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Meyer R, Wright C, Rother HA. Assessment of SADC Countries' National Adaptation Planning Health Impacts Inclusion: A Thorough Review. Ann Glob Health 2024; 90:57. [PMID: 39309760 PMCID: PMC11414460 DOI: 10.5334/aogh.4458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 08/19/2024] [Indexed: 09/25/2024] Open
Abstract
Background: The impacts of climate change are recognised as a key challenge of the 21st century. By 2030, Sub-Saharan Africa is projected to have the globally highest burden of disease due to climate change. Objectives: This study aims to evaluate the strengths and weaknesses of the National Adaptation Plans (NAPs) of the Southern African Development Community (SADC), a sub-region under-represented at a global level, in addressing current and future climate change-related health impacts. It specifically assesses the NAPs of Botswana, Mozambique, Namibia, South Africa, and Zimbabwe. Methods: A thorough review was conducted, analysing articles, government reports, and national communications related to NAPs and climate change health outcomes in the selected countries. Sources were evaluated against pre-defined inclusion and exclusion criteria. Main findings: All five countries prioritised health in their NAPs; however, health departments were excluded from assessments in two of the countries. Although health surveillance and early warning systems were included in the NAPs, there was limited evidence of their integration into broader climate, health, economic, and labour policies. National climate change focal points were identified, but governance and implementation at district and local levels were not well-documented. This review highlighted a need for greater inclusion of Indigenous and locally led knowledge. Common barriers identified included the lack of data with appropriate frequency and scale. Governance and implementation difficulties were also identified in all five countries; these difficulties included both a lack of coordination and a lack of institutional capacity. These challenges, especially a lack of political will to address the compound impacts of altered climate and health on all earth systems, are also found at the regional level. Conclusions: National strategies and implementation programs in SADC countries need to be agile in their ability to scale and adapt, yet they also need to include measurable actions and timeframes. Given the shared climate and health trends and the interconnected socio-economic, environmental, and political landscape, there is significant potential for regional coordination to address cross-border climate change impacts and to optimise resource use.
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Affiliation(s)
- Renate Meyer
- Division of Environmental Health, School of Public Health, University of Cape Town, South Africa
| | - Caradee Wright
- Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Hanna-Andrea Rother
- Division of Environmental Health, School of Public Health, University of Cape Town, South Africa
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2
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Walter TG, Bricknell LK, Preston RG, Crawford EGC. Climate Change Adaptation Methods for Public Health Prevention in Australia: an Integrative Review. Curr Environ Health Rep 2024; 11:71-87. [PMID: 38221599 PMCID: PMC10907446 DOI: 10.1007/s40572-023-00422-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE OF REVIEW Climate change poses a serious threat to human health and well-being. Australia is not immune to the public health impacts and continues to be underprepared, putting the population health at risk. However, there is a dearth in knowledge about how the Australian public health system will address the impacts of climate change. RECENT FINDINGS This integrative review synthesises tools, frameworks, and guidance material suitable for climate change adaptation from a preventive public health perspective. The literature search was conducted in electronic databases MEDLINE, PubMed, CINAHL, and Web of Science. Of 4507 articles identified, 19 articles met the inclusion criteria that focused on operational methods in public health and excluded the clinical context and reactive disaster response approaches. This review revealed that Australia is ill-prepared to manage climate change adverse health impacts due to ineffective adaptation strategies. The review highlights that Australia urgently requires effective adaptation strategies such as undertaking a National Adaptation Plan process and an improved understanding in managing complex health risks. Taking this action will strengthen the public health system and build health resilience especially for vulnerable populations. These findings will help understand and develop of the necessary adaptive strategies in Australia.
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Affiliation(s)
- Tony G Walter
- School of Health, Medical and Applied Sciences, Central Queensland University, 554-700 Yaamba Road, Norman Gardens, 4701, Australia.
