Far-reaching changes to the structure and function of the Earth's natural systems represent a growing threat to human health. And yet, global health has mainly improved as these changes have gathered ...pace. What is the explanation? As a Commission, we are deeply concerned that the explanation is straightforward and sobering: we have been mortgaging the health of future generations to realise economic and development gains in the present.
In September-October 2015, El Niño and positive Indian Ocean Dipole conditions set the stage for massive fires in Sumatra and Kalimantan (Indonesian Borneo), leading to persistently hazardous levels ...of smoke pollution across much of Equatorial Asia. Here we quantify the emission sources and health impacts of this haze episode and compare the sources and impacts to an event of similar magnitude occurring under similar meteorological conditions in September-October 2006. Using the adjoint of the GEOS-Chem chemical transport model, we first calculate the influence of potential fire emissions across the domain on smoke concentrations in three receptor areas downwind-Indonesia, Malaysia, and Singapore-during the 2006 event. This step maps the sensitivity of each receptor to fire emissions in each grid cell upwind. We then combine these sensitivities with 2006 and 2015 fire emission inventories from the Global Fire Assimilation System (GFAS) to estimate the resulting population-weighted smoke exposure. This method, which assumes similar smoke transport pathways in 2006 and 2015, allows near real-time assessment of smoke pollution exposure, and therefore the consequent morbidity and premature mortality, due to severe haze. Our approach also provides rapid assessment of the relative contribution of fire emissions generated in a specific province to smoke-related health impacts in the receptor areas. We estimate that haze in 2015 resulted in 100 300 excess deaths across Indonesia, Malaysia and Singapore, more than double those of the 2006 event, with much of the increase due to fires in Indonesia's South Sumatra Province. The model framework we introduce in this study can rapidly identify those areas where land use management to reduce and/or avoid fires would yield the greatest benefit to human health, both nationally and regionally.
Changes in the type and prevalence of human diseases have occurred during shifts in human social organization, for example, from hunting and gathering to agriculture and with urbanization during the ...Industrial Revolution. The recent emergence and reemergence of infectious diseases appears to be driven by globalization and ecological disruption. We propose that habitat destruction and biodiversity loss associated with biotic homogenization can increase the incidence and distribution of infectious diseases affecting humans. The clearest connection between biotic homogenization and infectious disease is the spread of nonindigenous vectors and pathogens. The loss of predators and hosts that dilute pathogen transmission can also increase the incidence of vectorborne illnesses. Other mechanisms include enhanced abiotic conditions for pathogens and vectors and higher host-pathogen encounter rates. Improved understanding of these causal mechanisms can inform decisionmaking on biodiversity conservation as an effective way to protect human health.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NMLJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Multiple sectors-health and non-health-can determine the health and well-being of people and the condition of the socio-ecological environment on which it depends. At the climate and human health ...nexus, a systems-based understanding of climate change and health should inform all stages of the policy process from problem conceptualization to design, implementation, and evaluation. Such an understanding should guide countries, their partners, and donors to incorporate health in strategic climate actions based on how health is affected by, and plays a role in, the dynamic interactions across economic, environmental, and societal domains. A systems-based approach to sustainable development has been widely promoted but operationalizing it for project level and policy development and implementation has not been well articulated. Such an approach is especially valuable for informing how to address climate change and health together through policy actions which can achieve multiple, mutually reinforcing goals. This commentary article describes strategic steps including the complementary use of health impact assessment, quantification of health impacts, and linking climate and health actions to national and global policy processes to apply a systems-based approach for developing climate mitigation and adaptation actions with human health benefits.
Noncommunicable diseases (NCDs) represent a significant global public health burden. As more countries experience both epidemiologic transition and increasing urbanization, it is clear that we need ...approaches to mitigate the growing burden of NCDs. Large and growing urban environments play an important role in shaping risk factors that influence NCDs, pointing to the ineluctable need to engage sectors beyond the health sector in these settings if we are to improve health. By way of one example, the transportation sector plays a critical role in building and sustaining health outcomes in urban environments in general and in megacities in particular. We conducted a qualitative comparative case study design. We compared Bus Rapid Transit (BRT) policies in 3 megacities—Lagos (Africa), Bogotá (South America), and Beijing (Asia). We examined the extent to which data on the social determinants of health, equity considerations, and multisectoral approaches were incorporated into local politics and the decision-making processes surrounding BRT. We found that all three megacities paid inadequate attention to health in their agenda-setting, despite having considerable healthy transportation policies in principle. BRT system policies have the opportunity to improve lifestyle choices for NCDs through a focus on safe, affordable, and effective forms of transportation. There are opportunities to improve decision-making for health by involving more available data for health, building on existing infrastructures, building stronger political leadership and commitments, and establishing formal frameworks to improve multisectoral collaborations within megacities. Future research will benefit from addressing the political and bureaucratic processes of using health data when designing public transportation services, the political and social obstacles involved, and the cross-national lessons that can be learned from other megacities.
