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Environment, climate change and health for practitioners and actors guiding policy change

Integrating Sustainability into Healthcare Quality Improvement Education

Sustainable Perioperative Care

Greenhouse Gas Emissions Estimation in Canadian Healthcare

Communicating on Climate Change and Health: Toolkit for health professionals

Business Action for Adaptation & Resilience

Non-Economic Loss and Damage (NELD): policy gaps and recommendations

Global Cooling Watch 2023

Plan de acción de salud y cambio climático de la provincia de Neuquén

2023 State of Climate Services – Health

Environmental Stewardship: An implementation guide for boards, management, and clinical staffL meeting long term care standards and beyond

Climate Resilience for Frontline Clinics Toolkit

Introduction: Climate change and the legal, ethical, and health issues facing healthcare and public health systems

Integrating planetary health into healthcare: A document analysis

BACKGROUND: Anthropogenic climate change poses a major health risk to humankind. The healthcare sector both contributes to climate change and is vulnerable to its impacts. Healthcare’s greenhouse gas emissions are primarily derived from its supply chain: the production, transport, and disposal of goods. METHODS: Document analysis was used to investigate the workplace policies of one large, Western Canadian healthcare organization. Policies that indicated how employees should engage with resources were reviewed through the lens of environmentally responsible practice and planetary health. Content and thematic analysis were applied. RESULTS: Four themes were identified: procurement of resources, resource utilization, resource conservation, and waste management. CONCLUSION: There was little evidence of environmental or climate impact consideration within the organization’s policies. IMPLICATIONS: Healthcare organizations could benefit from integrating a planetary health perspective into their policies to deliver healthcare that considers the health and safety of both humans and the climate.

Impact of heatwave intensity using excess heat factor on emergency department presentations and related healthcare costs in Adelaide, South Australia

Background: The health impacts of heatwaves are a growing public health concern with the frequency, intensity, and duration of heatwaves increasing with global climate change. However, little is known about the healthcare costs and the attributable morbidity associated with heatwaves Objective This study aims to examine the relationship between heatwaves and costs of emergency department (ED) presentations, and to quantify heat-attributable burden during the warm seasons of 2014-2017, in Adelaide, South Australia. Methods: Daily data on ED presentations and associated costs for the period 2014-2017 were obtained from the South Australian Department of Health and Wellbeing. Heatwave intensity was determined using the excess heat factor (EHF) index, obtained from the Australian Bureau of Meteorology. A distributed lag non-linear model (DLNM) was used to quantify the cumulative risk of heatwave-intensity over a lag of 0-7 days on ED presentations and costs. Effects of heatwaves were estimated relative to no heatwave. The number of ED presentations and costs attributable to heatwaves was calculated separately for two EHF severity categories (low-intensity and severe/extreme heatwaves). Subgroup analyses by disease-diagnosis groups and age categories were performed. Results: For most disease diagnosis and age categories, low-intensity and severe heatwaves were associated with higher rates of ED presentations and costs. We estimated a total of 1161 (95% empirical confidence interval (eCI): 342, 1944) heatwave-attributable all-cause ED presentations and associated healthcare costs (thousands) of AU $1020.3 (95% eCI: 224.9, 1804.7) during the warm seasons of 2014-2017. The heat-related illness was the disease category contributing most to ED presentations and costs. Age groups 0-14 and >= 65 years were most susceptible to heat. Conclusions: Heatwaves produced a statistically significant case-load and cost burden to the ED. Developing tailored interventions for the most vulnerable populations may help reduce the health impacts of heatwaves and to minimise the cost burden to the healthcare system. (C) 2021 Elsevier B.V. All rights reserved.

