Climate Change,Health, and Communication: A Primer

Climate change is one of the most serious and pervasive challenges facing us today. Our changing climate has implications not only for the ecosystems upon which we depend, but also for human health. Health communication scholars are well-positioned to aid in the mitigation of and response to climate change and its health effects. To help theorists, researchers, and practitioners engage in these efforts, this primer explains relevant issues and vocabulary associated with climate change and its impacts on health. First, this primer provides an overview of climate change, its causes and consequences, and its impacts on health. Then, the primer describes ways to decrease impacts and identifies roles for health communication scholars in efforts to address climate change and its health effects.     

Climate Change,Human Health,and Biomedical Research: Analysis of the National Institutes of Health Research Portfolio

Background: According to a wide variety of analyses and projections, the potential effects of global climate change on human health are large and diverse. The U.S. National Institutes of Health (NIH), through its basic, clinical, and population research portfolio of grants, has been increasing efforts to understand how the complex interrelationships among humans, ecosystems, climate, climate variability, and climate change affect domestic and global health.Objectives: In this commentary we present a systematic review and categorization of the fiscal year (FY) 2008 NIH climate and health research portfolio.Methods: A list of candidate climate and health projects funded from FY 2008 budget appropriations were identified and characterized based on their relevance to climate change and health and based on climate pathway, health impact, study type, and objective.Results: This analysis identified seven FY 2008 projects focused on climate change, 85 climate-related projects, and 706 projects that focused on disease areas associated with climate change but did not study those associations. Of the nearly 53,000 awards that NIH made in 2008, approximately 0.17% focused on or were related to climate.Conclusions: Given the nature and scale of the potential effects of climate change on human health and the degree of uncertainty that we have about these effects, we think that it is helpful for the NIH to engage in open discussions with science and policy communities about government-wide needs and opportunities in climate and health, and about how NIH’s strengths in human health research can contribute to understanding the health implications of global climate change. This internal review has been used to inform more recent initiatives by the NIH in climate and health.     

Implications of global climate change for housing, human settlements and public health

Global climate change has profound implications for human societies. The present---ecologically unsustainable--trajectory of human development fails to provide for the basic needs of a substantial fraction of the global population, while diminishing the prospects for future generations. Human-caused climate change has already begun to affect weather patterns, physical and biological phenomena, and vulnerable human communities. Because the social processes of production and consumption have their own momentum, and because carbon dioxide has a long atmospheric lifetime, further climate change is inevitable over the coming century, even allowing for the adoption of mitigation measures. This situation implies that we should also try to reduce, and where possible to prevent, the adverse effects of climate changes by planned adaptation. Will human settlements be able to provide a healthy living environment and shelter from extreme climate events, such as cyclones and heat waves? In this paper, we review the nexus between human health, climate change, and the planning of housing and human settlements. We conclude that adapting to a rapidly changing global environment will be a major challenge, in the context of increasing population and per capita consumption, without increasing pressures on natural systems. Energy-efficient cities and the creation of opportunities for poor countries will be important elements of people centered, ecologically sustainable, development in the twenty-first century.     

Educating for a healthy, sustainable world: an argument for integrating health promoting schools and sustainable schools

Al Gore's movie An Inconvenient Truth and the British government's Stern Review of the economics of climate change have provided heightened awareness of how humans are over-stretching the Earth's life support systems. The health of human populations and the health of global ecosystems are inextricably linked and the need for fundamental changes in how we live is becoming impossible to ignore. While not the complete answer, education must be a part of imagining and transforming our patterns of living. Learning embedded in educational systems derived from worldviews that replicate unhealthy and unsustainable lifestyles and environments is not a part of the solution but a significant part of the problem. In Australia, two internationally implemented whole-school reform movements, health promoting schools (HPS) and sustainable schools (SS)--seek to provide ways of operationalizing transformative educational processes. Both movements aim to build resilience and optimism, use action-oriented teaching and learning approaches, and have a focus on the future. While these two approaches to educational and social change have much in common, currently there is virtually no conversation between their proponents and advocates. This paper makes a case for HPS and SS to work together--both theoretically and practically--with the ultimate goal being the emergence of schools that are both green and healthy. Such integration would make an important educational contribution to the creation of a healthy, sustainable world.     

