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Prevalence of household food insecurity in East Africa: Linking food access with climate vulnerability

The prevalence of food insecurity is much higher in East Africa than in other parts of the world. Climate change and associated variability are important contributors to food insecurity in the region. Using primary data collected in 2018/19 from Ethiopia, Kenya and Tanzania, this study examines the links between the prevalence of household food insecurity (the access to food dimension) and vulnerability to climate change in East Africa. The Household Food Insecurity Access Scale (HFIAS) was constructed to measure the prevalence of household food insecurity, and an ordered probit econometrics model was used to investigate the factors affecting the prevalence rates. The aggregate results show that 52% of the total sampled households in the region were food-secure; 15% and 26% were mildly food-secure and moderately food-insecure, respectively; and the remaining 7% were severely food-insecure. The ordered probit results suggest that exposure to climate change extremes and crop losses caused by these extremes significantly contribute to the prevalence of food insecurity across countries in East Africa. The results also indicate that households’ adaptive capacity plays a significant role in reducing the prevalence of food insecurity. The demographic/human, social, financial, physical, and natural assets/capital of the household also play a significant role in reducing household-level food insecurity in Ethiopia, Kenya, and Tanzania.

Water, sanitation, and hygiene vulnerability among rural areas and small towns in South Africa: Exploring the role of climate change, marginalization, and inequality

Access to water, sanitation, and hygiene (WASH)-including drainage-services-is essential for public health and socio-economic development, but access remains inadequate and inequitable in low- to middle-income countries such as South Africa. In South Africa, rural areas and small towns generally depend on a limited and climate-sensitive economic base (e.g., farming), and they have a limited capacity and are located in areas where transport challenges can increase WASH access risks. Climate change shifts hydrological cycles, which can worsen WASH access and increase susceptibility to the interlinked impacts of droughts and flooding in already vulnerable regions. We adopted a transdisciplinary approach to explore the needs, barriers, and vulnerabilities with respect to WASH in rural areas and small towns in South Africa-using two case studies to explore climate risk and vulnerability assessment (CRVA) in one rural village in the northern Limpopo province and a small town in the Western Cape province. This holistic approach considered natural (environment and climate) and socio-economic (economic, social, governance, and political) factors and how they interplay in hampering access to WASH. Extreme weather events characterized by frequent and intense droughts or floods aggravate surface and groundwater availability and damage water infrastructure while threatening agriculture-dependent livelihoods. The lack of reliable transport infrastructure increases risks posed by flooding as roads to vital supplies are prone to damage. High inequality linked to rising unemployment and the Apartheid legacy of a segregated service delivery system result in inequitable access to WASH services. The intertwined ways in which natural elements and historical, social, economic, governance, and policy aspects are changing in South Africa increase WASH vulnerability in rural areas and small towns.

Seasonality, climate change, and food security during pregnancy among indigenous and non-indigenous women in rural Uganda: Implications for maternal-infant health

BACKGROUND: Climate change is expected to decrease food security globally. Many Indigenous communities have heightened sensitivity to climate change and food insecurity for multifactorial reasons including close relationships with the local environment and socioeconomic inequities which increase exposures and challenge adaptation to climate change. Pregnant women have additional sensitivity to food insecurity, as antenatal undernutrition is linked with poor maternal-infant health. This study examined pathways through which climate change influenced food security during pregnancy among Indigenous and non-Indigenous women in rural Uganda. Specific objectives were to characterize: 1) sensitivities to climate-associated declines in food security for pregnant Indigenous women; 2) women’s perceptions of climate impacts on food security during pregnancy; and 3) changes in food security and maternal-infant health over time, as observed by women. METHODS: Using a community-based research approach, we conducted eight focus group discussions-four in Indigenous Batwa communities and four in non-Indigenous communities-in Kanungu District, Uganda, on the subject of climate and food security during pregnancy. Thirty-six women with ≥1 pregnancy participated. Data were analysed using a constant comparative method and thematic analysis. RESULTS: Women indicated that food insecurity was common during pregnancy and had a bidirectional relationship with antenatal health issues. Food security was thought to be decreasing due to weather changes including extended droughts and unpredictable seasons harming agriculture. Women linked food insecurity with declines in maternal-infant health over time, despite improved antenatal healthcare. While all communities described food security struggles, the challenges Indigenous women identified and described were more severe. CONCLUSIONS: Programs promoting women’s adaptive capacity to climate change are required to improve food security for pregnant women and maternal-infant health. These interventions are particularly needed in Indigenous communities, which often face underlying health inequities. However, resiliency among mothers was strong and, with supports, they can reduce food security challenges in a changing climate.

Drivers and barriers to sustained use of blair ventilated improved pit latrine after nearly four decades in rural Zimbabwe

BACKGROUND: Some latrines remain unused even under conditions of high coverage in rural areas of low- and middle-income countries. Not much is known on household latrine use in the long term in the absence of an intervention. The current work assesses drivers and barriers to sustained use of a ventilated improved pit latrine (Blair VIP) design where it originated and how rural households adapt it to climate change. METHODS: A mixed methods study was conducted from November 2020 to May 2021 among rural households of Mbire district, Zimbabwe. A cross sectional survey of 238 households with Blair ventilated improved pit (BVIP) latrines was conducted using a questionnaire and a latrine observation checklist. Data were analysed using logistic regression. Qualitative data were collected using six focus groups among house heads and analysed by thematic analysis. RESULT: The latrine has perceived health, non-health and hygiene benefits for its sustained use. However, there are design, environmental and social barriers. The quantitative study indicated that determinants of latrine use were contextual (individual and household levels) and technology (individual level) factors. Focus groups indicated that latrine use was influenced by social, technology and contextual factors at multiple level factors. Interplay of factors influenced the intention to adapt the BVIP latrine to climate change. Local climate change adaptation strategies for the latrine were odour and erosion control, construction of the conventional latrine design and raised structures. CONCLUSION: The conventional BVIP latrine design is durable and relatively resilient to climate change with high local household use. High construction cost of the latrine causes households to build incomplete and poor quality designs which affect odour and fly control. These are barriers to sustained latrine use. The government should implement the new sanitation policy which considers alternative sanitation options and offer community support for adapting sanitation to climate change.

Home gardening in sub-Saharan Africa: A scoping review on practices and nutrition outcomes in rural Burkina Faso and Kenya

Home gardening is promoted as an adaptation strategy to ameliorate the increasing food insecurity from climate change impacts among subsistence farming families in rural sub-Saharan Africa. Yet, the geographic distribution of home gardens, their setup, management, and the effects on nutrition outcomes have not been fully described. This scoping review aimed to map and synthesize recent evidence on home gardening for two exemplar countries: Burkina Faso and Kenya. Between June and August 2020, we searched, screened, and extracted evidence about home garden projects in both countries, following the PRISMA guidelines for scoping reviews. Peer-reviewed scientific publications, and gray literature in English and French that reported about subsistence horticulture in rural settings of Burkina Faso or Kenya were included. The characteristics of the documents and the data pertaining to our research objectives were extracted into predefined spreadsheets. The data were synthesized in the form of a narrative review. Our search yielded 949 documents, of which 20 documents were included in the synthesis (Burkina Faso: 8, Kenya: 12). While the gardens varied in composition and size, the majority provided green leafy vegetables and indigenous horticultural crops. The challenges for successful home garden implementation comprised unfavorable climatic conditions, access to and affordability of inputs, water and land, and lack of know-how. We identified trends for improved food security, diet quality, and nutritional status among the target populations. This scoping review found that there is limited evidence on home garden practices in rural Burkina Faso and Kenya. To enhance the sustainability of home gardens, research and resources should he invested in codesigning context-specific home gardening projects. Pending rigorous impact evaluation, home gardens appear to be a promising tool for climate change adaptation while simultaneously improving food security and the nutritional situation among women and young children in these two exemplar countries of sub-Saharan Africa.

Causes, indicators and impacts of climate change: Understanding the public discourse in Goat based agro-pastoral livelihood zone, Ethiopia

This study assessed the perceived causes, indicators and impacts of climate change by disaggregating farmers in to adaptor and non-adaptor groups in Goat based agro-pastoral livelihood zone of Ethiopia. The collected quantitative and qualitative data were analysed in descriptive statistics, linear regression, anomaly index, Likert rating scale and conceptual narrations. The findings demonstrated that an increasing temperature and a decreasing rainfall trends were perceived by farmers across the study decades. Higher deforestation rate, rash natural resource exploitation, poor soil and water management rehearses and alarming population growth in descending order were identified as climate change causes. Livestock and crop yield decline, livestock/human diseases epidemics and death, as well as recurrent conflicts due to grazing land were its associated impacts. The status and nature of climate change causes, indicators and impacts were however significantly diverse within similar awareness groups. To mitigate its adverse impacts, the farmers were thus applied livestock, crop and non-agriculture related adaptation strategies. Shortage of finance and eligible household labor combined with the absence of climate related information, training and extension services were hindered farmers to take any measure to the climate change. Therefore, to encourage the farmers’ responsiveness, the finding underlines the importance of supplying applicable as well as legitimate natural resource exploitation system, followed by access to climate related information, awareness rising trainings, credit and input delivery services at local and community level.

Examining local perspectives on the influence of climate change on the health of Hamer pastoralists and their livestock in Ethiopia

This study explores the perceived influence of climate change on the health of Hamer pastoralists and their livestock in south-western Ethiopia. A combination of focus group discussions and key informant interviews were conducted with Hamer communities as well as local health workers, animal health workers and non-governmental organisation (NGO) staff. Thematic framework analysis was used to analyse the data. Reductions in rangeland, erratic rainfall, recurrent droughts and loss of seasonality were perceived to be the biggest climate challenges influencing the health and livelihoods of the Hamer. Communities were travelling greater distances to access sufficient grazing lands, and this was leading to livestock deaths and increases in ethnic violence. Reductions in suitable rangeland were also precipitating disease outbreaks in animals due to increased mixing of different herds. Negative health impacts in the community stemmed indirectly from decreases in livestock production, uncertain crop harvests and increased water scarcity. The remoteness of grazing lands has resulted in decreased availability of animal milk, contributing to malnutrition in vulnerable groups, including children. Water scarcity in the region has led to utilisation of unsafe water sources resulting in diarrhoeal illnesses. Further, seasonal shifts in climate-sensitive diseases such as malaria were also acknowledged. Poorly resourced healthcare facilities with limited accessibility combined with an absence of health education has amplified the community’s vulnerability to health challenges. The resilience and ambition for livelihood diversification amongst the Hamer was evident. The introduction of camels, increase in permanent settlements and new commercial ideas were transforming their livelihood strategies. However, the Hamer lack a voice to express their perspectives, challenges and ambitions. There needs to be collaborative dynamic dialogue between pastoral communities and the policy-makers to drive sustainable development in the area without compromising the values, traditions and knowledge of the pastoralists.

Gendered vulnerability, perception and adaptation options of smallholder farmers to climate change in eastern Ethiopia

Climate change has become a global phenomenon, but its impact is unevenly distributed among regions, economic classes, age classes and genders. Gender is among the factors that influence the perception and adaptation of smallholder farmers to the impacts of climate change. This study assessed the level of gender vulnerability, perception and adaptation options against climate change in the rural areas of Meta District, eastern Ethiopia. Data were collected from 193 respondents through household survey, focus group discussions (FGD) and key informant interviews. Long-term climate data (1990-2019) were acquired from the National Meteorological Agency (NMA) of Ethiopia. Integrated vulnerability assessment method through the construction of indices from selected indicators of climate change was used to describe vulnerability. A multivariate probit model (MVP) was employed to identify factors affecting the choice of adaptation options to climate change. Climate data analysis showed that long-term annual, belg (short rainy season from February-April) and kiremt (long rainy season from June-September) seasonal rainfall had high variability with a coefficient of variation of 37.7%, 42.5% and 34.4%, respectively. Approximately 90% of male- and 74% of female-headed households perceived declining and erratic rainfall and rising temperature over time in their locality in the last three decades. The lower perception of women implies that they had less access to climate information and lack awareness, which constrains their adaptation against the impacts of climate change. The likelihood of household heads adopting soil and water conservation (SWC) practices, adjusting planting dates and use of drought-tolerant varieties was 77.2%, 56.9% and 53.9%, respectively. Women were more vulnerable, with a vulnerability index (VI) of – 0.138, to climate change than men (VI = 0.009) in the study area. These findings necessitate the formulation and implementation of gender-sensitive and context-specific policies that provide poor female farmers with the opportunities to diversify their livelihood with non-farm income. Moreover, non-formal trainings and better extension services are needed to enhance the perception of climate change and the use of adaptation practices to improve resilience against climate change.

Building resilience: The gendered effect of climate change on food security and sovereignty in Kakamega-Kenya

Climate change is a global threat, affecting the food security and food sovereignty of many depending on agriculture for their livelihoods. This is even more pronounced in Kenya, given their over-reliance on rain-fed crops and the frequency of floods and droughts in the country. Through qualitative interviews, this study set out to establish how climate change not only affects the food security, production and consumption of rural women farmers in Kakamega County, Kenya, but their response to climate shocks. Using resilience theory as a lens, we established that women use different pathways to mitigate the effects of climate change on their livelihoods. The study found that initially women adopt coping strategies that are reactive and not sustainable, but soon adapted their farming strategies, using their indigenous knowledge to exercise some control over both their food security and food sovereignty. Besides this, they use their human and social capital to expand their networks of support. By linking up to other organizations and gaining access to government support, they are able to challenge patriarchal relations that perpetuate poverty and inequality and bring about more transformative and sustainable responses to climate change.

A black dog enters the home: Hunger and malnutrition in Malawi

Hunger and inadequate nutrition are ongoing concerns in rural Malawi and are exemplified in traditional proverbs. Traditional proverbs and common expressions offer insight into commonly held truths across societies throughout sub-Saharan Africa. Strong oral traditions allow community beliefs embodied in proverbs to be passed down from generation to generation. In our qualitative study, we conducted 8 individual and 12 focus group interviews with a total of 83 participants across two districts in rural central Malawi with the aim of soliciting context-specific details on men and women’s knowledge, attitudes and practices related to nutrition, gender equality and women’s empowerment. Each interview began by asking participants to share common proverbs related to nutrition. Our qualitative analysis, informed by an indigenous-based theoretical framework that recognises and centres African indigenous knowledge production, yielded six themes: ‘a black dog enters the home’, ‘don’t stay with your hands hanging’, ‘a man is at the stomach’, ‘showers have fallen’, ‘we lack peace in our hearts’ and ‘the hunger season’. Traditional proverbs can provide insight into the underlying causes of hunger and malnutrition. Physicians, nurses and other allied health professionals around the world have a role to play in addressing hunger and malnutrition, which have been exacerbated by climate change. We have an ethical duty to educate ourselves and others, and change our behaviours, to mitigate the root causes of climate change, which are contributing to food insecurity and resultant poor health outcomes in countries like Malawi.

Climate change and child malnutrition: A Nigerian perspective

Erratic temperatures and precipitation influence nutrition, human capital investment, and living standards, particularly for children. This study investigates the effect of climate change (changes in the monthly maximum average near-surface temperature and total monthly precipitation) on children’s health outcomes, particularly stunting and underweight, in Nigeria. We combine Living Standards Measurement Study -Integrated Surveys on Agriculture (LSMS-ISA) data with high resolution gridded climate data. We find that the rise in temperature is associated with higher levels of stunting – even more so in rural areas. The paper’s findings highlight the need for climate-friendly policies to mitigate the long-term effect of climate change on malnourishment. Without such policies, climate change could reverse years of progress in lowering children’s malnutrition.

A framework to assess forest-agricultural landscape management for socioecological well-being outcomes

Global demand for agricultural products continues to grow. However, efforts to boost productivity exacerbate existing pressures on nature, both on farms and in the wider landscape. There is widespread appreciation of the critical need to achieve balance between biodiversity and human well-being in rural tropical crop production landscapes, that are essential for livelihoods and food security. There is limited empirical evidence of the interrelationships between natural capital, the benefits and costs of nature and its management, and food security in agricultural landscapes. Agroforestry practices are frequently framed as win-win solutions to reconcile the provision of ecosystem services important to farmers (i.e., maintaining soil quality, supporting pollinator, and pest control species) with nature conservation. Yet, underlying trade-offs (including ecosystem disservices linked to pest species or human-wildlife conflicts) and synergies (e.g., impact of ecosystem service provision on human well-being) are seldom analysed together at the landscape scale. Here, we propose a systems model framework to analyse the complex pathways, with which natural capital on and around farms interacts with human well-being, in a spatially explicit manner. To illustrate the potential application of the framework, we apply it to a biodiversity and well-being priority landscape in the Southern Agricultural Growth Corridor of Tanzania, a public-private partnership for increasing production of cash and food crops. Our framework integrates three main dimensions: biodiversity (using tree cover and wildlife as key indicators), food security through crop yield and crop health, and climate change adaptation through microclimate buffering of trees. The system model can be applied to analyse forest-agricultural landscapes as socio-ecological systems that retain the capacity to adapt in the face of change in ways that continue to support human well-being. It is based on metrics and pathways that can be quantified and parameterised, providing a tool for monitoring multiple outcomes from management of forest-agricultural landscapes. This bottom-up approach shifts emphasis from global prioritisation and optimisation modelling frameworks, based on biophysical properties, to local socio-economic contexts relevant in biodiversity-food production interactions across large parts of the rural tropics.

Climate change, women’s workload in smallholder agriculture, and embodied political ecologies of undernutrition in northern Ghana

The burden of child undernutrition across Africa remains extraordinarily high. Among children under age five, chronic and acute undernutrition is responsible for more ill-health than any other cause. While climate change exacerbates the multiple burdens of undernutrition, we know very little about the embodied effects on women’s workload in agriculture and implications for feeding practices, especially for infants whose nutrition depends on mothers’ time. In this article, political ecologies of health, with its nested, place-based analysis, is used as a framework to address this knowledge gap. The study took place in Ghana’s Upper West Region, a semi-arid and resource-poor setting with higher undernutrition rates. In-depth interviews were conducted with smallholder farmers (n = 33) whose infants have sub-optimal growth, and key informants (n = 7) with expertise in nutrition and health. Findings from the study demonstrate how climate change puts pressure on women’s productive time, leading to poor child feeding practices and undernutrition. Ultimately, the article argues that there are hidden impacts of climate change on undernutrition. Global undernutrition interventions should therefore move beyond biomedical solutions to address these hidden impacts, some of which are social, gendered, and structural in nature.

A feasibility study of the use of Umbiflow™ to assess the impact of heat stress on fetoplacental blood flow in field studies

OBJECTIVE: To evaluate the use of UmbiFlow™ in field settings to assess the impact of heat stress on umbilical artery resistance index (RI). METHODS: This feasibility study was conducted in West Kiang, The Gambia, West Africa; a rural area with increasing exposure to extreme heat. We recruited women with singleton fetuses who performed manual tasks (such as farming) during pregnancy to an observational cohort study. The umbilical artery RI was measured at rest, and during and at the end of a typical working shift in women at 28 weeks or more of pregnancy. Adverse pregnancy outcomes (APO) were classified as stillbirth, preterm birth, low birth weight, or small for gestational age, and all other outcomes as normal. RESULTS: A total of 40 participants were included; 23 normal births and 17 APO. Umbilical artery RI demonstrated a nonlinear relationship to heat stress, with indication of a potential threshold value for placental insufficiency at 32°C by universal thermal climate index and 30°C by wet bulb globe temperature. CONCLUSIONS: The Umbiflow device proved to be an effective field method for assessing placental function. Dynamic changes in RI may begin to explain the association between extreme heat and APO with an identified threshold of effect.

Growing spatial overlap between dam-related flooding, cropland and domestic water points: A water-energy-food nexus management challenge in Malawi and Ghana

In sub-Saharan Africa, land cover change, expansion of hydropower infrastructure, and increased flooding complicate country-level efforts to meet the Sustainable Development Goal target concerning access to safe water. The Water, Energy and Food (WEF) nexus approach recognises that addressing these complex challenges requires cross-sectoral analyses at multiple scales. Building on such an approach, our study examined the interrelationships between land cover change, dam-related flooding and access to safe water via a national-level spatial analysis with local case studies in Malawi and Ghana. Our assessment of the water-food interactions found that areas of overlap between water points and cropland increased from 2000 to 2020 for both countries at national scale, but overlap extent varied greatly depending on the land cover product used. Local-scale exploration of water point installation patterns in Zomba, Malawi confirmed this pattern, highlighting increasing non-governmental funding of borehole installation programmes. Our assessment of water-energy interactions found that flooding mediated by hydropower dams increased for the White Volta Basin in Ghana, thereby increasing inundation of groundwater points. Local-scale focus group discussions revealed flooding resulted in contaminated water sources and high risk of injury or drowning whilst fetching water. Overall, our study highlights how socio-economic drivers are bringing water points, flooding and cropland into closer proximity, requiring flood mitigation measures at water points and agro-chemical management to minimise potential water quality impacts. Given differences between land cover products, we recommend more robust integration of existing land cover products to better monitor these phenomena.

Engineering environmental resilience: A matched cohort study of the community benefits of trailbridges in rural Rwanda

Rural isolation can limit access to basic services and income-generating opportunities. Among some communities, rainfall induced flooding can cause increased uncertainty where first-mile transportation infrastructure is limited. In Rwanda, this challenge is apparent, where 90% of the population below the poverty line live in rural areas that are typically mountainous with frequent flooding – events that may be increasing in frequency and severity as the climate changes. To reduce these transportation barriers, the non-profit organization Bridges to Prosperity (B2P) plans to construct hundreds of trailbridges in Rwanda between 2018 and 2023. This scale of rural infrastructure services presents an opportunity for experimental investigation of the effects of these new trailbridges on economic, health, agricultural and education outcomes in rural communities. In this paper, we present a cohort study evaluating the potential community benefits of rural trailbridges – including economic, health and social outcomes for Rwandan communities experiencing environmental change. We examined households living near 12 trailbridge sites and 12 comparison sites over February 2019-March 2020. We found that labor market income increased by 25% attributable to the trailbridges. We did not observe any significant effects on agricultural income, education or health outcomes, however given the small sample and short duration of this study we anticipate observing additional outcomes within the recently started 200 site, 4 year trial.

Institutional responses to drought in a high HIV prevalence setting in rural South Africa

In 2015, South Africa experienced one of the worst (El Ni??o-induced) droughts in 35 years. This affected economic activities, individual and community livelihoods and wellbeing especially in rural communities in northern KwaZulu-Natal. Drought’s direct and indirect impacts on public health require urgent institutional responses, especially in South Africa’s stride to eliminate HIV as a public health threat by 2030 in line with the UNAIDS goals. This paper draws on qualitative data from interviews and policy documents to discuss how the devastating effect of the 2015 drought experience in the rural Hlabisa sub-district of uMkhanyakude, a high HIV prevalence area, imposes an imperative for more proactive institutional responses to drought and other climate-related events capable of derailing progress made in South Africa’s HIV/AIDS response. We found that drought had a negative impact on individual and community livelihoods and made it more difficult for people living with HIV to consistently engage with care due to economic losses from deaths of livestock, crop failure, food insecurity, time spent in search of appropriate water sources and forced relocations. It also affected government institutions and their interventions. Interviewed participants’ reflections on drought-related challenges, especially those related to institutional and coordination challenges, showed that although current policy frameworks are robust, their implementation has been stalled due to complex reporting systems, and inadequate interdepartmental collaboration and information sharing. We thus argue that to address the gaps in the institutional responses, there is a need for more inclusive systems of drought-relief implementation, in which government departments, especially at the provincial and district levels, work with national institutions to better share data/information about drought-risks in order to improve preparedness and implementation of effective mitigation measures.

Socio-economic determinants of increasing household food insecurity during and after a drought in the District of iLembe, South Africa

In 2015 and 2016, South Africa experienced a severe drought resulting in water restrictions and food price inflation. A year later, while the proportion of food secure households remained constant, the proportion of those experiencing severe food insecurity increased. This paper investigates the socio-economic determinants of increasing food insecurity during and after the drought. Two cross-sectional household surveys were carried out in the district of iLembe in November 2016 and 2017. Household food insecurity was measured using the Coping Strategies Index. The results indicated changes in socio-economic determinants of food insecurity over time, with the poorest households experiencing the worst levels of food insecurity. After the drought, having a child under-five years was positively associated with food insecurity, while being located in a rural area was negatively associated. Policies that limit household vulnerability to price inflation, and interventions that protect poorer households from the effects of drought should be considered.

Mapping and managing livelihoods vulnerability to drought: A case study of Chivi District in Zimbabwe

The assessment of the vulnerability to drought hazards in smallholder farming systems dependent on rain-fed agriculture has recently gained global popularity, given the need to identify and prioritize climate hotspots for climate adaptation. Over the past decade, numerous studies have focused on vulnerability assessments with respect to drought and other meteorological hazards. Nonetheless, less research has focused on applying common measurement frameworks to compare vulnerability in different communities and the sources of such vulnerability. Yet, the crucial question remains: who is more vulnerable and what contributes to this vulnerability? This article is a case study for assessing the vulnerability to drought of smallholder farmers in two wards in Chivi district, Masvingo Province, Zimbabwe. This study is timely, as climate change is increasingly affecting populations dependent on rainfed agriculture. This assessment has been conducted by calculating the Livelihood Vulnerability Index (LVI) and Livelihood Vulnerability Index of the Intergovernmental Panel on Climate Change (LVI-IPCC). This empirical study used data from 258 households from the two wards and triangulated it through Key Informant Interviews and Focus Group Discussions. To calculate the LVI, twenty-six subcomponents made up of seven major components, including socio-demographic variables; livelihood strategies; social capital; access to food, health, and water; and exposure to drought, were considered. To calculate the LVI-IPCC, we combined the three contributing factors of vulnerability (exposure, sensitivity, and adaptive capacity). Our results indicate that the LVI forward 14 is statistically higher than for ward 19 (F = 21.960; p <= 0.01) due to high exposure to drought, food insecurity, and compromised social networks. Concerning the LVI-IPCC, ward 14 was significantly more vulnerable to the impacts of drought than ward 19 (F = 7.718; p <= 0.01). Thus, reducing exposure to drought through early warning systems, building diversified agricultural systems, and social networks are of high priority to reduce the vulnerability of the farmers.

Malnutrition pathway for the impact of in utero drought shock on child growth indicators in rural households

This paper evaluates the short-term health effects of in utero drought shock using repeated cross-section household data on Malawi. The main finding reveals that the effects of in utero harvest variability caused by rainfall shocks on child growth indices are driven by the deleterious effects of negative rainfall deviations, namely droughts. Negative rainfall deviation during the agricultural season prior to the gestational period of a child leads to a 21.8 per cent average local level reduction in age-standardized height scores, with the counterpart positive rainfall deviation having no apparent effect. The paper also uses harvest and consumption patterns to establish an important link between early-life malnutrition and growth serving as a precursor for the fetal period programming hypothesis in the literature. The direct impact of embryonic period shocks on growth provides supportive evidence on potential interaction between nutritional and environmental pathways.

Applying a wash risk assessment tool in a rural south African setting to identify risks and opportunities for climate resilient communities

Climate change threatens the health and well-being of populations. We conducted a risk assessment of two climate-related variables (i.e., temperature and rainfall) and associated water, sanitation and hygiene (WASH)-related exposures and vulnerabilities for people living in Mopani District, Limpopo province, South Africa. Primary and secondary data were applied in a qualitative and quantitative assessment to generate classifications of risk (i.e., low, medium, or high) for components of hazard/threat, human exposure, and human vulnerability. Climate-related threats were likely to impact human health due to the relatively high risk of waterborne diseases and WASH-associated pathogens. Vulnerabilities that increased the susceptibility of the population to these adverse outcomes included environmental, human, physical infrastructure, and political and institutional elements. People of low socio-economic status were found to be least likely to cope with changes in these hazards. By identifying and assessing the risk to sanitation services and water supply, evidence exists to inform actions of government and WASH sector partners. This evidence should also be used to guide disaster risk reduction, and climate change and human health adaptation planning.

Pastoral coping and adaptation climate change strategies: Implications for women’s well-being

Pastoral women in the semi-arid rangelands of East Africa are significantly burdened by the vulnerability to and responsibility for responding to changing climates. Consequently, understanding how adaptation and coping strategies impact pastoral women’s well-being is critical for supporting the climate resilience of communities and the landscapes on which they rely. We used a household survey, guided by a multi-dimensional framework of well-being, to investigate how the use of drought-related coping and adaptation strategies by Samburu households influenced livestock loss and women’s well-being in northern Kenya. Coping and adaptation strategies predicted numerous social-cognitive components of well-being, although not livestock loss. We conjecture these results are a product of a gendered division of labor within households and the community. We argue that interventions aimed at supporting drought resilience must consider the gendered implications of climate response strategies, multiple indicators for evaluation, and the influence of community and place.

Drought, hunger and coping mechanisms among rural household in Southeast Ethiopia

Protracted and prolonged droughts lead to famine and substantial decline in agricultural productivity that contribute to food insecurity and hunger in sub-Saharan Africa which needs to explore the risk coping strategies to better target risk mitigation. The main research question of this paper was to analyze ex-post coping strategies and their determinants in rural Ethiopia. We use a cross-section data collected in 2013 from vulnerable rural households in Rayitu district, Bale Zone of Oromia Regional State. Using population-proportionate to size (PPS) sampling technique, a total number of 1,402 households in the district participated in this study. The data were analyzed using a three-stage least squares (3SLS) method. Our analysis confirms that rural households in Rayitu district experience drought and are vulnerable to the consequences of shocks. As a response, rural households adopt interdependent risk coping strategies. This supports the notion of addressing the problem of risk through integrated rural development strategies (and policies) to help the poor to improve the vulnerability to shock and help to escape out of poverty. In addition, we found that the risk coping strategies that households adopt are influenced by the resource holdings and income levels of the rural households, their access to product and financial market, and their socio-demographic characteristics. Hence, we argue that strategies and interventions to improve the livelihood of the poor and to support the vulnerable ones should be targeted to fit to the needs and priorities of households.

Coping with drought: Narratives from smallholder farmers in semi-arid Kenya

Globally, drought impacts more people than any other natural hazard. However, drought is also the most complex natural hazard, and its impacts are not evenly distributed across the landscape or among human populations. Just as the impacts of drought vary, so do the coping strategies used by people during drought. The research to-date on drought coping strategies in Sub-Saharan Africa are highly quantitative, focused on top-down interventions, and do not emphasize individual perceptions, experience, and autonomous decision-making when coping with drought. This paper aims to fill these gaps by examining the human experience of coping with drought through narratives from farmers in Burat and Kinna, Isiolo County, Kenya. This paper highlights (1) their perceived impacts of drought, and (2) the various coping strategies used. A total of 83 interviews were conducted in 20 households. Results found that the perceived impacts of drought were decreased agricultural productivity, livestock hunger, death, and relocation, a lack of water in rivers, human hunger and disease, and violent conflict. The strategies for coping with drought included changing agricultural practices, adopting irrigation, relying on aid, charcoal burning, casual labor, livelihood diversification, and others. Importantly, these coping strategies can be classified into four categories: livelihood diversification, longer-term livelihood strategies, short-term coping activities, and erosive coping strategies. This research contributes to the effort to better document and understand farmers? perceptions and strategies to cope with drought through qualitative research methods and from the perspective of the individual smallholder farmer, which is important for making context-specific policy and project recommendations aimed at smallholder farmers.

Geostatistical modeling of malaria prevalence among under-five children in Rwanda

BACKGROUND: Malaria has continued to be a life-threatening disease among under-five children in sub-Saharan Africa. Recent data indicate rising cases in Rwanda after some years of decline. We aimed at estimating the spatial variations in malaria prevalence at a continuous spatial scale and to quantify locations where the prevalence exceeds the thresholds of 5% and 10% across the country. We also consider the effects of some socioeconomic and climate variables. METHODS: Using data from the 2014-2015 Rwanda Demographic and Health Survey, a geostatistical modeling technique based on stochastic partial differential equation approach was used to analyze the geospatial prevalence of malaria among under-five children in Rwanda. Bayesian inference was based on integrated nested Laplace approximation. RESULTS: The results demonstrate the uneven spatial variation of malaria prevalence with some districts including Kayonza and Kirehe from Eastern province; Huye and Nyanza from Southern province; and Nyamasheke and Rusizi from Western province having higher chances of recording prevalence exceeding 5%. Malaria prevalence was found to increase with rising temperature but decreases with increasing volume for rainfall. The findings also revealed a significant association between malaria and demographic factors including place of residence, mother’s educational level, and child’s age and sex. CONCLUSIONS: Potential intervention programs that focus on individuals living in rural areas, lowest wealth quintile, and the locations with high risks should be reinforced. Variations in climatic factors particularly temperature and rainfall should be taken into account when formulating malaria intervention programs in Rwanda.

Seasonal profile and five-year trend analysis of malaria prevalence in Maygaba Health Center, Welkait District, Northwest Ethiopia

BACKGROUND: Malaria is a serious public health problem of most developing countries, including Ethiopia. The burden of malaria is severely affecting the economy and lives of people, particularly among the productive ages of rural society. Thus, this study was targeted to analyze the past five-year retrospective malaria data among the rural setting of Maygaba town, Welkait district, northwest Ethiopia. METHODS: The study was done on 36,219 outpatients attending for malaria diagnosis during January 2015 to 2019. Data was extracted from the outpatient medical database. Chi-square (χ (2)) test and binary logistic regression model were used to analyze the retrospective data. Statistical significance was defined at p < 0.05. RESULTS: Of 36,219 outpatients examined, 7,309 (20.2%) malaria-positive cases were reported during 2015-2019. There was a fluctuating trend in the number of malaria-suspected and -confirmed cases in each year. Male slide-confirmed (61.4%, N = 4,485) were significantly higher than females (38.6%, N = 2,824) (p < 005). Plasmodium falciparum and Plasmodium vivax were the dominant parasites detected, which accounted for 66.1%; N = 4832, 33.9%; N = 2477, respectively. Despite the seasonal abundance of malaria cases, the highest prevalence was recorded in autumn (September to November) in the study area. Binary logistic regression analysis revealed that statistically significant associations were observed between sexes, interseasons, mean seasonal rainfall, and mean seasonal temperature with the prevalence of P. vivax. However, P. falciparum has shown a significant association with interseasons and mean seasonal temperature. CONCLUSIONS: Although the overall prevalence of malaria was continually declined from 2015-2019, malaria remains the major public health problem in the study area. The severe species of P. falciparum was found to be the dominant parasite reported in the study area. A collaborative action between the national malaria control program and its partners towards the transmission, prevention, and control of the two deadly species is highly recommended.

