Sistema de Alerta Temprana por Temperaturas Extremas Calor (SAT-TE Calor): la evolución del SAT-OCS

Fil: Herrera, Natalia. Servicio Meteorológico Nacional. Dirección Nacional de Ciencia e Innovación en Productos y Servicios. Dirección Central de Monitoreo del Clima; Argentina.Fil: Chesini, Francisco. Ministerio de Salud de la Nación; Argentina.Fil: Saucedo, Marcos. Servicio Meteorológico Nacional. Dirección Nacional de Pronósticos y Servicios para la Sociedad. Dirección de Pronósticos del Tiempo y Avisos; Argentina.Los extremos de temperatura muy elevados son una amenaza natural para la salud humana. En un escenario donde los fenómenos climáticos extremos -en especial las olas de calor- serán más frecuentes e intensos, es indispensable contar con un sistema de alerta temprana, que pueda advertir a la población acerca de la llegada de olas de calor (o temperaturas muy elevadas) y a los sistemas de salud, con el fin de aplicar políticas de promoción y protección de la salud. A partir del verano 2017-2018 se implementó en el Servicio Meteorológico Nacional el Sistema de Alerta Temprana por Olas de Calor y Salud (SAT-OCS). Y a partir del 2021 este sistema se reemplaza por el Sistema de Alerta Temprana por Temperaturas Extremas Calor (SAT-TE Calor), el cual pasa a cubrir todo el territorio nacional. Se emite un alerta diario y se encuentra disponible en https://www.smn.gob.ar/sistema_temp_extremas_calor. El objetivo es que tanto la población como los organismos de salud, protección civil, emergencias y gestión del riesgo de desastre puedan tomar las medidas de prevención, mitigación y de respuesta adecuadas a cada nivel de alerta. En esta Nota Técnica se describe la metodología utilizada y se ilustra su funcionamiento con resultados del primer verano en uso.Extremely high temperature are a natural threat to human health. In a scenario where extreme weather events will be more frequent and intense -especially heat waves- it is essential to have an early warning system, which can warn the population about the arrival of heat waves (or very high temperatures) and to health systems, in order to implement health promotion and protection policies. In summer 2017-2018, the Early Warning System of Heat Waves and Health (SAT-OCS in spanish) was implemented in the argentinian National Meteorological Service. As of 2021, this system is replaced by the Early Warning System for Extreme Heat Temperatures (SAT-TE Calor in spanish), which now covers the entire national territory. A daily alert is issued and is available at https://www.smn.gob.ar/sistema_temp_extremas_calor. The objective is that both the population and the health organizations, civil protection, emergency and disaster risk management can take the appropriate prevention, mitigation and response measures at each alert level. This Technical Note describes the methodology used and its operation is illustrated with results from the first summer in use

Sistema de Alerta Temprana por Temperaturas Extremas Frío (SAT-TE Frío)

Fil: Herrera, Natalia. Servicio Meteorológico Nacional. Dirección Nacional de Ciencia e Innovación en Productos y Servicios. Dirección Central de Monitoreo del Clima; Argentina.Fil: Saucedo, Marcos. Servicio Meteorológico Nacional. Dirección Nacional de Pronósticos y Servicios para la Sociedad. Dirección de Pronósticos del Tiempo y Avisos; Argentina.Fil: Menalled, Matías. Servicio Meteorológico Nacional. Dirección Nacional de Pronósticos y Servicios para la Sociedad; Argentina.Las temperaturas frías extremas pueden afectar a la salud de manera de producir un impacto negativo que podría incluso desembocar en la muerte. El impacto de las bajas temperaturas sobre la mortalidad se verifica con posterioridad a los eventos de frío, persistiendo durante rezagos de hasta 14 días. Es indispensable contar con un sistema de alerta temprana, que pueda advertir a la población acerca de la llegada de olas de frío (o temperaturas muy bajas) y a los sistemas de salud, con el fin de aplicar políticas de promoción y protección de la salud. En 2022 se implementará en el Servicio Meteorológico Nacional el Sistema de Alerta Temprana por Temperaturas Extremas Frío (SAT-TE Frío). Este sistema funcionará de manera automatizada para todo el territorio nacional y emitirá un alerta diario. El objetivo es que tanto la población como los organismos de salud, protección civil, emergencias y gestión del riesgo de desastre puedan tomar las medidas de prevención, mitigación y de respuesta adecuadas a cada nivel de alerta. En esta Nota Técnica se describe la metodología utilizada y se ilustra su funcionamiento con resultados del invierno 2021.Extreme cold temperatures can affect health in a way to produce a negative impact that could even lead to death. The impact of low temperatures on mortality is more pronounced days after cold events, persisting for lags of up to 14 days. It is essential to have an early warning system, which can warn the population about the arrival of cold waves (or very low temperatures) and to health services, in order to implement health promotion and protection policies. The Early Warning System of Extreme Cold and Health (SAT-TE Frío in spanish) will be implemented in the argentinian National Meteorological Service in 2022. This system will work in an automated way for the entire national territory and will issue a daily alert. The objective is that both the population and the health organizations, civil protection, emergency and disaster risk management can take the appropriate prevention, mitigation and response measures at each alert level. In this Technical Note the methodology used is described and its operation is illustrated with results of the winter 2021

