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Fitzpatrick JH, Willard A, Edwards JR, Harhay MN, Schinasi LH, Matthews J, May N. Time Series Analysis: Associations Between Temperature and Primary Care Utilization in Philadelphia, Pennsylvania. Am J Prev Med 2024:S0749-3797(24)00208-3. [PMID: 38908724 DOI: 10.1016/j.amepre.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 06/24/2024]
Abstract
INTRODUCTION Earth's temperature has risen by an average of 0.11°F per decade since 1850 and experts predict continued global warming. Studies have shown that exposure to extreme temperatures is associated with adverse health outcomes. Missed primary care visits can lead to incomplete preventive health screenings and unmanaged chronic diseases. This study examines the associations between extreme temperature conditions and primary care utilization among adult Philadelphians. METHODS A total of 1,048,575 appointments from 91,580 patients age ≥ 18 years enrolled in the study at thirteen university-based outpatient clinics in Philadelphia from January 1, 2009 to December 31, 2019. Statistical analysis was performed from June to December 2023. Data on attended and missed appointments was linked with measures of daily maximum temperature and precipitation, stratified by warm and cold seasons. Sociodemographic variables and associations with chronic disease status were explored. RESULTS Rates of missed appointments increased by 0.72% for every 1°F decrease in daily maximum temperatures below 39°F and increased by 0.64% for every 1°F increase above 89°F. Individuals ≥ 65 years and those with chronic conditions had stronger associations with an increased rate of missed appointments. CONCLUSIONS Temperature extremes were associated with higher rates of missed primary care appointments. Individuals with chronic diseases were more likely to have missed appointments associated with extreme temperatures. The findings suggest the need for primary care physicians to explore different modes of care delivery to support vulnerable populations, such as making telemedicine during extreme weather events a viable and affordable option.
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Affiliation(s)
- Janet H Fitzpatrick
- Drexel University College of Medicine, Drexel University, Philadelphia, Pennsylvania
| | - Adrienne Willard
- Drexel University College of Medicine, Drexel University, Philadelphia, Pennsylvania
| | - Janelle R Edwards
- Department of Environmental & Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Meera N Harhay
- Drexel University College of Medicine, Drexel University, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Penn Transplant Institute, University of Pennsylvania Health System, Philadelphia, Pennsylvania
| | - Leah H Schinasi
- Department of Environmental & Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Janet Matthews
- Drexel University College of Medicine, Drexel University, Philadelphia, Pennsylvania
| | - Nathalie May
- Drexel University College of Medicine, Drexel University, Philadelphia, Pennsylvania.
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Sullivan JK, Basu G, Patel L, Teherani A, Sorensen C. Editorial: Climate and health education: defining the needs of society in a changing climate. Front Public Health 2023; 11:1307614. [PMID: 37965511 PMCID: PMC10642042 DOI: 10.3389/fpubh.2023.1307614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/16/2023] [Indexed: 11/16/2023] Open
Affiliation(s)
- James K. Sullivan
- Global Consortium on Climate and Health Education, Mailman School of Public Health, Columbia University, New York, NY, United States
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, United States
| | - Gaurab Basu
- Center for Climate Health and the Global Environment, Harvard T.H. Chan School of Medicine, Boston, MA, United States
| | - Lisa Patel
- Medical Society Consortium on Climate and Health, George Mason University, Fairfax, VA, United States
- Stanford School of Medicine, Stanford University, Stanford, CA, United States
| | - Arianne Teherani
- University of California Center for Climate, Health and Equity, University of California, San Francisco, San Francisco, CA, United States
| | - Cecilia Sorensen
- Department of Emergency Medicine, Columbia Irving Medical Center, New York, NY, United States
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
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3
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Smirnova N, Shaver AC, Mehta AJ, Philipsborn R, Scovronick N. Climate Change, Air Quality, and Pulmonary Health Disparities. Clin Chest Med 2023; 44:489-499. [PMID: 37517829 DOI: 10.1016/j.ccm.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Climate change will alter environmental risks that influence pulmonary health, including heat, air pollution, and pollen. These exposures disproportionately burden populations already at risk of ill health, including those at vulnerable life stages, with low socioeconomic status, and systematically targeted by oppressive policies. Climate change can exacerbate existing environmental injustices by affecting future exposure, as well as through differentials in the ability to adapt; this is compounded by disparities in rates of underlying disease and access to health care. Climate change is therefore a dire threat not only to individual and population health but also to health equity.
