Research Priorities for NCD Prevention and Climate Change: An International Delphi Survey

Extreme weather events and death based on temperature and CO2 emission - A global retrospective study in 77 low-, middle- and high-income countries from 1999 to 2018

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Summary of reported number of extreme weather events/associated deaths globally.

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Data from a humanitarian disaster database (77 countries, 425 events, 1999–2018).

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Number of deaths increased significantly with the repetition of extreme events.

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Mortality rate in heat season was 7 fold higher than that in cold/severe winter.

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Consistent reporting measures, is needed, from severe weather-related events.

Due to rising temperatures and CO₂ emissions, climate change has become one of the most important global issues. We described the relationship between extreme weather-related events and death, globally, from 1999 through 2018. We used data from the emergency events database of the Université Catholique de Louvain. We also categorized the countries’ income according to the World Bank GDP and we used the CO₂ emission levels data from the Carbon Dioxide Information Analysis Center to link the GDP and CO₂ emissions to years of extreme weather conditions in each country. We conducted descriptive and Poisson Regression analysis to analyze the data. A total of 77 countries reported 425 extreme weather-related events from1999 through 2018. Mortality related events were highest in middle-income countries due to severe winter conditions (N = 2,020) and cold-waves (N = 70,972). The total number of recorded deaths due to heat waves was highest in high-income countries (N = 84,344). Furthermore, the number of deaths in high-income countries, compared to low-income countries, was five-fold higher (IRR 5.18; 95%CI 4.58; 5.85, p < 0.001). The mortality rate in heat season was almost seven-fold higher than that in cold/severe winter (IRR 33.43; 95%CI 32.85; 34.02, p < 0.001). The number of deaths increased significantly with the repetition of extreme events (IRR 6.82; 95%CI 6.68; 6.96, p < 0.001). We found the number of deaths increased in high-income countries, and this was associated with an increase in the number of times extreme events occurred per year and with heat wave.

Global priorities for climate change and mental health research

BACKGROUND

Compared with other health areas, the mental health impacts of climate change have received less research attention. The literature on climate change and mental health is growing rapidly but is characterised by several limitations and research gaps. In a field where the need for designing evidence-based adaptation strategies is urgent, and research gaps are vast, implementing a broad, all-encompassing research agenda will require some strategic focus.

METHODS

We followed a structured approach to prioritise future climate change and mental health research. We consulted with experts working across mental health and climate change, both within and outside of research and working in high, middle, and low-income countries, to garner consensus about the future research priorities for mental health and climate change. Experts were identified based on whether they had published work on climate change and mental health, worked in governmental and non-governmental organisations on climate change and mental health, and from the professional networks of the authors who have been active in the mental health and climate change space.

RESULTS

Twenty-two experts participated from across low- and middle-income countries (n = 4) and high-income countries (n = 18). Our process identified ten key priorities for progressing research on mental health and climate change.

CONCLUSION

While climate change is considered the biggest threat to global mental health in the coming century, tackling this threat could be the most significant opportunity to shape our mental health for centuries to come because of health co-benefits of transitioning to more sustainable ways of living. Research on the impacts of climate change on mental health and mental health-related systems will assist decision-makers to develop robust evidence-based mitigation and adaptation policies and plans with the potential for broad benefits to society and the environment.

Understanding linkages between environmental risk factors and noncommunicable diseases-A review

Environmental factors such as climate change are now underway, which have substantial impacts on health and well-being of human kind, but still imprecisely quantified, implications for human health. At present, one of the most significant discussions among scientists worldwide is interdependency of escalating environmental risk factors and the increasing rates of noncommunicable diseases (NCDs), which are the leading cause of death and disability worldwide. Climate change also triggers the occurrence of NCDs through a variety of direct and indirect pathways. Therefore, it is likely that the interdependence of climate change, environmental risk factors, and NCDs as a whole poses great threat to global health. Hence, this paper aims to review the latest evidence on impacts of environmental risk factors on NCDs and methods used in establishing the cause or correlation of environmental risk factors and NCDs. The literature review leveraged online databases such as PubMed and Google Scholar with articles that matched keywords "climate change", "environmental risk factors," and "noncommunicable diseases". This review shows that the burden of NCDs is increasing globally and attribution of environmental risk factors such as climate change is significant. Understanding the nature of the relation between NCDs and the environment is complex and has relied on evidence generated from multiple study designs. This paper reviews eight types of study designs that can be used to identify and measure causal and correlational nature between environment and NCDs. Future projections suggest that increases in temperatures will continue and also increase the public health burden of NCDs.

A scoping review of policies promoting and supporting sustainable food systems in the university setting

BACKGROUND

Transitioning towards sustainable food systems for the health of the population and planet will require governments and institutions to develop effective governance to support the adoption of sustainable food practices. The aim of the paper is to describe current governance within Australian and New Zealand universities designed to support sustainable food systems.

METHODS

A systematic search of governance documents to support sustainable food systems within Australian and New Zealand universities was conducted. Data were obtained from 1) targeted websites 2) internet search engines and 3) expert consultations. Inclusion criteria consisted of university governance documents including by-laws, policies, guidelines, frameworks, and procedures that support sustainable food systems.

RESULTS

Twenty-nine governance documents across nineteen Australian and New Zealand universities were included for synthesis, including waste management policies (n = 3), fair-trade/procurement policies (n = 6), catering and or event guidelines (n = 7) and catering policies (n = 2), and environmental management plans (n = 11). The main strategies adopted by universities were sustainable waste management and prevention (e.g. reducing landfill, reducing wasted food, (27%)), ethical procurement practices (i.e. fair-trade (27%)) and environmentally sustainable food consumption (e.g. local, seasonal, organic, vegetarian food supply (14.5%)). Only 12.5% of universities addressed all three of the main strategies identified.

