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The MJA-Lancet Countdown on health and climate change was established in 2017 and produced its first Australian national assessment in 2018. It examined 41 indicators across five broad domains: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. It found that, overall, Australia is vulnerable to the impacts of climate change on health, and that policy inaction in this regard threatens Australian lives. In this report we present the 2019 update. We track progress on health and climate change in Australia across the same five broad domains and many of the same indicators as in 2018. A number of new indicators are introduced this year, including one focused on wildfire exposure, and another on engagement in health and climate change in the corporate sector. Several of the previously reported indicators are not included this year, either due to their discontinuation by the parent project, the Lancet Countdown, or because insufficient new data were available for us to meaningfully provide an update to the indicator. In a year marked by an Australian federal election in which climate change featured prominently, we find mixed progress on health and climate change in this country. There has been progress in renewable energy generation, including substantial employment increases in this sector. There has also been some progress at state and local government level. However, there continues to be no engagement on health and climate change in the Australian federal Parliament, and Australia performs poorly across many of the indicators in comparison to other developed countries; for example, it is one of the world's largest net exporters of coal and its electricity generation from low carbon sources is low. We also find significantly increasing exposure of Australians to heatwaves and, in most states and territories, continuing elevated suicide rates at higher temperatures. We conclude that Australia remains at significant risk of declines in health due to climate change, and that substantial and sustained national action is urgently required in order to prevent this., (© 2019 AMPCo Pty Ltd.)

BACKGROUND: While some evidence has potentially linked climate change to carcinogenic factors, the long-term effect of climate change on liver cancer risk largely remains unclear. OBJECTIVES: Our objective is to evaluate the long-term relationship between temperature increase and liver cancer incidence in Australia. METHODS: We mapped the spatial distribution of liver cancer incidence from 2001 to 2019 in Australia. A Bayesian spatial conditional autoregressive (CAR) model was used to estimate the relationships between the increase in temperature at different lags and liver cancer incidence in Australia, after controlling for chronic hepatitis B prevalence, chronic hepatitis C prevalence, and the Index of Relative Socio-economic Disadvantage. Spatial random effects obtained from the Bayesian CAR model were also mapped. RESULTS: The research showed that the distribution of liver cancer in Australia is spatially clustered, most areas in Northern Territory and Northern Queensland have higher incidence and relative risk. The increase in temperature at the lag of 30 years was found to correlate with the increase in liver cancer incidence in Australia, with a posterior mean of 30.57 [95% Bayesian credible interval (CrI): 0.17, 58.88] for the univariate model and 29.50 (95% CrI: 1.27, 58.95) after controlling for confounders, respectively. The results were not highly credible for other lags. DISCUSSION: Our Bayesian spatial analysis suggested a potential relationship between temperature increase and liver cancer. To our knowledge, this research marks the first attempt to assess the long-term effect of global warming on liver cancer. If the relationship is confirmed by other studies, these findings may inform the development of prevention and mitigation strategies based on climate change projections. https://doi.org/10.1289/EHP14574, Introduction Liver cancer is a disease with a heavy burden on patients. Global Burden of Disease Study 2019 (GBD 2019) reported that there were 534,000 new cases and 485,000 deaths [...]

