30. Backholer K, Baum F, Finlay SM, Friel S, Giles-Corti B, Jones A, Patrick R, Shill J, Townsend B, Armstrong F, Baker P, Bowen K, Browne J, Büsst C, Butt A, Canuto K, Canuto K, Capon A, Corben K, Daube M, Goldfeld S, Grenfell R, Gunn L, Harris P, Horton K, Keane L, Lacy-Nichols J, Lo SN, Lovett RW, Lowe M, Martin JE, Neal N, Peeters A, Pettman T, Thoms A, Thow AMT, Timperio A, Williams C, Wright A, Zapata-Diomedi B, Demaio S. Australia in 2030: what is our path to health for all? Med J Aust. 2021 May;214 Suppl 8:S5-S40. doi: 10.5694/mja2.51020. PMID: 33934362.
Abstract
CHAPTER 1: HOW AUSTRALIA IMPROVED HEALTH EQUITY THROUGH ACTION ON THE SOCIAL DETERMINANTS OF HEALTH: Do not think that the social determinants of health equity are old hat. In reality, Australia is very far away from addressing the societal level drivers of health inequity. There is little progressive policy that touches on the conditions of daily life that matter for health, and action to redress inequities in power, money and resources is almost non-existent. In this chapter we ask you to pause this reality and come on a fantastic journey where we envisage how COVID-19 was a great disruptor and accelerator of positive progressive action. We offer glimmers of what life could be like if there was committed and real policy action on the social determinants of health equity. It is vital that the health sector assists in convening the multisectoral stakeholders necessary to turn this fantasy into reality. CHAPTER 2: ABORIGINAL AND TORRES STRAIT ISLANDER CONNECTION TO CULTURE: BUILDING STRONGER INDIVIDUAL AND COLLECTIVE WELLBEING: Aboriginal and Torres Strait Islander peoples have long maintained that culture (ie, practising, maintaining and reclaiming it) is vital to good health and wellbeing. However, this knowledge and understanding has been dismissed or described as anecdotal or intangible by Western research methods and science. As a result, Aboriginal and Torres Strait Islander culture is a poorly acknowledged determinant of health and wellbeing, despite its significant role in shaping individuals, communities and societies. By extension, the cultural determinants of health have been poorly defined until recently. However, an increasing amount of scientific evidence supports what Aboriginal and Torres Strait Islander people have always said - that strong culture plays a significant and positive role in improved health and wellbeing. Owing to known gaps in knowledge, we aim to define the cultural determinants of health and describe their relationship with the social determinants of health, to provide a full understanding of Aboriginal and Torres Strait Islander wellbeing. We provide examples of evidence on cultural determinants of health and links to improved Aboriginal and Torres Strait Islander health and wellbeing. We also discuss future research directions that will enable a deeper understanding of the cultural determinants of health for Aboriginal and Torres Strait Islander people. CHAPTER 3: PHYSICAL DETERMINANTS OF HEALTH: HEALTHY, LIVEABLE AND SUSTAINABLE COMMUNITIES: Good city planning is essential for protecting and improving human and planetary health. Until recently, however, collaboration between city planners and the public health sector has languished. We review the evidence on the health benefits of good city planning and propose an agenda for public health advocacy relating to health-promoting city planning for all by 2030. Over the next 10 years, there is an urgent need for public health leaders to collaborate with city planners - to advocate for evidence-informed policy, and to evaluate the health effects of city planning efforts. Importantly, we need integrated planning across and between all levels of government and sectors, to create healthy, liveable and sustainable cities for all. CHAPTER 4: HEALTH PROMOTION IN THE ANTHROPOCENE: THE ECOLOGICAL DETERMINANTS OF HEALTH: Human health is inextricably linked to the health of the natural environment. In this chapter, we focus on ecological determinants of health, including the urgent and critical threats to the natural environment, and opportunities for health promotion arising from the human health co-benefits of actions to protect the health of the planet. We characterise ecological determinants in the Anthropocene and provide a sobering snapshot of planetary health science, particularly the momentous climate change health impacts in Australia. We highlight Australia's position as a major fossil fuel producer and exporter, and a country lacking cohesive and timely emissions reduction policy. We offer a roadmap for action, with four priority directions, and point to a scaffold of guiding approaches - planetary health, Indigenous people's knowledge systems, ecological economics, health co-benefits and climate-resilient development. Our situation requires a paradigm shift, and this demands a recalibration of health promotion education, research and practice in Australia over the coming decade. CHAPTER 5: DISRUPTING THE COMMERCIAL DETERMINANTS OF