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Framework for an Integrated Assessment of Health, Climate Change, and Ecosystem Vulnerability

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... Other approaches to integrative assessments have been proposed that focus on human and environmental linkages including socioeconomic and political factors (e.g., Bruins and Heberling 2005;Stahl et al. in press), or have focused more broadly on human health-ecological integrity reflecting dimensions of both the natural and social systems (Miranda et al. 2002). Epstein (Epstein 1994) developed an integrated assessment framework of climate change and ecosystem vulnerability. His generalized framework depicted overlapping and interacting climate and social systems with ecosystems whose intersection directly or indirectly produced various outcomes ranging from changes in health, crop yields, and demography to economic productivity. ...
... Epstein noted that integration was dependent on the use of specific biological, social or geochemical indicators depicting the functions of complex systems. Referring to the complex relationship between disease emergence and changes in climate and ecosystems, Epstein (Epstein 1994) proposed a number of principles for modeling and monitoring complex ecosystems. He emphasized the need to account not only for direct impacts to the different systems but also those indirect effects resulting from the interactions among factors within the three overlapping systems. ...
... The examples include a mix of conceptual, integrated approaches that are either descriptive or consist of parallel risk assessments. Considering the models presented by Epstein (Epstein 1994) and VanLeeuwen et al. (VanLeeuwen et al. 1999), it is clear that an evaluation of interactions among human populations, their environment, and other important ecological factors are needed in conducting an integrated analysis. This type of evaluation is similar to that encompassed by an ecoepidemiological approach. ...
Article
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Environmental and public health policy continues to evolve in response to new and complex social, economic and environmental drivers. Globalization and centralization of commerce, evolving patterns of land use (e.g., urbanization, deforestation), and technological advances in such areas as manufacturing and development of genetically modified foods have created new and complex classes of stressors and risks (e.g., climate change, emergent and opportunist disease, sprawl, genomic change). In recognition of these changes, environmental risk assessment and its use are changing from stressor-endpoint specific assessments used in command and control types of decisions to an integrated approach for application in community-based decisions. As a result, the process of risk assessment and supporting risk analyses are evolving to characterize the human-environment relationship. Integrating risk paradigms combine the process of risk estimation for humans, biota, and natural resources into one assessment to improve the information used in environmental decisions (Suter et al. 2003b). A benefit to this approach includes a broader, system-wide evaluation that considers the interacting effects of stressors on humans and the environment, as well the interactions between these entities. To improve our understanding of the linkages within complex systems, risk assessors will need to rely on a suite of techniques for conducting rigorous analyses characterizing the exposure and effects relationships between stressors and biological receptors. Many of the analytical techniques routinely employed are narrowly focused and unable to address the complexities of an integrated assessment. In this paper, we describe an approach to integrated risk assessment, and discuss qualitative community modeling and Probabilistic Relational Modeling techniques that address these limitations and evaluate their potential for use in an integrated risk assessment of cyanobacteria.
... De M. Santos (2005), taking note of impacts of El Niños, stresses the likely dangers from loss of predators and increases in rodents and other pests (see also Epstein 1994). Chivian (1997) expands on these, also discussing stratospheric ozone depletion, toxic pollution, habitat destruction and loss of indicator species as these relate to human health (see also Patz et al. 2000). ...
... In some cases, pathogens and vectors may be lost, but in many other situations, increased levels of disease have followed deforestation'. Epstein (1994) makes general observations about the relationship between forest clearing, subsequent changes in rodent species (as disease vectors) and the introduction of vulnerable human populations, as important factors in the appearance of arenaviruses. Walsh et al. (1993) provide a more complete survey of diseases exacerbated by forest clearing. ...
... De M. Santos (2005), taking note of impacts of El Niños, stresses the likely dangers from loss of predators and increases in rodents and other pests (see also Epstein 1994). Chivian (1997) expands on these, also discussing stratospheric ozone depletion, toxic pollution, habitat destruction and loss of indicator species as these relate to human health (see also Patz et al. 2000). ...
