Environment and population health in the Bay of Bengal (EnHealth-BoB)

Over half the world’s 2.4 billion people living in low-lying coastal zones and islands are concentrated in densely-populated low-and-middle-Income countries (LMICs) of South and Southeast Asia. The region continues to be a focus for persistent poverty and deprivation in diverse areas of development. It is vulnerable to disproportionately higher risks from both slow and sudden onsets of biophysical environmental events triggered by global climate change, which further accentuates adverse impacts on human health and livelihood. 

The Bay of Bengal region has been a focal area for storm surges over the past century, with new and additional hazards emerging in the region from frequent coastal flooding, gradual sea-level rise and consequent inundation and damages from saline-water intrusion. These multiple threats mutually interact and reinforce adverse impacts on the overall coastal ecosystems. Coastal dwellers traditionally engaged in primary sector economic activities in the region are exposed to these different emergent adversities from the environment they live in, often accentuated by frequent natural hazards. These result in immediate public health crises as well as having longer-term impacts through posing critical challenges for the wider determinants of health and livelihood. 

However, empirical, real-world evidence from the region demonstrating the complex causal pathways of interactions between human actions on the environment, and their public health implications remains scarce. There is a need to better understanding of the diverse direct and indirect risks of climate change in the region, related to changes in weather patterns (e.g., intensity and frequency of extreme events), and mediated through resultant changes in water, air, food quality and quantity, ecosystems and agriculture. In particular, more evidence is needed on how these factors affect livelihoods and generate profound effects on people’s physical, social and psychological wellbeing. The region urgently needs bespoke approaches to improve system-level efficiency across several domains through appropriate local level adaptations. This will help to build the resilience needed to deal with multiple hazards, both those faced currently as well as those that may arise in the not-too-distant future. Understanding the links between environmental change and health and wellbeing at regional and local level, which is essential to provide evidence on which policy and interventions can be improved, requires appropriate integration of available data across environmental, demographic and health domains.