Global Environmental Assessments (GEAs) are intended to gather expert knowledge on a topic of global importance and present it in a useful format to those who could use the knowledge in decision-making. GEAs have disseminated new knowledge, influenced environmental policy, changed the evolution of science, and furthered many careers. The GEA community has always adapted to changing circumstances, often by increasing the complexity of the assessment process. The current level of complexity of most GEAs, alongside today’s increasingly polarized societies, changes in international trade, biophysical changes to the planet, greater interest in cross-sectoral problems and solutions, enhanced technological capacity, and increasingly contested nature of some aspects of environmental science may indicate that we’ve reached a point where further adaptation cannot be achieved merely by adding more complexity. It may be time for more fundamental changes to the GEA scope, process, and delivery. We use the MA as a touchstone in exploring how GEAs have evolved, considering both challenges and possible paths forward to retain legitimacy, credibility, and salience in a changing world. One strong possibility is for GEAs to reorient to serve as support structures for a broader diversity of levels and types of decision-making and a broader array of decision-making actors. In a rapidly changing world, a diverse ecosystem of assessment approaches is likely to be more robust, have more impact, and evolve more quickly. Continuing to experiment with different models for delivering multi-scale environmental information will help GEAs fit the needs of the 21st century.

Sustainable development will only be achieved when governments base decisions on human skills and natural resources, not just gross domestic product. Sustainable development will only be achieved when governments base decisions on human skills and natural resources, not just gross domestic product.

Multiple diseases in children have been linked to manufactured synthetic chemicals, which are subject to few legal or policy constraints. A revamping of law and restructuring of the chemical industry are required.

Plastic production, plastic waste disposal, and chemicals in plastics harm human health and well-being and create great inequity. Production of single-use plastics is especially harmful. The harms caused by plastics result in increased mortality and morbidity, which in turn undermine human capital and compromise sustainable growth in the inclusive wealth of nations. Exclusive use of Gross Domestic Product (GDP) as a metric of national wealth fails to measure these damages. The use of the Inclusive Wealth Index to supplement the GDP will provide a more comprehensive assessment of economy-environment interactions and better assess inequity than the GDP alone and can better guide ethically grounded, health-protective, and economically sound remedies to the global plastics crisis.

Background: Climate change is increasingly recognized as a driver of mental health disorders, exacerbating conditions such as anxiety, depression, and post-traumatic stress. However, climate policies rarely address mental health considerations. Objective: This study investigates the extent to which mental health is incorporated into national climate adaptation policies, specifically Nationally Determined Contributions (NDCs), from countries classified as high or very high risk according to the INFORM index. Methods: We conducted a systematic literature review and policy analysis of NDCs from 38 high-risk countries. A keyword-based approach was used to assess the frequency and depth of mental health references in climate policies. Findings: Only 8 of 38 countries explicitly referenced mental health in their NDCs. Most policies prioritized physical health, with little attention given to the psychological impacts of climate-related disasters. Vulnerable populations, including children, women, and individuals with preexisting mental health conditions, remain largely unaddressed in these national policies. Conclusions: There is a significant gap in the integration of mental health impact and interventional indicators within climate change policies. Greater investment in interdisciplinary research and policy reforms are needed to ensure climate adaptation strategies address both physical and mental health concerns.

Background: Since the Industrial Revolution, humanity has amassed great wealth and achieved unprecedented material prosperity. These advances have come, however, at great cost to the planet. They are guided by an economic model that focuses almost exclusively on short-term gain, while ignoring natural capital and human capital. They have relied on the combustion of vast quantities of fossil fuels, massive consumption of the earth's resources, and production and environmental release of enormous quantities of chemicals, pesticides, fertilizers, and plastics. They have caused climate change, pollution, and biodiversity loss, the "Triple Planetary Crisis". They are responsible for more than 9 million premature deaths per year and for widespread disease - impacts that fall disproportionately upon the poor and the vulnerable . Goals: To map the human health impacts of climate change, pollution, and biodiversity loss. To outline a framework for assessing the health benefits of interventions against these threats. Findings: Actions taken by national governments and international agencies to mitigate climate change, pollution, and biodiversity loss can improve health, prevent disease, save lives, and enhance human well-being. Yet assessment of health benefits is largely absent from evaluations of environmental remediation programs. This represents a lost opportunity to quantify the full benefits of environmental remediation and to educate policy makers and the public. Recommendations: We recommend that national governments and international agencies implementing interventions against climate change, pollution, and biodiversity loss develop metrics and strategies for quantifying the health benefits of these interventions. We recommend that they deploy these tools in parallel with assessments of ecologic and economic benefits. Health metrics developed by the Global Burden of Disease (GBD) study may provide a useful starting point. Incorporation of health metrics into assessments of environmental restoration will require building transdisciplinary collaborations. Environmental scientists and engineers will need to work with health scientists to establish evaluation systems that link environmental and economic data with health data. Such systems will assist international agencies as well as national and local governments in prioritizing environmental interventions.

