Examining health equity in Nepal's climate change and health policies through the lens of environmental justice: insights from a content analysis.

IF 2.2 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Global Health Action Pub Date : 2024-12-31 Epub Date: 2024-11-29 DOI:10.1080/16549716.2024.2432069
Sudeepa Khanal, Rehana Shrestha, Melanie Boeckmann
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Abstract

Background: Climate change presents a multifaceted challenge with unequal health implications, particularly for vulnerable populations with limited adaptive capacity. Socioeconomic factors are intricately linked with environmental health outcomes and environmental factors significantly exacerbate existing health inequities. Health equity as a goal of environmental justice can address these issues.

Objective: To examine the integration of health equity within climate change and health policy documents in Nepal.

Methods: Using a qualitative content analysis approach based on Schlosberg's framework of environmental justice, we analyzed the coverage of health equity considerations in climate and health policies, assessing aspects of distribution, recognition, and participation.

Results: Twenty-one national-level policies, strategies, and plans/guidelines on climate change and health were analyzed. Nepal's policy documents lack clear definitions of health equity in relation to climate change, and related terms are used inconsistently. Health vulnerability is often addressed broadly rather than specifically. Health equity-related statements from environmental justice viewpoint vary across sectors. Many documents emphasize equitable distribution of resources and benefits, with participation in decision-making processes being the least discussed.

Conclusions: In Nepal, lack of shared understanding of health equity across sectors hinders coordinated policy efforts. There is an urgent need to expand climate change responses to consider specific health vulnerabilities. By positioning health equity as a key element of environmental justice, this study provides a broader perspective on climate change-related health equity that could encourage collaborative action between the environment and health sectors.

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从环境正义的角度审视尼泊尔气候变化和卫生政策中的卫生公平:来自内容分析的见解。
背景:气候变化带来了多方面的挑战,对健康的影响不平等,特别是对适应能力有限的弱势群体。社会经济因素与环境卫生结果有着错综复杂的联系,环境因素严重加剧了现有的卫生不公平现象。卫生公平作为环境正义的目标可以解决这些问题。目的:检查尼泊尔气候变化和卫生政策文件中卫生公平的整合。方法:采用基于Schlosberg环境正义框架的定性内容分析方法,我们分析了气候和卫生政策中健康公平考虑的覆盖范围,评估了分配、认可和参与方面的内容。结果:分析了21项关于气候变化与健康的国家级政策、战略和计划/指南。尼泊尔的政策文件缺乏与气候变化相关的卫生公平的明确定义,相关术语的使用也不一致。健康脆弱性往往被广泛而非具体地处理。从环境正义的角度来看,与健康公平有关的陈述因部门而异。许多文件强调资源和利益的公平分配,对参与决策过程的讨论最少。结论:在尼泊尔,各部门缺乏对卫生公平的共同理解,阻碍了协调一致的政策努力。迫切需要扩大气候变化应对措施,以考虑具体的健康脆弱性。通过将卫生公平定位为环境正义的一个关键要素,本研究为与气候变化有关的卫生公平提供了一个更广阔的视角,可以鼓励环境和卫生部门之间的合作行动。
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来源期刊
Global Health Action
Global Health Action PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
5.10
自引率
3.80%
发文量
108
审稿时长
16 weeks
期刊介绍: Global Health Action is an international peer-reviewed Open Access journal affiliated with the Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine at Umeå University, Sweden. The Unit hosts the Umeå International School of Public Health and the Umeå Centre for Global Health Research. Vision: Our vision is to be a leading journal in the global health field, narrowing health information gaps and contributing to the implementation of policies and actions that lead to improved global health. Aim: The widening gap between the winners and losers of globalisation presents major public health challenges. To meet these challenges, it is crucial to generate new knowledge and evidence in the field and in settings where the evidence is lacking, as well as to bridge the gaps between existing knowledge and implementation of relevant findings. Thus, the aim of Global Health Action is to contribute to fuelling a more concrete, hands-on approach to addressing global health challenges. Manuscripts suggesting strategies for practical interventions and research implementations where none already exist are specifically welcomed. Further, the journal encourages articles from low- and middle-income countries, while also welcoming articles originated from South-South and South-North collaborations. All articles are expected to address a global agenda and include a strong implementation or policy component.
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