... In some cases, pathogens and vectors may be lost, but in many other situations, increased levels of disease have followed deforestation'. Epstein (1994) makes general observations about the relationship between forest clearing, subsequent changes in rodent species (as disease vectors) and the introduction of vulnerable human populations, as important factors in the appearance of arenaviruses. Walsh et al. (1993) provide a more complete survey of diseases exacerbated by forest clearing. ...
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"This study has two central concerns: the state of human health in forests, and the causal links between forests and human health. Within this framework, we consider four issues related to tropical forests and human health. First, we discuss forest foods, emphasizing the forest as a food-producing habitat, human dependence on forest foods, the nutritional contributions of such foods, and nutrition-related problems that affect forest peoples. Our second topic is disease and other health problems. In addition to the major problems--HIV/AIDS, malaria, Ebola and mercury poisoning, we address some 20 other tropical diseases and health problems related to forests. The third topic is medicinal products. We review the biophysical properties of medicinal species and consider related indigenous knowledge, human uses of medicinal forest products, the serious threats to forest sustainability, and the roles of traditional healers, with a discussion of the benefits of forest medicines and conflicts over their distribution. Our fourth and final topic is the cultural interpretations of human health found among forest peoples, including holistic world views that impinge on health and indigenous knowledge. The Occasional Paper concludes with some observations about the current state of our knowledge, its utility and shortcomings, and our suggestions for future research."
... Climatic and environmental factors -Harvard scientists in the 1990's had already anticipated a dramatic global scenario for the next decades with global warming leading to proliferation and dislocation of mosquito vectors of arboviral diseases, as well as other vectors of infectious diseases, from tropical to temperate zones of the globe. (18)(19)(20) More recently, other ecologists of infectious diseases (21,22) have noted that in temperate zones, where the winter temperature is very low for transmission of mosquito-borne infections, warmer summers can trigger the transmission and dislocation of these diseases into new areas, accelerating the parasite development rate and, thereby, making the region more suitable for the transmission of arboviral diseases. Another crucial climatic variable playing a crucial role on mosquito transmitted arbovirus besides temperature is rainfall by supplying suitable larval habitats. ...
Article
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We discuss the complex eco-social factors involved in the puzzle of the unexpected rapid viral spread in the ongoing Brazilian yellow fever (YF) outbreak, which has increased the reurbanisation risk of a disease without urban cases in Brazil since 1942. Indeed, this rapid spatial viral dissemination to the Southeast and South regions, now circulating in the Atlantic Forest fragments close to peri-urban areas of the main Brazilian megalopolises (São Paulo and Rio de Janeiro) has led to an exponential increase in the number of yellow fever cases. In less than 18 months, 1,833 confirmed cases and 578 deaths were recorded most of them reported in the Southeast region (99,9%). Large epizooties in monkeys and other non-human primates (NHPs) were communicated in the country with 732 YF virus (YFV) laboratory confirmed events only in the 2017/2018 monitoring period. We also discuss the peculiarities and similarities of the current outbreak when compared with previous great epidemics, examining several hypotheses to explain the recent unexpected acceleration of epizootic waves in the sylvatic cycle of the YFV together with the role of human, NHPs and mosquito mobility with respect to viral spread. We conclude that the most feasible hypothesis to explain this rapidity would be related to human behavior combined with ecological changes that promoted a significant increase in mosquito and NHP densities and their contacts with humans. We emphasize the urgent need for an adequate response to this outbreak such as extending immunisation coverage to the whole Brazilian population and developing novel strategies for immunisation of NHPs confined in selected reserve areas and zoos. Finally, we stress the urgent need to improve the quality of response in order to prevent future outbreaks and a catastrophic reurbanisation of the disease in Brazil and other South American countries. Continuous monitoring of YFV receptivity and vulnerability conditions with effective control of the urban vector Aedes aegypti and significant investments in YF vaccine production capacity and research and development for reduction of adverse effects are of the highest priority.
... In the early 1990s, vulnerability became an important concept in connection to the HIV/AIDS pandemic (see, for example, Ankrah 1991). Since the mid-1990s, vulnerability surged as a conceptual tool in two emerging discourses: first, climate change (Brown 1994) and environmental degradation in general (Epstein 1994) and, second, globalization, focused on global health (Jaggar 2002) and global natural resources (Vörösmarty et al. 2000), often in connection with human rights discourse (Whelan 1998). Finally, since 2000 the notion of vulnerability has been applied in analyses and discussions on bioterrorism (Kahn, Swerdlow, and Juranek 2001) and human security (Gutlove and Thompson 2003). ...