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Affiliation(s)
- Natalia Smirnova
- Division of Pulmonary, Department of Medicine, Allergy, Critical Care & Sleep Medicine, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA
| | - Adam C Shaver
- Division of Pulmonary, Department of Medicine, Allergy, Critical Care & Sleep Medicine, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA
| | - Ashish J Mehta
- Division of Pulmonary, Department of Medicine, Allergy, Critical Care & Sleep Medicine, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA; Atlanta VA Medical Center, Decatur, GA, USA
| | - Rebecca Philipsborn
- Department of Pediatrics, Emory University School of Medicine, 49 Jesse Hill Jr Dr Southeast, Atlanta, GA 30303, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
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Salvador Costa MJ, Melo P. Community Empowerment Assessment and Community Nursing Diagnosis for Climate Change Mitigation and Adaptation in the Northern Region of the Portuguese Atlantic Coast: A Mixed-Methods Study Using MAIEC Framework. NURSING REPORTS 2023; 13:969-981. [PMID: 37489407 PMCID: PMC10366727 DOI: 10.3390/nursrep13030085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/29/2023] [Accepted: 07/06/2023] [Indexed: 07/26/2023] Open
Abstract
The Community Intervention and Empowerment Assessment Model (MAIEC) offers a framework for community empowerment in several fields such as Climate Change (CC), the largest health emergency crisis globally, through diagnosis and interventions in Community Health Nursing. This study aims to assess the level of community empowerment in climate change mitigation and adaptation, and to identify nursing diagnosis through the MAIEC clinical decision matrix, within a local intermunicipal association in the northern region of the Portuguese Atlantic Coast. A convergent mixed-methods design was used, applying a focus group technique to a purposive sampling of ten key stakeholders of this community. A Portuguese version of the Empowerment Assessment Rating Scale and a questionnaire were both applied to the same participants, and qualitative and quantitative data generated were analysed using a content analysis technique and an Excel database sheet created using Microsoft Office 365. The analysis of the Portuguese northern community exposed: a low level of community empowerment for mitigation and adaptation to climate change; a nursing diagnosis of community management impairments in several dimensions, such as community process, community participation and community leadership. However, the study confirmed that MAIEC contributed to future community-based solutions, responding to the challenges of climate change, and enabling the planning of interventions to address MAIEC diagnoses in the form of CC-specific training and recommendations for new cooperation approaches from all stakeholders. This study was not registered.
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Affiliation(s)
- Maria João Salvador Costa
- Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Católica Portuguesa, Rua de Diogo Botelho 1327, 4169-005 Porto, Portugal
| | - Pedro Melo
- Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Católica Portuguesa, Rua de Diogo Botelho 1327, 4169-005 Porto, Portugal
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5
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Govender I. The role of family medicine and primary health care and its impact on the climate crisis. S Afr Fam Pract (2004) 2023; 65:e1-e2. [PMID: 36861908 PMCID: PMC9982468 DOI: 10.4102/safp.v65i1.5658] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/07/2022] [Indexed: 02/15/2023] Open
Abstract
No abstract available.
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Affiliation(s)
- Indiran Govender
- Department Family Medicine and Primary Health Care, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria.
