The journal of climate change and health最新文献

Introduction

Environmental heat can have a negative impact on health, leading to increased healthcare utilization, disability, and death. Specific clinical conditions, in combination with a global rise in temperature, may amplify the risk of heat related illnesses.

Materials and Methods

We conducted a retrospective analysis of VA's national electronic health record database from January 1, 2002, through December 31, 2019. Heat related illness diagnoses were assessed for associations with patient demographics, comorbidities, and geographic residence at the time of a heat related illness diagnosis. Descriptive statistics, linear regression, and additive seasonal decomposition methods were utilized to assess risk factors and trends.

Results

There were 33,114 documented cases of heat related illness, which impacted 28,039 unique patients, during our 18 year assessment period. Veterans were diagnosed with heat related illnesses in all 50 US states and there was an increase in the rate over time. The likelihood of heat related illnesses was greater for those with increased comorbidity burden. Rates increased for homeless Veterans in the first half of the assessment period, and then declined for the second half. Black, as well as American Indian/Alaska Native Veterans accounted for a greater proportion of heat related illnesses.

Conclusion

There has been a statistically significant and clinically important increase in the incidence of heat related illnesses over time. There has also been an increased number of heat related diagnoses associated with existing health and demographic factors, and the increase over time did not strictly follow the expected geographic North-South climate trends.

Background

If health and social care delivery systems are to achieve net zero targets, fundamental changes are required to how organizations deliver care, how individuals practice clinically, how people access care, and how systems reduce the demand for healthcare. This paper explores how professionals, patients and citizens respond to this need for change.

Methods

We conducted a mixed methods study, comprising 12 deliberative workshops (n = 35) and a survey (n = 413) with health and social care staff, patients and citizens in the North of England.

Results

We found that while few people were aware of the net zero target, they supported it. Some, however, questioned organizational commitment, highlighting potential conflicts between cost and sustainability. Staff described a lack of agency to make changes to their practice, despite identifying many opportunities to do so. Some believed that healthcare should be exempt from carbon reduction targets. The strongest messages we found to interest, empower, and motivate people to make changes are: that individual actions matter; that we have a responsibility to set a good example of tackling climate change; and that making changes saves lives and should be a priority. We also found that people need to be reassured that the changes will not adversely affect clinical outcomes. Finally, progress towards targets needs to be tracked and publicly available.

Conclusion

Our results indicate a need for clear leadership which gives sustainability a higher priority, a need for staff training to enable conversations about the environmental effects of treatment, and support for shifting the focus from treating illness to promoting health.

Climate change is real and here. Climate change has a wide range of effects on the environment – increasing global temperatures and extreme weather events, which in turn are impacting human health. Changes in weather and man-made pollution affect the quality of the air we breathe, the water we drink and the food we eat, resulting in a serious threat to our planet and our health. By examining the current literature, using a systematic review process, we explore the current and potential impact that climate change has on human health with particular relevance to the Western Australian population.

There is overwhelming evidence for climate change and how it is affecting the people of planet Earth. The environmental impact will affect human health and may result in increases in cardiovascular respiratory, neurological disorders (including neurodegeneration), vector-borne illnesses (malaria, COVID-19, Ross River Virus) and lead to a detriment in the mental health of Western Australians. Natural diseases and crises complicate healthcare. The COVD-19 pandemic revealed inadequacies in healthcare systems—shortage of healthcare workers and resources—which will compromise the ability to manage climate change induced diseases. Bushfires and raised environmental temperatures, which are particular problems for Western Australia, can impact upon climate change. Mental health may be affected through illness, drought and food insecurity. Those socially disadvantaged, individuals in remote regions and First Nations peoples will be vulnerable. An urgent response to climate change is necessary. Western Australia is particularly vulnerable to the deleterious impacts of climate change.

Introduction

The Caribbean region is repeatedly exposed to extreme climate-related events, such as hurricanes and tropical storms, which are expected to increase in severity with climate change. This study aims to better understand how extreme climate events affect human mobility, social circumstances, and health-related issues in the Eastern Caribbean, focusing more specifically on Dominica, a Small Island Developing State (SIDS).

Methods

Semi-structured qualitative interviews were conducted with people who were internally displaced following an extreme climate event in Dominica, and with people who migrated from Dominica to Guadeloupe.

Results

Mental health was a central issue discussed by participants. Some respondents raised issues regarding loss of livelihoods and poverty that affected their living conditions. For those who decided to migrate to Guadeloupe, the difficulties of getting migrant authorized status were very stressful. Other themes related to displacement trajectory, income, occupation, housing, access to food and water, health and psychosocial services, and the role of local and international assistance and social support and ties – that are well known social determinants of mental health, were raised by participants.

Discussion and conclusion

Mental health and related determinants should be seen as a public health priority in Caribbean SIDS. Psycho-social interventions that focus on potential sources of vulnerabilities to mental health issues should be integrated in climate preparedness and response efforts. Otherwise, pre-existing social vulnerabilities may be aggravated, limiting the adaptation capacities of Caribbean SIDS to climate change. Public health and the health care system have a role to play in climate change adaptation.

