Lancet Planetary Health最新文献

英文中文

Groundwater depletion in a drying world 干旱世界的地下水枯竭。

IF 21.6 1区医学 Q1 ENVIRONMENTAL SCIENCES

Lancet Planetary Health

Pub Date : 2025-11-01 DOI: 10.1016/j.lanplh.2025.101372

Cahal McQuillan

引用次数: 0

A multilevel analysis of climate change worry: determinants and vulnerabilities 气候变化担忧的多层次分析：决定因素和脆弱性

IF 21.6 1区医学 Q1 ENVIRONMENTAL SCIENCES

Lancet Planetary Health

Pub Date : 2025-11-01 DOI: 10.1016/j.lanplh.2025.101347

Friederike Mast , Timo-Kolja Pförtner

Background

A growing body of evidence highlights that public perceptions and concern about climate change (CC) are key drivers of support for mitigation and adaptation policies. Understanding the determinants of CC worry is essential for effective communication strategies and policy making.

Methods

Data from the 2016 European Social Survey, comprising 44 387 individuals aged 15–100 years from 22 European countries were used to conduct multilevel logistic regression analyses to assess the association between CC worry and individual demographic (age, sex, and self-rated health), socioeconomic (education, income, household size, and political engagement), and macro-level (PM_2·5 exposure, expenditure on environmental protection, and GDP) factors.

Findings

Overall, 76·1% of the respondents were worried about CC. Younger individuals (p<0·01), those with higher education levels (p<0·01), and females (p<0·001) were more likely to be concerned about CC. Political engagement also emerged as a significant predictor (p<0·01), suggesting that civic participation correlates with environmental concerns. However, lower income was not consistently associated with higher CC worry, with the relationship varying across countries. Furthermore, macro-level indicators showed no significant association with CC worry.

Interpretation

Individual-level factors are key to understanding CC concerns and further investigation into contextual influences on CC worries is warranted. Policy efforts should target groups less concerned about CC, such as older individuals and those with lower education and income levels. Enhancing political engagement could amplify concerns about CC, leading to more robust public support for environmental policies.

Funding

None.

背景：越来越多的证据表明，公众对气候变化的认识和关注是支持减缓和适应政策的关键驱动因素。了解CC担忧的决定因素对于有效的沟通策略和政策制定至关重要。方法采用2016年欧洲社会调查（European Social Survey）数据，对来自22个欧洲国家的44 387名年龄在15-100岁的个体进行多水平logistic回归分析，评估CC担忧与个人人口统计学（年龄、性别和自评健康）、社会经济（教育、收入、家庭规模和政治参与）和宏观层面（PM2·5暴露、环境保护支出和GDP）因素的相关性。总体而言，76.1%的受访者担心环境污染，其中年轻人（p< 0.01）、受教育程度较高的人（p< 0.01）和女性（p< 0.001）更可能担心环境污染，政治参与也成为一个显著的预测因子（p< 0.01），表明公民参与与环境问题相关。然而，较低的收入并不总是与较高的CC担忧相关，各国之间的关系各不相同。宏观指标与CC担忧无显著相关。解释个人层面的因素是理解CC担忧的关键，需要进一步调查情境对CC担忧的影响。政策努力应针对不太关心CC的群体，如老年人和受教育程度和收入水平较低的人。加强政治参与可能会扩大对CC的关注，从而导致公众对环境政策的更强有力的支持。

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引用次数: 0

Rethinking planetary health assumptions about ontology through ethnography 通过民族志重新思考关于本体论的地球健康假设

IF 21.6 1区医学 Q1 ENVIRONMENTAL SCIENCES

Lancet Planetary Health

Pub Date : 2025-11-01 DOI: 10.1016/j.lanplh.2025.101350

Carlos E Sanchez-Pimienta

Background

Planetary health seeks to promote human and ecological wellbeing, emphasising the interconnectedness of humans as part of nature and the inclusion of Indigenous Knowledges. However, critiques highlight the reliance of Planetary Health on the Western ontological categories of nature and human, and the low engagement with indigenous worldviews. In this study, I examined whether the terms nature and human can effectively convey how Mexican grassroots-level land-defence organisations promote planetary health.

