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PurposeThe extraction of natural resources has long been part of economic development in small islands. The damage to environment and health is extensive, even rendering once productive islands virtually uninhabitable. Rather than providing long-term benefits to the population or to the environment, the culture of “extractivism” – a nonreciprocal approach where resources are removed and used with little care or regard to consequences – has instead left many in far more fragile circumstances, increasingly dependent on external income. The purpose of this paper is to show how continued extractivism in small islands is contributing to global climate change and increasing climate risks to the local communities.Design/methodology/approachThrough a series of case studies, this paper examines the history of extractivism in small islands in Oceania, its contribution to environmental degradation locally and its impacts on health.FindingsIt examines how extractivism continues today, with local impacts on environment, health and wellbeing and its much more far-reaching consequences for global climate change and human health. At the same time, these island countries have heightened sensitivity to climate change due to their isolation, poverty and already variable climate, whereas the damage to natural resources, the disruption, economic dependence and adverse health impacts caused by extractivism impart reduced resilience to the new climate hazards in those communities.Practical implicationsThis paper proposes alternatives to resource extractivism with options for climate compatible development in small islands that are health-promoting and build community resilience in the face of increasing threats from climate change.Originality/valueExtractivism is a new concept that has not previously been applied to understanding health implications of resource exploitation thorough the conduit of climate change. Small-island countries are simultaneously exposed to widespread extractivism, including of materials contributing to global climate change, and are among the most vulnerable to the hazards that climate change brings.

While morbidity outcomes for major disease categories during extreme heat have received increasing research attention, there has been very limited investigation at the level of specific disease subcategories. We analyzed daily hospital admissions for cardiovascular (CVD), respiratory (RD), genitourinary (GU) and mental diseases (MD), diabetes (DIA), dehydration (DEH) and 'the effects of heat and light' (HEAT) in Sydney between 1991 and 2009. We further investigated the sensitivity to heat of subcategories within the major disease groups. We defined hot days as those with temperatures in the 95(th) and 99(th) percentiles within the study period. We applied time-stratified case-crossover analysis to compare the hospital admissions on hot days with those on non-hot days matched by day of the week. We calculated the odds ratios (OR) of admissions between the two types of days, accounting for other environmental variables (relative humidity, ozone and particulate matter) and non-environmental trends (public and school holidays). On hot days, hospital admissions increased for all major categories except GU. This increase was not shared homogeneously across all diseases within a major category: within RD, only 'other diseases of the respiratory system' (includes pleurisy or empyema) increased significantly, while admissions for asthma decreased. Within MD, hospital admissions increased only for psychoses. Admissions due to some major categories increased one to three days after a hot day (e.g., DIA, RD and CVD) and on two and three consecutive days (e.g., HEAT and RD). High ambient temperatures were associated with increased hospital admissions for several disease categories, with some within-category variation. Future analyses should focus on subgroups within broad disease categories to pinpoint medical conditions most affected by ambient heat.

Background Protection Motivation Theory (PMT) was developed by Rogers in 1975, to describe how individuals are motivated to react in a self-protective way towards a perceived health threat. Rogers expected the use of PMT to diversify over time, which has proved true over four decades. The purpose of this paper is to explore how PMT can be used and expanded to inform and improve public safety strategies in natural hazards. As global climate change impacts on the Australian environment, natural hazards seem to be increasing in scale and frequency, and Emergency Services’ public education campaigns have necessarily escalated to keep pace with perceived public threat. Of concern, is that the awareness-preparedness gap in residents’ survival plans is narrowing disproportionately slowly compared to the magnitude of resources applied to rectify this trend. Practical applications of adaptable social theory could be used to help resolve this dilemma. Discussion PMT has been used to describe human behaviour in individuals, families, and the parent-child unit. It has been applied to floods in Europe and wildfire and earthquake in the United States. This paper seeks to determine if an application of PMT can be useful for achieving other-directed human protection across a novel demographic spectrum in natural hazards, specifically, animal owners and emergency responders in bushfire emergencies. These groups could benefit from such an approach: owners to build and fortify their response- and self-efficacy, and to help translate knowledge into safer behaviour, and responders to gain a better understanding of a diverse demographic with animal ownership as its common denominator, and with whom they will be likely to engage in contemporary natural hazard management. Mutual collaboration between these groups could lead to a synergy of reciprocated response efficacy, and safer, less traumatic outcomes. Summary Emergency services’ community education programs have made significant progress over the last decade, but public safety remains suboptimal while the magnitude of the awareness-preparedness gap persists. This paper examines an expanded, other-directed application of PMT to expand and enhance safer mitigation and response behaviour strategies for communities threatened by bushfire, which may ultimately help save human life.

