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Special Issue "Extreme Weather-Related Morbidity and Mortality: Risks and Responses"

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (15 September 2014)

Special Issue Editors

Guest Editor
Dr. Kristie L. Ebi

ClimAdapt, LLC, 424 Tyndall St., Los Altos, CA 94022, USA
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Guest Editor
Dr. Jeremy Hess

Department of Emergency Medicine, Emory University School of Medicine, 49 Jesse Hill Jr. Drive, Atlanta, GA 30303, USA
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Phone: 001-404-251-8851

Special Issue Information

Dear Colleagues,

Climate change is increasing the frequency, intensity, duration, and spatial extent of some weather and climate extremes. The associated human health risks have been only too well demonstrated recently, with significant impacts in countries across all levels of socioeconomic development. These events presented opportunities for evaluating approaches to risk assessment, communication, and management; for addressing barriers to climate change adaptation; and for recalibration of adaptation limits. Lessons learned include the importance of preparedness for extremes outside the historic coping range, having early warning and response plans that address underlying vulnerabilities as well as exposure, the critical role of coordination and inter-sectoral collaboration, and that wealth alone is insufficient to prevent adverse impacts.

Despite recent advances, public health and health care institutions need a better understanding of the vulnerability of exposed populations, particularly subgroups with higher sensitivity because of location, social and cultural factors, or biophysical factors; of approaches to characterizing and managing risks from extreme events in a changing climate; of effective techniques to anticipating and communicating shifting risks over time, particularly in the medium-term; and of appropriate responses. Evidence related to interventions that may reduce risks, including factors affecting implementation as well as intervention outcomes, is a high priority. Theoretical work, including methods for characterizing extremes such as exposures, strategies for modeling and projecting associated health impacts, and epidemiological approaches to evaluating interventions, are also important. Such enhanced understanding can inform actions to increase population and community resilience to current and future extremes.

This special issue will synthesize what is known about exposures, vulnerabilities, and the capacities to manage current and projected extreme weather and climate events, with emphasis on exposures and events other than high temperatures and heatwaves, projections exploring the extent to which climate and development could alter risk, lessons learned across regions, and best practices in transitional and transformational adaptive management.

Dr. Kristie L. Ebi
Dr. Jeremy Hess
Guest Editors

Submission

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. Papers will be published continuously (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are refereed through a peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed Open Access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs).


Keywords

  • climate variability
  • extreme weather and climate events
  • vulnerability
  • adaptation
  • adaptive capacity
  • coping capacity
  • disaster risk management
  • resilience

Published Papers (15 papers)

