The journal of climate change and health最新文献

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.

Human population growth and development coupled with centuries of atmospheric colonization by the world's richest regions have now made evident a potentially irreversible disruption in the restoration capacity of the planet's ecosystems. The production, utilization, and consumption of animal products has been closely intertwined to human biologic and social evolution. This relationship is now threatening human health and the equilibrium of the planet's ecosystem. Global food production is responsible for 35% of all greenhouse gas emissions (GHGE) with the use of animals as a source for food, as well as livestock feed, responsible for almost 60% of all food production emissions. Consumption of a high-resource diet based on animal products without a reciprocal nutritional value while degrading the environment and animal and human health is unethical and no longer sustainable. Without a major and urgent transformation in global meat consumption, and even if zero GHGE in all other sectors are achieved, agriculture alone will consume the entire world's carbon budget needed to keep global temperature rise under 2 °C by 2050. In this viewpoint, we illustrate the impact our current food-production system has on resource utilization and human and animal health. There is an urgent need to shift to a predominantly plant-based diet to arrest and potentially revert the negative environmental, animal, and human health impact of industrial animal agriculture. Healthcare professionals have the ethical responsibility to provide evidence-based information to patients and their families for their health benefits.

Introduction

Climate change poses a considerable risk of further increasing the world's mental health burden. The ways that, and extent to which, climate change is affecting mental health service users is poorly known. Mental health professionals (MHP)s' views on the nature of climate-related distress and the need for specialist training to support service users is undetermined globally.

Methods

A questionnaire survey was disseminated to an opportunity sample of MHPs based in the United Kingdom (UK). It investigated whether MHPs perceived that the number of service users mentioning climate change as affecting their mental health or emotional distress had increased in the five years prior to 2021, and if they believe it will increase further. The survey explored MHPs’ perceptions of the influence of climate change on service users’ mental health needs, if they perceive this to be rational, and if they feel adequately prepared to manage climate change related mental health problems or emotional distress.

Results

We surveyed 75 MHPs, including professionals in psychotherapy (38), psychology (19), psychiatry (6). MHPs reported a significant increase in the perceived prevalence of mental health problems or emotional distress related to climate change, believing this increase will continue. MHPs reported a range of impacts on service users due to climate change, typically viewed as a rational response. MHPs felt equipped to manage the consequences of climate change but would benefit from specific training.

Conclusions

Our results indicate an increasing incidence of climate-related emotional distress among service users as perceived by MHPs. The expectation among professionals is that this service need is here now but will continue to increase in the future, with potential implications for the provision of training.

Background

In the face of climate change the health sector will need to tackle both the increasing consequences for health worldwide and to reduce its own carbon footprint, which is estimated at 4.4% of global emissions. Raising the voice of health professionals has been identified as paramount to achieving the wide-scale and urgent response required to limit the consequences of climate change for health. Among health professionals, anesthetic practitioners are ideally placed to lead the way given that they make daily decisions regarding anesthetic gasses with a considerable footprint on climate and the environment.

Methods

Here, we describe a cross-sectional nationwide survey among 3,300 anesthesiologists and nurse anesthetists in Norway, focusing on climate change, health, and sustainable anesthetic care. Responses were tabulated and characterized using descriptive statistics.

Results

A large majority of the responding anesthesiologists and nurse anesthetists (n = 697, response rate 21.1%) agreed or strongly agreed that the world is facing a climate crisis; that nurses and doctors have a particular responsibility to warn about health threats; and that health organizations should limit their impact on climate and the environment. We found that desflurane is still widely used in Norway, despite its high climate footprint. We also identified several barriers to development of sustainable anesthetic care, including a lack of easy access to waste management systems, an absence of guidelines which promote sustainable care, and inadequate means for disposal of drug residues.

Conclusions

Alongside other surveys, the present survey identifies safe and feasible adjustments to anesthetic practice which can give substantial emission reductions, pave the way for a wider health sector response, and yield considerable benefits to planetary health.

Due to the many benefits of physical activity for human health, its promotion has established itself as an important public health topic. Global warming is influencing how and when people can be physically active, requiring adaptation measures to combat heat. At the same time, many physical activities, particularly when it comes to sports and exercise, cause carbon emissions and effect environments negatively, which opens discussions on potential ways of mitigation. This commentary lays out a framework for research priorities in the field of physical activity promotion from a perspective of planetary health. Its intent is to stimulate discussions on how research in this field can be aligned with planetary health.