The Bahamas is an archipelago formed of over 700 islands in the Atlantic Ocean; less than 30 of these islands are occupied by people (1). The climate of The Bahamas is tropical marine, with hurricanes often affecting the nation (2). Five per cent of the world’s coral and the world’s third largest barrier reef are located in The Bahamas. These natural wonders are a key draw for tourists, resulting in an economy highly reliant on tourism; the service industry (mostly comprising tourism) constitutes around 90% of the economy. The islands of The Bahamas are largely flat, with approximately 80% of the land being less than 1.5 m above sea level. Furthermore, the majority of the population live along the coast (1). Poverty rates vary across The Bahamas, with regional disparities in the proportion of people living below the poverty line (3).
The Bahamas’ reliance on tourism, low-lying land, and high concentration of coastal inhabitants makes it particularly vulnerable to climate change. Climate-related risks of particular concern include sea level rise, extreme weather events (especially tropical storms), rising temperatures, and changing precipitation patterns. These represent significant threats to human health; notably, forced displacement from sea level rise; saltwater intrusion of groundwater aquifers; loss of livelihoods; spread of infectious diseases; and death and injury from extreme weather events.
The contribution of The Bahamas to global greenhouse gas emissions is negligible (0.01%), yet it is already feeling the impacts of climate change. Tropical storms, such as Hurricane Dorian in 2019, can leave devastation in their paths. Despite its minimal contribution to global greenhouse gas emissions, The Bahamas still commits in its Nationally Determined Contribution (NDC) to reducing its 2030 emissions by 30% compared with its business-as-usual trajectory. Adaptation is absolutely essential in The Bahamas. Protection of its marine environment is highlighted in the NDC as a key means of adaptation, in providing natural protection to the islands. The Bahamas NDC also outlines potential adaptation actions specifically to protect health and wellbeing: educating health personnel and the public about the links between climate change and health, and ensuring that national emergency measures account for climate-related health risks (such as heat stress and vector-borne diseases) (4).
Country-specific projections are outlined up to the year 2100 for climate hazards under a ‘business as usual’ high emissions scenario compared to projections under a ‘two-degree’ scenario with rapidly decreasing global emissions (see Figures 1–5). The climate model projections given below present climate hazards under a high emissions scenario, Representative Concentration Pathway 8.5 (RCP8.5 – in orange) and a low emissions scenario (RCP2.6 – in green). 1 1Model projections are from CMIP5 for RCP8.5 (high emissions) and RCP2.6 (low emissions). Model anomalies are added to the historical mean and smoothed.
The text describes the projected changes averaged across about 20 global climate models (thick line). The figures 2 2Analysis by the Climatic Research Unit, University of East Anglia, 2018. also show each model individually as well as the 90% model range (shaded) as a measure of uncertainty and the annual and smoothed observed record (in blue).3 3Observed historical record of mean temperature is from CRU-TSv3.26 and total precipitation is from GPCC. Observed historical records of extremes are from JRA55 for temperature and from GPCC-FDD for precipitation. In the following text the present-day baseline refers to the 30-year average for 1981–2010 and the end-of-century refers to the 30-year average for 2071–2100.
Modelling uncertainties associated with the relatively coarse spatial scale of the models compared with that of small island States are not explicitly represented. There are also issues associated with the availability and representativeness of observed data for such locations.
Under a high emissions scenario, the mean annual temperature is projected to rise by about 3°C on average by the end of the century (i.e. 2071–2100 compared with 1981-2010). If emissions decrease rapidly, the temperature rise is limited to about 0.9°C.
Total annual precipitation is projected to decrease by about 5% on average under a high emissions scenario, although the uncertainty range is large (-17% to +8%). If emissions decrease rapidly, there is little projected change on average: an increase of 4% with an uncertainty range of -4% to +13%.
The percentage of hot days 4 4A ‘hot day’ (‘hot night’) is a day when maximum (minimum) temperature exceeds the 90th percentile threshold for that time of the year. is projected to increase substantially from about 15% of all observed days on average in 1981–2010 (10% in 1961–1990). Under a high emissions scenario, almost 100% of days on average are defined as ‘hot’ by the end of the century. If emissions decrease rapidly, about 70% of days on average are ‘hot’. Note that the models overestimate the observed increase in hot days (about 25% of days on average in 1981–2010 rather than 15%). Similar increases are seen in hot nights (not shown).
