The Intergovernmental Panel on Climate Change (IPCC) Technical Paper Climate Change and Water draws together and evaluates the information in IPCC Assessment and Special Reports concerning the impacts of climate change on hydrological processes and regimes, and on freshwater resources – their availability, quality, use and management. It takes into account current and projected regional key vulnerabilities, prospects for adaptation, and the relationships between climate change mitigation and water. Its objectives are:

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Climate change and water.

Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health

There is scientific consensus that the global climate is changing, with rising surface temperatures, melting ice and snow, rising sea levels, and increasing climate variability. These changes are expected to have substantial impacts on human health. There are known, effective public health responses for many of these impacts, but the scope, timeline, and complexity of climate change are unprecedented. We propose a public health approach to climate change, based on the essential public health services, that extends to both clinical and population health services and emphasizes the coordination of government agencies (federal, state, and local), academia, the private sector, and nongovernmental organizations.

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Climate Change: The Public Health Response

The notions of resilience that have emerged in developmental psychology and psychiatry in recent years require systematic rethinking to address the distinctive cultures, geographic and social settings, and histories of adversity of indigenous peoples. In Canada, the overriding social realities of indigenous peoples include their historical rootedness to a specific place (with traditional lands, communities, and transactions with the environment) and the profound displacements caused by colonization and subsequent loss of autonomy, political oppression, and bureaucratic control. We report observations from an ongoing collaborative project on resilience in Inuit, Metis, Mi'kmaq, and Mohawk communities that suggests the value of incorporating indigenous constructs in resilience research. These constructs are expressed through specific stories and metaphors grounded in local culture and language; however, they can be framed more generally in terms of processes that include: regulating emotion and supporting adaptation through relational, ecocentric, and cosmocentric concepts of self and personhood; revisioning collective history in ways that valorize collective identity; revitalizing language and culture as resources for narrative self-fashioning, social positioning, and healing; and renewing individual and collective agency through political activism, empowerment, and reconciliation. Each of these sources of resilience can be understood in dynamic terms as emerging from interactions between individuals, their communities, and the larger regional, national, and global systems that locate and sustain indigenous agency and identity. This social-ecological view of resilience has important implications for mental health promotion, policy, and clinical practice.

https://journals.sagepub.com/doi/pdf/10.1177/070674371105600203

Rethinking Resilience from Indigenous Perspectives

Since beginning a tenure appointment, my research has focused on four research areas, all elements of the political tradecraft of leadership: bargaining, persuasion, operational routines, and managing subordinates. In each area, I have created new theory and brought these analytics closer to the actual practices of those who govern. I have also created innovative data resources on these core processes. This research moves the discipline closer to understanding political decision-making, innovates new theory, generates new data from “behind the scenes,” and focuses on the nature of politics. Because these activities reflect much more closely the actual practices of political leaders, contemporary leaders, both in the national government and abroad, find my scholarship useful and informative.

At the University of North Carolina

This article provides examples of adverse health effects, including weather-related injury, food insecurity, mental health issues, and water infrastructure damage, and the responses to these effects that are currently being applied in two Northwest Alaska communities. Background: In Northwest Alaska, warming is resulting in a broad range of unusual weather and environmental conditions, including delayed freeze-up, earlier breakup, storm surge, coastal erosion, and thawing permafrost. These are just some of the climate impacts that are driving concerns about weatherrelated injury, the spread of disease, mental health issues, infrastructure damage, and food and water security. Local leaders are challenged to identify appropriate adaptation strategies to address climate impacts and related health effects. Implementation process: The tribal health system is combining local observations, traditional knowledge, and western science to perform community-specific climate change health impact assessments. Local leaders are applying this information to develop adaptation responses. Objective: The Alaska Native Tribal Health Consortium will describe relationships between climate impacts and health effects and provide examples of community-scaled adaptation actions currently being applied in Northwest Alaska. Findings: Climate change is increasing vulnerability to injury, disease, mental stress, food insecurity, and water insecurity. Northwest communities are applying adaptation approaches that are both specific and appropriate. Conclusion: The health impact assessment process is effective in raising awareness, encouraging discussion, engaging partners, and implementing adaptation planning. With community-specific information, local leaders are applying health protective adaptation measures. Keywords: climate change; health impact assessment; health effects; Arctic health (Published: 18 October 2011) Citation: Global Health Action 2011, 4 : 8445 - DOI: 10.3402/gha.v4i0.8445

Climate change and health effects in Northwest Alaska.

