Synergies between the build environment and climate change: Elevated risks but greater opportunities

Many health outcomes and diseases are sensitive to climate, including: heat-related mortality or morbidity; air pollution-related illnesses; infectious diseases, particularly those indirectly transmitted via water or by insect or rodent vectors; and refugee health issues linked to forced population migration. Yet, the environmental exposure risks of climate change should not be assessed in isolation from other concomitant environment risks, such as changing landscapes that can significantly affect local weather even more acutely than long-term climate change. Land cover change can influence temperature, evapotranspiration, and surface runoff, key determinants of the emergence of vector- and water-borne diseases. Coaster wetland degradation places coastal settlements at greater risk from hurricanes or storm surges, as exemplified by the recent disaster of Hurricane Katrina. Such synergistic processes pose heightened risks to large segments of the population. But understanding these synergies also affords win-win options in building healthier communities and urban environments, while also combating the threat of global climate change. From this broader context of a health impact assessment, while climate change and urban sprawl pose both two of the greatest threats to human health and well-being, solutions afford large opportunities to improve public health on a grand scale.