Publications

    Obokata R, Veronis L, McLeman R. Empirical research on international environmental migration: a systematic review. Popul Environ [Internet]. 2014;36 :111-135. Publisher's VersionAbstract

    This paper presents the findings of a systematic review of scholarly publications that report empirical findings from studies of environmentally-related international migration. There exists a small, but growing accumulation of empirical studies that consider environmentally-linked migration that spans international borders. These studies provide useful evidence for scholars and policymakers in understanding how environmental factors interact with political, economic and social factors to influence migration behavior and outcomes that are specific to international movements of people, in highlighting promising future research directions, and in raising important considerations for international policymaking. Our review identifies countries of migrant origin and destination that have so far been the subject of empirical research, the environmental factors believed to have influenced these migrations, the interactions of environmental and non-environmental factors as well as the role of context in influencing migration behavior, and the types of methods used by researchers. In reporting our findings, we identify the strengths and challenges associated with the main empirical approaches, highlight significant gaps and future opportunities for empirical work, and contribute to advancing understanding of environmental influences on international migration more generally. Specifically, we propose an exploratory framework to take into account the role of context in shaping environmental migration across borders, including the dynamic and complex interactions between environmental and non-environmental factors at a range of scales.

    Rebaudet S, Sudre B, Faucher B, Piarroux R. Environmental determinants of cholera outbreaks in inland Africa: a systematic review of main transmission foci and propagation routes. J Infect Dis [Internet]. 2013;208 Suppl 1 :S46-54. Publisher's VersionAbstract

    Cholera is generally regarded as the prototypical waterborne and environmental disease. In Africa, available studies are scarce, and the relevance of this disease paradigm is questionable. Cholera outbreaks have been repeatedly reported far from the coasts: from 2009 through 2011, three-quarters of all cholera cases in Africa occurred in inland regions. Such outbreaks are either influenced by rainfall and subsequent floods or by drought- and water-induced stress. Their concurrence with global climatic events has also been observed. In lakes and rivers, aquatic reservoirs of Vibrio cholerae have been evocated. However, the role of these reservoirs in cholera epidemiology has not been established. Starting from inland cholera-endemic areas, epidemics burst and spread to various environments, including crowded slums and refugee camps. Human displacements constitute a major determinant of this spread. Further studies are urgently needed to better understand these complex dynamics, improve water and sanitation efforts, and eliminate cholera from Africa.

    Hosking J, Campbell-Lendrum D. How well does climate change and human health research match the demands of policymakers? A scoping review. Environ Health Perspect [Internet]. 2012;120 (8) :1076-82. Publisher's VersionAbstract

    BACKGROUND: In 2008, the World Health Organization (WHO) Member States passed a World Health Assembly resolution that identified the following five priority areas for research and pilot projects on climate change and human health: health vulnerability, health protection, health impacts of mitigation and adaptation policies, decision-support and other tools, and costs of health protection from climate change. OBJECTIVES: To assess the extent to which recently published research corresponds to these priorities, we undertook a scoping review of original research on climate change and human health. Scoping reviews address topics that are too broad for a systematic review and commonly aim to identify research gaps in existing literature. We also assessed recent publication trends for climate change and health research. METHODS: We searched for original quantitative research published from 2008 onward. We included disease burden studies that were specific to climate change and health and included intervention studies that focused on climate change and measured health outcomes. We used MEDLINE, Embase, and Web of Science databases and extracted data on research priority areas, geographic regions, health fields, and equity (systematic differences between advantaged and disadvantaged social groups). DISCUSSION: We identified 40 eligible studies. Compared with other health topics, the number of climate change publications has grown rapidly, with a larger proportion of reviews or editorials. Recent original research addressed four of the five priority areas identified by the WHO Member States, but we found no eligible studies of health adaptation interventions, and most of the studies focused on high-income countries. CONCLUSIONS: Climate change and health is a rapidly growing area of research, but quantitative studies remain rare. Among recently published studies, we found gaps in adaptation research and a deficit of studies in most developing regions. Funders and researchers should monitor and respond to research gaps to help ensure that the needs of policymakers are met.

