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IMPACTS OF CLIMATE CHANGE ON NUTRITION AND HEALTH

Climate change, subsistence farming, and the nutritional status of young children in Burkina Faso (NutriClim)

Scientific lead: Rainer Sauerborn

Contributing scientists: Sandra Barteit, Ina Danquah, Isabel Mank, Raïssa Sorgho

The NutriClim cohort study addresses the urgent situation of small-scale subsistence farmers and their children, living in North-West Burkina Faso – one of the poorest countries in the world. There, nutritional intake among small-scale subsistence farming families is defined to a large extent by previous harvest yields. Due to weather extremes and a yearly changing climate, agricultural management has become challenging in our study region, the Nouna Health District. Weather variability and severity in Nouna (e.g. mini droughts, unpredictable rainy season) have already led to reduced harvest yields over the past years. Given that undernutrition in children is caused by a web of interdependent factors such as illness, socio-economic status and dietary intakes, the NutriClim project aims to disentangle the current and prospective links between child undernutrition and household food production of subsistence farmers through harvest yields and weather variability. The specific objectives are:

  1. To identify the associations between child development and their diets as possible risk factors for stunting and wasting;
  2. To attribute child undernutrition to rainfall patterns consistent with climate change;
  3. To define crop types and measure yearly yield output through earth observation methods; and
  4. To determine the association between child undernutrition, household food production and weather variability.

NutriClim is a long-term cohort study that started in 2014/ 2015, and continues regular follow-up of about 400 families with young children. We combine existing long-term time series information on meteorological, agricultural, socio-economic, behavioral, and clinical information. Specifically, we combine weather analyses and climate predictors with earth observation methods for crop types and yields to estimate the effects of weather variability on agricultural harvest. For the characterization of dietary habits in young children, we use culture-specific dietary assessment methods, such as Food Frequency Questionnaires and 24hours dietary recalls, and exploratory as well as hypothesis-oriented dietary pattern analyses. Nutritional status of children is assessed using anthropometric measures.

This project is funded through the European Space Agency (ESA) under the name MyFoods, and the Heidelberg Institute of Global Health (HIGH) from 2017 to 2019. From 2020, NutriClim will be funded through the DFG Research Unit “Climate Change and Health in sub-Saharan Africa”. Isabel Mank has been financed through a doctoral fellowship by the Landesgraduiertenförderung (LGF) Baden-Württemberg (2017-2020) and the DAAD (2017). Raissa Sorgho receives funding from the Fiat Panis Foundation (2018-2019) and a doctoral scholarship by the DAAD (2019-2020).

Project partners:

Remote Sensing Solutions GmbH (RSS), Munich, Jonas Franke: www.rssgmbh.de/

Centre de Recherche en Santé de Nouna (CRSN)/ Ministry of Health, Burkina Faso, Aristide Quédraogo: www.crsn-nouna.bf/

Environment & Health Section, Centre de Recherche en Santé de Nouna (CRSN)/ Ministry of Health, Burkina Faso/ University of Ouagadougou (Joseph Ki-Zerbo), Issouf Traoré: www.crsn-nouna.bf/

Project-related publications:

Phalkey, R. K., Aranda-Jan, C., Marx, S., Höfle, B., & Sauerborn, R. (2015). Systematic review of current efforts to quantify the impacts of climate change on undernutrition. Proc Nat Acad Sci, 112(33), E4522-4529. https://doi.org/10.1073/pnas.1409769112

Sorgho, R., Franke, J., Simboro, S., Phalkey, R., & Sauerborn, R. (2016). NUTRItion and CLIMate (NUTRICLIM): Investigating the relationship between climate variables and childhood malnutrition through agriculture, an exploratory study in Burkina Faso. Public Health Reviews, 37, 16. https://doi.org/10.1186/s40985-016-0031-6

Sorgho, R., Jonas, F., Simboro, S., Barteit, S., & Sauerborn, R. (2018). Utilizing Remote Sensing at a Subsistence Farming Level to Explore Child Undernutrition in the Context of Climate Change. In A. Kallel, M. Ksibi, H. Ben Dhia, & N. Khélifi (Eds.), Recent Advances in Environmental Science from the Euro-Mediterranean and Surrounding Regions (pp. 1725–1728). https://doi.org/10.1007/978-3-319-70548-4_502

Taking anthropometric measurements and collecting dietary information of children <5 years of age, and field assessment of the harvest quantity using GPS data, weighing of field square harvest, and field observations, in the Nouna Health District, Burkina Faso; Image source: Isabel Mank

Climate change, food security and migration in Burkina Faso between 1992 and 2016

Scientific lead: Somkeita Pascal Zabré

Contributing scientists: Sandra Barteit, Rainer Sauerborn

The history of mankind merges with population movements. People regularly change habitual places of residence for a minimum conventional duration such as during dry seasons. It is not trivial to determine the causes for this behavior, because migration is too diverse and multifaceted to be explained by a single theory. The increasing internationalization of the global market and newly emerging economies have led to increased migration movements. Specifically, slow economic growth, unequal income distribution, high rates of unemployment, armed conflicts, human rights’ abuses, persecutions, environmental upheavals, and globalization, among many others, cause various forms of migration and displacement between and within countries.

