It’s hot here this week and it’s interesting to see the heat health warning system being rolled out in real life. Here’s what else caught my eye this month.
Research: Climate impacts and older people
Two studies that caught my eye recently have a demographic in common – older people. One study, published in the International Journal of Environmental Research and Public Health, used a variety of participatory research methods to explore climate adaptation for older people in the city of Porto. It looked at climate change impacts, health and mobility challenges, and found that each research method brought a new perspective. For example, in addition to interviews, researchers used observation of movement in public spaces and ‘go-along’ interviews in green and other public spaces. It's a really interesting study design.
The researchers found that the older adults were concerned about increasing temperatures and extreme weather events, perceiving them as a direct threat to their health and wellbeing as well as reporting limiting their physical activity and social interactions as they avoid outdoor activities in hot weather. The interviewees were keen on local authorities creating more shaded areas, including through tree-planting, and providing more seating in the shade. There's lots of interesting detail about urban planning, public spaces, parks, lighting, hydration points and public toilets.
The second study is a scoping review, looking at existing evidence on the psychological impact of flooding on older adults. The review was conducted by a team based in Bath in the UK, but the papers included in the review were from several high-income countries. Older age is linked to more health conditions and mobility problems and older adults can be more vulnerable to the impact of flooding. The review found that climate-related flooding is associated with depression and post-traumatic stress in older adults. It also showed that poor social support contributes to worse mental health outcomes.
Some papers focused on factors that mitigated poor mental health outcomes. Greater support and a strong sense of community cohesion were associated with lower levels of depression and posttraumatic stress.
Article: Checklist for including planetary health perspective in complex interventions
“When we try to pick out anything by itself, we find it hitched to everything else in the universe.” John Muir
I was reminded of this quote when reading an article in The BMJ this month. A group of authors from the London School of Hygiene and Tropical Medicine (LSHTM) and the University of Victoria in Canada have tackled the knotty problem of designing and evaluating complex interventions for climate and health, where so much is connected.
Building on existing Medical Research Council guidance for complex interventions in public health, they have developed a checklist that adds a planetary health perspective – integrating natural systems and considering larger scales and longer time-frames.
There are so many unintended or extra effects to any intervention – potentially positive and negative – and this is a welcome attempt to support researchers to consider co-benefits, risks and trade-offs in a careful and methodical way.
Report: Climate adaptation in the NHS
Earlier this month, the UK Health Alliance on Climate Change (UKHACC) published a policy report, Building a climate-resilient health system in the UK.
It recognises the current and increasing challenges facing the healthcare system as the climate changes, from extreme weather events including flooding and heatwaves, and changing patterns of disease.
The report sets out seven key recommendations for policy makers, including around funding, infrastructure, workforce and public health, and calls for immediate action.
Dr Mark Harber, special adviser on sustainability at the Royal College of Physicians, said, "Investing in NHS infrastructure to prevent our hospitals from overheating during high temperatures and equipping our workforce to respond to climate-related risks must be prioritised with urgency. Without committed and sustained action, we risk leaving the NHS – and the communities it serves – unprepared for the significant health challenges posed by a changing climate.”
Policy change: Sustainability and England’s 10-year plan for health
A new ten-year plan for the NHS in England is expected any day now.
Of course, the devil will be in the detail, but so far the government has frequently trailed the intention to include three shifts: moving care from hospitals to communities, focusing on prevention rather than just treatment, and moving from analogue to digital.
These three shifts could be so beautifully aligned with the principles of sustainable healthcare. The shifts could be implemented in ways that benefit patients, public finances and the environment, all at the same time. I worked with the Centre for Sustainable Healthcare (CSH) on an article (linked below) explaining the origins of the ten-year plan and mapping existing work in the NHS and at CSH against the three shifts we expect to see in the plan.
“The 10-year plan will set the direction for healthcare in England over the coming decade. The changes the government seeks to bring about could help to ensure the NHS is sustainable for future generations – financially, environmentally and socially – but only if sustainability is a guiding principle throughout the implementation of the plan.” Chris Naylor, Policy Lead, Centre for Sustainable Healthcare
Report: Realistic Medicine – Critical Connections
Scotland’s Chief Medical Officer published their annual report earlier this month and I found it surprising, in a good way. It’s become the norm to hear health and healthcare systems described in terms of innovation and efficiency, targets and waiting lists, but here is a text about healthcare that is full of kindness, connection and purpose. What a treat.
"Empathy and human connection sit at the heart of what it means to be a health and care professional. To care for the planet, is to care for ourselves, our families and our communities; to be proactive in living healthily is not only investing in health for ourselves but contributes also to planetary health. This is the virtuous cycle of mutuality."
