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Krippl N, Mezger NCS, Danquah I, Nieder J, Griesel S, Schildmann J, Mikolajczyk R, Kantelhardt EJ, Herrmann A. Climate-sensitive health counselling in Germany: a cross-sectional study about previous participation and preferences in the general public. BMC Public Health 2024; 24:1519. [PMID: 38844875 PMCID: PMC11155184 DOI: 10.1186/s12889-024-18998-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/29/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND In response to climate change (CC), medicine needs to consider new aspects in health counselling of patients. Such climate-sensitive health counselling (CSHC) may include counselling patients on preventing and coping with climate-sensitive diseases or on leading healthy and climate-friendly lifestyles. This study aimed to identify previous participation in and preferences for CSHC as well as associated sociodemographic and attitudinal factors among the general public in Germany. METHODS We conducted a cross-sectional study in a population-based online panel in five German federal states (04-06/2022). We performed descriptive statistics and multivariable regression analysis to assess prior participation in CSHC and content preferences regarding CSHC, as well as associations between sociodemographic variables and general preference for CSHC. RESULTS Among 1491 participants (response rate 47.1%), 8.7% explicitly reported having participated in CSHC, while 39.9% had discussed at least one CSHC-related topic with physicians. In the studied sample, 46.7% of participants would like CSHC to be part of the consultation with their physician, while 33.9% rejected this idea. Participants aged 21 to 40 years (versus 51 to 60), individuals alarmed about CC (versus concerned/cautious/disengaged/doubtful/dismissive), and those politically oriented to the left (vs. centre or right) showed greater preference for CSHC in the multivariable regression model. Most participants wanted to talk about links to their personal health (65.1%) as opposed to links to the health of all people (33.2%). CONCLUSIONS Almost half of the participants in this sample would like to receive CSHC, especially those who are younger, more alarmed about CC and more politically oriented to the left. More research and training on patient-centred implementation of CSHC is needed.
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Affiliation(s)
- Nicola Krippl
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
| | - Nikolaus C S Mezger
- Global and Planetary Health Working Group, Interdisciplinary Center for Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06097, Halle (Saale), Germany
| | - Ina Danquah
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
- Hertz-Chair Innovation for Planetary Health, Center for Development Research (ZEF), Rhenish Friedrich Wilhelm University of Bonn, Genscherallee 3, 53113, Bonn, Germany
| | - Jessica Nieder
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Silvan Griesel
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Jan Schildmann
- Institute for History and Ethics in Medicine, Interdisciplinary Center for Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 20, 06112, Halle (Saale), Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin, Luther University Halle-Wittenberg, Magdeburger Straße 8, 06097, Halle (Saale), Germany
| | - Eva J Kantelhardt
- Global and Planetary Health Working Group, Interdisciplinary Center for Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06097, Halle (Saale), Germany
| | - Alina Herrmann
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
- Institute of General Medicine, University Hospital Cologne, Medical Faculty Cologne University, Kerpener Straße 62, 50937, Cologne, Germany
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Litke NA, Poß-Doering R, Fehrer V, Köppen M, Kümmel S, Szecsenyi J, Wensing M. Building climate resilience: awareness of climate change adaptation in German outpatient medical practices. BMC Health Serv Res 2024; 24:184. [PMID: 38336703 PMCID: PMC10858569 DOI: 10.1186/s12913-024-10664-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Climate change is seen as the biggest health threat of the twenty-first century. Making outpatient medical practices resilient is therefore crucial to protect vulnerable groups and maintain quality of care. Awareness is a precondition for action. This study aims to explore awareness (knowledge, experience and attention) of climate change adaptation among stakeholders of outpatient medical practices. METHODS Semi-structured interviews and focus groups with stakeholders of outpatient medical practices were conducted. The qualitative data were analysed in a two-step Thematic Analysis process. RESULTS In total, n = 40 stakeholders participated in two focus groups and 26 interviews. The findings show a mixed degree of awareness in outpatient medical practices. The spectrum ranged from a passive role with curative acting only, handing over responsibility to others and a low perceived self-efficacy to a proactive and responsible implementation of adaptation strategies. Participants who saw the need and responsibility of climate change adaptation in medical practices perceived low additional workload. In general, implementation of climate change adaptation measures and general awareness of climate change adaptation appeared to be depending on a certain tension for change and a higher self-efficacy. CONCLUSION Medical practices, and specifically primary care, plays a crucial role in climate change adaptation, and awareness needs to be increased further in order to cope with consequences of climate change. To facilitate this, there should be a strong emphasis on climate change adaptation strategies being part of outpatient care provider roles rather than being perceived as an "add-on" to already high workloads.
