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Saraswati CM, Judge MA, Weeda LJZ, Bassat Q, Prata N, Le Souëf PN, Bradshaw CJA. Net benefit of smaller human populations to environmental integrity and individual health and wellbeing. Front Public Health 2024; 12:1339933. [PMID: 38504675 PMCID: PMC10949988 DOI: 10.3389/fpubh.2024.1339933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/13/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction The global human population is still growing such that our collective enterprise is driving environmental catastrophe. Despite a decline in average population growth rate, we are still experiencing the highest annual increase of global human population size in the history of our species-averaging an additional 84 million people per year since 1990. No review to date has accumulated the available evidence describing the associations between increasing population and environmental decline, nor solutions for mitigating the problems arising. Methods We summarize the available evidence of the relationships between human population size and growth and environmental integrity, human prosperity and wellbeing, and climate change. We used PubMed, Google Scholar, and Web of Science to identify all relevant peer-reviewed and gray-literature sources examining the consequences of human population size and growth on the biosphere. We reviewed papers describing and quantifying the risks associated with population growth, especially relating to climate change. Results These risks are global in scale, such as greenhouse-gas emissions, climate disruption, pollution, loss of biodiversity, and spread of disease-all potentially catastrophic for human standards of living, health, and general wellbeing. The trends increasing the risks of global population growth are country development, demographics, maternal education, access to family planning, and child and maternal health. Conclusion Support for nations still going through a demographic transition is required to ensure progress occurs within planetary boundaries and promotes equity and human rights. Ensuring the wellbeing for all under this aim itself will lower population growth and further promote environmental sustainability.
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Affiliation(s)
| | - Melinda A. Judge
- Telethon Kids Institute, Perth, WA, Australia
- School of Mathematics and Statistics, University of Western Australia, Nedlands, WA, Australia
| | - Lewis J. Z. Weeda
- School of Medicine, University of Western Australia, Nedlands, WA, Australia
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
- Paediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Ndola Prata
- Bixby Center for Population Health and Sustainability, School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Peter N. Le Souëf
- School of Medicine, University of Western Australia, Nedlands, WA, Australia
| | - Corey J. A. Bradshaw
- Global Ecology | Partuyarta Ngadluku Wardli Kuu, College of Science and Engineering, Flinders University, Adelaide, SA, Australia
- Australian Research Council Centre of Excellence for Australian Biodiversity and Heritage, Wollongong, NSW, Australia
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Kowalcyk M, Dorevitch S. A Framework for Evaluating Local Adaptive Capacity to Health Impacts of Climate Change: Use of Kenya's County-Level Integrated Development Plans. Ann Glob Health 2024; 90:15. [PMID: 38370864 PMCID: PMC10870949 DOI: 10.5334/aogh.4266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/20/2024] [Indexed: 02/20/2024] Open
Abstract
Background Health National Adaptation Plans were developed to increase the capacity of low- and middle-income countries (LMICs) to adapt to the impacts of climate change on the health sector. Climate and its health impacts vary locally, yet frameworks for evaluating the adaptive capacity of health systems on the subnational scale are lacking. In Kenya, counties prepare county integrated development plans (CIDPs), which contain information that might support evaluations of the extent to which counties are planning climate change adaptation for health. Objectives To develop and apply a framework for evaluating CIDPs to assess the extent to which Kenya's counties are addressing the health sector's adaptive capacity to climate change. Methods CIDPs were analyzed based on the extent to which they addressed climate change in their description of county health status, whether health is noted in their descriptions of climate change, and whether they mention plans for developing climate and health programs. Based on these and other data points, composite climate and health adaptation (CHA) scores were calculated. Associations between CHA scores and poverty rates were analyzed. Findings CHA scores varied widely and were not associated with county-level poverty. Nearly all CIDPs noted climate change, approximately half mentioned health in the context of climate change and only 16 (34%) noted one or more specific climate-sensitive health conditions. Twelve (25%) had plans for a sub-program in both adaptive capacity and environmental health. Among the 24 counties with plans to develop climate-related programs in health programs, all specified capacity building, and 20% specified integrating health into disaster risk reduction. Conclusion Analyses of county planning documents provide insights into the extent to which the impacts of climate change on health are being addressed at the subnational level in Kenya. This approach may support governments elsewhere in evaluating climate change adaptation for health by subnational governments.
