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      Emerging Threats to Human Health from Global Environmental Change

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      Annual Review of Environment and Resources
      Annual Reviews

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          Abstract

          Large-scale anthropogenic changes to the natural environment, including land-use change, climate change, and the deterioration of ecosystem services, are all accelerating. These changes are interacting to generate five major emerging public health threats that endanger the health and well-being of hundreds of millions of people. These threats include increasing exposure to infectious disease, water scarcity, food scarcity, natural disasters, and population displacement. Taken together, they may represent the greatest public health challenge humanity has faced. There is an urgent need to improve our understanding of the dynamics of each of these threats: the complex interplay of factors that generate them, the characteristics of populations that make them particularly vulnerable, and the identification of which populations are at greatest risk from each of these threats. Such improved understanding would be the basis for stepped-up efforts at modeling and mapping global vulnerability to each of these threats. It would also help natural resource managers and policy makers to estimate the health impacts associated with their decisions and would allow aid organizations to target their resources more effectively.

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          Climate Change 2007

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            Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study.

            Prevention and control of disease and injury require information about the leading medical causes of illness and exposures or risk factors. The assessment of the public-health importance of these has been hampered by the lack of common methods to investigate the overall, worldwide burden. The Global Burden of Disease Study (GBD) provides a standardised approach to epidemiological assessment and uses a standard unit, the disability-adjusted life year (DALY), to aid comparisons. DALYs for each age-sex group in each GBD region for 107 disorders were calculated, based on the estimates of mortality by cause, incidence, average age of onset, duration, and disability severity. Estimates of the burden and prevalence of exposure in different regions of disorders attributable to malnutrition, poor water supply, sanitation and personal and domestic hygiene, unsafe sex, tobacco use, alcohol, occupation, hypertension, physical inactivity, use of illicit drugs, and air pollution were developed. Developed regions account for 11.6% of the worldwide burden from all causes of death and disability, and account for 90.2% of health expenditure worldwide. Communicable, maternal, perinatal, and nutritional disorders explain 43.9%; non-communicable causes 40.9%; injuries 15.1%; malignant neoplasms 5.1%; neuropsychiatric conditions 10.5%; and cardiovascular conditions 9.7% of DALYs worldwide. The ten leading specific causes of global DALYs are, in descending order, lower respiratory infections, diarrhoeal diseases, perinatal disorders, unipolar major depression, ischaemic heart disease, cerebrovascular disease, tuberculosis, measles, road-traffic accidents, and congenital anomalies. 15.9% of DALYs worldwide are attributable to childhood malnutrition and 6.8% to poor water, and sanitation and personal and domestic hygiene. The three leading contributors to the burden of disease are communicable and perinatal disorders affecting children. The substantial burdens of neuropsychiatric disorders and injuries are under-recognised. The epidemiological transition in terms of DALYs has progressed substantially in China, Latin America and the Caribbean, other Asia and islands, and the middle eastern crescent. If the burdens of disability and death are taken into account, our list differs substantially from other lists of the leading causes of death. DALYs provide a common metric to aid meaningful comparison of the burden of risk factors, diseases, and injuries.
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              Prioritizing climate change adaptation needs for food security in 2030.

              Investments aimed at improving agricultural adaptation to climate change inevitably favor some crops and regions over others. An analysis of climate risks for crops in 12 food-insecure regions was conducted to identify adaptation priorities, based on statistical crop models and climate projections for 2030 from 20 general circulation models. Results indicate South Asia and Southern Africa as two regions that, without sufficient adaptation measures, will likely suffer negative impacts on several crops that are important to large food-insecure human populations. We also find that uncertainties vary widely by crop, and therefore priorities will depend on the risk attitudes of investment institutions.
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                Author and article information

                Journal
                Annual Review of Environment and Resources
                Annu. Rev. Environ. Resour.
                Annual Reviews
                1543-5938
                1545-2050
                November 2009
                November 2009
                : 34
                : 1
                : 223-252
                Affiliations
                [1 ]Department of Medicine, Harvard Medical School and Mount Auburn Hospital Walk-In Center, Cambridge, Massachusetts 02138; email:
                [2 ]Nelson Institute, Center for Sustainability and the Global Environment, and Department of Population Health Sciences, University of Wisconsin, Madison, Wisconsin 53726; email:
                Article
                10.1146/annurev.environ.033108.102650
                9364ac35-ea12-43a1-a327-6407c70c1269
                © 2009
                History

                Earth & Environmental sciences,Environmental change,General environmental science,Health & Social care,Public health,Infectious disease & Microbiology

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