{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T20:53:40Z","timestamp":1776113620781,"version":"3.50.1"},"reference-count":68,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2018,8,21]],"date-time":"2018-08-21T00:00:00Z","timestamp":1534809600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Climate change and variability are known to have an influence on human wellbeing in a variety of ways. In Latin America, such forces are especially conspicuous, particularly in respect of extreme climatological, hydrological, and weather events (EWEs) and climate-sensitive disasters (CSDs). Consistent with the need to study further such connections, this paper presents an analysis of some of the vulnerabilities of environmental health issues and climate-related impacts that are focusing on EWEs and CSDs in Latin American countries. The research includes an analysis of the (i) human and socio-economic development; (ii) geographical and socio-economic determinants of vulnerability and adaptability of environmental health issues (exposure, sensitivity, and adaptive capacity); (iii) occurrence of CSDs from 1988 to 2017 and their direct impacts on human wellbeing (Total death and Affected people); (iv) an online survey on the perceptions of the effects of EWEs on human wellbeing in a sample of countries in the region; and (v) discussion of possible solutions. The socio-economic and development indices, and the International Disaster Database (EM-DAT) and Climate-Risk Index (CRI) disaster statistics suggest that the impacts of CSDs are primarily related to socio-economic determinants of human wellbeing and health inequalities. Also, &gt;80% respondents to the survey say that the leading causes of climate-related human impacts are the lack of (i) public awareness; (ii) investment and (iii) preparedness. The paper concludes by adding some suggestions that show how countries in Latin America may better cope with the impacts of Climate-sensitive Disasters.<\/jats:p>","DOI":"10.3390\/ijerph15091802","type":"journal-article","created":{"date-parts":[[2018,8,21]],"date-time":"2018-08-21T11:12:42Z","timestamp":1534849962000},"page":"1802","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["An Assessment of the Relationships between Extreme Weather Events, Vulnerability, and the Impacts on Human Wellbeing in Latin America"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8296-4465","authenticated-orcid":false,"given":"Gustavo J.","family":"Nagy","sequence":"first","affiliation":[{"name":"Instituto de Ecolog\u00eda y Ciencias Ambientales (IECA), Facultad de Ciencias, Universidad de la Rep\u00fablica, Montevideo 11400, Uruguay"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1241-5225","authenticated-orcid":false,"given":"Walter Leal","family":"Filho","sequence":"additional","affiliation":[{"name":"School of Science and the Environment, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, UK"},{"name":"Sustainable Development and Climate Change Management (FTZ-NK), Research and Transfer Centre (FTZ-NK), Faculty of Life Science, Hamburg University of Applied Sciences (HAW), Ulmenliet 20, D-21033 Hamburg, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5252-1700","authenticated-orcid":false,"given":"Ulisses M.","family":"Azeiteiro","sequence":"additional","affiliation":[{"name":"Department of Biology &amp; CESAM Centre for Environmental and Marine Studies, University of Aveiro, 3810-193 Aveiro, Portugal"}]},{"given":"Johanna","family":"Heimfarth","sequence":"additional","affiliation":[{"name":"Sustainable Development and Climate Change Management (FTZ-NK), Research and Transfer Centre (FTZ-NK), Faculty of Life Science, Hamburg University of Applied Sciences (HAW), Ulmenliet 20, D-21033 Hamburg, Germany"}]},{"given":"Jos\u00e9 E.","family":"Verocai","sequence":"additional","affiliation":[{"name":"Instituto de Ecolog\u00eda y Ciencias Ambientales (IECA), Facultad de Ciencias, Universidad de la Rep\u00fablica, Montevideo 11400, Uruguay"}]},{"given":"Chunlan","family":"Li","sequence":"additional","affiliation":[{"name":"Sustainable Development and Climate Change Management (FTZ-NK), Research and Transfer Centre (FTZ-NK), Faculty of Life Science, Hamburg University of Applied Sciences (HAW), Ulmenliet 20, D-21033 Hamburg, Germany"},{"name":"Key Laboratory of Geographic Information Science (Ministry of Education), East China Normal University, Shanghai 200241, China"}]}],"member":"1968","published-online":{"date-parts":[[2018,8,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.wace.2015.10.001","article-title":"Extreme