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Deborah Balk

Other affiliations: Baruch College, University of Hawaii, Johns Hopkins University  ...read more
Bio: Deborah Balk is an academic researcher from City University of New York. The author has contributed to research in topics: Population & Urbanization. The author has an hindex of 29, co-authored 76 publications receiving 10389 citations. Previous affiliations of Deborah Balk include Baruch College & University of Hawaii.


Papers
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Journal ArticleDOI
21 Feb 2008-Nature
TL;DR: It is concluded that global resources to counter disease emergence are poorly allocated, with the majority of the scientific and surveillance effort focused on countries from where the next important EID is least likely to originate.
Abstract: Emerging infectious diseases (EIDs) are a significant burden on global economies and public health. Their emergence is thought to be driven largely by socio-economic, environmental and ecological factors, but no comparative study has explicitly analysed these linkages to understand global temporal and spatial patterns of EIDs. Here we analyse a database of 335 EID 'events' (origins of EIDs) between 1940 and 2004, and demonstrate non-random global patterns. EID events have risen significantly over time after controlling for reporting bias, with their peak incidence (in the 1980s) concomitant with the HIV pandemic. EID events are dominated by zoonoses (60.3% of EIDs): the majority of these (71.8%) originate in wildlife (for example, severe acute respiratory virus, Ebola virus), and are increasing significantly over time. We find that 54.3% of EID events are caused by bacteria or rickettsia, reflecting a large number of drug-resistant microbes in our database. Our results confirm that EID origins are significantly correlated with socio-economic, environmental and ecological factors, and provide a basis for identifying regions where new EIDs are most likely to originate (emerging disease 'hotspots'). They also reveal a substantial risk of wildlife zoonotic and vector-borne EIDs originating at lower latitudes where reporting effort is low. We conclude that global resources to counter disease emergence are poorly allocated, with the majority of the scientific and surveillance effort focused on countries from where the next important EID is least likely to originate.

5,992 citations

Journal ArticleDOI
TL;DR: In this article, the authors undertake the first global review of the population and urban settlement patterns in the Low Elevation Coastal Zone (LECZ), defined as the contiguous area along the coast that is less than 10 meters above sea level.
Abstract: Settlements in coastal lowlands are especially vulnerable to risks resulting from climate change, yet these lowlands are densely settled and growing rapidly. In this paper, we undertake the fi rst global review of the population and urban settlement patterns in the Low Elevation Coastal Zone (LECZ), defi ned here as the contiguous area along the coast that is less than 10 metres above sea level. Overall, this zone covers 2 per cent of the world's land area but contains 10 per cent of the world's population and 13 per cent of the world's urban population. A dis- proportionate number of the countries with a large share of their population in this zone are small island countries, but most of the countries with large populations in the zone are large countries with heavily populated delta regions. On average, the Least Developed Countries have a higher share of their population living in the zone (14 per cent) than do OECD countries (10 per cent), with even greater disparities in the urban shares (21 per cent compared to 11 per cent). Almost two- thirds of urban settlements with populations greater than 5 million fall, at least partly, in the zone. In some countries (most notably China), urbanization is driving a movement in population towards the coast. Reducing the risk of disasters related to climate change in coastal settlements will require a combination of mitigation, migration and settlement modifi cation.

2,171 citations

Journal ArticleDOI
TL;DR: Cities in certain regions will struggle to find enough water for the needs of their residents and will need significant investment if they are to secure adequate water supplies and safeguard functioning freshwater ecosystems for future generations.
Abstract: Nearly 3 billion additional urban dwellers are forecasted by 2050, an unprecedented wave of urban growth. While cities struggle to provide water to these new residents, they will also face equally unprecedented hydrologic changes due to global climate change. Here we use a detailed hydrologic model, demographic projections, and climate change scenarios to estimate per-capita water availability for major cities in the developing world, where urban growth is the fastest. We estimate the amount of water physically available near cities and do not account for problems with adequate water delivery or quality. Modeled results show that currently 150 million people live in cities with perennial water shortage, defined as having less than 100 L per person per day of sustainable surface and groundwater flow within their urban extent. By 2050, demographic growth will increase this figure to almost 1 billion people. Climate change will cause water shortage for an additional 100 million urbanites. Freshwater ecosystems in river basins with large populations of urbanites with insufficient water will likely experience flows insufficient to maintain ecological process. Freshwater fish populations will likely be impacted, an issue of special importance in regions such as India's Western Ghats, where there is both rapid urbanization and high levels of fish endemism. Cities in certain regions will struggle to find enough water for the needs of their residents and will need significant investment if they are to secure adequate water supplies and safeguard functioning freshwater ecosystems for future generations.