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Affiliation(s)
- Nicola Alexandra Litke
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
| | - Regina Poß-Doering
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Valeska Fehrer
- Poliklinik Für Zahnerhaltungskunde, Department for Translational Health Economics, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Martina Köppen
- aQua Institute for Applied Quality Improvement and Research in Healthcare, Maschmühlenweg 8-10, 37073, Göttingen, Germany
| | - Stephanie Kümmel
- aQua Institute for Applied Quality Improvement and Research in Healthcare, Maschmühlenweg 8-10, 37073, Göttingen, Germany
| | - Joachim Szecsenyi
- aQua Institute for Applied Quality Improvement and Research in Healthcare, Maschmühlenweg 8-10, 37073, Göttingen, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
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Rudolph TE, Roths M, Freestone AD, White-Springer SH, Rhoads RP, Baumgard LH, Selsby JT. Heat stress alters hematological parameters in barrows and gilts. J Anim Sci 2024; 102:skae123. [PMID: 38706303 PMCID: PMC11141298 DOI: 10.1093/jas/skae123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 05/02/2024] [Indexed: 05/07/2024] Open
Abstract
The purpose of this investigation was to establish the role biological sex plays in circulating factors following heat stress (HS). Barrows and gilts (36.8 ± 3.7 kg body weight) were kept in either thermoneutral (TN; 20.8 ± 1.6 °C; 62.0% ± 4.7% relative humidity; n = 8/sex) conditions or exposed to HS (39.4 ± 0.6 °C; 33.7% ± 6.3% relative humidity) for either 1 (HS1; n = 8/sex) or 7 (HS7; n = 8/sex) d. Circulating glucose decreased as a main effect of the environment (P = 0.03). Circulating non-esterified fatty acid (NEFA) had an environment × sex interaction (P < 0.01) as HS1 barrows had increased NEFA compared to HS1 gilts (P = 0.01) and NEFA from HS7 gilts increased compared to HS1 gilts (P = 0.02) and HS7 barrows (P = 0.04). Cortisol, insulin, glucagon, T3, and T4 were reduced as a main effect of environment (P ≤ 0.01). Creatinine was increased in HS1 and HS7 animals compared to TN (P ≤ 0.01), indicative of decreased glomerular filtration rate. White blood cell populations exhibited differential patterns based on sex and time. Neutrophils and lymphocytes had an environment × sex interaction (P ≤ 0.05) as circulating neutrophils were increased in HS1 barrows compared to TN and HS7 barrows, and HS1 gilts (P ≤ 0.01) and HS7 barrows had less neutrophils compared to TN barrows (P = 0.01), whereas they remained similar in gilts. In contrast, barrow lymphocyte numbers were similar between groups, but in HS7 gilts they were decreased compared to TN and HS1 gilts (P ≤ 0.04). In total, these data demonstrate that HS alters a host of circulating factors and that biological sex mediates, at least in part, the physiological response to HS.
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Affiliation(s)
- Tori E Rudolph
- Department of Animal Science, Iowa State University, Ames, IA, 50010, USA
| | - Melissa Roths
- Department of Animal Science, Iowa State University, Ames, IA, 50010, USA
| | - Alyssa D Freestone
- Department of Animal Science, Iowa State University, Ames, IA, 50010, USA
| | - Sarah H White-Springer
- Department of Animal Science, Texas A&M University and Texas A&M AgriLife Research, College Station, TX, 77843, USA
- Department of Kinesiology and Sport Management, Texas A&M University, College Station, TX, 77843, USA
| | - Robert P Rhoads
- School of Animal Sciences, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Lance H Baumgard
- Department of Animal Science, Iowa State University, Ames, IA, 50010, USA
| | - Joshua T Selsby
- Department of Animal Science, Iowa State University, Ames, IA, 50010, USA
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Shrikhande S, Merten S, Cambaco O, Lee TT, Lakshmanasamy R, Röösli M, Dalvie MA, Utzinger J, Cissé G. Barriers to climate change and health research in India: a qualitative study. BMJ Open 2023; 13:e073381. [PMID: 37821134 PMCID: PMC10582851 DOI: 10.1136/bmjopen-2023-073381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/04/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVES Almost a quarter of the global burden of disease and mortalities is attributable to environmental causes, the magnitude of which is projected to increase in the near future. However, in many low- and middle-income settings, there remains a large gap in the synthesis of evidence on climate-sensitive health outcomes. In India, now the world's most populous country, little remains known about the impacts of climate change on various health outcomes. The objective of this study is to better understand the challenges faced in conducting climate change and health research in Puducherry, India. DESIGN AND SETTING In this study, we employed key informant interviews to deepen the understanding of the perceived research barriers in Puducherry. The findings were analysed using data-driven qualitative thematic analysis to elaborate the major perceived barriers to conducting environmental health research. PARTICIPANTS This study was conducted among 16 public health professionals, including medical researchers, and professionals involved in environmental policies and planning in Puducherry. RESULTS We identify three key barriers faced by public health professionals as key stakeholders, namely: (1) political and institutional barriers; (2) education and awareness barriers; and (3) technical research barriers. We show there is a need, from the professionals' perspective, to improve community and political awareness on climate change and health; strengthen technical research capacity and collaboration among researchers; and strengthen health surveillance, resource allocation and access to health data for research. CONCLUSION Evidence informed policies and interventions are a key element in the adaptation response for countries. In the context of the paucity of data on environmental health from India, despite recognised climate change related health vulnerabilities, these findings could contribute to the development and improvement of relevant interventions conducive to a strong research environment.