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Research

Open AccessArticle Temperature Variation and Heat Wave and Cold Spell Impacts on Years of Life Lost Among the Urban Poor Population of Nairobi, Kenya
Int. J. Environ. Res. Public Health 2015, 12(3), 2735-2748; doi:10.3390/ijerph120302735
Received: 16 October 2014 / Revised: 7 February 2015 / Accepted: 13 February 2015 / Published: 2 March 2015
Cited by 2 | PDF Full-text (774 KB) | HTML Full-text | XML Full-text
Abstract
Weather extremes are associated with adverse health outcomes, including mortality. Studies have investigated the mortality risk of temperature in terms of excess mortality, however, this risk estimate may not be appealing to policy makers assessing the benefits expected for any interventions to be
[...] Read more.
Weather extremes are associated with adverse health outcomes, including mortality. Studies have investigated the mortality risk of temperature in terms of excess mortality, however, this risk estimate may not be appealing to policy makers assessing the benefits expected for any interventions to be adopted. To provide further evidence of the burden of extreme temperatures, we analyzed the effect of temperature on years of life lost (YLL) due to all-cause mortality among the population in two urban informal settlements. YLL was generated based on the life expectancy of the population during the study period by applying a survival analysis approach. Association between daily maximum temperature and YLL was assessed using a distributed lag nonlinear model. In addition, cold spell and heat wave effects, as defined according to different percentiles, were investigated. The exposure-response curve between temperature and YLL was J-shaped, with the minimum mortality temperature (MMT) of 26 °C. An average temperature of 21 °C compared to the MMT was associated with an increase of 27.4 YLL per day (95% CI, 2.7–52.0 years). However, there was no additional effect for extended periods of cold spells, nor did we find significant associations between YLL to heat or heat waves. Overall, increased YLL from all-causes were associated with cold spells indicating the need for initiating measure for reducing health burdens. Full article
(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)
Open AccessArticle Evaluating the Performance of a Climate-Driven Mortality Model during Heat Waves and Cold Spells in Europe
Int. J. Environ. Res. Public Health 2015, 12(2), 1279-1294; doi:10.3390/ijerph120201279
Received: 31 October 2014 / Accepted: 19 January 2015 / Published: 23 January 2015
Cited by 3 | PDF Full-text (3417 KB) | HTML Full-text | XML Full-text
Abstract
The impact of climate change on human health is a serious concern. In particular, changes in the frequency and intensity of heat waves and cold spells are of high relevance in terms of mortality and morbidity. This demonstrates the urgent need for reliable
[...] Read more.
The impact of climate change on human health is a serious concern. In particular, changes in the frequency and intensity of heat waves and cold spells are of high relevance in terms of mortality and morbidity. This demonstrates the urgent need for reliable early-warning systems to help authorities prepare and respond to emergency situations. In this study, we evaluate the performance of a climate-driven mortality model to provide probabilistic predictions of exceeding emergency mortality thresholds for heat wave and cold spell scenarios. Daily mortality data corresponding to 187 NUTS2 regions across 16 countries in Europe were obtained from 1998–2003. Data were aggregated to 54 larger regions in Europe, defined according to similarities in population structure and climate. Location-specific average mortality rates, at given temperature intervals over the time period, were modelled to account for the increased mortality observed during both high and low temperature extremes and differing comfort temperatures between regions. Model parameters were estimated in a Bayesian framework, in order to generate probabilistic simulations of mortality across Europe for time periods of interest. For the heat wave scenario (1–15 August 2003), the model was successfully able to anticipate the occurrence or non-occurrence of mortality rates exceeding the emergency threshold (75th percentile of the mortality distribution) for 89% of the 54 regions, given a probability decision threshold of 70%. For the cold spell scenario (1–15 January 2003), mortality events in 69% of the regions were correctly anticipated with a probability decision threshold of 70%. By using a more conservative decision threshold of 30%, this proportion increased to 87%. Overall, the model performed better for the heat wave scenario. By replacing observed temperature data in the model with forecast temperature, from state-of-the-art European forecasting systems, probabilistic mortality predictions could potentially be made several months ahead of imminent heat waves and cold spells. Full article
(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)
Open AccessArticle Impacts of Tropical Cyclones and Accompanying Precipitation on Infectious Diarrhea in Cyclone Landing Areas of Zhejiang Province, China
Int. J. Environ. Res. Public Health 2015, 12(2), 1054-1068; doi:10.3390/ijerph120201054
