Correction to: The attribution of human health outcomes to climate change: transdisciplinary practical guidance

Climate change and degradation of ecosystem services functioning may threaten the ability of current agricultural systems to keep up with demand for adequate and inexpensive food and for clean water, waste disposal and other broader ecosystem services. Human health is likely to be affected by changes occurring across multiple geographic and time scales. Impacts range from increasing transmissibility and the range of vectorborne diseases, such as malaria and yellow fever, to undermining nutrition through deleterious impacts on food production and concomitant increases in food prices. This paper uses case studies to describe methods that make use of satellite remote sensing and Demographic and Health Survey data to better understand individual-level human health and nutrition outcomes. By bringing these diverse datasets together, the connection between environmental change and human health outcomes can be described through new research and analysis.

Just eight years from now, in 2030, the world will once again review our progress toward the United Nations Sustainable Development Goals (SDGs), a bold set of 17 interconnected goals with 169 targets, agreed upon by the 191 United Nations (UN) members, centered around creating a more equitable world for all. The SDGs were originally published in 2015 on the seventieth anniversary of the UN to set out a “supremely ambitious and transformational vision…a world free of poverty, hunger, disease and want, where all life can thrive” [1]. The SDGs were developed with a full recognition that humanity’s needs are deeply connected and not siloed. Despite this recognition, we continue to approach humanity’s needs in ways that belie the interconnectedness of those needs; we continue to work in ways that do not fully acknowledge that basic development needs such as housing, water, food, gender equality, food insecurity, poverty alleviation, and the environment are interconnected. We believe this is unacceptable because it fragments the discourse around the fullness of what humanity itself needs to thrive.The world of research is just as fragmented as the world of programs and policies around the SDGs. Development aid and government investments in sectoral programs are normally examined for their impacts on narrow outcomes. For example, few programs in nonhealth sectors are assessed for their influence on human health outcomes. While annual global development aid reached $161.2 billion in 2020 [2], economic and agricultural development programs rarely evaluate their health impacts [3, 4]. More importantly, most poverty alleviation and food security programs are not developed with improving health or health equity as a key objective, and as a result, improvements in health are not optimized with traditional development approaches. Additional research examining the linkage between poverty alleviation, improved food security, gender equality, planetary health, and human health could further encourage large global health and development actors to invest in more interdisciplinary approaches.Systemic racism as well as ethnic, gender, and other forms of discrimination negatively affect progress toward achieving the SDGs. Minoritized racial and ethnic groups are generally further behind advantaged racial and ethnic groups in poverty, economic growth, and access to clean water and food, all of which adversely affect health and well-being. Those who live in poverty typically have less access to food, less access to clean water and sanitation, and more exposure to pollution than those who have a higher income [5]. Physical and psychological health disparities are further exacerbated by racial disparities related to environmental injustice and climate change [6]. Despite a call by several UN human rights groups, the SDGs are silent on the eradication of systemic racism and racial, ethnic, and many other forms of discrimination, which constitute global barriers to human development and the fulfillment of human rights throughout the life span.Prior to the COVID-19 pandemic, many countries around the world had made substantial progress toward ending poverty in all its forms (SDG 1). While 36% of the world’s population lived in extreme poverty in 1990, by 2015 this had fallen to 10%. Due to the COVID-19 pandemic, however, it is estimated that an additional half a billion people have been pushed or pushed further into poverty [7]. The effects of infectious diseases like COVID-19 on economic outcomes serve as yet another illustration of the strong positive correlation established between health and wealth over decades of economics research. Moreover, a vibrant literature in economics has demonstrated a strong bidirectional relationship between health and economic outcomes in both low- and high-income countries [8]. This research has demonstrated that there are large returns to investing in health and that programs that protect or improve economic outcomes—such as social protection programs—result in significant health improvements as well. Moreover, in the field of economics, the past two decades have witnessed a revolution in scientific methods for learning how to end poverty and improve well-being in low- and middle-income countries. Randomized trials of interventions and policies have become far more common and have opened new possibilities for understanding how to achieve SDG 1, and also with important impacts on SDG 3 (“Good health and well-being”) [9]. However, most of the economic research on poverty alleviation and health in low- and middle-income countries typically appears in journals that are not widely read by health scientists or by stakeholders in the countries where the research takes place. Through the section on SDG 1, Advances in Global Health aims to provide new opportunities for dissemination of research on the linkages between poverty and health.Food insecurity and poor diets (SDG 2) compromise nutrition and health outcomes in profound ways. Global and national models suggest that malnutrition and poor diets are the leading contributors to the burden of disease around the world [10]. These impacts operate through multiple pathways. For instance, maternal and child undernutrition contribute to almost half of all child deaths each year in the developing world, and 11% of the global burden of disease, including noncommunicable disease, is linked to poor diets [11]. These poor health outcomes, in turn, can affect other SDGs through increased health expenditures, loss of wages when people are too sick to work, or care burdens that often fall disproportionately on women. The connections between food insecurity, diets, nutrition, and health are strong, mutually reinforcing, and rooted in social and economic inequities. Often, the intergenerational transmission of food insecurity and poor