Development of key indicators to quantify the health impacts of climate change on Canadians

Climate-related health impact indicators for public health surveillance in a changing climate: a systematic review and local suitability analysis

Climate change challenges public health. Effective management of climate-related health risks relies on robust public health surveillance (PHS) and population health indicators. Despite existing global and country-specific indicators, their integration into local PHS systems is limited, impacting decision-making. We conducted a systematic review examining population health indicators relevant to climate change impacts and their suitability for national PHS systems. Guided by a registered protocol, we searched multiple databases and included 41 articles. Of these, 35 reported morbidity indicators, and 39 reported mortality indicators. Using Chile as a case study, we identified three sets of indicators for the Chilean PHS. The high-priority set included vector-, food-, and water-borne diseases, as well as temperature-related health outcomes indicators due to their easy integration into existing PHS systems. This review highlights the importance of population health indicators in monitoring climate-related health impacts, emphasising the need for local contextual factors to guide indicator selection.

Funding

This research project was partly funded by ANID Chile and University College London. None of these sources had any involvement in the research conceptualisation, design, or interpretation of the results.

Understanding Flood Risk Perception: A Case Study from Canada

In recent years, understanding and improving the perception of flood risk has become an important aspect of flood risk management and flood risk reduction policies. The aim of this study was to explore perceptions of flood risk in the Petite Nation River watershed, located in southern Quebec, Canada. A survey was conducted with 130 residents living on a floodplain in this river watershed, which had been affected by floods in the spring of 2017. Participants were asked about different aspects related to flood risk, such as the flood hazard experience, the physical changes occurring in the environment, climate change, information accessibility, flood risk governance, adaptation measures, and finally the perception of losses. An analysis of these factors provided perspectives for improving flood risk communication and increasing the public awareness of flood risk. The results indicated that the analyzed aspects are potentially important in terms of risk perception and showed that the flood risk perceptions varied for each aspect analyzed. In general, the information regarding flood risk management is available and generally understandable, and the level of confidence was good towards most authorities. However, the experiences of flood risk and the consequences of climate change on floods were not clear among the respondents. Regarding the adaptation measures, the majority of participants tended to consider non-structural adaptation measures as being more relevant than structural ones. Moreover, the long-term consequences of flooding on property values are of highest concern. These results provide a snapshot of citizens’ risk perceptions and their opinions on topics that are directly related to such risks.

Indicators to Guide and Monitor Climate Change Adaptation in the US Pacific Northwest

Objectives. To develop a set of indicators to guide and monitor climate change adaptation in US state and local health departments.Methods. We performed a narrative review of literature on indicators of climate change adaptation and public health service capacity, mapped the findings onto activities grouped by the Centers for Disease Control and Prevention's Ten Essential Services, and drafted potential indicators to discuss with practitioners. We then refined the indicators after key informant interviews with 17 health department officials in the US Pacific Northwest in fall 2018.Results. Informants identified a need for clarity regarding state and local public health's role in climate change adaptation, integration of adaptation into existing programs, and strengthening of communication, partnerships, and response capacity to increase resilience. We propose a set of climate change indicators applicable for state and local health departments.Conclusions. With additional context-specific refinement, the proposed indicators can aid agencies in tracking adaptation efforts. The generalizability, robustness, and relevance of the proposed indicators should be explored in other settings with a broader set of stakeholders.

Summary of the underlying dataset to assist in tracking resilience of rural agricultural communities

A list of indicators that can be used to track resilience of agricultural communities is presented in this brief. The provided data set covers a unique overview of policy-relevant indicators based on data on climate change impacts, vulnerability, adaptation, agriculture and rural development. This data is grouped into six critical sectors that are crucial for policy-makers to track resilience. The data is transferable and can be adjusted to different communities as the listed definitions can be modified to account for the specific local conditions. The indicators were used to identify a set of resilience indicators for rural agricultural communities in Ontario Canada (for details see “An Indicator Set to Track Resilience to Climate Change in Agriculture: A policy-maker׳s perspective” [1]).

