Climate Change, Human Rights, and Social Justice

Does climate change increase the risk of marine toxins? Insights from changing seawater conditions

Marine toxins produced by marine organisms threaten human health and impose a heavy public health burden on coastal countries. Lately, there has been an emergence of marine toxins in regions that were previously unaffected, and it is believed that climate change may be a significant factor. This paper systematically summarizes the impact of climate change on the risk of marine toxins in terms of changes in seawater conditions. From our findings, climate change can cause ocean warming, acidification, stratification, and sea-level rise. These climatic events can alter the surface temperature, salinity, pH, and nutrient conditions of seawater, which may promote the growth of various algae and bacteria, facilitating the production of marine toxins. On the other hand, climate change may expand the living ranges of marine organisms (such as algae, bacteria, and fish), thereby exacerbating the production and spread of marine toxins. In addition, the sources, distribution, and toxicity of ciguatoxin, tetrodotoxin, cyclic imines, and microcystin were described to improve public awareness of these emerging marine toxins. Looking ahead, developing interdisciplinary cooperation, strengthening monitoring of emerging marine toxins, and exploring more novel approaches are essential to better address the risks of marine toxins posed by climate change. Altogether, the interrelationships between climate, marine ecology, and marine toxins were analyzed in this study, providing a theoretical basis for preventing and managing future health risks from marine toxins.

Climate Change

As human-induced climate change warms the planet, its health impacts will affect all populations, but certain groups will be more vulnerable to its impacts. Given its role as a health care safety net, emergency medicine will play a crucial role in addressing these health conditions. Additionally, with its expertise in disaster medicine, interdisciplinary collaboration, and health care systems knowledge, emergency medicine has the potential to lead the health care sector's response to climate change.

The Global Burden of Gynecological Diseases from 1990 to 2019

INTRODUCTION

Gynecological diseases ranked second among new cases of noncommunicable diseases in women of reproductive age in 1990 and 2019 globally. The aim of this study was to estimate the disease burden of gynecological diseases and describe their trends in women of all ages from 1990 to 2019.

METHODS

Using data from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD 2019), authors examined the incidence, disability-adjusted life years, and deaths from gynecological diseases by age in 204 countries and territories worldwide from 1990 to 2019. Analyses were conducted in 2022.

RESULTS

Globally, the age-standardized incidence rate and age-standardized disability-adjusted life year rate (ASDR) of gynecological diseases decreased by -0.176% and -0.245%, respectively from 1990 to 2019. Low socioeconomic development index countries had the highest age-standardized incidence rate and ASDR in 2019. The age-specific incidence rate of gynecological diseases in women aged 15-29 years increased from 1990 to 2019, and the 20-24-year age group increased the greatest by 0.21%. Polycystic ovary syndrome and other types of benign disorders contributed to the major increase.

CONCLUSIONS

Although the disease burden of gynecological diseases decreased slightly between 1990 and 2019 globally, it remained highest in low socioeconomic development index countries. The disease burden in 20-24-year age group exhibited the fastest growth, with polycystic ovary syndrome and other types of benign disorders playing a significant role. Urgent and effective measures should be taken to target different age groups, types of gynecological disease, and regions with high disease burdens.

Paradoxical gender effects in meat consumption across cultures

Men tend to eat more meat than women, but it is not clear why. We tested three hypotheses in a cross-cultural design (20,802 individuals in 23 countries across four continents): that gender differences are (a) universal, (b) related to gender roles and thus weaker in countries with higher gender equality and human development, or (c) related to opportunities to express gender roles and thus stronger in countries with higher gender equality and human development. Across all countries, men tended to consume more meat than women. However, this difference increased significantly in countries with greater human development and gender equality. The paradoxical gender gap in meat consumption aligns with previous research that suggests greater differences in behavior across genders in contexts that are more developed and gender equal. We discuss implications for theories of culture and gender as well as practical implications for global meat reduction.

Comprehensive evaluation framework for intervention on health effects of ambient temperature

Despite the existence of many interventions to mitigate or adapt to the health effects of climate change, their effectiveness remains unclear. Here, we introduce the Comprehensive Evaluation Framework for Intervention on Health Effects of Ambient Temperature to evaluate study designs and effects of intervention studies. The framework comprises three types of interventions: proactive, indirect, and direct, and four categories of indicators: classification, methods, scope, and effects. We trialed the framework by an evaluation of existing intervention studies. The evaluation revealed that each intervention has its own applicable characteristics in terms of effectiveness, feasibility, and generalizability scores. We expanded the framework's potential by offering a list of intervention recommendations in different scenarios. Future applications are then explored to establish models of the relationship between study designs and intervention effects, facilitating effective interventions to address the health effects of ambient temperature under climate change.

Climate change and healthy ageing: An assessment of the impact of climate hazards on older people

Background

Climate change not only directly impacts older people's longevity but also healthy ageing, which is the process of maintaining physical and mental capacities while optimising functional abilities. The urgency to address both population ageing and climate change necessitates a rethink and assessment of the impact of climate change on older people. This includes identifying what can be done to anticipate, mitigate and adapt to climate change and engage older persons.

Methods

A review of climate change and healthy ageing forms the basis of evidence in this report. We developed a comprehensive search to assess current literature, combining terms related to ageing and climate change across four major data sets and assessing articles published up to the end of 2021.

Results

We summarised the current and future impact of climate change on older people and developed a framework identifying climate change impacts on older persons, recognising social and environmental determinants of healthy ageing. Major hazards and some key exposure pathways include extreme temperatures, wildfire, drought, flooding, storm and sea level rise, air quality, climate-sensitive infectious diseases, food and water insecurities, health and social care system displacement, migration, and relocation. Strategies to address climate change require interventions to improve systems and infrastructure to reduce vulnerability and increase resilience. As a heterogeneous group, older people's perceptions of climate change should be integrated into climate activism. Increasing climate change literacy among older people and enabling them to promote intergenerational dialogue will drive the development and implementation of equitable solutions. Pathways may operate via direct or indirect exposures, requiring longitudinal studies that enable assessment of exposures and outcomes at multiple time points, and analyses of cumulative impacts of hazards across the life course.

