Vulnerabilities

Higher temperatures increase the risk of insect-borne diseases from, for instance, mosquitoes, ticks or slugs.Higher tempera­tures would increase the risk of infection via food arti­cles. Furthermore, the change in temperature would also directly affect the public’s health.

While climatic factors may favor autochthonous transmission, increased vector density, and accelerated parasite development, other factors (socioeconomic, building codes, land use, treatment, etc) limit the likelihood of climate related re-emergence of malaria in Europe (4).

Most European countries have between 5 and 30 % higher death rates in winter than in summer. Winter‑related mortality in many European populations has declined since the 1950s (2). Cold days, cold nights and frost days have become rarer, but explain only a small part of this reduction: improved home heating, better general health and improved prevention and treatment of winter infections have played a more significant role (3).

More frequent extreme weather events would mean that the public would be exposed to risk situations such as flooding and landslides more frequently. Climate change will also affect the composition of pollen and pollination levels, as well as dispersion patterns (1).

Floods

Floods are the most common natural disaster in Europe. The adverse human health consequences of flooding are complex and far-reaching: these include drowning, injuries, and an increased incidence of common mental disorders. Anxiety and depression may last for months and possibly even years after the flood event and so the true health burden is rarely appreciated (5).

Effects of floods on communicable diseases appear relatively infrequent in Europe. The vulnerability of a person or group is defined in terms of their capacity to anticipate, cope with, resist and recover from the impact of a natural hazard. Determining vulnerability is a major challenge. Vulnerable groups within communities to the health impacts of flooding are the elderly, disabled, children, women, ethnic minorities, and those on low incomes (5).

Adaptation strategies - Norway

Public health measures consist of a combination of pre­vention and health service adaptation measures. Pre­vention could involve measures to limit the spread of disease-carrying species and information and hygiene-promoting initiatives within critical areas, such as food and drinking water. Health service adaptation meas­ures would involve extensive monitoring and vaccina­tion programme assessments, as well as adaptation of competence and capacity to changes in the clinical picture (1).

Adaptation strategies - General - Heatwaves

The outcomes from the two European heat waves of 2003 and 2006 have been summarized by the IPCC (6) and are summarized below. They include public health approaches to reducing exposure, assessing heat mortality, communication and education, and adapting the urban infrastructure.

1. Public health approaches to reducing exposure

A common public health approach to reducing exposure is the Heat Warning System (HWS) or Heat Action Response System. The four components of the latter include an alert protocol, community response plan, communication plan, and evaluation plan (7). The HWS is represented by the multiple dimensions of the EuroHeat plan, such as a lead agency to coordinate the alert, an alert system, an information outreach plan, long-term infrastructural planning, and preparedness actions for the health care system (8).

The European Network of Meteorological Services has created Meteoalarm as a way to coordinate warnings and to differentiate them across regions (9). There are a range of approaches used to trigger alerts and a range of response measures implemented once an alert has been triggered. In some cases, departments of emergency management lead the endeavor, while in others public health-related agencies are most responsible (10).

2. Assessing heat mortality

Assessing excess mortality is the most widely used means of assessing the health impact of heat-related extreme events.

3. Communication and education

One particularly difficult aspect of heat preparedness is communicating risk. In many locations populations are unaware of their risk and heat wave warning systems go largely unheeded (11). Some evidence has even shown that top-down educational messages do not result in appropriate resultant actions (12).

More generally, research shows that communication about heat preparedness centered on engaging with communities results in increased awareness compared with top-down messages (13).

4. Adapting the urban infrastructure

Several types of infrastructural measures can be taken to prevent negative outcomes of heat-related extreme events. Models suggest that significant reductions in heat-related illness would result from land use modifications that increase albedo, proportion of vegetative cover, thermal conductivity, and emissivity in urban areas (14). Reducing energy consumption in buildings can improve resilience, since localized systems are less dependent on vulnerable energy infrastructure. In addition, by better insulating residential dwellings, people would suffer less effect from heat hazards. Financial incentives have been tested in some countries as a means to increase energy efficiency by supporting those who are insulating their homes. Urban greening can also reduce temperatures, protecting local populations and reducing energy demands (15).

References

The references below are cited in full in a separate map 'References'. Please click here if you are looking for the full references for Norway.

1. Ministry of the Environment of Norway (2009)
2. Kunst et al. (1991); Lerchl (1998); Carson et al. (2006), in: EEA, JRC and WHO (2008)
3. Carson et al. (2006), in: EEA, JRC and WHO (2008)
4. Semenza and Menne (2009)
5. Hajat et al. (2003)
6. IPCC (2012)
7. Health Canada (2010), in: IPCC (2012)
8. WHO (2007), in: IPCC (2012)
9. Bartzokas et al. (2010), in: IPCC (2012)
10. McCormick (2010b), in: IPCC (2012)
11. Luber and McGeehin (2008), in: IPCC (2012)
12. Semenza et al. (2008)), in: IPCC (2012)
13. Smoyer-Tomic and Rainham (2001), in: IPCC (2012)
14. Yip et al. (2008); Silva et al. (2010), both in: IPCC (2012)
15. Akbari et al. (2001), in: IPCC (2012)