Climate change and food security in Sri Lanka: Towards food sovereignty

This study explored food security and climate change issues and assessed how food sovereignty contributes to addressing the climate change impacts on entire food systems. The study aimed to contextualise food security, climate change, and food sovereignty within Sri Lanka’s current development discourse by bringing global learning, experience, and scholarship together. While this paper focused on many of the most pressing issues in this regard, it also highlighted potential paths towards food sovereignty in the context of policy reforms. This study used a narrative review that relied on the extant literature to understand the underlying concepts and issues relating to climate change, food security and food sovereignty. Additionally, eight in-depth interviews were conducted to obtain experts’ views on Sri Lanka’s issues relating to the thematic areas of this study and to find ways forward. The key findings from the literature review suggest that climate change has adverse impacts on global food security, escalating poverty, hunger, and malnutrition, which adversely affect developing nations and the poor and marginalised communities disproportionately. This study argues that promoting food sovereignty could be the key to alleviating such impacts. Food sovereignty has received much attention as an alternative development path in international forums and policy dialogues while it already applies in development practice. Since the island nation has been facing many challenges in food security, poverty, climate change, and persistence of development disparities, scaling up to food sovereignty in Sri Lanka requires significant policy reforms and structural changes in governance, administrative systems, and wider society.

Climate change impacts on glacier-fed and non-glacier-fed ecosystems of the Indian Himalayan Region: People’s perception and adaptive strategies

Mountains are considered as the early indicators of climate change. The study aims to understand how the Himalayan communities perceive climate change, and how this change has impacted the livelihood and sus-tenance of local people particularly in the remote and rural areas of the region. In view of this, 994 house-holds of 25 villages were interviewed from five basins (five villages per basin) of the Indian Himalayan Region. Their perceptions mainly of climate change were validated/compared with the available climatic indices. People perceived rainfall pattern to be less predictable, greater change in land-use pattern, adverse impacts on forests and human health and overall reduction in their harvests. Seasonal increase in temperature was also reported. Capacity-building programmes for the inhabitants, including the most vulnerable communities in the wake of climate change would be significantly fruitful by way of mitigation and adaptation strategies.

Are multidimensional poor more vulnerable to climate change? Evidence from rural Bihar, India

Does deprivation of assets imply an increased likelihood of vulnerability to climate change? Our study attempts to answer this question by analyzing the multidimensional poverty in rural Bihar, followed by deciphering the link between the developed poverty index and vulnerability of agriculture to climate change. Vulnerability index used in the present study was developed under the National Initiative on Climate Resilient Agriculture (NICRA) by the Government of India. As most people in rural areas and those dependent on rural based livelihood activities (such as agriculture, forestry and livestock) are more vulnerable to vagaries of weather, related attributes (i.e. land ownership, livestock ownership as well as access to agriculture equipments) are included in our analysis. We found that the extent of multidimensional poverty in rural Bihar was 0.278 indicating that rural poor were deprived in 27.8 percent of the total potential deprivations that they could experience overall. It varied from 0.19 to 0.39 across districts. The findings highlight that a majority of the population were deprived in living standard dimension, followed by health and education dimensions. Further, the districts where the multidimensional poverty was high were also more vulnerable to climate change. The study advocates for formulation of district specific programs that can target major contributing factors resulting in reducing the extent of multidimensional poverty and vulnerability.

Btex in ambient air of India: A scoping review of their concentrations, sources, and impact

Toxic gaseous organic air pollutants such as benzene, toluene, ethylbenzene, and xylene isomers (m, p, and o-x) (BTEX) are considered hazardous due to its adverse impacts on human health and on climate change. This review identifies the major research questions addressed so far and the research gap in research articles, published between 2001 and 2022, focusing on the ambient BTEX concentrations in different locations in India along with its sources, ozone formation potential (OFP), and associated health risks. The ambient levels of BTEX were also compared with those of other Asian countries. A comparison of ambient BTEX levels with different microenvironments in India is also presented. BTEX concentrations were found in the range of 30.95 to 317.18 mu g m(-3) and multi-fold higher in urban environments than those measured in the rural air. In most reported studies, the order of occurrence of BTEX compounds was toluene > benzene > xylene isomers > ethylbenzene and winter had higher concentrations than in other seasons, including summer. As far as BTEX levels in classified areas of urban environments are concerned, traffic locations have shown the highest BTEX concentrations, followed by residential, commercial, and industrial locations. OFP indicated that xylene isomers and toluene contributed to ozone formation. The major gaps in reported studies on BTEX measurement are (1) source apportionment; (2) impact on lower tropospheric chemistry, human health, and climate change; and (3) removal techniques from air.

Feeling solastalgia: A study of the effects of changing climate in rural India

Rural communities are dependent on their native environment for supporting their customs, traditions, and other rural activities. This study attempts to understand the effects of the changing climate on rural individuals by investigating their feelings and experiences of perceived changes in the home environment and village life. Thirty-four in-depth interviews were conducted during the months of May-June 2019 in two districts-Gaya and Jehanabad of South Bihar, India. The findings reveal that the rural population have experienced changes in climate such as a rise in the incidence of heatwaves, erratic rainfall patterns, delay in monsoon onset, early drying of water resources, and loss of particular tree and bird species. Worries and uncertainties of the rural population have emerged from the experiences of involuntary separation from traditional farm activities, forced adaptation strategies, loss of cultural and religious practices, and reduced self-worth in coping with the deteriorating environment. The changing climate instigates feelings of emotional distress, resulting in adverse mental health and psychological well-being outcomes. It is concluded that the changing climate is responsible for the loss of traditional village customs and nature-related cultural practices, subsequently inducing solastalgia among the rural population.

Assessment of livelihood vulnerability in the riparian region of the Tista River, west Bengal, India

The Tista floodplain is one of the major food baskets of North Bengal and is sensitive to a multitude of issues regarding vulnerability. The riparian areas and the river island or charland of the lower Tista River basin in India, specifically from Sevoke to the Indo-Bangladesh border, generally suffer due to flood-prone, river course shifting, limited livelihood activities, low adaptive capacity, and poor accessibility. The present work is conducted to assess the livelihood vulnerability based on the livelihood vulnerability index (LVI) framework of the agriculture-dependent riparian villages and the charlands of the River Tista in the Jalpaiguri district. Total 337 households of five villages from the Mal and Maynaguri block at the left bank of the Tista River were selected to conduct the field survey. The livelihood vulnerability was assessed based on eight major components (viz., socio-demographic profile, health condition, livelihood strategies, food support, water support, climatic variability, flood hazards, and social safety) and 42 sub-components. The three contributing factors, i.e., adaptive capacity, sensitivity, and exposure, have been combined to calculate the livelihood vulnerability employing the LVI and LVI-IPCC methodologies. The outcome of the study exhibit that LVI scored highest in Premganj Majhiali (0.436), followed by Basusuba (0.403), Uttar Marichbari (0.349), Domohani (0.335), and Chat Rarpur village (0.328). According to the LVI-IPCC results, Basusuba has the most vulnerability (0.015), whereas Domohani has the least (0.007). In terms of flood hazard, variations were noticed based on increasing distance from the river. Lack of adaptive capacity prevailed in the villages with significant flooding events. Building awareness of the inhabitants will be an effective way to improve the adaptive capacity of the rural villagers. Therefore, giving priority to the policies depending on the natural environment of the active flood-prone region would make long-term sustainability.

Mapping heat-health vulnerability based on remote sensing: A case study in Karachi

As a result of global climate change, the frequency and intensity of heat waves have increased significantly. According to the World Meteorological Organization (WMO), extreme temperatures in southwestern Pakistan have exceeded 54 degrees C in successive years. The identification and assessment of heat-health vulnerability (HHV) are important for controlling heat-related diseases and mortality. At present, heat waves have many definitions. To better describe the heat wave mortality risk, we redefine the heat wave by regarding the most frequent temperature (MFT) as the minimum temperature threshold for HHV for the first time. In addition, different indicators that serve as relevant evaluation factors of exposure, sensitivity and adaptability are selected to conduct a kilometre-level HHV assessment. The hesitant analytic hierarchy process (H-AHP) method is used to evaluate each index weight. Finally, we incorporate the weights into the data layers to establish the final HHV assessment model. The vulnerability in the study area is divided into five levels, high, middle-high, medium, middle-low and low, with proportions of 3.06%, 46.55%, 41.85%, 8.53% and 0%, respectively. Health facilities and urbanization were found to provide advantages for vulnerability reduction. Our study improved the resolution to describe the spatial heterogeneity of HHV, which provided a reference for more detailed model construction. It can help local government formulate more targeted control measures to reduce morbidity and mortality during heat waves.

Rural cooling needs assessment towards designing community cooling hubs: Case studies from Maharashtra, India

In a rapidly warming world, sustainable cooling is directly related to the protection of fresh and nutritious food, medicines, and the population from extreme heat for work conditions, the economic productivity of the working population, and income generation. This study aimed to understand how rural communities are meeting their nutrition, livelihood, health, living space, and mobility requirements regarding the role of cooling. We selected three villages as case studies in Maharashtra, India and conducted household surveys, in-depth interviews of key informants, focus group discussions (FGDs), and social mapping building typology study. The objective was to assess the rural community cooling to propose a community cooling hub (CCH) framework that could be economically, environmentally, and socially sustainable for the three villages. Our study showed that agriculture, dairy, buildings (domestic and commercial), and healthcare require cooling intervention in the studied communities. Based on the needs assessment for cooling, we proposed a CCH framework to provide cooling solutions in an integrated system for rural contexts.

Individually experienced heat stress among elderly residents of an urban slum and rural village in India

The elderly are one of the most vulnerable groups to heat-related illnesses and mortality. In tropical countries like India, where heat waves have increased in frequency and severity, few studies have focused on the level of stress experienced by the elderly. The study presented here included 130 elderly residents of Kolkata slums and 180 elderly residents of rural villages about 75 km south of Kolkata. It used miniature monitoring devices to continuously measure temperature, humidity, and heat index experienced during everyday activities over 24-h study periods, during hot summer months. In the Kolkata slum, construction materials and the urban heat island effect combined to create hotter indoor than outdoor conditions throughout the day, and particularly at night. As a result, elderly slum residents were 4.3 times more likely to experience dangerous heat index levels (≥ 45°C) compared to rural village elderly. In both locations, the median 24-h heat indexes of active elderly were up to 2°C higher than inactive/sedentary elderly (F = 25.479, p < 0.001). Among Kolkata slums residents, there were no significant gender differences in heat exposure during the day or night, but in the rural village, elderly women were 4 times more likely to experience dangerous heat index levels during the hottest times of the day compared to elderly men. Given the decline in thermoregulatory capacity associated with aging and the increasing severity of extreme summer heat in India, these results forecast a growing public health challenge that will require both scientific and government attention.

Heat exposure, heat-related symptoms and coping strategies among elderly residents of urban slums and rural vilages in West Bengal, India

The impact of heat stress among the elderly in India-particularly the elderly poor-has received little or no attention. Consequently, their susceptibility to heat-related illnesses is virtually unknown, as are the strategies they use to avoid, or deal with, the heat. This study examined perceptions of comfort, heat-related symptoms, and coping behaviors of 130 elderly residents of Kolkata slums and 180 elderly residents of rural villages south of Kolkata during a 90-day period when the average 24-h heat indexes were between 38.6 °C and 41.8 °C. Elderly participants in this study reported being comfortable under relatively warm conditions-probably explained by acclimatization to the high level of experienced heat stress. The prevalence of most heat-related symptoms was significantly greater among elderly women, who also were more likely to report multiple symptoms and more severe symptoms. Elderly women in the rural villages were exposed to significantly hotter conditions during the day than elderly men, making it likely that gender differences in symptom frequency, number and severity were related to gender differences in heat stress. Elderly men and elderly village residents made use of a greater array of heat-coping behaviors and exhibited fewer heat-related symptoms than elderly women and elderly slum residents. Overall, heat measurements and heat-related symptoms were less likely to be significant predictors of most coping strategies than personal characteristics, building structures and location. This suggests that heat-coping behaviors during hot weather were the result of complex, culturally influenced decisions based on many different considerations besides just heat stress.

Socioeconomic determinants of climate change adaptations in the flood-prone rural community of Indus Basin, Pakistan

Climate change threatens global sustainability, especially in rural communities of developing countries. In Pakistan, severe impacts of climate change have become evident in the recent past. Large-scale floods in the Indus river system have caused massive damages in the past decade. Also, frequent droughts and heatwaves are among other consequences of the changing climate in the country. Understanding the perspective of local communities regarding climate change adaptation strategies is pivotal to effective policymaking. We surveyed the rural community in the Indus Basin, in southern Punjab, Pakistan, to assess the climate change adaptations currently practiced. We found that the respondents perceive droughts, floods, and disease outbreaks (which are frequently followed by flooding events) as major climate change-induced threats. The respondents used flood and drought-resistant crop varieties, field boundaries (spate irrigation), migration to safe places, and loans as key adaptation strategies. We also assessed the socioeconomic determinants of climate change adaptation behaviour using a binary logistic regression model. Gender, occupation, and education influenced the adaptations to climate change. The present study highlights the need for monetary support to flood-prone communities, better medical facilities, provision of drought and flood-resistant crop varieties, and awareness campaigns to enhance adaptive capacity in the study area.

Emergence of dengue as a febrile illness in Rewa and nearby districts of Madhya Pradesh during the year, 2021: A cross-sectional study

Introduction: Dengue is a mosquito borne viral disease. found in tropical and subtropical countries. Dengue virus (DENV) infected mosquitoes of Aedes species are crucial for the transmission of disease. It has emerged as a threat to the public health systems. Dengue is endemic in many parts of India but still the status of dengue cases in Rewa Madhya Pradesh is not reported convincingly. Aim: To investigate the presence of dengue in Rewa district of Madhya Pradesh. Materials and Methods: This cross-sectional study was conducted in the Department of Microbiology at Shyam Shah Medical college Rewa under National Vector Borne Disease Control Programme (NVBDCP), Rewa, Madhya Pradesh, India, including 1113 Outpatient/Inpatient Department samples received during March 2021 to October 2021. Blood samples were collected from patients having febrile illness and after serum separation, serum were subjected to NS1 Enzyme Linked Immunosorbent Assay (ELISA) test. Descriptive statistics and Chi-square tests were applied for data analysis. Results: A total of 1113 sample were received and tested for dengue NS1 out of that 108 sample were found NS1 positive by ELISA. The cases of dengue started from the month of July 2021. But in the month of October dengue positivity was highest in number. Dengue cases reported were 297 (6.73%) in the rainy season (July-August), but the dengue positivity increased (713, 9.3%) in the post rainy season (September-October). Overall prevalence of dengue was higher in the 21-30 years (34.3%) age group followed by 11-20 years (24.1%), 31-40 years (18.5%), 41-50 years (18.5%), 51-60 years (7.4%) and >60 years (3.70%) age groups with respect to total positive cases. The prevalence of dengue was higher in male (12.94%) in comparison to females (5.54%). Conclusion: This study warrants the dengue virus infection as one of the important causes of fever during rainy and post rainy season in this region. Early diagnosis and reporting of cases are important for the better management of disease.

Climate and environmental health: Education for rural communities

Rural populations experience underinvestment in communication and technology infrastructure that may contribute to an information gap about climate change and the relationship to health impacts in rural communities. This report describes how a student and nursing faculty member provided community edu-cation to 3 rural communities about how climate change impacts the health of rural communities through the local community newspaper serving the 3 communities. Climate and health-related topics in a weekly newspaper column in this project included extreme heat events, Lyme disease, air pollution, water quality, soil health, environmental justice, and the role of the nurse in planetary health.(c) 2021 Elsevier Inc. All rights reserved.

Navigating supported employment and education services for youths during COVID-19 and severe weather events

In 2021, the British Columbia (BC) Interior experienced a series of unprecedented disasters, ranging from extreme heat and wildfires to catastrophic flooding and evacuations. Along with these severe weather events, BC was affected by COVID-19 outbreaks and public health restrictions. Despite these challenges, communities worked to ensure that youths who are at risk for increased mental health challenges continued to have access to services that promote well-being, such as individual placement and support programs for supported employment and education. This Open Forum presents program considerations and adaptations in Foundry Penticton, one of 12 province-wide integrated youth hubs, to ensure service delivery during acute and chronic disasters.

Climate change, aging, and well-being: How residential setting matters

How do older people’s living environments influence their vulnerabilities to climate change? Much has been written about the physiological consequences of climate change for older individuals, particularly the dangers of increased incidence of severe heat. Less is known about how older people’s residential settings moderate their exposure to climate stressors, their particular sensitivities to the effects of climate change, or their capacities to respond to extreme events or adapt to long-term environmental changes. Drawing on literature in English, with a focus on work relevant to the United States, we examine how the housing, neighborhood, and urban or rural contexts in which older people live shape their experiences of climate change, moderating their exposure to risks related to climate change, sensitivity to those events and trends, and their capacities to adapt and recover. Older people face multiple life changes, making prioritizing climate readiness more challenging. They are also diverse, with different vulnerabilities and perceptions of risks and the ability to manage them. This paper lays out an agenda where additional research can inform policy and planning efforts aimed at reducing older individuals’ risk and building the capacity to adapt to climate change. The agenda includes understanding specific vulnerabilities and how older people and their housing providers are already responding.

Temperature and place associations with Inuit mental health in the context of climate change

BACKGROUND: Climate change has important implications for mental health globally. Yet, few studies have quantified the magnitude and direction of associations between weather and mental health-related factors, or assessed the geographical distribution of associations, particularly in areas experiencing rapid climatic change. This study examined the associations between air temperature variables and mental health-related community clinic visits across Nunatsiavut, Labrador, Canada, and the place-specific attributes of these associations. METHODS: Daily de-identified community clinic visit data were collected from the provincial electronic health recording system and linked to historical weather data (2012-2018). A multilevel, multivariable negative binomial regression model was fit to investigate associations between temperature variables and mental health-related community clinic visits across the region, adjusting for seasonality as a fixed effect and community as a random effect. A multivariable negative binomial model was then fit for each Nunatsiavut community, adjusting for seasonality. RESULTS: Mental health-related visits contributed to 2.4% of all 228,104 visit types across the study period; this proportion ranged from 0.6% to 11.3% based on community and year. Regionally, the incidence rate of mental health-related community clinic visits was greater after two weeks of warm average (i.e. above -5ᵒC) temperatures compared to temperatures below -5ᵒC (IRR(-5≤5ᵒC) = 1.47, 95% CI = 1.21-1.78; IRR(6≤15ᵒC) = 2.24, 95% CI = 1.66-3.03; IRR(>15ᵒC) = 1.73, 95% CI = 1.02-2.94), and the incidence rate of mental health-related clinic visits was lower when the number of consecutive days within -5 to 5ᵒC ranges (i.e. temperatures considered to be critical to land use) increased (IRR = 0.96; 95% CI = 0.94-0.99), adjusting for seasonal and community effects. Community-specific models, however, revealed that no two communities had the same association between meteorological conditions and the incidence rate of daily mental health-related visits. DISCUSSION: Regionally, longer periods of warm temperatures may burden existing healthcare resources and shorter periods of temperatures critical to land use (i.e. -5 to 5ᵒC) may present enjoyable or opportunistic conditions to access community and land-based resources. The heterogeneity found in temperature and mental health-related clinic visits associations across Nunatsiavut communities demonstrates that place quantitatively matters in the context of Inuit mental health and climate change. This evidence underscores the importance of place-based approaches to health policy, planning, adaptation, and research related to climate change, particularly in circumpolar regions such as Nunatsiavut where the rate of warming is one of the fastest on the planet.

Social disparities in neighborhood heat in the Northeast United States

Upward trends in ground-level warming are expected to intensify, affecting the health of human populations. Specific to the United States, the Northeast (NE) region is one of the most vulnerable to these warming trends. Previous research has found social disparities in the distribution of heat, while recent studies have examined associations between metropolitan racial/ethnic segregation and heat exposures. We advance upon previous research by including a novel measure of neighborhood-level racial/ethnic diversity in our examination of social inequalities in heat for NE neighborhoods (census tracts). We paired data derived from the United States Geological Survey on mean land surface temperature (LST) for the summer months of 2013-2017 with sociodemographic data from the American Community Survey (5-year estimates, 2013-2017). We use multivariable generalized estimating equations (GEEs) that adjust for geographic clustering. Findings reveal heat exposure disparities across NE neighborhoods. Neighborhoods with higher proportions of racial/ethnic minorities, people of lower socioeconomic status, households without access to an automobile, and greater diversity experience higher temperatures. Diversity was more strongly related to increased heat in neighborhoods with lower Latinx and lower Black composition suggesting that neighborhood homogeneity confers a differentially greater cooling effect based on higher White composition. The social groups that carry the unequal thermal burdens are also those who are most vulnerable. Interventions to reduce heat risks in the NE should therefore prioritize reducing the burden on historically disadvantaged communities.

Characterization of heat index experienced by individuals residing in urban and rural settings

Heatwave warning systems rely on forecasts made for fixed-point weather stations (WS), which do not reflect variation in temperature and humidity experienced by individuals moving through indoor and outdoor locations. We examined whether neighborhood measurement improved the prediction of individually experienced heat index in addition to nearest WS in an urban and rural location. Participants (residents of Birmingham, Alabama [N = 89] and Wilcox County, Alabama [N = 88]) wore thermometers clipped to their shoe for 7 days. Shielded thermometers/hygrometers were placed outdoors within participant’s neighborhoods (N = 43). Nearest WS and neighborhood thermometers were matched to participant’s home address. Heat index (HI) was estimated from participant thermometer temperature and WS humidity per person-hour (HI[individual]), or WS temperature and humidity, or neighborhood temperature and humidity. We found that neighborhood HI improved the prediction of individually experienced HI in addition to WS HI in the rural location, and neighborhood heat index alone served as a better predictor in the urban location, after accounting for individual-level factors. Overall, a 1 °C increase in HI[neighborhood] was associated with 0.20 °C [95% CI (0.19, 0.21)] increase in HI[individual]. After adjusting for ambient condition differences, we found higher HI[individual] in the rural location, and increased HI[individual] during non-rest time (5 a.m. to midnight) and on weekdays.

Source-to-tap assessment of microbiological water quality in small rural drinking water systems in Puerto Rico six months after Hurricane Maria

Maria made a landfall in Puerto Rico on September 20, 2017 as a category 4 hurricane, causing severe flooding, widespread electricity outages, damage to infrastructure, and interruptions in water and wastewater treatment. Small rural community water systems face unique challenges in providing drinking water, which intensify after natural disasters. The purpose of this study was to evaluate the functionality of six very small rural public water systems and one large regulated system in Puerto Rico six months after Maria and survey a broad sweep of fecal, zoonotic, and opportunistic pathogens from the source to tap. Samples were collected from surface and groundwater sources, after water treatment and after distribution to households. Genes indicative of pathogenic Leptospira spp. were detected by polymerase chain reaction (PCR) in all systems reliant on surface water sources. Salmonella spp. was detected in surface and groundwater sources and some distribution system water both by culture and PCR. Legionella spp. and Mycobacteria spp. gene numbers measured by quantitative PCR were similar to nonoutbreak conditions in the continental U.S. Amplicon sequencing provided a nontarget screen for other potential pathogens of concern. This study aids in improving future preparedness, assessment, and recovery operations for small rural water systems after natural disasters.

The association between drought conditions and increased occupational psychosocial stress among U.S. farmers: An occupational cohort study

BACKGROUND: Drought represents a globally relevant natural disaster linked to adverse health. Evidence has shown agricultural communities to be particularly susceptible to drought, but there is a limited understanding of how drought may impact occupational stress in farmers. METHODS: We used repeated measures data collected in the Musculoskeletal Symptoms among Agricultural Workers Cohort study, including 498 Midwestern U.S. farmers surveyed with a Job Content Questionnaire (JCQ) at six-month intervals in 312 counties from 2012 through 2015. A longitudinal linear mixed effects model was used to estimate the change in job strain ratio, a continuous metric of occupational psychosocial stress, during drought conditions measured with a 12-month standardized precipitation index. We further evaluated associations between drought and psychological job demand and job decision latitude, the job strain components, and applied a stratified analysis to evaluate differences by participant sex, age, and geography. RESULTS: During the growing season, the job strain ratio increased by 0.031 (95% CI: 0.012, 0.05) during drought conditions, an amount equivalent to a one-half standard deviation change (Cohen’s D = 0.5), compared to non-drought conditions. The association between drought and the job strain ratio was driven mostly by increases in the psychological job demand (2.09; 95% CI: 0.94, 3.24). No risk differences were observed by sex, age group, or geographic region. CONCLUSIONS: Our results suggest a previously unidentified association between drought and increased occupational psychosocial stress among farmers. With North American climate anticipated to become hotter and drier, these findings could provide important health effects data for federal drought early warning systems and mitigation plans.

Temperature-mortality relationship in North Carolina, USA: Regional and urban-rural differences

BACKGROUND: Health disparities exist between urban and rural populations, yet research on rural-urban disparities in temperature-mortality relationships is limited. As inequality in the United States increases, understanding urban-rural and regional differences in the temperature-mortality association is crucial. OBJECTIVE: We examined regional and urban-rural differences of the temperature-mortality association in North Carolina (NC), USA, and investigated potential effect modifiers. METHODS: We applied time-series models allowing nonlinear temperature-mortality associations for 17 years (2000-2016) to generate heat and cold county-specific estimates. We used second-stage analysis to quantify the overall effects. We also explored potential effect modifiers (e.g. social associations, greenness) using stratified analysis. The analysis considered relative effects (comparing risks at 99th to 90th temperature percentiles based on county-specific temperature distributions for heat, and 1st to 10th percentiles for cold) and absolute effects (comparing risks at specific temperatures). RESULTS: We found null effects for heat-related mortality (relative effect: 1.001 (95% CI: 0.995-1.007)). Overall cold-mortality risk for relative effects was 1.019 (1.015-1.023). All three regions had statistically significant cold-related mortality risks for relative and absolute effects (relative effect: 1.019 (1.010-1.027) for Coastal Plains, 1.021 (1.015-1.027) for Piedmont, 1.014 (1.006-1.023) for Mountains). The heat mortality risk was not statistically significant, whereas the cold mortality risk was statistically significant, showing higher cold-mortality risks in urban areas than rural areas (relative effect for heat: 1.006 (0.997-1.016) for urban, 1.002 (0.988-1.017) for rural areas; relative effect for cold: 1.023 (1.017-1.030) for urban, 1.012 (1.001-1.023) for rural areas). Findings are suggestive of higher relative cold risks in counties with the less social association, higher population density, less green-space, higher PM(2.5,) lower education level, higher residential segregation, higher income inequality, and higher income (e.g., Ratio of Relative Risks 1.72 (0.68, 4.35) comparing low to high education). CONCLUSION: Results indicate cold-mortality risks in NC, with potential differences by regional, urban-rural areas, and community characteristics.

A multi-year assessment of blacklegged tick (Ixodes scapularis) population establishment and Lyme disease risk areas in Ottawa, Canada, 2017-2019

Canadians face an emerging threat of Lyme disease due to the northward expansion of the tick vector, Ixodes scapularis. We evaluated the degree of I. scapularis population establishment and Borrelia burgdorferi occurrence in the city of Ottawa, Ontario, Canada from 2017-2019 using active surveillance at 28 sites. We used a field indicator tool developed by Clow et al. to determine the risk of I. scapularis establishment for each tick cohort at each site using the results of drag sampling. Based on results obtained with the field indicator tool, we assigned each site an ecological classification describing the pattern of tick colonization over two successive cohorts (cohort 1 was comprised of ticks collected in fall 2017 and spring 2018, and cohort 2 was collected in fall 2018 and spring 2019). Total annual site-specific I. scapularis density ranged from 0 to 16.3 ticks per person-hour. Sites with the highest density were located within the Greenbelt zone, in the suburban/rural areas in the western portion of the city of Ottawa, and along the Ottawa River; the lowest densities occurred at sites in the suburban/urban core. B. burgdorferi infection rates exhibited a similar spatial distribution pattern. Of the 23 sites for which data for two tick cohorts were available, 11 sites were classified as “high-stable”, 4 were classified as “emerging”, 2 were classified as “low-stable”, and 6 were classified as “non-zero”. B. burgdorferi-infected ticks were found at all high-stable sites, and at one emerging site. These findings suggest that high-stable sites pose a risk of Lyme disease exposure to the community as they have reproducing tick populations with consistent levels of B. burgdorferi infection. Continued surveillance for I. scapularis, B. burgdorferi, and range expansion of other tick species and emerging tick-borne pathogens is important to identify areas posing a high risk for human exposure to tick-borne pathogens in the face of ongoing climate change and urban expansion.

Associations between weather-related data and influenza reports: A pilot study and related policy implications

AIM: The purpose of this retrospective, correlational pilot study was to explore the relationship between historical weekly weather data including temperature, dew point, humidity, barometric pressure, visibility, and cloud cover compared to weekly influenza-like illness reports over a four year period. BACKGROUND: Climate and weather-related conditions may affect the viral activity and transmission of influenza, although this relationship has not been widely studied in nursing. Some research suggests that there are causal links between cold temperatures, low indoor humidity, minimal sun exposure, and influenza outbreaks. Additionally, rapid weather variability in a warming climate can increase influenza epidemic risk. METHODS: Data from a local public health district were extracted and used to correlate with weekly weather averages for the area. RESULTS: Findings showed that current influenza reports are significantly associated with temperature and visibility, both lagged two weeks. CONCLUSIONS: Though more research is needed, nurses must understand, recognize, and act upon weather and climate factors that affect the health of populations. With a greater understanding of the relationship between weather and influenza-like illness, nurses and other healthcare providers can potentially work to respond to and mitigate the consequences of weather-related illness as well as anticipate and prepare for increased flu burden. Furthermore, nurses can remain engaged in climate protective initiatives and policy development at their local community and/or organizational levels to underscore and advocate for the needs of populations and groups they serve.

Disproportionate impacts of wildfires among elderly and low-income communities in California from 2000-2020

Wildfires can be detrimental to urban and rural communities, causing impacts in the form of psychological stress, direct physical injury, and smoke-related morbidity and mortality. This study examined the area burned by wildfires over the entire state of California from the years 2000 to 2020 in order to quantify and identify whether burned area and fire frequency differed across Census tracts according to socioeconomic indicators over time. Wildfire data were obtained from the California Fire and Resource Assessment Program (FRAP) and National Interagency Fire Center (NIFC), while demographic data were obtained from the American Community Survey. Results showed a doubling in the number of Census tracts that experienced major wildfires and a near doubling in the number of people residing in wildfire-impacted Census tracts, mostly due to an over 23,000 acre/year increase in the area burned by wildfires over the last two decades. Census tracts with a higher fire frequency and burned area had lower proportions of minority groups on average. However, when considering Native American populations, a greater proportion resided in highly impacted Census tracts. Such Census tracts also had higher proportions of older residents. In general, high-impact Census tracts tended to have higher proportions of low-income residents and lower proportions of high-income residents, as well as lower median household incomes and home values. These findings are important to policymakers and state agencies as it relates to environmental justice and the allocation of resources before, during, and after wildfires in the state of California.

Providing APPE pharmacy students rural health assessment experience following wildfire event in western Montana

Background and purpose: We describe a novel, interprofessional, experiential training involving pharmacy students in response to a health emergency in rural Montana (MT). Educational activity and setting: Fourth-year pharmacy students on clinical rotations were recruited to participate in screening events assessing effects of wildfire smoke in Seeley Lake, MT. Students were required to fulfill at least two hours of supplementary training in addition to education on human research guidelines. Students assisted with patient surveys (demographics, health, and respiratory), physiological testing with biomedical researchers, blood pressure and medication counseling, and spirometry specialists. Findings: At least 20 pharmacy students have participated in this project in addition to nursing (n = 8), public health (n = 1), and social work (n = 1) students. In initial and subsequent screenings, students worked alongside a team of biomedical researchers and faculty from the University of Montana. An initial cohort of 95 patients was recruited. Summary: This unique experiential training opportunity has affordedpharmacy students access to rural community patient interaction and exposure to and performance of a variety of tests in response to an environmental health emergency. Furthermore, it enabled health professionals and researchers to assess individual and overall community health following an extreme wildfire smoke event, providing the groundwork for utilization of pharmacy students in healthcare responses to public health emergencies. (c) 2021 Elsevier Inc. All rights reserved.

Level of air BTEX in urban, rural and industrial regions of Bandar Abbas, Iran; indoor-outdoor relationships and probabilistic health risk assessment

This study focused on the measurement of BTEX (benzene, toluene, ethylbenzene and xylene) concentrations in the air of various regions and indoor-outdoor environments in Bandar Abbas, Iran. Air samples were taken actively and analyzed by gas chromatography-mass spectrometry (GC-MS) during two one-month periods i.e., Feb 2020 (period I) and Sep/Oct 2020 (period II). The mean air temperature and the levels of all BTEX compounds were higher in period II. The highest total BTEX (t-BTEX) levels (median [min-max]) were found in the urban region (18.00 [5.21-67.24] μg m(-3)), followed by industrial region (7.00 [2.05-14.76] μg m(-3)) and rural region (2.81 [ND-7.38] μg m(-3)). The significant positive correlations between all BTEX compounds and T/B ratio >1 indicated the vehicular traffic as the main source of emission. At 95th percentile probability, the non-cancer risk of t-BTEX in urban region was only less than one order of magnitude below the threshold level of unity (1.91E-01) and the cancer risk of benzene exceeded the recommended level of 1.0E-06 by U.S. EPA in urban (7.69E-06) and industrial (2.97E-06) regions. It was found that the indoor/outdoor ratio of BTEX concentration in beauty salon and hospital was greater than 1. Overall, the current levels of BTEX in the ambient air of study area, especially near urban roadside and in some indoor environments, should not be overlooked and appropriate mitigation actions should be undertaken.

