Population Health Adaptation Approaches to the Increasing Severity and Frequency of Weather-Related Disasters Resulting From our Changing Climate: A Literature Review and Application to Charleston, South Carolina

Effects of Climate Change on Health and Health Systems: A Systematic Review of Preparedness, Resilience, and Challenges

Climate change has a significant impact on the population's health and negatively affects the functioning of healthcare systems. Health systems must be operationally prepared to handle the challenges posed by environmental change. Resilience is required to adapt quickly to critical environmental conditions and reduce carbon emissions. In this systematic review strategies, for health system preparedness and resilience are examined to address the impacts of climate change, and the barriers and challenges faced when implementing them. To identify studies, the Scopus, PubMed and Google Scholar databases were searched three times (from April to October 2024, 21 April, 15 June, and 9 September) for the years 2018 to 2024, using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. Specifically, the search identified 471 articles, of which the specified inclusion and exclusion criteria (secondary studies with inclusion criteria, being in English, etc.) were met by sixteen (16) studies. According to the findings of the studies reviewed, adaptation strategies focus on structural changes, the development of training programs, the development of surveillance systems, and appropriate operational plans. The leader's ability to motivate employees to achieve defined goals, continuous evaluation of goals and interventions, and learning from previous disasters play an important role in their implementation. Similarly, key policies and strategies for mitigation include the adoption of sustainable practices, such as recycling and cultural change. However, lack of resources (human, material, financial) and increased demand for health services make it difficult to implement adaptation and mitigation strategies. The findings of the review are mainly theoretical in nature and are confirmed by other studies. It is suggested that further research on resilience and preparedness of health systems should be pursued, leading to their sustainability and the formulation of appropriate policies.

Climate change, climate disasters and oncology care: a descriptive global survey of oncology healthcare professionals

PURPOSE

Climate disasters and climate change have implications for healthcare globally. As the number and intensity of climate disasters increase, it is important to understand the effects on healthcare. We conducted a global survey of oncology healthcare providers to identify awareness, experiences, and educational needs related to climate change.

METHODS

An existing climate and health survey was adapted to oncology. This IRB- approved, 30-item survey measured demographics, climate disaster awareness, effects on cancer care and educational needs. Healthcare professionals employed in oncology settings (practice, research, or academic) were eligible. The survey was disseminated via social media and professional organizations. Descriptive statistics were computed using SPSS.

RESULTS

154 responses from 26 countries were received from nurses (56%), physicians (19%), and other healthcare professionals (25%). Common climate change-related events impacting oncology care were extreme heat (63.8%) and heavy rains (52.2%). Respondents reported their workplace has a disaster plan for climate-related weather events (50.4%) or has taken steps to prepare for a climate-related weather event (48.5%). Respondents were aware that the planet has warmed significantly (98.7%), that healthcare contributes to greenhouse gas emissions (98.6%) and reported wanting to learn more about how climate change affects cancer care (88.3%). Preferred educational modalities include webinars (69%), e-learning (55%), journal articles (48.3%), conferences (46.3%) and podcasts (38.9%).

CONCLUSIONS

This global survey is the first to identify the awareness, experiences, and educational needs of oncology healthcare professionals related to climate change and climate disasters. Healthcare providers are positioned to take leadership roles related to climate and health.

A Difference-In Difference Analysis of the South Carolina 2015 Extreme Floods and the Association with Maternal Health

Research documenting the public health impacts of natural disasters often focuses on adults and children. Little research has examined the influence of extreme events, like floods, on maternal health, and less has examined the effect of disasters on maternal indicators like severe maternal morbidity (SMM) or unexpected outcomes of labor and delivery that result in significant short-or long-term consequences to a woman's health. The aim of this study is to identify the impacts of the 2015 flood events on maternal health outcomes in South Carolina, USA. We employ a quasi-experimental design using a difference-in-difference analysis with log-binomial regressions to evaluate maternal outcomes for impacted and control locations during the disaster event. Unlike previous studies, we extended our difference-in-difference analysis to include a trimester of exposure to assess the timing of flood exposure. We did not find evidence of statistically significant main effects on maternal health from the 2015 flood events related to preterm birth, gestational diabetes, mental disorders of pregnancy, depression, and generalized anxiety. However, we did find a statistically significant increase in SMM and low birth weight during the flood event for women in select trimester periods who were directly exposed. Our work provides new evidence on the effects of extreme flood events, like the 2015 floods, which can impact maternal health during specific exposure periods of pregnancy. Additional research is needed across other extreme weather events, as the unique context of the 2015 floods limits the generalizability of our findings.

