This study was conducted on Manoka Island (Littoral Region of Cameroon) with the aim of analyzing climate change vulnerability and local adaptation strategies based on the local community’s perceptions and biophysical evidence. We used household surveys, focus group discussions, field observation, GIS, and remote sensing to collect data on variables of exposure, sensitivity, and adaptive capacity. Historical changes in rainfall and temperature, mangrove cover, and the occurrence of extreme climatic events were used as indicators of exposure. Property losses and income structure were used as indicators of sensitivity, while human, natural, social, financial, and physical assets represented adaptive capacity. 89 households were interviewed in the nine settlements of the island. Results show that Manoka Island is experiencing irregular rainfall patterns (with average annual values deviating from the mean by -1.9 to +1.8 mm) and increasing temperature (with annual values deviating from the mean by -1.2 to +3.12). The dynamics of the coastline between 1975 and 2017 using EPR show average setbacks of more than ±3 m/year, with erosion levels varying depending on the period and location. The number of households perceiving extreme climatic events like seasonal variability, flood, and rain storm was higher. From respondents’ perception, housing and health are the sectors most affected by climate change. The reported high dependence of households on fishing for income, their overall low livelihood diversification, and their poor access to climate information reported by 65% of respondents portray their poor adaptive capacity. Local response initiatives are ineffective and include among others constructing buildings on stilts and using car wheels to counter the advancement of seawater inland. The study concludes that households on Manoka Island are vulnerable to the impacts of climate change. Income diversification, mangrove reforestation, the development of sustainable supply chains for wood fuel, and sustainable fish smoking devices are the main pathways for adaptation planning in this area.
Of the four atoll countries in the world, the Maldives has the lowest average elevation. Therefore, it is likely to be the first country to lose its land when the sea level rises due to climate change. As a countermeasure to sea level rise, the government of the Maldives is constructing an artificial island called Hulhumale by raising an atoll adjacent to the capital city of Male. Other atoll countries may employ the same method to adapt to the anticipated sea level rise. There is a concern that people who are forced to relocate to the artificial island will be affected in various ways. Therefore, the purpose of this study was to identify measures to reduce the potential impacts of migration to artificial islands. This study aimed to identify factors that will work effectively to satisfy migrants from outside the Male region to Hulhumale. At this stage, sea level rise is not a motivating factor for migration to Hulhumale. For the time being, enhancing high-income employment and high-level education in Hulhumale, which are the main motivations for migration, will help sustain voluntary migration. Over the past two decades, rapid economic growth has changed the desire of Maldivians. Hulhumale is attracting people with its new urban environment and employment opportunities. A small-scale questionnaire survey on the satisfaction level of post-migration life was conducted among the residents of Hulhumale and the results showed that those who changed their jobs before and after migration were less satisfied with their migration than those who did not. In Hulhumale, smart cities are being developed and new types of employment are being created. In order to facilitate the smooth migration of residents from remote islands, policies that focus on occupational changes before and after migration are needed, such as public job placement programs that enable migrants to find the same jobs that they had before migration, and job training programs that prepare them for career changes and enable them to adapt smoothly to new jobs. At present, mental health issues among migrants are not a major problem. Strengthening people-to-people networks through the use of information technology (IT) will contribute to smooth migration and resettlement.
BACKGROUND: Hurricanes are the immediate ways that people experience climate impacts in the Caribbean. These events affect socio-ecological systems and lead to major disruptions in the healthcare system, having effects on health outcomes. In September 2017, Puerto Rico (PR) and the United States Virgin Islands (USVI) experienced one of the most catastrophic hurricane seasons in recent history (Hurricane Irma was a Category 5 and Hurricane Mar?¡a was a Category 4 when they hit PR). OBJECTIVE: This study examines environmental stressors experienced by women with gynecologic (GYN) cancers from PR and USVI who received oncologic cancer care in PR, in the aftermath of the hurricanes. METHODS: A descriptive qualitative study design was used to obtain rich information for understanding the context, barriers, knowledge, perspectives, risks, vulnerabilities, and attitudes associated to these hurricanes. We performed focus groups among GYN cancer patients (n = 24) and key-informant interviews (n = 21) among health-care providers and administrators. Interviews were conducted from December 2018-April 2019. RESULTS: Environmental health stressors such as lack of water, heat and uncomfortable temperatures, air pollution (air quality), noise pollution, mosquitos, and rats ranked in the top concerns among cancer patients and key-informants. CONCLUSIONS: These findings are relevant to cancer patients, decision-makers, and health providers facing extreme events and disasters in the Caribbean. Identifying environmental secondary stressors and the most relevant cascading effects is useful for decision-makers so that they may address and mitigate the effects of hurricanes on public health and cancer care.
Dengue fever is a mosquito-borne viral disease caused by the dengue virus of the Flaviviridae family and is responsible for colossal health and economic burden worldwide. This study aimed to investigate the effect of environmental, seasonal, and spatial variations on the spread of dengue fever in Sri Lanka. The study used secondary data of monthly dengue infection and the monthly average of environmental parameters of 26 Sri Lankan regions from January 2015 to December 2019. Besides the descriptive measurements, Kendall’s tau_b, Spearman’s rho, and Kruskal-Wallis H test have been performed as bivariate analyses. The multivariate generalized linear negative binomial regression model was applied to determine the impacts of meteorological factors on dengue transmission. The aggregate negative binomial regression model disclosed that precipitation (odds ratio: 0.97, p < 0.05), humidity (odds ratio: 1.05, p < 0.01), and air pressure (odds ratio: 1.46, p < 0.01) were significantly influenced the spread of dengue fever in Sri Lanka. The bioclimatic zone is the vital factor that substantially affects the dengue infection, and the wet zone (odds ratio: 6.41, p < 0.05) was more at-risk than the dry zone. The climate season significantly influenced dengue fever transmission, and a higher infection rate was found (odds ratio: 1.46, p < 0.01) in the northeast monsoon season. The findings of this study facilitate policymakers to improve the existing dengue control strategies focusing on the meteorological condition in the local as well as global perspectives.
In September of 2017, Hurricane Maria made landfall in Puerto Rico, bringing widespread damage to public systems across the island, which included particularly devastating impacts to local hospitals and medical facilities. Health care organisations operating on the ground played an essential role in hurricane response efforts as they attempted to address the medical needs of vulnerable populations. However, minimal research has discussed how the provision of post-disaster healthcare rested on the knowledge and participation of local communities. This study aims to fill these gaps by exploring the ways in which health care workers relied on their relationships with informal community networks to navigate the post-disaster landscape and provide adequate health services. This study uses post-disaster response data collected in Puerto Rico, which includes interviews with private, non-profit, and university-affiliated health organisations, as well as community health centers and emergent health outreach groups. Findings from this study highlight the critical role informal networks, community outreach, and relationship building play in response work as organisations attempt to overcome the specific complexities and challenges of operating in the post-disaster context. Furthermore, our research illustrates how deficient government support and systematic failings shift the burden of resilience building onto community members and organisations.
BACKGROUND: On September 20, 2017, Hurricane Maria, a devastating Category 5 storm struck the Caribbean Island of Puerto Rico and officially took the lives of 2 975 people although the Harvard University survey in 2018 placed that number much higher at 4 645 [12]. The island’s infrastructure was devastated. Eight months later in May 2020, many vital services including telecommunications, utilities, and health care systems had not yet been repaired. OBJECTIVES: To (1) review the immediate public health problems and the longer-term repercussions of Hurricane Maria; (2) identify pre-existing infrastructural deficiencies, health disparities, and problems in governance that may have increased vulnerability and delayed recovery; and (3) offer proposals for preventive measures to increase resiliency and adequately prepare Puerto Rico for future disasters. METHODS: Data from the CDC and the Puerto Rico’s Health Department were collected and analyzed. Government publications, news articles, scholarly journal entries and previous research were examined. Interviews were conducted with local citizens and public health professionals. The author’s personal experience is referenced. FINDINGS: The Puerto Rican Electric Power Authority (PREPA) and the Puerto Rico Aqueduct and Sewer Authority (PRASA) both had severely weakened infrastructures before the hurricane as a result of a massive financial crisis that had begun in 2006. These pre-existing weaknesses increased vulnerability and made reconstruction more challenging. Approximately 95% of the cell towers in Puerto Rico sustained significant damage during the hurricane and resulted in almost total loss of cell phone communication [3]. Subpar management of relief efforts by both federal agencies and the local government further hindered recovery, resulting in mass emigration of Puerto Ricans. The public health problems of Hurricane Maria continue to plague Puerto Rico’s citizens and will have long-term consequences. CONCLUSION: Lack of resilience in Puerto Rico’s infrastructure and government agencies rendered the island highly vulnerable to the detrimental effects of Hurricane María. Improvements to infrastructures and a transition towards a more sustainable way of life could improve Puerto Rico’s preparation and response to future disasters – natural and human-made.
