title: Initial findings from the implementation of a community-based sentinel surveillance system to assess the health effects of climate change in Alaska.
abstract: BACKGROUND
  This report describes the results of a study to determine whether a community-based sentinel surveillance system can be developed and implemented to assess the health effects of climate change, and to contribute to local discussions to mitigate these health effects. The purpose of this report is to describe the process and outcomes of this innovative approach to identifying priority areas for adaptation investment. This report can be used to assist local, state and federal governments in determining how to develop actions and policies to promote adaptation to climate change.
  
  
  OBJECTIVE
  To evaluate the health effects of climate change in rural Alaska.
  
  
  METHODS
  We conducted an iterative and participatory process to develop metrics, an instrument and a protocol to collect sentinel surveillance data on the health effects of climate change in 3 ecologically distinct regions of the state.
  
  
  RESULTS
  We collected surveillance data from 91 study participants over the course of 12 months. These data were analyzed and categorized by frequency and association between specific health outcomes or health-related factors (such as food security) and reported exposure to environmental effects of climate change. We found significant associations between several health outcomes and health outcome mediators and reported exposures. We presented these data to study participants in community settings and moderated discussions of likely causal factors for these measured associations, and helped community residents to identify specific adaption measures to mitigate those health effects.
  
  
  CONCLUSIONS
  We conclude that community-based sentinel surveillance is an effective method for assessing health outcomes from exposure to environmental effects of climate change, and informing climate change health adaptation planning in Alaskan communities. We contend that it would be effective in other regions of the nation as well.
authors.affiliation: Institute for Circumpolar Health Studies, University of Alaska, Anchorage, AK, USA.
authors.forename: David L
authors.initials: DL
authors.lastname: Driscoll
authors.forename: Tenaya
authors.initials: T
authors.lastname: Sunbury
authors.forename: Janet
authors.initials: J
authors.lastname: Johnston
authors.forename: Sue
authors.initials: S
authors.lastname: Renes
mesh_terms: D000413:Alaska / Q000453:epidemiology; D057231:Climate Change / Q000706:statistics & numerical data*; D005260:Female; D006291:Health Policy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D012424:Rural Population / Q000706:statistics & numerical data; D018571:Sentinel Surveillance; D014887:Weather
keywords: Alaska; adaptation; climate change; community-based; surveillance