Climate change is directly and indirectly linked to human activity. Climate change is defined as changes in the composition of the global atmosphere and adds to the natural variability of the observed weather over long time periods. Given its strong impact on human life, climate change belongs to one of the factors that induce human migration. While the impacts of climate change on agriculture and food security are relatively well established, the cascading effects of climate change on migration are not well understood. Therefore, this project aims to contribute to the understanding of the links between climate change, food security and out-migration in rural Burkina Faso, using retrospective migration data from the Nouna Health and Demographic Surveillance System (HDSS), and meteorological data from NASA stations and the National Agency of Meteorology in Burkina Faso. The specific objectives are:

  1. To quantify climate variability over the past 25 years in rural Burkina Faso;
  2. To describe migration trends and typology, and the destination of migrants;
  3. To determine associations between weather variability and out-migration; and
  4. To identify the relationships between climate variability, food security, and out-migration.

A qualitative pilot study was conducted in 2017 with 50 households in Bourasso entitled “ClimMig: Modèles de migration climatique au Burkina Faso”. The present project runs from December 2017 to 2020.

The project is funded through the Centre de Recherche en Santé de Nouna (CRSN) and the Heidelberg Institute of Global Health (HIGH). Somkeita Pascal Zabré is financed through a PhD scholarship by the Baden-Wurttemberg Foundation (SBWS) (since 2017).

Project partners:

Institut Pasteur, Paris, France, Michel Garenne: https://www.pasteur.fr/en

Centre de Recherche en Santé de Nouna (CRSN)/ Ministère de la Santé, Burkina Faso, Ali Sié, Issouf Traoré, Aristide Ouédraogo: http://www.crsn-nouna.bf/

Potsdam Institute for Climate Impact Research (PIK), Germany, Kira Vinke: https://www.pik-potsdam.de/members/kvinke

Project-related publications:

Zabré S.P., Barteit, S., Mank I., Sorgho, R., Traoré I, Tientega V., Schwerdtle P; Sié A., Garenne M., Sauerborn R.: Does climate variability influence the out-migration in sub-Saharan Africa? Study from Nouna Health and demographic surveillance system in Burkina Faso between 1992 – 2016

Climate migration patterns in rural Burkina Faso

Scientific lead: Rainer Sauerborn

The linkages between climate change impacts and human mobility are complex and their understanding bears crucial implications for mitigation, adaptation and development policies. In Burkina Faso the general trend of seasonal migration may be amplified by the negative effects of climate change on agricultural production being a major source of livelihoods in the countryside, and on human health. Therefore, this project addresses the question whether migration is an effective adaptation to the impacts of climate change?

We assembled a purposeful sample of 30 households from Bourasso, an autochthonous village of some 5,000 inhabitants. For the first time in its existence of hundreds of years, this village sent 50 young men from as many households abroad to earn money as field laborers. The main reason given in key informant interviews was a very bad harvest in 2016, when rainfall failed after harvest and a second sowing was required. Crops were threatened by torrential rainfalls and a premature end of the rainy season. Key informant and household interviews were conducted and are currently analyzed by the project team.

This project receives institutional funding.

Project partners:

Potsdam Institute for Climate Impact Research (PIK), Kira Vinke: https://www.pik-potsdam.de/

Centre de Recherche en Santé de Nouna, Moubassira Kagoné: http://www.crsn-nouna.bf/

Climate change-related migration, nutrition and health in the Pacific Island Countries

Scientific lead: Patricia Nayna Schwerdtle
Contributing scientists: Ina Danquah, Isabel Mank, Rainer Sauerborn

Changes in climate, in conjunction with other drivers of mobility, shape human migration. While there is an increasing focus on the adaptive potential of migration, the health impacts of climate change-related migration, including planned relocation and forced displacement, have not been thoroughly examined. This project establishes the current state of empirical knowledge on migration and health in the context of climate change, both, on a global scale and on a local level, applying a systematic literature review and an observational study design. The local level addresses the Pacific Island countries where populations are particularly vulnerable to the impacts of climate change. We will use a mixed-methods approach to determine the perceptions of dietary shifts, health, and well-being among individuals on the Solomon Islands, and how these compare to their actual dietary habits and health status.

This project has started in 2018 and data collection for the mixed-methods study is anticipated for Spring 2020. Patricia Schwerdtle receives a PhD scholarship from the German Academic Exchange Service (DAAD).

Project partners

Institute for Advanced Sustainability Studies, Berlin. Australian National University, ACT, Kathryn Bowen: https://www.iass-potsdam.de/en/people/kathryn-bowen

University of Melbourne, Australia, Celia McMichael: https://www.findanexpert.unimelb.edu.au/display/person5164#tab-Awards

Project-related publications:

Schwerdtle P, Bowen K, McMichael C (2018) ‘The health impacts of climate-related migration’. BMC Med. 16:1. DOI 10.1186/s12916-017-0981-7

Nayna Schwerdtle P, Bowen K, McMichael C, Sauerborn R (2019) ‘Human mobility and health in a warming world’, Journal of Travel Medicine, Volume 26, Issue. https://doi.org/10.1093/jtm/tay160

Nayna Schwerdtle P, Bowen K (2019) Climate Change and Health in the Pacific: A scoping review. Report for the Australia Pacific Climate Partnership Support Unit. Department of Foreign Affairs and Trade, Australian Government.