Book
Alongside globalization, the sense of vulnerability among people and populations has increased. We feel vulnerable to disease as new infections spread rapidly across the globe, while disasters and climate change make health increasingly precarious. Moreover, clinical trials of new drugs often exploit vulnerable populations in developing countries that otherwise have no access to healthcare and new genetic technologies make people with disabilities vulnerable to discrimination. Therefore the concept of 'vulnerability' has contributed new ideas to the debates about the ethical dimensions of medicine and healthcare. This book explains and elaborates the new concept of vulnerability in today's bioethics. Firstly, Henk ten Have argues that vulnerability cannot be fully understood within the framework of individual autonomy that dominates mainstream bioethics today: it is often not the individual person who is vulnerable, rather that his or her vulnerability is created through the social and economic conditions in which he or she lives. Contending that the language of vulnerability offers perspectives beyond the traditional autonomy model, this book offers a new approach which will enable bioethics to evolve into a global enterprise. This groundbreaking book critically analyses the concept of vulnerability as a global phenomenon. It will appeal to scholars and students of ethics, bioethics, globalization, healthcare, medical science, medical research, culture, law, and politics.
... Demographic differentiation in adaptation and coping abilities occurs frequently with regard to health effects of climate change, especially as a result of differences in wealth, age, and race (Epstein 1994; Kalkstein 1998; Ebi et al. 2006; CBCF 2004; Sagar and Banuri 1999; Williams 1999; Kalkstein and Greene 1997; McGeehin and Mirabelli 2001). It also occurs due to differentiated access to health care resources (Collins et al. 2003; Collins et al. 2002; Doty and Ives 2002) and health insurance (Bulatao and Anderson 2004) across socioeconomic and racial groups. ...
... Adapted from Ogden and Innes (2007a Chapin et al. 2004, FAO 2008, Johnston et al. 2006, Kellomaki et al. 2005, Keskitalo 2008, Lemmen and Warren 2004, Ogden 2007, Ogden and Innes 2008, Ohlson et al. 2005, Spittlehouse 2005, Spittlehouse and Stewart 2003 Appendix 6.6 Strategic-and operational-level climate-change adaptation options that may be considered to achieve the management objective of conserving and maintaining the soil and water resources in forest ecosystems. Adapted from Ogden and Innes (2007a Butler 2008, Colfer et al. 2006, 2008b, Cunningham et al. 2008, Dounias and Colfer 2008, Epstein 1994, Fowler 2008, Gonzalez et al. 2008, Kwa 2008, Lopez 2008, Pattanayak and Yasuoka 2008, Persoon 2008, Smith 2008, Vinceti et al. 2008 Appendix 6.9 Strategic-and operational-level climate-change adaptation options that may be considered to achieve the management objective of maintaining and enhancing long-term multiple intangible socioeconomic benefits to meet the needs of societies. Adapted from Ogden and Innes (2007a Berkes et al. 2000, BCMOF 2006a, Chapin et al. 2004, FAO 2008, Johnston et al. 2006, Kellomaki et al. 2005, Ohlson et al. 2005, Ramakrishnan 2007, Spittlehouse 2005, Spittlehouse and Stewart 2003 ...
Chapter
Full-text available
This chapter develops a framework to explore examples of adaptation options that could be used to ensure that the ecosystem services provided by forests are maintained under future climates. The services are divided into broad areas within which managers can identify specific management goals for individual forests or landscapes. Adaptation options exist for the major forest regions of the world but the scientific basis for these adaptation options and their potential effectiveness varies across regions. Because of the great variation in local conditions, no recommendations can be made that are applicable to an entire domain. The choice of management option will depend on the likely changes occurring in the forest, the management objectives of that forest, its past management history and a range of other factors. Local managers must have sufficient flexibility to choose the most appropriate suite of management options for their conditions. The current failure to implement fully the multi-faceted components of sustainable forest management is likely to limit the ability of forest management to adapt to climate change. Forest managers will need to plan at multiple spatial and temporal scales and will need to adopt adaptive collaborative management as their primary form of management. Careful monitoring and evaluation will be required, with a change in focus from outputs to outcomes.
