The Political Economy of Health Co-Benefits: Embedding Health in the Climate Change Agenda.

A complex, whole-of-economy issue such as climate change demands an interdisciplinary, multi-sectoral response. However, evidence suggests that human health has remained elusive in its influence on the development of ambitious climate change mitigation policies for many national governments, despite a recognition that the combustion of fossil fuels results in pervasive short- and long-term health consequences. We use insights from literature on the political economy of health and climate change, the science–policy interface and power in policy-making, to identify additional barriers to the meaningful incorporation of health co-benefits into climate change mitigation policy development. Specifically, we identify four key interrelated areas where barriers may exist in relation to health co-benefits: discourse, efficiency, vested interests and structural challenges. With these insights in mind, we argue that the current politico-economic paradigm in which climate change is situated and the processes used to develop climate change mitigation policies do not adequately support accounting for health co-benefits. We present approaches for enhancing the role of health co-benefits in the development of climate change mitigation policies to ensure that health is embedded in the broader climate change agenda.

The Role of Health Co-Benefits in the Development of Australian Climate Change Mitigation Policies.

Reducing domestic carbon dioxide and other associated emissions can lead to short-term, localized health benefits. Quantifying and incorporating these health co-benefits into the development of national climate change mitigation policies may facilitate the adoption of stronger policies. There is, however, a dearth of research exploring the role of health co-benefits on the development of such policies. To address this knowledge gap, research was conducted in Australia involving the analysis of several data sources, including interviews carried out with Australian federal government employees directly involved in the development of mitigation policies. The resulting case study determined that, in Australia, health co-benefits play a minimal role in the development of climate change mitigation policies. Several factors influence the extent to which health co-benefits inform the development of mitigation policies. Understanding these factors may help to increase the political utility of future health co-benefits studies.

Early emergence in a butterfly causally linked to anthropogenic warming.

There is strong correlative evidence that human-induced climate warming is contributing to changes in the timing of natural events. Firm attribution, however, requires cause-and-effect links between observed climate change and altered phenology, together with statistical confidence that observed regional climate change is anthropogenic. We provide evidence for phenological shifts in the butterfly Heteronympha merope in response to regional warming in the southeast Australian city of Melbourne. The mean emergence date for H. merope has shifted -1.5 days per decade over a 65-year period with a concurrent increase in local air temperatures of approximately 0.16°C per decade. We used a physiologically based model of climatic influences on development, together with statistical analyses of climate data and global climate model projections, to attribute the response of H. merope to anthropogenic warming. Such mechanistic analyses of phenological responses to climate improve our ability to forecast future climate change impacts on biodiversity.

Attributing physical and biological impacts to anthropogenic climate change.

Significant changes in physical and biological systems are occurring on all continents and in most oceans, with a concentration of available data in Europe and North America. Most of these changes are in the direction expected with warming temperature. Here we show that these changes in natural systems since at least 1970 are occurring in regions of observed temperature increases, and that these temperature increases at continental scales cannot be explained by natural climate variations alone. Given the conclusions from the Intergovernmental Panel on Climate Change (IPCC) Fourth Assessment Report that most of the observed increase in global average temperatures since the mid-twentieth century is very likely to be due to the observed increase in anthropogenic greenhouse gas concentrations, and furthermore that it is likely that there has been significant anthropogenic warming over the past 50 years averaged over each continent except Antarctica, we conclude that anthropogenic climate change is having a significant impact on physical and biological systems globally and in some continents.

Climate change and primary health care.

BACKGROUND: Climate change and rising average global temperatures threaten to disrupt the physical, biological and ecological life support systems on which human health depends. OBJECTIVE: This article overviews the evidence for human induced climate change, the predicted health impacts, and the role of primary health care professionals in managing these impacts. DISCUSSION: Climate change has substantial potential health effects. These include heat stress related to heatwaves; injuries related to extreme weather events such as storms, fires and floods; infectious disease outbreaks due to changing patterns of mosquito borne and water borne diseases; poor nutrition from reduced food availability and affordability; the psychosocial impact of drought; and the displacement of communities. Primary health care has an important role in preparing for and responding to these climate change related threats to human health.

