The figure below shows the DPSEEA model causal pathway by which climate change and natural disasters affect health. Structural Fund spending in this area can influence different parts of this pathway. Possible approaches and actions for Structural Funds to improve health gains are shown in the blue box.

Click on any topic in the boxes to learn more.

 
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Understanding the policy context

The EU’s policy framework for Civil Protection addresses prevention, preparedness and response to disasters.

 

The EU framework for adaptation measures and policies to reduce the vulnerability to the impacts of climate is summarised in the adaptation White Paper of April 2009. The White Paper underlines the importance of addressing climate change impacts in all areas of Cohesion Policy funding. A more comprehensive EU adaptation strategy is to be prepared in 2013.

 

EU policy and legislation addresses risks in the water sector:

  • The EU Floods Directive (2007/60/EC) requires Member States to assess the risks and to prepare, by 2015, flood risk management plans (these should be integrated with river basin management plans under the Water Framework Directive).
  • The Blueprint to Safeguard Europe’s Waters is expected to launch new initiatives in 2012 including in the areas of water scarcity and drought.

 

Member States are preparing action programmes for climate change adaptation under the UN convention on climate change, and many regional and local governments are developing their own strategies and plans for adaptation.

 

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Developing projects

Specific projects for adaption to climate change will depend on the characteristics of the region and the needs of its population.

 

The Approaches to Consider page provides examples of some types of climate change adaptation projects that will impact health gains.

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Developing Operational Programmes

Member States and regions will need to have in place national and regional risk assessments for disaster management to meet the ex ante conditionality for this thematic objective: these assessments should take into account climate change adaptation, including adaptation strategies. It will be important for Operational Programmes to consider vulnerable groups, such as the elderly and other groups less able to cope with disaster and change.

 

The Approaches to Consider page provides further priorities for responding to climate change impacts that should be considered in OPs, as they will have an impact on health, particularly for vulnerable groups.

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An urban world

For the first time in history more than 50 % of the world’s population live in urban areas. By 2050, about 70 % of people are likely to be urban, compared with less than 30 % in 1950.

Cities concentrate investment and employment opportunities, promoting economic growth and increasing productivity. They provide higher-income jobs, as well as greater access to goods, services and facilities and improved health, literacy and quality of life.

Urban development offers unique chances for improvement in the quality of life and environmental protection if it is governed effectively. It offers major opportunities to reduce energy demand and minimise pressures on surrounding lands and natural resources, as a consequence of the concentrated form and efficiencies of scale in cities. However, poor governance can exacerbate two main environmental problems: poverty and increased affluence.

How urban areas, particularly in South East Asia, are built and governed will have strong impacts on global emissions of greenhouse gases and on resource demand. Once built, they are difficult and slow to change, and so is individual behaviour adapted to these structures. In many places in the developing world, cities currently run the risk of locking in energy- and resource-intensive models of urban development for decades ahead.

From (European Environment Agency, 2010: 15-18)

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Global limits

The stocks of greenhouse gases in the atmosphere (including carbon dioxide, methane, nitrous oxides and a number of gases that arise from industrial processes) are rising, as a result of human activity.

The current level or stock of greenhouse gases in the atmosphere is equivalent to around 430 parts per million (ppm) CO2.

Even if the annual flow of emissions did not increase beyond today's rate, the stock of greenhouse gases in the atmosphere would reach double pre-industrial levels by 2050 - that is reaching 550ppm CO2equivalent (CO2e) - and would continue growing thereafter. But the annual flow of emissions is accelerating, as fast-growing economies invest in high carbon infrastructure and as demand for energy and transport increases around the world. Consequently, the level of 550ppm CO2e could be reached as early as 2035.

From (Stern Review, 2006: iii).

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Growth in consumption

A larger and richer global population, with expanding consumption needs, will place growing demands on natural systems to provide food, water and energy. European resource stocks may likewise face increasing pressures.

