Lea Berrang-Ford

Vulnerability of Aboriginal health systems in Canada to climate change.

Abstract Climate change has been identified as potentially the biggest health threat of the 21st century. Canada in general has a well developed public health system and low burden of health which will moderate vulnerability. However, there is significant heterogeneity in health outcomes, and health inequality is particularly pronounced among Aboriginal Canadians. Intervention is needed to prevent, prepare for, and manage climate change effects on Aboriginal health but is constrained by a limited understanding of vulnerability and its determinants. Despite limited research on climate change and Aboriginal health, however, there is a well established literature on Aboriginal health outcomes, determinants, and trends in Canada; characteristics that will determine vulnerability to climate change. In this paper we systematically review this literature, using a vulnerability framework to identify the broad level factors constraining adaptive capacity and increasing sensitivity to climate change. Determinants identified include: poverty, technological capacity constraints, socio-political values and inequality, institutional capacity challenges, and information deficit. The magnitude and nature of these determinants will be distributed unevenly within and between Aboriginal populations necessitating place-based and regional level studies to examine how these broad factors will affect vulnerability at lower levels. The study also supports the need for collaboration across all sectors and levels of government, open and meaningful dialogue between policy makers, scientists, health professionals, and Aboriginal communities, and capacity building at a local level, to plan for climate change. Ultimately, however, efforts to reduce the vulnerability of Aboriginal Canadians to climate change and intervene to prevent, reduce, and manage climate-sensitive health outcomes, will fail unless the broader determinants of socio-economic and health inequality are addressed.

Systematic review approaches for climate change adaptation research

Recent controversy has led to calls for increased standardization and transparency in the methods used to synthesize climate change research. Though these debates have focused largely on the biophysical dimensions of climate change, human dimensions research is equally in need of improved methodological approaches for research synthesis. Systematic review approaches, and more recently realist review methods, have been used within the health sciences for decades to guide research synthesis. Despite this, penetration of these approaches into the social and environmental sciences has been limited. Here, we present an analysis of approaches for systematic review and research synthesis and examine their applicability in an adaptation context. Customized review frameworks informed by systematic approaches to research synthesis provide a conceptually appropriate and practical opportunity for increasing methodological transparency and rigor in synthesizing and tracking adaptation research. This review highlights innovative applications of systematic approaches, with a focus on the unique challenges of integrating multiple data sources and formats in reviewing climate change adaptation policy and practice. We present guidelines, key considerations, and recommendations for systematic review in the social sciences in general and adaptation research in particular. We conclude by calling for increased conceptual and methodological development of systematic review approaches to address the methodological challenges of synthesizing and tracking adaptation to climate change.

The risk of Rift Valley fever virus introduction and establishment in the United States and European Union

Rift Valley fever virus (RVFV) is an arthropod-borne disease resulting in severe morbidity and mortality in both human and ruminant populations. First identified in Kenya in 1930, the geographical range of RVFV has been largely constrained to the African continent, yet has recently spread to new regions, and is identified as a priority disease with potential for geographic emergence. We present a systematic literature review assessing the potential for RVFV introduction and establishment in the United States (US) and European Union (EU). Viable pathways for the introduction of RVFV include: transport of virus-carrying vectors, importation of viremic hosts and intentional entry of RVFV as a biological weapon. It is generally assumed that the risk of RVFV introduction into the US or EU is low. We argue that the risk of sporadic introduction is likely high, though currently an insufficient proportion of such introductions coincide with optimal environmental conditions. Future global trends may increase the likelihood of risk factors for RVFV spread.

