Anneliese Depoux

Climate change and human health: what are the research trends? A scoping review protocol

Introduction For 28 years, the Intergovernmental Panel on Climate Change (IPCC) has been assessing the potential risks associated with anthropogenic climate change. Although interest in climate change and health is growing, the implications arising from their interaction remain understudied. Generating a greater understanding of the health impacts of climate change could be key step in inciting some of the changes necessary to decelerate global warming. A long-term and broad overview of the existing scientific literature in the field of climate change and health is currently missing in order to ensure that all priority areas are being adequately addressed. In this paper we outline our methods to conduct a scoping review of the published peer-reviewed literature on climate change and health between 1990 and 2015. Methods and analysis A detailed search strategy will be used to search the PubMed and Web of Science databases. Specific inclusion and exclusion criteria will be applied in order to capture the most relevant literature in the time frame chosen. Data will be extracted, categorised and coded to allow for statistical analysis of the results. Ethics and dissemination No ethical approval was required for this study. A searchable database of climate change and health publications will be developed and a manuscript will be complied for publication and dissemination of the findings. We anticipate that this study will allow us to map the trends observed in publications over the 25-year time period in climate change and health research. It will also identify the research areas with the highest volume of publications as well as highlight the research trends in climate change and health.

Communicating climate change and health in the media

The translation of science from research to real-world change is a central goal of public health. Communication has an essential role to play in provoking a response to climate change. It must first raise awareness, make people feel involved and ultimately motivate them to take action. The goal of this research is to understand how the information related to this issue is being addressed and disseminated to different audiences—public citizens, politicians and key climate change stakeholders. Initial results show that the scientific voice struggles to globally highlight this issue to a general audience and that messages that address the topic do not meet the challenges, going from a dramatic framing to a basic adaptation framing. Communication experts can help inform scientists and policy makers on how to best share information about climate change in an engaging and motivating way. This study gives an insight about the key role of the media and communications in addressing themes relating to climate change and transmitting information to the public in order to take action.

The influence of health concerns in scientific and policy debates on climate change

In 2009, scientists argued that climate change was the ‘biggest global health threat of the 21st century’,1 and 6 years later ‘the greatest global health opportunity of the 21st century’.2 While a minority of populations may experience health benefits (mostly due to a reduction in diseases related to cold weather), the global burden of disease and premature death is expected to increase progressively.3 For instance, one study showed that heat-related deaths would be expected to rise by around 257% by the 2050s from a current annual baseline of approximately 2000 deaths.4 Much of the policy development on climate change comes from the negotiations between the 195 parties to the United Nations Framework Convention on Climate Change (UNFCCC), working towards a common long-term vision of limiting global warming. The 21th Conference of the Parties (COP21) in Paris in December 2015 was one milestone in the fight against climate change, as all countries agreed to take action by curbing greenhouse gas emissions (GHGE) and keep global warming well below 2°C. The agreement also included a regular review of national commitments every 5 years to check progress. Moreover, it represented an important step to protect and promote health in the face of climate change: for the first time ‘the right to health’ was mentioned in the global agreement on climate change. The WHO referred to the COP21 as ‘a historic win for human health’, and this climate treaty might actually become a public health treaty as countries take action to develop adaptation plans that will protect human health from the worst impacts of climate change.5 This opinion article seeks to present the role of health concerns in the scientific debates on climate change, but also in actual climate policies and international negotiations. ### Climate change-related health concerns in scientific debates Awareness of the health risks caused by …

A multi-faceted pandemic: a review of the state of knowledge on the Zika virus

While until recently the small and isolated Zika outbreaks in Eastern Asia and Pacific islands had been overlooked, the large-scale outbreak that started in Brazil in 2015 and the increase of microcephaly cases in the same place and time made media headlines. Considered as harmless until recently, Zika has given rise to an important global crisis that poses not only health challenges but also environmental, economical, social, and ethical challenges for states and people around the world. The main objective of this paper is to review the recent Zika outbreak by covering a broad range of disciplines and their interactions. This paper synthetises experts’ interviews and reactions conducted during a Massive Open Online Course (MOOC) entitled “In the footsteps of Zika…approaching the unknown.” It reviews knowledge and uncertainties around epidemiology, geographical dispersion of the virus and its vectors through globalization and climate change, and also its modes of transmission, diagnosis, symptoms, and treatment of the disease. The resulting societal and ethical issues in pregnancy and women of reproductive age were also addressed as well as the global outbreak alert and response network in international organizations and social media. This paper attempted to combine each piece of the jigsaw puzzle of the Zika phenomenon to complete the best realistic picture, while keeping in mind the balance between the interdisciplinary nature and international context of Zika and its unique characteristics.