Conclusions

The lack of systematic reviews and primary research on the impact of most climate hazards, except for heat, on older people is apparent. Future research should include outcomes beyond mortality and morbidity and assess how older people interact with their environment by focusing on their capacities and optimising abilities for being and doing what they value.

Climate Change and Children's Health: Building a Healthy Future for Every Child

The warming of our planet matters to every child. Driven by fossil fuel-generated greenhouse gas emissions, climate conditions stable since the founding of modern pediatrics in the mid-nineteenth century have shifted, and old certainties are falling away. Children's physical and mental health are threatened by climate change through its effects on temperature, precipitation, and extreme weather; ecological disruption; and community disruption. These impacts expose and amplify existing inequities and create unprecedented intergenerational injustice. Fossil fuel extraction and combustion cause harm today and reach centuries into the future, jeopardizing the health, safety, and prosperity of today's children and future generations. Appreciating the unique vulnerability of their patients, pediatricians have become leading health advocates for climate actions necessary to protect all living and future children. Policies that reduce reliance on fossil fuels and promote cleaner air, facilitate walking and bicycling, encourage more sustainable diets, increase access to nature, and develop more connected communities lead to immediate gains in child health and equity, and build a foundation for generations of children to thrive.

Climate Change and Children's Health: Building a Healthy Future for Every Child

Observed changes in temperature, precipitation patterns, sea level, and extreme weather are destabilizing major determinants of human health. Children are at higher risk of climate-related health burdens than adults because of their unique behavior patterns; developing organ systems and physiology; greater exposure to air, food, and water contaminants per unit of body weight; and dependence on caregivers. Climate change harms children through numerous pathways, including air pollution, heat exposure, floods and hurricanes, food insecurity and nutrition, changing epidemiology of infections, and mental health harms. As the planet continues to warm, climate change's impacts will worsen, threatening to define the health and welfare of children at every stage of their lives. Children who already bear higher burden of disease because of living in low-wealth households and communities, lack of access to high quality education, and experiencing racism and other forms of unjust discrimination bear greater risk of suffering from climate change hazards. Climate change solutions, advanced through collaborative work of pediatricians, health systems, communities, corporations, and governments lead to immediate gains in child health and equity and build a foundation for generations of children to thrive. This technical report reviews the nature of climate change and its associated child health effects and supports the recommendations in the accompanying policy statement on climate change and children's health.

Scientific activism to protect the world's primates and their environments from extinction: Introduction to the special issue

Nonhuman primates and their habitats are facing an impending extinction crisis. Approximately 69% of primate species are listed by the International Union for Conservation of Nature as threatened and 93% have declining populations. Human population growth (expected to reach 10.9 billion by the year 2100), the unsustainable demands of a small number of consumer nations for forest-risk commodities, deforestation and habitat conversion, the expansion of roads and rail networks, cattle ranching, the hunting and trapping of wild primate populations, and the potential spread of infectious diseases are among the primary drivers of primate population decline. Climate change will only exacerbate the current situation. The time to act to protect primate populations is now! In this special issue of the American Journal of Primatology, we present a series of commentaries, formulated as "Action Letters." These are designed to educate and inform primatologists, conservation biologists, wildlife ecologists, political leaders, and global citizens about the conservation challenges faced by particular primate taxa and particular world regions, and present examples of specific actions that one can take, individually and collectively, to promote the persistence of wild primate populations and environmental justice for local human populations and impacted ecological communities. As scientists, researchers, and educators, primatologists are in a unique position to lead local, national, and international efforts to protect biodiversity. In this special issue, we focus on primates of the Brazilian Amazon, lemurs of northeast Madagascar, Temminck's red colobus monkey (Piliocolobus badius temminckii), night monkeys (Aotus spp.), long-tailed macaques (Macaca fascicularis), the primate pet trade, and professional capacity building to foster conservation awareness and action. We encourage primatologists, regardless of their research focus, to engage in both advocacy and activism to protect wild primate populations worldwide.

The Impact of Climate Change on Global Oncology

Climate change is the greatest threat to human health of our time, with significant implications for global cancer control efforts. The changing frequency and behavior of climate-driven extreme weather events results in more frequent and increasingly unanticipated disruptions in access to cancer care. Given the significant threat that climate change poses to cancer control efforts, oncology professionals should champion initiatives that help protect the health and safety of patients with cancer, such as enhancing emergency preparedness and response efforts and reducing emissions from our own professional activities, which has health cobenefits for the entire population.

Mindful Eco-Wellness: Steps Toward Personal and Planetary Health

Rising greenhouse gas levels heat the earth's surface and alter climate patterns, posing unprecedented threats to planetary ecology and human health. At the same time, obesity, diabetes, and cardiovascular disease have reached epidemic proportions across the globe, caused in part by decreases in physical activity and by over-consumption of carbon-intensive foods. Thus, interventions that support active transportation (walking or cycling rather than driving) and healthier food choices (eating plant-based rather than meat-based diets) would yield health and sustainability "co-benefits." Emerging research suggests that mindfulness-based practices might be effective means toward these ends. At the University of Wisconsin-Madison, we have developed a mindfulness-based group program, Mindful Eco-Wellness: Steps Toward Healthier Living. Loosely based on the Mindfulness-Based Stress Reduction course, our curriculum teaches mindfulness practices in tandem with sustainability principles, following weekly themes of Air, Water, Food, Energy, Transportation, Consumption, Nature Experience, and Ethics. For example, the "Air" class offers participants practice in guided breath meditations while they learn about the benefits of clean air. The theme of "Food" is presented through mindful eating, accompanied by educational videos highlighting the consequences of food production and consumption. "Transportation" includes walking/movement meditations and highlights the health benefits of physical activity and detriments of fossil-fueled transportation. Pedagogical lessons on energy, ecological sustainability, and the ethics of planetary health are intertwined with mindful nature experience and metta (loving-kindness) meditation. Curricular materials, including teaching videos, are freely available online. Pilot testing in community settings (n = 30) and in group medical visits (n = 34) has demonstrated feasibility; pilot data suggests potential effectiveness. Rigorous evaluation and testing are needed.

