Climate Change and Human Health: Argument of Solution

Of all the effects caused by climate change, human health is arguably one of the most worrying. Direct consequences of this phenomenon include famine due to inadequate food production, widened spread of disease, and increased mortality led by natural hazards. Of course, these are not all the problems; further issues such as declining newborn health and air pollution are equally troublesome. Therefore, the negative impact of climate change on human health should not be underestimated. If effective and comprehensive preventive measures are not taken, the future of human beings is disquieting. It is our job to protect the Earth from being exhausted and to protect ourselves. 

The Centres for Disease Control and Prevention

According to a large amount of data and research, human health losses caused by climate change are worsening each year and are getting especially serious in poverty and remote areas where medical and emergency equipment are inadequate. In the United States, health is damaged both during and after extreme events, and the country has already experienced costly lives and economic damages. Moreover, according to the World Health Organization, climate change is estimated to cause approximately 250,000 additional deaths per year between 2030 and 2050, from malnutrition, malaria, diarrhoea, and heat stress. This is a disastrous sign for human beings; we are exhausting the earth's resources for the sake of survival and development, but at the same time, we are bringing bigger troubles for ourselves. The good news is that the governments and relevant departments in multiple countries have realized this phenomenon and started to prepare prevention strategies. 

The Centres for Disease Control and Prevention (CDC) has begun working on constructing guidelines to prevent and mitigate the health effects brought by climate change. CDC is a subordinate institution of the U.S. Department of Health and Human Services. The center focuses on the development and application of disease prevention and control, environmental health, occupational health, and health promotion aimed at improving the health of the population. The institution provides reliable information for the protection of public health and safety and also promotes the health of citizens through a strong partnership with national health authorities and other organizations to improve decisions in favor of the public’s health. To resolve the passive consequences of climate change, CDC played a leading role and established three-pronged approaches (Schramm 2020).  

Firstly, knowing the importance of massive data support, CDC built an evidence base depending on studies of health effects of climate change. Adequate and reliable data can be a powerful assistance in prevention actions. Understanding the pattern, range, and periodic changes of climate change require long and precise observations, but once the valid data are gathered, governments and departments can formulate more effective intervention policies based on the evidence and make necessary adjustments in time according to the changes of the data. Secondly, CDC provided technical and funding support to expand the capacity of regions where intervention measures are implemented. As mentioned in the previous context, numerous poverty areas do not have adequate technology to deal with climate change impacts because of a lack of funds, as a result, public health is not guaranteed. Providing physical assistance solves the fundamental problem and provides substantial help to these areas. Finally, to synchronize prevention knowledge across regions, CDC has also stepped-up communication intensity. Through unimpeded and timely connection, relevant departments and governments can receive feedback and suggestions on prevention policies, and also have access to the latest data support. 

The impacts of climate change are getting worse, there is a lot more that needs to be done. It will also take a long period of time to control the situation completely; for the sake of managing climate change more effectively, CDC developed the BRACE framework. 

The Building Resilience Against Climate Effects (BRACE)

The BRACE framework is a “five-step process that allows health officials to develop strategies and programs to help communities to prepare for the health effects of climate change (centers for disease control and prevention)”. As shown in figure 1, the five steps of the BRACE framework specifically mapped out how to prevent human health decline, and is also applicable to different regions and cities, which is one of the most constructive and crucial solutions to control climate change.

Step 1: Anticipate Climate Impacts and Assess Vulnerabilities

The very first step of the BRACE framework is to forecast climate impacts and assess the vulnerabilities. Estimating possible risks and damages such as extreme weather, types of disease, and the death rate will greatly help establish detailed contingency plans. When making the assessment, climate models are the fundamental tools. 

According to The National Oceanic and Atmospheric Administration (NOAA) Climate Prediction Center, climate models are “mathematical models for quantitatively describing, simulating, and analyzing the interactions between the atmosphere and underlying surface”. They can divide the earth into a mass of tiny modules and make different predictions and assessments of sea level, temperature, climate change, and so on for each module. Furthermore, these predictions are based on duplications of past and current climates, then estimate the likelihood of a specific event in a particular situation. On the whole, climate models are very important not only for the researchers but also lay the foundation for the BRACE framework. 

