The journal of climate change and health最新文献

Introduction

Climate change impacts human health by exacerbating existing vulnerabilities to communicable and non-communicable diseases and creating new ones. Consequently, there has been increasing recognition of the need for a dedicated focus on ‘climate health’ in medical education and the healthcare profession globally. In this study, we explored the perspectives of doctors on the impact of heat on human health in Hyderabad, India and how a climate health approach can be adopted across Indian healthcare.

Methods

A global literature review on climate health broadly, and heat health specifically was carried out. Based on our analysis of the literature, we developed an interview questionnaire and conducted semi-structured interviews with 16 specialist physicians in order to understand their perspectives on the impacts of heat on human health in the region of Hyderabad and institutional transformations necessary to better address questions of heat health. Interview findings were interpreted against extant research on climate health.

Results

Climate health and heat-health challenges are aggravating globally, and the doctors perceive that the Hyderabad region is no exception. While efforts are underway to operationalize a climate health approach in healthcare systems in countries of the Global North, such an orientation is almost absent from the context of Indian medical education and healthcare.

Conclusion

Impacts of climate change and heat on human health are becoming more apparent in the Hyderabad region. This suggests a strong need to incorporate greater attention to climate health and heat health as part of medical education and the healthcare system in India.

Funding

This research has been conducted as part of the “Cool Infrastructures: Life with Heat in the Offgrid City” project funded by the Economic and Social Research Council (ESRC), UK (Award No: ES/T008091/1).

Limiting global temperatures in line with the Paris Agreement requires deep and urgent cuts to emissions this decade from across all sectors, including healthcare. Yet, it can often take many years, even decades, for evidence from health research to be translated into practice. This article explores how researchers in the climate change and health field can and perhaps should operate in such an environment. Should they shift towards ‘action-orientated’ research? Should they pursue alternative pathways, such as advocacy? Should they take to the streets? First, I describe how value judgements can shape scientific research and discourse, and, in turn, policy and practice; I then discuss the recent history of advocacy amongst climate scientists and draw parallels with the experience of health researchers; finally, I consider some possible ways to navigate the tensions between research and advocacy inherent to climate change and health research. I conclude that greater reflexivity upon the values underpinning our work on can help researchers navigate the challenges we face.

Background

There are indications that heatwaves will be intensified in duration, frequency and magnitude and will pose threats to the livelihoods and health of the global working population. The purpose of this scoping review was to map evidence regarding occupational heat stress risk factors, their impact on workers’ health and productivity, and potential adaptation measures.

Methods

Keywords reflecting climate change, heat stress, health, productivity and adaptation strategies were used for searches in PubMed, PubMed Central, Scopus and Web of Science. Manuscripts that focused on heat adaptation, health and productivity outcomes of heat exposure among working populations were considered eligible for this review, while reviews, preprints and papers focused on the general population were excluded.

Results

The evidence suggests that gender, age, pre-shift dehydration, piece-rate payment, poor access to sanitation facilities, use of inappropriate personal protective equipment, physically demanding work, high workload, low job control, and high temperatures are risk factors for heat-related illness, dehydration, kidney diseases and mental distress. Specific working populations including migrants, pregnant women, and children were found to be extremely vulnerable to heat stress. The review identified that frequent intake of fluids, resting under shade or in cooling facilities, changing work hours, and increased electrolyte intake were used as adaptation measures.

Conclusion

Measures targeting adequate hydration, self-pacing, work-rest regimes, provision of shade and appropriate sanitation facilities need to be matched with improved psychosocial work conditions such as optimal work hours, job autonomy and control, and social supports to ensure safe working conditions in changing climates.

Introduction

Climate factors influence the state of human health and wellbeing. Climate-related threats are particularly being experienced by vulnerable populations in Africa. A Question (Q)-Storming session was convened at an international climate adaptation conference. It promoted dialog among a diverse spectrum of researchers, climate and medical scientists, health professionals, national government officials, civil society, business, and international governing organizations. The session identified approaches for the effective integration of health within African national climate adaptation policies.

Materials and methods

Two organizations partnered to convene the session at the Adaptations Futures 2018 Conference in Cape Town. Q-storming (which is an inverse approach to brainstorming) was applied to extract ideas from all participants. Four topics were presented during the session: (i) adaptive capacities related to climate change and infectious diseases; (ii) adaptive capacity of African governments in relation to health and climate change; (iii) making climate science work to protect the health of vulnerable populations; and (iv) making climate-health research usable.

Results

Nine cross-cutting adaptation themes were generated (i.e. key definitions, adaptive capacity, health sector priorities, resources, operational capacities and procedures, contextual conditions, information pathways, and information utility). The Q-Storming approach was a valuable tool for improving the understanding of the complexities of climate-health research collaborations, and priority identification for improved adaptation and service delivery.

Conclusion

Concerted recognition regarding difficulties in linking climate science and health vulnerability at the interface of practitioners and decision-makers is required, for better integration and use of climate-health research in climate adaptation in Africa. This can be achieved by innovations offered through Q-Storming.