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6
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Davis D, Roberts C, Williamson R, Kurz E, Barnes K, Behie AM, Aroni R, Nolan CJ, Phillips C. Opportunities for primary health care: a qualitative study of perinatal health and wellbeing during bushfire crises. Fam Pract 2022; 40:458-464. [PMID: 36444891 DOI: 10.1093/fampra/cmac133] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND During the summer of 2019/2020, Australia experienced a catastrophic wildfire season that affected nearly 80% of Australians either directly or indirectly. The impacts of climate crisis on perinatal health have only recently begun to receive attention. The objective of this study was to understand experiences of perinatal women during the bushfire and smoke events of 2019-2020 regarding health, health care, and public health messaging. METHODS Semistructured interviews were conducted by phone or web conferencing platforms with 43 participants living in the south-east of Australia who were either pregnant or who had recently had a baby during the 2019/2020 fires. RESULTS The health impacts on participants of the fires, associated smoke, and evacuations for some, were both physical and psychological. Many participants sought information regarding how to protect their own health and that of their unborn/recently born children, but reported this difficult to find. CONCLUSIONS Pregnant women and new mothers exposed to bushfire events are a risk group for adverse physical and psychological outcomes. At the time of the 2019/2020 Australian bushfires, exposed women could not easily access evidence-based information to mitigate this risk. Family practitioners are well placed to provide pregnant women and new mothers with this sought-after information, but they need to be prepared well in advance of future similar events.
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Affiliation(s)
- Deborah Davis
- School of Nursing, Midwifery and Public Health, University of Canberra, Canberra, Australia.,ACT Government Health Directorate, Canberra, Australia
| | - Celia Roberts
- School of Sociology, College of Arts and Social Science, The Australian National University, Canberra, Australia
| | - Rebecca Williamson
- School of Sociology, College of Arts and Social Science, The Australian National University, Canberra, Australia
| | - Ella Kurz
- School of Nursing, Midwifery and Public Health, University of Canberra, Canberra, Australia
| | - Katelyn Barnes
- ACT Government Health Directorate, Canberra, Australia.,Medical School, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Alison M Behie
- School of Archaeology and Anthropology, College of Arts and Social Sciences, The Australian National University, Canberra, Australia
| | - Rosalie Aroni
- Medical School, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Christopher J Nolan
- Medical School, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Christine Phillips
- Social Foundations of Medicine, Medical School, College of Health and Medicine, The Australian National University, Canberra, Australia
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7
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Ray S, Goronga T, Chigiya PT, Madzimbamuto FD. Climate change, disaster management and primary health care in Zimbabwe. Afr J Prim Health Care Fam Med 2022; 14:e1-e3. [PMID: 36226938 PMCID: PMC9575364 DOI: 10.4102/phcfm.v14i1.3684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/21/2022] [Indexed: 11/01/2022] Open
Abstract
The health crises related to climate change in African countries are predicted to get worse and more prevalent. The response to catastrophic events such as cyclones, flooding and landslides must be rapid and well-coordinated. Slower adverse events such as droughts, heat stress and food insecurity must similarly be anticipated, planned for and resourced. There are lessons to be learnt by the health system following the crisis created by Cyclone Idai in Zimbabwe during March 2019, which required a massive humanitarian response to mitigate the impact of torrential rainfall on lives and livelihoods. Several researchers and organisations documented the emergency response in detail. They reported that the government response was hampered by a lack of preparedness, poor planning, inadequate resource mobilisation and weak coordination. Rural communities did not access the early warning cyclone alerts disseminated through television, print and social media, nor did they appreciate the seriousness of events until it was too late. Primary health care (PHC) teams are familiar and trusted by the communities they serve and have a critical role in raising public awareness and in documenting the evolving impact of climate change, using established health indicators and local narratives. PHC leaders and providers have the knowledge and skills to mediate between government bodies, international agencies, other stakeholders and communities on the predicted impact of climate change on health outcomes, highlighting the vulnerability of disadvantaged and impoverished groups. They are also able to work with community leaders, using indigenous knowledge on weather patterns, to build local engagement in protection plans.Contribution: This article describes the role health professionals and civil society can play in educating the public on the dangers faced in the near future as a result of climate change and actions that can be taken to become more resilient and to mitigate this impact.
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Affiliation(s)
- Sunanda Ray
- Department of Medical Education, Faculty of Medicine, University of Botswana, Gaborone.