BACKGROUND: Hurricane Maria, which hit Puerto Rico in 2017, catastrophically impacted infrastructure and severely disrupted medical services. The US Department of Veterans Affairs Caribbean Healthcare System (VA CHCS), which serves approximately 67,000 patients and has most of its facilities on the island of Puerto Rico, was able to successfully maintain operations after the hurricane. As a part of the larger VA system, VA CHCS also has a mission to support “national, state, and local emergency management, public health, safety and homeland security efforts.” The objective of this study is to better understand the ways VA and its facilities meet this mission by exploring how VA CHCS acted as a community resource following Hurricane Maria. METHODS: This study investigated experiences of five employees in critical emergency response positions for VA CHCS, Veterans Integrated Service Networks (VISN) 8, and the Office of Emergency Management. All respondents were interviewed from March to July 2019. Data were collected via semistructured interviews exploring participants’ experiences and knowledge about VA’s activities provided to the community of Puerto Rico following Hurricane Maria. Data were analyzed using thematic and in vivo coding methods. RESULTS: All respondents underscored VA’s primary mission after a disaster was to maintain continuity of care to Veterans, while concomitantly describing the role of VA in supporting community recovery. Three major themes emerged: continuity of operations for the San Juan VA Medical Center (VAMC) and its affiliated outpatient clinics, provision of services as a federal partner, and services provided directly to the Puerto Rican community. DISCUSSION: Recent disasters have revealed that coordinated efforts between multidisciplinary agencies can strengthen communities’ capacity to respond. This case example demonstrates how a VA hospital not only continued serving its patients but, with the support from the greater VA system, also filled a wide variety of requests and resource gaps in the community. Building relationships with local VAMCs can help determine how VA could be incorporated into emergency management strategies. In considering the strengths community partners can bring to bear, a coordinated regional response would benefit from involving VA as a partner during planning.
IMPORTANCE: On September 20, 2017, one of the most destructive hurricanes in US history made landfall in Puerto Rico. Anecdotal reports suggest that many persons with kidney failure left Puerto Rico after Hurricane Maria; however, empirical estimates of migration and health outcomes for this population are scarce. OBJECTIVE: To assess the changes in migration and mortality among patients with kidney failure in need of dialysis treatment in Puerto Rico after Hurricane Maria. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used an interrupted time-series design of 6-month mortality rates and migration of 11 652 patients who received hemodialysis or peritoneal dialysis care in Puerto Rico before Hurricane Maria (before October 1, 2017) and/or during and after Hurricane Maria (on/after October 1, 2017). Data analyses were performed from February 12, 2019, to June 16, 2022.. MAIN OUTCOMES AND MEASURES: Number of unique persons dialyzed in Puerto Rico per quarter; receipt of dialysis treatment outside Puerto Rico per quarter; and 6-month mortality rate per person-quarter for all persons undergoing dialysis. EXPOSURES: Hurricane Maria. RESULTS: The entire study sample comprised 11 652 unique persons (mean [SD] age, 59 [14.7] years; 7157 [61.6%] men and 4465 [38.4%] women; 10 675 [91.9%] Hispanic individuals). There were 9022 patients with kidney failure and dialysis treatment before and 5397 patients after Hurricane Maria. Before the hurricane, the mean quarterly number of unique persons dialyzed in Puerto Rico was 2834 per quarter (95% CI, 2771-2897); afterwards it dropped to 261 (95% CI, -348 to -175; relative change, 9.2%). The percentage of persons who had 1 or more dialysis sessions outside of Puerto Rico in the next quarter following a previous dialysis in Puerto Rico was 7.1% before Hurricane Maria (95% CI, 4.8 to 9.3). There was a significant increase of 5.8 percentage points immediately after the hurricane (95% CI, 2.7 to 9.0). The 6-month mortality rate per person-quarter was 0.08 (95% CI, 0.08 to 0.09), and there was a nonsignificant increase in level of mortality rates and a nonsignificant decreasing trend in mortality rates. CONCLUSIONS AND RELEVANCE: The findings of this cross-sectional study suggest there was a significant increase in the number of people receiving dialysis outside of Puerto Rico after Hurricane Maria. However, no significant differences in mortality rates before and after the hurricane were found, which may reflect disaster emergency preparedness among dialysis facilities and the population with kidney failure, as well as efforts from other stakeholders.
Hurricane Maria is regarded as one of the worst natural disasters in United States history as it devasted Puerto Rico (PR) in September 2017. This study compared population-based key health indicators among PR residents pre-and post-Hurricane Maria. We examined Behavioral Risk Factor Surveillance System (BRFSS) PR data from five survey years, including pre-and post-Hurricane Maria: 2015 (N = 4556), 2016 (N = 5765), 2017 (N = 4462), 2018 (N = 4814), and 2019 (N = 4958). The sample consisted of non-institutionalized adults aged ≥ 18 years with access to a landline or a cellular telephone. Using logistic regression we compared health care utilization, health behaviors, and outcomes pre-and post-Hurricane Maria. Models adjusted for age, sex, race, education, employment, income, and marital status (2017 = referent). Compared to 2017, post-hurricane participants were more likely to have a college degree or higher, be currently employed, and not married/partnered. Post-hurricane, participants were less likely to have health insurance coverage (2018 AOR, 95% CI: 0.75, 0.58-0.97) and had lower rates of diabetes (2018 AOR: 0.82, 0.70-0.96). The odds of being overweight/obese were lower pre-hurricane compared to 2017 (2015 AOR, 95% CI: 0.88, 0.79-0.97). There was no statistically significant difference in health behaviors across survey years. Results may suggest that PR residents with lower socioeconomic status and/or chronic illness were more likely to emigrate, resulting in a compositional change in the population post-hurricane. This analysis highlights the need for long-term follow-up of PR residents to better determine the impact of Hurricane Maria, and adequately design public health programs to address healthcare needs, access, and outcomes.
OBJECTIVE: To assess changes in the availability of mental health crisis services in Puerto Rico relative to US states before and after Hurricanes Maria and Irma. DATA SOURCES/STUDY SETTING: National Mental Health Services Surveys conducted in 2016 and 2020. STUDY DESIGN: Repeated cross-sectional design. The independent variable was mental health facility location in Puerto Rico or a US state. Dependent variables were the availability of three mental health crisis services (psychiatric emergency walk-in services, suicide prevention services, and crisis intervention team services). DATA COLLECTION/EXTRACTION METHODS: The proportion and per 100,000 population rate of facilities offering crisis services were calculated. PRINCIPAL FINDINGS: The availability of crisis services at mental health facilities in Puerto Rico remained stable between 2016 and 2020. These services were offered less at indigent care facilities in Puerto Rico than US states (e.g., 38.2% vs. 49.5% for suicide prevention, p = 0.06) and the magnitude of difference increased following Hurricane Maria. CONCLUSIONS: There are disparities between Puerto Rico and US states in the availability of mental health crisis services for indigent patients.
Five-year retrospective analysis of respiratory viruses in children less than 18 years old at Tripler Army Medical Center and outlying clinics in Oahu. Respiratory syncytial virus and influenza A showed pronounced seasonality with peaks from September to December and December to March, respectively. Results provide a better understanding of the timing of viral preventive strategies in Oahu.
Extensive flooding caused by Hurricane María in Puerto Rico (PR) created favorable conditions for indoor growth of filamentous fungi. These conditions represent a public health concern as contamination by environmental fungi is associated with a higher prevalence of inflammatory respiratory conditions. This work compares culturable fungal spore communities present in homes that sustained water damage after Hurricane María to those present in dry, non-flooded homes. We collected air samples from 50 houses in a neighborhood in San Juan, PR, 12 and 22 months after Hurricane María. Self-reported data was used to classify the homes as flooded, water-damage or dry non-flooded. Fungi abundances, composition and diversity were analyzed by culturing on two media. Our results showed no significant differences in indoor fungal concentrations (CFU/m(3)) one year after the Hurricane in both culture media studied (MEA and G25N). During the second sampling period fungal levels were 2.7 times higher in previously flooded homes (Median = 758) when compared to dry homes (Median = 283), (p-value < 0.005). Fungal profiles showed enrichment of Aspergillus species inside flooded homes compared to outdoor samples during the first sampling period (FDR-adjusted p-value = 0.05). In contrast, 22 months after the storm, indoor fungal composition consisted primarily of non-sporulated fungi, most likely basidiospores, which are characteristic of the outdoor air in PR. Together, this data highlights that homes that suffered water damage not only have higher indoor proliferation of filamentous fungi, but their indoor fungal populations change over time following the Hurricane. Ultimately, after nearly two years, indoor and outdoor fungal communities converged in this sample of naturally ventilated homes.
CONTEXT: Tropical areas and small islands are identified as highly vulnerable to climate change, and already experiencing shifts in their temperature distribution. However, the knowledge on the health impacts of temperatures under tropical marine climate is limited. We explored the influence of temperature on mortality in four French overseas regions located in French Guiana, French West Indies, and in the Indian Ocean, between 2000 and 2015. METHOD: Distributed lag non-linear generalized models linking temperature and mortality were developed in each area, and relative risks were combined through a meta-analysis. Models were used to estimate the fraction of mortality attributable to non-optimal temperatures. The role of humidity was also investigated. RESULTS: An increased risk of mortality was observed when the temperature deviated from median. Results were not modified when introducing humidity. Between 2000 and 2015, 979 deaths [confidence interval (CI) 95% 531:1359] were attributable to temperatures higher than the 90th percentile of the temperature distribution, and 442 [CI 95% 178:667] to temperature lower than the 10th percentile. DISCUSSION: Heat already has a large impact on mortality in the French overseas regions. Results suggest that adaptation to heat is relevant under tropical marine climate.
