Climate Change and Health: Transcending Silos to Find Solutions

Climate Change Adaptation Methods for Public Health Prevention in Australia: an Integrative Review

PURPOSE OF REVIEW

Climate change poses a serious threat to human health and well-being. Australia is not immune to the public health impacts and continues to be underprepared, putting the population health at risk. However, there is a dearth in knowledge about how the Australian public health system will address the impacts of climate change.

RECENT FINDINGS

This integrative review synthesises tools, frameworks, and guidance material suitable for climate change adaptation from a preventive public health perspective. The literature search was conducted in electronic databases MEDLINE, PubMed, CINAHL, and Web of Science. Of 4507 articles identified, 19 articles met the inclusion criteria that focused on operational methods in public health and excluded the clinical context and reactive disaster response approaches. This review revealed that Australia is ill-prepared to manage climate change adverse health impacts due to ineffective adaptation strategies. The review highlights that Australia urgently requires effective adaptation strategies such as undertaking a National Adaptation Plan process and an improved understanding in managing complex health risks. Taking this action will strengthen the public health system and build health resilience especially for vulnerable populations. These findings will help understand and develop of the necessary adaptive strategies in Australia.

Positioning zoonotic disease research in forced migration: A systematic literature review of theoretical frameworks and approaches

BACKGROUND

The emergence and transmission of zoonotic diseases are driven by complex interactions between health, environmental, and socio-political systems. Human movement is considered a significant and increasing factor in these processes, yet forced migration remains an understudied area of zoonotic research-due in part to the complexity of conducting interdisciplinary research in these settings.

OBJECTIVES

We conducted a systematic review to identify and analyze theoretical frameworks and approaches used to study linkages between forced migration and zoonotic diseases.

METHODS

We searched within eight electronic databases: ProQuest, SCOPUS, Web of Science, PubMed, PLoSOne, Science Direct, JSTOR, and Google Scholar, to identify a) research articles focusing on zoonoses considering forced migrants in their study populations, and b) forced migration literature which engaged with zoonotic disease. Both authors conducted a full-text review, evaluating the quality of literature reviews and primary data using the Critical Appraisal Skills Programme (CASP) model, while theoretical papers were evaluated for quality using a theory synthesis adapted from Bonell et al. (2013). Qualitative data were synthesized thematically according to the method suggested by Noblit and Hare (1988).

RESULTS

Analyses of the 23 included articles showed the increasing use of interdisciplinary frameworks and approaches over time, the majority of which stemmed from political ecology. Approaches such as EcoHealth and One Health were increasingly popular, but were more often linked to program implementation and development than broader contextual research. The majority of research failed to acknowledge the heterogeneity of migrant populations, lacked contextual depth, and insufficient acknowledgments of migrant agency in responding to zoonotic threats.

CONCLUSIONS

Addressing the emergence and spread of zoonoses in forced migration contexts requires more careful consideration and use of interdisciplinary research to integrate the contributions of social and natural science approaches. Robust interdisciplinary theoretical frameworks are an important step for better understanding the complex health, environment, and socio-political drivers of zoonotic diseases in forced migration. Lessons can be learned from the application of these approaches in other hard-to-reach or seldom-heard populations.

Comparison of fuel characteristics of hydrotreated waste cooking oil with its biodiesel and fossil diesel

Compression ignition engines powered by diesel are the work horses of developing countries like India. However, burning fossil fuel causes a lot of air pollution and the depletion of fuel at an alarming rate. Fuels produced from biomass or wastes can partially substitute fossil diesel to decrease its consumption. One such feedstock is waste cooking oil (WCO) which can be easily converted into fuel for diesel engines. The hydrotreating process stands out among the methods available for converting WCO into fuel, since its properties are almost similar to fossil diesel with little or no oxygen content. In this study, the physico-chemical properties of the hydrotreated waste cooking oil (HVO), biodiesel of waste cooking oil, diesel and blends of HVO and diesel are compared. The blends were prepared by mixing 10%, 20%, 30%, 40% and 50% of HVO on volume basis in diesel. The evaporation rate and ignition probability of the fuel samples were found by using a hot-plate test setup. HVO had higher ignition probability than all the test sample. As the percentage of HVO increased in the test samples, the ignition probability increased. The Sauter mean diameter (SMD) of the samples was also found using Malvern Spraytec. The SMD of HVO was larger than diesel but smaller than biodiesel. The study shows that blends of HVO up to 30% are feasible for present use in diesel engines, as the viscosity (2.54, 2.59 and 2.62cSt) and calorific value (42.41, 42.29, 42.08 MJ/kg) of the three blends (10%, 20% and 30%) is close to diesel (2.51cSt and 42.58 MJ/kg). Also, due to high cetane index, neat HVO or blends having higher HVO content (> 30%) cannot be used in the existing engines as the engine power output may be affected. Therefore, to use these fuels, the engine needs to be modified which is not feasible for existing engines. The FTIR and GC-MS analysis shows that the HVO has low oxygen content and high amount of paraffins, whereas biodiesel of waste cooking oil has high unsaturation and high oxygen content.