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8
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Lugten E, Hariharan N. Strengthening Health Systems for Climate Adaptation and Health Security: Key Considerations for Policy and Programming. Health Secur 2022; 20:435-439. [PMID: 35904944 PMCID: PMC9595646 DOI: 10.1089/hs.2022.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Elizabeth Lugten
- Elizabeth Lugten, MPH, and Neetu Hariharan, MPH, are Health Systems Technical Advisors and Credence Management Solutions Contractors, Office of Health Systems, Global Health Bureau, US Agency for International Development, Washington, DC
| | - Neetu Hariharan
- Elizabeth Lugten, MPH, and Neetu Hariharan, MPH, are Health Systems Technical Advisors and Credence Management Solutions Contractors, Office of Health Systems, Global Health Bureau, US Agency for International Development, Washington, DC
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9
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Gonzalez-Holguera J, Gaille M, del Rio Carral M, Steinberger J, Marti J, Bühler N, Kaufmann A, Chiapperino L, Vicedo-Cabrera AM, Schwarz J, Depoux A, Panese F, Chèvre N, Senn N. Translating Planetary Health Principles Into Sustainable Primary Care Services. Front Public Health 2022; 10:931212. [PMID: 35937241 PMCID: PMC9355637 DOI: 10.3389/fpubh.2022.931212] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/13/2022] [Indexed: 12/27/2022] Open
Abstract
Global anthropogenic environmental degradations such as climate change are increasingly recognized as critical public health issues, on which human beings should urgently act in order to preserve sustainable conditions of living on Earth. "Planetary Health" is a breakthrough concept and emerging research field based on the recognition of the interdependent relationships between living organisms-both human and non-human-and their ecosystems. In that regards, there have been numerous calls by healthcare professionals for a greater recognition and adoption of Planetary Health perspective. At the same time, current Western healthcare systems are facing their limits when it comes to providing affordable, equitable and sustainable healthcare services. Furthermore, while hospital-centrism remains the dominant model of Western health systems, primary care and public health continue to be largely undervalued by policy makers. While healthcare services will have to adapt to the sanitary impacts of environmental degradations, they should also ambition to accompany and accelerate the societal transformations required to re-inscribe the functioning of human societies within planetary boundaries. The entire health system requires profound transformations to achieve this, with obviously a key role for public health. But we argue that the first line of care represented by primary care might also have an important role to play, with its holistic, interdisciplinary, and longitudinal approach to patients, strongly grounded in their living environments and communities. This will require however to redefine the roles, activities and organization of primary care actors to better integrate socio-environmental determinants of health, strengthen interprofessional collaborations, including non-medical collaborations and more generally develop new, environmentally-centered models of care. Furthermore, a planetary health perspective translated in primary care will require the strengthening of synergies between institutions and actors in the field of health and sustainability.
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Affiliation(s)
| | - Marie Gaille
- Laboratory SPHERE, UMR 7219, University Paris Diderot CNRS, Paris, France
| | | | - Julia Steinberger
- Institute of Geography and Sustainability, University of Lausanne, Lausanne, Switzerland
| | - Joachim Marti
- Department of Epidemiology and Health Systems, University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Nolwenn Bühler
- STS Lab, Institute of Social Sciences, University of Lausanne, Lausanne, Switzerland
| | - Alain Kaufmann
- ColLaboratoire (ColLAB), University of Lausanne, Lausanne, Switzerland
| | - Luca Chiapperino
- STS Lab, Institute of Social Sciences, University of Lausanne, Lausanne, Switzerland
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Joelle Schwarz
- Department of Family Medicine, University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Anneliese Depoux
- Centre Virchow-Villermé and Centre des Politiques de la Terre, Université Paris Cité, Paris, France
| | - Francesco Panese
- Institute of Social Sciences, University of Lausanne, Lausanne, Switzerland
| | - Nathalie Chèvre
- Faculty of Geosciences and the Environment, Institute of Earth Surface Dynamics (IDYST), University of Lausanne, Lausanne, Switzerland
| | - Nicolas Senn
- Department of Family Medicine, University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
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Lokotola CL, Mash R. Climate change and primary health care in Africa - A call for short reports. Afr J Prim Health Care Fam Med 2022; 14:e1-e2. [PMID: 35695436 PMCID: PMC9210164 DOI: 10.4102/phcfm.v14i1.3583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 11/01/2022] Open
Abstract
No abstract available.
