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1.
High temperatures and heatwaves can cause large societal impacts by increasing health risks, mortality rates, and personal discomfort. These impacts are exacerbated in cities because of the Urban Heat Island (UHI) effect, and the high and increasing concentrations of people, assets and economic activities. Risks from high temperatures are now widely recognised but motivation and implementation of proportionate policy responses is inhibited by inadequate quantification of the benefits of adaptation options, and associated uncertainties. This study utilises high spatial resolution probabilistic projections of urban temperatures along with projections of demographic change, to provide a probabilistic risk assessment of heat impacts on urban society. The study focuses on Greater London and the surrounding region, assessing mortality risk, thermal discomfort in residential buildings, and adaptation options within an integrated framework. Climate change is projected to increase future heat-related mortality and residential discomfort. However, adjusting the temperature response function by 1–2 °C, to simulate adaptation and acclimatisation, reduced annual heat related mortality by 32–69 % across the scenarios tested, relative to a no adaptation scenario. Similar benefits of adaptation were seen for residential discomfort. The study also highlights additional benefits in terms of reduced mortality and residential discomfort that mitigating the urban heat island, by reducing albedo and anthropogenic heat emissions, could have.  相似文献   

2.
Through the 21st century, a significant increase in heat events is likely across California (USA). Beyond any climate change, the state will become more vulnerable through demographic changes resulting in a rapidly aging population. To assess these impacts, future heat-related mortality estimates are derived for nine metropolitan areas in the state for the remainder of the century. Heat-related mortality is first assessed by initially determining historical weather-type mortality relationships for each metropolitan area. These are then projected into the future based on predicted weather types created in Part I. Estimates account for several levels of uncertainty: for each metropolitan area, mortality values are produced for five different climate model-scenarios, three different population projections (along with a constant-population model), and with and without partial acclimatization. Major urban centers could have a greater than tenfold increase in short-term increases in heat-related mortality in the over 65 age group by the 2090s.  相似文献   

3.
The study examines temporal changes in mortality associated with spells of large positive temperature anomalies (hot spells) in extended summer season in the population of the Czech Republic (Central Europe) during 1986?C2009. Declining trends in the mortality impacts are found in spite of rising temperature trends. The finding remains unchanged if possible confounding effects of within-season acclimatization to heat and the mortality displacement effect are taken into account. Recent positive socioeconomic development, following the collapse of communism in Central and Eastern Europe in 1989, and better public awareness of heat-related risks are likely the primary causes of the declining vulnerability. The results suggest that climate change may have relatively little influence on heat-related deaths, since changes in other factors that affect vulnerability of the population are dominant instead of temperature trends. It is essential to better understand the observed nonstationarity of the temperature-mortality relationship and the role of adaptation and its limits, both physiological and technological, and to address associated uncertainties in studies dealing with climate change projections of temperature-related mortality.  相似文献   

4.
Illness and mortality related to heat and worsening air quality are core public health concerns associated with climate change projections. We examined the historical relationship between age- and cause-specific mortality rates from 1980 through 2006 and heat events at the 99th percentile of humidex values in the historic period from January 1, 1970 to December 31, 2006 in the greater Seattle area (King, Pierce and Snohomish counties), Spokane County, the Tri-Cities (Benton and Franklin counties) and Yakima County; the relative risks of mortality during heat events were applied to population and climate projections for Washington State to calculate number of deaths above the baseline (1980–2006) expected during projected heat events in 2025, 2045 and 2085. Three different warming scenarios were used in the analysis. Relative risks for the greater Seattle area showed a significant dose-response relationship between heat event duration and daily mortality rates for non-traumatic deaths for persons ages 45 and above, typically peaking at four days of exposure to humidex values above the 99th percentile. The largest number of projected excess deaths in all years and scenarios for the Seattle region was found for age 65 and above. Under the middle warming scenario, this age group is expected to have 96, 148 and 266 excess deaths from all non-traumatic causes in 2025, 2045 and 2085, respectively. We also examined projected excess deaths due to ground-level ozone concentrations at mid century (2045–2054) in King and Spokane counties. Current (1997–2006) ozone measurements and mid-twenty-first century ozone projections were coupled with dose-response data from the scientific literature to produce estimates overall and cardiopulmonary mortality. Daily maximum 8-h ozone concentrations are forecasted to be 16–28% higher in the mid twenty-first century compared to the recent decade of 1997–2006. By mid-century in King County the non-traumatic mortality rate related to ozone was projected to increase from baseline (0.026 per 100,000; 95% confidence interval 0.013–0.038) to 0.033 (95% CI 0.017–0.049). For the same health outcome in Spokane County, the baseline period rate of 0.058 (95% CI 0.030–0.085) was estimated increase to 0.068 (95% CI 0.035–0.100) by mid-century. The cardiopulmonary death rate per 100,000 due to ozone was estimated to increase from 0.011 (95% CI 0.005–0.017) to 0.015 (0.007–0.022) in King County, and from 0.027 (95% CI 0.013–0.042) to 0.032 (95% CI 0.015–0.049) in Spokane County. Public health interventions aimed at protecting Washington’s population from excessive heat and increased ozone concentrations will become increasingly important for preventing deaths, especially among older adults. Furthermore, heat and air quality related illnesses that do not result in death, but are serious nevertheless, may be reduced by the same measures.  相似文献   

