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Among the challenges for rural communities and health services in Australia, climate change and increasing extreme heat are emerging as additional stressors. Effective public health responses to extreme heat require an understanding of the impact on health and well-being, and the risk or protective factors within communities. This study draws on li...
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Context 1
... process of heat-adaptation will require supportive policy development across a number of areas, as indicated in the model (Figure 2). Current health policy in South Australia includes maintaining vulnerable client lists, and educating and monitoring these groups during extreme heat, and these policies, together with media attention to heat-health risks, may explain the level of community heat awareness described by participants in this study. Ongoing provision of evidence-based health advice will continue to be important, together with training for primary health care providers who are well placed to deliver tailored advice to individual ...
Context 2
... study has drawn on the experiences of health service providers to examine the impact of extreme heat, and the factors that influence how people in rural communities adapt, framing these within a socio-ecological model (Figure 2). While there are many similarities across communities, it is clear that heat experiences are inseparable from contextual factors, particularly the local climate and geography, so that a local approach to the development of heat-adaptation strategies is warranted. Although participants described instances of heat-related illness in their communities, their narratives placed a major emphasis on the social impact of heat, both at the interpersonal and community levels. In smaller communities they described limited public spaces to provide a cool meeting place or refuge during the heat, and for elderly residents in particular, extended periods of heat can make them housebound and detract from their quality of life. Banwell et al. [39] have proposed that a reliance on air-conditioning is "drawing people from their social networks on the verandas back inside their homes," which concurs with our findings in rural communities. It may be possible for local Councils or businesses to provide cool refuges within small towns; however barriers to access may be difficult to overcome, bearing in mind that both heat and fire risk can discourage travel in rural ...
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This study explores the efficacy of providing targeted information to older individuals to prevent adverse health outcomes during extreme heat. Participants ≥65 years of age (n = 637) were recruited from previous population-based studies and randomized into intervention and control groups. The intervention group received evidence-based information...
Many agricultural studies have identified that wheat yield is sensitive to seasonal rainfall and extreme high temperatures. We investigate the impact of extreme heat events, in particular on wheat yields in South-East Australia (SEA) and South-West Western Australia (SWWA). We define a 'heat-day' as a day where the daily maximum temperature exceeds...
Abstract:
Extreme heat is already a threat to South Australians – especially to new migrant communities. Following the IPCC (2007 and 2012) and the recent predictions, global climate scientific models have predicted its risk. Culturally and linguistically diverse (CALD) communities (e.g. Bangladeshi, Bhutanese and Sudanese) are thought to be vulner...
Citations
... However, vulnerability is essential from the humanist perspective as it takes human existence into consideration on many levels. According to FAO and IPCC [39][40][41][42], the VCC varies in time and space depending on multiple factors. A system's vulnerability to climate change and variability depends on the nature, extent, and pace of the climate change and variability to which the system is exposed, its sensitivity, and adaptive capacity [39][40][41][42]. ...
... According to FAO and IPCC [39][40][41][42], the VCC varies in time and space depending on multiple factors. A system's vulnerability to climate change and variability depends on the nature, extent, and pace of the climate change and variability to which the system is exposed, its sensitivity, and adaptive capacity [39][40][41][42]. Exposure to climate change is thought to depend on location. ...
Green energy production has become a common and recognized method of electricity generation. Giving up reliance on non-renewable energy sources is an important trend in the economies of many countries. The paper presents an analysis of the impact of indicators like increased green energy production on the level of vulnerability to climate change. The model of the Climate Change Vulnerability Index (VCC) recommended by the Intergovernmental Panel on Climate Change (considering three aspects: exposure, vulnerability, and adaptive capacity of the studied spatial unit/society) was applied. Sensitivity analysis, spatial heterogeneity, and temporal dynamics of indicators characterizing changes in electricity consumption, renewable energy production, greenhouse gas emissions, and variability of financial losses due to extreme weather events and their number were implemented. Several findings arose. First, the vulnerability to climate change (the level of the VCC index), does not decrease after the implementation of a single action, like the development of green energy production. The level of index of vulnerability to climate change (VCC1) from the reference year (2017) relative to VCC2 (2021) has changed slightly, despite the development of RES. The variation does not exceed a 1% reduction in the value of the VCC1 index. Second, the decrease in the level of the vulnerability requires global, coordinated action. The value of the VCC3 index, reflecting, including changes in green energy production (X15), electricity consumption/inhabitant (X38), and green-house gas emissions (X14), exhibited more favorably the impact of these indicators on vulnerability to climate change, compared to the VCC1 reference value. In eleven poviats, the VCC3 index decreased between 1 and 4%. In seven of these poviats, green energy production increased, resulting in an average 10% decrease in the X15 indicator, the X14 indicator representing green-house gas emissions decreased by an average of 7%, while the X38 indicator describing electricity consumption/per capita decreased by an average of 16%. Third, harmonized and inclusive action by the population holds the potential to be the clue to reducing vulnerability to climate change
... Education is a commonly adopted indicator of social vulnerability (66 of 205 studies). Studies tend to find that lower educational attainment at an individual or area level is correlated with poorer health outcomes as the result of climate change impacts across all settings, in high, middle, and lower countries as well as urban and rural environments (43,46,72,73,89,95,114,120,(178)(179)(180). Similar to socioeconomic status, the generally observed positive relationship between low educational attainment and climate-related health impacts is attributed to people with lower education having access to fewer resources and therefore less adaptive capacity (73, 179), though health related education interventions can reduce vulnerability (179). ...
