文章基本信息

标题：Readying Health Services for Climate Change: A Policy Framework for Regional Development
本地全文：下载
作者：Erica Bell
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2011
卷号：101
期号：5
页码：804-813
DOI：10.2105/AJPH.2010.202820
语种：English
出版社：American Public Health Association
摘要：Climate change presents the biggest threat to human health in the 21st century. However, many public health leaders feel ill equipped to face the challenges of climate change and have been unable to make climate change a priority in service development. I explore how to achieve a regionally responsive whole-of-systems approach to climate change in the key operational areas of a health service: service governance and culture, service delivery, workforce development, asset management, and financing. The relative neglect of implementation science means that policymakers need to be proactive about sourcing and developing models and processes to make health services ready for climate change. Health research funding agencies should urgently prioritize applied, regionally responsive health services research for a future of climate change. Climate change has emerged as the biggest global health threat of the 21st century. That finding was published in a watershed 2009 article in The Lancet, ¹ a study that analyzed the global health implications of the summary work of the Intergovernmental Panel on Climate Change.^{2 , 3} The Lancet piece¹ is supported by more than 10 000 articles on the health effects of climate change published in other leading journals, such as BMJ , Nature , and JAMA. ^{4 – 6} Over the last 10 years a raft of books^{7 – 10} on the subject have also been published, offering detailed discussions of the public health implications of climate change. The health effects of climate change are also the subject of ongoing work for the Global Environmental Change and Human Health project.¹¹ Many people are now familiar with the attribution of extreme weather events to climate change and the direct health effects of these events: death, injuries, and problems with water and food security caused by heat waves, droughts, flooding rains, and cyclones.^{12 , 13} Less familiar—but increasingly well documented in the literature—are the indirect health effects of climate change. These include changes in the distribution of insect-borne diseases, such as Ross River virus¹⁴; increases in conditions linked to changes in the distribution and seasonality of plant allergens, such as asthma¹⁵; and mental health issues linked to extended drought.¹⁶ Climate change research has also frequently identified vulnerable groups who may be differently affected by climate change, often within socioeconomically disadvantaged populations, such as older citizens or indigenous peoples.¹⁷ However, many key issues involved with translating the climate change literature into health services and workforce development have been neglected. Even relatively affluent nations lack policy frameworks and regional-level evidence that can equip health policymakers to make the translation from big-picture climate change issues to on-the-ground regional service development. The United States has contributed the vast bulk of climate change research, together with other developed countries such as the United Kingdom, Canada, and Australia. However, most public health leaders in the United States feel unprepared for climate change and ill equipped to make the necessary service adaptations,¹⁸ despite the recent rapid proliferation of national service-oriented policy guidelines, such as the US Centers for Disease Control and Prevention's CDC Policy on Climate Change and Public Health ¹⁹ and the UK Department of Health's The Health Impact of Climate Change: Promoting Sustainable Communities .²⁰ Australia has prioritized investment in research that can inform national planning for climate change, and the government has a human health and climate change National Adaptation Research Plan ,²¹ but little is known about changing regional health needs and the related changes to local health care infrastructure that will likely be needed.^{21 , 22}