Towards a Latin American Health & Climate Observatory: Seminary on Instrumentation and Methodologies

El estudio de la relaci n entre clima y salud requiere la articulaci n de diversos actores y disciplinas. En este art culo se presenta la experiencia del Seminario Latinoamericano Instrumentos y Metodolog as para un observatorio de clima y salud, realizado en Buenos Aires en 2019, apoyado por el Centro Latinoamericano de Formaci n Interdisciplinaria (CELFI), como un espacio de vinculaci n, capacitaci n y referencia a experiencias que se vienen desarrollando en este campo en Am rica Latina. En este trabajo se presenta el dise o del seminario, su contenido, did ctica y desarrollo, as  como los resultados en cuanto a participaci n, productos y evaluaci n. Asimismo, durante el proceso se reflexiona en torno a las metodolog as que permitan articular diferentes disciplinas en un proceso de construcci n de conocimiento sobre la relaci n clima-salud. Finalmente, se explicitan los principales lineamientos del observatorio, surgidos de una instancia de intercambio con actores clave. El desarrollo del seminario, los proyectos presentados como producto, las discusiones surgidas durante el intercambio y la continuidad de trabajo en los meses posteriores permiten dar cuenta de la importancia y necesidad de construir interdisciplinariamente este observatorio para Am rica Latina y el Caribe.O estudo da relação entre o clima e a saúde requere a articulação de diversos atores e disciplinas. Neste artigo, apresenta-se a experiência do Seminário Latino-americano Instrumentos e Metodologias para um observatório de clima e saúde, realizado em Buenos Aires em 2019. Foi apoiado pelo Centro Latino-americano de Formação Interdisciplinar (CELFI), como espaço de vinculação, capacitação e referência das experiências que se estão a desenvolver neste campo na América Latina. Neste trabalho, apresentase a conceção do seminário, o seu conteúdo, dinâmica e desenvolvimento, bem como, os resultados em termos de participação, produtos e avaliação. Da mesma forma, durante o processo, é feita uma reflexão sobre as metodologias que permitem a articulação de diferentes disciplinas, num processo de construção do conhecimento sobre a relação clima-saúde. Por fim, explicitam-se as principais diretrizes do observatório, decorrentes de uma plataforma de intercâmbio dos atores chave. O desenvolvimento do seminário, os projetos apresentados como produto, as discussões ocorridas durante o intercâmbio e a continuidade de trabalho nos meses seguintes, permitem perceber a importância e a necessidade de construir este observatório interdisciplinar, para a América Latina e Caribe.The study of the relationship between health and climate requires articulating various actors and disciplines. This paper presents the experience of the Latin American Seminar on Instruments and Methodologies for a climate and health observatory— held in Buenos Aires in 2019 and supported by the Latin American Center for Interdisciplinary Training (CELFI)—as a linking and training facility referencing the projects that are being carried out in this field throughout Latin American. This paper presents the design, contents, didactic approach and execution of the seminar, as well as its results regarding participation, products and evaluation. Likewise, the methodologies that could allow articulating different disciplines in a process of gainingknowledge about the climate-health relationship are reflected throughout this process. Finally, the main guidelines for this observatory, arising from an exchange with key actors, are set forth herein. The execution of the seminar, the projects presented as the products thereof, the discussions that arose during the exchange, and the need to continue with this work over the following months point out to the importance and necessity of building this observatory for Latin America and the Caribbean in an interdisciplinary way.Fil: Rusticucci, Matilde Monica. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ciencias de la Atmósfera y los Océanos; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Fontan, Silvia Graciela. Universidad Nacional de la Matanza. Departamento de Cs. de la Salud; ArgentinaFil: Abrutzki, Rosana. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: Bartolomeu, María Lucía. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Chesini, Francisco. Ministerio de Salud de la Nación; ArgentinaFil: Mantilla, Gilma. Pontificia Universidad Javeriana; Colombi