About a quarter of the Earth’s potential net primary production has been converted by humans, either through direct cropping (53 %), land-use-induced productivity changes (40 %) or human-induced fires (7 %).

Given that the world’s population may grow significantly over decades and that diets are shifting from cereals to meat as wealth increases, the demand for agricultural production may rise steeply. According to the United Nations Food and Agriculture Organisation (FAO), demand for food, feed and fibres could grow by 70 % by 2050.

This has considerable implications for land use and natural ecosystems. A projected population increase of 27% and a wealth increase of 83% by 2030 would imply a demand for agricultural production that is twice as high as today’s.

Even if it is assumed that agricultural productivity will increase at current rates, the global agricultural area may have to expand by roughly 10 % to meet demand. After 2030, no further expansion of agricultural land at the global level is foreseen as yield increase through technological advances is expected to provide for further increasing demand.

From (European Environment Agency, 2010: 48)

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Population growth and demographic change

The main demographic characteristics of this century will be:

  • ageing of societies which will spread to most countries;
  • slower global population growth, with major regional differences; and
  • migration, especially caused by environmental factors.

Today the world population continues to grow, though much more slowly than in the recent past. It has more than doubled since the 1960s, but is very unlikely to double again during this century.

It is expected to peak at around nine billion people by around 2050.

Populations are expected to grow older throughout this century. The speed at which this is happening is not steady.

Demographers assume that populations will grow older more rapidly in the next few decades especially in some developing countries (China, some Pacific islands, Central Asia) and that from about 2030 to 2050, this trend will spread to most regions of the world.

Developing countries are expected by 2050 to be aging as fast as the developed world does now. This will leave developing countries less time to adapt and pose challenges of how to deal with changes in the structure of society, but with only limited resources.

From (European Environment Agency, 2010: 9-15)

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Use of non-renewable energy (greenhouse gas emission)

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Food supply and agricultural production

The global food supply system is facing serious new challenges from economic and related crises and climate change, which directly affect the nutritional well-being of the poor by reducing their access to affordable and nutritious food (Bloem, Semba, & Kraemer, 2010).

Climate change exerts pressures on agricultural yield and on water, and fuel costs. This is already resulting in increasing food prices with potential effects on the non-communicable disease (NCD) burden and health inequities (Friel et al., 2011: 141).

About a quarter of the Earth’s potential net primary production has been converted by humans, either through direct cropping (53 %), land-use-induced productivity changes (40 %) or human-induced fires (7 %).

Given that the world’s population may grow significantly over decades and that diets are shifting from cereals to meat as wealth increases, the demand for agricultural production may rise steeply. According to the United Nations Food and Agriculture Organisation (FAO), demand for food, feed and fibres could grow by 70 % by 2050.

This has considerable implications for land use and natural ecosystems. A projected population increase of 27% and a wealth increase of 83% by 2030 would imply a demand for agricultural production that is twice as high as today’s.

Even if it is assumed that agricultural productivity will increase at current rates, the global agricultural area may have to expand by roughly 10 % to meet demand. After 2030, no further expansion of agricultural land at the global level is foreseen as yield increase through technological advances is expected to provide for further increasing demand.

From (European Environment Agency, 2010: 48)

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Migration

The five key drivers of migration are (Government Office for Science, 2011: 44-45):

  • economic;
  • social;
  • political;
  • demographic; and
  • environmental.

Economic drivers are the most important. Each driver coexists and interacts with the others.

Migration influenced by environmental change can take different forms, including (Government Office for Science, 2011: 103-104):

  • urbanisation;
  • short term migration;
  • illegal/irregular migration; and
  • displacement.

Environmental change is equally likely to prevent migration as it is to increase it.

A general finding is that ‘expensive’ migration involving longer-distance, longer-term international migration, is less likely to occur when there is environmental change.

‘Cheaper’ and easier migration, including short-distance, internal migration, is more likely to occur as a result of environmental change: the social networks that exist across, and the low political barriers between, European Member States appear likely to facilitate cheaper migration.

