The journal of climate change and health最新文献

The global urgency to address the adverse effects of climate change on health, particularly within marginalized communities, necessitates concerted action from healthcare systems and professionals. Recognizing the critical role of health professionals in climate mitigation and adaptation, the Climate & Health 2023 Conference convened to address gaps in preparedness, build community, and foster international collaboration. The conference aimed to educate healthcare students and professionals, facilitate research dissemination, raise awareness of health disparities exacerbated by climate change, and promote innovative climate-responsive healthcare practices. Several key themes emerged from the conference sessions, spanning climate and health education, sustainability in healthcare delivery, community resilience, effective communication strategies, ethical considerations, and addressing healthcare disparities. Participants highlighted the urgent need to continue to integrate climate education into healthcare curricula and promote climate-smart healthcare practices, such as reducing greenhouse gas emissions and promoting sustainability in clinical care. The importance of effective communication by healthcare professionals to engage the public and policymakers in climate action as well as storytelling by doctors in society as trusted voices were further emphasized as powerful tools to convey the health relevance of climate change. Sessions emphasized the imperative of addressing health disparities exacerbated by climate change, particularly in vulnerable communities. Moving forward, healthcare professionals must continue to advocate for climate action, integrate climate considerations into clinical practice, and prioritize health equity to build a resilient and climate-ready healthcare sector for the 21st century.

Anthropogenic climate change, with co-factors, threatens civilization, and thus human health. I first show that climate change is an important element of a system of hazards called “Limits to Growth”. I then argue that the interaction of climate change and other Limits to Growth elements risks civilization “failure” and possibly its “collapse”. Either consequence, were one to occur, entails profound risks to global population health, yet appreciation of this is still largely outside the health literature. I then discuss these relationships (including with civilization's destiny) with bioethical schools. The oldest of these (also called medical ethics) is strongly related to health and medicine, but in a later (1970) formulation the prefix “bio” is broader than human biology, though this school also has roots in human health. Van Rensselaer Potter, widely recognized as the founder of this school, subtitled it “the science of survival”. This subtitle seems to acknowledge an at least implicit risk to civilization. I also briefly discuss environmental ethics. By calling for greater discussion of the risk of civilization failure (or its collapse) this paper makes an important and original contribution to bioethics, however conceptualized. The major scholarly contribution of this paper is its call for the human health literature to refresh its consideration of Limits to Growth, to reconsider aspects that have become marginalized in the health literature, and for health workers to deepen their engagement with related literatures, especially of human ecology. We must contemplate the unthinkable if we are to help avert it.

Introduction

Climate and land use change may cause the geographical range of mosquitoes to expand, shift, or contract, ultimately changing what communities are at risk for contracting mosquito-borne diseases. Across North and South America, mosquitoes from the Aedes and Culex genera are vectors for numerous diseases, including chikungunya, dengue, various equine encephalitis viruses, Saint Louis encephalitis virus, West Nile virus, yellow fever virus, and Zika virus. The goal of our study was to project the geographical distributions of important mosquito vectors across North and South America in response to climate change, which is important to inform public health planning.

Methods

We used an ecological niche model and future projections of climate and land use to project the geographical ranges of two Aedes species (Ae. aegypti, Ae. albopictus) and seven Culex species (Cx. erraticus, Cx. nigripalpus, Cx. pipiens, Cx. quinquefasciatus, Cx. restuans, Cx. salinarius, Cx. tarsalis) over North and South America in response to both a high (Shared Socioeconomic Pathway [SSP] 5, Representative Concentration Pathway [RCP] 8.5) and moderate (SSP2 RCP4.5) climate warming scenario through years 2050 and 2090.

Results

For SSP5 RCP8.5, six species (Ae. aegypti, Ae. albopictus, Cx. erraticus, Cx. nigripalpus, Cx. quinquefasciatus, Cx. restuans) are projected to expand in geographical range, two species (Cx. pipiens, Cx. tarsalis) are projected to shift in geographical range, and one species (Cx. salinarius) is projected to nearly remain the same. Five species (Ae. aegypti, Ae. albopictus, Cx. erraticus, Cx. nigripalpus, Cx. quinquefasciatus) show the largest increase in high habitat suitability (>0.5 on a 0–1 scale) for SSP5 RCP8.5, three species (Cx. pipiens, Cx. restuans, Cx. tarsalis) show the largest increase for SSP2 RCP4.5, and one species (Cx. salinarius) shows a relatively small decrease in response to both scenarios.