Health in climate migrants: generating qualitative accounts of health in the Bhola slum, Dhaka, Bangladesh

Scientific lead: Kate Bärnighausen

When climate migrants move as a result of increased vulnerability to long-term climatic change or as a result of an extreme weather event, their health is often suboptimal. Many suffer from chronic undernutrition as a result of extended periods of food insecurity, and also experience varying waterborne diseases due to inadequate and unsafe water supply. Therefore, when climate migrants reach their intended destination, they are often in need of extended periods of health care, but are unable to access it. Bhola Slum in Dhaka, Bangladesh is home to approximately 45,000 migrants. Many of them are thought to have relocated as a means of climate change adaptation, when in fact, they experience the ill health, socio-economic and social effects of forced climate migration. This study employs an applied qualitative design using semi-structured in-depth interviews to elicit the lived experiences and stories of climate migrants and health care providers in Bhola slum, Bangladesh. We aim to describe the health experiences of climate migrants, the impact of migrants on the formal and informal health care provision within the slum, and highlight intervention points to support appropriate policy design and improved access to care.

This project is partially funded by the Alexander von Humboldt foundation.

Project Partners:

Centre for Sustainable Development, University of Liberal Arts, Dhaka, Bangladesh, Samiya Selim: https://csd.ulab.edu.bd/ 

Project-related publications:

Williams, A., Scanlan, O., & Selim, S. (2019). Breathing Health(ier) Amid Rapid Urbanisation: Challenges and opportunities related to tackling the primary contributors to Dhaka’s air pollution. Dhaka, Bangladesh: Center for Sustainable Development.

Sultana, R., Alam, M. S., & Selim, S. A. (2018). Household Level Coping Strategies for Flood Disaster: A Study on Padma River Islands of Bangladesh. In S. A. Selim, S. K. Saha, R. Sultana, & C. Roberts (Eds.), The Environmental Sustainable Development Goals in Bangladesh (pp. 96-112). London, UK: Routledge.

Household air pollution effects on respiratory and cardiovascular health of women in the rural villages of India and Nepal

Scientific lead: Rasmila Kawan
Contributing scientists: Rainer Sauerborn

Air pollution exposure is a growing environmental and health concern in the world today and has been regarded as the second most important risk factor for ill health in South Asia. People rely on solid fuels for cooking and heating, mainly in low- and middle-income countries. The inefficient use of such fuels in poorly ventilated conditions results in high levels of indoor air pollution, increasing the risks of cardiovascular and respiratory diseases. In 2016, 7 million deaths globally were attributable to the joint effects of household (HAP) and ambient air pollution (AAP), among which about 94% of these deaths occur in low and middle‐income (LMI) countries. The South East Asian and Western Pacific regions bear most of the burden with 2.4 and 2.2 million deaths, respectively. Approximately 74% of South Asian households use solid fuels such as wood, dung, or coal for cooking and heating practices in traditional cook stoves. Inefficient burning produces high levels of health damaging Climate Active Pollutants (CAPs) such as black carbon, particulate matter, methane, nitrous oxide, and carbon dioxide. Household air pollution was responsible for 77 million of disability-adjusted life-years (DALYs, 3.2% of the global total) in 2016.

Up to date, only few studies used rigorous, quantitative analysis to assess the impacts of indoor air pollution from biomass fuels on cardiovascular and respiratory health. Therefore, this project establishes the long-term (5 years) effects of cooking methods (biomass fuels vs. clean fuels) on cardio-vascular as well as respiratory conditions among women living in rural India and Nepal. The specific objectives are:

  1. To determine the association between cook stove design, type of fuel and lung function, using spirometer as an indicator for Chronic Obstructive Pulmonary Disease (COPD); and
  2. To quantify the effects of long-term biomass smoke exposure on cardiovascular health using Electrocardiogram (ECG), blood pressure measurements, and oximetry.

The project runs since 2017, and is funded by the Heidelberg Institute of Global Health (HIGH), the Intergovernmental Panel on Climate Change (IPCC), the Prince Albert II Monaco Foundation, and the International Centre for Integrated Mountain Development (ICIMOD), Kathmandu, Nepal.

Project partners:

Indian Institute of Tropical Meteorology (Ministry of Earth Sciences, Govt. of India), Gufran Beig: http://safar.tropmet.res.in/index.php?menu_id=1

Vadu Health and Demographic Surveillance System (Vadu HDSS), Vadu Rural Health Program (VRHP), KEM Hospital Research Centre Pune, Sanjay K Juvekar: https://www.kemhrcpune.org/vadu-hospital 

Livelihoods, International Centre for Integrated Mountain Development, Kathmandu, Nepal, Arabinda Mishra: http://www.icimod.org/?q=abt

CRF - Chest Research Foundation, Pune, India, Sundeep Salvi: https://www.crfindia.com/

A 25-year-old woman cooking food, in the morning while taking care of her four-year-old son as indoor biomass smoke exposure is being measured by equipment installed by the team of the International Centre for Integrated Mountain Development (ICIMOD) Image source: Rasmila Kawan