HEALTH: Our vision for 2030 is an Australian economy that promotes optimal human and planetary health for current and future generations. To achieve this, current patterns of corporate practice and consumption of harmful commodities and services need to change. In this chapter, we suggest ways forward for Australia, focusing on pragmatic actions that can be taken now to redress the power imbalances between corporations and Australian governments and citizens. We begin by exploring how the terms of health policy making must change to protect it from conflicted commercial interests. We also examine how marketing unhealthy products and services can be more effectively regulated, and how healthier business practices can be incentivised. Finally, we make recommendations on how various public health stakeholders can hold corporations to account, to ensure that people come before profits in a healthy and prosperous future Australia. CHAPTER 6: DIGITAL DETERMINANTS OF HEALTH: THE DIGITAL TRANSFORMATION: We live in an age of rapid and exponential technological change. Extraordinary digital advancements and the fusion of technologies, such as artificial intelligence, robotics, the Internet of Things and quantum computing constitute what is often referred to as the digital revolution or the Fourth Industrial Revolution (Industry 4.0). Reflections on the future of public health and health promotion require thorough consideration of the role of digital technologies and the systems they influence. Just how the digital revolution will unfold is unknown, but it is clear that advancements and integrations of technologies will fundamentally influence our health and wellbeing in the future. The public health response must be proactive, involving many stakeholders, and thoughtfully considered to ensure equitable and ethical applications and use. CHAPTER 7: GOVERNANCE FOR HEALTH AND EQUITY: A VISION FOR OUR FUTURE: Coronavirus disease 2019 has caused many people and communities to take stock on Australia's direction in relation to health, community, jobs, environmental sustainability, income and wealth. A desire for change is in the air. This chapter imagines how changes in the way we govern our lives and what we value as a society could solve many of the issues Australia is facing - most pressingly, the climate crisis and growing economic and health inequities. We present an imagined future for 2030 where governance structures are designed to ensure transparent and fair behaviour from those in power and to increase the involvement of citizens in these decisions, including a constitutional voice for Indigenous peoples. We imagine that these changes were made by measuring social progress in new ways, ensuring taxation for public good, enshrining human rights (including to health) in legislation, and protecting and encouraging an independent media. Measures to overcome the climate crisis were adopted and democratic processes introduced in the provision of housing, education and community development.
31. Dupraz J, Burnand B. Role of Health Professionals Regarding the Impact of Climate Change on Health-An Exploratory Review. Int J Environ Res Public Health. 2021 Mar 20;18(6):3222. doi: 10.3390/ijerph18063222. PMID: 33804669; PMCID: PMC8003659.
Abstract
Health professionals are increasingly urged to act to protect individuals and populations against the negative effects of climate and environment change on health. However, the amount of evidence supporting initiatives to that end is unknown. We explored the literature examining the awareness, preparedness, and role of healthcare professionals to inform about the impact of climate change on health on the one hand, and literature about the effectiveness of interventions mediated by health professionals aiming at reducing the environmental impact of human activities on the other hand. We included 137 articles published between 2000 and 2020, mostly in general medical and nursing journals. The typical article was a perspective, commentary, or other special article aimed at alerting readers about the impact of climate and environment change on health. We identified 22 studies, of which only two reported interventions. Despite increasing efforts of health professionals to address climate and environment change and related health risks, health literature supporting such efforts remains scarce, and studies assessing the effectiveness of interventions are lacking. We need appropriate evidence to indicate which interventions should be prioritized, considering that the association of health issues with climate and environment change could constitute an effective lever for change.
Keywords: climate change; health professionals; intervention; role.
32. Ebi KL, Vanos J, Baldwin JW, Bell JE, Hondula DM, Errett NA, Hayes K, Reid CE, Saha S, Spector J, Berry P. Extreme Weather and Climate Change: Population Health and Health System Implications. Annu Rev Public Health. 2021 Apr 1;42:293-315. doi: 10.1146/annurev-publhealth-012420-105026. Epub 2021 Jan 6. PMID: 33406378.