Rights, Knowledge, and Governance for Improved Health Equity in Urban Settings

All three of the interacting aspects of daily urban life (physical environment, social conditions, and the added pressure of climate change) that affect health inequities are nested within the concept of urban governance, which has the task of understanding and managing the interactions among these different factors so that all three can be improved together and coherently. Governance is defined as: "the process of collective decision making and processes by which decisions are implemented or not implemented": it is concerned with the distribution, exercise, and consequences of power. Although there appears to be general agreement that the quality of governance is important for development, much less agreement appears to exist on what the concept really implies and how it should be used. Our review of the literature confirmed significant variation in meaning as well as in the practice of urban governance arrangements. The review found that the linkage between governance practices and health equity is under-researched and/or has been neglected. Reconnecting the fields of urban planning, social sciences, and public health are essential "not only for improving local governance, but also for understanding and addressing global political change" for enhanced urban health equity. Social mobilization, empowering governance, and improved knowledge for sustainable and equitable development in urban settings is urgently needed. A set of strategic research questions are suggested.     

Governing for a healthy population: towards an understanding of how decision-making will determine our global health in a changing climate

Enhancing the adaptive capacity of individuals, communities, institutions and nations is pivotal to protecting and improving human health and well-being in the face of systemic social inequity plus dangerous climate change. However, research on the determinants of adaptive capacity in relation to health, particularly concerning the role of governance, is in its infancy. This paper highlights the intersections between global health, climate change and governance. It presents an overview of these key concerns, their relation to each other, and the potential that a greater understanding of governance may present opportunities to strengthen policy and action responses to the health effects of climate change. Important parallels between addressing health inequities and sustainable development practices in the face of global environmental change are also highlighted. We propose that governance can be investigated through two key lenses within the earth system governance theoretical framework; agency and architecture. These two governance concepts can be evaluated using methods of social network research and policy analysis using case studies and is the subject of further research.     

Climate Justice,Humans Rights,and the Case for Reparations

The global community is facing an existential crisis that threatens the web of life on this planet. Climate change, in addition to being a fundamental justice and ethical issue, constitutes a human rights challenge. It is a human rights challenge because it undermines the ability to promote human flourishing and welfare through the implementation of human rights, particularly the right to life and the right to health. It is also a human rights challenge because climate change disproportionately impacts poor and the vulnerable people in both low-income and high-income countries. Those living in many low-income countries are subject to the worst impacts of climate change even though they have contributed negligibly to the problem. Further, low-income countries have the fewest resources and capabilities at present to adapt or cope with the severe, long-lasting impacts of climate change. Building on human rights principles of accountability and redress for human rights violations, this paper responds to this injustice by seeking to make long-neglected societal amends through the implementation of the concept of climate reparations. After discussing the scientific evidence for climate change, its environmental and socioeconomic impacts, and the ethical and human rights justifications for climate reparations, the paper proposes the creation of a new global institutional mechanism, the Global Climate Reparations Fund, which would be linked with the United Nations Human Rights Council, to fund and take action on climate reparations. This paper also identifies which parties are most responsible for the current global climate crisis, both historically and currently, and should therefore fund the largest proportion of climate-related reparations.     

Protecting human health in a changing world: the role of social and economic development

The biological and physical environment of the planet is changing at an unprecedented rate as a result of human activity, and these changes may have an enormous impact on human health. One of the goals of human development is to protect health in the face of rapid environmental change, but we often fail to do this. The aim in this paper is to distinguish between socioeconomic aspects of development that are likely to be protective and those that are likely to increase vulnerability (the capacity for loss resulting from environmental change). Examples include climate change in the Pacific. We conclude that protecting human health in a changing world requires us to take steps to minimize harmful change wherever possible, and at the same time to be prepared for surprises. The goals of mitigation (reducing or preventing change) and adaptation (response to change) are not mutually exclusive. In fact, steps to make populations more resilient in the face of change are often similar to those that are needed to lighten the load on the environment. We need social policies that convert economic growth into human development. Wider application of sustainable development concepts is part of the solution. In particular, there is a need to promote health as an essential asset of poor and vulnerable populations. It is their key to productivity and to surviving shocks; it is also the key to achieving broader development goals such as universal education. For these reasons it is in the interests of all sectors--economic, social and environmental--to play their particular roles in protecting and improving health.     