... In the early 1990s, vulnerability became an important concept in connection to the HIV/AIDS pandemic (see, for example, Ankrah 1991). Since the mid-1990s, vulnerability surged as a conceptual tool in two emerging discourses: first, climate change (Brown 1994) and environmental degradation in general (Epstein 1994) and, second, globalization, focused on global health (Jaggar 2002) and global natural resources (Vörösmarty et al. 2000), often in connection with human rights discourse (Whelan 1998). Finally, since 2000 the notion of vulnerability has been applied in analyses and discussions on bioterrorism (Kahn, Swerdlow, and Juranek 2001) and human security (Gutlove and Thompson 2003). ...
Article
Vulnerability has become a popular though controversial topic in bioethics, notably since 2000. As a result, a common body of knowledge has emerged (1) distinguishing between different types of vulnerability, (2) criticizing the categorization of populations as vulnerable, and (3) questioning the practical implications. It is argued that two perspectives on vulnerability, i.e., the philosophical and political, pose challenges to contemporary bioethics discourse: they re-examine the significance of human agency, the primacy of the individual person, and the negativity of vulnerability. As a phenomenon of globalization, vulnerability can only be properly addressed in a global bioethics that takes the social dimension of human existence seriously.
... Because local climate conditions vary, vulnerability to the effects of climate change will be different in different locales. [35][36][37] Drought conditions in the Southwest and Southeast create different challenges than in areas where annual rainfall is increasing. The effects of the "urban heat island" create different challenges than those faced in rural areas, where dependence on well water may cause residents to be vulnerable to ground water contamination in conditions of flood or ubiquitous rain. ...
Conference Paper
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Climate change is likely to have substantial impact on the health of the populations cared for by U.S. clinicians. The level of knowledge of physicians and other health professionals about the health effects of climate change is unknown. Assessment is needed to inform education policy and produce professionals who are sufficiently informed to provide appropriate health care and support policy development. A brief pilot survey was administered to two groups of physicians (N1=50, N2=49) in June 2008. There were questions on knowledge, attitudes, and specific medical problems related to global warming. Surveys were returned by 50/65 (77%) of the first group and 49/68 (75%) of the second. The first group had an older mean age, a male majority, were more likely to be urban and were less likely to be practicing in a primary care field. A majority of both groups (76%/67%) agreed that global warming is happening and threatens future generations' well-being and safety. Fewer of each group were concerned about the health effects of climate change on their patients (47%/52%). Even fewer agreed that global warming is associated with increases in mosquito born diseases like dengue fever or malaria (33%/33%), or infectious diarrhea from contamination of drinking water with heavy rains (35%/25%). Awareness of associated heat stress and asthma and chronic lung disease was higher (59%/65%). Only 60% and 46% had received prior environmental training. This pilot demonstrates knowledge deficiencies and points to the need for education of physicians and other health professionals about climate and health.
... This suggests another category of surprises, for which there already has been considerable analysis: human health. Several studies have already suggested that the direct effects of increased heating on cardiovascular disease could lead to increased mortality rates in already warm climates for those who are vulnerable or could also alter disease vectors (Epstein, 1994 ). However, it is usually noted that adaptations, ranging from simple acclimatization to proper choice of clothing, nutrition, diet, housing, medicine and the like can substantially mitigate high vulnerability to such stress. ...