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Affiliation(s)
- Shreya Shrikhande
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Sonja Merten
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Olga Cambaco
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Manhiça Health Research Centre, Maputo, Mozambique
| | - Tristan T Lee
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Ravivarman Lakshmanasamy
- Department of Health and Family Welfare Services, Goverment of Puducherry, Puducherry, India
- Non-communicable Diseases Team, World Health Organization Country Office for India, New Delhi, India
| | - Martin Röösli
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Mohammad Aqiel Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Jürg Utzinger
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Guéladio Cissé
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Kastaun S, Herrmann A, Müller BS, Klosterhalfen S, Hoffmann B, Wilm S, Kotz D. Are people interested in receiving advice from their general practitioner on how to protect their health during heatwaves? A survey of the German population. BMJ Open 2023; 13:e076236. [PMID: 37770266 PMCID: PMC10546099 DOI: 10.1136/bmjopen-2023-076236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/01/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVE Climate change increases the frequency, intensity and length of heatwaves, which puts a particular strain on the health of vulnerable population groups. General practitioners (GPs) could reach these people and provide advice on protective health behaviour against heat. Data is lacking on whether and what topic of GP advice people are interested in, and whether specific person characteristics are associated with such interests. DESIGN Cross-sectional, nationwide, face-to-face household survey, conducted during winter 2022/2023. SETTING Germany. PARTICIPANTS Population-based sample of 4212 respondents (aged 14-96 years), selected by using multistratified random sampling (50%) combined with multiquota sampling (50%). MAIN OUTCOME MEASURE Interest in receiving GP advice on health protection during heatwaves (yes/no), and the topic people find most important (advice on drinking behaviour, nutrition, cooling, cooling rooms, physical activity or medication management). Associations between predefined person characteristics and the likelihood of interest were estimated using adjusted logistic regressions. RESULTS A total of 4020 respondents had GP contact and provided data on the outcome measure. Of these, 23% (95% CI=22% to 25%) expressed interest in GP advice. The likelihood of expressing interest was positively associated with being female, older age (particularly those aged 75+ years: 38% were interested), having a lower level of educational attainment, having a migration background, living in a more urban area, and living in a single-person household. It was negatively associated with increasing income. Advice on medication management received highest interest (25%). CONCLUSIONS During winter season 2022/2023, around one quarter of the German population with GP contact-and around 40% of those aged 75+ years-was estimated to have a stated interest in receiving GP advice on protective health behaviour during heatwaves, especially on medication management. Climate change is creating new demands for healthcare provision in general practice. This study provides initial relevant information for research and practice aiming to address these demands.
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Affiliation(s)
- Sabrina Kastaun
- Institute of General Practice, Centre for Health and Society, Patient-Physician Communication Research Unit, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of General Practice, Centre for Health and Society, Addiction Research and Clinical Epidemiology Unit, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Alina Herrmann
- Institute of General Practice, University of Cologne, Cologne, Germany
- Institute for Global Health (HIGH), Climate, Change, Nutrition and Health, Heidelberg University, Heidelberg, Germany
| | - Beate S Müller
- Institute of General Practice, University of Cologne, Cologne, Germany
| | - Stephanie Klosterhalfen
- Institute of General Practice, Centre for Health and Society, Addiction Research and Clinical Epidemiology Unit, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Stefan Wilm
- Institute of General Practice, Centre for Health and Society, Patient-Physician Communication Research Unit, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Daniel Kotz
- Institute of General Practice, Centre for Health and Society, Addiction Research and Clinical Epidemiology Unit, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Behavioural Science and Health, University College London, London, UK
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Shrikhande SS, Merten S, Cambaco O, Lee T, Lakshmanasamy R, Röösli M, Dalvie MA, Utzinger J, Cissé G. "Climate Change and Health?": Knowledge and Perceptions among Key Stakeholders in Puducherry, India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4703. [PMID: 36981615 PMCID: PMC10048771 DOI: 10.3390/ijerph20064703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Climate change has far-reaching impacts on human health, with low- and middle-income countries, including India, being particularly vulnerable. While there have been several advances in the policy space with the development of adaptation plans, little remains known about how stakeholders who are central to the strengthening and implementation of these plans perceive this topic. We conducted a qualitative study employing key interviews with 16 medical doctors, researchers, environmentalists and government officials working on the climate change agenda from Puducherry, India. The findings were analysed using the framework method, with data-driven thematic analysis. We elucidated that despite elaborating the direct and indirect impacts of climate change on health, there remains a perceived gap in education and knowledge about the topic among participants. Knowledge of the public health burden and vulnerabilities influenced the perceived health risks from climate change, with some level of scepticism on the impacts on non-communicable diseases, such as cardiovascular diseases. There was also a felt need for multi-level awareness and intervention programmes targeting all societal levels along with stakeholder recommendations to fill these gaps. The findings of this study should be taken into consideration for strengthening the region's climate change and health adaptation policy. In light of limited research on this topic, our study provides an improved understanding of how key stakeholders perceive the impacts of climate change on health in India.