INTRODUCTION: Food security in Small Island Developing States (SIDS) is an international policy priority. SIDS have high rates of nutrition-related non-communicable diseases, including obesity and type 2 diabetes, micronutrient deficiencies and, in many, persistent childhood stunting. This is associated with an increasing reliance on imported processed food of poor nutritional quality. Calls have been made for strengthening local food systems, resilient to climate change, to increase the consumption of nutritious locally produced food. We aimed to systematically review interventions intended to improve diet in SIDS, and specifically explore whether these interventions applied a local food approach. METHODS: The search strategy was applied to 11 databases, including in health, social science and agriculture. Screening of titles, abstracts and data extraction was undertaken in duplicate. Risk of bias was assessed using Cochrane tools. Narrative synthesis of the results was undertaken. The study protocol was registered (PROSPERO registration number: 2020CRD42020201274). RESULTS: From 26 062 records, 154 full texts were reviewed and 24 were eligible. Included studies were from the Caribbean, Pacific, Mauritius and Singapore. Five were a randomised study design, one an interrupted time series analysis, eight controlled and ten uncontrolled pre-test and post-test. Nine studies included some aspect of a local food approach. Most interventions (n=15) included nutrition education, with evidence of effectiveness largely limited to those that also included practical skills training, such as vegetable gardening or food preparation. Three studies were considered low risk of bias, with the majority (n=13) of moderate risk. CONCLUSION: There is a lack of robust evidence on interventions to improve diet in SIDS. The evidence suggests that multifaceted approaches are likely to be the most effective, and local food approaches may promote effectiveness, through mechanisms of cultural and contextual relevance. Further development and evaluation of interventions is urgently required to increase the comparability of these studies, to help guide policy on improving nutrition in SIDS.
Global inaction on climate change is leading many Pacific peoples towards a reality separated from their ancestral lands. Yet, discussions of climate-related mobility often sideline Pacific understandings of well-being. This systematic qualitative review synthesizes the literature on the psychosocial and cultural impacts of climate-related mobility in the Pacific and outlines the methods employed in this field. We identified 36 relevant empirical studies from online databases and citations covering 28 cases of climate-related mobility. Our approach assessed studies against the Pacific Health Research Guidelines and the Critical Appraisal Skills Programme. We conducted a thematic synthesis of qualitative findings, recognizing social factors influencing acculturation and relationship to land as superordinate themes for both cross-border and internal mobility. Eleven sub-themes were identified as outcomes of cross-border and internal mobility. Overall, climate-related mobility shifted people’s relationships with their homelands, disrupting community and cultural continuities. People resisted disruptions through engaging with cultural practices, values, knowledge, and community life. Yet, even the least disruptive movements caused significant stress, suggesting that Pacific conceptualisations of well-being and land should be considered when developing climate policy.
PurposeThis paper aims to address a gap in investigating specific impacts of climate change on mental health in the Pacific region, a region prone to extreme events. This paper reports on a study on the connections between climate change, public health, extreme weather and climate events (EWEs), livelihoods and mental health, focusing on the Pacific region Islands countries. Design/methodology/approachThis paper deploys two main methods. The first is a bibliometric analysis to understand the state of the literature. For example, the input data for term co-occurrence analysis using VOSviewer is bibliometric data of publications downloaded from Scopus. The second method describes case studies, which outline some of the EWEs the region has faced, which have also impacted mental health. FindingsThe results suggest that the increased frequency of EWEs in the region contributes to a greater incidence of mental health problems. These, in turn, are associated with a relatively low level of resilience and greater vulnerability. The findings illustrate the need for improvements in the public health systems of Pacific nations so that they are in a better position to cope with the pressures posed by a changing environment. Originality/valueThis paper contributes to the current literature by identifying the links between climate change, extreme events, environmental health and mental health consequences in the Pacific Region. It calls for greater awareness of the subject matter of mental health among public health professionals so that they may be better able to recognise the symptoms and relate them to their climate-related causes and co-determinant factors.
Energy affordability and climatic variability are associated to human health and this study investigates their impacts on public health for Cyprus, an eastern Mediterranean island afflicted by extreme summer heat and cold winters, especially in the Troodos mountains. Energy poverty indicators are computed through statistical analysis of mortality data and household consumption information, the latter collected through a tailored survey. Results show that almost half of the survey participants spend large proportions of their incomes towards essential energy services. Moreover, ambient temperature is significantly linked to mortality, with a 20-fold higher risk of death in winter and a major shift in mortality noticed around 2013, following a severe financial crisis which exposed rural populations to a higher mortality risk.
First Nations Peoples have a long history of living in Australia’s changing climate and a deep knowledge of their traditional estate (‘Country’). However, human-induced climate change raises unforeseen risks to the health of First Nations Peoples-especially in remotely located communities. This includes the Torres Strait Islands, where a local leader asked our Torres Strait Islander co-author, ‘We know that you will return to your Country-unlike previous researchers. So how can you help with climate change?’ In response, this research describes four core values focused on supporting First Nations Peoples’ health and wellbeing: co-design, appropriate governance, support for self-determination, and respectfully incorporating Indigenous Knowledges into health-protective climate initiatives. Supporting the health and wellbeing of Torres Strait Islanders to continue living in the remote Torres Strait Islands in a changing climate can enable long-term care for Country, maintenance of culture, and a sense of identity for First Nations Peoples. Ensuring these core values are implemented can support the health of present and future generations and will likely be applicable to other First Nations communities.
OBJECTIVES: This study explored the health problems of inhabitants of small South Pacific Islands under the influence of climate change, focusing on three communities in the Solomon Islands. DESIGN: Cross-sectional study of the Solomon Islands’ populations. SETTING: A field survey was conducted in Taro Island, a small, urbanised island with a whole-community relocation plan; Manuopo community of Reef Islands, a small remote island on an atoll environment and Sasamungga, an intermediately urbanised community on a larger island. The Sasamungga community was used for comparison. PARTICIPANTS: Each community’s participants were recruited through local health authorities, and 113, 155 and 116 adults (aged 18+ years) from Taro, Manuopo and Sasamungga, respectively, participated voluntarily. METHODS: Each participant’s body height, weight and body mass index were measured. A drop of blood was sampled for malaria testing; glycated haemoglobin and C reactive protein levels, measured from another drop of blood, were markers for diabetes and inflammation, respectively. The Primary Care Screening Questionnaire for Depression measured depressive mental states. PRIMARY AND SECONDARY OUTCOME MEASURES: Regarding health status, the dependent variables-communicable diseases, non-communicable diseases and mental state-and independent variables-differences in communities and socioeconomic status-were measured through health check-ups and interviews of individual participants. RESULTS: Taro Island inhabitants had a higher risk of obesity (OR 1.13, 95% CI 1.02 to 1.27, p=0.0189), and Manuopo inhabitants had a higher risk of depression (1.25, 95% CI 1.08 to 1.44, p=0.0026) than Sasamungga inhabitants. Manuopo inhabitants recognised more serious problems of food security, livelihood, place to live and other aspects of daily living than other communities’ inhabitants. CONCLUSIONS: The three small island communities’ observation identified different health problems: the urbanised community and remote community had a high risk of non-communicable diseases and mental disorders, respectively. These health problems should be monitored continuously during future climate-related changes.
INTRODUCTION: This focused ethnographic study used qualitative, ethnographic, and participatory methods to explore determinants of maternal, infant, and young child nutrition (MIYCN) during the first 1,000 days of life as part of efforts to address the double burden of malnutrition in Solomon Islands. METHODS: An iterative study design was used to first explore and then confirm findings related to food and nutrition security and social and behavioral determinants of MIYCN in urban and rural settings. The first phase included in-depth interviews, household observations, free lists, and seasonal food availability calendar workshops while the second phase included focus group discussions, pile sorts, participatory community workshops, and repeated household observations. RESULTS AND DISCUSSION: We found that MIYCN is shaped by a complex interaction of factors at the macro- and micro-levels. At the macro-level, globalization of the food system, a shifting economy, and climate change are driving a shift toward a delocalized food system based on imported processed foods. This shift has contributed to a food environment that leaves Solomon Islanders vulnerable to food and nutrition insecurity, which we found to be the primary determinant of MIYCN in this context. At the micro-level, this food environment leads to household- and individual-level food decisions that often do not support adequate MIYCN. Multi-sectoral interventions that address the macro- and micro-level factors shaping this nutrition situation may help to improve MIYCN in Solomon Islands.
Disasters and climate-related risks displace millions of people each year. Planned relocation is one strategy used to address displacement and is increasingly being analyzed for the potential opportunities and challenges it creates for relocated people. However, little attention has been paid to the secondary impacts of planned relocations, and how they influence the risk, vulnerability and well-being of other groups, particularly people who live on the land that is selected for relocation sites, or in neighboring areas. This paper explores how current and potential future planned relocations in Fiji and the Philippines redistribute vulnerabilities to non-target communities who previously lived on, or alongside, relocation site land. The notion of cascading displacement is introduced to illustrate a serious consequence of planned relocations in which insecurity and displacement are re-created and perpetuated due to a failure to consider the needs of non-target groups who are directly disadvantaged by relocation processes. Insights from this paper may be used to inform future relocation policy and practice for more equitable and sustainable outcomes for all involved. This article is protected by copyright. All rights reserved.
