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      Health co-benefits and risks of public health adaptation strategies to climate change: a review of current literature

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          Abstract

          Objectives

          Many public health adaptation strategies have been identified in response to climate change. This report reviews current literature on health co-benefits and risks of these strategies to gain a better understanding of how they may affect health.

          Methods

          A literature review was conducted electronically using English language literature from January 2000 to March 2012. Of 812 articles identified, 22 peer-reviewed articles that directly addressed health co-benefits or risks of adaptation were included in the review.

          Results

          The co-benefits and risks identified in the literature most commonly relate to improvements in health associated with adaptation actions that affect social capital and urban design. Health co-benefits of improvements in social capital have positive influences on mental health, independently of other determinants. Risks included reinforcing existing misconceptions regarding health. Health co-benefits of urban design strategies included reduced obesity, cardiovascular disease and improved mental health through increased physical activity, cooling spaces (e.g., shaded areas), and social connectivity. Risks included pollen allergies with increased urban green space, and adverse health effects from heat events through the use of air conditioning.

          Conclusions

          Due to the current limited understanding of the full impacts of the wide range of existing climate change adaptation strategies, further research should focus on both unintended positive and negative consequences of public health adaptation.

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          Most cited references41

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          Obesity relationships with community design, physical activity, and time spent in cars.

          Obesity is a major health problem in the United States and around the world. To date, relationships between obesity and aspects of the built environment have not been evaluated empirically at the individual level. To evaluate the relationship between the built environment around each participant's place of residence and self-reported travel patterns (walking and time in a car), body mass index (BMI), and obesity for specific gender and ethnicity classifications. Body Mass Index, minutes spent in a car, kilometers walked, age, income, educational attainment, and gender were derived through a travel survey of 10,878 participants in the Atlanta, Georgia region. Objective measures of land use mix, net residential density, and street connectivity were developed within a 1-kilometer network distance of each participant's place of residence. A cross-sectional design was used to associate urban form measures with obesity, BMI, and transportation-related activity when adjusting for sociodemographic covariates. Discrete analyses were conducted across gender and ethnicity. The data were collected between 2000 and 2002 and analysis was conducted in 2004. Land-use mix had the strongest association with obesity (BMI >/= 30 kg/m(2)), with each quartile increase being associated with a 12.2% reduction in the likelihood of obesity across gender and ethnicity. Each additional hour spent in a car per day was associated with a 6% increase in the likelihood of obesity. Conversely, each additional kilometer walked per day was associated with a 4.8% reduction in the likelihood of obesity. As a continuous measure, BMI was significantly associated with urban form for white cohorts. Relationships among urban form, walk distance, and time in a car were stronger among white than black cohorts. Measures of the built environment and travel patterns are important predictors of obesity across gender and ethnicity, yet relationships among the built environment, travel patterns, and weight may vary across gender and ethnicity. Strategies to increase land-use mix and distance walked while reducing time in a car can be effective as health interventions.
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            Public health benefits of strategies to reduce greenhouse-gas emissions: urban land transport.

            We used Comparative Risk Assessment methods to estimate the health effects of alternative urban land transport scenarios for two settings-London, UK, and Delhi, India. For each setting, we compared a business-as-usual 2030 projection (without policies for reduction of greenhouse gases) with alternative scenarios-lower-carbon-emission motor vehicles, increased active travel, and a combination of the two. We developed separate models that linked transport scenarios with physical activity, air pollution, and risk of road traffic injury. In both cities, we noted that reduction in carbon dioxide emissions through an increase in active travel and less use of motor vehicles had larger health benefits per million population (7332 disability-adjusted life-years [DALYs] in London, and 12 516 in Delhi in 1 year) than from the increased use of lower-emission motor vehicles (160 DALYs in London, and 1696 in Delhi). However, combination of active travel and lower-emission motor vehicles would give the largest benefits (7439 DALYs in London, 12 995 in Delhi), notably from a reduction in the number of years of life lost from ischaemic heart disease (10-19% in London, 11-25% in Delhi). Although uncertainties remain, climate change mitigation in transport should benefit public health substantially. Policies to increase the acceptability, appeal, and safety of active urban travel, and discourage travel in private motor vehicles would provide larger health benefits than would policies that focus solely on lower-emission motor vehicles.
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              Cool surfaces and shade trees to reduce energy use and improve air quality in urban areas

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                Author and article information

                Contributors
                +1-905-9125015 , june.cheng@medportal.ca
                613-952-1927 , Peter.Berry@hc-sc.gc.ca
                Journal
                Int J Public Health
                Int J Public Health
                International Journal of Public Health
                SP Birkhäuser Verlag Basel (Basel )
                1661-8556
                1661-8564
                31 October 2012
                31 October 2012
                April 2013
                : 58
                : 2
                : 305-311
                Affiliations
                [ ]Public Health and Preventive Medicine Program, Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, HSC2C2, Hamilton, ON L8S 4K1 Canada
                [ ]Climate Change and Health Office, Health Canada/Santé Canada, 269 Laurier Avenue West, Room 9-062, Postal Locator: 4909C, Ottawa, ON K1A 0K9 Canada
                Article
                422
                10.1007/s00038-012-0422-5
                3607711
                23111371
                1373ee80-933c-4a98-97ea-976c9443c6a8
                © The Author(s) 2012
                History
                : 29 May 2012
                : 1 September 2012
                : 10 October 2012
                Categories
                Review
                Custom metadata
                © Swiss School of Public Health 2013

                Public health
                climate change adaptation,health co-benefits,health risks
                Public health
                climate change adaptation, health co-benefits, health risks

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