OBJECTIVES: To perform geographic contour analysis of sea and land ambulance rescue times in an archipelago subject to super typhoons; to design point-of-care testing strategies for medical emergencies and weather disasters made more intense by global warming and rising oceans; and to assess needs for prehospital testing on spatial care paths that accelerate decision making, increase efficiency, improve outcomes, and enhance standards of care in island nations. METHODS: We performed needs assessments, inspected healthcare facilities, and collected ambulance rescue times from professionals in the Bantayan Archipelago, Philippines. We mapped sea/land ambulance rescue routes and time contours. To reveal gaps, we statistically compared the fastest and slowest patient rescue times from islands/islets and barangays to the District Hospital on Bantayan Island. We developed spatial care paths (the fastest routes to care) for acute myocardial infarction, community care, and infectious diseases. We generated a compendium of prehospital diagnostic testing and integrated outcomes evidence, diagnostic needs, and public health goals to recommend point-of-care strategies that build geographic health resilience. RESULTS: We observed limited access to COVID-19 assays, absence of blood gas/pH testing for critical care support, and spatial gaps in land and airborne rescues that worsened during inclement weather and sea swells. Mean paired differences (slowest-fastest) in ambulance rescue times to the District Hospital for both islands and barangays were significant (P < 0.0001). Spatial care path analysis showed where point-of-care cardiac troponin testing should be implemented for expedited care of acute myocardial infarction. Geospatial strengths comprised distributed primary care that can be facilitated by point-of-care testing, logical interisland transfers for which decision making and triage could be accelerated with onboard diagnostics, and healthcare networks amenable to medical advances in prehospital testing that accelerate treatment. CONCLUSIONS: Point-of-care testing should be positioned upstream close to homes and island populations that have prolonged rescue time contours. Geospatially optimized point-of-need diagnostics and distributed prehospital testing have high potential to improve outcomes. These improvements will potentially decrease disparities in mortality among archipelago versus urban dwellers, help improve island public health, and enhance resilience for increasingly adverse and frequent climate change weather disasters that impact vulnerable coastal areas. [350 words].
Sea level rise (SLR) and heavy precipitation events are increasing the frequency and extent of coastal flooding, which can trigger releases of toxic chemicals from hazardous sites, many of which are in low-income communities of color. We used regression models to estimate the association between facility flood risk and social vulnerability indicators in low-lying block groups in California. We applied dasymetric mapping techniques to refine facility boundaries and population estimates and probabilistic SLR projections to estimate facilities’ future flood risk. We estimate that 423 facilities are at risk of flooding in 2100 under a high emissions scenario (RCP 8.5). One unit standard deviation increases in nonvoters, poverty rate, renters, residents of color, and linguistically isolated households were associated with a 1.5-2.2 times higher odds of the presence of an at-risk site within 1 km (ORs [95% CIs]: 2.2 [1.8, 2.8], 1.9 [1.5, 2.3], 1.7 [1.4, 1.9], 1.5 [1.2, 1.9], and 1.5 [1.2, 1.9], respectively). Among block groups near at least one at-risk site, the number of sites increased with poverty, proportion of renters and residents of color, and lower voter turnout. These results underscore the need for further research and disaster planning that addresses the differential hazards and health risks of SLR.
Innovative actions are local initiatives which leverage the interactions between the ocean and human health to reduce the risks and enhance the benefits for the stakeholders and the natural environment. These initiatives can have strong positive effects on human health and wellbeing as well as on the marine environment. We analysed 150 such innovative actions in Europe. Using a combined case study and survey approach, innovative actions were identified using interviews and content analysis of websites and compiled into a database. Quantitative data were analysed according to the Drivers, Pressures, State, Impact and Response (DPSIR) framework, guided by selected in-depth interviews. Overall, the innovative actions provided a positive impact on the health of both the ocean and humans through increasing food provision, water quality and tourism opportunities; and addressing environmental issues such as commercial fish stock depletion, pollution and climate change. Innovative actions contributed to meeting various targets of the Sustainable Development Goals (SDGs) 3, 13 and 14. These actions played a potential role ahead of and alongside policy. Some of the innovative actions may have potential to be put in place elsewhere. Such up-scaling would need to be adapted to local circumstances and could be facilitated by an innovative action exchange platform.
Vibrio vulnificus is an opportunistic bacterial pathogen, occurring in warm low-salinity waters. V. vulnificus wound infections due to seawater exposure are infrequent but mortality rates are high (~ 18%). Seawater bacterial concentrations are increasing but changing disease pattern assessments or climate change projections are rare. Here, using a 30-year database of V. vulnificus cases for the Eastern USA, changing disease distribution was assessed. An ecological niche model was developed, trained and validated to identify links to oceanographic and climate data. This model was used to predict future disease distribution using data simulated by seven Global Climate Models (GCMs) which belong to the newest Coupled Model Intercomparison Project (CMIP6). Risk was estimated by calculating the total population within 200 km of the disease distribution. Predictions were generated for different “pathways” of global socioeconomic development which incorporate projections of greenhouse gas emissions and demographic change. In Eastern USA between 1988 and 2018, V. vulnificus wound infections increased eightfold (10-80 cases p.a.) and the northern case limit shifted northwards 48 km p.a. By 2041-2060, V. vulnificus infections may expand their current range to encompass major population centres around New York (40.7°N). Combined with a growing and increasingly elderly population, annual case numbers may double. By 2081-2100 V. vulnificus infections may be present in every Eastern USA State under medium-to-high future emissions and warming. The projected expansion of V. vulnificus wound infections stresses the need for increased individual and public health awareness in these areas.