Anthropogenic climate change appears to be increasing the frequency, duration and intensity of extreme weather events. Such events have already had substantial impacts on socioeconomic development and population health. Climate change's most profound impacts are likely to be on food, health systems and water. This paper explores how climate change will affect food, human health and water in China. Projections Indicate that the overall effects of climate change, land conversion and reduced water availability could reduce Chinese food production substantially--although uncertainty Is Inevitable in such projections. Climate change will probably have substantial impacts on water resources--e.g. changes in rainfall patterns and increases in the frequencies of droughts and floods in some areas of China. Such impacts would undoubtedly threaten population health and well-being in many communities. In the short-term, population health in China is likely to be adversely affected by Increases in air temperatures and pollution. In the medium to long term, however, the indirect impacts of climate change--e.g. changes in the availability of food, shelter and water, decreased mental health and well-being and changes in the distribution and seasonality of infectious diseases--are likely to grow in importance. The potentially catastrophic consequences of climate change can only be avoided if all countries work together towards a substantial reduction in the emission of so-called greenhouse gases and a substantial increase in the global population's resilience to the risks of climate variability and change. Le changement climatique anthropique est a l'origine d'une augmentation de la frequence, de la duree et de l'intensite de phenomenes meteorologiques extremes. Ces phenomenes ont deja eu des consequences notables sur le developpement socioeconomique et la sante des populations. Les effets les plus marques du changement climatique se manifesteront certainement au niveau de l'alimentation, des systemes sanitaires et de l'eau. Cet article examine la maniere dont le changement climatique affectera l'alimentation, la sante humaine et l'eau en Chine. Selon les previsions, les effets globaux du changement climatique, la conversion des terres et la diminution de l'eau disponible pourraient considerablement reduire la production alimentaire chinoise, bien que de telles previsions comportent inevitablement un certain degre d'incertitude. Le changement climatique aura probablement des consequences importantes sur les ressources en eau, avec par exemple des modifications des regimes de precipitations ou encore des secheresses et des inondations plus frequentes dans certaines regions de Chine. Ces effets mettront indubitablement en peril la sante et le bien-etre de nombreuses communautes. A court terme, la sante des populations en Chine devrait se trouver affectee par l'augmentation des temperatures de l'air et de la pollution. Sur le moyen et le long terme, cependant, ce sont les effets indirects du changement climatique (par ex., changements au niveau de la disponibilite des denrees alimentaires, de l'eau et des lieux de residence, degradation de la sante mentale et du bien-etre des personnes, changements dans la repartition et la saisonnalite des maladies infectieuses) qui devraient prendre de l'importance. Les consequences potentiellement catastrophiques du changement climatique ne peuvent etre evitees que si tous les pays ouuvrent ensemble en vue de reduire sensiblement les emissions de gaz a effet de serre et d'augmenter la resilience de la population mondiale face aux risques de variabilite et de changement climatiques. Parece que el cambio climatico antropogenico esta aumentando la frecuencia, duracion e intensidad de fenomenos meteorologicos extremos. Tales fenomenos ya han afectado enormemente el desarrollo socioeconomico y la salud publica. Los efectos mas profundos del cambio climatico tienen posibilidades de afectar a la alimentacion, los sistemas sanitarios y el agua. En este articulo se explora como influira el cambio climatico en la alimentacion, la salud publica y el agua en China. Las previsiones indican que los efectos generales del cambio climatico, la conversion del suelo y la menor disponibilidad de agua podrian reducir la produccion de alimentacion en China de forma sustancial, a pesar de que la incertidumbre es inevitable en dichas previsiones. Es probable que el cambio climatico afecte de manera importante a los recursos de agua, por ejemplo, cambios en los patrones de las precipitaciones y aumentos de la frecuencia de las sequias y las inundaciones en algunas zonas de China. Sin duda, tales impactos amenazaran la salud publica y el bienestar de muchas comunidades. A corto plazo, la salud publica china se vera perjudicada por los aumentos de la temperatura del aire y la contaminacion. Sin embargo, de medio a largo plazo, es probable que aumente la importancia de los efectos indirectos del cambio climatico, como los cambios de la disponibilidad de alimentos, refugioy agua, una reduccion del bienestar y la salud mental y cambios en la propagacion y estacionalidad de enfermedades infecciosas. Las posibles consecuencias catastroficas del cambio climatico pueden evitarse unicamente si todos los paises trabajan juntos para reducir en gran medida la emision de los conocidos gases de efecto invernadero y para aumentar la resistencia de la poblacion mundial ante los riesgos de la variabilidad y el cambio climaticos., Introduction The consequences of climate change will be felt in all of the world's continents, countries and populations. (1) As climate change proceeds, continuing temperature increases and changes in precipitation [...]

