Health Impacts of Climate Change in Pacific Island Countries: A Regional Assessment of Vulnerabilities and Adaptation Priorities
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BACKGROUND: Between 2010 and 2012, the World Health Organization Division of Pacific Technical Support led a regional climate change and health vulnerability assessment and adaptation planning project, in collaboration with health sector partners, in 13 Pacific island countries-Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Marshall Islands, Nauru, Niue, Palau, Samoa, Solomon Islands, Tonga, Tuvalu, and Vanuatu. OBJECTIVE: We assessed the vulnerabilities of Pacific island countries to the health impacts of climate change and planned adaptation strategies to minimize such threats to health. METHODS: This assessment involved a combination of quantitative and qualitative techniques. The former included descriptive epidemiology, time series analyses, Poisson regression, and spatial modeling of climate and climate-sensitive disease data, in the few instances where this was possible; the latter included wide stakeholder consultations, iterative consensus building, and expert opinion. Vulnerabilities were ranked using a "likelihood versus impact" matrix, and adaptation strategies were prioritized and planned accordingly. RESULTS: The highest-priority climate-sensitive health risks in Pacific island countries included trauma from extreme weather events, heat-related illnesses, compromised safety and security of water and food, vector-borne diseases, zoonoses, respiratory illnesses, psychosocial ill-health, non-communicable diseases, population pressures, and health system deficiencies. Adaptation strategies relating to these climate change and health risks could be clustered according to categories common to many countries in the Pacific region. CONCLUSION: Pacific island countries are among the most vulnerable in the world to the health impacts of climate change. This vulnerability is a function of their unique geographic, demographic, and socioeconomic characteristics combined with their exposure to changing weather patterns associated with climate change, the health risks entailed, and the limited capacity of the countries to manage and adapt in the face of such risks. Citation: McIver L, Kim R, Woodward A, Hales S, Spickett J, Katscherian D, Hashizume M, Honda Y, Kim H, Iddings S, Naicker J, Bambrick H, McMichael AJ, Ebi KL. 2016. Health impacts of climate change in Pacific island countries: a regional assessment of vulnerabilities and adaptation priorities. Environ Health Perspect 124:1707-1714; http://dx.doi.org/10.1289/ehp.1509756.
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Mental health was identified as a high-priority climate-sensitive health risk in eight out of 13 Pacific Island countries.
“Mental health was identified as a high-priority climate-sensitive health risk in eight out of the 13 countries [99].”
From Climate Change and Mental Health: A Scoping Review (2021) · cites this paper as [99]
The Abstract Results list psychosocial ill-health among the highest-priority climate-sensitive health risks, and the Results discuss disorders of mental/psychosocial health as a concern in the Pacific. The retrieved portion of Table 3 lists 13 countries but does not show the mental-health row, so the specific count of eight countries cannot be verified from the passages available. (LLM, conf=0.76)
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Golden, C. D. W., Gephart, J. A., Eurich, J. G., McCauley, D. J., Sharp, M. K., Andrew, N. L., & Seto, K. L. (2021) · Global Food Security · doi:10.1016/j.gfs.2021.100561 · Cited by 55 · see citing works
Improving the quality of maternal and newborn care in the Pacific region: A scoping review
Wilson, A. N., Spotswood, N. E., Hayman, G. S., Vogel, J. P., Narasia, J., Elijah, A., Morgan, C., Morgan, A., Beeson, J. G., & Homer, C. (2020) · The Lancet Regional Health - Western Pacific · doi:10.1016/j.lanwpc.2020.100028 · Cited by 50 · see citing works
“[16] McIver L , Kim R , Woodward A , et al.”
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Ecosystem services for human health in Oceania
McFarlane, R. A., Horwitz, P., Arabena, K., Capon, A. G., Jenkins, A., Jupiter, S. D., Negin, J., Parkes, M. W., & Saketa, S. (2019) · Ecosystem Services · doi:10.1016/j.ecoser.2019.100976 · Cited by 49 · see citing works
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The Climate Change Vulnerability and Risk Management Matrix for the Coastal Zone of The Gambia
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“Reduced Rainfall frequency and Intensity Increase crop diversification and rotation to reduce total crop failure; Educational and outreach programme on conservation agriculture and improved pasture and graze-land management; use of water conservation technique like the Zai technique adopted from Burkina Faso [99,105,1…”
MethodSoutheast Asia island coastline changes and driving forces from 1990 to 2015
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Self-citationDoenças sensíveis ao clima no Brasil e no mundo: revisão sistemática
de Sousa, T. M., Amancio, F., Hacon, S. D. S., & Barcellos, C. (2018) · Revista Panamericana de Salud Pública · doi:10.26633/rpsp.2018.85 · Cited by 38 · see citing works
“Após retirada de 145 duplicatas e exclusão de 911 artigos, permaneceram 106 publicações (7-112) (figura 1).”