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Affiliation(s)
- Shreya S. Shrikhande
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Sonja Merten
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Olga Cambaco
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Tristan Lee
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Ravivarman Lakshmanasamy
- State Surveillance Officer, Department of Health and Family Welfare Services, Government of Puducherry, Puducherry 605001, India
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Mohammad Aqiel Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
| | - Guéladio Cissé
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Faculty of Science, University of Basel, 4001 Basel, Switzerland
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Palinkas LA, Hurlburt MS, Fernandez C, De Leon J, Yu K, Salinas E, Garcia E, Johnston J, Rahman MM, Silva SJ, McConnell RS. Vulnerable, Resilient, or Both? A Qualitative Study of Adaptation Resources and Behaviors to Heat Waves and Health Outcomes of Low-Income Residents of Urban Heat Islands. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11090. [PMID: 36078804 PMCID: PMC9517765 DOI: 10.3390/ijerph191711090] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/19/2022] [Accepted: 09/01/2022] [Indexed: 06/15/2023]
Abstract
Little is known of how low-income residents of urban heat islands engage their knowledge, attitudes, behaviors, and resources to mitigate the health impacts of heat waves. In this qualitative study, we conducted semi-structured interviews with 40 adults in two such neighborhoods in Los Angeles California to explore their adaptation resources and behaviors, the impacts of heat waves on physical and mental health, and threat assessments of future heat waves. Eighty percent of participants received advanced warning of heat waves from television news and social media. The most common resource was air conditioning (AC) units or fans. However, one-third of participants lacked AC, and many of those with AC engaged in limited use due primarily to the high cost of electricity. Adaptation behaviors include staying hydrated, remaining indoors or going to cooler locations, reducing energy usage, and consuming certain foods and drinks. Most of the participants reported some physical or mental health problem or symptom during heat waves, suggesting vulnerability to heat waves. Almost all participants asserted that heat waves were likely to increase in frequency and intensity with adverse health effects for vulnerable populations. Despite limited resources, low-income residents of urban heat islands utilize a wide range of behaviors to minimize the severity of health impacts, suggesting they are both vulnerable and resilient to heat waves.
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Affiliation(s)
- Lawrence A. Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Michael S. Hurlburt
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Cecilia Fernandez
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Jessenia De Leon
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Kexin Yu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Erika Salinas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Erika Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Jill Johnston
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Md. Mostafijur Rahman
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Sam J. Silva
- Department of Earth Sciences, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Rob S. McConnell
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
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Exploring the Climate Temperature Effects on Settlement Intentions of Older Migrants: Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084896. [PMID: 35457763 PMCID: PMC9028836 DOI: 10.3390/ijerph19084896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/10/2022] [Accepted: 04/14/2022] [Indexed: 12/10/2022]
Abstract
Permanent migration across provinces in China has become an important strategy for Chinese older people to respond to a temperature-unfriendly place of residence in late life. However, the relation between temperature effects and permanent settlements of older migrants remains unclear. Based on the data obtained from China Migrants Dynamic Survey, this paper examined how four temperature effects (i.e., cold effect, heat effect, temperature gap effect, and temperature zone effect) play a role in shaping older migrants’ intentions to settle permanently in a destination place by conducting logistic regression analysis. Our findings show that: (1) extreme cold (rather than extreme heat or mild temperature) was found to have significant effects on settlement intentions of older people; (2) relative winter temperature between origin and destination places rather than absolute winter temperature in the destination place has a significant positive effect on the settlement intentions; (3) spatially, older migrants tend to migrate to geographically adjacent temperature zones. Our findings will inform a more effective planning and allocation of services for supporting older people by better understanding trends and intentions of older migrants.
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Häußler S, Haupt W. Climate change adaptation networks for small and medium-sized cities. SN SOCIAL SCIENCES 2021; 1:262. [PMID: 34704073 PMCID: PMC8530548 DOI: 10.1007/s43545-021-00267-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/22/2021] [Indexed: 12/04/2022]
Abstract
Cities are particularly vulnerable to the impacts of climate change. Many larger cities have identified the potential impacts of different climate change adaptation scenarios. However, their smaller and medium-sized counterparts are often not able to address climate risks effectively due to a lack of necessary resources. Since a large number of cities worldwide are indeed small and medium-sized, this lack of preparedness represents a crucial weakness in global response systems. A promising approach to tackling this issue is to establish regional municipal networks. Yet, how might a regional network for small and medium-sized cities be systematically designed and further developed? Focussing on the German federal state of Baden-Wuerttemberg, we have explored this question by applying a participatory action research approach. As part of our research, we established a regional network framework for small and medium-sized cities. The framework supports small and medium-sized cities in identifying key regional actors, while taking local and regional contextual factors into account. Based on our findings, we suggest that other small and medium sized cities follow these steps: develop the knowledge base; build the network; and transfer and consolidate knowledge.