Climate change: challenges and opportunities to scale up surgical, obstetric, and anaesthesia care globally

Climate change affects human health in a myriad of ways, requiring reassessment of the nature of scaling up care delivery and the effect that care delivery has on the environment. 5 billion people do not have access to safe and timely surgical care, and the quantity and severity of conditions that require surgical, obstetric, and anaesthesia care will increase substantially as a result of climate change. However, surgery is resource intensive and contributes substantially to greenhouse-gas emissions. In response to climate change, the surgical, obstetric, and anaesthesia community has a key role to play to ensure that a scale-up of service delivery incorporates mitigation and adaptation strategies. As countries scale up surgical care, understanding the implications of surgery on climate change and the implications of climate change on surgical care will be crucial in the development of health policies.

Catalytic dehydrogenation of liquid organic hydrogen carrier dodecahydro-N-ethylcarbazole over palladium catalysts supported on different supports

The system based on liquid organic hydrogen carrier (LOHC) is one of the technologies to solve the problem of hydrogen storage and transportation capacity in large-scale applications. In this paper, the catalytic dehydrogenation of LOHC dodecahydro-N-ethylcarbazole (H12-NEC) over supported Pd nanoparticles (NPs) catalyst on four kinds of different supports, such as Pd/C, Pd/Al₂O₃, Pd/TiO₂, and Pd/SiO₂, was studied. It was found from catalyst characterization and dehydrogenation reaction that the volcano-type dependence of the activity on the Pd particle size, catalytic activity improvement with large specific surface area, and high Pd reduction degree indicated that the structure, particle size, and reduction degree of Pd NPs and textural properties of supports had a synergistic effect on the catalytic performance. Among all the catalysts, Pd/C displayed outstanding catalytic performance with the H12-NEC conversion of 99.9% and hydrogen storage capacity of 5.69 wt% at 180 °C after 12 h. The particle size of Pd/C distributes in the range of 1.5-6.0 nm with an average size of 3.0 nm. The results of dehydrogenation reaction kinetics showed that the rate limiting step and rate constant for different catalysts were mainly related to the physicochemical properties and adsorption and activation abilities towards the reactants and intermediates. In terms of the stationarity of dehydrogenation process, Pd/Al₂O₃ was excellent, indicating that it was best for dehydrogenation of H12-NEC.

China-UK partnership for global health: practices and implications of the Global Health Support Programme 2012-2019

Background

Over the past few decades, a series of major challenges to global health have successively emerged, which call for China’s deeper engagement in global health governance. In this context, the China-UK Global Health Support Programme (GHSP) was launched in 2012 with about 12 million pounds funded by the United Kingdom.

Objectives

The GHSP was expected to explore a new type of China-UK partnership to strengthen the cooperation in global health, and enhance China’s capacity to engage in global health governance and provide effective development assistance in health (DAH), in order to jointly improve global health outcomes.

Programme design and implementation

The GHSP was programmed to support capacity building activities in Chinese experience distillation, DAH, global health governance and pilot partnership at national and institutional levels between October 2012 and March 2019. These activities were assigned to different project implementing agencies (PIAs) and their project cooperative agencies (PCAs) or pilot areas, and were then implemented under the guidance and management by the strategic oversight committee and the project management office of GHSP respectively.

Main achievements

At the national level, the GHSP held five rounds of China-UK high-level dialogues, conducted studies on China Global Health Strategies to provide robust evidence for developing and issuing relevant national policies, and supported the establishment of the China Global Health Network. At the institutional level, the GHSP funded a series of activities in research, training, international exchange and pilots etc., produced a large number of high-quality research outputs and policy briefings, cultivated a group of PIAs and individual researchers, facilitated the partnership building between the PIAs and PCAs, enhanced the practical ability of Chinese institutions to conduct overseas DAH, and improved the health service delivery and outcomes in pilot areas of three Asian and African countries.

Policy implications

In the GHSP, China and UK have established a good model for North-South Cooperation and the programme facilitated the 2030 Agenda for Sustainable Development by building a new type of bilateral partnership and carrying out triangular cooperation practices. This model has demonstrated huge potential for cooperation through partnership and can also be referred to by other countries to develop bilateral partnerships.

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.