Emergency health in the aftermath of disasters: A post-Hurricane Matthew skin outbreak in rural Haiti

Purpose The purpose of this paper is to analyze the context of the emergence of a skin infection outbreak in the aftermath of Hurricane Matthew in Haiti and detail the role of community-based participatory research in mobilizing local action in a country with low state capacity. Design/methodology/approach While implementing a post-disaster study that combined a survey of 984 households and 69 community leaders with 23 focus groups, 60 ethnographic interviews and community mapping, a skin infection outbreak was detected. Using study results, the research team in partnership with different stakeholders responded to the outbreak with a health intervention. Findings The findings illustrate how pre-existing conditions shape local communities’ vulnerability to health crises in the aftermath of disasters and the critical role research can play in informing the recovery processes. Community-based approaches to emergency health reinforced by multi-stakeholder partnerships with local government can strengthen post-disaster response and governance structures setting the groundwork for the development of local resilience. Research limitations/implications The health intervention was implemented as a result of the study. Patients served were not derived from the study sample but were self-selected based on their need for skin-related medical treatment. Originality/value This article highlights the integral role research can play in identifying the health impacts of disaster events in vulnerable, hard-to-reach communities and strengthening government involvement in disaster governance.

An ecological study of chronic kidney disease in five Mesoamerican countries: Associations with crop and heat

BACKGROUND: Mesoamerica is severely affected by an epidemic of Chronic Kidney Disease of non-traditional origin (CKDnt), an epidemic with a marked variation within countries. We sought to describe the spatial distribution of CKDnt in Mesoamerica and examine area-level crop and climate risk factors. METHODS: CKD mortality or hospital admissions data was available for five countries: Mexico, Guatemala, El Salvador, Nicaragua and Costa Rica and linked to demographic, crop and climate data. Maps were developed using Bayesian spatial regression models. Regression models were used to analyze the association between area-level CKD burden and heat and cultivation of four crops: sugarcane, banana, rice and coffee. RESULTS: There are regions within each of the five countries with elevated CKD burden. Municipalities in hot areas and much sugarcane cultivation had higher CKD burden, both compared to equally hot municipalities with lower intensity of sugarcane cultivation and to less hot areas with equally intense sugarcane cultivation, but associations with other crops at different intensity and heat levels were not consistent across countries. CONCLUSION: Mapping routinely collected, already available data could be a first step to identify areas with high CKD burden. The finding of higher CKD burden in hot regions with intense sugarcane cultivation which was repeated in all five countries agree with individual-level studies identifying heavy physical labor in heat as a key CKDnt risk factor. In contrast, no associations between CKD burden and other crops were observed.

Assessing the effect of climate variables on the incidence of dengue cases in the metropolitan region of Panama City

The present analysis uses the data of confirmed incidence of dengue cases in the metropolitan region of Panama from 1999 to 2017 and climatic variables (air temperature, precipitation, and relative humidity) during the same period to determine if there exists a correlation between these variables. In addition, we compare the predictive performance of two regression models (SARIMA, SARIMAX) and a recurrent neural network model (RNN-LSTM) on the dengue incidence series. For this data from 1999-2014 was used for training and the three subsequent years of incidence 2015-2017 were used for prediction. The results show a correlation coefficient between the climatic variables and the incidence of dengue were low but statistical significant. The RMSE and MAPE obtained for the SARIMAX and RNN-LSTM models were 25.76, 108.44 and 26.16, 59.68, which suggest that any of these models can be used to predict new outbreaks. Although, it can be said that there is a limited role of climatic variables in the outputs the models. The value of this work is that it helps understand the behaviour of cases in a tropical setting as is the Metropolitan Region of Panama City, and provides the basis needed for a much needed early alert system for the region.

A comparative analysis of urban and rural household water insecurity experiences during the 2011-17 drought in Ceara, Brazil

This article compares urban and rural household water insecurity experiences during the last major drought period (2011-17) in the semi-arid interior region of Ceara, Brazil. Using data from a household survey (N = 322), we determined that households in small urban areas are more and differently water insecure than rural counterparts. Factor analysis and an ordinal logistic regression pinpoint key dimensions, such as water distress, water-sharing and intermittency, contribute differently to water insecurity in rural and urban households. Policy recommendations are made.

Multilevel analysis of social, climatic and entomological factors that influenced dengue occurrence in three municipalities in Colombia

According to the World Health Organization, dengue is a neglected tropical disease. Latin America, specifically Colombia is in alert regarding this arbovirosis as there was a spike in the number of reported dengue cases at the beginning of 2019. Although there has been a worldwide decrease in the number of reported dengue cases, Colombia has shown a growing trend over the past few years. This study performed a Poisson multilevel analysis with mixed effects on STATA® version 16 and R to assess sociodemographic, climatic, and entomological factors that may influence the occurrence of dengue in three municipalities for the period 2010-2015. Information on dengue cases and their sociodemographic variables was collected from the National Public Health Surveillance System (SIVIGILA) records. For climatic variables (temperature, relative humidity, and precipitation), we used the information registered by the weather stations located in the study area, which are managed by the Instituto de Hidrologia, Meteorologia y Estudios Ambientales (IDEAM) or the Corporación Autónoma Regional (CAR). The entomological variables (house index, container index, and Breteau index) were provided by the Health office of the Cundinamarca department. SIVIGILA reported 1921 dengue cases and 56 severe dengue cases in the three municipalities; of them, three died. One out of four cases occurred in rural areas. The age category most affected was adulthood, and there were no statistical differences in the number of cases between sexes. The Poisson multilevel analysis with the best fit model explained the presentation of cases were temperature, relative humidity, precipitation, childhood, live in urban area and the contributory healthcare system. The temperature had the biggest influence on the presentation of dengue cases in this region between 2010 and 2015.

Climate change, weather, housing precarity, and homelessness: A systematic review of reviews

This systematic review of reviews was conducted to examine housing precarity and homelessness in relation to climate change and weather extremes internationally. In a thematic analysis of 15 reviews (5 systematic and 10 non-systematic), the following themes emerged: risk factors for homelessness/housing precarity, temperature extremes, health concerns, structural factors, natural disasters, and housing. First, an increased risk of homelessness has been found for people who are vulnerably housed and populations in lower socio-economic positions due to energy insecurity and climate change-induced natural hazards. Second, homeless/vulnerably-housed populations are disproportionately exposed to climatic events (temperature extremes and natural disasters). Third, the physical and mental health of homeless/vulnerably-housed populations is projected to be impacted by weather extremes and climate change. Fourth, while green infrastructure may have positive effects for homeless/vulnerably-housed populations, housing remains a major concern in urban environments. Finally, structural changes must be implemented. Recommendations for addressing the impact of climate change on homelessness and housing precarity were generated, including interventions focusing on homelessness/housing precarity and reducing the effects of weather extremes, improved housing and urban planning, and further research on homelessness/housing precarity and climate change. To further enhance the impact of these initiatives, we suggest employing the Human Rights-Based Approach (HRBA).

Food security and climate change: Differences in impacts and adaptation strategies for rural communities in the global south and north

This research highlights the mismatch between food security and climate adaptation literature and practice in the Global North and South by focusing on nested case studies in rural India and the United States during the COVID-19 pandemic. The United States is one of the wealthiest countries in the world, but also has one of the largest wealth gaps. Comparatively, India has one of the largest populations of food insecure people. To demonstrate how adaptive food security approaches to climate change will differ, we first review the unique climate, agricultural, demographic, and socio-economic features; and then compare challenges and solutions to food security posed by the COVID-19 pandemic. While both countries rely on rural, low-income farmworkers to produce food, the COVID-19 pandemic has highlighted how agricultural and food security policies differ in their influence on both food insecurity and global hunger alike. Emphasis on agricultural production in developing regions where a majority of individuals living in rural areas are smallholder subsistence farmers will benefit the majority of the population in terms of both poverty alleviation and food production. In the Global North, an emphasis on food access and availability is necessary because rural food insecure populations are often disconnected from food production.

Ambient temperature and stillbirth risks in northern Sweden, 1880-1950

BACKGROUND: Climate vulnerability of the unborn can contribute to adverse birth outcomes, in particular, but it is still not well understood. We investigated the association between ambient temperature and stillbirth risk among a historical population in northern Sweden (1880-1950). METHODS: We used digitized parish records and daily temperature data from the study region covering coastal and inland communities some 600 km north of Stockholm, Sweden. The data included 141,880 births, and 3,217 stillbirths, corresponding to a stillbirth rate of 22.7 (1880-1950). The association between lagged temperature (0-7 days before birth) and stillbirths was estimated using a time-stratified case-crossover design. Incidence risk ratios (IRR) with 95% confidence intervals were computed, and stratified by season and sex. RESULTS: We observed that the stillbirth risk increased both at low and high temperatures during the extended summer season (April to September), at -10°C, and the IRR was 2.3 (CI 1.28, 4.00) compared to the minimum mortality temperature of +15°C. No clear effect of temperature during the extended winter season (October to March) was found. Climate vulnerability was greater among the male fetus compared to the female counterparts. CONCLUSION: In this subarctic setting before and during industrialization, both heat and cold during the warmer season increased the stillbirth risk. Urbanization and socio-economic development might have contributed to an uneven decline in climate vulnerability of the unborn.

Projections of temperature-attributable mortality in Europe: A time series analysis of 147 contiguous regions in 16 countries

BACKGROUND: Europe has emerged as a major climate change hotspot, both in terms of an increase in seasonal averages and climate extremes. Projections of temperature-attributable mortality, however, have not been comprehensively reported for an extensive part of the continent. Therefore, we aim to estimate the future effect of climate change on temperature-attributable mortality across Europe. METHODS: We did a time series analysis study. We derived temperature-mortality associations by collecting daily temperature and all-cause mortality records of both urban and rural areas for the observational period between 1998 and 2012 from 147 regions in 16 European countries. We estimated the location-specific temperature-mortality relationships by using standard time series quasi-Poisson regression in conjunction with a distributed lag non-linear model. These associations were used to transform the daily temperature simulations from the climate models in the historical period (1971-2005) and scenario period (2006-2099) into projections of temperature-attributable mortality. We combined the resulting risk functions with daily time series of future temperatures simulated by four climate models (ie, GFDL-ESM2M, HadGEM2-ES, IPSL-CM5A-LR, and MIROC5) under three greenhouse gas emission scenarios (ie, Representative Concentration Pathway [RCP]2.6, RCP6.0, and RCP8.5), providing projections of future mortality attributable fraction due to moderate and extreme cold and heat temperatures. FINDINGS: Overall, 7·17% (95% CI 5·81-8·50) of deaths registered in the observational period were attributed to non-optimal temperatures, cold being more harmful than heat by a factor of ten (6·51% [95% CI 5·14-7·80] vs 0·65% [0·40-0·89]), and with large regional differences across countries-eg, ranging from 4·85% (95% CI 3·75-6·00) in Germany to 9·87% (8·53-11·19) in Italy. The projection of temperature anomalies by RCP scenario depicts a progressive increase in temperatures, more exacerbated in the high-emission scenario RCP8.5 (4·54°C by 2070-2099) than in RCP6.0 (2·89°C) and RCP2.6 (1·67°C). This increase in temperatures was transformed into attributable fraction. Projections consistently indicated that the increase in heat attributable fraction will start to exceed the reduction of cold attributable fraction in the second half of the 21st century, especially in the Mediterranean and in the higher emission scenarios. The comparison between scenarios highlighted the important role of mitigation, given that the total attributable fraction will only remain stable in RCP2.6, whereas the total attributable fraction will rapidly start to increase in RCP6.0 by the end of the century and in RCP8.5 already by the middle of the century. INTERPRETATION: The increase in heat attributable fraction will start to exceed the reduction of cold attributable fraction in the second half of the 21st century. This finding highlights the importance of implementing mitigation policies. These measures would be especially beneficial in the Mediterranean, where the high vulnerability to heat will lead to an imbalance between the decreasing cold and increasing heat-attributable mortality. FUNDING: None.

Managed retreat in response to flooding: Lessons from the past for contemporary climate change adaptation

Managed retreat is increasingly advocated as a means to promote resilience and adaptation to climate change. However, there are various uncertainties and challenges associated with the impacts of displacement and attachments to place. In this context, it is useful to study past examples of relocation to understand how these challenges have been addressed. This paper draws on a case study relocation scheme which took place in Ireland following major flooding in 1954. This represented a radical and comprehensive approach to relocation which sought to address the root causes of vulnerability. The analysis shows that this comprehensive approach was made possible through a connection between managed retreat and land reform. The scheme also faced opposition linked to attachments to place and property. This led to compromises and a failure to fully address the effects of flooding on livelihoods but contributed to resilience through ensuring that family and community ties remained intact. The paper’s distinctive contributions are its analysis of the requirements of transformative approaches to adaptation and relocation, its identification of challenges associated with place and property even in the context of such transformative approaches, and its adding of historical depth to contemporary debates on climate adaptation.

Analysis of the impact of heat waves on daily mortality in urban and rural areas in Madrid

The objective of this study was to analyze and compare the effect of high temperatures on daily mortality in the urban and rural populations in Madrid. Data were analyzed from municipalities in Madrid with a population of over 10,000 inhabitants during the period from January 1, 2000 to December 31, 2020. Four groups were generated: Urban Metropolitan Center, Rural Northern Mountains, Rural Center, and Southern Rural. The dependent variable used was the rate of daily mortality due to natural causes per million inhabitants (CIE-X: A00-R99) between the months of June and September for the period. The primary independent variable was maximum daily temperature. Social and demographic “context variables” were included: population >64 years of age (%), deprivation index and housing indicators. The analysis was carried out in three phases: 1) determination of the threshold definition temperature of a heat wave (Tumbral) for each study group; 2) determination of relative risks (RR) attributable to heat for each group using Poisson linear regression (GLM), and 3) calculation of odds ratios (OR) using binomial family GLM for the frequency of the appearance of heat waves associated with context variables. The resulting percentiles (for the series of maximum daily temperatures for the summer months) corresponding to Tthreshold were: 74th percentile for Urban Metropolitan Center, 76th percentile for Southern Rural, 83rd for Rural Northern Mountains and 98th percentile for Center Rural (98). Greater vulnerability was found for the first two. In terms of context variables that explained the appearance of heat waves, deprivation index level, population >64 years of age and living in the metropolitan area were found to be risk factors. Rural and urban areas behaved differently, and socioeconomic inequality and the composition of the population over age 64 were found to best explain the vulnerability of the Rural Center and Southern Rural zones.

Analysis of vulnerability to heat in rural and urban areas in Spain: What factors explain heat’s geographic behavior?

INTRODUCTION: There is currently little knowledge and few published works on the subject of vulnerability to heat in rural environments at the country level. Therefore, the objective of this study was to determine whether rural areas are more vulnerable to extreme heat than urban areas in Spain. This study aimed to analyze whether a pattern of vulnerability depends on contextual, environmental, demographic, economic and housing variables. METHODS: An ecological, longitudinal and retrospective study was carried out based on time series data between January 01, 2000 and December 31, 2013 in 42 geographic areas in 10 provinces in Spain. We first analyzed the functional relationship between the mortality rate per million inhabitants and maximum daily temperature (Tmax). We then determined the summer temperature threshold (Pthreshold) (June-September) at which increases in mortality are produced that are attributable to heat. In a second phase, based on Pthreshold, a vulnerability variable was calculated, and its distribution was analyzed using mixed linear models from the Poisson family (link = log). In these models, the dependent variable was vulnerability, and the independent variables were exposure to high temperatures, aridity of the climate, deprivation index, percentage of people over age 65, rurality index, percentage of housing built prior to 1980 and condition of dwellings. RESULTS: Rurality was a protective factor, and vulnerability in urban areas was six times greater. In contrast, risk factors included aridity (RR = 5.89 (2.26 15.36)), living in cool summer zones (2.69 (1.23, 5.91)), poverty (4.05 (1.91 8.59)) and the percentage of dysfunctional housing (1.13 (1.04 1.24)). CONCLUSIONS: Rural areas are less vulnerable to extreme heat than the urban areas analyzed. Also, population groups with worse working conditions and higher percentages of dwellings in poor conditions are more vulnerable.

Heat-related mortality in two regions of Poland: Focus on urban and rural areas during the most severe and long-lasting heatwaves

The vast majority of studies on heat-related mortality are focused on large cities. The aim of this study is to fill this research gap and to estimate the impact of high temperatures on the risk of death in smaller towns and villages. The results show that increased mortality is not only a problem in large cities. The risk of death, although usually slightly lower than in highly populated areas, may be higher for the age-related risk group. At temperatures above 35 degrees C, it may exceed 1.3 in smaller towns and even 1.6 in villages. The increase in mortality during five selected heat waves of high intensity and long duration was also studied for two regions of Poland: Malopolska and Wielkopolska. Towns with a population of less than 10,000 in Malopolska region, during the 2006 heatwave, experienced an increase in the number of deaths by as much as 18%. At the same time in the largest city of Malopolska-Krakow, the death toll rose by 4%. This paper also presents some differences between regions in terms of the impact of heat waves: in the lowland region of Wielkopolska, the mortality rate is generally higher than in the upland region of Malopolska.

The effect of cold waves on mortality in urban and rural areas of Madrid

Background While many studies analyze the effect of extreme thermal events on health, little has been written about the effects of extreme cold on mortality. This scarcity of papers is particularly relevant when we search studies about extreme cold on the health of rural population. Therefore, we tried to analyze the effect of cold waves on urban areas and rural areas from Madrid and to test whether differentiated effects exist between both population classes. For this purpose, we analyzed data from the municipalities with over 10,000 inhabitants for the period from January 1, 2000 through December 31, 2013. Municipalities were classified as urban or rural (Eurostat), and they were grouped into similar climatological zones: Urban Metropolitan Centre (UMC), Rural Northern Mountains (RNM), Rural Centre (RC) and Southern Rural (SR). The dependent variable was the daily mortality rate due to natural causes per million inhabitants (CIE-X: A00-R99) that occurred between the months of November and March for the period. The independent variable was minimum daily temperature (oC) (T-min). Social and demographic contextual variables were used, including: population > age 64 (%), deprivation index and housing indicators. The analysis was carried out in three phases: (1) determination of the threshold temperature (T-threshold) which defines the cold waves; (2) determination of the relative risk (RR) for cold waves using Poisson linear regression (GLM); and (3) using GLM of the binomial family, Odds Ratios (OR) were calculated to analyze the relationship between the frequency of the appearance of cold waves and the socioeconomic variables. Results The UMC zone experienced 585 extreme cold events related to attributable increases in the mortality rate. The average number of cold waves in the rural zones was 319. The primary risk factor was the percentage of population over age 64, and the primary protective factor was housing rehabilitation. As a whole, the period experienced more cold waves (1542) than heat waves (1130). Conclusion The UMC was more vulnerable than the rural areas. Furthermore, the results support the development of prevention policies, especially considering the fact that cold wave events were more frequent than heat waves.

Planning for the health impacts of climate change: Flooding, private groundwater contamination and waterborne infection – A cross-sectional study of risk perception, experience and behaviours in the Republic of Ireland

The frequency and severity of flooding events will increase over the coming decades due to global climate change. While close attention has typically been paid to infrastructural and environmental outcomes of flood events, the potential adverse human health consequences associated with post-event consumption from private groundwater sources have received minimal attention, leading to a poor understanding of private well users’ preparedness and the drivers of positive behavioural adoption. The current study sought to quantify the capacity of private well users to cope with flood-triggered contamination risks and identify the social psychological determinants of proactive attitudes in the Republic of Ireland, using a cross-sectional questionnaire incorporating two distinct models of health behaviour, the Health Belief Model and Risk-Attitude-Norms-Ability-Self Regulation model. Adoption of healthy behaviours prior to flooding was evaluated with respect to respondents’ risk exposure, risk experience and risk perception, in addition to systematic supply stewardship under normal conditions. Associations between adoption of protective behaviours and perception, experience and socio-demographic factors were evaluated through multinomial and multiple logistic regressions, while a multi-model inferential approach was employed with the predictors of health behaviour models. Findings suggest that floods are not considered likely to occur, nor were respondents worried about their occurrence, with 72.5% of respondents who reported previous flooding experience failing to adopt protective actions. Prior experience of well water contamination increased adoption of proactive attitudes when flooding occurred (+47%), with a failure to adopt healthy behaviours higher among rural non-agricultural residents (136%). Low levels of preparedness to deal with flood-related contamination risks are a side-effect of the general lack of appropriate well stewardship under normal conditions; just 10.1% of respondents adopted both water treatment and frequent testing, in concurrence with limited risk perception and poor awareness of the nexus between risk factors (e.g. floods, contamination sources) and groundwater quality. Perceived risk, personal norms and social norms were the best predictors of protective behaviour adoption and should be considered when developing future awareness campaigns.

Negative trend in seroprevalence of anti-toxoplasma Gondii igg antibodies among the general population of the province of Vojvodina, Serbia, 2008-2021

This study aimed to estimate dynamic changes in seroprevalence of Toxoplasma gondii within the general population living in the northern part of the Republic of Serbia (Province of Vojvodina) during a 14-year period. The differences in prevalence of anti-toxoplasma antibodies were analyzed in correlation with age, gender, residential area (rural/urban) and meteorological factors. In this cohort retrospective study, 24,440 subjects between 1 and 88 years old were enrolled. To determine the presence of T. gondii-specific IgM and IgG antibodies in serum samples, commercially available ELISA kits were used (Euroimmun, Luebeck, Germany). During the study period, the overall T. gondii seroprevalence was 23.5%. The seroprevalence continuously decreased over time from 31.7% in 2008 to 20.4% in 2021 (0.81% per year, p < 0.001). Approximately 2% of patients had a serologic profile positive for both anti-Toxoplasma IgG and IgM antibodies. The seroprevalence was higher (28.87%) among men compared to women (24.28%), while urban residents (24.94%) had lower seroprevalence than the rural population (28.17%). A statistically significant negative correlation (r = -0.559) was found between serologic profile of patients positive for both T. gondii IgG and IgM antibodies and the annual mean air temperature. No significant association was observed between seropositivity to T. gondii infection and examined meteorological factors. These data could be useful to national and regional health authorities to create an optimal health policy to reduce rate of T. gondii infections.

Analyzing climate change impacts on health, energy, water resources, and biodiversity sectors for effective climate change policy in South Korea

This study analyzes how climate change affects the economy, society, and environment in South Korea. Then, the study explores the ways to strengthen capabilities that can alleviate climate change impacts. To find them, the study employs a system dynamics simulation method and builds a model with several sectors including the urban, rural, population, and social-environmental sectors. The study compares the size of climate change damages in rural and urban areas. The results with representative concentration path (RCP) 8.5 show that the size of climate change damage will continue to increase by 2050. The projected damages from the reduced industrial outputs in urban areas will be larger than that in rural areas. The results also show that the service sector will face stronger impacts from climate change than the manufacturing and agricultural sectors. However, the total size of damage in the rural areas will be bigger than that of the urban areas. It is because the size of reduced industrial outputs per capita in the rural areas is twice bigger than that of the urban areas. The climate change damage in the social and environmental sectors (including a loss of biodiversity and an increase in health costs) account for the largest part of the total damage. The study finally provides suggestions and policies that can improve the capabilities to reduce the climate change damages. One of the major suggestions of this study is that the increase in the climate change budget corresponding to the GDP growth can minimize the size of climate change impacts.

Determinants of maternal, infant, and young child nutrition during the 1,000-day window of opportunity in Solomon Islands: A focused ethnographic study

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.

Appraisal of shallow groundwater quality with human health risk assessment in different seasons in rural areas of the Guanzhong Plain (China)

Groundwater is the major source of water for drinking and irrigation purposes in and around Hua County, Shaanxi Province, China. The main purposes of this research is to evaluate the groundwater quality in the rainy and dry seasons of Hua County and analyze the causes of seasonal differences and determine the areas with serious pollution. Groundwater quality was assessed in this study using entropy water quality index (EWQI) and some graphical approaches such as Gibbs and Piper diagrams. The contour maps of groundwater quality were drawn by Geographical Information System (GIS). According to the obtained results, the locations where groundwater quality was rated as excellent or good in both wet and dry seasons were mainly in the north and east of the research area. COD and NO3- are the parameters that have the most serious negative effect on water quality. The dominant factors influencing groundwater chemical evolution in the study area were rock weathering and dissolution, and the precipitation and evaporation during the wet and dry seasons do not cause significant changes in groundwater chemistry. Adults’ health risks results revealed that 27.69% and 52.31% of the groundwater samples exceeded the acceptable limit for non-carcinogenic risk in the wet and dry season, respectively, while for children the ratios are 30.16% and 47.62%, respectively. The contributive percentages of nitrate, fluoride and nitrate to the total risk are 61.29%, 28.71% and 10.00% in the wet season and 68.84%, 20.85% and 10.31% in the dry season. The risk is higher in the south than in the north of the study area, and is especially high in the southwest of the study area.

Climate change and farmers’ household financial vulnerability: Evidence from China

Climate change is one of the most severe threats to human survival and a significant factor influencing financial stability. Different from previous studies, this paper investigates the economic impact of climate change at the micro level based on data from China Meteorological Administration database, and China Household Finance Survey (CHFS) 2017 released in 2019. The empirical findings indicate that climate change contributes to the financial vulnerability of farmers’ households, which is confirmed following robustness tests. The mechanism analysis reveals that climate change has effects on rural households’ financial vulnerability via farmers’ health, credit availability, and agricultural output. Furthermore, the effect of climate change on farmers’ household financial vulnerability (HFV) is more pronounced in farmers with lower education levels. The changes in temperature and precipitation show different intensity effects in different areas, but all of them provide reasonable heterogeneity mechanisms. This paper’s policy value is demonstrated by the fact that it uncovers the effects of climate change on farmers’ HFV, information that may be useful for addressing climate change and rural financial stability.

Impact of ambient temperature on hospital admissions for respiratory diseases in suburban rural villages in northwest China

Extreme temperature is strongly associated with human health, but few studies are available for the effects of extreme temperatures on respiratory disease (RD) in rural villages in Jiuquan, China over 2018-2019. In this study, we evaluate the effect of daily mean temperature on RD hospitalizations in suburban rural villages. A distribution lag non-linear model was constructed to analyze the relationship between the temperature and the daily risk of RD hospitalizations; and stratified analysis by sex and age group was performed. The effect of daily mean temperature on RD hospitalizations was non-linear and lagging. With a reference 25th percentile of temperature (-1.8 °C), exposure to extremely low temperature (-15.8 °C, 1st percentile), or moderate low temperature (-8.3 °C, 10th percentile) were associated with 1.396 (95% CI: 1.251, 1.558) and 1.216 (95% CI: 1.180, 1.253) increased risks of RD hospitalizations over lag 0-21 days. For RD morbidity, the effects of moderate high temperature (90th percentile of temperature, 22.5 °C) appeared at on the exposed day (lag 0), with the largest hot effect (RR 1.008, 95% CI 1.001, 1.020), while the effects of extremely high temperature (99th percentile of temperature, 27.0 °C) were insignificant. The effect of ambient temperature varied with gender and age. Both cold and high temperatures have more serious influence on males than females. In contrast, the elderly (age ≥ 65) seemed to be more sensitive in extremely low temperature (RR = 3.471; 95% CI, 2.183, 5.518; lag 0-21). The effect of moderate high temperature on the < 65 years group appeared for the first time at lag 0 (RR = 1.012; 95% CI, 1.001, 1.029). Both high temperature and low temperature increased the RD hospitalization risk; the harmful effect and duration of low temperature were greater than that of high temperature; the ≥ 65-year group and male were more sensitive to low temperature.

Indoor thermal comfort in a rural dwelling in southwest China

Recently, indoor thermal comfort has received more scholarly attention than ever due to the COVID-19 pandemic and global warming. However, most studies on indoor thermal comfort in China concentrated on urban buildings in the east and north. The indoor thermal comfort of rural dwellers in southwest China is insufficiently investigated. Hence, this study assesses residents’ indoor thermal comfort in a rural dwelling in Linshui, obtains the thermal neutral temperature of the rural area, and analyzes the thermal adaptation behavior of rural dwellers. The results reveal that the thermal neutral temperature of rural dwellers is 29.33°C (operative temperature), higher than that presented in previous studies based on the same climate region. Indoor thermal conditions in rural dwellings are relatively harsh, but various thermal adaptation behavior of rural dwellers significantly improve their ability to withstand the harsh conditions. When people live in an environment with a (relatively) constant climate parameter (e.g., humidity), their perception of that parameter seems compromised. Most rural dwellers are unwilling to use cooling equipment with high energy consumption. Therefore, more passive cooling measures are recommended in the design and renovation of rural dwellings.

Effect modification of greenness on temperature-mortality relationship among older adults: A case-crossover study in China

BACKGROUND: Climate change exacerbates temperature-related mortality, but effects may vary by geographic characteristics. We hypothesize that higher greenness may mitigate temperature-related mortality, and that the effect may vary in different areas. OBJECTIVE: We examined how mortality among older adults in China was associated with temperature for 2000-2014, and how geolocation and residential greenness may modulate this association. METHODS: We used health data from the China Longitudinal Healthy Longevity Survey (CLHLS), and meteorological data from the Global Surface Summary of Day (GSOD) product by National Climate Data Center. We used a case-crossover study design with distributed nonlinear modeling to estimate mortality risks in relation to temperature, and stratified analysis by quartile of greenness. Greenness was estimated by Normalized Difference Vegetation Index (NDVI) from remote-sensed imagery. In addition to the national analysis, we also assessed three provinces (Jiangsu, Guangdong, and Liaoning) to examine differences by climatic regions. RESULTS: Extreme temperatures had a significant association with higher mortality, with regional differences. Findings from the national analysis suggest that individuals in the lowest quartile of greenness exposure had a ratio of relative risks (RRR) of 1.38 (0.79, 2.42) for mortality risk on extreme hot days at the 95th percentile compared to those at the 50th percentile, compared to those in the highest quartile, which means those residing in the lowest quartile of greenness had a 38% higher RR than those residing in the highest quartile of greenness, where RR refers to the risk of mortality on days at the 95th percentile of temperature compared to days at the 50th percentile. The RRR for the highest to lowest quartiles of greenness for mortality risk on extreme cold days at the 5th percentile compared to the 50th percentile was 2.08 (0.12, 36.2). In Jiangsu and Guangdong provinces, both the heat effects and cold effects were the lowest in the highest greenness quartile, and the results in Liaoning province were not statistically significant, indicating different regional effects of greenness on modulating the temperature-mortality relationship. DISCUSSION: We elucidated one pathway through which greenness benefits health by decreasing impact from extreme high temperatures. The effects of greenness differed by climatic regions. Policymakers should consider vegetation in the context of climate change and health.

Prevalence and spatial heterogeneity of Trichomonas vaginalis infection among the female population and association with climate in Guangxi Zhuang autonomous region, Southern China

BACKGROUND: Two cervical cancer screening (CCS) projects have been ongoing for years in Guangxi Zhuang autonomous region (Guangxi), and some Trichomonas vaginalis infection (TVI) cases have been found as an opportunistic finding. This study aimed to identify the high-risk population and expound the spatial epidemiological features of TVI in Guangxi. METHODS: This study was based on CCS from 2012 to 2019. Adjusted odds ratio (AOR), and spatial analyses were used to identify the high-risk subgroups, as well as to depict the spatial epidemiological feature and its relationship with meteorological factors. RESULTS: The infection rate of TVI was 0.38% in 873,880 samples. Significant association with a high risk of TVI was found in the following: females aged 40-49 years (aOR=4.464; 95% CI, 3.359-5.932; p<0.001), aged 50-59 years (aOR=3.169; 95% CI, 2.370-4.237; p<0.001), from urban (aOR=1.577; 95% CI, 1.471-1.691; p<0.001), from minority areas (aOR=1.183; 95% CI, 1.060-1.320; p=0.003), areas with GPD <41,500 CNY (aOR=1.191; 95% CI, 1.106-1.282; p<0.001), and inland areas (aOR=1.520; 95% CI, 1.339-1.726; p<0.001). Counties with higher infection rate were concentrated in northwest Guangxi's mountainous area (Z-score=3.9656, p<0.001), in the upper reaches of the Hongshui River and Yu River, and with a significant spatial autocorrelation (Moran's I=0.581, p=0.002). Spatial error model showed significantly negative regressions among temperature (B=-0.295, p=0.002), annual temperature range (B=-0.295, p=0.002), and TVI spatial distribution. CONCLUSION: The spatial clustering and disparity of TVI in northwest Guangxi warrant further study, and meteorological conditions may play an important role in TVI in northwest Guangxi.

Impact of diurnal temperature range on cardiovascular disease hospital admissions among Chinese farmers in Dingxi (the Northwest China)

BACKGROUND: Diurnal temperature range (DTR) has been widely applied in exploring its effect on cardiovascular disease (CVD). However, few studies have investigated the correlations between DTR and CVD in poor rural areas in China. This study aimed to examine the association between DTR and CVD in rural China. METHODS: A distributed lag nonlinear model was used to evaluate the relationship between DTR and CVD risk among farmers living in the city of Dingxi (Northwest China) in the period from January 1, 2016 to December 31, 2019. RESULTS: We observed nonlinear M-patterns between the relative risk (RR) of DTR (reference: median DTR, 12 °C) and CVD hospitalizations in all subgroups. The peak RR of CVD was noticed at DTR of 6 °C (total: 1.418; men: 1.546; women: 1.403; young: 1.778; old: 2.549) and 17 °C (total: 1.781; men: 1.937; women: 1.712; young: 2.233; old: 1.798). The adverse effect of DTR on CVD risk was more pronounced in females (RR 1.438) and elderly (RR 2.034) than males (RR 1.141) and younger adults (RR 1.852) at the extremely low (5th, 4 °C) DTR. The reverse was observed at the extremely high DTR (95th, 19 °C) (male: 1.267; females: 0.993; young: 1.586; old: 1.212). CONCLUSIONS: DTR is associated with CVD morbidity. This association was more pronounced in women and elderly, but men and younger peoples at extremely high DTR (19 °C). Future measures should take DTR into account to prevent CVD among susceptible populations.