Article
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In addition to assessing the impacts of CO 2 doubling on environment and society, more consideration is needed to estimate extreme events or ‘surprises’. This is particularly important at the intersection of disciplines like climate and ecology because the potential for large discontinuities is high given all the possible climate/biota interactions. The vast disparities in scales encountered by those working in traditional ecology (typically 20 m) and climatology (typically 200 km) make diagnoses of such interactions difficult, but these can be addressed by an emerging research paradigm we call strategic cyclical scaling (SCS). The need to anticipate outlier events and assign them subjective probabilities suggests emphasis on interdisciplinary research associations. The desire to reduce societal vulnerability to such events suggests the need to build adaptive management and diverse economic activities into social organizations. The effectiveness of adaptation responses to anticipated climatic changes is complicated when consideration of transient changes, regional disturbances, large unforseeable natural fluctuations and surprises are considered. Slowing down the rate of disturbances and decreasing vulnerability are advocated as the most prudent responses to the prospect of human-induced climatic changes. Peer Reviewed http://deepblue.lib.umich.edu/bitstream/2027.42/42439/1/10531_2004_Article_BF00052720.pdf
Chapter
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This chapter develops a framework to explore examples of adaptation options that could be used to ensure that the ecosystem services provided by forests are maintained under future climates. The services are divided into broad areas within which managers can identify specific management goals for individual forests or landscapes. Adaptation options exist for the major forest regions of the world but the scientific basis for these adaptation options and their potential effectiveness varies across regions. Because of the great variation in local conditions, no recommendations can be made that are applicable to an entire domain. The choice of management option will depend on the likely changes occurring in the forest, the management objectives of that forest, its past management history and a range of other factors. Local managers must have sufficient flexibility to choose the most appropriate suite of management options for their conditions. The current failure to implement fully the multi-faceted components of sustainable forest management is likely to limit the ability of forest management to adapt to climate change. Forest managers will need to plan at multiple spatial and temporal scales and will need to adopt adaptive collaborative management as their primary form of management. Careful monitoring and evaluation will be required, with a change in focus from outputs to outcomes.
Article
Over the last 50 years, national, international and private stewardship and conservation organizations have spent billions of dollars collecting marine ecosystem information. This remains divided among many custodians, scattered among thousands of published sources and, from a global perspective, is fragmentary in nature. It is argued that new resource management questions regarding coastal ecosystem health can be addressed through the recovery and `data mining' of this previously collected and often discarded information. A retrospective marine epidemiological approach was developed to demonstrate that marine morbidity, mortality, and disease information is recoverable by keyword searching of academic journals and through the retrieval of publicly available digital and print-media information. Observational records compiled from disturbances occurring within the Northwestern Atlantic, Gulf of Mexico, and Caribbean Sea confirm that anomalous marine morbidity and mortality events have increased in number and frequency during the last 30 years. A global approach is summarized for systematically reconstructing spatial and temporal disturbance indicator time series using data mining and data reduction techniques.
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Climate change will likely have adverse human health effects that require federal agency involvement in adaptation activities. In 2009, President Obama issued Executive Order 13514, Federal Leadership in Environmental, Energy, and Economic Performance. The order required federal agencies to develop and implement climate change adaptation plans. The Centers for Disease Control and Prevention (CDC), as part of a larger Department of Health and Human Services response to climate change, is developing such plans. We provide background on Executive Orders, outline tenets of climate change adaptation, discuss public health adaptation planning at both the Department of Health and Human Services and the CDC, and outline possible future CDC efforts. We also consider how these activities may be better integrated with other adaptation activities that manage emerging health threats posed by climate change.
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Mögliche Auswirkungen von Klimaveränderungen auf die Ausbreitung von primär humanmedizinisch relevanten Krankheitserregern über tierische Vektoren sowie auf die wichtigen Humanparasiten in Deutschland. Emerging and re-emerging vector- borne diseases, seem especially in respect to climatic changes, to become a world-wide problem. Until recently Germany seemed not to be affected. To be sure that not insufficient information due to missing experts led to this impression, this report is supposed to give a detailed description of all actuel and assumed vector-borne diseases and their vectors. Therefore a group of experts in the field of arachnoentomology got together. The members of the group were selected among other criterias due to their practical experiences with special groups of insects and ticks as well as the diseases they transmit. It was shown that a great number of pathogens already exist in Germany and that suitable vectors for other pathogens have been found, which means that when pathogens are imported by reservoir hosts or infected travelers autochthonous cases are to be expected. The relationship between vector host and pathogen is a rather complex system in which especially the vector and the development of the pathogen in the vector are dependent upon their environment and climate. Numerous vectors and pathogens seem to display due to the recent warm periods an expansion tendency towards the north. This is for example the case for ticks and diseases transmitted by these vectors, such as TBE and Lyme disease. Also sandflies and leishmaniasis one would have not expected in Germany. On the other hand this project made it apparent that scientific data which seemed to emphasize that trend still appears to be missing to a large extend. Under such given criteria one cannot predict the outbreak of diseases, endemics or even epidemics. In the European Union (European Network for Ressearch in Global Change, ENRICH) the topic "Climate and Vector Borne Diseases" was already discussed and recomended to register the extent and spread of vector-borne diseases on a europen basis and among other goals to map vectors and "hot spots" of pathogen transmission.