Nutrition policy critical to optimize response to climate, public health crises

The effects of unanticipated crises on health care and first-responder systems are reflected in climate-fueled environmental emergencies, to which human resilience is diminished by our chronic disease epidemic. For example, people who depend on specialized medications, like refrigerated insulin for diabetes, will likely face additional challenges in receiving treatment and care during extreme heat, floods, disasters, and other adverse events. These circumstances may be compounded by staff and equipment shortages, lack of access to fresh food, and inadequate healthcare infrastructure in the wake of a disaster. Simply put, our health care and first-response systems struggle to meet the demands of chronic disease without such crises and may be fundamentally unable to adequately function with such crises present. However, nutrition's primacy in preventing and controlling chronic disease directly enhances individual and public resilience in the face of existential threats. Highlighting the shared diet-related etiology clearly demonstrates the need for a national policy response to reduce the disease burden and potentiate mitigation of the sequelae of climate risks and capacity limits in our food and health care systems. Accordingly, this article proposes four criteria for nutrition policy in the Anthropocene: objective government nutrition recommendations, healthy dietary patterns, adequate nutrition security, and effective nutrition education. Application of such criteria shows strong potential to improve our resiliency despite the climate and public health crises.

The use of climate information in humanitarian relief efforts: a literature review

Purpose

This paper aims to provide a systematic literature review of the state-of-the-art applications of climate information in humanitarian relief efforts, to further the knowledge of how climate science can be better integrated into the decision-making process of humanitarian supply chains.

Design/methodology/approach

A systematic literature review was conducted using a combination of key search terms developed from both climate science and humanitarian logistics literature. Articles from four major databases were retrieved, reduced and analyzed.

Findings

The study illustrates the status of application of climate information in humanitarian work, and identifies usability, collaboration and coordination as three key themes.

Originality/value

By delivering an overview of the current applications and challenges of climate information, this literature review proposes a three-phase conceptual framework.

Flood Risk to Hospitals on the United States Atlantic and Gulf Coasts From Hurricanes and Sea Level Rise

Hurricanes have caused major healthcare system disruptions. No systematic assessment of hurricane risk to United States hospital-based healthcare delivery has been performed. Here, we show that 25 of 78 metropolitan statistical areas (MSAs) on the United States Atlantic and Gulf Coasts have half or more of their hospitals at risk of flooding from relatively weak hurricanes. 0.82 m of sea level rise expected within this century from climate change increases the odds of hospital flooding 22%. Furthermore, in 18 MSAs at least half of the roads within 1.6 km of hospitals were at risk of flooding from a category 2 storm. These findings identify previously undescribed risks to hospital-based care delivery in Atlantic and Gulf Coast communities. They suggest that lower intensity hurricanes can have outsized impacts on healthcare access, particularly in places where per capita bed availability is low.

Disasters and Investment: Assessing the Performance of the Underlying Economy Following a Large-Scale Stimulus in the Built Environment

Disasters are often followed by a large-scale stimulus supporting the economy through the built environment, which can last years. During this time, official economic indicators tend to suggest the economy is doing well, but as activity winds down, the sentiment can quickly change. In response to the damaging 2011 earthquakes in Canterbury, New Zealand, the regional economy outpaced national economic growth rates for several years during the rebuild. The repair work on the built environment created years of elevated building activity. However, after the peak of the rebuilding activity, as economic and employment growth retracts below national growth, we are left with the question of how the underlying economy performs during large scale stimulus activity in the built environment. This paper assesses the performance of the underlying economy by quantifying the usual, demand-driven level of building activity at this time. Applying an Input–Output approach and excluding the economic benefit gained from the investment stimulus reveals the performance of the underlying economy. The results reveal a strong growing underlying economy, and while convergence was expected as the stimulus slowed down, the results found that growth had already crossed over for some time. The results reveal that the investment stimulus provides an initial 1.5% to 2% growth buffer from the underlying economy before the growth rates cross over. This supports short-term economic recovery and enables the underlying economy to transition away from a significant rebuild stimulus. Once the growth crosses over, five years after the disaster, economic growth in the underlying economy remains buoyant even if official regional economic data suggest otherwise.

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.

The Triple Blow Effect: Retailing in an Era of Disasters and Pandemics—The Case of Christchurch, New Zealand

In the last two decades, the retail sector has experienced unprecedented upheaval, having severe implications for economic development and sustenance of traditional inner-city retail districts. In the city of Christchurch, New Zealand, this effect has been exacerbated by a series of earthquakes in 2010/2011 which destroyed much of the traditional retail precinct of the city. After extensive rebuild activity of the city’s infrastructure, the momentum of retailers returning to the inner city was initially sluggish but eventually gathered speed supported by increased international visitation. In early 2020, the return to retail normality came to an abrupt halt after the emergence of the COVID-19 pandemic. This study uses spending and transaction data to analyze the compounding impact of the earthquake’s aftermath, shift to online shopping, and the retail disruption in the Christchurch central retail precinct because of COVID-19. The findings illustrate how consumers through their spending respond to different types of external shocks, altering their consumption patterns and retail mode (offline and online) to cope with an ever-changing retail landscape. Each event triggers different spending patterns that have some similarities but also stark differences, having implications for a sustainable and resilient retail industry in Christchurch. Implications for urban retail precinct development are also discussed.

