Category: Climate change and health

Human health is entwined with the health of our planet

Posted on by janet.crompton

 

It’s a short time since COP26 finished in Glasgow. Many colleagues from the University of Bristol were there to discuss their research and share knowledge with those who are making decisions about policies that impact everyone’s futures. When we think about climate change, we often think about the health of the planet and the natural world, but the health of our planet is entwined to the health of the human population too. Here, Elizabeth Blackwell Institute Director, Rachael Gooberman-Hill, gives a timely update on our research looking at the intersection between climate and health.

We’re already seeing local and global impacts of climate change on human health. The World Health Organization states that in the 20 years from 2030 to 2050 climate change will cause around 250,000 additional deaths per year, which is a timeframe that starts in just eight years from now.

These, arguably preventable, deaths will relate to malnutrition, malaria, diarrhoea and heat. Health impacts of climate change will disproportionately affect people who are already vulnerable in other ways, including people who are young, old, living with other conditions, or living in situations of vulnerability including poverty and other dimensions of disadvantage. Climate change is associated with changes in infectious diseases and non-communicable conditions, such as mental health difficulties. Heat and extreme weather events have major impact on health, cause forced migration and these issues are global in scale. In the UK, extreme weather events and heat are already visible and are likely to become more common and more impactful.

Embedding climate in current research

Broadly speaking, research efforts include work to reduce rise in our planet’s temperature and attempts to address, mitigate, and adapt to the impact of the rises that are already happening. At the Elizabeth Blackwell Institute we are working with the Cabot Institute for the Environment. As researchers, we can change focus of our research, can embed climate in the research that we are already planning or doing, and we can also consider that all of the research that we do is already impacted by climate change and will already have much to add to the evidence base that can underpin change and make a difference.

Mapping activity in climate research

The University of Bristol has a world-leading track record in environment-focused research already. We recently mapped the research activity in this area and identified 39 climate and health related research projects and over 150 members of our research community working in this area. We work on many topics, including extreme weather events, heat, water and sanitation, animal health, crops and nutrition, and social impacts of climate change. The University is an active member of the Met Office Academic Partnership (MOAP), we contribute considerable and internationally recognised expertise to the Intergovernmental Panel on Climate Change (IPCC), including in the crucial assessment reports which provide the scientific evidence base. We’re active in the GW4 Climate Alliance, comprising the Universities of Bristol, Cardiff, Bath, and Exeter.

Potential to pivot

There is real potential now to build this area even more. Many members of our University are deeply concerned about climate change and many are doing work that helps, or want to do so. We are a community whose research is often driven by our sense of social responsibility and we’ve seen before how our desire to make a difference can drive new focus. In the early days of the COVID-19 pandemic we saw large parts of the University’s research community turn skills and attention to the virus and its impact. At the Elizabeth Blackwell Institute we supported over 90 projects that focused on COVID-19 and owe thanks to everyone for the vast effort that has been put into research with real world impact. The effort to focus on COVID-19 showed how our expert researchers can pivot quickly onto new topic areas, although other topics remained urgent and important alongside our pandemic-related work.

Supporting more climate research

The Elizabeth Blackwell Institute wants to support the desire and need to work on climate change and health, whether that’s to enable people to pivot to the area, build on existing work or to encompass climate change into existing workstreams. We’ve already supported projects focused on climate change and health, with particular emphasis on interdisciplinary research. We want to support even more. As we move forward from COP26, please consider how your research can address climate change and health and let us know about your plans and ideas.

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This blog is by Elizabeth Blackwell Institute Director, Rachael Gooberman-Hill . View the original post.

Rachel Gooberman-Hill

Violence and mental health are likely to get worse in a warming world

Posted on by janet.crompton
As heat levels increase, mental health conditions are likely to worsen.
Pxfuel

Extreme weather has been the cause of some of the biggest public health crises across the world in recent years. In many cases, these have been enhanced by human-induced climate change. For instance, in 2003, high summer temperatures in Europe were believed to cause 50,000 to 70,000 excess deaths across 16 European countries.

Globally, it’s been estimated that a total of 296,000 deaths over the past two decades have been related to heat.

But heat doesn’t just affect physical health. It can have equally serious effects on mental health conditions. Research has shown that rising temperatures are associated with an increase in suicides and in violent behaviour, as well as exacerbating mood and anxiety disorders.

Studies in England and Wales conducted between 1993 and 2003 have revealed that, when temperatures were above 18°C, every 1°C rise in temperature was associated with a 3.8% increased risk of suicide across the population.

