed to a Health in All Policies (HiAP) approach as part of its National Health and Climate Strategy (the Strategy). Specifically, the Strategy supports ‘whole-of-government action which recognises the relationship between health and climate outcomes’ (DHAC, 2023, p.7). This includes ‘actions to tackle the health impacts of rising heat and air pollution through collaborative action with states and territories’ (DHAC, 2023, p.7).

Assessing the potential health costs and benefits of cross-sectoral climate policies can be achieved through conducting a health impact assessment (HIA) (enHealth, 2017). By holistically examining the potential health impacts of policy options, HIA is a tool that can be used to achieve a HiAP approach.

Despite the strong link between climate change and human health, HIAs are not currently mandated in Australian policymaking processes, and most climate policies in Australia do not adequately address health impacts (Delpa et al., 2021). Where HIAs are conducted, there is often a lack of transparency around the extent to which the results of the HIA process inform and influence decision-making processes.

To support the implementation of a Health in all Policies approach and protect Australians’ health in a changing climate, we recommend:

• Mandating independently conducted health impact assessments in the approval and development of projects or policies that are likely to result in substantial greenhouse gas emissions, either directly or indirectly. This would be separate and in addition to other required impact assessments, such as environmental impact assessments (EIAs).
• Creating a central database to publicly house all completed HIAs to ensure transparency and accountability. The database could be coordinated and funded by DHAC, and maintained in close partnership with State and Territory Governments.