ADAPTATIONS TO CLIMATE CHANGE

Agro-biodiversification and nutrition intervention in rural Burkina Faso and Kenya

Scientific lead: Ina Danquah
Contributing scientists: Isabel Mank, Raissa Sorgho

This project addresses the projected agricultural losses based on the current CO2 emissions until 2050 and their consequences for the nutritional status of children under-5 years of age living in two selected regions of sub-Saharan Africa. We will determine the potential of an integrated agriculture and nutrition program as one possible adaptation strategy to improve the children’s nutritional status for climate-sensitive nutrients in rural Burkina Faso and Kenya, where climate change will impact on agriculture most strongly. The program focuses on bio-diversification of subsistence farming by horticultural agriculture in home gardens, and is accompanied by nutrition and health counselling using the 7 Essential Nutrition Action messages by the World Health Organization. For sub-Saharan Africa, bio-diversification constitutes one of the most promising and most practicable adaptation strategies for CO2-dependent agricultural losses, both, for the absolute amounts of crops and for the contents of protein, iron and zinc. As a novelty, this project identifies the controversially discussed, potential effects of such agriculture and nutrition program on the risk of clinical malaria in children under-5 years of age in both regions. In the first project phase, the adaptation program will be tailored to the needs of the study regions and pre-tested in 60 households in collaboration with established non-governmental organizations at place. Thereby, we will determine the horticultural crops to be cultivated as well as the practicability and the acceptability of the program. Based on this knowledge, we will conduct two cluster-randomized controlled trials in the two study areas, each with 2x 600 children and their mothers. We will recruit households with children at the age of supplementary feed introduction (6-24 months) and follow them up for at least 1 year. For these children, the protective effects of the program will be calculated for anthropometric measures and biomarkers reflecting protein, iron and zinc status as well as for malaria risk. Moreover, the changes in dietary behavior and maternal nutritional status will be established and cost-effectiveness will be estimated.

The project parts in Burkina Faso are funded by the Robert Bosch Foundation (July 2019 – June 2024), and in Kenya by the German Research Foundation (DFG) within the framework of the Research Unit “Climate Change and Health in sub-Saharan Africa” (January 2020 – December 2022).

Project partners:

Centre de Recherche en Santé de Nouna (CRSN)/ Ministry of Health, Burkina Faso, Ali Sié and Issouf Traoré: www.crsn-nouna.bf/

Kenya Medical Research Institute (KEMRI), Kisumu, Kenya, Erick Muok: https://kemri-wellcome.org/

Institute of Crop Science and Resource Conservation, University of Bonn, Bonn, Germany, Thomas Döring and Mathias Becker: https://www.inres.uni-bonn.de/

Climate Change Adaptation policies in West-Africa

Scientific lead: Rainer Sauerborn
Contributing scientists: Peter Dambach, Ina Danquah, Olaf Horstick, Raïssa Sorgho, Aurélia Souares, Volker Winkler

Globally, climate change is recognised as a threat to health and livelihood of populations. Governments across the world have collectively negotiated and worked on solutions to combat climate change. To mitigate and adapt to the effects of CC and finance relevant measures, representatives of the 196 state parties within the United Nations Framework Convention on Climate Change (UNFCCC) have agreed on various international treaties such as the 1997 Kyoto Protocol, and the 2015 Paris Agreement. Furthermore, adaptation efforts are addressed international organizations that mobilize funding streams such as the United Nation Framework Convention on Climate Change (UNFCCC), The Global Environment Facility (GEF), and The Green Climate Fund (GCF). Low- and middle-income countries are disproportionately affected by climate change in terms of impact and their limited ability for planning, mitigation and adaptation. The development of climate change policies is especially important for West-African countries, where climate change is an amplifying risk factor for malnutrition due to the reliance on manually managed and rain-fed subsistence farming for food security. Therefore, this project addresses the political dimension of climate change adaptation in West-Africa. The specific objectives are:

  1. To systematically review the existing and published policy documents covering climate change adaptation in 16 West-African countries;
  2. To determine awareness and perceptions of experts and decision makers concerning the existing policies in Burkina Faso, applying in-depth qualitative interviews;
  3. To identify activities and implementation strategies for climate change adaptation in Burkina Faso, using the IPCC Adaptation Action Feasibility Assessment; and
  4. To establish determinants of successful policy implementation among small-scale, subsistence farmers in rural North-West Burkina Faso, using semi-structured guided interviews.  

This project runs from 2017-2020. In addition, Raissa Sorgho receives funding from the Fiat Panis Foundation (2018-2019) and a doctoral scholarship by the DAAD (2019-2020).