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Affiliation(s)
- Simone Häußler
- Aalen University, Electrical Engineering - Renewable Energies, Anton-Huber-Straße 25, 73430 Aalen, Germany
| | - Wolfgang Haupt
- Leibniz-Institute for Research on Society and Space, Flakenstraße 29-31, 15537 Erkner, Germany
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Jay O, Capon A, Berry P, Broderick C, de Dear R, Havenith G, Honda Y, Kovats RS, Ma W, Malik A, Morris NB, Nybo L, Seneviratne SI, Vanos J, Ebi KL. Reducing the health effects of hot weather and heat extremes: from personal cooling strategies to green cities. Lancet 2021; 398:709-724. [PMID: 34419206 DOI: 10.1016/s0140-6736(21)01209-5] [Citation(s) in RCA: 116] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 12/19/2020] [Accepted: 05/20/2021] [Indexed: 01/01/2023]
Abstract
Heat extremes (ie, heatwaves) already have a serious impact on human health, with ageing, poverty, and chronic illnesses as aggravating factors. As the global community seeks to contend with even hotter weather in the future as a consequence of global climate change, there is a pressing need to better understand the most effective prevention and response measures that can be implemented, particularly in low-resource settings. In this Series paper, we describe how a future reliance on air conditioning is unsustainable and further marginalises the communities most vulnerable to the heat. We then show that a more holistic understanding of the thermal environment at the landscape and urban, building, and individual scales supports the identification of numerous sustainable opportunities to keep people cooler. We summarise the benefits (eg, effectiveness) and limitations of each identified cooling strategy, and recommend optimal interventions for settings such as aged care homes, slums, workplaces, mass gatherings, refugee camps, and playing sport. The integration of this information into well communicated heat action plans with robust surveillance and monitoring is essential for reducing the adverse health consequences of current and future extreme heat.
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Affiliation(s)
- Ollie Jay
- Thermal Ergonomics Laboratory, The University of Sydney, Sydney, NSW, Australia; Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia; Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
| | - Anthony Capon
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia; Monash Sustainable Development Institute, Monash University, Melbourne, VIC, Australia
| | - Peter Berry
- Faculty of Environment, University of Waterloo, ON, Canada
| | - Carolyn Broderick
- School of Medical Sciences, UNSW Medicine, Sydney, UNSW, Australia; The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Richard de Dear
- Indoor Environmental Quality Laboratory, School of Architecture, Design, and Planning, The University of Sydney, Sydney, NSW, Australia
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, UK
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - R Sari Kovats
- NIHR Health Protection Research Unit in Environmental Change and Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Wei Ma
- School of Public Health, Shandong University, Jinan, China; Climate Change and Health Center, Shandong University, Jinan, China
| | - Arunima Malik
- School of Physics, Faculty of Science, ISA, The University of Sydney, Sydney, NSW, Australia; Discipline of Accounting, Business School, The University of Sydney, Sydney, NSW, Australia
| | - Nathan B Morris
- Thermal Ergonomics Laboratory, The University of Sydney, Sydney, NSW, Australia; Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Lars Nybo
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Sonia I Seneviratne
- Institute for Atmospheric and Climate Science, ETH Zurich, Zurich, Switzerland
| | - Jennifer Vanos
- School of Sustainability, Arizona State University, AZ, USA
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, WA, USA
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11
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Nagle Alverio G, Hoagland SH, Coughlan de Perez E, Mach KJ. The role of international organizations in equitable and just planned relocation. JOURNAL OF ENVIRONMENTAL STUDIES AND SCIENCES 2021; 11:511-522. [PMID: 34002121 PMCID: PMC8117123 DOI: 10.1007/s13412-021-00698-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
Since 2010, States party to the United Nations Framework Convention on Climate Change have recognized planned relocation as a viable adaptation to climate change. Planned relocation has been attempted in many communities globally and has raised serious issues of equity in some cases. Implementation driven by principles of equity is crucial in ensuring successful planned relocations that decrease loss and damage. In this Policy Analysis, we put forth a framework for equitable planned relocation rooted in theories of justice as a basis for implementation. The framework centers around three principles: comprehensive recognition of affected stakeholders in decision-making, consideration of socio-cultural risk factors relevant to relocation, and evaluation of multiple measures of well-being. There are many actors involved in planned relocation. Unique features and abilities of international organizations lend themselves to promoting equitable planned relocation in partnership with other stakeholders. Through the exploration of case studies, we identify best practices that international organizations have available to influence the design, implementation, and evaluation of planned relocation processes. These practices are relevant when striving for equity for all affected individuals and communities. Points of intervention include agenda-setting and advocacy, funding and implementation standards, and facilitation of international cooperation. International organizations also face barriers to supporting equitable planned relocation. Limitations include lack of enforcement mechanisms, limited resources, and fundamental dependence on existing governance structures and global collaboration. As the necessity of planned relocations grows, the need for leadership from international organizations in implementation is magnified, underscoring the importance of developing and evaluating approaches to just implementation.