Abstract
Extreme weather and climate events, such as heat waves, cyclones, and floods, are an expression of climate variability. These events and events influenced by climate change, such as wildfires, continue to cause significant human morbidity and mortality and adversely affect mental health and well-being. Although adverse health impacts from extreme events declined over the past few decades, climate change and more people moving into harm's way could alter this trend. Long-term changes to Earth's energy balance are increasing the frequency and intensity of many extreme events and the probability of compound events, with trends projected to accelerate under certain greenhouse gas emissions scenarios. While most of these events cannot be completely avoided, many of the health risks could be prevented through building climate-resilient health systems with improved risk reduction, preparation, response, and recovery. Conducting vulnerability and adaptation assessments and developing health system adaptation plans can identify priority actions to effectively reduce risks, such as disaster risk management and more resilient infrastructure. The risks are urgent, so action is needed now.
Keywords: climate change; climate variability; extreme events; health systems; population health.
33. Madden DL, McLean M, Brennan M, Moore A. Why use indicators to measure and monitor the inclusion of climate change and environmental sustainability in health professions' education? Med Teach. 2020 Oct;42(10):1119-1122. doi: 10.1080/0142159X.2020.1795106. Epub 2020 Jul 24. PMID: 32707000.
Abstract
Currently, health professionals are inadequately prepared to meet the challenges that climate change and environmental degradation pose to health systems. Health professions' education (HPE) has an ethical responsibility to address this and must include the health effects of climate change and environmental sustainability across all curricula. As there is a narrow, closing window in which to take action to avoid the worst health outcomes from climate change, urgent, systematic, system-level change is required by the education sector. Measuring, monitoring, and reporting activity using indicators have been demonstrated to support change by providing a focus for action. A review of the literature on the use of indicators in medical education for climate change and health, however, yielded no publications. The framework of targets and indicators developed for implementation of the Sustainable Development Goals (SDGs) by 2030 and the UNESCO initiative of the Education for Sustainable Development provide a guide for the development of indicators for HPE. Engaging stakeholders and achieving consensus on an approach to indicator development is essential and, where they exist, accreditation standards may have a supporting role. Creating capacity for environmentally sustainable health care at scale and pace should be our collective goal as health professions' educators.
Keywords: Evaluation; climate change; curriculum; environmentally sustainable healthcare; health professions’ education; indicators; multiprofessional; sustainable development goals.
34. Kumar A, Singh P, Raizada P, Hussain CM. Impact of COVID-19 on greenhouse gases emissions: A critical review. Sci Total Environ. 2021 Sep 17;806(Pt 1):150349. doi: 10.1016/j.scitotenv.2021.150349. Epub ahead of print. PMID: 34555610; PMCID: PMC8445775.
Abstract
The global outburst of coronavirus 2019 (COVID-19) has posed severe challenges to human health, environment, energy and economy all over the world. The stringent measures to control the spread of COVID-19 results a significant slowdown in economic activities which in turn affected the environment by reducing the greenhouse gas (GHG) emissions, specifically lower atmospheric CO2 levels. Considering that, the present study intends to highlight the substantial impact of COVID-19 pandemic on GHG emissions, by systematically reviewing the available scientific literatures. The study further outlined the variation in GHG emissions by comparing the data focused on pre-pandemic, during pandemic, and post-pandemic (predictions) scenarios. Further, the assessment on elevating CO2 levels, global economic, and energy impacts of COVID-19 has also been reviewed. Also, the possible recovery plan for the framework of sustainable environmental and energy development is presented. Finally, the review concludes with an insightful summary involving the challenges and future outlook towards sustainable development goals in a hope that the present study can help the researchers to assess the global environmental and energy related consequences.
Keywords: CO(2) emission; COVID-19; Climate change; Greenhouse gas emission; Sustainable development.
35. Romanello M, van Daalen K, Anto JM, Dasandi N, Drummond P, Hamilton IG, Jankin S, Kendrovski V, Lowe R, Rocklöv J, Schmoll O, Semenza JC, Tonne C, Nilsson M. Tracking progress on health and climate change in Europe. Lancet Public Health. 2021 Nov;6(11):e858-e865. doi: 10.1016/S2468-2667(21)00207-3. Epub 2021 Sep 23. PMID: 34562381.