Connecting planetary health, climate change, and migration

www.thelancet.com/planetary-health Vol 2 February 2018 e58 Climate change is increasingly understood to be an important driver of migration and displacement worldwide, although the magnitude of such population movements remains disputed. Improving the health of migrants and reducing adverse health outcomes related to migration are also growing concerns globally. Current crises related to migration and displacement, whether in the Horn of Africa or the Mediterranean, highlight the different challenges related to migrants’ health, especially in humanitarian emergencies. Planetary health, as a new discipline, was created to safeguard human health in the Anthropocene epoch. It revolves around a new interdisciplinary and transdisciplinary approach that seeks to explore the effects of environmental change on human health. Planetary health focuses in particular on two dimensions: the first situates human health within human systems, looking at the threats faced by our species such as pandemics or climate change; the second concentrates on the natural systems within which our species evolve and looks at the health and diversity of the biosphere. Although migrants’ health and climate-induced migration are known to be major challenges at present, few attempts have been made to consider the complex associations that unite climate change, migration, and health in an integrated three-pronged nexus. Therefore, we propose a basic explanatory framework that highlights the linkages between these three dimensions and seeks to encourage debate, and new research, about how planetary health is concerned with, and within, this three-pronged nexus (figure). Climate change is known to affect populations’ health (pathway A; figure). Most of this influence is through direct exposures such as heatwaves or extreme weather events, although less direct impacts arise from disruptions to environmental, ecological, and social systems. Issues such as proliferation of new or resistant strains of pathogens are also an unwelcome scenario. The indirect impacts arising from environmental, ecological and social systems will affect human health through changes in food yields, freshwater flows and quality, stability of infectious disease patterns, air quality, social cohesion, and family income and livelihoods. Indeed, climate change could threaten food security through reductions in agricultural and fishery yields. This effect is particularly alarming in regions that are already facing food insecurity such as in sub-Saharan Africa and south Asia. Moreover, the occurrence of flooding or drought cycles as well as hotter summers in some regions are likely to increase risks to agricultural productivity. Climate change will also impact the geographical range, seasonality, and incidence of various infectious diseases, such as malaria, diarrhoeal diseases, and cholera. These impacts, especially extreme weather events, sea-level rise, soil degradation, and food and water scarcity are strongly associated with migration (pathway B; figure). In some cases migration will be a strategy of last resort, with people left with no other choice as a result of loss of habitable land, extreme health risks, or deteriorating livelihoods. In this case, displacement might increase the risks of adverse health outcomes, in particular for vulnerable groups such as children and the elderly, as well as those who are already suffering from (chronic) illnesses (pathway C; figure). Migration can also be a voluntary choice, although forced migration and voluntary migration are not two discrete categories, but rather the two ends of a continuum. Migration is not automatically an indicator of vulnerability; it can also be an adaptive Connecting planetary health, climate change, and migration

Migrants’ and refugees’ health: towards an agenda of solutions

Despite the greatly increased numbers of migrants and refugees worldwide in recent years, insufficient attention has been paid to addressing their health needs. While a variety of international instruments assert the right to health, in practice, migrants and refugees—especially those awaiting clarification of their status, such as asylum seekers and those without documentation—often fall in cracks between service providers and humanitarian relief programmes at national and regional levels.This report provides a summary of the current state of knowledge regarding the health issues of migrants and refugees and of the extent to which they are being met. It highlights, through a series of case studies, the diverse approaches to policies, entitlements and services provided in different jurisdictions, ranging from regional (Europe) and country (Germany, Iran, Italy, Turkey, South Africa) levels to provinces and cities (Quebec/Montreal, Berlin). These provide evidence of successes and challenges and highlight areas requiring further effort, including in the domains of policy, service design and delivery, education and training, research and communication. They also underscore the challenges of highly neglected aspects such as mental health and the critical importance of developing cultural/transnational competence in the health professional individuals and institutions working with migrants and refugees.Results from discussions taking place in an M8 Alliance Expert Group Meeting (Rome, 23–24 June 2017) and from the literature are synthesised to develop an ‘agenda of solutions’. This agenda aims to provide a comprehensive framework, which bridges humanitarian, ethical and rights-based imperatives to provide a framework for action to tackle this crucial area.

Massive Open Online Courses (MOOCs) on Climate Change and Health: Teaching a Global Audience

Massive open online courses (MOOCs) give the opportunity to engage and teach a global audience into the rationale and arguments of climate change and its impact on health. We want to describe the possibilities of MOOCs for climate change education on the example of three MOOCs on climate change and health that were offered on the online learning platform iversity and FUN-MOOC: one MOOC was designed for a broader audience without prior requirements in the area of climate system and climate change. The learning target was health impacts worldwide, best practices in adaptation and mitigation strategies, as well as the promotion of health co-benefits. This MOOC was subtitled in ten different languages. An executive MOOC was targeted at policy makers as part of their conference briefing for the climate conference COP21 in Paris in 2015. The key arguments of the MOOC included the development of climate policies and their fair share of the burden and benefits, as well as scientific evidence behind the four key arguments based on human health for climate policy (Sauerborn 2016a, b). The third MOOC focused again on a broader audience on climate change and health within an African context for a francophone audience. In the following, we introduce MOOCs for teaching climate change education to a global audience, also with a focus on developing countries, followed by a description of the three MOOCs on the topic of climate change and health in more detail with regards to their contents, participant demographics, retention rate and encountered challenges. We discuss our findings with regards to all three MOOCs and will give insights into practices for employing MOOCs in climate change education, for developed and developing countries.

How Well Do COP22 Attendees Understand Graphs on Climate Change Health Impacts from the Fifth IPCC Assessment Report

Graphs are prevalent in the reports of the Intergovernmental Panel on Climate Change (IPCC), often depicting key points and major results. However, the popularity of graphs in the IPCC reports contrasts with a neglect of empirical tests of their understandability. Here we put the understandability of three graphs taken from the Health chapter of the Fifth Assessment Report to an empirical test. We present a pilot study where we evaluate objective understanding (mean accuracy in multiple-choice questions) and subjective understanding (self-assessed confidence in accuracy) in a sample of attendees of the United Nations Climate Change Conference in Marrakesh, 2016 (COP22), and a student sample. Results show a mean objective understanding of M = 0.33 for the COP sample, and M = 0.38 for the student sample. Subjective and objective understanding were unrelated for the COP22 sample, but associated for the student sample. These results suggest that (i) understandability of the IPCC health chapter graphs is insufficient, and that (ii) particularly COP22 attendees lacked insight into which graphs they did, and which they did not understand. Implications for the construction of graphs to communicate health impacts of climate change to decision-makers are discussed.