title: Delays reducing waterborne and water-related infectious diseases in China under climate change.
abstract: Despite China's rapid progress improving water, sanitation and hygiene (WSH) access, in 2011, 471 million people lacked access to improved sanitation and 401 million to household piped water. Because certain infectious diseases are sensitive to changes in both climate and WSH conditions, we projected impacts of climate change on WSH-attributable diseases in China in 2020 and 2030 by coupling estimates of the temperature sensitivity of diarrheal diseases and three vector-borne diseases, temperature projections from global climate models, WSH-infrastructure development scenarios, and projected demographic changes. By 2030, climate change is projected to delay China's rapid progress toward reducing WSH-attributable infectious disease burden by 8-85 months. This development delay summarizes the adverse impact of climate change on WSH-attributable infectious diseases in China, and can be used in other settings where a significant health burden may accompany future changes in climate even as the total burden of disease falls due to non-climate reasons.
authors.affiliation: Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA ; Emory University School of Medicine, 1648 Pierce Dr NE, Atlanta, GA 30322, USA.
authors.forename: Maggie
authors.initials: M
authors.lastname: Hodges
authors.affiliation: Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA.
authors.forename: Jessica H
authors.initials: JH
authors.lastname: Belle
authors.affiliation: Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, 13001 E. 17th Place, Aurora, CO, 80045, USA.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Carlton
authors.affiliation: Department of Environmental and Global Health, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, Gainesville, FL, 32610, USA.
authors.forename: Song
authors.initials: S
authors.lastname: Liang
authors.affiliation: Office of Disease Control and Emergency Response, China Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206, China.
authors.forename: Huazhong
authors.initials: H
authors.lastname: Li
authors.affiliation: Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, 18 Shuangqing Road, Haidian District, Beijing, 100085, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Luo
authors.affiliation: Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Freeman
authors.affiliation: Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Atmospheric Science and Global Change Division, Pacific Northwest National Laboratory, 902 Battelle Boulevard, Richland, WA, 99352USA.
authors.forename: Yang
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA ; Emory University School of Medicine, 1648 Pierce Dr NE, Atlanta, GA 30322, USA.
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Hess
authors.affiliation: Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA.
authors.forename: Justin V
authors.initials: JV
authors.lastname: Remais