Impacts of climate change in the Pacific are far reaching and include effects on mental health and wellbeing. Pacific concepts around the interrelation of these global giants are yet to be described. The aim of this study was to seek consensus amongst Pacific mental health and/or climate change experts on key principles underpinning mental health and wellbeing, and climate change, and the intersection of the two, for Pacific peoples. The Delphi method included forming a panel of 70 experts. Two rounds of online questionnaires sought their views on mental health and wellbeing, and climate change and the impact upon Pacific peoples. Of the panel 86% identified with one or more Pacific ethnicities. Six themes emerged, 92% of items reached consensus and 36% reached strong consensus of >95%. Recurring subthemes included culture and spirituality, family and community, connection to ancestors, connection to the environment, resilience, disasters, livelihoods, government, education, workforce, migration and stigma. This is the first time these concepts have been explored and described for, and by Pacific peoples in this format. It is a necessary first step towards development of responses in preparedness of mental health services, in the Pacific region, and Aotearoa New Zealand.
Non-economic loss and damage induced by climate change in the Pacific Islands region has been reported as fears of cultural loss, deterioration of vital ecosystem services, and dislocation from ancestral lands, among others. This paper undertakes an in-depth systematic review of literature from the frontlines of the Pacific Islands to ascertain the complexities of non-economic loss and damage from climate change. We synthesise knowledge to date on different but inter-connected categories of non-economic loss and damage, namely: human mobility and territory, cultural heritage and Indigenous knowledge, life and health, biodiversity and ecosystem services, and sense of place and social cohesion. Identifying gaps and possibilities for future research agendas is presented. Synthesising knowledge to date and identifying remaining gaps about non-economic loss and damage is an important step in taking stock of what we already know and fostering action and support for addressing loss and damage in the years to come.
Communities throughout the Pacific Islands region have experienced, and will continue to experience, extensive non-economic loss and damage (NELD) from climate change. Assessments of loss and damage, however, often fall short on their coverage of these non-economic dimensions, which can distort our understanding of climate change impacts, discount the experiences of some and skew future decision-making. This paper explores how stakeholders in the Pacific Islands understand NELD and what they perceive to be the best ways of responding to it. An open-ended questionnaire was used to collect qualitative and quantitative data from representatives from governments, donors and development partners, civil society, intergovernmental organisations, and relevant others. This study found that NELD in the Pacific Islands is understood, perceived and experienced through the lens of intangible values, identity and cultural landscapes, and this is encapsulated by a typology with eight interconnected core dimensions. These eight dimensions include: health and wellbeing, ways of being, future ways of being, cultural sites and sacred places, Indigenous and local knowledge, life sustaining tools, biodiversity and ecosystem services, and connection to land and sea. NELD is complex, entangled and interconnected, thereby significantly undermining entire socio-ecological systems. Moving forward, responding to NELD in the Pacific Islands region will require a comprehensive approach that protects, conserves and restores complex socio-ecological systems, and provides opportunities to work through loss and damage by means of education and training, safeguarding knowledge systems, community activities, cultural connection and maintenance, and strong relationships with land and sea.
This study focuses on an arts-based mental health and psychosocial support (MHPSS) intervention in the form of TOT (training of trainers) conducted under the auspices of IsraAID in the aftermath of the Yolanda typhoon in the Philippines in 2013. Interviews were conducted with 10 female education and healthcare professionals, who also made drawings of their experiences. The goal was to better understand how they evaluated the training program, both for themselves and their communities. Analysis of the interviews and drawings, based on the principles of Consensual Qualitative Research (CQR), identified three main domains: (1) Supportive and inhibiting factors for participants in the training course; (2) Supportive and inhibiting factors with respect to the participants’ implementation of the training goals in their local communities; (3) Perceptions of the benefits of the training program for the participants and their communities. The discussion centers on the value of the creative process, the importance of the group in the training course and in the context of multiculturalism, and the impact these factors in interventions applying the TOT model.
This is a one-page summary of findings from EPA’s report Climate Change and Social Vulnerability in the United States: A Focus on Six Impacts related to disproportionate risks of climate change to Asian individuals and Pacific Islanders.
With the acceleration of urbanization throughout the world, climate problems related to climate change including urban heat islands and global warming have become challenges to urban human settlements. Numerous studies have shown that greenways are beneficial to urban climate improvement and can provide leisure places for people. Taking the coastal greenway in Qingdao as the research object, mobile measurements of the microclimate of the greenway were conducted in order to put forward an evaluation method for the research of outdoor thermal comfort. The results showed that different vegetation coverage affected the PET (physiologically equivalent temperature), UTCI (Universal Thermal Climate Index) as well as thermal comfort voting. We found no significant correlation between activities, age, gender, and thermal comfort voting. Air temperature sensation and solar radiation sensation were the primary factors affecting the thermal comfort voting of all sections. Otherwise, within some sections, wind sensation and humidity sensation were correlated with thermal sensation voting and thermal comfort voting, respectively. Both PET and UTCI were found to have a negative correlation with the vegetation coverage on both sides of the greenway. However, the vegetation coverage had positive correlation (R = 0.072) for thermal sensation and significant positive correlation (R = 0.077*) for thermal comfort. The paved area cover was found to have a positive correlation with PET and UTCI, while having a negative correlation with thermal sensation (R = -0.049) and thermal comfort (R = -0.041). This study can provide scientific recommendations for the planning and design of greenway landscapes to improve thermal comfort.
Vanuatu, a Pacific Small Island Developing State, has high exposure to climate extremes, such as tropical cyclones and interannual rainfall variability, which can have devastating short- and long-term impacts on food and nutrition security (FNS). This paper presents local experiences of the effects of climate extremes on FNS in Vanuatu through a case study of two recent events: Tropical Cyclone Pam (2015) and an El Nino-induced drought (2015-2017). A qualitative research approach, using a range of data collection methods, was used to document people’s lived experiences in two villages in Vanuatu. This study found that climate extremes affected the FNS of people in the two study villages directly, with effects on gardens and food production, and indirectly, by exacerbating the nutrition transition, a shift away from traditional diets energy-dense imported food that is already progressing in Vanuatu. These effects undermine long-term FNS and health. Climate extremes also eroded food-related cultural practices and traditions and constrained local agency to make food choices. The magnitude and extent of these impacts, however, are influenced by structural vulnerabilities and local resiliencies. The adaptive capacity and resilience of communities needs to be strengthened in a way that allows people to exercise agency in their responses to climate extremes and to promote FNS, including cultural acceptability and food preferences, and long-term health.
Drinking water on isolated islands includes treated rainwater, water shipped from the mainland, and desalinated seawater. However, marine transportation and desalination plants are vulnerable to emergencies, such as extreme weather. making self-sustaining stand-by water for emergency response essential. Rainwater is ideal for producing the stand-by water, and rainwater harvesting is sustainable and clean, and prolonged biostability can be ensured by managing biological and chemical parameters. The present study applied a stand-by drinking water purification system (primarily including nanofiltration and low-dose chlorination) to explore the feasibility of producing and storing cleaner drinking water from rainwater and the following conclusions were drawn. First, treatment of rainwaters ensures biosafety for seven days, which is longer than that for untreated rainwater; the proportion of opportunistic pathogens decreased from 23.40-7.77% after nanofiltration, and it was proposed that the microbial community converges after advanced water treatment. Second, chemical qualities were improved. Local resource coral sand prevents pH in rainwater from decreasing below 6.5, and treated rainwater had lower disinfection by-product potential and higher disinfection efficiency, allowing periodical rainwater recycling. Third, harvesting rainwater was extremely cost-effective, with an operation cost of 1.5-2.5 RMB/m(3). From biosafety, chemical safety, and economic cost perspectives, self-sustaining water from rainwater can contributes to the development of sustainable and cost-effective water supply systems on isolated islands. Mixing treated rainwater and desalinated seawater reasonably guarantees sufficiency and safety. (C) 2021 Elsevier B.V. All rights reserved.
BACKGROUND: Dengue dynamics result from the complex interactions between the virus, the host and the vector, all being under the influence of the environment. Several studies explored the link between weather and dengue dynamics and some investigated the impact of climate change on these dynamics. Most attempted to predict incidence rate at a country scale or assess the environmental suitability at a global or regional scale. Here, we propose a new approach which consists in modeling the risk of dengue outbreak at a local scale according to climate conditions and study the evolution of this risk taking climate change into account. We apply this approach in New Caledonia, where high quality data are available. METHODS: We used a statistical estimation of the effective reproduction number (R(t)) based on case counts to create a categorical target variable : epidemic week/non-epidemic week. A machine learning classifier has been trained using relevant climate indicators in order to estimate the probability for a week to be epidemic under current climate data and this probability was then estimated under climate change scenarios. RESULTS: Weekly probability of dengue outbreak was best predicted with the number of days when maximal temperature exceeded 30.8°C and the mean of daily precipitation over 80 and 60 days prior to the predicted week respectively. According to scenario RCP8.5, climate will allow dengue outbreak every year in New Caledonia if the epidemiological and entomological contexts remain the same. CONCLUSION: We identified locally relevant climatic factor driving dengue outbreaks in New Caledonia and assessed the inter-annual and seasonal risk of dengue outbreak under different climate change scenarios up to the year 2100. We introduced a new modeling approach to estimate the risk of dengue outbreak depending on climate conditions. This approach is easily reproducible in other countries provided that reliable epidemiological and climate data are available.