Step 2: Projecting Disease Burden

The next step of the BRACE framework uses the gathered information from climate models to determine how the intensity and duration of exposure or environmental hazards may change in the future. There are several steps needed when projecting the possible burden, as shown below, which will play a crucial supporting role in the whole step two (Hess).

The causal pathway, also known as exposure pathways or causal process maps, are maps that reveal the health consequences caused by climate change. By adding potential variables, they can illustrate the results with varying degrees of complexity. In other words, the causal pathways establish one or more causal relationships between climate change and its possible consequences. After such relationships are constructed, it is then necessary to assemble data elements. During this process, CDC mainly utilizes two models: the global climate models (GCMs) and the baseline health data. These tools provide comprehensive data support to predict future changes that are likely to occur in a given situation, while also exposing the possibility of disease occurrence. 

Once all the data are collected, the next thing is to combine this information for summarizing the health burden predictions. Since there will be plenty of uncertainties in the forecasting process, it is necessary to analyze and quantify these inherent uncertainties and then reduce them. For example, one of the uncertainties of climate change health impacts is “whether and how to model climate change adaptation, which has the potential to reduce climate change impacts, including those on public health (Hess)”. In general, uncertainty is caused by an inability to fully understand the factors that influence a particular process during the prediction of climate change, while analysis aims to identify the main sources, try determining their effects, and make other findings. Finally, adaptive management helps build complex systems aimed at predicting human health effects of climate change, in which it manages, designs, tests, and evaluates these systems, then makes adjustments based on past results.

In general, step 2 of the BRACE framework focuses on future changes in the negative consequences under specific circumstances and uses the data to design systems, therefore, preventing this issue. During this process, it is important to follow the guideline so that a systematic predicting strategy can be established to improve the solution in controlling climate change. 

Step 3: Assess Public Health Interventions

The purpose of step three of the BRACE framework is to formulate different plans based on distinct conditions of each city and region. An important factor to consider when dealing with climate change is that the environmental conditions can be contrasting. For example, in the United States, drought conditions appear to be worsening in the southwest, which is significantly more severe than in the northeast. Under such situations, it is necessary to formulate the most applicable health interventions.

Evidence is the foundation of thorough public health practice, which confirms risk suspicions, clarifies the relative burden of disease, and helps to prioritize demands. Evidence also drives causal reasoning, confirms the effectiveness of interventions, and illuminates how interventions should be carried out in various situations. Some evidence comes from experience, but more of it is now developed and systematically evaluated. There are three types of evidence for adaptation to climate-related health effects: Evidence linking climate-sensitive exposures to health outcomes of interest, evidence on the effectiveness of interventions, and evidence on evaluation and implementation within a community (Anderson). Each evidence contains distinct measuring methods and a typical research design. Together, they can evaluate the health impacts caused by climate change, thus making the preferable interference. 

One case study focusing on climate change-related drinking water and water-borne disease provided specific intervention strategies to address the issue. Knowing that changes in rainfall, seasonality, and precipitation intensity may lead to increased flood risk and thus have an impact on water-borne diseases, there are two types of interventions that are pervasively acknowledged: at-home treatment and community-level treatment. The purpose of both of these two treatments is to purify and filter the water of poor quality to make it potable.

As the figure above shows, both treatments are proved to have a certain degree of effectiveness, which indicates that current defense strategies, aided by evidence, can produce positive impacts.

Step 4: Develop and Implement a Plan

The main purpose of step four is to summarize the collected information from previous steps and generate them into a climate and health adaptation plan. These plans focus on coordinating, emphasizing, and potentially triggering a series of actions to prevent or at least alleviate the expected impacts of climate change on specific regions. It is also worth noting that the plans need to be updated regularly to cope with the changing climate and that it is important to reinforce an overview of how these actions will be implemented and how their success will be measured. In Marinucci’s article, for example, the development of memorandums can facilitate greater exchange of information, skills, and resources between public health agencies and those responsible for housing, planning, transport, and water quality, and may lead to earlier input into development plans that further optimize public health benefits or mitigate unintended harm. On the other hand, planning requires attention to coordination between multiple departments and needs to be balanced with considerations mentioned in previous steps. 