| | - Lisa K Bricknell
- School of Health, Medical and Applied Sciences, Central Queensland University, 554-700 Yaamba Road, Norman Gardens, 4701, Australia
| | - Robyn G Preston
- School of Health, Medical and Applied Sciences, Central Queensland University, 538 Flinders Street, Townsville, QLD, 4810, Australia
| | - Elise G C Crawford
- School of Health, Medical and Applied Sciences, Central Queensland University, 554-700 Yaamba Road, Norman Gardens, 4701, Australia
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3
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Paz-Soldán VA, Valcarcel A, Canal-Solis K, Miranda-Chacon Z, Palmeiro-Silva YK, Hartinger SM, Suárez-Linares AG, Falla-Valdez V, Intimayta-Escalante C, Lehoucq M, Pretell A, Castillo-Neyra R. A critical analysis of national plans for climate adaptation for health in South America. LANCET REGIONAL HEALTH. AMERICAS 2023; 26:100604. [PMID: 37876674 PMCID: PMC10593566 DOI: 10.1016/j.lana.2023.100604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/15/2023] [Accepted: 09/15/2023] [Indexed: 10/26/2023]
Abstract
Climate adaptation measures are critical for protecting human health. National Adaptation Plans (NAPs), Nationally Determined Contributions (NDCs), and National Communications (NCs) play a crucial role in helping countries identify, analyze, and address their vulnerabilities to climate change impacts, while also assessing available resources and capacities. This study aimed to assess the comprehensiveness of South American countries' NAPs, NDCs, and NCs in addressing the effects of climate change on health. A total of 38 NAPs, NDCs, and NCs of 12 South American countries were analysed. Ad hoc scores were developed to assess baseline information, adaptation proposals, identification of involved institutions, funding needs and allocation, measurable progress indicators, and coherence. Overall, all South American countries have NDCs and NCs, and seven have NAPs. In most countries, the intersectoral health analysis revealed a lack of linkage to health issues related to that sector. Additionally, most planning documents lack detailed information to guide policymakers in taking practical actions; areas with low scores include allocation of funds, involvement of health-related institutions, and measurable indicators. While South American countries acknowledge the health impacts of climate change in their plans, enhancing public health protection requires maximizing climate policy benefits and including health-related issues across all relevant sectors. Funding This study was not funded. However, three co-authors received funding for some of their time: AV and KC were supported by the Wellcome Trust (209734/Z/17/Z); RCN was funded by K01AI139284 (NIH-NIAID). Funding for the publication was provided by Universidad Peruana Cayetano Heredia.
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Affiliation(s)
- Valerie A. Paz-Soldán
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | | | | | - Zaray Miranda-Chacon
- Anatomy Department, School of Medicine, Universidad de Costa Rica, San José, Costa Rica
| | | | - Stella M. Hartinger
- School of Public Health and Management "Carlos Vidal Layseca", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ana G. Suárez-Linares
- School of Public Health and Management "Carlos Vidal Layseca", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Valeria Falla-Valdez
- School of Public Health and Management "Carlos Vidal Layseca", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Claudio Intimayta-Escalante
- School of Public Health and Management "Carlos Vidal Layseca", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Mariana Lehoucq
- School of Public Health and Management "Carlos Vidal Layseca", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Angelica Pretell
- School of Public Health and Management "Carlos Vidal Layseca", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ricardo Castillo-Neyra
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, PA, USA
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Baldwin JW, Benmarhnia T, Ebi KL, Jay O, Lutsko NJ, Vanos JK. Humidity's Role in Heat-Related Health Outcomes: A Heated Debate. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:55001. [PMID: 37255302 PMCID: PMC10231239 DOI: 10.1289/ehp11807] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 04/01/2023] [Accepted: 04/04/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND As atmospheric greenhouse gas concentrations continue to rise, temperature and humidity will increase further, causing potentially dire increases in human heat stress. On physiological and biophysical grounds, exposure to higher levels of humidity should worsen heat stress by decreasing sweat evaporation. However, population-scale epidemiological studies of heat exposure and response often do not detect associations between high levels of humidity and heat-related mortality or morbidity. These divergent, disciplinary views regarding the role of humidity in heat-related health risks limit confidence in selecting which interventions are effective in reducing health impacts and in projecting future heat-related health risks. OBJECTIVES Via our multidisciplinary perspective we seek to a) reconcile the competing realities concerning the role of humidity in heat-related health impacts and b) help ensure robust projections of heat-related health risks with climate change. These objectives are critical pathways to identify and communicate effective approaches to cope with present and future heat challenges. DISCUSSION We hypothesize six key reasons epidemiological studies have found little impact of humidity on heat-health outcomes: a) At high temperatures, there may be limited influence of humidity on the health conditions that cause most heat-related deaths (i.e., cardiovascular collapse); b) epidemiological data sets have limited spatial extent, a bias toward extratropical (i.e., cooler and less humid), high-income nations, and tend to exist in places where temporal variations in temperature and humidity are positively correlated; c) analyses focus on older, vulnerable populations with sweating, and thus evaporative, impairments that may be further aggravated by dehydration; d) extremely high levels of temperature and humidity (seldom seen in the historical record) are necessary for humidity to substantially impact heat strain of sedentary individuals; e) relationships between temperature and humidity are improperly considered when interpreting epidemiological model results; and f) sub-daily meteorological phenomena, such as rain, occur at high temperatures and humidity, and may bias epidemiological studies based on daily data. Future research must robustly test these hypotheses to advance methods for more accurate incorporation of humidity in estimating heat-related health outcomes under present and projected future climates. https://doi.org/10.1289/EHP11807.