Simple Summary The globalization of trade and travel, in combination with climate change, have resulted in the geographical expansion of mosquito-borne diseases. Moreover, over-reliance on chemical pesticides to control mosquitoes has resulted in resistance, which threatens the management of disease risk. We show, for the first time, that mosquito traps baited with human odors, in combination with controlling mosquito larvae in breeding sites, resulted in the near elimination of mosquito populations on two small islands, and the elimination of Aedes mosquitoes for 6+ months on a third island, in the Maldives. The levels of control achieved are comparable to current genetic control methods that are far more costly and impractical for implementation on small islands. The approach presented here poses the first alternative in decades to manage mosquito-borne disease risk on small (tropical) islands in an affordable and environmentally friendly manner. Globally, environmental impacts and insecticide resistance are forcing pest control organizations to adopt eco-friendly and insecticide-free alternatives to reduce the risk of mosquito-borne diseases, which affect millions of people, such as dengue, chikungunya or Zika virus. We used, for the first time, a combination of human odor-baited mosquito traps (at 6.0 traps/ha), oviposition traps (7.2 traps/ha) and larval source management (LSM) to practically eliminate populations of the Asian tiger mosquito Aedes albopictus (peak suppression 93.0% (95% CI 91.7-94.4)) and the Southern house mosquito Culex quinquefasciatus (peak suppression 98.3% (95% CI 97.0-99.5)) from a Maldivian island (size: 41.4 ha) within a year and thereafter observed a similar collapse of populations on a second island (size 49.0 ha; trap densities 4.1/ha and 8.2/ha for both trap types, respectively). On a third island (1.6 ha in size), we increased the human odor-baited trap density to 6.3/ha and then to 18.8/ha (combined with LSM but without oviposition traps), after which the Aedes mosquito population was eliminated within 2 months. Such suppression levels eliminate the risk of arboviral disease transmission for local communities and safeguard tourism, a vital economic resource for small island developing states. Terminating intense insecticide use (through fogging) benefits human and environmental health and restores insect biodiversity, coral reefs and marine life in these small and fragile island ecosystems. Moreover, trapping poses a convincing alternative to chemical control and reaches impact levels comparable to contemporary genetic control strategies. This can benefit numerous communities and provide livelihood options in small tropical islands around the world where mosquitoes pose both a nuisance and disease threat.
Murine typhus is a flea-borne zoonotic disease that has been recently reported on Reunion Island, an oceanic volcanic island located in the Indian Ocean. Five years of survey implemented by the regional public health services have highlighted a strong temporal and spatial structure of the disease in humans, with cases mainly reported during the humid season and restricted to the dry southern and western portions of the island. We explored the environmental component of this zoonosis in an attempt to decipher the drivers of disease transmission. To do so, we used data from a previously published study (599 small mammals and 175 Xenopsylla fleas from 29 sampling sites) in order to model the spatial distribution of rat fleas throughout the island. In addition, we carried out a longitudinal sampling of rats and their ectoparasites over a 12 months period in six study sites (564 rats and 496 Xenopsylla fleas) in order to model the temporal dynamics of flea infestation of rats. Generalized Linear Models and Support Vector Machine classifiers were developed to model the Xenopsylla Genus Flea Index (GFI) from climatic and environmental variables. Results showed that the spatial distribution and the temporal dynamics of fleas, estimated through the GFI variations, are both strongly controlled by abiotic factors: rainfall, temperature and land cover. The models allowed linking flea abundance trends with murine typhus incidence rates. Flea infestation in rats peaked at the end of the dry season, corresponding to hot and dry conditions, before dropping sharply. This peak of maximal flea abundance preceded the annual peak of human murine typhus cases by a few weeks. Altogether, presented data raise novel questions regarding the ecology of rat fleas while developed models contribute to the design of control measures adapted to each micro region of the island with the aim of lowering the incidence of flea-borne diseases.
There is a dearth of research on the hourly risk of ambulance dispatches with respect to ambient conditions. We evaluated hourly relative risks (RR) and 95% confidence interval (CI) of ambulance dispatches in Taiwan to treat respiratory distress, coma and unconsciousness, and out-of-hospital cardiac arrest (OHCA), from 2006 to 2015. We considered island-wide ambient temperatures, fine particulate matter (PM(2.5)), and ozone (O(3)) at lag 0-180 h while using a distributed lag nonlinear model and meta-analysis. Results showed the pooled risks peaked at lag 16-18 h for all ambulance dispatches at 99th percentile of hourly temperature (32 °C, versus reference temperature of 25 °C), with significant excess risk of 0.11% (95% CI; 0.06, 0.17) for coma and unconsciousness, and 0.06% (95% CI; 0.01, 0.11) for OHCA. The risks of exposure to 90th percentile of hourly O(3) of 52.3 ppb relative to the Q1 level of 17.3 ppb peaked at lag 14 h, with excess risk of 0.17% (95% CI; 0.11, 0.23) for respiratory distress, 0.11% (95% CI; 0.06, 0.16) for coma and unconsciousness, and 0.07% (95% CI; 0.01, 0.14) for OHCA. The population exposed to reference temperatures of 28 °C, 20 °C, and 26 °C were exposed to the lowest levels of ambulance dispatches risk for respiratory distress, coma and unconsciousness, and OHCA, respectively; the highest cumulative 0-96 h RRs of ambulance dispatches were 1.27 (95% CI; 1.19, 1.35) for OHCA at 5th percentile temperatures and 1.25 (95% CI; 1.11, 1.41) for OHCA at 99th percentile temperatures. Following an accumulating lag of 0-96 h, no significant risk was identified for hourly levels of PM(2.5) and O(3). In conclusion, the analytical results of hourly data speak to immediate and real-time responses to environmental changes, rather than to short-term relationships. In our analyses, we emphasized health events in extreme heat; thus, we recommend a comparative study of daily versus hourly associations.
Small island developing states (SIDS) are often at the forefront of climate change impacts, including those related to health, but information on mental health and wellbeing is typically underreported. To help address this research lacuna, this paper reviews research about mental health and wellbeing under climate change in SIDS. Due to major differences in the literature’s methodologies, results, and analyses, the method is an overview and qualitative evidence synthesis of peer-reviewed publications. The findings show that mental health and wellbeing in the context of climate change have yet to feature prominently and systematically in research covering SIDS. It seems likely that major adverse mental health and wellbeing impacts linked to climate change impacts will affect SIDS peoples. Similar outcomes might also emerge when discussing climate change related situations, scenarios, and responses, irrespective of what has actually happened thus far due to climate change. In the context of inadequate health systems and stigmatisation of mental health diagnoses and treatments, as tends to occur globally, climate change narratives might present an opening for conversations about addressing mental health and wellbeing issues for SIDS.
The health risks of a changing climate are immediate and multifaceted. Policies, plans, and programs to reduce climate-related health impacts exist, but multiple barriers hinder the uptake of these strategies, and information remains limited on the factors affecting implementation. Implementation science-a discipline focused on systematically examining the gap between knowledge and action-can address questions related to implementation and help the health sector scale up successful adaptation measures in response to climate change. Implementation science, in the context of a changing climate, can guide decision makers in introducing and prioritizing potential health adaptation and disaster risk management solutions, advancing sustainability initiatives, and evaluating and improving intervention strategies. In this article we highlight examples from Pacific Island countries and outline approaches based on implementation science to enhance the capacity of health systems to anticipate, prepare for, respond to, and recover from climate-related exposures.
As climate change alters the behavior of Atlantic hurricanes, these storms are trending stronger, wetter, and slower moving over coastal and island populations. Hurricane Dorian exemplified all three attributes. Dorian’s destructive passage over the Abaco Islands, Bahamas, on September 1, 2019, exposed residents of its capital, Marsh Harbour, to a prolonged encounter with the storm’s core. After Dorian’s fierce front eyewall and towering storm surge tore apart shanty town habitats and eviscerated concrete homesites, residents desperately sought refuge during the brief respite when Dorian’s eye passed directly overhead. The category 5 winds then resumed abruptly and Dorian continued its relentless destruction. This article focuses on the storm’s mental health consequences, drawing on observations of on-site clinicians as well as findings from previous research on the mental health effects of Atlantic hurricanes and the transformation of hurricane hazards resulting from climate change. To protect island and coastal populations against climate-driven storms, disaster planning policy should emphasize resilience-focused prevention and mitigation strategies. In the aftermath of these events, health system response should include community outreach, case finding, and evidence-based interventions that optimize the use of mental health professionals.