Effects of ambient temperature on the risk of preterm birth in offspring of adolescent mothers in rural Henan, China

BACKGROUND: A number of studies have explored the association between ambient temperature and preterm birth (PTB), but rarely among adolescent mothers. OBJECTIVES: To estimate the effects of ambient temperature on the risk of PTB and gestational age of newborns delivered by adolescent mothers in rural areas of Henan province. METHODS: We obtained 5394 medical records of adolescent mothers with results of pre-pregnancy physical examination and pregnancy outcomes from the National Free Preconception Health Examination Project (NFPHEP) in Henan province. Meteorological information was obtained from the China Meteorological Data Sharing Service System. Individual exposure levels were evaluated with an inverse distance-weighted model. A multiple logistic regression model and multiple linear regression model were used to estimate the effects of ambient temperature on the risk of PTB and gestational age, respectively. Stratified and interaction analyses were also performed. RESULTS: Of newborns in this study, 3.45% (186/5394) were PTB. Mean, maximum and minimum temperature during the entire pregnancy, especially the last 1-4 weeks of pregnancy, were positively associated with the risk of PTB and negatively associated with gestational age (P < 0.05). Nevertheless, a masking effect was observed that gestational age was positively associated with ambient temperature during the first trimester of pregnancy, due to the strongly inverse correlation between ambient temperature during the early and late stages of pregnancy. Stratified analyses showed that increasing temperature during the last 1-4 weeks of pregnancy increased the risk of PTB and decreased gestational age in newborns born in the cold season (P < 0.05). Furthermore, interaction analyses showed that birth season modified the effects of temperature on the gestational age (P(interaction) < 0.10). CONCLUSIONS: Elevated ambient temperature can decrease gestational age and increase the risk of PTB in offspring of adolescent mothers in rural areas. The birth season may modify the effects of temperature on gestational age.

Climate change risk perceptions, facilitating conditions and health risk management intentions: Evidence from farmers in rural China

Climate variability exerts severe threats to farmers and agriculture related activities and farmers. A growing number of studies have paid attention to mitigating carbon emission and adapting to climate change. Very few studies, however, have investigated farmers’ health risk management associated with climate change. This study, therefore, proposed a hybrid theoretical model to explore the roles of farmers’ climate risk perceptions and facilitating conditions in farmers’ health risk management, both theoretically and empirically. Using a sample of 1499 rice farmers in China, the partial least squares structural equation modeling (PLS-SEM) was adopted for empirical analysis, and the Multi-group Analysis (MGA) was employed to examine the heterogeneity among farmers’ socio-economic status. This study found that farmers’ perceived severity of climate change and perceived benefits of addressing climate change have significant impacts on their resources and technical facilitating conditions, in turn, those two types of facilitating conditions significantly impact their health risk management intentions. Subjective norms are also identified as predictors of resources facilitating condition and technical facilitating condition. In addition, farmers with lower income are more likely to suffer from health risks induced by climate change. They have fewer resources for resilience and maintaining health. Based on the findings identified above, strategies for coping with the negative impacts of climate change on farmers’ health were proposed for climate adaptation from the perspective of health risk management.

Climate disasters and subjective well-being among urban and rural residents in Indonesia

Climate disasters pose a risk to residents’ well-being globally. However, information about the impact of climate disasters among urban and rural residents remains lacking, especially in Indonesia. This study aims to fill the gap by investigating the impact of climate disaster on subjective well-being based on urban and rural typology model. The data were cross-sectional, involving 7110 Indonesian residents who had experienced climate disasters, 3813 from urban areas and 3297 from rural areas. An ordered probit model was employed to estimate the impact of climate disasters on subjective well-being (i.e., happiness and life satisfaction). In general, the empirical results show that climate disasters do not significantly affect the happiness of Indonesian residents, but they significantly and negatively impact their life satisfaction. Further analysis reveals that climate disasters impact urban and rural residents differently. The subjective well-being of rural residents is more severely affected than those living in urban areas. Further estimation also indicated that climate disaster significantly reduces residents’ subjective well-being at the lowest income level for both rural and urban residents. Our finding confirms that rural residents remain the most vulnerable to the impacts of climate change.

Enhancing the resilience and well-being of rural poor to climate risks: Are the economic functions of social protection enough?

As climate change accelerates, adaptive social protection programmes are becoming increasingly more popular than conventional social assistance programmes, since they are seen to enhance people’s resilience and well-being outcomes. Despite this upsurge, little is known about the impacts of adaptive programmes on resilience and well-being outcomes as compared to conventional programmes. This paper examines the economic functions that both types of social protection programmes offer through empirical studies in two climate-vulnerable zones in Bangladesh. By operationalising a simplified analytical framework to comprehend subjective resilience, the qualitative data reveal that the adaptive programme is more effective in enhancing beneficiaries’ perceived resilience to climate risks. Regrettably, neither programme is found to contribute much significantly in terms of enabling beneficiaries to achieve the desired well-being outcomes that one might expect to see. The paper offers rich insights into the design components of the programmes, affording an on-the-ground understanding of their implications for resilience and well-being.

Rural institutions, social networks, and self-organized adaptation to climate change

Support for rural livelihoods to adapt to climate change is a top policy priority around the world. We advance the concept of ‘self-organized adaptation’ to analyze how long-term pathways of transformation come about as the organic outcome of farmers’ incremental and continuous responses to climate and other challenges. Through an analysis of four decades’ responses to changing climate conditions in an agricultural system of the Indian Himalayas, we show how several key policy interventions-institutional support for the dissemination of agricultural knowledge, investments in infrastructure, and strengthening of market linkages-have produced favorable conditions for successful, long-term self-organized adaptation to climate change. This has led to the transformation of an agricultural system specialized in apple production to one with a great diversity of fruit, vegetable, and food grain crops. We find that farmers growing these crops cluster into five distinct agricultural portfolios that reflect the constraints and opportunities that different farmers face, and which are patterned by interaction with rural institutions and household social networks. We highlight the role of distributed decision-making in shaping broader trajectories of systemic transformation, and we argue for the need to move beyond pre-defined climate interventions toward the identification of policy mechanisms that can support more effective self-organization over the long-term.

An assessment of rural household vulnerability and resilience in natural hazards: Evidence from flood prone areas

This study develops and assesses the application of a livelihood vulnerability index (LVI), LVI-IPCC and livelihood effect index for the natural and agricultural resources in Northwestern Pakistan. By using structured questionnaire, primary data were collected from the targeted households in the study region. Data on socio-demographics, water security, health, social networks and climate variability were collected from the targeted respondents in this study area, and combined into indices. The IPCC framework was utilized that characterizes vulnerability into exposure, sensitivity and its adaptive capacity. Findings of our study showed that tehsil Shabqadar was more vulnerable among three studied tehsils particularly in natural disasters, health, water and land holding status. Tehsil Tangi was the second high vulnerable tehsil followed by tehsil Charsadda relative to other LVI components with the exclusion of livelihood strategies and financial constraints. Findings of this study provide a better understanding of the social and behavioral trends as well as an integrated and holistic view of the agriculture, climate change and livelihoods process in assessing the vulnerability. The findings and this pragmatic approach will be helpful in intending specific strategies and policy effectiveness to lessen susceptibility of households to climatic variations.

Exposure to risk and experiences of river flooding for people with disability and carers in rural Australia: A cross-sectional survey

OBJECTIVES: In this paper, we explore the exposure to risk and experiences of people with disability and carers during a flooding event and the subsequent mental health impacts. DESIGN: A cross-sectional survey between September and November 2017. Binary logistic regression models were used to investigate associations between the mental health of people with disability and carers and their exposure to the flood. Inductive content analysis was used to analyse qualitative data. SETTING: Flood-affected communities in the rural area of Northern Rivers, New South Wales, Australia, 6 months after river flooding in 2017. PARTICIPANTS: People over 16 years and a resident in the Northern Rivers at the time of the flood were invited to participate. Using a purposive, snowballing sampling technique participants were drawn from a wide range of socioeconomic backgrounds and had experienced different degrees of flood exposure. RESULTS: Of 2252 respondents, there were 164 people with disability and 91 carers. Both groups had increased odds of having their home flooded (people with a disability: OR 2.41 95% CI 1.71 to 3.39; carers: OR 1.76 95% CI 1.10 to 2.84). On evacuation, respondents reported inaccessible, conflicting and confusing information regarding flood warnings. Essential services such as healthcare and social services were disrupted (people with a disability: OR 3.98 95% CI 2.82 to 5.60; carers 2.17 95% CI 1.33 to 3.54) and access to safe and mould free housing post flood event was limited. After taking sociodemographic factors into account, respondents with a disability and carers had greater odds of probable post-traumatic stress disorder compared with other respondents (people with a disability: 3.32 95% CI 2.22 to 4.96; carers: 1.87 95% CI 1.10 to 3.19). CONCLUSION: Our findings show the profound impact and systemic neglect experienced by people with disability and carers during and after the 2017 flood event in the Northern Rivers. As people with disability will take longer to recover, they will require longer-term tailored supports and purposeful inclusion in flood preparedness and recovery efforts.

Insurance issues as secondary stressors following flooding in rural Australia—a mixed methods study

Flood events can be dramatic and traumatic. People exposed to floods are liable to suffer from a variety of adverse mental health outcomes. The adverse effects of stressors during the recovery process (secondary stressors) can sometimes be just as severe as the initial trauma. Six months after extensive flooding in rural Australia, a survey of 2530 locals was conducted focusing on their flood experiences and mental health status. This mixed methods study analysed (a) quantitative data from 521 respondents (21% of total survey respondents) who had insurance coverage and whose household was inundated, 96 (18%) of whom reported an insurance dispute or denial; and (b) qualitative data on insurance-related topics in the survey’s open comments sections. The mental health outcomes were all significantly associated with the degree of flood inundation. The association was strong for probable PTSD and ongoing distress (Adjusted Odds Ratios (AORs) with 95% confidence intervals 2.67 (1.8-4.0) and 2.30 (1.6-3.3), respectively). The associations were less strong but still significant for anxiety and depression (AORs 1.79 (1.2-2.7) and 1.84 (1.2-2.9)). The secondary stressor of insurance dispute had stronger associations with ongoing distress and depression than the initial flood exposure (AORs 2.43 (1.5-3.9) and 2.34 (1.4-3.9), respectively). Insurance was frequently mentioned in the open comment sections of the survey. Most comments (78% of comments from all survey respondents) were negative, with common adverse trends including dispute/denial, large premium increases after a claim, inconsistencies in companies’ responses and delayed assessments preventing timely remediation.

The association of meteorological factors with cognitive function in older adults

Individual and meteorological factors are associated with cognitive function in older adults. However, how these two factors interact with each other to affect cognitive function in older adults is still unclear. We used mixed effects models to assess the association of individual and meteorological factors with cognitive function among older adults. Individual data in this study were from the database of China Family Panel Studies. A total of 3448 older adults from 25 provinces were included in our analysis. Cognitive functions were measured using a memory test and a logical sequence test. We used the meteorological data in the daily climate dataset of China’s surface international exchange stations, and two meteorological factors (i.e., average temperature and relative humidity) were assessed. The empty model showed significant differences in the cognitive scores of the older adults across different provinces. The results showed a main impact of residence (i.e., urban or rural) and a significant humidity-residence interaction on memory performance in older adults. Specifically, the negative association between humidity and memory performance was more pronounced in urban areas. This study suggested that meteorological factors may, in concert with individual factors, be associated with differences in memory function in older adults.

The effect of heat events on prehospital and retrieval service utilization in rural and remote areas: A scoping review

INTRODUCTION: It is well-established that heatwaves increase demand for emergency transport in metropolitan areas; however, little is known about the impact of heat events on demand for prehospital retrieval services in rural and remote areas, or how heatwaves are defined in this context. INCLUSION CRITERIA: Papers were eligible for inclusion if they reported on the impact of a heat event on the activity of a prehospital and retrieval service in a rural or remote area. METHODS: A search of PubMed, Cochrane, Science Direct, CINAHL, and Google Scholar databases was undertaken on August 18, 2020 using search terms related to emergency medical transport, extreme heat, and rural or remote. Data relevant to the impact of heat on retrieval service activity were extracted, as well as definitions of extreme heat. RESULTS: Two papers were identified, both from Australia. Both found that heat events increased the number of road ambulance call-outs. Both studies used the Excess Heat Factor (EHF) to define heatwave periods of interest. CONCLUSIONS: This review found almost no primary literature on demand for prehospital retrieval services in rural and remote areas, and no data specifically related to aeromedical transport. The research did recognize the disproportionate impact of heat-related increase in service demand on Australian rural and regional health services. With the effects of climate change already being felt, there is an urgent need for more research and action in this area.

An intervention study of the rural elderly for improving exposure, risk perception and behavioral responses under high temperature

The frequency and intensity of high-temperature events continue to increase, resulting in a surge of pathogenicity and mortality. People with low levels of risk perception and adaptability, such as the elderly, suffer more from high temperatures. Effective intervention measures may lead to reduced levels of high temperature-related risk. The purpose of this study was to compare changes in temperature exposure, risk perception and coping behaviors under different intervention methods. Herein we conducted three different interventions including education, subsidies for electricity and uses of spray-cooling appliances as well as collected data about temperature exposure, risk perception, and coping behaviors. Before and after the experiment, we evaluated the intervention effectiveness with a number of variables related to alerting human responses under high temperatures. We conducted nonparametric tests for paired samples and generalized linear mixed effect models. Compared with subsidy support and outdoor spray-cooling methods, education is more effective as it leads to lower levels of temperature exposure, higher levels of risk perception, and more behavioral responses. The subsidy support intervention is useful in increasing risk perception and promoting home cooling practices as well. In comparison, spray cooling barely contributes to the reduction of personal temperature exposure. The encouragement of risk-related education and continued government subsidy may prevent elderly individuals from experiencing high-temperature exposure.

Indoor heat measurement data from low-income households in rural and urban South Asia

Rising temperatures are causing distress across the world, and for those most vulnerable, it is a silent killer. Information about indoor air temperature in residential dwellings is of interest for a range of reasons, such as health, thermal comfort and coping practices. However, there have been only few studies that measure indoor heat exposure, and contrast these to outdoor temperatures in rural-urban areas, of which none are in South Asia. We aim to close this knowledge gap with our indoor and outdoor heat measurement dataset, covering five low-income sites in South Asia. Two sites are in rural areas (Maharashtra, India), while three sites focus on urban areas (Dhaka, Delhi and Faisalabad). Data are based on 206 indoor temperature data loggers and complemented by data from five outdoor automated weather stations. The data-set can be used to examine temperature and humidity variation in low-socioeconomic status households in rural and urban areas and to better understand factors aggravating heat stress. This is important to plan and implement actions for combating heat stress.

Effects of urbanization on vulnerability to heat-related mortality in urban and rural areas in South Korea: A nationwide district-level time-series study

BACKGROUND: Although urbanization is often an important topic in climate change studies, the complex effect of urbanization on heat vulnerability in urban and rural areas has rarely been studied. We investigated the disparate effects of urbanization on heat vulnerability in urban and rural areas, using nationwide data. METHODS: We collected daily weather data for all 229 administrative districts in South Korea (2011-17). Population density was applied as an urbanization indicator. We calculated the heat-mortality risk using a distributed lag nonlinear model and analysed the relationship with population density. We also examined district characteristics that can be related to the spatial heterogeneity in heat-mortality risk. RESULTS: We found a U-shaped association between population density and heat-mortality risk, with the highest risk for rural populations; in urban areas, risk increases with increasing population density. Higher heat-mortality risk was associated with a lower number of hospital beds per person and higher percentage of people requiring recuperation. The association between hospital beds and heat-mortality risk was prominent in high-density urban areas, whereas the association between the percentage of people requiring recuperation and heat-mortality risk was pronounced in rural areas. CONCLUSIONS: Our findings indicate that the association between population density and heat-mortality risk is different in urban and rural areas, and that district characteristics related to heat-mortality risk also differ by urbanicity. These results can contribute to understanding the complex role of urbanization on heat vulnerability and can provide evidence to policy makers for prioritizing resources.

Effect of apparent temperature on hospitalization from a spectrum of cardiovascular diseases in rural residents in Fujian, China

Cardiovascular disease (CVD) is a leading threat to global public health. Although associations between temperature and CVD hospitalization have been suggested for developed countries, limited evidence is available for developing countries or rural residents. Moreover, the effect of apparent temperature (AT) on the spectrum of cause-specific CVDs remains unknown. Based on 2,024,147 CVD hospitalizations for rural residents from eight regions in Fujian Province, China, during 2010-2016, a quasi-Poisson regression with distributed lag non-linear model was fitted to estimate the AT effect on daily CVD hospitalization for each region, and then pooled in a meta-regression that included regional indicators related to rural residents. Stratified analyses were performed according to the cause of hospitalization, sex and age groups. Finally, we calculated the fraction of CVD hospitalizations attributable to AT, as a reflection of the burden associated with AT. The heat effect appeared at lag 0-1 days, with 19% (95% CI, 11-26%) increased risk of CVD hospitalization, which was worse for ischemic heart disease, heart failure, arrhythmias and ischemic stroke. The decreased AT was associated with increase of hemorrhagic stroke at lag 0-28 days. People aged 65 and above suffered more from the heat effect on cardiovascular and cerebrovascular diseases. Regions with a lower gross value of agricultural production, rural residents’ per capita net income, number of air conditioners and water heaters were more susceptible. A large number of hospitalizations were attributable to heat for most subcategories. High AT level increased CVD hospitalization, and the subcategories had different susceptibilities. The effects were modified by individual and regional characteristics. These findings have important implications for the development of targeted interventions and for hospital service planning.

The relationship between population heat vulnerability and urbanization levels: A county-level modeling study across China

The purpose of this work was to assess population vulnerability to heat-related health risks and its relationship with urbanization levels to provide essential information for the future development and policy-making for climate change adaptation. We constructed a heat vulnerability index (HVI), quantified the population heat vulnerability in each county across China by a principal component analysis (PCA) of multiple factors, and assessed urbanization levels in each county using multisource data. Then, the HVI was validated using the heat-attributable fraction (heat-AF) of nonaccidental mortality based on death monitoring data and meteorological data from 95 counties across China. The results showed that our HVI was significantly positively associated with the heat AF of nonaccidental mortality. A negative correlation was observed between the urbanization level and the HVI. The HVI was generally higher in less urbanized western China and lower in the more urbanized eastern regions. The baseline mortality occupies the top position in the importance ranking of the heat-vulnerability indicators at all three urbanization levels, but the other indicators, including the aging rate, agricultural population rate, education, ethnic structure, economic status, air conditioner ownership rate, and number of hospitals, ranked differently among different urbanization levels. This finding indicates that to reduce population heat vulnerability, the most important approach is to improve the health status of the whole population and reduce baseline mortality; additionally, regional-specific measures and emphasis should be adjusted reasonably along with the process of urbanization according to the characteristics and key factors of local heat vulnerability.

Outdoor heat stress and cognition: Effects on those over 40 years old in China

With the increases in hot weather frequency and intensity induced by observed and predicted climate change, heat exposure is an evolving challenge. We estimated a fixed effect econometric model to data on 5,404 individuals drawn from the China Health and Retirement Longitudinal Study database. These observations were used to examine the effect of heat stress on cognitive performance for those above 40 years of age who are often household decision-makers. We found today’s heat stress decreases performance on verbal and math test scores, and that cumulative heat exposure over the last 3 days adversely affects verbal test scores. We also found that middle-aged women and people in rural areas exhibit substantial heat stress-induced reductions on cognitive test scores. This finding implies that continuing climate change may well diminish decision-making capacity and effectiveness.

Nexus of heat-vulnerable chronic diseases and heatwave mediated through tri-environmental interactions: A nationwide fine-grained study in Australia

The warming trend over recent decades has already contributed to the increased prevalence of heat-vulnerable chronic diseases in many regions of the world. However, understanding the relationship between heat-vulnerable chronic diseases and heatwaves remains incomplete due to the complexity of such a relationship mingling with human society, urban and natural environments. Our study extends the Social Ecological Theory by constructing a tri-environmental conceptual framework (i.e., across social, built, and natural environments) and contributes to the first nationwide study of the relationship between heat-vulnerable chronic diseases and heatwaves in Australia. We utilize the random forest regression model to explore the importance of heatwaves and 48 tri-environmental variables that contribute to the prevalence of six types of heat-vulnerable diseases. We further apply the local interpretable model-agnostic explanations and the accumulated local effects analysis to interpret how the heat-disease nexus is mediated through tri-environments and varied across urban and rural space. The overall effect of heatwaves on diseases varies across disease types and geographical contexts (latitudes; inland versus coast). The local heat-disease nexus follows a J-shape function-becoming sharply positive after a certain threshold of heatwaves-reflecting that people with the onset of different diseases have various sensitivity and tolerance to heatwaves. However, such effects are relatively marginal compared to tri-environmental variables. We propose a number of policy implications on reducing urban-rural disparity in Healthcare and service distribution, delineating areas, and identifying the variations of sensitivity to heatwaves across urban/rural space and disease types. Our conceptual framework can be further applied to examine the relationship between other environmental problems and health outcomes.

High-heat days and presentations to emergency departments in regional Victoria, Australia

Heat kills more Australians than any other natural disaster. Previous Australian research has identified increases in Emergency Department presentations in capital cities; however, little research has examined the effects of heat in rural/regional locations. This retrospective cohort study aimed to determine if Emergency Department (ED) presentations across the south-west region of Victoria, Australia, increased on high-heat days (1 February 2017 to 31 January 2020) using the Rural Acute Hospital Data Register (RAHDaR). The study also explored differences in presentations between farming towns and non-farming towns. High-heat days were defined as days over the 95th temperature percentile. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes associated with heat-related illness were identified from previous studies. As the region has a large agricultural sector, a framework was developed to identify towns estimated to have 70% or more of the population involved in farming. Overall, there were 61,631 presentations from individuals residing in the nine Local Government Areas. Of these presentations, 3064 (5.0%) were on days of high-heat, and 58,567 (95.0%) were of days of non-high-heat. Unlike previous metropolitan studies, ED presentations in rural south-west Victoria decrease on high-heat days. This decrease was more prominent in the farming cohort; a potential explanation for this may be behavioural adaption.

Impact of COVID-19 on lifestyle and mental wellbeing in a drought-affected rural Australian population

INTRODUCTION: The SARS-CoV-2 (COVID-19) pandemic has caused unprecedented social and economic disruption, accompanied by the enactment of a multitude of public health measures to restrain disease transmission. These public health and social measures have had a considerable impact on lifestyle and mental wellbeing, which has been well studied with metropolitan populations. However, limited literature concerning such effects on a selectively rural population is presently available. Additionally, the use of a standardised scoring system for lifestyle may be valuable for an overall assessment of lifestyle that may be incorporated into clinical practice. METHODS: This study examined the associations between psychological distress and changes in SNAPS health behaviours (smoking, nutrition, alcohol, physical activity, sleep) since the onset of COVID-19 in Australia. A cross-sectional anonymous survey was distributed online to adults in the Western New South Wales Primary Health Network in August 2020 and included measures of psychological distress, income, disposition and lifestyle factors during the pandemic as well as changes to lifestyle due to COVID-19. A novel Global Lifestyle Score (GLS) was generated as a holistic assessment of lifestyle across multiple domains. RESULTS: The survey was completed by 304 individuals (modal age group 45-54 years, 86.8% female). High distress on the Kessler-5 scale was present in over one-third of participants (n=95, 33.7%). Detrimental change was reported for sleep (22.7%), nutrition (14.5%), alcohol (16.7%), physical exercise (34.0%) and smoking (24.7%) since the onset of the pandemic. Changes in sleep, nutrition, physical activity and smoking were associated with distress. Participants with a poor lifestyle (GLS) during the pandemic were significantly more distressed. Perceived COVID-19 impact was associated with high distress, drought impact and loss of income. Participants who reported negative impact from both COVID-19 and drought were significantly more distressed than those reporting a negative impact from drought alone or neither event. CONCLUSION: High rates of distress among rural Australians during the COVID-19 pandemic was linked to low GLS, worsening lifestyles and loss of income. Healthy lifestyle strategies should be considered by health professionals for the management of crisis-related distress. Further research may explore the impact of COVID-19 on a larger study population with a greater proportion of male participants and to examine the effect of modifying lifestyle factors in reducing distress in the context of a stressor such as this pandemic.

Why are some drought-affected farmers less distressed than others? The association between stress, psychological distress, acceptance, behavioural disengagement and neuroticism

OBJECTIVE: To identify the modifiable psychological and behavioural coping strategies associated with low levels of psychological distress, independent of more stable personality and demographic factors, in a sample of farmers who reported being exposed to a recent stressful event during an extended drought. DESIGN/SETTING/PARTICIPANTS: Three hundred and nine South Australian, drought-affected grain, sheep and/or cattle farmers completed printed or online questionnaires. Only those who reported experiencing a stressful event in the past month that they rated ≥7 on a scale ranging from 1 (not stressful at all) to 10 (extremely stressful) were included in the analyses (n = 175, 65.06%). Participants ranged in age from 24 to 85 years and 40% were female. MAIN OUTCOME MEASURES: Psychological distress was measured using the Kessler Psychological Distress Scale, and coping strategies were measured using a situational version of the COPE inventory. Five personality factors (extraversion, neuroticism, openness, conscientiousness and agreeableness) were assessed using the Quickscales-R. RESULTS: In the final multivariable model, distress was elevated among individuals reporting higher neuroticism and behavioural disengagement, and lower in individuals reporting greater use of acceptance. These 3 variables explained 44% of the variance in distress. CONCLUSION: Farmers recently exposed to a significant stressor, who used acceptance as a coping strategy, did not engage in behavioural disengagement and scored low on neuroticism, were least likely to experience distress. Given the stability of personality factors, interventions that foster farmers’ use of acceptance and prevent behavioural disengagement as coping strategies might assist them with the management of future stressors, particularly in times of drought.

How effectively do drought indices capture health outcomes? An investigation from rural Australia

Drought is a global threat to public health. Increasingly, the impact of drought on mental health and wellbeing is being recognized. This paper investigates the relationship between drought and well-being to determine which drought indices most effectively capture well-being outcomes. A thorough understanding of the relationship between drought and well-being must consider the (i) three aspects of drought (duration, frequency, and magnitude); (ii) different types of drought (meteorological, agricultural, etc.); and (iii) the individual context of specific locations, communities, and sectors. For this reason, we used a variety of drought types, drought indices, and time windows to identify the thresholds for wet and dry epochs that enhance and suppress impacts to well-being. Four postcodes in New South Wales (NSW), Australia, are used as case studies in the analysis to highlight the spatial variability in the relationship between drought and well-being. The results demonstrate that the relationship between drought indices and well-being outcomes differs temporally, spatially, and according to drought type. This paper objectively tests the relationship between commonly used drought indices and wellbeing outcomes to establish whether current methods of quantifying drought effectively capture well-being outcomes. For funding, community programs, and interventions to result in successful adaptation, it is essential to critically choose which drought index, time window, and well-being outcome to use in empirical studies. The uncertainties associated with these relationships must be accounted for, and it must also be realized that results will differ on the basis of these decisions.

Mosquito abundance in relation to extremely high temperatures in urban and rural areas of Incheon Metropolitan City, South Korea from 2015 to 2020: An observational study

BACKGROUND: Despite concerns regarding increasingly frequent and intense heat waves due to global warming, there is still a lack of information on the effects of extremely high temperatures on the adult abundance of mosquito species that are known to transmit vector-borne diseases. This study aimed to evaluate the effects of extremely high temperatures on the abundance of mosquitoes by analyzing time series data for temperature and mosquito abundance in Incheon Metropolitan City (IMC), Republic of Korea, for the period from 2015 to 2020. METHODS: A generalized linear model with Poisson distribution and overdispersion was used to model the nonlinear association between temperature and mosquito count for the whole study area and for its constituent urban and rural regions. The association parameters were pooled using multivariate meta-regression. The temperature-mosquito abundance curve was estimated from the pooled estimates, and the ambient temperature at which mosquito populations reached maximum abundance (TMA) was estimated using a Monte Carlo simulation method. To quantify the effect of extremely high temperatures on mosquito abundance, we estimated the mosquito abundance ratio (AR) at the 99th temperature percentile (AR(99th)) against the TMA. RESULTS: Culex pipiens was the most common mosquito species (51.7%) in the urban region of the IMC, while mosquitoes of the genus Aedes (Ochlerotatus) were the most common in the rural region (47.8%). Mosquito abundance reached a maximum at 23.5 °C for Cx. pipiens and 26.4 °C for Aedes vexans. Exposure to extremely high temperatures reduced the abundance of Cx. pipiens mosquitoes {AR(99th) 0.34 [95% confidence interval (CI) 0.21-0.54]} to a greater extent than that of Anopheles spp. [AR(99th) 0.64 (95% CI 0.40-1.03)]. When stratified by region, Ae. vexans and Ochlerotatus koreicus mosquitoes showed higher TMA and a smaller reduction in abundance at extreme heat in urban Incheon than in Ganghwa, suggesting that urban mosquitoes can thrive at extremely high temperatures as they adapt to urban thermal environments. CONCLUSIONS: We confirmed that the temperature-related abundance of the adult mosquitoes was species and location specific. Tailoring measures for mosquito prevention and control according to mosquito species and anticipated extreme temperature conditions would help to improve the effectiveness of mosquito-borne disease control programs.

Air pollution and cognitive functions: Evidence from straw burning in ChinaJEL codes

This study examines the impact of air pollution from straw burning on human cognitive health in China by linking household health surveys with PM2.5 emissions derived from remote sensing data on fire activity. The identification strategy leverages the spatial dispersion of air pollutants due to exogenous wind directions. The results indicate that PM2.5 emissions from upwind straw burning have a negative impact on cognitive functions of respondents aged 55 and above, but PM2.5 emissions from downwind fires do not. The impact is transitory and caused by contemporaneous PM2.5 emissions on the day of cognitive testing. Our findings demonstrate a link from air pollution to cognitive declines and suggest that through this link, climate change could result in additional health costs by increasing the risk of wildfires.

Associations of combined exposures to ambient temperature, air pollution, and green space with hypertension in rural areas of Anhui Province, China: A cross-sectional study

Hypertension (HTN) was a major preventable cause of cardiovascular disease (CVD), contributing to a huge disease burden. Ambient temperature, air pollution and green space were important influencing factors of HTN, and few studies have assessed the effects and interactions of ambient temperature, air pollution and green space on HTN in rural areas. In this study, we selected 8400 individuals randomly in rural areas of Anhui Province by a multi-stage stratified cluster sampling. A total of 8383 individuals were included in the final analysis. We collected particulate pollutants and meteorological data from the local air quality monitoring stations and National Center for Meteorological Science from January 1 to December 31, 2020, respectively. The normalized differential vegetation index (NDVI) of Anhui Province in 2020 was produced and processed by remote sensing inversion on the basis of medium resolution satellite images. The average annual mean exposure concentrations of air pollution, meteorological factors, and NDVI were calculated for each individual based on the geocoded residential address. HTN was defined according the Chinese Guidelines for Prevention and Treatment of HTN. The effects and interactions of ambient temperature, air pollution and green space on HTN were evaluated by generalized linear model and interaction model, respectively. In this study, the prevalence of HTN was 24.14%. The adjusted odd ratio of HTN for each 1 μg/m(3) increasing in PM(2.5) and PM(10), 1 °C of ambient temperature, and 0.1 of NDVI were:1.276 (1.013, 1.043), 1.012 (1.006, 1.018), 0.862 (0.862, 0.981) and 0.669 (0.611, 0.733), respectively. The results showed that air pollutants were positively correlated with HTN, while ambient temperature and green space were negatively correlated with HTN. Meanwhile, the negative associations of green space on HTN could decrease with the increasing concentrations of air pollution, but increase with the rising of ambient temperature.

Compositions, sources, and potential health risks of volatile organic compounds in the heavily polluted rural North China Plain during the heating season

Severe volatile organic compound (VOC) pollution has become an urgent problem during the heating season in the North China Plain (NCP), as exposure to hazardous VOCs can lead to chronic or acute diseases. A campaign with online VOC measurements was conducted at a rural site in Wangdu, NCP during the 2018 heating season to characterize the compositions and associated sources of VOCs and to assess their potential health risks. The total concentration of VOCs with 94 identified species was 77.21 +/- 54.39 ppb. Seven source factors were identified by non-negative matrix factorization, including coal combustion (36.1%), LPG usage (21.1%), solvent usage (13.9%), biomass burning and secondary formation (142%), background (7.0%), industrial emissions (4.5%), and vehicle emissions (3.3%). The point estimate approach and Monte Carlo simulation were used to estimate the carcinogenic and non-carcinogenic risks of harzadous VOCs. The results showed that the cumulative health risk of VOCs was above the safety level. Acrolein, 1.2-dichlorprothane, 12-dichloropropane, chloroform, 1,3-butadiene, and benzene were identified as the key hazardous VOCs in Wangdu. Benzene had the highest average carcinogenic risk. Solvent usage and secondary formation were the dominant sources of adverse health effects. During the Spring Festival, most sources were sharply reduced; and VOC concentration declined by 49%. However, coal and biomass consumptions remained relatively large, probably due to heating demand. This study provides important references for the control strategies of VOCs during the heating season in heavily polluted rural areas in the NCP. (C) 2021 Elsevier B.V. All rights reserved.

