Public health impacts of drought in high-income countries: a systematic review
Abstract Introduction The health effects of drought are significant and widespread, but primarily indirect. As climate change projections indicate future increases in drought events globally, it is essential that we continue to develop the evidence base on the health consequences of drought to inform future public health policy and practice (i.e. the quantification of impacts now and in the future). Methods A systematic review was preformed using: MEDLINE, EMBASE, PsycINFO, Maternity and Infant Care, Global Health, CINAHL and Cochrane. Articles were included in the analysis if they met the following criteria: exposure was specified as drought; outcome was a defined and measured human health outcome; a distinct link had to be made between exposure and outcome; drought was defined as a shortage or deficiency that was climate related; population studied was member countries of the Organisation for Economic Co-operation and Development (OECD) to represent HICs; reported original data; published in English from May 2012 to June 2017. Results 10,383 citations were initially identified; 24 papers met the eligibility criteria. Additionally, seven papers not meeting the criteria were incorporated as supporting text. The majority of studies were from Australia and the USA. Five main categories of health effects were found: (i) water borne disease (ii) vector borne disease (iii) airborne, dust and respiratory related diseases (iv) mental health and wellbeing and (v) other health effects. Conclusion The limited evidence suggests that the mental health impacts of drought in rural and farming populations and outbreaks of West Nile Fever in places that harbour the transmitting vector represent the greatest public health concern for drought prone High-Income Countries (HICs). A range of initiatives were identified, including health services preparedness alongside targeted public health policies. Further studies are needed to address gaps in the evidence including the absence of a standardised definition and/or measure of drought exposure, and methods to measure and assess health impacts related to drought.