The United Nations’ invocation of ‘human security’ a generation ago promised a world increasingly governed by a ‘people-centred’ security agenda. In this paper we focus on arguably the most vital global security challenge faced throughout the planet today: climate resilience. We outline how advancing smart climate action and securing climate resilience can be aided by securitization practices that recall the earlier emphases of the United Nations’ human security concept. The paper draws upon evidence from the Caribbean as a territory defined dominantly as part of the Global South, yet offering vital knowledge of productive climate security governance that can be instructive to the Global North. The impacts of global warming are particularly evident for the people of small island developing states such as those located in the Caribbean. By analysing the case of Cuba as a country increasingly resilient to extreme weather events, and by interrogating the genealogy of the broader Caribbean’s hurricane culture, we show how an effective human security vision for climate justice and resilience can be achieved by recognizing and integrating the valuable forms of locally attuned knowledge that continue to emerge and coalesce in vulnerable geographies.
Extreme weather events in the Caribbean region are becoming increasingly severe because of climate change. The region also has high rates of poorly controlled chronic noncommunicable diseases (NCDs), which were responsible for at least 30 percent of deaths after two recent hurricanes. We conducted a scoping review of literature published between 1974 and 2020 to understand the burden and management of chronic NCDs in the Caribbean after natural disasters. Of the twenty-nine articles included in this review, most described experiences related to Hurricanes Dorian (2019) and Irma and Maria (2017) and the Haiti earthquake (2010). Challenges included access to medication, acute care services, and appropriate food, as well as communication difficulties and reliance on ad hoc volunteers and outside aid. Mitigating these challenges requires different approaches, including makeshift points of medication dispensing, disease surveillance systems, and chronic disease self-management education programs. Evidence is needed to inform policies to build resilient health systems and integrate NCD management into regional and national disaster preparedness and response plans.
In this literature review, we analyze existing research on climate change and its impact on mental health and well-being, primarily among Pacific Islanders. To compensate for a lack of research in this area, we also address some of the projected mental health implications resulting from disasters linked to climate change, such as flooding, hurricanes, and cyclones. This broader scope enables the identification of areas where more research into mental health concerns related to climate change in the Pacific is needed. In closing, we provide recommendations for further research into the mental health and well-being of Pacific peoples and suggest ways to develop resilience to the effects of climate change.
Climate change will necessitate evermore frequent and complex managed retreats in the future, and drafting policies that are equitable and just for those residents who are relocating will be essential. The USA’s first federally funded, community-scale, climate-driven resettlement is currently underway in coastal Louisiana. In January 2016, the U.S. Department of Housing and Urban Development (HUD) awarded the state of Louisiana $48.3 million to plan, design, and implement a structured, just, and scalable resettlement with former and current Isle de Jean Charles residents. Most Island households are multi-generational and directly descended from Jean Marie Naquin, after whose father the Island is named. Using interviews, ethnographic data, and policy documents, this paper will delineate and analyze the dimensions of sense of place, which, in this case, prompted policy changes dramatically different from standard relocation policies: assurance that the properties and land from which residents are departing will remain in their possession as long as the land remains. For most Island residents, this was non-negotiable. The intangible connection to place-feelings of belonging, lifestyle, family connections, and culture-plays a central role in many families’ decision to stay or go. The choice to relocate is rooted in this complex entanglement of identity, familial ties, land loss, historical and current marginalization, and a way of life passed on by multiple generations. In forthcoming community resettlements, continued access and ownership of the properties being left behind should be considered as a critical component for planning just retreats.
Desert dust transported from the Saharan-Sahel region to the Caribbean Sea is responsible for peak exposures of particulate matter (PM). This study explored the potential added value of satellite aerosol optical thickness (AOT) measurements, compared to the PM concentration at ground level, to retrospectively assess exposure during pregnancy. MAIAC MODIS AOT retrievals in blue band (AOT(470)) were extracted for the French Guadeloupe archipelago. AOT(470) values and PM(10) concentrations were averaged over pregnancy for 906 women (2005-2008). Regression modeling was used to examine the AOT(470)-PM(10) relationship during pregnancy and test the association between dust exposure estimates and preterm birth. Moderate agreement was shown between mean AOT(470) retrievals and PM(10) ground-based measurements during pregnancy (R(2)?=?0.289). The magnitude of the association between desert dust exposure and preterm birth tended to be lower using the satellite method compared to the monitor method. The latter remains an acceptable trade-off between epidemiological relevance and exposure misclassification, in areas with few monitoring stations and complex topographical/meteorological conditions, such as tropical islands.
Coastal floods are the most prominent natural disaster causing severe damages to the local communities regarding food security, economy and shelter. Risks can be defined by physiographical sensitivity and vulnerability associated with socio-economic, demographic and infrastructure aspects of the region. Population with poor socio-economic status and high dependence on natural resources for livelihood in coastal dwellings of rural India are extremely vulnerable to flood hazards. Policy formulation to reduce coastal flood risks necessitates quantifying hazard vulnerability at an administrative scale. In this context, we propose a method for evaluating the coastal flood risk of an island located in the habited part of Sundarbans, West Bengal. Extending up to 282 sq. km, Sagar Island has been a keystone in harbouring and supporting both local and migrant population since the 1880s. Land-use classification of the island indicates an increase of 1.7% to 3.6% in the built-up class, almost double in the past eight years (2012-2020). A considerable rise in area under the water bodies is also seen from 6.6 to 8.6%, signifying fair evidence of a coastal breach. Flood risk assessment of Sagar Island was carried out using high spatial resolution data from Indian remote sensing satellites and census data. This assessment was performed by modifying the established MCDA technique considering the data limitations and accounting accessibility to infrastructure as a novel variable to a multi-dimensional framework. The framework maps spatial vulnerability of the region using sub-factors such as socio-demographic, economic, infrastructure and accessibility. The exposure profile of the area is drawn with the help of topographic factors and classified land-use results. Literature evidence was used to develop classification rules for data standardization from very high to very low based on their flood sensitivity. Further, the factors and sub-factors were ranked using AHP by a panel of experts belonging to diverse fields such as disaster management, regional planning, environment, hydrology and social science. The weighted sum technique was used to quantify total vulnerability and exposure parameters, respectively. The total risk map generated is the product of the hazard and vulnerability map of the region. The findings reveal the dominance of economic and accessibility parameters in defining the vulnerability of the regional population towards coastal flood risks. Proximity to coastline and tidal creeks enhances disaster sensitivity due to frequent inundation, erosion, saltwater intrusion and complete submergence of land area. Water bodies engulfing the coastline emerge as a serious threat to sustenance given the present rate of submergence of about 6 m/year. The research highlights the pressing need for grassroots development through social and economic upliftment. It also advocates the undeniable need for proactive adaptation such as flood resilient housing and coastline protection by stabilizing sandbars and planting/nurturing/maintaining native species (mangroves).
Natural disasters have negative health impacts on patients who need dialysis in affected areas. Severely affected areas are usually rural, with limited basic infrastructure and a population without optimal dialysis-specific care after a disaster. A population-based longitudinal case-cohort study enrolled 715,244 adults from the National Health Insurance Registry who lived in areas affected by a major natural disaster, Typhoon Morakot, in 2009. The observation period was from 2008 to 2011. A total of 13,268 patients (1.85%) had a history of end-stage renal disease (ESRD). Of the ESRD patients, 1264 patients (9.5%) received regular dialysis. Only eight patients missed dialysis sessions in the first month after the disaster. Compared to the moderately affected areas, the incidences of acute cerebrovascular and cardiovascular diseases were higher in patients in severely affected areas. Male dialysis patients aged 45-75 years had a higher mortality rate than that of the general population. Among the affected adults receiving regular dialysis, patients with diabetes (adjusted hazard ratio (aHR): 1.58, 95% confidence interval (CI): 1.20-2.08) or a history of cerebrovascular disease (aHR: 1.58, 95% CI: 1.12-2.21), chronic obstructive pulmonary disease (COPD) or asthma (aHR: 1.99, 95% CI: 1.24-3.17) in moderately affected areas had significantly elevated mortality rates. Additionally, among dialysis patients living in severely affected areas, those with a history of cerebrovascular disease (aHR: 4.52 95% CI: 2.28-8.79) had an elevated mortality rate. Early evacuation plans and high-quality, accessible care for cardiovascular and cerebrovascular diseases are essential to support affected populations before and after disasters to improve dialysis patients’ health outcomes.
This paper uses a holistic approach within a catchment scale, through the application of both climatic and non-climatic parameters, to analyze the impacts of river floods on the human security needs of rural riverine communities in the Waimanu Catchment situated in Nausori, Fiji. Consideration of both climatic and non-climatic factors is required since non-climatic factors could be controlled to build resilience against floods. The indicator-based flood vulnerability index methodology is applicable worldwide, but the indicators used in this study were specifically related to the Pacific Island context. In the context of fluvial flood vulnerability, effects of land management and climate change are not mutually exclusive of each other. Consequently, vulnerability assessments should consider the connection between people’s actions and ecosystems for the entire catchment area since upstream land use practices influence flood vulnerabilities downstream. In our research, a community-based flood vulnerability index system in conjunction with rainfall variability and land use assessments was used to quantitatively and qualitatively analyze the flood vulnerability, and it was found that increased rainfall, poor agricultural practices, gravel extraction, and improper waste management predominantly increased the exposure and sensitivity of midstream and downstream communities to river floods by modifying river morphology. Midstream communities in the Waimanu Catchment were most vulnerable to river floods due to their very low adaptive capacity in terms of poor ecosystem health and lack of natural resources to cope with the subsequent impacts of floods, being most sensitive to changes in land use and land cover.
