Last updated June 25, 2020 at 11:23 am
Death certificates need to be updated to reflect the relationship between our health and the environment, such as bushfire smoke or hot weather.

Rising temperatures are one of the major risks to health in Australia. Credit: Chayathorn Lertpanyaroj/Shutterstock
Why This Matters: Climate change is a killer.
Heat-related deaths have been “substantially underreported” on Australia’s national records, according to experts from The Australian National University (ANU).
Researchers say the amount of deaths attributed to excessive natural heat is at least 50 times more than recorded on death certificates.
Analysis published in The Lancet Planetary Health shows over the past 11 years 340 deaths in Australia were recorded as being due to excessive heat but statistical analysis found 36,765 deaths could have been attributed to heat.
Environmental factors aren’t acknowledged on death certificates
“Climate change is a killer, but we don’t acknowledge it on death certificates,” co-author Dr Arnagretta Hunter, from the ANU Medical School, says.
“There is second component on a death certificate which allows for pre-existing conditions and other factors.
“If you have an asthma attack and die during heavy smoke exposure from bushfires, the death certificate should include that information.
Also: Bushfire smoke is choking the east coast and it’s more dangerous than a dust storm
“We can make a diagnosis of disease like coronavirus, but we are less literate in environmental determinants like hot weather or bushfire smoke.”
Globally, climate change is the greatest health threat
The new analysis suggests Australia’s national heat-related mortality rate is around two per cent.
“Climate change is the single greatest health threat that we face globally even after we recover from coronavirus,” Hunter says.
“In Australia heat is the most dominant risk posed from climate change.”
Also: Heatwave deaths likely to rise steadily
“We are successfully tracking deaths from coronavirus, but we also need healthcare workers and systems to acknowledge the relationship between our health and our environment.
The researchers say death certification needs to be modernised to reflect the impact of large-scale environmental events.
“We know the summer bushfires were a consequence of extraordinary heat and drought and people who died during the bushfires were not just those fighting fires – many Australians had early deaths due to smoke exposure,” Hunter says.