events as sources of health vulnerability: Drought as an example","volume":"11","author":"Ebi","year":"2016","journal-title":"Weather Clim. Extreme"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/S0140-6736(17)32464-9","article-title":"The Lancet Countdown on health and climate change: From 25 years of inaction to a global transformation for public health","volume":"391","author":"Watts","year":"2018","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Field, C.B., Barros, V., Stocker, T.F., Qin, D., Dokken, D.J., Ebi, K.L., Mastrandrea, M.D., Mach, K.J., Plattner, G.K., and Allen, S.K. (2012). IPCC: Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation, Cambridge University Press.","DOI":"10.1017\/CBO9781139177245"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Field, C.B., Barros, V.R., Dokken, D.J., Mach, K.J., Mastrandrea, M.D., Bilir, T.E., Chatterjee, M., Ebi, K.L., Estrada, Y.O., and Genova, R.C. (2014). IPCC: Climate Change 2014: Impacts, Adaptation, and Vulnerability, Cambridge University Press.","DOI":"10.1017\/CBO9781107415386"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Banwell, N., Rutherford, S., Mackey, B., and Chu, C. (2018). Towards Improved Linkage of Disaster Risk Reduction and Climate Change Adaptation in Health: A Review. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15040793"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1038\/nclimate2100","article-title":"Increasing frequency of extreme El Ni\u00f1o events due to greenhouse warming","volume":"4","author":"Cai","year":"2014","journal-title":"Nat. Clim. Chang."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1177\/0309133314538644","article-title":"Attributing weather extremes to \u2018climate change\u2019: A review","volume":"38","author":"Hulme","year":"2014","journal-title":"Prog. Phys. Geogr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1016\/j.jclepro.2017.07.209","article-title":"Risk management of extreme events under climate change","volume":"166","author":"Yuan","year":"2017","journal-title":"J. Clean. Prod."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/j.puhe.2006.01.002","article-title":"Climate change and human health: Impacts, vulnerability and public health","volume":"120","author":"Haines","year":"2006","journal-title":"Public Health"},{"key":"ref_10","unstructured":"WHO (2018, June 01). Climate Change and Health. Available online: http:\/\/www.who.int\/mediacentre\/factsheets\/fs266\/en\/."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Paavola, J. (2017). Health Impacts of Climate Change and Health and Social Inequalities in the UK. Environ. Health, Available online: http:\/\/eprints.whiterose.ac.uk\/115910.","DOI":"10.1186\/s12940-017-0328-z"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Leal-Filho, W., and Esteves Freitas, L. (2018). Preface. Climate Change Adaptation in Latin America: Managing Vulnerability, Fostering Resilience, Springer.","DOI":"10.1007\/978-3-319-56946-8"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Leal-Filho, W., Azeiteiro, U.M., and Alves, F. (2016). Climate Change and Health: An Overview of the Issues and Needs. Climate Change and Health, Springer.","DOI":"10.1007\/978-3-319-24660-4"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.envsci.2014.08.011","article-title":"Extended impacts of climate change on health and wellbeing","volume":"44","author":"Thomas","year":"2014","journal-title":"Environ. Sci. Policy"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejim.2014.12.008","article-title":"Impact on human health of climate changes","volume":"26","author":"Franchini","year":"2015","journal-title":"Eur. J. Intern. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1136\/pgmj.2009.082727","article-title":"Primary, secondary and tertiary effects of eco-climatic change: The medical response","volume":"86","author":"Butler","year":"2010","journal-title":"Postgrad. Med. J."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Leal-Filho, W., Al-Amin, A.Q., Nagy, G.J., Azeiteiro, U.M., Wiesb\u00f6ck, L., Ayal, D.Y., Morgan, E.A., Mugabe, P., Aparicio-Effen, M., and Fudjumdjum, H. (2018). A comparative analysis of climate-risk and extreme event-related impacts on well-being and health: Policy implications. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15020331"},{"key":"ref_18","unstructured":"PAHO\/WHO (2018, June 02). Health in the Americas 2017. Available online: http:\/\/www.paho.org\/hq\/index."