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Affiliation(s)
- Megan Kowalcyk
- Division of Environmental and Occupational Health Sciences, University of Illinois Chicago, School of Public Health, Chicago IL, US
| | - Samuel Dorevitch
- Division of Environmental and Occupational Health Sciences, University of Illinois Chicago, School of Public Health, Chicago IL, US
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Kemajou Njatang D, Bouba Djourdebbé F, Adda Wadou ND. Climate variability, armed conflicts and child malnutrition in sub-saharan Africa: A spatial analysis in Ethiopia, Kenya and Nigeria. Heliyon 2023; 9:e21672. [PMID: 38027550 PMCID: PMC10656247 DOI: 10.1016/j.heliyon.2023.e21672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Sub-Saharan Africa (SSA) has one of the highest prevalence of malnutrition among children under 5 in the world. It is also the region most vulnerable to the adverse effect of climate change, and the one that records the most armed conflicts. The chains of causality suggested in the literature on the relationship between climate change, armed conflict, and malnutrition have rarely been supported by empirical evidence for SSA countries. Methods This study proposes to highlight, under the hypothesis of spatial non-stationarity, the influence of climatic variations and armed conflicts on malnutrition in children under 5 in Ethiopia, Kenya, and Nigeria. To do this, we use spatial analysis on data from Demographic and Health Surveys (DHS), Uppsala Conflict Data Program Georeferenced Event Dataset (UCDP GED), Climate Hazards center InfraRed Precipitation with Station data (CHIRPS) and Moderate Resolution Imaging Spectroradiometer (MODIS). Results The results show that there is a spatial autocorrelation of malnutrition measured by the prevalence of underweight children in the three countries. Also, local geographically weighted analysis shows that armed conflict, temperature and rainfall are positively associated with the prevalence of underweight children in localities of Somali in Ethiopia, Mandera and Turkana of Wajir in Kenya, Borno and Yobe in Nigeria. Conclusion In conclusion, the results of our spatial analysis support the implementation of conflict-sensitive climate change adaptation strategies.
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Rosinger AY. Extreme climatic events and human biology and health: A primer and opportunities for future research. Am J Hum Biol 2023; 35:e23843. [PMID: 36449411 PMCID: PMC9840683 DOI: 10.1002/ajhb.23843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 12/05/2022] Open
Abstract
Extreme climatic events are increasing in frequency, leading to hotter temperatures, flooding, droughts, severe storms, and rising oceans. This special issue brings together a collection of seven articles that describe the impacts of extreme climatic events on a diverse set of human biology and health outcomes. The first two articles cover extreme temperatures extending from extreme heat to cold and changes in winter weather and the respective implications for adverse health events, human environmental limits, well-being, and human adaptability. Next, two articles cover the effects of exposures to extreme storms through an examination of hurricanes and cyclones on stress and birth outcomes. The following two articles describe the effects of extreme flooding events on livelihoods, nutrition, water and food insecurity, diarrheal and respiratory health, and stress. The last article examines the effects of drought on diet and food insecurity. Following a brief review of each extreme climatic event and articles covered in this special issue, I discuss future research opportunities-highlighting domains of climate change and specific research questions that are ripe for biological anthropologists to investigate. I close with a description of interdisciplinary methods to assess climate exposures and human biology outcomes to aid the investigation of the defining question of our time - how climate change will affect human biology and health. Ultimately, climate change is a water, food, and health problem. Human biologists offer a unique perspective for a combination of theoretical, methodological, and applied reasons and thus are in a prime position to contribute to this critical research agenda.
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Affiliation(s)
- Asher Y. Rosinger
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
- Department of Anthropology, Pennsylvania State University, University Park, PA, USA
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Candela-Martínez B, Ramallo-Ros S, Cañabate J, Martínez-Carrión JM. Month of birth and height. A case study in rural Spain. ECONOMICS AND HUMAN BIOLOGY 2022; 47:101157. [PMID: 35834878 DOI: 10.1016/j.ehb.2022.101157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/12/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Season of birth correlates to a wide range of health conditions throughout life measured by anthropometrics. This study explores whether the month of birth and weather during gestation influence male adult height, based on Spain's rural population before the end of the modernization process. METHODS The database of heights (N = 16.266) is composed of conscripts who reached the age of 21 between 1908 and 1985 (birth cohorts 1886-1965). The population sample has been taken from a municipality in inner Spain: Hellín, in the region of Castilla-La Mancha, mainly an agrarian area, with poor resources and low income until the 1970 s/1980 s. Two different methodologies have been implemented: a harmonic regression using sinusoidal covariables and a random forest model. RESULTS we find that being born at the end of the summer and during the autumn was favorable to height. The birth month with the highest statures is September, with heights 0.5 cm above the annual average and 0.9 cm above February, the birth month with the lowest average height. Furthermore, we can observe that rainfall and temperature during gestation had little additional influence due to a substitution effect with the birth month variable. CONCLUSIONS Our results suggest that the seasonal effects on height can be significant and that it can be partially affected by environmental factors during early life. Our findings could be of interest for low-income populations and developing rural societies.
