The health impacts of climate-related migration

Background: Changes in climate, in conjunction with other drivers of mobility, shape human migration. While there is an increasing focus on the adaptive potential of migration, the health impacts of climate-related migration, including planned relocation and forced displacement, have not been thoroughly examined. The Intergovernmental Panel on Climate Change stated that migration is currently, and will increasingly be, influenced by environmental degradation and climate change, and that it needs to be addressed in a focused and coordinated manner. Discussion: This paper examines the links between climate change, migration, and health, considering diverse migration responses, including immobility, forced displacement and planned migration, as well as the associated health risks and opportunities in different contexts. Using case studies, the paper illustrates strategies to reduce the health risks associated with climate change-related migration. Conclusion: While there is an increasing body of research examining the climate change–migration nexus, a dual approach is now required. This approach must include debate and further research regarding the health consequences and responses associated with climate migration as well as immediate strengthening of health systems to make them both climate resilient and migrant inclusive

Climate change adaptation to extreme heat: a global systematic review of implemented action

Extreme heat events impact people and ecosystems across the globe, and they are becoming more frequent and intense in a warming climate. Responses to heat span sectors and geographic boundaries. Prior research has documented technologies or options that can be deployed to manage extreme heat and examples of how individuals, communities, governments and other stakeholder groups are adapting to heat. However, a comprehensive understanding of the current state of implemented heat adaptations—where, why, how and to what extent they are occurring—has not been established. Here, we combine data from the Global Adaptation Mapping Initiative with a heat-specific systematic review to analyze the global extent and diversity of documented heat adaptation actions (n = 301 peer-reviewed articles). Data from 98 countries suggest that documented heat adaptations fundamentally differ by geographic region and national income. In high-income, developed countries, heat is overwhelmingly treated as a health issue, particularly in urban areas. However, in low- and middle-income, developing countries, heat adaptations focus on agricultural and livelihood-based impacts, primarily considering heat as a compound hazard with drought and other hydrological hazards. 63% of the heat-adaptation articles feature individuals or communities autonomously adapting, highlighting how responses to date have largely consisted of coping strategies. The current global status of responses to intensifying extreme heat, largely autonomous and incremental yet widespread, establishes a foundation for informed decision-making as heat impacts around the world continue to increase

Structure, Function, and Evolution of the Thiomonas spp. Genome

Bacteria of the Thiomonas genus are ubiquitous in extreme environments, such as arsenic-rich acid mine drainage (AMD). The genome of one of these strains, Thiomonas sp. 3As, was sequenced, annotated, and examined, revealing specific adaptations allowing this bacterium to survive and grow in its highly toxic environment. In order to explore genomic diversity as well as genetic evolution in Thiomonas spp., a comparative genomic hybridization (CGH) approach was used on eight different strains of the Thiomonas genus, including five strains of the same species. Our results suggest that the Thiomonas genome has evolved through the gain or loss of genomic islands and that this evolution is influenced by the specific environmental conditions in which the strains live

The effects on public health of climate change adaptation responses: a systematic review of evidence from low- and middle-income countries.

Climate change adaptation responses are being developed and delivered in many parts of the world in the absence of detailed knowledge of their effects on public health. Here we present the results of a systematic review of peer-reviewed literature reporting the effects on health of climate change adaptation responses in low- and middle-income countries (LMICs). The review used the 'Global Adaptation Mapping Initiative' database (comprising 1682 publications related to climate change adaptation responses) that was constructed through systematic literature searches in Scopus, Web of Science and Google Scholar (2013-2020). For this study, further screening was performed to identify studies from LMICs reporting the effects on human health of climate change adaptation responses. Studies were categorised by study design and data were extracted on geographic region, population under investigation, type of adaptation response and reported health effects. The review identified 99 studies (1117 reported outcomes), reporting evidence from 66 LMICs. Only two studies were ex ante formal evaluations of climate change adaptation responses. Papers reported adaptation responses related to flooding, rainfall, drought and extreme heat, predominantly through behaviour change, and infrastructural and technological improvements. Reported (direct and intermediate) health outcomes included reduction in infectious disease incidence, improved access to water/sanitation and improved food security. All-cause mortality was rarely reported, and no papers were identified reporting on maternal and child health. Reported maladaptations were predominantly related to widening of inequalities and unforeseen co-harms. Reporting and publication-bias seems likely with only 3.5% of all 1117 health outcomes reported to be negative. Our review identified some evidence that climate change adaptation responses may have benefits for human health but the overall paucity of evidence is concerning and represents a major missed opportunity for learning. There is an urgent need for greater focus on the funding, design, evaluation and standardised reporting of the effects on health of climate change adaptation responses to enable evidence-based policy action

