Building Resilience to Climate Change: Pilot Evaluation of the Impact of India’s First Heat Action Plan on All-Cause Mortality

Hess, Jeremy; Lm, Sathish; Knowlton, Kim; Saha, Shubhayu; Dutta, Priya; Ganguly, Parthasarathi; Tiwari, Abhiyant; Jaiswal, Anjali; Sheffield, Perry; Sarkar, Jayanta; Bhan, S. C.; Begda, Amit; Shah, Tejas; Solanki, Bhavin; Mavalankar, Dileep

doi:10.1155/2018/7973519

Cited by 65 publications

(49 citation statements)

References 32 publications

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“…While most common in North America and Europe, major cities in China and a growing number of cities in India have implemented early-warning systems that notify residents of poor air quality and alert health professionals to prepare for air pollution-related hospitalizations. In 2014, Ahmedabad, India, was the first city in South Asia to implement a heatwave early warning system [122], with preliminary evidence indicating lower summertime mortality rates after its implementation and larger declines at the highest temperatures [123].…”

Section: The Role Of Cities In Mitigating Pollution and Related Cvd Bmentioning

confidence: 99%

The role of cities in reducing the cardiovascular impacts of environmental pollution in low- and middle-income countries

Baumgartner

Bräuer

Ezzati

2020

BMC Med

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Background: As low-and middle-income countries urbanize and industrialize, they must also cope with pollution emitted from diverse sources. Main text: Strong and consistent evidence associates exposure to air pollution and lead with increased risk of cardiovascular disease occurrence and death. Further, increasing evidence, mostly from high-income countries, indicates that exposure to noise and to both high and low temperatures may also increase cardiovascular risk. There is considerably less research on the cardiovascular impacts of environmental conditions in low-and middleincome countries (LMICs), where the levels of pollution are often higher and the types and sources of pollution markedly different from those in higher-income settings. However, as such evidence gathers, actions to reduce exposures to pollution in low-and middle-income countries are warranted, not least because such exposures are very high. Cities, where pollution, populations, and other cardiovascular risk factors are most concentrated, may be best suited to reduce the cardiovascular burden in LMICs by applying environmental standards and policies to mitigate pollution and by implementing interventions that target the most vulnerable. The physical environment of cities can be improved though municipal processes, including infrastructure development, energy and transportation planning, and public health actions. Local regulations can incentivize or inhibit the polluting behaviors of industries and individuals. Environmental monitoring can be combined with public health warning systems and publicly available exposure maps to inform residents of environmental hazards and encourage the adoption of pollution-avoiding behaviors. Targeted individual or neighborhood interventions that identify and treat high-risk populations (e.g., lead mitigation, portable air cleaners, and preventative medications) can also be leveraged in the very near term. Research will play a key role in evaluating whether these approaches achieve their intended benefits, and whether these benefits reach the most vulnerable. Conclusion: Cities in LMICs can play a defining role in global health and cardiovascular disease prevention in the next several decades, as they are well poised to develop innovative, multisectoral approaches to pollution mitigation, while also protecting the most vulnerable.

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Section: The Role Of Cities In Mitigating Pollution and Related Cvd Bmentioning

confidence: 99%

The role of cities in reducing the cardiovascular impacts of environmental pollution in low- and middle-income countries

Baumgartner

Bräuer

Ezzati

2020

BMC Med

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“…Higher ozone and additional warming in the mitigation scenario may reduce crop productivity 21 ; however, this may be partially compensated by a lower ambient PM 2.5 that also has a negative association with productivity 22 . The additional warming may enhance heat stress condition; however, this can be tackled by an effective heat management plan that has been proven to save lives in India 23 . Quantifying such impact for the two emission pathways is beyond the scope of this work and will be reported separately.…”

