Abstract

The direct and urinary electrolyte-mediated effects of ambient temperature on systolic blood pressure in tropical coastal Bangladesh

Ayesha Mukhopadhyay, MBBS, MBA, MPH ¹, Momenul Hoque², Mahbubur Rahman³, Solaiman Doza³, Farjana Jahan³, Alberto Caban-Martinez⁴, Romaina Iqbal⁵, Fawaz Mzayek¹, Lora Fleming⁶, Faruk Ahmed⁷, Anwar Musah⁸, Matthew Gribble⁹, Csaba Kovesdy¹⁰, Xichen Mou¹, Abu Mohd Naser¹ (1)Division of Epidemiology, Biostatistics, and Environmental Health; School of Public Health, The University of Memphis, Memphis, TN, USA (2)Department of Statistics, University of Barishal, Barishal, Bangladesh, (3)International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Bangladesh, (4)Department of Public Health Sciences, University of Miami, Miller School of Medicine, (5)Department of Community Health Sciences, Age Khan University, Pakistan , (6)European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall UK, (7)Department of Engineering Technology, The University of Memphis, Memphis, TN, USA , (8)UCL Department of Geography, University College London, London, UK, (9)Department of Epidemiology, University of Alabama at Birmingham, AL, USA, (10)Division of Nephrology, University of Tennessee Health Science Centre, Memphis, TN

APHA 2022 Annual Meeting and Expo

Background/Objective: With global climate change, many communities increasingly experience high ambient heat that can directly influence blood pressure by vasodilation, and indirectly by influencing urinary electrolyte levels. We evaluated the direct and urine electrolyte-mediated effects of ambient temperature on systolic blood pressure (SBP) in a tropical coastal community.
Methods: We pooled 5624 person-visit data from a community-based stepped-wedge randomized control trial in southwest coastal Bangladesh from November 2016 to April 2017. Ambient temperature data from local weather stations were collected and spatiotemporally linked to participant residences. We implemented causal mediation analysis in a linear mixed-model using sequential ignorability assumption separately for each urinary electrolyte mediator (sodium, potassium, calcium, and magnesium); and evaluated the natural direct and separate electrolyte-mediated natural indirect effects of average daily temperature on systolic blood pressure. Models had participant level random intercepts and were adjusted for age, sex, BMI , religion, physical exercise, smoking status, sleep hours, alcohol consumption, and date of urine sample collection.
Results: We had 3365 female and 2259 males with a mean age of 42.9 years. For every 5°C increase in average daily temperature, the direct and urine sodium-mediated effect of average daily temperature on SBP were -1.32 (95% CI: -0.77, -1.77) mmHg and -0.04 (-0.01, -0.08) mmHg; direct and potassium-mediated effects were -1.42 (-0.93, -1.89) mmHg and 0.06 (0.01, 0.11) mmHg; direct and calcium-mediated effects were -1.38 (-0.93, -1.93) mmHg and 0.03 (-0.01, 0.08) mmHg; and direct and magnesium-mediated effects were -1.31 (-0.83, -1.75) mmHg and -0.004 (: 0.02, -0.03) mmHg.
Conclusions: We found a significant consistent and inverse direct effect of ambient temperature on systolic blood pressure, compared to only modest electrolyte-mediated indirect effects. These findings suggest that when the ambient temperature is high for prolonged period, a population can suffer from low blood pressure-induced health consequences.

Abstract

Climate change, malnutrition, and the effects on children's health

Natalie Miller, Nana Abrefah, Andrew Chen, Amanda Chou University of Southern California, Keck School of Medicine

APHA 2022 Annual Meeting and Expo

One billion children are at high risk of suffering the negative impacts of climate change, making it one of the greatest threats to children’s rights, particularly the right to nutrition (UNICEF, 2021). Changing climate has many negative implications as emphasized in the Intergovernmental Panel on Climate Change (IPCC) Assessment Reports, including increasing frequency and severity of natural disasters, particularly droughts and floods. Droughts and floods severely harm the agricultural sector’s ability to produce food of adequate quantity and quality, furthering undernutrition across the world. According to the WHO, undernutrition currently accounts for 45% of deaths in children under five making it one of the leading causes of mortality. Climate change will exacerbate these effects and is threatening the achievement of the UN Sustainable Development Goals, specifically goal 2 of reaching zero hunger and goal 3 regarding decreasing child mortality. This review analyzes the current state of climate change and malnutrition within the context of the Convention on the Rights of the Child; addresses current models used to monitor climate change and undernutrition; recommends a new predictive model to identify locations at greatest risk for negative climate change effects coinciding with undernutrition; identifies practical long-term solutions to be implemented including community specific sustainable irrigation systems, cover crops, drought resistant crops, and effective policy; and identifies short-term solutions to be implemented immediately to help reduce the current burden of malnutrition including preventative use of ready to use therapeutic foods and promotion of breastfeeding.

Abstract

Famine in the horn of Africa: multi-dimensional analysis and interventional approaches to improving children’s health

Kiana Khodadoostan-Shahraki, Dahlia Earleywine, Gabriela Dutra-Clarke University of Southern California

APHA 2022 Annual Meeting and Expo

Famine in the horn of Africa is a multi-dimensional threat. Though hunger is universally debilitating, children are among the most vulnerable populations. Famine in this region has killed an estimated 285,000 people, about half of whom were children under five years old. Interconnected and dynamic factors of climate change, poverty, and conflict prompt and exacerbate these risks. Despite international instruments such as the Convention on the Rights of the Child, the UN Sustainable Development Goals, and the International Covenant on Economic, Social, and Cultural Rights defining the standards for global child health and nutrition, a lack of sustainable practices leaves the future health of these communities in peril.

The objectives of this paper include:
Describing the factors that contribute to disastrous famine in the Horn of Africa
Analyzing the effects of famine on population well-being
Establishing resilience frameworks as foundational in protecting the health of vulnerable children

Human rights-based interventions will improve health equity for some of the globe’s most vulnerable children. Recommendations include evidence-based approaches to foster:
Transnational support systems that create sustainable funding for humanitarian action, child-centered climate policy language, and peace promotion
Sustainable food production
Standardized treatment of undernutrition

Abstract

Youth Experience with Climate-Related Events & Well-Being

Lexi Nutkiewicz, Aminah Habib, Miguel Duenas, Lorely Ruiz, Gwendolyn Anderson University of San Francisco

APHA 2022 Annual Meeting and Expo

As climate change continues to cause more frequent and intense weather events, communities are experiencing negative effects not only in their environment but also on their mental and emotional health (Buis, 2020). The consequences have led mental health professionals to create the term “eco-anxiety, a chronic fear of environmental doom or distress/anxiety associated with worsening environmental conditions (Coffey et al., 2021). Young people are disproportionately affected by climate change due to their critical developmental stage, lack of power, and experiences with higher severity and prevalence of mental health concerns related to climate change (Cox et al., 2018). These impacts can compound existing inequities in underserved adolescent groups. While research on feelings about climate change has been conducted with adults, more research is critical to understand the experiences and effects on young people.
Research suggests eco-anxiety can lead to a constructive response, by driving focus to engage in positive situations that reduce worry (Verplanken et al., 2020). Given the growth in resources and organizations devoted to climate activism over recent years, we hope to investigate the impact of climate activism on adolescent mental health.
We created a measurement instrument to examine the adolescent experience with climate-related events, perceptions and feelings about climate change, and positive environmental action. We explore variances based on the following factors: urban/rural location, gender, socioeconomic status, political ideology, sources of information on the environment, and activism on other social issues. We will present key findings to inspire further research.