1
|
Turner GA, de’Donato F, Hoeben AD, Nordeng Z, Coleman S, Otto IM, Hajat S, Kovats S. Implementation of climate adaptation in the public health sector in Europe: qualitative thematic analysis. Eur J Public Health 2024; 34:544-549. [PMID: 38099866 PMCID: PMC11161147 DOI: 10.1093/eurpub/ckad218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Adaptation, to reduce the health impacts of climate change, is driven by political action, public support and events (extreme weather). National adaptation policies or strategies are limited in addressing human health risks and implementation of adaptation in the public health community is not well understood. AIM To identify key issues in climate change adaptation implementation for public health in Europe. METHODS Key informant interviews with decision-makers in international, national and local city governments in 19 European countries. Participants were recruited if a senior decision-maker working in public health, environmental health or climate adaptation. INTERVIEWS ADDRESSED Barriers and levers for adaptation, policy alignment, networks and evidence needs. RESULTS Thirty-two interviews were completed between June and October 2021 with 4 international, 5 national and 23 city/local government stakeholders. Respondents reported inadequate resources (funding, training and personnel) for health-adaptation implementation and the marginal role of health in adaptation policy. A clear mandate to act was key for implementation and resource allocation. Limited cross-departmental collaboration and poor understanding of the role of public health in climate policy were barriers to implementation. CONCLUSIONS Across Europe, progress is varied in implementation of climate adaptation in public health planning. Providing appropriate resources, training, knowledge mobilization and supporting cross-departmental collaboration and multi-level governance will facilitate adaptation to protect human health.
Collapse
Affiliation(s)
- Grace A Turner
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
- NIHR Health Protection Research Unit in Environmental Change and Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Francesca de’Donato
- Department of Epidemiology, Lazio Regional Health Service - ASL Roma 1, Rome, Italy
| | - Annechien D Hoeben
- Wegener Center for Climate and Global Change and Institute for Environmental Systems Sciences, University of Graz, Graz, Austria
| | - Zuzana Nordeng
- Department of Research Administrative Support, Norwegian Public Health Institute, Oslo, Norway
| | - Samantha Coleman
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Ilona M Otto
- Wegener Center for Climate and Global Change and Institute for Environmental Systems Sciences, University of Graz, Graz, Austria
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
- NIHR Health Protection Research Unit in Environmental Change and Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Sari Kovats
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
- NIHR Health Protection Research Unit in Environmental Change and Health, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
2
|
Badger MS. The Intersection of Geriatrics, Climate Change, and Wilderness Medicine: Education is Critical. Wilderness Environ Med 2024:10806032241245399. [PMID: 38850046 DOI: 10.1177/10806032241245399] [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: 06/09/2024]
Abstract
According to the US Census, for the first time in history, older adults are projected to exceed the number of children by 2035. These seniors are headed to the outdoors in increasing numbers and face unique risks. They benefit from careful pre-event evaluation planning to maintain their health in wilderness environments. Climate change is affecting all of us, but seniors are considered an especially vulnerable group. This vulnerability needs to be addressed not only when older adults head into the wilderness but also when the wilderness "comes to them" in areas where wilderness medicine and disaster medicine overlap. Education of both providers and patients is vital. This article aims to discuss the special needs of older adults/seniors /elders (defined as those over 65 unless otherwise indicated) in the wilderness as well as the vulnerability of older adults to climate change, both during planned wilderness activities and when the wilderness "comes to them" because of climate change, and to identify opportunities for education and adaptation of patients and education of physicians and wilderness and disaster responders to care for these older patients. The PubMed and Google Scholar Database search engines were utilized to review relevant English language publications between 2000 and 2023 that addressed individuals over 65 and explored the overlap of geriatrics (aged over 65), wilderness and disaster medicine, and climate change and create a perspective summary. Because of increased numbers of older adults heading into the wilderness for outdoor activities or having wilderness thrust upon them due to climate change, cross training of all specialties including the fields of emergency, geriatrics, wilderness medicine, and disaster medicine is needed in collaboration with other organizations and search and rescue. Response agencies must recognize that training in wilderness medicine provides a background for practitioners working in dangerous and remote settings and ought to seek out individuals with such skills when placing responders in the field. Climate change is making these intersections and the need for this education more urgent with time.
