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Document 52023IR3364

Opinion of the European Committee of the Regions on the European Green Deal and Health

COR 2023/03364

OJ C, C/2024/1977, 18.3.2024, ELI: (BG, ES, CS, DA, DE, ET, EL, EN, FR, GA, HR, IT, LV, LT, HU, MT, NL, PL, PT, RO, SK, SL, FI, SV)


European flag

Official Journal
of the European Union


Series C



Opinion of the European Committee of the Regions on the European Green Deal and Health



Juan Manuel MORENO BONILLA (ES/EPP), President of the Regional Government of Andalusia



Introductory comments: impact of climate change and environmental degradation on human health


stresses that there is robust scientific evidence testifying to the effects of changing temperatures and precipitation, and changes to biological diversity and ecosystems, on Europeans’ physical, social, and mental health. This means that there will be increasingly frequent and intense adverse climate events (such as droughts, floods, tropical storms and cyclones), environmental pollution and indirect land use change;


points out that climate change is significantly increasing the pressures on and risks to ecosystems, human health and the economy, both for individuals and for Europe as a whole. Building on the Green Deal, it is essential to address the challenges, seize the opportunities and deliver on the ultimate goal of green transition — a climate-neutral Europe;


points out that the Declaration on Climate Change and Health adopted at the 28th Conference of the Parties to the United Nations Framework Convention on Climate Change held in Dubai (COP28) underlined the importance of addressing the interplay between climate change and health, and includes a commitment to better integrate health considerations into climate policy and climate considerations into health policy;


recognises the urgency of addressing the impact of climate change and environmental degradation on human health, emphasising the crucial role of local and regional authorities in implementing specific measures, especially in less developed and the outermost regions, to reduce the health disparities in the implementation of measures to mitigate or adapt to this impact, and in healthcare access, ensuring resilient healthcare systems and access to drinking water and proper nutrition;


draws attention to forecasts of more days of heatwaves, which are set to become twice as frequent in all European regions and increase dramatically in many of them. This contributes not only to deaths from cardiovascular and respiratory diseases, but also to a sharp rise in common conditions such as heat exhaustion, nausea, dizziness and weakness, which can lead to heat stroke and potential organ failure;


calls for comprehensive strategies to combat the spread of diseases related to climate change, including vector-borne and water-borne illnesses, emphasising the importance of region-specific assessments to develop and organise health systems. These assessments should focus on specific mitigation and adaptation measures for these regions and their populations based on their specific characteristics, and minimise differences in quality of care, particularly in less developed and the outermost regions, to ensure equitable access to healthcare services;


warns that this progressive rise in temperatures may have other damaging effects, such as rising sea levels, groundwater salinisation and outbreaks of or increases in many vector-borne (dengue, Zika virus disease or malaria) and water-borne (vibrio bacteria) diseases, as climate conditions become ideal for them to spread, and the optimal period for their transmission becomes longer. Furthermore, points out that exposure of food to increasingly high temperatures can facilitate the transmission of dietary diseases such as salmonella, cryptosporidiosis and campylobacteriosis;


highlights the numerous direct and indirect effects that extreme weather events — such as heavy rainfall, winds and floods — have on human health. In addition to direct physical injuries and deaths, they lead to the loss of homes, property and communities, with a significant impact on people’s mental health and well-being in the form of post-traumatic stress disorder (PTSD), anxiety and depressive disorders;


considers the changes in rainfall patterns, resulting in longer, more frequent and more intense droughts, especially in southern European regions, particularly worrying. These episodes not only jeopardise water supply and water resource management, limiting access to drinking water (compromising hygiene and increasing the risk of water-borne diseases such as diarrhoea and cholera), but also threaten food and nutrition security due to price hikes or shortages of certain foods, and can have negative spillover effects on the economy and jobs, with a major impact on health;


notes that the progressively rising temperatures and lower rainfall increase the risk of fires, which lead to soil and biodiversity loss, affect human safety and engender economic losses;


points out that deteriorating air quality is the main environmental risk factor, causing more than 300 000 premature deaths per year in Europe due to respiratory and cardiovascular diseases, and a rise in respiratory allergies and associated disorders. Food and nutrition deficiencies caused by the impact of high CO2 levels on the nutritional value of agricultural crops are also cause for concern;


underlines, in connection with the previous point, how climate change is altering the flowering period of many plant species whose pollen is carried by the wind, causing an increase in allergic reactions among the population. This has an adverse effect on human health and impacts public health systems by using up more resources;