Autopercepción de las condiciones de trabajo y de salud de las personas recuperadoras de residuos del Ecoparque Gualeguaychú

Introducción: las personas recuperadoras de residuos son un actor clave de la gestión de los residuos urbanos y su salud puede verse afectada por sus condiciones de trabajo. Objetivo: Describir las condiciones de trabajo y de salud autopercibida por las personas recuperadoras de residuos del Ecoparque Gualeguaychú.  Materiales y Métodos: Se realizó un estudio descriptivo observacional de corte transversal. Se aplicaron 48 encuestas sobre condiciones de trabajo y proceso de salud - enfermedad – atención. Se efectuó un análisis de frecuencia general de las variables y estratificadas por género y grupos de edad. Resultados: El 85,4% de las personas recuperadoras dijo estar conforme o muy conforme con su trabajo y en las mujeres asciende al 100%. Entre los factores de riesgo autopercibidos se destacan: contacto con pañales, papel higiénico, toallas higiénicas, gasas y algodones (93,8%); contacto con agujas, metales y vidrios (>90%); exposición a calor o frío extremo (89,6%); movimientos repetitivos (87,5%); ruidos molestos (72,9%) y levantar cargas pesadas (58,3%). En relación a las medidas de protección, el 93,8% señaló usarlas de manera permanente y 74,5% que los elementos son provistos por la Cooperativa. Los principales problemas de salud referidos fueron: osteomusculares (58,3%), neurológicos (41,7%), oculares (27,1%), dérmicos (22,9%), respiratorios (20,8%) y digestivos (16,7%). El 75% de las personas recuperadoras solo tiene cobertura del sistema público de salud y el 89,6% concurre a un efector público cuando tiene un problema.  Conclusión: Las personas recuperadoras están expuestas a situaciones y a materiales que pueden afectar su salud, sin embargo, la organización en una cooperativa contribuye a generar ciertos estándares mínimos en las condiciones de trabajo.   Palabras Clave: Segregadores de Residuos Sólidos; Ambiente de Trabajo; Estado de Salud; Gestión de Residuos.

Sistema de Alerta Temprana por Olas de Calor y Salud (SAT-OCS)

Fil: Herrera, Natalia. Servicio Meteorológico Nacional. Gerencia de Investigación, Desarrollo y Capacitación. Departamento de Climatología; Argentina.Fil: Skansi, María de los Milagros. Servicio Meteorológico Nacional. Gerencia de Investigación, Desarrollo y Capacitación. Departamento de Climatología; Argentina.Fil: Berón, Miguel Ángel. Servicio Meteorológico Nacional. Gerencia de Teleprocesamiento de Datos. Departamento de Desarrollo; Argentina.Fil: Campetella, Claudia Marcela. Servicio Meteorológico Nacional. Gerencia de Servicios a la Comunidad; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones del Mar y la Atmosfera; Argentina.Fil: Cejas, Alicia. Servicio Meteorológico Nacional. Gerencia de Servicios a la Comunidad. Departamento de Pronóstico; Argentina.Fil: Chasco, Julia. Servicio Meteorológico Nacional. Gerencia de Servicios a la Comunidad. Departamento de Meteorología y Sociedad; Argentina.Fil: Chesini, Francisco. Ministerio de Salud de la Nación; Argentina.Fil: Titto, Ernesto de. Ministerio de Salud de la Nación; Argentina.Fil: Gatto, Mauricio. Servicio Meteorológico Nacional. Gerencia de Teleprocesamiento de Datos. Departamento de Procesos Automatizados; Argentina.Fil: Saucedo, Marcos. Servicio Meteorológico Nacional. Gerencia de Servicios a la Comunidad. Centro Meteorológico Nacional; Argentina.Fil: Suaya, Martina. Servicio Meteorológico Nacional. Gerencia de Teleprocesamiento de Datos. Departamento de Procesos Automatizados; Argentina.Las olas de calor son una amenaza natural para la salud humana. En un escenario donde los fenómenos climáticos extremos -en especial las olas de calor- serán más frecuentes e intensos, es indispensable contar con un sistema de alerta temprana, que pueda advertir a la población acerca de la llegada de olas de calor (o temperaturas muy elevadas) y a los sistemas de salud, con el fin de aplicar políticas de promoción y protección de la salud. A partir del verano 2017-2018 se implementó en el Servicio Meteorológico Nacional el Sistema de Alerta Temprana por Olas de Calor y Salud (SAT-OCS). Este sistema funciona de manera automatizada para 57 localidades del país, emite un alerta diario y se encuentra disponible desde el primer día de octubre de cada año hasta el 31 de marzo en https://www.smn.gob.ar/smn_alertas/olas_de_calor. El objetivo es que tanto la población como los organismos de protección civil puedan tomar las medidas de prevención, mitigación y de respuesta adecuadas a cada nivel de alerta. En esta Nota Técnica se describe la metodología utilizada y se ilustra su funcionamiento con resultados del primer verano en uso.The Heat Waves are a natural threat to human health. In a scenario where extreme weather events will be more frequent and intense -especially heat waves- it is essential to have an early warning system, which can warn the population about the arrival of heat waves (or very high temperatures) and to health systems, in order to implement health promotion and protection policies. From summer 2017-2018, the Early Warning System of Heat Waves and Health (SAT-OCS in spanish) was implemented in the argentinian National Meteorological Service. This system works in an automated way for 57 localities in the country, issues a daily alert and is available from the first day of October of each year until March 31 at https://www.smn.gob.ar/smn_alertas/olas_de_calor. The objective is that both the population and civil protection organizations can take appropriate prevention, mitigation and response measures at each level of alert. In this Technical Note the methodology used is described and its operation is illustrated with results of the first summer in use