Between 1996 and 2013 in Finland, every 1°C increase in temperature accounted for a 1.7% increase in violent crime across the country. It has even been estimated that 1.2 million more assaults might occur in the United States between 2010 to 2099 than would without climate change.

The association between high temperatures and mental health is an active area of research. Scientists have found that some health consequences of increased heat, like disturbed sleep and levels of serotonin – a hormone critical for adjusting our feelings, emotions and behaviours – might play a role in triggering the appearance of mental health conditions.

A world map coloured red, with darker areas indicating greater temperature rises (up to 6°C).
This map shows the projected changes in daily temperature extremes at 1.5°C of global warming compared to the pre-industrial period (since 1861).
Author provided

Sleep deprivation often occurs during heatwaves, which then may lead to frustration, irritability, impulsive behaviours and even violence.

Extreme temperatures, such as those observed during heatwaves, are also found to be associated with some forms of dementia and disturbed mental health states, especially for those who are already in vulnerable conditions such as psychiatric patients.

And low levels of serotonin are associated with depression, anxiety, impulsivity, aggression and occurrence of violent incidents.

Implications

In the future, heatwaves will be hotter and last longer. Temperature records are likely to be broken ever more frequently as the world continues to warm. In north-west Asia, for example, temperatures could increase by 8.4°C by 2100.

A world that is on average 1.5°C warmer will see many average regional temperatures rise by more than this. This problem is compounded as the population – and therefore the number of people living in cities – increases. By 2050, it is projected that two thirds of the world’s population will live in urban areas.

A city in summer
Cities are often hotter than rural regions, exacerbating negative mental health effects caused by heat.
PedroFigueras/Pixabay

Urban environments are known to be warmer than their rural surroundings, a phenomenon known as the “urban heat island”. Climate projections show not only that cities will warm faster than rural areas, but that this effect is increased at night. This may further exacerbate the effects of heat extremes on our sleep.

Both adaptation to and mitigation of climate change will be necessary to lessen these potentially devastating effects as much as possible.

Options for adapting our lives to a warmer world could include increasing air circulation within buildings and adjusted work hours in times of extreme heat. Paris, for example, has already created a network of “cool islands”: green and blue spaces such as parks, ponds and swimming pools which provide places to seek refuge from the heat.

Most simply, educating people on the potential impacts of heat on mental health, aggression and violence – allowing them to understand exactly why it is so important to support initiatives that help keep our planet cool – could support better mental health at the same time as fighting the climate crisis.

—————————————–The Conversation

This blog is written by Cabot Institute for the Environment members Dr Mary Zhang, Senior Research Associate in Policy Studies, University of Bristol; Professor Dann Mitchell, Associate Professor in Atmospheric Sciences, University of Bristol, and Dr Vikki Thompson, Senior Research Associate in Geographical Sciences, University of Bristol

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Dann Mitchell
Mary Zhang
Vikki Thompson

 

 

Read all blogs in our COP26 blog series:

Life of breath: Understanding air pollution and disease through the Arts

Posted on by janet.crompton
Media vita in morte sumus.  Image from You Tube.

I have written on the Life of Breath blog about the symmetry between breathing as life, and breathlessness as death (as it appears in the words of the haka – see ‘I will not be drowned’).  The line media vita in morte sumus (‘in the midst of life we are in death’) was supposedly composed around the end of the first millennium, but is now believed to be a much older phrase, encapsulating a still older idea: that understanding something means encountering and attempting to understand its counterpart (1).  Just as All Hallows and All Saints are separated by nothing more than midnight, life and death cannot be separated from (nor understood without) each other. The Life of Breath project is a five-year senior investigator award funded by the Wellcome Trust (PIs Prof. Havi Carel at the University of Bristol and Prof. Jane Macnaughton at Durham University), considering breathing and its ‘pathological derivative’ breathlessness as two halves of a whole.

This sense of opposing ideas, linked and hinged in the middle, can also be found in some of the causes of breathlessness, such as smoke. Smoke resists definition. It can be dirty, as in Blake’s poem ‘London’ (‘Every black’ning Church appals’) or at the beginning of ‘Paradise Lost’ (‘a pitchy cloud of locusts’); or it can be cleansing, for example when fumigating a building. It can be a tool, to give food flavour and longevity, or to stupefy bees; or it can be a silent killer in a house fire, more dangerous than the fire itself. Smoke can also be holy, as in the veils of smoke and incense that surround God in the Old Testament. Steven Connor speaks of the God encountered in the Old Testament as ‘a smoky God … His ineffability and unapproachability are signified in the cloud of smoke’ that descends on Mount Sinai, and notes the duality I just mentioned, stating that ‘Smoke can be life, spirit, meaning itself; but it is also horror, filth, chaos’(2).  It seems natural, then, that we can find smoke both comforting (smokers may enjoy the smell of cigarette smoke, church-goers the spicy smell and ritual of the thurible) and disturbing: something that causes us to cough or wheeze, or which, over time, permanently compromises our ability to sing, speak or breathe (3).