nutrition prevents families and communities from escaping these vicious cycles. And yet too much research on food security and nutrition is out of the view of those working on achieving health goals, because it sits in literatures in agriculture, food policy, nutrition, and economics, and lacks a transdisciplinary and trans-SDG emphasis.Gender issues and global health challenges are diverse, emanating out of a complex global context, including a multiplicity of social and cultural contexts. SDG 5 is committed to gender equality, with several targets geared toward ending discrimination against women and improving their opportunities, especially in economics, leadership, and reproductive health. Gender equality is important to advancing global health for several reasons [12, 13]. Without attention to gender equality, females will continue to suffer from reproductive health challenges such as high rates of teenage pregnancies, infertility, and maternal mortality and increased risk of sexually transmitted infections including HIV. Beyond reproductive health, gender matters in the field of gender-based violence, access to health-care services, gender-disaggregated data, and much more [14, 15, 16]. These, in turn, invite us to interrogate the gender-biased norms and gender responsiveness of health policies, financing, and the entire political economy. Engendered by different crises and challenges, these matters play out differently in unique cultural and social environments.Since the 1950s and 1960s, humans have been transforming and disrupting most of our planet’s natural systems at a much-accelerated pace, from the deep oceans to the upper atmosphere, causing loss of biodiversity, overexploitation of fisheries, rising carbon dioxide in the atmosphere, acidification of oceans, and loss of tropical forests. Those disruptions interact with each other in complex ways to alter the fundamental conditions for human health and well-being and, ultimately, affect nearly every dimension of human health [17]. Planetary health focuses on understanding and quantifying the human health impacts of these global environmental disruptions and on developing solutions that will allow humanity and the natural systems we depend on to thrive now and in the future [18]. Our vision is to encourage the preservation and sustainability of natural systems for the benefit of human health (SDG 3), aligned with SDGs 13 (Climate Action), 14 (Life below Water), and 15 (Life on Land) through the study and characterization of the inextricably linked dependencies between human health and the health of natural systems.Inequities in the representation of scientists from low- and middle-income countries as well as minority groups in most countries has plagued academic research. For example, in a systematic review of health research in sub-Saharan Africa between 2014 and 2016, 14% of papers had no local coauthors (i.e., from the country where the research took place), and representation of local coauthors as first author was also low (23%) when the research involved researchers from the United States, Canada, or Europe [19]. This is consistent with extensive global health literature [20, 21]. Even higher rates of nonrepresentation of local coauthors are reported in economics research that takes place in low- and middle-income countries. A recent review discovered that only 23% of first authors were from the country of the study’s focus [22, 23]. Research funding and publication fees contribute to such inequities and are some of the barriers that need to be addressed to improve equity in the recognition of research. We believe that supporting the SDGs cannot be separated from addressing these significant inequities in research dissemination.Advances in Global Health is a peer-reviewed, open-access research journal that is committed to decolonizing and democratizing global health. This entails purposefully giving prominence to knowledge and knowledge production from low- and middle-income countries as well as racial and ethnic minority communities within all countries. In so doing, Advances in Global Health is committed to the following: (1) having an editorial board that is representative of relevant disciplines and inclusive of scholars from low- and middle-income countries; (2) publishing knowledge from low- and middle-income countries; (3) focusing on issues that are pertinent to low- and middle-income countries; and (4) securing representation of lead authors from low- and middle-income countries. The journal is dedicated to transdisciplinarity and inclusivity; seeks to fully engage researchers from low- and middle-income countries in all aspects of the journal; and specifically encourages contributions led by authors situated in these regions. Furthermore, we have chosen to use an open-access format to ensure that the journal content is freely available to researchers, policy makers, and the general community free of charge. For at least through the end of 2023, publication is free of charge; in subsequent years, the publication charge will be reduced or free for authors from low- and middle-income countries.Thematically, Advances in Global Health is focused on advancing health equity throughout the world by publishing research aligned with the SDGs. Advances in Global Health centers health as its focus and promotes an interdisciplinary approach to studying the bidirectional relationship between health outcomes and other key sectors—for example, ending poverty and promoting food security, gender equality, and planetary health. These sections emphasize individual disciplinary approaches to the SDGs as outlined in each section’s aims and scope, forming the core areas of research inquiry and editorial activity of the journal (Figure 1). However, the journal specifically welcomes and encourages research that is interdisciplinary or transdisciplinary in nature and that cuts across multiple SDGs, to avoid research fragmentation and generate a commonplace for integrative science. Finally, as an underlying theme of the journal connected with each of the sections, we will promote scholarly activity that addresses racism and other forms of discrimination, including the rights of Indigenous people.In summary, the Editorial Board, UC Press, and the UC Global Health Institute are firmly committed to having Advances in Global Health be a leading academic journal to share cutting-edge transdisciplinary research and commentaries aiming at improving health equity worldwide. Advances’ editorial policies will actively address research publishing inequities in low- and middle-income countries to effectively promote free sharing of knowledge around the globe.AGL is sponsored by Emerge, the Emerging Diseases Epidemiology Research Training grant D43 TW007393 awarded by the Fogarty International Center of the US National Institutes of Health.The authors declare that they have no competing interests.

