The Impacts of Climate-related Disasters on Vulnerable Populations in China, Indonesia and Viet Nam: A Scoping Review of Health Adaptation and Implications for Measurement
Implementations
December 2019
- December 2021
Implementing partners
Guangdong Provincial Institute of Public Health, Center for Disease Control and Prevention of Guangdong Province (China); Institute for Hospital Management of Tsinghua University (China); Universitas Syiah Kuala (Indonesia); Hanoi University of Public Health (Viet Nam); Danang University of Medical Technology and Pharmacy (Viet Nam)
Lead research institution: Griffith University (Australia)
Principal investigator: Dr Cordia Chu
Total budget
| Phase 1: | US$ | 83 200.00 |
Background
There have been rapid increases in climate-related disasters and emergencies since the beginning of the 21st Century, resulting in significant public health burdens globally. While there is increasing global interest in developing public health programmes and strategies, current scientific evidence is still insufficient for decision-makers to develop and implement effective evidence-informed interventions. In addition, populations are impacted unevenly with higher burdens affecting the more vulnerable and marginalised populations. These high-risk groups may include ethnic minorities, poor communities, migrants and displaced people, older people, women and children, although the complete spectrum of vulnerable sub-groups has yet to be determined and described. Therefore, identifying these groups remains a challenge since both evidence and established methodologies for identifying these sub-populations in need are still lacking. Hence, a key approach of the Health-emergency and disaster risk management (Health EDRM) approach is to improve the identification of sub-populations in various contexts who have unique needs in mitigating the short and long-term effects and risks. Addressing these sub-populations’ needs on important health-emergency and disaster risks can facilitate the creation of targeted strategies (and measures) to enhance the effectiveness of prevention, preparedness, response and recovery efforts that protect health.
Less is known and published in English about disaster adaptation strategies in non-English speaking populations. Within Asia, China, Indonesia and Viet Nam are three countries that are highly susceptible to climate change and the adverse effects from climate events. For example, within the last 20 years, the absolute death toll from disasters in Indonesia has ranked consistently as one of the top two nations globally, with more than 78% of disasters resulting from floods, extreme waves, land cum forest fires, drought and extreme weather.
Goal
This project aimed to map out existing global studies on adaptation strategies addressing primarily health impacts, and secondarily, socio-economic impacts of climate-related disasters, with a focus on vulnerable populations in China, Indonesia and Viet Nam. These results fed into a global expert panel consultation that expanded on the global implications of the scoping review results, existing evidence gaps, and future research directions.
Methods
A systematic review was conducted in English, Chinese, Indonesian, Japanese and Vietnamese to identify studies relevant to climate change, health and other socio-economic outcomes in climate related disasters. Four electronic databases - MEDLINE, Scopus, Embase and Google Scholar, as well as relevant grey literature, were searched for studies dating from 1997 (the year of the UN Kyoto Protocol on Climate Change) with outcomes that focussed on health impacts and/or vulnerability assessments of susceptible populations. Researchers also conducted manual searches with local sources of data sources to identify primary studies and policy documents for this review (as part of the grey literature review). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) checklist was adopted for this review. Data were extracted and appraised qualitatively using a Thematic Analysis approach (e.g., themes included type of disaster, vulnerable populations, health impacts, health adaptation measures among other categories). After screening 10,139 articles, 298 studies were finally included in the review.
Furthermore, the research team conducted a global knowledge synthesis by convening a panel of global experts from Europe, Africa, as well as the Asia-Pacific, to dicuss the best way to combine and disseminate knowledge and evidence in this field.
Results
Global findings
- Majority of research focused on infectious or single disease, such as diarrhea or mental health issues resulting from a single type of disaster (e.g., flood). Only a small number of studies (n=26) applied vulnerability assessments to identify vulnerable groups. Definitions, approaches, and methods for vulnerability assessment to climate-related disasters differ globally, making comparisons across countries difficult.
- No good quality data or data sources to indicate exposure, vulnerability, risks and impacts for vulnerable sub-populations. More data is needed to identify adaptive capacities of different sub-populations to climate-related disasters.
- A lack of multi-disciplinary/interdisciplinary, multi-sector collaborative, translational research that address sub-populations’ needs and interest. A strong need for a universally agreed conceptual framework to guide research that frames Health EDRM issues in climate-related disasters and emergencies which is constructed from the perspective of vulnerable sub-populations.
Specific findings relevant to China, Indonesia and Viet Nam
China
- Many studies focused on policy responses to single hazard disasters (e.g., flood) or specific infectious diseases and injuries using the established national notifiable diseases reporting system as data source.
- The majority of China's climate related policies aimed at mitigating emissions.
Indonesia
- Geographically disadvantaged groups, children under five, people living with disabilities, people with low socio-economic status, and women were identified as groups that were most vulnerable to climate-related disasters.
- Most of the adaptation measures and policies relating to climate-related disasters and health were formulated at the national level but have not been operationalized at the local level.
Viet Nam
- Limited research on health risks due to climate-change, vulnerable populations or adaptation measures,
- Most of the available publications described adaptation strategies for one or several types of disasters in socio-economic areas, such as agriculture, construction, the environment, natural resources and rural development, but not for health.
Global Implications
There is a need to create a framework and expand vulnerability assessments globally to identify groups that carry higher risk from climate-related disasters and emergencies. This requires appropriate research to identify community adaptation capacities and strategies, where such strategies are developed to manage emergencies and disasters using an all-hazards/all health risks based approach, rather than addressing merely a single disease or type of disaster.
In addition, policies and adaptation measures are often devised at the national level using a one-size-fits-all approach. However, for effective implementation, there is a need to develop actionable policies and practices tailored to sub-populations and vulnerable groups, and at the appropriate sub-national or local government levels. These policies are only made possible by effective translational research that starts from the identification of the problem and which goes on to provide the necessary evidence for effective, actions, strategies and intervention measures. Vulnerable sub-populations should be involved in the design, conduct and management of such research.
In addition, policies and adaptation measures are often devised at the national level using a one-size-fits-all approach. However, for effective implementation, there is a need to develop actionable policies and practices tailored to sub-populations and vulnerable groups, and at the appropriate sub-national or local government levels. These policies are only made possible by effective translational research that starts from the identification of the problem and which goes on to provide the necessary evidence for effective, actions, strategies and intervention measures. Vulnerable sub-populations should be involved in the design, conduct and management of such research.
Local implications
Kansai and Japan are not immune from climate-related disasters. Vulnerability assessments, especially with older people over the age of 65 may be a priority. The development of policies and interventions that are appropriate to the regional and local municipality levels may also be important to future developments in this area.
Products
Published Journals
- Gan CCR, Oktari RS, Nguyen HX, Yuan L, Yu X, KC A, Hanh TTT, Phung DT, Dwirahmadi F, Liu T, Musumari PM, Kayano R, Chu C. A scoping review of climate-related disasters in China, Indonesia and Vietnam: Disasters, health impacts, vulnerable populations and adaptation measures. International Journal of Disaster Risk Reduction. Volume 66, 2021, 102608, ISSN 2212-4209, https://doi.org/10.1016/j.ijdrr.2021.102608.
- Oktari RS, Dwirahmadi F, Gan CCR, Darundiyah K, Nugroho PC, Wibowo A, Chu C. Indonesia’s Climate-Related Disasters and Health Adaptation Policy in the Build-Up to COP26 and Beyond. Sustainability. 2022; 14(2):1006. https://doi.org/10.3390/su14021006