Under a high emissions scenario, the proportion of total annual rainfall from very wet days5 5The proportion (%) of annual rainfall totals that falls during very wet days, defined as days that are at least as wet as the historically 5% wettest of all days (about 25% for 1981–2010) could increase a little by the end of the century (to about 30% on average with an uncertainty range of about 15% to 40%), with similar change if emissions decrease rapidly. These projected changes are accompanied by little or no change in total annual rainfall (see Figure 2).
The Standardized Precipitation Index (SPI) is a widely used drought index which expresses rainfall deficits/excesses over timescales ranging from 1 to 36 months (here 12 months, i.e. SPI12). It shows how at the same time extremely dry and extremely wet conditions, relative to the average local conditions, change in frequency and/or intensity.
SPI12 values show little projected change from about 0.2 on average, though year-to-year variability remains large. A few models indicate larger decreases (more frequent/intense dry/ drought events), particularly under a high emissions scenario, or increases (more frequent/ intense wet events), particularly if emissions decrease rapidly.6 6SPI is unitless but can be used to categorize different severities of drought (wet): above +2.0 extremely wet; +2.0 to +1.5 severely wet; +1.5 to +1.0 moderately wet; +1.0 to +0.5 slightly wet; +0.5 to -0.5 near normal conditions; -0.5 to -1.0 slight drought; -1.0 to -1.5 moderate drought; -1.5 to -2.0 severe drought; below -2.0 extreme drought.
Information and understanding about tropical cyclones (including hurricanes and typhoons) from observations, theory and climate models have improved in the past few years (6–13). Despite this, robust projections for specific ocean basins or for changes in storm tracks are difficult to make. It is anticipated that the total number of tropical cyclones may decrease towards the end of the century. However, it is likely that human-induced warming will make cyclones more intense.
Case Study
Hurricane Dorian, the strongest hurricane in modern Bahamian history, devastated the north-western Bahamas when it struck on 1 September 2019. More than 76 000 residents were affected and 10 000 people evacuated these islands. This created an unprecedented need for mental health and psychosocial support (MHPSS). Shortly after Hurricane Dorian passed, staff from the Sandilands Rehabilitation Centre, Public Hospitals Authority, the Bahamas Psychological Association, and a number of NGOs and INGOs were dispatched to the islands and different tent shelters to provide MHPSS. More than 3000 children and 3000 adults received MHPSS either face to face and/or by the telepsychology method. Helplines were also established immediately after the hurricane and more than 500 calls were received, between March 2020 and September 2020, from five islands and also Bahamians in universities outside the country.
It is anticipated that there will be a continuation of MHPSS services, as there may be an increased need given the traumatic experiences, uncertainty, effects of ongoing isolation, and economic situation resulting from both Hurricane Dorian and COVID-19 (case study provided by the Ministry of Health).
Sea level rise is one of the most significant threats to low-lying areas on small islands and atolls. Research indicates that rates of global mean sea level rise are almost certainly accelerating as a result of climate change.
The average change in Caribbean sea level over the period 1993–2010 (17) is projected at 1.7 mm/year (± 1.3), with substantial spatial variability across the region. A further 0.5–0.6m rise is expected in the Caribbean by the end of the century (18) with variation amongst models and emissions scenarios.
The relatively long response times to global warming mean that sea level will continue to rise for a considerable time after any reduction in emissions.
Potential impacts of sea level rise include:
Some of the world’s most virulent infections are also highly sensitive to climate: temperature, precipitation and humidity have a strong influence on the life-cycles of the vectors and the infectious agents they carry and influence the transmission of water- and foodborne diseases (19,20).