The COVID-19 pandemic coincided with a resurgence of dengue in Brazil, raising concern for countries in Asia where dengue occurring across tropical and subtropical regions of Asia accounts for approximately 70% of the global disease burden [2]. At a time of continuous lockdowns, when public health staff are diverted to control COVID-19 transmission and community engagement focused on the pandemic, routine mosquito vector surveillance and control programs are discontinued or paused in many countries [3], which will impair dengue control and prevention. [...]within dengue endemic countries, international air travel bans are unlikely to alter local dengue transmission patterns substantially; nationally, human movements along busiest national road of the country have been found to play a major role in the spread of dengue infection in dengue endemic countries [11]. Lower socioeconomic conditions with large numbers of people living in densely populated areas in poorly constructed housing without adequate clean water and sanitation tend to promote Aedes aegypti populations and lead to dengue outbreaks [12].

Between 2010 and 2012, the World Health Organization Division of Pacific Technical Support led a regional climate change and health vulnerability assessment and adaptation planning project, in collaboration with health sector partners, in 13 Pacific island countries-Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Marshall Islands, Nauru, Niue, Palau, Samoa, Solomon Islands, Tonga, Tuvalu, and Vanuatu. We assessed the vulnerabilities of Pacific island countries to the health impacts of climate change and planned adaptation strategies to minimize such threats to health. This assessment involved a combination of quantitative and qualitative techniques. The former included descriptive epidemiology, time series analyses, Poisson regression, and spatial modeling of climate and climate-sensitive disease data, in the few instances where this was possible; the latter included wide stakeholder consultations, iterative consensus building, and expert opinion. Vulnerabilities were ranked using a \"likelihood versus impact\" matrix, and adaptation strategies were prioritized and planned accordingly. The highest-priority climate-sensitive health risks in Pacific island countries included trauma from extreme weather events, heat-related illnesses, compromised safety and security of water and food, vector-borne diseases, zoonoses, respiratory illnesses, psychosocial ill-health, non-communicable diseases, population pressures, and health system deficiencies. Adaptation strategies relating to these climate change and health risks could be clustered according to categories common to many countries in the Pacific region. Pacific island countries are among the most vulnerable in the world to the health impacts of climate change. This vulnerability is a function of their unique geographic, demographic, and socioeconomic characteristics combined with their exposure to changing weather patterns associated with climate change, the health risks entailed, and the limited capacity of the countries to manage and adapt in the face of such risks. Citation: McIver L, Kim R, Woodward A, Hales S, Spickett J, Katscherian D, Hashizume M, Honda Y, Kim H, Iddings S, Naicker J, Bambrick H, McMichael AJ, Ebi KL. 2016. Health impacts of climate change in Pacific island countries: a regional assessment of vulnerabilities and adaptation priorities. Environ Health Perspect 124:1707-1714; http://dx.doi.org/10.1289/ehp.1509756.

The use of internet-based query data offers a novel approach to improve disease surveillance and provides timely disease information. This paper systematically reviewed the literature on infectious disease predictions using internet-based query data and climate factors, discussed the current research progress and challenges, and provided some recommendations for future studies. We searched the relevant articles in the PubMed, Scopus, and Web of Science databases between January 2000 and December 2019. We initially included studies that used internet-based query data to predict infectious disease epidemics, then we further filtered and appraised the studies that used both internet-based query data and climate factors. In total, 129 relevant papers were included in the review. The results showed that most studies used a simple descriptive approach (n=80; 62%) to detect epidemics of influenza (including influenza-like illness (ILI)) (n=88; 68%) and dengue (n=9; 7%). Most studies (n=61; 47%) purely used internet search metrics to predict the epidemics of infectious diseases, while only 3 out of the 129 papers included both climate variables and internet-based query data. Our research shows that including internet-based query data and climate variables could better predict climate-sensitive infectious disease epidemics; however, this method has not been widely used to date. Moreover, previous studies did not sufficiently consider the spatiotemporal uncertainty of infectious diseases. Our review suggests that further research should use both internet-based query and climate data to develop predictive models for climate-sensitive infectious diseases based on spatiotemporal models.