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Affiliation(s)
- Gabriela Nagle Alverio
- School of Earth, Energy, and Environmental Sciences, Stanford University, Stanford, CA USA
- Sanford School of Public Policy, Duke University, Durham, NC USA
- Nicholas School of the Environment, Duke University, Durham, NC USA
- School of Law, Duke University, Durham, NC USA
| | - Sara H. Hoagland
- School of Earth, Energy, and Environmental Sciences, Stanford University, Stanford, CA USA
| | - Erin Coughlan de Perez
- Red Cross Red Crescent Climate Centre, The Hague, The Netherlands
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA USA
| | - Katharine J. Mach
- Rosenstiel School of Marine and Atmospheric Science, University of Miami, Miami, FL USA
- Leonard and Jayne Abess Center for Ecosystem Science and Policy, University of Miami, Coral Gables, FL USA
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12
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Heat Emergencies: Perceptions and Practices of Community Members and Emergency Department Healthcare Providers in Karachi, Pakistan: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094736. [PMID: 33946755 PMCID: PMC8125281 DOI: 10.3390/ijerph18094736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/18/2021] [Accepted: 04/22/2021] [Indexed: 11/29/2022]
Abstract
Heat waves are the second leading cause of weather-related morbidity and mortality affecting millions of individuals globally, every year. The aim of this study was to understand the perceptions and practices of community residents and healthcare professionals with respect to identification and treatment of heat emergencies. A qualitative study was conducted using focus group discussions and in-depth interviews, with the residents of an urban squatter settlement, community health workers, and physicians and nurses working in the emergency departments of three local hospitals in Karachi. Data was analyzed using content analysis. The themes that emerged were (1) perceptions of the community on heat emergencies; (2) recognition and early treatment at home; (3) access and quality of care in the hospital; (4) recognition and treatment at the health facility; (5) facility level plan; (6) training. Community members were able to recognize dehydration as a heat emergency. Males, elderly, and school-going children were considered at high risk for heat emergencies. The timely treatment of heat emergencies was widely linked with availability of financial resources. Limited availability of water, electricity, and open public spaces were identified as risk factors for heat emergencies. Home based remedies were reported as the preferred practice for treatment by community members. Both community members and healthcare professionals were cognizant of recognizing heat related emergencies.
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13
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Barbosa HP, Roué-Le Gall A, Deloly C, Regnaux JP, Thomas MF. Mapping the links between climate change and human health in urban areas: how is research conducted? A Scoping review protocol. BMJ Open 2020; 10:e034667. [PMID: 32988936 PMCID: PMC7523206 DOI: 10.1136/bmjopen-2019-034667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Scientists from a wide variety of fields of knowledge are increasingly interested in climate change issues. The importance given to the phenomenon is explained by the uncertainties surrounding it and its consequences not yet fully known. However, there is wide agreement that human activities are modifying the Earth's climate beyond the natural cyclical changes and that these changes impact human health. This scoping review aimed to understand how research on the links between climate change and human health in urban areas is conducted and how this research is approached holistically or not. METHODS AND ANALYSIS This scoping review is mainly guided by the Arskey and O'Malley scoping review framework. A broad range of databases will be used, including PubMed, ScienceDirect, Web of Science Core Collection, GreenFILE and Information Science & Technology Abstracts. Predefined inclusion and exclusion criteria will be used, with a focus on climate change and human health outcome studies published between January 1990 and July 2019. An interdisciplinary team has formulated search strategies and the reviewers will independently screen eligible studies for final study selection. We will apply a thematic analysis to evaluate and categorise the study findings. We expect to map the research according to the scientific research methods, the scientific fields and the determinants of health studied. Along these lines, we will be able to understand how holistic the research is. ETHICS AND DISSEMINATION No primary data will be collected since all data presented in this review are based on published articles and publicly available documents. Therefore, ethics committee approval is not a requirement. The findings will be disseminated through publication in a peer-reviewed journal, presentations at conferences relevant to the field of this research, as well as presentations to relevant stakeholders.
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Affiliation(s)
- Hiago Pereira Barbosa
- Université de Rennes, EHESP, Inserm, Irset (Research Institute for Environmental and Occupational Health), UMR_S 1085, Rennes, France
| | - Anne Roué-Le Gall
- Université de Rennes, EHESP, CNRS, ARENES, UMR 6051, F-35000 Rennes, France
- Department of Environmental and occupational Health, EHESP, Rennes, France
| | - Clément Deloly
- Department of Environmental and occupational Health, EHESP, Rennes, France
| | - Jean-Philippe Regnaux
- INSERM 1153, CRESS, EpiAgeing Team, Université de Paris, Paris, France
- Department of Social Sciences and Health, EHESP, Rennes, France
| | - Marie-Florence Thomas
- Université de Rennes, EHESP, Inserm, Irset (Research Institute for Environmental and Occupational Health), UMR_S 1085, Rennes, France
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14
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Heat Health Prevention Measures and Adaptation in Older Populations-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224370. [PMID: 31717424 PMCID: PMC6888447 DOI: 10.3390/ijerph16224370] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 10/29/2019] [Accepted: 11/06/2019] [Indexed: 11/25/2022]
Abstract
The population of older people is increasing at a rapid rate, with those 80 years and older set to triple by 2050. This systematic review aimed to examine older people’s perceptions and behaviours against existing heatwaves prevention measures and systematically categorize and analyse those measures using the Ottawa charter for health promotion framework. Peer-reviewed published literature between 22nd September 2006 and 24th April 2018 was retrieved, according to the PRISMA guidelines, from five different databases. Eighteen articles were finally included. There is a lack of published studies from developing countries. Results were categorized and analysed using the Ottawa charter five action areas. Mitigation strategies from current heat action plans are discussed and gaps are highlighted. A lack of systematic evaluation of heat action plans efficacy was identified. Older people are not demonstrating all recommended preventative measures during heatwaves. Support personnel and health professionals are not being pro-active enough in facilitating prevention of adverse effects from heatwaves. Governments are beginning to implement policy changes, but other recommended support measures outlined in the Ottawa charter are still lacking, and hence require further action. Linkage between specific components of heat action plans and outcomes cannot be ascertained; therefore, more systematic evaluation is needed.