One of the five chapters is devoted to exploring planetary health in the Scottish context, touching on resource use, prevention, broader determinants of health and connection with nature.
The report and the approach it reflects is rooted in a broader movement in Scotland referred to as ‘realistic medicine’, which promotes a personalised approach to care, while reducing harm and waste.
Interview: Primary care and climate change
I enjoyed this episode of
, featuring Dr Munro Stewart, a GP in Dundee. In just 24 minutes, it covers all sorts of things related to being an environmentally conscious health professional seeing patients in a busy practice, including flooding, diet, mental health, air pollution, broader determinants of health and health inequalities.Consultations: Nutrition data and heat stability insights
The Alliance for Transformative Action on Climate and Health (ATACH) has shared two international calls for input, both with a deadline of 30th June, so you'll need to be quick if you have something to say!
The first is a call for data to help a team working on the integration of nutrition in climate and health policies. The aim is to put together guidance that will help countries integrate nutrition into their own climate and health policies. If you know of peer-reviewed literature, policy documents or case studies that are relevant to the alignment of nutrition, health and climate goals, the team would love to hear from you.
The second is a survey inviting insights on heat instability or vulnerability of health products to extreme heat. Health products include medicines, devices and equipment. As well as studies and technical reports, real-world examples and personal stories are welcome. There is a follow-up meeting planned for September.
Webinar: Global Action Plan on Climate Change and Health
Back in May, at the 78th World Health Assembly, World Health Organization (WHO) member states adopted the first-ever global action plan on climate change and health. I can only imagine the hard work that goes into getting agreement at that level.
And it’s nothing if not ambitious. The plan aims to guide member states, “in developing climate-resilient, low-carbon health systems; enhancing surveillance and early warning systems; protecting vulnerable populations; and integrating health into climate policy and financing mechanisms”.
If you're intrigued, WHO is hosting a public webinar to talk through the key bits of the plan, implementation steps and opportunities to support action, on 10th July, 2-4pm CET.
Opportunities: Climate and health roles
The Maximising UK Adaptation to Climate Change (MACC) Hub is recruiting four short-term research roles, including one which is focused on health impacts of overheating in prison settings. Apply by 4th July.
The new Centre for Net Positive Health and Climate Solutions at the University of Exeter is recruiting a social science research fellow. Apply by 8th July.
The climate and health team at Wellcome is recruiting a climate finance consultant on a short-term basis. Expressions of interest by 8th July.
The National Institute for Health and Care Research (NIHR) is offering an opportunity to take part in a residential ‘Team Science Camp’ themed around decarbonisation and adaptation of health, social care and research systems. It's open for applications from researchers working in relevant areas. Apply by 9th July.
The Climate-Life-Nexus Initiative at Heidelberg University is recruiting a coordinator and manager, supporting operations and strategic development. Apply by 21st July.
Admin update: Free for all
This publication has been running for almost 18 months. I enjoy the work involved in putting it together and I’ve had lovely feedback from people receiving it. I had hoped it might slowly build an audience of enough paying subscribers to cover some of my time and interviewees’ time too.
Although the overall audience is steadily growing, paid subscriptions have been fairly static. I am so incredibly grateful to my handful of paid subscribers, but I’ve decided to transition to a fully free model. There are some boring international tax issues which cost more to manage than I bring in. And I’m not comfortable putting a paywall on content, when my motivation is all about sharing information.
If you can see a way to pay for my time some other way, do let me know! Otherwise, I will gladly accept the gift of your time reading. In other words, please do not upgrade to paid. You’re wonderful just as you are.
What else is catching my eye?
Here’s what I’m reading / what I saw at the cinema this month / what I’m listening to (hat tip to
)
Isn’t that poetry film lovely? Thanks for reading, and for your work! 💚
Heavily researched does not guarantee correct. Even one erroneous assumption in common renders pages of references, papers and citations useless. CAGW’s GHE contains three such assumptions.
GHE claims without it Earth becomes 33 C cooler, a 255 K, -18 C, ball of ice.
Wrong.
Naked Earth would be much like the Moon, barren, 400 K lit side, 100 K dark.
TFK_bams09 heat balance graphic uses the same 63 twice violating GAAP and calculating out of thin air a 396 BB/333 “back”/63 net GHE radiative forcing loop violating LoT 1 & 2.
Wrong.
Likewise, the ubiquitous plethora of clones.
GHE requires Earth to radiate “extra” energy as a BB.
Wrong.
A BB requires all energy leaving the system to do so by radiation. Per TFK_bams09 60% leaves by kinetic modes, i.e. conduction, convection, advection and latent rendering BB impossible.
GHE is bogus and CAGW a scam so alarmists must resort to fear mongering, lies, lawsuits, censorship and violence.