Section: Discussionmentioning

confidence: 99%

Tradeoffs between air pollution mitigation and meteorological response in India

Upadhyay

Dey

Chowdhury

et al. 2020

Sci Rep

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To curb the staggering health burden attributed to air pollution, the sustainable solution for India would be to reduce emissions in future. Here we project ambient fine particulate matter (PM2.5) exposure in India for the year 2030 under two contrasting air pollution emission pathways for two different climate scenarios based on Representative Concentration Pathways (RCP4.5 and RCP8.5). All-India average PM2.5 is expected to increase from 41.4 ± 26.5 μg m−3 in 2010 to 61.1 ± 40.8 and 58.2 ± 37.5 μg m−3 in 2030 under RCP8.5 and RCP4.5 scenarios, respectively if India follows the current legislation (baseline) emission pathway. In contrast, ambient PM2.5 in 2030 would be 40.2 ± 27.5 (for RCP8.5) and 39.2 ± 25.4 (for RCP4.5) μg m−3 following the short-lived climate pollutant (SLCP) mitigation emission pathway. We find that the lower PM2.5 in the mitigation pathway (34.2% and 32.6%, respectively for RCP8.5 and RCP4.5 relative to the baseline emission pathway) would come at a cost of 0.3–0.5 °C additional warming due to the direct impact of aerosols. The premature mortality burden attributable to ambient PM2.5 exposure is expected to rise from 2010 to 2030, but 381,790 (5–95% confidence interval, CI 275,620–514,600) deaths can be averted following the mitigation emission pathway relative to the baseline emission pathway. Therefore, we conclude that given the expected large health benefit, the mitigation emission pathway is a reasonable tradeoff for India despite the meteorological response. However, India needs to act more aggressively as the World Health Organization (WHO) annual air quality guideline (10 µg m−3) would remain far off.

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“…The initial result returned 51 sources. After reviewing these sources manually, it became evident that the articles by Hess et al [8], Knowlton et al [14], and Azhar et al [32], with overlapping authorship, are the main data sources, based on which the appraisals of the HAP were made.…”

Section: Methodsmentioning

confidence: 99%

“…A pilot evaluation of the HAP conducted by Hess et al [8] suggested that the HAP may be effective in addressing heat vulnerability in disadvantaged communities in crowded cities. Drawing on epidemiological evidence, their research evaluated the impacts of the HAP on all-cause mortality in 2014-2015, relative to a baseline from 2007-2010.…”

Section: Acclaimed Impactsmentioning

confidence: 99%

“…To achieve these aims, the paper draws on the case of Ahmedabad's HAP, which represents a critical case, which has strategic importance regarding the general problem [7]. Ahmedabad's HAP is considered to be a critical case because of its increasing popularity among policy-makers, considered to be so effective that the governments of India and other South Asian countries have urged heatwave-prone cities to develop similar plans [8]. A pilot evaluation of Ahmedabad's HAP suggests that more than one thousand deaths were avoided annually after its implementation (ibid).…”

Section: Introductionmentioning

confidence: 99%

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Message Sent, Now What? A Critical Analysis of the Heat Action Plan in Ahmedabad, India

Nastar

2020

Urban Science

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To protect public health, heat-related policies are increasingly being adopted by city authorities to address the unequal impact of heatwaves. Ahmedabad’s Heat Action Plan (HAP) is an acclaimed and successful policy response in India and beyond. While the pilot evaluation of the initiative suggests that almost a thousand deaths were avoided annually after its implementation, it is not yet clear whose lives were saved, and to what extent this statistic was due to the HAP, rather than other factors. By reviewing the published and grey literature centering on the HAP target groups, outreach strategies, and impacts on urban services, this paper points out major knowledge gaps concerning the potentials and impacts of the HAP, which may lead to the systematical exclusion of vulnerable and disadvantaged groups from the intended benefits. In this paper, it is argued that the effectiveness and inclusiveness of the HAP predominantly depend on its integration into urban development projects, which is a challenging task given the existing horizontal and vertical fragmentation in the planning of city projects. Moreover, urban plans and policies, including the HAP, are shown to be overly focused on technology, and as a consequence, they do not realize their limited scope in addressing the associated issues, which are fundamentally social, deep, and structural, such as spatial inequality in Indian cities.

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Building Resilience to Climate Change: Pilot Evaluation of the Impact of India’s First Heat Action Plan on All-Cause Mortality

Cited by 65 publications

References 32 publications

The role of cities in reducing the cardiovascular impacts of environmental pollution in low- and middle-income countries

The role of cities in reducing the cardiovascular impacts of environmental pollution in low- and middle-income countries

Tradeoffs between air pollution mitigation and meteorological response in India

Message Sent, Now What? A Critical Analysis of the Heat Action Plan in Ahmedabad, India

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