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Affiliation(s)
- Begoña Candela-Martínez
- International School of Doctoral Studies, University of Murcia, Campus de Espinardo, 30100 Murcia, Spain
| | - Salvador Ramallo-Ros
- International School of Doctoral Studies, University of Murcia, Campus de Espinardo, 30100 Murcia, Spain
| | | | - José-Miguel Martínez-Carrión
- Department of Applied Economics, Faculty of Economics and Business, University of Murcia, Campus de Espinardo, 30100 Murcia, Spain
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Le K, Nguyen M. Droughts and child health in Bangladesh. PLoS One 2022; 17:e0265617. [PMID: 35312716 PMCID: PMC8936449 DOI: 10.1371/journal.pone.0265617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 03/04/2022] [Indexed: 12/04/2022] Open
Abstract
This paper investigates the extent to which in-utero exposure to droughts influences the health outcomes of Bangladeshi children in early childhood. Exploiting the plausibly exogenous deviations of rainfall from the location-specific norms, we find that deficient rainfall during the prenatal period is harmful to child health. Specifically, in-utero exposure to droughts decreases the height-for-age, weight-for-height, and weight-for-age z-scores by 0.10, 0.11, and 0.11 standard deviations among children under five years old, respectively. Our heterogeneity analyses reveal that the adverse health setbacks fall disproportionately on children of disadvantaged backgrounds. Exploring the differential effects by trimesters of exposure, we further show that experiencing droughts during the second and the third trimesters leaves injurious effects on early childhood health.
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Affiliation(s)
- Kien Le
- Faculty of Economics and Public Management, Ho Chi Minh City Open University, Ho Chi Minh City, Vietnam
| | - My Nguyen
- Faculty of Economics and Public Management, Ho Chi Minh City Open University, Ho Chi Minh City, Vietnam
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Asmall T, Abrams A, Röösli M, Cissé G, Carden K, Dalvie MA. The adverse health effects associated with drought in Africa. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 793:148500. [PMID: 34174598 DOI: 10.1016/j.scitotenv.2021.148500] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 06/11/2021] [Accepted: 06/13/2021] [Indexed: 06/13/2023]
Abstract
Droughts are associated with several health effects and Africa is uniquely vulnerable. Despite this, there has been no previous review of the literature on the health effects of drought in Africa. This study systematically reviewed the epidemiological research on the association between drought and adverse health effects in Africa (2012-2019). A total of fifteen articles were included in the review after screening 1922 published (peer-reviewed) and unpublished articles. These studies were all conducted in 9 Sub-Saharan African countries. The drought-related health effects identified were on adverse nutritional health (n = 8) including malnutrition resulting in reduced body size and wasting, stunting and underweight, mortality from food insecurity, anaemia from food insecurity and nutrition-related disability from food insecurity; drought and diseases due to microbial contamination of water (n = 6) including cholera, diarrhoeal diseases, scabies, vector-borne diseases and malaria-related mortality; and drought and health behaviours (n = 1) including HIV prevention and care behaviours. The study found limited evidence of a high prevalence of malnutrition, an increased prevalence of anaemia, cholera, scabies, dengue and an increased incidence in child disabilities during periods of drought. Additionally, there was limited evidence on improved child nutritional health with improved water and sanitation access, and an increased prevalence of child wasting, stunting and underweight in drought-prone areas. No evidence of drought on other health outcomes was found. However, all the studies had more than one limitation including weak study design, a lack of comparison to a drought period, uncertainty on the onset and end of drought, lack of control for confounding, presence of contextual factors, weak outcome and/or exposure measure, small sample size and lack of generalizability. This review found weak evidence for all health outcomes measured but highlights key areas for further research and contextual factors which need to be considered for interventions.
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Affiliation(s)
- Taherah Asmall
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
| | - Amber Abrams
- Future Water Institute, University of Cape Town, Rondebosch, 7700, Cape Town, South Africa.
| | - Martin Röösli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland; University of Basel, P.O. Box, CH-4003, Basel, Switzerland.
| | - Guéladio Cissé
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland; University of Basel, P.O. Box, CH-4003, Basel, Switzerland.
| | - Kirsty Carden
- Future Water Institute, University of Cape Town, Rondebosch, 7700, Cape Town, South Africa.
| | - Mohamed Aqiel Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Future Water Institute, University of Cape Town, Rondebosch, 7700, Cape Town, South Africa.
