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Tropical forest loss currently exceeds forest gain, leading to a net greenhouse gas emission that exacerbates global climate change. This has sparked scientific debate on how to achieve natural climate solutions. Central to this debate is whether sustainably managing forests and protected areas will deliver global climate mitigation benefits, while ensuring local peoples' health and well-being. Here, we evaluate the 10-y impact of a human-centered solution to achieve natural climate mitigation through reductions in illegal logging in rural Borneo: an intervention aimed at expanding health care access and use for communities living near a national park, with clinic discounts offsetting costs historically met through illegal logging. Conservation, education, and alternative livelihood programs were also offered. We hypothesized that this would lead to improved health and well-being, while also alleviating illegal logging activity within the protected forest. We estimated that 27.4 km2 of deforestation was averted in the national park over a decade (∼70% reduction in deforestation compared to a synthetic control, permuted P = 0.038). Concurrently, the intervention provided health care access to more than 28,400 unique patients, with clinic usage and patient visitation frequency highest in communities participating in the intervention. Finally, we observed a dose-response in forest change rate to intervention engagement (person-contacts with intervention activities) across communities bordering the park: The greatest logging reductions were adjacent to the most highly engaged villages. Results suggest that this community-derived solution simultaneously improved health care access for local and indigenous communities and sustainably conserved carbon stocks in a protected tropical forest.

Objective: Comorbid asthma and obesity leads to poorer asthma outcomes, partially due to decreased response to controller medication. Increased oral steroid prescription, a marker of uncontrolled asthma, may follow. Little is known about this phenomenon among Latino children. Our objective was to determine whether obesity is associated with increased oral steroid prescription for children with asthma, and to assess potential disparities in these associations between Latino and non-Hispanic white children. Methods: We examined electronic health record data from the ADVANCE national network of community health centers. The sample included 16,763 children aged 5–17 years with an asthma diagnosis and ≥1 ambulatory visit in ADVANCE clinics across 22 states between 2012 and 2017. Poisson regression analysis was used to examine the rate of oral steroid prescription overall and by ethnicity controlling for potential confounders. Results: Among Latino children, those who were always overweight/obese at study visits had a 15% higher rate of receiving an oral steroid prescription than those who were never overweight/obese [rate ratio (RR) = 1.15, 95% CI 1.05–1.26]. A similar effect size was observed for non-Hispanic white children, though the relationship was not statistically significant (RR = 1.10, 95% CI: 0.92–1.33). The interactions between body mass index and ethnicity were not significant (sometimes overweight/obese p = 0.95, always overweight/obese p = 0.58), suggesting a lack of disparities in the association between obesity and oral steroid prescription by ethnicity. Conclusions: Children with obesity received more oral steroid prescriptions than those at a healthy weight, which may be indicative of worse asthma control. We did not observe significant ethnic disparities. [ABSTRACT FROM AUTHOR]

The increase in global water insecurity is one of the first perceivable effects of climate change. Two billion people are now without access to safe drinking water, and four billion experience water stress at least once a year, primarily in low per-capita emission countries. This nexus between climate change and water insecurity has significant implications for the global economy, with the water sector contributing 10% of global emissions. Though traditionally a local issue, climate finance mechanisms like the voluntary carbon market (VCM) present opportunities for a global, sustainable, performance-based funding stream to address water insecurity. Since 2010, water-related carbon projects have yielded over 45 million emission reduction credits. Our analysis estimates a global potential of over 1.6 billion tCO2e per year across various water project subsectors. At a $10 per credit average, this could attract over $160 billion in investments over the next decade, enhancing global water security. However, barriers like high intervention costs and limited technologies hinder widespread implementation, creating a tension between standardized and bespoke credits. We present case studies, spanning drinking water initiatives to the wastewater treatment sector that illustrate VCM's role in channeling private sector capital for water security in climate-vulnerable regions., Competing Interests: The authors declare the following competing financial interest(s): Authors Thomas, Johnson, MacDonald and Fankhauser are also affiliated and part time compensated by Virridy, a social enterprise engaged in carbon financed water treatment programs globally., (© 2024 The Authors. Published by American Chemical Society.)