Katie Oven

Geographies of health and climate change

Climate change presents significant challenges for human health and well-being and geography is contributing a growing field of knowledge relating to these processes. We outline here key dimensions of the debate, pointing to areas where human geographers can make a particularly strong contribution. These include: issues of adaptation and resilience; sustainability; environmental justice and socially unequal impacts of climate change; and psychological as well as physical impacts of environment on health. Key themes in the emerging research agenda include the significance of affect and emotion for the perception and communication of hazard and risk associated with the health impacts of climate change. Also, understanding exposure to health risks of climate change requires knowledge of complex and individually variable daily action spaces and residential mobility over the lifecourse. We argue for research that considers complex processes operating at various geographical scales, linking arguments about ‘global health’ with the more local and individual processes that contribute to health determinants. Much of the literature on health impacts of climate change demonstrates socially and geographically unequal effects, which often exacerbate existing health disparities. This highlights the links between this field of health geography and other geographical research concerned with sustainability and environmental justice.

The role of formal and informal networks in supporting older people’s care during extreme weather events.

We use theories of formal and informal networks of care, within a local governance system, to interpret networks supporting older people during extreme weather events. Drawing on international literatures about network governance and emergency management this paper outlines an approach which considers the views of older people and service providers to explore resilience of infrastructures and service agencies. During emergencies, links between different networks of care are important to avoid discontinuities that could endanger older peoples health and well-being. This paper explores the scope to draw on local knowledge and local caring networks to inform preparedness for extreme weather.

Adaptation to extreme weather events in complex health and social care systems: The example of older people’s services in England

Our findings contribute to a growing international literature on how conceptual models from complexity theory may be relevant to inform planning in health and social care systems, helping to adapt and improve preparedness and resilience to extreme weather events. We focus on findings from two case studies in England and their relationship to national policy for adaptation. Complexity theory helped to frame strategies for planning for events that are emergent and unpredictable. We find from our case studies that, in spite of the uncertainty involved, some ‘principles’ derived from parts of the literature on complexity theory may provide a helpful framework for the development of more robust preparedness strategies in the health and social care sector. By viewing health and social care as a ‘system of systems’, adaptation planning recognises the interrelationships of built, institutional and social infrastructures. The idea of local systems, with variable, path-dependent attributes, which are partially closed, but permeable to other parts of the wider network, leads to an actionable model of adaptation which emphasises the potential value of local self-organisation, but also underlines the importance of co-evolution across the wider system and the vital role of national initiatives and support for adaptation strategies. The value of sharing experience from local case studies across the national system, as well as among local partners, is very apparent in the experience reported here.

Impact of extreme weather events and climate change for health and social care systems

This review, commissioned by the Research Councils UK Living With Environmental Change (LWEC) programme, concerns research on the impacts on health and social care systems in the United Kingdom of extreme weather events, under conditions of climate change. Extreme weather events considered include heatwaves, coldwaves and flooding. Using a structured review method, we consider evidence regarding the currently observed and anticipated future impacts of extreme weather on health and social care systems and the potential of preparedness and adaptation measures that may enhance resilience. We highlight a number of general conclusions which are likely to be of international relevance, although the review focussed on the situation in the UK. Extreme weather events impact the operation of health services through the effects on built, social and institutional infrastructures which support health and health care, and also because of changes in service demand as extreme weather impacts on human health. Strategic planning for extreme weather and impacts on the care system should be sensitive to within country variations. Adaptation will require changes to built infrastructure systems (including transport and utilities as well as individual care facilities) and also to institutional and social infrastructure supporting the health care system. Care sector organisations, communities and individuals need to adapt their practices to improve resilience of health and health care to extreme weather. Preparedness and emergency response strategies call for action extending beyond the emergency response services, to include health and social care providers more generally.

The best of intentions? managing disasters and constructions of risk and vulnerability in Asia.

Drawing on research on landslide risk reduction in Nepal and the impacts of the Indian Ocean tsunami of 2004 in southern Thailand, this paper considers how risk, in the context of natural hazards, is produced by processes of social and economic transformation; understood and experienced by vulnerable groups; and framed by governments and experts. In so doing, we propose an agenda for more effective disaster risk management. We open the discussion by exploring the spatiality of risk, vulnerability and opportunity in the two research contexts, in particular, why people live in hazardous places and the processes that explain the intersection of human settlement and livelihoods on the one hand, and risk on the other. The paper then turns to consider the way that “risk”—and the framing and prioritisation of risk(s) by governments, experts and by vulnerable groups themselves—plays a role in setting the disaster risk management agenda. Underpinning this is the hidden question of what evidence is used—and valued—in the identification and delineation of risk. In order to understand disaster vulnerability, we argue that it is necessary to look beyond the immediate “hazardscape” to understand the wider risk context both spatially and structurally. Effective disaster risk management requires not only an appreciation of the different framings and understandings of risk, but a true integration of knowledge and expertise.

Use of scenario ensembles for deriving seismic risk

Significance High death tolls from recent earthquakes have highlighted the need to better identify ways to effectively reduce seismic risk. We address this need by developing a new earthquake scenario ensemble approach. We model impacts from multiple different earthquake scenarios, identifying impacts that are common to multiple scenarios. This method allows us to estimate whether particular impacts are specific to certain earthquakes or occur irrespective of the location or magnitude of the next earthquake. Our method provides contingency planners with critical information on the likelihood, and probable scale, of impacts in future earthquakes, especially in situations where robust information on the likelihood of future earthquakes is incomplete, allowing disaster risk-reduction efforts to focus on minimizing such effects and reducing seismic risk. High death tolls from recent earthquakes show that seismic risk remains high globally. While there has been much focus on seismic hazard, large uncertainties associated with exposure and vulnerability have led to more limited analyses of the potential impacts of future earthquakes. We argue that as both exposure and vulnerability are reducible factors of risk, assessing their importance and variability allows for prioritization of the most effective disaster risk-reduction (DRR) actions. We address this through earthquake ensemble modeling, using the example of Nepal. We model fatalities from 90 different scenario earthquakes and establish whether impacts are specific to certain scenario earthquakes or occur irrespective of the scenario. Our results show that for most districts in Nepal impacts are not specific to the particular characteristics of a single earthquake, and that total modeled impacts are skewed toward the minimum estimate. These results suggest that planning for the worst-case scenario in Nepal may place an unnecessarily large burden on the limited resources available for DRR. We also show that the most at-risk districts are predominantly in rural western Nepal, with ∼9.5 million Nepalis inhabiting districts with higher seismic risk than Kathmandu. Our proposed approach provides a holistic consideration of seismic risk for informing contingency planning and allows the relative importance of the reducible components of risk (exposure and vulnerability) to be estimated, highlighting factors that can be targeted most effectively. We propose this approach for informing contingency planning, especially in locations where information on the likelihood of future earthquakes is inadequate.