Step 5: Evaluate and Improve

The final step of the BRACE framework is to conduct a systematic evaluation to determine whether the program is worthwhile based on the implementation effect. Evaluation means the opportunity for improvement, and summarizing problems and advantages based on experience can bring a lot of convenience for subsequent defensive measures. “At any point in the implementation of BRACE, process evaluation measures can help to validate methods employed and to reveal flaws in the plan (Marinucci 2014)”. Except for evaluating the implementation approach, developing metrics can help determine whether the most appropriate and needed stakeholders are already involved in the implementation and whether their participation increases or changes the input variables. To ensure the reliability of the assessment, public health agencies should pay more attention to the duration of learning, as well as improving skills and future planning. 

Marinucci emphasizes in her article that, while conducting the evaluation, organizations should pay attention to problems during the process: 

• Does the public health agency have a reasonable estimate of the health impacts of climate change in its jurisdiction?
• Has the process allowed the public health agency to prioritize health impacts of greatest concern and the most suitable interventions?
• Has the public health agency prepared an adaptation plan for the public health sector within the jurisdiction?
• Are climate change considerations accommodated in public health planning and implementation activities?
• Are public health considerations accommodated in climate change planning and implementation activities?
• Are indicators in place that will evaluate the interventions implemented as a result of utilizing BRACE?
• How can the process be improved in the next iteration?
• What is the agency’s top learning priorities in the next iteration of BRACE?

Discussion and Conclusion

During the process of implementing BRACE, one fact that governments and departments need to understand is, because the impacts of climate change are so widespread, and their consequences are destructive, a single department will not be able to solve all the problems. This is a very worrying reality, and once again proves how challenging it is to control climate change. Multi-departmental collaboration requires cooperation between local government, health, and other organizations, while multi-disciplinary collaboration needs joint research on climate change between different academic fields. Solving climate change is a long-term goal, and more progress can be made only when mankind realizes the importance of working together. 

The article Climate Change and Health: Transcending Silos to Find Solutions pointed out the value of partnership with academic and research institutions. These institutions can provide professional and constructive data and forecasts, which is one of the most important steps in the development of prevention strategies. For example, as the author stated, “linking information resources, such as clinical decision support systems, local disease reporting, and ecological trend data, may help empower expanded stakeholder participation by making population health outcomes of environmental changes more visible”. Similar works, such as cooperation with hospitals, educational institutions, and engineering schools, will go a long way in preventing the negative consequences of climate change. 

To conclude, climate change will be a long-term problem because humans cannot stop taking the earth's resources. When there is a major impact on human health, it is comforting to be able to recognize the problem and start doing something about it. But a complete solution to the problem will not be achieved in a short period of time. Countries need comprehensive and effective solutions. The BRACE framework is a very constructive example. It provides detailed steps, from prediction to assessment, to illustrate the relationship between climate change and health, and how to effectively address the problem. At the same time, it can be used in multiple countries and regions. As stated in Marinucci’s article, “following the steps laid out in BRACE will enable an agency to use the best available science to project likely climate change health impacts in a given jurisdiction and prioritize interventions”. It can be said that the BRACE framework is an ideal solution to climate change and human health.

Works Cited

“Evidence on Public Health Interventions to Prevent the Negative Health Effects of Climate Change.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, https://stacks.cdc.gov/view/cdc/105980.

Hess, Jeremy, et al. “Projecting Climate-Related Disease Burden.” Centers for Disease Control and Prevention, https://www.cdc.gov/climateandhealth/docs/ProjectingClimateRelatedDiseaseBurden_508.pdf.

Marinucci, Gino D., et al. “Building Resilience against Climate Effects-a Novel Framework to Facilitate Climate Readiness in Public Health Agencies.” MDPI, Multidisciplinary Digital Publishing Institute, 20 June 2014, https://doi.org/10.3390/ijerph110606433. 

Schramm, P.J., Ahmed, M., Siegel, H. et al. Climate Change and Health: Local Solutions to Local Challenges. Curr Envir Health Rpt 7, 363–370 (2020). https://doi.org/10.1007/s40572-020-00294-1

Schramm, Paul J., et al. “Climate Models and the Use of Climate Projections: A Brief Overview for Health Departments” Centers for Disease Control and Prevention, https://www.cdc.gov/climateandhealth/pubs/climate_models_and_use_of_climate_projections.pdf.

Usgcrp. The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment, 4 Apr. 2016, https://health2016.globalchange.gov/.