Ismael Henrique Silveira

Background: Climate change is likely to affect health outcomes, particularly for vulnerable populations. Innovative research tools integrating environmental, climate, social, and health data are needed to better understand short and long-term impact of climate change on health and the impact of adaptive or mitigating interventions. Methods: Using social and health data from the Center for Data and Knowledge Integration for Health (CIDACS/Fiocruz) linked to climate and environmental data, we developed the CIDACS-Clima Platform, an innovative resource that integrates longitudinal, standardised environmental, climate, social, and health data for Brazil from 2000 to the present. Climate and environmental data are from different open-access sources, including weather and air quality stations, climate reanalysis, and Earth Observation satellite products, ensuring consistent data quality and fine spatial and temporal resolution across Brazil. Social and health data from two different resources: the open-access Deidentified Data Platform and the controlled-access 100 Million Brazilian and CIDACS Birth Cohorts, assembled with identified data and therefore secured with strict data protection requirements. Findings: The Platform provides environmental and climate exposures, including air temperature, humidity, rainfall, and PM2.5, as well as extreme event indicators, such as heatwaves and droughts. This allows studies of the effects of climate change on health outcomes across the social spectrum and the marked geographical and environmental variation observed in Brazil. The integration of data from social protection and adaptation policies enables evaluation of the impact on health of efforts to adapt to or mitigate climate change. Interpretation: By aligning open-access and controlled-access environmental, climate, social, and health data under a rigorous data protection framework, the CIDACS-Clima Platform provides an unprecedented infrastructure to investigate climate change-related health risks and their attribution, and to examine how structural inequalities and policies aimed at adaptation or mitigation could amplify or attenuate these risks.

Background We investigated the association between short-term exposure to heatwaves and infant and young child feeding practices in Brazil. Methods We obtained individual-level data from the Brazilian Food and Nutrition Surveillance System (SISVAN) and temperature data from the Brazilian Daily Weather Gridded Data for 2015–2022. Heatwaves were defined as periods of at least 2 consecutive days with daily mean ambient temperature above the municipality-specific 92·5th, 95th, or 97·5th percentile. Outcomes included minimum meal frequency (MMF), minimum dietary diversity (MDD), minimum acceptable diet (MAD), egg and/or flesh food consumption (EFF), sugar-sweetened beverage consumption (SwB), and unhealthy food consumption (UF). We used logistic regression combined with distributed lag non-linear models to estimate cumulative associations over 7 days. Findings Among 1,100,321 children aged 6–23 months, heatwave exposure was consistently associated with higher odds of not meeting MAD, with estimates increasing at higher temperature thresholds: OR 1·11 (95% CI 1·07–1·14), 1·16 (1·11–1·21), and 1·24 (1·15–1·33) at the 92·5th, 95th, and 97·5th percentiles, respectively. For MMF, corresponding ORs were 1·05 (1·02–1·09), 1·09 (1·05–1·14), and 1·09 (1·01–1·17). Heatwaves were also associated with higher odds of SwB consumption and non-consumption of EFF. No consistent associations were observed for MDD or UF. Associations were more pronounced in the Northeast and in municipalities with higher material deprivation. Interpretation Short-term exposure to heatwaves may disrupt complementary feeding practices, particularly in socially vulnerable settings. These findings may help inform public health strategies to support young children and caregivers during extreme heat events.

Background: We investigated the association between short-term exposure to heatwaves and infant and young child feeding practices in Brazil.Methods: We obtained individual-level data from the Brazilian Food and Nutrition Surveillance System (SISVAN) and temperature data from the Brazilian Daily Weather Gridded Data for 2015–2022. Heatwaves were defined as periods of at least 2 consecutive days with daily mean ambient temperature above the municipality-specific 92·5th, 95th, or 97·5th percentile. Outcomes included minimum meal frequency (MMF), minimum dietary diversity (MDD), minimum acceptable diet (MAD), egg and/or flesh food consumption (EFF), sugar-sweetened beverage consumption (SwB), and unhealthy food consumption (UF). We used logistic regression combined with distributed lag non-linear models to estimate cumulative associations over 7 days.Findings: Among 1,100,321 children aged 6–23 months, heatwave exposure was consistently associated with higher odds of not meeting MAD, with estimates increasing at higher temperature thresholds: OR 1·11 (95% CI 1·07–1·14), 1·16 (1·11–1·21), and 1·24 (1·15–1·33) at the 92·5th, 95th, and 97·5th percentiles, respectively. For MMF, corresponding ORs were 1·05 (1·02–1·09), 1·09 (1·05–1·14), and 1·09 (1·01–1·17). Heatwaves were also associated with higher odds of SwB consumption and non-consumption of EFF. No consistent associations were observed for MDD or UF. Associations were more pronounced in the Northeast and in municipalities with higher material deprivation.Interpretation: Short-term exposure to heatwaves may disrupt complementary feeding practices, particularly in socially vulnerable settings. These findings may help inform public health strategies to support young children and caregivers during extreme heat events.