Health risks from climate change are increasing and becoming a critical global concern. Implementation of health adaptation policies is vital, particularly in settings with high socioeconomic vulnerability and physical exposure to climate-risks, such as the Philippines. We identified from the literature a set of reference principles and categories of barriers to the implementation of national health adaptation policy. These were then used to assess the extent to which these policy principles and barriers are evident in Philippine national health adaptation. This assessment was undertaken based on data and information from policy analysis, key informant interviews, and an expert workshop. The results suggest that the Philippines have made notable progress on health adaptation by establishing a strong policy framework. However, implementation remains challenging and requires continued commitment. The health adaptation policy principles identified in the Philippines are policy congruence, mainstreaming, multi-sectoral approach, multiscale approach, adaptive management, and evidence-based decision-making. The most important implementation barriers are uncertain leadership, appropriateness and longevity of the governance structures within the Department of Health, and data and evidence. The value of considering policy principles alongside implementation barriers is twofold. First, this enables understanding of how implementation barriers relate directly to policy principles. Second, it facilitates identification of future implementation barriers that may arise in relation to current policy principles. Multi-sectoral governance and the integration of evidence in decision-making arose as potential future challenges in the Philippines. These areas may require special consideration in future policy design and planning.
Over recent decades, substantial funding from a variety of sources has been directed towards climate change adaptation projects in Pacific Island countries. There remains, however, considerable uncertainty about which factors influence adaptation project completion, as a pre-cursor to effective adaptation. In this study, we empirically establish the links between project attributes (duration, funding, cash co-financing, in-kind contributions, location, and adaptation approach) and whether a project is likely to complete or be terminated. We examine this issue by developing a logistic regression model to predict the probability of completion for small-scale climate change adaptation projects using a new dataset of 190 projects in the South Pacific (with end dates ranging from November 1995 to May 2016) that were financed through the Global Environment Facility Small Grants Programme. Empirical results suggest that all else equal, such a project was more likely to complete if it was shorter, received more co-financing cash input and in-kind support from other donors and project partners, was explicitly targeted towards climate change adaptation, focused on a single adaptation approach, and was undertaken in Micronesia or Fiji. Our results can be used to help funders and project proponents design projects to mitigate the risks of non-completion, particularly in high-risk settings. These findings should not be misinterpreted to undermine the importance of continued investment in adaptation projects across the whole of South Pacific region.
Food poisoning is caused by pathogenic bacteria in water and aquatic products, especially bivalves (e.g., oysters, clams), which can bioaccumulate pathogenic bacteria. Polluted water and aquatic products thus pose a serious threat to human health and safety. In this study, the types of pathogenic bacteria in water samples and shellfish collected from the Dadeng offshore area in Xiamen were examined. We also analyzed the relationships between dominant pathogens and major climate and water quality parameters. Our objective was to provide reference data that may be used to help prevent bacterial infections and to improve aquatic food hygiene in Xiamen and its surrounding areas to safe levels, thus ensuring the health of Xiamen residents. We found that the main pathogenic bacteria were Vibrio and Bacillus, with the dominant pathogen being Vibrio parahaemolyticus. Physical and chemical indexes (water temperature, salinity, pH, dissolved oxygen, and turbidity) of water bodies and the 3-day accumulated rainfall were found to be important factors affecting the occurrence and abundance of V. parahaemolyticus.
Human society has experienced, and will continue to experience, extensive loss and damage from worsening anthropogenic climate change. Despite our natural tendencies to categorise and organise, it can be unhelpful to delineate clean boundaries and linear understandings for complex and messy concepts such as loss and damage. Drawing on the perspectives of 42 local and regional Pacific Islander stakeholders, an underexplored resource for understanding loss and damage, we explore the complexity and interconnectedness of non-economic loss and damage (NELD). According to participants, Pacific Islander worldviews, knowledge systems and cosmologies often make it difficult to separate and evaluate NELD independently, challenging the nomenclature of NELD categories developed through international mechanisms. Instead, NELD understandings are often centred on the interdependencies between losses, including the cascading flow-on effects that can occur and the nature of some losses as risk multipliers (i.e. one loss creating the risk for further losses). Most notably, losses to biodiversity, ecosystem services and land are critically linked to, and have cascading effects on, livelihoods, knowledge, ways of life, wellbeing, and culture and heritage. We argue that loss and damage is not always absolute, and that there are NELD that are arguably reparable. Concerning, however, is that biodiversity loss, as a risk multiplier, was considered the least reparable by participants. We put forward that NELD understandings must consider interconnectivity, and that biodiversity and ecosystem conservation and restoration must be the focus for interventions to prevent irreparable and cascading losses from climate change in the Pacific Islands.
The environment plays a significant role in the global burden of disease for children. Climate-related disasters such as the 2017 Atlantic hurricane season are increasingly contributing to this burden. United Nations designated Small Island Developing States (SIDS) like Puerto Rico and the U.S. Virgin Islands are particularly at risk due to environmental health hazards caused by natural disasters, and health care structure vulnerabilities. United Nations’ Sustainable Development Goals (UN SDG), specifically UN SDG 3, 13 and 17, focus on climate impacts via promotion of health preparedness and building partnerships between different sectors of society, respectively. The Pediatric Environmental Health Specialty Unit’s (PEHSU) work is consistent with these most notably via the delivery of environmental health services along with training nurses, doctors, and other health professionals, formation of partnerships and linking resources. Therefore, training a diverse array of health professionals and linking these groups to relevant community resources is of utmost importance and has the potential to enhance the effective management and early prevention of top environmental health (EH) risks. Nursing is identified as a key health sector to engage for this initiative. This article describes the work of the Federal Region 2 PEHSU in Puerto Rico and the U.S. Virgin Islands that supports health professionals’ knowledge building, development of environmental health services, and promotion of wide scale access to such services for children and families. The PEHSU’s work is consistent with these most notably with regards to the delivery of environmental health services in pediatrics.
Global warming and air pollution affect the transmission pathway and the survival of viruses, altering the human immune system as well. The first wave of the COVID-19 pandemic dramatically highlights the key roles of climate and air chemistry in viral epidemics. The elongated form of the Italian peninsula and the two major islands (the largest in Europe) is a perfect case study to assess some of these key roles, as the fate of the virus is mirroring the industrialization in the continental part of our country. Fine particulate matter (PM(2.5)), geography, and climate explain what is happening in Italy and support cleaner air actions to address efficiently other outbreaks. Besides the environmental factors, future works should also address the genetic difference among individuals to explain the spatial variability of the human response to viral infections.
Climate change poses significant threats to wellbeing and livelihoods of people and the ecosystems in many Small Island Developing States (SIDS). Adaptation solutions must counteract these threats while also supporting development in vulnerable SIDS. Suitable options need to ensure that connections between the social, economic, and environmental dimensions of socio-economic systems are defined in a way that can support how decisions are made (and by whom) and how these can impact on other parts of these systems. This is particularly important in many Pacific SIDS, where communities practise customary natural resource management and continue to rely on local natural resources. In this study, we model the anticipated impacts of climate change and the benefits of the ecosystem-based adaptation (EbA) approaches on community wellbeing in Vanuatu. To do this, we applied participatory and expert elicitation methods to develop a Bayesian network model, which was designed to evaluate community wellbeing responses at four explicit spatial scales. The model includes both acute and chronic impacts of climate change, the impact of coral bleaching, and the potential loss of Vanuatu’s fringing coral reefs. The model predicts that all proposed EbA interventions will have a positive impact on wellbeing in all four locations to some degree, by either directly improving the integrity of Vanuatu’s ecosystems or by protecting these ecosystems as a positive spill-over of related actions. Significantly, it also predicts that if climate change exceeds 1.5 degrees C of warming, the costs of achieving the same level of wellbeing are increased.
Climate change and mental health concerns are both defining issues of the generation of today. It has been established that the worsening climate causes many environmental disasters and physical health problems. However, its psychological impacts are still not well understood. Climate change has brought about an emerging psychological phenomenon termed ‘climate anxiety’ or ‘eco-anxiety,’ which has been described as a “chronic fear of environmental doom” (Clayton et al., 2017, p. 68) due to the impact of climate change. This predictive cross-sectional study investigated the link between climate change anxiety and mental health among 433 Filipinos. A total of 145 males and 288 females aged 18 to 26 completed the Climate Change Anxiety Scale and the Mental Health Inventory (MHI-38). Results show a significant relationship between climate change anxiety and mental health, with climate change anxiety predicting 13.5% of the overall Mental Health Index variance. Significantly, climate change anxiety was associated with the MHI-38’s global scale of Psychological Distress but not with the global scale of Psychological Well-being. The findings are discussed concerning the broader context of research on the mental health impacts of climate change.
This paper explores the perceived adaptation preference of rural island communities in addressing future climate change risks, particularly those concerning sea-level rise. The research explores the role of culture and local politics, and differences among various age and gender groups within the community regarding preferred adaptation pathways for coping with the impacts of future sea-level rise. A participatory action approach, in the form of a community workshop, was employed, which separated participants into community identified groupings. Differences in community groups’ adaptation preferences emerged, though the range of adaptation measures considered were limited, probably due to the participants’ limited exposure to adaptation mechanisms in their immediate surroundings. Overall, the communities surveyed tended to be conservative, especially in their attitudes towards western adaptation solutions developed in non-island contexts.