BackgroundClimate change, food security and health in Kiribati: a narrative review of the literature
Cauchi, J. P., Correa‐Velez, I., & Bambrick, H. (2019) · Global Health Action · doi:10.1080/16549716.2019.1603683 · Cited by 38 · see citing works
“Peer reviewed articles focused on the health impacts of climate change [16,23], and on food security and risks posed by climate change [24–30].”
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Climate Change Effects on Respiratory Health: Implications for Nursing
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My island home: place-based integration of conservation and public health in Oceania
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Vietnam Climate Change and Health Vulnerability and Adaptation Assessment, 2018
Hanh, T. T. T., Hương, L. T., Hương, N. T. L., Tran, N. Q. L., Quyen, N. H., Nhung, N. T. T., Ebi, K. L., Cuong, N. D., Nhu, H. V., Kien, T. M., et al. (2020) · Environmental Health Insights · doi:10.1177/1178630220924658 · Cited by 35 · see citing works
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“Many researchers considered this connection in their studies, like Mehrara et al. (2010) who, observed that the income elasticity of all countries was more than one, i.e., 2.59., indicating, health expenditures could be considered as luxury, and it did not appear that per capita income was affected. Furthermore, healt…”
BackgroundInfluentialClimate change, extreme events and mental health in the Pacific region
Filho, W. L., Krishnapillai, M. V., Minhas, A., Ali, S., Alverio, G. N., Ahmed, M. S. H., Naidu, R., Prasad, R. R., Bhullar, N., Sharifi, A., et al. (2022) · International Journal of Climate Change Strategies and Management · doi:10.1108/ijccsm-03-2022-0032 · Cited by 34 · see citing works
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“Moreover, it is undoubtedly a severe problem to residents of Pacific Small Island Developing States (PSIDS), who are living near the sea and in a small island state such as Tuvalu in the Pacific (IPCC, 2007): pernicious effects of social disruption related to enforced migrations, injuries, disease, loss of livelihoods…”
BackgroundTandon, I., Schuster‐Wallace, C. J., Caretta, M. A., Vij, S., & Irvine, A. (2022) · Climate and Development · doi:10.1080/17565529.2022.2051418 · Cited by 30 · see citing works
“Yet, analyses of how climate change will worsen impacts in urban areas, particularly as they concern health and WaSH, remain sparse (e.g. Bhandari et al., 2020) and evidence on how these challenges are mediated through adaptation is similarly limited (McIver et al., 2016; Tong et al., 2016).”
BackgroundClimate change, mental health and wellbeing: privileging Pacific peoples’ perspectives – phase one
Tiatia‐Seath, J., Langridge, F. C., Newport, C., Underhill‐Sem, Y., & Woodward, A. J. (2022) · Climate and Development · doi:10.1080/17565529.2022.2145171 · Cited by 30 · see citing works
“The World Health Organization (WHO) identified that the main climate change-related health risks in the Pacific included the increasing risk of mental health challenges (McIver et al., 2016).”
BackgroundSelf-citationMatthews, R. J., Kaluthotage, I., Russell, T. L., Knox, T. B., Horwood, P. F., & Craig, A. T. (2022) · Pathogens · doi:10.3390/pathogens11010074 · Cited by 29 · see citing works
Dealing with climate change on small islands: Towards effective and sustainable adaptation
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“Risks posed to SIDS by climate change include food insecurity (Barnett, 2011), water resource issues (Dore and Singh, 2013) and a range of human health impacts (McIver et al., 2016).”
BackgroundYassi, A., Lockhart, K., Gray, P., & Hancock, T. (2017) · Critical Public Health · doi:10.1080/09581596.2017.1384796 · Cited by 26 · see citing works
“The Anthropocene refers to the new geological time period that marks rapid human impacts on the Earth’s systems (Hancock et al., 2015; Whitmee et al., 2015), including the impacts of climate change (Bickton, 2016; McIver et al., 2016).”
