The journal of climate change and health最新文献

With climate change accelerated at a worrisome rate, global warming also will have implications for surgery and surgical practice. The goal of this current study was to systematically survey the literature and better understand how climate change has affected surgical disease burden, surgical care delivery, and surgical outcomes. We performed a comprehensive scoping review, screening 3334 unique citations from three databases – 1766 from Embase, 1329 from Pubmed and 239 from Scopus – to identify studies that had associated climate change with surgery. After systematic searching, quality appraisal, and data extraction, we synthesized findings from qualitative and quantitative studies. Twenty-six studies that met the inclusion criteria were included in the review. The studies associating climate change with surgery spanned all surgical subspecialties, although most notable examples came from urology, trauma surgery, and burns and reconstructive surgery. Although there is increasingly strong evidence for how climate change might affect surgery, there is a paucity of research attempting to establish a more direct correlation or causal link between the two. Additionally, we identified several studies that did not directly address climate change but instead focused on chronobiology and its effects on surgery, highlighting directions for future research. The existing evidence, despite its limitations, generates hypotheses for future work, implicating climate change as an independent contributor towards increased surgical disease burden, decreased surgical care delivery, and worsened surgical outcomes.

Humanity is currently confronted with simultaneous complex environmental crises of unprecedented scale. These include, but are not limited to, the ongoing sixth mass extinction and the depletion of biodiversity, and ongoing anthropogenic greenhouse gas emissions which are causing changes in the climate that humanity has never before witnessed. As these ecological crises continue to progress, there is increasing recognition of the impact this has on mental health. Within this context, the notion of ecoanxiety has gained traction, primarily from the perspective of psychology, with the view to elevate suffering. However, in our view, the risk of considering ecoanxiety, and other ecological emotions, solely from a medicalized perspective as a mental disorder is that it places too much responsibility on individuals, decontextualizes ecological emotions from their social and political settings, and detaches these emotions from their ethical and moral dimensions. This article proposes to reconsider ecological emotions from the perspective of moral distress. Environmental moral distress resituates ecological emotions within their social and political contexts, and sheds light on their entanglement with ethical realms that medicalized conceptions of ecoanxiety fail to recognize. We argue that responding to environmental moral distress requires a shift to an ethics of care and ecofeminist paradigm which enables us to consider ecological emotions as contextualized indicators of the experience of morally questionable actions. This approach opens the door to collective responses aiming to empower and build moral agency in the face of the shared moral and political struggles which characterize the ecological crisis.

Introduction

Climate change is a health emergency and healthcare professionals represent critical and trusted points of contact between communities and the health effects of climate change.  However, healthcare professionals require training in the complex dynamics governing the interaction between climate and health as this education is not a part of traditional healthcare oriented curricula.

Methods

From February-April 2022, a free, live-virtual, 8-session climate and health course was offered in a collaboration between the Global Consortium on Climate and Health Education (GCCHE), Project ECHO and the United States National Oceanic and Atmospheric Administration (NOAA). The goal of the course was to increase health professionals’ knowledge, self-efficacy, and communication skills related to the climate crisis. Participants were invited to complete pre-, post- and 6-month post surveys to assess their readiness to lead climate and health education and programmatic development at their own institutions or within their own communities.

Results

Between February-April 2022, 1,047 unique attendees participated in the Climate and Health Responder ECHO series. The primary outcome measured of communication regarding climate change trended toward increased communication. Survey respondents reported increased motivation to teach climate and health topics and confidence in training others following completion of the course.

Conclusion

Live-virtual, evidence, and competency-based courses have the potential to change health professional behaviors towards addressing the climate impacts on health and equip health professionals with the knowledge and skills needed to implement climate and health programs in their own work in order to scale-up climate and health knowledge, self-efficacy, and communication skills.

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.