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Global communities increasingly struggle to provide ample healthful food for growing populations in the face of social and environmental pressures. Insect agriculture is one underexplored and innovative approach. Sustainable cultivation of nutrient-dense edible insects could help boost food access, support human nutrition, and mitigate key drivers of climate change. The edible insects industry is in its nascent stages, as relatively few entities have committed resources towards optimizing farming methods. Nevertheless, insect farming is poised to benefit food insecure populations, and the planet as a whole if more targeted research and conducive policies are implemented. The purpose of this paper is to outline the state of the science regarding edible insects, define a research agenda, and recommend policy action to support the growing industry. Edible insects are not a panacea for current challenges, but they have the potential to confer numerous benefits to people and the environment. Rigorous research is needed to establish optimal farming methods, strengthen food safety, understand health impacts of consumption, explore consumer acceptance, tackle ethical considerations, and investigate economic viability. A clear definition for insects as food, industry guidance support for obtaining generally regarded as safe designation, and collaboration by industry stakeholders to develop production standards will also help move the industry forward. Generating and galvanizing knowledge sharing networks, investing in critical interdisciplinary research, and advocating for conducive policies that support emerging entrepreneurs will be necessary to capitalize on the benefits of edible insects in the future.

The ongoing emission of greenhouse gases (GHGs) is triggering changes in many climate hazards that can impact humanity. We found traceable evidence for 467 pathways by which human health, water, food, economy, infrastructure and security have been recently impacted by climate hazards such as warming, heatwaves, precipitation, drought, floods, fires, storms, sea-level rise and changes in natural land cover and ocean chemistry. By 2100, the world’s population will be exposed concurrently to the equivalent of the largest magnitude in one of these hazards if emmisions are aggressively reduced, or three if they are not, with some tropical coastal areas facing up to six simultaneous hazards. These findings highlight the fact that GHG emissions pose a broad threat to humanity by intensifying multiple hazards to which humanity is vulnerable.

Climate change will increase extreme heat related health risks. To quantify the health impacts of mid-century climate change, we assess heat-related excess mortality across the eastern United States. Health risks are estimated using the US Environmental Protection Agency’s Environmental Benefits Mapping and Analysis Program (BenMAP). Mid-century temperature estimates, downscaled using the Weather Research and Forecasting model, are compared to 2007 temperatures at 36 km and 12 km resolutions. Models indicate the average apparent and actual summer temperatures rise by 4.5° and 3.3 °C, respectively. Warmer average apparent temperatures could cause 11,562 additional annual deaths (95% Confidence Interval, CI: 2,641–20,095) due to cardiovascular stress in the population aged 65 years and above, while higher minimum temperatures could cause 8,767 (95% CI: 5,030–12,475) additional deaths each year. Modeled future climate data available at both coarse (36 km) and fine (12 km) resolutions predict significant human health impacts from warmer climates. The findings suggest that currently available information on future climates is sufficient to guide regional planning for the protection of public health. Higher resolution climate and demographic data are still needed to inform more targeted interventions.

Given predictions of increased intensity and frequency of heat waves, it is important to study the effect of high temperatures on human mortality and morbidity. Many studies focus on heat wave-related mortality; however, heat-related morbidity is often overlooked. The goals of this study are to examine the historical observed relationship between temperature and morbidity (illness), and explore the extent to which observed historical relationships could be used to generate future projections of morbidity under climate change. We collected meteorological, air pollution, and hospital admissions data in Milwaukee, Wisconsin, for the years 1989–2005, and employed a generalized additive model (GAM) to quantify the relationship between morbidity (as measured by hospital admissions) and high temperatures with adjustment for the effects of potential confounders. We also estimated temperature threshold values for different causes of hospital admissions and then quantified the associated percent increase of admissions per degree above the threshold. Finally, the future impact of higher temperatures on admissions for the years 2059–2075 was examined. Our results show that five causes of admission (endocrine, genitourinary, renal, accidental, and self-harm) and three age groups (15–64, 75–84, >85 years) were affected by high temperatures. Future projections indicate a larger number of days above the current temperature threshold leading to an increase in admissions. Our results indicate that climate change may increase heat-related hospital admissions in the US urban mid-West and that health systems should include heat wave planning.