Overview of the strengths and challenges associated with healthcare service rendered in the first 10 days after the great flood in northern Iran, 2019

Background: Iran is a disaster-prone country, and many flood events occur in its provinces annually. The unprecedented amount of rainfall in the northern region of Iran (from March 17 to 22, 2019) led to flash flooding of the Golestan Province. Objectives: This study assessed the challenges and strengths of health-related needs in the first 10 days after the great flood in Golestan; via interviews with experts. Methods: This cross-sectional and qualitative study was carried out in Gonbad-e-Kavoos, Anbar Alum, Aq-Qala, Simin Shahr, and Gomishan cities of the flood-hit province of Golestan from March 21, to April 13 in 2019. The data were collected using the researcher’s field observations and interviews with 26 experts and policymakers. Results: The findings were categorized into 10 main groups namely mental health, environmental health, health education, maternal, infant, and child health, nutrition, epidemics, drugs, mobile hospitals, non-communicable diseases, and management. Environmental health issues were faced with a wide range of challenges. Conclusion: Due to the insufficient development of many health infrastructures in underdeveloped and developing countries, health policymakers and disaster management experts should collaborate before and after the disaster to detect and resolve the flaws. This could help reduce health problems and challenges when a natural disaster occurs, particularly by diminishing the number of morbidities and mortalities.

Modelling geographical accessibility to support disaster response and rehabilitation of a healthcare system: An impact analysis of cyclones Idai and Kenneth in Mozambique

OBJECTIVES: Modelling and assessing the loss of geographical accessibility is key to support disaster response and rehabilitation of the healthcare system. The aim of this study was therefore to estimate postdisaster travel times to functional health facilities and analyse losses in accessibility coverage after Cyclones Idai and Kenneth in Mozambique in 2019. SETTING: We modelled travel time of vulnerable population to the nearest functional health facility in two cyclone-affected regions in Mozambique. Modelling was done using AccessMod V.5.6.30, where roads, rivers, lakes, flood extent, topography and land cover datasets were overlaid with health facility coordinates and high-resolution population data to obtain accessibility coverage estimates under different travel scenarios. OUTCOME MEASURES: Travel time to functional health facilities and accessibility coverage estimates were used to identify spatial differences between predisaster and postdisaster geographical accessibility. RESULTS: We found that accessibility coverage decreased in the cyclone-affected districts, as a result of reduced travel speeds, barriers to movement, road constraints and non-functional health facilities. In Idai-affected districts, accessibility coverage decreased from 78.8% to 52.5%, implying that 136?941 children under 5 years of age were no longer able to reach the nearest facility within 2?hours travel time. In Kenneth-affected districts, accessibility coverage decreased from 82.2% to 71.5%, corresponding to 14?330 children under 5 years of age having to travel >2?hours to reach the nearest facility. Damage to transport networks and reduced travel speeds resulted in the most substantial accessibility coverage losses in both Idai-affected and Kenneth-affected districts. CONCLUSIONS: Postdisaster accessibility modelling can increase our understanding of spatial differences in geographical access to care in the direct aftermath of a disaster and can inform targeting and prioritisation of limited resources. Our results reflect opportunities for integrating accessibility modelling in early disaster response, and to inform discussions on health system recovery, mitigation and preparedness.

Impact of recurrent floods on the utilization of maternal and newborn healthcare in Bangladesh

OBJECTIVE: Floods are one of the most common types of disasters in Bangladesh and lead to direct and indirect impacts on health. The aim of the study was to assess the impact of floods on Maternal and Newborn Healthcare (MNH) utilization in Bangladesh between the years 2011 and 2014. METHODS: We used variables from the Bangladesh Demographic and Health Survey 2014 data and georeferenced data of floods between 2011 and 2014 from the Emergency Events Database. Multivariate logistic regression was used to determine whether the flood-affected exposures were significant in predicting differences in MNH utilization. RESULTS: The odds for the received antenatal care by skilled providers, institutional deliveries, deliveries by c-section, and postnatal care of the babies were significantly lower (Unadjusted OR?=?0.81, 0.88, 0.83, and 0.82 respectively; P?

