Division of Environmental Health, and Centre for Environmental and Occupational Health, School of Public Health and Family Medicine, University of Cape Town, Anzio Rd., Observatory 7925, South Africa.
Sci Total Environ. 2020 Jun 20;722:137772. doi: 10.1016/j.scitotenv.2020.137772. Epub 2020 Mar 9.
Research continues to highlight the link between climate change and health outcomes. There is, however, limited evidence in research, policies and in the Sustainable Development Goals (SDGs) about the impact of environmental factors on noncommunicable diseases (NCDs) for people living in urban areas of sub-Saharan Africa (SSA). Important is that 80% of NCDs are taking place in low- and middle-income countries (LMICs) and linked to a third of the deaths in SSA. The question is, what would these statistics look like if environmental risk factors (e.g., pollution, chemicals) for NCDs, linked to climate change, were prevented and controlled. This article presents a framework for understanding climatic pathways' impacts on climate-sensitive NCDs and achieving the SDGs. It further explains how current global mitigation interventions in high income urban settings, with implied health co-benefits for NCD reduction (i.e., promoting use of less polluting vehicles, bicycles, walking, public transport, green spaces), experience major implementation challenges in SSA cities (i.e., too costly, lack of availability, poor road conditions, gender and cultural norms, security problems). Recommendations are made for applying this framework to control climate change impacts on NCDs and achieving the SDGs in SSA cities. These include, support for more research on the climate - NCD nexus, ensuring health professional training includes sustainable health education, and including a focus on climate change and health in primary and secondary school curricula. Further recommendations for addressing climate-sensitive NCDs and urban environmental health towards achieving and sustaining the SDGs, are linked to promoting climate-sensitive and health policies and governance, as well as controlling the influence of advertising. Lastly, improving communication of research findings for policy makers and the public in a manner for informed policy making, and how to comprehend this information to promote the reduction and prevention of NCDs in urban SSA, is key.
研究继续强调气候变化与健康结果之间的联系。然而，在研究、政策和可持续发展目标（SDGs）中，关于环境因素对撒哈拉以南非洲（SSA）城市地区居民的非传染性疾病（NCDs）的影响的证据有限。重要的是，80%的非传染性疾病发生在中低收入国家（LMICs），并与 SSA 三分之一的死亡有关。问题是，如果预防和控制与气候变化有关的非传染性疾病的环境风险因素（例如，污染，化学物质），这些统计数据会是什么样子。本文提出了一个理解气候途径对气候敏感型非传染性疾病的影响并实现可持续发展目标的框架。它进一步解释了目前在高收入城市环境中采取的全球缓解干预措施如何带来非传染性疾病减少的健康共同效益（即，促进使用污染较少的车辆、自行车、步行、公共交通、绿地），在 SSA 城市中面临重大实施挑战（即，成本过高、缺乏可用性、道路条件差、性别和文化规范、安全问题）。建议将该框架应用于控制气候变化对 NCD 的影响并实现 SSA 城市的可持续发展目标。其中包括，支持对气候-NCD 关系进行更多研究，确保健康专业人员的培训包括可持续健康教育，并将气候变化和健康纳入中小学课程。进一步的建议包括，应对气候敏感型非传染性疾病和城市环境卫生问题，以实现和维持可持续发展目标，包括促进气候敏感型和健康政策及治理，以及控制广告的影响。最后，以知情决策的方式改善决策者和公众对研究结果的交流，以及如何理解这些信息以促进撒哈拉以南非洲城市非传染性疾病的减少和预防，是关键。