Clima y salud en la Argentina: diagnóstico de situación 2018

Fil: Domínguez, Diana Analía. Servicio Meteorológico Nacional. Dirección Nacional de Ciencia e Innovación en Productos y Servicios. Dirección Central de Monitoreo del Clima; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ciencias de la Atmósfera y los Océanos; Argentina.El presente diagnóstico de situación sobre Clima y Salud en Argentina fue realizado por la Mesa de Trabajo sobre Cambio Climático de la Secretaría de Gobierno de Salud. Se realizó un estudio de tipo descriptivo, en el cual se presenta por un lado el comportamiento de las variables meteorológicas y por otro, algunos eventos seleccionados en salud. Asimismo, se desarrolla el estado del conocimiento sobre la relación entre el clima y la salud en Argentina en el período comprendido entre los años 2005 y 2017. La descripción climática fue realizada por el Departamento de Climatología del Servicio Meteorológico Nacional (SMN). Las estadísticas se basan en valores medios (promedio) del periodo 1981-2010. Los efectos del clima sobre la salud humana fueron estudiados a partir de su clasificación en efectos directos e indirectos, entendiendo como efectos directos aquellos ocurridos a raíz de la ocurrencia de eventos meteorológicos extremos tales como olas de frío y calor, inundaciones, sequías y vientos fuertes. Para el análisis de estos eventos se realizó el análisis de la frecuencia y distribución espacial de los eventos extremos para el período 2005-2017. Para el estudio de las patologías sensible al clima se priorizaron las patologías más relevantes para ser descriptas en base a la evidencia científica. Se realizó una descripción de la evolución temporal de los casos entre 2005 y 2017, a partir de los datos obtenidos de la vigilancia clínica (a través del módulo C2 del SNVS). Por último se presentan las tendencias y retos que afrontará el sistema sanitario debido al cambio climático

The 2023 Latin America report of the Lancet Countdown on health and climate change: the imperative for health-centred climate-resilient development

