Four major non-communicable diseases (NCDs) now account for over 60% of the world’s mortality or around 36million deaths per year. This is projected to reach 75% of deaths by 2030 and, in some developing countries, such as the small Pacific Island nations, has already reached 75% of deaths. These diseases (diabetes, cardiovascular disease, cancer and chronic lung disease) often involve long years of disability preceding death. This causes untold personal suffering, family hardship, burgeoning health care costs, and a huge burden on national economies through lost productivity.

It is no accident that the escalating prevalence of these diseases coincides with the 21^st century’s financial, environmental crises. This lecture will provide an overview of current thinking and evidence of the link between diabetes and related NCDs and vectors of climate change (such as mass food production, over-urbanisation, automated work, inactive transport) and the relentless push to expand markets and increase economic growth – and possible solutions.

Effective and accessible health care and education, along with individuals taking responsibility for their health and lifestyle behaviours, are important inputs for optimising NCD health outcomes.  However, we must remain mindful that Ill health is not generated in the health system, but in the way we live, work, play and manage our societies ie the social, physical and policy environment.  There are contemporary and emerging solutions to the prevention and control of diabetes and related NCDs that have co-benefits for the environment.  These include better urban design, promoting active transport and increased consumption of plant-based versus high protein meat diets, and strategies such as the South Australian Governments “Health in All Policies” approach. As health care providers, researchers and public health practitioners, we are failing our patients and our communities if we do not advocate and take action to promote these strategies for creating healthier environments.