Some Lessons Learned from Public Health on the Process of Adaptation

Lessons learned from more than 150 years of public health research and intervention can provide insights to guide public health professionals and institutions as they design and implement specific strategies, policies, and measures to increase resilience to climate variability and change. This paper identifies both some modifications to public health systems that may enhance adaptive capacity, and lessons drawn from the history of managing environmental and other threats in the public health sector that may have relevance for other sectors as they design approaches to increase their adaptive capacity to more effectively cope with climate variability and change. The views expressed are the author’s own and do not represent official US EPA policy.     

Climate change adaptation and mitigation: next steps for cross-sectoral action to protect global health

Effectively addressing the health risks of climate change necessitates an active crosssectoral approach because health risks arise predominantly via sectors such as water, agriculture and energy. Much has been written on climate change and its impact on health, but little attention has focused on the realpolitik of how to progress the development and implementation of health-relevant strategies and policies to reduce this impact. The objective of this paper is to propose three solutions to address current deficiencies: i) strengthening the capacity and understanding of health officials in relation to climate change and health; ii) improving cross-sectoral partnerships with sectors relevant to climate change and health, and iii) identifying organisations influential in the development of climate change mitigation and adaptation strategies and policies, with a view to better target advocacy efforts. Practical examples of each solution are provided. In conclusion, as a steward of public health, the health sector must take the initiative to encourage a cross-sectoral approach that includes capacity development, coupled with an understanding of influential organisations. If this is done effectively, health, social and economic development goals can be reached more efficiently.     

Distance-weighted traffic density in proximity to a home is a risk factor for leukemia and other childhood cancers

Occupational exposure to elevated concentrations of benzene is a known cause of leukemia in adults. Concentrations of benzene from motor vehicle exhaust could be elevated along highly trafficked streets. Several studies have reported significant associations between proximity to highly trafficked streets and the occurrence of childhood cancers and childhood leukemia. These associations may be due to chronic exposure to benzene or other carcinogenic components of vehicle exhaust from these nearby streets or to some other factor (e.g., noise, increased light exposure, or some unaccounted--for socioeconomic variable). We used data for homes studied in an earlier childhood cancer study conducted in Denver, CO, in the 1980s. No air pollution measurements were made in the original study. We identified the highest trafficked street near each study home and obtained the traffic density in 1979 and 1990. Traffic density was weighted for the distance from the street to the home using 3 different widths of Gaussian curves to approximate the decay of the emissions into the surrounding neighborhoods. The associations between the 750-ft-wide distance-weighted traffic density metrics and all childhood cancers and childhood leukemia are strongest in the highest traffic density category (> or = 20,000 vehicles per day [VPD]). The odds ratio is 5.90 (95% confidence interval [CI] 1.69-20.56) for all cancers and 8.28 (95% CI 2.09-32.80) for leukemia. The results are suggestive of an association between proximal high traffic streets with traffic counts > or = 20,000 VPD and childhood cancer, including leukemia.