Climate change: Overview of risks to pregnant persons and their offspring

Climate change is one of the greatest challenges confronting humanity. Pregnant persons, their unborn children, and offspring are particularly vulnerable, as evidenced by adverse perinatal outcomes and increased rates of childhood illnesses. Environmental inequities compound the problem of maternal health inequities, and have given rise to the environmental justice movement.  The International Federation of Gynecology and Obstetrics and other major medical societies have worked to heighten awareness and address the deleterious health effects of climate change and toxic environmental exposures. As part of routine prenatal, neonatal, and pediatric care, neonatal-perinatal care providers should incorporate discussions with their patients and families on potential harms and also identify actions to mitigate climate change effects on their health. This article provides clinicians with an overview of how climate change affects their patients, practical guidance in caring for them, and a frame setting of the articles to follow. Clinicians have a critical role to play, and the time to act is now.

Climate Change: The Ultimate Determinant of Health

Climate change ubiquitously influences social determinants of health via various pathways. Disproportionately burdening communities who have contributed the least to greenhouse gas (GHG) emissions and benefitted the least from economic benefits obtained through high-emission activities that cause climate change, climate justice must be centered in any discussion of health equity. This article will explore how climate change contributes to health disparities in vulnerable populations, why this is a justice issue for primary care to address, and what we can do to promote equity, resilience, and adaption in our current economic system while mitigating GHG emissions, leveraging the health sector.

Climate Change and Occupational Therapy: Meeting the Urgent Need for Adaptation, Mitigation, and Resilience

Climate change may be the most pressing existential threat to human health and wellbeing in the twenty first century. In this paper, the authors provide context and critique on barriers to climate action in the United States and other high-income countries, including the profit-driven approach to health, consumerism, and the climate change countermovement. The reciprocal connections between occupational engagement and climate damage are examined from a lens of collective and irresponsible occupations and subsequent accountability. The authors propose the United Nations' Sustainable Development Goals as a basis for recommendations occupational therapy practitioners could implement within the priorities of adaptation, mitigation, and resilience.

Global warming may significantly increase childhood anemia burden in sub-Saharan Africa

Childhood anemia constitutes a global public health problem, especially in low- and middle-income countries (LMICs). However, it remains unknown whether global warming has an impact on childhood anemia. Here, we examined the association between annual temperatures and childhood anemia prevalence in sub-Saharan Africa and then projected childhood anemia burden attributable to climate change. Each 1°C increment in annual temperature was associated with increased odds of childhood anemia (odd ratio = 1.138, 95% confidence interval: 1.134-1.142). Compared with the baseline period (1985-2014), the attributable childhood anemia cases would increase by 7,597 per 100,000 person-years under a high-emission scenario in the 2090s, which would be almost 2-fold and over 3-fold more than those projected in moderate- and low-emission scenarios. Our results reveal the vulnerabilities and inequalities of children for the excess burden of anemia due to climate warming and highlight the importance of climate mitigation and adaptation strategies in LMICs.

Sexual and Gender Minorities Facing the Coronavirus Pandemic: A Systematic Review of the Distinctive Psychosocial and Health-Related Impact

Sexual and gender minorities (SGM) constitute vulnerable groups in many countries. Thus, they might be affected to a different extent than heterosexual and cisgender individuals by the Coronavirus pandemic. This systematic review aimed to summarize the state of international research on the mental and physical health-related as well as socioeconomic effects of the Coronavirus pandemic on SGM individuals. Following the PRISMA protocol, we identified 35 publications, including different article formats. We considered minority stress theory and intersectionality in synthesizing the reviewed literature. Our key finding implicates that both minority- and pandemic-specific adversities have increased the vulnerabilities of SGM individuals during the Coronavirus pandemic. Minority-specific stressors include discrimination experiences, poorer mental and physical health, and fewer socioeconomic resources. Pandemic-specific challenges such as the deferral and delay of medication or school closing have exposed certain SGM subgroups (transgender individuals, young SGM) to particularly high risk. Moreover, the reviewed evidence suggests distinctive interactive effects of minority-specific stressors with pandemic-specific challenges (e.g., being forced to stay close to rejecting others during lockdown periods). A significant share of the included literature was US-based, while research from other countries remained scarce. The specific mechanisms still deserve to be better understood to protect SGM in future crises, especially during pandemics.

Mental Health Impacts of Climate Change Among Vulnerable Populations Globally: An Integrative Review

Background

Climate change has been shown to be directly linked to multiple physiological sequelae and to impact health consequences. However, the impact of climate change on mental health globally, particularly among vulnerable populations, is less well understood.

Objective

To explore the mental health impacts of climate change in vulnerable populations globally.

Methods

We performed an integrative literature review to identify published articles that addressed the research question: What are the mental health impacts of climate change among vulnerable populations globally? The Vulnerable Populations Conceptual Model served as a theoretical model during the review process and data synthesis.

Findings/Results

One hundred and four articles were selected for inclusion in this review after a comprehensive review of 1828 manuscripts. Articles were diverse in scope and populations addressed. Land-vulnerable persons (either due to occupation or geographic location), Indigenous persons, children, older adults, and climate migrants were among the vulnerable populations whose mental health was most impacted by climate change. The most prevalent mental health responses to climate change included solastalgia, suicidality, depression, anxiety/eco-anxiety, PTSD, substance use, insomnia, and behavioral disturbance.

Conclusions

Mental health professionals including physicians, nurses, physician assistants and other healthcare providers have the opportunity to mitigate the mental health impacts of climate change among vulnerable populations through assessment, preventative education and care. An inclusive and trauma-informed response to climate-related disasters, use of validated measures of mental health, and a long-term therapeutic relationship that extends beyond the immediate consequences of climate change-related events are approaches to successful mental health care in a climate-changing world.

