Editing IPCC:AR6/SROCC/Chapter-3 (section)

==== 3.5.2.8 Arctic Human Health and Well Being ====

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At present health adaptation to climate change is generally under-represented in policies, planning, and programming (AHDR, 2014 <sup>[[#fn:r2092|2092]]</sup> ). For instance, all initiatives of the Fifth National Communications of Annex I parties to the UNFCCC affect health vulnerability, however, only 15% of initiatives had an explicit human health component described (Lesnikowski et al., 2011 <sup>[[#fn:r2093|2093]]</sup> ). The Arctic is no exception to this global trend. Despite the substantial health risks associated with climate change in the Arctic, health adaptation responses remain sparse and piecemeal (Lesnikowski et al., 2011 <sup>[[#fn:r2094|2094]]</sup> ; Panic and Ford, 2013 <sup>[[#fn:r2095|2095]]</sup> ; Ford et al., 2014b <sup>[[#fn:r2096|2096]]</sup> ; Loboda, 2014 <sup>[[#fn:r2097|2097]]</sup> ), with the health sector substantially under-represented in adaptation initiatives compared to other sectors (Pearce et al., 2011 <sup>[[#fn:r2098|2098]]</sup> ; Ford et al., 2014b <sup>[[#fn:r2099|2099]]</sup> ; National Research Council, 2015 <sup>[[#fn:r2100|2100]]</sup> ). Furthermore, the geographic distribution of publicly available documentation on adaptation initiatives is skewed in the Arctic, with more than three-quarters coming from Canada and USA (Ford et al., 2014a <sup>[[#fn:r2101|2101]]</sup> ; Loboda, 2014 <sup>[[#fn:r2102|2102]]</sup> ).

Many Arctic health adaptation efforts by governments have been groundwork actions, focused increasing awareness of the health impacts of climate change and conducting vulnerability assessments (Lesnikowski et al., 2011 <sup>[[#fn:r2103|2103]]</sup> ; Panic and Ford, 2013 <sup>[[#fn:r2104|2104]]</sup> ; Austin et al., 2015 <sup>[[#fn:r2105|2105]]</sup> ). For instance, in Canada this effort has included training, information resources, frameworks, general outreach and education and dissemination of information to decision makers (Austin et al., 2015 <sup>[[#fn:r2106|2106]]</sup> ). Finland’s national adaptation strategy outlines various anticipatory and reactive measures for numerous sectors, including health (Gagnon-Lebrun and Agrawala, 2007 <sup>[[#fn:r2107|2107]]</sup> ). In Alaska, the Arctic Investigations Program responds to infectious disease via advancing molecular diagnostics, integrating data from electronic health records and environmental observing networks, as well as improving access to in-home water and sanitation services. Furthermore, circumpolar efforts are also underway, including a circumpolar working group with experts from public health to assess climate-sensitive infectious diseases, and to identify initiatives that reduce the risks of disease (Parkinson et al., 2014 <sup>[[#fn:r2108|2108]]</sup> ). Importantly, health adaptation is occurring at the local scale in the Arctic (Ford et al., 2014a <sup>[[#fn:r2109|2109]]</sup> ; Ford et al., 2014b <sup>[[#fn:r2110|2110]]</sup> ). Adaptation at the local-scale is broad, ranging from community freezers to increase food security, to community-based monitoring programs to detect and respond to climate health events, to Elders mentoring youth in cultural activities to promote mental health when people are ‘stuck’ in the communities due to unsafe travel conditions (Pearce et al., 2010 <sup>[[#fn:r2111|2111]]</sup> ; Brubaker et al., 2011 <sup>[[#fn:r2112|2112]]</sup> ; Harper et al., 2012 <sup>[[#fn:r2113|2113]]</sup> ; Brubaker et al., 2013 <sup>[[#fn:r2114|2114]]</sup> ; Douglas et al., 2014 <sup>[[#fn:r2115|2115]]</sup> ; Austin et al., 2015 <sup>[[#fn:r2116|2116]]</sup> ; Bunce et al., 2016 <sup>[[#fn:r2117|2117]]</sup> ; Cunsolo et al., 2017 <sup>[[#fn:r2118|2118]]</sup> ) ( ''high confidence'' ). Several regional and national-level initiatives on food security (ICC, 2012), as well as research reporting high levels of household food insecurity (Kofinas et al., 2016 <sup>[[#fn:r2119|2119]]</sup> ; Watts et al., 2017 <sup>[[#fn:r2120|2120]]</sup> ) have prompted greater concerns for climate change (Loring et al., 2013 <sup>[[#fn:r2121|2121]]</sup> ; Beaumier et al., 2015 <sup>[[#fn:r2122|2122]]</sup> ; Islam and Berkes, 2016 <sup>[[#fn:r2123|2123]]</sup> ). A new initiative to operationalise One Health concepts and approaches under the AC’s Sustainable Development Working Group has gained momentum since 2015 (Ruscio et al., 2015 <sup>[[#fn:r2124|2124]]</sup> ). One Health approaches seek to link human, animal, and environmental health, using interdisciplinary and participatory methods that can draw on indigenous knowledge and local knowledge (Dudley et al., 2015 <sup>[[#fn:r2125|2125]]</sup> ). Thus far, the initiative has supported new regional-to-international networks, and proposals for its expansion. In the future, the ability to manage, respond, and adapt to climate-related health challenges will be a defining issue for the health sector in the Arctic (Ford et al., 2010 <sup>[[#fn:r2126|2126]]</sup> ; Durkalec et al., 2015 <sup>[[#fn:r2127|2127]]</sup> ) ( ''medium confidence'' ).