Methods

9 months of ethnographic fieldwork (November 2023 to August 2024) was conducted in El Salto and Juanacatlán in Mexico, which are communities severely impacted by industrial pollution, to learn from two grassroot-level organisations, Un Salto de Vida (A Leap of Life) and the Concejo Indígena de Xonacatlán (Xonacatlán Indigenous Council). I observed participants and conducted interviews and storytelling workshops to examine the relationship between local practices and the ontological assumptions of planetary health (ie, a single nature and a universal human) using an abductive data analysis approach.

Findings

Two ethnographic stories illustrate these challenges. The first contrasts two ways of making pollution real: one based on threshold theories, the other on the disappearance of native animals. The second story examines Indigenous Coca resurgence in Juanacatlán, highlighting the risks of studying using a non-indigenous lens.

Interpretation

The first story disrupts the assumption of a single nature by revealing two ways to enact pollution. The second story questions the universal human by exposing Indigenous-mestizo power relations in development projects that might harm planetary health. Overall, this study calls for meaningful engagement with grassroots and indigenous ontologies in planetary health scholarship.

Funding

The Vanier Canada Graduate Scholarship and Pierre Elliot Trudeau Foundation scholarship supported this work as part of the authors’ graduate studies.

行星健康旨在促进人类和生态福祉，强调人类作为自然的一部分的相互联系，并纳入土著知识。然而，批评强调了行星健康对西方自然和人类本体论范畴的依赖，以及与土著世界观的低接触。在这项研究中，我考察了自然和人类这两个术语是否能有效地传达墨西哥基层土地防御组织如何促进地球健康。方法于2023年11月至2024年8月在墨西哥受工业污染严重影响的El Salto和Juanacatlán社区进行为期9个月的民族志实地调查，向两个基层组织Un Salto de Vida（生命的飞跃）和Concejo Indígena de Xonacatlán （Xonacatlán土著委员会）学习。我观察了与会者，并进行了访谈和讲故事讲习班，以利用溯因数据分析方法审查当地做法与地球健康的本体论假设（即单一自然和普遍人类）之间的关系。两个民族志故事说明了这些挑战。第一个对比了两种使污染成为现实的方法：一种基于阈值理论，另一种基于本地动物的消失。第二个故事考察了Juanacatlán上土著古柯的复苏，强调了使用非土著视角进行研究的风险。第一个故事通过揭示两种制定污染的方式，打破了单一性质的假设。第二个故事通过揭露可能危害地球健康的发展项目中的土著与混血人的权力关系，对全人类提出了质疑。总的来说，这项研究呼吁在地球健康学术中与基层和土著本体论进行有意义的接触。Vanier Canada研究生奖学金和Pierre Elliot Trudeau基金会奖学金支持这项工作，作为作者研究生学习的一部分。

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引用次数: 0

Resident-led action for greener operating rooms: a pilot using the national perioperative sustainability scorecard 居民主导的绿色手术室行动：使用国家围手术期可持续性记分卡的试点

IF 21.6 1区医学 Q1 ENVIRONMENTAL SCIENCES

Lancet Planetary Health

Pub Date : 2025-11-01 DOI: 10.1016/j.lanplh.2025.101395

Gordon Best , Olivia Cheng-Boivin , Connor Brenna , Phil Williams , Ishita Aggarwal , Owen Luo , Nicole Simms , Sarah Ward , Anita Rao , Melissa Ho , Husein Moloo , Mary Hanna , Dave Smith

Background

Environmental determinants such as air pollution and extreme heat contribute to approximately 13 million preventable deaths globally every year. Paradoxically, the health-care sector itself considerably affects planetary health, with operating rooms accounting for 10–20% of hospital-related greenhouse gas emissions. In response, the Sustainable Health Systems Community of Practice developed a sustainability scorecard, later adapted into the national Sustainable Perioperative Care Scorecard by the CASCADES initiative. This tool outlines 13 evidence-based targets to guide sustainable practices in perioperative care. This quality improvement pilot project aimed to show the utility of this national, freely available scorecard in a resident-led assessment of perioperative sustainability practices.