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Data Sources for Understanding the Social Determinants of Health: Examples from Two Middle-Income Countries: the 3-D Commission. J Urban Health 2021; 98:31-40. [PMID: 34472014 PMCID: PMC8409472 DOI: 10.1007/s11524-021-00558-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2021] [Indexed: 01/05/2023]
Abstract
The expansion in the scope, scale, and sources of data on the wider social determinants of health (SDH) in the last decades could bridge gaps in information available for decision-making. However, challenges remain in making data widely available, accessible, and useful towards improving population health. While traditional, government-supported data sources and comparable data are most often used to characterize social determinants, there are still capacity and management constraints on data availability and use. Conversely, privately held data may not be shared. This study reviews and discusses the nature, sources, and uses of data on SDH, with illustrations from two middle-income countries: Kenya and the Philippines. The review highlights opportunities presented by new data sources, including the use of big data technologies, to capture data on social determinants that can be useful to inform population health. We conducted a search between October 2010 and September 2020 for grey and scientific publications on social determinants using a search strategy in PubMed and a manual snowball search. We assessed data sources and the data environment in both Kenya and the Philippines. We found limited evidence of the use of new sources of data to study the wider SDH, as most of the studies available used traditional sources. There was also no evidence of qualitative big data being used. Kenya has more publications using new data sources, except on the labor determinant, than the Philippines. The Philippines has a more consistent distribution of the use of new data sources across the HEALTHY determinants than Kenya, where there is greater variation of the number of publications across determinants. The results suggest that both countries use limited SDH data from new data sources. This limited use could be due to a number of factors including the absence of standardized indicators of SDH, inadequate trust and acceptability of data collection methods, and limited infrastructure to pool, analyze, and translate data.
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Macharia PM, Mumo E, Okiro EA. Modelling geographical accessibility to urban centres in Kenya in 2019. PLoS One 2021; 16:e0251624. [PMID: 33989356 PMCID: PMC8127925 DOI: 10.1371/journal.pone.0251624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 04/30/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Access to major services, often located in urban centres, is key to the realisation of numerous Sustainable Development Goals (SDGs). In Kenya, there are no up-to-date and localised estimates of spatial access to urban centres. We estimate the travel time to urban centres and identify marginalised populations for prioritisation and targeting. METHODS Urban centres were mapped from the 2019 Kenya population census and combined with spatial databases of road networks, elevation, land use and travel barriers within a cost-friction algorithm to compute travel time. Seven travel scenarios were considered: i) walking only (least optimistic), ii) bicycle only, iii) motorcycle only, iv) vehicle only (most optimistic), v) walking followed by motorcycle transport, vi) walking followed by vehicle transport, and vii) walking followed by motorcycle and then vehicle transport (most pragmatic). Mean travel time, and proportion of the population within 1-hour and 2-hours of the urban centres were summarized at sub-national units (counties) used for devolved planning. Inequities were explored and correlations between the proportion of the population within 1-hour of an urban centre and ten SDG indicators were computed. RESULTS A total of 307 urban centres were digitised. Nationally, the mean travel time was 4.5-hours for the walking-only scenario, 1.0-hours for the vehicle only (most optimistic) scenario and 1.5-hours for the walking-motorcycle-vehicle (most pragmatic) scenario. Forty-five per cent (21.3 million people) and 87% (41.6 million people) of Kenya's population resided within 1-hour of the nearest urban centre for the least optimistic and most pragmatic scenarios respectively. Over 3.2 million people were considered marginalised or living outside the 2-hour threshold in the pragmatic scenario, 16.0 million Kenyans for walking only, and 2.2 million for the most optimistic scenario. County-level spatial access was highly heterogeneous ranging between 8%-100% and 32%-100% of people within the 1-hour threshold for the least and most optimistic scenarios, respectively. Counties in northern and eastern parts of Kenya were generally most marginalised. The correlation coefficients for nine SDG indicators ranged between 0.45 to 0.78 and were statistically significant. CONCLUSION Travel time to urban centres in Kenya is heterogeneous. Therefore, marginalised populations should be prioritised during resource allocation and policies should be formulated to enhance equitable access to public services and opportunities in urban areas.