Occupational therapy's contributions to combating climate change and lifestyle diseases

BACKGROUND

The interdependence between human occupations, lifestyle diseases and climate change provides an opportunity to address them simultaneously. Occupational therapists' training in lifestyle modification and knowledge about the impact of the physical environment on daily occupations puts them in a unique position to contribute to global efforts of combating climate change and lifestyle diseases through the promotion of sustainable occupations.

AIM

To illustrate how occupational therapists can contribute to global efforts of combating climate change and lifestyle diseases by framing climate change from a personal and public health perspective.

METHOD

In this discussion paper we argue that occupational therapists can use education and lifestyle modification to support individuals in the prevention and management of lifestyle diseases and that they can help design and advocate for environments that promote sustainable occupations.

RESULT

This discussion paper highlights the contributions that occupational therapists can make to how we understand and address climate change and lifestyle diseases.

CONCLUSIONS AND SIGNIFICANCE

We argue that by framing the climate change discourse from a health perspective, occupational therapists can contribute to global efforts of combating climate change and lifestyle diseases by supporting individuals to engage in sustainable occupations and communities to facilitate this engagement.

Climate Change and Child Health Equity

The climate crisis is a major public health threat for children, disproportionately affecting the most vulnerable populations. Climate change causes a myriad of health issues for children, including respiratory illness, heat stress, infectious disease, the effects of weather-related disasters, and psychological sequelae. Pediatric clinicians must identify and address these issues in the clinical setting. Strong advocacy from pediatric clinicians is needed to help prevent the worst effects of the climate crisis and to support the elimination of use of fossil fuels and enactment of climate-friendly policies.

Reimagining the Role of Health Departments and Their Partners in Addressing Climate Change: Revising the Building Resilience against Climate Effects (BRACE) Framework

Public health departments have important roles to play in addressing the local health impacts of climate change, yet are often not well prepared to do so. The Climate and Health Program (CHP) at the Centers for Disease Control and Prevention (CDC) created the Building Resilience Against Climate Effects (BRACE) framework in 2012 as a five-step planning framework to support public health departments and their partners to respond to the health impacts of climate change. CHP has initiated a process to revise the framework to address learnings from a decade of experience with BRACE and advances in the science and practice of addressing climate and health. The aim of this manuscript is to describe the methodology for revising the BRACE framework and the expected outputs of this process. Development of the revised framework and associated guidance and tools will be guided by a multi-sector expert panel, and finalization will be informed by usability testing. Planned revisions to BRACE will (1) be consistent with the vision of Public Health 3.0 and position health departments as "chief health strategists" in their communities, who are responsible for facilitating the establishment and maintenance of cross-sector collaborations with community organizations, other partners, and other government agencies to address local climate impacts and prevent further harm to historically underserved communities; (2) place health equity as a central, guiding tenet; (3) incorporate greenhouse gas mitigation strategies, in addition to its previous focus on climate adaptation; and (4) feature a new set of tools to support BRACE implementation among a diverse set of users. The revised BRACE framework and the associated tools will support public health departments and their partners as they strive to prevent and reduce the negative health impacts of climate change for everyone, while focusing on improving health equity.

Envisioning environmental equity: climate change, health, and racial justice

Climate change has a broad range of health impacts and tackling climate change could be the greatest opportunity for improving global health this century. Yet conversations on climate change and health are often incomplete, giving little attention to structural discrimination and the need for racial justice. Racism kills, and climate change kills. Together, racism and climate change interact and have disproportionate effects on the lives of minoritised people both within countries and between the Global North and the Global South. This paper has three main aims. First, to survey the literature on the unequal health impacts of climate change due to racism, xenophobia, and discrimination through a scoping review. We found that racially minoritised groups, migrants, and Indigenous communities face a disproportionate burden of illness and mortality due to climate change in different contexts. Second, this paper aims to highlight inequalities in responsibility for climate change and the effects thereof. A geographical visualisation of responsibility for climate change and projected mortality and disease risk attributable to climate change per 100 000 people in 2050 was conducted. These maps visualise the disproportionate burden of illness and mortality due to climate change faced by the Global South. Our third aim is to highlight the pathways through which climate change, discrimination, and health interact in most affected areas. Case studies, testimony, and policy analysis drawn from multidisciplinary perspectives are presented throughout the paper to elucidate these pathways. The health community must urgently examine and repair the structural discrimination that drives the unequal impacts of climate change to achieve rapid and equitable action.

The Association Between Domestic Violence and Adverse Pregnancy Outcomes in Pregnant Women Seeking Antenatal Care at Public Hospitals in Gedeo Zone: A Prospective Cohort Study

Background

Domestic violence is any harmful behavior by an intimate partner, such as physical, sexual, or psychological abuse. In Ethiopia, domestic violence is a serious and widespread problem. It affects two-thirds (64.6%) of pregnant women and increases the risk of maternal and perinatal morbidity and mortality. Domestic violence during pregnancy is a growing public health problem that may contribute to maternal and perinatal mortality, especially in low- and middle-income countries. This study aims to assess the association between domestic violence during pregnancy and the risk of adverse pregnancy outcomes in Gedeo Zone Public Hospitals, Southern Ethiopia.

Material and Methods

We conducted a prospective cohort study on 142 pregnant women in their third trimester who attended public health institutions in Gedeo Zone for antenatal care. We compared 47 women who were exposed to domestic violence with 95 who were not and followed them until 24 hours after delivery or drop-out. We used SPSS version-24 to analyze data and logistic regression to examine the association between domestic violence and pregnancy outcomes. We reported the results using an adjusted odds ratio with 95% confidence interval and P-value.

Results

Out of 142 women, who completed the follow-up, 47 were exposed to domestic violence and 95 were not. We found a strong link between domestic violence and preterm birth. Women exposed to domestic violence had a four-fold higher risk of preterm birth (AOR= 4.392, 95% CI: 1.117, 6.588) than those who were not. They also had a 2.5-fold higher risk of perinatal death (AOR= 2.562, 95% CI: 1.041, 6.308).

Conclusion

Domestic violence during pregnancy affects many pregnant women in southern Ethiopia and harms their babies. It leads to preterm birth and perinatal death, which can be prevented. The Ethiopian government and other stakeholders need to protect pregnant women from intimate partner violence urgently.