Measuring a country’s sustainable development by its gross domestic product (GDP) is insufficient to capture the loss of capital that determines future human welfare. To address this, we propose the inclusive wealth index, which integrates biophysical quantities and monetary values of natural, human, and produced capital. We analyzed the level of Inclusive Wealth in 163 countries over the past 30 years to assess sustainable development goals (SDGs) going beyond GDP. Global wealth has suffered significant losses in natural capital, with the biased accumulation of capital assets leading to unsustainable and unequal development. In low-income countries, soaring population levels and biased capital investments exacerbate the depletion of natural capital. Our results underscore the critical role of natural capital and inclusive capital management in sustainable development. Policymakers can use this information to make capital investments in their economies and promote recovery from COVID-19 that aligns with the SDGs, the Paris Climate Agreement, and initiatives beyond GDP.

A healthy ocean is essential for human health, and yet the links between the ocean and human health are often overlooked. By providing new medicines, technologies, energy, foods, recreation, and inspiration, the ocean has the potential to enhance human health and wellbeing. However, climate change, pollution, biodiversity loss, and inequity threaten both ocean and human health. Sustainable realisation of the ocean’s health benefits will require overcoming these challenges through equitable partnerships, enforcement of laws and treaties, robust monitoring, and use of metrics that assess both the ocean’s natural capital and human wellbeing. Achieving this will require an explicit focus on human rights, equity, sustainability, and social justice. In addition to highlighting the potential unique role of the healthcare sector, we offer science-based recommendations to protect both ocean health and human health, and we highlight the unique potential of the healthcare sector tolead this effort.

This article details a correction to: Landrigan PJ, Raps H, Cropper M, et al. The Minderoo-Monaco Commission on Plastics and Human Health. Annals of Global Health. 2023; 89(1): 23. DOI: https://doi.org/10.5334/aogh.4056.

[This corrects the article DOI: 10.5334/aogh.4056.].

Background: Human activities have induced unprecedented global shifts in natural systems including the climate, the oceans, cryosphere and biosphere. The impacts of these changes on physical health are clear and are accelerating at an alarming rate. Climate change and its consequences, especially disruptive events like floods, droughts and heat waves also impact the mental health of affected populations, increasing risk for post-traumatic stress, depression and anxiety disorders. However, the impact of climate change on mental health is not well examined and has received less attention than climate’s impacts on physical health. Goal: The paper examines the planetary health–mental health nexus. It assesses the existing state of knowledge on the association between climate events, natural disasters, pollution, access to green space and mental health. It also presents a global analysis of the economic costs of climate-related mental health disorders by developing scenarios estimating the costs of mental illness at the country level predicted to be attributable to changes in environmental factors during the period 2020–2050. Findings: Globally, the additional societal costs of mental disorders due to changes in climate-related hazards, air pollution and inadequate access to green space are estimated to be almost US$47 billion annually in 2030. These estimated costs will continue to grow exponentially to US$537 billion in 2050, relative to a baseline scenario in which these environmental factors remain at 2020 levels. Conclusions: Our scenario analysis shows that the costs associated with climate-related mental health morbidity and mortality are high already and continue to will increase sharply in coming decades. There is need therefore to strengthen the evidence linking climate change to mental health and to prioritize the development of evidence-based and impactful interventions to address the global burden of environment-related mental disorders.

Climate change may affect mental health. We conducted an umbrella review of meta-analyses examining the association between mental health and climate events related to climate change, pollution and green spaces. We searched major bibliographic databases and included meta-analyses with at least five primary studies. Results were summarized narratively. We included 24 meta-analyses on mental health and climate events (n = 13), pollution (n = 11), and green spaces (n = 2) (two meta-analyses provided data on two categories). The quality was suboptimal. According to AMSTAR-2, the overall confidence in the results was high for none of the studies, for three it was moderate, and for the other studies the confidence was low to critically low. The meta-analyses on climate events suggested an increased prevalence of symptoms of post-traumatic stress, depression, and anxiety associated with the exposure to various types of climate events, although the effect sizes differed considerably across study and not all were significant. The meta-analyses on pollution suggested that there may be a small but significant association between PM2.5, PM10, NO2, SO2, CO and mental health, especially depression and suicide, as well as autism spectrum disorders after exposure during pregnancy, but the resulting effect sizes varied considerably. Serious methodological flaws make it difficult to draw credible conclusions. We found reasonable evidence for an association between climate events and mental health and some evidence for an association between pollution and mental disorders. More high-quality research is needed to verify these associations.

Wetland quality is a critical factor in determining values of wetland goods and services. However, in many studies on wetland valuation, wetland quality has been ignored. While those studies might give useful information to the local people for decision-making, their lack of wetland quality information may lead to the difficulty in integrating wetland quality into a cross-studies research like meta-analysis. In a meta-analysis, a statistical regression function needs withdrawing from those individual studies for analysis and prediction. This research introduces the wetland quality factor, a critical but frequently missed factor, into a meta-analysis and simultaneously considers other influential factors, such as study method, socio-economic state and other wetland site characteristics, as well. Thus, a more accurate and valid meta-regression function is expected. Due to no obvious quality information in primary studies, we extract two kinds of wetland states from the study context as relative but globally consistent quality measurement to use in the analysis, as the first step to explore the effect of wetland quality on values of ecosystem services.