Abstract
Left unabated, climate change will have catastrophic effects on the health of present and future generations. Such effects are already seen in Europe, through more frequent and severe extreme weather events, alterations to water and food systems, and changes in the environmental suitability for infectious diseases. As one of the largest current and historical contributors to greenhouse gases and the largest provider of financing for climate change mitigation and adaptation, Europe's response is crucial, for both human health and the planet. To ensure that health and wellbeing are protected in this response it is essential to build the capacity to understand, monitor, and quantify health impacts of climate change and the health co-benefits of accelerated action. Responding to this need, the Lancet Countdown in Europe is established as a transdisciplinary research collaboration for monitoring progress on health and climate change in Europe. With the wealth of data and academic expertise available in Europe, the collaboration will develop region-specific indicators to address the main challenges and opportunities of Europe's response to climate change for health. The indicators produced by the collaboration will provide information to health and climate policy decision making, and will also contribute to the European Observatory on Climate and Health.
36. Ebi KL, Bowen KJ, Calkins J, Chen M, Huq S, Nalau J, Palutikof JP, Rosenzweig C. Interactions between two existential threats: COVID-19 and climate change. Clim Risk Manag. 2021;34:100363. doi: 10.1016/j.crm.2021.100363. Epub 2021 Sep 6. PMID: 34518797; PMCID: PMC8426141.
Abstract
The COVID-19 pandemic and climate change are complex existential threats, unpredictable in many ways and unprecedented in modern times. There are parallels between the scale and scope of their impacts and responses. Understanding shared drivers, coupled vulnerabilities, and criteria for effective responses will help societies worldwide prepare for the simultaneous threats of climate change and future pandemics. We summarize some shared characteristics of COVID-19 and climate change impacts and interventions and discuss key policy implications and recommendations.
Keywords: COVID-19; Climate change adaptation; Policy implications; Synergies; Trade-offs.
37. Dresser C, Gentile E, Lyons R, Sullivan K, Balsari S. Climate Change and Health in New England: A Review of Training and Policy Initiatives at Health Education Institutions and Professional Societies. R I Med J (2013). 2021 Nov 1;104(9):49-54. PMID: 34705909.
Abstract
Background: There has been increasing interest in climate change among healthcare professionals, but it is unclear to what extent resources on this topic are available to students and clinicians in New England.
Methods: Structured review of publicly available information regarding climate change and health activity at schools of medicine, public health, and physician assistant studies and in state medical and physician assistant societies in New England.
Results: Of 39 programs reviewed, 18 (46%) had at least one climate-related initiative. Six universities accounted for 87% of climate change and health initiatives in the region. Three out of 12 state professional associations had committees or position statements addressing climate change.
Conclusion: There is substantial activity related to climate change and health in New England, but it is concentrated in a small number of locations. Opportunities exist to improve access to education on this topic and increase involvement of health professional associations.
Keywords: climate change; health education; organized medicine; physician assistant; public health.
38. Arpin E, Gauffin K, Kerr M, Hjern A, Mashford-Pringle A, Barros A, Rajmil L, Choonara I, Spencer N. Climate Change and Child Health Inequality: A Review of Reviews. Int J Environ Res Public Health. 2021 Oct 17;18(20):10896. doi: 10.3390/ijerph182010896. PMID: 34682662; PMCID: PMC8535343.
Abstract
There is growing evidence on the observed and expected consequences of climate change on population health worldwide. There is limited understanding of its consequences for child health inequalities, between and within countries. To examine these consequences and categorize the state of knowledge in this area, we conducted a review of reviews indexed in five databases (Medline, Embase, Web of Science, PsycInfo, Sociological Abstracts). Reviews that reported the effect of climate change on child health inequalities between low- and high-income children, within or between countries (high- vs low-middle-income countries; HICs and LMICs), were included. Twenty-three reviews, published between 2007 and January 2021, were included for full-text analyses. Using thematic synthesis, we identified strong descriptive, but limited quantitative, evidence that climate change exacerbates child health inequalities. Explanatory mechanisms relating climate change to child health inequalities were proposed in some reviews; for example, children in LMICs are more susceptible to the consequences of climate change than children in HICs due to limited structural and economic resources. Geographic and intergenerational inequalities emerged as additional themes from the review. Further research with an equity focus should address the effects of climate change on adolescents/youth, mental health and inequalities within countries.