Project partners:

Centre de Recherche en Santé de Nouna (CRSN)/ Ministry of Health, Burkina Faso, Moubassira Kagoné: www.crsn-nouna.bf/

Heidelberg Center for the Environment, Heidelberg University, Germany, Maximilian Jungmann: https://www.hce.uni-heidelberg.de/

Cool roofs to protect African populations from heat-related cardiovascular conditions

Scientific lead: Aditi Bunker
Contributing scientists: Till Bärnighausen, Rainer Sauerborn

Millions of people live in poor housing conditions and are exposed to high indoor temperatures. Adaptation solutions are needed in the housing sector to protect vulnerable populations against increasing climate stresses such as heat. Sunlight reflecting cool-roof coatings are a promising, economical passive cooling technology that can reduce indoor temperature by 1.5 to 4°C in varied settings. The human health, environmental and economic effects of cool-roofs remain unknown in areas where climate change is going to affect populations the hardest, such as in sub-Saharan Africa. We conduct a cluster-randomised controlled trial of cool roof effectiveness on health, environmental and economic outcomes. Our long-term research goal is to identify viable passive housing adaptation technologies with proven health and environmental benefits to reduce the burden of heat stress in communities affected by heat in Africa.

This project runs from January 2020 until December 2022 and is funded by the German Research Foundation (DFG) within the Research Unit “Climate Change and Health in sub-Saharan Africa”. We receive additional funding from the European Cool Roof Council (ECRC): https://coolroofcouncil.eu/#section0.

Project partners:

Centre de Recherche en Santé de Nouna (CRSN)/ Ministry of Health, Burkina Faso, Ali Sié, Millogo Ourohiré, Moubassira Kagoné: www.crsn-nouna.bf/

Project-related publications:

Bunker, A., Sewe, M., Sie, A., Rocklöv, J., Sauerborn, R. (2017). The excess burden of heat on non-communicable disease years of life lost in rural Burkina Faso: a time series analysis of daily deaths between 2000-2010. BMJ Open, 7:e018068.

Odhiambo, S., Bunker, A., Egondi, T., Hondula, D., Astrom, D., Rocklöv, J., Schumann, B. (2017). The impact of temperature on years of life lost in low-and-middle income countries; a multi-city analysis. Environmental health perspectives, 126 (1).

Bunker, A., Wildenhain, J., Vandenbergh, A., Henschke, N., Rocklöv, J., Hajat, S., & Sauerborn, R. (2016). Effects of Air Temperature on Climate-Sensitive Mortality and Morbidity Outcomes in the Elderly; a Systematic Review and Meta-analysis of Epidemiological Evidence. EBioMedicine, 6, 258–268.

Gosling, SN., Hondula, DM., Bunker, A., Sauerborn, R. (2017). Modelling adaptation in climate change impact assessments of heat-related mortality. Environmental health perspectives, 125(8):087008.

Example of cool roof application in Burkina Faso. Note: This image is a visualization and the final effect might differ. Image source: Dambach and Pajak, 2019

Heat-health action plans for Germany and the potential of General Practitioners

Scientific lead: Alina Herrmann
Contributing scientists: Aditi Bunker, Rainer Sauerborn

In recent years, Germany experienced several extreme heat waves with annual cases of 6,000-7,000 heat-related deaths in hot summers like 2003 and 2015. Many of these were among the elderly who are particularly vulnerable to heat stress. Due to climate change and population aging, adaptations to heat waves become increasingly relevant for our health systems. At the population level, action plans for heat waves can pool and coordinate the prevention of negative heat impacts on human health. Since 2005, there has been a German heat warning system in place by the German Meteorological Service (www.dwd.de). Yet, the translation of heat warnings into action is still lacking. Although General Practitioners (GPs) are important stakeholders in action plans for heat waves, their perceptions of heat-related health risks and their role in respective action plans were virtually unknown. Therefore, this project aims at establishing GPs’ perceptions of heat-related health risks and determining their possible contributions to the prevention of future heat-related deaths in Germany. We used qualitative expert interviews and applied content analysis. The data for this project were collected between 2012 and 2014; analyses are ongoing. Since then, our group has contributed to the development of heat-health action plans at the Federal Ministry of Health, the Ministry of Health Baden-Württemberg, and the city of Cologne. 

For this project, Alina Herrmann received a scholarship from the Klaus Tschira Foundation as part of the NAR-Kolleg (Network Aging Research in Heidelberg).

Project partners:

Geriatrcs and Geriatric Rehabilitation, Robert Bosch Hospital Stuttgart, Germany, Clemens Becker: https://www.rbk.de/standorte/robert-bosch-krankenhaus/abteilungen/geriatrie-und-geriatrische-rehabilitation.html

Department of Clinical Pharmacology and Pharmaceutical Epidemiology, Universitaetsklinikum Heidelberg, Germany, Walter-Emil Haefeli: https://www.klinikum.uni-heidelberg.de/personen/prof-dr-med-walter-e-haefeli-3335/

Project-related publications:

Herrmann A, Haefeli WE, Rapp K, Roigk P, Lindemann U, Becker C: CME zertifizierte Fortbildung – Epidemiologie und Prävention hitzebedingter Gesundheitsschäden älterer Menschen. Zeitschrift für Gerontologie und Geriatrie. Accepted June 2019

Becker C, Herrmann A, Haefeli WE, Rapp K, Lindemann U: Neue Wege zur Prävention gesundheitlicher Risiken und der Übersterblichkeit von älteren Menschen bei extremer Hitze. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 2019.

