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Heat-Related Mortality Projections for Cardiovascular and Respiratory Disease Under the Changing Climate in Beijing, China

Because heat-related health effects tend to become more serious at higher temperatures, there is an urgent need to determine the mortality projection of specific heat-sensitive diseases to provide more detailed information regarding the variation of the sensitivity of such diseases. In this study, the specific mortality of cardiovascular and respiratory disease in Beijing was initially projected under five different global-scale General Circulation Models (GCMs) and two Representative Concentration Pathways scenarios (RCPs) in the 2020s, 2050s, and 2080s compared to the 1980s. Multi-model ensembles indicated cardiovascular mortality could increase by an average percentage of 18.4 percent, 47.8 percent, and 69.0 percent in the 2020s, 2050s, and 2080s under RCP 4.5, respectively, and by 16.6 percent, 73.8 percent and 134 percent in different decades respectively, under RCP 8.5 compared to the baseline range. The same increasing pattern was also observed in respiratory mortality. The heat-related deaths under the RCP 8.5 scenario were found to reach a higher number and to increase more rapidly during the 21st century compared to the RCP4.5 scenario, especially in the 2050s and the 2080s. The projection results show potential trends in cause-specific mortality in the context of climate change, and provide support for public health interventions tailored to specific climate-related future health risks.

health

Interactions Between Two Existential Threats: COVID-19 and Climate Change

The COVID-19 pandemic and climate change are complex existential threats, unpredictable in many ways and unprecedented in modern times. There are parallels between the scale and scope of their impacts and responses. Understanding shared drivers, coupled vulnerabilities, and criteria for effective responses will help societies worldwide prepare for the simultaneous threats of climate change and future pandemics. We summarize some shared characteristics of COVID-19 and climate change impacts and interventions and discuss key policy implications and recommendations.

Climate change adaptation

Moderate-Resolution Imaging Spectroradiometer (MODIS): Data from the Goddard DAAC

This century, especially in the last few decades, Earth's history was marked by intense study and concern about our environment and how we affect it. Scientific studies show that the level of carbon dioxide in the atmosphere is rising, the ocean's productivity is changing, and the average global temperatures have risen by 0.511. What we do not completely understand is: What fraction of this variation is due to human interference with the environment? What fraction is due to natural phenomena? How do these changes correlate with each other? In order to obtain a better understanding of how land, atmosphere and ocean interact to produce changes on Earth's climate and how human intervention affects these changes, NASA started planning for the Earth Observing System (EOS) in the early 1980's. As a result, a series of satellites will be sent into orbit to monitor the Earth for the next 18 years, providing scientists with necessary data to help them answer these questions.

Source record

Bundling measures for food systems transformation: a global, multimodel assessment

Background Current food systems leave one in ten individuals at risk of hunger while driving unsustainable environmental impacts. Inaction risks further exacerbating negative impacts on both human and planetary health. These challenges emerge from complex system interactions, requiring approaches that engage with this complexity and consider how transformation measures interact across food systems. We aimed to quantify the magnitude and uncertainty of the impacts of key food systems transformation measures both individually and in a bundle using an ensemble of global economic models. Methods In this global multimodel assessment, we applied an ensemble of ten state-of-the-art global economic models to evaluate the potential of four key measures in transforming food systems: increasing agricultural productivity, halving food loss and waste, shifting towards healthier diets, and economy-wide climate mitigation policies aligned with limiting warming to 1·5°C. The scenarios used a middle-of-the-road shared socioeconomic pathway for population and gross domestic product growth, climate impact data from Jägermeyr and colleagues, Thornton and colleagues, and Nelson and colleagues, and dietary targets based on the EAT–Lancet healthy reference diet, with model simulations conducted from 2020 to 2050. We then assessed the effect of these measures in isolation and in combination in a bundled scenario. To further understand the interactions between these measures, we conducted a decomposition analysis that distinguishes between the individual effects of a measure (effect when implemented alone), total effects (its contribution within the bundle), and interaction effects (the difference between total and individual effects). This approach aimed to show complementarities and trade-offs that emerge when multiple measures are implemented simultaneously. Findings Our analysis showed that individual measures in isolation are insufficient to achieve high-level environmental objectives and might generate unintended consequences. In contrast, bundling measures produces co-benefits: avoiding 50% of projected agricultural greenhouse gas emissions by 2050 and almost 20% of anticipated land conversion, while moderating food price increases associated with ambitious climate change mitigation policies. Our decomposition analysis further shows that measures can have varying effects across different dimensions. Although dietary shifts and climate mitigation policies are the largest drivers of environmental benefits (each contributing to a median decline of >10 percentage points in non-CO 2 emissions and 5 percentage points in agricultural land use globally), productivity improvements and reducing food loss and waste play essential roles in moderating price increases (each contributing to a median decline of >5 percentage points in average prices). Interpretation This study highlights the importance of implementing coordinated approaches to food system transformation and climate change mitigation rather than relying on isolated interventions. Comprehensive transformation requires understanding how supply-side and demand-side changes can interact with climate mitigation policies, enabling policy makers to design intervention packages that maximise benefits while minimising trade-offs across environmental, economic, and social dimensions.