In 2023, a series of climatological and political events unfolded, partly driving forward the global climate and health agenda while simultaneously exposing important disparities and vulnerabilities to climate-related events. On the policy front, a significant step forward was marked by the inaugural Health Day at COP28, acknowledging the profound impacts of climate change on health. However, the first-ever Global Stocktake showed an important gap between the current progress and the targets outlined in the Paris Agreement, underscoring the urgent need for further and decisive action. From a Latin American perspective, some questions arise: How do we achieve the change that is needed? How to address the vulnerabilities to climate change in a region with longstanding social inequities? How do we promote intersectoral collaboration to face a complex problem such as climate change? The debate is still ongoing, and in many instances, it is just starting. The renamed regional centre Lancet Countdown Latin America (previously named Lancet Countdown South America) expanded its geographical scope adding Mexico and five Central American countries: Costa Rica, El Salvador, Guatemala, Honduras, and Panama, as a response to the need for stronger collaboration in a region with significant social disparities, including research capacities and funding. The centre is an independent and multidisciplinary collaboration that tracks the links between health and climate change in Latin America, following the global Lancet Countdown’s methodologies and five domains. The Lancet Countdown Latin America work hinges on the commitment of 23 regional academic institutions, United Nations agencies, and 34 researchers who generously contribute their time and expertise. Building from the first report, the 2023 report of the Lancet Countdown Latin America, presents 34 indicators that track the relationship between health and climate change up to 2022, aiming at providing evidence to public decisionmaking with the purpose of improving the health and wellbeing of Latin American populations and reducing social inequities through climate actions focusing on health. This report shows that Latin American populations continue to observe a growing exposure to changing climatic conditions. A warming trend has been observed across all countries in Latin America, with severe direct impacts. In 2022, people were exposed to ambient temperatures, on average, 0.38 ◦C higher than in 1986–2005, with Paraguay experiencing the highest anomaly (+1.9 ◦C), followed by Argentina (+1.2 ◦C) and Uruguay (+0.9 ◦C) (indicator 1.1.1). In 2013–2022, infants were exposed to 248% more heatwave days and people over 65 years old were exposed to 271% more heatwave days than in 1986–2005 (indicator 1.1.2). Also, compared to 1991–2000, in 2013–2022, there were 256 and 189 additional annual hours per person, during which ambient heat posed at least moderate and high risk of heat stress during light outdoor physical activity in Latin America, respectively (indicator 1.1.3). Finally, the region had a 140% increase in heat-related mortality from 2000–2009 to 2013–2022 (indicator 1.1.4). Changes in ecosystems have led to an increased risk of wildfires, exposing individuals to very or extremely high fire danger for more extended periods (indicator 1.2.1). Additionally, the transmission potential for dengue by Aedes aegypti mosquitoes has risen by 54% from 1951–1960 to 2013–2022 (indicator 1.3), which aligns with the recent outbreaks and increasing dengue cases observed across Latin America in recent months. Based on the 2023 report of the Lancet Countdown Latin America, there are three key messages that Latin America needs to further explore and advance for a health-centred climate-resilient development. Latin American countries require intersectoral public policies that simultaneously increase climate resilience, reduce social inequities, improve population health, and reduce greenhouse gas (GHG) emissions. The findings show that adaptation policies in Latin America remain weak, with a pressing need for robust vulnerability and adaptation (V&A) assessments to address climate risks effectively. Unfortunately, such assessments are scarce. Up to 2021, Brazil is the only country that has completed and officially reported a V&A to the 2021 Global Survey conducted by the World Health Organization (WHO). Argentina, Guatemala, and Panama have also conducted them, but they have not been reported (indicator 2.1.1). Similarly, efforts in developing and implementing Health National Adaptation Plans (HNAPs) are varied and limited in scope. Brazil, Chile, and Uruguay are the only countries that have an HNAP (indicator 2.1.2). Moreover, self-reported city-level climate change risk assessments are very limited in the region (indicator 2.1.3). The collaboration between meteorological and health sectors remains insufficient, with only Argentina, Brazil, Colombia, and Guatemala self-reporting some level of integration (indicator 2.2.1), hindering comprehensive responses to climate-related health risks in the region. Additionally, despite the urgent need for action, there has been minimal progress in increasing urban greenspaces across the region since 2015, with only Colombia, Nicaragua, and Venezuela showing slight improvements (indicator 2.2.2). Compounding these challenges is the decrease in funding for climate change adaptation projects in Latin America, as evidenced by the 16% drop in funds allocated by the Green Climate Fund (GCF) in 2022 compared to 2021. Alarmingly, none of the funds approved in 2022 were directed toward climate change and health projects, highlighting a critical gap in addressing health-related climate risks (indicator 2.2.3). From a vulnerability perspective, the Mosquito Risk Index (MoRI) indicates an overall decrease in severe mosquitoborne disease risk in the region due to improvements in water, sanitation, and hygiene (WASH) (indicator 2.3.1). Brazil and Paraguay were the only countries that showed an increase in this indicator. It is worth noting that significant temporal variation within and between countries still persists, suggesting inadequate preparedness for climate-related changes. Overall, population health is not solely determined by the health sector, nor are climate policies a sole responsibility of the environmental sector. More and stronger intersectoral collaboration is needed to pave development pathways that consider solid adaptation to climate change, greater reductions of GHG emissions, and that increase social equity and population health. These policies involve sectors such as finance, transport, energy, housing, health, and agriculture, requiring institutional structures and policy instruments that allow long-term intersectoral collaboration. Latin American countries need to accelerate an energy transition that prioritises people’s health and wellbeing, reduces energy poverty and air pollution, and maximises health and economic gains. In Latin America, there is a notable disparity in energy transition, with electricity generation from coal increasing by an average of 2.6% from 1991–2000 to 2011–2020, posing a challenge to efforts aimed at phasing out coal (indicator 3.1.1). However, this percentage increase is conservative as it may not include all the fossil fuels for thermoelectric electricity generation, especially during climate-related events