Nelson’s Column during The Great
Smog, 1952.  Image taken from
geograph.org.uk via Wikipedia

This last is our most pressing concern when we consider smoke discharged directly into the air, whether it is via an exhaust pipe or a chimney (what Connor calls ‘the sewer into the sky’). These ideas are also bound up in historical approaches to breathlessness, respiratory diseases and conditions, and their relationship with smoke and air pollution (4).  A member of the project advisory board, Mark Jackson, notes that, before chronic or seasonal respiratory conditions such as asthma were properly understood, patients were given conflicting advice. Those suffering from hay fever or ‘summer sneezing’ were often told to treat their condition with ‘fresh air’, visiting the coast to inhale the supposedly clean sea breezes (5).  Elsewhere, Jackson tells us that during the Industrial Revolution, asthma sufferers might be given the opposite advice and told to breathe sooty air for its supposedly antibacterial properties (6).  Both Connor and Jackson write about the Great Smog of 1952, which killed several thousand people in the capital through exacerbating or inducing respiratory and cardiac disease. Here we might note another pair (the heart and the lungs) that cannot be easily separated, as we discussed at the first meeting of the core project team (see ‘Taking a deep breath’). Jackson notes that the link between pollution and disease was already well established before the Great Smog, and before the 1956 Clean Air Act it led to (7).  He states that the Act focused on ‘visible’ pollution, specifically prohibiting the emission of ‘dark smoke’, but paid less attention to invisible pollutants such as sulphur oxides and carbon monoxide.

As well as ignoring or dismissing pollutants that we cannot see, perhaps it is a natural human response to look on the vastness of the sky or the ocean, and assume that their sheer size dwarfs anything discharged into those spaces, rendering it dilute and harmless. As suggested by the invisible poisonous gases wafting stealthily around our towns and cities (or, indeed, our supposedly clean countryside and coastline), very often we are oblivious to that which threatens us. However, complacency offers us no protection from the consequences of air pollution, particularly for respiratory health. For example, chronic obstructive pulmonary disease (COPD) is now the fourth most-common cause of death worldwide, but there is no comprehensive history of breathlessness in a clinical context, a lacuna that the Life of Breath project aims to fill. The project will also attempt to situate breathing and breathlessness in their proper context via an interdisciplinary approach that draws on patient experience and clinical practice, as well as other relevant disciplines, such as medical humanities, history, philosophy, literature and anthropology, using each area to inform the others.

The funeral sentences in the Book of Common Prayer include the line ‘in the midst of life we are in death’. They go on, ‘Thou knowest, Lord, the secrets of our hearts’. As the Life of Breath project indicates, our lungs have secrets, too.

References

  1. The phrase media vita in morte sumus is sometimes attributed to Notker I, also known as Notker the Stammerer, a Benedictine monk and poet. He is supposed to have coined it after observing a half-built bridge stretching shakily out over a chasm.
  2. Steven Connor, ‘Smog’, a talk broadcast on Nightwaves (Radio 3), 2nd December 2002, to mark fifty years since London’s Great Smog.
  3. See Steven Connor’s essay ‘Whisper Music’ for his (and Aristotle’s) comments on coughing.
  4. Steven Connor, ‘Unholy Smoke’, a talk given at Trailing Smoke, Art Workers Guild, London, 12 November 2008, accompanying the exhibition Smoke.
  5. See Mark Jackson, Allergy: The history of a modern malady (London: Reaktion).
  6. Mark Jackson (2004), ‘Cleansing the air and promoting health: the politics of pollution in post-war Britain’, in Medicine, the Market and Mass Media: Producing Health in the Twentieth Century, eds. Virginia Berridge and Kelly Loughlin (London: Routledge).
  7. Jackson, ‘The politics of pollution’.

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This blog is written by Jess Farr-Cox in the School of Arts at the University of Bristol, Research Secretary on the Life of Breath project.

A full description of the scope of research, including all the different research strands, can be found on the About the project page of the project website.

Do people respond to air pollution forecasts?

Posted on by janet.crompton

In 2010, the House of Commons Environmental Audit Committee published a report on air quality in which they concluded that “poor air quality probably causes more mortality and morbidity than passive smoking, road traffic accidents or obesity”. Concerned that the Government was still not giving air quality a high enough priority, the Committee published another report in 2011. To date, the Committee’s main recommendations have not been implemented. Amidst new evidence on the negative effects of air pollution on health and a court case that found the UK Government guilty of failing to meet EU air quality targets, the Committee published a third report on air quality last week.