Sundiang, Marina [Cornell Univ., Ithaca, NY (Unite

Investigation of the Sensitivity of Tropical Cyclogenesis to Aerosol Intervention

Abstract As risks from tropical cyclones (TCs) are fueled by climate change escalation, there is an urgent need for transformational solutions to complement traditional approaches. Seeding TCs using aerosols can be a promising method to reduce cyclone intensity, supported by theoretical understanding of the microphysical effects of aerosols on TC clouds. The ideal time to intervene effectively in TCs is likely during their initial stage, before TC wind speeds reach their peak. However, studies exploring potential aerosol effects on TC formation remain scarce. This study investigates how a TC embryo responds to the addition of aerosols of varying sizes using the Weather Research & Forecasting (WRF) model coupled with a spectral‐bin microphysics model. We found that aerosols of different sizes and concentrations distinctively affect the pre‐TC vortex's microstructure and dynamics. Fine and ultrafine aerosols enhance the latent heat of condensation, freezing, deposition, and riming, initially intensifying the vortex. However, this results in enhancement of the cold pool, thereby reducing inflow and surface fluxes, subsequently weakening the vortex. Coarse aerosols produce the opposite effect to that of fine and ultrafine aerosols. Coarse aerosols lead to a slower initial acceleration owing to enhanced warm rain. However, the resulting weaker cold pool is insufficient to effectively reduce the strength of the vortex at the later stage. This study provides critical insights into how aerosols of varying sizes and concentrations modulate the energy cascade and impact the evolution of a TC embryo, laying the groundwork for further research on TC risk management through aerosol intervention.

54 ENVIRONMENTAL SCIENCES

Aging Will Amplify the Heat-Related Mortality Risk Under a Changing Climate: Projection for the Elderly in Beijing, China

An aging population could substantially enhance the burden of heat-related health risks in a warming climate because of their higher susceptibility to extreme heat health effects. Here, we project heatrelated mortality for adults 65 years and older in Beijing China across 31 downscaled climate models and 2 representative concentration pathways (RCPs) in the 2020s, 2050s, and 2080s. Under a scenario of medium population and RCP8.5, by the 2080s, Beijing is projected to experience 14,401 heat-related deaths per year for elderly individuals, which is a 264.9% increase compared with the 1980s. These impacts could be moderated through adaptation. In the 2080s, even with the 30% and 50% adaptation rate assumed in our study, the increase in heat-related death is approximately 7.4 times and 1.3 times larger than in the 1980s respectively under a scenario of high population and RCP8.5. These findings could assist countries in establishing public health intervention policies for the dual problems of climate change and aging population. Examples could include ensuring facilities with large elderly populations are protected from extreme heat (for example through back-up power supplies and/or passive cooling) and using databases and community networks to ensure the home-bound elderly are safe during extreme heat events.

age factor

Downscaled and Bias-Adjusted Climate Projections for Afghanistan

Climate change is already having devastating impacts on human communities and natural landscapes, from increasing severity and frequency of natural disasters to drought and desertification that degrade both natural ecosystems and human livelihoods. However, the impacts of climate change are not evenly distributed across the world—some places are at far greater risk than others. These highly vulnerable places should be a higher priority for investments and interventions to help people and nature adapt to changing climatic conditions. Afghanistan is one of the most at-risk countries from climate change. Within the country, the river basins are particularly sensitive as climate change will dramatically alter their water regimes upon which ecosystems and a vast proportion of the Afghan population and millions of people in neighbouring countries rely. As part of an EU-funded project implemented by the Wildlife Conservation Society (WCS), WCS conducted a vulnerability assessment for the Amu Darya River Basin that drains c. 14% of Afghanistan’s land area and is critically important for supporting both people and sensitive biodiversity (Elsen et al., 2023). Central to the vulnerability assessment was the development of downscaled and bias-adjusted climate projections, produced by the Center for Climate Systems Research (CCSR)1. The climate projections were produced at a much higher resolution (1 km2) than were otherwise available and were tailored to the local environment.