Keywords: children; climate change; global health; health inequality; scoping review.
39. Heaney E, Hunter L, Clulow A, Bowles D, Vardoulakis S. Efficacy of Communication Techniques and Health Outcomes of Bushfire Smoke Exposure: A Scoping Review. Int J Environ Res Public Health. 2021 Oct 16;18(20):10889. doi: 10.3390/ijerph182010889. PMID: 34682636; PMCID: PMC8536189.
Abstract
Public health officials communicate the relevant risks of bushfire smoke exposure and associated health protection measures to affected populations. Increasing global bushfire incidence in the context of climate change motivated this scoping review. English-language publications related to adverse health outcomes following bushfire smoke exposure and publications relating to communication during natural disasters were included. Bushfire smoke events potentially increase healthcare contact, especially presentations triggered by respiratory illness. At-risk populations include those with underlying cardiorespiratory disease, elderly, paediatric, pregnant persons, and First Nations people. We found that social media, television, and radio are among the most common information sources utilised in bushfire smoke events. Message style, content, and method of delivery can directly influence message uptake and behaviour modification. Age, rurality, and geographical location influence information source preferences. Culturally and linguistically diverse groups and those with hearing, vision, and mobility-related disabilities may benefit from targeted health recommendations. This review emphasises the health effects of bushfire smoke exposure and related communication recommendations during and after bushfire smoke events. Additional investigation may further clarify the health effects of bushfire smoke exposure and efficacy of related health messaging, particularly in at-risk populations. Quantitative comparison of communication methods may yield more specific recommendations for future bushfire smoke events.
Keywords: air pollution; bushfire; communication; environmental health literacy; media; public health; smoke; wildfire.
40. Yang Q, Yang D, Li P, Liang S, Zhang Z. A Bibliometric and Visual Analysis of Global Community Resilience Research. Int J Environ Res Public Health. 2021 Oct 15;18(20):10857. doi: 10.3390/ijerph182010857. PMID: 34682602; PMCID: PMC8535544.
Abstract
Resilience is an important issue in urban development, and community resilience (CR) is the most typical representative in building urban resilience, which has become the forefront of international resilience research. This paper presents a bibliometric and visual analysis of community resilience research collected from the WoS Core Collection database over the past two decades. H-index, citation frequency, centrality and starting year were adopted to analyze the research objects by bibliometric tools including CiteSpace, VOSviewer, and Gephi. The national and institutional characteristics of macro-geographical distribution and the characteristics of disciplines, journals, authors, and author cooperation of micro-knowledge network distribution were revealed. Finally, the potential research directions of community resilience in the future were discussed. The results show that there are three stages in community resilience research. Seven intellectual bases constitute the research background for community resilience, including social capital mechanism, the evolution of resilience knowledge, earthquake resistance and disaster mitigation, substance abuse, resilient development in rural communities, resilience-building in the least-developed countries, and emergency preparedness. Our analysis shows that the hottest community resilience research topics are the concept of resilience, climate resilience, the social capital mechanism, macro-environment and disaster-reduction policies, and an evaluation index system for community resilience.
41. Semenza JC, Paz S. Climate change and infectious disease in Europe: Impact, projection and adaptation. Lancet Reg Health Eur. 2021 Oct;9:100230. doi: 10.1016/j.lanepe.2021.100230. Epub 2021 Oct 7. PMID: 34664039; PMCID: PMC8513157.
Abstract
Europeans are not only exposed to direct effects from climate change, but also vulnerable to indirect effects from infectious disease, many of which are climate sensitive, which is of concern because of their epidemic potential. Climatic conditions have facilitated vector-borne disease outbreaks like chikungunya, dengue, and West Nile fever and have contributed to a geographic range expansion of tick vectors that transmit Lyme disease and tick-borne encephalitis. Extreme precipitation events have caused waterborne outbreaks and longer summer seasons have contributed to increases in foodborne diseases. Under the Green Deal, The European Union aims to support climate change health policy, in order to be better prepared for the next health security threat, particularly in the aftermath of the traumatic COVID-19 experience. To bolster this policy process we discuss climate change-related hazards, exposures and vulnerabilities to infectious disease and describe observed impacts, projected risks, with policy entry points for adaptation to reduce these risks or avoid them altogether.