Background Pacific Island countries, many of which are low- and middle-income countries, have some of the highest rates of diet-related non-communicable diseases (DR-NCDs) globally. These countries also face some of the earliest and most significant impacts of climate change. Several pathways between climate change and DR-NCDs have been described in the literature; however, the scope is broad and lacks context specificity. This paper uses a case study of one Pacific Island country, Vanuatu, to investigate links between climate change and DR-NCDs. Methods An ethnographic qualitative research approach was used to share the lived experiences of community participants and to explore and contrast these with the perspectives of key informants at the national level. Data collection comprised thirty-two semi-structured interviews and community fieldwork in two villages using a mix of methods, including group workshops, informal conversations, and observations. Reflexive thematic analysis was conducted on both data sets. Results This study found that DR-NCDs are a prominent health concern for ni-Vanuatu people and that structural determinants, including climate change, are the main driving forces for increased DR-NCD risk in the country. However, there was a lack of understanding of the links between climate change and DR-NCDs both at the community and national levels. Structural factors, such as social determinants and climate change, constrained individual and community agency in making optimal food and health choices and promoted the nutrition transition in Vanuatu. Despite the critical role of social determinants and climate change in driving DR-NCD risk, the responsibility for prevention and treatment was considered to rest mainly with the individual. A systems approach is advocated to grasp the complexity and interrelatedness of the causes of DR-NCD risk. Conclusions The interaction of structural determinants creates food and health environments that amplify the risk, burden, and consequences of DR-NCDs. It is recommended that the DR-NCD narrative in Vanuatu be re-framed with an emphasis on the range of structural determinants of DR-NCD risk. This will serve to enhance individual and collective agency to not only make healthy food and other behavioural choices but also to exercise agency to transform the structures in a culturally appropriate way.

Dengue transmission is climate-sensitive and permissive conditions regularly cause large outbreaks in Asia-Pacific area. As climate change progresses, extreme weather events such as heatwaves and unusually high rainfall are predicted more intense and frequent, but their impacts on dengue outbreaks remain unclear so far. This paper aimed to investigate the relationship between extreme weather events (i.e., heatwaves, extremely high rainfall and extremely high humidity) and dengue outbreaks in China. We obtained daily number of locally acquired dengue cases and weather factors for Guangzhou, China, for the period 2006–2015. The definition of dengue outbreaks was based on daily number of locally acquired cases above the threshold (i.e., mean + 2SD of daily distribution of dengue cases during peaking period). Heatwave was defined as ≥2 days with temperature ≥ 95th percentile, and extreme rainfall and humidity defined as daily values ≥95th percentile during 2006–2015. A generalized additive model was used to examine the associations between extreme weather events and dengue outbreaks. Results showed that all three extreme weather events were associated with increased risk of dengue outbreaks, with a risk increase of 115–251% around 6 weeks after heatwaves, 173–258% around 6–13 weeks after extremely high rainfall, and 572–587% around 6–13 weeks after extremely high humidity. Each extreme weather event also had good capacity in predicting dengue outbreaks, with the model’s sensitivity, specificity, accuracy, and area under the receiver operating characteristics curve all exceeding 86%. This study found that heatwaves, extremely high rainfall, and extremely high humidity could act as potential drivers of dengue outbreaks.

[...]environmental justice and global equity are imperative to understanding the drivers and implications of the Anthropocene; people living in poverty and instability will be most vulnerable to the impact of global changes, but they contribute little to global crises. [...]we live in an increasingly interconnected and interdependent world and should see ourselves as members of a global village. [...]international partnership and cooperation are key for planetary and human health.

Dengue is a mosquito-borne viral disease and its transmission is closely linked to climate. We aimed to review available information on the projection of dengue in the future under climate change scenarios. Using five databases (PubMed, ProQuest, ScienceDirect, Scopus and Web of Science), a systematic review was conducted to retrieve all articles from database inception to 30th June 2019 which projected the future of dengue under climate change scenarios. In this review, \"the future of dengue\" refers to disease burden of dengue, epidemic potential of dengue cases, geographical distribution of dengue cases, and population exposed to climatically suitable areas of dengue. Sixteen studies fulfilled the inclusion criteria, and five of them projected a global dengue future. Most studies reported an increase in disease burden, a wider spatial distribution of dengue cases or more people exposed to climatically suitable areas of dengue as climate change proceeds. The years 1961-1990 and 2050 were the most commonly used baseline and projection periods, respectively. Multiple climate change scenarios introduced by the Intergovernmental Panel on Climate Change (IPCC), including B1, A1B, and A2, as well as Representative Concentration Pathway 2.6 (RCP2.6), RCP4.5, RCP6.0 and RCP8.5, were most widely employed. Instead of projecting the future number of dengue cases, there is a growing consensus on using \"population exposed to climatically suitable areas for dengue\" or \"epidemic potential of dengue cases\" as the outcome variable. Future studies exploring non-climatic drivers which determine the presence/absence of dengue vectors, and identifying the pivotal factors triggering the transmission of dengue in those climatically suitable areas would help yield a more accurate projection for dengue in the future. Projecting the future of dengue requires a systematic consideration of assumptions and uncertainties, which will facilitate the development of tailored climate change adaptation strategies to manage dengue.