Commonalities between Disaster and Climate Change Risks for Health: A Theoretical Framework

Climate Change Adaptation Methods for Public Health Prevention in Australia: an Integrative Review

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.

Health Problems of Increasing Man-Made and Climate-Related Disasters on Forcibly Displaced populations: A Scoping Review on Global Evidence

Forcibly displaced populations are among the most vulnerable groups in disasters. They experience poorer health conditions compared with nondisplaced individuals. However, a clear picture is lacking regarding the overall health problems encountered by disaster-induced mid- to long-term displaced people. This study investigated these disorders prevalence and identified their correlates among long-settled displaced populations worldwide. The current scoping review follows the PRISMA-ScR guidelines; a systematic search was conducted on PubMed, Web of Science, and CINAHL and included original peer-reviewed studies, commentary, reviews, and grey literature published in English between January 1990 to June 2022. In the thematic and content analysis, the authors applied the narrative review approach to identify themes and sub-themes. Forty-eight documents were identified as fully relevant to this study. The largest number of published papers were from Asia, followed by the Middle East, the United States, and Europe. IDPs in developed countries were the most researched populations. Human-made disasters were addressed by 89% of the included studies. The four main thematic categories included were "physical health," "mental health," "inadequate facilities," and "lack of healthy behaviour." The worsening of noncommunicable diseases had the highest prevalence, followed by communicable diseases. Due to their condition, forcibly displaced migrants face a triple burden of communicable diseases and noncommunicable diseases such as mental health issues. Health-related research and policy need to consider the links among disasters, health problems, and forced migration as a determinant of health in the new era of climate change-driven displacements.

The Impact of Temperature on 24-Hour Movement Behaviors among Chinese Freshmen Students

BACKGROUND

Human populations worldwide have experienced substantial climate change issues. Gaps in scientific literature remain regarding the relationship between temperature and 24-hour movement behavior among people. The purpose of this study is to examine the impact of temperature on 24-hour movement behavior including physical activity (PA), sedentary behavior (SB) and sleep duration among university students living in Beijing, China.

METHODS

We conducted follow-up health surveys on 44,693 freshmen students enrolled at Tsinghua University from 2012 to 2018. PA and SB were measured by using the short version of the International Physical Activity Questionnaire (IPAQ-s); sleep duration was estimated by using The Pittsburgh Sleep Quality Index (CPSQI). Corresponding temperature data measured by the Beijing Meteorological Service were collected to include average daily temperature from the nearest weather station to Tsinghua university. The data were analyzed using linear individual fixed-effect regressions.

RESULTS

An increase in temperature (temperature range 2.29-28.73 °C) by 1 °C was associated with an increase in 0.66 weekly minutes of vigorous physical activity (VPA) (95% confidence interval [CI] = 0.49, 0.82), an increase in 0.56 weekly minutes of moderate physical activity (MPA)(95% CI = 0.32, 0.79), an increase in 1.21 weekly minutes of moderate to vigorous physical activity (MVPA) (95% CI = 0.90, 1.53), an increase in 0.55 weekly minutes of walking (95% CI = 0.31, 0.78), an increase in 1.76 weekly minutes of total PA (95% CI = 1.35, 2.17), and a reduction in 1.60 weekly minutes of sleeping (95% CI = -2.09, -1.11). There was no significant correlation between temperature and sedentary behavior among participants.

CONCLUSIONS

Temperature was significantly positively correlated with physical activity levels in the Chinese freshmen students, and significantly negatively correlated with sleep duration. Replication of this study is warranted among various populations within China. The evidence of this novel study focused on understanding the relationship between climate change and 24-hour movement behaviors among people for developing effective adaptation strategies to climate change to improve people's health behavior. This study has important implications for future study, as knowledge of the impact of temperature on movement behavior may help in the interpretation of their results and translate into improving people's health behavior.

Does climate change transform military medicine and defense medical support?

Background

Climate change has effects on multiple aspects of human life, such as access to food and water, expansion of endemic diseases as well as an increase of natural disasters and related diseases. The objective of this review is to summarize the current knowledge on climate change effects on military occupational health, military healthcare in a deployed setting, and defense medical logistics.

Methods

Online databases and registers were searched on August 22^nd, 2022 and 348 papers retrieved, published between 2000 and 2022, from which we selected 8 publications that described climate effects on military health. Papers were clustered according to a modified theoretical framework for climate change effects on health, and relevant items from each paper were summarized.

Results

During the last decades a growing body of climate change related publications was identified, which report that climate change has a significant impact on human physiology, mental health, water- and vector borne infectious diseases, as well as air pollution. However, regarding the specific climate effects on military health the level of evidence is low. The effects on defense medical logistics include vulnerabilities in the cold supply chain, in medical devices functioning, in need for air conditioning, and in fresh water supply.