The possible extent of environmental migration is uncertain with estimates ranging from 10 to 200 million people being affected: most estimates are based upon one or two sources (Myers, 2005;Myers & Kent, 1995). These have been criticised for downplaying the capacity of people in low-income countries to adapt to environmental events. The focus on migration has also been criticised for overlooking the implications of environmental change for those who are unable to migrate (Government Office for Science, 2011: 28).

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Regional climate change

Observational evidence from all continents and most oceans shows that many natural systems are being affected by regional climate changes, particularly temperature increases (IPCC, 2007).

The yearly maximum temperature is expected to increase much more in southern and central Europe than in northern Europe. In summer, large parts of central, southern and eastern Europe may face higher temperatures.

A large increase is also expected for yearly minimum temperature across most of Europe. Much of the warming in winter is connected to higher temperatures on cold days, which indicates a decrease in winter temperature variability.

A large increase in the highest summer temperatures would expose Europeans to unprecedented high temperatures (Alcamo et al., 2007: 548).

The mean for winter precipitation is increasing in most of Atlantic and northern Europe. In southern Europe, rainfall is already decreasing as summer rains become more scarce. In many parts of Europe, rainfall (or other precipitation) is heavier: an increase in mean precipitation per wet day is observed in most parts of the continent, even in some areas which are becoming drier.

The warming trend and changes in rainfall have affected the composition and the functioning of the cryosphere. This is the area of the Earth’s surface where water is in solid form: glaciers are in retreat and the extent of permafrost is decreasing. The warming trend and the changes in rainfall also affect natural and managed ecosystems: we see a lengthening of growing seasons and a shift of species (Alcamo et al., 2007: 543).

Climate-related hazards will mostly increase, although changes will vary geographically. Winter floods are likely to increase in maritime regions and flash floods are likely to increase throughout Europe. Coastal flooding related to increasing storminess and sea-level rise is likely to threaten up to 1.6 million additional people annually (Alcamo et al., 2007: 543).

Change in mean wind speed is highly sensitive to the differences in large-scale circulation that can result between different global models. Mean annual wind speed increases over northern Europe by about 8% and decreases over Mediterranean Europe. The increase for northern Europe is largest in winter and early spring, when the increase in the average north south pressure gradient is largest.

From (Alcamo et al., 2007: 543-548).

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Food security and nutrition security

Climate change directly affects food and nutrition security (UNSCN, 2010: 2, 9).

  • Food security exists when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life and
  • Nutrition security exists when food security is combined with a sanitary environment, adequate health services, and proper care and feeding practices to ensure a healthy life for all household members.

An increase in the frequency of droughts, heat-waves and floods may lead to loss of food production and exacerbate malnutrition in some regions.

Crop productivity is projected to decrease in some areas in Europe, though it will increase in Northern Europe. Hotter summers may threaten food safety and shorten growing seasons.

Projected changes in the frequency and severity of extreme climate events have significant consequences for food production, and food insecurity.

Climate change scenarios that include increased frequency of heat stress, droughts and flooding events are shown to reduce crop yields and livestock productivity.

Climate variability and change also change the risks of fires, and pest and pathogen outbreaks, with negative consequences for food, fibre and forestry.

From (World Health Organization Regional Office for Europe, 2008b: 20)

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Health system conditions

The health system has a major role in identifying possibilities for preventive actions and in acting to deal with people whose health has been affected. WHO regional offices have already developed guidelines for health services.

A key areas for work is "prediction" and "surveillance".

Prediction included working with climate forecasts to identify potential health hazards and the types of health problems that may serve as "sentinels" of climate change impacts. The health sector would work in collaboration with meteorological and environmental services to identify changes in the environment that may trigger certain health problems (World Health Organization Centre for Health Development, 2009).

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Living and working conditions

Hot days, hot nights and heatwaves have become more frequent.