Climate change, as an environmental hazard operating at the global scale, poses a unique and “involuntary exposure” to many societies, and therefore represents possibly the largest health inequity of our time. According to statistics from the World Health Organization (WHO), regions or populations already experiencing the most increase in diseases attributable to temperature rise in the past 30 years ironically contain those populations least responsible for causing greenhouse gas warming of the planet. Average global carbon emissions approximate one metric ton per year (tC/yr) per person. In 2004, United States per capita emissions neared 6 tC/yr (with Canada and Australia not far behind), and Japan and Western European countries range from 2 to 5 tC/yr per capita. Yet developing countries’ per capita emissions approximate 0.6 tC/yr, and more than 50 countries are below 0.2 tC/yr (or 30-fold less than an average American). This imbalance between populations suffering from an increase in climate-sensitive diseases versus those nations producing greenhouse gases that cause global warming can be quantified using a “natural debt” index, which is the cumulative depleted CO2 emissions per capita. This is a better representation of the responsibility for current warming than a single year’s emissions. By this measure, for example, the relative responsibilities of the U.S. in relation to those of India or China is nearly double that using an index of current emissions, although it does not greatly change the relationship between India and China. Rich countries like the U.S. have caused much more of today’s warming than poor ones, which have not been emitting at significant levels for many years yet, no matter what current emissions indicate. Along with taking necessary measures to reduce the extent of global warming and the associated impacts, society also needs to pursue equitable solutions that first protect the most vulnerable population groups; be they defined by demographics, income, or location. For example, according to the WHO, 88% of the disease burden attributable to climate change afflicts children under age 5 (obviously an innocent and “nonconsenting” segment of the population), presenting another major axis of inequity. Not only is the health burden from climate change itself greatest among the world’s poor, but some of the major mitigation approaches to reduce the degree of warming may produce negative side effects disproportionately among the poor, for example, competition for land from biofuels creating pressure on food prices. Of course, in today’s globalized world, eventually all nations will share some risk, but underserved populations will suffer first and most strongly from climate change. Moreover, growing recognition that society faces a nonlinear and potentially irreversible threat has deep ethical implications about humanity’s stewardship of the planet that affect both rich and poor.

Nonsustainable depletion of our natural resources threatens ecosystems, wildlife populations, and ultimately human/societal health and well-being. Our understanding of these linkages rapidly is becoming clear, as documented in international assessments such as the Millennium Ecosystem Assessment and the United Nations Intergovernmental Panel on Climate Change (IPCC). There is a subsequent need to establish a nexus for the cross-sectoral and interdisciplinary efforts examining these ecology/health relationships. I am pleased to formally announce the establishment of a revitalized and expanded international association to do just that! The International Association for Ecology and Health was launched at the EcoHealth ONE Conference that took place October 6–9, 2006, in Madison, Wisconsin. Nearly 400 attendees, including over 250 presenters from 30 countries around the world, and from several scientific disciplines, participated in the event. Most importantly, the Conference attracted over 30 new student members, and there is a vibrant student organization within the Association. This new Association incorporates ongoing work from organizations such as the expanding Consortium for Conservation Medicine, governmental agencies such as the Canadian International Development Research Centre (IDRC), and past efforts of organizations such as the Society for Ecosystem Health, just as a few examples of spheres of science and policy coming together under this expanded and well-networked international organization. The new Association builds on and combines member scientists, academics, and practitioners. The International Association for Ecology and Health (‘‘EcoHealth,’’ serving as the official simple ‘‘acronym’’) Figure 1. International Association for Ecology and Health President Elect, Jonathan Patz, MD, MPH.

We investigated how climate change could affect ambient ozone concentrations and the subsequent human health impacts. Hourly concentrations were estimated for 50 eastern US cities for five representative summers each in the 1990s and 2050s, reflecting current and projected future climates, respectively. Estimates of future concentrations were based on the IPCC A2 scenario using global climate, regional climate, and regional air quality models. This work does not explore the effects of future changes in anthropogenic emissions, but isolates the impact of altered climate on ozone and health. The cities’ ozone levels are estimated to increase under predicted future climatic conditions, with the largest increases in cities with present-day high pollution. On average across the 50 cities, the summertime daily 1-h maximum increased 4.8 ppb, with the largest increase at 9.6 ppb. The average number of days/summer exceeding the 8-h regulatory standard increased 68%. Elevated ozone levels correspond to approximately a 0.11% to 0.27% increase in daily total mortality. While actual future ozone concentrations depend on climate and other influences such as changes in emissions of anthropogenic precursors, the results presented here indicate that with other factors constant, climate change could detrimentally affect air quality and thereby harm human health.