Solar UV forecasts: a randomized trial assessing their impact on adults' sun-protection behavior.

This study examined the effectiveness of solar UV forecasts and supporting communications in assisting adults to protect themselves from excessive weekend sun exposure. The study was conducted in Australia, where 557 adult participants with workplace e-mail and Internet access were randomly allocated to one of three weather forecast conditions: standard forecast (no UV), standard forecast + UV, standard forecast + UV + sun-protection messages. From late spring through summer and early autumn, they were e-mailed weekend weather forecasts late in the working week. Each Monday they were e-mailed a prompt to complete a Web-based questionnaire to report sun-related behavior and any sunburn experienced during the previous weekend. There were no significant differences between weather forecast conditions in reported hat use, sunscreen use, sun avoidance, or sunburn. Results indicate that provision of solar-UV forecasts in weather forecasts did not promote markedly enhanced personal sun-protection practices among the adults surveyed.

Detection of a human influence on North American climate.

Several indices of large-scale patterns of surface temperature variation were used to investigate climate change in North America over the 20th century. The observed variability of these indices was simulated well by a number of climate models. Comparison of index trends in observations and model simulations shows that North American temperature changes from 1950 to 1999 were unlikely to be due to natural climate variation alone. Observed trends over this period are consistent with simulations that include anthropogenic forcing from increasing atmospheric greenhouse gases and sulfate aerosols. However, most of the observed warming from 1900 to 1949 was likely due to natural climate variation.

Atmospheric science. Ozone and climate change.

Over the past 40 years, Southern Hemisphere circumpolar westerly winds have strengthened. In his Perspective, Karoly highlights the modeling study by Gillett and Thompson, who show that these observed Southern Hemisphere climate changes in spring and summer can be explained as a response to stratospheric ozone depletion over Antarctica. The observed strengthening of the circumpolar westerlies in winter is less likely to be the response to springtime Antarctic ozone depletion, but may be due in part to increasing atmospheric greenhouse gases. Understanding the different causes and practical impacts of these trends in Southern Hemisphere circulation is an important next step for climate researchers.

[Molecular genetic background of developmental bony malformations at the craniocervical junction and cervical spine]. / A nyaki gerinc és a craniocervicalis átmenet csontos-fúziós fejlódési rendellenességeinek molekuláris genetikai háttere.

In this review a new interpretation of the origin of bony developmental malformations affecting the craniocervical junction and the cervical spine is presented based on recent advances in the understanding of embryonic development of the spine and its molecular genetic control. Radiographs, CT and MRI scans or CT myelograms of patients with Klippel-Feil syndrome were used for demonstration. Detailed clinical and radiological analysis of these patients was published earlier [David KM, Stevens JM, Thorogood P, Crockard HA. The dysmorphic cervical spine in Klippel-Feil syndrome: interpretations from developmental biology. Neurosurg Focus 1999;6(6):1.]. Homeotic transformation due to mutations or disturbed expression of Hox genes is a possible mechanism responsible for Cl assimilation. Notochordal defects and/or signalling problems, that result in reduced or impaired Pax-1 gene expression, may underlie vertebral fusions. This, together with asymmetrical distribution of paraxial mesoderm cells and a possible lack of communication across the embryonic mid-line, could cause the asymmetrical fusion patterns. The wide and flattened shape of the fused vertebral bodies, their resemblance to the embryonic cartilaginous vertebrae and the process of progressive bony fusion with age suggest that the fusions occur before or, at the latest, during chondrification of vertebrae. The authors suggest that the aforementioned mechanisms are likely to be, at least in part, responsible for the origin of the bony developmental malformations affecting the craniocervical junction and the cervical spine.