CONCLUSIONS

This study indicates that while sustainable food systems are considered in some university governance documents, efforts are predominantly focused on aspects such as waste management or procurement of fair-trade items which as stand-alone practices are likely to have minimal impact. This review highlights the scope of universities to provide strong leadership in promoting and supporting sustainable food systems through holistic institutional policies and governance mechanisms.

Controlling and preventing climate-sensitive noncommunicable diseases in urban sub-Saharan Africa

Research continues to highlight the link between climate change and health outcomes. There is, however, limited evidence in research, policies and in the Sustainable Development Goals (SDGs) about the impact of environmental factors on noncommunicable diseases (NCDs) for people living in urban areas of sub-Saharan Africa (SSA). Important is that 80% of NCDs are taking place in low- and middle-income countries (LMICs) and linked to a third of the deaths in SSA. The question is, what would these statistics look like if environmental risk factors (e.g., pollution, chemicals) for NCDs, linked to climate change, were prevented and controlled. This article presents a framework for understanding climatic pathways' impacts on climate-sensitive NCDs and achieving the SDGs. It further explains how current global mitigation interventions in high income urban settings, with implied health co-benefits for NCD reduction (i.e., promoting use of less polluting vehicles, bicycles, walking, public transport, green spaces), experience major implementation challenges in SSA cities (i.e., too costly, lack of availability, poor road conditions, gender and cultural norms, security problems). Recommendations are made for applying this framework to control climate change impacts on NCDs and achieving the SDGs in SSA cities. These include, support for more research on the climate - NCD nexus, ensuring health professional training includes sustainable health education, and including a focus on climate change and health in primary and secondary school curricula. Further recommendations for addressing climate-sensitive NCDs and urban environmental health towards achieving and sustaining the SDGs, are linked to promoting climate-sensitive and health policies and governance, as well as controlling the influence of advertising. Lastly, improving communication of research findings for policy makers and the public in a manner for informed policy making, and how to comprehend this information to promote the reduction and prevention of NCDs in urban SSA, is key.

"There's Not Really Much Consideration Given to the Effect of the Climate on NCDs"-Exploration of Knowledge and Attitudes of Health Professionals on a Climate Change-NCD Connection in Barbados

Despite widespread awareness of the rise of non-communicable diseases (NCDs) and the growing threat of climate change, little research has explored future health outcomes that will occur at the intersection of these challenges. Ten Barbadian health professionals were interviewed to assess their knowledge of health risks of climate change as it relates to NCDs in Barbados as a case study of a small island state at risk. There is widespread concern among health professionals about the current and future prevalence of non-communicable diseases among Barbadians. There is less concern about the future burden of NCDs in the context of a changing climate, largely because of a lack of knowledge among the majority of the health experts interviewed. Those knowledgeable about potential connections noted the difficulty that climate change would pose to the prevention and management of NCDs, given the impacts of climate stressors to food security, the built environment, and physiological and psychosocial health impacts. Lack of awareness among health professionals of the risk climate change poses to NCD prevalence and impact is reflective of the country’s health priorities that fail to recognize the risk of climate change. We recommend efforts to disseminate information about climate change to stakeholders in the health sector to increase awareness.

Development of post-disaster psychosocial evaluation and intervention for children: Results of a South Korean delphi panel survey

OBJECTIVE

This study aimed to administer a Delphi panel survey and provide evidence for the development of a psychological intervention protocol for use after disasters in South Korea.

METHOD

A three-round Delphi survey was conducted. In all rounds, respondents answered open- or closed-ended questions regarding their views on i) the concept of disaster, ii) evaluation, iii) intervention, and iv) considerations in a disaster. Data from Round 1 were subjected to content analysis. In Round 2, items with content validity ratios (CVRs) greater than 0.49 were included, and in Round 3, items with a CVR≥0.38 were accepted.

RESULTS

The response rates for the Delphi survey were high: 83% (n = 15, Round 1), 80% (n = 16, Round 2), and 86% (n = 24, Round 3). The data collected during this survey showed a need for a support system for children; for preventive strategies, including disaster readiness plans; for the protection of children's safety; and for the development of post-disaster psychosocial care.

CONCLUSIONS

The panel experts reached a consensus regarding the steps they considered critical in post-disaster evaluation and intervention. The findings suggest a unified model for advancing the development of the Korean version of an intervention protocol for children and adolescents exposed to traumatic events.

International Occupational Therapy Research Priorities

Occupational therapy is a global profession represented by the World Federation of Occupational Therapists (WFOT). International research priorities are needed for strategic guidance on global occupational therapy practice. The objective of this study was to develop international research priorities to reflect global occupational therapy practice. A Delphi study using three rounds of electronic surveys, distributed to WFOT member organizations and WFOT accredited universities, was conducted. Data were analyzed after each round, and priorities were presented for rating and ranking in order of importance. Forty-six (53%) out of 87 WFOT member countries participated in the Delphi process. Eight research priorities were confirmed by the final electronic survey round. Differences were observed in rankings given by member organizations and university respondents. Despite attrition at Round 3, the final research priorities will help to focus research efforts in occupational therapy globally. Follow-up research is needed to determine how the research priorities are being adopted internationally.