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Scientific evidence accumulating over the past decade documents that climate change impacts are already being experienced in the US Northeast. Policy-makers and resource managers must now prepare for the impacts from climate change and support implementing such plans on the ground. In this paper we argue that climate change challenges the region to maintain its economic viability, but also holds some opportunities that may enhance economic development, human well-being, and social justice. To face these challenges and seize these opportunities effectively we must better understand adaptation capacities, opportunities and constraints, the social processes of adaptation, approaches for engaging critical players and the broader public in informed debate, decision-making, and conscious interventions in the adaptation process. This paper offers a preliminary qualitative assessment, in which we emphasize the need for (1) assessing the feasibility and side effects of technological adaptation options, (2) increasing available resources and improving equitable access to them, (3) increasing institutional flexibility, fit, cooperation and decision-making authority, (4) using and enhancing human and social capital, (5) improving access to insurance and other risk-spreading mechanisms, and (6) linking scientific information more effectively to decision-makers while engaging the public. Throughout, we explore these issues through illustrative sectoral examples. We conclude with a number of principles that may guide the preparation of future adaptation plans for the Northeast.
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Climate change will have an effect on the health and well-being of the populations cared for by practicing physicians. The anticipated medical effects include heat- and cold-related deaths, cardiovascular illnesses, injuries and mental harms from extreme weather events, respiratory illnesses caused by poor air quality, infectious diseases that emanate from contaminated food, water, or spread of disease vectors, the injuries caused by natural disasters, and the mental harm associated with social disruption. Within several years, such medical problems are likely to reach the doorsteps of many physicians. In the face of this reality, physicians should assume their traditional roles as medical professionals, health educators, and community leaders. Clinicians provide individual health services to patients, some of whom will be especially vulnerable to the emerging health consequences of global warming. Physicians also work in academic medical institutions and hospitals that educate and provide continuing medical education to students, residents, and practitioners. The institutions also produce a measurable carbon footprint. Societies of physicians at national, state, and local levels can choose to use their well-developed avenues of communication to raise awareness of the key issues that are raised by climate change as well as other environmental concerns that have profound implications for human health and well-being.
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Climatic factors influence the emergence and reemergence of infectious diseases, in addition to multiple human, biological, and ecological determinants. Climatologists have identified upward trends in global temperatures and now estimate an unprecedented rise of 2.0 degrees C by the year 2100. Of major concern is that these changes can affect the introduction and dissemination of many serious infectious diseases. The incidence of mosquito-borne diseases, including malaria, dengue, and viral encephalitides, are among those diseases most sensitive to climate. Climate change would directly affect disease transmission by shifting the vector's geographic range and increasing reproductive and biting rates and by shortening the pathogen incubation period. Climate-related increases in sea surface temperature and sea level can lead to higher incidence of water-borne infectious and toxin-related illnesses, such as cholera and shellfish poisoning. Human migration and damage to health infrastructures from the projected increase in climate variability could indirectly contribute to disease transmission. Human susceptibility to infections might be further compounded by malnutrition due to climate stress on agriculture and potential alterations in the human immune system caused by increased flux of ultraviolet radiation. Analyzing the role of climate in the emergence of human infectious diseases will require interdisciplinary cooperation among physicians, climatologists, biologists, and social scientists. Increased disease surveillance, integrated modeling, and use of geographically based data systems will afford more anticipatory measures by the medical community. Understanding the linkages between climatological and ecological change as determinants of disease emergence and redistribution will ultimately help optimize preventive strategies.