Becker, C., Haefeli, W.E., Herrmann, A., Rapp, K., Lindemann, U. "Vermeidung von hitzebedingter Übersterblichkeit", Ärzteblatt Baden-Württemberg 07/2018, ISSN 07203489, E1041

Herrmann, A., Sauerborn, R.: General Practitioners' Perceptions of Heat Health Impacts on the Elderly in the Face of Climate Change-A Qualitative Study in Baden-Wurttemberg, Germany. Int J Environ Res Public Health 2018, 15(5).

Bunker, A., Wildenhain, J., Vandenbergh, A., Henschke, N., Rocklöv, J., Hajat, S., Sauerborn, R. Effects of air temperature on climate-sensitive mortality and morbidity outcomes in the elderly: a systematic review and meta-analysis of epidemiological evidence. EBioMedicine. 2016;6:258–268. 

Augustin, J., Sauerborn, R., Burkart, K., Endlicher, W., Herrmann, A., Jochner, S., Koppe, C., Menzel,ücke. H.-G., „Klimawandel und Gesundheit“ in „Klimawandel in Deutschland. Entwicklung, Folgen Risiken und Perspektiven“ Guy P. Brasseur, Daniela Jacob, Susanne Schuck-Zöller (Hrgs) (2016) Berlin Heidelberg. DOI 10.1007/978-3-662-50397-3


MITIGATION OF CLIMATE CHANGE AND CO-BENEFITS

Sustainable diets for urban populations in Burkina Faso

Scientific lead: Ina Danquah
Contributing scientists: Alina Herrmann

This project addresses the multi-facetted links of climate change, nutrition and health in sub-Saharan Africa. Beside food insecurity in rural areas, environmental impacts from altering dietary habits are foreseeable for the rapidly developing urban settings in sub-Saharan Africa. There, dietary habits modernize and overnutrition-related chronic diseases among adults are on the rise. The current project aims at developing dietary intervention strategies that meet the four essential criteria of sustainable diets for urban sub-Saharan Africa. These criteria are: healthfulness, economic affordability, cultural acceptability, and environmental friendliness.

For urban Burkina Faso, we will conduct an individually randomized controlled trial (RCT) for the cardio-metabolic effects and the cost-effectiveness of a culturally acceptable dietary weight-loss intervention among adults living in the capital Ouagadougou. In the first project phase, we will conduct formative research to shape the dietary intervention according to the cultural and contextual needs of the target population. The dietary weight-loss program to prevent cardio-metabolic conditions is based on the latest international Guidelines for the Management of Overweight and Obesity. Within the framework of the Health and Demographic Surveillance System (HDSS) Ouagadougou, we will recruit 2x 125 adults with overweight or obesity to participate in the RCT. This RCT comprises a 6-months intensive intervention phase and examinations, plus a 6-months consolidation period. The control group will be offered standard dietary counselling. The intervention group will additionally receive 12 family-based contacts by trained health workers, including group counselling sessions on healthy diets, picture-guided information posters, home-based cooking sessions, guided market purchase, smartphone-reminders, and objective monitoring of physical activity, dietary habits, and health care utilization. Beside weight-loss, the primary outcome is change in fasting plasma glucose; and secondary outcomes are reductions in blood pressure, blood lipids, cost-benefits as well as the reduction of the diet-related carbon footprint.

This project has started in July 2019 and is funded by the Robert Bosch Foundation under the framework of the Robert Bosch Junior Professorship 2019.

Project partners:

Institut Supérieur des Sciences de la Population (ISSP), University of Ouagadougou, Ouagadougou, Burkina Faso, Abdramane Soura: http://www.indepth-network.org/prof-abdramane-soura

Inst. for Social and Cultural Anthropology, Free University of Berlin, Berlin, Germany, Hans-Jörg Dilger, Caroline von Meyer zu Biesen: https://www.polsoz.fu-berlin.de/ethnologie/forschung/arbeitsstellen/medical_anthropology/index.html

Household Preferences for reducing greenhouse gas emissions in four European high-income countries (HOPE)

Scientific lead: Rainer Sauerborn
Contributing scientists: Dorothee Amelung, Fabio Bothner, Florian Dorner, Helen Fischer, Alina Herrmann, Valerie Louis, Raïssa Sorgho

In the multi-center HOPE project (https://hope-project.net/), we conducted household surveys in France, Germany, Norway and Sweden to determine the readiness for lifestyle changes to reduce the carbon footprint at household level. We challenged the participating households to half their carbon footprint. More specifically, we calculated the households’ carbon footprints for the domains “mobility”, “housing”, “food and recycling” and ”other consumption” using a Carbon Footprint Calculation and Simulation Tool, which was specifically developed for the study. After that, simulations for emission reductions were employed, and we offered each household up to 60 options to reduce their greenhouse gas emissions. In-depth qualitative interviews were conducted with a sub-sample of households to identify motivators and barriers for the reduction of emissions, including benefits to human health from sustainable lifestyles. We complemented the household surveys with an analysis of current household-oriented climate policies. For this analysis, different quantitative and qualitative methods were used. The data for the HOPE project were collected between 2015 and 2018. This project was supported under the umbrella of the Joint Program Initiative (JPI) on Climate. This includes the following national funding agencies: French National Research Agency (ANR-14-JCLI-0001-03), German Federal Ministry of Education and Research (01UV1414A), Research Council of Norway (244,905/E10), Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning (214–2014-1717).