An optimal diet for planet and people

Tackling the Research Challenges of Health and Climate Change

The role of the composition of the gut microbiota on human health is not well understood. However, during the past decade, an increased emphasis has been placed on the influence of the impact of nutrition on the composition of gut microbiota and how the gut microbiota affects human health. The current review focuses on the role of some of the most studied phytochemicals on the composition of the gut microbiota. First, the review highlights the state of the research evidence regarding dietary phytochemical consumption and gut microbiota composition, including the influence of phytochemicals such as polyphenols, glucosinolates, flavonoids, and sterols that are present in vegetables, nuts, beans, and other foods. Second, the review identifies changes in health outcomes with altered gut microbiota composition, in both animal and human model studies. Third, the review highlights research that includes both associations between dietary phytochemical consumption and gut microbiota composition, and associations between the gut microbiota composition and health outcomes, in order to elucidate the role of the gut microbiota in the relationship between dietary phytochemical consumption and health outcomes in humans and animals. The current review indicated that phytochemicals can beneficially alter gut microbiota composition and decrease the risk for some diseases, such as cancers, and improve some cardiovascular and metabolic risk biomarkers. There is an urgent demand for high-quality studies that determine the relationships between the consumption of phytochemicals and health outcomes, examining gut microbiota as a moderator or mediator.

Coming Together for Climate and Health: Proceedings of the Second Annual Clinical Climate Change Meeting, January 24, 2020.

Environments are shifting rapidly in the Circumpolar Arctic and Subarctic regions as a result of climate change and other external stressors, and this has a substantial impact on the health of northern populations. Thus, there is a need for integrated surveillance systems designed to monitor the impacts of climate change on human health outcomes as part of broader adaptation strategies in these regions. This review aimed to identify, describe, and synthesize literature on integrated surveillance systems in Circumpolar Arctic and Subarctic regions, that are used for research or practice. Following a systematic realist review approach, relevant articles were identified using search strings developed for MEDLINE® and Web of Science™ databases, and screened by two independent reviewers. Articles that met the inclusion criteria were retained for descriptive quantitative analysis, as well as thematic qualitative analysis, using a realist lens. Of the 3431 articles retrieved in the database searches, 85 met the inclusion criteria and were analyzed. Thematic analysis identified components of integrated surveillance systems that were categorized into three main groups: structural, processual, and relational components. These components were linked to surveillance attributes and activities that supported the operations and management of integrated surveillance. This review advances understandings of the distinct contributions of integrated surveillance systems and data to discerning the nature of changes in climate and environmental conditions that affect population health outcomes and determinants in the Circumpolar North. Findings from this review can be used to inform the planning, design, and evaluation of integrated surveillance systems that support evidence-based public health research and practice in the context of increasing climate change and the need for adaptation.