Methods

Residents partnered with staff surgeons to apply the 2023 CASCADES Sustainable Perioperative Care Scorecard across two major academic institutions. Assessments covered domains such as sustainability leadership, anaesthetic gas usage, reduction of low-value care, reusable instrument adoption, and waste segregation.

Findings

Both institutions showed strong engagement with resident-led evaluations. Scorecard results could distinguish differences and opportunities in practice between the two sites. Both hospitals scored well on elements relating to limiting low-value care, minimising intraoperative fresh gas flows, and implementing reusable anaesthesia equipment, and several opportunities for improvement were identified.

Interpretation

This pilot project illustrates the practicality of a national scorecard for evaluating perioperative sustainability and underscores the important role of residents in leading climate-conscious health-care improvements. Engaging trainees in structured assessments can accelerate institutional efforts towards more sustainable perioperative practices.

Funding

None.

背景：空气污染和极端高温等环境决定因素每年在全球造成约1300万例可预防的死亡。矛盾的是，卫生保健部门本身对地球健康影响很大，手术室占医院相关温室气体排放量的10-20%。作为回应，可持续卫生系统实践社区开发了可持续性记分卡，后来被CASCADES倡议纳入国家可持续围手术期护理记分卡。该工具概述了13个循证目标，以指导围手术期护理的可持续实践。这个质量改进试点项目旨在展示这个全国性的、免费的记分卡在住院医生主导的围手术期可持续性实践评估中的效用。方法住院医师与主治医生合作，在两家主要学术机构应用2023 CASCADES可持续围手术期护理记分卡。评估涵盖了可持续性领导、麻醉气体使用、减少低价值护理、可重复使用仪器的采用和废物分类等领域。两所机构都表现出对住院医生主导的评估的强烈参与。记分卡结果可以区分两个站点在实践中的差异和机会。两家医院在限制低价值护理、尽量减少术中新鲜气体流动和使用可重复使用的麻醉设备等方面得分很高，并确定了一些改进的机会。该试点项目说明了评估围手术期可持续性的国家记分卡的实用性，并强调了居民在领导气候意识卫生保健改进方面的重要作用。让受训者参与结构化评估可以加速机构朝着更可持续的围手术期实践的努力。

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引用次数: 0

Mainstreaming agrobiodiversity in planet-friendly school meals for children: a scoping review 将农业生物多样性纳入地球友好型儿童校餐的主流：范围审查

IF 21.6 1区医学 Q1 ENVIRONMENTAL SCIENCES

Lancet Planetary Health

Pub Date : 2025-11-01 DOI: 10.1016/j.lanplh.2025.101374

Natalia Estrada-Carmona PhD , Maaike MA van Houtert MSc , Silvia Araujo de Lima MA , Paul Fauchon MSc , Danny Hunter PhD , Sarah K Jones PhD , Ian Ondo MSc , Piedad Pareja Cabrejos MSc , Silvia Pastorino PhD , Samuel Pironon PhD , Meghajit Shijagurumayum PhD , Mulele Sibeso MSc , Samrat Singh PhD , Roseline Remans PhD

The global shift away from healthy, diverse, and sustainable diets threatens children’s health and futures. Although school gardens and home-grown school feeding can reconnect children with nutritious, sustainably produced food, these interventions are often implemented separately and with little attention to agrobiodiversity, which is a cornerstone for sustainability and healthy diets. Via a scoping review of 124 articles from 35 countries, we identified wide-ranging and complementary benefits of these interventions beyond health and education. The benchmark of the species used in these interventions against cultivated, predicted, and listed edible plants shows that agrobiodiversity is underused. Despite fragmented and incomplete evidence, our research shows that these interventions can jointly drive profound transformation. Realising this potential demands systemic shifts toward holistic, rights-based approaches that overcome surmountable barriers and build objective, sustainable, and resilient food systems delivering planet-friendly school meals.