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Affiliation(s)
- Jane W. Baldwin
- Department of Earth System Science, University of California, Irvine, Irvine, California, USA
- Lamont-Doherty Earth Observatory, Palisades, New York, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, San Diego, California, USA
| | - Kristie L. Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, Washington, USA
| | - Ollie Jay
- Thermal Ergonomics Laboratory, Heat and Health Research Incubator, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Nicholas J. Lutsko
- Scripps Institution of Oceanography, University of California, San Diego, San Diego, California, USA
| | - Jennifer K. Vanos
- School of Sustainability, Arizona State University, Tempe, Arizona, USA
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Viveros-Uehara T. Health Care in a Changing Climate: A Review of Climate Change Laws and National Adaptation Plans in Latin America. Health Hum Rights 2021; 23:139-151. [PMID: 34966231 PMCID: PMC8694288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Given that the health-related impacts of climate change in Latin America disproportionately affect the most marginalized sections of the population, there is a need to enhance countries' adaptive capacity through improved health systems. Though public health institutions have delineated guidelines to enhance health care systems' preparedness for climate change, embedding a human rights perspective in their translation into laws and policies further adds important value. Crucially, a rights-based approach strengthens health responses to climate change by calling attention to how climate law and policy fail to account for persistent and interlocking socioeconomic inequalities. This is an area that has not been fully present in the provision of health services in Latin America, which rely almost exclusively on a conventional epidemiological perspective and do not consider the historical and sociocultural nature of health challenges. Hence, this paper draws on two case studies-Brazil and Colombia-to identify the extent to which their national climate change laws and adaptation plans incorporate a human rights-based approach in their tasks to enhance their adaptive capacity through the expansion of affordable and quality health care. With respect to the countries' laws, the absence of explicit references to the right to health exemplifies the fragmentation between the international human rights framework and international climate change law. Further, both countries' adaptation plans hold considerable room for improving their engagement with the human rights framework, particularly by establishing mechanisms to promote transparency, monitoring, and the participation of marginalized groups.
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Affiliation(s)
- Thalia Viveros-Uehara
- PhD student at the School for Global Inclusion and Social Development at the University of Massachusetts Boston, USA.,Please address correspondence to the author.
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Lutchmun W, Ablorde A, Chang HW, Froeschl G, Misganaw E, Sapkota BP, Scholze S, Singo J, Hoffaeller L. Proceedings from the CIH-LMU 2021 Symposium: "Global Health Perspectives: Climate Change & Migration". BMC Proc 2021; 15:21. [PMID: 34645438 PMCID: PMC8515916 DOI: 10.1186/s12919-021-00225-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 11/18/2022] Open
Abstract
Climate change shapes human migration through the interaction of environmental changes with political, social, economic, and demographic drivers of mobility. Low-and middle-income countries bear the brunt of the health impacts of climate change and migration, despite their overall low contribution to greenhouse gas emissions. The CIHLMU Symposium 2021 aimed to explore the complex interconnections between climate change, migration and health from diverse global perspectives. A number of themes, such as the relationship between climate and trade, the role of technology, and the issue of responsibility were tackled. The speakers also highlighted the need for climate resilient health-systems, gender mainstreaming in climate strategies, collaboration between the Global North and South and urgently defining the ‘climate refugee’. It is crucial that the narrative around climate change moves from an environmental framing to encompass human health and migration within climate discussions and strategies.
