Cool Communities—Urban Density, Trees, and Health

A move towards more compact and climate-resilient cities is being encouraged around the world. As part of these plans, there is a need to manage the potential conflict between increasing urban densities and the extent of tree canopy in cities. Reductions in tree canopy are a major contributor to the urban heat island (UHI) effect, which will act to reduce rather than increase climate resilience in many cities. A systems thinking approach called Collaborative Conceptual Modelling was used to study the interaction between urban infill, tree canopy, and human health in Perth, Australia. The results indicated that under current planning policies and development practices, the behaviour of the system is dominated by the drive towards higher housing densities. While this may result in the attainment of urban infill targets, it is likely to lead to a reduction in tree canopy, higher temperatures, and a decrease in a range of other benefits provided by trees. Recommended actions to overcome this behaviour were determined by the identification of leverage points in the system. These included a shift to a sustainable development paradigm that places greater value on the environmental and social benefits provided by trees and a greater emphasis on a climate-resilient future. Market and legislative mechanisms should be integrated into the city’s greening strategy and development plans to ensure the protection of existing trees and the inclusion of new trees on public and private land.This research was funded by CSIRO Urbanism, Climate Adaptation and Health Research Cluster. H.B. was supported by an Australian Postgraduate Award and a Curtin University Postgraduate Scholarship

Promoting health

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An holistic economic evaluation of an Aboriginal community-controlled midwifery programme in Western Sydney.

OBJECTIVES: To conduct an holistic economic evaluation of an Aboriginal community (Daruk)-controlled midwifery service in Western Sydney. METHODS: The study estimated direct programme costs and downstream savings to the health sector. Measures of antenatal attendance and perinatal outcome were compared between Aboriginal women with and without experiences of the antenatal programme through examination of antenatal clinic records and the New South Wales Midwives Data Collection for the period 1991-1996. Qualitative outcomes were analysed through interviews and focus groups. RESULTS: The net cost to the health sector was estimated to be $A1200 per client. Compared with Aboriginal women who received antenatal care in two conventional settings, there were no statistically significant differences in birthweight and perinatal survival. Gestational age at first visit was lower (17.2 vs 21.2 and 19.9 weeks), mean number of antenatal visits was higher (10.5 vs 5.5 and 9.5) and attendance for routine antenatal tests was better (94% vs 71% and 84%). Aboriginal clients were strongly positive about their experience of the Daruk service in terms of relationship and trust, accessibility, flexibility, provision of clear and appropriate information, continuity of care, empowerment and family-centred care. CONCLUSIONS: Net per client costs to the health service were modest. Quantitative evidence of improved antenatal outcomes was limited, but qualitative evaluation suggested the service was strongly valued. The outcomes examined in this study were broader than those used in conventional forms of economic evaluation and this enabled identification and analysis of more diverse sources of value from this programme

Effects of high temperatures and heatwaves on dengue fever: a systematic review and meta-analysisResearch in context

Summary: Background: Studies have shown that dengue virus transmission increases in association with ambient temperature. We performed a systematic review and meta-analysis to assess the effect of both high temperatures and heatwave events on dengue transmission in different climate zones globally. Methods: A systematic literature search was conducted in PubMed, Scopus, Embase, and Web of Science from January 1990 to September 20, 2022. We included peer reviewed original observational studies using ecological time series, case crossover, or case series study designs reporting the association of high temperatures and heatwave with dengue and comparing risks over different exposures or time periods. Studies classified as case reports, clinical trials, non-human studies, conference abstracts, editorials, reviews, books, posters, commentaries; and studies that examined only seasonal effects were excluded. Effect estimates were extracted from published literature. A random effects meta-analysis was performed to pool the relative risks (RRs) of dengue infection per 1 °C increase in temperature, and further subgroup analyses were also conducted. The quality and strength of evidence were evaluated following the Navigation Guide systematic review methodology framework. The review protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO). Findings: The study selection process yielded 6367 studies. A total of 106 studies covering more than four million dengue cases fulfilled the inclusion criteria; of these, 54 studies were eligible for meta-analysis. The overall pooled estimate showed a 13% increase in risk of dengue infection (RR = 1.13; 95% confidence interval (CI): 1.11–1.16, I2 = 98.0%) for each 1 °C increase in high temperatures. Subgroup analyses by climate zones suggested greater effects of temperature in tropical monsoon climate zone (RR = 1.29, 95% CI: 1.11–1.51) and humid subtropical climate zone (RR = 1.20, 95% CI: 1.15–1.25). Heatwave events showed association with an increased risk of dengue infection (RR = 1.08; 95% CI: 0.95–1.23, I2 = 88.9%), despite a wide confidence interval. The overall strength of evidence was found to be “sufficient” for high temperatures but “limited” for heatwaves. Our results showed that high temperatures increased the risk of dengue infection, albeit with varying risks across climate zones and different levels of national income. Interpretation: High temperatures increased the relative risk of dengue infection. Future studies on the association between temperature and dengue infection should consider local and regional climate, socio-demographic and environmental characteristics to explore vulnerability at local and regional levels for tailored prevention. Funding: Australian Research Council Discovery Program

South East Coastal Adaptation (SECA): coastal urban climate futures in SE Australia from Wollongong to Lakes Entrance: final report

Coastal Urban Climate Futures in South East Australia from Wollongong to Lakes Entrance is an investigation into possible coastal urban futures to 2030 and beyond. The study focus is on coastal adaptation in the context of climate change. It is broad in its scope by considering environmental, social and economic change in the south east coastal region. It has a multi-disciplinary approach to the spatial and temporal dimension in considering action on the ground. It involves seven local government areas (Wollongong, Shellharbour, Kiama, Shoalhaven, Eurobodalla, Bega and East Gippsland), two states and several regional organisations and explores some of the critical governance issues. The research uses a range of methods, including a review of peer-reviewed journal articles and government reports, local case studies, targeted focus groups and fieldwork. The time horizon is to 2030 but longer time frames have been considered where appropriate. An important dimension is the interdisciplinary approach. The outcome is an integrated framework for describing what a climate-adapted coastal community may be like in 2030

Healthy, regenerative and just: Guiding the development of a national strategy on climate, health and well-being for Australia

This case report is a reflective narrative, documenting the methods used to develop a policy framework for a National Strategy on Climate, Health and Well-being for Australia. The report aims to guide advocates, communities of practice, and governments in developing a comprehensive policy response to climate change and its health impacts.</p