Wildfires and Older Adults: A Scoping Review of Impacts, Risks, and Interventions

Climate change is leading to worsening disasters that disproportionately impact older adults. While research has begun to measure disparities, there is a gap in examining wildfire-specific disasters. To address this gap, this scoping review analyzed literature to explore the nexus of wildfires and older adults. We searched peer-reviewed literature using the following inclusion criteria: (1) published in a peer-reviewed journal; (2) available in English; (3) examines at least one topic related to wildfires; and (4) examines how criterion three relates to older adults in at least one way. Authors screened 261 titles and abstracts and 138 were reviewed in full, with 75 articles meeting inclusion criteria. Findings heavily focused on health impacts of wildfires on older adults, particularly of smoke exposure and air quality. While many articles mentioned a need for community-engaged responses that incorporate the needs of older adults, few addressed firsthand experiences of older adults. Other common topics included problems with evacuation, general health impacts, and Indigenous elders' fire knowledge. Further research is needed at the nexus of wildfires and older adults to highlight both vulnerabilities and needs as well as the unique experience and knowledge of older adults to inform wildfire response strategies and tactics.

Climate Change, Skin Health, and Dermatologic Disease: A Guide for the Dermatologist

Climate change has a pervasive impact on health and is of clinical relevance to every organ system. Climate change-related factors impact the skin's capacity to maintain homeostasis, leading to a variety of cutaneous diseases. Stratospheric ozone depletion has led to increased risk of melanoma and keratinocyte carcinomas due to ultraviolet radiation exposure. Atopic dermatitis, psoriasis, pemphigus, acne vulgaris, melasma, and photoaging are all associated with rising levels of air pollution. Elevated temperatures due to global warming induce disruption of the skin microbiome, thereby impacting atopic dermatitis, acne vulgaris, and psoriasis, and high temperatures are associated with exacerbation of skin disease and increased risk of heat stroke. Extreme weather events due to climate change, including floods and wildfires, are of relevance to the dermatologist as these events are implicated in cutaneous injuries, skin infections, and acute worsening of inflammatory skin disorders. The health consequences as well as the economic and social burden of climate change fall most heavily on vulnerable and marginalized populations due to structural disparities. As dermatologists, understanding the interaction of climate change and skin health is essential to appropriately manage dermatologic disease and advocate for our patients.

Updated assessment of occupational safety and health hazards of climate change

Workers, particularly outdoor workers, are among the populations most disproportionately affected by climate-related hazards. However, scientific research and control actions to comprehensively address these hazards are notably absent. To assess this absence, a seven-category framework was developed in 2009 to characterize the scientific literature published from 1988-2008. Using this framework, a second assessment examined the literature published through 2014, and the current one examines literature from 2014-2021. The objectives were to present literature that updates the framework and related topics and increases awareness of the role of climate change in occupational safety and health. In general, there is substantial literature on worker hazards related to ambient temperatures, biological hazards, and extreme weather but less on air pollution, ultraviolet radiation, industrial transitions, and the built environment. There is growing literature on mental health and health equity issues related to climate change, but much more research is needed. The socioeconomic impacts of climate change also require more research. This study illustrates that workers are experiencing increased morbidity and mortality related to climate change. In all areas of climate-related worker risk, including geoengineering, research is needed on the causality and prevalence of hazards, along with surveillance to identify, and interventions for hazard prevention and control.

TURNING UP THE HEAT: A CONCEPTUAL MODEL FOR UNDERSTANDING THE MIGRATION AND HEALTH IN THE CONTEXT OF GLOBAL CLIMATE CHANGE

Background

The triangular relationship between climate change-related events, patterns of human migration and their implications for health is an important yet understudied issue. To improve understanding of this complex relationship, a comprehensive, interdisciplinary conceptual model will be useful. This paper investigates relationships between these factors and considers their impacts for affected populations globally.

Methods

A desk review of key literature was undertaken. An open-ended questionnaire consisting of 11 items was designed focusing on three themes: predicting population migration by understanding key variables, health implications, and suggestions on policy and research. After using purposive sampling we selected nine experts, reflecting diverse regional and professional backgrounds directly related to our research focus area. All responses were thematically analysed and key themes from the survey were synthesised to construct the conceptual model focusing on describing the relationship between global climate change, migration and health implications and a second model focusing on actionable suggestions for organisations working in the field, academia and policymakers.

Results

Key themes which constitute our conceptual model included: a description of migrant populations perceived to be at risk; health characteristics associated with different migratory patterns; health implications for both migrants and host populations; the responsibilities of global and local governance actors; and social and structural determinants of health. Less prominent themes were aspects related to slow-onset migratory patterns, voluntary stay, and voluntary migration. Actionable suggestions include an interdisciplinary and innovative approach to study the phenomenon for academicians, preparedness and globalized training and awareness for field organisations and migrant inclusive and climate sensitive approach for policymakers.

Conclusion

Contrary to common narratives, participants framed the impacts of climate change-related events on migration patterns and their health implications as non-linear and indirect, comprising many interrelated individual, social, cultural, demographic, geographical, structural, and political determinants. An understanding of these interactions in various contexts is essential for risk reduction and preventative measures. The way forward broadly includes inclusive and equity-based health services, improved and faster administrative systems, less restrictive (im)migration policies, globally trained staff, efficient and accessible research, and improved emergency response capabilities. The focus should be to increase preventative and adaptation measures in the face of any environmental changes and respond efficiently to different phases of migration to aim for better "health for all and promote universal well-being" (WHO) (World Health Organization 1999).

