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BACKGROUND: The Global Burden of Disease (GBD) study, coordinated by the Institute for Health Metrics and Evaluation (IHME), produces influential, data-driven estimates of the burden of disease and premature death due to major risk factors. Expanded quantification of disease due to environmental health (EH) risk factors, including climate change, will enhance accuracy of GBD estimates, which will contribute to developing cost-effective policies that promote prevention and achieving Sustainable Development Goals. OBJECTIVES: We review key aspects of the GBD for the EH community and introduce the Global Burden of Disease-Pollution and Health Initiative (GBD-PHI), which aims to work with IHME and the GBD study to improve estimates of disease burden attributable to EH risk factors and to develop an innovative approach to estimating climate-related disease burden-both current and projected. METHODS: We discuss strategies for improving GBD quantification of specific EH risk factors, including air pollution, lead, and climate change. We highlight key methodological challenges, including new EH risk factors, notably evidence rating and global exposure assessment. DISCUSSION: A number of issues present challenges to the scope and accuracy of current GBD estimates for EH risk factors. For air pollution, minimal data exist on the exposure-risk relationships associated with high levels of pollution; epidemiological studies in high pollution regions should be a research priority. For lead, the GBD's current methods do not fully account for lead's impact on neurodevelopment; innovative methods to account for subclinical effects are needed. Decisions on inclusion of additional EH risk-outcome pairs need to be guided by findings of systematic reviews, the size of exposed populations, feasibility of global exposure estimates, and predicted trends in exposures and diseases. Neurotoxicants, endocrine-disrupting chemicals, and climate-related factors should be high priorities for incorporation into upcoming iterations of the GBD study. Enhancing the scope and methods will improve the GBD's estimates and better guide prevention policy. [ABSTRACT FROM AUTHOR]

Highlights • Climate change can affect human fertility, family planning use, and births. • We find recent delays in monsoon rains are linked with lower family planning use. • Women on farms exposed to high temperatures are less likely to give birth. • Pathways linking climate change, livelihoods and fertility behaviors are unclear. Abstract Climate change is likely to induce a large range of household- and individual-level responses, including changes in human fertility behaviors and outcomes. These responses may have important implications for human and economic development and women's empowerment. Drawing on the literature linking climate conditions to rice cultivation in Indonesia, we use longitudinal household survey and high-resolution climate data to explore changes in childbearing intentions, family planning use, and births following community-level climate shocks from 1993 to 2015. We find that fertility intentions increase and family planning use declines in response to delays in monsoon onset occurring within the previous year, particularly for wealthier populations. However, women on farms are significantly more likely to use family planning and less likely to give birth following abnormally high temperatures during the previous five years. We also measure parallel shifts in household well-being as measured by rice, food, and non-food consumption expenditures. Our findings advance the environmental fertility literature by showing that longer duration environmental shocks can have impacts on fertility behaviors and outcomes. Collectively, our results illustrate human fertility responses to climate change in a country vulnerable to its effects, and demonstrate that in some cases, climate shocks can constrain human fertility. [ABSTRACT FROM AUTHOR]

BACKGROUND: Abundant historical evidence demonstrates how environmental changes can affect social stability and, in turn, human health. A rapidly growing body of literature, largely from political science and economics, is examining the potential for and consequences associated with social instability related to current climate change. However, comparatively little of this research incorporates the effects on human health or the role of health systems in influencing the magnitude and types of instability that could occur. OBJECTIVE: The objective of this commentary is to articulate a conceptual framework incorporating health outcomes and health systems into theorized and observed linkages between climate change and social instability, illustrating in particular the health effects of natural resource shortages, infectious disease outbreaks, and migration. DISCUSSION: Although increasing evidence exists that climate change, health, and social instability are related, key questions remain about the pathways linking these factors, as well as the magnitude, causality, and directionality of relationships across spatial and temporal scales. Models seeking to explain and predict climate-related social unrest should incorporate the many linkages between climate change, human health, and social instability. Members of the environmental health research community should work closely with those in the political science and economics communities to help deepen understandings of climate-related stressors and shocks that affect instability and worsen health outcomes. [ABSTRACT FROM AUTHOR]