Collapse
|
3
|
Borghi J, Cuevas Garcia-Dorado S, Anton B, Gerardo D, Gasparri G, Hanson M, Soucat A, Bustreo F, Langlois EV. Climate finance opportunities for health and health systems. Bull World Health Organ 2024; 102:330-335. [PMID: 38680468 PMCID: PMC11046152 DOI: 10.2471/blt.23.290785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 05/01/2024] Open
Abstract
Climate change poses significant risks to health and health systems, with the greatest impacts in low- and middle-income countries - which are least responsible for greenhouse gas emissions. The Conference of Parties 28 at the 2023 United Nations Climate Change Conference led to agreement on the need for holistic and equitable financing approaches to address the climate and health crisis. This paper provides an overview of existing climate finance mechanisms - that is, multilateral funds, voluntary market-based mechanisms, taxes, microlevies and adaptive social protection. We discuss these approaches' potential use to promote health, generate additional health sector resources and enhance health system sustainability and resilience, and also explore implementation challenges. We suggest that public health practitioners, policy-makers and researchers seize the opportunity to leverage climate funding for better health and sustainable, climate-resilient health systems. Emphasizing the wider benefits of investing in health for the economy can help prioritize health within climate finance initiatives. Meaningful progress will require the global community acknowledging the underlying political economy challenges that have so far limited the potential of climate finance to address health goals. To address these challenges, we need to restructure financing institutions to empower communities at the frontline of the climate and health crisis and ensure their needs are met. Efforts from global and national level stakeholders should focus on mobilizing a wide range of funding sources, prioritizing co-design and accessibility of financing arrangements. These stakeholders should also invest in rigorous monitoring and evaluation of initiatives to ensure relevant health and well-being outcomes are addressed.
Collapse
Affiliation(s)
- Josephine Borghi
- London School of Hygiene & Tropical Medicine, Keppel Street, LondonWC1E 7HT, England
| | | | - Blanca Anton
- London School of Hygiene & Tropical Medicine, Keppel Street, LondonWC1E 7HT, England
| | - Domenico Gerardo
- Partnership for Maternal, Newborn and Child Health, World Health Organization, Geneva, Switzerland
| | - Giulia Gasparri
- Partnership for Maternal, Newborn and Child Health, World Health Organization, Geneva, Switzerland
| | - Mark Hanson
- Faculty of Medicine, University of Southampton, Southampton, England
| | - Agnès Soucat
- Agence Française de Développement, Paris, France
| | | | - Etienne V Langlois
- Partnership for Maternal, Newborn and Child Health, World Health Organization, Geneva, Switzerland
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Lemon SC, Joseph HA, Williams S, Brown C, Aytur S, Catalano K, Chacker S, Goins KV, Rudolph L, Whitehead S, Zimmerman S, Schramm PJ. Reimagining the Role of Health Departments and Their Partners in Addressing Climate Change: Revising the Building Resilience against Climate Effects (BRACE) Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6447. [PMID: 37568988 PMCID: PMC10419192 DOI: 10.3390/ijerph20156447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/07/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023]
Abstract
Public health departments have important roles to play in addressing the local health impacts of climate change, yet are often not well prepared to do so. The Climate and Health Program (CHP) at the Centers for Disease Control and Prevention (CDC) created the Building Resilience Against Climate Effects (BRACE) framework in 2012 as a five-step planning framework to support public health departments and their partners to respond to the health impacts of climate change. CHP has initiated a process to revise the framework to address learnings from a decade of experience with BRACE and advances in the science and practice of addressing climate and health. The aim of this manuscript is to describe the methodology for revising the BRACE framework and the expected outputs of this process. Development of the revised framework and associated guidance and tools will be guided by a multi-sector expert panel, and finalization will be informed by usability testing. Planned revisions to BRACE will (1) be consistent with the vision of Public Health 3.0 and position health departments as "chief health strategists" in their communities, who are responsible for facilitating the establishment and maintenance of cross-sector collaborations with community organizations, other partners, and other government agencies to address local climate impacts and prevent further harm to historically underserved communities; (2) place health equity as a central, guiding tenet; (3) incorporate greenhouse gas mitigation strategies, in addition to its previous focus on climate adaptation; and (4) feature a new set of tools to support BRACE implementation among a diverse set of users. The revised BRACE framework and the associated tools will support public health departments and their partners as they strive to prevent and reduce the negative health impacts of climate change for everyone, while focusing on improving health equity.