Exposure to bisphenol A associated with multiple health-related outcomes in humans: An umbrella review of systematic reviews with meta-analyses

Water sprays from an open fire hydrant in Brooklyn, New York, in the midst of a July 2010 heat wave that affected much of the eastern United States.In 2007 the New York City Department of Environmental Protection first teamed up with Alianza Dominicana, a Washington Heights community organization, to educate city residents about the appropriate use of fire hydrants and other ways

The purpose of this scoping review was to systematically search and chronicle the available scientific literature pertinent to chicken/poultry intake and human health. The protocol was uploaded to Open Science Framework (https://osf.io/2k7bj/) and was conducted in accordance with recommended guidelines from PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews (PRIMSA-Scr). Articles and scientific literature of all types (observational, experimental, narrative/literature reviews, systematic reviews and meta-analyses) assessing chicken/poultry intake and human health were included. A total of 13,141 articles were identified and 540 met the inclusion criteria. Among these 540 articles, 212 articles focused on cancer morbidity and mortality; 22 on cancer risk factors; 41 on cardiovascular disease (CVD) morbidity and mortality; 52 on CVD risk factors; 32 on diabetes morbidity and mortality; 33 on diabetes risk factors; 42 articles on body weight and body composition, and 181 categorized as “Other”, which included nutrient status, psychological well-being/mental health, cognitive outcomes, microbiome outcomes, chronic kidney disease, non-alcoholic fatty liver disease, skin disorders, and fertility, among others. Among the included articles, 373 were observational, 77 were reviews and meta-analyses and 70 were experimental. This scoping review systematically identifies scientific literature pertinent to poultry intake and all facets of human health. It provides the types of article designs that exist for each designated health outcome, as well as the years in which research was published by health outcome. This review highlights areas where poultry research is apparently lacking. The influences of processed poultry in human health outcomes should be assessed, and cooking methods of poultry should be reported in both RCTs and OBS articles to understand the role of poultry more completely in human health outcomes. This review also provides suggestions for potential RCTs that would help to elucidate the effects of consuming fresh versus processed poultry products on cardiometabolic and cancer risk factor outcomes. Additionally, this review gave guidance on where systematic reviews assessing poultry intake and the following health outcomes are warranted: body mass index/overweight/obesity, CVD morbidity and mortality, and T2DM risk factors and morbidity.

Water-land-food-human health nexus in bioenergy supply chain optimization under climatic constraints.

Can nature deliver on the sustainable development goals?

Background: Climate change influences patterns of human mobility and health outcomes. While much of the climate change and migration discourse is invested in quantitative predictions and debates about whether migration is adaptive or maladaptive, less attention has been paid to the voices of the people moving in the context of climate change with a focus on their health and wellbeing. This qualitative research aims to amplify the voices of migrants themselves to add nuance to dominant migration narratives and to shed light on the real-life challenges migrants face in meeting their health needs in the context of climate change. Methods: We conducted 58 semi-structured in-depth interviews with migrants purposefully selected for having moved from rural Bhola, southern Bangladesh to an urban slum in Dhaka, Bangladesh. Transcripts were analysed using thematic analysis under the philosophical underpinnings of phenomenology. Coding was conducted using NVivo Pro 12. Findings: We identified two overarching themes in the thematic analysis: Firstly, we identified the theme “A risk exchange: Exchanging climate change and health risks at origin and destination”. Rather than describing a “net positive” or “net negative” outcome in terms of migration in the context of climate change, migrants described an exchange of hazards, exposures, and vulnerabilities at origin with those at destination, which challenged their capacity to adapt. This theme included several sub-themes—income and employment factors, changing food environment, shelter and water sanitation and hygiene (WaSH) conditions, and social capital. The second overarching theme was “A changing health and healthcare environment”. This theme also included several sub-themes—changing physical and mental health status and a changing healthcare environment encompassing quality of care and barriers to accessing healthcare. Migrants described physical and mental health concerns and connected these experiences with their new environment. These two overarching themes were prevalent across the dataset, although each participant experienced and expressed them uniquely. Conclusion: Migrants who move in the context of climate change face a range of diverse health risks at the origin, en route, and at the destination. Migrating individuals, households, and communities undertake a risk exchange when they decide to move, which has diverse positive and negative consequences for their health and wellbeing. Along with changing health determinants is a changing healthcare environment where migrants face different choices, barriers, and quality of care. A more migrant-centric perspective as described in this paper could strengthen migration, climate, and health governance. Policymakers, urban planners, city corporations, and health practitioners should integrate the risk exchange into practice and policies.