TO CITE THIS ARTICLE: Landrigan PJ, Raps H, Symeonides C, Chiles T, Cropper M, Enck J, Hahn ME, Hixson R, Kumar P, Mustapha A, Park Y, Spring M, Stegeman J, Thompson R, Wang Z, Wolff M, Yousuf A, Dunlop S. Announcing the Minderoo – Monaco Commission on Plastics and Human Health. Annals of Global Health. 2022; 88(1): 73, 1–9. DOI: https://doi.org/10.5334/ aogh.3916 Announcing the Minderoo – Monaco Commission on Plastics and Human Health

In September 2015, the United Nations General Assembly agreed on an agenda for sustainable development in member countries. Nations committed themselves to meeting 17 Sustainable Development Goals (SDGs), involving 169 socio-economic targets, by year 2030. To measure progress in meeting those targets, it was proposed to track more than 240 socio-economic indicators over the coming years. What is, however, missing from the list is an indicator that can be used to judge whether the policies that countries follow to meet the targets protect and promote sustainable development. We offer an account of the concept of inclusive wealth report findings that has tracked the inclusive wealth of 140 countries for the period 1992–2014.

SummaryBackgroundAfrica is undergoing both an environmental and an epidemiological transition. Household air pollution is the predominant form of air pollution, but it is declining, whereas ambient air pollution is increasing. We aimed to quantify how air pollution is affecting health, human capital, and the economy across Africa, with a particular focus on Ethiopia, Ghana, and Rwanda.MethodsData on household and ambient air pollution were from WHO Global Health Observatory, and data on morbidity and mortality were from the 2019 Global Burden of Disease Study. We estimated economic output lost due to air pollution-related disease by country, with use of labour income per worker, adjusted by the probability that a person (of a given age) was working. Losses were expressed in 2019 international dollars and as a proportion of gross domestic product (GDP). We also quantified the contribution of particulate matter (PM)2·5 pollution to intelligence quotient (IQ) loss in children younger than 10 years, with use of an exposure–response coefficient based on previously published data.FindingsAir pollution was responsible for 1·1 million deaths across Africa in 2019. Household air pollution accounted for 697 000 deaths and ambient air pollution for 394 000. Ambient air pollution-related deaths increased from 361 000 in 2015, to 383 000 in 2019, with the greatest increases in the most highly developed countries. The majority of deaths due to ambient air pollution are caused by non-communicable diseases. The loss in economic output in 2019 due to air pollution-related morbidity and mortality was $3·02 billion in Ethiopia (1·16% of GDP), $1·63 billion in Ghana (0·95% of GDP), and $349 million in Rwanda (1·19% of GDP). PM2·5 pollution was estimated to be responsible for 1·96 billion lost IQ points in African children in 2019.InterpretationAmbient air pollution is increasing across Africa. In the absence of deliberate intervention, it will increase morbidity and mortality, diminish economic productivity, impair human capital formation, and undercut development. Because most African countries are still early in development, they have opportunities to transition rapidly to wind and solar energy, avoiding a reliance on fossil fuel-based economies and minimising pollution.FundingUN Environment Programme.

Background An unusual feature of SARS-Cov-2 infection and the COVID-19 pandemic is that children are less severely affected than adults. This is especially paradoxical given the epidemiological links between poor air quality and increased COVID-19 severity in adults and that children are generally more vulnerable than adults to the adverse consequences of air pollution. Objectives To identify gaps in knowledge about the factors that protect children from severe SARS-Cov-2 infection even in the face of air pollution, and to develop a transdisciplinary research strategy to address these gaps. Methods An international group of researchers interested in children’s environmental health was invited to identify knowledge gaps and to develop research questions to close these gaps. Discussion Key research questions identified include: what are the effects of SAR-Cov-2 infection during pregnancy on the developing fetus and child; what is the impact of age at infection and genetic susceptibility on disease severity; why do some children with COVID-19 infection develop toxic shock and Kawasaki-like symptoms; what are the impacts of toxic environmental exposures including poor air quality, chemical and metal exposures on innate immunity, especially in the respiratory epithelium; what is the possible role of a “dirty” environment in conveying protection – an example of the “hygiene hypothesis”; and what are the long term health effects of SARS-Cov-2 infection in early life. Conclusion A concerted research effort by a multidisciplinary team of scientists is needed to understand the links between environmental exposures, especially air pollution and COVID-19. We call for specific research funding to encourage basic and clinical research to understand if/why exposure to environmental factors is associated with more severe disease, why children appear to be protected, and how innate immune responses may be involved. Lessons learned about SARS-Cov-2 infection in our children will help us to understand and reduce disease severity in adults, the opposite of the usual scenario.

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