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Affiliation(s)
- Peter M. Macharia
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust
Research Programme, Nairobi, Kenya
| | - Eda Mumo
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust
Research Programme, Nairobi, Kenya
| | - Emelda A. Okiro
- Population Health Unit, Kenya Medical Research Institute-Wellcome Trust
Research Programme, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of
Medicine, University of Oxford, Oxford, United Kingdom
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Opoku SK, Filho WL, Hubert F, Adejumo O. Climate Change and Health Preparedness in Africa: Analysing Trends in Six African Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094672. [PMID: 33925753 PMCID: PMC8124714 DOI: 10.3390/ijerph18094672] [Citation(s) in RCA: 186] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/12/2021] [Accepted: 04/17/2021] [Indexed: 11/23/2022]
Abstract
Climate change is a global problem, which affects the various geographical regions at different levels. It is also associated with a wide range of human health problems, which pose a burden to health systems, especially in regions such as Africa. Indeed, across the African continent public health systems are under severe pressure, partly due to their fragile socioeconomic conditions. This paper reports on a cross-sectional study in six African countries (Ghana, Nigeria, South Africa, Namibia, Ethiopia, and Kenya) aimed at assessing their vulnerabilities to climate change, focusing on its impacts on human health. The study evaluated the levels of information, knowledge, and perceptions of public health professionals. It also examined the health systems’ preparedness to cope with these health hazards, the available resources, and those needed to build resilience to the country’s vulnerable population, as perceived by health professionals. The results revealed that 63.1% of the total respondents reported that climate change had been extensively experienced in the past years, while 32% claimed that the sampled countries had experienced them to some extent. Nigerian respondents recorded the highest levels (67.7%), followed by Kenya with 66.6%. South Africa had the lowest level of impact as perceived by the respondents (50.0%) when compared with the other sampled countries. All respondents from Ghana and Namibia reported that health problems caused by climate change are common in the two countries. As perceived by the health professionals, the inadequate resources reiterate the need for infrastructural resources, medical equipment, emergency response resources, and technical support. The study’s recommendations include the need to improve current policies at all levels (i.e., national, regional, and local) on climate change and public health and to strengthen health professionals’ skills. Improving the basic knowledge of health institutions to better respond to a changing climate is also recommended. The study provides valuable insights which may be helpful to other nations in Sub-Saharan Africa.
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Affiliation(s)
- Samuel Kwasi Opoku
- Research and Transfer Centre “Sustainable Development and Climate Change Management”, Hamburg University of Applied Sciences, Ulmenliet 20, D-21033 Hamburg, Germany; (S.K.O.); (F.H.)
| | - Walter Leal Filho
- Research and Transfer Centre “Sustainable Development and Climate Change Management”, Hamburg University of Applied Sciences, Ulmenliet 20, D-21033 Hamburg, Germany; (S.K.O.); (F.H.)
- Correspondence:
| | - Fudjumdjum Hubert
- Research and Transfer Centre “Sustainable Development and Climate Change Management”, Hamburg University of Applied Sciences, Ulmenliet 20, D-21033 Hamburg, Germany; (S.K.O.); (F.H.)
| | - Oluwabunmi Adejumo
- Institute for Entrepreneurship and Development Studies, Obafemi Awolowo University, Ile-Ife 220282, Osun State, Nigeria;
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Macharia PM, Joseph NK, Sartorius B, Snow RW, Okiro EA. Subnational estimates of factors associated with under-five mortality in Kenya: a spatio-temporal analysis, 1993-2014. BMJ Glob Health 2021; 6:e004544. [PMID: 33858833 PMCID: PMC8054106 DOI: 10.1136/bmjgh-2020-004544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/26/2021] [Accepted: 03/27/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND To improve child survival, it is necessary to describe and understand the spatial and temporal variation of factors associated with child survival beyond national aggregates, anchored at decentralised health planning units. Therefore, we aimed to provide subnational estimates of factors associated with child survival while elucidating areas of progress, stagnation and decline in Kenya. METHODS Twenty household surveys and three population censuses conducted since 1989 were assembled and spatially aligned to 47 subnational Kenyan county boundaries. Bayesian spatio-temporal Gaussian process regression models accounting for inadequate sample size and spatio-temporal relatedness were fitted for 43 factors at county level between 1993 and 2014. RESULTS Nationally, the coverage and prevalence were highly variable with 38 factors recording an improvement. The absolute percentage change (1993-2014) was heterogeneous ranging between 1% and 898%. At the county level, the estimates varied across space and over time with a majority showing improvements after 2008 which was preceded by a period of deterioration (late-1990 to early-2000). Counties in Northern Kenya were consistently observed to have lower coverage of interventions and remained disadvantaged in 2014 while areas around Central Kenya had and historically have had higher coverage across all intervention domains. Most factors in Western and South-East Kenya recorded moderate intervention coverage although having a high infection prevalence of both HIV and malaria. CONCLUSION The heterogeneous estimates necessitates prioritisation of the marginalised counties to achieve health equity and improve child survival uniformly across the country. Efforts are required to narrow the gap between counties across all the drivers of child survival. The generated estimates will facilitate improved benchmarking and establish a baseline for monitoring child development goals at subnational level.