5.
Excessive heat significantly impacts the health of Californians during irregular but intense heat events. Through the 21st century, a significant increase in impact is likely, as the state experiences a changing climate as well as an aging population. To assess this impact, future heat-related mortality estimates were derived for nine metropolitan areas in the state for the remainder of the century. Here in Part I, changes in oppressive weather days and consecutive-day events are projected for future years by a synoptic climatological method. First, historical surface weather types are related to circulation patterns at 500mb and 700mb, and temperature patterns at 850mb. GCM output is then utilized to classify future circulation patterns via discriminant function analysis, and multinomial logistic regression is used to derive future surface weather type at each of six stations in California. Five different climate model-scenarios are examined. Results show a significant increase in heat events over the 21st century, with oppressive weather types potentially more than doubling in frequency, and with heat events of 2?weeks or longer becoming up to ten times more common at coastal locations.  相似文献   

6.
Cold related mortality among people aged over 50 in England and Wales has decreased at a rate of 85 deaths per million population per year over the period 1976–2005. This trend is two orders of magnitude higher than the increase in heat-related mortality observed after 1976. Long term changes in temperature-related mortality may be linked to human activity, natural climatic forcings, or to adaptation of the population to a wider range of temperatures. Here we employ optimal detection, a formal statistical methodology, to carry out an end to end attribution analysis. We find that adaptation is a major influence on changing mortality rates. We also find that adaptation has prevented a significant increase in heat-related mortality and considerably enhanced a significant decrease in cold-related mortality. Our analysis suggests that in the absence of adaptation, the human influence on climate would have been the main contributor to increases in heat-related mortality and decreases in cold-related mortality.  相似文献   

7.
预估气候变化背景下中国未来近期、中期及远期温度热相关人群超额死亡风险,为未来热相关人群健康风险防范提供科学依据。基于中国网格化日均气温数据集与3种排放情景下未来日均气温数据、历史人口数据与3种生育率情景下未来人口数据以及死因数据资料计算的热效应暴露-反应关系,计算每日热相关死亡人数。结果表明:（1）未来中国平均气温将持续升高,且北方地区升温幅度较大。（2）1986—2005年中国热相关非意外总死亡人数约为7.1（95%置信区间:5.7—8.5）万。（3）RCP2.6、RCP4.5情景下未来中国热相关非意外总死亡人数均呈现先升后降的变化趋势。21世纪末,不同情景下的热相关非意外总死亡人数均高于基准年代。（4）未来不同情景下中国热相关非意外总死亡人数在黄淮海地区以及成渝地区均呈上升趋势,在RCP2.6、RCP4.5情景下北方地区热相关非意外总死亡人数呈下降趋势,东南沿海地区在21世纪30年代后开始呈下降趋势。总体而言在全球变暖的背景下未来中国热相关死亡风险将上升,而在RCP2.6情景下可以有效抑制其上升趋势。   相似文献   

