Integrating injury prevention into the planetary health agenda: a vital opportunity

Climate change dominates planetary health discourse. Concerns about rising sea levels and extreme weather events are one part of the conversation; mitigation, adaptation, and climate finance are other important parts.1 A missing dimension, however, is the complex and underappreciated relationship between climate change and injuries and violence—including prevention.2 With the increasing frequency and intensity of climate related disasters, coupled with the growing recognition of the interconnectedness of global health issues, now is a critical time to integrate injury prevention into planetary health discourse.

We urge the integration of injury and violence prevention into health and climate agendas. The 15th World Conference on Injury Prevention and Safety Promotion in New Delhi in September 2024 presents a critical opportunity to pursue this integration agenda. The UN Climate Change Conference in Baku later this year provides a complementary opportunity to foster awareness, inform policy, and strengthen commitments to integration interventions.

Globally, preventable injuries are a leading cause of death and disability, claiming an estimated 4.4 million lives each year. The burden of these injuries, like climate change, is inequitably distributed geographically and economically.3 For well over 10 years, climate change has been recognised as a threat multiplier, first in relation to security, and later to health security and health more generally. It exacerbates existing vulnerabilities—including driving new injury risks. But global health and climate agendas remain largely silent on this critical intersection of climate and injury which, if tackled, could support both agendas.

We propose three illustrative entry points that provide impetus for exploring how action on climate change and injury prevention could be integrated.   First, investment in sustainable transport, particularly electric vehicles, holds promise for cleaner air and greener transport networks.4 These innovations should complement, not replace, safe and accessible walking and cycling infrastructure. Pedestrians and cyclists face a disproportionately high risk of fatalities. Prioritising their safety is critical and will promote more active transport and support environmental aims. Prioritising safety standards when investing in sustainable transport and infrastructure can deliver lasting public health benefits and help prevent injuries.

Second, safety considerations can be integrated into climate adaptation and mitigation measures. Urban green spaces and green roofs, for example, promote local biodiversity and respite from heat related illnesses, but also act as natural buffers against flooding, which helps to prevent deaths by drowning. There is an opportunity to position drowning prevention in the next report of the Intergovernmental Panel on Climate Change for integrated action.5 Low income countries are particularly vulnerable to drowning risks during flooding owing to weak warning, evacuation, and community protection systems.6 Protecting vulnerable communities, who bear the burden of climate related injuries, requires harm reduction strategies such as investing in seawalls, flood warning systems, evacuation plans, and fostering hazard awareness in coastal communities—all of which are crucial for drowning prevention.

Finally, human activity accelerates climate change. This activity is presently a result of the structures and practices of an extractive and exploitative capitalist system of unfettered production, marketing, and consumption. A comprehensive climate change agenda must prioritise research on extractive economies and commercial influences on planetary health and their association with injuries and violence—and how to prevent them. On the opposite side of the coin, the climate agenda must consider degrowth strategies and economies7 and their potential for injuries and violence prevention in the context of climate adaptation and mitigation.

It is becoming clear that the long term externalities of corporate practices and the environmental harms of industries with weak occupational safety and labour protections perpetuate violence and injuries. Gig economies, for example, contribute to climate change and increase the risks of people working in them. The vulnerabilities of gig workers include limited access to injury coverage offered with more permanent employment, pressure to meet quotas that incentivises risky behaviour, and exposure to violence. Conversely, the pursuit of alternative economic models provides further avenues to prevent injuries and protect the planet. Stronger protections are needed along with robust enforcement mechanisms.

Adapting to changing climate and reducing the injury burden is not just a technical exercise, it is a moral imperative and a political challenge. The integration agenda will be served by communities advocating for both the right to participate through inclusive governance and the right to a healthy environment.8 By integrating injury prevention into climate action, we can build a future in which injury and violence are not collateral damage of an exploitative economic system, and health equity, safety, and wellbeing become cornerstones of a healthy planet.