BACKGROUND: Between 2010 and 2012, the World Health Organization Division of Pacific Technical Support led a regional climate change and health vulnerability assessment and adaptation planning project, in collaboration with health sector partners, in 13 Pacific island countries--Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Marshall Islands, Nauru, Niue, Palau, Samoa, Solomon Islands, Tonga, Tuvalu, and Vanuatu. OBJECTIVE: We assessed the vulnerabilities of Pacific island countries to the health impacts of climate change and planned adaptation strategies to minimize such threats to health. METHODS: This assessment involved a combination of quantitative and qualitative techniques. The former included descriptive epidemiology, time series analyses, Poisson regression, and spatial modeling of climate and climate-sensitive disease data, in the few instances where this was possible; the latter included wide stakeholder consultations, iterative consensus building, and expert opinion. Vulnerabilities were ranked using a 'likelihood versus impact' matrix, and adaptation strategies were prioritized and planned accordingly. RESULTS: The highest-priority climate-sensitive health risks in Pacific island countries included trauma from extreme weather events, heat-related illnesses, compromised safety and security of water and food, vector-borne diseases, zoonoses, respiratory illnesses, psychosocial ill-health, noncommunicable diseases, population pressures, and health system deficiencies. Adaptation strategies relating to these climate change and health risks could be clustered according to categories common to many countries in the Pacific region. CONCLUSION: Pacific island countries are among the most vulnerable in the world to the health impacts of climate change. This vulnerability is a function of their unique geographic, demographic, and socioeconomic characteristics combined with their exposure to changing weather patterns associated with climate change, the health risks entailed, and the limited capacity of the countries to manage and adapt in the face of such risks. http://dx.doi.org/10.1289/ehp.1509756, Introduction Climate change is widely acknowledged to be one of the most serious global threats to future human population health and international development (Costello et al. 2009; Stephenson et al. [...]

Community biogas facilities are being implemented in many informal urban settlements across Africa, often funded by foreign aid. We measured the public health impacts of a facility in Ethiopia, particularly the effects of training, in the context of extreme poverty. Two waves of panel-data were generated by household surveys (N = 200 per wave), informed by participatory focus groups, and a propensity-score matching technique was applied. After controlling for household distance from the facility, training itself generated positive effects on health including use of improved sanitation facilities and self-assessed health. We conclude that training should be considered a key component in biogas development. [ABSTRACT FROM AUTHOR]

Background: Climate change is recognised as having a 'multiplier effect' on food insecurity and adverse health experiences of communities in the Pacific region. Islands are especially at risk due to their limited land availability, population pressures and, in the case of atolls, their low-lying topography making them vulnerable to sea level rise. Aim: This review examines the literature describing the relationship between climate change, food security and health in Kiribati. Method: A narrative review was conducted, looking at both peer-reviewed and non-peer-reviewed literature available online from 1 January 2008 to 14 August 2018, the search date. Sources from three databases of peer-reviewed literature, Google and additional sources from reference lists were included in the review. Results: Thirty-seven items were included in this review. These show climate change is having a noticeable impact on food security and health in Kiribati. Four themes were identified from the literature that provide different perspectives to the problem outlined. Conclusion: Climate change is a pressing concern for the government of Kiribati and communities alike, and yet the problem is worsening, not improving. Further research is required to look at effective policies and cultural perspectives to address this problem. [ABSTRACT FROM AUTHOR]

[Display omitted] • Four of the planetary boundaries have been exceeded and other are under pressure. • Planetary changes pose increasing threats to human health. • Imperative to identify the research progress and knowledge gaps in this field. It has been widely recognised that the threats to human health from global environmental changes (GECs) are increasing in the Anthropocene epoch, and urgent actions are required to tackle these pressing challenges. A scoping review was conducted to provide an overview of the nine planetary boundaries and the threats to population health posed by human activities that are exceeding these boundaries in the Anthropocene. The research progress and key knowledge gaps were identified in this emerging field. Over the past three decades, there has been a great deal of research progress on health risks from climate change, land-use change and urbanisation, biodiversity loss and other GECs. However, several significant challenges remain, including the misperception of the relationship between human and nature; assessment of the compounding risks of GECs; strategies to reduce and prevent the potential health impacts of GECs; and uncertainties in fulfilling the commitments to the Paris Agreement. Confronting these challenges will require rigorous scientific research that is well-coordinated across different disciplines and various sectors. It is imperative for the international community to work together to develop informed policies to avert crises and ensure a safe and sustainable planet for the present and future generations. [ABSTRACT FROM AUTHOR]

