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GLOBAL HEALTH
A. Climate Change and Health
There is growing concern going into 2016 that there are limited data and knowl- edge on the long-term impact of prolonged climate change on environmental ecology, agricultural production, human health, and infectious disease. Climate change increases risks of respiratory stress, heat stress, mental anxiety, chemical contamination, and spread of food-born, insect-born, and water-born diseases. Climate change also increases risks of respiratory stress, heat stress, and cardio- vascular risk factors. The effects of prolonged climate change on environmental ecology, infectious disease, and health are understudied. Improvement in predict- able models is needed, including more baseline information. Models for causal
relationships between climate change and patterns of infectious disease need to be strengthen to measure multiple health outcomes, and they must control for cofounders (e.g., social and environ- mental). The impact of long-term climate change on the food chain and human nutritional and health status remains to be evaluated.
Sources: McCarthy JJ, Canziani O, Leary NA, et al. Climate Change 2001: Impacts, Adaptation, and Vulnerability. Contribution of Working Group II to the Third Assessment Report of the Intergovernmental Panel on Climate Change. New York, NY: Cambridge University Press; 2001 [link]. National Academy of Sciences Committee on Climate, Ecosystems, Infectious Disease, and Human Health. Under the Weather: Climate, Ecosystems, and Infectious Disease. Washington, DC: National Academy Press; 2001 [link]. National Oceanic and Atmospheric Administration [link].
US Global Change Research Program [link]. World Health Organization [link]. B. Global Burden of Health
The rst series of annual updates from the Global Burden of Disease, Injuries, and Risk Factor Study 2013 (GBD 2013) was published on 2015 September 11. Key ndings are as follows:
• Globally, all risks combined account for 57.2% of deaths and 41.6% of disability-adjusted life- years (DALYs).
• Risks quanti ed account for 87.9% of cardiovascular disease DALYs.
• Global DALYs: Six risks or clusters of risks each caused more than 5% of DALYs.
• Dietary risks accounting for 11.3 million deaths and 241.4 million DALYs.
• High systolic blood pressure accounting for 10.4 million deaths and 208.1 million DALYs.
• Child and maternal malnutrition accounting for 1.7 million deaths and 176.9 million DALYs.
• Tobacco smoke accounting for 6.1 million deaths and 143.5 million DALYs.
• Air pollution accounting for 5.5 million deaths and 141.5 million DALYs.
• High body mass index (BMI) accounting for 4.4 million deaths and 134.0 million DALYs.
• Risk factor patterns vary across regions and countries and with time.
• Leading risk factors in Sub-Saharan Africa are child and maternal malnutrition, unsafe sex,
and unsafe water, sanitation, and handwashing.
• For women from most countries in the Americas, North Africa, and the Middle East, the
leading risk factor is BMI, compared with high systolic blood pressure as the leading risk in
most of Central Europe, Eastern Europe, South Asia, and East Asia.
• For men, high systolic blood pressure and tobacco use are the leading risks in North Africa,
the Middle East, Europe, Asia, and South Africa.
☼ Implications: The GBD 2013 provides a baseline template to build future comparative risk assessment with new data for exposure, relative risks, and evidence.
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