Background

: Climate change impacts humans and society both directly and indirectly. Alaska, for example, is warming twice as fast as the global mean, and researchers are starting to grapple with the varied and interconnected ways in which climate change affects the people there. With the number of wildfires increasing in Alaska as a result of climate change, the number of asthma cases has increased, driven by exposure to small particulate matter. However, it is not clear how far away smoke from wildfires can affect health. In this study, we hope to establish a relationship between proximity to wildfires and asthma in locations where direct PM_2.5 measurement is not easily accomplished.

Methods

: In this study, we examined whether proximity to wildfire exposure is associated with regional counts of adults with asthma, calculated using Behavioral Risk Factor Surveillance System (BRFSS) survey data and US Census data. We assigned "hotspots" around population centers with a range of various distances to wildfires in Alaska.

Results

: We found that wildfires are associated with asthma prevalence, and the association is strongest within 25 miles of fires.

Conclusions

: This study highlights the fact that proximity to wildfires has potential as a simple proxy for actual measured wildfire smoke, which has important implications for wildfire management agencies and for policy makers who must address health issues associated with wildfires, especially in rural areas.

Introduction

Deepening global inequalities in the health impacts of climate change highlight the need for transformative solutions through international and transdisciplinary collaborations. While the emerging field of planetary health provides a unique lens for recognizing interlinkages across a broader range of knowledge systems, a deeper understanding is needed about the processes through which such knowledge systems can be developed and integrated. Existing transdisciplinarity scholarship offers useful concepts of integration across boundaries; however, such understanding predominantly reflects the perspectives of Global North academic stakeholders, conceivably due to systemic power imbalance as an enduring colonial legacy. This study aims to identify opportunities for learning from the experiences of Global South stakeholders in transdisciplinary collaboration.

Methods

We empirically explore the process of transdisciplinary collaboration in a case study of a large-scale planetary health research project. Through multi-method thematic analysis, this study seeks to understand Global South stakeholders’ contributions, motivations, and interactions on transdisciplinary collaboration, through their experiences in the case study context.

Results & Discussion

The study found that Global South stakeholders contributed a plethora of disciplinary and non-disciplinary knowledge and other resources, guided by strong cultural inclinations for collaboration. The opening up of boundary spaces was key to multi-directional knowledge integration. Analysis revealed concepts of interdependence and complementarity towards a common vision, and provides insight into stakeholders’ motivations for initial and continuing engagement.

Conclusion

Recognizing interdependence provides strong motivation for transdisciplinary collaboration and can help revalorize contributions from historically disadvantaged knowledge systems and stakeholders.

Background

Climate change is one of the biggest threats to global health and primary health care (PHC). In Africa, building climate resilient PHC is a challenge as there is little evidence to inform health systems and policymakers.

Aim

To determine the extent of the literature on climate change and PHC in the African context and identify knowledge gaps.

Methods

A scoping review systematically searched the published and grey literature (2010–2021) including six databases (Scopus, Pubmed, Cinahl, Africa Wide, Web of Science, and Open Grey) and research repositories from prominent African universities. A comprehensive search strategy and data extraction from included studies were used. Data were analyzed both quantitatively and qualitatively.

Results

A total of 1242 studies were identified and 12 included. Most of the articles were published from 2016 onwards. Publications came from five countries, with South Africa and Ghana having more than one. Most studies were narrative reviews or descriptive studies, using qualitative interviews or surveys. PHC services in Africa will experience increasing challenges of malnutrition, infectious diseases, heat-related conditions, injuries, non-communicable diseases, mental health problems and migration. However, there is an absence of actual surveillance or monitoring data. Only one study focused on the use of renewable energy as a means of resilience and mitigation. There were no studies on health financing implications.

Conclusion

The literature is accruing on climate change and health in the African context, but there is a lack of evidence on climate resilient PHC. Ten priority research questions were identified.

Introduction

In the past decade, the City of Boston has experienced a record number of hot days and has implemented measures to help residents stay cool, such as encouraging the use of air-conditioned cooling centers at community centers and public libraries. This study aimed to investigate spatial access to these cooling centers in relation to race, poverty, and heat intensity.

Methods

Geospatial analysis was used to estimate the proportion of the population within a 15-minute walk of a cooling center. Data on race, poverty, and urban heat exposure also were analyzed.

Results

The analysis showed that 77% of Boston's population is located within a 15-minute walk of a community center or library. There were no large disparities in access by race or poverty status and current cooling centers are located in areas with higher values on an urban heat island index. We estimate the City of Boston would need to construct a minimum of 19 new cooling centers to reach 95% of Boston's population, and 45 new centers to reach all residents.

Conclusion

These findings suggest that the majority of Boston's population has good access to cooling centers, but there is still a need for additional centers in certain areas. Further research could explore the effectiveness of these cooling centers in reducing heat-related health impacts.