Impact of extreme weather conditions on healthcare provision in urban Ghana

Extreme weather events pose significant threats to urban health in low- and middle-income countries, particularly in sub-Saharan Africa where there are systemic health challenges. This paper investigates health system vulnerabilities associated with flooding and extreme heat, along with strategies for resilience building by service providers and community members, in Accra and Tamale, Ghana. We employed field observations, rainfall records, temperature measurements, and semi-structured interviews in health facilities within selected areas of both cities. Results indicate that poor building conditions, unstable power supply, poor sanitation and hygiene, and the built environment reduce access to healthcare for residents of poor urban areas. Health facilities are sited in low-lying areas with poor drainage systems and can be 6 °C warmer at night than reported by official records from nearby weather stations. This is due to a combination of greater thermal inertia of the buildings and the urban heat island effect. Flooding and extreme heat interact with socioeconomic conditions to impact physical infrastructure and disrupt community health as well as health facility operations. Community members and health facilities make infrastructural and operational adjustments to reduce extreme weather stress and improve healthcare provision to clients. These measures include: mobilisation of residents to clear rubbish and unclog drains; elevating equipment to protect it from floods; improving ventilation during extreme heat; and using alternative power sources for emergency surgery and storage during outages. Stakeholders recommend additional actions to manage flood and heat impacts on health in their cities, such as, improving the capacity of drainage systems to carry floodwaters, and routine temperature monitoring to better manage heat in health facilities. Finally, more timely and targeted information systems and emergency response plans are required to ensure preparedness for extreme weather events in urban areas.

Impact of Hurricane Harvey on healthcare utilization and emergency department operations

INTRODUCTION: Hurricanes have increased in severity over the past 35 years, and climate change has led to an increased frequency of catastrophic flooding. The impact of floods on emergency department (ED) operations and patient health has not been well studied. We sought to detail challenges and lessons learned from the severe weather event caused by Hurricane Harvey in Houston, Texas, in August 2017. METHODS: This report combines narrative data from interviews with retrospective data on patient volumes, mode of arrival, and ED lengths of stay (LOS). We compared the five-week peri-storm period for the 2017 hurricane to similar periods in 2015 and 2016. RESULTS: For five days, flooding limited access to the hospital, with a consequent negative impact on provider staffing availability, disposition and transfer processes, and resource consumption. Interruption of patient transfer capabilities threatened patient safety, but flexibility of operations prevented poor outcomes. The total ED patient census for the study period decreased in 2017 (7062 patients) compared to 2015 (7665 patients) and 2016 (7770) patients). Over the five-week study period, the arrival-by-ambulance rate was 12.45% in 2017 compared to 10.1% in 2016 (p < 0.0001) and 13.7% in 2015 (p < 0.0001). The median ED length of stay (LOS) in minutes for admitted patients was 976 minutes in 2015 (p < 0.0001) compared to 723 minutes in 2016 and 591 in 2017 (p < 0.0001). For discharged patients, median ED LOS was 336 minutes in 2016 compared to 356 in 2015 (p < 0.0001) and 261 in 2017 (p < 0.0001). Median boarding time for admitted ED patients was 284 minutes in 2016 compared to 470 in 2015 (p < 0.0001) and 234.5 in 2017 (p < 0.001). Water damage resulted in a loss of 133 of 179 inpatient beds (74%). Rapid and dynamic ED process changes were made to share ED beds with admitted patients and to maximize transfers post-flooding to decrease ED boarding times. CONCLUSION: A number of pre-storm preparations could have allowed for smoother and safer ride-out functioning for both hospital personnel and patients. These measures include surplus provisioning of staff and supplies to account for limited facility access. During a disaster, innovative flexibility of both ED and hospital operations may be critical when disposition and transfer capibilities or bedding capacity are compromised.

Health checks during extreme heat events

Protocolo para evaluar la situación del agua, el saneamiento y la higiene en establecimientos de salud con atención a la resiliencia al clima

Training a new generation of professionals to use climate information in public health decision-making

Care provider assessment of thermal state of children in day-care centers

Heatwave lesson plan

WHO Guidance for Climate Resilient and Environmentally Sustainable Health Care Facilities

Managing Heat Risk During the Covid-19 Pandemic

Healthy environments for healthier populations: Why do they matter, and what can we do?

Environmentally sustainable health systems

Operational framework for building climate resilient health systems

Clinical Guidelines on Management of Heat Related Illness at Health Clinic and Emergency and Trauma Department

Heat-Ready: Heatwave awareness, preparedness and adaptive capacity in aged care facilities in three australian states: New South Wales, Queensland and South australia (Final Report)