Editorial: Journal of the American Medical Association. Health is inextricably linked to climate change. It is important for clinicians to understand this relationship in order to discuss associated health risks with their patients and to inform public policy. To provide new US-based temperature projections from downscaledclimate modeling and to review recent studies on health risks related to climate change and the cobenefits of efforts to mitigate greenhouse gas emissions. We searched PubMed from 2009 to 2014 for articles related to climate change and health, focused on governmental reports, predictive models, and empirical epidemiological studies. Of the more than 250 abstracts reviewed, 56 articles were selected. In addition, we analyzed climate data averaged over 13 climate models and based future projections on downscaled probability distributions of the daily maximum temperature for 2046-2065. We also compared maximum daily 8-hour average with air temperature data taken from the National Oceanic and Atmospheric Administration National Climate Data Center. By 2050, many US cities may experience more frequent extreme heat days. For example, New York and Milwaukee may have 3 times their current average number of days hotter than 32°C (90°F). The adverse health aspects related to climate change may include heat-related disorders, such as heat stress and economic consequences of reduced work capacity; and respiratory disorders, including those exacerbated by fine particulate pollutants, such as asthma and allergic disorders; infectious diseases, including vectorborne diseases and water-borne diseases, such as childhood gastrointestinal diseases; food insecurity, including reduced crop yields and an increase in plant diseases; and mental health disorders, such as posttraumatic stress disorder and depression, that are associated with natural disasters. Substantial health and economic co-benefits could be associated with reductions in fossil fuel combustion. For example, the cost of greenhouse gas emission policies may yield net economic benefit, with health benefits from air quality improvements potentially offsetting the cost of US carbon policies. Evidence over the past 20 years indicates that climate change can be associated with adverse health outcomes. Health care professionals have an important role in understanding and communicating the related potential health concerns and the cobenefits from reducing greenhouse gas emissions.
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Observations and simulations link anthropogenicgreenhouse and aerosol emissions with rapidly
increasing Indian Ocean sea surface temperatures (SSTs). Over the past 60 years, the Indian Ocean warmed two to three times faster than the central tropical Pacific, extending the tropical warm pool to the west by *40 longitude ([4,000 km). This propensity toward rapid warming in the Indian Ocean has been the dominant mode of interannual variability among SSTs throughout the tropical Indian and Pacific Oceans (55E–140W) since at least 1948, explaining more variance than anomalies associated with the El Nin˜o-Southern Oscillation (ENSO). In the atmosphere, the primary mode of variability has been a corresponding trend
toward greatly increased convection and precipitation over the tropical Indian Ocean. The temperature and rainfall increases in this region have produced a westward extension of the western, ascending branch of the atmospheric Walker circulation. Diabatic heating due to increased mid-tropospheric water vapor condensation elicits a westward atmospheric response that sends an easterly flow of dry air aloft toward eastern Africa. In recent decades (1980–2009), this response has suppressed convection over tropical eastern Africa, decreasing precipitation during the ‘long-rains’ season of March–June. This trend toward drought contrasts with projections of increased rainfall in eastern Africa and more ‘El Nin˜o-like’ conditions globally by the Intergovernmental Panel on Climate Change. Increased Indian Ocean SSTs appear likely to continue to strongly modulate the Warm Pool circulation, reducing precipitation in eastern Africa, regardless of whether the projected trend in ENSO is realized. These results have important food security implications,
informing agricultural development, environmental conservation, and water resource planning.
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