The journal of climate change and health最新文献

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.

Introduction

While numerous studies have assessed the association of diarrhea with temperature, few have addressed the relationship between within-day variation of temperature and diarrhea.

Materials and methods

We investigated the association between diurnal temperature range (DTR) and daily counts of hospitalizations for all-cause diarrhea in Dhaka, Bangladesh using time series regression analysis employing distributed lag-linear models. Defining DTRs below 10th, 5th and 1st percentiles as low, very low and extremely low DTR, and DTRs above 90th, 95th and 99th percentiles as high, very high and extremely high DTRs, we additionally analyzed the effects of extreme DTR on diarrhea hospitalization. Effects were assessed for all ages, under-5 children and by gender.

Results

Although we did not find any significant effects of overall DTR and large DTRs, we detected significant effects of small DTRs on diarrhea hospitalization in all subgroups. A unit rise in low, very low and extremely low DTR was associated with a 4.9 % (95 % CI: 3.6 – 6.2), 7.1 % (95 % CI: 5.4 – 8.9) and 11.8 % (95 % CI: 8.3 – 15.5) increase in all-cause diarrhea hospitalization in all ages, respectively. A unit increase in low, very low and extremely low DTR was associated with a 4.9 %, 5.1 % and 18.4 % increase in all-cause diarrhea hospitalization in children under 5 years of age, respectively. The impact of extremely low DTR varied by gender (16.2 % in females versus 10.1 % in males). The effect of extremely low DTR was most pronounced in children under 5 years of age.

Conclusion

Less variation in within-day temperatures is a risk factor for diarrhea hospitalization in Dhaka, Bangladesh. Further research is needed to elucidate the causal pathways and identify the preventive measures necessary to mitigate the impacts of lowering DTRs on diarrhea.

Climate change interacts with social and biological factors to exacerbate the vulnerabilities and health inequities of people in displacement, with particularly severe implications for women and girls. In 2022, over 100 million people –1 in every 78 people in the world – were forced to flee their homes to a location within or beyond their country's borders, due to climatic or other man-made catastrophes. Most displaced people are housed in communities already experiencing climatic stress, exacerbating the risk of water insecurity, food insecurity, disease, struggles over resources, marginalization, and conflict between host and displaced populations. Amid the social upheaval caused by displacement, we call for a gendered approach to fostering resilience, with a particular emphasis on women. In this perspective piece, we advocate for policy and program changes that respond to the unique challenges and circumstances of displaced women and locally derived solutions that promote resilience. We start by providing an overview of health inequities during displacement, exacerbated by climate change, and then examine how gender interacts with displacement to shape women's health and wellbeing. We close with an illustrative example of Rohingya women displaced in Bangladesh who have adapted technology to combat climate change and mitigate social and health inequities to build resilience, even under severe restrictions. Gender-informed research on health, climate change, and resilience in contexts of humanitarian disasters and mass population displacement can elucidate the effectiveness of culturally- and contextually- specific interventions over the short- and long-term.

Background: Anthropogenic climate change is causing a rise in global temperatures, with this trend projected to increase into the future. Heatwaves are associated with a rise in preventable deaths, however this association is less well understood in regions experiencing cooler climates. Methods: We used a space-time-stratified conditional Poisson (-quasi) regression analysis to assess if heatwaves were associated with all-cause mortality in Tasmania, Australia, for the period 2010–2018. Results: We found that across Tasmania, low-intensity heatwaves were relatively common, with less occurrence of severe and extreme heatwaves. We found that for all heatwave types combined, there was a rise in mortality of 8 % (RR=1.08, 95 %CI 1.01–1.16). For low-intensity heatwaves, we found mortality increased by 9 % (RR=1.09, 95 %CI 1.02–1.17). Conclusion: These results have health promotion and health protection policy and practice implications for Tasmanian healthcare services, and potentially other cooler climate regions around the world.

This short communication highlights the role of digital health equity in supporting climate-resilient digital healthcare pathways for global communities experiencing the health crisis exacerbated by climate change and environmental degradation. Specifically, to design digital health responsibly to support climate change adaptation as an inclusive, equitable, human-centered process means acknowledging the interconnectedness of human health and the health of the natural environment. In this process, we recommend a more integrated and participatory approach to the dimensions of ecological and environmental determinants of health and ethical representation of diverse and vulnerable voices.