A/HRC/41/26 responsibility for collection. 16 Longer walks to get water require greater physical effort and increase the potential for exposure to sexual and gender-based violence. The greater burden of water collection may contribute to psychological distress, and the time spent reduces time for activities such as education and income generation.17 10. Poor air quality caused by emissions from fossil fuel combustion contributes to millions of deaths and health complications each year. Indoor and outdoor air pollution combined cause an estimated 7 million deaths per year. 18 Women are at an especially high risk of disease and death, owing to their higher exposure to indoor air pollution from inefficient and dirty fuels such as wood or dung being used for cooking and heating in homes.19 The lack of viable fuel alternatives contributes to a public health crisis and to climate change. 11. Climate change can also increase the spread of vector-borne diseases that women are particularly vulnerable to.20 Mosquitoes are sensitive to climatic variations, and temperature rises can increase the prevalence of malaria. Combined with harmful gender stereotypes that impose unequal responsibilities on women for care of family and community members, an increased incidence of disease can deprive women of other opportunities. 21 12. The effects of climate change can also affect women’s mental health. When extreme weather events occur, there is generally an increased and disproportionate pressure on women to support their families.22 This can increase risks of poor mental health outcomes 23 including stress-related disorders and depression. 24 Exclusion of women from climate action and decision-making can further exacerbate the stress of dealing with climate change. C. Sexual and reproductive health and rights 13. Climate change can limit women’s access to sexual and reproductive health services. For example, climate change-related human mobility can lead to reduced access to these services.25 Extreme weather events, which are increasing in frequency and intensity because of climate change, can destroy essential infrastructure and otherwise contribute to a decrease in the quality, availability and accessibility of sexual and reproductive health services. 26 Such contexts may also exacerbate pre-existing forms of gender-based discrimination, creating additional barriers.27 A lack of access to contraceptive services can lead to unplanned pregnancies; and when safe abortion services are denied, women may resort to unsafe and potentially life-threatening methods to terminate their pregnancies, 16 17 18 19 20 21 22 23 24 25 26 27 Gender and Climate Change: A Closer Look at Existing Evidence. Ibid. World Health Organization (WHO), “7 million premature deaths annually linked to air pollution”, available at www.who.int/mediacentre/news/releases/2014/air-pollution/en/. WHO, “Household air pollution and health” available at www.who.int/news-room/fact-sheets/detail/household-air-pollution-and-health. Public Health Institute, and Center for Climate Change and Health, “Special focus: climate change and pregnant women” (2016), available at http://climatehealthconnect.org/wp-content/uploads/2016/ 09/PregnantWomen.pdf. UN WomenWatch, “Women, gender equality and climate change” (fact sheet, 2009), available at www.un.org/womenwatch/feature/climate_change/downloads/Women_and_Climate_Change_Factsh eet.pdf. WHO, “Gender and disaster”, available at www.searo.who.int/entity/gender/topics/disaster_women/ en/. F.H. Norris, M.J. Friedman and P.J. Watson, “60,000 disaster victims speak: part II: summary and implications of the disaster mental health research”, Psychiatry: Interpersonal and Biological Processes (2002), p. 247. Gender and Climate Change: A Closer Look at Existing Evidence. Cecilia Sorensen et al., “Climate change and women’s health: impacts and policy directions”, available at https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002603#sec003. WHO, “Integrating sexual and reproductive health into health emergency and disaster risk management”, available from www.who.int/reproductivehealth/publications/emergencies/rhr-1232/en/. United Nations Population Fund, State of World Population: Shelter from the Storm (2015). 5