全球远离健康、多样化和可持续饮食的趋势威胁着儿童的健康和未来。虽然学校菜园和自产学校供餐可以让儿童重新获得可持续生产的营养食物，但这些干预措施往往是单独实施的，很少关注农业生物多样性，而农业生物多样性是可持续性和健康饮食的基石。通过对来自35个国家的124篇文章的范围审查，我们确定了这些干预措施在健康和教育之外的广泛和互补效益。这些干预措施中使用的物种与栽培、预测和列出的可食用植物的基准表明，农业生物多样性未得到充分利用。尽管证据零散且不完整，但我们的研究表明，这些干预措施可以共同推动深刻的变革。要实现这一潜力，就需要系统性地转向以权利为基础的整体方法，克服可克服的障碍，建立客观、可持续和有弹性的粮食系统，提供对地球友好的校餐。

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引用次数: 0

Planet-friendly school meals: opportunities to improve children's health and leverage change in food systems 爱护地球的学校膳食：改善儿童健康和促进食品系统变革的机会。

IF 21.6 1区医学 Q1 ENVIRONMENTAL SCIENCES

Lancet Planetary Health

Pub Date : 2025-11-01 DOI: 10.1016/S2542-5196(24)00302-4

Silvia Pastorino , Ulrika Backlund , Raffaella Bellanca , Danny Hunter , Minna Kaljonen , Samrat Singh , Melissa Vargas , Donal Bundy , Research Consortium White Paper writing team

引用次数: 0

Advancing heat-related mental health research: moving beyond epidemiological links 推进与热有关的心理健康研究：超越流行病学联系。

IF 21.6 1区医学 Q1 ENVIRONMENTAL SCIENCES

Lancet Planetary Health

Pub Date : 2025-11-01 DOI: 10.1016/j.lanplh.2025.101341

Joshua R Wortzel , Emma L Lawrance , Kelton Minor , Holly K Boyle , Jeremy D Wortzel , Michelle L Bell , Henry Klar Yaggi

引用次数: 0

Planetary Health Research Digest 行星健康研究文摘。

IF 21.6 1区医学 Q1 ENVIRONMENTAL SCIENCES

Lancet Planetary Health

Pub Date : 2025-11-01 DOI: 10.1016/j.lanplh.2025.101386

Cahal McQuillan

引用次数: 0

Towards climate-resilient health systems: implementation of climate adaptation for health in Western Cape, South Africa 建立适应气候变化的卫生系统：在南非西开普省实施适应气候变化的卫生措施

IF 21.6 1区医学 Q1 ENVIRONMENTAL SCIENCES

Lancet Planetary Health

Pub Date : 2025-11-01 DOI: 10.1016/j.lanplh.2025.101353

Amanda Victoria Quintana , Susannah H Mayhew

Background

As climate change accelerates, its impact on human health intensifies. For the health system to protect communities and effectively respond to climate-related shocks and stressors, climate adaptation should be prioritised. Although countries have made commitments to climate-resilient and sustainable health systems, their implementation remains understudied. The Western Cape province in South Africa, aff5cted by a severe drought in 2015–18 and extreme heat events, has emphasised health as a priority adaptation sector.

Methods

Through a policy document analysis and in-depth interviews, in this study, we investigated the factors influencing the implementation of climate adaptation for health in the Western Cape. The study comprised three interconnected analyses of responses to drought and heat. The first analysis involved assessment of the coherence of climate, environment, and health policies and revealed minimal connections at the national level, especially in relation to heat, and none at the provincial level. The second analysis highlighted the provincial health sector’s response to the 2017–18 drought, underscoring the importance of health-system software factors, such as values, knowledge, and relationships, in managing the response. The third analysis examined the governance of heat-related health risks and revealed fragmented local action despite a national heat health policy, with challenges linked to unclear responsibilities and inadequate contextualisation.

Findings

Collectively, this research shows that adaptive responses often emerge outside formal policies and are driven by informal practices and cross-sectoral collaboration between individuals and organisations.

Interpretation

Effective climate adaptation depends on context-specific, inclusive actions and the institutionalisation of learning to strengthen both individual and organisational adaptive capacity.

Funding

None.