The ISO (1989) standard aims to limit the core body temperature to 38oC for a typical person and states that the "reference values are those at which almost all individuals can be ordinarily exposed without any harmful effect".

Heatwaves are associated with marked short-term increases in mortality (Confalonieri et al., 2007: 394).

From (Kjellstrom, 2009: 22-24).

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Local climate change

The changes described by global atmospheric models will be experienced in very different ways at the local level.

Changes in weather patterns, the local variations in the expression of climate change and the behavioural patterns of the local population will have links to health effects.

An example the heat island effect is a concern in urban areas. This creates higher heat exposure in densely populated modern urban areas with large areas covered in concrete buildings or tar sealed roads that absorb solar heat radiation during the day. Heat emissions from local energy sources (including air conditioning units) also contribute to the heat island effect.

From (Kjellstrom, 2009: 14).

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Sea level rise

With climate change, winter floods are likely to increase throughout the European Region. Coastal flooding related to increasing storminess and sea-level rise is likely to threaten up to 1.6 million additional people annually in the EU alone (World Health Organization Regional Office for Europe, 2008b: 16).

To some extent this is a long-term issue to which cities and regions will be able to adapt. Lower-income groups, however, may face greater difficulties moving away from coastal areas exposed to sea-level rise.

A more immediate risk to human life and health can arise from a possible increase in extreme events, such as storm surges inundating low-level areas.

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Water access

In southern Europe, rainfall is already decreasing as summer rains become more scarce and summer temperatures rise. In coming decades, southern Europe is likely to face more extended periods of drought and water scarcity. In contrast, northern European countries are expected to receive higher levels of rainfall – a trend already seen in recent years – and the risk of floods is likely to increase (WISE, 2011).

These differences in water availability between regions are anticipated to become sharper: the annual average runoff increases in the North and North-west and decreases in the South and South-east (Alcamo et al., 2007: 543).

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Access to affordable and nutritious food

An estimated 43 million people in the EU are at risk of food poverty: this includes a wide range of people living in poverty, including families in difficulties, elderly people with insufficient means, the homeless, the disabled, children at risk, the working poor, migrant workers and asylum seekers. Food poverty is defined as meaning that they cannot afford a meal with meat, chicken or fish every second day (European Commission, 2011a).

Vulnerable households will reduce expenditure on food to meet other bills. The European Commission reports that food prices in Europe are high and that, in 2011, the average total household expenditure devoted to food was 14.1%. This was down by 6% when compared with 1999 (European Commission, 2011b: 4).

Vulnerable populations with poor access to food prioritize consumption of calorie-rich but nutrient-poor food. This means that dietary quality, and eventually quantity, could decline (Bloem, Semba, & Kraemer, 2010).

Climate change also threatens food safety. Higher temperatures favour the growth of bacteria in food, such as Salmonella spp.

Weather can affect human behaviour, such as food consumption and preparation practices, which again can increase the risk of food borne diseases. Refrigeration failure is more likely to occur during hot weather.

During the heat-wave in 2003, interruption of the cold chain led to serious food-safety problems. In addition, warmer weather and milder winters will favour flies and other pests that affect food safety.

Further, food safety is an important economic concern affecting consumer confidence and choice.

From (World Health Organization Regional Office for Europe, 2008b: 20)

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Air pollution

One of the effects of an increasing temperature trend in cities is the increasing level of ozone in the air, assuming that motor vehicle emissions remain at current levels. Ozone is a major pollutant formed when emissions from motor vehicles and UV-radiation from sunshine react in air.

Ozone formation is faster and greater when the air temperature increases, as happens with climate change. Ozone is one of the major air pollutants that increase the incidence and mortality of heart and lung diseases as well as causing respiratory irritation symptoms.

From (Kjellstrom, 2009; 26).

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Disease vectors

Climate change is likely to cause changes in ecological systems that will affect the risk of infectious diseases in the European Region, including the seasonal activity of local vectors and the establishment of tropical and subtropical species.