Conclusions

Climate change may transform both the theoretical framework and practical implementations in military medicine and military healthcare systems. There are significant knowledge gaps on climate change effects on the health of military personnel in operations of both combat and non-combat nature, alerting the need for prevention and mitigation of climate-related health issues. Further research within the fields of disaster and military medicine is needed to explore this novel field. As climate effects on humans and the medical supply chain may degrade military capability, significant investments in military medical research and development are needed.

Loss of participation among evacuees aged 20-37 years in the disaster cohort study after the Great East Japan Earthquake

The present study aimed to clarify the characteristics of young evacuees who had missed the Comprehensive Health Check of the Fukushima Health Management Survey (FHMS) after the Great East Japan Earthquake in 2011. The FHMS has been conducted as a prospective cohort study to evaluate the health status of evacuees annually after the great earthquake in 2011. This study focused on the annual participation rate in the Comprehensive Health Check of evacuees aged between 20 and 37 years in 2011 who evacuated due to the Fukushima Daiichi Nuclear Power Plant accident. The characteristics of subjects who did not participate after the second survey year were identified with a multivariate logistic regression model. The participation rate was estimated at 26.6% (9720 among 36,502 residents) and 15.6% (5691 residents) in 2011 and 2012, respectively. The logistic regression model revealed the following characteristics at baseline as independent predictors of non-participation after the second year of the survey: age ≤ 24 years (adjusted odds ratio 2.11, 95% CI 1.84-2.42), 25-29 years of age (1.28, 1.13-1.45), men (1.52, 1.38-1.69), evacuation outside the municipality but within Fukushima prefecture (1.54, 1.40-1.70), evacuation outside the Fukushima prefecture (1.40, 1.21-1.63), anemia (1.23, 1.06-1.43), smoking habit (1.34, 1.21-1.48), and drinking habit (1.20, 1.09-1.32). A medical history of heart disease showed opposite odds ratios, which indicate the association with continuous participation (0.43, 0.26-0.72, respectively). We observed deteriorated participation in the prospective study of the Comprehensive Health Check of the FHMS among evacuees of a younger age group, men, those evacuated outside their municipalities, and those with history of anemia, smoking and drinking habits. Hence, the cohort study may have missed certain population groups with worse health behaviors. Thus, it is necessary to consider various measures to increase the participation rate in the disaster cohort study to understand the long-term health effects of disasters on younger residents in evacuation zones.

Changes in the proportion of anemia among young women after the Great East Japan Earthquake: the Fukushima health management survey

This study aimed to evaluate the sequential changes in the proportion of anemia among young women over eight years after the Great East Japan Earthquake in 2011 using a prospective study of the Fukushima Health Management Survey. This study focused on the women aged between 20 and 44 who lived in the evacuation area of the nuclear power plant accident. The yearly age-adjusted proportion of anemia was accessed with data between July 2011 and March 2019. A total of 9,198 women participated in the health checkup in 2011, albeit the participation was decreased to 1,241 in 2018. The age-adjusted proportion of anemia was 16.7% in 2012 and then declined after 2013 (p with Cochran-Armitage trend test = 0.03). The multivariate regression analysis identified < 23 kg/m² of body mass index (BMI), no history of smoking, and no habitual alcohol use as independent baseline characteristics predictive of temporality anemic condition after the disaster (Adjusted odds ratios [95% confidence interval]; 1.98 [1.43-2.74], 1.85 [1.21-2.83], and 1.42 [1.07-1.90], respectively). Thus, women with low BMI and healthier habits might risk temporarily anemic status after the disaster. Our findings signal the importance of preventing anemia in young women after the disaster.

Climate change and emergency care in Africa: A scoping review

Introduction

Climate change is a global public health emergency with implications for access to care and emergency care service disruptions. The African continent is particularly vulnerable to climate-related extreme weather events due to an already overburdened health system, lack of early warning signs, poverty, inadequate infrastructure, and variable adaptive capacity. Emergency care services are not only utilized during these events but also threatened by these hazards. Considering that the effects of climate change are expected to increase in intensity and prevalence, it is increasingly important for emergency care to prepare to respond to the changes in presentation and demand. The aim of this study was to perform a scoping review of the available literature on the relationship between climate change and emergency care on the African continent.

Methods

A scoping review was completed using five databases: Pubmed, Web of Science, GreenFILE, Africa Wide Information, and Google Scholar. A 'grey' literature search was done to identify key reports and references from included articles. Two independent reviewers screened articles and a third reviewer decided conflicts. A total of 1,382 individual articles were initially screened with 17 meeting full text review. A total of six articles were included in the final analysis. Data from four countries were represented including Uganda, Ghana, Tanzania, and Nigeria.