climate projections

Aboveground carbon loss associated with the spread of ghost forests as sea levels rise

Coastal forests sequester and store more carbon than their terrestrial counterparts but are at greater risk of conversion due to sea level rise. Saltwater intrusion from sea level rise converts freshwater-dependent coastal forests to more salt-tolerant marshes, leaving 'ghost forests' of standing dead trees behind. Although recent research has investigated the drivers and rates of coastal forest decline, the associated changes in carbon storage across large extents have not been quantified. We mapped ghost forest spread across coastal North Carolina, USA, using repeat Light Detection and Ranging (LiDAR) surveys, multi-temporal satellite imagery, and field measurements of aboveground biomass to quantify changes in aboveground carbon. Between 2001 and 2014, 15% (167 km2) of unmanaged public land in the region changed from coastal forest to transition-ghost forest characterized by salt-tolerant shrubs and herbaceous plants. Salinity and proximity to the estuarine shoreline were significant drivers of these changes. This conversion resulted in a net aboveground carbon decline of 0.13 ± 0.01 TgC. Because saltwater intrusion precedes inundation and influences vegetation condition in advance of mature tree mortality, we suggest that aboveground carbon declines can be used to detect the leading edge of sea level rise. Aboveground carbon declines along the shoreline were offset by inland aboveground carbon gains associated with natural succession and forestry activities like planting (2.46 ± 0.25 TgC net aboveground carbon across study area). Our study highlights the combined effects of saltwater intrusion and land use on aboveground carbon dynamics of temperate coastal forests in North America. By quantifying the effects of multiple interacting disturbances, our measurement and mapping methods should be applicable to other coastal landscapes experiencing saltwater intrusion. As sea level rise increases the landward extent of inundation and saltwater exposure, investigations at these large scales are requisite for effective resource allocation for climate adaptation. In this changing environment, human intervention, whether through land preservation, restoration, or reforestation, may be necessary to prevent aboveground carbon loss.

ghost forests

Satellite imaging reveals increased proportion of population exposed to floods

Flooding affects more people than any other environmental hazard and hinders sustainable development. Investing in flood adaptation strategies may reduce the loss of life and livelihood caused by floods. Where and how floods occur and who is exposed are changing as a result of rapid urbanization4, flood mitigation infrastructure and increasing settlements in floodplains6. Previous estimates of the global flood-exposed population have been limited by a lack of observational data, relying instead on models, which have high uncertainty. Here we use daily satellite imagery at 250-metre resolution to estimate flood extent and population exposure for 913 large flood events from 2000 to 2018. We determine a total inundation area of 2.23 million square kilometres, with 255–290 million people directly affected by floods. We estimate that the total population in locations with satellite-observed inundation grew by 58–86 million from 2000 to 2015. This represents an increase of 20 to 24 per cent in the proportion of the global population exposed to floods, ten times higher than previous estimates. Climate change projections for 2030 indicate that the proportion of the population exposed to floods will increase further. The high spatial and temporal resolution of the satellite observations will improve our understanding of where floods are changing and how best to adapt. The global flood database generated from these observations will help to improve vulnerability assessments, the accuracy of global and local flood models, the efficacy of adaptation interventions and our understanding of the interactions between landcover change, climate and floods.

B.Tellman

Remote sensing of wetland parameters related to carbon cycling

Measurement of the rates of important biogeochemical fluxes on regional or global scales is vital to understanding the geochemical and climatic consequences of natural biospheric processes and of human intervention in those processes. Remote data gathering and interpretation techniques were used to examine important cycling processes taking place in wetlands over large geographic expanses. Large area estimation of vegetative biomass and productivity depends upon accurate, consistent measurements of canopy spectral reflectance and upon wide applicability of algorithms relating reflectance to biometric parameters. Results of the use of airborne multispectral scanner data to map above-ground biomass in a Delaware salt marsh are shown. The mapping uses an effective algorithm linking biomass to measured spectral reflectance and a means to correct the scanner data for large variations in the angle of observation of the canopy. The consistency of radiometric biomass algorithms for marsh grass when they are applied over large latitudinal and tidal range gradients were also examined. Results of a 1 year study of methane emissions from tidal wetlands along a salinity gradient show marked effects of temperature, season, and pore-water chemistry in mediating flux to the atmosphere.