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Field, C.B., Barros, V., Stocker, T.F., Qin, D., Dokken, D.J., Ebi, K.L., Mastrandrea, M.D., Mach, K.J., Plattner, G.K., and Allen, S.K. (2014). Central and South America. Climate Change 2014: Impacts, Adaptation, and Vulnerability: Part B: Regional Aspects, Cambridge University Press. Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change.","DOI":"10.1017\/CBO9781107415379"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1108\/IJCCSM-03-2017-0069","article-title":"Human mobility in the context of climate change and disasters: A South American approach","volume":"10","author":"Yamamoto","year":"2018","journal-title":"Int. J. Clim. Chang. Strateg. Manag."},{"key":"ref_21","unstructured":"McBreen, J. (2016). Regional Assessment on Ecosystem-Based Disaster Risk Reduction and Biodiversity in South America, International Union for Conservation of Nature. Available online: https:\/\/www.iucn.org\/sites\/dev\/files\/content\/documents\/regional_assessment_eco-drr_and_biodiversity_in_south_america_2016_0.pdf."},{"key":"ref_22","unstructured":"Murti, R., and Buyck, C. (2014). Introduction. Safe Havens: Protected Areas for Disaster Risk Reduction and Climate Change Adaptation, International Union for Conservation of Nature (IUCN). Available online: https:\/\/www.iucn.org\/sites\/dev\/files\/2014-038.pdf."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Garlati, A. (2013). Climate Change and Extreme Weather Events in Latin America: An Exposure Index, Inter-American Development Bank Department of Research. Available online: http:\/\/www.iadb.org.","DOI":"10.18235\/0009074"},{"key":"ref_24","first-page":"1","article-title":"Environment Wellbeing and Human Wellbeing","volume":"Volume II","author":"Neller","year":"2009","journal-title":"Encyclopedia of Life Support Systems (EOLSS), Developed under the Auspices of the UNESCO"},{"key":"ref_25","unstructured":"ND-Gain (2018, March 01). ND-GAIN Country Index. Available online: http:\/\/index.gain.org\/."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1930","DOI":"10.1289\/ehp.8430","article-title":"An Approach for Assessing Human Health Vulnerability and Public Health Interventions to Adapt to Climate Change. Research Mini-Monograph","volume":"114","author":"Ebi","year":"2006","journal-title":"Environ. Health Perspect."},{"key":"ref_27","unstructured":"National Environmental Health Association (NEHA) (2018, June 01). Environmental Health Definition. Available online: https:\/\/www.neha.org\/about-neha\/definitions-environmental-health."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Coral, C., and Bokelmann, W. (2017). The Role of Analytical Frameworks for Systemic Research Design, Explained in the Analysis of Drivers and Dynamics of Historic Land-Use Changes. Systems, 5.","DOI":"10.3390\/systems5010020"},{"key":"ref_29","unstructured":"Guha-Sapir, D. (2018). The International Disaster Database, Centre for Research on the Epidemiology of Disasters (CRED). Available online: http:\/\/www.emdat.be\/."},{"key":"ref_30","unstructured":"Eckstein, D., K\u00fcnzel, V., and Sch\u00e4fer, L. (2018, March 01). Global Climate Index 2018. Available online: www.germanwatch.org\/en\/cri."},{"key":"ref_31","unstructured":"United Nations Development Program (UNDP) (2007). Fighting Climate Change: Human Solidarity in a Divided World, United Nations Development Program United Nations Development Program. Available online: www.tr.undp.org\/content\/turkey\/en\/home\/library\/human_development\/human_development_report_2007-2008.html."},{"key":"ref_32","unstructured":"United Nations Development Program (UNDP) (2016). Human Development for Everyone, Human Development Report 2015; United Nations Development Program. Available online: http:\/\/hdr.undp.org\/sites\/default\/files\/2016_human_development_report.pdf."},{"key":"ref_33","unstructured":"(2018, March 31). Legatum Prosperity Index (LPI). Available online: www.prosperity.com."},{"key":"ref_34","unstructured":"USAID (2018, June 01). Design and use of Composite Indices in Assessments of Climate Change Vulnerability and Resilience. Available online: www.ciesin.org\/documents\/Design_Use_of_Composite_Indices.pdf."},{"key":"ref_35","unstructured":"World Bank (2018, June 01). The Costs to Developing Countries of Adapting to Climate Change New Methods and Estimates. Available online: https:\/\/es.scribd.com\/document\/111276310\/Adapting-to-Climate-Change-Assessing-World-Bank-Group-Experience."