Climate Change, Human Health, and Biomedical Research: Analysis of the National Institutes of Health Research Portfolio

Article excerpt

BACKGROUND: According to a wide variety of analyses and projections, the potential effects of global climate change on human health are large and diverse. The U.S. National Institutes of Health (NIH), through its basic, clinical, and population research portfolio of grants, has been increasing efforts to understand how the complex interrelationships among humans, ecosystems, climate, climate variability, and climate change affect domestic and global health.

OBJECTIVES: In this commentary we present a systematic review and categorization of the fiscal year (FY) 2008 NIH climate and health research portfolio.

METHODS: A list of candidate climate and health projects funded from FY 2008 budget appropriations were identified and characterized based on their relevance to climate change and health and based on climate pathway, health impact, study type, and objective.

RESULTS: This analysis identified seven FY 2008 projects focused on climate change, 85 climate-related projects, and 706 projects that focused on disease areas associated with climate change but did not study those associations. Of the nearly 53,000 awards that NIH made in 2008, approximately 0.17% focused on or were related to climate.

CONCLUSIONS: Given the nature and scale of the potential effects of climate change on human health and the degree of uncertainty that we have about these effects, we think that it is helpful for the NIH to engage in open discussions with science and policy communities about government-wide needs and opportunities in climate and health, and about how NIH's strengths in human health research can contribute to understanding the health implications of global climate change. This internal review has been used to inform more recent initiatives by the NIH in climate and health.

KEY WORDS: climate change, climate variability, health impacts, health research, research portfolio. Environ Health Perspect 121:399-404 (2013). [Online 18 January 2013]

Global climate change is anticipated to have multiple impacts on human health, many of them adverse and some severe, but most of these impacts are poorly understood [Climate Change Science Program (CCSP) 2008; Intergovernmental Panel on Climate Change (IPCC) 2007]. The National Institutes of Health (NIH) has been urged by members of the research and advocacy communities (e.g., Ebi et al. 2009), by the World Health Organization (e.g., Chan 2007), and by experts within the U.S. government (Portier et al. 2010) to address the issue. The NIH has taken a strategic approach, including the formation of an agency-wide Working Group on Climate and Health (Glass et al. 2009), to conduct a gaps analysis and help develop a research agenda. One of the first steps was a portfolio analysis to better understand the gaps in current and historical activities in relation to the types of climate and health research urged by these stakeholders. The NIH has since begun to address those gaps with targeted funding opportunities. In this commentary we present the results of a comprehensive project funding analysis and briefly describe some of the funding efforts that have followed.

The pathways by which climate change is projected to affect human health range from relatively straightforward effects on heat stress and heat mortality (Luber and McGeehin 2008; McGeehin and Mirabelli 2001) to more complex effects on infectious and other diseases (Lafferty 2009; Paaijmans et al. 2009). Other secondary and more complex pathways may include population migration or human conflict arising from food or water scarcity brought on or exacerbated by climate change. These varied potential impacts are likely to be more severe for populations and geographic regions already experiencing a high burden of public health problems and resource scarcity (Tang et al. 2009).

As manifestations of global climate change become more apparent, the scientific community is placing increasing emphasis on research and science-based decision making for responding to climate change (CCSP 2008; IPCC 2007; Semenza and Menne 2009). …