579 citations

Journal ArticleDOI
TL;DR: In this article, the authors conducted the first global survey of the large cities' water sources, and showed that previous global hydrologic models that ignored urban water infrastructure significantly overestimated urban water stress.
Abstract: A B S T R A C T Urban growth is increasing the demand for freshwater resources, yet surprisingly the water sources of the world’s large cities have never been globally assessed, hampering efforts to assess the distribution and causes of urban water stress. We conducted the first global survey of the large cities’ water sources, and show that previous global hydrologic models that ignored urban water infrastructure significantly overestimated urban water stress. Large cities obtain 78 � 3% of their water from surface sources, some of which are far away: cumulatively, large cities moved 504 billion liters a day (184 km 3 yr � 1 ) a distance of 27,000 � 3800 km, and the upstream contributing area of urban water sources is 41% of the global land surface. Despite this infrastructure, one in four cities, containing $4.8 � 0.7 trillion in economic activity, remain water stressed due to geographical and financial limitations. The strategic management of these cities’ water sources is therefore important for the future of the global economy.

494 citations

Book ChapterDOI
TL;DR: The basic methods for constructing estimates of global population distribution with attention to recent advances in improving both spatial and temporal resolution are described.
Abstract: Evaluating the total numbers of people at risk from infectious disease in the world requires not just tabular population data, but data that are spatially explicit and global in extent at a moderate resolution. This review describes the basic methods for constructing estimates of global population distribution with attention to recent advances in improving both spatial and temporal resolution. To evaluate the optimal resolution for the study of disease, the native resolution of the data inputs as well as that of the resulting outputs are discussed. Assumptions used to produce different population data sets are also described, with their implications for the study of infectious disease. Lastly, the application of these population data sets in studies to assess disease distribution and health impacts is reviewed. The data described in this review are distributed in the accompanying DVD.

438 citations


Cited by
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Journal ArticleDOI
TL;DR: The Commission on Social Determinants of Health (CSDH) as mentioned in this paper was created to marshal the evidence on what can be done to promote health equity and to foster a global movement to achieve it.

7,335 citations

Journal ArticleDOI
25 Apr 2013-Nature
TL;DR: These new risk maps and infection estimates provide novel insights into the global, regional and national public health burden imposed by dengue and will help to guide improvements in disease control strategies using vaccine, drug and vector control methods, and in their economic evaluation.
Abstract: Dengue is a systemic viral infection transmitted between humans by Aedes mosquitoes. For some patients, dengue is a life-threatening illness. There are currently no licensed vaccines or specific therapeutics, and substantial vector control efforts have not stopped its rapid emergence and global spread. The contemporary worldwide distribution of the risk of dengue virus infection and its public health burden are poorly known. Here we undertake an exhaustive assembly of known records of dengue occurrence worldwide, and use a formal modelling framework to map the global distribution of dengue risk. We then pair the resulting risk map with detailed longitudinal information from dengue cohort studies and population surfaces to infer the public health burden of dengue in 2010. We predict dengue to be ubiquitous throughout the tropics, with local spatial variations in risk influenced strongly by rainfall, temperature and the degree of urbanization. Using cartographic approaches, we estimate there to be 390 million (95% credible interval 284-528) dengue infections per year, of which 96 million (67-136) manifest apparently (any level of disease severity). This infection total is more than three times the dengue burden estimate of the World Health Organization. Stratification of our estimates by country allows comparison with national dengue reporting, after taking into account the probability of an apparent infection being formally reported. The most notable differences are discussed. These new risk maps and infection estimates provide novel insights into the global, regional and national public health burden imposed by dengue. We anticipate that they will provide a starting point for a wider discussion about the global impact of this disease and will help to guide improvements in disease control strategies using vaccine, drug and vector control methods, and in their economic evaluation.

7,238 citations

Journal ArticleDOI

6,278 citations

Journal ArticleDOI
01 May 1981
TL;DR: This chapter discusses Detecting Influential Observations and Outliers, a method for assessing Collinearity, and its applications in medicine and science.
Abstract: 1. Introduction and Overview. 2. Detecting Influential Observations and Outliers. 3. Detecting and Assessing Collinearity. 4. Applications and Remedies. 5. Research Issues and Directions for Extensions. Bibliography. Author Index. Subject Index.

4,948 citations