The Impacts of Climate Change on Mental Health of Tribal Communities in Jharkhand

Research and Action Agenda on Climate Change and Mental Health for Small Farmers and Fisher Peoples

Nature exclosures for carbon sequestration to generate revenue, rehabilitate nature and improve agricultural yields in the highlands of Ethiopia

Climate change and health resilience actions in São Tomé and Príncipe

Human Climate Horizons (HCH)

The impact of drought on the health and livelihoods of women and children in India: A systematic review

Climate change is expected to have severe consequences for the world, some of which are already being felt. According to projections, in some regions, droughts will be more frequent and intense in the 21st century. This calls for purposeful interventions by governments to mitigate the impacts. Drought-affected communities are more vulnerable to famine. The effects of drought are felt in people’s education levels, nutrition, health, sanitation, and women and the safety of children in these communities. The impact of drought can be seen in the livelihoods of people affected by it. Against this backdrop, there is the need to document the effects of drought on women and children’s health in the affected communities. Such a study calls for a systematic approach. This study explores the various dimensions of the effects of droughts. It accessed electronic databases, including Google Scholar, Scopus, Pub-Med, JSTOR to identify a substantial number of studies using key words and expressions. To begin with, the word drought was kept constant in all combinations of keywords and phrases. The search was then refined by using the word drought with keywords, such as livelihood, vulnerability, sustainable development, adaption and mitigation, migration, health impact, and risk management to search the required articles. Only studies conducted in the period 2000 – 2019 were considered for this review. The review’s findings show that due to a lack of water during a drought, the burden of work on women and children increased considerably. Most faced severe health issues like malnutrition and anemia. The livelihoods of women were also affected because of which they were forced to adopt various strategies to overcome the problems posed by droughts. Droughts occur every year in different parts of India. Actions are required to mitigate the effects of drought, including the provision of drinking water, food, aid and relief aid to distressed farmers, employment support, support for changes in livelihoods, water security, and drought-proofing. State policies and actions must give particular attention to women and children because they are the most vulnerable. Employment-generation actions should also include youth by providing appropriate training for developing appropriate skills.

Impact of environmental injustice on children’s health-Interaction between air pollution and socioeconomic status

Air pollution disproportionately affects marginalized populations of lower socioeconomic status. There is little literature on how socioeconomic status affects the risk of exposure to air pollution and associated health outcomes, particularly for children’s health. The objective of this article was to review the existing literature on air pollution and children’s health and discern how socioeconomic status affects this association. The concept of environmental injustice recognizes how underserved communities often suffer from higher air pollution concentrations in addition to other underlying risk factors for impaired health. This exposure then exerts larger effects on their health than it does in the average population, affecting the whole body, including the lungs and the brain. Children, whose organs and mind are still developing and who do not have the means of protecting themselves or creating change, are the most vulnerable to the detrimental effects of air pollution and environmental injustice. The adverse health effects of air pollution and environmental injustice can harm children well into adulthood and may even have transgenerational effects. There is an urgent need for action in order to ensure the health and safety of future generations, as social disparities are continuously increasing, due to social discrimination and climate change.

Factors that influence climate change-related mortality in the United States: An integrative review

Global atmospheric warming leads to climate change that results in a cascade of events affecting human mortality directly and indirectly. The factors that influence climate change-related mortality within the peer-reviewed literature were examined using Whittemore and Knafl’s framework for an integrative review. Ninety-eight articles were included in the review from three databases-PubMed, Web of Science, and Scopus-with literature filtered by date, country, and keywords. Articles included in the review address human mortality related to climate change. The review yielded two broad themes in the literature that addressed the factors that influence climate change-related mortality. The broad themes are environmental changes, and social and demographic factors. The meteorological impacts of climate change yield a complex cascade of environmental and weather events that affect ambient temperatures, air quality, drought, wildfires, precipitation, and vector-, food-, and water-borne pathogens. The identified social and demographic factors were related to the social determinants of health. The environmental changes from climate change amplify the existing health determinants that influence mortality within the United States. Mortality data, national weather and natural disaster data, electronic medical records, and health care provider use of International Classification of Disease (ICD) 10 codes must be linked to identify climate change events to capture the full extent of climate change upon population health.

Scoping the nexus between climate change and water-security realities in rural South Africa

While the global response to climate change has been scant and uncoordinated, especially with regard to providing adequate water resources for the most improvised, water scarcity has become an increasingly neglected phenomenon in rural areas. The long-term imbalance resulting from the water demand exceeding the available water resources has been identified in the literature, with the majority of rural dwellers negatively affected by water scarcity. Using a scoping review technique to explore the nexus between climate change and water-security realities in view of coping and planning mechanisms in the South African context, 246,443 articles published between 2010 and 2019 were collated and reviewed in a bid to ascertain the state of knowledge, study, and focus on the coping and planning strategies adopted by rural communities in the face of climate change-induced water insecurity in South Africa. The identified gaps in the literature indicate the omission of spatial planning principles in responding to water-scarcity issues. This review concludes that, although policy research that links the impacts of climate change in rural communities exists, stronger focus on the quality and quantity issues in the implementation of water-security matters is critical. Hence, the impact of climate change on climate-sensitive supplies available in these rural areas as well as the consequent coping and planning alternatives for rural communities require a more robust policy and spatial research. Thus, as rural communities deal with the impacts of climate change, implementation cycles of water-security measures need to be ensured along with further integration of spatial planning issues in rural areas. Hence, a deeper engagement with spatial planning issues is needed, in order to further mitigate and address the impacts of climate change on water security in rural areas.

Climate change, water quality and water-related challenges: A review with focus on Pakistan

Climate variability is heavily impacting human health all around the globe, in particular, on residents of developing countries. Impacts on surface water and groundwater resources and water-related illnesses are increasing, especially under changing climate scenarios such as diversity in rainfall patterns, increasing temperature, flash floods, severe droughts, heatwaves and heavy precipitation. Emerging water-related diseases such as dengue fever and chikungunya are reappearing and impacting on the life of the deprived; as such, the provision of safe water and health care is in great demand in developing countries to combat the spread of infectious diseases. Government, academia and private water bodies are conducting water quality surveys and providing health care facilities, but there is still a need to improve the present strategies concerning water treatment and management, as well as governance. In this review paper, climate change pattern and risks associated with water-related diseases in developing countries, with particular focus on Pakistan, and novel methods for controlling both waterborne and water-related diseases are discussed. This study is important for public health care, particularly in developing countries, for policy makers, and researchers working in the area of climate change, water quality and risk assessment.

Yoga as a potential psychosocial tool: Results from a quasi-experimental single-arm study on victims of flood affected state of Kerala

Objectives: Mental and social health is among the notable domains affected by natural disasters, with nearly one-quarter of the people living in an area affected by natural disasters expressing the symptoms of depression, anxiety, post-traumatic stress disorder, bipolar disorder, or schizophrenia. Bringing harmony among these affected individuals is an important clinical priority. The effect of yoga, which is reported to reduce mental disorders to a great extent in many conditions, has not been studied in the setting of natural disaster recovery. Methods: Thirty-two participants [Mean age 37.8(SD +/- 8.9)] from a flood-affected state of India exhibiting mental and social impacts from the natural disaster were enrolled for 15 days of yoga interventions after obtaining written consent. Breathing exercises and guided relaxation techniques were provided as intervention after obtaining a self-rated visual analog scale (VAS) for fear, sadness, anxiety, and lack of sleep. Results: All participants completed the study. Statistically significant changes were observed (P < 0.05) in all the VAS dependent scale variables such as fear, sadness, anxiety, and lack of sleep. No adverse events were reported. Conclusion: Fifteen days of yoga interventions in victims of the flood-affected region might offer resilience to the people affected by natural disasters. Results of this study are encouraging and yoga can be introduced for addressing mental health issues in such emergencies and can be a valuable tool. However, more studies with robust designs and focused tools to determine the effects are warranted. (C) 2021 Elsevier Ltd. All rights reserved.

A meta-synthesis of policy recommendations regarding human mobility in the context of climate change

Changing mobility patterns combined with changes in the climate present challenges and opportunities for global health, requiring effective, relevant, and humane policy responses. This study used data from a systematic literature review that examined the intersection between climate change, migration, and health. The study aimed to synthesize policy recommendations in the peer-reviewed literature, regarding this type of environmental migration with respect to health, to strengthen the evidence-base. Systematic searches were conducted in four academic databases (PubMed, Ovid Medline, Global Health and Scopus) and Google Scholar for empirical studies published between 1990-2020 that used any study design to investigate migration and health in the context of climate change. Studies underwent a two-stage protocol-based screening process and eligible studies were appraised for quality using a standardized mixed-methods tool. From the initial 2425 hits, 68 articles were appraised for quality and included in the synthesis. Among the policy recommendations, six themes were discernible: (1) avoid the universal promotion of migration as an adaptive response to climate risk; (2) preserve cultural and social ties of mobile populations; (3) enable the participation of migrants in decision-making in sites of relocation and resettlement; (4) strengthen health systems and reduce barriers for migrant access to health care; (5) support and promote optimization of social determinants of migrant health; (6) integrate health into loss and damage assessments related to climate change, and consider immobile and trapped populations. The results call for transformative policies that support the health and wellbeing of people engaging in or affected by mobility responses, including those whose migration decisions and experiences are influenced by climate change, and to establish and develop inclusive migrant healthcare.

The social correlates of flood risk: Variation along the US rural-urban continuum

Compositional and contextual characteristics of a place capture the collective fnancial, physical, human, and social capital of an area and its ability to prevent, plan for, and recover from severe weather events. Research that examines the compositional and contextual characteristics of places with elevated food risk is largely limited to urban-centric analyses and case studies. However, rural areas of the USA are not immune to fooding. In this paper, we integrate social and physical data to identify the social correlates of food risk and determine if and how they vary across the rural–urban continuum for all census tracts in the coterminous USA. Our results show that risk of fooding is higher in rural tracts, in tracts with larger relative shares of socioeconomically vulnerable populations, and in tracts reliant on food-vulnerable industries. We also show that compositional social correlates of fooding are not consistent across rural–urban areas. This work widens the scope of discourse on fooding to attend to the heterogeneity of social correlates and the implications for policy and future research.

Understanding risk perception from floods: A case study from China

Understanding and improving the public risk perception have become an important element in the management of flood risk. In China, the risk government is of so-called nationwide catastrophe response mode which is different from the widely adopted “bottom up” risk governance mode in the Western countries. Such a particular mode may make Chinese people perceive risk in a different way from people in other countries. Hence, a further discussion of risk perception is of great value in China. ?This paper presents a case study on the public perception of flood hazard and flood risk in a city prone to floods. The relationship between risk perception and exposure was examined by spatial analysis. Meanwhile, inferential testing with chi-squared tests was undertaken regarding experience, social trust, and protective behaviors. Our results suggest that (1) the relationship between exposure and risk perception of people in Nanjing is positive and statistically significant, (2) flood experience was strongly related to risk perception, (3) trust showed a significant relationship to risk perception, and (4) people who have perceived the probability of floods and associated loss of life have a higher willingness to take more protective measures. These findings will help local government to develop effective flood risk communication strategies for improving public awareness creation, emergency response and preparedness.

The last mile: Flood risk communication for better preparedness in Nepal

Over the last decade, several flood early warning systems have been established in Nepal, helping reduce the number of people affected and killed by floods. However, there are still challenges in communicating flood warning to the most vulnerable. The unavailability of real-time monitoring in smaller streams and tributaries has created challenges for communicating early warning. The ongoing restructuring process of the multilevel governance system in the country also presents challenges, specifically institutional such as insufficient coordination among relevant agencies, lack of adequate personnel, limited budget, and unclear roles and responsibilities. This study uses the Alexander framework (2015) to identify gaps in flood early warning communication in relation to their technical, institutional and socio-cultural components. Qualitative research methods in the form of key informant interviews and on-site focus group discussions were conducted at the national, district and local levels to collect data, taking Ratu watershed as a case study. Based on our analysis, we conclude that, first, while progress has been made in the monitoring and forecasting of floods, integration of socio-cultural aspects that can make early warning information accessible to the most vulnerable has to be strengthened. Second, warning messages need to be co-designed with communities and tailored to meet their diverse needs for proper dissemination and timely protective action. Finally, for flood risk communication to bridge ‘the last mile’ in terms of reaching the most vulnerable in the community must take account of their distinct social, economic and political experiences in both content and delivery of the information.

The lived experience of disadvantaged communities affected by the 2015 South Indian floods: Implications for disaster risk reduction dialogue

Poverty and discrimination compound vulnerability to disasters. Yet, people who experience these are some of the least involved groups in Disaster Risk Reduction (DRR) dialogue and research. This study aims to fill that gap by narrating the lived experience of underprivileged flood-affected communities. We conducted in-depth interviews (N = 48) with community members (n = 36) and staff members of collaborating non-governmental organisations (n = 12). We also conducted focus group discussions with staff members of the same NGOs. The results describe how systemic issues entrenched with socio-economic and cultural factors impact a community?s ability to prepare for floods. These communities received no warning or timely evacuation messages, and perceived the received support as inadequate and unfair. Communities recovered through their resourcefulness and thoughtfulness. They resented the government for its lack of action throughout the disaster cycle. Priorities for future efforts involve actively engaging these vulnerable groups and tailoring DRR activities for them.

Social work empowerment model for mainstreaming the participation of rural women in the climate change discourse

Despite the direct linkage between climate change and social work practice, the involvement of social workers in addressing climate change issues remains discouraging. This is attributed to lack of exposure in climate change issues during training as social workers leading to lack of adequate tools for social workers to integrate climate change issues into their day-to-day interventions with clients. This paper is aimed at providing guidelines for social work practice in mainstreaming the participation of rural women in the climate change discourse. Social workers and rural women are absent from climate change interventions at professional, practice and personal levels. The precarious impacts of climate change manifesting through floods, droughts, water scarcity, depletion of the natural resource base, cyclones and heat waves disproportionally affect women particularly those in rural communities. Women’s vulnerability to climate change is emanating from exclusion in climate change decision-making processes, cultural norms and patterns which confines them to household responsibilities, lack of adaptive capacity, low literacy levels, patriarchal dominance and high poverty levels. As such, social workers are required to enhance social change, through empowerment and liberation of women to participate in discussions on climate change like men. A model is presented based on experiences in southern Africa to provide some guidance for social workers on how best to mainstream gender dimensions in climate change interventions. This would foster social and environmental justice, social resilience, equal participation in the climate change discourse, capacity building and adaptive capacity for rural women.

Socioeconomic disparities in climate vulnerability: Neonatal mortality in northern Sweden, 1880-1950

The aim of this study was to analyse the association between season of birth, temperature and neonatal mortality according to socioeconomic status in northern Sweden from 1880 to 1950. The source material for this study comprised digitised parish records combined with local weather data. The association between temperature, seasonality, socioeconomic status and neonatal mortality was modelled using survival analysis. We can summarise our findings according to three time periods. During the first period (1880–1899), temperature and seasonality had the greatest association with high neonatal mortality, and the socioeconomic differences in vulnerability were small. The second period (1900–1929) was associated with a decline in seasonal and temperature-related vulnerabilities among all socioeconomic groups. For the last period (1930–1950), a new regime evolved with rapidly declining neonatal mortality rates involving class-specific temperature vulnerabilities, and there was a particular effect of high temperature among workers. We conclude that the effect of season of birth on neonatal mortality was declining for all socioeconomic groups (1880–1950), whereas weather vulnerability was pronounced either when the socioeconomic disparities in neonatal mortality were large (1880–1899) or during transformations from high to low neonatal rates in the course of industrialisation and urbanisation.

Respiratory health effects of wildfire smoke during summer of 2018 in the Jämtland Härjedalen region, Sweden

During the summer of 2018 Sweden experienced a high occurrence of wildfires, most intense in the low-densely populated Jämtland Härjedalen region. The aim of this study was to investigate any short-term respiratory health effects due to deteriorated air quality generated by the smoke from wildfires. For each municipality in the region Jämtland Härjedalen, daily population-weighted concentrations of fine particulate matter (PM(2.5)) were calculated through the application of the MATCH chemistry transport model. Modelled levels of PM(2.5) were obtained for two summer periods (2017, 2018). Potential health effects of wildfire related levels of PM(2.5) were examined by studying daily health care contacts concerning respiratory problems in each municipality in a quasi-Poisson regression model, adjusting for long-term trends, weekday patterns and weather conditions. In the municipality most exposed to wildfire smoke, having 9 days with daily maximum 1-h mean of PM(2.5) > 20 ?g/m(3), smoke days resulted in a significant increase in daily asthma visits the same and two following days (relative risk (RR) = 2.64, 95% confidence interval (CI): 1.28-5.47). Meta-estimates for all eight municipalities revealed statistically significant increase in asthma visits (RR = 1.68, 95% CI: 1.09-2.57) and also when grouping all disorders of the lower airways (RR = 1.40, 95% CI: 1.01-1.92).

Seasonality of drinking water sources and the impact of drinking water source on enteric infections among children in Limpopo, South Africa

Enteric infections and water-related illnesses are more frequent during times of relative water abundance, especially in regions that experience bimodal rainfall patterns. However, it is unclear how seasonal changes in water availability and drinking water source types affect enteric infections in young children. This study investigated seasonal shifts in primary drinking water source type and the effect of water source type on enteric pathogen prevalence in stool samples from 404 children below age 5 in rural communities in Limpopo Province, South Africa. From wet to dry season, 4.6% (n = 16) of households switched from a source with a higher risk of contamination to a source with lower risk, with the majority switching to municipal water during the dry season. In contrast, 2.6% (n = 9) of households switched from a source with a lower risk of contamination to a source with higher risk. 74.5% (n = 301) of the total households experienced interruptions in their water supply, regardless of source type. There were no significant differences in enteric pathogen prevalence between drinking water sources. Intermittent municipal water distribution and household water use and storage practices may have a larger impact on enteric infections than water source type. The limited differences in enteric pathogen prevalence in children by water source could also be due to other exposure pathways in addition to drinking water, for example through direct contact and food-borne transmission.

Predicting social and health vulnerability to floods in Bangladesh

Population preparedness for disasters and extreme weather events as a predictor of building a resilient society: The Slovak Republic

The current increase and severity of the natural disasters whose effects on the public health are likely to be even more extreme and complex, requires enhancing and developing the disaster preparedness on the population level. In order to be able to do so, it is inevitable and determinative to know the factors that affect people’s preparedness on the population level. Therefore, the objective of this article is to present the results from assessing the factors related to the population preparedness for the disasters on a sample of citizens living from the Slovak Republic. Our research is based on the exploration of the questionnaire survey’ results aimed at investigating the preparedness and preventive proactive behaviour of the population against the disasters. The search for the initiators of such a behaviour and assessment of the influence of various aspects (e.g., the respondents’ experience with disasters, their vulnerability to disasters, the risk awareness, the perception of the disaster risks in the changing environment, etc.) on the respondents’ behaviour against disasters is the main part of the article and is supported by the statistical analysis. The results of the survey suggest that the disaster risk awareness and overall disaster preparedness level is rather poor and the population is inactive. The proactive behaviour of the respondents against the disasters is partially affected by some of their personality and socio-economic characteristics, especially the younger respondents currently incline more to adopting the protective measures. In addition, other aspects, e.g., the negative experience with the disasters in the past influence the preparedness. However, the impacts must have been relatively serious for the proactive behaviour to be influenced. The influences of other aspects as well as the possible methods for improving the disaster preparedness and the possibilities of increasing the resilience of the population as a whole are also discussed in this article.

Preconception ambient temperature and preterm birth: A time-series study in rural Henan, China

Changes in the preconception ambient temperature (PAT) can affect the gametogenesis, disturbing the development of the embryo, but the health risks of PAT on the developing fetus are still unclear. Here, based on the National Free Preconception Health Examination Project in the rural areas of Henan Province, we evaluate the effects of PAT on preterm birth (PTB). Data of 1,231,715 records from self-reported interviews, preconception physical examination, early gestation follow-up, and postpartum follow-up were collected from 1 January 2013 to 31 December 2016. Generalized additive models were used to assess the cumulative and lag effects of PAT upon PTB. The significant cumulative effects of mean temperature within 2 weeks and 3 weeks on the risk of PTB, especially upon late PTB (34-36 weeks) (P < 0.05), were observed. Exposure to extreme heat (> 90th percentile) within 2 weeks (RR = 1.470) and 3 weeks (RR = 1.375) before conception could increase the risk of PTB. After stratifying PTB, exposure to extreme heat within 2 weeks before conception can increase the risks of early (< 34 weeks) and late PTB (P < 0.05). Besides, exposure to extreme cold (< 10th percentile) within 3 weeks or longer before conception can elevate the risk of PTB, especially late PTB. The significant lag effects of temperature changes on the risk of early PTB (lag-8 days or earlier) were observed. In conclusion, the risk of PTB was susceptible to PAT changes within 2 weeks or longer before conception. Our findings provide (i) guidance for rural couples to make pregnancy plans and (ii) scientific evidence for the government to formulate policies to prevent PTB.

Participatory modeling of water vulnerability in remote Alaskan households using causal loop diagrams

Despite perceptions of high water availability, adequate access to sufficient water resources remains a major challenge in Alaska. This paper uses a participatory modeling approach to investigate household water vulnerability in remote Alaska and to examine factors that affect water availability and water access. Specifically, the work asks: how do water policy stakeholders conceptualize the key processes that affect household water vulnerability in the context of rural Alaska? Fourteen water policy stakeholders participated in the modeling process, which included defining the problem of household water vulnerability and constructing individual causal loop diagrams (CLDs) that represent their conceptualization of household water vulnerability. Individual CLDs were subsequently combined and five sub-models emerged: environmental, economic, infrastructure, social, and health. The environmental and economic sub-models of the CLD are explored in depth. In the environmental sub-model, climate change and environmental barriers due to geography influence household water vulnerability. In the economic sub-model, four processes and one feedback loop affect household water vulnerability, including operations and maintenance funding, the strength of the rural Alaskan economy, and the impact of regulations. To overcome household water vulnerability and make households more resilient, stakeholders highlighted policy solutions under five themes: economics, social, regulatory, technological, and environmental.

Perceived impacts of climate variability and change: An exploration of farmers’ adaptation strategies in Zimbabwe’s intensive farming region

Climate variability and change (CVC) affect many economic sectors including agriculture. In order to alleviate the negative impact of CVC on food production, farmers must adopt a range of strategies. However, the strategies will be less effective if farmers’ perceptions on CVC are not considered. This study therefore, examined the perceptions of commercial farmers on CVC and their adaptation strategies to the perceived impacts. It used a cross-sectional survey involving 365 farmers in the intensive farming region of Zimbabwe. Results showed that farmers’ perceptions on increasing temperatures and decreasing rainfall amounts were cognate with climate data from the meteorological office. The findings also demonstrated that farmers were well aware of the CVC impacts on their livelihoods. These include increases in the frequency and severity of drought, and a shortening of the length of the rainy season. However, the most significant changes were observed among the natural and economic capitals including soil salinization, reduction in grazing pastures, fodder and crop yields in addition to increases in food prices. In response to the perceived impacts of local CVC, the farmers were adopting crop and land use management strategies that include planting rotation, cultivating short-season varieties and drought tolerant crops, crop and farm diversification, intensified irrigation, agroforestry, soil moisture conservation and mixed farming. The study concludes that farmers are active observers of local CVC. Therefore, they should modify their agricultural calendar and diversify their farming systems so as to better meet current and future risks from CVC.

Perception of indigenous people of climate change and its impact on the Everest National Nature Preserve

Using interviews and surveys of 212 households in villages situated at different elevations in the Everest National Nature Preserve (ENNP), correlations and comparative analyses were employed to reveal the residents’ perceptions and understanding of climate change and its effects on the ENNP. Results showed that: (1) nearly all residents thought that climate warming and ice-snow landscape decrease were very significant, but there was an obvious difference between the residents’ cognition and observations to the change of runoff; (2) higher altitude is, more obvious warming is, and stronger residents’ perception of climate change and its impacts is in the ENNP, for which educational level and age were the main factors affecting their degree of perception; (3) especially, higher altitude is, more frequent the tourism participation of residents is and higher their income is; and (4) because the centralized pollutant treatment facilities have a low efficiency, and because the area receives a large number of tourists whose activities are spatially scattered, the potential risk of environmental pollution has been increasing in recent years. At present there is an urgent need for policy suggestions at the strategic level of national ecological security and interregional equity principles concerning the adaptation to climate and environmental changes in the ENNP.

Modeling dengue vector population with earth observation data and a generalized linear model

Mosquitoes propagate many human diseases, some widespread and with no vaccines. The Ae. aegypti mosquito vector transmits Zika, Chikungunya, and Dengue viruses. Effective public health interventions to control the spread of these diseases and protect the population require models that explain the core environmental drivers of the vector population. Field campaigns are expensive, and data from meteorological sites that feed models with the required environmental data often lack detail. As a consequence, we explore temporal modeling of the population of Ae. aegypti mosquito vector species and environmental conditions- temperature, moisture, precipitation, and vegetation- have been shown to have significant effects. We use earth observation (EO) data as our source for estimating these biotic and abiotic environmental variables based on proxy features, namely: Normalized difference vegetation index, Normalized difference water index, Precipitation, and Land surface temperature. We obtained our response variable from field-collected mosquito population measured weekly using 791 mosquito traps in Vila Velha city, Brazil, for 36 weeks in 2017, and 40 weeks in 2018. Recent similar studies have used machine learning (ML) techniques for this task. However, these techniques are neither intuitive nor explainable from an operational point of view. As a result, we use a Generalized Linear Model (GLM) to model this relationship due to its fitness for count response variable modeling, its interpretability, and the ability to visualize the confidence intervals for all inferences. Also, to improve our model, we use the Akaike Information Criterion to select the most informative environmental features. Finally, we show how to improve the quality of the model by weighting our GLM. Our resulting weighted GLM compares well in quality with ML techniques: Random Forest and Support Vector Machines. These results provide an advancement with regards to qualitative and explainable epidemiological risk modeling in urban environments.

Integrated flood vulnerability assessment of villages in the Waimanu River Catchment in the South Pacific: The case of Viti Levu, Fiji

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.

Investigating the urban heat and cool island effects during extreme heat events in high-density cities: A case study of Hong Kong from 2000 to 2018

Urban heat island (UHI) and cool island (UCI) effects are well-known and prevalent in cities worldwide. An increasing trend of extreme heat events has been observed over the last few decades and is expected to continue in the foreseeable future. In this study, warm periods (May to September) of 2000-2018 were examined to acquire a comprehensive understanding of the UHI and UCI characteristics for the case study of Hong Kong, China. Twenty-two weather stations in Hong Kong were classified into four categories, namely urban, urban oasis, suburban, and rural, with reference to the local climate zone (LCZ) scheme, to analyze UHI and UCI phenomena during extreme heat and non-extreme heat situations. One representative type of extreme heat events was considered in this study: three consecutive hot nights with two very hot days in between (2D3N). Results show that both the UHI and UCI effects are exacerbated during extreme heat events. Using the concept of the UHI degree hours (UHIdh) and UCI degree hours (UCIdh), their spatial patterns in Hong Kong during extreme heat and non-extreme heat situations were mapped based on multiple linear regression models. It is found that the predictor variable – windward/leeward index is a significant influential factor of both UHIdh and UCIdh during extreme heat events. The resulting UHIdh and UCIdh maps not only enhance our understanding on the spatial pattern and characteristics of the UHI and UCI during extreme heat events, but could also serve as a useful reference in climate change adaptation, heat-health risk detection, cooling-energy estimation and policy making.

Is vulnerability to climate change gendered? And how? Insights from Egypt

Most climate change literature tends to downplay the gendered nature of vulnerability. At best, gender is discussed in terms of the male-female binary, seen as opposing forces rather than in varying relations of interdependency. Such construction can result in the adoption of maladaptive culturally unfit gender-blind policy and interventions. In Egypt, which is highly vulnerable to climate change, gender analysis of vulnerability is almost non-existent. This paper addresses this important research gap by asking and drawing on a rural Egyptian context ‘How do the gendered relational aspects of men’s and women’s livelihoods in the household and community influence vulnerability to climate change?’. To answer this question, I draw on gender analysis of social relations, framed within an understanding of sustainable livelihoods. During 16 months of fieldwork, I used multiple ethnographic methods to collect data from two culturally and ethnically diverse low-income villages in Egypt. My main argument is that experiences of climate change are closely intertwined with gender and wider social relations in the household and community. These are shaped by local gendered ideologies and cultures that are embedded in conjugal relations, kinship and relationship to the environment, as compared across the two villages. In this paper, I strongly argue that vulnerability to climate change is highly gendered and therefore gender analysis should be at the heart of climate change discourses, policy and interventions.

Livelihood vulnerability and adaptability of coastal communities to extreme drought and salinity intrusion in the Vietnamese Mekong Delta

Many deltas worldwide have increasingly faced extreme drought and salinity intrusion, which have adversely affected millions of coastal inhabitants in terms of lives and property. The Vietnamese Mekong Delta (VMD) is considered one of the world?s most vulnerable regions to drought and saline water intrusion, especially in the context of climate change. This study aims to assess livelihood vulnerability and adaptation of the coastal people of the VMD under the impacts of drought and saltwater intrusion. A multi-disciplinary approach was applied, including desktop literature reviews, field surveys, interviews, and focus group discussions with 120 farmers and 30 local officials in two representative hamlets of Soc Trang, a coastal province of the VMD. A vulnerability assessment tool in combination with a sustainable livelihood framework was used to evaluate livelihood vulnerability using the five capital resources to indicate the largest effects of drought and salinity intrusion on the migration of local young people to large cities for adaptation. Livelihood Vulnerability Indexes revealed higher vulnerability in terms of the five capitals of coastal communities living in Nam Chanh hamlet compared to Soc Leo. Results of interviews with officials indicated an optimized mechanism between social organizations and local communities before, at the time, and after being impacted by the drought and salinity intrusion. Our findings contribute evidence-based knowledge to decision-makers to enable coastal communities in the VMD and other deltas worldwide to effectively adapt to the impacts of drought and salinity intrusion.

Livelihood vulnerability to climate change in the mountains of Northern Vietnam: Comparing the Hmong and the Dzao ethnic minority populations

Livelihoods of ethnic minority populations living in the mountains of Northern Vietnam are highly vulnerable to climate-induced natural hazards. Therefore, the livelihoods of vulnerable ethnic minority populations in these areas could be improved through climate change adaptation measures. This study pursues an enhancement of three different aggregate indices such as Livelihood Vulnerability Index (LVI), Livelihood Vulnerability Index framed within the IPCC vulnerability framework (LVI-IPCC), and Livelihood Effect Index (LEI) to find out components contributing to the livelihood vulnerability of major ethnic minority populations in a case study of Mo Vang mountain (Yen Bai, Vietnam). A total of 120 Dzao and Hmong respondents from 11 villages are surveyed based on a combination of informal interviews, a questionnaire survey, and Focused Group Discussions (FGD). Twenty-nine sub-components belonging to 10 major components (socio-demographic profile, livelihood strategies, social networks, revenue, health, food, water, housing, land, and natural hazards and climate variability) are conducted to calculate LVI, LVI-IPCC, and LEI. The results show that the livelihood of Hmong populations is more vulnerable to climate change for natural conditions such as natural hazards and climate variability, housing, land, water, food, and health. However, the livelihood of Dzao populations is more vulnerable because of socio-economic conditions such as socio-demographic profile, livelihood strategies, revenue, and social networks. The results provide a scientific basis for both residents, local officials, and policy-makers prioritizing solutions to enhance livelihood capitals as well as to improve adaptive capacity to climate change in the mountains of Northern Vietnam.

Livelihood vulnerability to flood hazard: Understanding from the flood-prone Haor ecosystem of Bangladesh

Bangladesh is a country of natural disasters and climatic hazards, which frequently affect its inhabitants’ lives and livelihoods. Among the various risks and disasters, floods are the most frequent hazard that makes haor households vulnerable. Therefore, this study was undertaken to estimate livelihood vulnerability to flooding within the flood-prone haor ecosystem in Bangladesh. Primary data were collected from 100 haor households each from Kishoreganj, Netrokona, and Sunamganj districts (N?=?300) by applying a multistage random sampling technique. Data were collected through face-to-face interviews using a pretested structured questionnaire. The Livelihood Vulnerability Index (LVI) and the Intergovernmental Panel on Climate Change (IPCC) framework of vulnerability were applied to compare vulnerabilities among the selected haor-based communities. The empirical results revealed that haor households in Sunamganj district were more vulnerable to flood hazard and natural disaster in terms of food, water, and health than households in the other two districts. Taking into account the major components of the LVI, the IPCC framework of vulnerability indicated that households in Sunamganj district were the most vulnerable due to their lowest adaptive capacity and highest sensitivity and exposure. These findings enable policymakers to formulate and implement effective strategies and programs to minimize vulnerability and enhance resilience by improving the livelihoods of the vulnerable haor households of Bangladesh, especially those in Sunamganj district.

Influence of the meteorological conditions and some pollutants on PM(10) concentrations in Lamphun, Thailand

Particulate matter (PM) has been occurring regularly during the dry season in the upper north of Thailand including Lamphun Province that might be influenced by various factors including climatologic and other pollutants. This paper aims to investigate the climatologic and gaseous factors influencing the occurrence of PM(10) concentration using Pollution Control Department (PCD) data. The secondary data of 2009 to 2017 obtained from the PCD was used for analysis. We used descriptive statistics, Pearson’s correlation coefficient, multiple regression and graphic presentation using R program (R packages of ‘open air’ and ‘ncdf4’) and Microsoft Excel Spreadsheet®. In addition, the periodic measurement of PM(2.5) and PM(10) were investigated to determine the ratio of PM(2.5)/PM(10). The results indicated that haze episodes (daily PM(10) concentration always over the PCD standard) normally occur during the dry season from February to April. The maximum concentration was always found in March. The PM(10) concentration was negatively associated with relative humidity and temperature while the PM(10) concentration showed a strongly positive association with CO and NO(2) concentration with correlation values of 0.70 and 0.57, respectively. Furthermore, we found CO and PM(10) concentration was associated with ozone concentration. This finding will benefit local communities and the public health sector to provide a warning system for preparation and response plans to react to PM(10) episodes in their responsible areas.