The Water-Energy-Food Nexus as a Tool to Transform Rural Livelihoods and Well-Being in Southern Africa

About 60% of southern Africa’s population lives in rural areas with limited access to basic services and amenities such as clean and safe water, affordable and clean energy, and balanced and nutritious diets. Resource scarcity has direct and indirect impacts on nutrition, human health, and well-being of mostly poor rural communities. Climate change impacts in the region are manifesting through low crop yields, upsurge of vector borne diseases (malaria and dengue fever), and water and food-borne diseases (cholera and diarrhoea). This study applied a water–energy–food (WEF) nexus analytical livelihoods model with complex systems understanding to assess rural livelihoods, health, and well-being in southern Africa, recommending tailor-made adaptation strategies for the region aimed at building resilient rural communities. The WEF nexus is a decision support tool that improves rural livelihoods through integrated resource distribution, planning, and management, and ensures inclusive socio-economic transformation and development, and addresses related sustainable development goals, particularly goals 2, 3, 6 and 7. The integrated WEF nexus index for the region was calculated at 0.145, which is marginally sustainable, and indicating the region’s exposure to vulnerabilities, and reveals a major reason why the region fails to meet its developmental targets. The integrated relationship among WEF resources in southern Africa shows an imbalance and uneven resource allocation, utilisation and distribution, which normally results from a ‘siloed’ approach in resource management. The WEF nexus provides better adaptation options, as it guides decision making processes by identifying priority areas needing intervention, enhancing synergies, and minimising trade-offs necessary for resilient rural communities. Our results identified (i) the trade-offs and unintended negative consequences for poor rural households’ livelihoods of current silo approaches, (ii) mechanisms for sustainably enhancing household water, energy and food security, whilst (iii) providing direction for achieving SDGs 2, 3, 6 and 7.

Bovine tuberculosis disturbs parasite functional trait composition in African buffalo

Novel parasites can have wide-ranging impacts, not only on host populations, but also on the resident parasite community. Historically, impacts of novel parasites have been assessed by examining pairwise interactions between parasite species. However, parasite communities are complex networks of interacting species. Here we used multivariate taxonomic and trait-based approaches to determine how parasite community composition changed when African buffalo (Syncerus caffer) acquired an emerging disease, bovine tuberculosis (BTB). Both taxonomic and functional parasite richness increased significantly in animals that acquired BTB than in those that did not. Thus, the presence of BTB seems to catalyze extraordinary shifts in community composition. There were no differences in overall parasite taxonomic composition between infected and uninfected individuals, however. The trait-based analysis revealed an increase in direct-transmitted, quickly replicating parasites following BTB infection. This study demonstrates that trait-based approaches provide insight into parasite community dynamics in the context of emerging infections.

The Influence of Climate and Livestock Reservoirs on Human Cases of Giardiasis

Giardia duodenalis is an intestinal parasite which causes diarrhoeal illness in people. Zoonotic subtypes found in livestock may contribute to human disease occurrence through runoff of manure into multi-use surface water. This study investigated temporal associations among selected environmental variables and G. duodenalis occurrence in livestock reservoirs on human giardiasis incidence using data collected in the Waterloo Health Region, Ontario, Canada. The study objectives were to: (1) evaluate associations between human cases and environmental variables between 1 June 2006 and 31 December 2013, and (2) evaluate associations between human cases, environmental variables and livestock reservoirs using a subset of this time series, with both analyses controlling for seasonal and long-term trends. Human disease incidence exhibited a seasonal trend but no annual trend. A Poisson multivariable regression model identified an inverse association with water level lagged by 1 month (IRR = 0.10, 95% CI 0.01, 0.85, P < 0.05). Case crossover analysis found varying associations between lagged variables including livestock reservoirs (1 week), mean air temperature (3 weeks), river water level (1 week) and flow rate (1 week), and precipitation (4 weeks). This study contributes to our understanding of epidemiologic relationships influencing human giardiasis cases in Ontario, Canada.

Bioaerosols and Transmission, a Diverse and Growing Community of Practice

The transmission of infectious microbes via bioaerosols is of significant concern for both human and animal health. However, gaps in our understanding of respiratory pathogen transmission and methodological heterogeneity persist. New developments have enabled progress in this domain, and one of the major turning points has been the recognition that cross-disciplinary collaborations across spheres of human and animal health, microbiology, biophysics, engineering, aerobiology, infection control, public health, occupational health, and industrial hygiene are essential. Collaborative initiatives support advances in topics such as bioaerosol behavior, dispersion models, risk assessment, risk/exposure effects, and mitigation strategies in clinical, experimental, agricultural, and other field settings. There is a need to enhance the knowledge translation for researchers, stakeholders, and private partners to support a growing network of individuals and agencies to achieve common goals to mitigate inter- and intra-species pathogen transmission via bioaerosols.