Conclusions

We found that all nine species responded resiliently to climate change under both the high and moderate climate warming scenario, suggesting mosquito-borne disease is likely to be a continued threat in response to climate change. The projected geographical ranges can be used to inform disease risk analyses and mitigation strategies in response to climate change.

Introduction

Climate change has negatively impacted the agricultural and socioeconomic infrastructure of Latin American and Caribbean (LAC) countries leading to conditions that promote human migration. It has also led to emergence and reemergence of infectious diseases. This pilot study aimed to identify climate-related drivers of migration and to describe the burden of climate-sensitive neglected tropical diseases (NTD) in immigrants living in Atlanta, Georgia, USA.

Methods

First generation immigrants from LAC countries living in the Atlanta-metro area were recruited between May and December 2021. Participants completed a survey concerning demographics, socioeconomics, living conditions in their country of origin and living conditions in Atlanta, and motivations for migration. Blood and stool samples were collected to identify Chagas disease and soil-transmitted helminths, and skin exams screened for leprosy and leishmaniasis. Descriptive, univariate, and multivariable analyses of this dataset looked at the association between a climate-driven motivation to migrate and geographic and socioeconomic factors.

Results

Fifty-seven individuals were recruited representing 11 LAC countries of origin. Most originated from Central America (n = 32; 56 %) and Mexico (n = 13; 23%). Forty-two participants reported a change in climate or weather in their country of origin prior to moving and direct climate drivers of migration (e.g., floods, drought, etc.) were identified by 12 participants (21.1%). Infectious diseases screening found one definitive case of Chagas (2.5%) out of 40 blood samples screened. Food insecurity was significantly associated with a climate-related factor for migrating: aOR = 6.3 (95 % CI 1.1, 35.5).

Conclusions

While most participants did not directly identify “climate change” as a reason for migration, our study reveals many factors such as food insecurity, agricultural occupations, and region of origin that may underlie climate-motivated migration. Finding one case of Chagas was also noteworthy and shows the need for improved surveillance for this important NTD.

Background

Fossil fuel combustion and climate change are endangering respiratory health. As these threats increase, healthcare delivery systems must adapt and build resilience. In this scoping review, we aim to assess the current landscape of respiratory care impacts from climate change, identifying priorities for future study.

Methods

We performed a scoping review of scientific and gray literature, and selected institutional websites, to understand the impacts of climate change on respiratory healthcare.

Results

Medline, Embase, Scopus, Cochrane Library, Lens.org, and Google Scholar were searched from database inception through 28 July 2023. The initial search yielded 1207 unique articles. Of the 67 articles identified as relevant to the impacts of climate change on respiratory care, 50 (74.6 %) had been published between 2020 and 2023. The most studied climate change and severe weather exposures were extreme heat (n = 31, 46.3 %), particulate matter not from wildfires (n = 22, 32.8 %), and wildfires (n = 19, 28.4 %). Respiratory-related hospital admissions (n = 33, 49.3 %) and emergency department visits (n = 24, 35.8 %) were the most common study outcomes. Few studies identified potential impacts on telehealth services, facility energy distribution, and pharmaceutical supplies.

Discussion

Climate change is projected to increase respiratory-related emergency department visits and hospital admissions. Limited research is available on current and projected economic costs, infrastructure effects, and supply chain impacts. While climate change and extreme weather are increasing strain on respiratory care systems, additional work is needed to develop evidence-based strategies for climate adaptation.

Background

Heat is becoming a global public health concern. This paper presents a comprehensive Twitter data analysis (2011–2023) to gain insights into public perceptions of heatwaves and their health-related concerns.

Methods

A number (N = 2,070,197) of filtered tweets were included for analysis after preprocessing. Utilizing the Extractor of Demographic Characteristics (EDC) module, we extracted demographic attributes, including user type, gender, and age, highlighting the diverse voices in the Twitter conversation. Sentiment and emotional analyses were conducted utilizing BERT models. An active learning content analysis approach was employed using the GPT-3 model to identify health outcomes and concerns related to heat waves.

Results

Our results show that joy and anger were the dominant emotions, reflecting positive and negative sentiments surrounding heat waves. Public sentiment varied, revealing concern and optimism in response to changing weather patterns.