and when hydropower is affected (Panel 4). Yet, renewable energy sources have been growing, increasing by an average of 5.7% during the same period. Access to clean fuels for cooking remains a concern, with 46.3% of the rural population in Central America and 23.3% in South America lacking access to clean fuels in 2022 (indicator 3.1.2). It is crucial to highlight the concerning overreliance on fossil fuels, particularly liquefied petroleum gas (LPG), as a primary cooking fuel. A significant majority of Latin American populations, approximately 74.6%, rely on LPG for cooking. Transitioning to cleaner heating and cooking alternatives could also have a health benefit by reducing household air pollution-related mortality. Fossil fuels continue to dominate road transport energy in Latin America, accounting for 96%, although some South American countries are increasing the use of biofuels (indicator 3.1.3). Premature mortality attributable to fossil-fuel-derived PM2.5 has shown varied trends across countries, increasing by 3.9% from 2005 to 2020 across Latin America, which corresponds to 123.5 premature deaths per million people (indicator 3.2.1). The Latin American countries with the highest premature mortality rate attributable to PM2.5 in 2020 were Chile, Peru, Brazil, Colombia, Mexico, and Paraguay. Of the total premature deaths attributable to PM2.5 in 2020, 19.1% was from transport, 12.3% from households, 11.6% from industry, and 11% from agriculture. From emission and capture of GHG perspective, commodity-driven deforestation and expansion of agricultural land remain major contributors to tree cover loss in the region, accounting for around 80% of the total loss (indicator 3.3). Additionally, animal-based food production in Latin America contributes 85% to agricultural CO2 equivalent emissions, with Argentina, Brazil, Panama, Paraguay, and Uruguay ranking highest in per capita emissions (indicator 3.4.1). From a health perspective, in 2020, approximately 870,000 deaths were associated with imbalanced diets, of which 155,000 (18%) were linked to high intake of red and processed meat and dairy products (indicator 3.4.2). Energy transition in Latin America is still in its infancy, and as a result, millions of people are currently exposed to dangerous levels of air pollution and energy poverty (i.e., lack of access to essential energy sources or services). As shown in this report, the levels of air pollution, outdoors and indoors, are a significant problem in the whole region, with marked disparities between urban and rural areas. In 2022, Peru, Chile, Mexico, Guatemala, Colombia, El Salvador, Brazil, Uruguay, Honduras, Panama, and Nicaragua were in the top 100 most polluted countries globally. Transitioning to cleaner sources of energy, phasing out fossil fuels, and promoting better energy efficiency in the industrial and housing sectors are not only climate mitigation measures but also huge health and economic opportunities for more prosperous and healthy societies. Latin American countries need to increase climate finance through permanent fiscal commitments and multilateral development banks to pave climate-resilient development pathways. Climate change poses significant economic costs, with investments in mitigation and adaptation measures progressing slowly. In 2022, economic losses due to weather-related extreme events in Latin America were US$15.6 billion –an amount mainly driven by floods and landslides in Brazil–representing 0.28 America’s Gross Domestic Product (GDP) (indicator 4.1.1). In contrast to high-income countries, most of these losses lack insurance coverage, imposing a substantial financial strain on affected families and governments. Heat-related mortality among individuals aged 65 and older in Latin America reached alarming levels, with losses exceeding the equivalent of the average income of 451,000 people annually (indicator 4.1.2). Moreover, the total potential income loss due to heat-related labour capacity reduction amounted to 1.34 disproportionately affecting the agriculture and construction sectors (indicator 4.1.3). Additionally, the economic toll of premature mortality from air pollution was substantial, equivalent to a significant portion of regional GDP (0.61 On a positive note, clean energy investments in the region increased in 2022, surpassing fossil fuel investments. However, in 2020, all countries reviewed continued to offer net-negative carbon prices, revealing fossil fuel subsidies totalling US$23 billion. Venezuela had the highest net subsidies relative to current health expenditure (123%), followed by Argentina (10.5%), Bolivia (10.3%), Ecuador (8.3%), and Chile (5.6%) (indicator 4.2.1). Fossil fuel-based energy is today more expensive than renewable energy. Fossil fuel burning drives climate change and damages the environment on which people depend, and air pollution derived from the burning of fossil fuels causes seven million premature deaths each year worldwide, along with a substantial burden of disease. Transitioning to sustainable, zero-emission energy sources, fostering healthier food systems, and expediting adaptation efforts promise not only environmental benefits but also significant economic gains. However, to implement mitigation and adaptation policies that also improve social wellbeing and prosperity, stronger and solid financial systems are needed. Climate finance in Latin American countries is scarce and strongly depends on political cycles, which threatens adequate responses to the current and future challenges. Progress on the climate agenda is lagging behind the urgent pace required. While engagement with the intersection of health and climate change is increasing, government involvement remains inadequate. Newspaper coverage of health and climate change has been on the rise, peaking in 2022, yet the proportion of climate change articles discussing health has declined over time (indicator 5.1). Although there has been significant growth in the number of scientific papers focusing on Latin America, it still represents less than 4% of global publications on the subject (indicator 5.3). And, while health was mentioned by most Latin American countries at the UN General Debate in 2022, only a few addressed the intersection of health and climate change, indicating a lack of awareness at the governmental level (indicator 5.4). The 2023 Lancet Countdown Latin America report underscores the cascading and compounding health impacts of anthropogenic climate change, marked by increased exposure to heatwaves, wildfires, and vector-borne diseases. Specifically, for Latin America, the report emphasises three critical messages: the urgent action to implement intersectoral public policies that enhance climate resilience across the region; the pressing need to prioritise an energy transition that focuses on health co-benefits and wellbeing, and lastly, that need for increasing climate finance by committing to sustained fiscal efforts and engaging with multilateral development banks. By understanding the problems, addressing the gaps, and taking decisive action, Latin America can navigate the challenges of climate change, fostering a more sustainable and resilient future for its population. Spanish and Portuguese translated versions of this Summary can be found in Appendix B and C, respectively. The full translated report in Spanish is available in Appendix D