Association between cold spells and serum lipid levels among the elders: a distributed-lagged effects analysis

Little evidence about the effects of cold spells on serum lipid levels is available. The aim of this study was to explore the association between cold spells and serum lipid levels among the elders in Jinan, China. Data of old adults from health check-up program in Shandong Provincial Qianfoshan Hospital was collected for this study. Linear mixed models combined with distributed lag nonlinear models were used to examine the relationship between cold spells and serum lipid levels, considering the confounding effects of age, sex, blood pressure, body mass index, and other meteorological factors. Subgroup analysis by gender and analysis based on different definitions of cold spells were also conducted. Increased TG levels in lag 0-lag 2 days and decreased TG levels in lag 5-lag 8 days after cold spells were observed among the elders. The largest increase was 0.363 mmol/L (95% CI: 0.184 ~ 0.543) in lag 0 day, while the largest decreased TG levels was 0.083 mmol/L (95% CI: 0.147 ~ 0.019) in lag 6 day. Similar results were obtained in the analysis of different sex and based on different definitions of cold spells. However, no significant association was found between cold spells with TC, LDL-C, and HDL-C. This study indicates that cold spells were significantly associated with serum TG levels in the elders. Effective preventive measures should be implemented around the cold spells to reduce the volatility of serum lipid levels and the occurrence of subsequent cardiovascular diseases.

Public Concern about Water Safety, Weather, and Climate: Insights from the World Risk Poll

Water safety refers to the quality of one's drinking water and whether it lacks dangerous contaminants. Limited access to safe water is projected to impact approximately 5 billion people worldwide by 2050. Climate change and worsening severe weather events pose increasing threats to global water safety. However, people may not perceive links between climate change and water safety, potentially undermining their willingness to implement behaviors that improve water safety. Existing studies on water safety risk perceptions have mostly been conducted in single-country contexts, which limits researchers' ability to make cross-national comparisons. Here, we assessed the extent to which people's severe weather concern and climate change concern predict their water safety concern. Our analyses used survey data from the 142-country 2019 Lloyd's Register Foundation World Risk Poll, including 21 low-income and 34 lower-middle-income countries. In mixed-effects models, severe weather concern was significantly more predictive of water safety concern than was climate change concern, although both resulted in positive associations. Worldwide, this finding was robust, insensitive to key model specifications and countries' varying protection against unsafe drinking water. We suggest communicators and policymakers improve messaging about water safety and other environmental threats by explaining how they are impacted by worsening severe weather.

Integrated transcriptome and metabolome analysis reveals molecular responses of spider to single and combined high temperature and drought stress

High temperature and drought are abiotic stresses restricting many arthropods' survival and growth. Wolf spiders are poikilothermic arthropods that are vital in managing insects and pests. Nonetheless, investigating changes in spiders under temperature and drought stress are limited, especially at the molecular and gene expression levels. The study found that the combined effects of high temperature and drought stress significantly reduced survival rates and raised superoxide dismutase and malondialdehyde levels in the wolf spider Pardosa pseudoannulata. An integrated transcriptome and metabolome analysis showed that differentially expressed genes and metabolites were highly enriched in pathways involved in the proteolysis and oxidation-reduction process. The gene expression profiles displayed that heat shock protein (HSP) families (i.e., small heat shock protein, HSP70, HSP90, and HSP beta protein) were up-regulated under temperature and/or drought stresses. Additionally, a conjoint analysis revealed that under the combined stress, several important enzymes, including maltase-glucoamylase, glycerol-6-phosphate transporter, alanine-glyoxylate transaminase, and prostaglandin-H2 D-isomerase, were altered, affecting the metabolism of starch, sucrose, amino acids, and arachidonic acid. The protein interaction network further confirmed that under the combined stress, metabolic processes, peptide metabolic processes, and ATP generation from ADP were up-regulated, indicating that spiders could accelerate the metabolism of carbohydrates and proteins to combat stress and maintain homeostasis. Overall, this work showed that exposure to a combination of pressures might cause distinct defensive reactions in spiders and offered novel perspectives to research the molecular underpinnings of spider adaptation to a changing climate.

Climate Change and Nutrition: Implications for the Eastern Mediterranean Region

The Eastern Mediterranean Region (EMR) is considered among the world's most vulnerable to the dire impacts of climate change. This review paper aims at (1) characterizing climate change in countries of the EMR; (2) examining the potential effects of climate change on the nutritional and health status of the population; and (3) identifying the most vulnerable population groups. The paper explored several climate change indicators including daily temperatures, extreme temperature, daily precipitation, extreme precipitation (flooding, drought, storms, etc.), humidity, CO₂ concentrations and sea surface temperature in EMR countries. Findings suggest that climate change will exert a significant adverse effect on water and food security and showed that the nutritional status of the population, which is already characterized by the triple burden of malnutrition, is likely to worsen via three main pathways mediated by climate change, namely, its impact on food security, care and health. Women, infants, children, those living in poor households and those experiencing displacement will be among the most vulnerable to the nutritional impacts of climate change. The paper concludes with a set of recommendations from the Initiative on Climate Action and Nutrition, which can support the region in tackling the critical nexus of climate change and nutrition.

Climate Change, Pollution, Deforestation, and Mental Health: Research Trends, Gaps, and Ethical Considerations

Climate change, pollution, and deforestation have a negative impact on global mental health. There is an environmental justice dimension to this challenge as wealthy people and high-income countries are major contributors to climate change and pollution, while poor people and low-income countries are heavily affected by the consequences. Using state-of-the art data mining, we analyzed and visualized the global research landscape on mental health, climate change, pollution and deforestation over a 15-year period. Metadata of papers were exported from PubMed®, and both relevance and relatedness of terms in different time frames were computed using VOSviewer. Co-occurrence graphs were used to visualize results. The development of exemplary terms over time was plotted separately. The number of research papers on mental health and environmental challenges is growing in a linear fashion. Major topics are climate change, chemical pollution, including psychiatric medication in wastewater, and neurobiological effects. Research on specific psychiatric syndromes and diseases, particularly on their ethical and social aspects is less prominent. There is a growing body of research literature on links between mental health, climate change, pollution, and deforestation. This research provides a graphic overview to mental healthcare professionals and political stakeholders. Social and ethical aspects of the climate change-mental health link have been neglected, and more research is needed.