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Affiliation(s)
- Peter M Macharia
- Population Health Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Noel K Joseph
- Population Health Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Benn Sartorius
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Robert W Snow
- Population Health Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Emelda A Okiro
- Population Health Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Seiler J, Harttgen K, Kneib T, Lang S. Modelling children's anthropometric status using Bayesian distributional regression merging socio-economic and remote sensed data from South Asia and sub-Saharan Africa. ECONOMICS AND HUMAN BIOLOGY 2021; 40:100950. [PMID: 33321408 DOI: 10.1016/j.ehb.2020.100950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 06/12/2023]
Abstract
A history of insufficient nutritional intake is reflected by low anthropometric measures and can lead to growth failures, limited mental development, poor health outcomes and a higher risk of dying. Children below five years are among those most vulnerable and, while improvements in the share of children affected by insufficient nutritional intake has been observed, both sub-Saharan Africa and South Asia have a disproportionately high share of growth failures and large disparities at national and sub-national levels. In this study, we use a Bayesian distributional regression approach to develop models for the standard anthropometric measures, stunting and wasting. This approach allows us to model both the mean and the standard deviation of the underlying response distribution. Accordingly, the whole distribution of the anthropometric measures can be evaluated. This is of particular importance, considering the fact that (severe) growth failures of children are defined having a z-score below -2 (-3), emphasising the need to extend the analysis beyond the conditional mean. In addition, we merge individual data taken from the Demographic and Health Surveys with remote sensed data for a large sample of 38 countries located in sub-Saharan Africa and South Asia for the period 1990-2016, in order to combine individual and household specific characteristics with geophysical and environmental characteristics, and to allow for a comparison over time. Our results show besides gender differences across space, and strong non-linear effects of included socio-economic characteristics, in particular for maternal education and the wealth of the household that, surprisingly, in the presence of socio-economic characteristics, remote sensed data does not contribute to variations in growth failures, and including a pure spatial effect excluding remote sensed data leads to even better results. Further, while all regions showed improvements towards the target of the Sustainable Development Goals (SDGs), our analysis identifies hotspots of growth failures at sub-national levels within India, Nigeria, Niger, and Madagascar, emphasising the need to accelerate progress to reach the target set by the SDGs.
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Affiliation(s)
- Johannes Seiler
- Department of Statistics, University of Innsbruck, Universitätsstr. 15, 6020 Innsbruck, Austria.
| | - Kenneth Harttgen
- Department of Humanities, Social and Political Sciences, ETH Zurich, Clausiusstr. 37, 8092 Zurich, Switzerland.
| | - Thomas Kneib
- University of Göttingen, Chair of Statistics, Humboldtallee 3, 37073 Göttingen, Germany.
| | - Stefan Lang
- Department of Statistics, University of Innsbruck, Universitätsstr. 15, 6020 Innsbruck, Austria.
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Lieber M, Chin-Hong P, Kelly K, Dandu M, Weiser SD. A systematic review and meta-analysis assessing the impact of droughts, flooding, and climate variability on malnutrition. Glob Public Health 2020; 17:68-82. [PMID: 33332222 DOI: 10.1080/17441692.2020.1860247] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Both the World Health Organization and the Intergovernmental Panel on Climate Change project that malnutrition will be the greatest contributor to climate change-associated morbidity and mortality. Although there have been several studies that have examined the potential effects of climate change on human health broadly, the effects on malnutrition are still not well understood. We conducted a systematic review investigating the role of three climate change proxies (droughts, floods, and climate variability) on malnutrition in children and adults. METHODS AND FINDINGS We identified 22 studies examining the effects of droughts, floods, and climate variability on at least one malnutrition metric. We found that 17 out of 22 studies reported a significant relationship between climate change proxies and at least one malnutrition metric. In meta-analysis, drought conditions were significantly associated with both wasting (Odds Ratio [OR] 1.46, 95% Confidence Interval [CI] 1.05-2.04) and underweight prevalence (OR 1.46, 95% CI 1.01-2.11). CONCLUSIONS Given the long-term consequences of malnutrition on individuals and society, adoption of climate change adaptation strategies such as sustainable agriculture and water irrigation practices, as well as improving nutritional interventions aimed at children aged 1-2 years and older adults, should be prioritised on global policy agendas in the coming years.