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Affiliation(s)
- Wandini Lutchmun
- Teaching & Training Unit, Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU, Munich, Germany. .,Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany.
| | - Aikins Ablorde
- Teaching & Training Unit, Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU, Munich, Germany.,Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany
| | - Han-Wen Chang
- Teaching & Training Unit, Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU, Munich, Germany.,Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany
| | - Guenter Froeschl
- Teaching & Training Unit, Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU, Munich, Germany.,Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany
| | - Equlinet Misganaw
- Teaching & Training Unit, Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU, Munich, Germany.,Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany
| | - Bhim Prasad Sapkota
- Teaching & Training Unit, Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU, Munich, Germany.,Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany
| | - Sarah Scholze
- Teaching & Training Unit, Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU, Munich, Germany.,Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany
| | - Josephine Singo
- Teaching & Training Unit, Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU, Munich, Germany.,Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany
| | - Lisa Hoffaeller
- Teaching & Training Unit, Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU, Munich, Germany.,Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany
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7
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Rublee C, Bills C, Theron E, Brysiewicz P, Singh S, Muya I, Smith W, Akpevwe OE, Ali LA, Dauda E, Calvello Hynes E. Outcomes of a Climate Change Workshop at the 2020 African Conference on Emergency Medicine. Afr J Emerg Med 2021; 11:372-377. [PMID: 34367899 PMCID: PMC8326188 DOI: 10.1016/j.afjem.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/15/2021] [Accepted: 05/09/2021] [Indexed: 11/08/2022] Open
Abstract
A changing climate will have demonstrable effects on health and healthcare systems, with specific and disproportionate effects on communities in Africa. Emergency care systems and providers have an opportunity to be at the forefront of efforts to combat the worst health effects from climate change. The 2020 African Conference on Emergency Medicine, under the auspices of the African Federation for Emergency Medicine, convened its first ever workshop on the topic of climate change and human health. Structured as a full day virtual course, the didactic sections were available for both live and asynchronous learning with more than 100 participants enrolled in the course. The workshop introduced the topic of the health effects of climate as they relate to emergency care in Africa and provided a forum to discuss ideas regarding the way forward. Lectures and focused discussions addressed three broad themes related to: health impacts, health care delivery, and advocacy. To our knowledge, this is the first workshop for health professionals to cover topics specific to emergency care, climate change, and health in Africa. The results of this workshop will help to guide future efforts aimed at advancing emergency care approaches in Africa with regard to medical education, research, and policy. African relevance Climate-related extreme weather events are adversely affecting health and health care delivery in African countries. African organisations, cities, and nations have taken positive steps to adapt and build climate resilience. There are opportunities for emergency care professionals and scholars to continue to expand, and lead, climate and health education, research, and policy initiatives on the continent.
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8
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Harper SL, Cunsolo A, Babujee A, Coggins S, De Jongh E, Rusnak T, Wright CJ, Domínguez Aguilar M. Trends and gaps in climate change and health research in North America. ENVIRONMENTAL RESEARCH 2021; 199:111205. [PMID: 33961824 DOI: 10.1016/j.envres.2021.111205] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 04/16/2021] [Accepted: 04/17/2021] [Indexed: 06/12/2023]
Abstract
The Intergovernmental Panel on Climate Change (IPCC) 5th Assessment Report (2014) assessed the state of climate change and health knowledge, globally through the Human Health: Impacts, Adaptation, and Co-Benefits Chapter and regionally through chapters, such as the North America Chapter. With IPCC's 6th Assessment Report scheduled to be released in 2021-22, we asked: how has climate change and health research in North America advanced since the IPCC's 5th Assessment Report in 2014? Specifically, we systematically identified and examined trends in the extent, range, and nature of climate-health research conducted in North America. We used a scoping review methodology to systematically identify literature and map publication trends. A search string was used to search five academic databases. Two independent reviewers first screened titles and abstracts, and then the full texts of articles for relevance. Research articles and reviews using systematic methods published since 2013 were eligible for inclusion, and no language restrictions were applied. To be included, articles had to measure and link climatic variables or hazards to health outcomes in North America. Relevant articles were analysed using descriptive statistics to explore publication trends. The number of climate-health articles has significantly increased since the last IPCC Assessment Report. Published research about climate change impacts, heat-related mortality and morbidity, and respiratory illness taking place in urban centres and in the USA continue to dominate the North American climate-health literature, reflected by the high proportion of articles published. Important research gaps on previously neglected climate-sensitive health outcomes, however, are beginning to be filled, including climate change impacts on mental health, nutrition, and foodborne disease. We also observed progress in research that included future projections of climate-health risks; however, projection research is still relatively nascent and under-studied for many climate-sensitive health outcomes in North America, and would benefit from considering social and demographic variables in models. Important research disparities in geographical coverage were noted, including research gaps in Canada and Mexico, and in rural and remote regions. Overall, these publication trends suggest an improved understanding of exposure-response relationships and future projections of climate-health risks for many climate-sensitive health outcomes in North America, which is promising and provides an evidence-base to inform the IPCC 6th Assessment Report. Despite these advancements and considering the urgent policy and practice implications, more research is needed to deepen our understanding of climate-sensitive health outcomes, as well as examine new arising issues that have limited evidence-bases. In particular, transdisciplinary and cross-sector research, that includes the social sciences, examining current and future climate-health adaptation, mitigation, and the adaptation-mitigation nexus should become a top priority for research, given the urgent need for this evidence to inform climate change policies, actions, and interventions.