Bartlett, David S.

Investigating Building Energy Consumption and CO2 Emission in Phoenix Using AutoBEM and Future Typical Meteorological Year (fTMY) Weather Data

This research investigates the energy performance and CO2 emissions of each building stock across the Phoenix metropolitan area using the Automatic Building Energy Modeling (AutoBEM) framework and Model America v2 (MAv2) dataset from Oak Ridge National Laboratory (ORNL). Typical Meteorological Year (TMY) and Future Typical Meteorological Year (fTMY) files were used for AutoBEM simulation. The simulation results from TMY and fTMY were compared. It was found that a projected 10.28% increase in total CO2 emissions and a 9.30% rise in total energy consumption by 2080–2099 relative to current typical conditions. The results highlight the disparities in emissions among different building stocks and the influence of climate change on future energy demand. The findings underscore the necessity of targeted policy interventions and retrofitting strategies (eg. advanced HVAC systems, improved insulation, reflective roofing) to mitigate emissions in high-energy-use and emission-intensed buildings, particularly as climate conditions evolve. This study contributes to the growing understanding of building-sector emissions and their long-term implications under future climate scenarios.

Li, Hang [ORNL] (ORCID:0000000306001920)

Asheville Urban Development II: Mapping Urban Heat to Support Cooling Initiatives and Climate Resilience Planning in the Greater Asheville Area

Asheville, North Carolina experiences the urban heat island effect, where temperatures in the city are higher than in surrounding rural areas. This effect intensifies with increased urbanization and less vegetative cover. Asheville’s urban heat island was exacerbated by population increases and tree cover decline, escalating the need for heat mitigation. We partnered with the City of Asheville’s Sustainability Department and Asheville GreenWorks whose actions prioritize sustainable city planning and equitable climate resilience. Using NASA Earth observations and ancillary datasets we spatially mapped urban heat, heat vulnerability, and cooling and adaptive capacity from 2019-2023. To map urban heat, we used Landsat 8 and 9 Operational Land Imager and Thermal Infrared Sensor for land surface temperature and albedo data and the ECOsystem Spaceborne Thermal Radiometer Experiment on Space Station for evapotranspiration data. We assessed heat vulnerability using the urban heat data andthe Centers for Disease Control and Prevention’s Social Vulnerability Index. To evaluate cooling and adaptive capacity we used the InVEST Urban Cooling Model, integrating our heat vulnerability analysis with land use and cover data from Sentinel-1 Synthetic Aperture Rada rand Sentinel-2 Multispectral Instrument. Our results revealed distinct spatial patterns of urban heat, heat vulnerability, and cooling and adaptive capacity in Asheville with downtown as the focal hotspot and an outward decreasing radial pattern. These findings highlight targeted need for interventions to reduce heat impacts, address environmental injustices, and enhance climate resilience. Our project provided research to local organizations that can be used for heat mitigation in the greater Asheville area.

Authors not in NED but are confirmed contractors.

AgMIP Local, National and Global Assessments of Food System Challenges in A Changing Climate

Food systems connect a diverse network of stakeholders around the world, with complex dynamics governing production, processing, transportation, trade and consumption of food products. Extreme conditions can disrupt multiple components of the food system, with systemic connections providing structure that can both buffer and exacerbate risks. Climate change is shifting current practices in agricultural production and the broader food system, encouraging shifts toward more diverse value chains capable of drawing from multiple food producing regions to reduce the chance that an entire value chain be subject to simultaneous impacts. The IPCC Working Group I report assessed that heat waves, fires, floods and severe storms are becoming more pronounced and widespread with each degree of global warming, increasing food system risk. Food system disruptions can also come from outside the climate system, including from viral outbreaks, geopolitical conflict and socioeconomic changes. This presentation will highlight how the Agricultural Model Intercomparison and Improvement Project (AgMIP) develops modeling approaches that connect climate, biophysical and socioeconomic models in order to capture complex responses of the food system and potential interventions by diverse stakeholders in the public and private sectors. Models are applied on a range of scales that match decision contexts. These include households in specific agricultural production regions (e.g., within a country), national-level policymakers considering policies, sustainability and development priorities for a country’s agricultural sector, and global food market models that balance production and consumption around the world with competition for land, water, energy and sustainability priorities. Models are capable of capturing many important responses, but further development is needed to represent key systemic risks and the possibility for additional interventions beyond the farm gate. Improved food system models will provide important insights into our society’s ability to cope with climate change, as well as our ability to identify agricultural adaptation and mitigation opportunities to reduce overall risk.