Summary: Population, health and environment (PHE) projects are an increasingly popular strategy for addressing lack of access to healthcare and livelihood opportunities in settings with threats to biodiversity loss. PHE projects integrate services and messaging from different development sectors, including health (particularly family planning), conservation and livelihoods. However, a question remains: do such projects produce value-added outcomes; that is, synergistic effects as a result of integration across sectors? Using qualitative data to explore value-added outcomes resulting from a PHE project serving communities along Lake Victoria in Kenya and Uganda, this study explores several theories about why this integrated project may be generating value-added outcomes, including changes in established gender roles, as well as substitution of time and investment of new income into sustainable livelihood activities, particularly among women. Integration led to several value-added benefits, particularly for women, although long-term sustainability of project outcomes remains a key concern. [ABSTRACT FROM AUTHOR]

We evaluate the impact of collaborative management agreements (CMAs) designed to protect forests and raise incomes for smallholders living adjacent to Rwenzori Mountains National Park (RMNP), Uganda. We use a quasi-experimental study design to estimate changes in several income measures, as well as land cover using three waves (2003, 2007, and 2012) of household survey and remote sensing data. Overall, we find no significant impact of CMAs on any of our income measures. However, when disaggregating households by income quartile, we find that access to forest resources in RMNP may have had an income stabilizing effect for poor households. Forest income grew significantly faster among the poorest quartile of treatment relative to control households, partially because poor households recorded very low income from forests at baseline. The effect of CMAs on forest cover is minimal, although we find that conversion of woody savanna and savanna to cropland is more pronounced in villages with CMAs. These findings suggest that in the medium-term, CMAs have failed to deliver conservation or development benefits related to enhancing livelihoods or conserving forests near RMNP. Practitioners should consider different CMA models or other strategies for improving welfare and forest health outcomes in communities neighboring protected areas. [ABSTRACT FROM AUTHOR]

Amazonian indigenous populations are approaching a critical stage in their history in which increasing education and market integration, rapid population growth and degradation of natural resources threaten the survival of their traditions and livelihoods. A topic that has hardly been touched upon in this context is migration and population mobility. We address this by analysing a unique longitudinal dataset from the Ecuadorian Amazon on the spatial mobility of five indigenous groups and mestizo co-residents. Analyses reveal traditional and new forms of population mobility and migrant selectivity, including gendered forms of marriage migration and rural-urban moves driven by education. These results illustrate a dynamic present and an uncertain future for indigenous populations in which rural, natural-resource-based lifeways may well be sustained but with increasing links to urban areas. [ABSTRACT FROM PUBLISHER]

Despite an abundant literature exploring the relationship between population growth and forest cover change, comparatively little research has examined the forest cover impacts of family planning use-a key determinant of population growth rates in many developing countries. Using data from a panel survey of farms in the Northern Ecuadorian Amazon, this paper explores whether family planning use affects changes in forest cover. After controlling for household life cycle effects, family planning use among female heads of farm households did not have an independent effect on deforestation, reforestation, or net forest loss between 1990 and 2008. Rather, shorter-term drivers of forest change tend to be associated with household life cycles and shifts in production and consumption. However, family planning will continue to improve development and health outcomes for women by reducing unwanted fertility and may offer longer-term environmental benefits. [ABSTRACT FROM AUTHOR]

Population, health, and environment (PHE) projects integrate family planning, community health, conservation, and livelihoods activities into a single effort. Despite growing calls for integrated services, relatively little academic research on PHE has been published, which has hampered the development of the approach. This article argues that additional partnerships between academics and NGOs are necessary to further advance learning around PHE. However, such partnerships need not be approached in the same way. The article discusses barriers that currently impede the development of stronger partnerships and adapts (Roper, L. 2002. “Achieving Successful Academic-Practitioner Research Collaborations.”Development in Practice12 (3–4): 338–345) typology of NGO–academic partnership models to describe how different relationship types are currently leveraged within the PHE community.ABSTRACT FROM PUBLISHER [ABSTRACT FROM AUTHOR]