The built environment, climate change, and health: opportunities for co-benefits

The earth's climate is changing, due largely to greenhouse gas emissions resulting from human activity. These human-generated gases derive in part from aspects of the built environment such as transportation systems and infrastructure, building construction and operation, and land-use planning. Transportation, the largest end-use consumer of energy, affects human health directly through air pollution and subsequent respiratory effects, as well as indirectly through physical activity behavior. Buildings contribute to climate change, influence transportation, and affect health through the materials utilized, decisions about sites, electricity and water usage, and landscape surroundings. Land use, forestry, and agriculture also contribute to climate change and affect health by increasing atmospheric levels of carbon dioxide, shaping the infrastructures for both transportation and buildings, and affecting access to green spaces. Vulnerable populations are disproportionately affected with regard to transportation, buildings, and land use, and are most at risk for experiencing the effects of climate change. Working across sectors to incorporate a health promotion approach in the design and development of built environment components may mitigate climate change, promote adaptation, and improve public health.     

A review of frameworks for developing environmental health indicators for climate change and health

The role climate change may play in altering human health, particularly in the emergence and spread of diseases, is an evolving area of research. It is important to understand this relationship because it will compound the already significant burden of diseases on national economies and public health. Authorities need to be able to assess, anticipate, and monitor human health vulnerability to climate change, in order to plan for, or implement action to avoid these eventualities. Environmental health indicators (EHIs) provide a tool to assess, monitor, and quantify human health vulnerability, to aid in the design and targeting of interventions, and measure the effectiveness of climate change adaptation and mitigation activities. Our aim was to identify the most suitable framework for developing EHIs to measure and monitor the impacts of climate change on human health and inform the development of interventions. Using published literature we reviewed the attributes of 11 frameworks. We identified the Driving force-Pressure-State-Exposure-Effect-Action (DPSEEA) framework as the most suitable one for developing EHIs for climate change and health. We propose the use of EHIs as a valuable tool to assess, quantify, and monitor human health vulnerability, design and target interventions, and measure the effectiveness of climate change adaptation and mitigation activities. In this paper, we lay the groundwork for the future development of EHIs as a multidisciplinary approach to link existing environmental and epidemiological data and networks. Analysis of such data will contribute to an enhanced understanding of the relationship between climate change and human health.     

Climate change, air quality, and human health

Weather and climate play important roles in determining patterns of air quality over multiple scales in time and space, owing to the fact that emissions, transport, dilution, chemical transformation, and eventual deposition of air pollutants all can be influenced by meteorologic variables such as temperature, humidity, wind speed and direction, and mixing height. There is growing recognition that development of optimal control strategies for key pollutants like ozone and fine particles now requires assessment of potential future climate conditions and their influence on the attainment of air quality objectives. In addition, other air contaminants of relevance to human health, including smoke from wildfires and airborne pollens and molds, may be influenced by climate change. In this study, the focus is on the ways in which health-relevant measures of air quality, including ozone, particulate matter, and aeroallergens, may be affected by climate variability and change. The small but growing literature focusing on climate impacts on air quality, how these influences may play out in future decades, and the implications for human health is reviewed. Based on the observed and anticipated impacts, adaptation strategies and research needs are discussed.     

Health and environment in Brazil: development, territory, and social iniquity

The present paper deals with the subject of socio-environmental injustice in Brazil as a consequence of the country's current development model in the context of globalization and from the perspective of social struggle. Over time the realization of the development ideology has introduced profound changes in the country's territory, with severe repercussions for population and ecosystem health that have only recently been included on the social agenda. Efforts to reconcile solutions to the social and environmental crises have converged in the concept of sustainable development, within new discourses in the field of collective health (and whose analysis provides the point of departure for this paper). Territory is explored as a useful tool for analyzing the relationship between health, environment, and development, revealing the paradox between Brazil's great natural and human potential and its poverty, reflecting environmental injustice and disregard for human rights. This expanded concept of territorial organization is important for understanding the context of modernization and the possibility for poor populations to enjoy a better life.     

