IPCC Fourth Assessment Report: Climate Change 2007
Climate Change 2007: Working Group II: Impacts, Adaptation and Vulnerability

6.4.2.4 Human health

Coastal communities, particularly in low income countries, are vulnerable to a range of health effects due to climate variability and long-term climate change, particularly extreme weather and climate events (such as cyclones, floods and droughts) as summarised in Table 6.7.

Table 6.7. Health effects of climate change and sea-level rise in coastal areas.

Exposure/hazard Health outcome Sources 
(Catastrophic) flooding Deaths (drowning, other causes), injuries, infectious disease (respiratory, intestinal, skin), mental health disorders, impacts from interruption of health services and population displacement. Sections 6.4.2, 6.5.2 and 8.2.2; Box 6.4 (Few and Matthies, 2006) 
Impairment of food quality and/or food supplies (loss of crop land, decreased fisheries productivity). Climate change effects on HABs. Food safety: marine bacteria proliferation, shellfish poisoning, ciguatera. Malnutrition and micro-nutrient deficiencies. Sections 6.4.1.3 6.4.2.2 and 8.2.4 
Reduced water quality and/or access to potable water supplies due to salinisation, flooding or drought. Diarrhoeal diseases (giardia, cholera), and hepatitis, enteric fevers. Water-washed infections. Sections 6.4.2.1, 7.5 and 8.2.5 
Change in transmission intensity or distribution of vector-borne disease. Changes in vector abundance. Changes in malaria, and other mosquito-borne infections (some Anopheles vectors breed in brackish water). Sections 8.2.8 and 16.4.5 
Effects on livelihoods, population movement, and potential “environmental refugees”. Health effects are less well described. Large-scale rapid population movement would have severe health implications. Section 6.4.2.3 and limited health literature. 

The potential impacts of climate change on populations in coastal regions will be determined by the future health status of the population, its capacity to cope with climate hazards and control infectious diseases, and other public health measures. Coastal communities that rely on marine resources for food, in terms of both supply and maintaining food quality (food safety), are vulnerable to climate-related impacts, in both health and economic terms. Marine ecological processes linked to temperature changes also play a role in determining human health risks, such as from cholera, and other enteric pathogens (Vibrio parahaemolyticus), HABs, and shellfish and reef fish poisoning (Pascual et al., 2002; Hunter, 2003; Lipp et al., 2004; Peperzak, 2005; McLaughlin et al., 2006).

Convincing evidence of the impacts of observed climate change on coastal disease patterns is absent (Kovats and Haines, 2005). There is an association between ENSO and cholera risk in Bangladesh (Pascual et al., 2002). Rainfall changes associated with ENSO are known to increase the risk of malaria epidemics in coastal regions of Venezuela and Colombia (Kovats et al., 2003). The projection of health impacts of climate change is still difficult and uncertain (Ebi and Gamble, 2005; Kovats et al., 2005), and socio-economic factors may be more critical than climate. There are also complex relationships between ecosystems and human well-being, and the future coastal ecosystem changes discussed in Section 6.4.1 may affect human health (cf. Butler et al., 2005).