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Affiliation(s)
- Mark Lieber
- Johns Hopkins Bayview Medical Center, Baltimore, USA
| | - Peter Chin-Hong
- University of California, San Francisco (UCSF) School of Medicine, San Francisco, USA
| | - Knox Kelly
- Pacific Inpatient Medical Group, San Francisco, USA
| | - Madhavi Dandu
- University of California, San Francisco (UCSF) School of Medicine, San Francisco, USA
| | - Sheri D Weiser
- University of California, San Francisco (UCSF) Division of HIV, Infectious Disease and Global Medicine, San Francisco, USA
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14
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Estimating Yields of Household Fields in Rural Subsistence Farming Systems to Study Food Security in Burkina Faso. REMOTE SENSING 2020. [DOI: 10.3390/rs12111717] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Climate change has an increasing impact on food security and child nutrition, particularly among rural smallholder farmers in sub-Saharan Africa. Their limited resources and rainfall dependent farming practices make them sensitive to climate change-related effects. Data and research linking yield, human health, and nutrition are scarce but can provide a basis for adaptation and risk management strategies. In support of studies on child undernutrition in Burkina Faso, this study analyzed the potential of remote sensing-based yield estimates at household level. Multi-temporal Sentinel-2 data from the growing season 2018 were used to model yield of household fields (median 1.4 hectares (ha), min 0.01 ha, max 12.6 ha) for the five most prominent crops in the Nouna Health and Demographic Surveillance (HDSS) area in Burkina Faso. Based on monthly metrics of vegetation indices (VIs) and in-situ harvest measurements from an extensive field survey, yield prediction models for different crops of high dietary importance (millet, sorghum, maize, and beans) were successfully generated producing R² between 0.4 and 0.54 (adj. R² between 0.32 and 0.5). The models were spatially applied and resulted in a yield estimation map at household level, enabling predictions of up to 2 months prior to harvest. The map links yield on a 10-m spatial resolution to households and consequently can display potential food insecurity. The results highlight the potential for satellite imagery to provide yield predictions of smallholder fields and are discussed in the context of health-related studies such as child undernutrition and food security in rural Africa under climate change.
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Coates SJ, Enbiale W, Davis MDP, Andersen LK. The effects of climate change on human health in Africa, a dermatologic perspective: a report from the International Society of Dermatology Climate Change Committee. Int J Dermatol 2020; 59:265-278. [PMID: 31970754 DOI: 10.1111/ijd.14759] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 11/04/2019] [Accepted: 11/25/2019] [Indexed: 12/14/2022]
Abstract
Throughout much of the African continent, healthcare systems are already strained in their efforts to meet the needs of a growing population using limited resources. Climate change threatens to undermine many of the public health gains that have been made in this region in the last several decades via multiple mechanisms, including malnutrition secondary to drought-induced food insecurity, mass human displacement from newly uninhabitable areas, exacerbation of environmentally sensitive chronic diseases, and enhanced viability of pathogenic microbes and their vectors. We reviewed the literature describing the various direct and indirect effects of climate change on diseases with cutaneous manifestations in Africa. We included non-communicable diseases such as malignancies (non-melanoma skin cancers), inflammatory dermatoses (i.e. photosensitive dermatoses, atopic dermatitis), and trauma (skin injury), as well as communicable diseases and neglected tropical diseases. Physicians should be aware of the ways in which climate change threatens human health in low- and middle-income countries in general, and particularly in countries throughout Africa, the world's lowest-income and second most populous continent.
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Affiliation(s)
- Sarah J Coates
- Department of Dermatology, The University of California San Francisco, San Francisco, CA, USA
| | | | - Mark D P Davis
- Division of Clinical Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Louise K Andersen
- Department of Dermato-Venereology, Aarhus University Hospital, Aarhus, Denmark
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Epstein A, Torres JM, Glymour MM, López-Carr D, Weiser SD. Do Deviations From Historical Precipitation Trends Influence Child Nutrition? An Analysis From Uganda. Am J Epidemiol 2019; 188:1953-1960. [PMID: 31497852 DOI: 10.1093/aje/kwz179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 08/01/2019] [Accepted: 08/08/2019] [Indexed: 11/13/2022] Open
Abstract
Changes in precipitation patterns might have deleterious effects on population health. We used data from the Uganda National Panel Survey from 2009 to 2012 (n = 3,223 children contributing 5,013 assessments) to evaluate the link between rainfall and undernutrition in children under age 5 years. We considered 3 outcomes (underweight, wasting, and stunting) and measured precipitation using household-reported drought and deviations from long-term precipitation trends measured by satellite. We specified multilevel logistic regression models with random effects for the community, village, and individual. Underweight (13%), wasting (4%), and stunting (33%) were common. Reported drought was associated with underweight (marginal risk ratio (RR) = 1.18, 95% confidence interval (CI): 1.04, 1.35) in adjusted analyses. Positive annual deviations (greater rainfall) from long-term precipitation trends were protective against underweight (marginal RR per 50-mm increase = 0.94, 95% CI: 0.92, 0.97) and wasting (marginal RR per 50-mm increase = 0.93, 95% CI: 0.87, 0.98) but not stunting (marginal RR per 50-mm increase = 1.00, 95% CI: 0.98, 1.01). Precipitation was associated with measures of acute but not chronic malnutrition using both objective and subjective measures of exposure. Sudden reductions in rainfall are likely to have acute adverse effects on child nutritional status.