Equitable buyouts? Learning from state, county, and local floodplain management programs

Climate change-exacerbated flooding has renewed interest in property buyouts as a pillar of managed retreat from coastal zones and floodplains in the United States. However, federal buyout programs are widely critiqued for being inaccessible and inequitable. To learn whether and how subnational buyout programs overcome these limitations, we examined five leading US state, county, and local buyout programs to see what they teach us about redesigning future federal policies. Our mixed-methods research used interviews and document analysis to develop case studies, juxtaposed subnational strategies against a review of critiques of federal buyouts, and focus group discussions with subnational buyout managers and experts to identify limitations of their programs. We find that subnational programs can be more inclusive and better respond to resident needs as compared to existing federal programs due to their access to dedicated, non-federal funding and their standing institutional status, which allows them to learn and evolve over time. Nevertheless, these programs lack coordination with and control over agencies that permit development and produce affordable housing. This gives buyout programs limited power in shaping the overall equity of who lives in floodplains and who has access to affordable, resilient housing after a buyout. Their experiences suggest federal programs can support managed retreat nationwide by increasing support for institutional and staff capacity at state and county levels, encouraging efforts to bridge institutional silos at subnational levels, and holistically mainstream climate considerations into regional floodplain development, affordable housing production, and flood risk mitigation.

Climate Change, Public Health and Human Rights

Climate change poses a cataclysmic threat to public health and human rights [...].

The role of critical methodologies in climate psychology scholarship: themes, gaps, and futures

Climate change is a global problem caused by humans. Climate psychology scholarship aims to assist human beings in mitigating and adapting to this problem’s consequences. A brief scoping review was conducted first. The findings indicated that most of the literature was quantitative and theoretical in orientation, with only two qualitatively focused. A dearth of information exploring qualitative methodologies was found. The brief scoping review justified the need for this narrative review that explored the critical methodologies used by climate psychology scholars. The narrative review covered the period 2009–2022. Search terms included ‘climate psychology’ and ‘climate change and psychology’. A critical transformative paradigm informed the analysis. The narrative review found that climate psychology scholars in the selected articles actively addressed social justice and represented marginalised peoples’ voices through participatory action research, grounded theory, narrative theory, capabilities theory, discursive psychology, and strengths-based approaches. Three authors presented their positionality statements. Ten articles used a qualitative approach, while three used a quantitative approach. The use of interviews and thematic analysis was dominant. Researchers demonstrated an awareness of power and its influence on the research process. The methodology could be enhanced if they provided more detail on how they addressed power as a guide for future researchers. Furthermore, it would be beneficial to explore their perceptions of how critical methodologies can be more actively incorporated into climate psychology scholarship.

Scaling Up Change: A Critical Review and Practical Guide to Harnessing Social Norms for Climate Action

Anthropogenic carbon emissions have the potential to trigger changes in climate and ecosystems that would be catastrophic for the well-being of humans and other species. Widespread shifts in production and consumption patterns are urgently needed to address climate change. Although transnational agreements and national policy are necessary for a transition to a fully decarbonized global economy, fluctuating political priorities and lobbying by vested interests have slowed these efforts. Against this backdrop, bottom-up pressure from social movements and shifting social norms may offer a complementary path to a more sustainable economy. Furthermore, norm change may be an important component of decarbonization policies by accelerating or strengthening the impacts of other demand-side measures. Individual actions and policy support are social processes—they are intimately linked to expectations about the actions and beliefs of others. Although prevailing social norms often reinforce the status quo and unsustainable development pathways, social dynamics can also create widespread and rapid shifts in cultural values and practices, including increasing pressure on politicians to enact ambitious policy. We synthesize literature on social-norm influence, measurement, and change from the perspectives of psychology, anthropology, sociology, and economics. We discuss the opportunities and challenges for the use of social-norm and social-tipping interventions to promote climate action. Social-norm interventions aimed at addressing climate change or other social dilemmas are promising but no panacea. They require in-depth contextual knowledge, ethical consideration, and situation-specific tailoring and testing to understand whether they can be effectively implemented at scale. Our review aims to provide practitioners with insights and tools to reflect on the promises and pitfalls of such interventions in diverse contexts.

The Role of Ageism in Climate Change Worries and Willingness to Act

This study examined the association of negative ageist prescriptive expectations regarding older people with worries about climate change and willingness to act. An online survey was completed by 250 Australians over the age 18. Higher levels of ageism (e.g., negative prescriptive views towards older people) were associated with fears about the impact of climate change on one's life, worries about the impact of climate change on older members of the family, and willingness to pay higher taxes to fight climate change. Holding more negative prescriptive views towards older people can serve as an incentive to act and at the same time carries an emotional negative valence associated with concerns and worries about the impact of climate change. Although willingness to act and concerns about climate change may inspire adaptation and mitigation efforts, it is important to ensure that they are not tied to ageism.

Pediatric tuberculosis in India: Justice and human rights

Tuberculosis (TB) is the deadliest infectious disease across the world, with the greatest burden occurring in India. Pregnant women and children are especially vulnerable to adverse effects from infection, and they tend to have diminished ability to protect themselves. Malnutrition, HIV, and other causes of immune suppression such as exposure to air pollution make one more prone to serious illness or death from TB infection. Risk factors are influenced by maternal education, access to health care, poverty, nutrition, healthcare stigma, and sanitation, among others. Current literature is heavily clinical, lacking focus on upstream factors, with a skew toward secondary and tertiary prevention strategies (i.e., case finding and treatment), and less emphasis on primary prevention (e.g., wealth equity and environmental regulation). Given concerns with extremely drug resistant TB and because infectious diseases can permeate National borders, public health nurses, and other healthcare professionals must educate themselves and advocate on behalf of vulnerable populations such as children in India. Improved sanitation, air quality monitoring, women's education, and increased access to health care are cost-effective and evidence-based strategies to address pediatric TB in India, a challenge which is grounded in human rights and justice.

