Public Health Adaptation Research Articles

Climate change and public health adaptation measures in the United States

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Climate change and public health adaptation measures in the United States

Climate change and public health adaptation measures in the United States

Public Health Responses to the Risks of Climate Variability and Change in the United States

Discuss issues related to the capacity of the United States to effectively adapt to current and future climate change. Review literature on public health adaptation measures to reduce the burden of climate-sensitive health outcomes. Most health risks of concern with climate change already exist in the United States. Current interventions may need to be augmented or deployed in new regions to prevent additional climate change-related morbidity and mortality. Monitoring and surveillance systems will need to be modified to ensure programs remain effective under a changing climate. Explicit consideration of climate change is needed in the many programs and research activities within federal, state, and local agencies that are relevant to adaptation to ensure that they have maximum effectiveness in reducing future vulnerability to the projected health impacts of climate change.

Costs of Public Health Adaptation to Climate Change

Costs of Public Health Adaptation to Climate Change

The Effects of Temperature and Recovery of Vector on the Spatial Distribution of Dengue Fever Occurrences in Taiwan

TM4-O-08 Climate change has influenced the occurrence and distribution of vector-borne diseases in the world. Identifying vulnerable population in response to future changes of climate is therefore important for public health adaptation decision. Our study therefore conducted spatial analysis to examine the linkage between temperature and other environmental factors on dengue fever distribution and predicting the area with potential risk of dengue fever endemics in future climatic change. We used Geographical Information System (ArcGIS 8.2) to demonstrate the spatial patterns of dengue fever occurrence, climatic and nonclimatic factors. The basic spatial unit used in this study is township, and 357 townships with complete case number of dengue fever, weather, population density, and vector surveillance data were included in the analysis. Computerized database containing daily registration of dengue fever cases in Taiwan for the period of 1998 to 2002 were obtained from Taiwan CDC. Logistic regressions were further adopted to evaluate the linkage between spatial characteristics of climatic and nonclimatic factors, and occurrence of dengue fever to further identify risk factors of dengue fever distribution. Incidence rates per square kilometer were used to map out the incidence rate from 1998 to 2002 in each township. Significantly higher monthly average temperature could be observed in those townships with occurrence of dengue fever (nonparametric Mann-Whitney test). Significantly elevated risk of dengue fever occurrence could be observed, with odds ratios between 1.65 and 19.18, when the average monthly temperature for the specific township exceeded certain levels. Warmer winter season seemed to impose relatively higher risk than the warmer summer season. The recovery rate of household vectors higher than 30% in the township was also found to be associated with dengue fever occurrence (OR = 1.80; 95% CI, 1.05–3.02). However, greater population density did not seem to be a critical factor for increasing vector population in Taiwan. The map of risk scores, based on temperature and recovery rate of vector density over 12 months, were plot to indicate the areas with potential risk for dengue fever occurrence. In our study, 39 townships with scores higher than 10, account for almost 11% of 357 townships in Taiwan, have contributed to nearly 95% indigenous cases between 1998 and 2002. The predicted risk scores using temperature and recovery rate of vector density could be considered a worth-taking approach for identifying vulnerable regions in Taiwan to highlight those areas with greater potential risk for dengue fever outbreak in the future.

Barriers to use of geospatial data for adaptation to climate change and variability: case studies in public health

This paper presents two case studies of the barriers to the use of geospatial data in the context of public health adaptation to climate change and variability. The first case study is on the hazards of coastal zone development in the United States with the main emphasis on Hurricane Katrina. An important barrier to the use of geospatial data is that the legal system does not support restrictions on land use intended to protect the coastal zone. Economic interests to develop New Orleans and the Mississippi River, both over the long term and the short term, had the effect of increasing the impact of the hurricane. The second case study is epidemics of climate-sensitive diseases with the main emphasis on malaria in Africa. Limits to model accuracy may present a problem in using climate data for an early warning system, and some geographic locations are likely to be more suitable than others. Costs of the system, including the costs of errors, may also inhibit implementation. Deriving societal benefits from geospatial data requires an understanding of the particular decision contexts and organizational processes in which knowledge is developed and used. The data by themselves will not usually generate a societal response. Scientists working in applications should develop partnerships to address the use of geospatial data for societal benefit.

Uruguay on the world stage: how child health became an international priority.

The evolution of international health has typically been assessed from the standpoint of central institutions (international health organizations, foundations, and development agencies) or of one-way diffusion and influence from developed to developing countries. To deepen understanding of how the international health agenda is shaped, I examined the little-known case of Uruguay and its pioneering role in advancing and institutionalizing child health as an international priority between 1890 and 1950. The emergence of Uruguay as a node of international health may be explained through the country's early gauging of its public health progress, its borrowing and adaptation of methods developed overseas, and its broadcasting of its own innovations and shortcomings.

Older women's perceptions of independence versus dependence in food-related work.

This qualitative study aims to explore the cultural meaning of accomplishing food-related work by older women, when disease has diminished their abilities and threatens to make them dependent. Seventy-two women with stroke, rheumatoid arthritis, and Parkinson's disease, as well as women without those diseases, were interviewed. All were living at home. Results showed that older women valued independence and feared dependence when declining ability threatened performance of food-related work. They also had strong beliefs about living a "normal life," managing by oneself as long as possible, and becoming their own masters again. To remain independent, participants used three kinds of strategies: Public Health Service Support, self-managing, and adaptation. Their beliefs about dependence included not becoming a burden, retaining self-determination, and maintaining order in life. Implications for nursing include supporting independent cooking, developing care plans with the care recipient, and demonstrating respect for the women's self-determination.

Distribution of blood pressure, body mass index and smoking habits in the urban population of Dar es Salaam, Tanzania, and associations with socioeconomic status.

To estimate the distribution of blood pressure (BP), body mass index (BMI), smoking habits and their associations with socioeconomic status (SES) in an urban population in early epidemiological transition. Cross-sectional survey of the entire population aged 25-64 years in five branches of Dar es Salaam (Tanzania) through visits to all homes in the study area. Blood pressure was based on the mean of the second and third readings with an automated device. Socioeconomic status was estimated with indicators of education, occupation and wealth. In all 9254 people were examined. Age-adjusted prevalence (%) among men/ women aged 35-64 years was 27.1/30.2 for BP > or = 140/90 mmHg or antihypertensive medication, 13.1/17.7 for BP > or = 160/95 mmHg or antihypertensive medication, 28.0/27.4 for BMI of 25.0-29.9 kg/m(2), 6.9/17.4 for BMI > or = 30 kg/m(2), and 22.0/2.6 for smoking (> or = 1 cigarette per day). Prevalence of categories of drinking frequency and history of diabetes are also reported. After adjustment for covariates, SES was associated inversely with BP and smoking and directly with BMI. Body mass index was associated positively with BP (1.01 and 0.91 mmHg systolic BP per 1 kg/m(2) BMI in men and women, respectively) and inversely with smoking (-1.14 kg/m(2) in male smokers versus non-smokers). Hypertension treatment rates were low, particularly in people of low SES. High prevalence of several cardiovascular risk factors in the urban population of a low-income country stresses the need for early public health interventions and adaptation of the health care infrastructure to meet the emerging challenge of cardiovascular disease. The direct SES-BMI association may drive increasing BMI and BP while the population becomes more affluent.