Shifts in the global and regional distribution and behaviour of insect and bird species are early signs that biological systems are already responding to climate change. In 2007, the IPCC projected that climate change would lead to changes in infectious disease transmission by vectors such as mosquitoes and ticks, as a result of changes in their geographic ranges, seasons of activity and population sizes.

The movement of people and goods, changes in hosts and land use will continue to affect patterns of infectious disease in the Region. Chikungunya virus has been introduced into the Region by travellers returning from endemic countries.

The presence of a suitable vector would allow for local outbreaks. An example is the tiger mosquito, Aedes albopictus, which has substantially extended its range in Europe over the last 15 years and presents reasons for concern about the transmission of other viral diseases.

From (World Health Organization Regional Office for Europe, 2008b: 22).

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Heat exposure

The commonly accepted average core body temperature is 37oC.

There is a general physiological need to reduce core body temperature when there is external exposure to heat and/or internal heat production, from work or other physical activity.

Heat exposure and heat stress has a major effect on a persons’ ability to carry out physical activity, whether it is part of daily work or a part of the general daily activities (such as carrying things to and from the household or working in the family garden).

People engaging in heavy physical labour are most affected as this generates body heat. If the body cannot be cooled down sufficiently by sweating or other cooling mechanisms, the only way to avoid heat stroke is to work more slowly and reduce the work output.

The physiological effects of heat exposure also reduce psychological performance: there is an increased risk of mistakes in daily activities and an increase in accidental injuries.

Heat exposure creates a need for additional liquid intake, as body water is lost through sweating (up to 10 litres or more during a day of heavy physical activity and heat exposure).

If sufficient drinking water or other liquid is not taken, the body will dehydrate with potential damage to the kidneys. Dehydration is likely to be a particular issue for the elderly and infants, but may also occur among workers doing hard physical work in hot environments without sufficient water access.

Differences in mean annual temperatures are estimated to account for 70% of the geographical variation in the distribution of kidney stone diseases in the USA. Dehydration increases the concentration of calcium and other compounds in the urine, which facilitates the formation of kidney stones. A hotter climate across the USA is predicted to contribute to an additional 1.6-2.3 million new cases by 2050.

People with pre-existing diseases, chronic or acute are likely to experience more severe clinical status when exposed to heat. These important physiological and clinical effects must be included particularly because they will be repeated every day during the hot season when the threshold for these effects has been reached

From (Kjellstrom, 2009; 22-25).

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People resident in vulnerable areas

 The increased risk of flooding of human settlements in coastal areas from both rising sea levels and increased heavy precipitation may increase food contamination and disease, reducing consumption patterns (Intergovernmental Panel on Climate Change, 2008: 65-66).

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Storms and extreme weather

Storms or floods can cause serious chemical emergencies if the industries that use and process toxic chemicals are located close to rivers, lakes, coasts and ports, and are not resilient.

Extreme weather and floods can cause chemical contamination from industries, damaged sewage systems or hazardous waste dumps.

Extreme weather can also damage road access or electricity supply to industrial establishments with potential consequences for chemical emergencies and associated health impacts. From (Kjellstrom, 2009; 28).

Flooding may lead to contamination of waters with dangerous chemicals, heavy metals or other hazardous substances, from storage or from chemicals already in the environment (e.g., pesticides).

Chemical contamination following Hurricane Katrina in the USA included oil spills from refineries and storage tanks, pesticides, metals and hazardous waste. Concentrations of most contaminants were within acceptable short-term levels, except for lead and volatile organic compounds (VOCs) in some areas.

There are also health risks associated with long-term contamination of soil and sediment; however, there is little published evidence demonstrating a causal effect of chemical contamination on the pattern of morbidity and mortality following flooding events.

Increases in population density and accelerating industrial development in areas subject to natural disasters increase the probability of future disasters and the potential for mass human exposure to hazardous materials released during disasters.