ANÁLISE DA PREVALÊNCIA DE DOENÇAS CRÔNICO-DEGENERATIVAS DE MORADORES DA CIDADE DE SANTO ANASTÁCIO – SP ATENDIDOS PELO PROJETO DE EXTENSÃO “MUTIRÃO DA SAÚDE”.

O objetivo do estudo foi identificar a prevalência de doenças crônico-degenerativas (DCD) dos habitantes da cidade de Santo Anastácio-SP, atendidos pelo projeto “Mutirão da Saúde”. Este estudo analisou 94 indivíduos, homens e mulheres, através do “Standard Health Questionnaire” (SHQ). A DCD de maior prevalência em homens foi hipertensão arterial e em mulheres, doenças osteomusculares. Quanto à idade, indivíduos acima de 40 anos apresentaram maior prevalência de todas as doenças. Ao estratificar por sexo/idade, mulheres acima de 40 anos apresentam maior prevalência de hipertensão arterial, doenças metabólicas e osteomusculares. Todos os achados nas estratificações citadas não apresentam relação direta dos participantes com sua hereditariedade. Conclui-se que há maior prevalência de hipertensão arterial em homens, doenças osteomusculares em mulheres, todas as patologias em indivíduos acima de 40 anos de idade e maior prevalência de hipertensão arterial, doenças cardiovasculares e osteomusculares em mulheres acima de 40 anos de idade

The 2022 South America report of The Lancet Countdown on health and climate change: trust the science. Now that we know, we must act

The health of South American populations is being severely impacted by increasing climate change-driven environmental changes. Exacerbated by increased social inequities and vulnerability, deforestation, land degradation, and global climate variabilities in sea temperature, can potentially lead to extreme weather and climate events, magnifying the negative effects of climate change on health. Understanding the direct and indirect exposure routes to climate hazards and the effects on health and wellbeing is critical to design successful and effective evidence-based adaptation and mitigation plans and policies. This report is part of the Lancet Countdown's broader efforts to develop expertise and understanding of the links between health and climate change at the regional level. The Lancet Countdown South America (LCSA), a newly launched chapter of the Lancet Countdown, is an independent, multidisciplinary academic collaboration dedicated to tracking the links between public health and climate change in South America (SA). This collaboration brings together 21 academic institutions and UN agencies with 28 researchers representing various disciplines. The data and results provided in this report for the 12 countries of the region,∗ explore in regional detail the results of the 2022 global Lancet Countdown report and provide the evidence to support targeted response strategies for decision-makers. Its findings and conclusions represent the consensus of experts across multiple fields, covering 25 indicators summarised below in four key messages

Diagnóstico espacial das áreas verdes públicas na cidade de Concepción del Uruguay. Uma abordagem para avaliação da equidade espacial