Analyzing Healthcare Facility Resilience: Scientometric Review and Knowledge Map

In contemporary “high-risk” society, unexpected disasters (epidemics and extreme weather) and chronic pressures (aging problems) put tremendous pressure on healthcare facilities. Enhancing the healthcare facilities' resilience ability to resist, absorb, and respond to disaster disruptions is urgent. This study presents a scientometric review for healthcare facility resilience research. A total of 374 relevant articles published between 2000 and 2020, collected from Web of Science (WoS) core collection database, Scopus database and MEDLINE database were reviewed and analyzed. The results indicated that research on resilience in healthcare facilities went through three development periods, and the research involved countries or institutions that are relatively scattered. The studies have been focused on the subject categories of engineering, public, environmental, and occupational health. The keywords of “resilience,” “hospital,” “disaster,” “healthcare,” and “healthcare facility” had the most frequency. Furthermore, based on the literature co-citation networks and content analysis, the detected seven co-citation clusters were grouped into four knowledge domains: climate change impact, strengthening resilience in response to war and epidemic, resilience assessment of healthcare facility, and the applications of information system. Moreover, the timeline view of literature reflected the evolution of each domain. Finally, a knowledge map for resilience of healthcare facilities was put forward, in which critical research contents, current knowledge gaps, and future research work were discussed. This contribution will promote researchers and practitioners to detect the hot topics, fill the knowledge gaps, and extend the body of research on resilience of healthcare facilities.

The Impact of Natural Disasters on Suicide in the United States, 2003–2015

Abstract. Background: Natural disasters are increasing in frequency and severity and impacted populations develop mental health conditions at higher rates than those not impacted. Aims: In this study, we investigate the association between exposure to a major natural disaster and suicide in the US. Method: Using county-level data on disaster declarations, mortality files, and population data, suicide rates were estimated for three 12-month periods before and after the disaster. Pooled rates were estimated predisaster and compared with postdisaster suicide rates using Poisson-generated Z tests and 95% confidence intervals. Results: A total of 281 major disasters were included. The suicide rate increased for each type of disaster and across all disasters in the first 2 years of follow-up. The largest overall increases in suicide rates were seen 2 years postdisaster. Limitations: Limitations include the ecologic study design, county-level exposure, and low power. Conclusion: Increases in county-level suicide rates after disasters were not statistically significant, although there was evidence that increases were delayed until 2 years postdisaster. Additional studies are needed to improve understanding of nonfatal suicide attempts after disasters and the role elevated social support plays in suicide prevention postdisaster. Future studies should consider pre-existing mental health, secondary stressors, and proximity to hazards.

Assessing perceptions and priorities for health impacts of climate change within local Michigan health departments

Climate change affects Michigan's public health in several primary ways, including increased incidences of vector-borne, waterborne, heat-related, and respiratory illness. Because local health departments (LHDs) play a central role in surveillance and preventative health services, they are among the first institutions to contend with the local impacts of climate change. To assess current perceptions among Michigan public health officials, an online survey was conducted in partnership with the Michigan Association for Local Public Health (MALPH). Most of the Michigan respondents (62%, n = 34) agreed that their jurisdictions have experienced climate change in the last 20 years, and 77% agreed that climate change will impact their jurisdictions in the coming 20 years. However, only 35% (n = 34) of Michigan officials agreed that climate change is a priority in their departments. About one quarter (25%, n = 34) of Michigan LHD respondents did not know about the level of expertise of either the state and federal agencies, responsible for assisting them with information and programs related to climate change and health. Uncertainty regarding the resources available to them may hinder LHDs from developing necessary preparedness, so meeting this need could bolster the public health response to climate change.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s13412-021-00679-0.

Drought disaster monitoring using MODIS derived index for drought years: A space-based information for ecosystems and environmental conservation

Drought disaster is one of the major factors restricting the development of vegetation across a wide variety of environments. Monitoring the temporal and spatial dynamics of drought episodes in the study area is crucial for environmental and ecosystem conservation. This study assesses drought disaster by utilising space-based data and R programming for drought years 2003, 2007, 2012 and 2019 in the Free State Province, South Africa. Results revealed that the study area witnessed drought events in the year 2003 where March, August, September, October, November and December were more affected by drought disaster events. It was further observed that February and March were affected by extreme drought conditions in the year 2007. In year 2012, January, October, November and December, there exist moderate to severe drought conditions in the study area where some regions were more affected than the other. Finally, year 2019 witnessed variations in drought event distributions across the months with January, October and November witnessing severe to extreme drought conditions from about 0 to 30% drought values. Overall, this study shows that the 16-day Terra-MODIS composite and EVI products are sensitive to stressors associated with drought. The Vegetation Condition Monitoring Index (VCI) based on MODIS is suited for monitoring drought disasters. The technique used in this study revealed the suitability of MODIS data for assessing drought conditions and their potential environmental impacts.