随着气候变化的加速，其对人类健康的影响也在加剧。为了使卫生系统保护社区并有效应对与气候有关的冲击和压力源，应优先考虑气候适应。尽管各国已对气候适应型和可持续的卫生系统作出承诺，但其实施情况仍未得到充分研究。南非西开普省在2015-18年遭受严重干旱和极端高温事件的影响，强调卫生是优先适应部门。方法本研究通过政策文件分析和深度访谈，调查影响西开普省实施气候适应健康的因素。这项研究包括对干旱和高温反应的三个相互关联的分析。第一次分析涉及对气候、环境和卫生政策的一致性进行评估，结果显示，在国家一级，特别是在供暖方面，它们之间的联系微乎其微，而在省一级则没有联系。第二项分析强调了省级卫生部门对2017-18年干旱的反应，强调了卫生系统软件因素（如价值观、知识和关系）在管理反应中的重要性。第三项分析检查了与热相关的健康风险的治理，并揭示了尽管有国家热健康政策，但地方行动零散，挑战与责任不明确和背景化不足有关。总的来说，这项研究表明，适应性反应往往出现在正式政策之外，并由非正式实践和个人与组织之间的跨部门合作驱动。有效的气候适应取决于具体环境的包容性行动和学习的制度化，以加强个人和组织的适应能力。

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引用次数: 0

The role of health workers in Kenya’s transition to a net-zero health-care system: a mixed-methods study 卫生工作者在肯尼亚向净零卫生保健系统过渡中的作用：一项混合方法研究

IF 21.6 1区医学 Q1 ENVIRONMENTAL SCIENCES

Lancet Planetary Health

Pub Date : 2025-11-01 DOI: 10.1016/j.lanplh.2025.101352

Iris Martine Blom , Melvine Anyango Otieno , Marie-Claire Wangari , Agan Leonard , Winslet Mwende , Naomi Wanjiku Gitau , Iain Cross , Anita Berlin , Andy Haines , Sarah Whitmee

Background

Climate change presents a major challenge to health-care systems, particularly in low-income and middle-income countries such as Kenya. Health workers are key to leading the transition towards a sustainable, climate-resilient health-care system. This mixed-methods study explored the perceptions, knowledge, and roles of Kenyan health workers in mitigation and adaptation in health care.

Methods

An online questionnaire was used to assess the understanding of health workers regarding the impact of climate change on health, the health-care system’s role in emissions reduction and adaptation, and current practices. A subsequent focus group discussion delved deeper into the identified themes, with a particular focus on educating health workers to support climate action.

Findings

The questionnaire was completed by 118 health workers. Although the respondents recognised the health risks of climate change, financial constraints and insufficient training were major barriers to implementing sustainable practices. The focus group highlighted the need for practical, context-specific education to equip health workers with actionable knowledge and skills, while also fostering emotional resilience and ethical leadership.

Interpretation

We recommend co-creating educational programmes with communities and health workers, integrating climate–health modules into curricula, and using innovative approaches such as peer-led workshops and social media campaigns. These insights underscore the transformative potential of education in empowering health workers to lead Kenya’s transition to a sustainable, climate-resilient health-care system.

Funding

None.

气候变化对卫生保健系统提出了重大挑战，特别是在肯尼亚等低收入和中等收入国家。卫生工作者是领导向可持续、适应气候变化的卫生保健系统过渡的关键。这项混合方法研究探讨了肯尼亚卫生工作者在卫生保健减缓和适应方面的看法、知识和作用。方法采用在线调查问卷，评估卫生工作者对气候变化对健康的影响、卫生保健系统在减排和适应方面的作用以及当前做法的理解。随后的焦点小组讨论深入探讨了确定的主题，特别侧重于教育卫生工作者支持气候行动。118名卫生工作者完成了问卷调查。虽然答复者承认气候变化对健康的风险，但财政限制和培训不足是实施可持续做法的主要障碍。焦点小组强调，需要针对具体情况开展切实可行的教育，使卫生工作者掌握可付诸行动的知识和技能，同时培养情感韧性和道德领导力。我们建议与社区和卫生工作者共同制定教育方案，将气候卫生模块纳入课程，并采用创新方法，如由同行领导的讲习班和社交媒体活动。这些见解强调了教育在增强卫生工作者权能、领导肯尼亚向可持续、适应气候变化的卫生保健系统过渡方面的变革潜力。

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引用次数: 0

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