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Affiliation(s)
- Christian L Lokotola
- Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town.
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11
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Marten R, Yangchen S, Campbell-Lendrum D, Prats EV, Neira MP, Ghaffar A. Climate change: an urgent priority for health policy and systems research. Health Policy Plan 2021; 36:218-220. [PMID: 33347561 PMCID: PMC7996636 DOI: 10.1093/heapol/czaa165] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Robert Marten
- Alliance for Health Policy and Systems Research, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland
| | - Sonam Yangchen
- Alliance for Health Policy and Systems Research, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland
| | - Diarmid Campbell-Lendrum
- Environment, Climate Change and Health Department, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland
| | - Elena Villalobos Prats
- Environment, Climate Change and Health Department, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland
| | - Maria Purificacion Neira
- Environment, Climate Change and Health Department, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland
| | - Abdul Ghaffar
- Alliance for Health Policy and Systems Research, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland
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12
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Family Physician Perceptions of Climate Change, Migration, Health, and Healthcare in Sub-Saharan Africa: An Exploratory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126323. [PMID: 34207979 PMCID: PMC8296126 DOI: 10.3390/ijerph18126323] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 11/30/2022]
Abstract
Although family physicians (FPs) are community-oriented primary care generalists and should be the entry point for the population’s interaction with the health system, they are underrepresented in research on the climate change, migration, and health(care) nexus (hereafter referred to as the nexus). Similarly, FPs can provide valuable insights into building capacity through integrating health-determining sectors for climate-resilient and migration-inclusive health systems, especially in Sub-Saharan Africa (SSA). Here, we explore FPs’ perceptions on the nexus in SSA and on intersectoral capacity building. Three focus groups conducted during the 2019 WONCA-Africa conference in Uganda were transcribed verbatim and analyzed using an inductive thematic approach. Participants’ perceived interactions related to (1) migration and climate change, (2) migration for better health and healthcare, (3) health impacts of climate change and the role of healthcare, and (4) health impacts of migration and the role of healthcare were studied. We coined these complex and reinforcing interactions as continuous feedback loops intertwined with socio-economic, institutional, and demographic context. Participants identified five intersectoral capacity-building opportunities on micro, meso, macro, and supra (international) levels: multi-dimensional and multi-layered governance structures; improving FP training and primary healthcare working conditions; health advocacy in primary healthcare; collaboration between the health sector and civil society; and more responsibilities for high-income countries. This exploratory study presents a unique and novel perspective on the nexus in SSA which contributes to interdisciplinary research agendas and FP policy responses on national, regional, and global levels.
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Barkley S, Marten R, Reynolds T, Kelley E, Dalil S, Swaminathan S, Ghaffar A. Primary health care: realizing the vision. Bull World Health Organ 2020; 98:727-727A. [PMID: 33177765 PMCID: PMC7607456 DOI: 10.2471/blt.20.279943] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Shannon Barkley
- Integrated Health Services, Universal Health Coverage and Life Course, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Robert Marten
- Alliance for Health Policy and Systems Research, Science Division, World Health Organization, Geneva, Switzerland
| | - Teri Reynolds
- Integrated Health Services, Universal Health Coverage and Life Course, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Edward Kelley
- Integrated Health Services, Universal Health Coverage and Life Course, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Suraya Dalil
- Primary Health Care Programme, World Health Organization, Geneva, Switzerland
| | | | - Abdul Ghaffar
- Alliance for Health Policy and Systems Research, Science Division, World Health Organization, Geneva, Switzerland
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