... Studies tend to find that lower educational attainment at an individual or area level is correlated with poorer health outcomes as the result of climate change impacts across all settings, in high, middle, and lower countries as well as urban and rural environments (43,46,72,73,89,95,114,120,(178)(179)(180). Similar to socioeconomic status, the generally observed positive relationship between low educational attainment and climate-related health impacts is attributed to people with lower education having access to fewer resources and therefore less adaptive capacity (73, 179), though health related education interventions can reduce vulnerability (179). ...
... Multiple dimensions of housing and housing affordances as a resource that is inequitably distributed in society were used as indicators of social vulnerability in the review ( (95,127,166,179,192), and housing structural security (e.g., slum dwellers and informal settlement) (68,213,214). Housing adequacy in terms of housing affordability (110,189), energy efficiency (113), dwelling conditions such as ventilation and roof construction (157), and homelessness (42) are less incorporated. ...
This paper is a scoping review of social vulnerability to the health effects of climate change. The review provides an overview of the state of literature on social vulnerability indicators published in English between 2012 and 2022. An initial corpus of 1307 studies were identified from four bibliographic databases (Scopus, Web of Science, PubMed and CAB direct) and after screening 205 relevant studies were identified that contained social vulnerability indicators that mediated between climate change impacts and health outcomes. A frequency analysis was conducted to show the overall scope of the research and a thematic analysis of the results was conducted to examine substantive trends within the literature. A total of 125 indicators of social vulnerability were identified yet a relatively small set of indicators received most of the attention. Indicators that operationalized social vulnerability beyond individual and demographic characteristics were found to be under-researched and needed to further support climate resilience and adaptation planning.
... Besides identifying factors and determinants contributing to mental impacts, the type of community-based, qualitative approach used by these authors has been successful at identifying protective factors intrinsic to the community, such as strong social networks and independence (Williams et al., 2013). These protective factors signal opportunities to further bolster resiliency in the community and consequently for affected individuals. ...
... Physical environmental conditions, [109,177] from landscape to infrastructure to wildlife, in Australia, are unique and carry specific risk factors that expose rural individuals to an increased risk of injury (Table 8). Road conditions were identified as a significant risk factor for rural injury, with significantly more rural road transport injuries occurring on a straight/open road than in metropolitan areas [109]. ...
... The socio-economic index (Index of Relative Socio-economic Advantage and Disadvantage (IRSAD)) was found to be a significant risk factor for injury in rural areas [9,65,147,159,176]. In most circumstances, relative disadvantage positively correlated to an increased risk of injury [9,147,159,177]. However, in some circumstances, this was not the case [25]. ...
... From the 108 studies identifying injury risk factors, 26 (24.1%) showed risk factors relating to the increased burden of rural injury [6,25,26,28,29,43,48,51,75,79,88,92,112,122,130,134,139,140,153,154,156,158,160,164,171,177] ( Table S6). The increased morbidity, mortality, and burden of rural injury related directly to the severity of the incident, access to medical services, definitive care management received, and some demographical features (i.e., socio-economic disadvantage, private health insurance, being an Aboriginal and Torres Strait Islander person, etc.). ...
Rural populations experience injury-related mortality and morbidity rates 1.5 times greater than metropolitan residents. Motivated by a call for stronger epidemiological evidence around rural injuries to inform prevention, a systematic review of peer-reviewed literature published between January 2010 and March 2021 was undertaken to explore the epidemiology of rural injury and associated risk factors in Australia. A subsequent aim was to explore definitions of rurality used in injury prevention studies. There were 151 papers included in the review, utilizing 23 unique definitions to describe rurality. People living in rural areas were more likely to be injured, for injuries to be more severe, and for injuries to have greater resulting morbidity than people in metropolitan areas. The increase in severity reflects the mechanism of rural injury, with rural injury events more likely to involve a higher energy exchange. Risk-taking behavior and alcohol consumption were significant risk factors for rural injury, along with rural cluster demographics such as age, sex, high socio-economic disadvantage, and health-related comorbidities. As injury in rural populations is multifactorial and nonhomogeneous, a wide variety of evidence-based strategies are needed. This requires funding, political leadership for policy formation and development, and implementation of evidence-based prevention interventions.
