Associate National Centre for Epidemiology and Population Health, Building 62, Australian National University, Canberra 0200, Australia.
Postgrad Med J. 2010 Apr;86(1014):230-4. doi: 10.1136/pgmj.2009.082727.
Climatic and ecological change threaten human health globally. Manifestations include lost species, vanishing glaciers and more frequent heavy rain. In the second half of this century, accelerating sea level rise is likely to cause crop loss, and population dislocation. These problems may be magnified by dysfunctional human responses, including conflict. The population health consequences of these events can be classified as primary, secondary and tertiary. Primary signs include the acute and chronic stress of heat waves, and trauma from increased bush fires and flooding. Secondary signs are indirect, such as an altered distribution of arthropod vectors, intermediate hosts and pathogens that will produce changes in the epidemiology of many infectious diseases. More severe future health consequences of climate change are classified here as tertiary effects. If moderate or severe climate change scenarios prove accurate then these manifestations will occur over large areas, and could include famine, war and significant population displacement. Such effects would threaten governance and health. The health professions must respond to these challenges, especially the task of recognising and seeking to minimise tertiary health consequences. The gap between what we know and what we need to know concerning these issues can be narrowed by a new field of medical practice. The framework for this emerging discipline includes climate change, ecology and global health. Combined, these dimensions may be called ecomedicine. Actions to reduce individual emissions, to promote active transport (with its 'co-benefit' of preventing chronic disease), and involvement in group action to protect the environment and to prevent war, informed by understanding of the health of individual patients and populations, will be central to the practice of ecomedicine.
气候变化和生态变化在全球范围内威胁着人类健康。其表现包括物种灭绝、冰川消失以及暴雨频发等。在本世纪下半叶，海平面加速上升可能导致作物歉收和人口流离失所。人类应对措施的失灵，包括冲突，可能会使这些问题进一步恶化。这些事件对人口健康的影响可以分为原发性、继发性和 tertiary 性。原发性症状包括热浪引起的急性和慢性压力以及因森林火灾和洪水增加而导致的创伤。继发性症状是间接的，例如节肢动物传播媒介、中间宿主和病原体的分布改变，这些改变将导致许多传染病的流行病学发生变化。这里将气候变化的更严重未来健康后果归类为 tertiary 性影响。如果中度或重度气候变化情景被证明是准确的，那么这些表现将在大面积地区发生，可能包括饥荒、战争和大量人口流离失所。这些影响将威胁到治理和健康。医疗专业人员必须应对这些挑战，特别是要认识到并尽量减少 tertiary 性健康后果。我们对这些问题的了解和需要了解之间的差距可以通过一个新的医学实践领域来缩小。这一新兴学科的框架包括气候变化、生态学和全球健康。这些维度结合在一起，可能被称为生态医学。减少个人排放、促进积极的交通方式（及其预防慢性疾病的“共同益处”）以及参与保护环境和预防战争的集体行动，这些行动的基础是了解个体患者和人群的健康状况，这将是生态医学实践的核心。