BackgroundClimate change glossary for public health practice: from vulnerability to climate justice
Buse, C. G., & Patrick, R. (2020) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2020-213889 · Cited by 27 · see citing works
Human health and climate change in the Pacific: a review of current knowledge
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“Regionally, extremes of rainfall are correlated with the incidence of water-borne diseases (such as diarrhoeal disease, cholera, and typhoid fever) (McIver et al., 2016).”
BackgroundInfluentialSelf-citationYates, O. E. T., Manuela, S., Neef, A., & Groot, S. (2021) · Climate and Development · doi:10.1080/17565529.2021.1911775 · Cited by 25 · see citing works
“Elsewhere, the contribution of social ties to mental health post-migration has been isolated (Torres & Casey 2017) or related to psychopathology (Manning & Clayton 2018; McIver et al. 2016), but not to holistic well-being.”
BackgroundLau, C. L., Mayfield, H. J., Lowry, J. H., Watson, C., Kama, M., Nilles, E. J., & Smith, C. S. (2017) · Environmental Modelling & Software · doi:10.1016/j.envsoft.2017.08.004 · Cited by 25 · see citing works
Brolan, C. E., Kὃrver, S., Phillips, G. A., Sharma, D., Herron, L., O’Reilly, G. M., Mitchell, R. D., Kendino, M., Poloniati, P., Kafoa, B., et al. (2022) · The Lancet Regional Health - Western Pacific · doi:10.1016/j.lanwpc.2022.100514 · Cited by 23 · see citing works
“29,30 Our study illuminated the lack of pre-pandemic investment in ‘business as usual’ EC systems with human resources and training.”
Ten new insights in climate science 2020 – a horizon scan
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“In this regard, governmental acknowledgment of mental ill-health as a worrying and increasing burden of disease is growing (McIver et al., 2016; Rehm & Shield, 2019).”
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“For example, climate change has been associated with a rise in infectious vector borne diseases, heat effects, and malnutrition, which impacts patients from Micronesia [117].”
BackgroundFood, hunger, health, and climate change
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Self-citationUsing Implementation Science For Health Adaptation: Opportunities For Pacific Island Countries
Boyer, C. J., Bowen, K., Murray, V. S. G., Hadley, J., Hilly, J. J., Hess, J. J., & Ebi, K. L. (2020) · Health Affairs · doi:10.1377/hlthaff.2020.01101 · Cited by 19 · see citing works
Self-citationThe value of lost output and cost of illness of noncommunicable diseases in the Pacific
Hou, X., Anderson, I., & Burton-McKenzie, E.-J. (2022) · Health Policy OPEN · doi:10.1016/j.hpopen.2022.100073 · Cited by 19 · see citing works
“The rates of government tax revenue as a percentage of GDP are generally low and countries have high vulnerability to external economic shocks and natural disasters [17].”
BackgroundClimate Change and Mental Health: Implications for Nurses
Kameg, B. N. (2020) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/02793695-20200624-05 · Cited by 18 · see citing works
Pradyumna, A., & Sankam, J. (2022) · The Journal of Climate Change and Health · doi:10.1016/j.joclim.2022.100153 · Cited by 18 · see citing works
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Self-citationClimate change adaptation: no one size fits all
Hansen, A. L., & Bi, P. (2017) · The Lancet Planetary Health · doi:10.1016/s2542-5196(17)30160-2 · Cited by 18 · see citing works
Hossain, B. (2025) · Environmental Development · doi:10.1016/j.envdev.2025.101166 · Cited by 17 · see citing works
Potential adverse health consequences of climate change related to rheumatic diseases
Bush, T. M. (2021) · The Journal of Climate Change and Health · doi:10.1016/j.joclim.2021.100029 · Cited by 17 · see citing works
Kim, H. S., Ryan, A. D., Harding, A. B., Moskowitz, A. F., Passe, A. I., & Kawazu, E. C. (2022) · The Journal of Climate Change and Health · doi:10.1016/j.joclim.2022.100166 · Cited by 16 · see citing works
Self-citationMihaere, S., Holman-Wharehoka, M.-T.-O., Mataroa, J., Kiddle, G. L., Zari, M. P., Blaschke, P., & Bloomfield, S. (2024) · Frontiers in Environmental Science · doi:10.3389/fenvs.2024.1278235 · Cited by 16 · see citing works
Oluwatimilehin, I. A., Akerele, J. O., Oladeji, T. A., Omogbehin, M. H., & Atai, G. (2022) · Regional Sustainability · doi:10.1016/j.regsus.2022.11.007 · Cited by 15 · see citing works
Asugeni, R., Redman-MacLaren, M. L., Asugeni, J., Esau, T., Timothy, F., Massey, P., & MacLaren, D. J. (2017) · Climate and Development · doi:10.1080/17565529.2017.1411239 · Cited by 15 · see citing works
“Rising sea-levels are negatively impacting many Pacific Islands Countries and Territories (PICTs) (McIver et al., 2015).”
