Department of Health Policy and Management, Risk Sciences and Public Policy Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Int J Environ Res Public Health. 2019 Sep 4;16(18):3232. doi: 10.3390/ijerph16183232.
Policy action in the coming decade will be crucial to achieving globally agreed upon goals to decarbonize the economy and build resilience to a warmer, more extreme climate. Public health has an essential role in climate planning and action: "Co-benefits" to health help underpin greenhouse gas reduction strategies, while safeguarding health-particularly of the most vulnerable-is a frontline local adaptation goal. Using the structure of the core functions and essential services (CFES), we reviewed the literature documenting the evolution of public health's role in climate change action since the 2009 launch of the US CDC Climate and Health Program. We found that the public health response to climate change has been promising in the area of assessment (monitoring climate hazards, diagnosing health status, assessing vulnerability); mixed in the area of policy development (mobilizing partnerships, mitigation and adaptation activities); and relatively weak in assurance (communication, workforce development and evaluation). We suggest that the CFES model remains important, but is not aligned with three concepts-governance, implementation and adjustment-that have taken on increasing importance. Adding these concepts to the model can help ensure that public health fulfills its potential as a proactive partner fully integrated into climate policy planning and action in the coming decade.
在未来十年,政策行动对于实现全球商定的经济脱碳目标和增强对更温暖、更极端气候的抵御能力至关重要。公共卫生在气候规划和行动中发挥着重要作用:“共同效益”有助于支持温室气体减排战略,而保护健康——特别是最脆弱群体的健康——则是地方适应的首要目标。我们利用核心职能和基本服务(CFES)的结构,回顾了文献,记录了自美国疾病控制与预防中心(CDC)气候与健康计划于 2009 年启动以来,公共卫生在气候变化行动中角色的演变。我们发现,公共卫生部门在评估领域(监测气候危害、诊断健康状况、评估脆弱性)对气候变化的应对是有希望的;在政策制定方面(动员伙伴关系、减排和适应活动)则喜忧参半;在保证方面(沟通、劳动力发展和评估)则相对薄弱。我们认为,CFES 模型仍然很重要,但与三个概念——治理、实施和调整——不匹配,这些概念在过去十年中变得越来越重要。将这些概念纳入模型可以帮助确保公共卫生发挥其作为积极伙伴的潜力,全面融入未来十年的气候政策规划和行动。
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