Widening the lens of population-based health research to climate change impacts and adaptation: the climate change and health evaluation and response system (CHEERS)

Abstract

BackgroundClimate change significantly impacts health in low-and middle-income countries (LMICs), exacerbating vulnerabilities. Comprehensive data for evidence-based research and decision-making is crucial but scarce. Health and Demographic Surveillance Sites (HDSSs) in Africa and Asia provide a robust infrastructure with longitudinal population cohort data, yet they lack climate-health specific data. Acquiring this information is essential for understanding the burden of climate-sensitive diseases on populations and guiding targeted policies and interventions in LMICs to enhance mitigation and adaptation capacities.ObjectiveThe objective of this research is to develop and implement the Change and Health Evaluation and Response System (CHEERS) as a methodological framework, designed to facilitate the generation and ongoing monitoring of climate change and health-related data within existing Health and Demographic Surveillance Sites (HDSSs) and comparable research infrastructures.MethodsCHEERS uses a multi-tiered approach to assess health and environmental exposures at the individual, household, and community levels, utilizing digital tools such as wearable devices, indoor temperature and humidity measurements, remotely sensed satellite data, and 3D-printed weather stations. The CHEERS framework utilizes a graph database to efficiently manage and analyze diverse data types, leveraging graph algorithms to understand the complex interplay between health and environmental exposures.ResultsThe Nouna CHEERS site, established in 2022, has yielded significant preliminary findings. By using remotely-sensed data, the site has been able to predict crop yield at a household level in Nouna and explore the relationships between yield, socioeconomic factors, and health outcomes. The feasibility and acceptability of wearable technology have been confirmed in rural Burkina Faso for obtaining individual-level data, despite the presence of technical challenges. The use of wearables to study the impact of extreme weather on health has shown significant effects of heat exposure on sleep and daily activity, highlighting the urgent need for interventions to mitigate adverse health consequences.ConclusionImplementing the CHEERS in research infrastructures can advance climate change and health research, as large and longitudinal datasets have been scarce for LMICs. This data can inform health priorities, guide resource allocation to address climate change and health exposures, and protect vulnerable communities in LMICs from these exposures.

Strengthening Global Health Research

“…The Global Health Research community should argue for global funding of HCSMN as astronomers and physicists have succeeded to fund observatories and particle accelerators for decades. A tentative funder is the proposed global fund with 1 billion $ annual budget to finance global challenges as suggested by International Science Council (ISC) representing 250 national and global scientific societies and associations across disciplines [ 19 , 28-29 ]. This infrastructure can also serve as innovation hubs for health technologies.…”

“…The researchers used population and climate data covering 15 years and verified that periods of extreme hot temperatures increased cause-specific deaths [ 18 ]. Today, there are a few other African sites that long-term monitor demographics, collect climate data (temperature, precipitation and wind), follow health parameters of the population with wearable devices (heart and ventilation rates, temperature, mobility and sleep) and verify health status with verbal autopsies [ 19 ]. The sites have started to explore geospatial events over time using satellite-collected sensed data, i.e.…”

“…The sites have started to explore geospatial events over time using satellite-collected sensed data, i.e. crop yields [ 19 ].…”

“…This is a chance for Global Health Journals and leading Centers and Global Health Alliances to collaborate with ISC and play a key role for the provision of knowledge and evidence when the SDG programme is redirected. An apparent issue to address for such a global diplomacy network is to convince UN and WHO representatives about the need to fund a global research site infrastructure for the study and monitoring of the interaction between climate and health (HCSMN) [ 19 , 31 , 32 ].…”

Developing Climate Change and Health Impact Monitoring with eHealth at the South East Asia Community Observatory and Health and Demographic Surveillance Site, Malaysia (CHIMES)

“…With the Climate Change and Health Impact Monitoring with eHealth system (CHIMES) we will implement a system for the continuous monitoring of health and climate metrics within the SEACO HDSS, Malaysia, adopting modules from the Climate Change and Health Evaluation and Response System (CHEERS) ( 33 ). This study centers on three tiers of data collection (individual, household, and community) using digital, sensor-based devices.…”