Received: 1 November 2014 / Accepted: 16 January 2015 / Published: 22 January 2015
Cited by 3 | PDF Full-text (1211 KB) | HTML Full-text | XML Full-text
Abstract
Background: Zhejiang Province, located in southeastern China, is frequently hit by tropical cyclones. This study quantified the associations between infectious diarrhea and the seven tropical cyclones that landed in Zhejiang from 2005–2011 to assess the impacts of the accompanying precipitation on the
[...] Read more.
Background: Zhejiang Province, located in southeastern China, is frequently hit by tropical cyclones. This study quantified the associations between infectious diarrhea and the seven tropical cyclones that landed in Zhejiang from 2005–2011 to assess the impacts of the accompanying precipitation on the studied diseases. Method: A unidirectional case-crossover study design was used to evaluate the impacts of tropical storms and typhoons on infectious diarrhea. Principal component analysis (PCA) was applied to eliminate multicollinearity. A multivariate logistic regression model was used to estimate the odds ratios (ORs) and the 95% confidence intervals (CIs). Results: For all typhoons studied, the greatest impacts on bacillary dysentery and other infectious diarrhea were identified on lag 6 days (OR = 2.30, 95% CI: 1.81–2.93) and lag 5 days (OR = 3.56, 95% CI: 2.98–4.25), respectively. For all tropical storms, impacts on these diseases were highest on lag 2 days (OR = 2.47, 95% CI: 1.41–4.33) and lag 6 days (OR = 2.46, 95% CI: 1.69–3.56), respectively. The tropical cyclone precipitation was a risk factor for both bacillary dysentery and other infectious diarrhea when daily precipitation reached 25 mm and 50 mm with the largest OR = 3.25 (95% CI: 1.45–7.27) and OR = 3.05 (95% CI: 2.20–4.23), respectively. Conclusions: Both typhoons and tropical storms could contribute to an increase in risk of bacillary dysentery and other infectious diarrhea in Zhejiang. Tropical cyclone precipitation may also be a risk factor for these diseases when it reaches or is above 25 mm and 50 mm, respectively. Public health preventive and intervention measures should consider the adverse health impacts from tropical cyclones. Full article
(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)
Open AccessArticle Trends in Water Level and Flooding in Dhaka, Bangladesh and Their Impact on Mortality
Int. J. Environ. Res. Public Health 2015, 12(2), 1196-1215; doi:10.3390/ijerph120201196
Received: 17 October 2014 / Accepted: 16 January 2015 / Published: 22 January 2015
Cited by 3 | PDF Full-text (3228 KB) | HTML Full-text | XML Full-text
Abstract
Climate change is expected to impact flooding in many highly populated coastal regions, including Dhaka (Bangladesh), which is currently among the fastest growing cities in the world. In the past, high mortality counts have been associated with extreme flood events. We first analyzed
[...] Read more.
Climate change is expected to impact flooding in many highly populated coastal regions, including Dhaka (Bangladesh), which is currently among the fastest growing cities in the world. In the past, high mortality counts have been associated with extreme flood events. We first analyzed daily water levels of the past 100 years in order to detect potential shifts in extremes. A distributed lag non-linear model was then used to examine the connection between water levels and mortality. Results indicate that for the period of 2003–2007, which entails two major flood events in 2004 and 2007, high water levels do not lead to a significant increase in relative mortality, which indicates a good level of adaptation and capacity to cope with flooding. However, following low water levels, an increase in mortality could be found. As our trend analysis of past water levels shows that minimum water levels have decreased during the past 100 years, action should be taken to ensure that the exposed population is also well-adapted to drought. Full article
(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)
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Open AccessArticle Public Health Adaptation to Climate Change in Canadian Jurisdictions
Int. J. Environ. Res. Public Health 2015, 12(1), 623-651; doi:10.3390/ijerph120100623
Received: 23 September 2014 / Accepted: 22 December 2014 / Published: 12 January 2015
Cited by 5 | PDF Full-text (1420 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Climate change poses numerous risks to the health of Canadians. Extreme weather events, poor air quality, and food insecurity in northern regions are likely to increase along with the increasing incidence and range of infectious diseases. In this study we identify and characterize
[...] Read more.