The inclusion of social determinants of health offers a more comprehensive lens to fully appreciate and effectively address health. However, decision-makers across sectors still struggle to ...appropriately recognise and act upon these determinants, as illustrated by the ongoing COVID-19 pandemic. Consequently, improving the health of populations remains challenging. This paper seeks to draw insights from the literature to better understand decision-making processes affecting health and the potential to integrate data on social determinants. We summarised commonly cited conceptual approaches across all stages of the policy process, from agenda-setting to evaluation. Nine conceptual approaches were identified, including two frameworks, two models and five theories. From across the selected literature, it became clear that the context, the actors and the type of the health issue are critical variables in decision-making for health, a process that by nature is a dynamic and adaptable one. The majority of these conceptual approaches implicitly suggest a possible role for data on social determinants of health in decision-making. We suggest two main avenues to make the link more explicit: the use of data in giving health problems the appropriate visibility and credibility they require and the use of social determinants of health as a broader framing to more effectively attract the attention of a diverse group of decision-makers with the power to allocate resources. Social determinants of health present opportunities for decision-making, which can target modifiable factors influencing health—i.e. interventions to improve or reduce risks to population health. Future work is needed to build on this review and propose an improved, people-centred and evidence-informed decision-making tool that strongly and explicitly integrates data on social determinants of health.
The need for a systems approach to planetary health Pongsiri, Montira J; Gatzweiler, Franz W; Bassi, Andrea M ...
The Lancet. Planetary health,
October 2017, 2017-Oct, 2017-10-00, 20171001, 2017-10-01, Letnik:
1, Številka:
7
Journal Article
Human health and wellbeing and the health of the biosphere are inextricably linked. The state of Earth's life-support systems, including freshwater, oceans, land, biodiversity, atmosphere, and ...climate, affect human health. At the same time, human activities are adversely affecting natural systems. This review paper is the outcome of an interdisciplinary workshop under the auspices of the Future Earth Health Knowledge Action Network (Health KAN). It outlines a research agenda to address cross-cutting knowledge gaps to further understanding and management of the health risks of these global environmental changes through an expert consultation and review process. The research agenda has four main themes: (1) risk identification and management (including related to water, hygiene, sanitation, and waste management); food production and consumption; oceans; and extreme weather events and climate change. (2) Strengthening climate-resilient health systems; (3) Monitoring, surveillance, and evaluation; and (4) risk communication. Research approaches need to be transdisciplinary, multi-scalar, inclusive, equitable, and broadly communicated. Promoting resilient and sustainable development are critical for achieving human and planetary health.
The Intermediate Disturbance Hypothesis (IDH) is well-known in ecology providing an explanation for the role of disturbance in the coexistence of climax and colonist species. Here, we used the IDH as ...a framework to describe the role of forest disturbance in shaping the mosquito community structure, and to identify the ecological processes that increase the emergence of vector-borne disease. Mosquitoes were collected in central Panama at immature stages along linear transects in colonising, mixed and climax forest habitats, representing different levels of disturbance. Species were identified taxonomically and classified into functional categories (i.e., colonist, climax, disturbance-generalist, and rare). Using the Huisman-Olff-Fresco multi-model selection approach, IDH testing was done. We did not detect a unimodal relationship between species diversity and forest disturbance expected under the IDH; instead diversity peaked in old-growth forests. Habitat complexity and constraints are two mechanisms proposed to explain this alternative postulate. Moreover, colonist mosquito species were more likely to be involved in or capable of pathogen transmission than climax species. Vector species occurrence decreased notably in undisturbed forest settings. Old-growth forest conservation in tropical rainforests is therefore a highly-recommended solution for preventing new outbreaks of arboviral and parasitic diseases in anthropic environments.
Objective
To explore possible changes in the community attributes of haematophagous insects as a function of forest disturbance. We compare the patterns of diversity and abundance, plus the ...behavioural responses of three epidemiologically distinct vector assemblages across sites depicting various levels of forest cover.