Coastal communities face escalating risks from rising sea levels and the increasing growth of vulnerable, aging populations in high-risk zones. These threats are expected to intensify as population growth and aging trends continue. In response to these challenges, this study represents a novel investigation into the synergistic impacts of demographic shifts and climate change in shaping the vulnerability of coastal communities, particularly focusing on elderly populations. This study’s primary objectives are to assess the potential impacts of these threats on vulnerable older adults and to explore effective adaptation strategies. To achieve these objectives, we used census tract data from Hawaii and the Hamilton-Perry cohort-component method to project the elderly population trends in each census tract for Honolulu in 2050. The vulnerabilities of older adults were estimated under different sea level rise level conditions and mapped according to three planning scenarios: (1) maintaining the status quo; (2) relocating or redeveloping vulnerable elderly residents to safer, low-density neighborhoods; (3) relocating or redeveloping vulnerable elderly residents to secure, high-density areas with amenities for older adults. We further evaluated transportation accessibility to emergency services in these scenarios. The findings reveal that with a projected sea level rise of 1.1 feet, the number of elderly individuals without timely access (within 8 min) to emergency and healthcare services would double by 2050. This is primarily attributed to reduced transportation access and increased aging in high-risk areas. Compared to the status quo, both relocation (or redevelopment) strategies significantly improve the vulnerable elderly population’s access to emergency and healthcare services, even without enhancements in transportation and infrastructure. Given that many developments and aging trends are yet to fully unfold, we propose that existing adaptation strategies should prioritize land use development, along with housing and transportation solutions that align with development scenarios 2 and 3, to support age-friendly activities and lifestyles. By directing population growth towards less vulnerable zones in the coming decades, we can achieve protective effects equivalent to those of future relocation efforts, but without incurring substantial protection or relocation costs.
This research paper is an attempt to define and analyse the concept of the blue economy (BE) and its implications for achieving Sustainable Development Goals (SDGs). This study covers aspects such as building a blue economy to achieve SDGs, the importance of a healthy ocean for current and future generations, maintaining the momentum to save the ocean, achievements of the United Nations (UN) conference on the Sustainable Blue Economy, and the highlights of the UN World Water Development Report 2020. This study specifically analyses the health effects and threats to biodiversity, adaptation and mitigation, improved wastewater management, prioritizing water, accessing climate funds, water and climate change, and the relationship between the blue economy and UN SDGs as well as identification of key stakeholders. This is achieved through a detailed literature review on the blue economy that identifies global organizations working on creating a blue economy, elements of the blue economy and current development efforts, United Nations Convention on the Law of the Sea, sustainability and equity, ocean governance, international law and frameworks, and improvement in governance frameworks among other issues. The methodology used attempted to develop a macro, comprehensive, and systematic aggregate database at the country level on macro parameters, namely blue economy, blue finance, BE-SDGs linkages, water development, marine sector, SDGs data on SDG-14 (life underwater), SDG-6 (access to safe drinking water and sanitation), SDG-3 (good health and well-being), and optimal management of water resources through scientific techniques, such as building several small reservoirs instead of mega projects, develop small catchment dams and protect wetlands, soil management, micro catchment development, recharging of underground aquifers thus reducing the need for large dams, which has encountered challenges due to data limitations. The results of this research study emphasize broader stakeholder consultations at the global level to resolve the issues relating to blue economy, blue finance, and ocean governance. The most important conclusion and policy implications of the study are that international organizations including the United Nations, the Asian Development Bank, and the World Bank are working towards achieving the SDGs in general, and the blue economy, blue finance, and ocean governance in particular.
The emergence of ocean and human health (OHH) science as a distinct scholarly discipline has led to increased research outputs from experts in both the natural and social sciences. Formal research on communication strategies, messaging, and campaigns related to OHH science remains limited despite its importance as part of the social processes that can make knowledge actionable. When utilized to communicate visible, local issues for targeting audiences, OHH themes hold the potential to motivate action in pursuit of solutions to environmental challenges, supplementing efforts to address large-scale, abstract, or politicized issues such as ocean acidification or climate change. Probing peer-reviewed literature from relevant areas of study, this review article outlines and reveals associations between society and the quality of coastal and marine ecosystems, as well as key themes, concepts, and findings in OHH science and environmental communication. Recommendations for future work concerning effective ocean and human health science communication are provided, creating a platform for innovative scholarship, evidence-based practice, and novel collaboration across disciplines.