The status of climate change adaptation in Africa and Asia

Adaptation is a key component of climate policy, yet we have limited and fragmented understanding of if and how adaptation is currently taking place. In this paper, we document and characterize the current status of adaptation in 47 vulnerable ‘hotspot’ nations in Asia and Africa, based on a systematic review of the peer-reviewed and grey literature, as well as policy documents, to extract evidence of adaptation initiatives. In total, 100 peer-reviewed articles, 161 grey literature documents, and 27 United Nations Framework Convention on Climate Change National Communications were reviewed, constituting 760 adaptation initiatives. Results indicate a significant increase in reported adaptations since 2006. Adaptations are primarily being reported from African and low-income countries, particularly those nations receiving adaptation funds, involve a combination of groundwork and more concrete adaptations to reduce vulnerability, and are primarily being driven by national governments, NGOs, and international institutions, with minimal involvement of lower levels of government or collaboration across nations. Gaps in our knowledge of adaptation policy and practice are particularly notable in North Africa and Central Asia, and there is limited evidence of adaptation initiatives being targeted at vulnerable populations including socioeconomically disadvantaged populations, children, indigenous peoples, and the elderly.

Internet-based partner selection and risk for unprotected anal intercourse in sexual encounters among men who have sex with men: a meta-analysis of observational studies.

Introduction Men who have sex with men (MSM) who identify sex partners over the internet are more likely than other MSM to report having unprotected anal intercourse (UAI). It is unclear whether the internet facilitates pursuit of high-risk sex or whether MSM seeking sex online are a higher-risk population than other MSM. To summarise evidence as to whether internet-based partner selection predisposes MSM to high-risk behaviour, we conducted a meta-analysis of observational studies comparing MSMs UAI risk in online-initiated encounters to their UAI risk in offline-initiated encounters. Methods We systematically searched published, peer-reviewed literature to identify studies reporting MSM participants’ engagement in UAI with online-identified and offline-identified male partners. We calculated pooled odds ratios for any UAI and for seroadaptive UAI practices with partners identified online relative to partners identified offline. Results We included 11 studies representing 39 602 sexual encounters. Odds for any UAI, seroconcordant UAI and serodiscordant UAI with strategic positioning were higher in online-initiated than offline-initiated encounters. Odds for UAI in group sex were higher in online-initiated encounters only among HIV-positive MSM. Effect sizes for all outcomes were greater among HIV-positive than HIV-negative MSM. Effect sizes were greatest when bathhouses, saunas and sex resorts were treated as offline comparison venues. Conclusions Encounters initiated online have elevated odds for entailing UAI and seroadaptive UAI practices. Online-delivered behavioural interventions should address insufficiency of risk-reducing practices involving UAI relative to consistent condom use and promote frequent HIV testing among MSM seeking UAI partners online. http://group.bmj.com/products/journals/instructions-for-authors/licence-forms.

Authorship in IPCC AR5 and its implications for content: climate change and Indigenous populations in WGII.

This essay examines the extent to which we can expect Indigenous Knowledge, understanding, and voices on climate change (‘Indigenous content’) to be captured in WGII of the IPCC Fifth Assessment Report (AR5), based on an analysis of chapter authorship. Reviewing the publishing history of 309 chapter authors (CAs) to WGII, we document 9 (2.9%) to have published on climate change and Indigenous populations and involved as authors in 6/30 chapters. Drawing upon recent scholarship highlighting how authorship affect structure and content of assessment reports, we argue that, unaddressed, this will affect the extent to which Indigenous content is examined and assessed. While it is too late to alter the structure of AR5, there are opportunities to prioritize the recruitment of contributing authors and reviewers with expertise on Indigenous issues, raise awareness among CAs on the characteristics of impacts, adaptation, and vulnerability faced by Indigenous peoples, and highlight how Indigenous perspectives can help broaden our understanding of climate change and policy interventions.