Methods
Over a 3‐year period, we sampled mosquitoes, sandflies and biting‐midges in forested habitats of central Panama. We placed CDC light traps in the forest canopy and in the understorey to gather blood‐seeking females.
Results
We collected 168 405 adult haematophagous dipterans in total, including 26 genera and 86 species. Pristine forest settings were always more taxonomically diverse than the disturbed forest sites, confirming that disturbance has a negative impact on species richness. Species of Phlebotominae and Culicoides were mainly classified as climax (i.e. forest specialist) or disturbance‐generalist, which tend to decrease in abundance along with rising levels of disturbance. In contrast, a significant portion of mosquito species, including primary and secondary disease vectors, was classified as colonists (i.e. disturbed‐areas specialists), which tend to increase in numbers towards more disturbed forest habitats. At pristine forest, the most prevalent species of Phlebotominae and Culicoides partitioned the vertical niche by being active at the forest canopy or in the understorey; yet this pattern was less clear in disturbed habitats. Most mosquito species were not vertically stratified in their habitat preference.
Conclusion
We posit that entomological risk and related pathogen exposure to humans is higher in pristine forest scenarios for Culicoides and Phlebotominae transmitted diseases, whereas forest disturbance poses a higher entomological risk for mosquito‐borne infections. This suggests that the Dilution Effect Hypothesis (DEH) does not apply in tropical rainforests where highly abundant, yet unrecognised insect vectors and neglected zoonotic diseases occur. Comprehensive, community level entomological surveillance is, therefore, the key for predicting potential disease spill over in scenarios of pristine forest intermixed with anthropogenic habitats. We suggest that changes in forest quality should also be considered when assessing arthropod‐borne disease transmission risk.
Objectif
Explorer les changements possibles dans les attributs communautaires des insectes hématophages en fonction de la perturbation des forêts. Nous comparons les modèles de diversité et d'abondance, ainsi que les réponses comportementales de trois assemblages de vecteurs épidémiologiquement distincts sur des sites illustrant divers niveaux de couverture forestière.
Méthodes
Au cours d'une période de trois ans, nous avons échantillonné des moustiques, des phlébotomes et des moucherons piqueurs dans les habitats forestiers du centre de Panama. Nous avons placé des pièges à lumière CDC dans la canopée de la forêt et dans le sous‐étage pour recueillir les femelles en quête de sang.
Résultats
Nous avons collecté un total de 168.405 diptères hématophages adultes, dont 26 genres et 86 espèces. Les environnements de forêt intacts étaient toujours plus diversifiés du point de vue taxonomique que les sites forestiers perturbés, confirmant que les perturbations avaient un impact négatif sur la richesse en espèces. Les espèces de phlébotome et Culicoïdes étaient principalement classés comme climax (spécialiste de la forêt) ou généralistes de perturbation, qui ont tendance à diminuer en abondance parallèlement aux niveaux croissants de perturbation. En revanche, une partie importante des espèces de moustiques, y compris les vecteurs primaires et secondaires de maladies, a été classée dans la catégorie des colons (c'est‐à‐dire spécialistes des zones perturbées), qui ont tendance à se multiplier vers des habitats forestiers plus perturbés. Dans la forêt vierge, les espèces de phlébotomes et Culicoïdes les plus répandues cloisonnaient la niche verticale en étant actives dans la canopée de la forêt ou dans le sous‐étage; pourtant, cette tendance était moins nette dans les habitats perturbés. La plupart des espèces de moustiques n’étaient pas stratifiées verticalement dans leur préférence d'habitat.
Conclusion
Nous estimons que le risque entomologique et l'exposition associée des agents pathogènes à l'homme est plus élevé dans les scénarios de forêt vierge pour les maladies transmises par les phlébotomes et Culicoïdes, alors que la perturbation des forêts pose un risque entomologique plus élevé pour les infections transmises par les moustiques. Cela suggère que l'hypothèse de l'effet de dilution ne s'applique pas dans les forêts tropicales humides où se reproduisent très abondamment les insectes vecteurs, mais non reconnus, et où des maladies zoonotiques négligées surviennent. Une surveillance entomologique approfondie au niveau de la communauté est donc la clé pour prédire le potentiel de propagation des maladies dans des scénarios de forêt vierge mélangée à des habitats anthropiques. Nous suggérons que les changements dans la qualité des forêts soient également pris en compte lors de l’évaluation du risque de propagation de maladies transmises par les arthropodes.
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