Project partners:

Quantiative Analysis TEC-Conseil, Marseille, France (Private Consultancy), Ghislain Dubois: https://www.tec-conseil.com/

Centre International de Recherche sur l'Environnement et le Dévelopement (CIRED), Carine Barbier: http://www.centre-cired.fr/ 

Western Norway Research Institute, Sogndal, Norway, Carlo Aall: https://www.vestforsk.no/en

Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden, Maria Nilsson: https://www.umu.se/en/department-of-epidemiology-and-global-health/

City councils of the four partner cities: Frau Agnes Schönfelder, Mannheim (Ger) and other representatives from Aix-en Provence (Fra), Bergen (Nor), Umeå (Swe)

Project-related publications:

Herrmann A, de Jong L, Kowalski C, Sauerborn R: Gesundheitliche Vorteile von Klimaschutzmaßnahmen – wie Haushalte und Politik profitieren können. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 2019.

Amelung D, Fischer H, Herrmann A, Aall C, Louis VR, Becher H, Wilkinson P, Sauerborn R. Human health as a motivator for climate change mitigation: results from four European high-income countries. Global Environmental Change. 2019 Jul 1;57:101918.

Dubois G, Sovacool B, Aall C, Nilsson M, Barbier C, Herrmann A, Bruyère S, Andersson C, Skold B, Nadaud F et al: It starts at home? Climate policies targeting household consumption and behavioral decisions are key to low-carbon futures. Energy Research & Social Science 2019, 52:144-158.

Bothner F, Dorner F, Herrmann A, Fischer H, Sauerborn R: Explaining climate policies’ popularity—An empirical study in four European countries. Environmental Science & Policy 2019, 92:34-45.

Sköld B, Baltruszewicz M, Aall C, Andersson C, Herrmann A, Amelung D, Barbier C, Nilsson M, Bruyère S, Sauerborn R: Household Preferences to Reduce Their Greenhouse Gas Footprint: A Comparative Study from Four European Cities. Sustainability 2018, 10(11):4044

Wilkinson P, Fischer H, Louis V, Herrmann A, Amelung D, Barbier C, Dubois G, Nadaud F, Sköld B, Sauerborn R (2018) Multi-criteria assessment of household preferences for reducing greenhouse gas emissions: an analysis of household survey data from 4 European cities. Global Public Health. Accepted March 2019.

Herrmann, A., Fischer, H., Amelung, D., Litvine, D., Aal, C., Andersson, C., Baltruszewicz, M., Barbier, C., Bruyère, S., Louis, V.R., Bénévise, F, Dubois, F., Richardsen-Moberg, K., Nilsson, M, Sköld, B., Sauerborn, R. Household preferences for reducing greenhouse gas emissions in four European high-income countries: Does health information matter? A mixed-methods study protocol. BMC Public Health. 2017 Aug 1;18(1):71. doi: 10.1186/s12889-017-4604-1.

Carbon footprints of the diet among Ghanaian adults under transition

Scientific lead: Ina Danquah
Contributing scientists: Julia Stockemer

Sustainable nutrition embraces the responsible use of natural resources to secure food and nutrition for future generations, while combating overnutrition-related diseases at low costs. A transition towards a sustainable diet is considered to be fundamental for achieving global development goals and counteracting climate changes. This challenge applies to high-income countries and likely to the growing populations of sub-Saharan African cities, where the dietary habits modernize rapidly and overnutrition emerges. A comprehensive framework has been developed that describes the fundamental pillars of sustainable diets. The four key features of a sustainable diet are healthfulness, cultural acceptability, financial affordability, and environmental friendliness. This concept constitutes the groundwork for a global change of food consumption and production on industrial, agricultural, political, and social levels. However, this theoretical framework needs to be adapted and carefully translated into the reality of different social, cultural and environmental settings to show the extend of possible effects and the feasibility of the concept. While food consumption and climate effects of dietary patterns have been largely studied in industrial countries, few studies have looked at the climate effects of food consumption in sub-Saharan African societies under rapid economic transition.

Therefore, this project will identify the role of urbanization and migration among Ghanaian adults for two features of a sustainable diet: healthfulness and environmental friendliness. The specific objectives are:

  1. To quantify the carbon footprint from foods in rural and urban Ghana, and among Ghanaian migrants in Amsterdam, London and Berlin;
  2. To determine associations of demographic, socio-economic, lifestyle, and cultural factors with the individual carbon footprint from dietary habits;
  3. To establish a hypothesis-driven index for a sustainable diet that is healthful and climate-friendly and compare adherence across study sites, and
  4. To identify the relevance of demographic, socio-economic, lifestyle and cultural factors for the potential site-specific adherence to the sustainable diet index.

This project uses data of the EU/FP7-funded Research on Obesity and Diabetes among African Migrants (RODAM) Study (grant number: 278901; www.rod-am.eu). The study was conducted from 2012-2015.