The World Health Organisation estimates that the warming and precipitation trends due to anthropogenic climate change of the past 30 years already claim over 150,000 lives annually. Many prevalent human diseases are linked to climate fluctuations, from cardiovascular mortality and respiratory illnesses due to heatwaves, to altered transmission of infectious diseases and malnutrition from crop failures. Uncertainty remains in attributing the expansion or resurgence of diseases to climate change, owing to lack of long-term, high-quality data sets as well as the large influence of socio-economic factors and changes in immunity and drug resistance. Here we review the growing evidence that climate-health relationships pose increasing health risks under future projections of climate change and that the warming trend over recent decades has already contributed to increased morbidity and mortality in many regions of the world. Potentially vulnerable regions include the temperate latitudes, which are projected to warm disproportionately, the regions around the Pacific and Indian oceans that are currently subjected to large rainfall variability due to the El Nino/Southern Oscillation sub-Saharan Africa and sprawling cities where the urban heat island effect could intensify extreme climatic events.

This comparative review of three assessment reports, the Intergovernmental Panel on Climate Change, (IPCC), The National Research Council (NRC), and United States Global Change Research Program (USGCRP), respectively is presented in response to comments in the press suggesting that the three reports varied substantially in their assessments of associations between global climate and infectious disease in humans. Comparisons of the assessment teams, approach, reports' findings, views on predictive modeling, recommendations to policymakers and future research are presented. All teams were interdisciplinary, two international, one US-based. Although their approaches differed somewhat, all addressed the role of climate change, El Nino and climate variability, and ultimately, human health, especially infectious disease. The panels agreed that a paucity of long-term data and complexity of relationships among factors affecting climate variability and change and human health rendered projections of current predictive models inadequate as the basis for policy decisions. Each team suggested further study of associations among climate variability/climate change and human infectious disease and downscaled models to project regional and subregional outcomes. Each added additional areas for investigation, e.g., mathematical modeling, effects of socioeconomic factors, emergence of zoonotic disease in humans, transmission dynamics of disease agents. Rather than disagreements, there were differences in emphasis on known components and on hypothesized additional contributing factors and relationships among climate and human infectious disease variables.

Professor Emeritus Anthony J. (Tony) McMichael, MBBS, PhD, who passed away on September 26, 2014 was a hugely influential pioneer of global environmental health and a giant in the field of environmental epidemiology. He could be regarded along with other legendary names like Rene Dubos and Rachel Carson, who during their lives, challenged conventional assumptions and majorly advanced our understanding of the links between our environment and our health in the twentieth century; Tony Michael’s discoveries and teachings are foundational for the global challenges facing us today in the twenty-first century. McMichael’s exemplary and impactful career includes some of the most important advancements to date in the field of environmental and occupational health. For example, McMichael was the epidemiologist and co-author for the 15-year prospective study on children’s IQ and lead exposure: the Port Pirie study. Tony therefore was among the first health scientists to provide robust quantitative evidence of the link between lead and brain function. Tony McMichael’s next major discovery applied to occupational health. Hazardous exposures in the workplace were common in our industrializing era, with subsequent morbidity and mortality among workers. Eventually, guidelines were made establishing ‘‘safe’’ levels of exposures to workers. But why did workers continue to get sick? It was Professor McMichael who first described ‘‘The Healthy Worker Effect’’—whereby very sick individuals who were no longer in the workforce were left out of risk calculations. This discovery led to lowering the exposure thresholds across numerous occupational settings. I first met Tony at the World Health Organization in 1993. At that time, WHO had just been approached by the United Nations Intergovernmental Panel on Climate Change (IPCC) to contribute a health chapter for their 2nd Assessment Report—the subject of health was missing in IPCC’s first report. Naturally, it was Professor Tony McMichael who was invited to serve as ‘‘Convening Lead Author, a role for which he graciously undertook across many IPCC Assessment Reports. He also served as the lead on many other high-level international initiatives addressing global environmental health challenges. McMichael produced over 300 peer-reviewed papers and three major books, including his 1993 book Planetary Published online: November 19, 2014