The aim of this article is to systematise the scientific evidence on the socio-environmental and health impacts caused by floods and heatwaves in Brazil. This is a scoping review conducted using the Medline, SciELO, Lilacs, Embase, and Scopus databases. The search was independently carried out in pairs, covering the period from 1992 to 2023. A total of 2,950 articles were identified, resulting in a final corpus of 53 studies, which were analysed thematically. The findings include 37 studies on floods and 16 on heatwaves, with reports from all regions of Brazil. The results indicate negative effects on territorial organisation, living conditions, and the process of illness and death, whether due to infectious diseases, chronic conditions, or other health issues, as well as economic losses, structural damage, and disruptions in service provision. Environmental damage such as wildfires, landslides, river siltation, and vegetation loss are also highlighted. The impacts vary according to social class, gender, and age group, with a more clearly defined pattern of exposure found in studies on floods than on heatwaves. It is concluded that floods and heatwaves have exacerbated inequalities in Brazil through negative impacts on the economy, society, agriculture, the environment, and health.

RESUMO Objetivou-se sistematizar as evidências científicas sobre os impactos socioambientais e na saúde provocados por enchentes e ondas de calor no Brasil. Trata-se de uma revisão de escopo realizada nas bases Medline, SciELO, Lilacs, Embase e Scopus. A busca foi conduzida por pares de forma independente, com recorte histórico de 1992 a 2023. Foram identificados 2.950 artigos, que resultaram em um corpus final de 53 estudos analisados tematicamente. Os resultados apresentam 37 estudos abordando enchentes e 16 sobre ondas de calor, com relatos para todas as regiões do Brasil. Apontam-se efeitos negativos na organização dos territórios, nas condições de vida e no processo de adoecimento e morte, seja para doenças infectocontagiosas, crônicas ou outros agravos; prejuízos na economia, estrutura e oferta de serviços; além de danos ao ambiente, como queimadas, deslizamentos de terra, assoreamento de rios e perda da vegetação. Os impactos variam segundo classe social, gênero, faixa etária e um padrão de exposição mais caracterizado pelos estudos para as enchentes do que para as ondas de calor. Conclui-se que as enchentes e as ondas de calor têm agravado as iniquidades no Brasil a partir de impactos negativos na economia, na sociedade, na agricultura, no ambiente e na saúde.

Background Pregnant individuals and children are particularly vulnerable to the adverse health consequences of exposure to heat. Leveraging the robust ecosystem of Brazilian linked administrative data, we aim to advance our understanding of how high temperatures and heatwaves influence birth outcomes and child nutrition. Objectives Investigate the association between high ambient temperatures/ heatwaves and 1) birth outcomes (low birth weight (LBW), small for gestational age (SGA), large for gestational age (LGA), and preterm birth), 2) child nutrition (growth), and 3) breastfeeding practices and complementary feeding in children. Methods We will triangulate results from complementary analytical approaches, including time-stratified case-crossover designs and time-to-event techniques. We will explore the influence of high temperatures and heatwaves at different periods (or lags) preceding the event and apply distributed lag non-linear models to account for delayed and non-linear effects. We will conduct subgroup analyses to identify the population groups most at risk. Results and Conclusions Our study will generate new insights into the relationship between heat, birth outcomes, and child nutrition in Brazil. By providing evidence from a middle-income country with diverse ecosystems and climate zones in a context of social inequalities, this research will contribute to advancing the current knowledge base. Additionally, by identifying critical windows of vulnerability and at-risk groups, our findings can potentially inform targeted and equitable climate adaptation policies.