Managing the ecosystem to improve human health: integrated approaches to safe drinking water

The ecosystem approach to human health is a holistic concept of health for both humans and the environment in which they live. This approach requires a holistic management of all facets of the ecosystem, be they physical, biologic, or indeed human-such as culture, economy, and developmental needs. This paradigm may at first glance seem theoretical and difficult to put into practice in everyday field research. However, using basic human needs, such as water and sanitation, as entry points illustrates how ecosystem health can indeed prove a powerful tool for sustainable development, promoting both human well-being and sustainable ecosystems. The authors describe the efforts of international agencies, particularly the International Development Research Centre (IDRC), to promote household safe drinking water security in developing countries. Essential to the success of these endeavors are strong partnerships with communities, research institutions, and donor agencies. The roles of these players are delineated. An important feature of IDRC projects, which is critical to their success, is the establishment of a simple, community-based water-quality monitoring program that the people can maintain with the limited resources available to them. The process and outcomes of past IDRC projects are presented and ongoing efforts are described.     

The sustainability of functional foods

In times of climate change, growing world populations, and with clear evidence of the depletion or damage to critical resources, it is imperative to take action to sustain and develop the capacity of agricultural and manufacturing systems to continue to provide food, the most basic of human needs. Functional foods, generally defined as foods that provide benefits beyond basic nutrition, represent an important growth category for the commercial sector in many countries around the world. Because of widespread concerns about risks to health, the public is vulnerable to messages about potential health protective advantages of foods formulated in response to emerging nutrition science. This paper argues that it is important to finds ways to evaluate the effects of innovation in this sector. Now more broadly defined, the concept of sustainability provides guidelines for decision-making and a framework for assessing the impact of the development of functional foods as a health protective panacea for diet-related human health problems. However, this paper concludes that when criteria for sustainable practice are applied, there are some strong arguments in support of delaying investment in the development and promotion of functional foods to the general public.     

Farmer health and adaptive capacity in the face of climate change and variability. Part 2: Contexts, personal attributes and behaviors

This study extends the emerging body of research on farmer adaptation to climate change, by segmenting farmers on the basis of specific attributes (health, values, belief about climate change, sense of responsibility for climate change, desire to change, social, human and financial capitals and farmer demographics) and considering such attributes as critical social aspects of the contextualized capacity to adapt. The segmental analysis was based on a nationally representative sample of 3,993 farmers concerned with farmer adaptation of climate risks. The resulting data were subjected to two-step cluster analysis to identify homogenous groups of farmers based on factors related to climate change adaptation. A three-cluster solution was identified wherein farmers were distinguishable on the basis of belief in climate change, desire for financial assistance and advice, social connectedness, information seeking, and adverse farm conditions. The largest group (Cluster 1: 55%) was characterized by farmers who recognized being affected by drought and drying and who were actively engaged in adaptive practices, despite the fact that they had little income and poor farm resources. One third of these farmers reported that their health was a barrier to sustained activity in farming. Cluster 2 (26%) was characterized by farmers not readily affected by drying, who enjoyed good incomes, good health and better farming conditions. They expressed little desire to adapt. The smallest cluster (Cluster 3: 19%) was also characterized by farmers who recognized that they were affected by drying. However, despite a desire to adapt, they had very little means to do so. They reported the poorest natural resources and the poorest health, despite being younger. The findings suggest that it is the intent to adapt, starting from where people are at, which is a more important indicator of the capacity to work towards sustainable practices than assets tests alone.     

Climate change: impacts on and implications for global health

The most severe consequences of climate change will accrue to the poorest people in the poorest countries, despite their own negligible contribution to greenhouse gas emissions. In recent years, global health efforts in those same countries have grown dramatically. However, the emerging scientific consensus about climate change has not yet had much influence on the routine practice and strategies of global health. We review here the anticipated types and global distribution of health impacts of climate change, discuss relevant aspects of current global interventions for health in low-income countries, and consider potential elements of a framework for appropriately and efficiently mainstreaming global climate change-mitigation and -adaptation strategies into the ongoing enterprise of global health. We propose a collaborative learning initiative involving four areas: (1) increased awareness among current global health practitioners of climate change and its potential impacts for the most disadvantaged, (2) strengthening of the evidence base, (3) incorporation now of climate change-mitigation and -adaptation concerns into design of ongoing global health programs, and (4) alignment of current global health program targets and methods with larger frameworks for climate change and sustainable development. The great vulnerability to climate change of populations reached by current global health efforts should prompt all concerned with global health to take a leading role in advocating for climate change mitigation in their own countries.     