Climate change presents a significant challenge to global health. This paper examines the health impacts of climate change from extreme weather events, temperature changes, rising sea levels and changes in precipitation. These health impacts include heat-related illnesses and deaths, air pollution-related health effects, allergic diseases, infectious diseases, malnutrition, and disasters associated with extreme weather-related health effects such as hurricanes, tornadoes, droughts, fires, heavy precipitation, storms and flooding. Most populations will be impacted by climate change in the next decades, putting peoples’ lives and wellbeing at risk. Vulnerable populations across the globe will be impacted disproportionately due to climate change. It is populations that are often least responsible for climate change that experience the greatest adverse impacts, raising important moral issues of equity and fairness. In addition to reviewing the literature on the health impacts of climate change, this paper will examine issues of inequity across vulnerable populations and generations due to climate change, the health co-benefits of greenhouse gas mitigation, and potential options for adaptation to increasingly extreme weather events.

Repeatedly these days, we read about newly emergent diseases or public health catastrophes, from severe acute respiratory syndrome (SARS) and avian influenza to the 2003 European heatwave and 2005 Hurricane Katrina. New diseases have always cropped up throughout history, especially since the age of modern agriculture, which brought about a major shift in our societal practices and personal behaviors. Thus, in some ways, these new health threats are not new; but are they occurring at an accelerating frequency? Many would argue that indeed they are, and this begs the question, why? Could it be that our rapid rate of ecological and earth systems change is shifting the balance in a way that enhances disease risk? Intact ecosystems play an important role in regulating the transmission of many infectious diseases, according to the Millennium Ecosystem Assessment (an international assessment of the links between ecological conditions and human well-being (www.millenniumassessment.org)). Biological mechanisms that have altered the incidence of many infectious diseases include altered habitat (leading to changes in the number of vector breeding sites or reservoir host distribution), niche invasions or interspecies host transfers, changes in biodiversity (including loss of predator species and changes in host population density), human-induced genetic changes of disease vectors or pathogens (such as mosquito resistance to pesticides or the emergence of antibiotic-resistant bacteria), and environmental contamination of infectious disease agents. Unhealthy landscape changes are well known in the literature. New water projects may provide increased food crops, but they also provide ideal habitat for snails that serve as the intermediate reservoir host species for schistosomiasis; irrigated rice fields increase the extent of mosquito breeding areas, leading to greater transmission of mosquito-borne malaria, lymphatic filariasis, Japanese encephalitis, and Rift Valley fever. Deforestation alters malaria risk, depending on the region of the world, by favoring the proliferation of Anopheles gambiae and A. darlingi in Africa and South America, respectively. Noninfectious diseases also have their roots in environmental and ecological degradation. Unplanned urbanization and sprawl contribute to numerous health conditions in the ‘‘built’’ environment: obesity, heart disease, and diabetes are exacerbated by sedentary lifestyles from our overdependence on automobiles; heat-related mortality and respiratory illness are exacerbated by the urban ‘‘heat island’’ effect; and depression and social isolation are exacerbated by a reduction in social capital and other stresses of urbanized living. In recognition of the inextricable links between ecosystems, earth systems, and human and wildlife health, the first conference of the International EcoHealth Association (‘‘EcoHealth ONE’’) will convene in Madison, Wisconsin, October 7–10, 2006. International experts from the fields of Published online: January 21, 2006 Correspondence to: Jonathan A. Patz, e-mail: patz@wisc.edu EcoHealth 3, 66–67, 2006 DOI: 10.1007/s10393-005-0011-7

Disease outbreaks are known to be often influenced by local weather, but how changes in disease trends might be affected by long-term global warming is more difficult to establish. In a study of malaria in the African highlands, Hay et al.1 found no significant change in long-term climate at four locations where malaria incidence has been increasing since 1976. We contend, however, that their conclusions are likely to be flawed by their inappropriate use of a global climate data set. Moreover, the absence of a historical climate signal allows no inference to be drawn about the impact of future climate change on malaria in the region.