The journal of climate change and health最新文献

First Nations people in remote Australia hold important historical and local knowledge on how to respond effectively to environmental changes and extreme environmental conditions. However, there has been comparatively little attention paid to the use of First Nations people's environmental knowledge to devise environmental health responses or the effects of various environmental factors on remote residents’ health and well-being. The report explores environmental health injustice among First Nations people living in remote Australia caused by inadequate engagement of remote community members and remote health professionals in environmental health decision-making, a lack of continuous environmental monitoring in remote locations and reliance on health outcome data sets that do not reflect the actual environmental health effects on remote residents. Such environmental health injustice affects people's right to have information on the constituents of the environment they interact with daily and contributes to the lost opportunity to capitalize on local cultural knowledge to create successful environmental health responses for remote residents of Australia.

Background

The body of scientific literature on climate change and human health has exponentially grown over the past two decades, outlining a diverse list of health risks, vulnerable populations, protocols, and public policy frameworks. However, not all of these topics resonated equally among the health sciences community. This bibliometric citation analysis sets out to explore the priorities and interests reflected in the top cited articles on climate change and human health.

Methods

We searched the PubMed database for all publications containing the term "climate change" in either title, abstract, or keywords, published after January 1st, 2009. The NCBI Entrez API was used to collect citation counts for the retrieved articles. The search yielded 55,590 articles. The top 200 cited publications were manually analyzed and classified according to topic and type of article.

Findings

: Out of the 200 top-cited articles containing “Climate change” in either the title, abstract, or keywords, 40 articles engaged directly with human health or food security, receiving a total of 13,857 citations, with a range of 233–1865 citations (mean = 407.5, median = 316). Only 11 of the 40 articles were original studies. Infectious diseases were discussed in 24 of the 40 articles - 23 discuss vector-borne diseases. In comparison, only 11 refer to temperature extremes, 10 discuss nutritional insecurity and only 3 discuss migration and climate refugees. 50.9 % of all citations were published in either “Science” or “The Lancet”.

Interpretation

While climate change and human health had captured the attention of public policymakers, the consistent selection of resources and topics – favoring the Lancet commissions over environmental health publications and the IPCC, citing infectious diseases more frequently than mental health, air pollution, and extreme weather, and the overall relatively low number of citations – could indicate a low level of interest amongst the broader health sciences community.

Background

Migration from Latin America to the US has been increasing over the past few decades. Migrants may experience structural and environmental vulnerabilities that increase their risk for negative impacts of climate change upon resettlement. This pilot study examined these determinants of health for Latin American immigrants in Atlanta.

Methods

Between May and December 2021, Latin American immigrants were recruited to complete a questionnaire, with a subset completing an in-depth interview. Questionnaire results were analyzed descriptively, and interview responses were analyzed using grounded theory analysis.

Results

Fifty-four participants from 11 countries were enrolled and were majority female (87 %), ranging in age from 20 to 72. Length of time in the US varied with 48 % living here for over 15 years. Challenges with structural and environmental determinants of health included running out of medication (54 % of those on daily medication) or food (37 %), household pests (40 %), trouble paying utility bills (31 %), mold (17 %), and no air conditioning (10 %). Only 33 % stated they could easily satisfy their material needs. Fifty-four percent had an emergency plan, while 65 % knew how to find out about emergency alerts. Qualitative analysis identified language barriers, access to healthcare, and poor mental health as common challenges. Social support was a potential factor of resilience.

Conclusion

Our findings underscore the influence of social and environmental determinants of health on climate resilience in Atlanta-area immigrants and may inform migrant-focused organizations in providing resources to this community and supporting climate adaptation to safeguard health in this at-risk population.

Context

The medical sector has a significant impact on greenhouse gas emissions which, in turn, impacts global health. In the context of the climate emergency, measures should be adopted to reduce greenhouse gas emissions from the health care sector. So far, few regulations have been implemented for general practice facilities, despite the fact that the potential impact of general practice is large, due to the size of this sector. This study seeks to establish the carbon footprint of general practices in a rural French department, and to identify the main vectors of CO₂ emissions.