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15
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Ye H, Fetzer EJ. Asymmetrical Shift Toward Longer Dry Spells Associated with Warming Temperatures During Russian Summers. GEOPHYSICAL RESEARCH LETTERS 2019; 46:11455-11462. [PMID: 31894171 PMCID: PMC6919415 DOI: 10.1029/2019gl084748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 09/21/2019] [Accepted: 10/10/2019] [Indexed: 06/10/2023]
Abstract
This study examines the changing behavior of summer dry spell duration in response to increasing air temperatures at 517 Russian stations during 1966-2010. We found that the frequency distribution of dry spell duration (as represented by histograms) is becoming skewed toward longer dry spells. This asymmetrical shift is accompanied by mean increases in dry spell duration. This asymmetry is also reflected in exponentially higher increasing rates of dry spell duration toward higher percentiles. Consequently, across Russia, summers have experienced significant increases in 7-day-or-longer dry spells (at 6.1%/°C of warming) and fewer occurrences of 3-day-or-shorter dry spells (at 2.4%/°C). This study suggests that hotter summers favor more frequent prolonged dry spells, exacerbating drought and heat wave conditions during Russian summers as air temperatures continue to rise.
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Affiliation(s)
- Hengchun Ye
- College of Natural and Social SciencesCalifornia State UniversityLos AngelesCAUSA
| | - Eric J. Fetzer
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
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16
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Becker C, Herrmann A, Haefeli WE, Rapp K, Lindemann U. [New approaches in preventing health risks and excess mortality of older persons during extreme heat]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:565-570. [PMID: 30887088 DOI: 10.1007/s00103-019-02927-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
More and longer heatwaves can be expected in Germany as a consequence of climate change. Older persons are predominantly threatened with the associated health-related problems and premature death. So far, heat action plans have failed to prevent excess mortality. Therefore, new approaches of prevention must be found.General practitioner, ambulant care, hospital, and nursing home settings were investigated in a project funded by the German ministry of health. Workshops were conducted and the results are presented here.Sufficient knowledge and continuous care are available in hospitals and nursing homes. The basic challenge for general practitioners and ambulatory caregivers is to provide appropriate care for older persons living alone and in need of help. Proactive care during extremely hot days cannot be provided due to staff shortages. Experience from other countries indicates that a new course of action must be found. The main tasks of general practitioners should be the identification and consultation of persons at risk. Experience from previous years have demonstrated that formal structures of nursing and medical care alone failed to prevent the recurrence of a catastrophe caused by a heatwave and that human loss is substantial.A possible approach could be volunteer-based disaster protection, which is well-developed in Germany. After proclamation of a major (heat) disaster in the community, close cooperation with general practitioners would be essential. A registry of persons at health risk from heat waves would also be essential. The feasibility and effectiveness of the suggested approach should be tested and ultimately regulated at a political level.
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Affiliation(s)
- Clemens Becker
- Abteilung Geriatrie und Klinik für Geriatrische Rehabilitation, Robert-Bosch-Krankenhaus Stuttgart, Auerbachstr. 120, 70376, Stuttgart, Deutschland
| | - Alina Herrmann
- Heidelberger Institut für Global Health, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Walter E Haefeli
- Abteilung Klinische Pharmakologie und Pharmakoepidemiologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Kilian Rapp
- Abteilung Geriatrie und Klinik für Geriatrische Rehabilitation, Robert-Bosch-Krankenhaus Stuttgart, Auerbachstr. 120, 70376, Stuttgart, Deutschland
| | - Ulrich Lindemann
- Abteilung Geriatrie und Klinik für Geriatrische Rehabilitation, Robert-Bosch-Krankenhaus Stuttgart, Auerbachstr. 120, 70376, Stuttgart, Deutschland.