One of the Committee’s recommendations is that the Government works more closely with the Met Office, the BBC and other broadcasters to ensure that forecasts of high air pollution episodes are disseminated widely together with advice on what action should be taken. The Committee’s rationale is that information about air pollution allows individuals to take action that reduces exposure. However, avoidance behaviour, such as staying indoors, imposes a cost on individuals that might exceed the perceived gains.

A BBC weather forecast for Bristol showing the commonly
encountered “green” air pollution forecast.

In a paper published this month in the Journal of Health Economics (Link with free access until 22 January 2015) I investigate responses to air pollution warnings in England. I obtained data on the air pollution forecasts issued by Defra from 2002 to 2008. During this period the daily air pollution forecast was freely available via the internet, a Freephone telephone service, Teletext and with the weather forecast on the BBC website. The forecast was disseminated using traffic light colour-coding, with green indicating low levels of air pollution, amber moderate and red high levels. “Red” forecasts were extremely rare (3% of forecasts) and “green” forecasts very common (70% of forecasts), so a change from “green” to “amber” (27% of forecasts) was akin to an air pollution warning. Hence, I define an “amber” or “red” forecast as an air pollution warning.

Air pollution warnings and hospital emergency admissions

First, I looked at indirect evidence of avoidance behaviour by estimating the relationship between air pollution warnings and hospital emergency admissions for respiratory diseases in children aged 5 to 19 years. I controlled for actual air pollution levels and therefore essentially compared days with a certain level of air pollution for which an air pollution warning was issued with days with the same level of air pollution for which no air pollution warning was issued. If parents and children do respond to air pollution warnings by reducing their exposure or taking other preventive measures, we expect fewer emergency hospital admissions on days for which an air pollution warning was issued compared to days with the same level of air pollution but no warning.

Looking at all respiratory admissions I found no effect. Looking at a subset of respiratory admissions – admissions for acute respiratory infections such as pneumonia and bronchitis – I also found no effect. Only when I examined another subset of respiratory admissions, namely admissions for asthma, did I find that air pollution warnings reduce hospital emergency admissions, by about 8%.

Presumably, it is less costly for asthmatics to respond to an air pollution warning. Standard advice for asthmatics is to adjust the dose of their reliever medicine and to make sure they carry their inhaler with them. Other types of respiratory disease require far more disruptive preventive measures such as staying indoors, making the cost of responding to air pollution warnings larger than the perceived gains.

Direct evidence of avoidance behaviour: visitors to Bristol Zoo

To find direct evidence of avoidance behaviour, I examined daily visitor counts to Bristol Zoo Gardens. Zoos are attractive destinations for families with children. Even with some animal houses under cover, most people will consider a zoo visit to be an outdoor activity and therefore susceptible individuals might adjust their plans to the air pollution forecast.  I found that lower temperature, more rain and higher wind speed reduced visitor numbers but found no effect of air pollution warnings on visitor numbers. Only when I looked at members – visitors who have an annual membership that entitles them to unlimited visits for a year – did I find that air pollution warnings reduce visits by about 6%. For members it is less costly to respond to air pollution warnings as they tend to be local residents who can just drop in for a quick visit. Thus, the perceived gains from postponing a visit are more likely to exceed the cost of postponing than for day visitors.

This graph shows monthly means of visitors to Bristol Zoo Gardens, daily maximum temperature and monthly total of air pollution warnings. Day visitors (grey bars) are far more responsive to temperature (yellow line) than to air pollution warnings (purple bars). Members’ visits (green bars) seem to be fewer in months with more air pollution warnings (purple bars).

Overall, my results show that whether individuals respond to air quality information depends on the costs and benefits of doing so: where costs are low and the benefits clear, responses are higher. This finding suggests, that wider dissemination of high air pollution forecasts as recommended by the Commons Environmental Audit Committee may not bring about the desired prevention of adverse health effects from air pollution. The Committee’s other recommendations aimed at lowering air pollution levels are more likely to succeed in preventing ill health.

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This blog is written by Cabot Institute member Katharina Janke, Research Associate in Applied Microeconomics and Health Economics at the Centre for Market and Public Organisation at the University of Bristol.
Katharina Janke

Fostering interdisciplinarity in sustainable development

Posted on by janet.crompton

On 15 October 2014, we had a fascinating talk from Prof. Wendy Gibson from the University of Bristol’s School of Biological Sciences launching the University’s ‘Sustainable Development and Poverty Reduction: Capacity Building in the face of Environmental Uncertainty’ network.