Human infectious diseases and the changing climate in the Arctic

Climatic factors, especially temperature, precipitation, and humidity play an important role in disease transmission. As the Arctic changes at an unprecedented rate due to climate change, understanding how climatic factors and climate change affect infectious disease rates is important for minimizing human and economic costs. The purpose of this systematic review was to compile recent studies in the field and compare the results to a previously published review. English language searches were conducted in PubMed, ScienceDirect, Scopus, and PLOS One. Russian language searches were conducted in the Scientific Electronic Library "eLibrary.ru". This systematic review yielded 22 articles (51%) published in English and 21 articles (49%) published in Russian since 2012. Articles about zoonotic and vector-borne diseases accounted for 67% (n = 29) of the review. Tick-borne diseases, tularemia, anthrax, and vibriosis were the most researched diseases likely to be impacted by climatic factors in the Arctic. Increased temperature and precipitation are predicted to have the greatest impact on infectious diseases in the Arctic.

Monitoring and Evaluation Indicators for Climate Change-Related Health Impacts, Risks, Adaptation, and Resilience

Climate change poses a range of current and future health risks that health professionals need to understand, track, and manage. However, conventional monitoring and evaluation (M&E) as practiced in the health sector, including the use of indicators, does not adequately serve this purpose. Improved indicators are needed in three broad categories: (1) vulnerability and exposure to climate-related hazards; (2) current impacts and projected risks; and (3) adaptation processes and health system resilience. These indicators are needed at the population level and at the health systems level (including clinical care and public health). Selected indicators must be sensitive, valid, and useful. And they must account for uncertainties about the magnitude and pattern of climate change; the broad range of upstream drivers of climate-sensitive health outcomes; and the complexities of adaptation itself, including institutional learning and knowledge management to inform iterative risk management. Barriers and constraints to implementing such indicators must be addressed, and lessons learned need to be added to the evidence base. This paper describes an approach to climate and health indicators, including characteristics of the indicators, implementation, and research needs.

Climate Change and Public Health Surveillance: Toward a Comprehensive Strategy

CONTEXT

Climate change poses a host of serious threats to human health that robust public health surveillance systems can help address. It is unknown, however, whether existing surveillance systems in the United States have adequate capacity to serve that role, nor what actions may be needed to develop adequate capacity.

OBJECTIVE

Our goals were to review efforts to assess and strengthen the capacity of public health surveillance systems to support health-related adaptation to climate change in the United States and to determine whether additional efforts are warranted.

METHODS

Building on frameworks issued by the Intergovernmental Panel on Climate Change and the Centers for Disease Control and Prevention, we specified 4 core components of public health surveillance capacity relevant to climate change health threats. Using standard methods, we next identified and analyzed multiple assessments of the existing, relevant capacity of public health surveillance systems as well as attempts to improve that capacity. We also received information from selected national public health associations.

FINDINGS

Multiple federal, state, and local public health agencies, professional associations, and researchers have made valuable, initial efforts to assess and strengthen surveillance capacity. These efforts, however, have been made by entities working independently and without the benefit of a shared conceptual framework or strategy. Their principal focus has been on identifying suitable indicators and data sources largely to the exclusion of other core components of surveillance capacity.

CONCLUSIONS

A more comprehensive and strategic approach is needed to build the public health surveillance capacity required to protect the health of Americans in a world of rapidly evolving climate change. Public health practitioners and policy makers at all levels can use the findings and issues reviewed in this article as they lead design and execution of a coordinated, multisector strategic plan to create and sustain that capacity.

Quantification of Rotavirus Diarrheal Risk Due to Hydroclimatic Extremes Over South Asia: Prospects of Satellite-Based Observations in Detecting Outbreaks