    McLeman RA. Settlement abandonment in the context of global environmental change. Environmental Change Part A: Human and Policy Dimensions [Internet]. 2011;21 :S108-S120. Publisher's VersionAbstract

    This article reports findings from a study of settlement abandonment and the interactions between environmental and non-environmental factors that may give rise to it. Through a modified systematic review of scholarly literature, an inventory of 246 ancient and modern examples of settlement abandonment was generated. Common spatial and temporal parameters were identified and a typology created to summarize environmental and non-environmental drivers common across cases. Dynamic interactions of drivers that lead to a progression from vulnerability to population decline and abandonment were examined in the cases of Plymouth, Montserrat, abandoned due to volcanism in the 1990s; recent rural depopulation in northeastern Iraq and the southern marshes; outmigration from the southern Aral Sea region; and, neighbourhood abandonment and a proposal to convert abandoned lands in Detroit to commercial farming. The study finds that with growing vulnerability to environmental change across many regions, there is greater potential for increased numbers of abandonments. However, abandonment should be seen as only one possible outcome of environment and population interactions that create vulnerability and stimulate environmental migration. The study concludes with a series of observations relevant to anticipating and planning for potential population decline and settlement abandonment in the face of future global environmental change. [Copyright &y& Elsevier] Copyright of Global Environmental Change Part A: Human & Policy Dimensions is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. 

    Gracey M, King M. Indigenous Health Part 1: Determinants and Disease Patterns. The Lancet. 2009;374 :65-75.Abstract

    The world's indigenous people have low standards of health associated with poverty, malnutrition, overcrowding, poor hygiene, prevalent infections and environmental contamination. This summary is not an official abstract. Users should refer to the original published version of the material for the full abstract

    At. W. Shared waters: conflict and cooperation. Annu. Rev. Environ. Resour. [Internet]. 2007;32 :241-69. Publisher's VersionAbstract

    This review examines the state of conflict and cooperation over transboundary water resources from an environmental, political, and human development perspective. Although the potential for outright war between countries over water is low, cooperation is also often missing in disputes over transboundary resources. This background chapter will

    • Provide a brief overview of the nature of conflict and experiences of cooperation over transboundary resources.
    • Provide a conceptual basis for understanding cooperation and the costs of noncooperation over water. Indicate the possible triggers for conflict over water sharing and the implications on the livelihoods of ordinary communities. Offer evidence on the potential costs of noncooperation or even conflict over water resources.
    • Analyze power asymmetries between riparian states and how they affect the outcomes of negotiations.
    • Analyze different examples of cases that countries have used to manage the competition for water resources.
    • Propose general principles and conclusions on conflict and cooperation.
    Myers SS, Gaffikin L, Golden CD, Ostfeld RS, Redford KH, Ricketts TH, Turner WR, Osofsky SA. Human health impacts of ecosystem alteration. PNAS [Internet]. 2013;110 (47) :18753-18760. Publisher's VersionAbstract

    Human activity is rapidly transforming most of Earth’s natural systems. How this transformation is impacting human health, whose health is at greatest risk, and the magnitude of the associated disease burden are relatively new subjects within the field of environmental health. We discuss what is known about the human health implications of changes in the structure and function of natural systems and propose that these changes are affecting human health in a variety of important ways. We identify several gaps and limitations in the research that has been done to date and propose a more systematic and comprehensive approach to applied research in this field. Such efforts could lead to a more robust understanding of the human health impacts of accelerating environmental change and inform decision making in the land-use planning, environmental conservation, and public health policy realms.

    Schneider SH, Semenov S, Patwardhan A, Burton I, Magadza CHD. Assessing key vulnerabilities and the risk from climate change. In: In Climate Change 2007: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change (ed. ML Parry, OF Canziani, JP Palutikof, PJ Van der Linden, Hanson CE). ; 2007. pp. 779–810. Publisher's Version
    McCloskey LA, Southwick K. Psychosocial problems in refugee children exposed to war. Pediatrics [Internet]. 1996;97 :394. Publisher's VersionAbstract

    At any one time there are about two dozen armed conflicts throughout the world. It has been estimated that during 1993 alone violent upheavals generated about 16 million refugees worldwide. The United States has received a significant refugee population from war zones. The two largest groups of refugees entering the country since 1975 were from Southeast Asia (about 820 000) and Central America (between 800 000 and 1 900 000). Although exact statistics are unavailable, it appears that as many as half of the Central American immigrants were children.