underlines the devastating impact that severe climate conditions such as drought and wildfires are having on the agricultural sector across Europe, adding extra strain and pressure on already struggling farmers who are having to deal with rising production costs due to increases in the cost of inputs like fertiliser and water. The impact on their mental health is not to be underestimated;


in this regard, calls on the European Commission to take action to provide concrete help to the regions affected by the severe impact of climate change on agriculture as the Common Agricultural Policy is not able to respond to the great challenges imposed by climate change to alleviate the stress and health risks farmers are currently facing;


warns that the pollution of water reserves — resulting both from more frequent extreme climate events and from the proliferation of toxic algae due to rising water temperatures — threatens to further increase the spread of various diseases transmitted through water, such as diarrhoea, cholera and dysentery;


stresses that soil degradation is causing a worrying fall in ecosystem services and consequent greater pressure on remaining healthy soils, and that it is therefore vital to make progress in the area of sustainable land use in order to ensure food security and safety and to protect people’s health;


points out that the European Environment Agency considers that various forms of environmental pollution are responsible for one in eight deaths per year in the European Union; that 18 % of cardiovascular diseases and 10 % of cancers are related to environmental degradation, and some 238 000 premature deaths per year are due to chronic exposure to harmful particles;


recognises, therefore, the urgent need to continue investing more in scientific research, to ensure the development of digital tools, and to have more public investments in national health systems to be able to address the effects of these threats to human health as well as by adopting and implementing the strategies and regulations set out in the Green Deal, which should involve an increased role of local regional and authorities;


stresses in this regard that it is important to step up cooperation with third countries on health and climate change, particularly EU action in neighbouring African countries, and to promote the work of research centres specialising in monitoring, preventing, diagnosing and investigating a large number of tropical diseases whose incidence is on the rise in Europe;

The European Green Deal as a tool for addressing threats to human health


recognises the importance of the European Green Deal in the face of the challenges arising from the interplay of climate change, pollution and environmental degradation. Acknowledges that the European Green Deal provides a comprehensive and ambitious regulatory framework, which is necessary to achieve a sustainable and climate-neutral Europe, in line with the 2030 Agenda Sustainable Development Goals on human health and environmental protection. A healthy and resilient population will be better able to address challenges and to seize opportunities such as the Green Deal;


points out that proper implementation of the Climate Law in a socially and economically feasible manner is essential to achieve climate neutrality in Europe by 2050 if we are to mitigate the many harmful health effects of rising temperatures;


stresses the need to push forward with the Fit for 55 package aimed at reducing direct CO2 emissions, which will reduce respiratory and cardiovascular diseases and the increase in temperatures and frequent extreme weather events. Therefore welcomes initiatives such as those to decarbonise the construction sector promoted by the REPowerEU Directive; decarbonise heating and cooling as proposed in the Renewable Energy Directive; reduce the global emissions ceiling proposed by the amended Emissions Trading Scheme; introduce a carbon price for certain imports included in the Carbon Border Adjustment Mechanism; and those to harness the full potential of the agricultural and forestry sector under the amended Regulation on the inclusion of greenhouse gas emissions and removals from land use, land use change and forestry;


recognises the importance of adopting measures such as increasing access to reliable public transport, especially in rural areas where many people have no choice but to be dependent on the use of vehicles to get around, and revising the tax exemptions for aviation and maritime fuels introduced with the reform of the Energy Taxation Directive;


underlines the importance, with respect to clean energy, of revising the trans-European transport network (TEN-T) guidelines and creating a common framework to support EU cities in the transition to more sustainable mobility that promotes the use of energy-efficient modes of transport such as public transport and infrastructure for cycling and pedestrians, as well as accessible and affordable electric vehicles (battery electric vehicles, hydrogen-powered, etc.), in order to reduce health problems associated with transport pollution and generate positive health and shared societal effects related to increasing physical activity and reducing inequalities in access to goods and services;


points to the importance of the Green Deal Industrial Plan and the Net-Zero Industry Act in promoting investment in green technology, and of the Circular Economy Action Plan, with the regulatory reforms it promotes in the industrial strategy for a clean and circular economy, such as the regulation on persistent pollutants, which aims to remove organic pollutants and chemicals that bioaccumulate and remain in the long term, resulting in a threat to human health;


expresses great interest in action to reduce emissions from transport by implementing sustainable and smart mobility solutions, with emphasis on alternative fuels; promoting rail and public transport; active mobility; measures to shift freight transport — especially inter-regional freight transport — from road to rail; and revising the regulation on trans-European transport networks;


