Impacts of Climate Change on Public Health in India: Future Research Directions
Bush, Kathleen F., Luber, George, Kotha, S. Rani, Dhaliwal, R. S., Kapil, Vikas, Pascual, Mercedes, Brown, Daniel G., Frumkin, Howard, Dhiman, R. C., Hess, Jeremy, Wilson, Mark L., Balakrishnan, Kalpana, Eisenberg, Joseph, Kaur, Tanvir, Rood, Richard, Batterman, Stuart, Joseph, Aley, Gronlund, Carina J., Agrawal, Arun, Hu, Howard, Environmental Health Perspectives
BACKGROUND: Climate change and associated increases in climate variability will likely further exacerbate global health disparities. More research is needed, particularly in developing countries, to accurately predict the anticipated impacts and inform effective interventions.
OBJECTIVES: Building on the information presented at the 2009 Joint Indo-U.S. Workshop on Climate Change and Health in Goa, India, we reviewed relevant literature and data, addressed gaps in knowledge, and identified priorities and strategies for future research in India.
DISCUSSION: The scope of the problem in India is enormous, based on the potential for climate change and variability to exacerbate endemic malaria, dengue, yellow fever, cholera, and chikungunya, as well as chronic diseases, particularly among the millions of people who already experience poor sanitation, pollution, malnutrition, and a shortage of drinking water. Ongoing efforts to study these risks were discussed but remain scant. A universal theme of the recommendations developed was the importance of improving the surveillance, monitoring, and integration of meteorological, environmental, geo-spatial, and health data while working in parallel to implement adaptation strategies.
CONCLUSIONS: It will be critical for India to invest in improvements in information infrastructure that are innovative and that promote interdisciplinary collaborations while embarking on adaptation strategies. This will require unprecedented levels of collaboration across diverse institutions in India and abroad. The data can be used in research on the likely impacts of climate change on health that reflect India's diverse climates and populations. Local human and technical capacities for risk communication and promoting adaptive behavior must also be enhanced.
KEY WORDS: air pollution, climate change, climate variability, health, heat, India, vector-borne, waterborne. Environ Health Perspect 119:765-770 (2011). doi: 10.1289/ehp. 1003000 [Online 27 January 2011]
Climate Change and Human Health
Although low- and middle-income countries are responsible for only a small percentage of global greenhouse gas emissions, the adverse health effects associated with climate change will likely fall disproportionately on their populations. This inequity will further exacerbate global health disparities (McMichael et al. 2003; Patz and Olson 2006; Patz et al. 2007; Wiley and Gostin 2009). High-risk areas include those already experiencing a scarcity of resources, environmental degradation, high rates of infectious disease, weak infrastructure, and overpopulation (Patz et al. 2005; Wiley and Gostin 2009). In particular, tropical regions will experience significant changes in human--pathogen relationships because of climate change (Sattenspiel 2000). Changing temperatures and precipitation patterns linked to climate change will further affect health by changing the ecology of various vector-borne diseases, such as malaria, dengue, chikungunya, Japanese encephalitis, kala-azar, and filariasis (Bhattacharya et al. 2006; Dhiman et al. 2008). Vulnerable populations include the elderly, children, urban populations, and the poor (Ebi and Paulson 2010; O'Neill and Ebi 2009).
The goals of this report are to briefly summarize relevant literature and highlight the enormous challenges and opportunities for innovative research, with a particular focus on India. Such research is needed to pave the way for unique and pioneering solutions that can improve public health in the face of increasing climate variability. Therefore, we review the current state of the science relevant to the 2009 Joint Indo-U.S. Workshop on Climate Change and Health that was held in Goa, India, and then discuss the observed relationships between climate variability and human health, specifically in relation to the Indian subcontinent, highlighting future research directions.
Potential health impacts discussed at the Goa workshop fell into three categories: heat stress and air pollution, waterborne disease, and vector-borne disease focusing on malaria. …