Abstract
Current risk assessments of the likely regional health impacts of global climate change (GCC) are hindered by two factors. First, dose-response relationships between weather parameters and many of the likely health effects have not been developed, and second, reliable estimates of future regional climates across the United States are still beyond the scope of current modeling efforts. Consequently, probabilistic risk estimates of most of the likely regional health impacts of GCC have such a high degree of uncertainty that their usefulness to health officials dealing with regional issues is very limited. With the numerous pressures on today's health care systems, it is understandable that the possible consequences of GCC have received scant attention from regional health care decision makers. Indeed, the consensus among this community appears to be that any increases in health effects associated with GCC will be easily handled by the current health care system. However, such a position may be naive as the potential exists that an unequal distribution of such effects could overwhelm some regions, whereas others may feel little or no impact. This review of the likely regional impacts of GCC has been structured as a semianalytical look at this issue of distributional effects. Because of the lack of dose-response information and reliable estimates of future regional climates, however, it takes a historical perspective. That is, it assumes that the quality and quantity of health risks a region faces under GCC will be directly related to its recent history of health risks from warm weather/climate-related diseases as well as to the size, characteristics, and distribution of the sensitive subpopulations currently residing within its borders. The approach is semiquantitative; however, it uses national data gathered on a regional level and as such should only be used to generate a hypothesis rather than test it. When applied to the United States, its outcome leads to the hypothesis that if indeed history repeats itself, some states or regions may be more greatly affected by GCC than others, not only because historically they are more prone to summer weather/climate-related diseases, but also because they contain a greater proportion of the sensitive subpopulations in the United States.
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- Birren J. E., Fisher L. M. Aging and slowing of behavior: consequences for cognition and survival. Nebr Symp Motiv. 1991;39:1–37. [PubMed] [Google Scholar]
- Brown M. E., Bindman A. B., Lurie N. Monitoring the consequences of uninsurance: a review of methodologies. Med Care Res Rev. 1998 Jun;55(2):177–210. doi: 10.1177/107755879805500203. [DOI] [PubMed] [Google Scholar]
- Buchner D. M. Preserving mobility in older adults. West J Med. 1997 Oct;167(4):258–264. [PMC free article] [PubMed] [Google Scholar]
- Freeman H. E., Aiken L. H., Blendon R. J., Corey C. R. Uninsured working-age adults: characteristics and consequences. Health Serv Res. 1990 Feb;24(6):811–823. [PMC free article] [PubMed] [Google Scholar]
- Grimstad P. R. Mosquitoes and the incidence of encephalitis. Adv Virus Res. 1983;28:357–438. doi: 10.1016/s0065-3527(08)60727-7. [DOI] [PubMed] [Google Scholar]
- Gyetko M. R., Toews G. B. Immunology of the aging lung. Clin Chest Med. 1993 Sep;14(3):379–391. [PubMed] [Google Scholar]
- Haile D. G., Weidhaas D. E. Computer simulation of mosquito populations (Anopheles albimanus) for comparing the effectiveness of control technologies. J Med Entomol. 1977 Jan 31;13(4-5):553–567. doi: 10.1093/jmedent/13.4-5.553. [DOI] [PubMed] [Google Scholar]
- Kalkstein L. S., Greene J. S. An evaluation of climate/mortality relationships in large U.S. cities and the possible impacts of a climate change. Environ Health Perspect. 1997 Jan;105(1):84–93. doi: 10.1289/ehp.9710584. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kilbourne E. M., Choi K., Jones T. S., Thacker S. B. Risk factors for heatstroke. A case-control study. JAMA. 1982 Jun 25;247(24):3332–3336. [PubMed] [Google Scholar]
- Longstreth J. Anticipated public health consequences of global climate change. Environ Health Perspect. 1991 Dec;96:139–144. doi: 10.1289/ehp.9196139. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Reeves W. C., Hardy J. L., Reisen W. K., Milby M. M. Potential effect of global warming on mosquito-borne arboviruses. J Med Entomol. 1994 May;31(3):323–332. doi: 10.1093/jmedent/31.3.323. [DOI] [PubMed] [Google Scholar]
- Reisen W. K., Meyer R. P., Presser S. B., Hardy J. L. Effect of temperature on the transmission of western equine encephalomyelitis and St. Louis encephalitis viruses by Culex tarsalis (Diptera: Culicidae). J Med Entomol. 1993 Jan;30(1):151–160. doi: 10.1093/jmedent/30.1.151. [DOI] [PubMed] [Google Scholar]
- Rosenblum L. S., Mirkin I. R., Allen D. T., Safford S., Hadler S. C. A multifocal outbreak of hepatitis A traced to commercially distributed lettuce. Am J Public Health. 1990 Sep;80(9):1075–1079. doi: 10.2105/ajph.80.9.1075. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Weissman J. S., Stern R., Fielding S. L., Epstein A. M. Delayed access to health care: risk factors, reasons, and consequences. Ann Intern Med. 1991 Feb 15;114(4):325–331. doi: 10.7326/0003-4819-114-4-325. [DOI] [PubMed] [Google Scholar]
- Wick G., Grubeck-Loebenstein B. The aging immune system: primary and secondary alterations of immune reactivity in the elderly. Exp Gerontol. 1997 Jul-Oct;32(4-5):401–413. doi: 10.1016/s0531-5565(96)00152-0. [DOI] [PubMed] [Google Scholar]
- Young A. Ageing and physiological functions. Philos Trans R Soc Lond B Biol Sci. 1997 Dec 29;352(1363):1837–1843. doi: 10.1098/rstb.1997.0169. [DOI] [PMC free article] [PubMed] [Google Scholar]