42. Semenza JC. Lateral public health: Advancing systemic resilience to climate change. Lancet Reg Health Eur. 2021 Oct;9:100231. doi: 10.1016/j.lanepe.2021.100231. Epub 2021 Oct 7. PMID: 34642677; PMCID: PMC8495299.
43. Destoumieux-Garzón D, Matthies-Wiesler F, Bierne N, Binot A, Boissier J, Devouge A, Garric J, Gruetzmacher K, Grunau C, Guégan JF, Hurtrez-Boussès S, Huss A, Morand S, Palmer C, Sarigiannis D, Vermeulen R, Barouki R. Getting out of crises: Environmental, social-ecological and evolutionary research is needed to avoid future risks of pandemics. Environ Int. 2021 Oct 8;158:106915. doi: 10.1016/j.envint.2021.106915. Epub ahead of print. PMID: 34634622; PMCID: PMC8500703.
Abstract
The implementation of One Health/EcoHealth/Planetary Health approaches has been identified as key (i) to address the strong interconnections between risk for pandemics, climate change and biodiversity loss and (ii) to develop and implement solutions to these interlinked crises. As a response to the multiple calls from scientists on that subject, we have here proposed seven long-term research questions regarding COVID-19 and emerging infectious diseases (EIDs) that are based on effective integration of environmental, ecological, evolutionary, and social sciences to better anticipate and mitigate EIDs. Research needs cover the social ecology of infectious disease agents, their evolution, the determinants of susceptibility of humans and animals to infections, and the human and ecological factors accelerating infectious disease emergence. For comprehensive investigation, they include the development of nature-based solutions to interlinked global planetary crises, addressing ethical and philosophical questions regarding the relationship of humans to nature and regarding transformative changes to safeguard the environment and human health. In support of this research, we propose the implementation of innovative multidisciplinary facilities embedded in social ecosystems locally: ecological health observatories and living laboratories. This work was carried out in the frame of the European Community project HERA (www.HERAresearchEU.eu), which aims to set priorities for an environment, climate and health research agenda in the European Union by adopting a systemic approach in the face of global environmental change.
Keywords: Biodiversity loss; Climate change; Ecology; Emerging infectious disease; Evolution; Nature-based solutions.
44. Bertrand C, Pascal M, Médina S. Do we know enough to quantify the impact of urban green spaces on mortality? An analysis of the current knowledge. Public Health. 2021 Nov;200:91-98. doi: 10.1016/j.puhe.2021.09.015. Epub 2021 Oct 25. PMID: 34710719.
Abstract
Objectives: The addition of green spaces (GS) in cities is perceived as an efficient solution to combat climate change and biodiversity loss while also improving human health. Quantitative health impact assessment (QHIA) is a powerful tool to assess the health benefits of GS and support policy-making decisions. In France, a preliminary analysis of the literature led to the decision of developing guidance for QHIA applied to GS and mortality. This paper focuses on the choice of exposure-response functions (ERF) for those QHIA.
Study design: Literature review and analysis of the key steps of QHIA.
Methods: Articles providing ERF for all-cause, cardiovascular and respiratory mortality in relation to GS were identified through a literature review and ranked based on a quality score. ERF from the articles with the highest scores was pooled in meta-analyses.
Results: In total, 13 ERF were selected for all-cause mortality, 10 for cardiovascular mortality and 5 for respiratory mortality. Meta-risk for a 0.1 increase in the normalised differential vegetation index were, 0.96 (95% confidence interval [CI] 0.94; 0.97), 0.98 (95% CI 0.96; 0.99) and 0.97 (95% CI 0.92; 1.02) for all-cause, cardiovascular and respiratory mortality, respectively.
Conclusions: While current knowledge makes it possible to use QHIA on GS and mortality, interdisciplinary research is still needed to clarify the shape of the relationship and its temporality and to assess exposure in a meaningful way for decision-making.