BackgroundRumsey, M., Iro, E., Brown, D., Larui, M., Sam, H., & Brooks, F. M. (2022) · Policy Politics & Nursing Practice · doi:10.1177/15271544221095768 · Cited by 14 · see citing works
“Many of the islands have small landmasses, are geographically remote and are low-lying making them particularly vulnerable to climate change and natural disasters (McIver et al., 2016).”
BackgroundMitchell, R. D., O’Reilly, G. M., Herron, L., Phillips, G. A., Sharma, D., Brolan, C. E., Körver, S., Kendino, M., Poloniati, P., Kafoa, B., et al. (2022) · The Lancet Regional Health - Western Pacific · doi:10.1016/j.lanwpc.2022.100515 · Cited by 14 · see citing works
Hardy, M. C., & Barrington, D. (2017) · Tropical Medicine and Infectious Disease · doi:10.3390/tropicalmed2010001 · Cited by 14 · see citing works
“The spread of these diseases will not be curbed by high level policies and procedures alone, but must be tackled through a holistic systems-based approach to improving environmental health that includes a consideration of local context and the contribution that local communities can make to reducing disease prevalence…”
BackgroundPerspectives of artist-practitioners on the communication of climate change in the Pacific
Capstick, S., Hemstock, S., & Senikula, R. (2017) · International Journal of Climate Change Strategies and Management · doi:10.1108/ijccsm-03-2017-0058 · Cited by 8 · see citing works
“For those living in the islands of the Pacific, the consequences of climate change include risks to health and livelihoods from extreme weather events and changing weather patterns, as well as threats to food and water security (McIver et al., 2016).”
BackgroundHealth threats of climate change: from intersectional analysis to justice-based radicalism
Ghosh, A., & Dutta, K. (2024) · Ecology and Society · doi:10.5751/es-14045-290215 · Cited by 18 · see citing works
“Climate change is significantly threatening public health (Portier et al. 2010), in particular of the marginal communities, across the world (Portier et al. 2010, Patz et al. 2014, Franchini and Mannucci 2015, McIver et al. 2015, Watts et al. 2015, Berry et al. 2018).”
Climate effects on health in Small Islands Developing States
Tukuitonga, C., & Vivili, P. (2021) · The Lancet Planetary Health · doi:10.1016/s2542-5196(21)00004-8 · Cited by 13 · see citing works
Health and well-being in small island communities: a cross-sectional study in the Solomon Islands
Furusawa, T., Pitakaka, F., Gabriel, S., Sai, A., Tsukahara, T., & Ishida, T. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-055106 · Cited by 12 · see citing works
A scoping review of climate resilient health system strategies in low-resource settings
Myhre, S. L., Frønsdal, K. B., Ames, H. M. R., & Papadopoulou, E. (2025) · Public Health · doi:10.1016/j.puhe.2025.106026 · Cited by 16 · see citing works
Systems Thinking Research in Science and Sustainability Education: A Theoretical Note
Semız, G. K. (2021) · MDPI eBooks · doi:10.3390/books978-3-03897-893-0-3 · Cited by 14 · see citing works
Sabūnas, A., Miyashita, T., Fukui, N., Shimura, T., & Mori, N. (2021) · Frontiers in Built Environment · doi:10.3389/fbuil.2021.752599 · Cited by 12 · see citing works
“On the other hand, one may note that compounding effects could aggravate the following climate-sensitive risks: water security and safety, food security and safety, vector-borne diseases, and population pressures (McIver et al., 2016).”