Households’ flood vulnerability and adaptation: Empirical evidence from mountainous regions of Pakistan

Households’ vulnerability assessment is considered an essential step towards reducing the harmful consequences of disaster risks. Adaptation helps in reducing their future vulnerability. The aims of this study are to (1) assess the different components of vulnerability, (2) compare the individual components and the composite vulnerability between the two regions and (3)assess the households’ adaptation to floods. Data were collected from 382 households and statistical tests were applied for comparison among these households living in two regions. A total of 32 and 17 indicators were used for vulnerability and adaptation assessment respectively. Results revealed that social, economic, physical and institutional components of vulnerability were found higher in Region 1 than Region 2. Except for social and attitudinal vulnerability, all the other vulnerability components had significant differences. Similarly, the overall composite vulnerability was higher in Region 1 than Region 2 and statistically significant. Moreover, in both regions, informal adaptation was mostly practiced compared to formal adaptation. Thus, it is recommended that the government and non-governmental stakeholders provide options and facilitation for formal adaptation at the community level.

Human health vulnerability to summer heat extremes in Romanian-Bulgarian cross-border area

Human health vulnerability (HHV) to different climate change-related phenomena, that is, summer heat extremes, is related to the exposure, sensitivity, and adaptive capacity of the affected entities. The current research is an empirical regional assessment of the human health effects of summer heat extremes in the Romania-Bulgarian Danube floodplain Calafat-Vidin-Turnu Magurele-Nikopol (CV-TMN) sector. The external biophysical and socioeconomic factors that shape the vulnerability are supported by the climate approach. The research relies on processing meteorological data from the most representative climate stations in the study area based on which some indicators-significant for measuring the impact on human health-were computed (e.g., number of extremely hot days, number of tropical days, number of tropical nights) and integrated into a composite summer heat extremes index (SHEI). To assess HHV to summer heat extremes, the vulnerability framework was completed by the internal socioeconomic factors revealed by the characteristics of the population living in urban and rural settlements in terms of demographic, health provisions, and quality of indoor living spaces. Finally, the authors computed the index of human health vulnerability to summer heat extremes (HHVI) as the Hull Score at the level of territorial local administrative units.

Farmer suicides: Effects of socio-economic, climate, and mental health factors

BACKGROUND: People working in agriculture, fishing, and forestry have elevated risks of suicide. The suicide rates for the occupations of “agriculture, fishing, and forestry” are significantly higher than any other occupation. AIMS OF STUDY: This study evaluates whether the variability in socioeconomic and demographic factors and in climate as well as the support from mental health providers and social associations affected the suicide rates of farmers in the US. METHODS: We estimate Poisson count data regression and county level-fixed effects regressions using data from the National Center for Health Statistics complemented with relevant socio-economic, climate data and data on mental health providers from a variety of sources. RESULTS: The results show more suicides in counties with more farms and with higher share of population without health insurance, lower agricultural wages and, in non-rural counties higher poverty rate. Surprisingly, we find more suicides in counties with more social associations, while the availability of mental health providers is associated with fewer suicides in non-rural counties, and lower suicide rate in southern counties. DISCUSSION: These results highlight the need for innovative targeted policy interventions instead of relying on one-size-fits-all approach. Farmers and farm workers are yet to be reached with modern and effective tools to improve mental health and prevent suicide. At the same time, factors such as the weather and climate as well as some more traditional factors such as social associations or religious participation play a limited role. IMPLICATIONS FOR HEALTH POLICIES: Support mechanisms have a differential effect in rural and urban areas. It is important to identify the specific demographic, climate, and policy changes that serve as external stressors and affect farm workers’ suicide and accidental death from on-farm injury. IMPLICATION FOR FURTHER RESEARCH: Ideally, individual level data on farmers would be best in a study that evaluates what factors cause suicides.

Flood affectedness and household adaptation measures in rural northern Chile: A cross-sectional study in the Upper Huasco Valley

Climate change is increasing the frequency and intensity of extreme events. Adaptation strategies at societal and household level are crucial to reduce vulnerability. We assessed to what extent personal flood affectedness, in particular health impacts, influence adaptive behavior. We conducted a cross-sectional survey in northern Chile one year after a major flood event and assessed several dimensions of flood affectedness and adaptive behavior at the household level. After the event, a wide range of adaptation measures, including water storage and prepa-ration of emergency kits, had been implemented by 80% of the population.

Flood exposure and social vulnerability in the United States

Human exposure to floods continues to increase, driven by changes in hydrology and land use. Adverse impacts amplify for socially vulnerable populations, who disproportionately inhabit flood-prone areas. This study explores the geography of flood exposure and social vulnerability in the conterminous United States based on spatial analysis of fluvial and pluvial flood extent, land cover, and social vulnerability. Using bivariate Local Indicators of Spatial Association, we map hotspots where high flood exposure and high social vulnerability converge and identify dominant indicators of social vulnerability within these places. The hotspots, home to approximately 19 million people, occur predominantly in rural areas and across the US South. Mobile homes and racial minorities are most overrepresented in hotspots compared to elsewhere. The results identify priority locations where interventions can mitigate both physical and social aspects of flood vulnerability. The variables that most distinguish the clusters are used to develop an indicator set of social vulnerability to flood exposure. Understanding who is most exposed to floods and where, can be used to tailor mitigation strategies to target those most in need.

Flood hazards, human displacement and food insecurity in rural riverine areas of Punjab, Pakistan: Policy implications

Rural communities inhabited on riverbank areas are frequently facing the ever-increasing psychological, social and economic distress due to negative effects of riverbank erosion. This study focused to investigate the impact of climate-based hazards particularly riverbank erosion on human displacement, food security and livelihood of rural riverine households and how vulnerable households act in response. The survey data of 398 households of erosion-prone riverbank area were collected, and group discussions connecting household heads from this area were also used for this study. In human displacement scenario of the last ten years due to riverbank erosion, almost 60% households lost their homestead once while 38% more than three times and forced to displaced. Empirical estimates of households’ food security status indicated the value of Food Security Index 2.11, highlighting households face issue of food security all over the year. Food security issue of vulnerable households is highly related with migration because these households have insufficient employment chances, and coupled with limited or no farming land, they are highly prone to migration. In conclusion, this study estimated that riverbank erosion risk is a co-exist reason of population displacement, increasing rural environmental vulnerability and obstacles to psychological, cultural and socioeconomic development. Implications of local-based proper policy interventions such as developing advance research regarding infusion of agro-based technology packages for emerging Bait areas for developing resilience, human capital development, credit access and institution service are necessary for improving livelihood and food security of these riverbank erosion households. State-based institutions and local community mutually need to focus increasing forestry specifically in riverbank areas to save fertile land from riverbank erosion and reducing environmental pollution. Convalescing livelihood and food security for erosion riverbank households, more employment opportunity needs to provided, investing more in training and education programmes to promoting income-generating activities that subsequently will develop livelihood and food security of households.

Effects of drought on infant mortality in China

This study focuses on Guizhou Province, a region with difficult geographical conditions and poor economic development, to examine the effect of rainfall shocks on contemporaneous infant health and long-run socioeconomic outcomes in China. The study results indicate that negative rainfall shocks are robustly correlated with higher infant mortality and lower birth weight. In the long run, early life rainfall shortages limit an individual’s income and housing conditions. The study findings indicate a significant interaction of rainfall shock with the severity of water scarcity. This result implies that drinking water safety is an essential channel through which early life rainfall shocks influence individual health endowments. However, agriculture production is not a likely channel for rainfall effects despite its association with infant mortality. Accordingly, our empirical results suggest that improving public facility coverage will reduce the vulnerability of infant health to adverse rainfall shocks in Guizhou and other developing areas.

Examining the determinants of flood risk mitigation measures at the household level in Bangladesh

Floods are the most common hazard in Bangladesh adversely affecting the lives and livelihoods of millions of riverine people. Flood-affected households adopt a variety of post-disaster mitigation measures, to the best of their ability, in recognition that similar events are likely to occur again in the future. However, little is known about what drives a household to adopt risk mitigation measures after experiencing a severe flood. The objective of this study was to investigate the determinants of households’ decisions on the implementation of flood risk mitigation measures, following the severe flood in 2017 in northern Bangladesh. The data used for this study were collected from the right bank of the Teesta River in Bangladesh through a survey of 377 households and six key informant interviews. Most of the households (83.3%) adopted at least one risk mitigation measure from either structural or nonstructural categories after the 2017 flood. Binary logistic regression models provide useful insights into the determinants of the implementation of mitigation measures and intention to implement mitigation measures in future. The results showed that the perceived probability of flood, perceived preparedness, flood experience, exposure to flood, membership, household head’s sex, income source, and landownership significantly influenced households to implement mitigation measures in the post-disaster period. Additionally, the intention to implement mitigation measures was influenced by the membership and education of households. This study contributes in terms of useful information about the determinants of post-disaster mitigation measures in riverine areas of Bangladesh. These findings can be used to target specific households to promote disaster risk reduction interventions.

Effects of diurnal temperature range on cardiovascular disease hospital admissions in farmers in China’s Western suburbs

Cardiovascular disease (CVD), reported to relate with climate change, is the leading cause of global mortality and morbidity. Since the relevant information is quite limited from suburbs and countryside in developing and underdeveloped countries, there are no studies that focused on morbidity through diurnal temperature range (DTR) for these regions. This is the first study to evaluate the short-term effect of DTR on CVD hospital admission in suburban farmers, as well as to identify vulnerable subpopulations. Daily time series data of CVD hospital admissions on suburban farmers of Qingyang, China, and meteorological data from 2011 to 2015 were collected, and a distributed lag non-linear model (DLNM) combined with a quasi-Poisson generalized additive regression model (GAM) was used to examine the exposure-response relationship and delayed effect between DTR and CVD hospital admissions. Stratified analyses by age and gender were performed and extreme DTR effects were examined. Non-linear relation between DTR and CVD hospital admissions was observed, and whether DTR lower or higher than the reference (13 °C, 50(th) percentile) had adverse effect while lower DTR have slightly higher impact. Also, both extreme low and extreme high DTR had adverse effect. Besides, adults (age < 65) and males were more vulnerable to the effects of DTR compared with the old (age ? 65) and females, respectively. This study provides evidence that not only high DTR but also low DTR had adverse effects on CVD which should be paid attention to. Adults and males were more vulnerable among suburban farmers. The results are inconsistent with the studies from urban and indicate differences between urban and suburban residents. Multiple factors such as occupations, risk awareness, and lifestyles could have a significant influence on CVD morbidity, and further study is needed to explore more evidence.

Do women farmers cope or adapt to strategies in response to climate extreme events? Evidence from rural Ghana

Climate extreme events have significant impacts on the livelihoods of smallholder women farmers. The aim of the present study is to investigate the coping and adaptation measures that women farmers use to respond to specific climate extreme events. The data for the study comes from 187 smallholder women farmers from Upper West region of Ghana. The study employed the Bivariate Probit model in the empirical analysis. The results revealed that membership of farmer-based organizations and the use of climate information were the key factors which influenced women farmers’ coping strategies against climate extreme events. Women farmers’ adaptation measures were mainly influenced by access to credit. The key policy variable that influenced both coping and adaptation measures of women farmers was access to agricultural extension services. The study recommends that policy should focus on the promotion of specific coping and adaptation interventions against climate extreme events among women farmers. Policy should create enabling environment for the establishments of farmer-based organizations, increase women farmers’ contact with women agricultural extension officers and remove institutional barriers that impede access to credit and the use of climate information.Climate extreme events have significant impacts on the livelihoods of smallholder women farmers. The aim of the present study is to investigate the coping and adaptation measures that women farmers use to respond to specific climate extreme events. The data for the study comes from 187 smallholder women farmers from Upper West region of Ghana. The study employed the Bivariate Probit model in the empirical analysis. The results revealed that membership of farmer-based organizations and the use of climate information were the key factors which influenced women farmers’ coping strategies against climate extreme events. Women farmers’ adaptation measures were mainly influenced by access to credit. The key policy variable that influenced both coping and adaptation measures of women farmers was access to agricultural extension services. The study recommends that policy should focus on the promotion of specific coping and adaptation interventions against climate extreme events among women farmers. Policy should create enabling environment for the establishments of farmer-based organizations, increase women farmers’ contact with women agricultural extension officers and remove institutional barriers that impede access to credit and the use of climate information.

Drivers of autochthonous and imported malaria in Spain and their relationship with meteorological variables

Since the early twentieth century, the intensity of malaria transmission has decreased sharply worldwide, although it is still an infectious disease with a yearly estimate of 228 million cases. The aim of this study was to expand our knowledge on the main drivers of malaria in Spain. In the case of autochthonous malaria, these drivers were linked to socioeconomic and hygienic and sanitary conditions, especially in rural areas due to their close proximity to the wetlands that provide an important habitat for anopheline reproduction. In the case of imported malaria, the main drivers were associated with urban areas, a high population density and international communication nodes (e.g. airports). Another relevant aspect is that the major epidemic episodes of the twentieth century were strongly influenced by war and military conflicts and overcrowding of the healthcare system due to the temporal overlap with the pandemic flu of 1918. Therefore, military conflicts and overlap with other epidemics or pandemics are considered to be drivers of malaria that can-in a temporary manner-exponentially intensify transmission of the disease. Climatic factors did not play a relevant role as drivers of malaria in Spain (at least directly). However, they did influence the seasonality of the disease and, during the epidemic outbreak of 1940-1944, the climate conditions favored or coadjuvated its spread. The results of this study provide additional knowledge on the seasonal and interannual variability of malaria that can help to develop and implement health risk control measures. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s41207-021-00245-8.

Eco-epidemiological aspects of zoonotic cutaneous leishmaniasis in Ouarzazate Province, Morocco

Some epidemiological and ecological aspects of Zoonotic cutaneous leishmaniasis (ZCL) in Ouarzazate province, southern Morocco, were explored with the objective of analyzing ZCL distribution and associated ecological factors. Information on cutaneous leishmaniasis patients attending the local health centers of Ouarzazate during the period 2002-2009 was gathered and compiled. Urban, peri-urban, rural origin, precipitation, wind speed, temperature, water irrigation, dam volume, and altitude were studied. The findings show that the disease affected 5405 person during this period; the major part was found in the municipalities near both oases (desert oasis) and water resources, with a high concentration of cases in the peri-urban area. The highest percentage of cases was recorded mainly in September. Considerable associations were found between relative humidity and wind speed with ZCL occurrence. A large number of cases were recorded in areas with altitude ranging from 800 to 2000 m.a.s.l. and spatial precipitation from 15 to 150 mm. The statistical analysis showed a strong association between water storage volume and water irrigation with the annual ZCL occurrence recorded in the downstream area (Zagora province). The results will lead us to understand ZCL risk areas for effective control. Further work is needed mainly for gathering these variables in one single and simplest model.

Ecological, social, and other environmental determinants of dengue vector abundance in urban and rural areas of northeastern Thailand

Aedes aegypti is the main vector of dengue globally. The variables that influence the abundance of dengue vectors are numerous and complex. This has generated a need to focus on areas at risk of disease transmission, the spatial-temporal distribution of vectors, and the factors that modulate vector abundance. To help guide and improve vector-control efforts, this study identified the ecological, social, and other environmental risk factors that affect the abundance of adult female and immature Ae. aegypti in households in urban and rural areas of northeastern Thailand. A one-year entomological study was conducted in four villages of northeastern Thailand between January and December 2019. Socio-demographic; self-reported prior dengue infections; housing conditions; durable asset ownership; water management; characteristics of water containers; knowledge, attitudes, and practices (KAP) regarding climate change and dengue; and climate data were collected. Household crowding index (HCI), premise condition index (PCI), socio-economic status (SES), and entomological indices (HI, CI, BI, and PI) were calculated. Negative binomial generalized linear models (GLMs) were fitted to identify the risk factors associated with the abundance of adult females and immature Ae. aegypti. Urban sites had higher entomological indices and numbers of adult Ae. aegypti mosquitoes than rural sites. Overall, participants’ KAP about climate change and dengue were low in both settings. The fitted GLM showed that a higher abundance of adult female Ae. aegypti was significantly (p < 0.05) associated with many factors, such as a low education level of household respondents, crowded households, poor premise conditions, surrounding house density, bathrooms located indoors, unscreened windows, high numbers of wet containers, a lack of adult control, prior dengue infections, poor climate change adaptation, dengue, and vector-related practices. Many of the above were also significantly associated with a high abundance of immature mosquito stages. The GLM model also showed that maximum and mean temperature with four-and one-to-two weeks of lag were significant predictors (p < 0.05) of the abundance of adult and immature mosquitoes, respectively, in northeastern Thailand. The low KAP regarding climate change and dengue highlights the engagement needs for vector-borne disease prevention in this region. The identified risk factors are important for the critical first step toward developing routine Aedes surveillance and reliable early warning systems for effective dengue and other mosquito-borne disease prevention and control strategies at the household and community levels in this region and similar settings elsewhere.

Climate change over UK cities: The urban influence on extreme temperatures in the UK climate projections

Increasing summer temperatures in a warming climate will increase the exposure of the UK population to heat-stress and associated heat-related mortality. Urban inhabitants are particularly at risk, as urban areas are often significantly warmer than rural areas as a result of the urban heat island phenomenon. The latest UK Climate Projections include an ensemble of convection-permitting model (CPM) simulations which provide credible climate information at the city-scale, the first of their kind for national climate scenarios. Using a newly developed urban signal extraction technique, we quantify the urban influence on present-day (1981-2000) and future (2061-2080) temperature extremes in the CPM compared to the coarser resolution regional climate model (RCM) simulations over UK cities. We find that the urban influence in these models is markedly different, with the magnitude of night-time urban heat islands overestimated in the RCM, significantly for the warmest nights (up to 4 degrees C), while the CPM agrees much better with observations. This improvement is driven by the improved land-surface representation and more sophisticated urban scheme MORUSES employed by the CPM, which distinguishes street canyons and roofs. In future, there is a strong amplification of the urban influence in the RCM, whilst there is little change in the CPM. We find that future changes in soil moisture play an important role in the magnitude of the urban influence, highlighting the importance of the accurate representation of land-surface and hydrological processes for urban heat island studies. The results indicate that the CPM provides more reliable urban temperature projections, due at least in part to the improved urban scheme.

Climate change risk to southern African wild food plants

Climate change is a threat to food security. Wild-harvested food plants (WFPs) are important for the diets of millions of people and contribute to food security, especially in rural and low-income communities, but little is known about climate change risk to WFPs. Using species distribution models, we examined climate change risk to 1190 WFP species used by 19 native language groups in southern Africa. We project that 60% of species will experience an increase (40% a decrease) in range extent within southern Africa by 2060-2080 under a low warming scenario (Representative Concentration Pathway (RCP) 2.6), while range reductions for 66% of species are projected under a high warming scenario (RCP 8.5). Decreases in geographic range are projected for > 70% of WFP species traditionally used by some language groups. Loss of suitable climatic conditions is projected to decrease WFP species richness most in north-eastern southern Africa-with losses of > 200 species-while increases in species richness are projected in the south and east of South Africa. Availability of WFP species for food security during lean times is also projected to change. In south-eastern South Africa, local diversity of WFPs is projected to increase, while maize and sorghum yields decrease. However, this potential WFP nutritional safety net may be lost in central parts of the region, where declines in both crop yield and WFPs are projected. By looking beyond conventional crops to the exceptional diversity of WFPs, this research helps understanding linkages between WFPs, traditional knowledge, food security and climate change adaptation.

Climate change, risk perception, and protection motivation among high-altitude residents of the Mt. Everest region in Nepal

Mountain ecosystems are considered vulnerable to early impacts of climate change. Whether and how local residents of these areas perceive these changes, however, remain under-studied questions. By conducting a household survey in the Khumbu region of Nepal, this study assessed local residents’ experience-based perception of changes in climate trends and patterns, perceived risk, and attitudes towards climate issues. Multivariate cluster analysis based on residents’ climate change beliefs revealed three segments: “Cautious,” “Disengaged,” and “Alarmed.” A comparison of these segments along key psychosocial constructs of Protection Motivation Theory (PMT) revealed significant inter-segment differences in residents’ perception of severity, vulnerability, response efficacy, self-efficacy, and response cost associated with engaging in mitigating behavior. Results shed light on how residents of high elevation areas that are considered to be exposed to early impacts of climate change perceive the risk and intend to respond. These findings could also assist stakeholders working in other similar mountain ecosystems in understanding vulnerability and in working towards climate readiness.

Climate variability and health in extremely vulnerable communities: Investigating variations in surface water conditions and food security in the West African Sahel

In this project we consider the ways that different livelihood strategies impact the climate-health linkage. Specifically, we build on knowledge of livestock mobility in the Sahel and use remotely sensed-based measures of waterholes with health survey data to investigate the linkages between child health outcomes related to food security. We focus on the landscape characteristics relevant to limitedly studied, but highly climate-vulnerable populations, pastoralists and agro-pastoralists in the Sahel. We combine remotely sensed-based data on surface waterholes and spatially referenced health survey data and use flexible regression modeling techniques to uncover the quantitative relationship between waterhole depth and a child’s height-for-age z-score (HAZ). The results suggest that the water depth level of nearby waterholes does indeed impact a child’s HAZ, even after accounting for other environmental factors. This relationship is impacted, however, by the livelihood practices of the area as well as by the source of household drinking water.

Climatic conditions and infant care: Implications for child nutrition in rural Ethiopia

We examine the relationships between climatic conditions, breastfeeding behavior, and maternal time use in Ethiopia. Infant feeding practices are important predictors of child nutrition that may be affected by a number of factors including mother’s time engaging in agricultural labor, food security, cultural beliefs, and antenatal care. We use panel data from the Living Standards Measurement Study to investigate linkages between climatic conditions during a child’s first year of life and year prior to birth and duration of exclusive breastfeeding. We then explore one potential mechanism: women’s agricultural labor. Results indicate that rainfall during the primary agricultural season-kiremt-in a child’s first year of life plays an important role in duration of exclusive breastfeeding. Experiencing 25 cm of average monthly kiremt rainfall, versus 5 cm, is associated with a 20-percentage-point decrease in the likelihood of being exclusively breastfed for the recommended six months. More kiremt rainfall is associated with a greater number of days that women spend planting and harvesting, and at high levels of rainfall women with infants do not engage in significantly fewer days of agricultural labor than those without infants. Lastly, we find that during the year before birth, greater rainfall during kiremt as well as the dry season is associated with a lower likelihood of six months of exclusive breastfeeding, potentially due to the early introduction of complementary foods. Our findings indicate that agricultural labor demands may in part drive breastfeeding behaviors, leading to “sub-optimal” feeding practices in the short-term, but resulting in improved household food security in the longer-term.

Climate and health concerns of Montana’s public and environmental health professionals: A cross-sectional study

BACKGROUND: Rural health professionals stand at the forefront of community response to climate change, but few studies have assessed their perceptions of the threat. Further, no previous study has compared the opinions of environmental to public health professionals or extensively analyzed the factors related to these experts’ climate beliefs, risk perceptions, and issue prioritization. METHODS: In conjunction with the Montana Climate Assessment’s 2021 Special Report on Climate Change and Human Health, the 479 members of the Montana Public Health Association and Montana Environmental Health Association were surveyed during September-October 2019, with 39% completing the survey. We summarized descriptive data about their perceptions of local climate-related changes and their beliefs that global warming is happening, is mostly human-caused, is a risk to human health, and that their offices and others should take action. We also evaluated which sociodemographic and risk perception factors related to these climate beliefs, risk perceptions, and workplace issue prioritization. RESULTS: Health professionals in Montana, a politically conservative state, demonstrated high levels of awareness that global warming is happening, human-caused, and a threat to human health, well above reported rates of public concern. Eighty-eight percent said that global warming is occurring and 69% that it is mostly anthropogenic. Sixty-nine percent said that their own health was already affected by climate, and 86% said they were already seeing at least one climate change-related event in their communities. Seventy-two percent said that their departments should be preparing to deal with climate change’s health effects, but just 30% said that it is currently happening. We found no statistically significant differences between Montana environmental health and public health professionals in regression models predicting climate beliefs, risk perception, and prioritization. As in studies of the public, political ideology and the observation of local climate-related changes were the strongest factors. CONCLUSIONS: Montana environmental and public health officials said that departmental action was needed on climate change, indicating the readiness of rural health professionals to take action. Further studies of health professionals in rural regions are warranted.

Climate anomalies and childhood growth in Peru

Climate change has been linked to poor childhood growth and development through maternal stress, nutritional insults related to lean harvests, and exposure to infectious diseases. Vulnerable populations are often most susceptible to these stressors. This study tested whether susceptibility to linear growth faltering is higher among Peruvian children from indigenous, rural, low-education, and low-income households. High-resolution weather and household survey data from Demographic and Health Survey 1996-2012 were used to explore height-for-age z-scores (HAZ) at each year of life from 0 to 5. Rural, indigenous children at age 0-1 experience a HAZ reduction of 0.35 units associated with prenatal excess rainfall which is also observed at age 4-5. Urban, non-indigenous children at age 4-5 experience a HAZ increase of 0.07 units associated with postnatal excess rainfall, but this advantage is not seen among rural, indigenous children. These findings highlight the need to consider developmental stage and social predictors as key components in public health interventions targeting increased climate change resilience.

Climate change impacts on household food security and adaptation strategies in southern Ethiopia

Climate change is predicted to adversely affect agricultural yields, particularly in African countries such as Ethiopia, where crop production relies heavily on environmental factors such as rainfall and temperature. However, there have only been a limited number of studies on the effects of climate change dynamics on food security in Africa, particularly at the household level. We therefore analyzed local climatic changes, the status of household food security, climate-related causes of food insecurity, food security determinants, and the adaptation strategies of local farmers. Three decades meteorological data were analyzed. A total of 185 farmers were selected using simple random sampling and interviewed, together with focus groups. Data were analyzed using the descriptive and inferential statistics were used together with the logit regression model. Climate change over the last three decades was found to have a negative impact the food security status of households. Crop production was constrained by poor rainfall, severe erosion, and increases in temperature. The unpredictability of rainfall, pests, and diseases were also contributing factors. Using the calorie intake approach, 60.5% of sampled respondents were found to be food insecure. Analysis using the logistic regression model showed that age and family size, as well as the amount of cultivated land and rainfall, were the significant (p < .05) factors influencing household food security status. A large proportion (69.8%) of farmers were incorporating adapting strategies into farm management including improved use of crop varieties and livestock production, in addition to income diversification. Taken together, these findings show that improving climate change awareness, facilitating the participation of female-led households in income generation, and strengthening existing adaptation measures have positive impacts on food security.

Analyzing spatial patterns of health vulnerability to drought in the Brazilian semiarid region

Health determinants might play an important role in shaping the impacts related to long-term disasters such as droughts. Understanding their distribution in populated dry regions may help to map vulnerabilities and set coping strategies for current and future threats to human health. The aim of the study was to identify the most vulnerable municipalities of the Brazilian semiarid region when it comes to the relationship between drought, health, and their determinants using a multidimensional index. From a place-based framework, epidemiological, socio-economic, rural, and health infrastructure data were obtained for 1135 municipalities in the Brazilian semiarid region. An exploratory factor analysis was used to reduce 32 variables to four independent factors and compute a Health Vulnerability Index. The health vulnerability was modulated by social determinants, rural characteristics, and access to water in this semiarid region. There was a clear distinction between municipalities with the highest human welfare and economic development and those municipalities with the worst living conditions and health status. Spatial patterns showed a cluster of the most vulnerable municipalities in the western, eastern, and northeastern portions of the semiarid region. The spatial visualization of the associated vulnerabilities supports decision making on health promotion policies that should focus on reducing social inequality. In addition, policymakers are presented with a simple tool to identify populations or areas with the worst socioeconomic and health conditions, which can facilitate the targeting of actions and resources on a more equitable basis. Further, the results contribute to the understanding of social determinants that may be related to medium- and long-term health outcomes in the region.

A risk exchange: Health and mobility in the context of climate and environmental change in Bangladesh-a qualitative study

BACKGROUND: Climate change influences patterns of human mobility and health outcomes. While much of the climate change and migration discourse is invested in quantitative predictions and debates about whether migration is adaptive or maladaptive, less attention has been paid to the voices of the people moving in the context of climate change with a focus on their health and wellbeing. This qualitative research aims to amplify the voices of migrants themselves to add nuance to dominant migration narratives and to shed light on the real-life challenges migrants face in meeting their health needs in the context of climate change. METHODS: We conducted 58 semi-structured in-depth interviews with migrants purposefully selected for having moved from rural Bhola, southern Bangladesh to an urban slum in Dhaka, Bangladesh. Transcripts were analysed using thematic analysis under the philosophical underpinnings of phenomenology. Coding was conducted using NVivo Pro 12. FINDINGS: We identified two overarching themes in the thematic analysis: Firstly, we identified the theme “A risk exchange: Exchanging climate change and health risks at origin and destination”. Rather than describing a “net positive” or “net negative” outcome in terms of migration in the context of climate change, migrants described an exchange of hazards, exposures, and vulnerabilities at origin with those at destination, which challenged their capacity to adapt. This theme included several sub-themes-income and employment factors, changing food environment, shelter and water sanitation and hygiene (WaSH) conditions, and social capital. The second overarching theme was “A changing health and healthcare environment”. This theme also included several sub-themes-changing physical and mental health status and a changing healthcare environment encompassing quality of care and barriers to accessing healthcare. Migrants described physical and mental health concerns and connected these experiences with their new environment. These two overarching themes were prevalent across the dataset, although each participant experienced and expressed them uniquely. CONCLUSION: Migrants who move in the context of climate change face a range of diverse health risks at the origin, en route, and at the destination. Migrating individuals, households, and communities undertake a risk exchange when they decide to move, which has diverse positive and negative consequences for their health and wellbeing. Along with changing health determinants is a changing healthcare environment where migrants face different choices, barriers, and quality of care. A more migrant-centric perspective as described in this paper could strengthen migration, climate, and health governance. Policymakers, urban planners, city corporations, and health practitioners should integrate the risk exchange into practice and policies.

Women’s vulnerability to climate-related risks to household water security in Centre-East, Burkina Faso

Variable climate conditions, resulting in periods of water scarcity and longer dry spells, or intense rainfall events, have serious implications for water and sanitation services. Climate change threatens to exacerbate these hazards, increasing risks to household water security, and associated impacts on health, wellbeing and livelihoods. These risks are not evenly distributed across individuals and communities, and there is a particular need to understand women’s vulnerabilities and responses to these risks due to disproportionate impacts of poor water and sanitation conditions. This study used mixed-methods data collection to assess how vulnerabilities to climate-related risks to household water security are produced and vary among women in the Centre-East region, Burkina Faso, as well as capacities to respond. Gendered water-related roles and norms were found to drive vulnerabilities for women in the case study site particularly related to increasingly inadequate water availability during the dry season. Other social differences such as Mossi and Peul ethnicity which influence ways of using water, also contributed to women’s differential vulnerability and capacities to respond. These findings show there is a need to consider how the development of ‘climate resilient’ water and sanitation services take social drivers of vulnerability into account.

Water scarcity and challenges for access to safe water: A case of Bangladesh’s coastal area vulnerable to climate change

Existing efforts to ensure safe water access in coastal Bangladesh are challenged by increasing freshwater salinity. This research explored/explores safe water consumption choices in coastal Bangladesh, which data are scarce to date, using a mixed-methods approach. In 2014, a cross-sectional survey was conducted in southwestern coastal Bangladesh (n=261) and data was generated on water supply and consumption. Data collection also involved 29 in-depth interviews of household care givers and focus group discussions were performed with three community groups. Descriptive statistics were applied to analyse quantitative data and thematic analysis was used for qualitative data. The survey showed that 60% of the study population used tube well water while 40% used pond water for drinking. It was observed that for cooking purposes, the use of pond water was slightly higher than the tube well water. Only 13% of the respondents mentioned that their drinking water tasted salty whereas 6% of the respondents reported health problem (diarrhoea, dysentery, gastric issues and skin problems) after using these water sources. The qualitative data reveals that water available for drinking and cooking is causing a serious threat to this coastal community, particularly during the dry season. In-depth assessments indicated that drinking water choices were less driven by concerns for health than practical issues such as travel distance and time taken and taste. The palatability of water was an important determinant of choice for drinking and other domestic uses. Furthermore, the utility of alternative options for safe drinking water is driven by beliefs and traditions and source maintenance. Given the increasing salinisation of freshwaters in many low-lying countries and likely exacerbation related to climate change-induced sea level rise, therefore, promotion of low saline drinking water along with salt reducing interventions consider that community beliefs and practices must be a made priority.

Waterborne outbreaks: A public health concern for rural municipalities with unchlorinated drinking water distribution systems

OBJECTIVES: The objective of this study is to describe an important waterborne outbreak of gastrointestinal illness observed in a rural municipality of Quebec. METHODS: A population-based retrospective cohort study was conducted to identify risk factors associated with acute gastroenteritis. Indirect surveillance data were used to estimate the extent and the resolution of the epidemic. RESULTS: The cohort consisted of 140 randomly selected individuals of whom 22 met the illness case definition (15.7% attack rate). The epidemic curve was similar to the evolution of antidiarrheal products sold by the only pharmacy in town and calls made to the Health Info Line. Bivariate analysis led to identifying five risk factors of gastrointestinal illness: consumption of municipal water, contact with someone with acute gastroenteritis (within and outside of the household), contact with a child in daycare, and being less than 35 years of age. Drinking municipal water had the highest risk ratio (RR?=?24.31; 95% CI?=?1.50-393.4). Drinking water from a private artesian well was a protective factor (RR?=?0.28; 95% CI?=?0.09-0.90). CONCLUSION: This study highlighted that managing the risks associated with the consumption of untreated drinking water remains an important public health challenge, particularly in small rural municipalities vulnerable to climate variability.