From (Confalonieri et al., 2007: 399).

When the climate gets warmer certain toxic environmental chemicals will evaporate more easily and cause higher exposure via air in workplaces and in the general environment. Absorption through skin may also increase creating higher exposures. This aspect of potential climate change health risks has not been investigated sufficiently.

From (Kjellstrom, 2009; 28).

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Water quality and quantity (drought)

Access to safe drinking-water is strongly connected to basic health. Hence, from a public health point of view, the proportion of the population with access to safe drinking-water is an indicator of the extent to which basic needs (as defined by the United Nations in recognition of water as a fundamental human right) are met (Office of the High Commissioner for Human Rights, 2002;World Health Organization, 2003).

In Western Europe, close to 100% of the population has had access to a public water supply since the 1990s (World Health Organization Regional Office for Europe, 2009).

However, water scarcity and drought could lead to high costs for water, potentially reducing the volume of water used by households, which in turn may influence hygiene practices and increase risks of disease transmission (World Health Organization, 2008: 92;World Health Organization Regional Office for Europe, 2010: 6).

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Changes in disease burden

By the 2020s, the average annual number of temperature-related cases of salmonella may have increased by a total of almost 20,000 as a result of climate change in Europe (on top of any increases expected from population changes) (Watkiss et al., 2009: 33).

Several climate-change-related models estimate an increase of malaria risk. For example, in the United Kingdom it was estimated that, with temperature increases, the risk of local malaria transmission could increase by 8–15% by 2050. In Portugal, the number of days suitable for survival of malaria vectors is projected to increase. Nevertheless, there is agreement that the risk of transmission of malaria related to localized climate change is very small. Risks are greater in the countries where importation of malaria coincides with socioeconomic degradation, the disintegration of health and social services, uncontrolled cross-border migration and lack of environmental management for mosquito control (World Health Organization Regional Office for Europe, 2008b: 22).

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Health risks from extreme weather

Extreme weather situations will cause emergencies through floods, landslides that block roads and damage houses, high winds, typhoons or hurricanes that damage electricity and water supply, buildings, etc. In extremely dry conditions forest fires are a risk (Kjellstrom, 2009: 29).

Injuries caused by extreme weather conditions may lead to long-term disabilities, particularly in people with pre-existing diseases.

Lack of access to pharmaceuticals for people with diabetes, high blood pressure, and other diseases requiring continuous medication, would make their condition worse. People relying on equipment powered by electricity for their survival (e.g. dialysis machines, ventilators) are at extreme risk if there are power cuts.

The most vulnerable will be poor people and those with pre-existing chronic diseases or disabilities.

A striking example of this occurred during the flooding of New Orleans where the effects were greatest on elderly rest home patients and poor people who could not evacuate because of lack of transport  (Kjellstrom, 2009: 29).

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Health risks from flooding

Flooding can have (Flood Hazard Research Centre, 1999):

  • an immediate impact e.g. physical injury and death, often to younger men; and
  • longer-term effects e.g. mental health concerns associated with loss of possessions and difficulty of insuring properties that have been subject to flood.

The health effects of water disasters are usually due to the lack of prompt restoration of public health services and interventions, with the resulting risk of epidemics and other ill health (Stanwell-Smith, 2008). Studies in the UK and USA suggest that infection problems are rare: the indirect nature of the risk means that they are also extremely difficult to quantify or attribute to the flood.

An exercise to model the effects of coastal flooding found a significant number of cases of psychological stress by the period 2071-2100. There will be potentially as many as 5 million additional cases of psychological stress per year (this occurred when the high sea level rise (A2 scenario) was considered). The authors note that these would be significantly reduced with adaptation (Watkiss et al., 2009: 33).

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Health risks from heat

Major heat-wave events are also associated with other health hazards – such as air pollution, wildfires and failures in water, food or electricity supply.

Heat-waves may have larger effects on mortality during high-ozone days, highlighting the interaction between climate change and air pollution.