Public green spaces (PGS) are considered fundamental elements in the sustainable city model, competing various environmental, ecosystemic, and social roles. The quality and accessibility are key factors in maximizing their positive effects on human health. This study was conducted in the city of Concepción del Uruguay, Argentina, with the aim of describing the situation of PGS in terms of their distribution, size, and analyzing their spatial accessibility using a quantitative descriptive approach. Firstly, public green spaces within the city were identified and classified using satellite imagery and field visits. The coverage of public green spaces was then quantified at a global level and stratified according to census areas. A proximity analysis was performed using different access distances to PGS according to their size, and the population with simultaneous coverage of three types of green spaces was calculated. Subsequently, differences in the surface area of green spaces were evaluated based on the unsatisfied basic needs of households in each census area using statistical tests. Finally, the spatial distribution pattern of green spaces was analyzed using spatial autocorrelation, and statistical tests were conducted to assess the existence of significant spatial clusters. 34 % (24,928 inhabitants) of the population have simultaneous coverage of three types of green spaces. There is no significant association between the size or quantity of PGS and the percentage of households with Unsatisfied Basic Needs according to census tracts (p <0.01). The results can be useful for the planning and management of these spaces, as well as for addressing challenges related to spatial equity and urban sustainability.Los espacios verdes públicos (EVP) son elementos fundamentales en el modelo de ciudad sustentable, desempeñando diversas funciones ambientales, ecosistémicas y sociales. Su calidad y accesibilidad son factores clave para maximizar sus efectos positivos en la salud humana. El presente estudio se realizó en la ciudad de Concepción del Uruguay, Argentina, con el objetivo de describir la situación de los EVP en relación a su distribución, dimensión y accesibilidad espacial, mediante un enfoque descriptivo cuantitativo. Primero, se identificaron y clasificaron los EVP a partir de imágenes satelitales y salidas de campo. Luego se cuantificó la cobertura a nivel global, estratificando según radios censales. Se realizó un análisis de proximidad utilizando diferentes distancias de acceso a los EVP según tamaño y se calculó la población con cobertura simultánea de tres de ellos. Posteriormente, se evaluaron las diferencias en la superficie de los espacios verdes según las Necesidades Básicas Insatisfechas (NBI) de los hogares en cada área censal mediante pruebas estadísticas. Finalmente, se analizó el patrón de distribución espacial de los EVP mediante autocorrelación espacial y se realizaron pruebas estadísticas para evaluar la existencia de agrupamientos espaciales significativos. El 34 % (24 928 habitantes) de la población cuenta con cobertura simultánea a tres tipos de EVP. No existe una asociación significativa entre el tamaño, ni la cantidad de los EVP con el porcentaje de hogares con NBI según radio censal (p <0,01). Los resultados pueden ser útiles para la planificación y gestión de estos espacios, así como para abordar desafíos relacionados con la equidad espacial y la sustentabilidad urbana.Os espaços verdes públicos (EVP) são elementos fundamentais no modelo de cidade sustentável, desempenhando diversas funções ambientais, ecossistêmicas e sociais. Sua qualidade e acessibilidade são fatores-chave para maximizar seus efeitos positivos na saúde humana. O presente estudo foi realizado na cidade de Concepción del Uruguay, Argentina, com o objetivo de descrever a situação dos EVP em relação à sua distribuição, dimensão e acessibilidade espacial, por meio de uma abordagem descritiva quantitativa. Primeiramente, os EVP foram identificados e classificados com base em imagens de satélite e saídas de campo. Em seguida, a cobertura foi quantificada em nível global, estratificada de acordo com as áreas censitárias. Foi realizado uma análise de proximidade utilizando diferentes distâncias de acesso aos EVP de acordo com o tamanho, e a população com cobertura simultânea de três deles foi calculada. Posteriormente, foram avaliadas as diferenças na área dos espaços verdes de acordo com as Necessidades Básicas Insatisfeitas (NBI) das residências em cada área censitária por meio de testes estatísticos. Por fim, foi analisado o padrão de distribuição espacial dos EVP por meio de autocorrelação espacial, e foram realizados testes estatísticos para avaliar a existência de agrupamentos espaciais significativos. 34 % (24 928 habitantes) da população possui cobertura simultânea de três tipos de EVP. Não existe uma associação significativa entre o tamanho ou quantidade dos EVP e a porcentagem de residências com NBI de acordo com a área censitária (p <0,01). Os resultados podem ser úteis para o planejamento e gestão desses espaços, bem como para enfrentar desafios relacionados à equidade espacial e sustentabilidade urbana