A scoping review of mentorship of health personnel to improve the quality of health care in low and middle-income countries

Abstract Background Most Low and Middle-Income Countries are facing a crisis in human resources for health which compromises their ability to meet health related targets outlined by the Sustainable Development Goals. The crisis is not limited to the availability of health personnel but also the quality of care and the training and development of the workforce. To address these challenges, evidence based education strategies are urgently required. Mentorship has been found to improve health personnel performance in High-Income Countries however, little is known about its role in Low and Middle-Income Countries. To address this gap in understanding, we conducted a scoping review of the current literature. Methods CINAHL, EMBASE and OVID Medline were systematically searched along with grey literature for peer-reviewed research papers specific to the research question. A six-step scoping review framework was utilised to identify the relevant literature and summarise the pertinent findings. Results The initial search identified 592 records, and five papers, reporting on four studies, were retained for data charting and extraction. All four studies described a positive effect of mentorship on the quality of care outcomes. The results are collated according to features of the intervention including mentor training, mentor-mentee ratios, mentorship model, intervention intensity and key findings in terms of outcome measures. Conclusions This review identifies a paucity of evidence of mentorship in this context however, current evidence supports the assertion that effective mentorship contributes to the improvement of certain quality of care outcomes. The features of successful mentorship interventions are outlined and the implications are discussed in the context of existing evidence

Waiting for the wave, but missing the tide: Case studies of climate-related (im)mobility and health

Climate change amplifies health risks, including through the health impacts of climate-related displacement. Yet diverse mobility responses in a warming world can also provide a pathway for climate change adaptation. This article examines the connections between climatic and environmental change, human mobility and health. It presents case studies across three countries: Fiji, Bangladesh, and Burkina Faso. All case studies used qualitative methods, including semi-structured interviews, storytelling, and group discussions. The Fiji case study focuses on relocation of a coastal village exposed to erosion, flooding and saltwater intrusion; it highlights self-reported health risks and opportunities following relocation. The Bangladesh case study includes seven sites that variously experience flooding, cyclones and riverbank erosion; while residents use migration and (im)mobility as a coping strategy, there are associated health risks, particularly for those who feel trapped in new sites of residence. The case study from a village in Burkina Faso examines seasonal labour migration to the Ivory Coast and Mali during times of drought and reduced agricultural productivity, and discusses health risks for men who migrate and for women who remain in sending communities. These case studies illustrate that there is no consistent figure that represents a 'climate migrant', ‘climate refugee’, or ‘trapped’ person. Accordingly, we argue that where planetary health looks to highlight ‘waves’ of climate displacement, it may miss the ‘tide’ of slower onset climatic changes and smaller-scale and diverse forms of (im)mobility. However, even where climate-related mobility is broadly adaptive - e.g. providing opportunities for livelihood diversification, or migration away from environmental risks - there can be health risks and opportunities that are shaped by socio-political contexts, access to healthcare, altered food sources, and living and working conditions. Responsive solutions are required to protect and promote the health of mobile and immobile populations in a warming world

Human mobility and health in a warming world

Humans have a long history of mobility on a spectrum from voluntary migration to forced displacement in response to social, political and environmental change. While many migration drivers exist, climate change is likely to amplify the environmental drivers of migration. At least 1.5°C of warming above pre-industrial levels between 2030 and 2052 are projected if global warming continues to increase at the current rate.1 The associated impacts are diverse and include temperature and precipitation extremes in most inhabited regions and increased probability of drought and flood.1 Migration can be an important and useful adaptive response to climate impacts when it increases household resilience and reduces socio-economic vulnerabilities,2 and yet can also have negative health consequences. The climate–migration–health nexus entails complex interactions including the following: first, climate-related risks to health faced by migrants at all stages of the migration journey. Second, the impacts of migration itself on health with possible specific health implications of climate-related migration. This article provides a brief overview of climate-related migration, identifies climate hotspots where substantial migration and displacement are anticipated and explores the health implications of climate-related migratio