    Various studies have documented common physical health problems in refugee children entering North America. Inactive tuberculosis and hepatitis are prevalent health risks for Southeast Asian youth; intestinal parasites and respiratory tract infections (eg, otitis media) are widespread in both Southeast Asian and Latin American refugee children. Histories of malnutrition and incomplete immunizations are common.

    Although physicians are well-equipped to treat the range of physical ailments of refugee children, some of the most serious symptoms are likely to be psychological. Recovery from physical deprivation appears to be more rapid and complete than recovery from emotional trauma and loss. The symptoms of posttraumatic stress disorder (PTSD), described below (Table 1), can be disabling and persistent and are often undetected by adult caretakers. Other psychological problems resulting from war-induced trauma and displacement, as well as immigration and chronic poverty, place refugee children at heightened risk.

    Pediatricians are typically the first and often the only contact these mothers and children have with any form of health care or social service.

    Burkle, Frederick M. J. Fortnightly review: Lessons learnt and future expectations of complex emergencies. BMJ [Internet]. 1999;319 :422-426. Publisher's VersionAbstract

    Complex emergencies today represent the ultimate pathway of state disruption. Zwi says that recent conflicts such as those in northern Iraq, Somalia, Rwanda, Angola, the former Yugoslavia, and the province of Kosovo should be interpreted as complex political disasters where “the capacity to sustain livelihood and life is threatened primarily by political factors, and in particular, by high levels of violence.”1 Although each of the over 38 major conflicts that have occurred in this decade since the end of the cold war is unique, all share similar characteristics (box). Most blatant is that they represent catastrophic public health emergencies in which over 70% of the victims are civilians, primarily children and adolescents.

    These mainly internal crises are popularly referred to as complex emergencies. The complexity refers to the multifacted responses initiated by the international community and further complicated by the lack of protection normally afforded by international treaties, covenants, and the United Nations Charter during conventional wars.

    Last JM. War and the demographic trap. Lancet [Internet]. 1993 :508. Publisher's VersionAbstract

    Advice is offered on alleviating environmental damage and the suffering of women and children from the effects of war. It is postured that the demographic trap, which was described by King and Elliott, is responsible for environmental stress and many wars. The surface cause may be identified as ideology, politics, or ethnicity, but as in the case of Bosnia, the "ethnic cleansing" makes farmland available to sustain expanding Serbian or Croatian populations. If the land is environmentally damaged by war, then there is little hope of sustainable development. Conflicts in many countries have driven people to urban areas or periurban slums because of displacement and the failure of subsistence economics. Mortality from wars has reached more than a 100 million since the early 1990s. A comparable number have died indirectly from famine and disease associated with the disruption of agriculture and infrastructure from wars. Since 1945, 66-75% of mortality victims have been civilians, of whom 15 million have been women and children. In 1993, there were at least 30 conflicts ongoing throughout the world. Not all of these conflicts are as "ferocious" as the Bosnian conflict, but these "so called low intensity wars" nonetheless disrupt and kill. The manifestations of the demographic trap can be alleviated through interventions that focus on multisectoral aid and conflict resolution. There must be a cooperative effort on the part of health workers, agricultural scientists, mediators, and development personnel. Unfortunately, the amount of development assistance from Europe and America has been reduced in recent years. The recession has affected the provision of international aid. African nations, in particular, have been affected, yet these countries remain the neediest in the world. It would appear that aid agencies have given up hope that the demographic trap can be closed. Population growth must be limited, as the only hope for relieving environmental stress, ecological collapse, and demographic entrapment. The challenge of reducing population must be recognized, and has been recognized by the Union of Concerned Scientists.