Food systems

The Interplay Between Climate and Urban Expansion on Building Energy Demand in Morocco

Understanding building energy demand is critical for addressing climate uncertainty challenges and ensuring sustainable urban growth. This study develops a building energy demand (BED) model to explore how climate variation and urban expansion affect residential and commercial space heating and cooling demands in Morocco for three scenarios, namely, 2005, 2018, and 2018 + 1.5 °C. The results show that coastal cities have lower heating and cooling needs due to the oceanic influence, while interior cities require significantly higher heating demand per-unit-floorspace. Between 2005 and 2018, urban growth increased total heating and cooling demand by 218.8 GWh, particularly in northern and coastal regions, despite per-unit-floorspace reductions in milder climates and improved building efficiency in 2018. Residential heating remains the dominant energy use, though commercial demand is significant in urban centers. Under the 2018 + 1.5 °C hypothetical scenario, heating demand across Morocco declines by 335.8 GWh compared to 2018, with urban areas amplifying this trend. Meanwhile, cooling demand increases slightly by 44.4 GWh, with major cities experiencing relative increases of up to 50%. These findings highlight a trade-off where reduced winter heating needs are partly offset by increased summer cooling demands in densely urbanized areas. In conclusion, the study identifies key urban hotspots for targeted interventions, emphasizing the need for energy-efficient building designs, climate-adaptive urban planning, and resilient energy management strategies to sustainably address shifting seasonal energy patterns.

Morocco

Developing Scenario‐Based Strategies for Health, Climate, and Environmental Preparedness: The One Health, One Earth Approach

Climate change amplifies many threats to human health. Despite advances in understanding climate change dynamics and impacts, there remains a critical gap in translating scientific knowledge into equitable, and community-driven health interventions. The inaugural One Earth, One Health workshop sought to explore this gap through human-centered design exercises involving interdisciplinary researchers from climate and Earth sciences, engineering, epidemiology, microbiology, and environmental health. Although participants did not co-develop solutions with affected communities, they used stakeholder role-playing to guide ideation and lay groundwork for actionable plans. Through these methods, participants identified community needs and proposed prototype solutions to alleviate health threats exacerbated by global environmental change. Prototypes were organized around infectious diseases, extreme weather, and air quality, as illustrative themes rather than an exhaustive set of risks. Key solutions included strategies for anticipatory systems and early warning (e.g., integrating environmental signals with health data), inclusive communication and infrastructure needs for responding to extreme weather events, and integrated platforms visualizing air quality trends to support tailored, context-aware guidance beyond one-size-fits-all alerts. The workshop highlighted opportunities such as leveraging machine learning, Earth observation, and real-time surveillance to protect communities, but also noted barriers including data quality, technological redundancy, privacy, and governance challenges. Additionally, participants emphasized the need for interdisciplinary teams capable of collaborating across sectors, breaking down silos and addressing gaps in training and education. Overall, the workshop illustrates how process-driven, human-centered approaches can help surface user needs and generate testable prototype concepts, while underscoring the importance of direct community partnership for implementation.

