ADVANCEMENT OF THE PRACTICE
level rise. The Pacific Islands are already experiencing accelerated sea level rise, lead- ing to coastal erosion, episodic flooding, permanent inundation, and increased expo- sure to marine hazards. In American Samoa and Guam, coastal flooding and erosion are projected to disproportionately a¢ect minor- ity and low-income populations and indi- viduals outside of the age range of 16–65 years (Reguero et al., 2021). The sea level rise threatens critical infrastructure such as housing, energy, and transportation systems and compromises access to essential services and resources, including food, fresh water, and healthcare. The Hawaii Climate Change Mitigation and Adaptation Commission (Hawaii Cli- mate Commission, 2017) reports that over the next 30–70 years, sea level rise will increase chronic flooding and, in doing so, will a¢ect approximately 6,500 structures, 38 mi of coastal roads, 550 cultural sites, 13 mi of beaches, and 19,800 people across Hawaii. This damage would equate to an estimated $19 billion of economic loss (Hawaii Climate Commission, 2017). Saltwater intrusion into surface and groundwater systems further jeopardizes the sustainability and quality of freshwater supplies, posing significant risks to public health (CDC, 2024a). Climate change is also amplifying the spread of vectorborne diseases in Hawaii and the USAPI (CDC, 2024a). Warming tempera- tures and changes in rainfall patterns are cre- ating more favorable conditions for mosquito populations, leading to a surge in diseases such as dengue and malaria (Kulkarni et al., 2022). Data from 2014–2020 identified 104 dengue, chikungunya, and Zika outbreaks across the USAPI (Matthews et al., 2022). The World Health Organization (2015) has identi- fied the USAPI as one of the most vulnerable regions to climate-sensitive diseases, warning that without adequate adaptation measures, these health risks will continue to intensify. Food safety and security are increasingly under threat (CDC, 2024a). In Hawaii, rising ocean temperatures, acidification, and damage to watersheds and reef systems—in combina- tion with drought conditions—are disrupting traditional food sources. The locations of fish- eries are shifting further out to sea, and tradi- tional crops such as taro are being inundated with saltwater, increasing the di¨culty for tra- ditional fishers and farmers.
Subsistence Fishing: This traditional practice is vital for communities in this region and is increasingly under threat by climate change eects on marine ecosystems and fish populations. These changes are forcing greater depen- dence on imported foods, which are often low in nutritional value and have hidden environmental, financial, social, and cultural costs. This dietary shift, combined with high rates of obesity and chronic diseases such as diabetes, is exacerbating the region’s health challenges (Novotny et al., 2015). Due to the islands’ small sizes and relative isolation, food and water security are the most impor- tant aspects related to drought for the USAPI (Heim et al., 2020). Maintaining adequate freshwater supplies in the face of climate change places stress of an uncertain magni- tude on already fragile water resources. The low-lying atoll island populations of the Federated States of Micronesia and the Republic of the Marshall Islands are the most vulnerable to freshwater supply shortages and agricultural crop losses during droughts. Higher islands such as Guam, Yap, and Palau have reservoirs, yet Guam su¢ers from an insu¨cient water distribution system. There- fore, as most agriculture is rainfed, the com- bination of reduced rainfall and saltwater intrusion is a hazard for crops. Furthermore, in response to drought, crops have reduced yield, increased mortality, and increased susceptibility to pests and diseases (Heim et al., 2020). In the Federated States of Micronesia, the 1997–1998 El Niño drought caused coconut production to decline by 20%, from which it did not recover for 4 years. From 1996–2018, federal crop insur- ance programs paid $11.2 million to Hawai- ian farmers for drought losses, followed by a loss of approximately $53.5 million in cattle production due to the most severe drought on record from 2008–2016 (Frazier et al., 2022). The mental health and well-being of Pacific Islanders are also being a¢ected profoundly by
Wildfire Aftermath: Charred coastal land in Saipan after a small wildfire. Scattered remnants of grasses, a coconut shell, and shrubs dot the scorched earth. While wildfires are not typically associ- ated with tropical islands, climate change is creating conditions that are more con- ducive to their occurrence (Dendy et al., 2022; Minton, 2006; Pacific Fire Exchange, 2017). Native Hawaiian and Pacific Islander communities already experience high rates of asthma, and rates are expected to increase as climate change worsens air qual- ity (Rudolph et al., 2017). In August 2023, as reported by the U.S. Fire Administra- tion (2024), a series of wildfires broke out in Hawaii, predominantly on the island of Maui. Wind-driven fires prompted evacua- tions and caused widespread damage, kill- ing at least 101 people. The fires destroyed more than 2,200 structures and caused an estimated $5.5 billion in damages (U.S. Fire Administration, 2024). The increasing frequency and severity of droughts—coupled with the spread of non-native, fire-prone grasses—are con- tributing to the growing wildfire risk in the region (Mass & Ovens, 2024). According to G. Bare (personal communication, June 3, 2024), when asked about the last climate- related impact on the community, John M. Tagabuel, the program administrator for Environmental Health Disease Prevention within the Commonwealth Healthcare Cor- poration, said: CNMI or the entire North Pacific islands region are facing the El Niño cycle. And this climate phenomenon, it exasperated already challenged island infrastructure, with wildfire—with limited fire equip- ment to address bush and structural fires. One of the most pressing concerns pre- sented by CDC (2024a) is the impact of sea
18
Volume 87 • Number 9
Powered by FlippingBook