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17
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Martinez GS, Linares C, Ayuso A, Kendrovski V, Boeckmann M, Diaz J. Heat-health action plans in Europe: Challenges ahead and how to tackle them. ENVIRONMENTAL RESEARCH 2019; 176:108548. [PMID: 31247429 DOI: 10.1016/j.envres.2019.108548] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 06/17/2019] [Accepted: 06/18/2019] [Indexed: 05/04/2023]
Abstract
High temperatures have periodically affected large areas in Europe and urban settings. In particular, the deadly 2003 summer heat waves precipitated a multitude of national and subnational health prevention and research efforts. Building on these and other international experiences the WHO Regional Office for Europe developed and published in 2008 a comprehensive framework for prevention, the heat-health action plans (HHAPs). This provided a blueprint used by several national and subnational authorities to design their prevention efforts. A decade after the publication of the WHO guidance, a wealth of new evidence and acquired implementation experience has emerged around HHAP effectiveness; heat exposure; acclimatization and adaptation; heat-health governance and stakeholder involvement; and the role of urban design and greening interventions in prevention. This evidence and experience can guide the strategies to tackle current and upcoming challenges in protecting health from heat under a warming climate.
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Affiliation(s)
| | | | - Ana Ayuso
- Carlos III National Institute of Health, Madrid, Spain
| | | | | | - Julio Diaz
- Carlos III National Institute of Health, Madrid, Spain
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18
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Herrmann A, Haefeli WE, Lindemann U, Rapp K, Roigk P, Becker C. [Epidemiology and prevention of heat-related adverse health effects on elderly people]. Z Gerontol Geriatr 2019; 52:487-502. [PMID: 31346679 DOI: 10.1007/s00391-019-01594-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 06/14/2019] [Indexed: 11/25/2022]
Abstract
Heat waves increase the morbidity and mortality in Germany, particularly of older patients in need of care. Due to climate change the number of heat waves in Germany will increase threefold by the end of the century. In addition, the proportion of patients at risk will grow due to demographic change. Therefore, the Government and the Federal States have developed recommendations for heat action plans, in which the medical profession should also participate in the prevention of heat-related damage to health. Physicians and their team should first become acquainted with the topic. In addition, they should inform patients at risk and their relatives of the risks and preventive measures. In the summer a critical check of drugs is also needed because medications impair cooling mechanisms in heat waves, the pharmacokinetics can change and unwanted side effects of drugs occur more frequently. Lastly, due to their central position in the healthcare system, physicians should participate in the coordination of a good nursing care and intensification of social contacts during heat waves.
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Affiliation(s)
- A Herrmann
- Heidelberger Institut für Global Health, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Deutschland.
| | - W E Haefeli
- Abteilung Klinische Pharmakologie und Pharmakoepidemiologie, Medizinische Klinik, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - U Lindemann
- Abteilung für Geriatrie und Klinik für Geriatrische Rehabilitation, Robert-Bosch-Krankenhaus, Stuttgart, Deutschland
| | - K Rapp
- Abteilung für Geriatrie und Klinik für Geriatrische Rehabilitation, Robert-Bosch-Krankenhaus, Stuttgart, Deutschland
| | - P Roigk
- Abteilung für Geriatrie und Klinik für Geriatrische Rehabilitation, Robert-Bosch-Krankenhaus, Stuttgart, Deutschland
| | - C Becker
- Abteilung für Geriatrie und Klinik für Geriatrische Rehabilitation, Robert-Bosch-Krankenhaus, Stuttgart, Deutschland
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A Survey of Rural Residents' Perception and Response to Health Risks from Hot Weather in Ethnic Minority Areas in Southwest China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122190. [PMID: 31234271 PMCID: PMC6616902 DOI: 10.3390/ijerph16122190] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 05/31/2019] [Accepted: 06/19/2019] [Indexed: 12/05/2022]
Abstract
Ethnic minority areas in southwestern China are facing frequent high-temperature heatwaves. The health risk perceptions and responses of the local residents need to be investigated in order to formulate public policies to mitigate the impacts of climate change on health. In this study, a household survey was conducted in Pengshui Miao and Tujia Autonomous County of Chongqing from January to February 2019. A total of 624 local residents were sampled using the multi-stage sampling method. We used multivariate logistic regression models to explore the factors affecting risk perceptions and responses with regard to hot weather. The results showed that despite a relatively high level of risk perception, the study population had a very low level of willingness to see a doctor (24.4%), especially ethnic minority residents (17.5%). In particular, 80% of residents were aware of climate warming and 79% of residents were aware of the health risks of hot weather. Almost all survey participants reported a response to hot weather, with more than half of the participants stating that they would go somewhere cooler (58.5%) and drink more water (56.3%). Compared with the Han Chinese, ethnic minority participants had a higher perception of warm temperature (p <0.001) and associated health risks (p <0.001) but a lower perception of physical discomfort (p <0.001) and aggravated diseases (p = 0.001). The logistic models indicated that ethnic minority, residence time, outdoor working hours, and health status can significantly influence perceptions and subsequently significantly affect coping behaviors. In conclusion, our findings provide significant implications for the development of policies and health education and promotion programs for ethnic minorities in southwest China to aid them in maintaining good health during future hot weather events.
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20
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Ding Y, Kaura S, Mutebi C. The diverse effects of climate change on health and related associations. ENVIRONMENTAL DISEASE 2019. [DOI: 10.4103/ed.ed_36_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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