stresses the importance of promoting sustainable agricultural practices through the Farm to Fork Strategy, which encourages organic farming, which is less dependent on synthetic pesticides and fertilisers and will lead to healthier food with more nutrients that is free of chemical waste;


recognises the importance of the action taken to preserve and protect ecosystems and biodiversity through the Biodiversity Strategy 2030, action taken to protect and restore European ecosystems, and the new EU Forest Strategy with its objective to plant at least 3 billion trees by 2030. To this end, the proposal for a nature restoration regulation promotes healthy forests and wetlands and the rewetting of bog soil that help reduce net greenhouse gas emissions and other threats to human health;


highlights the importance of the measures stemming from the Zero Pollution Action Plan, which aims to create a toxic-free environment in which air, water and soil pollution levels are no longer harmful to health and natural ecosystems, and the chemicals strategy for sustainability, which seeks to protect health and the environment from harmful chemicals;


stresses the importance of studying changes — attributable to climate change — in the flowering periods of plants and sporulation of anemophilic fungi, by analysing and identifying suspended pollen and spores. The aim is to anticipate the emergence of allergic episodes among those who are susceptible and to ensure that they take precautions;


notes the importance of the revision of the Urban Wastewater Treatment Directive, with its ambitious removal of nutrients and protection against microplastics and micro-pollutants, and of the Air Quality Directive, which sets more stringent ceilings and targets for several pollutants; calls for full and binding alignment of the Air Quality Directive with the 2021 WHO guidelines by 2035, so as to protect citizens’ health and to contribute to achieving the zero-pollution objective;


stresses the importance of the proposals for regulations on the production and marketing of plant reproductive material and forest reproductive material, which will result in more pest- and drought-resistant varieties and allow for a more sustainable agri-food production and the preservation of genetic crop diversity;


supports adapting forest management to climate change by managing more forests through strict protection measures, adopting more stringent sustainability criteria for production and forest reproductive material, and taking measures to protect endangered forest genetic resources. At the same time, account needs to be taken of the differences in circumstances and conditions for forest production in the Member States. Recognises the importance of national contingency plans to assess the risks of forest material shortages and their potential impact on human, animal and plant health and on the environment, in order to ensure sufficient supply for the reforestation of areas affected by extreme weather events and disasters;


points out that improving soil health is key to preventing and managing climate disasters, as healthy soil allows carbon storage and provides thriving land ecosystems that are more resilient to droughts, floods, heatwaves and other extreme weather events. It is therefore essential to push forward in the area of protection and sustainable use of soil, in line with the package on sustainable use of resources and the EU Soil Strategy for 2030;


highlights the urgent need for ongoing research into the effects of climate change on health and welcomes the fact that sustainability has become a cross-cutting pillar of all EU policies and notes that research and innovation will provide technological and scientific solutions to environmental challenges. Therefore highlights the Horizon Europe programme, in particular cluster 1 on health, and the importance of the General Environment Action Programme to 2030 (8th EAP), which strengthens the links between environmental, climate and health policy, aligning climate objectives with protecting people’s health and well-being;


considers it important, in all the aforementioned policy areas and regulations, for regulatory frameworks and actions to be effective and efficient, respecting proportionality and subsidiarity and allowing for local and regional trade-offs based on a broader focus on sustainable development. Draws attention, in this context, to its numerous more detailed opinions on the aforementioned areas, such as water treatment, forests, land use, soil health, energy efficiency, mobility, etc.;


emphasises the need to continue investigating the health risks related to climate change. To this end, highlights the Strategy on Adaptation to Climate Change launched in February 2021, the role of the Climate Adaptation Platform Climate-ADAPT as a specialised tool to communicate, monitor, analyse and prevent the effects of climate change, and the creation of the European Climate and Health Observatory on this platform, which serves both citizens and climate legislators;


stresses that the revision of the State aid regime, through the specific guidelines and the recent reform of the General Block Exemption Regulation, contribute to achieving these objectives;