Project partners:

Department Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany, Matthias B. Schulze: www.dife.de/abteilungen/mep

Charité – Universitätsmedizin Berlin, Berlin, Germany, Frank P. Mockenhaupt and Joachim Spranger: https://tropeninstitut.charite.de/

Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, The Netherlands, Karien Stronks and Charles Agyemang: https://www.amc.nl/web/specialismen/sociale-geneeskunde/current-project-co-leaders-dept-of-public-health/public-health-research.htm

Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom, Liam Smeeth:

https://www.lshtm.ac.uk/research/faculties/eph/department-non-communicable-disease-epidemiology

Project-related publications:

Osei-Kwasi HA, Boateng D, Danquah I, Holdsworth M, Mejean C, Terragni L, Powell K, Schulze MB, Owusu-Dabo E, Meeks K, Beune E, Agyemang C, Klipstein-Grobusch K, Stronks K, Galbete C, Nicolaou. Acculturation and Food Intake among Ghanaian Migrants in Europe: Findings from the RODAM Study. J Nutr Edu Behav (September 5, 2019)

Boateng D, Galbete C, Nicolaou M, Meeks K, Beune E, Smeeth L, Osei-Kwasi HA, Bahendeka S, Agyei-Baffour P, Mockenhaupt FP, Spranger J, Grobbee DE, Schulze MB, Stronks K, Agyemang C, Danquah I, Klipstein-Grobusch K. Dietary Patterns Are Associated with Predicted 10-Year Risk of Cardiovascular Disease Among Ghanaian Populations: the Research on Obesity and Diabetes in African Migrants (RODAM) Study. J Nutr. 2019 May 1;149(5):755-769. doi: 10.1093/jn/nxz002.

Galbete C, Nicolaou M, Meeks K, Klipstein-Grobusch K, de-Graft Aikins A, Addo J, Amoah SK, Smeeth L, Owusu-Dabo E, Spranger J, Agyemang C, Mockenhaupt FP, Beune E, Stronks K, Schulze MB, Danquah I. Dietary patterns and type 2 diabetes among Ghanaian migrants in Europe and their compatriots in Ghana: the RODAM study. Nutr Diabetes. 2018 Apr 25;8(1):25. doi: 10.1038/s41387-018-0029-x.

Danquah I, Galbete C, Meeks K, Nicolaou M, Klipstein-Grobusch K, Addo J, Aikins AD, Amoah SK, Agyei-Baffour P, Boateng D, Bedu-Addo G, Spranger J, Smeeth L, Owusu-Dabo E, Agyemang C, Mockenhaupt FP, Beune E, Schulze MB. Food variety, dietary diversity, and type 2 diabetes in a multi-center cross-sectional study among Ghanaian migrants in Europe and their compatriots in Ghana: the RODAM study. Eur J Nutr. 2018 Dec;57(8):2723-2733. doi: 10.1007/s00394-017-1538-4.

Galbete C, Nicolaou M, Meeks KA, de-Graft Aikins A, Addo J, Amoah SK, Smeeth L, Owusu-Dabo E, Klipstein-Grobusch K, Bahendeka S, Agyemang C, Mockenhaupt FP, Beune EJ, Stronks K, Schulze MB, Danquah I. Food consumption, nutrient intake, and dietary patterns in Ghanaian migrants in Europe and their compatriots in Ghana. Food Nutr Res. 2017 Jul 6;61(1):1341809. doi: 10.1080/16546628.2017.1341809.

Frank LK, Jannasch F, Kröger J, Bedu-Addo G, Mockenhaupt FP, Schulze MB, Danquah I. A Dietary Pattern Derived by Reduced Rank Regression is Associated with Type 2 Diabetes in An Urban Ghanaian Population. Nutrients. 2015 Jul 7;7(7):5497-514. doi: 10.3390/nu7075233.

Frank LK, Kröger J, Schulze MB, Bedu-Addo G, Mockenhaupt FP, Danquah I. Dietary patterns in urban Ghana and risk of type 2 diabetes. Br J Nutr. 2014 Jul 14;112(1):89-98. doi:10.1017/S000711451400052X

Climate migration patterns in rural Burkina Faso

Scientific lead: Rainer Sauerborn
Contributing scientists: Friederike Gutmann

The health sector itself has a significant carbon footprint. Studies in the UK and the US report that it contributes to 4% and 10% of national emissions, respectively. In Germany, the health sector contributes an estimated 5-8% to national emissions. This is a double the contribution of air travel. Surprisingly, most of the emissions seem NOT to be due to energy or transport of patients, but to consumables, such as pharmacological medication. This project aims at quantifying and attributing the emissions of pharmacological medications along the value chain from drug suppliers over hospital patients to the definite waste management.

Objectives

  1. Quantify the carbon footprint of the University Hospital Heidelberg;
  2. Identify the different main sources of these emissions;
  3. Attribute the sources to those from upstream and downstream uses in the value chain (STEP 3) and those emanating from the hospital itself (STEP1, as well as those contained in purchased energy (STEP 2)

Project partners:

Institute for Energy and the Environment (IFEU), Heidelberg, Germany, Bernd Franke: www.ifeu.de/

Sanofi-Aventis Group, Gentilly, France, François Bligny

Department of Health Policy and Management, Universitas Gadjah Mada, Yogyakarta, Indonesia, Yodi Mahendradhata: https://ugm.ac.id/en