BackgroundDevelopment of a Novel Climate Adaptation Algorithm for Climate Risk Assessment
Tung, C., Tsao, J.-H., Tien, Y.-C., Lin, C., & Jhong, B.-C. (2019) · Water · doi:10.3390/w11030497 · Cited by 12 · see citing works
Nelson, S., Abímbọ́lá, Ṣ., Mangubhai, S., Jenkins, A., Jupiter, S. D., Naivalu, K., Naivalulevu, V., & Negin, J. (2021) · International Journal of Water Resources Development · doi:10.1080/07900627.2021.1916449 · Cited by 13 · see citing works
Pathogen prospecting of museums: Reconstructing malaria epidemiology
Nelder, M. P., Schats, R., Poinar, H. N., Cooke, A., & Brickley, M. B. (2024) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2310859121 · Cited by 11 · see citing works
Craig, A. T., Joshua, C. A., Sio, A. R., Donoghoe, M. W., Betz‐Stablein, B., Bainivalu, N., Dalipanda, T., Kaldor, J. M., Rosewell, A. E., & Schierhout, G. (2018) · BMC Public Health · doi:10.1186/s12889-018-6295-7 · Cited by 13 · see citing works
Pacheco, L., Luo, N., Pujol, T., Gonzalez, J. R., & Ferrer, I. (2019) · International Journal of Sustainability in Higher Education · doi:10.1108/ijshe-10-2018-0166 · Cited by 11 · see citing works
Mental health in the Pacific: Urgency and opportunity
Ali, S., Williams, O. D., Chang, O., Shidhaye, R. R., Hunter, E. M., & Charlson, F. (2020) · Asia Pacific Viewpoint · doi:10.1111/apv.12286 · Cited by 11 · see citing works
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“Climate-induced changes in infectious disease transmission are a priority health risk in the Pacific Island Countries and Territories (PICTs) [26, 27].”
Self-citationCox, M., Phillips, G. A., Mitchell, R. D., Herron, L., Körver, S., Sharma, D., Brolan, C. E., Kendino, M., Masilaca, O. K., O’Reilly, G. M., et al. (2022) · The Lancet Regional Health - Western Pacific · doi:10.1016/j.lanwpc.2022.100517 · Cited by 10 · see citing works
Perceptions of drinking water access and quality in rural indigenous villages in Fiji
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Pacific Island Countries and Climate Change: Examining Associated Human Health Vulnerabilities
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Epidemic size, duration and vaccine stockpiling following a large-scale attack with smallpox
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Self-citationChildren’s Environmental Health Indicators for Pacific Island Countries
Brereton, C. F., Turagabeci, A., Wilson, D., Sly, P. D., & Jagals, P. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15071403 · Cited by 9 · see citing works
“The lack of systems and/or the need to establish information sharing systems on content, impact, and future direction of health and environment are noted in a substantial number of the reviewed literature [2,14,26,27].”
Background
- Authors
- McIver, L., Kim, R., Woodward, A., Hales, S., Spickett, J., Katscherian, D., Hashizume, M., Honda, Y., Kim, H., Iddings, S., Naicker, J., Bambrick, H., McMichael, A. J., & Ebi, K. L.
- Affiliations
- Australian National University (AU)
- World Health Organization (CH)
- University of Auckland (NZ)
- University of Otago (NZ)
- Curtin University (AU)
- Nagasaki University (JP)
- University of Tsukuba (JP)
- Seoul National University (KR)
- Western Sydney University (AU)
- University of Washington (US)
- Corresponding author
- McIver, Lachlan
- ORCID
- Venue
- Environmental Health Perspectives
- Publisher
- American Chemical Society (ACS)
- Published
- 2015-12-08
- Volume
- 124
- Issue
- 11
- Pages
- 1707-1714
- ISSN
- 0091-6765 (ISSN-L)
- 1552-9924
- PMC
- PMC5089897
- OpenAlex
- W2423872746
- Cited by
- 238
- References
- 38
- Citations by year
- 2026: 19 · 2025: 26 · 2024: 27 · 2023: 20 · 2022: 27 · 2021: 28 · 2020: 20 · 2019: 23 · 2018: 22 · 2017: 17 · 2016: 8 · 2013: 1
- FWCI
- 9.83
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Environmental Health Perspectives (publishedVersion, cc-by-sa)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- QUT ePrints (Queensland University of Technology) (submittedVersion)
- eSpace (Curtin University) (submittedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- Seoul National University Open Repository (Seoul National University) (submittedVersion)
- Funders
- World Health Organization
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
- Physical Sciences › Environmental Science › Global and Planetary Change › Climate Change and Environmental Impact
- Social Sciences › Sociology and Political Science › Climate Change Communication and Perception
- Keywords
- health impacts of climate change, climate change vulnerability, climate change adaptation, Pacific Island countries, heat-related illness, vector-borne diseases, zoonoses, respiratory diseases, non-communicable diseases, food and water security, health system capacity, adaptation planning
- MeSH terms
- Adaptation, Physiological, Health Status Indicators, Humans, Pacific Islands, Socioeconomic Factors, Poisson Distribution, Climate Change, Public Health Surveillance
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