Results

Analysis of the six articles yielded three key themes that were identified: climate-related health impacts that contribute to surges in demand and resource utilization, opportunities for health sector engagement, and solutions to improve emergency preparedness. Authors used the outcomes of the review to propose 10 recommendations for decision-makers and leaders.

DXDiscussion

Incorporating these key recommendations at the local and national level could help improve preparedness and adaptation measures in highly vulnerable, populated areas on the African continent.

Assessing Response Readiness to Health Emergencies: A Spatial Evaluation of Health and Socio-Economic Justice in Pakistan

COVID19 pandemic has put the global health emergency response to the test. Providing health and socio-economic justice across communities/regions helps in resilient response. In this study, a Geographic Information Systems-based framework is proposed and demonstrated in the context of public health-related hazards and pandemic response, such as in the face of COVID19. Indicators relevant to health system (HS) and socio-economic conditions (SC) are utilized to compute a response readiness index (RRI). The frequency histograms and the Analysis of Variance approaches are applied to analyze the distribution of response readiness. We further integrate spatial distributional models to explore the geographically-varying patterns of response readiness pinpointing the priority intervention areas in the context of cross-regional health and socio-economic justice. The framework's application is demonstrated using Pakistan's most developed and populous province, namely Punjab (districts scale, n = 36), as a case study. The results show that ~ 45% indicators achieve below-average scores (value < 0.61) including four from HS and five from SC. The findings ascertain maximum districts lack health facilities, hospital beds, and health insurance from HS and more than 50% lack communication means and literacy-rates, which are essential in times of emergencies. Our cross-regional assessment shows a north-south spatial heterogeneity with southern Punjab being the most vulnerable to COVID-like situations. Dera Ghazi Khan and Muzaffargarh are identified as the statistically significant hotspots of response incompetency (95% confidence), which is critical. This study has policy implications in the context of decision-making, resource allocation, and strategy formulation on health emergency response (i.e., COVID19) to improve community health resilience.

Risks to the Health of Russian Population from Floods and Droughts in 2010‒2020: A Scoping Review

Climate change and natural disasters caused by hydrological, meteorological, and climatic causes have a significant and increasing direct and indirect impact on human health, leading to increased mortality and morbidity. Russia is a country that suffers from frequent climatic and weather disasters. This is mainly due to its vast territory, complex geographical and ecological environment, and widely varying climatic conditions. This review provides information on climatological and hydrological extremes in Russia in 2010–2020, floods and droughts, and their impact on the health and well-being of the country’s population. A literature search was conducted using electronic databases Web of Science, Pubmed, Science Direct, Scopus, and e-Library, focusing on peer-reviewed journal articles published in English and in Russian from 2010 to 2021. Four conceptual categories were used: “floods”, “droughts”, “human health”, and “Russia”. It is concluded that while most hazardous weather events cannot be completely avoided, many health impacts can potentially be prevented. The recommended measures include early warning systems and public health preparedness and response measures, building climate resilient health systems and other management structures.

Global climate change, diet, and the complex relationship between human host and microbiome: Towards an integrated picture

Dietary changes can alter the human microbiome with potential detrimental consequences for health. Given that environment, health, and evolution are interconnected, we ask: Could diet-driven microbiome perturbations have consequences that extend beyond their immediate impact on human health? We address this question in the context of the urgent health challenges posed by global climate change. Drawing on recent studies, we propose that not only can diet-driven microbiome changes lead to dysbiosis, they can also shape life-history traits and fuel human evolution. We posit that dietary shifts prompt mismatched microbiome-host genetics configurations that modulate human longevity and reproductive success. These mismatches can also induce a heritable intra-holobiont stress response, which encourages the holobiont to re-establish equilibrium within the changed nutritional environment. Thus, while mismatches between climate change-related genetic and epigenetic configurations within the holobiont increase the risk and severity of diseases, they may also affect life-history traits and facilitate adaptive responses. These propositions form a framework that can help systematize and address climate-related dietary challenges for policy and health interventions.

Scoping Review of Climate Change and Health Research in the Philippines: A Complementary Tool in Research Agenda-Setting

The impacts of climate change on human health have been observed and projected in the Philippines as vector-borne and heat-related diseases have and continue to increase. As a response, the Philippine government has given priority to climate change and health as one of the main research funding topics. To guide in identifying more specific research topics, a scoping review was done to complement the agenda-setting process by mapping out the extent of climate change and health research done in the country. Research articles and grey literature published from 1980 to 2017 were searched from online databases and search engines, and a total of 34 quantitative studies were selected. Fifty-three percent of the health topics studied were about mosquito-borne diseases, particularly dengue fever. Seventy-nine percent of the studies reported evidence of positive associations between climate factors and health outcomes. Recommended broad research themes for funding were health vulnerability, health adaptation, and co-benefits. Other notable recommendations were the development of open data and reproducible modeling schemes. In conclusion, the scoping review was useful in providing a background for research agenda-setting; however, additional analyses or consultations should be complementary for added depth.

