Objective: To examine country engagement with the health impacts of climate change in (1) annual statements in the UN General Debate (UNGD); and (2) the Nationally Determined Contributions (NDCs) of the Paris Agreement; and to identify what factors drive country engagement.
Methods: First, we measure engagement by the total references to the health and climate change relationship in each text, using a keyword-in-context search with relevant search terms. Second, we use machine learning models, specifically random forest models, to identify the most important country-level predictors of engagement. Our predictors are political and economic factors, health outcomes, climate change-related variables, and membership of political negotiating groups in the UN.
Findings: For both UNGD statements and NDCs, we find that that low- and middle-income countries discuss the health impacts of climate change much more than high-income countries. We find that the most important predictors of country engagement are related health outcomes (infant mortality rates, maternal death risk, life expectancy), countries’ income levels (GDP per capita), and fossil fuel consumption. Membership of political negotiating groups (e.g. G77 and SIDS) is less important predictors.
Conclusion: Our analysis indicates a North-South division in engagement, and hence there is little to suggest that a health framing of climate change overcomes existing geopolitical divisions in climate change negotiations. Countries who carry the heaviest health burdens but lack necessary resources to address the impacts of climate change are shouldering responsibility for reminding the global community of the implications of climate change for people’s health.