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There is a growing body of critical literature on health, development and environmental sustainability in a world of finite resources and overburdened ecosystems. The ethics of progress and perpetual development in pursuit of unlimited economic growth and ever-expanding markets are no longer viable, given the constraints imposed on the life-support systems of the biosphere and a finite resource base, which poses the most serious threat to life on Earth. Despite increasing evidence of the linkages between economic growth and environmental deterioration and a rhetoric expressed in a growing body of laws, regulations, accords and global "agendas" at the national and international level, there are all too few success stories in reversing or even slowing down the current trends of ecosystem degradation and decreasing cultural and biological diversity. On the contrary, there is evidence that environmental stress and deterioration are increasing, and the impact on the mental, physical and social health and well-being of populations is more significant now than in any previous time in history. The fragmentation of countries, the rise of nationalism and ethnic conflict, the decimation of indigenous nations and human rights abuses are often closely interrelated with environmental degradation and development initiatives. This paper reviews some of the concepts and underlying values of the main "models" developed by health and social scientists for interpreting this reality, with the aim of stimulating debate that could lead to the adoption of a larger and more comprehensive framework for analysing the interactions between human health, development and environmental change.
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Control of imported communicable diseases hitherto has been based on a paradigm of exclusion, isolationism and quarantine. Yet such policy is inconsistent with globalization of communication, commerce and travel, thus ignoring the potential for rapid dissemination of infectious disease worldwide. Prevention and containment strategies founded on such a premise ultimately cannot be effective. Instead, the perspective in control of communicable diseases must become international with monitoring and study of disease emergence, vector and reservoir patterns, and factors which facilitate and impede pathogen traffic. Our public health system must be reorganized with an international focus to ensure adequacy of surveillance mechanisms, related applied research, prevention and control strategies (including vaccination and information dissemination and education), and maintenance of optimal infrastructure--nationally, locally and internationally. Clear national and provincial contingency plans must be developed, ideally with international cooperation, for dealing with emerging infectious disease threats.
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Many potential human health effects have been hypothesized to result either directly or indirectly from global climate change. Changes in the prevalence and spread of infectious diseases are some of the most widely cited potential effects of climate change, and could have significant consequences for human health as well as economic and societal impacts. These changes in disease incidence would be mediated through biologic, ecologic, sociologic, and epidemiologic processes that interact with each other and which may themselves be influenced by climate change. Although hypothesized infectious disease effects have been widely discussed, there have not yet been thorough quantitative studies addressing the many processes at work. In part this is because of the complexity of the many indirect and feedback interactions or mechanisms that bear on all aspects of the climate issue. It also results from the difficulty of including the multitude of always-changing determinants of these diseases. This paper proposes a framework for an integrated assessment of the impacts of climate change on infectious diseases. The framework allows identification of potentially important indirect interactions or mechanisms, identification of important research gaps, and a means of integrating targeted research from a variety of disciplines into an enhanced understanding of the whole system. Images Figure 1 Figure 2
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Emerging infectious diseases are characterized by complex interactions among disease agents, vectors, wildlife, humans, and the environment. Since the appearance of West Nile virus (WNV) in New York City in 1999, it has infected over 8,000 people in the United States, resulting in several hundred deaths in 46 contiguous states. The virus is transmitted by mosquitoes and maintained in various bird reservoir hosts. Its unexpected introduction, high morbidity, and rapid spread have left public health agencies facing severe time constraints in a theory-poor environment, dependent largely on observational data collected by independent survey efforts and much uncertainty. Current knowledge may be expressed as a priori constraints on models learned from data. Accordingly, we applied a Bayesian probabilistic relational approach to generate spatially and temporally linked models from heterogeneous data sources. Using data collected from multiple independent sources in Maryland, we discovered the integrated context in which infected birds are plausible indicators for positive mosquito pools and human cases for 2001 and 2002.
Book
A general description of the earth as a biosphere is presented. Divergent views of near-future world scenarios are presented; the Global 2000 report, and the analysis of Simon and Kahn. The basic principles and trends in global ecology are outlined, and the basic pollution and environmental degradation problems are discussed. Humanistic considerations which affect global ecology (population control, the effects of largescale nuclear war, and third-world socio-economics) are discussed.
Book
This book deals with the fundamental ecological variables and principles that govern the use of natural resources (including laws of matter, energy, space, time and diversity). It contains innovative, ecologically based strategies for managing energy, food, and environmental crises through specific conservation and rehabilitation measures.
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