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Affiliation(s)
- S L Harper
- School of Public Health, University of Alberta, 11405 87 Ave NW, Edmonton, AB, T6G 1C9, Canada.
| | - A Cunsolo
- School of Arctic & Subarctic Studies, Labrador Institute of Memorial University, 219 Hamilton River Road, PO Box 490, Stn B, Happy Valley-Goose Bay, NL, A0P 1E0, Canada
| | - A Babujee
- School of Public Health, University of Alberta, 11405 87 Ave NW, Edmonton, AB, T6G 1C9, Canada
| | - S Coggins
- School of Public Health, University of Alberta, 11405 87 Ave NW, Edmonton, AB, T6G 1C9, Canada
| | - E De Jongh
- School of Public Health, University of Alberta, 11405 87 Ave NW, Edmonton, AB, T6G 1C9, Canada
| | - T Rusnak
- School of Public Health, University of Alberta, 11405 87 Ave NW, Edmonton, AB, T6G 1C9, Canada
| | - C J Wright
- School of Public Health, University of Alberta, 11405 87 Ave NW, Edmonton, AB, T6G 1C9, Canada
| | - M Domínguez Aguilar
- Unidad de Ciencias Sociales, Universidad Autónoma de Yucatán, Calle 61 X 66 # 525. Col. Centro, Mérida, Yucatán, Mexico
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9
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Aracena S, Barboza M, Zamora V, Salaverry O, Montag D. Health system adaptation to climate change: a Peruvian case study. Health Policy Plan 2021; 36:45-83. [PMID: 33263753 DOI: 10.1093/heapol/czaa072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2020] [Indexed: 11/14/2022] Open
Abstract
Despite mitigation attempts, the trajectory of climate change remains on an accelerated path, with devastating health impacts. As a response to the United Nations Framework Convention on Climate Change call for National Adaptation Plans, Peru has developed a national and decentralized regional adaptation plans. The purpose of this article is to understand the role and priority status of health within the adaptation planning and process. Peru was used as a case study to analyse the policy process in the creation of adaptation plans, encompassing the need to address climate change impacts on health with a particular focus on marginalized people. An actor, content and context policy analyses were conducted to analyse 17 out of 25 regional adaptation plans, which are available. The national adaptation plans (2002, 2015) do not include health as a priority or health adaptation strategies. In a decentralized health care system, regional plans demonstrate an increased improvement of complexity, systematization and structure over time (2009-17). In general, health has not been identified as a priority but as another area of impact. There is no cohesiveness between plans in format, content, planning and execution and only a limited consideration for marginalized populations. In conclusion, the regional departments of Peru stand on unequal footing regarding adapting the health sector to climate change. Findings in the strategies call into question how mitigation and adaption to climate change may be achieved. The lack of local research on health impacts due to climate change and a particular focus on marginalized people creates a policy vacuum. The Peruvian case study resembles global challenges to put health in the centre of national and regional adaptation plans. In-depth cross-country analysis is still missing but urgently needed to learn from other experiences.