    Loutan L, Bierens de Haan D, Subilia L. The health of asylum seekers: from communicable disease screening to post-traumatic disorders. Bull Soc Pathol Exot [Internet]. 1997;90 :233-7. Publisher's VersionAbstract

    As the end of this century approaches, the pressure of migration is increasing. It is difficult to limit with restrictive measures the number of refugees and persons seeking asylum in Europe in each country, medical screening programs are organised for arriving refugees and asylum seekers. In Switzerland, they are screened for tuberculosis and hepatitis B. They are offered standard vaccinations and immunized for hepatitis B according to screening results. The prevalence of tuberculosis in asylum seekers is 414 per 100,000, 227 per 100,000 of bacteriologically active tuberculosis. Anti-HBc antibody is present in 22% of women and 39% of men. The frequency increases with age and varies greatly according to origin. Initially, refugees were screened for intestinal parasites. Over a quarter were carriers, a large majority asymptomatic. Increasing numbers of asylum seekers come from countries affected by war and insecurity. Systematic screening carried out in Geneva for previous exposure to violence revealed that 61% reported major trauma, 18% reported torture and 37% complained of symptoms such as nightmares, insomnia, flashbacks, etc. The authors discuss issues related to medical screening programs, and their relative usefulness in an increasingly mobile world where the distinction between travellers and migrants is not always clear.

    McMichael AJ. Insights from past millennia into climatic impacts on human health and survival. Proceedings of the National Academy of Sciences [Internet]. 2012. Publisher's VersionAbstract

    Climate change poses threats to human health, safety, and survival via weather extremes and climatic impacts on food yields, fresh water, infectious diseases, conflict, and displacement. Paradoxically, these risks to health are neither widely nor fully recognized. Historical experiences of diverse societies experiencing climatic changes, spanning multicentury to single-year duration, provide insights into population health vulnerability—even though most climatic changes were considerably less than those anticipated this century and beyond. Historical experience indicates the following. (i) Long-term climate changes have often destabilized civilizations, typically via food shortages, consequent hunger, disease, and unrest. (ii) Medium-term climatic adversity has frequently caused similar health, social, and sometimes political consequences. (iii) Infectious disease epidemics have often occurred in association with briefer episodes of temperature shifts, food shortages, impoverishment, and social disruption. (iv) Societies have often learnt to cope (despite hardship for some groups) with recurring shorterterm (decadal to multiyear) regional climatic cycles (e.g., El Niño Southern Oscillation)—except when extreme phases occur. (v) The drought–famine–starvation nexus has been the main, recurring, serious threat to health. Warming this century is not only likely to greatly exceed the Holocene’s natural multidecadal temperature fluctuations but to occur faster. Along with greater climatic variability, models project an increased geographic range and severity of droughts. Modern societies, although larger, better resourced, and more interconnected than past societies, are less flexible, more infrastructure-dependent, densely populated, and hence are vulnerable. Adverse historical climate-related health experiences underscore the case for abating human-induced climate change.

    McMichael AJ, Patz J, Kovats RS. Impacts of global environmental change on future health and health care in tropical countries. Br Med Bull [Internet]. 1998;54 :475-88. Publisher's VersionAbstract

    The aggregate human impact on the environment now exceeds the limits of absorption or regeneration of various major biophysical systems, at global and regional levels. The resultant global environmental changes include altered atmospheric composition, widespread land degradation, depletion of fisheries, freshwater shortages, and biodiversity losses. The drive for further social and economic development, plus an unavoidable substantial increase in population size by 2050--especially in less developed countries--will tend to augment these large-scale environmental problems. Disturbances of the Earth's life-support systems (the source of climatic stability, food, freshwater, and robust ecosystems) will affect disproportionately the resource-poor and geographically vulnerable populations in many tropical countries. Ecological disturbances will alter the pattern of various pests and pathogens in plants, livestock and humans. Overall, these large-scale environmental changes are likely to increase the range and seasonality of various (especially vector-borne) infectious diseases, food insecurity, of water stress, and of population displacement with its various adverse health consequences.

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