ABSTRACT: Self-organising systems adapt to environmental change, and this ability modulates the relationship between specific exposures and outcomes. Vulnerability can be thought of as the sensitivity of the system to multiple exposures, taking into account the system's ability to adapt. This paper describes 5 causes of vulnerability to climate change in the Asia Pacific region: destructive growth, poverty, political rigidity, dependency and isolation. Impoverished populations are always at greater risk because they have fewer choices. However, rapid increases in population size, density of settlement and use of natural resources may also compromise responsiveness by damaging the buffering capacity of ecological systems against environmental adversity. Public health depends on a responsive social order. Political rigidity may have contributed to recent, severe impacts of climate-related disasters in parts of Asia. Dependency (such as reliance on others for information) is a potent cause of vulnerability because it justifies fatalism. Geographically isolated countries are tied firmly to international fortunes by the increased mobility of people and goods. In these modern circumstances remoteness may be a liability. Vulnerability to climate change will be shaped by many factors, but effects on health will undoubtedly be most severe in populations that are already marginal. For these populations, climate change is one further cause of 'over-load'. The problem of human-induced climate change is global in extent and is long term, but that should not deter policy-makers--measures taken to reduce the future impact of climate change will bring other benefits sooner.
KEY WORDS: Climate change · Vulnerability · Adaptation · Human health · Infectious disease
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