In terms of health outcomes, the paper categorizes and analyzes a wide range of concerns during heat waves, from heat-related illnesses to mental health issues. These findings provide valuable insights into how different health concerns are distributed across gender, user type, and age categories. An overview of the measures people took to control these issues was also given.

Conclusions

This study illustrates the evolving dynamics of public emotional responses to heat waves, offering a holistic view of the various health-related concerns raised by the public during these extreme weather events. Such insights are essential for informing public health strategies and emergency responses to mitigate the adverse effects of heat waves and protect vulnerable populations.

Introduction

Climate change has been called a ‘Planetary Health Emergency’. Climate-induced health impacts are universal, but their expressions may be localized depending upon local determinants, necessitating the need for contextually grounded health adaptation actions. Community engagement is central to multisectoral climate and health actions. Communities need to be informed, educated, involved, and empowered to identify unique pathways through which climate change impacts health locally. The use of participatory approaches is recommended over top-down ones.

Case presentation

The present case study describes the experience of using a participatory approach to involve local rural communities in India, generating evidence towards climate health policies and implementation. A total of 30 participatory dialogues were carried out, interacting with approximately 374 individuals in 9 village communities from Bhor Block of Pune district in western India.

Discussion

Three lessons emerged from qualitative data analysis – a) Tailoring participatory approaches is important. Approaches like pictorial stories, causal loop diagrams, listing and ranking, timeline, and action-oriented dialogues were customized for climate and health discourse and action; b) The participatory approaches offer ample opportunities and advantages such as their appealing value, ability to unfold contextual vulnerability, and actionable insights for adaptation. c) The barriers a social system poses to the participatory approach cannot be overlooked.

Conclusion

Participatory approaches can build peoples’ abilities for critical analysis of situations and problem-solving about climate change and can enhance local community engagement. More research is needed in this area to facilitate education about climate change and health.

Indigenous peoples shoulder a disproportionate burden of risk posed by climate change and associated environmental shifts. Simultaneously, Indigenous communities are recognized as arbiters of planetary health and climate resilience due to their interdependence with local ecosystems, traditional lifeways and Indigenous Traditional Ecological Knowledge(s) (ITEKs) that inform adaptation and mitigation programming. Accordingly, Indigenous Peoples protect and steward 80% of the global biodiversity, while only inhabiting 22% of the earth's surface, and comprising only 5% of the earth's global population [1]. Yet, climate resilience often disregards opportunities for Indigenous communities to explore reparative frameworks that seek to heal the social and ecological determinants responsible for climate-related vulnerabilities associated with histories of colonial subjugation. This manuscript offers critical insights and Indigenous perspectives on climate justice, while redressing the intersection of place-based determinants of Indigenous health, sovereignty and self-determination, with ancestral land-based practices of birthing justice and rematriation of Indigenous territories. As Indigenous communities grapple with land dispossession and confinement - rematriation, ancestral remembrance and reciprocity offer novel insights on the critical relationship to territorial homelands and the sanctity of place to Indigenous health. In closing, the authors explore opportunities for decolonizing relationships to place from climate justice perspectives, while discussing a case of rematriation and healing at Bdóte, the place of genesis for Dakota Peoples, also known as Minneapolis and Saint Paul, MN.

Introduction

The planet is facing a substantial crisis of global warming from the burning of fossil fuels. The global healthcare system contributes to 4.4 % of global emissions part of which can be attributed to patient travel. Telemedicine has the opportunity to provide care while obviating the need for travel. We hypothesized that the use of pediatric telemedicine will decrease carbon emissions.

Methods

We performed a review of a prospective electronic medical record system of all children that presented to an outpatient children's hospital center from August 2019 through February 2022. The primary outcome was the number of telemedicine visits that occurred per month during the time period. The home zip code for each patient was included and used to calculated the median round trip distance to travel to the outpatient clinic. The EPA greenhouse gas equivalents calculator was utilized to convert car emissions data to carbon dioxide (CO2) emissions data.

Results

Over the investigation period, there were 20,845 pediatric telemedicine visits. The travel distance that was eliminated was 1,562,716 miles (roundtrip). Using an estimate of 22.5 miles per gallon, this represents a savings of 69,454 gallons of fuel, which translates to 618 metric tonnes of CO2 saved.

Conclusion

In children, telemedicine can decrease time away from school, work for parents, need for childcare, as well as the cost and time for travel. Pediatric telemedicine use can benefit the environment through the substantial reduction of carbon dioxide emissions.