Climate change poses numerous risks to the health of Canadians. Extreme weather events, poor air quality, and food insecurity in northern regions are likely to increase along with the increasing incidence and range of infectious diseases. In this study we identify and characterize Canadian federal, provincial, territorial and municipal adaptation to these health risks based on publically available information. Federal health adaptation initiatives emphasize capacity building and gathering information to address general health, infectious disease and heat-related risks. Provincial and territorial adaptation is varied. Quebec is a leader in climate change adaptation, having a notably higher number of adaptation initiatives reported, addressing almost all risks posed by climate change in the province, and having implemented various adaptation types. Meanwhile, all other Canadian provinces and territories are in the early stages of health adaptation. Based on publically available information, reported adaptation also varies greatly by municipality. The six sampled Canadian regional health authorities (or equivalent) are not reporting any adaptation initiatives. We also find little relationship between the number of initiatives reported in the six sampled municipalities and their provinces, suggesting that municipalities are adapting (or not adapting) autonomously. Full article
(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)
Open AccessArticle Water-Borne Diseases and Extreme Weather Events in Cambodia: Review of Impacts and Implications of Climate Change
Int. J. Environ. Res. Public Health 2015, 12(1), 191-213; doi:10.3390/ijerph120100191
Received: 10 September 2014 / Accepted: 10 December 2014 / Published: 23 December 2014
Cited by 5 | PDF Full-text (1360 KB) | HTML Full-text | XML Full-text
Abstract
Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence;
[...] Read more.
Cambodia is prone to extreme weather events, especially floods, droughts and typhoons. Climate change is predicted to increase the frequency and intensity of such events. The Cambodian population is highly vulnerable to the impacts of these events due to poverty; malnutrition; agricultural dependence; settlements in flood-prone areas, and public health, governance and technological limitations. Yet little is known about the health impacts of extreme weather events in Cambodia. Given the extremely low adaptive capacity of the population, this is a crucial knowledge gap. A literature review of the health impacts of floods, droughts and typhoons in Cambodia was conducted, with regional and global information reviewed where Cambodia-specific literature was lacking. Water-borne diseases are of particular concern in Cambodia, in the face of extreme weather events and climate change, due to, inter alia, a high pre-existing burden of diseases such as diarrhoeal illness and a lack of improved sanitation infrastructure in rural areas. A time-series analysis under quasi-Poisson distribution was used to evaluate the association between floods and diarrhoeal disease incidence in Cambodian children between 2001 and 2012 in 16 Cambodian provinces. Floods were significantly associated with increased diarrhoeal disease in two provinces, while the analysis conducted suggested a possible protective effect from toilets and piped water. Addressing the specific, local pre-existing vulnerabilities is vital to promoting population health resilience and strengthening adaptive capacity to extreme weather events and climate change in Cambodia. Full article
(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)
Open AccessArticle The Excess Heat Factor: A Metric for Heatwave Intensity and Its Use in Classifying Heatwave Severity
Int. J. Environ. Res. Public Health 2015, 12(1), 227-253; doi:10.3390/ijerph120100227
Received: 16 September 2014 / Accepted: 17 December 2014 / Published: 23 December 2014
Cited by 16 | PDF Full-text (2077 KB) | HTML Full-text | XML Full-text
Abstract
Heatwaves represent a significant natural hazard in Australia, arguably more hazardous to human life than bushfires, tropical cyclones and floods. In the 2008/2009 summer, for example, many more lives were lost to heatwaves than to that summer’s bushfires which were among the worst
[...] Read more.
Heatwaves represent a significant natural hazard in Australia, arguably more hazardous to human life than bushfires, tropical cyclones and floods. In the 2008/2009 summer, for example, many more lives were lost to heatwaves than to that summer’s bushfires which were among the worst in the history of the Australian nation. For many years, these other forms of natural disaster have received much greater public attention than heatwaves, although there are some signs of change. We propose a new index, called the excess heat factor (EHF) for use in Australian heatwave monitoring and forecasting. The index is based on a three-day-averaged daily mean temperature (DMT), and is intended to capture heatwave intensity as it applies to human health outcomes, although its usefulness is likely to be much broader and with potential for international applicability. The index is described and placed in a climatological context in order to derive heatwave severity. Heatwave severity, as characterised by the climatological distribution of heatwave intensity, has been used to normalise the climatological variation in heatwave intensity range across Australia. This methodology was used to introduce a pilot national heatwave forecasting service for Australia during the 2013/2014 summer. Some results on the performance of the service are presented. Full article
(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)
Open AccessArticle Developing a Heatwave Early Warning System for Sweden: Evaluating Sensitivity of Different Epidemiological Modelling Approaches to Forecast Temperatures