Climate Change and Health: Local Solutions to Local Challenges

Purpose of Review

Climate change has direct impacts on human health, but those impacts vary widely by location. Local health impacts depend on a large number of factors including specific regional climate impacts, demographics and human vulnerabilities, and existing local adaptation capacity. There is a need to incorporate local data and concerns into climate adaptation plans and evaluate different approaches.

Recent Findings

The Centers for Disease Control and Prevention (CDC) has provided funding, technical assistance, and an adaptation framework to assist localities with climate planning and activities. The differing processes with which states, cities, and tribes develop and implement adaptation plans have been observed. We outline examples of the implementation of CDC’s framework and activities for local adaptation, with a focus on case studies at differing jurisdictional levels (a state, a city, and a sovereign tribe).

Summary

The use of local considerations and data are important to inform climate adaptation. The adaptable implementation of CDC’s framework is helping communities protect health.

How Medical Studies in Poland Prepare Future Healthcare Managers for Crises and Disasters: Results of a Pilot Study

In the event of a crisis, rapid and effective assistance for victims is essential, and in many cases, medical assistance is required. To manage the situation efficiently, it is necessary to have a proactive management system in place that ensures professional assistance to victims and the safety of medical personnel. We evaluated the perceptions of students and graduates in public health studies at the Medical University of Lublin, Poland, concerning their preparation and management skills for crises such as the COVID-19 pandemic. This pilot study was conducted in March 2020; we employed an online survey with an anonymous questionnaire that was addressed to students and graduates with an educational focus in healthcare organization and management. The study involved 55 people, including 14 men and 41 women. Among the respondents, 41.8% currently worked in a healthcare facility and only 21.7% of them had participated in training related to preparation for emergencies and disasters in their current workplace. The respondents rated their workplaces' preparedness for the COVID-19 pandemic at four points. A significant number of respondents stated that if they had to manage a public health emergency, they would not be able to manage the situation correctly and not be able to predict its development. Managers of healthcare organizations should have the knowledge and skills to manage crises. It would be advisable for them to have been formally educated in public health or healthcare administration. In every healthcare facility, it is essential that training and practice of performing medical procedures in full personal protective equipment (PPE) be provided. Healthcare facilities must implement regular training combined with practical live scenario exercises to prepare for future crises.

Climate Change and Mental Health: Implications for Nurses

Climate change has received public health attention over the past 3 decades. It is well established that climate change is associated with myriad health issues, but less has been mentioned in public health discourse about the impacts of climate change on population mental health. The purpose of the current article is to provide an overview of the impacts of climate change on mental health, and to discuss opportunities for mental health nurses to reduce health problems related to climate change. Acute events and chronic consequences of climate change can impact mental health outcomes and contribute to depressive disorders, anxiety, and trauma-related disorders. The nursing profession must be prepared to address climate change to promote best health outcomes for individuals around the globe. It is critical that mental health nurses act as leaders in understanding and addressing climate change to improve the mental health of populations. [Journal of Psychosocial Nursing and Mental Health Services, 58(9), 25-30.].

Integrating Public Health into Climate Change Policy and Planning: State of Practice Update

Policy action in the coming decade will be crucial to achieving globally agreed upon goals to decarbonize the economy and build resilience to a warmer, more extreme climate. Public health has an essential role in climate planning and action: “Co-benefits” to health help underpin greenhouse gas reduction strategies, while safeguarding health—particularly of the most vulnerable—is a frontline local adaptation goal. Using the structure of the core functions and essential services (CFES), we reviewed the literature documenting the evolution of public health’s role in climate change action since the 2009 launch of the US CDC Climate and Health Program. We found that the public health response to climate change has been promising in the area of assessment (monitoring climate hazards, diagnosing health status, assessing vulnerability); mixed in the area of policy development (mobilizing partnerships, mitigation and adaptation activities); and relatively weak in assurance (communication, workforce development and evaluation). We suggest that the CFES model remains important, but is not aligned with three concepts—governance, implementation and adjustment—that have taken on increasing importance. Adding these concepts to the model can help ensure that public health fulfills its potential as a proactive partner fully integrated into climate policy planning and action in the coming decade.