Preventing disasters: public health vulnerability reduction as a sustainable adaptation to climate change

Global warming could increase the number and severity of extreme weather events. These events are often known to result in public health disasters, but we can lessen the effects of these disasters. By addressing the factors that cause changes in climate, we can mitigate the effects of climate change. By addressing the factors that make society vulnerable to the effects of climate, we can adapt to climate change. To adapt to climate change, a comprehensive approach to disaster risk reduction has been proposed. By reducing human vulnerability to disasters, we can lessen--and at times even prevent--their impact. Human vulnerability is a complex phenomenon that comprises social, economic, health, and cultural factors. Because public health is uniquely placed at the community level, it has the opportunity to lessen human vulnerability to climate-related disasters. At the national and international level, a supportive policy environment can enable local adaptation to disaster events. The purpose of this article is to introduce the basic concept of disaster risk reduction so that it can be applied to preventing and mitigating the negative effects of climate change and to examine the role of community-focused public health as a means for lessening human vulnerability and, as a result, the overall risk of climate-related disasters.     

Sustainable waste management in the UK: the public health role

This paper discusses waste management in the UK and its relationship with health. It aims to outline the role of health professionals in the promotion of waste management, and argues for a change in their role in waste management regulation to help make the process more sustainable. The most common definition of sustainable development is that by the Brundtland commission, i.e. "development that meets the needs of the present without compromising the ability of future generations to meet their own needs". Managing waste sites in a manner that minimises toxic impacts on the current and future generations is obviously a crucial part of this. Although the management of waste facilities is extremely complex, the Integrated Pollution Prevention and Control regime, which requires the input of public health professionals on the regulation of such sites, means that all waste management installations should now be operating in a fashion that minimises any toxicological risks to human health. However, the impacts upon climate change, resource use and health inequalities, as well as the effects of waste transportation, are currently not considered to be part of public health professionals' responsibilities when dealing with these sites. There is also no requirement for public health professionals to become involved in waste management planning issues. The fact that public health professionals are not involved in any of these issues makes it unlikely that the potential impacts upon health are being considered fully, and even more unlikely that waste management will become more sustainable. This paper aims to show that by only considering direct toxicological impacts, public health professionals are not fully addressing all the health issues and are not contributing towards sustainability. There is a need for a change in the way that health professionals deal with waste management issues.     

Readying health services for climate change: a policy framework for regional development

Climate change presents the biggest threat to human health in the 21st century. However, many public health leaders feel ill equipped to face the challenges of climate change and have been unable to make climate change a priority in service development. I explore how to achieve a regionally responsive whole-of-systems approach to climate change in the key operational areas of a health service: service governance and culture, service delivery, workforce development, asset management, and financing. The relative neglect of implementation science means that policymakers need to be proactive about sourcing and developing models and processes to make health services ready for climate change. Health research funding agencies should urgently prioritize applied, regionally responsive health services research for a future of climate change.     

Global environmental health and sustainable development: the role at Rio+20

The Rio+20 United Nations Conference on Sustainable Development represents a crucial opportunity to place environmental health at the forefront of the sustainable development agenda. Billions of people living in low- and middle-income countries continue to be afflicted by preventable diseases due to modifiable environmental exposures, causing needless suffering and perpetuating a cycle of poverty. Current processes of economic development, while alleviating many social and health problems, are increasingly linked to environmental health threats, ranging from air pollution and physical inactivity to global climate change. Sustainable development practices attempt to reduce environmental impacts and should, in theory, reduce adverse environmental health consequences compared to traditional development. Yet these efforts could also result in unintended harm and impaired economic development if the new "Green Economy" is not carefully assessed for adverse environmental and occupational health impacts. The environmental health community has an essential role to play in underscoring these relationships as international leaders gather to craft sustainable development policies.