Fecal indicator bacteria (FIB) (e.g., fecal coliforms, Escherichia coli, and enterococci) have been used for decades to monitor for and protect the public from waterborne pathogens from fecal contamination. However, FIB may not perform well at predicting the presence of waterborne pathogens or human health outcomes from recreational exposure to fecal-contaminated surface waters. Numerous factors can influence the relationship between FIB and pathogens or human health outcomes, including the source(s) of contamination, the type of pathogen(s) present, differences in the survival and behavior of FIB and pathogens in the wastewater conveyance and treatment process, and varying environmental conditions. As a result, different indicators, such as source-specific microbial source tracking (MST) markers and viral fecal indicators, have been used as possible surrogates to better approximate pathogen abundance and human health risks in recreational waters. The performance of these alternative indicators has been mixed, with some promise of viral indicators better approximating viral pathogens than bacterial fecal indicators, and FIB generally more closely associated with bacterial and protozoal pathogen presence than human MST markers. Many of the assays to detect and quantify fecal indicators and pathogens are polymerase chain reaction-based assays, which detect and quantify nucleic acid [deoxyribonucleic acid (DNA) and ribonucleic acid (RNA)] sequences specific to a target of interest. Recent advances in DNA and RNA sequencing technologies may push the field toward metabarcoding approaches, where multiple targets can be detected and quantified simultaneously. Metabarcoding is currently more applicable to bacterial and protozoal assessments than viral assessments based on a lack of universal metabarcoding markers for viruses. Innovative technologies, such as biosensors and nanotechnologies, may provide more sensitive and accurate tools to detect and quantify pathogens. When a specific pathogen is of concern for a recreational water body, a practical approach in estimating the likelihood of human health outcomes is the application of quantitative microbial risk assessments (QMRAs). Quantitative microbial risk assessments can be used to model the likelihood of pathogen-specific human health outcomes from recreational exposure as a function of a surrogate indicator. Inputs for QMRAs include the ratio between the indicator to be monitored and the pathogen of interest, the concentration of the indicator, the amount of water ingested, and the likelihood of the health outcome based on the estimated amount of pathogen consumed. There are numerous unknowns about the behavior and survival of fecal indicators and pathogens in environmental waters. Developing accurate models to predict pathogen concentrations from fecal indicators in recreational waters will require a better understanding of these unknowns. Current methods and technologies for detecting and quantifying fecal indicators and pathogens are limited due to the rare and patchy nature of pathogens. Technological advances may help improve sensitivity for detecting and quantifying pathogens.

With climate change contributing to an increase in frequency and severity of extreme weather events like wildfires, droughts, and hurricanes, there is a growing need for coordinated research efforts to understand the impact of these events on human health. Specialized research frameworks can help interdisciplinary teams organize and visualize complex exposure‐health pathways, identify knowledge gaps, and enhance coordination and communication across diverse groups of stakeholders. This article describes the development and application of a conceptual framework for wildfire‐related exposures and human health outcomes. This framework serves as a tool for integrating data resources and mapping known and hypothesized connections, between complex wildfire exposures and human health outcomes, across the lifecycle of a wildland urban interface (WUI) fire. We also demonstrate the utility and flexibility of this framework for disaster research settings through two example applications. The first demonstrates an application for studying WUI fires and respiratory health outcomes, and the second example shows how the framework can be expanded to visualize exposure and health modeling with potential biomarkers of exposure and effect. Our GeoHealth Framework for WUI Fires illustrates complex linkages between wildfire related exposures and health outcomes and highlights areas for future study. Given the destruction and complexity of WUI fires, this framework provides an important resource that can assist with evaluating these complex exposure‐health relationships, guiding and coordinating data collection, and informing communities and decision‐makers to improve response, recovery, and future preparedness for such events in the United States and globally.