Abadi, Azar M. [University of Alabama, Birmingham,

Impact of Climate Change on Heat-Related Mortality in Jiangsu Province, China

A warming climate is anticipated to increase the future heat-related total mortality in urban areas. However, little evidence has been reported for cause-specific mortality or nonurban areas. Here we assessed the impact of climate change on heat-related total and cause-specific mortality in both urban and rural counties of Jiangsu Province, China, in the next five decades. To address the potential uncertainty in projecting future heat-related mortality, we applied localized urban- and nonurban-specific exposure response functions, six population projections including a no population change scenario and five Shared Socioeconomic Pathways (SSPs), and 42 temperature projections from 21 global-scale general circulation models and two Representative Concentration Pathways (RCPs). Results showed that projected warmer temperatures in 2016-2040 and 2041-2065 will lead to higher heat-related mortality for total non-accidental, cardiovascular, respiratory, stroke, ischemic heart disease (IHD), and chronic obstructive pulmonary disease (COPD) causes occurring annually during May to September in Jiangsu Province, China. Nonurban residents in Jiangsu will suffer from more excess heat-related cause-specific mortality in 2016-2065 than urban residents. Variations across climate models and RCPs dominated the uncertainty of heat-related mortality estimation whereas population size change only had limited influence. Our findings suggest that targeted climate change mitigation and adaptation measures should be taken in both urban and nonurban areas of Jiangsu Province. Specific public health interventions should be focused on the leading causes of death (stroke, IHD, and COPD), whose health burden will be amplified by a warming climate.

projection

San Diego Urban Development: Utilizing NASA Earth Observations to Identify Drivers of Extreme Urban Heat and Generate a High-Resolution Vulnerability Index for Urban Planning and Climate Resiliency in San Diego, California

Exposure to heat exacerbated by an increase in urbanization as well as increasing global temperatures has become a growing concern for cities and their residents. Excess heat can cause increased heat-related morbidity, mortality, and energy costs. Vulnerability to heat-related illnesses is oftentimes correlated to demographics, socioeconomic status, and pre-existing health conditions. The City of San Diego, California boasts 1.4 million residents and, like many other major cities, has experienced increases in heat-related hospitalizations and mortality. The burden of urban heat is also not equal amongst communities; areas with lower income and communities of color bear a disproportionate burden. In partnership with the City of San Diego, and American Geophysical Union’s (AGU) Thriving Earth Exchange, the DEVELOP team used Landsat 8 Operational Land Imager (OLI) and Thermal Infrared Sensor (TIRS), and ECOsystem Spaceborne Thermal Radiometer Experiment on Space Station (ECOSTRESS) imagery to identify areas of highest heat based on land surface temperature from 2015-2020. Our analyses showed that health demographics such as obesity and cardiovascular health were the strongest indicators for heat vulnerability. In addition, various inputs (land use/land cover, tree canopy, and building intensity derived from the City of San Diego data along with albedo from Landsat 8) were used in the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) urban cooling model to investigate changes in cooling rates in current and future scenarios for the city. The model results showed that cooling is expected to occur due to a 5% increase in tree canopy. The City of San Diego can use these results to inform the development of the Climate Resilient San Diego plan and prioritize at-risk communities for cooling interventions.

John Dialesandro

Peru Health and Air Quality II: Leveraging Earth Observations and Health Data to Map Outbreak Risk and Inform Public Health Interventions for Zoonotic Disease Prevention

Peru's Madre de Dios region is a hotspot for dengue fever and leishmaniasis due to its tropical Amazonian climate. Though treatable, these zoonotic diseases are debilitating for under-resourced communities whose already close proximity to mosquito and sandfly vectors continues to increase via rapid urbanization and deforestation. Peru’s Ministries of Health (MINSA) and Environment (MINAM) are working to better understand the environmental factors amplifying the risk of dengue fever and leishmaniasis transmission. The first term of this project classified the land use and land cover of Madre de Dios’ 11 districts for 2010, 2015, and 2020 and identified a correlation between both diseases and urbanization. Our team expanded this analysis by creating urban-forest edge maps and incorporating climatic and topographic variables with data from Landsat 7 Enhanced Thematic Mapper Plus (ETM+), Landsat 8 Operational Land Imager (OLI), the Global Precipitation Measurement (GPM) Integrated Multi-satellitE Retrievals for GPM (IMERG), and the Shuttle Radar Topography Mission (SRTM). We determined these variables’ impacts on disease incidence by assessing existing literature and running regression models. Dengue fever correlated with urban-forest edge, urban area, slope, temperature, and precipitation. Leishmaniasis primarily correlated with forest-edge area and elevation, but lacking additional statistical significance prevented further work, a decision supported by the literature. Thus, the risk matrix and risk map which we scripted in R to visualize the risk of disease posed to districts alongside health post locations addresses only dengue fever. The results and products will inform MINSA and MINAM in public health interventions, resource distribution, and policy initiatives.

Jennifer Rogers