Assessing perceptions and priorities for health impacts of climate change within local Michigan health departments

A rapid review of best practices in the development of risk registers for public health emergency management

Introduction

Public health organizations (PHO) must prepare to respond to a range of emergencies. This represents an ongoing challenge in an increasingly connected world, where the scope, complexity, and diversity of public health threats (PHT) have expanded, as exemplified by the COVID-19 pandemic. Risk registers (RR) offer a framework for identifying and managing threats, which can be employed by PHOs to better identify and characterize health threats. The aim of this review is to establish best practices (BP) for the development of RRs within Public Health Emergency Management (PHEM).

Methods

In partnership with a librarian from Health Canada (HC), and guided by the Cochrane Rapid Review Guideline, journal articles were retrieved through MEDLINE, and a comprehensive search strategy was applied to obtain grey literature through various databases. Articles were limited to those that met the following criteria: published on or after January 1, 2010, published in the English language and published within an Organisation for Economic Co-operation and Development setting.

Results

57 articles were included for synthesis. 41 papers specifically discussed the design of RRs. The review identified several guidelines to establish RRs in PHEM, including forward-looking, multidisciplinary, transparent, fit-for-purpose, and utilizing a systems approach to analyze and prioritize threats. Expert consultations, literature reviews, and prioritization methods such as multi-criteria-decision-analysis (MCDA) are often used to support the development of RRs. A minimum five-year-outlook is applied to assess PHTs, which are revisited yearly, and iteratively revised as new knowledge arises.

Discussion

Based upon this review, RRs offer a systems approach to PHEM that can be expanded to facilitate the analysis of disparate threats. These approaches should factor in the multidimensionality of threats, need for multi-sectoral inputs, and use of vulnerability analyses that consider inherent drivers. Further research is needed to understand how drivers modify threats. The BPs and recommendations highlighted in our research can be adopted in the practice of PHEM to characterize the public health (PH) risk environment at a given point in time and support PHOs policy and decision-making.

Climate and health concerns of Montana's public and environmental health professionals: a cross-sectional study

BACKGROUND

Rural health professionals stand at the forefront of community response to climate change, but few studies have assessed their perceptions of the threat. Further, no previous study has compared the opinions of environmental to public health professionals or extensively analyzed the factors related to these experts' climate beliefs, risk perceptions, and issue prioritization.

METHODS

In conjunction with the Montana Climate Assessment's 2021 Special Report on Climate Change and Human Health, the 479 members of the Montana Public Health Association and Montana Environmental Health Association were surveyed during September-October 2019, with 39% completing the survey. We summarized descriptive data about their perceptions of local climate-related changes and their beliefs that global warming is happening, is mostly human-caused, is a risk to human health, and that their offices and others should take action. We also evaluated which sociodemographic and risk perception factors related to these climate beliefs, risk perceptions, and workplace issue prioritization.

RESULTS

Health professionals in Montana, a politically conservative state, demonstrated high levels of awareness that global warming is happening, human-caused, and a threat to human health, well above reported rates of public concern. Eighty-eight percent said that global warming is occurring and 69% that it is mostly anthropogenic. Sixty-nine percent said that their own health was already affected by climate, and 86% said they were already seeing at least one climate change-related event in their communities. Seventy-two percent said that their departments should be preparing to deal with climate change's health effects, but just 30% said that it is currently happening. We found no statistically significant differences between Montana environmental health and public health professionals in regression models predicting climate beliefs, risk perception, and prioritization. As in studies of the public, political ideology and the observation of local climate-related changes were the strongest factors.

CONCLUSIONS

Montana environmental and public health officials said that departmental action was needed on climate change, indicating the readiness of rural health professionals to take action. Further studies of health professionals in rural regions are warranted.