Global Disease Outbreaks Associated with the 2015-2016 El Niño Event

Interannual climate variability patterns associated with the El Niño-Southern Oscillation phenomenon result in climate and environmental anomaly conditions in specific regions worldwide that directly favor outbreaks and/or amplification of variety of diseases of public health concern including chikungunya, hantavirus, Rift Valley fever, cholera, plague, and Zika. We analyzed patterns of some disease outbreaks during the strong 2015–2016 El Niño event in relation to climate anomalies derived from satellite measurements. Disease outbreaks in multiple El Niño-connected regions worldwide (including Southeast Asia, Tanzania, western US, and Brazil) followed shifts in rainfall, temperature, and vegetation in which both drought and flooding occurred in excess (14–81% precipitation departures from normal). These shifts favored ecological conditions appropriate for pathogens and their vectors to emerge and propagate clusters of diseases activity in these regions. Our analysis indicates that intensity of disease activity in some ENSO-teleconnected regions were approximately 2.5–28% higher during years with El Niño events than those without. Plague in Colorado and New Mexico as well as cholera in Tanzania were significantly associated with above normal rainfall (p < 0.05); while dengue in Brazil and southeast Asia were significantly associated with above normal land surface temperature (p < 0.05). Routine and ongoing global satellite monitoring of key climate variable anomalies calibrated to specific regions could identify regions at risk for emergence and propagation of disease vectors. Such information can provide sufficient lead-time for outbreak prevention and potentially reduce the burden and spread of ecologically coupled diseases.

The INHERIT Model: A Tool to Jointly Improve Health, Environmental Sustainability and Health Equity through Behavior and Lifestyle Change

The need for analysis and action across the interrelated domains of human behaviors and lifestyles, environmental sustainability, health and inequality is increasingly apparent. Currently, these areas are often not considered in conjunction when developing policies or interventions, introducing the potential for suboptimal or conflicting outcomes. The INHERIT model has been developed within the EU-funded project INHERIT as a tool to guide thinking and intersectoral action towards changing the behaviors and lifestyles that play such an important role in today’s multidisciplinary challenges. The model integrates ecological public health and behavioral change models, emphasizing inequalities and those parts of the causal process that are influenced by human behaviors and lifestyles. The model was developed through web-based and live discussions with experts and policy stakeholders. To test the model’s usability, the model was applied to aspects of food consumption. This paper shows that the INHERIT model can serve as a tool to identify opportunities for change in important −food-related behaviors and lifestyles and to examine how they impact on health, health inequalities, and the environment in Europe and beyond. The INHERIT model helps clarify these interrelated domains, creating new opportunities to improve environmental health and health inequality, while taking our planetary boundaries into consideration.

Food, health, and complexity: towards a conceptual understanding to guide collaborative public health action

BACKGROUND

What we eat simultaneously impacts our exposure to pathogens, allergens, and contaminants, our nutritional status and body composition, our risks for and the progression of chronic diseases, and other outcomes. Furthermore, what we eat is influenced by a complex web of drivers, including culture, politics, economics, and our built and natural environments. To date, public health initiatives aimed at improving food-related population health outcomes have primarily been developed within 'practice silos', and the potential for complex interactions among such initiatives is not well understood. Therefore, our objective was to develop a conceptual model depicting how infectious foodborne illness, food insecurity, dietary contaminants, obesity, and food allergy can be linked via shared drivers, to illustrate potential complex interactions and support future collaboration across public health practice silos.

METHODS

We developed the conceptual model by first conducting a systematic literature search to identify review articles containing schematics that depicted relationships between drivers and the issues of interest. Next, we synthesized drivers into a common model using a modified thematic synthesis approach that combined an inductive thematic analysis and mapping to synthesize findings.

RESULTS

The literature search yielded 83 relevant references containing 101 schematics. The conceptual model contained 49 shared drivers and 227 interconnections. Each of the five issues was connected to all others. Obesity and food insecurity shared the most drivers (n = 28). Obesity shared several drivers with food allergy (n = 11), infectious foodborne illness (n = 7), and dietary contamination (n = 6). Food insecurity shared several drivers with infectious foodborne illness (n = 9) and dietary contamination (n = 9). Infectious foodborne illness shared drivers with dietary contamination (n = 8). Fewer drivers were shared between food allergy and: food insecurity (n = 4); infectious foodborne illness (n = 2); and dietary contamination (n = 1).

CONCLUSIONS

Our model explicates potential interrelationships between five population health issues for which public health interventions have historically been siloed, suggesting that interventions targeted towards these issues have the potential to interact and produce unexpected consequences. Public health practitioners working in infectious foodborne illness, food insecurity, dietary contaminants, obesity, and food allergy should actively consider how their seemingly targeted public health actions may produce unintended positive or negative population health impacts.