... Only a limited number of studies concentrated purely on the sensitivity aspect (Fig. 3b). The low number of heatwave sensitivity-related studies could be attributed to: (1) challenges associated with quantifying the epidemiological effects of heatwaves (Li et al., 2018); (2) the limited amount of data available regarding the health impacts of heatwaves of various age groups (Nitschke et al., 2013;Xu et al., 2017); and (3) the difficulty in understanding the effects of different heat adaptation techniques on public health based on differing demographic and socioeconomic backgrounds (Hansen et al., 2011(Hansen et al., , 2013(Hansen et al., , 2014Hatvani--Kovacs et al., 2016a;Williams et al., 2013). ...
... In rural communities, peoples' age, health, housing conditions, and cooling methods are attributed to individual heat vulnerability. Limited public transport services can potentially restrict the rural population from receiving emergency support during extreme heat events (Williams et al., 2013). Extreme heat events can cause various psychological issues in older people such as panic, anxiety, and fear. ...
Background: Heatwaves have received major attention globally due to their detrimental effects on human health and the environment. The frequency, duration, and severity of heatwaves have increased recently due to changes in climatic conditions, anthropogenic forcing, and rapid urbanization. Australia is highly vulnerable to this hazard. Although there have been an increasing number of studies conducted in Australia related to the heatwave phenomena, a systematic review of heatwave vulnerability has rarely been reported in the literature.
Objectives: This study aims to provide a systematic and overarching review of the different components of heatwave vulnerability (e.g., exposure, sensitivity, and adaptive capacity) in Australia.
Methods: A systematic review was conducted using the PRISMA protocol. Peer-reviewed English language articles published between January 2000 and December 2021 were selected using a combination of search keywords in Web of Science, Scopus, and PubMed. Articles were critically analyzed based on three specific heatwave vulnerability components: exposure, sensitivity, and adaptive capacity.
Results and discussion: A total of 107 articles meeting all search criteria were chosen. Although there has been an increasing trend of heat-related studies in Australia, most of these studies have concentrated on exposure and adaptive capacity components. Evidence suggests that the frequency, severity, and duration of heatwaves in Australian cities has been increasing, and that this is likely to continue under current climate change scenarios. This study noted that heatwave vulnerability is associated with geographical and climatic factors, space, time, socioeconomic and demographic factors, as well as the physiological condition of people. Various heat mitigation and adaptation measures implemented around the globe have proven to be efficient in reducing the impacts of heatwaves.
Conclusion: This study provides increased clarity regarding the various drivers of heatwave vulnerability in Australia. Such knowledge is crucial in informing extreme heat adaptation and mitigation planning.
... For example, a better economic level and medical conditions can help to prevent more deaths to a certain extent; a high air-conditioning utilization rate can also effectively reduce heat exposure; and a reduction in the proportion of highly exposed people engaged in agriculture, forestry, and animal husbandry in urban areas also greatly reduces the risk of outdoor high-temperature and O 3 overexposure. As a result, rural residents are more vulnerable to facing the dual high temperature and O 3 stress, and their exposure response function coefficients may also be higher than those of urban residents (Hu et al., 2019;Kovach et al., 2015;Li et al., 2017;Williams et al., 2013;Xing et al., 2020;Zhang et al., 2017). This also means that under co-occurring heatwaves and ozone-polluted weather patterns, vulnerable groups in the suburbs should be warned of the risks of outdoor activity and so limit their exposure to the pollutants. ...
Heatwaves (HWs) paired with higher ozone (O3)
concentration at the surface level pose a serious threat to human health. Their
combined modulation of synoptic patterns and urbanization remains unclear.
Using 5 years of summertime temperature and O3 concentration
observation in Beijing, this study explored potential drivers of compound
HWs and O3 pollution events and their public health effects. Three
favorable synoptic weather patterns were identified to dominate the
compound HWs and O3 pollution events. These weather patterns
contributing to enhance those conditions are characterized by sinking air
motion, low boundary layer height, and high temperatures. Under the
synergy of HWs and O3 pollution, the mortality risk from all
non-accidental causes increased by approximately 12.31 % (95 %
confidence interval: 4.66 %, 20.81 %). Urbanization caused a higher risk of HWs and O3 in urban areas than at rural stations. Particularly, due to
O3 depletion caused by NO titration at traffic and urban stations, the
health risks related to O3 pollution in different regions are
characterized as follows: suburban stations > urban stations
> rural stations > traffic stations. In general,
favorable synoptic patterns and urbanization enhanced the health risk of
these compound events in Beijing by 33.09 % and 18.95 %, respectively.