Changing Climatic Factors Favor Dengue Transmission in Lahore, Pakistan

Dengue fever (DF) is a national health problem in Pakistan. It has become endemic in Lahore after its recent reemergence in 2016. This study investigates the impacts of climatic factors (temperature and rainfall) on DF transmission in the district of Lahore through statistical approaches. Initially, the climatic variability was explored using a time series analysis on climatic factors from 1970 to 2012. Furthermore, ordinary and multiple linear regression analyses were used to measure the simulating effect of climatic factors on dengue incidence from 2007 to 2012. The time series analysis revealed significant annual and monthly variability in climatic factors, which shaped a dengue-supporting environment. It also showed a positive temporal relationship between climatic factors and DF. Moreover, the regression analyses revealed a substantial monthly relationship between climatic factors and dengue incidence. The ordinary linear regression of rainfall versus dengue showed monthly R2 = 34.2%, whereas temperature versus dengue presented R2 = 38.0%. The multiple regression analysis showed a monthly significance of R2 = 44.6%. Consequently, our study shows a substantial synergism between dengue and climatic factors in Lahore. The present study could help in unveiling new ways for health prediction modeling of dengue and might be applicable in other subtropical and temperate climates.

Population Health Adaptation Approaches to the Increasing Severity and Frequency of Weather-Related Disasters Resulting From our Changing Climate: A Literature Review and Application to Charleston, South Carolina

PURPOSE OF REVIEW

Recent changes in our planetary climate have and will continue to challenge historical knowledge and risk assumptions for weather-related disasters. While the public health community is rapidly working to develop epidemiological approaches and tools to mitigate and adapt to these weather-related disasters, recent high-profile events have exposed gaps in knowledge and response efforts. Limited work has been done to assess the climate readiness of the local public health and healthcare community as it pertains to local response planning and adaptation measures in the event of a weather-related disaster. The purpose of this paper is to review the existing literature related to climate change, weather-related disasters, and population health approaches to adapt to climate-related changes in weather-related disasters at the local level. We highlight a brief case study to illustrate an example of a local approach to adaptation planning in a coastal community.

RECENT FINDINGS

Few studies have put forth quantitative disaster epidemiology tools to aid public health officials in preparing for and responding to these weather-related disaster events. There is a general lack of understanding within the public health community about the epidemiological tools which are available to assist local communities in their preparation for, response to, and recovery from weather-related disasters. Cities around the nation are already working to assess their vulnerability and resilience to weather-related disasters by including climate change in emergency preparedness plans and developing adaptation strategies, as well as equipping local hospitals, health departments and other critical public health systems with climate information. But more work is needed and public health funding is lagging to support local and state-level efforts in preparing for and adapting to weather-related disasters in the context of a changing climate. Our population health disaster preparedness programs need to be adapted to address the increasing risks to local public health resulting from our changing climate.

Mitigation Policy Acceptance Model: An Analysis of Individual Decision Making Process toward Residential Seismic Strengthening

Mitigation policy is regarded as an effective strategy to achieve the purpose of building health resilience and reducing disaster risk with the current high frequency of environmental event occurrences. To enhance public acceptance of mitigation policy, the issue of decision-making behavior has been a concern of researchers and planners. In the past literature, qualitative measures employed to reveal the behavioral intention of hazard risk mitigation cause restricted outcomes due to the problem of sample representativeness and the fact that quantitative research is restricted to discuss the linear relationship between the two selected variables. The purpose of this article is to attempt to construct a Mitigation Policy Acceptance Model (MPAM) to analyze the behavioral intention of seismic risk mitigation strategies. Based on Dual Processing Theory, affective is conducted as the core variable for constructing two types of thinking processes, and the variables of risk perception, trust and responsibility are selected in MPAM from theories and past research. In this study, the mitigation policy of residential seismic strengthening, adapted in Yongkang District of Tainan, has been conducted as the case study. According to the results, the result of model fit test has confirmed the MPAM framework, and two thinking modes could be associated together when people face a risky decision-making process. The variable of affective is the most effective factor to influence each variable, and a direct effect on intention is also shown in this model. The results could provide suggestions in communication risk strategies for the government.

Towards Improved Linkage of Disaster Risk Reduction and Climate Change Adaptation in Health: A Review

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.