Wet bulb globe temperature and recorded occupational injury rates among sugarcane harvesters in southwest Guatemala

As global temperatures continue to rise it is imperative to understand the adverse effects this will pose to workers laboring outdoors. The purpose of this study was to investigate the relationship between increases in wet bulb globe temperature (WBGT) and risk of occupational injury or dehydration among agricultural workers. We used data collected by an agribusiness in Southwest Guatemala over the course of four harvest seasons and Poisson generalized linear modelling for this analysis. Our analyses suggest a 3% increase in recorded injury risk with each degree increase in daily average WBGT above 30 °C (95% CI: -6%, 14%). Additionally, these data suggest that the relationship between WBGT and injury risk is non-linear with an additional 4% acceleration in risk for every degree increase in WBGT above 30 °C (95% CI: 0%, 8%). No relationship was found between daily average WBGT and risk of dehydration. Our results indicate that agricultural workers are at an increased risk of occupational injury in humid and hot environments and that businesses need to plan and adapt to increasing global temperatures by implementing and evaluating effective occupational safety and health programs to protect the health, safety, and well-being of their workers.

Village-level climate and weather variability, mediated by village-level crop yield, is associated with linear growth in children in Uganda

INTRODUCTION: To investigate total annual precipitation, precipitation anomaly and aridity index in relation to linear growth in children under 5 in Uganda and quantify the mediating role of crop yield. METHODS: We analysed data of 5219 children under 5 years of age who participated in the 2016 Uganda Demographic and Health Survey. Annual crop yield in kilograms per hectare for 42 crops at a 0.1° (~10 km at the equator) spatial resolution square grid was obtained from the International Food Policy Research Institute. Normalised rainfall anomaly and total precipitation were derived from the African Rainfall Estimation Algorithm Version 2 product. Linear regression models were used to associate total annual precipitation and anomalies with height-for-age z-scores and to explore the mediating role of crop yield qualitatively. The intervening effects were quantitatively estimated by causal mediation models. RESULTS: Twenty-nine per cent of children were stunted (95% CI 28% to 31%). After adjusting for major covariates, higher total annual precipitation was significantly associated with increasing height-for-age z-scores. At the mean, an increase of 1 standard deviation in local annual rainfall was associated with a 0.07-point higher z-score. Aridity index and precipitation anomaly were not associated with height-for-age z scores in altitude-adjusted models. Crop yields of nuts, seeds, cereals and pulses were significant mediating factors. For instance, 38% of the association between total annual precipitation with height-for-age z-scores can be attributed to the yield of sesame seeds. CONCLUSIONS: Higher total annual precipitation at the village-level was significantly associated with higher height-for-age z-scores among children in Uganda. This association can be partially explained by higher crop yield, especially from seeds and nuts. This study suggests that more attention should be paid to villages with lower annual rainfall amounts to improve water availability for agriculture.

Time series analysis of climate and air pollution factors associated with atmospheric nitrogen dioxide concentration in Japan

Nitrogen dioxide (NO(2)) is an air pollutant discharged from combustion of human activities. Nitrous acid (HONO), measured as NO(2), is thought to impact respiratory function more than NO(2). HONO and NO(2) have an equilibrium relationship, and their reaction is affected by climate conditions. This study was conducted to discuss the extent of HONO contained in NO(2), depending on the level of urbanization. Whether climate conditions that promote HONO production enhanced the level of NO(2) measured was investigated using time series analysis. Climate and outdoor air pollution data measured in April 2009-March 2017 in urban (Tokyo, Osaka, and Aichi) and rural (Yamanashi) areas in Japan were used for the analysis. Air temperature had a trend of negative associations with NO(2), which might indicate the decomposition of HONO in the equilibrium between HONO and NO(2). The associations of relative humidity with NO(2) did not have consistent trends by prefecture: humidity only in Yamanashi was positively associated with NO(2). In high relative humidity conditions, the equilibrium goes towards HONO production, which was observed in Yamanashi, suggesting the proportion of HONO in NO(2) might be low/high in urban/rural areas.

The influence of seasonal river flooding in food consumption of riverine dwellers in the central Amazon region: An isotopic approach

In recent decades, the nutritional transition has been encroaching on remote rural areas of developing countries where feeding patterns are shifting from unprocessed foods to industrialized processed goods. Such changes in the Amazon region have been detected, for instance, by comparing the natural carbon (C-13:C-12) and nitrogen (N-15:N-14) isotopic ratios of people living in riverine communities with urban dwellers their putative diet. In this study, we considered how landscape variables impacted food consumption by comparing fingernail isotopic ratios of individuals in the rural settlement of Costa do Caldeirao located in the floodplain (varzea) of the Solimoes River, and in the rural settlement of Paquequer located in a non-flooded area (terra-firme) near the Madeira River banks. A total of 70 fingernails were sampled for carbon and nitrogen isotopic analysis during the low water period and again during the high water period from the same residents of the varzea and terra-firme. The consumption of C-4-like resources (e.g., frozen chicken and canned meat) increased in both rural settlements during the high water period when C-3-like resources (fish, cassava, rice, beans) are less available due to the flooding of lowland areas, but this difference was more pronounced in the terra-firme. The higher consumption of C-4-like resources in the varzea compared to the terra-firme shows how seasonal flooding is a key factor influencing food security and health, due to stark variations in river water levels. While fish and farinha are still important staple foods, differences within rural settlements suggest that, besides seasonal variation and changes in water levels, other factors such as age, origin, and income may be crucial to understanding individual dietary behavior change in line with the nutritional transition model.

The interplay between structural flood protection, population density, and flood mortality along the Jamuna River, Bangladesh

Levees protect floodplain areas from frequent flooding, but they can paradoxically contribute to more severe flood losses. The construction or reinforcement of levees can attract more assets and people in flood-prone area, thereby increasing the potential flood damage when levees eventually fail. Moreover, structural protection measures can generate a sense of complacency, which can reduce preparedness, thereby increasing flood mortality rates. We explore these phenomena in the Jamuna River floodplain in Bangladesh. In this study area, different levels of flood protection have co-existed alongside each other since the 1960s, with a levee being constructed only on the right bank and its maintenance being assured only in certain places. Primary and secondary data on population density, human settlements, and flood fatalities were collected to carry out a comparative analysis of two urban areas and two rural areas with different flood protection levels. We found that the higher the level of flood protection, the higher the increase of population density over the past decades as well as the number of assets exposed to flooding. Our results also show that flood mortality rates associated with the 2017 flooding in Bangladesh were lower in the areas with lower protection level. This empirical analysis of the unintended consequences of structural flood protection is relevant for the making of sustainable policies of disaster risk reduction and adaptation to climate change in rapidly changing environments.

The impact of early-life shocks on adult welfare in Brazil: Questions of measurement and timing

Recent literature provides evidence that income shocks early in life can have long-run consequences on adult welfare. Rural Brazil frequently suffers from rainfall variations that negatively impact vulnerable households, who often lack the means for coping with these events. This paper evaluates how early-life rainfall shocks influence adult health and socioeconomic outcomes in Brazil. We find evidence that several critical periods can produce long-run consequences. Using rainfall deviations, our two most robust results are that greater rainfall in utero negatively impacts adult incomes (finding that a one standard deviation increase in rainfall causes adult incomes to fall by 7-10 percent) and that greater rainfall in the second and third years of life improve adult health (increasing body mass index by 0.16). However, our results depend crucially on our choices regarding two features. First, our results differ across two common measures of critical periods, which are used to define shocks relative to the timing of one’s birth. Second, the way rainfall variation is measured also matters, with use of an extreme weather indicator suggesting heterogeneous effects by gender, with extreme weather negatively impacting women’s health (both before and after birth) but positively affecting several men’s outcomes (both before and after birth). We find some evidence that mortality selection may drive some of these results. This paper provides further evidence that early-life shocks (from in utero through the third year of life) can cause long-run consequences, but also suggests that more attention should be paid to the specific measurement and timing of rainfall shocks.

The impacts of drought and the adaptive strategies of small-scale farmers in uMsinga, KwaZulu-Natal, South Africa

Drought is a major challenge threatening agricultural productivity in uMsinga. The occurrence of drought is expected to increase in coming decades, intensifying in severity, duration and the way people are affected by drought. The objective of this study is to understand small-scale farmers’ and rural communities’ perceptions of drought, its environmental and socio-economic impacts, adaptive and mitigation measures at household level and their satisfaction with the government’s role in drought management in the community. The study utilized a combination of quantitative and qualitative research methods, in the form of questionnaires, focus groups and key informant interviews. The sample size for the research study was 180 respondents for the questionnaire component and a total of 30 respondents for the focus groups and key informant interviews. The results show that increased levels of poverty, food insecurity and increased migration were the main socio-economic impacts perceived by respondents. Water scarcity, crop failure, forest degradation and an increase in average temperatures were perceived by respondents as the main environmental impacts caused by drought in uMsinga. Respondents perceived drought as a serious threat to agricultural production and adopted various indigenous adaptive strategies. A majority of respondents adopted a reactive approach to drought management, and therefore did not adopt many mitigation measures.

The influence of apparent temperature on mortality in the Kintampo health and demographic surveillance area in the middle belt of Ghana: A retrospective time-series analysis

Globally, studies have shown that diurnal changes in weather conditions and extreme weather events have a profound effect on mortality. Here, we assessed the effect of apparent temperature on all-cause mortality and the modifying effect of sex on the apparent temperature-mortality relationship using mortality and weather data archived over an eleven-year period. An overdispersed Poisson regression and distributed lag nonlinear models were used for this analysis. With these models, we analysed the relative risk of mortality at different temperature values over a 10-day lag period. By and large, we observed a nonlinear association between mean daily apparent temperature and all-cause mortality. An assessment of different temperature values over a 10-day lag period showed an increased risk of death at the lowest apparent temperature (18°C) from lag 2 to 4 with the highest relative risk of mortality (RR?=?1.61, 95% CI: 1.2, 2.15, p value?=?0.001) occurring three days after exposure. The relative risk of death also varied between males (RR?=?0.31, 95% CI: 0.10, 0.94) and females (RR?=?4.88, 95% CI: 1.40, 16.99) by apparent temperature and lag. On the whole, males are sensitive to both temperature extremes whilst females are more vulnerable to low temperature-related mortality. Accordingly, our findings could inform efforts at reducing temperature-related mortality in this context and other settings with similar environmental and demographic characteristics.

The effects of household’s climate-related displacement on delivery and postnatal care service utilization in rural Bangladesh

Exposure to extreme climate events causes population displacement and adversely affects the health of mothers and children in multiple ways. This paper investigates the effects of displacement on whether a child is delivered at a health center, as opposed to at home, and on postnatal care service utilization in Bangladesh. Using cross-sectional survey data from 599 mothers who gave birth in the three years prior to the date of interview, including 278 from households which had previously been displaced and 231 from households which had not been displaced, we use multivariate logistic regression to identify the factors associated with maternal healthcare service utilization. The results show that displaced households’ mothers are only about a quarter as likely to deliver at a health center as mothers from non-displaced households. The use of health center-based delivery decreases as the numbers of past displacements increases. Higher number of previous children, lower use of antenatal care during pregnancy, lower household income, and lack of access to radio/television also significantly reduce a mother’s likelihood of delivery at a health center. Displaced mothers are also substantially less likely to use postnatal care services for their neonates, especially those supplied by trained providers. Use of health facilities for delivery, use of antenatal care services, and previous number of children are other important predictors of postnatal care service utilization for neonates. In light of these findings, relocation of local health facilities with basic and emergency care provisions to areas in which the displaced have resettled, reinforcement of Family Planning services, and extension of coverage of the Maternity Allowance benefits in the displacement-prone mainland riverine areas are recommended policy responses.

The effects of prenatal exposure to temperature extremes on birth outcomes: The case of China

This paper investigates the effects of prenatal exposure to extreme temperatures on birth outcomes-specifically, the log of birth weight and an indicator for low birth weight-using a nationally representative dataset on rural China. During the time period we examine (1991-2000), indoor air conditioning was not widely available and migration was limited, allowing us to address identification issues endemic in the climate change literature related to adaptation and location sorting. We find substantial heterogeneity in the effects of extreme temperature exposure on birth outcomes. In particular, prenatal exposure to heat waves has stronger negative effects than exposure to cold spells on surviving births.

The drivers of child mortality during the 2012-2016 drought in La Guajira, Colombia

During the 2012-2016 drought in La Guajira, Colombia, child mortality rates rose to 23.4 out of 1000. Most of these children belonged to the Wayuu indigenous community, the largest and one of the most vulnerable in Colombia. At the municipal level, this study found a significant positive correlation between the average child mortality rate and households with a monthly income of less than USD 100, the number of people without access to health insurance, being part of the indigenous population, being illiterate, lacking sewage systems, living in rural areas, and large households with members younger than 5 years old and older than 65 years old. No correlation was found with households without access to a water source. The stepwise regression analysis showed that households with a monthly income of less than USD 100, no members older than 65 years old, but several children younger than 5 years old, account for 90.4% of the child mortality rate. This study concludes that, if inhabitants had had better incomes or assets, as well as an adequate infrastructure, they could have faced the drought without the observed increase in child mortality.

The effect of spatial proximity to cities on rural vulnerability against flooding: An indicator based approach

Vulnerability to environmental hazards has widely been assessed in disaster risk science and climate change literature by integrating socio-economic and geographical features of a community or a place. However, the role of spatial proximity to cities – an important geographical feature – in influencing household vulnerability has not been scrutinized. This paper assesses how distance to cities affects the vulnerability of rural farming communities against flood hazard. This paper proposes a Vulnerability-Proximity Nexus (VPN) framework and operationalises it in the context of Pakistan. A household survey was conducted to collect primary data from three flood-affected sub-districts of Punjab province. A total of 325 samples were collected, out of which 164 samples were from villages located near to the cities and 161 were far from the cities. Vulnerability indices were developed through holistic (exposure, susceptibility, and capacity) and livelihood (human, social, financial, physical, and natural) perspective of vulnerability. Mann-Whitney U and Pearson’s correlation tests were performed to analyse linkages between distance and vulnerability. Results confirmed that the distance to the cities influences the vulnerability of surrounding farming communities. A significant and positive correlation between distance to city and rural livelihood vulnerability was found. Rural farming communities living close to the cities were less vulnerable, mainly due to better transfer of services and facilities from cities, which has also made rural communities more educated, informed, financially strong, and connected with easier access to public and private institutions. This study highlights the importance of regional and rural development discourse for vulnerability and can help disaster managers and planners to establish synergies for designing effective disaster risk reduction policies and strategies.

Temperature and preeclampsia: Epidemiological evidence that perturbation in maternal heat homeostasis affects pregnancy outcome

INTRODUCTION: This study aims to determine the association between temperature and preeclampsia and whether it is affected by seasonality and rural/urban lifestyle. METHODS: This cohort study included women who delivered at our medical center from 2004 to 2013 (31,101 women, 64,566 deliveries). Temperature values were obtained from a spatiotemporally resolved estimation model performing predictions at a 1×1km spatial resolution. In “Warm” pregnancies >50% of gestation occurred during the spring-summer period. In cold pregnancies >50% of gestation occurred during the fall and winter. Generalized estimating equation multivariable models were used to estimate the association between temperature and incidence of preeclampsia. RESULTS: 1) The incidence of preeclampsia in at least one pregnancy was 7% (2173/64,566); 2) during “warm” pregnancies, an elevation of one IQR of the average temperature in the 1st or the 3rd trimesters was associated with an increased risk to develop preeclampsia [patients with Jewish ethnicity: 1st trimester: relative risk (RR) of 2.38(95%CI 1.50; 3.80), 3rd trimester 1.94(95%CI 1.34;2.81); Bedouins: 1st trimester: RR = 2.91(95%CI 1.98;4.28), 3rd trimester: RR = 2.37(95%CI 1.75;3.20)]; 3) In “cold” pregnancies, an elevation of one IQR of average temperature was associated with a lower risk to develop preeclampsia among patients with Bedouin-Arab ethnicity RR = 0.68 (95% CI 0.49-0.94) for 1st trimester and RR = 0.62 (95% CI 0.44-0.87) for 3rd trimester. CONCLUSIONS: 1) Elevated averaged temperature during the 1st or 3rd trimesters in “warm” pregnancies confer an increased risk for the development of preeclampsia, especially in nomadic patients; 2) Of interest, during cold pregnancies, elevated averaged temperature was associated with a lower risk to develop preeclampsia for nomadic patients. 3) These findings suggest temperature might be associated with perturbations in maternal heat homeostasis resulting in reallocation of energy resources and their availability to the fetus that may increase the risk for preeclampsia. This observation is especially relevant in the context of global warming and its effects on maternal/fetal reproductive health.

Stunted from the start: Early life weather conditions and child undernutrition in Ethiopia

This paper examines the relationship between weather conditions and child nutrition in Ethiopia. We link data from four rounds of the Ethiopia Demographic and Health Survey to high-resolution climate data to measure exposure to rainfall and temperature in utero and during early life. We then estimate a set of multivariate regression models to understand how weather conditions impact child stunting, an indicator of sustained early life undernutrition. We find that greater rainfall during the rainy seasons in early life is associated with greater height for age. In addition, higher temperatures in utero, particularly during the first and third trimesters, and more rainfall during the third trimester, are positively associated with severe stunting, though stunting decreases with temperature in early life. We find potential evidence for a number of pathways underlying the weather-child nutrition relationship including agricultural livelihoods, heat stress, infectious disease transmission, and women’s time use during pregnancy. These findings illuminate the complex pathways through which climate change may influence child health and should motivate additional research focused on identifying the causal mechanisms underlying these links.

Support for Students Exposed to Trauma (SSET) Program: An approach for building resilience and social support among flood-impacted children

The present study is a pilot study to examine the initial effectiveness of the Support for Students Exposed to Trauma (SSET) program (Jaycox et al. in Support for Students Exposed to Trauma: the SSET program. Lesson plans, worksheets, and materials. TR-675, RAND, Santa Monica, CA, 2009) in reducing PTSD symptoms and building resilience and social support among children living in flood-affected rural areas of Southern Punjab, Pakistan. One hundred and ninety-three children were screened for symptoms of post-traumatic stress, and 38% met eligibility criteria. Children were then randomly assigned into experimental (n = 38) and control (n = 37) groups. The findings of the study showed a significant reduction in PTSD symptoms, and improvement in resilience, and perceived social support in the experimental group. The result of the study demonstrates that SSET, delivered by a clinically trained provider, may be an effective intervention for treating traumatic stress symptoms among children affected by natural disasters like flooding, particularly in under-resourced contexts. This pilot lays the initial groundwork for SSET in this context, which may ultimately be implemented by non-clinicians to address trauma-related psychological issues.

Spatio-temporal variation of the urban heat island in Santiago, Chile during summers 2005-2017

Urban heat islands (UHIs) can present significant risks to human health. Santiago, Chile has around 7 million residents, concentrated in an average density of 480 people/km(2). During the last few summer seasons, the highest extreme maximum temperatures in over 100 years have been recorded. Given the projections in temperature increase for this metropolitan region over the next 50 years, the Santiago UHI could have an important impact on the health and stress of the general population. We studied the presence and spatial variability of UHIs in Santiago during the summer seasons from 2005 to 2017 using Moderate Resolution Imaging Spectroradiometer (MODIS) satellite imagery and data from nine meteorological stations. Simple regression models, geographic weighted regression (GWR) models and geostatistical interpolations were used to find nocturnal thermal differences in UHIs of up to 9 degrees C, as well as increases in the magnitude and extension of the daytime heat island from summer 2014 to 2017. Understanding the behavior of the UHI of Santiago, Chile, is important for urban planners and local decision makers. Additionally, understanding the spatial pattern of the UHI could improve knowledge about how urban areas experience and could mitigate climate change.

Staying afloat: Community perspectives on health system resilience in the management of pregnancy and childbirth care during floods in Cambodia

INTRODUCTION: Resilient health systems have the capacity to continue providing health services to meet the community’s diverse health needs following floods. This capacity is related to how the community manages its own health needs and the community and health system’s joined capacities for resilience. Yet little is known about how community participation influences health systems resilience. The purpose of this study was to understand how community management of pregnancy and childbirth care during floods is contributing to the system’s capacity to absorb, adapt or transform as viewed through a framework on health systems resilience. METHODS: Eight focus group discussions and 17 semi-structured interviews were conducted with community members and leaders who experienced pregnancy or childbirth during recent flooding in rural Cambodia. The data were analysed by thematic analysis and discussed in relation to the resilience framework. RESULTS: The theme ‘Responsible for the status quo’ reflected the community’s responsibility to find ways to manage pregnancy and childbirth care, when neither the expectations of the health system nor the available benefits changed during floods. The theme was informed by notions on: i) developmental changes, the unpredictable nature of floods and limited support for managing care, ii) how information promoted by the public health system led to a limited decision-making space for pregnancy and childbirth care, iii) a desire for security during floods that outweighed mistrust in the public health system and iv) the limits to the coping strategies that the community prepared in case of flooding. CONCLUSIONS: The community mainly employed absorptive strategies to manage their care during floods, relieving the burden on the health system, yet restricted support and decision-making may risk their capacity. Further involvement in decision-making for care could help improve the health system’s resilience by creating room for the community to adapt and transform when experiencing floods.

Social vulnerability in a high-risk flood-affected rural region of NSW, Australia

We describe factors related to the social vulnerability of populations that experienced major river flooding in northern New South Wales (NSW), Australia. Using geographical information system methods, maps of 2017 flood-affected areas in the Lismore and Murwillumbah regions were combined with 2016 National census data to compare aspects of social vulnerability with the wider region and the region with Sydney. We also used individual-level data from the NSW 45 and Up Study to compare lifestyle, behavioural and health characteristics of residents of these flood-affected areas with the broader region (n = 13,561). Populations living in the Lismore Town Centre flood footprint exhibited significantly higher levels of social vulnerability over a range of factors; in particular, almost 82% resided in the most disadvantaged socio-economic quintile neighbourhoods. The flood-affected areas of Murwillumbah and Lismore regions included 47% and 60% of residents in the most disadvantaged quintile neighbourhoods compared to 27% for whole region and 16% for Sydney. This pattern of increased vulnerability was also apparent from the 45 and Up study; participants residing in the Lismore Town Centre flood footprint had significantly higher rates of riskier lifestyle-related behaviours (smoking, alcohol consumption), pre-existing mental health conditions (depression and anxiety) and poorer health. This detailed case study demonstrates extreme local vulnerability of flood-exposed populations, over and above the already highly vulnerable regional rural populations. This information is important to inform disaster planning and response and also reinforces the importance of having a detailed understanding of affected populations.

Responses of rice qualitative characteristics to elevated carbon dioxide and higher temperature: Implications for global nutrition

BACKGROUND: Protein and some minerals of rice seed are negatively affected by projected carbon dioxide (CO(2) ) levels. However, an in-depth assessment of rice quality that encompasses both CO(2) and temperature for a wide range of nutritional parameters is not available. Using a free-air CO(2) enrichment facility with temperature control, we conducted a field experiment with two levels of CO(2) (ambient; ambient?+?200?ppm) and two levels of temperature (ambient; ambient?+?1.5 °C). An in-depth examination of qualitative factors indicated a variable nutritional response. RESULTS: For total protein, albumin, glutelin, and prolamin, elevated CO(2) reduced seed concentrations irrespective of temperature. Similarly, several amino acids declined further as a function of higher temperature and elevated CO(2) relative to elevated CO(2) alone. Higher temperature increased the lipid percentage of seed; however, elevated CO(2) reduced the overall lipid content. At the nutrient elements level, whereas elevated CO(2) reduced certain elements, a combination of CO(2) and temperature could compensate for CO(2) reductions but was element dependent. CONCLUSION: Overall, these data are, at present, the most detailed analysis of rising CO(2) /temperature on the qualitative characteristics of rice. They indicate that climate change is likely to significantly impact the nutritional integrity of rice, with subsequent changes in human health on a global basis. © 2020 Society of Chemical Industry.

Reducing the risks of extreme heat for seniors: Communicating risks and building resilience

INTRODUCTION: As the global climate changes, heat waves are having a disproportionate impact on seniors and other socially vulnerable groups. In order to mitigate the threats of extreme heat, it is critical to develop and promote resources for coping during these events. A better understanding of the role of risk perceptions and the factors that influence them is needed in order to improve public responses to threatening events, particularly among seniors. METHODS: This mixed-methods study examined risk perceptions and coping practices in seniors using qualitative interviews (n = 15) and a survey (n = 244) of seniors across Waterloo Region, Ontario. RESULTS: Seniors showed relatively accurate risk tracking as indicated by the link between measures of actual risk and perception of personal risk. While vulnerability to heat is often believed to be associated with inaccurate perceptions of risk, within our sample, vulnerability appears more strongly related to social location and access to resources. Participants described social connections as important resources for resilience, but the stigma surrounding vulnerability, and other social norms, as barriers to seeking support. CONCLUSION: The positive relationship between participants’ risk perceptions and actual risk for negative consequences of extreme heat was an important finding, given that problems of emergency preparedness and risk reduction are often framed as issues of awareness of risk, rather than social location and inequality. Along with increased public resources for coping with extreme heat, communicating about resources, fostering social connections and reducing stigma may be important leverage points for increasing the resiliency of seniors to heat waves.

Rainfall and child weight in Uganda

We combine data from the 2006 and 2011 Uganda Demographic and Health Surveys (UDHS) with rainfall data and two waves of the Ugandan National Household Survey (UNHS) to study patterns in child weight, as measured by weight-for-height z scores (WHZ), among 3492 rural children below age 5 in Uganda. We focus on rainfall as a nutrition driver along agriculture and disease pathways. We find a positive and significant association between crop yield and WHZ, but the magnitude of this association diminishes as we control for covariates, especially the use of productivity-enhancing agricultural inputs. We find diarrheal disease to have a negative and significant association with WHZ, and modifying effects of social and environmental factors along the disease pathway. Contemporaneous rainfall is associated with a lower likelihood of diarrheal disease in areas with excess rainfall and a higher likelihood of diarrheal disease in rainfall deficit areas. Our findings reinforce calls for targeted and situation-sensitive policies to promote child nutrition.

Poor mental health of livestock farmers in Africa: A mixed methods case study from Ghana

BACKGROUND: Agriculture represents the mainstay of African economies and livestock products are essential to the human population’s nutritional needs. However, in many developing countries, including Ghana, livestock production fails to meet demand due to population growth and negative effects of climate change. One of the challenges to production is livestock loss affecting farmers. However, despite stressful events experienced, livestock farmers’ mental health is poorly documented. This study aims to identify the root causes of livestock losses and their influence on pastoralists’ mental health. METHODS: We conducted a mixed methods study in two districts in the Northern and Southern Belts of Ghana. Using the Depression Anxiety and Stress Scale-21 and guided interviews, we collected quantitative and qualitative data from 287 livestock farmers and 24 key-informants respectively. Mental health scores were categorized using standard guidelines. We evaluated the factors that explained variations in mental wellbeing using general linear models (??=?0.05). RESULTS: About 85% (240/287) of the livestock farmers lost cattle within 1 year. Of these, 91% lost cattle to animal diseases, 50% to theft and 27% to pasture shortages. Qualitative findings reveal that due to poor access to veterinary services, farmers treat livestock diseases themselves with drugs from unregulated sources and often sell diseased cows for meat to recover losses. Findings showed that 60% of livestock farmers had poor mental health. Of those, 72% were depressed, 66% anxious and 59% stressed. Mental wellbeing was negatively associated with the number of adverse events experienced, proportion of livestock lost to most of the major loss factors, emotional attachment to livestock and self-reported physical illnesses in farmers, but positively associated with increasing herd size [F (8,278)?=?14.18, p?

Poverty reduction effect of adaptation to climate change: Empirical evidence from China’s Loess Plateau and Qinba Mountains

Based on the micro-survey data of rural households in China’s Loess Plateau and Qinba Mountains, this paper empirically examines the poverty reduction effect and mechanism of adaptation to climate change. The research conclusions show that the adaptation actions can significantly reduce the poverty vulnerability of farmers, especially the future incidence of poverty in agricultural or poor households to a greater extent, which is characterized by a “pro-poor” effect. Adaptation actions can reduce poverty from two aspects: decreasing the expected income volatility (loss mitigation effect) and increasing the expected income level (opportunity effect), and the former is stronger than the latter. In the post-2020 period, China should enhance policy support in rural areas to adapt to climate change, improve the resilience of farmers’ livelihoods and climate change resilience of rural areas, and promote sustainable poverty reduction.

Predicting Malaria transmission dynamics in Dangassa, Mali: A novel approach using functional generalized additive models

Mali aims to reach the pre-elimination stage of malaria by the next decade. This study used functional regression models to predict the incidence of malaria as a function of past meteorological patterns to better prevent and to act proactively against impending malaria outbreaks. All data were collected over a five-year period (2012-2017) from 1400 persons who sought treatment at Dangassa’s community health center. Rainfall, temperature, humidity, and wind speed variables were collected. Functional Generalized Spectral Additive Model (FGSAM), Functional Generalized Linear Model (FGLM), and Functional Generalized Kernel Additive Model (FGKAM) were used to predict malaria incidence as a function of the pattern of meteorological indicators over a continuum of the 18 weeks preceding the week of interest. Their respective outcomes were compared in terms of predictive abilities. The results showed that (1) the highest malaria incidence rate occurred in the village 10 to 12 weeks after we observed a pattern of air humidity levels >65%, combined with two or more consecutive rain episodes and a mean wind speed <1.8 m/s; (2) among the three models, the FGLM obtained the best results in terms of prediction; and (3) FGSAM was shown to be a good compromise between FGLM and FGKAM in terms of flexibility and simplicity. The models showed that some meteorological conditions may provide a basis for detection of future outbreaks of malaria. The models developed in this paper are useful for implementing preventive strategies using past meteorological and past malaria incidence.

Perceptions of local vulnerability and the relative importance of climate change in rural Ecuador

Rural, natural resource dependent communities are especially vulnerable to climate change, and their input is critical in developing solutions, but the study of risk perception within and among vulnerable communities remains underdeveloped. Our multi-disciplinary research team used a mixed-methods approach to document, analyze, and conceptualize the interacting factors that shape vulnerability and to explore community members’ perceptions of the role and relative importance of climate change compared to other factors in three rural communities in Ecuador. Economic instability, lack of access to basic services, and environmental degradation are perceived as greater threats to community well being than increasing seasonal variability and flooding. Programs and policies directed at climate change adaptation should integrate climate and non-climate related stressors. Our findings also point to a greater need for collaboration across public health, poverty alleviation, and environmental management fields through practical research targeting assistance to vulnerable populations.

Mortality risk of a future heat event across a subtropical city: Implications for community planning and health policy

In this study, we applied the Weather Research and Forecasting model to project 2050 urban and rural temperature. We applied a time-stratified analysis to compare it with mortality between 2001 and 2014 and between 2011 and 2014, to estimate the elevated risk of a 2050 heat event. We included change in daytime versus nighttime and urban versus rural temperatures as factors to project mortality, to evaluate the potential influence of climate change on mortality risk. Increases of 2.9 degrees C and 2.6 degrees C in maximum and minimum air temperature are projected in a 2050 heat event, with a day and a night that will have respective temperatures 9.8 degrees C and 4.9 degrees C higher than 2001-2014. Significantly higher mortality risk is forecasted in 2050 compared to 2001-2014 (IRR 1.721 [1.650, 1.796]) and 2011-2014 (IRR 1.622 [1.547, 1.701]) without consideration of temperature change. After consideration of changing temperature, change in maximum temperature in rural areas will induce the highest mortality risk during 2050, possibly due to rapid urbanization across the city, and with the second highest mortality risk induced by the change in minimum temperature in urbanized areas, possibly because local people in the city have been adapted to the maximum level of urban thermal stress during a summer day. Improvements to heat warning systems and sustainable planning protocols are urgently needed for climate change mitigation.

Mountain specific multi-hazard risk management framework (MSMRMF): Assessment and mitigation of multi-hazard and climate change risk in the Indian Himalayan Region

Mountains are characterized by their specificities such as fragility, marginality and remoteness. They are prone to various hazards such as drought, flood, forest fire, landslide and therefore physical, ecological and social systems of the mountains are at risk. Climate change adds to intensifying the magnitude of multi-hazard risk in mountains. The present study attempts to evaluate risk induced by multi-hazard and climate change in the Indian Himalayan Region (IHR) using the Intergovernmental Panel on Climate Change (IPCC) framework. The proposed multi-hazard risk index was based on indicators from a broader domain and applied on 109 administrative districts of IHR. Exposure, sensitivity, adaptive capacity, and coping capacity were defined using comprehensive and sub-regional indicators identified through inductive and deductive approaches. The result showed that the differential risks among the districts of IHR were governed by the multiplicity of the factor such as demography, amenities, natural capital, partnership, technology and spatial specificities of the districts. The result highlighted the need of inclusion of spatial specificities for the risk mitigation in the IHR and therefore a Mountain Specific Risk Management Framework (MSMRMF) was proposed for sustaining the mountainous communities. The proposed MSMRMF contained two broad components as risk assessment and risk addressal. The framework detailed the risk mitigation and coping strategies (based on adjustment of internal and external strengths) for addressing risks. Risk mitigation was proposed to achieved through habitation resilience, natural capital enhancement, external partnerships, climate change adaptation, and technological interventions. The framework would provide an insight of risk and risk management strategies for the multi-hazard prone mountain regions for the sustainable development under the global change.

Neonatal mortality and temperature in two northern Swedish rural parishes, 1860-1899-The significance of ethnicity and gender

The aim of this study was to analyze the association between season of birth and daily temperature for neonatal mortality in two Swedish rural parishes between 1860 and 1899. Further, we aimed to study whether the association varied according to ethnicity (indigenous Sami reindeer herders and non-Sami settlers) and gender. The source material for this study comprised digitized parish records from the Demographic Data Base, Umeå University, combined with local weather data provided by the Swedish Meteorological and Hydrological Institute. Using a time event-history approach, we investigated the association between daily temperature (at birth and up to 28 days after birth) and the risk of neonatal death during the coldest months (November through March). The results showed that Sami neonatal mortality was highest during winter and that the Sami neonatal mortality risk decreased with higher temperatures on the day of birth. Male neonatal risk decreased with higher temperatures during the days following birth, while no effect of temperature was observed among female neonates. We conclude that weather vulnerability differed between genders and between the indigenous and non-indigenous populations.