Our findings provide robust evidence and implications for forecasting
compound HWs and O3 pollution events and their health risks in
Beijing or in other urban areas all over the world that have high concentrations
of O3 and high-density populations.
... For example, a better economic level and medical conditions, can help to prevent more deaths to a certain extent; high airconditioning utilization rate can also effectively reduce heat exposure; and the reduction in the proportion of highly exposed people engaged in agriculture, forestry and animal husbandry in urban areas also greatly reduces the risk of outdoor hightemperature and O 3 overexposure. As a result, rural residents are more vulnerable to face the dual high temperature and O 3 240 stress, and their exposure response function coefficients may also be higher than that of urban residents (Hu et al., 2019;Kovach et al., 2015;Li et al., 2017;Williams et al., 2013;Xing et al., 2020;Zhang et al., 2017). This also means that under co-occurring heatwaves and ozone-polluted weather patterns, vulnerable groups in the suburbs should be warned on the risks of outdoor activity and limiting their exposure to the pollutants. ...
Heatwaves (HWs) paired with higher ozone (O3) concentration at surface level pose a serious threat to human health. Their combined modulation of synoptic patterns and urbanization remains unclear. By using five years of summertime temperature and O3 concentrations observation in Beijing, this study explored potential drivers of compound HWs and O3 pollution events. Three unfavourable synoptic weather patterns were identified to dominate the compound HWs and O3 pollution events. The weather patterns contributing to enhance those conditions are characterized by sinking air motion, low boundary layer height, and hot temperatures. Under the synergistic stress of HWs and O3 pollution, the public mortality risk increased by approximately 12.59 % (95 % confidence interval: 4.66 %, 21.42 %). Relative to rural areas, urbanization caused higher risks for HWs, but lower risks for O3 over urban areas. In general, unfavourable synoptic patterns and urbanization can enhance the compound risk of events in Beijing by 45.46 % and 8.08 %, respectively. Our findings provide robust evidence and implications for forecasting compound heatwaves and O3 pollution event and its health risks in Beijing or in other urban areas all over the word having high concentrations of O3 and high-density populations.
... Optimal health can only be achieved by combining all aspects of social determinants of health and addressing all intrinsic and extrinsic factors influencing health outcomes. A study by Williams et al. [88] has found a similar network of relationship in factors influencing adaptation to extreme heat (see Figure 2). However, only two studies [50,60] demonstrated utilisation of all action areas of the Ottawa charter with seemingly more favourable outcomes (see Table 3). ...
... Ottawa charter action areas.Figure 2. Factors influencing heat adaptation[88]. ...
The population of older people is increasing at a rapid rate, with those 80 years and older set to triple by 2050. This systematic review aimed to examine older people’s perceptions and behaviours against existing heatwaves prevention measures and systematically categorize and analyse those measures using the Ottawa charter for health promotion framework. Peer-reviewed published literature between 22nd September 2006 and 24th April 2018 was retrieved, according to the PRISMA guidelines, from five different databases. Eighteen articles were finally included. There is a lack of published studies from developing countries. Results were categorized and analysed using the Ottawa charter five action areas. Mitigation strategies from current heat action plans are discussed and gaps are highlighted. A lack of systematic evaluation of heat action plans efficacy was identified. Older people are not demonstrating all recommended preventative measures during heatwaves. Support personnel and health professionals are not being pro-active enough in facilitating prevention of adverse effects from heatwaves. Governments are beginning to implement policy changes, but other recommended support measures outlined in the Ottawa charter are still lacking, and hence require further action. Linkage between specific components of heat action plans and outcomes cannot be ascertained; therefore, more systematic evaluation is needed.
... For example, their living conditions and their outdoor occupations mean that they are more frequently exposed to extreme temperatures. Moreover, they might have limited risk awareness and limited access to health services, particularly in developing countries (Bai et al. 2016;Li et al. 2017;Williams et al. 2013). ...
Background:
Temperature-related mortality risks have mostly been studied in urban areas, with limited evidence for urban–rural differences in the temperature impacts on health outcomes.
Objectives:
We investigated whether temperature–mortality relationships vary between urban and rural counties in China.