Role of local and regional authorities in implementing the European Green Deal


recognises the key role of local and regional authorities in implementing and developing policies and measures under the European Green Deal, and thus in mitigating the impact of climate change, pollution and environmental degradation on human health. Points, in this regard, to the Committee of the Regions’ Green Deal Going Local campaign, which brought the Green Deal closer to the people and put local and regional authorities at the heart of the strategy for speeding up the green and energy transitions;


acknowledges the connection between climate change and health-related social and environmental factors, and the exacerbation of people’s physical, social and mental health which risks increasing inequalities and social unrest. These challenges must be converted into opportunities for regional and local authorities through a just transition that takes into account the gender perspective and avoids creating inequalities due to certain regions or socioeconomic groups being worse affected; leaving no citizen or region behind;


welcomes the recommendations that the study ‘Healthier environment for healthier lives: impacts of the European Green Deal on Human Health’ (1) issues to political actors at different territorial levels, as in complex policy areas such as climate and health, clearly identifying and dividing up tasks is key to making things as efficient as possible;


stresses that regional and local authorities, as administrations closest to the challenges and needs of the people, are, given their sphere of competence, in a strategic position to adapt and contextualise environment policies at subnational level, and thus guarantee and ensure the health of their inhabitants by adopting regional and local mitigation and adaptation plans that support the implementation of integrated national energy and climate plans for managing sources of urban pollution, such as urban transport, or creating green and blue spaces that preserve natural habitats, especially within urban landscapes;


considers that adopting policies and regulations that promote sustainable mobility (encouraging efficient, safe public transport systems, shifting inter-regional freight transport in particular from road to rail, and promoting cycling and walking, which will reduce air pollution and boost physical activity), energy efficiency in buildings, urban planning concepts such as 15-minute cities, the assessment of the health impacts of public policies, nature conservation and proper waste management will help shift the regional and local productive fabric towards a modern, resource-efficient and competitive economy while promoting good health and preventing ill health, which will contribute to saving on health costs;


considers that, although local and regional authorities are responsible for implementing many of the measures needed to protect the environment and health, there are many obstacles to the effective implementation of these policies: lack of funding, lack of accurate and up-to-date information for decision-making and evaluating processes, and the need to strengthen their institutional and technical capacity;


considers that, in the light of the key role played by regional and local authorities in implementing EU policies, it is necessary to maintain and strengthen the competences, funding and capacity to act of the local and regional level as a whole, to step up the support given to them and to provide them with greater capacity to address the risks to society and the environment arising from climate change, encouraging them to simplify the administrative procedures necessary to implement the measures;


believes it is essential to provide substantial support and technical assistance to regional and local authorities, while promoting coherence between EU-funded projects and local and regional policies to maximise their impacts. Implementing environmental policies and measures requires significant investment in sustainable infrastructure, clean technologies and awareness-raising programmes. Local and regional authorities often face budgetary constraints and depend on external funding. It is essential to ensure that they have equal access to financial resources so that they can fully participate in the transition to a green model;


stresses, to this end, that a commitment to use European cohesion policy financial instruments to implement the Green Deal is essential, as is the possibility that they may be used to support local and regional action under the Deal; highlights, in this regard, the need to step up the level of climate and environmental ambition in the European Regional Development Fund (ERDF), and the key role that the European Social Fund+ should play in the just transition stemming from the Green Deal;


stresses that the health issues linked to climate change call for close cooperation on the implementation of the measures envisaged in the Green Deal between the various levels of government (European, national, regional and local) and the various sectors involved, especially in the field of health, environment, urban planning, energy and transport. The desired approach to combine health and environment quality — which is encompassed within the One Health approach — is not possible without liaising with health institutions, civil society organisations and other stakeholders;


stresses the importance of collaboration between LRAs (local and regional authorities), healthcare institutions, and environmental agencies in developing region-specific adaptation plans. These plans should address the unique challenges faced by all regions, especially the less developed regions, ensuring that health systems are resilient, adaptable, and responsive to the evolving climate-related health threats;


emphasises the importance of LRAs in disseminating public information and promoting awareness across EU communities. Accordingly, it is deemed essential to step up cooperation between local and regional authorities by setting up knowledge-sharing and information platforms to allow local and regional authorities and academic and scientific institutions to work together more closely, thereby providing a robust knowledge base for optimising decision-making and monitoring progress towards achieving health and environment objectives;


points, as an example of good practice, to the Zero Pollution Stakeholder Platform, set up by the Commission in cooperation with the Committee of the Regions, which aims to bring together stakeholders and experts from different policy areas such as health, agriculture, research and innovation, transport, digitalisation and the environment, thereby maximising synergies in decarbonisation and post-COVID-19 recovery;


believes that the proximity of regional and local authorities to European citizens puts them in a key position to achieve greater civic participation in all these initiatives, thereby ensuring a high level of acceptance and engagement. Considers, therefore, that environmental education campaigns and awareness-raising programmes should be a primary task for authorities, especially regional and local authorities.

Brussels, 31 January 2024.

The President of the European Committee of the Regions


(1) Healthier environment for healthier lives.pdf


ISSN 1977-091X (electronic edition)