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'''Table 3.4:''' Response of key human sectors /systems to climate change in polar regions. Table 3.4 summarises the consequences, interacting drivers, responses, and assets of climate change responses by select human sectors (i.e., social-ecological systems) of Arctic and Antarctic regions. Also noted are anticipated future conditions and level of certainty and other drivers of change that may interact with climate and affect outcomes. Implications to world demands on natural resources, innovation and development of technologies, population trends and economic growth are likely to affect all systems, as is the Paris Agreement (AMAP, 2017b <sup>[[#fn:r2128|2128]]</sup> ). In several cases, drivers of change interacting with climate change are regionally specific and not easily captured. In many cases there is limited information on human responses to climate change in the Russian Arctic.

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{| class="wikitable"
|-
| ''Sector /System''
| ''Consequence of climate change ''
| ''Documented responses ''
| ''Key assets and strategies of adaptive and transformative capacity''
| ''Anticipated future conditions/level of certainty''
| ''Other forces for change that may interact with climate and affect outcomes''
|-
| '''Commercial Fisheries '''
| Consequences are multi-dimensional, including impacts to abundance and distribution of different target species differently, by region. Changes in coastal ecosystems affecting fisheries productivity
| Implementation of adaptive management practices to assess stocks, change allocations as needed, and address issues of equity
| Implementation of adaptive management that is closely linked to monitoring, research, and public participation in decisions
| Displacement of fishing effort will impact fishing operations in the eastern Bering Sea and Barents Sea as well as the Convention for the Conservation of Antarctic Marine Living Resources area
| Changes in human preference, demand and markets, changes in gear, changes in policies affecting property rights. Changes due to offshore development and transportation
|-
| '''Subsistence (marine and terrestrial)'''
| Changes in species distribution and abundance (not all negative); impediments to access of harvesting areas; safety; changes in seasonality; reduced harvesting success and process of food production (processing, food storage; quality); threats to culture and food security
| Change in gear, timing of hunting, species switching; mobilisation to be involved in political action
| Systems of adaptive co-management that allow for species switching, changes in harvesting methods and timing, secure harvesting rights
| Less access to some areas, more in others. Changes in distribution and abundance of resources. More restrictions with regulations related to species at risk.
Adaptation at the individual, household, and community levels may be seriously restricted by conditions where there is poverty ''(high confidence'' )