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1080\/17565529.2016.1146120","article-title":"Climate adaptation in South America with emphasis in coastal areas: the state-of-the-art and case studies from Venezuela and Uruguay","volume":"9","author":"Villamizar","year":"2017","journal-title":"Clim. Dev."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1007\/s11027-017-9750-3","article-title":"Fostering coastal resilience to climate change vulnerability in Bangladesh, Brazil, Cameroon, and Uruguay: A cross-country comparison","volume":"23","author":"Modesto","year":"2018","journal-title":"J. Mitig. Adapt. Strateg. Glob. Chang."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.envsci.2018.05.004","article-title":"Strengthening climate change adaptation capacity in Africa- case studies from six major. African cities and policy implications","volume":"86","author":"Balogun","year":"2018","journal-title":"J. Environ. Sci. Policy"},{"key":"ref_39","unstructured":"World Bank (2018, June 01). \u201cGNI, PPP (int. $)\u201d. Available online: https:\/\/data.worldbank.org\/indicator\/NY.GNP.PCAP.PP.CD."},{"key":"ref_40","unstructured":"Comisi\u00f3n Econ\u00f3mica para Am\u00e9rica Latina y el Caribe (CEPAL) (2017). Panorama Social de Am\u00e9rica Latina, Comisi\u00f3n Econ\u00f3mica para Am\u00e9rica Latina y el Caribe (CEPAL) de las Naciones Unidas. Available online: www.cepal.org."},{"key":"ref_41","unstructured":"Makoka, D., and Kaplan, M. (2018, July 15). Poverty and Vulnerability. Available online: https:\/\/mpra.ub.uni-muenchen.de\/6964\/1\/poverty_and_vulnerability.pdf."},{"key":"ref_42","unstructured":"Worldometer (2018, March 15). Countries in the World by Population. Available online: http:\/\/www.worldometers.info\/world-population\/population-by-country\/."},{"key":"ref_43","unstructured":"CLIMATE-DATA.ORG (2018, March 05). Climate Data for Cities Worldwide. Available online: https:\/\/en.climate-data.org\/."},{"key":"ref_44","unstructured":"Nagy, G.J., Caffera, R.M., Aparicio, M., Barrenechea, P., Bidegain, M., Gim\u00e9nez, J.C., Lentini, J., Magrin, G., Murgida, A., and Nobre, C. (2006). Understanding the Potential Impacts of Climate Change and Variability in Latin America and the Caribbean, Department for International Development-DFID, HM Treasury. Available online: http:\/\/www.dfld.de\/Presse\/PMitt\/2006\/061030cA.pdf."},{"key":"ref_45","first-page":"181","article-title":"Monitoring equity in health and healthcare: A conceptual framework","volume":"21","author":"Braveman","year":"2003","journal-title":"J. Health Popul. Nutr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1136\/jech.56.9.647","article-title":"A glossary for health inequalities","volume":"56","author":"Kawachi","year":"2002","journal-title":"J. Epidemiol. Commun. Health"},{"key":"ref_47","unstructured":"Department of Health and Human Services (USDHHS) (2018, June 01). Healthy People 2020, Available online: https:\/\/www.healthypeople.gov\/."},{"key":"ref_48","unstructured":"Commission on Social Determinants of Health (CSDH) (2008). Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health, World Health Organization. Available online: www.who.int\/social_determinants\/thecommission\/finalreport\/en\/."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Leal Filho, W., Icaza, L.E., Emanche, V., and Al-Amin, A.Q. (2017). An Evidence-Based Review of Impacts, Strategies and Tools to Mitigate Urban Heat Islands. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14121600"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/j.jclepro.2017.12.144","article-title":"Climate change and health: An analysis of causal relations on the spread of vector-borne diseases in Brazil","volume":"177","author":"Spielmann","year":"2018","journal-title":"J. Clean. Prod."},{"key":"ref_51","unstructured":"Economic Commission for Latin America and the Caribbean (ECLAC) (2018). The Inefficiency of Inequality, ECLAC. Available online: https:\/\/www.cepal.org\/en\/...\/43443-inefficiency-inequality."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Leal Filho, W. (2015). Improving capacities and communication on climate threats for water resources adaptation in Paraguay. Handbook of Climate Change Adaptation, Springer.","DOI":"10.1007\/978-3-642-38670-1"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Leal Filho, W., Azeiteiro, U., and Alves, F. (2016). Impacts on well-being and health of excessive rainfall and floods in Paraguay, Uruguay and Bolivia. Climate Change and Health: Improving Resilience and Reducing Risks, Springer.","DOI":"10.1007\/978-3-319-24660-4"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Leal Filho, W., and de Freitas, L.E. (2018). A successful