8.
We use a predictive model of mean summer stream temperature to assess the vulnerability of USA streams to thermal alteration associated with climate change. The model uses air temperature and watershed features (e.g., watershed area and slope) from 569 US Geological Survey sites in the conterminous USA to predict stream temperatures. We assess the model for predicting climate-related variation in stream temperature by comparing observed and predicted historical stream temperature changes. Analysis of covariance confirms that observed and predicted changes in stream temperatures respond similarly to historical changes in air temperature. When applied to spatially-downscaled future air temperature projections (A2 emission scenario), the model predicts mean warming of 2.2 °C for the conterminous USA by 2100. Stream temperatures are most responsive to climate changes in the Cascade and Appalachian Mountains and least responsive in the southeastern USA. We then use random forests to conduct an empirical sensitivity analysis to identify those stream features most strongly associated with both observed historical and predicted future changes in summer stream temperatures. Larger changes in stream temperature are associated with warmer future air temperatures, greater air temperature changes, and larger watershed areas. Smaller changes in stream temperature are predicted for streams with high initial rates of heat loss associated with longwave radiation and evaporation, and greater base-flow index values. These models provide important insight into the potential extent of stream temperature warming at a near-continental scale and why some streams will likely be more vulnerable to climate change than others.  相似文献   

9.
Excessive heat is a health risk, yet previous studies have observed a general decline in sensitivity to heat despite increasing temperatures. Conclusive evidence is lacking on whether long-term changes of this sensitivity can be attributed to specific adaptation measures, such as air conditioning, or should be linked to societal adaptation, such as improved healthcare systems or socioeconomic well-being. The aim of this study was to assess the variation of the association between heat and daily mortality during summer in Japan since the 1970s and to examine the influence of air conditioning (AC) prevalence, healthcare resources, and socioeconomic developments at the prefecture level on this variation.We analyzed daily total, cardiovascular and respiratory disease mortality and temperature data from 1972 to 2010 for 47 prefectures. We used Poisson generalized linear model to estimate the effect of heat on mortality, random effects model to obtain the mean national effect estimates, and meta-regression to explore the impact of prefecture-level characteristics.Average summer temperature has increased across Japan during the 39-year period. Excess mortality attributable to summer heat has decreased, with a national reduction of 20 (95%CI: 17, 22), 21 (95%CI: 18, 25), and 46 (95%CI: 36, 55) cases of total, cardiovascular, and respiratory deaths (per 1000 deaths). The increase of AC prevalence was not associated with a reduction of excess mortality over time. Prefectures and populations with improved economic status documented a larger decline of excess mortality. Healthcare resources were associated with fewer heat-related deaths in the 1970s, but the associations did not persist in the more recent period (i.e., 2006–2010).Excess mortality due to heat has reduced in Japan, suggesting population adaptation. Yet, heat remains a significant health risk. Socioeconomic developments may play a role in heat adaptation. These findings may have implications for ensuring effective prevention of heat-related health impacts.  相似文献   

10.

This study presents near future (2020–2044) temperature and precipitation changes over the Antarctic Peninsula under the high-emission scenario (RCP8.5). We make use of historical and projected simulations from 19 global climate models (GCMs) participating in Coupled Model Intercomparison Project phase 5 (CMIP5). We compare and contrast GCMs projections with two groups of regional climate model simulations (RCMs): (1) high resolution (15-km) simulations performed with Polar-WRF model forced with bias-corrected NCAR-CESM1 (NC-CORR) over the Antarctic Peninsula, (2) medium resolution (50-km) simulations of KNMI-RACMO21P forced with EC-EARTH (EC) obtained from the CORDEX-Antarctica. A further comparison of historical simulations (1981–2005) with respect to ERA5 reanalysis is also included for circulation patterns and near-surface temperature climatology. In general, both RCM boundary conditions represent well the main circulation patterns of the historical period. Nonetheless, there are important differences in projections such as a notable deepening and weakening of the Amundsen Sea Low in EC and NC-CORR, respectively. Mean annual near-surface temperatures are projected to increase by about 0.5–1.5 \(^{\circ }\)C across the entire peninsula. Temperature increase is more substantial in autumn and winter (\(\sim \) 2 \(^{\circ }\)C). Following opposite circulation pattern changes, both EC and NC-CORR exhibit different warming rates, indicating a possible continuation of natural decadal variability. Although generally showing similar temperature changes, RCM projections show less warming and a smaller increase in melt days in the Larsen Ice Shelf compared to their respective driving fields. Regarding precipitation, there is a broad agreement among the simulations, indicating an increase in mean annual precipitation (\(\sim \) 5 to 10%). However, RCMs show some notable differences over the Larsen Ice Shelf where total precipitation decreases (for RACMO) and shows a small increase in rain frequency. We conclude that it seems still difficult to get consistent projections from GCMs for the Antarctic Peninsula as depicted in both RCM boundary conditions. In addition, dominant and common changes from the boundary conditions are largely evident in the RCM simulations. We argue that added value of RCM projections is driven by processes shaped by finer local details and different physics schemes that are introduced by RCMs, particularly over the Larsen Ice Shelf.