Abstract Objectives Evidence is limited on the relative contribution of different temperature exposures (i.e., heat, cold and significant temperature variability) to mortality. This study aims to examine mortality risk and associated mortality burden from heat, cold, and temperature variability in Australia. Methods We collected daily time-series data on all-cause deaths and weather variables for the five most populous Australian cities (Sydney, Melbourne, Brisbane, Adelaide, and Perth), from 2000 to 2009. Temperature variability was calculated from the standard deviation of hourly temperatures between two adjacent days. Three-stage analysis was used. We firstly used quasi-Poisson regression models to model the associations of mortality with heat (mean temperature) during the warm season, with cold (mean temperature) during the cold season, and with temperature variability all year round, while controlling for long-term trend and seasonality, day of week, and population change over time. We then estimated the effects of different non-optimum temperatures using the simplified log-linear regression model. Finally, we computed and compared the fraction (%) of deaths attributable to different non-optimum temperatures. Results The greatest percentage increase in mortality was for cold (2.0%, 95% confidence interval (CI): 1.4%, 2.6%), followed by heat (1.2%, 95% CI: 0.7%, 1.7%), and temperature variability (0.5%, 95% CI: 0.3%, 0.7%). There was no clear temporal pattern in mortality risk associated with any temperature exposure in Australia. Heat, cold and temperature variability together resulted in 42,414 deaths during the study period, accounting for about 6.0% of all deaths. Most of attributable deaths were due to cold (61.4%), and noticeably, contribution from temperature variability (28.0%) was greater than that from heat (10.6%). Conclusions Exposure to either cold or heat or a large variation in temperature was associated with increased mortality risk in Australia, but population adaptation appeared to have not occurred in most cities studied. Most of the temperature-induced deaths were attributable to cold, and contributions from temperature variability were greater than that from heat. Our findings highlight that, in addition to heat and cold, temperature variability needs to be considered in assessing and projecting the health impacts of climate change. Graphical abstract Unlabelled Image Highlights • Heat, cold, and temperature variability (TV) could increase mortality in Australia. • Mortality risk from any temperature exposure did not increase or decrease over time. • Cold posed the greatest mortality risk and cased the largest mortality burden. • TV posed the lowest mortality risk but cased more mortality burden than heat. • Heat, cold, and TV together accounted for about 6.0% of all deaths. [ABSTRACT FROM AUTHOR]

Vietnamese immigrants represent a substantial culturally and linguistically diverse population of Australia, but little is known about the health-related effects of acculturation in this population. This study investigated the relationship between measures of acculturation and lifestyle behaviors and health status among 797 older Vietnam-born Australians who participated in the 45 and Up Study (www.45andup.org.au). The findings suggested that higher degrees of acculturation were associated with increased consumption of red meat, white meat, and seafood; higher levels of physical activities; and lower prevalence of overweight and obesity, type 2 diabetes, and smoking (in men). Targeted health messages could emphasize eating more vegetables, avoiding smoking and alcohol drinking, and increasing levels of physical activity. [ABSTRACT FROM PUBLISHER]

Anthropogenic climate change appears to be increasing the frequency, duration and intensity of extreme weather events. Such events have already had substantial impacts on socioeconomic development and population health. Climate change's most profound impacts are likely to be on food, health systems and water. This paper explores how climate change will affect food, human health and water in China. Projections indicate that the overall effects of climate change, land conversion and reduced water availability could reduce Chinese food production substantially -- although uncertainty is inevitable in such projections. Climate change will probably have substantial impacts on water resources -- e.g. changes in rainfall patterns and increases in the frequencies of droughts and floods in some areas of China. Such impacts would undoubtedly threaten population health and well-being in many communities. In the short-term, population health in China is likely to be adversely affected by increases in air temperatures and pollution. In the medium to long term, however, the indirect impacts of climate change -- e.g. changes in the availability of food, shelter and water, decreased mental health and well-being and changes in the distribution and seasonality of infectious diseases -- are likely to grow in importance. The potentially catastrophic consequences of climate change can only be avoided if all countries work together towards a substantial reduction in the emission of so-called greenhouse gases and a substantial increase in the global population's resilience to the risks of climate variability and change. [ABSTRACT FROM AUTHOR]