Rotavirus is the most common cause of diarrheal disease among children under 5. Especially in South Asia, rotavirus remains the leading cause of mortality in children due to diarrhea. As climatic extremes and safe water availability significantly influence diarrheal disease impacts in human populations, hydroclimatic information can be a potential tool for disease preparedness. In this study, we conducted a multivariate temporal and spatial assessment of 34 climate indices calculated from ground and satellite Earth observations to examine the role of temperature and rainfall extremes on the seasonality of rotavirus transmission in Bangladesh. We extracted rainfall data from the Global Precipitation Measurement and temperature data from the Moderate Resolution Imaging Spectroradiometer sensors to validate the analyses and explore the potential of a satellite-based seasonal forecasting model. Our analyses found that the number of rainy days and nighttime temperature range from 16°C to 21°C are particularly influential on the winter transmission cycle of rotavirus. The lower number of wet days with suitable cold temperatures for an extended time accelerates the onset and intensity of the outbreaks. Temporal analysis over Dhaka also suggested that water logging during monsoon precipitation influences rotavirus outbreaks during a summer transmission cycle. The proposed model shows lag components, which allowed us to forecast the disease outbreaks 1 to 2 months in advance. The satellite data-driven forecasts also effectively captured the increased vulnerability of dry-cold regions of the country, compared to the wet-warm regions.

Evidence for genetic hybridization between Ixodes scapularis and Ixodes cookei

Ixodes scapularis Say, 1821 (the black-legged tick) is becoming established in Canada. The northwards expansion of I. scapularis leads to contact between I. scapularis and Ixodes cookei Packard, 1869, a well-established tick species in Eastern Canada. Examination of I. cookei and I. scapularis collected from New Brunswick revealed ticks with ambiguous morphologies, with either a mixture or intermediate traits typical of I. scapularis and I. cookei, including in characteristics typically used as species identifiers. Genetic analysis to determine if these ticks represent hybrids revealed that four had I. cookei derived mitochondrial DNA but I. scapularis nuclear DNA. In one case, the nuclear sequence showed evidence of heterozygosity for I. scapularis and I. cookei sequences, whereas in the others, the nuclear DNA appeared to be entirely derived from I. scapularis. These data strongly suggest genetic hybridization between these two species. Ixodes cookei and hybrid ticks were readily collected from humans and companion animals and specimens infected with Borrelia burgdorferi Johnson et al., 1984, the causative agent of Lyme disease, were identified. These findings raise the issue of genetic introgression of I. scapularis genes into I. cookei and warrant reassessment of the capacity of I. cookei and I. cookei × I. scapularis hybrids to vector Borrelia infection.

Developing Health-Related Indicators of Climate Change: Australian Stakeholder Perspectives

Climate-related health indicators are potentially useful for tracking and predicting the adverse public health effects of climate change, identifying vulnerable populations, and monitoring interventions. However, there is a need to understand stakeholders’ perspectives on the identification, development, and utility of such indicators. A qualitative approach was used, comprising semi-structured interviews with key informants and service providers from government and non-government stakeholder organizations in South Australia. Stakeholders saw a need for indicators that could enable the monitoring of health impacts and time trends, vulnerability to climate change, and those which could also be used as communication tools. Four key criteria for utility were identified, namely robust and credible indicators, specificity, data availability, and being able to be spatially represented. The variability of risk factors in different regions, lack of resources, and data and methodological issues were identified as the main barriers to indicator development. This study demonstrates a high level of stakeholder awareness of the health impacts of climate change, and the need for indicators that can inform policy makers regarding interventions.

Climate Change, Drought and Human Health in Canada

Droughts have been recorded all across Canada and have had significant impacts on individuals and communities. With climate change, projections suggest an increasing risk of drought in Canada, particularly in the south and interior. However, there has been little research on the impacts of drought on human health and the implications of a changing climate. A review of the Canadian, U.S. and international literature relevant to the Canadian context was conducted to better define these impacts and adaptations available to protect health. Drought can impact respiratory health, mental health, illnesses related to exposure to toxins, food/water security, rates of injury and infectious diseases (including food-, water- and vector-borne diseases). A range of direct and indirect adaptation (e.g., agricultural adaptation) options exist to cope with drought. Many have already been employed by public health officials, such as communicable disease monitoring and surveillance and public education and outreach. However, gaps exist in our understanding of the impacts of short-term vs. prolonged drought on the health of Canadians, projections of drought and its characteristics at the regional level and the effectiveness of current adaptations. Further research will be critical to inform adaptation planning to reduce future drought-related risks to health.