Modeling pastoralist movement in response to environmental variables and conflict in Somaliland: Combining agent-based modeling and geospatial data

Pastoralism is widely practiced in arid lands and is the primary means of livelihood for approximately 268 million people across Africa. Environmental, interpersonal, and transactional variables such as vegetation and water availability, conflict, ethnic tensions, and private/public land delineation influence the movements of these populations. The challenges of climate change and conflict are widely felt by nomadic pastoralists in Somalia, where resources are scarce, natural disasters are increasingly common, and protracted conflict has plagued communities for decades. Bereft of real-time data, researchers and programmatic personnel often turn to post hoc analysis to understand the interaction between climate, conflict, and migration, and design programs to address the needs of nomadic pastoralists. By designing an Agent-Based Model to simulate the movement of nomadic pastoralists based on typologically-diverse, historical data of environmental, interpersonal, and transactional variables in Somaliland and Puntland between 2008 and 2018, this study explores how pastoralists respond to changing environments. Through subsequent application of spatial analysis such as choropleth maps, kernel density mapping, and standard deviational ellipses, we characterize the resultant pastoralist population distribution in response to these variables. Outcomes demonstrate a large scale spatio-temporal trend of pastoralists migrating to the southeast of the study area with high density areas in the south of Nugaal, the northwest of Sool, and along the Ethiopian border. While minimal inter-seasonal variability is seen, multiple analyses support the consolidation of pastoralists to specifically favorable regions. Exploration of the large-scale population, climate, and conflict trends allows for cogent narratives and associative hypotheses regarding the pastoralist migration during the study period. While this model produces compelling associations between pastoralist movements and terrestrial and conflict variables, it relies heavily on assumptions and incomplete data that are not necessarily representative of realities on the ground. Given the paucity of data regarding pastoralist decision-making and migration, validation remains challenging.

Monitoring culicine mosquitoes (Diptera: Culicidae) as a vector of flavivirus in Incheon metropolitan city and Hwaseong-Si, Gyeonggi-Do, Korea, during 2019

The flaviviruses are small single-stranded RNA viruses that are typically transmitted by mosquitoes or tick vectors and are etiological agents of acute zoonotic infections. The viruses are found around the world and account for significant cases of human diseases. We investigated population of culicine mosquitoes in central region of Korean Peninsula, Incheon Metropolitan City and Hwaseong-si. Aedes vexans nipponii was the most frequently collected mosquitoes (56.5%), followed by Ochlerotatus dorsalis (23.6%), Anopheles spp. (10.9%), and Culex pipiens complex (5.9%). In rural regions of Hwaseong, Aedes vexans nipponii was the highest population (62.9%), followed by Ochlerotatus dorsalis (23.9%) and Anopheles spp. (12.0%). In another rural region of Incheon (habitat of migratory birds), Culex pipiens complex was the highest population (31.4%), followed by Ochlerotatus dorsalis (30.5%), and Aedes vexans vexans (27.5%). Culex pipiens complex was the predominant species in the urban region (84.7%). Culicine mosquitoes were identified at the species level, pooled up to 30 mosquitoes each, and tested for flaviviral RNA using the SYBR Green-based RT-PCR and confirmed by cDNA sequencing. Three of the assayed 2,683 pools (989 pools without Anopheles spp.) were positive for Culex flaviviruses, an insect-specific virus, from Culex pipiens pallens collected at the habitats for migratory birds in Incheon. The maximum likelihood estimation (the estimated number) for Culex pipiens pallens positive for Culex flavivirus was 25. Although viruses responsible for mosquito-borne diseases were not identified, we encourage intensified monitoring and long-term surveillance of both vector and viruses in the interest of global public health.

Mapping heat-related risks in Northern Jiangxi Province of China based on two spatial assessment frameworks approaches

Heat-health risk is a growing concern in many regions of China due to the more frequent occurrence of extremely hot weather. Spatial indexes based on various heat assessment frameworks can be used for the assessment of heat risks. In this study, we adopted two approaches-Crichton’s risk triangle and heat vulnerability index (HVI) to identify heat-health risks in the Northern Jiangxi Province of China, by using remote sensing and socio-economic data. The Geographical Information System (GIS) overlay and principal component analysis (PCA) were separately used in two frameworks to integrate parameters. The results show that the most densely populated community in the suburbs, instead of city centers, are exposed to the highest heat risk. A comparison of two heat assessment mapping indicates that the distribution of HVI highlights the vulnerability differences between census tracts. In contrast, the heat risk index of Crichton’s risk triangle has a prominent representation for regions with high risks. The stepwise multiple linear regression zero-order correlation coefficient between HVI and outdoor workers is 0.715, highlighting the vulnerability of this particular group. Spearman’s rho nonparametric correlation and the mean test reveals that heat risk index is strongly correlated with HVI in most of the main urban regions in the study area, with a significantly lower value than the latter. The analysis of variance shows that the distribution of HVI exhibits greater variety across urban regions than that of heat risk index. Our research provides new insight into heat risk assessment for further study of heat health risk in developing countries.

Localized floods, poverty and food security: Empirical evidence from Rural Pakistan

National level floods affect large sections of the population, and in turn, receive attention from the government and international agencies. Localized natural disasters, including localized floods, do not get the attention of the government and policymakers because their impact is felt within limited geographical areas, despite the fact that these disasters severely affect the livelihood of rural communities. This study examines the impact of localized floods on the livelihood of farmers in Pakistan using a cross-sectional data set collected from 812 households. The empirical results show that localized floods severely affect rural livelihoods, and affected households have lowered cereal crop yields, less income, and reduced food security levels. Farmers adopt a number of strategies, including crop and livestock insurance, bund-making, land-leveling, and tree planting, to combat the impact of localized floods. Among all these mitigating strategies, the tree plantation is ranked as the best mitigating strategy followed by crop and livestock insurance, land leveling, and bund making, respectively. Education, wealth, access to non-governmental organizations (NGOs), extension services, and infrastructure, influence the adoption of measures to mitigate the effect of flood risks. National policy on localized flood risks needs to strengthen local institutions to provide support to families and extension services to train farmers to mitigate the impact of localized floods.

Intra-urban differences of outdoor thermal comfort in Ghent on seasonal level and during record-breaking 2019 heat wave

A comprehensive analysis of meteorological (air temperature, relative humidity, wind speed and global radiation) and outdoor thermal comfort (OTC) conditions (Physiological Equivalent Temperature and Mean Radiant Temperature) was carried out in six Local Climate Zones (LCZs) in Ghent (Belgium) on annual and seasonal level (2017) and during two heat waves (moderate in 2017 and record-breaking in 2019). The continuously monitored data originates from the local urban climate network MOCCA (Monitoring the City’s Climate and Atmosphere). The maximum hourly urban heat island (UHI) of 8.7 degrees C was noticed during the record-breaking 2019 heat wave. OTC was calculated with RayMan based on the observations from the MOCCA network and characteristics of the micro-environment which affect the estimated OTC conditions. The results show that cold stress is more apparent in Ghent during all seasons, except for summer. Downtown locations had more comfortable conditions on seasonal and annual level when compared to the rural location which had the most uncomfortable OTC conditions mostly due to cold stress. However, during the daytime period of heat waves, the open downtown and rural location were most frequently exposed to extreme heat stress, while the urban park in the sparsely built LCZ was the most comfortable area because it was able to effectively mitigate heat stress. This study illustrates the subtlety of the results of a thermal comfort study if one investigates both heat and cold stress on a yearly basis and during the extreme heat wave periods in a city with a moderate climate.

Introducing experiences from African pastoralist communities to cope with climate change risks, hazards and extremes: Fostering poverty reduction

Pastoralist communities all over Africa have been facing a variety of social and economic problems, as well as climate risks and hazards for many years. They have also been suffering from climate change and extreme events, along with a variety of weather and climate threats, which pose many challenges to herders. On the one hand, pastoralist communities have little influence on policy decisions; however, on the other hand, they suffer to a significant extent from such policies, which limit their options for sustainable development and poverty alleviation. Also, the socio-cultural legacy of herders, and their role in food security and provision of ecosystem services, as well as their efforts towards climate change adaptation, are little documented, particularly in Eastern and Southern African countries. There is a perceived need for international studies on the risks and impacts of climate change and extreme events on the sustainability of pastoralist communities in Africa, especially in eastern and southern Africa. Based on the need to address this research gap, this paper describes the climate change risks and challenges that climate threats pose to the sustainability and livelihoods of pastoralist communities in eastern and southern Africa. Also, it discusses the extent to which such problems affect their wellbeing and income. Additionally, the paper reports on the socioeconomic vulnerability indices at country-level; identifies specific problems pastoralists face, and a variety of climate adaptation strategies to extreme events through field survey among pastoralist communities in a sample of five countries, namely Ethiopia, Kenya, Malawi, Uganda, and Zimbabwe. The study has shown that the long-term sustainability of the livelihoods of pastoral communities is currently endangered by climate change and the risks and hazards it brings about, which may worsen poverty among this social group. The study suggests that a more systematic and structured approach is needed when assessing the climate vulnerability of individual pastoral communities, since this may help in designing suitable disaster risk reduction strategies. Moreover, the paper shows that it is also necessary to understand better the socio-ecological systems (SES) of the various communities, and how their livelihoods are influenced by the changing conditions imposed by a changing climate.

Increased medical visits and mortality among adults with Cardiovascular Diseases in severely affected areas after Typhoon Morakot

Natural disasters have negative health impacts on chronic diseases in affected populations. Severely affected areas are usually rural areas with limited basic infrastructure and a population have that has limited access to optimal healthcare after a disaster. Patients with cardiovascular diseases are required to maintain quality care, especially after disasters. A population-based case-control study enrolled adults from the National Health Insurance Registry who had ischemic heart disease and cerebrovascular disease histories and lived in the area affected by Typhoon Morakot in 2009. Monthly medical visits for acute cerebrovascular and ischemic heart diseases markedly increased at approximately 1-2 months after the typhoon. Survival analysis during the two years following the typhoon indicated a significant increase in mortality in adults with an acute ischemic heart disease history who lived in the severely affected area. Mortality hazard analysis showed that among affected adults with previous cerebrovascular diseases and acute ischemic heart diseases, patients with diabetes (adjusted hazard ratio [HR]: 1.3-1.7), Chronic Kidney Disease (CKD) (adjusted HR: 2.0-2.7), chronic obstructive pulmonary diseases (COPD) and asthma (adjusted HR: 1.7-2.1), liver cirrhosis (adjusted HR: 2.3-3.3) and neoplasms (adjusted HR: 1.1-2.1) had significantly increased mortality rates. Consequently, high-quality and accessible primary healthcare plans should be made available to maintain and support affected populations after disasters.

Impact of climate variability on length of stay in hospital for childhood pneumonia in rural Bangladesh

OBJECTIVES: Pneumonia is a significant contributor to mortality and morbidity in children aged <5 years, and it is also one of the leading causes of hospitalisation for children in this age group. This study assessed the association between climate variability, patient characteristics (i.e. age, sex, weight, parental education, socio-economic status) and length of stay (LOS) in hospital for childhood pneumonia and its economic impact on rural Bangladesh. STUDY DESIGN: An ecological study design was used. METHODS: Data on daily hospitalisation for pneumonia in children aged <5 years (including patient characteristics) and daily climate data (temperature and relative humidity) between 1st January 2012 and 31st December 2016 were obtained from the Matlab Hospital (the International Centre for Diarrhoeal Disease Research, Bangladesh) and the Bangladesh Meteorological Department, respectively. A generalised linear model with Poisson link was used to quantify the association between climate factors, patient characteristics and LOS in hospital. RESULTS: The study showed that average temperature, temperature variation and humidity variation were positively associated with the LOS in hospital for pneumonia. A 1°C rise in average temperature and temperature variation during hospital stay increased the LOS in hospital by 1% (relative risk [RR]: 1.010, 95% confidence interval [CI]: 1.001-1.018) and 9.3% (RR: 1.093, 95% CI: 1.051-1.138), respectively. A 1% increase in humidity variation increased the LOS in hospital for pneumonia by 2.2% (RR: 1.022, 95% CI: 1.004-1.039). In terms of economic impact, for every 1° C temperature variation during the period of hospital stay, there is an addition of 0.81 USD/day/patient as a result of direct costs and 1.8 USD/day/patient for total costs. Annually, this results in an additional 443 USD for direct and 985 USD for total costs. CONCLUSIONS: Climate variation appears to significantly contribute to the LOS in hospital for childhood pneumonia. These findings may help policymakers to develop effective disease management and prevention strategies.

Impact of drought, farmers’ adaptation strategies and administrative mitigation measure in the Marathwada region, India

The number of serious and extreme drought events is increasing, causing a serious threat to ecosystems, food security, livelihood security, social stability, and sustainable development. The Marathwada region of India is highly vulnerable to the impacts of drought and has been severely affected because of consecutive drought events from 2012 to 2016. This article aims to understand the rural farming household’s perceptions of the impacts of drought, their adaptation and mitigation measures, and also attempts to assess the level of satisfaction of rural households with government mitigation measures. This study is based on primary and secondary sources of data collected from 192 farming households following a structured questionnaire survey. The survey reveals that crop failure, livelihood insecurity, declines in livestock production, livestock loss, water conflicts, and problems in meeting agricultural expenses, increased school dropout rates of children, and both psychological and health problems, were the most immediate socio-economic impacts of drought. The various environmental impacts of drought perceived by farmers included depleted groundwater levels, poor groundwater quality, land degradation, a decrease in seasonal river flows, degradation of pastures and declines in soil fertility. It was found that small and medium sized farmers were highly affected by drought compared with marginal and large scale farmers because of their high dependency on agriculture and poor adaptation strategies.

How does peri-urbanization trigger climate change vulnerabilities? An investigation of the Dhaka megacity in Bangladesh

This paper aims to scrutinize in what way peri-urbanization triggers climate change vulnerabilities. By using spatial analysis techniques, the study undertakes the following tasks. First, the study demarcates Dhaka’s-the capital of Bangladesh-peri-urban growth pattern that took place over the last 24-year period (1992-2016). Afterwards, it determines the conformity of ongoing peri-urban practices with Dhaka’s stipulated planning documents. Then, it identifies Dhaka’s specific vulnerabilities to climate change impacts-i.e., flood, and groundwater table depletion. Lastly, it maps out the socioeconomic profile of the climate change victim groups from Dhaka. The findings of the study reveal that: (a) Dhaka lacks adequate development planning, monitoring, and control mechanisms that lead to an increased and uncontrolled peri-urbanization; (b) Dhaka’s explicitly undefined peri-urban growth boundary is the primary factor in misguiding the growth pockets-that are the most vulnerable locations to climate change impacts, and; (c) Dhaka’s most vulnerable group to the increasing climate change impacts are the climate migrants, who have been repeatedly exposed to the climate change-triggered natural hazards. These study findings generate insights into peri-urbanization-triggered climate change vulnerabilities that aid urban policymakers, managers, and planners in their development policy, planning, monitoring and control practices.

Heatwave-related mortality risk and the risk-based definition of Heat Wave in South Korea: A nationwide time-series study for 2011-2017

Studies on the pattern of heatwave mortality using nationwide data that include rural areas are limited. This study aimed to assess the risk of heatwave-related mortality and evaluate the health risk-based definition of heatwave. We collected data on daily temperature and mortality from 229 districts in South Korea in 2011-2017. District-specific heatwave-related mortality risks were calculated using a distributed lag model. The estimates were pooled in the total areas and for each urban and rural area using meta-regression. In the total areas, the threshold point of heatwave mortality risk was estimated at the 93rd percentile of temperature, and it was lower in urban areas than in rural areas (92nd percentile vs. 95th percentile). The maximum risk of heatwave-related mortality in the total area was 1.11 (95% CI: 1.01-1.22), and it was slightly greater in rural areas than in the urban areas (RR: 1.23, 95% CI: 0.99-1.53 vs. RR: 1.10, 95% CI: 1.01-1.20). The results differ by age- and cause-specific deaths. In conclusion, the patterns of heatwave-related mortality risk vary by area and sub-population in Korea. Thus, more target-specific heatwave definitions and action plans should be established according to different areas and populations.

Heavy rainfall events and diarrheal diseases: The role of urban-rural geography

Diarrheal diseases remain a significant contributor to the global burden of disease. Climate change may increase their incidence by altering the epidemiology of waterborne pathogens through changes in rainfall patterns. To assess potential impacts of future changes in rainfall patterns, we analyzed 33,927 cases of diarrhea across all Ministry of Health clinical facilities in Esmeraldas Province, Ecuador, for a 24-month period from 2013 to 2014, using mixed-effects Poisson regression. We assessed the association between the incidence of diarrheal diseases and heavy rainfall events (HREs) and antecedent rainfall conditions. In rural areas, we found no significant associations between HREs and incidence. In urban areas, dry antecedent conditions were associated with higher incidence than wet conditions. In addition, HREs with dry antecedent conditions were associated with elevated incidence by up to 1.35 (incidence rate ratio, 95% CI: 1.14-1.60) times compared with similar conditions without HREs. These patterns may be driven by accumulation of fecal contamination during dry periods, followed by a flushing effect during HREs. This phenomenon is more important in dense urban environments with more impervious surfaces. These findings suggest that projected increases in rainfall variability and HREs may increase diarrhea burden in urban regions, which are rapidly expanding globally.

Health status and health care needs of drought-related migrants in the Horn of Africa-A qualitative investigation

Somalia, Kenya and Ethiopia, situated in the Horn of Africa, are highly vulnerable to climate change, which manifests itself through increasing temperatures, erratic rains and prolonged droughts. Millions of people have to flee from droughts or floods either as cross-border refugees or as internally displaced persons (IDPs). The aim of this study was to identify knowledge status and gaps regarding public health consequences of large-scale displacement in these countries. After a scoping review, we conducted qualitative in-depth interviews during 2018 with 39 stakeholders from different disciplines and agencies in these three countries. A validation workshop was held with a selection of 13 interviewees and four project partners. Malnutrition and a lack of vaccination of displaced people are well-known challenges, while mental health problems and gender-based violence (GBV) are less visible to stakeholders. In particular, the needs of IDPs are not well understood. The treatment of mental health and GBV is insufficient, and IDPs have inadequate access to essential health services in refugee camps. Needs assessment and program evaluations with a patients’ perspective are either lacking or inadequate in most situations. The Horn of Africa is facing chronic food insecurity, poor population health and mass displacement. IDPs are an underserved group, and mental health services are lacking. A development approach is necessary that moves beyond emergency responses to the building of long-term resilience, the provision of livelihood support and protection to reduce displacement by droughts.

Heat exposure from tropical deforestation decreases cognitive performance of rural workers: An experimental study

The effect of tropical deforestation on heat exposure and subsequent human health outcomes remains understudied, especially among an increasingly vulnerable population-healthy, adult subsistence workers in rural industrializing tropical countries. We report on a field experiment that estimated the short-term effects of heat exposure from deforestation on cognitive performance. We randomly assigned rural, adult subsistence workers in East Kalimantan, Indonesia to deforested or forested settings, and standard or high incentive piece rate payments. Participants worked in forested or deforested settings for up to 90 min, where ambient and black globe temperatures in deforested areas were, on average, 2.1 degrees C and 10 degrees C higher. After completing the experimental task, participants were asked to take a validated general cognitive assessment test (CAT) and episodic memory test (EMT). We found participants in deforested settings had statistically significant lower scores on both CAT and EMT. Effects were largely driven by heat effects on male participants and those working after noon. Our results highlight how heat exposure from tropical deforestation may lead to declines in cognitive performance even in favorable work settings. Policymakers should consider how land use planning that takes into account the cooling services of trees can play a significant role in increasing resilience to heat from climate and land use change in the tropics.

Heat stress risk and vulnerability under climate change in Durban metropolitan, South Africa – Identifying urban planning priorities for adaptation

There is an urgent need to map the geographic location of climate change risks and vulnerability, especially for cities in sub-Saharan Africa, which are experiencing the greatest urban development challenges and vulnerability to climate change impacts. The aim of this study is to investigate current and projected future heat risk, expressed as a heat stress exposure index using high-resolution climate change projections, and a social vulnerability index, to identify areas of potential future heat stress risk in the Durban (eThekwini) metropolitan area, South Africa. Additionally, this is the first study to use high-resolution downscaled climate change projections under Representative Concentration (RCP) 8.5, to construct the heat exposure index using apparent temperature and increases in minimum temperature and a social vulnerability index, using demographic and socio-economic census and land use data to, derived from principal component analysis (PCA) to spatially characterize heat stress within a South African city. Results show that while heat stress is not a current concern, it is projected to increase and become a future concern, mainly as a function of social vulnerability due to household demographic and infrastructural characteristics, and will be experienced in both the rural and inner-city areas of the metro. This study contributes a heat risk framework to identify locations for specific research and adaptation activities on heat stress risk and for urban planning in sub-Saharan African cities, which are characterized by both rural and urban contexts, to address climate change adaptation targeting and priority setting.

Framework for a community health observing system for the Gulf of Mexico region: Preparing for future disasters

The Gulf of Mexico (GoM) region is prone to disasters, including recurrent oil spills, hurricanes, floods, industrial accidents, harmful algal blooms, and the current COVID-19 pandemic. The GoM and other regions of the U.S. lack sufficient baseline health information to identify, attribute, mitigate, and facilitate prevention of major health effects of disasters. Developing capacity to assess adverse human health consequences of future disasters requires establishment of a comprehensive, sustained community health observing system, similar to the extensive and well-established environmental observing systems. We propose a system that combines six levels of health data domains, beginning with three existing, national surveys and studies plus three new nested, longitudinal cohort studies. The latter are the unique and most important parts of the system and are focused on the coastal regions of the five GoM States. A statistically representative sample of participants is proposed for the new cohort studies, stratified to ensure proportional inclusion of urban and rural populations and with additional recruitment as necessary to enroll participants from particularly vulnerable or under-represented groups. Secondary data sources such as syndromic surveillance systems, electronic health records, national community surveys, environmental exposure databases, social media, and remote sensing will inform and augment the collection of primary data. Primary data sources will include participant-provided information via questionnaires, clinical measures of mental and physical health, acquisition of biological specimens, and wearable health monitoring devices. A suite of biomarkers may be derived from biological specimens for use in health assessments, including calculation of allostatic load, a measure of cumulative stress. The framework also addresses data management and sharing, participant retention, and system governance. The observing system is designed to continue indefinitely to ensure that essential pre-, during-, and post-disaster health data are collected and maintained. It could also provide a model/vehicle for effective health observation related to infectious disease pandemics such as COVID-19. To our knowledge, there is no comprehensive, disaster-focused health observing system such as the one proposed here currently in existence or planned elsewhere. Significant strengths of the GoM Community Health Observing System (CHOS) are its longitudinal cohorts and ability to adapt rapidly as needs arise and new technologies develop.

Exploring wildfire occurrence: Local farmers’ perceptions and adaptation strategies in central Cote d’Ivoire, West Africa

Wildfires are an important ecological threat in Cote d’Ivoire with the northern half the most affected zone. This study assessed farmers’ perception of wildfire occurrence in the N’Zi River Watershed and compared this perception to remotely sensed fire data trends. To this end, 259 farmers were individually interviewed and 18 farmers were involved in three focus group discussions in three agro-ecological zones. A combination of descriptive statistics and regression analysis was used for data analysis. Results showed that 78.75% of farmers observed the upward trend in the annual wildfire activity identified by remote sensing data during 2001-2016. Most of the respondents identified hunting (65.83%), farm establishment (50%) and firebreaks establishment (46.67%) as main causes of wildfires. The perceived impacts of wildfires included immediate crop burning, crop growth delaying, mid-term post-fire crop destruction, destruction of material goods and loss of human life. Local population developed endogenous strategies to cope with this scourge. Amongst identified coping strategies, firebreaks establishment and maintenance around new clearings and farms and prohibition of fire-hunting during the dry season were highlighted. Therefore, policies and institutions that support local wildfires management initiatives must take advantage of the strong community knowledge and networks to strengthen their effectiveness and sustainability.

Effects of the 2018 heat wave on health in the elderly: Implications for adaptation strategies to climate change

There has been growing concern over the effects of heat waves on health. However, the effects of heat waves on the health of individuals in vulnerable groups have rarely been examined. We aimed to investigate the acute health effects of heat waves in elderly individuals living in rural areas and to survey their adaptation capacity. Repeated measurements of body temperature (BT), blood pressure, sleep disturbance, and indoor temperature were conducted up to six times for each of 104 elderly individuals living in rural areas of South Korea during the 2018 heat wave. Changes in BT, systolic blood pressure (SBP), and diastolic blood pressure (DBP) according to variations in indoor and outdoor temperature were analyzed using linear mixed effect models controlling for age, sex, smoking, and drug use. We also surveyed heat wave adaptation capacity, heat wave shelters, and self-reported health problems. The average indoor temperature measured during the study period was 30.5°C (range: 22.9-38.3°C) and that of ambient temperature was 30.6°C (range: 24.6-36.3°C). BT significantly increased with indoor and outdoor temperatures. The effect on BT was greater in elderly women and the elderly with hypertension. DBP generally decreased with increasing indoor temperature, though the correlation was only statistically significant among the elderly with hypertension. Only 22 (21.2%) individuals used air conditioners during the heat wave. Most did not use an air conditioner mainly to avoid high electricity costs. Of the participants, 58.7% reported experiencing sleep disturbance, which was the most frequent self-reported health problem. Elderly individuals living in rural areas are directly exposed to high temperatures during heat waves, and their vital signs are sensitive to increases in indoor temperature due to poor adaptation capacity. Well-designed strategies for alleviating health-related stress during heat waves are necessary.

Climate change, pesticides and health: Considering the risks and opportunities of adaptation for Zimbabwean smallholder cotton growers

There is potential for increased pesticide-related adverse health outcomes in the agricultural sector linked to adaptive increases in pesticide use necessitated, in part, by climate change-related increases in pest populations. To understand the role of adaptation practices in pesticide use and health risks, this study assessed Zimbabwean smallholder cotton farmers’ adaptive responses linked to their climate change perceptions. In depth interviews were conducted with 50 farmers who had been growing cotton for at least 30 years. The study identified farmers’ adaptation practices that increased their pesticide use, as well as those that presented opportunities for reducing pesticide use through non-pesticide-dependent adaptation pathways. The findings show that due to perceived climate change impacts, such as a shorter growing season, farmers were adopting a range of adaptive practices. These included changes in pest management practices, such as increasing pesticide spraying frequencies due to keeping ratoon crops, which were increasing farmers’ overall pesticide use. Such incremental adaptive practices are potentially maladaptive, as they may increase farmers’ pesticide-related health risks. Other practices, however, such as reducing cotton acreage and diversifying crops, resulting in transformational adaptation, suggest the existence of opportunities for decreasing overall pesticide use or totally eliminating pesticides from the farming system.

Climate variability and child nutrition: Findings from sub-Saharan Africa

Climatic variability affects many underlying determinants of child malnutrition, including food availability, access, and utilization. Evidence of the effects of changing temperatures and precipitation on children’s nutritional status nonetheless remains limited. Research addressing this knowledge gap is merited given the shortand long-run consequences of malnutrition. We address this issue by estimating the effects of temperature and precipitation anomalies on the weight and wasting status of children ages 0-59 months across 18 countries in sub-Saharan Africa. Linear regression models show that high temperatures and low precipitation are associated with reductions in child weight, and that high temperatures also lead to increased risk of wasting. We find little evidence of substantively meaningful differences in these effects across sub-populations of interest. Our results underscore the vulnerability of young children to climatic variability and its second-order economic and epidemiological effects. The study also highlights the corresponding need to design and assess interventions to effectively mitigate these impacts.

Consistency in vulnerability assessments of wheat to climate change – A district-level analysis in India

In India, a reduction in wheat crop yield would lead to a widespread impact on food security. In particular, the most vulnerable people are severely exposed to food insecurity. This study estimates the climate change vulnerability of wheat crops with respect to heterogeneities in time, space, and weighting methods. The study uses the Intergovernmental Panel on Climate Change (IPCC) framework of vulnerability while using composite indices of 27 indicators to explain exposure, sensitivity, and adaptive capacity. We used climate projections under current (1975-2005) conditions and two future (2021-2050) Representation Concentration Pathways (RCPs), 4.5 and 8.5, to estimate exposure to climatic risks. Consistency across three weighting methods (Analytical Hierarchy Process (AHP), Principal Component Analysis (PCA), and Equal Weights (EWs)) was evaluated. Results of the vulnerability profile suggest high vulnerability of the wheat crop in northern and central India. In particular, the districts Unnao, Sirsa, Hardoi, and Bathinda show high vulnerability and high consistency across current and future climate scenarios. In total, 84% of the districts show more than 75% consistency in the current climate, and 83% and 68% of the districts show more than 75% consistency for RCP 4.5 and RCP 8.5 climate scenario for the three weighting methods, respectively. By using different weighting methods, it was possible to quantify “method uncertainty” in vulnerability assessment and enhance robustness in identifying most vulnerable regions. Finally, we emphasize the importance of communicating uncertainties, both in data and methods in vulnerability research, to effectively guide adaptation planning. The results of this study would serve as the basis for designing climate impacts adjusted adaptation measures for policy interventions.

Being on land and sea in troubled times: Climate change and food sovereignty in Nunavut

Climate change driven food insecurity has emerged as a topic of special concern in the Canadian Arctic. Inuit communities in this region rely heavily on subsistence; however, access to traditional food sources may have been compromised due to climate change. Drawing from a total of 25 interviews among Inuit elders and experienced hunters from Cambridge Bay and Kugluktuk in Nunavut, Canada, this research examines how climate change is impacting food sovereignty and health. Our results show that reports of food insecurity were more pronounced in Kugluktuk than Cambridge Bay. Participants in Kugluktuk consistently noted declining availability of preferred fish and game species (e.g., caribou, Arctic char), a decline in participation of sharing networks, and overall increased difficulty accessing traditional foods. Respondents in both communities presented a consistent picture of climate change compounding existing socio-economic (e.g., poverty, disconnect between elders and youth) and health stressors affecting multiple aspects of food sovereignty. This article presents a situated understanding of how climate change as well as other sociocultural factors are eroding food sovereignty at the community-scale in the Arctic. We argue that a communal focus is required to address resilience and adaptation at the local level through programs that protect the local cultural knowledge, traditional ways of life, and indigenous sovereignty to reduce the severities of food insecurity in the Arctic stemming from climate change.

Belonging and inclusivity make a resilient future for all: A cross-sectional analysis of post-flood social capital in a diverse Australian rural community

In 2017, marginalised groups were disproportionately impacted by extensive flooding in a rural community in Northern New South Wales, Australia, with greater risk of home inundation, displacement and poor mental health. While social capital has been linked with good health and wellbeing, there has been limited investigation into its potential benefits in post-disaster contexts, particularly for marginalised groups. Six months post-flood, a cross-sectional survey was conducted to quantify associations between flood impact, individual social capital and psychological distress (including probable post-traumatic stress disorder). We adopted a community-academic partnership approach and purposive recruitment to increase participation from socio-economically marginalised groups (Aboriginal people and people in financial hardship). These groups reported lower levels of social capital (informal social connectedness, feelings of belonging, trust and optimism) compared to general community participants. Despite this, informal social connectedness and belonging were important factors for all participant groups, associated with reduced risk of psychological distress. In this flood-prone, rural community, there is a pressing need to build social capital collectively through co-designed strategies that simultaneously address the social, cultural and economic needs of marginalised groups. Multiple benefits will ensue for the whole community: reduced inequities; strengthened resilience; improved preparedness and lessened risk of long-term distress from disaster events.

Building resilience to climate change in vulnerable communities: A case study of uMkhanyakude district municipality

Climate change in South Africa remains an issue of socio-economic and environmental concern. An increase in frequency and intensity of climatic events pose significant threats to biophysical and socio-economic aspects, namely food security, water resources, agriculture, biodiversity, tourism, and poverty. In order to counteract the socio-economic and environmental concerns pertaining to issues of climate change, emergent insights on climate change strategies suggest that building resilience in human and environmental systems is an ideal way of combating dynamic environmental conditions and future uncertainties. Using the qualitative secondary data approach, this article evaluates whether vulnerable communities in uMkhanyakude District Municipality can become resilient to the implications of climate change. UMkhanyakude District Municipality is predominantly rural and one of the most impoverished districts in KwaZulu-Natal, with the majority of socially and economically marginalised individuals and households experiencing more severe impacts as a result of climate change compared to those in urban areas. Data was analysed using content analysis and a concise summary of the biophysical and socio-economic aspects is presented. This research suggests that building resilience to climate change is possible when bottom-up, proactive and systematic measures are taken to manage vulnerable areas such as those in uMkhanyakude District Municipality. It recommends that social impact assessments (SIA) be conducted to assist in terms of assessing social consequences that are likely to follow from policy actions.

Assessing diet quality of indigenous food systems in three geographically distinct Solomon Islands sites (Melanesia, Pacific Islands)

Indigenous Solomon Islanders, like many living in Pacific Small Island Developing States (PSIDS), are currently experiencing the global syndemic-the combined threat of obesity, undernutrition, and climate change. This mixed-method study aimed to assess nutrition transitions and diet quality by comparing three geographically unique rural and urban indigenous Solomon Islands populations. Participants in rural areas sourced more energy from wild and cultivated foods; consumed a wider diversity of foods; were more likely to meet WHO recommendations of >400g of non-starchy fruits and vegetables daily; were more physically active; and had significantly lower body fat, waist circumference, and body mass index (BMI) when compared to urban populations. Urban populations were found to have a reduced ability to self-cultivate agri-food products or collect wild foods, and therefore consumed more ultra-processed foods (classified as NOVA 4) and takeout foods, and overall had less diverse diets compared to rural populations. Clear opportunities to leverage traditional knowledge and improve the cultivation and consumption of underutilized species can assist in building more sustainable and resilient food systems while ensuring that indigenous knowledge and cultural preferences are respected.