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Affiliation(s)
- Stephanie Aracena
- Centre for Global Public Health, Queen Mary University of London, London, UK
| | - Marco Barboza
- Instituto Universitario de Investigación en Estudios Latinoamericanos, Madrid, España.,Centro de Investigaciones Tecnológicas, Biomédicas y Medioambientales - CITBM, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Victor Zamora
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Oswaldo Salaverry
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Doreen Montag
- Centre for Global Public Health, Queen Mary University of London, London, UK
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Green H, Bailey J, Schwarz L, Vanos J, Ebi K, Benmarhnia T. Impact of heat on mortality and morbidity in low and middle income countries: A review of the epidemiological evidence and considerations for future research. ENVIRONMENTAL RESEARCH 2019; 171:80-91. [PMID: 30660921 DOI: 10.1016/j.envres.2019.01.010] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 01/04/2019] [Accepted: 01/04/2019] [Indexed: 05/13/2023]
Abstract
Heat waves and high air temperature are associated with increased morbidity and mortality. However, the majority of research conducted on this topic is focused on high income areas of the world. Although heat waves have the most severe impacts on vulnerable populations, relatively few studies have studied their impacts in low and middle income countries (LMICs). The aim of this paper is to review the existing evidence in the literature on the impact of heat on human health in LMICs. We identified peer-reviewed epidemiologic studies published in English between January 1980 and August 2018 investigating potential associations between high ambient temperature or heat waves and mortality or morbidity. We selected studies according to the following criteria: quantitative studies that used primary and/or secondary data and report effect estimates where ambient temperature or heat waves are the main exposure of interest in relation to human morbidity or mortality within LMICs. Of the total 146 studies selected, eighty-two were conducted in China, nine in other countries of East Asia and the Pacific, twelve in South Asia, ten in Sub-Saharan Africa, eight in the Middle East and North Africa, and seven in each of Latin America and Europe. The majority of studies (92.9%) found positive associations between heat and human morbidity/mortality. Additionally, while outcome variables and study design differed greatly, most utilized a time-series study design and examined overall heath related morbidity/mortality impacts in an entire population, although it is notable that the selected studies generally found that the elderly, women, and individuals within the low socioeconomic brackets were the most vulnerable to the effects of high temperature. By highlighting the existing evidence on the impact of extreme heat on health in LMICs, we hope to determine data needs and help direct future studies in addressing this knowledge gap. The focus on LMICs is justified by the lack of studies and data studying the health burden of higher temperatures in these regions even though LMICs have a lower capacity to adapt to high temperatures and thus an increased risk.
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Affiliation(s)
- Hunter Green
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA
| | - Jennifer Bailey
- Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Lara Schwarz
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Jennifer Vanos
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Kristie Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA; Scripps Institution of Oceanography, University of California, San Diego, CA, USA.
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11
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Sellers S, Ebi KL, Hess J. Climate Change, Human Health, and Social Stability: Addressing Interlinkages. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:45002. [PMID: 30986089 PMCID: PMC6785235 DOI: 10.1289/ehp4534] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 03/18/2019] [Accepted: 03/19/2019] [Indexed: 05/31/2023]
Abstract
BACKGROUND Abundant historical evidence demonstrates how environmental changes can affect social stability and, in turn, human health. A rapidly growing body of literature, largely from political science and economics, is examining the potential for and consequences associated with social instability related to current climate change. However, comparatively little of this research incorporates the effects on human health or the role of health systems in influencing the magnitude and types of instability that could occur. OBJECTIVE The objective of this commentary is to articulate a conceptual framework incorporating health outcomes and health systems into theorized and observed linkages between climate change and social instability, illustrating in particular the health effects of natural resource shortages, infectious disease outbreaks, and migration. DISCUSSION Although increasing evidence exists that climate change, health, and social instability are related, key questions remain about the pathways linking these factors, as well as the magnitude, causality, and directionality of relationships across spatial and temporal scales. Models seeking to explain and predict climate-related social unrest should incorporate the many linkages between climate change, human health, and social instability. Members of the environmental health research community should work closely with those in the political science and economics communities to help deepen understandings of climate-related stressors and shocks that affect instability and worsen health outcomes. https://doi.org/10.1289/EHP4534.
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Affiliation(s)
- Samuel Sellers
- Center for Health and the Global Environment, Schools of Medicine and Public Health, University of Washington Seattle, Washington, USA
- Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, Washington, USA
| | - Kristie L. Ebi
- Center for Health and the Global Environment, Schools of Medicine and Public Health, University of Washington Seattle, Washington, USA
- Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, Washington, USA
| | - Jeremy Hess
- Center for Health and the Global Environment, Schools of Medicine and Public Health, University of Washington Seattle, Washington, USA
- Department of Global Health, Schools of Medicine and Public Health, University of Washington, Seattle, Washington, USA
- Department of Emergency Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, USA
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Katelaris CH, Beggs PJ. Climate change: allergens and allergic diseases. Intern Med J 2018; 48:129-134. [PMID: 29415354 DOI: 10.1111/imj.13699] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 07/14/2017] [Accepted: 08/14/2017] [Indexed: 11/29/2022]
Abstract
Climate change has been described as the biggest global health threat of the 21st century. The atmospheric concentrations of greenhouse gases, such as carbon dioxide, methane and nitrous oxide, have increased significantly since the start of the Industrial Era around 1750, with much of this increase occurring over just the last 50 years or so. This is resulting in warming of the climate system as well as changes in precipitation and weather and climate extremes. These changes in climate are having wide-ranging impacts on the Earth's physical, biological and human systems, including human health. It is these impacts of climate change on human health that are the focus of this paper, particularly the impacts on allergens and allergic diseases. Such impacts are particularly significant in many countries where the prevalence of such diseases is high and/or increasing. There is now compelling evidence that rising air temperatures and carbon dioxide concentrations are, in some plant species, resulting in increased pollen production and allergenicity and advancement and lengthening of the pollen season. Changes in extreme events, such as thunderstorms and tropical cyclones, will also have impacts on allergic diseases, with, for example, the flooding associated with tropical cyclones leading to proliferation of mould growth in damp homes. The article also considers a range of responses to these health threats, including greenhouse gas mitigation, and adaptation strategies, such as enhanced environmental monitoring and health surveillance and adequate planning for the future medical workforce.