From (World Health Organization Regional Office for Europe, 2008b: 15).

Many diseases are exacerbated by heat, for example endocrine disorders (e.g. diabetes), skin disease and infections.

In general heatwaves affect (Department of Health, 2010):

  • older people, especially those over 75 years old and living on their own, or in a care home;
  • people suffering from mental ill health, those with dementia, and those who rely on help from other people to manage day-to-day activities;
  • people who are bed-bound or have mobility problems;
  • people taking certain types of medication;
  • people with a serious chronic condition, particularly breathing or heart problems;
  • people who already have a high temperature from an infection;
  • people who use alcohol or illicit drugs;
  • babies and young children, especially under four years old;
  • people who are physically active such as manual workers, or sportsmen and women.

Mortality was clearly the most extreme effect of the 2003 heatwave in Europe. Emergency admissions to hospitals and attendance at health services also increased. These acute effects primarily affect elderly people, while infants, children and people with certain pre-existing diseases are also vulnerable. If high heat exposure occurs every day, the impacts of such repeated exposures need to be considered as a longer term health problem that cannot be dismissed as "acute and preventable" (Kjellstrom, 2009: 22).

      

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Malnutrition

Climate change directly affects food and nutrition security of millions of people. Malnutrition is a broad term that refers to all forms of poor nutrition. Malnutrition is a broad term that refers to all forms of poor nutrition and it includes undernutrition as well as overweight and obesity (UNSCN, 2010: 2, 9).

A diet in calorie-rich but nutrient-poor food increases micronutrient malnutrition (or hidden hunger) and exacerbates pre-existing vulnerabilities. This leads to poorer health, lower incomes, and reduced physical and intellectual capabilities (Bloem, Semba, & Kraemer, 2010).

Climate change affects food and nutrition security and undermines current efforts to reduce hunger and protect and promote nutrition. Undernutrition also undermines resilience to shocks and the coping mechanisms of vulnerable populations.

This reduces the capacity of vulnerable populations, such as the elderly and groups facing social exclusion, to resist and adapt to the consequences of climate change.

From (UNSCN, 2010: 3).

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Mental health

Poor mental health is a major growing global concern.

Today, almost 50 million citizens (about 11% of the population) are estimated to experience mental disorders, with women and men developing and exhibiting different symptoms. Depression is one of the most prevalent health problems in many EU-Member States (World Health Organization Regional Office for Europe, 2008a).

Poor mental health is a hidden and stigmatised problem.

There are several ways by which local climate change can influence the mental health status of the local population. Adaptation to climate change may in itself cause mental stress.  

Extreme weather and drought may seriously damage local agricultural production leading to increased suicides among farmers. Suicides rates are associated with temperature.

Dislocation and population displacement leads to mental stress and depression among the environmental refugees.

Different population groups will be vulnerable in times of extreme weather: for example, people with mental health problems may not perceive the risks associated with extreme heat.  

From (Kjellstrom, 2009: 32)

Heat stress exposure will cause isolation for elderly or other sensitive people. Some people may decide to not venture outdoors during hot days while they are protected from the outdoor heat by air conditioning in the home. This will disrupt regular social activities, such as visits to friends or community activities, and can cause depressed thoughts (World Health Organization Centre for Health Development, 2009: 16). Flooding has also been noted to cause short- and long-term mental health effects for victims (Tunstall et al., 2006).

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Non-communicable diseases

All across the world there is an ongoing ageing process with more and more people reaching ages beyond 65 years. Chronic diseases and mental health problems are most prevalent among older people.  (World Health Organization Centre for Health Development, 2009: 32).

Increasing food prices has potential effects on the non-communicable disease (NCD) burden and health inequities: some people will be able to purchase a healthy diet; some will only be able to purchase the cheapest sources of calories—energy-dense highly processed products that increase the risk of obesity and diabetes, and many millions will be unable to afford even that (Friel et al., 2011: 141).