Small island developing States (SIDS) are vulnerable to disease outbreaks. Climate change could affect the seasonality of such outbreaks, as well as the transmission of vector-borne diseases. Figure 6 presents modelled estimates for The Bahamas of the potential risk of dengue fever transmission under high and low emission scenarios.7 7A suite of mathematical models was systematically developed, then applied and interpreted by a team of researchers at Umeå University (Sweden) to assess the potential for mosquito-borne disease outbreaks (e.g. dengue, chikungunya, Zika and malaria) in terms of climate-dependent VC. The baseline year is 2015, Climatic Research Unit CRU-TSv4.01. Future projections are represented for two emissions futures (Representative Concentration Pathways: RCP2.6, RCP8.5), five climate change projections (Global Climate Models: gfdlesm2m, hadgem2-es, ipsl-cm5a-lr, mirocesm- chem, noresm1-m). (2018) Umeå University, Sweden. The seasonality and prevalence of dengue transmission may change with future climate change, but The Bahamas is consistently highly suitable for dengue transmission under all scenarios and thus vulnerable to outbreaks (21–24).8 8Given the climate dependence of transmission cycles of many vector-borne diseases, seasonality of epidemic risk is common; however, many SIDS, due to tropical latitudes, tend to have less seasonality than more temperate areas., 9 9The actual occurrences/severity of epidemics would be quite different for each disease in each setting and could depend greatly on vector- and host-related transmission dynamics, prevention, surveillance and response capacities that are not captured in this model.
Small island developing States (SIDS) face distinct challenges that render them particularly vulnerable to the impacts of climate change on food and nutrition security including: small, and widely dispersed, land masses and populations; large rural populations; fragile natural environments and lack of arable land; high vulnerability to climate change, external economic shocks, and natural disasters; high dependence on food imports; dependence on a limited number of economic sectors; and distance from global markets. The majority of SIDS also face a ‘triple-burden’ of malnutrition whereby undernutrition, micronutrient deficiencies and overweight and obesity exist simultaneously within a population, alongside increasing rates of diet-related NCDs.
Climate change is likely to exacerbate the triple-burden of malnutrition and the metabolic and lifestyle risk factors for diet-related NCDs. It is expected to reduce short- and long-term food and nutrition security both directly, through its effects on agriculture and fisheries, and indirectly, by contributing to underlying risk factors such as water insecurity, dependency on imported foods, urbanization and migration, and health service disruption. These impacts represent a significant health risk for SIDS, with their particular susceptibility to climate change impacts and already over-burdened health systems, and this risk is distributed unevenly, with some population groups experiencing greater vulnerability.
The following section measures progress in the health sector in responding to climate threats based on country reported data collected in the 2021 WHO Health and Climate Change Country Survey (35).
| Question | questioncategory | question | Answer |
|---|---|---|---|
| Has a national health and climate change strategy or plan been developed ? | NO | ||
| Are the health co-benefits of climate change mitigation action considered in the strategy/plan? | N/A | ||
| Level of implementation of the strategy/plan? | N/A | ||
| Portion of estimated costs to implement the strategy/plan covered in the health budget | N/A | ||
| Are health adaptation priorities identified in the strategy/plan? | N/A |
Is there an agreement in place between the ministry of health and this sector which defines specific roles and responsibilities in relation to links between health and climate change policy?
| Question | questioncategory | question | Answer |
|---|---|---|---|
| Is there an agreement in place between the ministry of health and this sector which defines specific roles and responsibilities in relation to links between health and climate change policy? | Transportation | NO | |
| Is there an agreement in place between the ministry of health and this sector which defines specific roles and responsibilities in relation to links between health and climate change policy? | Electricity generation | NO | |
| Is there an agreement in place between the ministry of health and this sector which defines specific roles and responsibilities in relation to links between health and climate change policy? | Household energy | NO | |
| Is there an agreement in place between the ministry of health and this sector which defines specific roles and responsibilities in relation to links between health and climate change policy? | Agriculture | NO | |
| Is there an agreement in place between the ministry of health and this sector which defines specific roles and responsibilities in relation to links between health and climate change policy? | Social services | NO | |
| Is there an agreement in place between the ministry of health and this sector which defines specific roles and responsibilities in relation to links between health and climate change policy? | Water, Sanitation & Waste-water management | NO |
| Question | questioncategory | question | Answer |
|---|---|---|---|
| Has an assessment of health vulnerability and impacts of climate change been conducted at a national level? | NO | ||
| → Level of influence of the assessment findings on policy prioritization to address the health risks of climate change | N/A | ||
| → Level of influence of the assessment findings on human and financial resource allocation to address the health risks of climate change | N/A |