early warning system for hydroclimatic extreme events: The case of La Paz City mega-landslide. Climate Change Adaptation in Latin America 2018, Springer.","DOI":"10.1007\/978-3-319-56946-8"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"12","DOI":"10.3200\/ENVT.51.2.12-23","article-title":"Communicating Climate Change: Why Frames Matter for Public Engagement","volume":"51","author":"Nisbet","year":"2009","journal-title":"Environment"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1177\/1075547008329201","article-title":"Fear Won\u2019t Do It\u2019: Promoting Positive Engagement with Climate Change through Visual and Iconic Representations","volume":"30","year":"2009","journal-title":"Sci. Commun."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1080\/17524032.2011.585026","article-title":"We\u2019re the ones to blame\u2019: Citizens\u2019 representations of climate change and the role of the media","volume":"5","author":"Olausson","year":"2011","journal-title":"Environ. Commun."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1111\/j.1460-2466.2011.01563.x","article-title":"Attention to Science\/Environment News Positively Predicts and Attention to Political News Negatively Predicts Global Warming Risk Perceptions and Policy Support","volume":"61","author":"Zhao","year":"2011","journal-title":"J. Commun."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.jclepro.2017.09.105","article-title":"Implementing Climate Change Research at Universities: Barriers, Potential and Actions","volume":"170","author":"LealFilho","year":"2018","journal-title":"J. Clean. Prod."},{"key":"ref_60","unstructured":"United Nations (2018, June 03). Transforming Our World: The 2030 Agenda for Sustainable Development A\/RES\/70\/1. Available online: https:\/\/sustainabledevelopment.un.org\/content\/documents\/21252030%20Agenda%20for%20Sustainable%20Development%20web.pdf."},{"key":"ref_61","first-page":"95","article-title":"Globalization, Climate Change, and Human Health","volume":"369","author":"McMichael","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"208","DOI":"10.3724\/SP.J.1248.2013.208","article-title":"Impacts of Climate Change on Human Health and Adaptation Strategies in South China","volume":"4","author":"Du","year":"2013","journal-title":"Adv. Clim. Chang. Res."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"362","DOI":"10.2471\/BLT.15.157362","article-title":"The Sendai framework: Disaster risk reduction through a health lens","volume":"93","author":"Murray","year":"2015","journal-title":"Bull. World Health Organ."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1017\/S1049023X15005531","article-title":"Protecting the health and well-being of populations from disasters: Health and health care in the Sendai framework for disaster risk reduction 2015\u20132030","volume":"31","author":"Murray","year":"2016","journal-title":"Prehosp. Disaster Med."},{"key":"ref_65","unstructured":"Institute of Medicine (2008). Global Climate Change and Extreme Weather Events: Understanding the Contributions to Infectious Disease Emergence: Workshop Summary, National Academies Press."},{"key":"ref_66","unstructured":"Field, C.B., Barros, V.R., Dokken, D.J., Mach, K.J., Mastrandrea, M.D., Bilir, T.E., Chatterjee, M., Ebi, K.L., Estrada, Y.O., and Genova, R.C. (2014). Human health: Impacts, adaptation and co-benefits. Climate Change Impacts: Adaptation and Vulnerability: Part A: Global and Sectoral Aspects, Cambridge University Press. Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"The Lancet Global Health (2016). The right(s) Approach to Zika. Lancet Glob. Health, 4, e427.","DOI":"10.1016\/S2214-109X(16)30109-7"},{"key":"ref_68","unstructured":"Corval\u00e1n, C.F., Hales, S., McMichael, A.J., Butler, C., Campbell-Lendrum, D., Confalonieri, U., Leitner, K., Lewis, N., Patz, P., and Sarukh\u00e1n, J. (2005). Ecosystems and Human Well-Being Health Synthesis: A Report of the Millennium Ecosystem Assessment, World Health Organization. Available online: http:\/\/www.who.int\/iris\/handle\/10665\/4335."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/9\/1802\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:20:09Z","timestamp":1760196009000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/9\/1802"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,21]]},"references-count":68,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2018,9]]}},"alternative-id":["ijerph15091802"],"URL":"https:\/\/doi.org\/10.3390\/ijerph15091802","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,21]]}}}