Introduction

Climate change is causing far-reaching yet underappreciated worsening of outcomes across the mental health and wellbeing spectrum. Despite increasing attention to the mental health impacts of climate change, an absence of a clear, cross-sectoral agenda for action has held back progress against the dual and interconnected challenges of supporting human and planetary health. This study aims to serve as an essential first step to address this gap.

Methods

Harnessing the expertise of a diverse panel of 61 participants, representing 24 nationalities, this study developed and prioritized recommendations for action on climate change and mental health across the relevant sectors of research, policy, healthcare and the third sector, and used a Delphi-style methodology to examine their feasibility and importance.

Results

Broadly, the prioritized recommendations highlighted the need to expand the evidence base, work collaboratively across sectors, and raise awareness. While broadly there was consensus on recommendation importance, there was greater variation in the reported feasibility of the recommendations, which differed across settings. Other common themes included the need for cultural and resource contextualization, raising awareness of and addressing mental health co-benefits via climate action, and working with communities with lived experience to develop and implement the findings. As there may be some interdependencies between the recommendations, further work needs to identify how best to implement them.

Conclusion

The recommendations serve as a robust and evidence-based framework that can be used as a foundation to devise locally appropriate, concrete implementation strategies matching levels of need and resource. These also serve as a clear call to action for investment from leaders across sectors to ensure they are realized.

Introduction

Climate change threatens physical and mental health. Hospitals have a key role in adapting to these impacts. At the same time, hospitals contribute to climate change due to their greenhouse gas emissions. To effectively reduce these emissions, stakeholder involvement is important. This study aimed at identifying possible mitigation measures, barriers, and enablers for their implementation from stakeholders’ perspectives in a German university hospital.

Materials and methods

We conducted a qualitative study with semi-structured interviews at Heidelberg University Hospital. The participants’ selection was based on purposive maximum variation sampling. The interviews were transcribed verbatim and analyzed using the framework approach, supported by NVivo.

Results

Five patients, twelve clinical and twelve administrative employees at different hierarchical levels were interviewed. Stakeholders suggested various possible mitigation measures. Only a few of them were specific to hospitals. Enablers and barriers were attributed to the structural, organizational, mitigation measure, and stakeholder levels. Common barriers on these levels were non-demanding policies, the complexity of organizational structures, the perceived risk of reduced healthcare performance, and lack of awareness and prioritization. Participants formulated enablers, e.g., knowing best-practice examples or hiring a sustainability manager. However, enablers were mostly hypothetical and based on perceived barriers.

Conclusion

Profound changes in regulatory frameworks and organizational management would support stakeholders at the investigated hospital in implementing mitigation measures. Furthermore, intensified research about climate-friendly health care and communication of these findings to hospital stakeholders as well as integration of these findings into curricula of the health workforce seems necessary for the climate-friendly transformation of hospitals.

Introduction

Climate change-related flooding and sea-level rise have important direct and indirect health effects. In order to support health and equity, adaptation responses require collaborative, transdisciplinary learning and consensus-building, across a wide range of local-level stakeholders. We aimed to co-develop a shared understanding of the complex interplay between health, health determinants, flooding, and sea-level rise in a low-income urban area of Aotearoa New Zealand, to inform action.

Methods

We used qualitative participatory system dynamics modeling, involving interviews and group workshops with transdisciplinary stakeholders. We developed a shared set of wellbeing outcomes and triangulated participants’ knowledge with published evidence to develop a set of causal loop diagrams (CLDs). These capture the system feedback behavior between flooding and sea-level rise, and local health and wellbeing.

Results

Thirty-three participants were involved across the project, identifying 22 wellbeing outcomes. The CLDs covered six intersecting themes: community-led development and participation in decision-making; quality of housing; the housing market; the insurance market; economic effects of flooding and sea-level rise; and access issues arising from flooding. Intervention points were identified, with the potential to inform health equity-focused adaptation policy. The process supported shifts in participants’ mental models towards consensus and effective intervention points, and transdisciplinary relationship-building.

Conclusion

Participatory systems modeling approaches may support cross-sector collaborative learning about the complex, dynamic influences on health and wellbeing in the context of local climate change adaptation. These shared, holistic understandings are essential to inform decision-making that promotes positive health and social equity outcomes.

Background

Climate anxiety, and the mental health and wellbeing impacts of extreme weather-related events, are of growing concern globally. In Australia, where the current authors are based, rural communities in particular are dealing with unprecedented drought, fires and/or floods every few weeks. The mental health and wellbeing impacts of such climate change induced events are numerous and varied and operate within complex systems. However, little is known about what promotes the resilience of rural communities to these impacts.

Methods

This study engaged participants from three highly impacted communities in rural New South Wales in workshops designed to explore the mental health and wellbeing impacts of climate change and ways to address it.

Findings

This study shows that, from the perspective of community members, community-led collective action and planning which strengthens social and relational capital engenders feelings of belonging and increases informal social connectedness, while simultaneously supporting communities to prepare for the impacts of climate change.

Conclusions

The design of strategies to mitigate the mental health and wellbeing risks from climate change may benefit from a move beyond an individual health focus to community-led and implemented collective actions that build community networks.