Materials and Methods

Three general practitioners’ offices located in Lot-et-Garonne agreed to participate in this study. This retrospective study extrapolated the carbon footprint of the practices during 2020 using the ADEME BEGES method and Life Cycle Assessment. We collected data and accounting reports directly from practices regarding different potential CO₂ emission sources (electricity, water, transport, waste, digital activities, stationery, and medical equipment).

Results

Medical practices emitted an average of 39.8t of CO₂ equivalent in 2020, i.e. 1.5 kg of CO₂eq per consultation. Transportation was the main vector of emissions with 95 % of the total (83 % via patient transportation and 12 % via physician transportation), followed by medical equipment (3 %), electricity consumption (1.1 %), office supplies (0.7 %), digital activities (0.1 %), then water and waste (both, < 0.1 %).

Conclusion

General Practice generates a significant amount of CO₂ and, therefore, requires specific actions to be implemented to reduce its impact on the environment.

Purpose

Climate change has several known impacts on health, from increasing the spread of communicable disease, exacerbating the impacts of health disparities, disrupting food supplies, and detrimentally impacting mental health.  Both the Lancet and the Global Consortium on Climate and Health Education (GCCHE) argue for the inclusion of climate and health competencies in health professional training programs. While these impacts on health are increasingly well documented, little is known about whether, and to what extent, physician associate/physician associate-comparable (PA/PA-comparable) professions around the world are trained on the health impacts of climate change.  With this study, we aimed to assess whether a global sample of international PA/PA-comparable programs incorporated information about climate change and its impacts on health into their curricula.

Methods

A survey developed by PA faculty members and an environmental epidemiologist was distributed to over 350 educational programs over a six-month period. Of these programs, 67 completed the survey, and these responses were analyzed using descriptive statistics.

Results

53.7% of programs do not currently incorporate climate change and health topics into their overall education plan. Main barriers include time constraints and coverage of a large amount of material. While most respondents felt only slightly knowledgeable in teaching related content, most felt a pre-made climate change curriculum would help facilitate inclusion of this content in their programs.

Conclusion

While climate change has well-documented and widespread health impacts, these were not addressed in the majority of curricula of a global convenience sample of PA/PA comparable programs.

Direct effects of climate change on health, such as a rise in the incidence of heat strokes due to summer heatwaves, and indirect health effects such as under-nutrition due to a rise in food prices because of climate change, are mediated through the social and environmental determinants of health (SEDH), which include but are not limited to potable water, clean air, adequate sanitation, safe shelter, and adequate food. Based on a narrative review, this paper identifies possible mechanisms through which human health is impacted by climate change. Evidence has shown that climate change-induced effects such as high temperatures and heat waves, Water, Sanitation and Hygiene (WASH), vector-borne diseases and undernutrition lead to undesirable health outcomes for the urban poor through unfavorable SEDH. Given that health of the urban poor is anticipated to be disproportionately affected by the risks of changing climate, this paper emphasizes the need for focusing on the environmental justice approach to safeguard the health of the urban poor in developing countries. It also argues for strengthening participatory and transparent urban governance to upgrade informal settlements and address factors that enhance health vulnerabilities of the urban poor. It contributes to the limited literature on environmental justice in the context of developing countries and provides a rationale behind mainstreaming the environmental justice approach for reducing the climate change-induced health risks for the urban poor.