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11.
The interconnection between weather and climate and the performance, well-being, and human health cannot be overemphasized. The relationship between them is of both local and global significance. Information about weather, climate, and thermal environment is very important to human health and medical practitioners. The most crucial environmental information needed by medical practitioners and for maintaining human health, performance, and well-being are thermal conditions. The study used meteorological variables: air temperature, relative humidity, wind speed, solar radiation, and RayMan model as an analytical tool to compute physiologically equivalent temperature (PET) in order to assess thermo-physiological thresholds in Ondo State. The study revealed that there are marked spatial and seasonal variations in the environmental thermal conditions in the study area. The results of physiologically equivalent temperature for different grades of thermal sensation and physiological stress on human beings indicate that about 60 % of the total study period (1998–2008) fall under physiological stress level of moderate heat stress (PET 31–36 °C). In derived savannah, 32.6 % out of the total study period was under strong heat stress. In view of this, the study concluded that Ondo State may likely be prone to heat-related ailments and that some of the death recorded in the State, in recent times, may be heat-related mortality, but this is difficult to ascertain because there is no postmortem records in Nigeria where it could be confirmed. This type of study is relevant to help government to improve health care interventions and achieve Millennium Development Goals in health sector.  相似文献   

12.
Great Britain’s main line railway network is known to experience various temperature-related impacts, e.g. track buckling and overhead power line sag at high ambient temperatures. Climate change could alter the frequency of occurrence of these impacts. We have therefore investigated the climate change impact on various temperature-related issues, identified during workshops with rail industry specialists, using a perturbed physics ensemble (PPE) of the Met Office’s regional climate model (RCM), HadRM3. We have developed novel approaches to combine RCM data with railway industry knowledge, typically by identifying key meteorological thresholds of interest and analysing exceedance of these out to the 2040s. We performed a statistical analysis of the projected changes for each issue, via bootstrapping of the unperturbed PPE member. Although neither the PPE nor the bootstrapping analysis samples the full range of uncertainty in the projections, they nonetheless provide complementary perspectives on the suitability of the projections for use in decision-making. Our main findings include projected increases in the summertime occurrence of temperature conditions associated with (i) track buckling, (ii) overhead power line sag, (iii) exposure of outdoor workers to heat stress, and (iv) heat-related delays to track maintenance; and (v) projected decreases in the wintertime occurrence of temperatures conditions associated with freight train failure owing to brake problems. For (i), the statistical significance varied with track condition and location; for (ii) and (iii), with location; and for (iv) and (v), projected changes were significant across Great Britain. As well as assessing the changes in climate-related hazard, information about the vulnerability of the network to past temperature-related incidents has been summarised. Combining the hazard and vulnerability elements will eventually support a climate risk assessment for the industry.  相似文献   

13.
This study surveys the most recent projections of future climate change provided by 20 Atmospheric-Ocean General Circulation Models (AOGCMs) participating in the Coupled Model Intercomparison Project 3 (CMIP3) with focus on the Italian region and in particular on the Italian Greater Alpine Region (GAR). We analyze historical and future simulations of monthly-mean surface air temperature (T) and total precipitation (P). We first compare simulated T and P from the AOGCMs with observations over Italy for the period 1951–2000, using bias indices as a metric for estimating the performance of each model. Using these bias indices and different ensemble averaging methods, we construct ensemble mean projections of future climate change over these regions under three different IPCC emission scenarios (A2, A1B, and B1). We find that the emissions pathway chosen has a greater impact on future simulated climate than the criteria used to obtain the ensemble means. Across all averaging methods and emission scenarios, the models project annual mean increase in T of 2–4°C over the period 1990–2100, with more pronounced increases in summer and warming of similar magnitude at high and low elevations areas (according to a threshold of 400 m). The models project decreases in annual-mean P over this same time period both over the Italian and GAR regions. This decrease is more pronounced over Italy, since a small increase in precipitation over the GAR is projected in the winter season.  相似文献   

14.