45. Yang BY, Zhao T, Hu LX, Browning MHEM, Heinrich J, Dharmage SC, Jalaludin B, Knibbs LD, Liu XX, Luo YN, James P, Li S, Huang WZ, Chen G, Zeng XW, Hu LW, Yu Y, Dong GH. Greenspace and human health: An umbrella review. Innovation (N Y). 2021 Sep 24;2(4):100164. doi: 10.1016/j.xinn.2021.100164. PMID: 34622241; PMCID: PMC8479545.
Abstract
Multiple systematic reviews on greenspace and health outcomes exist, but the overall evidence base remains unclear. Therefore, we performed an umbrella review to collect and appraise all relevant systematic reviews of epidemiological studies on greenness exposure and health. We searched PubMed, Embase, and Web of Science from inception to June 28, 2021, and screened references of relevant articles. Systematic reviews with or without meta-analyses of epidemiological studies that examined the associations of greenness with any health outcome were included. Two independent investigators performed study selection and data extraction. We also evaluated the methodological quality of the included systematic reviews using the "Assessing the Methodological Quality of Systematic Reviews 2" checklist. A total of 40 systematic reviews and meta-analyses were included, of which most were cross-sectional studies conducted in high-income countries. Greenspace exposure was estimated with various objective and subjective parameters. Beneficial associations of greenspace with all-cause and stroke-specific mortality, CVD morbidity, cardiometabolic factors, mental health, low birth weight, physical activity, sleep quality, and urban crime were observed. No consistent associations between greenspace and other health outcomes (e.g., cancers) were observed. Most of the included systematic reviews and meta-analyses had one or more limitations in methodology. Our findings provide supportive evidence regarding the beneficial effects of greenspace exposure on some aspects of human health. However, the credibility of such evidence was compromised by methodological limitations. Better performed systematic reviews and meta-analyses as well as longitudinal designed primary studies are needed to validate this conclusion.
Keywords: greenspace; human health; systematic review; umbrella review; vegetation.
46. ong S, Bambrick H, Beggs PJ, Chen L, Hu Y, Ma W, Steffen W, Tan J. Current and future threats to human health in the Anthropocene. Environ Int. 2021 Sep 25;158:106892. doi: 10.1016/j.envint.2021.106892. Epub ahead of print. PMID: 34583096.
Abstract
It has been widely recognised that the threats to human health from global environmental changes (GECs) are increasing in the Anthropocene epoch, and urgent actions are required to tackle these pressing challenges. A scoping review was conducted to provide an overview of the nine planetary boundaries and the threats to population health posed by human activities that are exceeding these boundaries in the Anthropocene. The research progress and key knowledge gaps were identified in this emerging field. Over the past three decades, there has been a great deal of research progress on health risks from climate change, land-use change and urbanisation, biodiversity loss and other GECs. However, several significant challenges remain, including the misperception of the relationship between human and nature; assessment of the compounding risks of GECs; strategies to reduce and prevent the potential health impacts of GECs; and uncertainties in fulfilling the commitments to the Paris Agreement. Confronting these challenges will require rigorous scientific research that is well-coordinated across different disciplines and various sectors. It is imperative for the international community to work together to develop informed policies to avert crises and ensure a safe and sustainable planet for the present and future generations.
Keywords: Anthropocene; Health; Scoping review; Threats.
47. Goldman RH, Zajac L, Geller RJ, Miller MD. Developing and implementing core competencies in children's environmental health for students, trainees and healthcare providers: a narrative review. BMC Med Educ. 2021 Sep 24;21(1):503. doi: 10.1186/s12909-021-02921-3. PMID: 34560874; PMCID: PMC8464086.