Methods:
We collected daily data on 1 km gridded temperature and mortality in 89 counties of Zhejiang Province, China, for 2009 and 2015. We first performed a two-stage analysis to estimate the temperature effects on mortality in urban and rural counties. Second, we performed meta-regression to investigate the modifying effect of the urbanization level. Stratified analyses were performed by all-cause, nonaccidental (stratified by age and sex), cardiopulmonary, cardiovascular, and respiratory mortality. We also calculated the fraction of mortality and number of deaths attributable to nonoptimum temperatures associated with both cold and heat components. The potential sources of the urban–rural differences were explored using meta-regression with county-level characteristics.
Results:
Increased mortality risks were associated with low and high temperatures in both rural and urban areas, but rural counties had higher relative risks (RRs), attributable fractions of mortality, and attributable death counts than urban counties. The urban–rural disparity was apparent for cold (first percentile relative to minimum mortality temperature), with an RR of 1.47 [95% confidence interval (CI): 1.32, 1.62] associated with all-cause mortality for urban counties, and 1.98 (95% CI: 1.87, 2.10) for rural counties. Among the potential sources of the urban–rural disparity are age structure, education, GDP, health care services, air conditioners, and occupation types.
Conclusions:
Rural residents are more sensitive to both cold and hot temperatures than urban residents in Zhejiang Province, China, particularly the elderly. The findings suggest past studies using exposure–response functions derived from urban areas may underestimate the mortality burden for the population as a whole. The public health agencies aimed at controlling temperature-related mortality should develop area-specific strategies, such as to reduce the urban–rural gaps in access to health care and awareness of risk prevention. Future projections on climate health impacts should consider the urban–rural disparity in mortality risks.
... The most susceptible health effects are observed in cardiovascular, respiratory, and well-known heatrelated diseases. Although a few studies have estimated the health risk attributable to temperature (Borg et al. 2017, Curtis et al. 2017, Williams et al. 2013, there was no unambiguous definition for extreme temperature and the contribution of persistent extreme temperatures to the risk of emergency incidences remains unclear in Shenzhen. ...
Extreme temperature has been reported to be associated with an increase in acute disease incidence in several cities. However, few similar studies were carried out in Shenzhen, which is a subtropical city located in the southern China. This study explored the relationship between the emergency incidences and extreme temperatures, and investigated the role of air pollutants played in the temperature-related effects on human health in Shenzhen. We conducted a distributed lag nonlinear model study on the effect of extreme temperatures on emergency incidences in Shenzhen city during 2013–2017. Here, only the total emergency incidences, emergency incidences for respiratory diseases, and cardiovascular diseases were taken into consideration. Air pollution, subgroups, and seasons were adjusted to investigate the impacts of extreme temperatures on emergency incidences. Relative risk (RR) and 95% confidence intervals were calculated with the R software. From lag 0 to 21 days, the RR of temperature-total emergency department visits, temperature-cardiovascular, and temperature-respiratory diseases was 1.09 (95% CI: 0.98–1.20), 1.22 (95% CI: 0.96–1.56), and 1.06 (95% CI: 0.70–1.60) at extremely low temperature (first percent of temperature, 10 °C), respectively. During the same lag days, the RR was 1.02 (95 % CI: 0.92–1.14), 0.64 (95% CI: 0.49–0.86), and 0.92 (95% CI: 0.56–1.53) between extremely high temperature and total emergency department visits, cardiovascular, and respiratory diseases, respectively. The cumulative effects gradually went up with time for all types of emergency incidences in warm seasons (5 days moving average of temperature < 22 °C). However, the cumulative effects of total emergency incidences and Cvd emergency incidences were increased within the first lag 5 days, and then decreased until lag 21 in hot seasons (5 days moving average of temperature ≥ 22 °C). The cumulative effects of Res emergency incidences showed a declined trend from lag 0 to lag 21. The elderly (≥ 65, P1: RR = 1.49, 95% CI (1.30, 1.71); P99: RR = 0.86, 95% CI (0.71, 1.04)) and men (P1: RR = 1.27, 95% CI (1.14, 1.42)) seemed to be more vulnerable to extreme temperature than the younger (≤ 64, P1: RR = 1.19, 95% CI (1.08, 1.32); P99: RR = 1.00, 95% CI (0.89, 1.12)) and women (P1: RR = 1.17, 95%CI (1.06, 1.30)). The effects of extremely low temperature on all types of emergency incidences were stronger than those of extremely high temperature in the whole year. In addition, impacts of cold weather lasted about several days while those of hot weather were acute and rapid. An increased frequency of emergency incidences is predicted by rising temperatures variations. These results have clinical and public health implications for the management of emergency incidences.