Int. J. Environ. Res. Public Health 2015, 12(1), 254-267; doi:10.3390/ijerph120100254
Received: 30 September 2014 / Accepted: 18 December 2014 / Published: 23 December 2014
Cited by 4 | PDF Full-text (3086 KB) | HTML Full-text | XML Full-text
Abstract
Over the last two decades a number of heatwaves have brought the need for heatwave early warning systems (HEWS) to the attention of many European governments. The HEWS in Europe are operating under the assumption that there is a high correlation between observed
[...] Read more.
Over the last two decades a number of heatwaves have brought the need for heatwave early warning systems (HEWS) to the attention of many European governments. The HEWS in Europe are operating under the assumption that there is a high correlation between observed and forecasted temperatures. We investigated the sensitivity of different temperature mortality relationships when using forecast temperatures. We modelled mortality in Stockholm using observed temperatures and made predictions using forecast temperatures from the European Centre for Medium-range Weather Forecasts to assess the sensitivity. We found that the forecast will alter the expected future risk differently for different temperature mortality relationships. The more complex models seemed more sensitive to inaccurate forecasts. Despite the difference between models, there was a high agreement between models when identifying risk-days. We find that considerations of the accuracy in temperature forecasts should be part of the design of a HEWS. Currently operating HEWS do evaluate their predictive performance; this information should also be part of the evaluation of the epidemiological models that are the foundation in the HEWS. The most accurate description of the relationship between high temperature and mortality might not be the most suitable or practical when incorporated into a HEWS. Full article
(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)
Open AccessArticle Health Care Facilities Resilient to Climate Change Impacts
Int. J. Environ. Res. Public Health 2014, 11(12), 13097-13116; doi:10.3390/ijerph111213097
Received: 5 June 2014 / Revised: 20 November 2014 / Accepted: 21 November 2014 / Published: 16 December 2014
Cited by 2 | PDF Full-text (687 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are
[...] Read more.
Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator’s guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change. Full article
(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)
Open AccessArticle A Survey of African American Physicians on the Health Effects of Climate Change
Int. J. Environ. Res. Public Health 2014, 11(12), 12473-12485; doi:10.3390/ijerph111212473
Received: 24 September 2014 / Revised: 28 October 2014 / Accepted: 17 November 2014 / Published: 28 November 2014
Cited by 5 | PDF Full-text (694 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The U.S. National Climate Assessment concluded that climate change is harming the health of many Americans and identified people in some communities of color as particularly vulnerable to these effects. In Spring 2014, we surveyed members of the National Medical Association, a society
[...] Read more.
The U.S. National Climate Assessment concluded that climate change is harming the health of many Americans and identified people in some communities of color as particularly vulnerable to these effects. In Spring 2014, we surveyed members of the National Medical Association, a society of African American physicians who care for a disproportionate number of African American patients, to determine whether they were seeing the health effects of climate change in their practices; the response rate was 30% (n = 284). Over 86% of respondents indicated that climate change was relevant to direct patient care, and 61% that their own patients were already being harmed by climate change moderately or a great deal. The most commonly reported health effects were injuries from severe storms, floods, and wildfires (88%), increases in severity of chronic disease due to air pollution (88%), and allergic symptoms from prolonged exposure to plants or mold (80%). The majority of survey respondents support medical training, patient and public education regarding the impact of climate change on health, and advocacy by their professional society; nearly all respondents indicated that the US should invest in significant efforts to protect people from the health effects of climate change (88%), and to reduce the potential impacts of climate change (93%). These findings suggest that African American physicians are currently seeing the health impacts of climate change among their patients, and that they support a range of responses by the medical profession, and public policy makers, to prevent further harm. Full article
(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)
Open AccessArticle Association of Weekly Suicide Rates with Temperature Anomalies in Two Different Climate Types
Int. J. Environ. Res. Public Health 2014, 11(11), 11627-11644; doi:10.3390/ijerph111111627
Received: 14 August 2014 / Revised: 27 October 2014 / Accepted: 7 November 2014 / Published: 13 November 2014
Cited by 9 | PDF Full-text (2751 KB) | HTML Full-text | XML Full-text
Abstract