How are we adapting to climate change? A global assessment

This paper applies a systematic approach to measuring adaptation actions being undertaken by 117 parties to the United Nations Framework Convention on Climate Change (UNFCCC) with the goal of establishing a baseline of global trends in adaptation. Data are systematically collected from National Communications prepared by Parties to the Convention and submitted periodically to the Secretariat. 4,104 discrete adaptation initiatives are identified and analyzed. Our findings indicate that while progress is being made on conducting impact and vulnerability assessments and adaptation research in nearly every country in the sample, translation of this knowledge into tangible adaptation initiatives is still limited. The largest number of reported adaptations falls under the category of infrastructure, technology, and innovation. Some types of vulnerability were more frequently reported across initiatives, including floods, drought, food and water safety and security, rainfall, infectious disease, and terrestrial ecosystem health. Notably, reporting on the inclusion of vulnerable sub-populations is low across all actions. Diffusion of adaptation across sectors remains underdeveloped, with the environment, water, and agricultural sectors emerging as the most active adaptors. Our analysis indicates that national communications provide a valuable source of information for global-scale adaptation tracking, but important gaps exist in the consistency of reporting that should be addressed, as these documents could greatly enhance efforts to monitor and evaluate adaptation progress.

What drives national adaptation? A global assessment

That the climate is changing and societies will have to adapt is now unequivocal, with adaptation becoming a core focus of climate policy. Our understanding of the challenges, needs, and opportunities for climate change adaptation has advanced significantly in recent years yet remains limited. Research has identified and theorized key determinants of adaptive capacity and barriers to adaptation, and more recently begun to track adaptation in practice. Despite this, there is negligible research investigating whether and indeed if adaptive capacity is translating into actual adaptation action. Here we test whether theorized determinants of adaptive capacity are associated with adaptation policy outcomes at the national level for 117 nations. We show that institutional capacity, in particular measures of good governance, are the strongest predictors of national adaptation policy. Adaptation at the national level is limited in countries with poor governance, and in the absence of good governance other presumed determinants of adaptive capacity show limited effect on adaptation. Our results highlight the critical importance of institutional good governance as a prerequisite for national adaptation. Other elements of theorized adaptive capacity are unlikely to be sufficient, effective, or present at the national level where national institutions and governance are poor.

Vulnerability of indigenous health to climate change: a case study of Uganda's Batwa Pygmies.

The potential impacts of climate change on human health in sub-Saharan Africa are wide-ranging, complex, and largely adverse. The regions Indigenous peoples are considered to be at heightened risk given their relatively poor health outcomes, marginal social status, and resource-based livelihoods; however, little attention has been given to these most vulnerable of the vulnerable. This paper contributes to addressing this gap by taking a bottom-up approach to assessing health vulnerabilities to climate change in two Batwa Pygmy communities in rural Uganda. Rapid Rural Appraisal and PhotoVoice field methods complemented by qualitative data analysis were used to identify key climate-sensitive, community-identified health outcomes, describe determinants of sensitivity at multiple scales, and characterize adaptive capacity of Batwa health systems. The findings stress the importance of human drivers of vulnerability and adaptive capacity and the need to address social determinants of health in order to reduce the potential disease burden of climate change.

Climate-related hydrological change and human vulnerability in remote mountain regions: a case study from Khumbu, Nepal

Inhabitants of mountainous regions in least developed countries are recognized to be among the most vulnerable to climate change globally. Despite this, human dimensions work is in its infancy in mountain regions where we have limited understanding of who is vulnerable (or adaptable), to what stresses, and why. This study develops a baseline understanding of vulnerability to climate-related hydrological changes in the mountainous Khumbu region of eastern Nepal. Using a vulnerability approach, 80 interviews combining fixed and open-ended questions were conducted in four communities representing the geographic and livelihood variability of the region. The study identifies four region-wide vulnerabilities currently affecting residents: reduced water access for household uses, declining crop yields, reduced water access for meeting the high water demands of tourists, and reduced hydro-electricity generation. These vulnerabilities are widespread among the population but arrange spatially as a function of varying exposure-sensitivity to hydrological change, livelihood opportunities, and access to foreign financial assistance. Our findings indicate that precipitation change (not glacial change) is the greatest biophysical driver of vulnerability.