2018 VOL. 42 NO. 5 Australian and New Zealand Journal of Public Health 419 © 2018 The Authors This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifcations or adaptations are made. G lobal warming owing to greenhouse gas (GHG) emissions is irrefutable. This has clear efects on human health. 1 The efects of global warming and climate disruption are only two of a series of issues facing Pacifc Island nations. Increasing GHGs and planetary temperatures, rising sea levels and extreme weather events are potentially catastrophic for these low-lying Islands. 2 Despite their predicament, the nations of the Pacifc are taking action to mitigate their risks and prepare for what they must do to survive physically and culturally. The speed of climate change is accelerating and with it the likelihood of ‘climate refugeeism’ is increasing. 2 Climate change has a wide-reaching impact on human health; both directly – for example, from injuries caused by adverse weather events – and indirectly, from issues including changing disease profles, efects on agriculture and fow-on socioeconomic impacts. These efects all combine to force emigration and pressure other countries. 3 Because of proximity and existing networks, Australia, New Zealand and the United States are key migration destinations. 4 The Paris Declaration focuses on displacement due to climate change but does not discuss voluntary migration as a method for reducing future refugeeism. Climate disruption may result in people feeling forced to fee, while others may decide to voluntarily migrate. There is no agreed distinction between forced displacement and voluntary migration. 4 Issues facing the Pacifc Islands from climate disruption Approximately 9.5 million people inhabit the Pacifc Islands. 5,6 Island populations are growing and emigration rates are already high. Migration has mixed efects; positive economic outcomes need to be balanced against adverse efects on cultural identity. 5 Climate-related issues afecting the Pacifc Islands include: coral bleaching, coastal erosion, adverse weather events and rising sea levels. 6 Tuvalu’s islands are particularly vulnerable. These are low-lying; their shallow fresh water supplies dehydrate easily in drought and the population is heavily dependent on fshing. 2 There is little capacity to adapt to climate change as no land is more than two metres above sea level. Coral bleaching, biodiversity and food security Coral reefs are exceptionally biodiverse ecosystems and provide resources for more than 500 million people. 7 Western Pacifc coral reefs have declined by up to 50% and continue to do so at a rate of 1–2% per annum 7 due to ocean warming and acidifcation, pollution, waste and over-fshing. The Pacifc Islands are more dependent than anywhere else globally on aquaculture for economic development, employment and food security. 6,8 Ocean warming has a direct efect on spawning and distribution of fsh populations. 8 For example, some species of tuna are already declining. 9 The decrease in coral reef fsh combined with increasing population sizes is hugely problematic; even well-maintained fsheries will fail to meet the growing demand. 9 The direct efects of altered weather patterns Climate disruption is likely to bring increased frequency and severity of adverse weather events, such as tropical cyclones, 5,10 and the loss of coral reefs equates to a loss of protection for low-lying coastal regions. 10 Temperatures are predicted to increase by 1.79 degrees Celsius by 2030, 6 leading to increased communicable diseases and further pressure on agriculture. This poses signifcant public health problems for Pacifc Island residents. 11 Kiribati, the Marshall Islands and Tuvalu have some of the highest rates of tuberculosis in the Pacifc region, owing to poverty and overcrowding. 12 Climate change-related natural disasters increase overcrowding and consequentially increase transmission of tuberculosis and other communicable diseases. Vector-borne diseases are climate sensitive and incidence increases in warmer, wetter conditions. 3 Rising sea levels Globally, sea levels are rising at a rate of 3.3mm/year and this is forecast 7 to rise to 5mm/year, 10 further stressing coral reefs. Together with bleaching events, decreased biodiversity will afect food security and the economy for Pacifc Islanders. Rising sea levels also cause erosion, submersion, fooding and salinisation of freshwater aquifers. By 2080, the food risk is expected to have increased 200 times since 2003, 6 further afecting agriculture and food security and increasing reliance on expensive imported foods. Kiribati and Tuvalu are signifcantly threatened by submersion and are predicted to be uninhabitable by 2050, with their populations likely to become the frst climate refugees. 13 Recent measures to prevent disaster The Pacifc Adaptation to Climate Change program aims to build resilience within Pacifc Island communities to cope with climate change 14 and addresses three climate- sensitive areas: coastal zone management, water resources management and food security. 15 Measures to address water supply include capturing and storing rainwater, water saving, water purifying and salt water reticulation. 15 Food security is being addressed via development of climate-resilient crop species, soil-conserving farming and improved aquaculture. Coastal area degradation is being mitigated by: protective coastal doi: 10.1111/1753-6405.12823 Preventing disaster in the Pacifc Islands: the battle against climate disruption Lea Merone, 1,2,3 Peter Tait 3 1. Centre for Chronic Disease Prevention, James Cook University, Queensland 2. Apunipima Cape York Health Council, Queensland 3. Ecology and Environment Special Interest Group, Public Health Association Australia, Australian Capital Territory Editorial