Annual suicide deaths outnumber the total deaths from homicide and war combined. Suicide is a complex behavioral endpoint, and a simple cause-and-effect model seems highly unlikely, but relationships with weather could yield important insight into the biopsychosocial mechanisms involved in suicide deaths. This
[...] Read more.
Annual suicide deaths outnumber the total deaths from homicide and war combined. Suicide is a complex behavioral endpoint, and a simple cause-and-effect model seems highly unlikely, but relationships with weather could yield important insight into the biopsychosocial mechanisms involved in suicide deaths. This study has been designed to test for a relationship between air temperature and suicide frequency that is consistent enough to offer some predictive abilities. Weekly suicide death totals and anomalies from Toronto, Ontario, Canada (1986–2009) and Jackson, Mississippi, USA (1980–2006) are analyzed for relationships by using temperature anomaly data and a distributed lag nonlinear model. For both analysis methods, anomalously cool weeks show low probabilities of experiencing high-end suicide totals while warmer weeks are more likely to experience high-end suicide totals. This result is consistent for Toronto and Jackson. Weekly suicide totals demonstrate a sufficient association with temperature anomalies to allow some prediction of weeks with or without increased suicide frequency. While this finding alone is unlikely to have immediate clinical implications, these results are an important step toward clarifying the biopsychosocial mechanisms of suicidal behavior through a more nuanced understanding of the relationship between temperature and suicide. Full article
(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)
Open AccessArticle Heat-Related Mortality in a Warming Climate: Projections for 12 U.S. Cities
Int. J. Environ. Res. Public Health 2014, 11(11), 11371-11383; doi:10.3390/ijerph111111371
Received: 16 September 2014 / Revised: 20 October 2014 / Accepted: 27 October 2014 / Published: 31 October 2014
Cited by 9 | PDF Full-text (794 KB) | HTML Full-text | XML Full-text
Abstract
Heat is among the deadliest weather-related phenomena in the United States, and the number of heat-related deaths may increase under a changing climate, particularly in urban areas. Regional adaptation planning is unfortunately often limited by the lack of quantitative information on potential future
[...] Read more.
Heat is among the deadliest weather-related phenomena in the United States, and the number of heat-related deaths may increase under a changing climate, particularly in urban areas. Regional adaptation planning is unfortunately often limited by the lack of quantitative information on potential future health responses. This study presents an assessment of the future impacts of climate change on heat-related mortality in 12 cities using 16 global climate models, driven by two scenarios of greenhouse gas emissions. Although the magnitude of the projected heat effects was found to differ across time, cities, climate models and greenhouse pollution emissions scenarios, climate change was projected to result in increases in heat-related fatalities over time throughout the 21st century in all of the 12 cities included in this study. The increase was more substantial under the high emission pathway, highlighting the potential benefits to public health of reducing greenhouse gas emissions. Nearly 200,000 heat-related deaths are projected to occur in the 12 cities by the end of the century due to climate warming, over 22,000 of which could be avoided if we follow a low GHG emission pathway. The presented estimates can be of value to local decision makers and stakeholders interested in developing strategies to reduce these impacts and building climate change resilience. Full article
(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)
Open AccessArticle Perceived Adverse Health Effects of Heat and Their Determinants in Deprived Neighbourhoods: A Cross-Sectional Survey of Nine Cities in Canada
Int. J. Environ. Res. Public Health 2014, 11(11), 11028-11053; doi:10.3390/ijerph111111028
Received: 22 July 2014 / Revised: 26 September 2014 / Accepted: 7 October 2014 / Published: 24 October 2014
Cited by 4 | PDF Full-text (705 KB) | HTML Full-text | XML Full-text
Abstract
This study identifies several characteristics of individuals who report their physical and/or mental health as being adversely affected by summertime heat and humidity, within the most disadvantaged neighbourhoods of the nine largest cities of Québec (Canada). The study is cross-sectional by stratified representative
[...] Read more.