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Affiliation(s)
- Constance H Katelaris
- Campbelltown Hospital, Clinical Immunology and Allergy, Sydney, New South Wales, Australia
| | - Paul J Beggs
- Department of Environmental Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales, Australia
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Banwell N, Rutherford S, Mackey B, Chu C. Towards Improved Linkage of Disaster Risk Reduction and Climate Change Adaptation in Health: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E793. [PMID: 29670057 PMCID: PMC5923835 DOI: 10.3390/ijerph15040793] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/05/2018] [Accepted: 04/16/2018] [Indexed: 11/16/2022]
Abstract
Climate change and climate-sensitive disasters significantly impact health. Linking Disaster Risk Reduction (DRR) and Climate Change Adaptation (CCA) is essential for addressing these ever present, complex and increasing risks. Recent calls have been made to build these links in health. However, there is a need to clearly articulate why linking DRR and CCA is important in health. Furthermore, little is known about how DRR and CCA should be linked in health. By extensively examining relevant literature, this review presents the current state of knowledge of linking DRR and CCA in health. This includes the potential for maximising conceptual synergies such as building resilience, and reducing vulnerability and risk. Additionally, technical and operational synergies are identified to link DRR and CCA in health, including: policy, Early Warning Systems, vulnerability and risk assessment, health systems strengthening, infrastructure resilience, disaster preparedness and response, and health impact pathways. Public health actors have a central role in building these links due to their expertise, work functions, and experience in addressing complex health risks. The review concludes with recommendations for future research, including how to better link DRR and CCA in health; and the opportunities, challenges and enablers to build and sustain these links.
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Affiliation(s)
- Nicola Banwell
- Centre for Environment and Population Health, School of Environment, Griffith University, Brisbane 4111, Australia.
| | - Shannon Rutherford
- Centre for Environment and Population Health, School of Medicine, Griffith University, Brisbane 4111, Australia.
| | - Brendan Mackey
- Griffith Climate Change Response Program, Griffith University, Gold Coast City 4222, Australia.
| | - Cordia Chu
- Centre for Environment and Population Health, School of Environment, Griffith University, Brisbane 4111, Australia.
- Centre for Environment and Population Health, School of Medicine, Griffith University, Brisbane 4111, Australia.
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Sellers S, Ebi KL. Climate Change and Health under the Shared Socioeconomic Pathway Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 15:ijerph15010003. [PMID: 29267204 PMCID: PMC5800104 DOI: 10.3390/ijerph15010003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 12/02/2017] [Accepted: 12/18/2017] [Indexed: 01/26/2023]
Abstract
A growing body of literature addresses how climate change is likely to have substantial and generally adverse effects on population health and health systems around the world. These effects are likely to vary within and between countries and, importantly, will vary depending on different socioeconomic development patterns. Transitioning to a more resilient and sustainable world to prepare for and manage the effects of climate change is likely to result in better health outcomes. Sustained fossil fuel development will likely result in continued high burdens of preventable conditions, such as undernutrition, malaria, and diarrheal diseases. Using a new set of socioeconomic development trajectories, the Shared Socioeconomic Pathways (SSPs), along with the World Health Organization’s Operational Framework for Building Climate Resilient Health Systems, we extend existing storylines to illustrate how various aspects of health systems are likely to be affected under each SSP. We also discuss the implications of our findings on how the burden of mortality and the achievement of health-related Sustainable Development Goal targets are likely to vary under different SSPs.
