Title: Exploring the evidence gaps related to the priorities of Local Authorities for mitigating the health and health inequality impacts of climate change.
Funder: Department of Health and Social Care

Abstract: Background: Climate change drives unfair and avoidable differences in people’s health and poses a sizable threat to the public’s physical and mental health. The impacts of climate change are wide reaching and include early death as well as increased risks for contracting infectious diseases and developing long-term breathing, heart and mental health related conditions. The threat of climate change in the UK is linked to an increased number of extreme weather events, increased air pollution, food availability and the running of health services such as the NHS. Worryingly, these threats are most likely to impact individuals and communities who are already vulnerable to existing health problems. Local level actions to tackle climate change are critical: Local Authorities (LA) have a direct and indirect influence over climate change emissions through housing and transport, industry, energy, waste and overall planning within communities. Tackling climate change at a local level is vital and has received wide-scale public support in the efforts to ‘build back better’ following the Covid-19 pandemic. Currently, 83% of LA have developed climate action plans with 55% setting ambitious targets to reduce carbon emissions by 2030. These plans have been scored by Climate Emergency UK to outline a standard for what a ‘good’ action plan should look like. The overall aim of this research is to explore the evidence gaps related to the priorities of LA for mitigating the physical and mental health and health inequality impacts of climate change. Design and methods: The study will involve 5 work packages, delivered over 6 months. These include; 1. A review of the evidence of the impacts impacts of climate change on the lived experiences of individuals and communities in relation to health and health inequalities in a UK context to identify evidence gaps related to local authority policy and actions 2. Comparison of councils according to Climate Emergency UK within the highest and lowest scoring climate change plans, in relation to health and unfair health differences and describing examples of good practice 3. An online questionnaire for LA Leads across the UK to identify LA priorities of climate change actions; the things that get in the way of collaborating with the community and how they could be improved; how LA find, share and access evidence from individuals and communities to support the development of their climate action plans; factors which may impact the delivery of the climate action plans. The questionnaire will be repeated 2 times during the project to help get agreement across the LA taking part. 4. Regular meetings with members from local charities and community groups who have been directly or indirectly affected by climate change to guide the research process 5. Bringing together the findings from 1-5 to inform future research questions for NIHR to progress the climate change agenda within local authorities Patient and public involvement: We will engage with members of local charities and community groups from the Lancashire region who have been directly or indirectly affected by climate change in the development, design and delivery of the research process. Dissemination: The main outputs will be a range of research questions and priorities to inform the future funding call for NIHR which aims to progress the climate change agenda within a LA context with a health and inequalities lens and two published research outputs.

Lay abstract: What are the evidence gaps related to the priorities of Local Authorities for mitigating the physical and mental health and health inequality impacts of climate change? Climate change is associated with 25% of the global burden of disease [1, 2]. In the UK, air pollution accounts for 36,000 deaths per annum and poses the largest environmental threat to public health [3, 4]. Additional health risks associated with climate change are attributed to an increased frequency of heat and cold events with younger, older and clinically vulnerable populations at a greater risk of adverse health outcomes [5-7]. Furthermore, in the UK, one in six households are at risk of flooding [8]. Growing evidence demonstrates these climate change related risks have a detrimental impact on physical and mental health outcomes and pose a significant burden to individuals and communities who are already vulnerable to existing health problems and health inequalities [9-13]. Local Authorities (LA) are vital for translating national ambition towards net zero into joint action [14, 15]. Currently 83% of LA have declared a climate emergency, with 55% setting ambitious plans to reach net zero by 2030. The objectives are to; 1. Understand the impacts of climate change on the lived experiences of individuals and communities in relation to health and health inequalities in a UK context (WP1 Month 1-5) 2. Compare Climate Emergency UK “high scoring” and ‘low scoring’ LA’s and identify actions to improve climate action planning in relation to health and inequalities (WP2 Month 1-2) 3. Explore LA prioritisation of climate change actions and decision-making actions and the factors influencing the development and implementation of the climate action plans (WP3 Month 2-5) 4. Engage local and community members in the development evaluation and dissemination process (WP4 Month 1, 3, 5) 5. Synthesise WP1-5 to generate key research outputs. (WP5 Month 6) WP1- Rapid review: A rapid review will gain an overview of the evidence of the impacts of climate change on the lived experiences of individuals and communities in relation to health and health inequalities in a UK context. WP2- LA Climate Action Plan Analysis: Descriptive analysis of the highest and lowest scoring Climate Action Plans in relation health and health inequalities. WP3- Modified Delphi: A two round, Delphi will identify barriers and facilitators towards co-constructing action plans with local communities; explore how LA leads use evidence related to individuals and communities lived experiences of climate change to support the development of their climate action plans; identify areas which LA leads feel could better support the implementation of the climate action plans. WP4- PPI consultation: Individuals with high exposure to, or lived experience of health or health inequalities as a result of climate change will meet at three timepoints during the research process. WP5- Synthesis of findings: Data from WP1-5 will be synthesised to inform the future funding commission for NIHR aiming to progress the climate change agenda within a LA context. Anticipated impact and dissemination: The main outputs will be a range of key research priorities to inform the future funding call for NIHR, including key actions and policies and adaptations that local authorities could adopt to limit climate change, and to mitigate the health and health inequality impacts of climate change and two peer reviewed publications.

Research activity codes: 8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health categories: GENERIC HEALTH RELEVANCE