Potential changes in future climate in the Texas Plains region were investigated in the context of agriculture by analyzing three climate model projections under the A2 climate scenario (medium–high emission scenario). Spatially downscaled historic (1971–2000) and future (2041–2070) climate datasets (rainfall and temperature) were downloaded from the North American Regional Climate Change Assessment Program (NARCCAP). Climate variables predicted by three regional climate models (RCMs) namely the Regional Climate Model Version3–Geophysical Fluid Dynamics Laboratory (RCM3-GFDL), Regional Climate Model Version3–Third Generation Coupled Global Climate Model (RCM3-CGCM3), and Canadian Regional Climate Model–Community Climate System Model (CRCM-CCSM) were evaluated in this study. Gaussian and Gamma distribution mapping techniques were employed to remove the bias in temperature and rainfall data, respectively. Both the minimum and maximum temperatures across the study region in the future showed an upward trend, with the temperatures increasing in the range of 1.9 to 2.9 °C and 2.0 to 3.2 °C, respectively. All three climate models predicted a decline in rainfall within a range of 30 to 127 mm in majority of counties across the study region. In addition, they predicted an increase in the intensity of extreme rainfall events in the future. The frost-free season as predicted by the three models showed an increase by 2.6–3.4 weeks across the region, and the number of frost days declined by 17.9 to 30 %. Overall, these projections indicate considerable changes to the climate in the Texas Plains region in the future, and these changes could potentially impact agriculture in this region.

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15.
The evolution of the Parisian urban climate under a changing climate is analyzed from long-term offline numerical integrations including a specific urban parameterization. This system is forced by meteorological conditions based on present-climate reanalyses (1970–2007), and climate projections (2071–2099) provided by global climate model simulations following two emission scenarios (A1B and A2). This study aims at quantifying the impact of climate change on air temperature within the city and in the surroundings. A systematic increase of 2-meter air temperature is found. In average according to the two scenarios, it reaches +?2.0/2.4°C in winter and +?3.5/5.0°C in summer for the minimum and maximum daily temperatures, respectively. During summer, the warming trend is more pronounced in the surrounding countryside than in Paris and suburbs due to the soil dryness. As a result, a substantial decrease of the strong urban heat islands is noted at nighttime, and numerous events with negative urban heat islands appear at daytime. Finally, a 30% decrease of the heating degree days is quantified in winter between present and future climates. Inversely, the summertime cooling degree days significantly increase in future climate whereas they are negligible in present climate. However, in terms of accumulated degree days, the increase of the demand in cooling remains smaller than the decrease of the demand in heating.  相似文献   

16.
Thomas Longden 《Climatic change》2018,150(3-4):343-375
Heat-related mortality tends to be associated with heatwaves that do not allow for sufficient acclimatisation to hot temperatures. In contrast, damage functions and most heatwave emergency response plans do not account for acclimatisation. Using an excess heat measure that accounts for acclimatisation, this paper produces estimates of temperature-related mortality for the five largest Australian capital cities. Fixed effects panel threshold regressions are applied to establish the thresholds that coincide with heightened mortality during extreme temperature events. The estimated parameters associated with these thresholds are then used to develop hindcast estimates for cold temperatures, moderate temperatures, hot temperatures and extreme heat. The estimated thresholds coincide with a notable impact of hot temperatures on mortality, but a limited cold temperature impact. This shows that the burden of risk associated with mortality related to future temperatures and climate change within Australia coincides with heatwaves rather than coldwaves. This is in contrast to recent studies that found that cold temperature-related mortality within Australian capital cities has and will continue to be notable. These studies also found a net benefit from climate change in Australia due to reduced cold temperature deaths.  相似文献   

17.
The 2007 Intergovernmental Panel on Climate Change report stated that in many regions extreme climate events are becoming increasingly frequent and that this trend will continue. However, few quantitative studies have examined the damage to society or industry that may be caused by future meteorological disasters. This study quantitatively estimates the risk of future drought and winter disasters (dzud) in Mongolia leading to massive livestock loss by applying an empirical tree-based model to data derived from the basic local trend in projections of an Earth system model (a climate model coupled with ecosystem models) based on the Special Report on Emissions Scenario A2. The results indicate that drought is the dominant factor for high livestock mortality, and the frequency of meteorological disasters leading to high livestock mortality during 2010–2099 will be lower than that during 1940–2003, mainly because of a slight increase in the leaf area index (LAI, representing forage for livestock), which is caused by increased summer rainfall. The increased precipitation in summer is likely caused mainly by increased precipitable water due to higher air temperature, rather than changes in atmospheric circulation. By the end of the 21st century, however, LAI will drop in the southern most province of Mongolia, inducing severe livestock mortality. This will be caused by extremely high temperatures, which may continue to increase in degree and extent after 2100 if climate change continues.  相似文献   