Introduction. Several frameworks exist to measure vulnerability to extreme heat events using a health equity approach, but little evidence validates these measures and their applications. We investigated the degree to which social vulnerability measures and their constituent elements correlate with excess emergency room visits as an outcome measure. Methods. The relationship between six commonly used social vulnerability indicators and measured excess emergency room visit rates (processed by including heat-related illnesses and all-internal causes diagnosis, with considerations for age and heat days) was tested through geospatial analytics and statistical regressions, for both California and Los Angeles County. Results. The vulnerability indicators and the outcome measure were significantly positively associated at the census tract-level but weaker (∼0.2 r_s) at the scale of California and stronger (∼0.6 r_s) at the scale of Los Angeles County. Hazard-specific vulnerability indicators showed stronger relationships with outcome measures regardless of scale. A Poisson regression model showed a significant inter-county variation, indicating the importance of localized assessments for equitable environmental policies. Conclusion. The findings identify communities that are overburdened by heat and pollution and highlight the need for use of both social vulnerability and indicators of adverse outcomes from excessive heat. Patterns are found across all measures that suggest that populations facing accessibility barriers may be less likely to visit emergency rooms. This suggestion needs to be tested in other environmental settings to draw broader conclusions but has direct implications for environmental scientists and mitigation planners who use these methods.

Background

With efforts underway globally to scale up access to surgical care for the billions who lack it, understanding the impact of climate change on surgical care delivery is critical for clinicians and policymakers. We aimed to assess the current state of knowledge regarding the impact of climate change on the Lancet Commission on Global Surgery Bellwether Procedures: laparotomy, caesarean delivery and treatment of an open fracture.

Methods

Adhering to PRISMA guidelines, we performed a systematic review of PubMed, Embase, CINAHL and Web of Science. We included studies that incorporated at least one of each of our two sets of search terms: (1) a specific Bellwether Procedure or its directly related pathophysiology, and (2) a climate change pressure (e.g. extreme heat, major storm, etc.). We excluded studies published before January 1, 2000; in languages outside coauthors’ fluency; and those without primary data (e.g. meta-analyses). Two co-authors screened each abstract and then the qualifying full articles for inclusion and data extraction. Our study is registered in PROSPERO (#CRD42021271933).

Results

We initially identified 4,618 references, narrowed to 32 for final analysis. Most studies (n = 18, 56.3%) were conducted in high income countries. Only one study was conducted in Africa; none were conducted in South America or the Western Pacific. Caesarean section was the most studied procedure (n = 20, 54.1%) and major storms were the most studied climate change pressure (n = 14, 37.8%).

Conclusion

Overall, the impact of climate change on surgery is understudied. Major specific content gaps include laparotomy procedures; long-term climate pressures (e.g. heat, air pollution); geographic regions in South America, the Western Pacific and Africa; and low income country contexts. Though the existing body of literature is small, current trends can inform future research and policy initiatives in global surgery.

Introduction

Community satisfaction and risk perception are important in addressing the challenges posed by climate change and developing comprehensive and equitable climate policy. This study focused on understanding the relationship between the risk perception of future local devastation due to climate change and community satisfaction in British Columbia, Canada.

Methods

Using British Columbia Climate Distress Monitoring System data, we conducted a multivariate logistical analysis to examine this association while considering confounders and independent predictors, including age, gender, income, education, ethnicity, population density, and political orientation.

Results

The results revealed that the perception of an increased risk of future local devastation due to climate change was negatively associated with neighborhood satisfaction. However, no statistical relationship was found between housing satisfaction and risk perception. Furthermore, individuals who had experienced displacement from natural disasters, identified as women, belonged to Indigenous communities, or held liberal political views were more likely to perceive higher climate risks. In contrast, a higher income level (above $90,000) and increased population density had the opposite effect on such risk perception.

Conclusions

These findings emphasize the importance of community satisfaction in shaping the perceived risk of climate disasters and informing the development of climate mitigation and adaptation policies. A cohesive community can help individuals cope with climate disasters mentally, physically, and financially. It is essential for equitable policy-making processes to address disparities in race, age, gender, income, and political orientation when considering the impact of climate change and policy readiness. Building climate-resilient communities involves strengthening social connections, integrating community resources, and supporting vulnerable populations.