Abstract
Knowledge of the health impacts of environmental exposures (such as pollution disasters, poor air quality, water contamination, climate change) on children's health has dramatically increased in the past 40 years. The World Health Organization (WHO) estimated that 23% of all deaths worldwide were attributable to the environment, and 26% of deaths in children less than 5 years old could be prevented with removal of environmental risks factors. Yet, little has permeated medical education, leaving pediatric providers ill equipped to address these issues. To address this gap, members from the Pediatric Environmental Health Specialty Units, a United States nationwide network of academically affiliated experts who have created numerous environmental health educational materials and programs, have identified fifteen core environmental health (EH) competencies needed by health care providers to enable them to effectively address environmental health concerns. These competencies can serve as the foundation for the development and implementation of relevant educational programs. The core EH competencies are based upon these foundational elements: 1) Definition of "children's environmental health" that describes how environmental exposures (positive and negative) in early life influence the health and development in childhood and across the entire human life span 2) Children are not "little adults" and so have unique vulnerabilities to environmental hazards; 3) Environmental health inequities exist, causing some children to have a disproportionate amount of unhealthy exposures and consequently a greater risk of adverse effects; 4) Climate change will translate to numerous adverse health effects that will particularly affect children worldwide. In this article, the authors describe the core environmental health competencies and provide resources, online tools, strategies, and examples targeted to all levels of training and practice to better enable leaders and educators to bring this important content to the forefront.
Keywords: Climate change; Competencies; Environmental health; Environmental justice; Environmental social determinates of health; Health disparities; Medical education; Pediatric environmental health.
48. Orantes C, Olano CG, Akram SM. Chronic Interstitial Nephritis in Agricultural Communities (CINAC). 2021 Sep 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 34283425.
CINAC is a new form of chronic kidney disease (CKD) with its own etiopathogenesis; not related to other well-known causes of CKD such as diabetes, hypertension, and glomerulopathies. However, the incidence and prevalence of CINAC have reached epidemic proportions. CINAC affects predominantly young men, occasionally women and adolescents in Central America, Sri Lanka, and other tropical countries.
This form of CKD of nontraditional causes has been reported from several world regions and has similar clinical and epidemiological characteristics. It is known by a variety of names. In Central America, the disease was named “Meso-American Nephropathy” (MeN), whereas in Sri Lanka, “CKD of unknown etiology” (CKDu) was the preferred terminology. The term chronic interstitial nephritis in agricultural communities (CINAC) was proposed to describe both entities.
CINAC affects people working in the agricultural sectors of these regions, which are described as CINAC endemic areas.
The socio-economic and occupational determinants such as poverty, exposure to toxic agrochemicals, and hot tropical climates correlate with clinical characteristics that help make the diagnosis. The disease most frequently occurs in men and affects women, children, and adolescents who live in these farming communities. In endemic regions, CINAC is noted even in those who do not work in agriculture.
In fact, according to The Pan American Health Organization, Nicaragua and El Salvador have CKD-related estimated mortality rates of 42.8 and 41.6 deaths per 100,000, respectively, which is fourfold higher than any other country. In El Salvador, CKD is the second most common cause of death in young men, with males affected at three times the rate of females.
49. Koch CA, Sharda P, Patel J, Gubbi S, Bansal R, Bartel MJ. Climate Change and Obesity. Horm Metab Res. 2021 Sep;53(9):575-587. doi: 10.1055/a-1533-2861. Epub 2021 Sep 8. PMID: 34496408; PMCID: PMC8440046.
Abstract
Global warming and the rising prevalence of obesity are well described challenges of current mankind. Most recently, the COVID-19 pandemic arose as a new challenge. We here attempt to delineate their relationship with each other from our perspective. Global greenhouse gas emissions from the burning of fossil fuels have exponentially increased since 1950. The main contributors to such greenhouse gas emissions are manufacturing and construction, transport, residential, commercial, agriculture, and land use change and forestry, combined with an increasing global population growth from 1 billion in 1800 to 7.8 billion in 2020 along with rising obesity rates since the 1980s. The current Covid-19 pandemic has caused some decline in greenhouse gas emissions by limiting mobility globally via repetitive lockdowns. Following multiple lockdowns, there was further increase in obesity in wealthier populations, malnutrition from hunger in poor populations and death from severe infection with Covid-19 and its virus variants. There is a bidirectional relationship between adiposity and global warming. With rising atmospheric air temperatures, people typically will have less adaptive thermogenesis and become less physically active, while they are producing a higher carbon footprint. To reduce obesity rates, one should be willing to learn more about the environmental impact, how to minimize consumption of energy generating carbon dioxide and other greenhouse gas emissions, and to reduce food waste. Diets lower in meat such as a Mediterranean diet, have been estimated to reduce greenhouse gas emissions by 72%, land use by 58%, and energy consumption by 52%.
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