BACKGROUND: Climate change is anticipated to have profound effects on mental health, particularly among populations that are simultaneously ecologically and economically vulnerable to its impacts. Various pathways through which climate change can impact mental health have been theorised, but the impacts themselves remain understudied. PURPOSE: In this article we applied psychological methods to examine if climate change is affecting individuals’ mental health in the Small Island Developing State of Tuvalu, a Pacific Island nation regarded as exceptionally vulnerable to climate change. We determined the presence of psychological distress and associated impairment attributed to two categories of climate change-related stressors in particular: 1) local environmental impacts caused or exacerbated by climate change, and 2) hearing about global climate change and contemplating its future implications. METHODS: The findings draw on data collected in a mixed-method study involving 100 Tuvaluan participants. Data were collected via face-to-face structured interviews that lasted 45?min on average and were subjected to descriptive, correlational, and between-group analyses. RESULTS: The findings revealed participants’ experiences of distress in relation to both types of stressor, and demonstrated that a high proportion of participants are experiencing psychological distress at levels that reportedly cause them impairment in one or more areas of daily life. CONCLUSIONS: The findings lend weight to the claim that climate change represents a risk to mental health and obliges decision-makers to consider these risks when conceptualizing climate-related harms or tallying the costs of inaction.
Mosquitoes are vectors of pathogens, causing human and animal diseases. Their ability to adapt and expand worldwide increases spread of mosquito-borne diseases. Climate changes contribute in enhancing these “epidemic conditions”. Understanding the effect of weather variables on mosquito seasonality and host searching activity contributes towards risk control of the mosquito-borne disease outbreaks. To enable early detection of Aedes invasive species we developed a surveillance network for both invasive and native mosquitoes at the main point of entry for the first time in Cyprus. Mosquito sampling was carried out for one year (May 2017-June 2018), at bimonthly intervals around Limassol port. Morphological and molecular identification confirmed the presence of 5 species in the study region: Culex. pipiens, Aedes detritus, Ae. caspius, Culiseta longiareolata and Cs. annulata. No invasive Aedes mosquito species were detected. The Pearson’s correlation and multiple linear regression were used to compare number of sampled mosquitoes and weather variables for three most numerous species (Cx. pipiens, Ae. detritus and Ae. caspius). The population densities of the most numerous species were highest from February to April. Number of Cx. pipiens (-0.48), Ae. detritus (-0.40) and Ae. caspius (-0.38) specimens sampled was negatively correlated with average daily temperature. Monthly relative humidity showed positive correlation with the numbers of the species sampled, Cx. pipiens (0.66) Ae. detritus (0.68), and Ae. caspius (0.71). Mosquito abundance of Cx. pipiens (0.97) and Ae. detritus (0.98) was strongly correlated to seasonal precipitation as well. Our work is a stepping stone to further stimulate implementation of International Health Regulations and implementation of early warning surveillance system for detection of invasive Aedes mosquitoes, native mosquitoes and arboviruses they may transmit. A network for the surveillance of both invasive and native mosquito species at the main point of entry for the first time in Cyprus was developed. Number of mosquitoes sampled was correlated with weather factors to identify parameters that might predict mosquito activity and species distribution to the prevention of international spread of vector mosquitoes and vector-borne diseases.
The recent emergence and established presence of Aedes aegypti in the Autonomous Region of Madeira, Portugal, was responsible for the first autochthonous outbreak of dengue in Europe. The island has not reported any dengue cases since the outbreak in 2012. However, there is a high risk that an introduction of the virus would result in another autochthonous outbreak given the presence of the vector and permissive environmental conditions. Understanding the dynamics of a potential epidemic is critical for targeted local control strategies. Here, we adopt a deterministic model for the transmission of dengue in Aedes aegypti mosquitoes. The model integrates empirical and mechanistic parameters for virus transmission, under seasonally varying temperatures for Funchal, Madeira Island. We examine the epidemic dynamics as triggered by the arrival date of an infectious individual; the influence of seasonal temperature mean and variation on the epidemic dynamics; and performed a sensitivity analysis on the following quantities of interest: the epidemic peak size, time to peak, and the final epidemic size. Our results demonstrate the potential for summer and autumn season transmission of dengue, with the arrival date significantly affecting the distribution of the timing and peak size of the epidemic. Late-summer arrivals were more likely to produce large epidemics within a short peak time. Epidemics within this favorable period had an average of 11% of the susceptible population infected at the peak, at an average peak time of 95 days. We also demonstrated that seasonal temperature variation dramatically affects the epidemic dynamics, with warmer starting temperatures producing large epidemics with a short peak time and vice versa. Overall, our quantities of interest were most sensitive to variance in the date of arrival, seasonal temperature, transmission rates, mortality rate, and the mosquito population; the magnitude of sensitivity differs across quantities. Our model could serve as a useful guide in the development of effective local control and mitigation strategies for dengue fever in Madeira Island.
The occurrence of infectious diseases may change tourists’ perceptions of a destination’s image and value. This article proposes and empirically tests a choice model to measure the effect of the risk of infectious disease outbreaks caused by climate change on tourists’ willingness to pay for holidays to island destinations. With this aim, an online survey was administrated to 2538 European frequent travellers at their country of residence. Tourists were presented with a hypothetical situation whereby they had to choose among eleven well-known European island destinations for their next holiday. The choice cards included the probability of the occurrence of infectious disease events in the context of other potential risks caused by climate change (i.e., forest fires, floods, heat waves, etc.). The results show infectious disease is the risk that more negatively affects tourists’ willingness to pay to visit islands, followed by forest fires. The results have implications for tourism policy, highlighting the importance of prevention and response strategies, and the design of climate-oriented services, which may raise opportunities to work towards the enhancement of those health and environmental conditions of tourist destinations that ensure their sustainability in the longer term.
Ciguatera poisoning (CP) results from the consumption of seafood contaminated with ciguatoxins (CTXs). This disease is highly prevalent in French Polynesia with several well-identified hotspots. Rapa Island, the southernmost inhabited island in the country, was reportedly free of CP until 2007. This study describes the integrated approach used to investigate the etiology of a fatal mass-poisoning outbreak that occurred in Rapa in 2009. Symptoms reported in patients were evocative of ciguatera. Several Gambierdiscus field samples collected from benthic assemblages tested positive by the receptor binding assay (RBA). Additionally, the toxicity screening of ?250 fish by RBA indicated ?78% of fish could contain CTXs. The presence of CTXs in fish was confirmed by liquid chromatography tandem mass spectrometry (LC-MS/MS). The potential link between climate change and this range expansion of ciguatera to a subtropical locale of French Polynesia was also examined based on the analysis of temperature time-series data. Results are indicative of a global warming trend in Rapa area. A five-fold reduction in incidence rates was observed between 2009 and 2012, which was due in part to self-regulating behavior among individuals (avoidance of particular fish species and areas). Such observations underscore the prominent role played by community outreach in ciguatera risk management.
Sri Lanka is experiencing various social and environmental challenges, including drought, storms, floods, and landslides, due to climate change. One of Sri Lanka’s biggest cities, Kurunegala, is a densely populated city that is gradually turning into an economic revitalization area. This fast-growing city needs to establish an integrated urban plan that takes into account the risks of climate change. Thus, a climate change risk assessment was conducted for both the water and heat wave risks via discussions with key stakeholders. The risk assessment was conducted as a survey based on expert assessment of local conditions, with awareness surveys taken by residents, especially women. The assessment determined that the lack of drinking water was the biggest issue, a problem that has become more serious due to recent droughts caused by climate change and insufficient water management. In addition, the outbreak of diseases caused by heat waves was identified as a serious concern. Risk assessment is integral to developing an action plan for minimizing the damage from climate change. It is necessary to support education and awareness in developing countries so that they can perform risk assessment well and develop both problem-solving and policy-making abilities to adapt to a changing climate.
With over one million cases worldwide annually and a high fatality in symptomatic forms, human leptospirosis is a growing public health concern for the most vulnerable populations, especially in the context of global warming and unplanned urbanization. Although the Asia-Pacific region is particularly affected, accurate epidemiological data are often lacking. We conducted an eleven-year retrospective laboratory-based epidemiological survey of human leptospirosis in New Caledonia. From 2006 to 2016, 904 cases were laboratory-confirmed, including 29 fatalities, corresponding to an average annual incidence of 30.6/100,000 and a case fatality rate of 3.2%. Over the period, there was a major shift from indirect serological diagnosis by MAT to direct diagnosis by real-time PCR, a more specific and sensitive test when performed early in the course of the disease. The systematic implementation of genotyping informed on the variety of the infective strains involved, with a predominance of serogroups Icterohaemorrhagiae and Pyrogenes. The epidemiological pattern showed a marked seasonality with an annual peak in March-April. Interestingly, the seasonal peak in children of school age was significantly earlier and corresponded to school holidays, suggesting that attending school from February on could protect children from environment-borne leptospirosis.