| Changes in cost of fuel, land use affecting access, food preferences, harvesting rights; international agreements to protect vulnerable species
|-
| '''Reindeer Herding'''
| Rain-on-snow events causing high mortality of herds; shrubification of tundra pasture lowering forage quality
| Changes in movement patterns of herders; policies to ensure free-range movements; supplemental feeding.
| Flexibility in movement to respond to changes in pastures, secure land use rights and adaptive management. Continued economic viability and cultural tradition.
| Increased frequency of extreme events and changing forage quality adding to vulnerabilities of reindeer and herders ( ''medium confidence'' )
| Change in market value of meat; overgrazing; land use policies affecting access to pasture and migration routes, property rights
|-
| '''Tourism (Arctic and Antarctic)'''
| Warmer conditions, more open water, public perception of ‘last chance’ opportunities
| Increased visitation, (quantity and quality) increase in off-season tourism to polar regions
| Policies to ensure safety, cultural integrity, ecological health, adequate quarantine procedures
| Increased risk of introduction of alien species and direct effects of tourists on wildlife
| Travel costs. Shifting tourism market, more enterprises
|-
| '''Non-Renewable Resource Extraction (Arctic only)'''
| Reduced sea ice and glaciers offering some new opportunities for development; changes in hydrology (spring runoff), thawing permafrost, and temperature affect production levels, ice roads, flooding events, and infrastructure
| Some shifts in practices, greater interest in offshore and on-land development opportunities in some regions
| Modification of practices and use of climate change scenario analysis
| Increased cost of operations in areas of permafrost thawing; more accessible areas in open waters and receding glaciers
| Changes in policies affecting extent of sea and land use area, new extraction technologies (e.g., fracking), changes in markets (e.g., price of barrel of oil)
|-
| '''Infrastructure '''
'''-urban and rural human settlements, year-round '''

| Thawing permafrost affecting stability of ground; coastal erosion
| Damaged and loss of infrastructure, increase in operating costs
| Resources for assessments, mitigation, and where needed, relocation
| Increasing cost to maintain infrastructure and greater demand for technological solutions to mitigate issues. Shortening windows of operation for use of ice roads; construction of all-season roads
| Weak regional and national economies, other disasters that divert resources, disinterest by southern-based law makers
|-
| '''Marine Transportation'''
| Open seas allowing for more vessels; greater constraints in use of ice roads
| Increased shipping, tourism, more private vessels. Increased risk of hazardous waste and oil spills and accidents requiring search and rescue.
| Strong international cooperation leading to agreed-upon and enforced policies that maintain standards for safety; well-developed response plans with readiness by agents in some regions
| Continued increases in shipping traffic with increased risks of accidents
| Political conflict in other areas that impeded acceptance of policies for safety requirements, timing, and movements. Changing insurance premiums
|-
| '''Human Health'''
| Threats to food security, potential threats to physical and psychological well being
| Greater focus on food security research; programs that address fundamental health issues
| Human and financial resources to support public programs in hinterland regions; cultural awareness of health issues as related to climate change
| Greater likelihood of illnesses, food insecurity, cost of health care
| A reduction (of increase) in public resources to support health services to rural community populations, research that links ecological change to human health
|-
| '''Coastal settlements (see Cross-Chapter Box 9)'''
| Change in extent of sea ice with more storm surges, thawing of permafrost, and coastal erosion
| Maintenance of erosion mitigation; relocation planning, some but incomplete allocation for funding
| Local leadership and community initiatives to initiate and drive processes, responsive agencies, established processes for assessments and planning, geographic options
| Increasing number of communities needing relocation, rising costs for mitigating erosion issues.
| Limitations of government budgets, other disasters that may take priority for spending, deficiencies in policies for addressing mitigation and relocation
|}
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