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Affiliation(s)
- Samuel Sellers
- Center for Health and the Global Environment, University of Washington, Seattle, WA 98105, USA.
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA 98105, USA.
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Ramirez B. Support for research towards understanding the population health vulnerabilities to vector-borne diseases: increasing resilience under climate change conditions in Africa. Infect Dis Poverty 2017; 6:164. [PMID: 29228976 PMCID: PMC5725740 DOI: 10.1186/s40249-017-0378-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/23/2017] [Indexed: 11/10/2022] Open
Abstract
Background Diseases transmitted to humans by vectors account for 17% of all infectious diseases and remain significant public health problems. Through the years, great strides have been taken towards combatting vector-borne diseases (VBDs), most notably through large scale and coordinated control programmes, which have contributed to the decline of the global mortality attributed to VBDs. However, with environmental changes, including climate change, the impact on VBDs is anticipated to be significant, in terms of VBD-related hazards, vulnerabilities and exposure. While there is growing awareness on the vulnerability of the African continent to VBDs in the context of climate change, there is still a paucity of research being undertaken in this area, and impeding the formulation of evidence-based health policy change. Main body One way in which the gap in knowledge and evidence can be filled is for donor institutions to support research in this area. The collaboration between the WHO Special Programme for Research and Training in Tropical Diseases (TDR) and the International Centre for Research and Development (IDRC) builds on more than 10 years of partnership in research capacity-building in the field of tropical diseases. From this partnership was born yet another research initiative on VBDs and the impact of climate change in the Sahel and sub-Saharan Africa. This paper lists the projects supported under this research initiative and provides a brief on some of the policy and good practice recommendations emerging from the ongoing implementation of the research projects. Conclusion Data generated from the research initiative are expected to be uptaken by stakeholders (including communities, policy makers, public health practitioners and other relevant partners) to contribute to a better understanding of the impacts of social, environmental and climate change on VBDs(i.e. the nature of the hazard, vulnerabilities, exposure), and improve the ability of African countries to adapt to and reduce the effects of these changes in ways that benefit their most vulnerable populations. Electronic supplementary material The online version of this article (10.1186/s40249-017-0378-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bernadette Ramirez
- Vectors, Environment and Society Unit, Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization (WHO), Geneva, Switzerland.
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Ebi KL, Otmani Del Barrio M. Lessons Learned on Health Adaptation to Climate Variability and Change: Experiences Across Low- and Middle-Income Countries. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:065001. [PMID: 28632491 PMCID: PMC5743455 DOI: 10.1289/ehp405] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 11/07/2016] [Accepted: 11/16/2016] [Indexed: 05/31/2023]
Abstract
BACKGROUND There is limited published evidence of the effectiveness of adaptation in managing the health risks of climate variability and change in low- and middle-income countries. OBJECTIVES To document lessons learned and good practice examples from health adaptation pilot projects in low- and middle-income countries to facilitate assessing and overcoming barriers to implementation and to scaling up. METHODS We evaluated project reports and related materials from the first five years of implementation (2008-2013) of multinational health adaptation projects in Albania, Barbados, Bhutan, China, Fiji, Jordan, Kazakhstan, Kenya, Kyrgyzstan, Philippines, Russian Federation, Tajikistan, and Uzbekistan. We also collected qualitative data through a focus group consultation and 19 key informant interviews. RESULTS Our recommendations include that national health plans, policies, and budget processes need to explicitly incorporate the risks of current and projected climate variability and change. Increasing resilience is likely to be achieved through longer-term, multifaceted, and collaborative approaches, with supporting activities (and funding) for capacity building, communication, and institutionalized monitoring and evaluation. Projects should be encouraged to focus not just on shorter-term outputs to address climate variability, but also on establishing processes to address longer-term climate change challenges. Opportunities for capacity development should be created, identified, and reinforced. CONCLUSIONS Our analyses highlight that, irrespective of resource constraints, ministries of health and other institutions working on climate-related health issues in low- and middle-income countries need to continue to prepare themselves to prevent additional health burdens in the context of a changing climate and socioeconomic development patterns. https://doi.org/10.1289/EHP405.
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Affiliation(s)
- Kristie L Ebi
- Department of Global Health and Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington , Seattle, Washington, USA
| | - Mariam Otmani Del Barrio
- Evidence and Policy on Environmental Health Unit, Department of Public Health, Environmental and Social Determinants of Health, World Health Organization , Geneva, Switzerland
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