In northern regions, climate change can include changes in precipitation magnitude and frequency, reductions in sea ice extent and thickness, and climate warming and cooling. These changes can increase the frequency and severity of storms, flooding, or erosion; other changes may include drought or degradation of permafrost. Climate change can result in damage to sanitation infrastructure resulting in the spread of disease or threatening a community`s ability to maintain its economy, geographic location and cultural tradition, leading to mental stress. Through monitoring of some basic indicators communities can begin to develop a response to climate change. With this information, planners, engineers, health care professionals and governments can begin to develop approaches to address the challenges related to climate change. (Int J Circumpolar Health 2005; 64(5):487-497) Keywords: Arctic, climate change, engineering, human health, infrastructure

Climate change and human health: infrastructure impacts to small remote communities in the north.

Objectives. Develop a process for assessing climate change impacts on public health that identifies climate-health vulnerabilities and mechanisms and encourages adaptation. Study design. Multi-stakeholder, participatory, qualitative research. Methods. A Climate Change Health Assessment (CCHA) was developed that involved 4 steps: (1) scoping to describe local conditions and engage stakeholders; (2) surveying to collect descriptive and quantitative data; (3) analysis to evaluate the data; and (4) planning to communicate findings and explore appropriate actions with community members. The health effects related to extreme weather, thinning ice, erosion, flooding, thawing permafrost and changing conditions of water and food resources were considered. Results. The CCHA process was developed and performed in north-west Arctic villages. Refinement of the process took place in Point Hope, a coastal Inupiat village that practices whaling and a variety of other traditional subsistence harvest practices. Local observers identified climate change impacts that resulted in damaged health infrastructure, compromised food and water security and increased risk of injury. Priority health issues included thawing traditional ice cellars, diminished quality of the community water source and increased safety issues related to sea ice change. The CCHA increased awareness about health vulnerability and encouraged informed planning and decision-making. Conclusion. A community-scale assessment process guided by observation-based data can identify climate health impacts, raise awareness and encourage adaptive actions, thereby improving the response capacity of communities vulnerable to climate change. (Int J Circumpolar Health 2011; 70(3):266-273) Keywords: Indigenous, Arctic, climate change, Alaska Natives, health assessment

Climate change health assessment: a novel approach for Alaska Native communities.

Forty-two communities in rural Alaska are considered unserved or underserved with water and sewer infrastructure. Many challenges exist to provide centralized piped water and sewer infrastructure to the homes, and they are exacerbated by decreasing capital funding. Unserved communities in rural Alaska experience higher rates of disease, supporting the recommendation that sanitation infrastructure should be provided. Organizations are pursuing alternative solutions to conventional piped water and sewer in order to maximize water use and reuse for public health. This paper reviews initiatives led by the State of Alaska, the Alaska Native Tribal Health Consortium, and the Yukon Kuskokwim Health Corporation to identify and develop potential long-term solutions appropriate and acceptable to rural communities. Future developments will likely evolve based on the lessons learned from the initiatives. Recommendations include Alaska-specific research needs, increased end-user participation in the design process, and integrated monitoring, evaluation, and information dissemination in future efforts.

The search for an alternative to piped water and sewer systems in the Alaskan Arctic.

Household water, sanitation and hygiene (WASH) practices in remote, rural, and unpiped communities are likely to impact exposure to pathogens beyond the fecal-oral transmission routes that are typically prioritized in WASH interventions. We studied 43 homes in two remote, rural, unpiped communities in Alaska to evaluate seasonal water haul, water sources, water quality, and water reuse, as well as greywater and human waste disposal over 1 year. Hauled quantities of water reportedly ranged from 3.0 to 5.4 gallons per capita per day (gpcd) depending on the community and season. Natural, untreated water sources contributed 0.5-1.1 gpcd to household water availability. Reported quantities of water hauled were significantly correlated with total water storage capacity in the home. Total coliforms were detected in 30-60% of stored household water samples from treated and untreated sources, and total coliform counts were significantly higher in specific sources and during specific seasons. Exposure to pathogens during periods of low water access, from untreated water reuse, from greywater disposal and from human waste disposal are important pathways of disease transmission in these remote, rural, unpiped communities. We discuss intermediate steps that can be taken at the household and community levels to interrupt exposure pathways before piped infrastructure is installed. This model of examining specific household practices to determine transmission routes can be applied to other remote communities or unique conditions to aid in the recommendation of targeted WASH interventions.

John Warren

Papers

Climate change and health effects in Northwest Alaska.

Climate change and human health: infrastructure impacts to small remote communities in the north.

Climate change health assessment: a novel approach for Alaska Native communities.

The search for an alternative to piped water and sewer systems in the Alaskan Arctic.

Household Water, Sanitation, and Hygiene Practices Impact Pathogen Exposure in Remote, Rural, Unpiped Communities