| Climate-sensitive diseases and health outcomes | qid | Health surveillance system is in place (a) | Health surveillance system includes meteorological information (b) |
|---|---|---|---|
| Thermal stress (e.g. heat waves) | 22111 | NO | NO |
| Vector-borne diseases | 22121 | YES | NO |
| Foodborne diseases | 22131 | YES | NO |
| Waterborne diseases | 22141 | YES | NO |
| Nutrition (e.g. malnutrition associated with extreme-climatic events) | 22151 | NO | |
| Injuries (e.g. physical injuries or drowning in extreme weather events) | 22161 | NO | NO |
| Mental health and well-being | 22171 | YES | NO |
| Airborne and respiratory diseases | 22181 | YES |
| Climate hazard | qid | Health early warning system (HEWS) in place? | Health sector response plan in place? | Health sector response plan includes meteorological information? |
|---|---|---|---|---|
| Heat waves | 23111 | NO | NO | NO |
| Storms (e.g. hurricanes, monsoons, typhoons) | 23131 | YES | YES | YES |
| Flooding | 23141 | YES | YES | YES |
| Drought | 23161 | NO | NO | NO |
| Air quality (e.g. particulate matter, ozone levels) | 23171 |
| Question | questioncategory | question | Answer |
|---|---|---|---|
| Is there a national curriculum developed to train health personnel on the health impacts of climate change? | NO | ||
| Does your human resource capacity as measured through the International Health Regulations Monitoring Framework (IHR) adequately consider the human resource requirements to respond to climate-related events? | NO |
| Question | questioncategory | question | Answer |
|---|---|---|---|
| Has there been a national assessment of the climate resilience of health infrastructure and technology? | |||
| Have measures been taken to increase the climate resilience of health infrastructure and technology? | |||
| Is there a national initiative/programme in place to promote the use of low-carbon, energy-efficient, sustainable technologies in the health sector? |
| Question | questioncategory | question | Answer |
|---|---|---|---|
| Is your government currently accessing international funds to support climate change and health work? | YES |
Greatest challenges faced in accessing international climate funds
| Question | questioncategory | question | Answer |
|---|---|---|---|
| Greatest challenges faced in accessing international climate funds | Lack of information on the opportunities | ||
| Greatest challenges faced in accessing international climate funds | Lack of country eligibility | YES | |
| Greatest challenges faced in accessing international climate funds | Lack of connection by health actors to climate change processes | ||
| Greatest challenges faced in accessing international climate funds | Lack of capacity to prepare country proposals | ||
| Greatest challenges faced in accessing international climate funds | Lack of success in submitted applications | ||
| Greatest challenges faced in accessing international climate funds | None (no challenges/challenges were minimal) | ||
| Greatest challenges faced in accessing international climate funds | Not applicable | ||
| Greatest challenges faced in accessing international climate funds | Other (please specify) |
Conduct a national assessment of climate change impacts, vulnerability and adaptation for health. Ensure that results of the assessment are used for policy prioritization and the allocation of human and financial resources in the health sector.
A climate change and health strategic action plan would help The Bahamas reduce its vulnerability to climate change. Ensuring that adaptation priorities are specified, health co-benefits from mitigation and adaptation measures are considered, necessary budget requirements are allocated and regular monitoring and review of progress will support its full implementation.
The Bahamas, as a low-lying SIDS, is particularly vulnerable to the impacts of extreme weather events. Establish integrated risk surveillance for health risks, such as heat stress, vector-borne, waterborne and foodborne diseases, which include meteorological information.
Measures can be taken to prevent the potentially devastating impacts of climate change on health service provision, including; conducting hazard assessments, climate-informed planning and costing, strengthening structural safety, contingency planning for essential systems (electricity, heating, cooling, ventilation, water supply, sanitation services, waste management and communications). A commitment towards low-emission, sustainable practices to improve system stability, promote a healing environment and to mitigate climate change impacts can also be taken.
The lack of country eligibility has been identified as a barrier to accessing international funding. Additional funding would help to further the implementation of policies and to expand risk surveillance and early warning systems.
WHO/HEP/ECH/CCH/21.01.03
© World Health Organization and the United Nations Framework Convention on Climate Change, 2021
Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence
All reasonable precautions have been taken by WHO and UNFCCC to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO and UNFCCC be liable for damages arising from its use.
Most estimates and projections provided in this document have been derived using standard categories and methods to enhance their cross-national comparability. As a result, they should not be regarded as the nationally endorsed statistics of Member States which may have been derived using alternative methodologies. Published official national statistics, if presented, are cited and included in the reference list.
Design by Inís Communication from a concept by N. Duncan Mills
Photos: Mr. Virgil Johnson, of the Media Unit of the Ministry of Health, The Bahamas