The Cabot Institute is supporting a number of ventures to foster an interdisciplinary network of academics across the University, whose work can be included under the broad ‘development studies’/’international development’ umbrella, due to its direct or indirect impact on sustainable development and poverty reduction in the Global South.

Uniquely, at Bristol, this includes academics working in the social sciences, but also in Physical Geography, Earth Sciences, Public Health, Engineering, Biological and Veterinary Sciences, to name but a few.  This ‘International Development Discussion Forum’ will have a regular monthly slot and it is therefore hoped that participants will come regularly, not because they may be specialists in the topic of that month’s presentation, but in order to hear the kinds of questions that parasitologists, or engineers, or lawyers, for example, raise for development research; questions that they can, in turn, contribute to from their own discipline.

Coping with parasitic diseases in Africa

 

Trypanosomes in human blood.
Credit: University of Bristol

The topic of Wendy’s talk was the extensive research she has undertaken as a parasitologist on the tsetse fly as a vector for trypanosomes, parasites which cause African sleeping sickness, or HAT – Human African Trypanosomiasis.  In light of the global media coverage of the Ebola outbreak, Wendy’s measured reminder about the ongoing impact of a lower profile disease such as HAT, on people and animals in rural areas of sub-Saharan Africa, was sobering.  Not only does the disease have a devastating impact on affected communities, but diagnosis and the treatment of the disease are extremely unpleasant and involve protracted intervention.  In situations in which people are coping with a range of daily hardships that impact upon their livelihoods, including drought, poor forage and a range of different diseases affecting human and animal populations, disease-focused approaches often fail to recognise this reality.

Interdisciplinary challenges in rural healthcare

After the talk, participants were asked to focus on three specific challenges identified by Wendy:

  1. How to maintain momentum in control programs as we move towards disease eradication.
  2. How to prioritise disease risks with a finite health budget.
  3. How to get different government departments to co-operate on shared goals.

Given that the subject clearly raised so many issues relating to the challenges of public health care in sub-Saharan Africa – including issues relating to rural (as opposed to urban) poverty, governance and the state, aid and non-governmental organisations – discussions were wide-ranging.  Rather than proffering standard academic critique of the material presented, participants were asked to focus on what they, positioned as they are within their own discipline, could bring to the table.  Consequently, it was fascinating how different tables touched upon similar issues but nevertheless raised specific insights depending on the differing make-up of the tables and the expertise included on them.

Specific challenges identified included:

  •  ongoing problems with top-down interventions,
  • the forging of rural (and regional) networks,
  • the difficulties in specifying the costs of such a disease,
  • raising the profile of a such a low-profile disease when its symptoms may take some years to become manifest, and
  • the difficulties of co-ordinating NGOs, aid, and governments in relation to healthcare priorities, particularly when healthcare demands are seen to ‘compete’ with each other.

And discussions continued into the networking drinks as participants identified a number of practical and funding obstacles in undertaking the kind of real interdisciplinary research that could be of such value in responding to some of the challenges relating to a disease such as African sleeping sickness.

Quotes from participants

“I knew that some of my research might be usefully applied in developing countries, but the complex challenges and the feeling that I lack a track record in ‘development research’ put me off. Through the forum I am learning about that world, and it has been a real eye-opener. I had no idea that so much was going on across the University in this area, nor that my naivety would be treated so generously in the friendly and open discussions that we’ve had so far.”
Dr. Eric Morgan, Veterinary Parasitology and Ecology

“As a scientist I want my work to be “useful”. However, translating knowledge into effective and successful, practical outcomes takes more than just generation of that scientific knowledge. This is being increasingly recognised by funders, many of whom now have a focus on interdisciplinarity, particularly for delivering outcomes that can make a difference to people living in developing countries (e.g. the Newton Fund, but also some Research Council funding calls).  While the topic of this workshop was not within my scientific field, it was fascinating, and gave me insight into the realities and difficulties of implementing change that really does require the bringing together of many different aspects of knowledge.  I met some colleagues that would be great to collaborate with in the future in order to better deliver effective outcomes.”

Dr. Jo House, Geographical Sciences

Future discussion

On 11 November 2014, the Cabot Institute will be supporting the next discussion forum in this series in which Prof. Thorsten Wagener will be giving a talk on his ongoing work in the field of sustainable water management.  His research focuses on a systems approach, which he argues is needed to adequately understand this dynamic physical and socio-economic system with the goal to provide water security for people and nature.

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This blog has been written by Dr Elizabeth Fortin, Cabot Institute, University of Bristol Law School.

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