18.
Global warming is one of the greatest environmental, economic, and social threats in the world. There are many assessments to estimate climate variability over many regions. A change in the Earth’s surface temperature leads to increase in extreme temperature events, which are harmful to the ecosystem, and moreover, they create danger on human health. In this study, we have selected the western part of Turkey as the study area, since climate change projections for Turkey point out that the highest temperature change can be expected on this region during summer, and the Turkish population is very dense here to be affected by extreme events. We have used apparent temperatures to define the heat waves which we have determined their frequencies for the summer months (June–August) of 1965–2006. Since the regional comparisons of station results are intended, we selected the 90th percentile value for each station as a threshold value to be used in the delineation of heat waves. Then, the number of heat waves is determined by imposing the constraint that apparent temperatures stay above the threshold value at least for three consecutive days. Then, the changes in the number of hot days and heat waves and also their durations are analyzed by using the linear least square method. We have found that the number of hot days, heat waves, and heat wave durations is increased between 1965 and 2006 on the western part of Turkey. Additionally, their rate of change is larger within the last decade and extremes are frequently observed after 1998. Regional distributions show that the tendency of the number of heat wave events increases towards the southern latitudes of the domain. Moreover, we investigated the relationship between the number of hot days and the sea surface temperatures of the Mediterranean Sea and Black Sea. Correlation analyses are carried out by the number of hot days and averaged sea surface temperatures on the regions of the western, central, and eastern Mediterranean Sea and the Black Sea. It is found that the number of hot days of west Turkey is better correlated with the sea surface temperatures averaged over eastern Mediterranean and Black Seas. The number of heat waves is found significantly correlated with the fire occurrences for most of the stations.  相似文献   

19.
Extreme heat events frequently have adverse effects on population health. Within every population certain groups and individuals are at a greater risk of heat-related morbidity and mortality than others. While certain physiological characteristics (advanced age, chronic conditions, etc.) are known to increase the risk of illness and/or death during periods of extreme heat, the role of social and community level factors in aggravating or mitigating this risk is poorly understood. This paper reviews the literature on the social and community level factors that affect heat-related morbidity and mortality in order to identify shortfalls in current heat health response plans so that new approaches can be recommended. While social isolation, ethnicity, socioeconomic status, and neighborhood characteristics have all been identified as potential factors affecting the risk of heat-related illness and mortality, these are rarely, if ever, identified as heat health research priorities and are thus often neglected in heat emergency planning. Current research and programming practices are often prioritized from the top down where decisions are made at the federal level and research priorities are determined by national research bodies. This, unfortunately, may not allow enough flexibility to meet the needs of physically, socially and culturally diverse communities. A more socio-ecological approach to heat health research and planning would better allow for the identification of community level vulnerabilities and available resources and would encourage communities to work with regional or national partners to adapt response plans accordingly. The development of future plans should involve more partnerships at the community level so that social and community level factors that are currently overlooked may be included in heat health response strategies.  相似文献   

20.
A changing climate will exacerbate many of the problems currently faced by California’s public health institutions. The public health impacts of climate change include: an increase in extreme heat events and associated increases in heat-related morbidity and mortality, increases in the frequency and severity of air pollution episodes, shifts in the range and incidence of vector-borne diseases, increases in the severity of wildfire, increased risks of drought and flooding, and other extreme events. This article assesses the readiness of California’s public health institutions to cope with the changes that will accompany a changing climate and how they relate to strategies laid out in the state’s Climate Adaptation Strategy. County-level health offices are the front line actors to preserve public health in the face of numerous threats, including climate change. Survey results show that local health officers in California believe that climate change is a serious threat to public health, but feel that they lack the funding and resources to reduce this risk. Local health agencies also have a number of tools in place that will be helpful for preparing for a changing climate.  相似文献   

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