This study identifies several characteristics of individuals who report their physical and/or mental health as being adversely affected by summertime heat and humidity, within the most disadvantaged neighbourhoods of the nine largest cities of Québec (Canada). The study is cross-sectional by stratified representative sample; 3485 people were interviewed in their residence. The prevalence of reported impacts was 46%, mostly physical health. Female gender and long-term medical leave are two impact risk indicators in people <65 years of age. Low income and air conditioning at home are risk indicators at all ages. Results for having ≥2 diagnoses of chronic diseases, particularly for people self-describing as in poor health (odds ratio, OR<65 = 5.6; OR≥65 = 4.2), and perceiving daily stress, are independent of age. The prevalence of reported heat-related health impacts is thus very high in those inner cities, with notable differences according to age, stress levels and long-term medical leave, previously unmentioned in the literature. Finally, the total number of pre-existing medical conditions seems to be a preponderant risk factor. This study complements the epidemiologic studies based on mortality or severe morbidity and shows that the heat-related burden of disease appears very important in those communities, affecting several subgroups differentially. Full article
(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)
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Open AccessArticle Managing the Health Impacts of Drought in Brazil
Int. J. Environ. Res. Public Health 2014, 11(10), 10737-10751; doi:10.3390/ijerph111010737
Received: 6 August 2014 / Revised: 1 October 2014 / Accepted: 7 October 2014 / Published: 16 October 2014
Cited by 8 | PDF Full-text (1228 KB) | HTML Full-text | XML Full-text
Abstract
Drought is often a hidden risk with the potential to become a silent public health disaster. It is difficult to define precisely when it starts or when it is over, and although it is a climatological event, its impacts depend on other human
[...] Read more.
Drought is often a hidden risk with the potential to become a silent public health disaster. It is difficult to define precisely when it starts or when it is over, and although it is a climatological event, its impacts depend on other human activities, and are intensified by social vulnerability. In Brazil, half of all natural disaster events are drought related, and they cause half of the impacts in number of affected persons. One large affected area is the semiarid region of Brazil’s Northeast, which has historically been affected by drought. Many health and well-being indicators in this region are worse than the rest of the country, based on an analysis of 5565 municipalities using available census data for 1991, 2000 and 2010, which allowed separating the 1133 municipalities affected by drought in order to compare them with the rest of the country. Although great progress has been made in reducing social and economic vulnerability, climate change and the expected changes in the semiarid region in the next few decades call for a review of current programs, particularly in public health, and the planning of new interventions with local communities. This study reviews the literature, analyzes available data and identifies possible actions and actors. The aim is to ensure there will be sufficient and sustainable local adaptive capacity and resilience, for a population already living within the limits of environmental vulnerability. Full article
(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)
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Open AccessArticle Development and Implementation of South Asia’s First Heat-Health Action Plan in Ahmedabad (Gujarat, India)
Int. J. Environ. Res. Public Health 2014, 11(4), 3473-3492; doi:10.3390/ijerph110403473
Received: 26 January 2014 / Revised: 26 February 2014 / Accepted: 4 March 2014 / Published: 25 March 2014
Cited by 7 | PDF Full-text (771 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Recurrent heat waves, already a concern in rapidly growing and urbanizing South Asia, will very likely worsen in a warming world. Coordinated adaptation efforts can reduce heat’s adverse health impacts, however. To address this concern in Ahmedabad (Gujarat, India), a coalition has been
[...] Read more.
Recurrent heat waves, already a concern in rapidly growing and urbanizing South Asia, will very likely worsen in a warming world. Coordinated adaptation efforts can reduce heat’s adverse health impacts, however. To address this concern in Ahmedabad (Gujarat, India), a coalition has been formed to develop an evidence-based heat preparedness plan and early warning system. This paper describes the group and initial steps in the plan’s development and implementation. Evidence accumulation included extensive literature review, analysis of local temperature and mortality data, surveys with heat-vulnerable populations, focus groups with health care professionals, and expert consultation. The findings and recommendations were encapsulated in policy briefs for key government agencies, health care professionals, outdoor workers, and slum communities, and synthesized in the heat preparedness plan. A 7-day probabilistic weather forecast was also developed and is used to trigger the plan in advance of dangerous heat waves. The pilot plan was implemented in 2013, and public outreach was done through training workshops, hoardings/billboards, pamphlets, and print advertisements. Evaluation activities and continuous improvement efforts are ongoing, along with plans to explore the program’s scalability to other Indian cities, as Ahmedabad is the first South Asian city to address heat-health threats comprehensively. Full article
(This article belongs to the Special Issue Extreme Weather-Related Morbidity and Mortality: Risks and Responses)

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