Collapse
Affiliation(s)
- Stephenie C. Lemon
- Prevention Research Center, UMass Chan Medical School, Worcester, MA 01655, USA;
| | - Heather A. Joseph
- Climate and Health Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (H.A.J.); (S.W.); (C.B.); (P.J.S.)
| | - Samantha Williams
- Climate and Health Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (H.A.J.); (S.W.); (C.B.); (P.J.S.)
| | - Claudia Brown
- Climate and Health Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (H.A.J.); (S.W.); (C.B.); (P.J.S.)
| | - Semra Aytur
- Department of Health Management and Policy, College of Health and Human Services, University of New Hampshire, Durham, NH 03824, USA;
| | - Katherine Catalano
- Center for Climate, Health and Equity, American Public Health Association, Washington, DC 20001, USA;
| | | | - Karin V. Goins
- Prevention Research Center, UMass Chan Medical School, Worcester, MA 01655, USA;
| | - Linda Rudolph
- Center for Climate Change and Health, Public Health Institute, Oakland, CA 94607, USA;
| | - Sandra Whitehead
- College of Professional Studies, Sustainable Urban Planning Program, The George Washington University, Washington, DC 20052, USA;
| | | | - Paul J. Schramm
- Climate and Health Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (H.A.J.); (S.W.); (C.B.); (P.J.S.)
| |
Collapse
|
6
|
Progress of Local Health Department Planning Actions for Climate Change: Perspectives from California, USA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137984. [PMID: 35805652 PMCID: PMC9266246 DOI: 10.3390/ijerph19137984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/24/2022] [Accepted: 06/26/2022] [Indexed: 11/18/2022]
Abstract
Public health departments are on the frontlines of protecting vulnerable groups and working to eliminate health disparities through prevention interventions, disease surveillance and community education. Exploration of the roles national, state and local health departments (LHDs) play in advancing climate change planning and actions to protect public health is a developing arena of research. This paper presents insights from local public health departments in California, USA on how they addressed the barriers to climate adaptation planning with support from the California Department of Public Health’s Office of Health Equity Climate Change and Health Equity Section (OHE), which administers the California Building Resilience Against Climate Effects Project (CalBRACE). With support from the U.S. Centers for Disease Control and Prevention (CDC) Climate-Ready States and Cities Initiative (CRSCI), CalBRACE initiated an adaptation project to seed climate planning and actions in county health departments. In this study, we compared the barriers and strategies of twenty-two urban and rural LHDs and explored potential options for climate change adaptation in the public health framework. Using key informant interviews and document reviews, the results showed how engagement with CalBRACE’s Local Health Department Partnership on Climate Change influenced the county departments’ ability to overcome barriers to adaptation through the diversification of funding sources, the leveraging strategic collaborations, extensive public education and communication campaigns, and the development of political capital and champions. The lessons learned and recommendations from this research may provide pathways and practices for national, state and local level health departments to collaborate in developing protocols and integrating systems to respond to health-related climate change impacts, adaptation and implementation.
Collapse
|