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Invited Perspective: Most Affected by Climate Change; Least Studied

2021; National Institute of Environmental Health Sciences; Volume: 129; Issue: 11 Linguagem: Inglês

10.1289/ehp10384

1552-9924

Kristie L. Ebi, Stanley Lüchters,

Air Quality and Health Impacts

Vol. 129, No. 11 Invited PerspectiveOpen AccessInvited Perspective: Most Affected by Climate Change; Least Studiedis companion ofEnvironmental Displacement and Mental Well-Being in Banjarnegara, Indonesia Kristie L. Ebi and Stanley Luchters Kristie L. Ebi Address correspondence to Kristie L. Ebi, Center for Health and the Global Environment, University of Washington, Seattle, WA 98105 USA. Email: E-mail Address: [email protected] https://orcid.org/0000-0003-4746-8236 Center for Health and the Global Environment, University of Washington, Seattle, Washington, USA and Stanley Luchters https://orcid.org/0000-0001-5235-5629 Department of Population Health, Aga Khan University, Nairobi, Kenya Published:8 November 2021CID: 111301https://doi.org/10.1289/EHP10384Cited by:2AboutSectionsPDF ToolsDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InReddit Each country that is a signatory to the Paris Agreement under the United Nations Framework Convention on Climate Change (UNFCCC) produces a nationally determined contribution (NDC), outlining national plans for mitigating and adapting to climate change. The NDCs of low- and middle-income countries (LMICs) have greater coverage of the health risks of and responses to climate change, in terms of risks, adaptation, mitigation, co-benefits, and trade-offs, whereas higher-income countries tend to focus on energy, the economy, and related sectors (Dasandi et al. 2021). This difference reflects the expectation that the largest health risks of climate change will occur in LMICs, where rising ambient temperatures, changing precipitation patterns, and rising sea levels are increasingly affecting air, water, and food systems. Such changes will affect the geographic and seasonal patterns of major causes of morbidity and mortality—particularly undernutrition, diarrheal diseases, malaria, dengue, and injuries—and will disproportionately affect the most vulnerable population groups, such as the lowest-income families, older individuals, pregnant women, and neonates (Smith et al. 2014; Watts et al. 2015). The timeliness and effectiveness of adaptation and mitigation efforts will determine the extent of increase in risks with additional climate change (Ebi and Hess 2020). There is a critical need for more evidence on effective locally led adaptation and mitigation interventions.Although substantial proportions of current and future climate-related adverse health outcomes are preventable, research and implementation funding are well below what is needed to minimize morbidity and mortality (Ebi et al. 2016; Green et al. 2017), with very little published research evidence from LMICs. Using machine learning, a comprehensive global mapping of English-language research published 1 January 2013–9 April 2020 predicted there were nearly 16,000 studies on climate and health (Berrang-Ford et al. 2021). Overall, 79% of studies that identified place names focused on high- and upper middle–income nations, particularly China. The numbers of publications from high-income countries were two times greater than from lower middle–income countries and close to 10 times those from low-income nations. For example, focusing just on the impact of high ambient temperatures on health, a review of epidemiological studies in LMICs from January 1980 to August 2018 identified 146 studies, of which 82 were conducted in China, 9 in other countries of East Asia and the Pacific, 12 in South Asia, 10 in sub-Saharan Africa, 9 in the Middle East and North Africa, and 7 each in Latin America and Europe (Green et al. 2019). More than 92% reported positive associations, noting that older people, women, and individuals within low socioeconomic brackets were the most vulnerable. Developing efficient and effective heat action plans is urgently needed yet requires more robust evidence.Burrows et al. (2021) contributes to the meager evidence of the extent to which climate change is affecting the mental well-being of populations in LMICs. In this study, individuals displaced by landslides were more likely than those not displaced to self-report improvements in several aspects of mental well-being. Although not providing the final word, the research importantly adds to our understanding of the complex nature, duration, and extent to which landslides and other climate- and weather-related events affect health and well-being in these communities, directly and indirectly. More, and more rigorous, research is needed to create a deeper understanding of the challenges and opportunities to effectively plan for a world with more landslides with additional climate change.The broad research agenda in climate change and health includes quantifying the burden of climate-sensitive health outcomes, and projecting risks at spatial and temporal scales useful for decision-making, under a range of climate and development scenarios. Research needs to be conducted in the context of other drivers of climate-sensitive health outcomes, such as population growth and aging, urbanization, and socioeconomic change. Climate change can also disrupt provision of and access to health care, with consequences for human health. Locally relevant adaptation and mitigation interventions, especially protecting the most vulnerable, need to be developed and evaluated. Research is needed to inform developing, implementing, and evaluating strategies, policies, and programs to proactively prepare for and manage health risks that will evolve with climate change and development. The health co-benefits of mitigation policies and technologies also need to be quantified.The UNFCCC recognizes climate change as a problem with common but differentiated responsibilities; everyone is responsible for climate change (United Nations 1992). Because the impacts are inequitably distributed across communities and countries, high-income countries agreed to lead on providing resources to support adaptation and mitigation. Funding increases for climate change and health research from Wellcome Trust, Horizon Europe, the U.S. National Institutes of Health, and others should develop and strengthen research capacity in LMICs and build it through South–South and South–North partnerships, knowledge exchanges, and research implementation. The need is urgent because climate change is already damaging health and well-being, with greater impacts on vulnerable populations in LMICs who have contributed the least to the largest challenge of this century.ReferencesBerrang-Ford L, Sietsma AJ, Callaghan M, Minx JC, Scheelbeek PFD, Haddaway NR, et al.2021. Systematic mapping of global research on climate and health: a machine learning review. Lancet Planet Health 5(8):e514–e525, PMID: 34270917, 10.1016/S2542-5196(21)00179-0. Crossref, Medline, Google ScholarBurrows K, Pelupessy DC, Khoshnood K, Bell ML. 2021. Environmental displacement and mental well-being in Banjarnegara, Indonesia. Environ Health Perspect 129(11):117002, 10.1289/EHP9391. Link, Google ScholarDasandi N, Graham H, Lampard P, Jankin Mikhaylov S. 2021. Engagement with health in national climate change commitments under the Paris Agreement: a global mixed-methods analysis of the nationally determined contributions. 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Related articlesEnvironmental Displacement and Mental Well-Being in Banjarnegara, Indonesia8 November 2021Environmental Health Perspectives Vol. 129, No. 11 November 2021Metrics About Article Metrics Publication History Manuscript received24 September 2021Manuscript revised30 September 2021Manuscript accepted4 October 2021Originally published8 November 2021 Financial disclosuresPDF download License information EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted. Note to readers with disabilities EHP strives to ensure that all journal content is accessible to all readers. However, some figures and Supplemental Material published in EHP articles may not conform to 508 standards due to the complexity of the information being presented. If you need assistance accessing journal content, please contact [email protected]. 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