In Search of the Innovative Digital Solutions Enhancing Social Pro-Environmental Engagement

Aim: In this paper, we analyze the potential of various digital tools such as gamification-based applications or digital currencies in enabling the social engagement in climate change mitigation processes by encouraging pro-environmental behaviors. Therefore, as a result of this study, we aim to develop a conceptual framework for a green digital tool, dedicated to cities seeking to shape their resilience by supporting bottom-up initiatives and encouraging residents to join the effort through educational interventions. Methods: The study was divided into four steps using a variety of methodological approaches, including a review of the SLR literature, analysis of the successes and failures of existing solutions, and qualitative workshops with stakeholders. Findings: The conceptual basis of the proposed solution has been developed based on the existing knowledge on pro-environmental nudging and lessons learnt from existing solutions. Value/originality: The developed conceptual framework can contribute to local economies while promoting social solidarity. It has the potential to build communities which can act together for the purpose of urban climate resilience because, from the very beginning, it is co-created together with residents. Practical implementation and beneficiaries: The concept described in this paper can serve cities as a supportive solution, shaping climate change awareness and attitudes toward active engagement.

Climate change and emergency care in Africa: A scoping review

Introduction

Climate change is a global public health emergency with implications for access to care and emergency care service disruptions. The African continent is particularly vulnerable to climate-related extreme weather events due to an already overburdened health system, lack of early warning signs, poverty, inadequate infrastructure, and variable adaptive capacity. Emergency care services are not only utilized during these events but also threatened by these hazards. Considering that the effects of climate change are expected to increase in intensity and prevalence, it is increasingly important for emergency care to prepare to respond to the changes in presentation and demand. The aim of this study was to perform a scoping review of the available literature on the relationship between climate change and emergency care on the African continent.

Methods

A scoping review was completed using five databases: Pubmed, Web of Science, GreenFILE, Africa Wide Information, and Google Scholar. A 'grey' literature search was done to identify key reports and references from included articles. Two independent reviewers screened articles and a third reviewer decided conflicts. A total of 1,382 individual articles were initially screened with 17 meeting full text review. A total of six articles were included in the final analysis. Data from four countries were represented including Uganda, Ghana, Tanzania, and Nigeria.

Results

Analysis of the six articles yielded three key themes that were identified: climate-related health impacts that contribute to surges in demand and resource utilization, opportunities for health sector engagement, and solutions to improve emergency preparedness. Authors used the outcomes of the review to propose 10 recommendations for decision-makers and leaders.

DXDiscussion

Incorporating these key recommendations at the local and national level could help improve preparedness and adaptation measures in highly vulnerable, populated areas on the African continent.

Occupational heat strain in outdoor workers: A comprehensive review and meta-analysis

The present comprehensive review (i) summarizes the current knowledge on the impacts of occupational heat stress on outdoor workers, (ii) provides a historical background on this issue, (iii) presents a meta-analysis of published data, (iv) explores inter-individual and intra-individual factors, (v) discusses the available heat mitigation strategies, (vi) estimates physical work capacity, labour productivity, and metabolic rate for the year 2030, and (vii) provides an overview of existing policy and legal frameworks on occupational heat exposure. Meta-analytic findings from 38 field studies that involved monitoring 2,409 outdoor workers across 41 jobs in 21 countries suggest that occupational heat stress increases the core (r = 0.44) and skin (r = 0.44) temperatures, as well as the heart rate (r = 0.38) and urine specific gravity (r = 0.13) of outdoor workers (all p < 0.05). Moreover, it diminishes the capacity of outdoor workers for manual labour (r = -0.82; p < 0.001) and is responsible for more than two thirds of the reduction in their metabolic rate. Importantly, our analysis shows that physical work capacity is projected to be highly affected by the ongoing anthropogenic global warming. Nevertheless, the metabolic rate and, therefore, labour productivity are projected to remain at levels higher than the workers' physical work capacity, indicating that people will continue to work more intensely than they should to meet their financial obligations for food and shelter. In this respect, complementary measures targeting self-pacing, hydration, work-rest regimes, ventilated garments, and mechanization can be adopted to protect outdoor workers.

Integrating Youth Perspectives: Adopting a Human Rights and Public Health Approach to Climate Action

Climate change is a multidimensional issue that affects all aspects of society, including public health and human rights. Climate change is already severely impacting people’s health and threatening people’s guaranteed fundamental rights, including those to life, health, self-determination, and education, among others. Across geographical regions, population groups and communities who are already marginalized due to age, gender, ethnicity, income, and other socioeconomic factors, are those who are disproportionately affected by climate impacts despite having contributed the least to global emissions. Although scholars have been calling for a human rights-based approach and a health perspective to climate action, the literature looking at this multidisciplinary intersection is still nascent, and governments have yet to implement such intersectoral policies. This commentary begins to reflect on the relationship between climate change, human rights, and public health from the perspective of young people engaged in climate action and discourse at the national and international levels. It presents a way forward on what we, as youth climate advocates and researchers, believe is a priority to bring intersectoral integration of human rights and public health approaches to climate change to fruition. First, scholars and practitioners should examine and support youth-led climate interventions that tackle human rights and public health violations incurred by the climate crisis. Second, participatory approaches to climate change must be designed by working synergistically with climate-vulnerable groups, including children and young people, practitioners and scholars in public health and human rights sectors to holistically address the social, health, and environmental impacts of the climate crisis and root causes of injustice. Finally, we recommend more holistic data collection to better inform evidence-based climate policies that operationalize human rights and public health co-benefits.

Unstable Housing and Kidney Disease: A Primer

Stable housing is essential for health. Over 580,000 Americans experienced homelessness during one night in 2020, and over 37 million households spend over 30% of their income on housing. Unstable housing has been associated with mortality, acute care utilization, communicable and non-communicable diseases, a higher risk of kidney disease, and kidney disease progression. In this review, we define various forms of unstable housing, provide an overview of the interaction between unstable housing and health, and discuss existing evidence associating housing and kidney disease. We provide historical context for unstable housing in the United States, and detail policy, community, and individual-level factors that contribute to the risk of unstable housing. Unstable housing likely affects kidney health via a complex interplay of individual and structural factors. Various screening tools are available for use by providers. Special considerations should be made when working with individuals experiencing unstable housing to meet their unique needs, facilitate health care engagement, and optimize outcomes. Housing interventions have been shown to improve outcomes and should be examined for their role in kidney disease.