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Belesova K, Agabiirwe CN, Zou M, Phalkey R, Wilkinson P. Drought exposure as a risk factor for child undernutrition in low- and middle-income countries: A systematic review and assessment of empirical evidence. ENVIRONMENT INTERNATIONAL 2019; 131:104973. [PMID: 31400736 DOI: 10.1016/j.envint.2019.104973] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/13/2019] [Accepted: 06/27/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Droughts affect around 52 million people globally each year, a figure that is likely to increase under climate change. OBJECTIVES To assess the strength of empirical evidence on drought exposure as a risk factor for undernutrition in children <5 years of age in low- and middle-income countries (LMICs). METHODS Systematic review of observational studies published between 1990 and 2018 in English and reporting undernutrition outcomes in children <5 years of age in relation to droughts in LMICs. The search was performed in the Global Health, Medline, Embase, and Scopus databases. We assessed the strength of evidence following the Navigation Guide. RESULTS 27 studies met our inclusion criteria. 12 reported prevalence estimates in drought-affected conditions without comparison to unaffected conditions. These showed high prevalence of chronic and mixed undernutrition and poor to critical levels of acute undernutrition. Only two studies were judged to have low risk of bias. Overall, the strength of evidence of drought as a risk factor was found to be limited, but the two studies with low risk of bias suggested positive associations of drought exposure with children being underweight and having anaemia. CONCLUSION Published evidence suggests high levels of all types of child undernutrition in drought-affected populations in low-income settings, but the extent to which these levels are attributable to drought has not been clearly quantified and may be context specific. This review offers suggestions for enhancing the quality of future studies to strengthen evidence on the potential magnitude, timing, and modifying factors of drought impacts.
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Affiliation(s)
- Kristine Belesova
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
| | - Caroline Noel Agabiirwe
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
| | - Margaret Zou
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
| | - Revati Phalkey
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK; Institute of Public Health, University of Heidelberg, Im Neuenheimer Feld 324, Heidelberg 69120, Germany.
| | - Paul Wilkinson
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
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18
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Negev M, Teschner N, Rosenthal A, Levine H, Lew-Levy C, Davidovitch N. Adaptation of health systems to climate-related migration in Sub-Saharan Africa: Closing the gap. Int J Hyg Environ Health 2018; 222:311-314. [PMID: 30503929 DOI: 10.1016/j.ijheh.2018.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 10/06/2018] [Accepted: 10/30/2018] [Indexed: 11/19/2022]
Abstract
Health systems worldwide need to be adapted to cope with growing numbers of migrants and to climate-exacerbated morbidity. Heatwaves, water stress, desertification, flooding, and sea level rise are environmental stressors that increase morbidity, mortality, and poor mental health in Sub-Saharan Africa. While most migration is intra-African, climate change is also affecting migration patterns outside the continent. To tackle the health challenges induced by these events, such as infectious diseases and malnutrition, health care providers in Sub-Saharan Africa and in receiving countries in Europe must adapt their systems to provide appropriate health services to these communities. While health systems differ greatly across the global north and south, adaptation measures are similar and should be integrated. We present recommendations for adaptation of health systems to climate-related migration, including strengthening health systems, providing access to healthcare, culturally-appropriate services, policy-oriented research and training, and inter-sectoral collaboration.
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Affiliation(s)
- Maya Negev
- School of Public Health, University of Haifa, Mt. Carmel, Haifa, 3190501, Israel.
| | - Na'ama Teschner
- Geography and Environmental Development, Ben-Gurion University of the Negev, P.O.Box 653, Beer-Sheva, 84105, Israel
| | - Anat Rosenthal
- Department of Health Systems Management, School of Public Health, Faculty of Health Sciences & The Tamar Golan Africa Center, Ben-Gurion University of the Negev, P.O.Box 653, Be'er Sheva, 84105, Israel
| | - Hagai Levine
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah Faculty of Medicine, P.O. Box 12272, Kiryat Hadassah, Ein Kerem, Jerusalem, 9112002, Israel
| | - Clara Lew-Levy
- School of Public Health, University of Haifa, Mt. Carmel, Haifa, 3190501, Israel
| | - Nadav Davidovitch
- Department of Health Systems Management, School of Public Health, Faculty of Health Sciences & Guilford Glazer Faculty of Business, Management Ben-Gurion University of the Negev, P.O.Box 653, Be'er Sheva, 84105, Israel
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