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气候变化下热浪和登革热健康风险的地方行动:中国南方基层医疗保健专业人员的策略和障碍。

Local actions to health risks of heatwaves and dengue fever under climate change: Strategies and barriers among primary healthcare professionals in southern China.

机构信息

School of Public Health, Sun Yat-sen University, Guangzhou, China.

Department of Public Health, La Trobe University, Melbourne, Australia.

出版信息

Environ Res. 2020 Aug;187:109688. doi: 10.1016/j.envres.2020.109688. Epub 2020 May 20.

Abstract

BACKGROUND

Climate change and extreme weather poses significant threats to community health, which need to be addressed by local health workforce. This study investigated the perceptions of primary healthcare professionals in Southern China on individual and institutional strategies for actions on health impacts of climate change and the related barriers.

METHODS

A mixed methodological approach was adopted, involving a cross-sectional questionnaire survey of 733 primary healthcare professionals (including medical doctors, nurses, public health practitioners, allied health workers and managers) selected through a multistage cluster randomized sampling strategy, and in-depth interviews of 25 key informants in Guangdong Province, China. The questionnaire survey investigated the perceptions of respondents on the health impacts of climate change and the individual and institutional actions that need to be taken in response to climate change. Multivariate logistic regression models were established to determine sociodemographic factors associated with the perceptions. The interviews tapped into coping strategies and perceived barriers in primary health care to adapt to tackle challenges of climate change. Contents analyses were performed to extract important themes.

RESULTS AND CONCLUSION

The majority (64%) of respondents agreed that climate change is happening, but only 53.6% believed in its human causes. Heat waves and infectious diseases were highly recognized as health problems associated with climate change. There was a strong consensus on the need to strengthen individual and institutional capacities in response to health impacts of climate change. The respondents believed that it is important to educate the public, take active efforts to control infectious vectors, and pay increased attention to the health care of vulnerable populations. The lack of funding and limited local workforce capacity is a major barrier for taking actions. Climate change should be integrated into primary health care development through sustainable governmental funding and resource support.

摘要

背景

气候变化和极端天气对社区健康构成重大威胁,需要当地卫生工作者来应对。本研究调查了中国南方基层医疗专业人员对个人和机构应对气候变化对健康影响的行动策略及其相关障碍的看法。

方法

采用混合方法研究,包括通过多阶段聚类随机抽样策略选择的 733 名基层医疗专业人员(包括医生、护士、公共卫生从业人员、辅助卫生工作者和管理人员)的横断面问卷调查,以及在中国广东省的 25 名关键信息人员的深入访谈。问卷调查调查了受访者对气候变化对健康的影响以及需要采取的个人和机构应对气候变化的行动的看法。建立了多变量逻辑回归模型,以确定与看法相关的社会人口因素。访谈深入了解基层医疗适应气候变化挑战的应对策略和感知障碍。进行内容分析以提取重要主题。

结果和结论

大多数(64%)受访者认为气候变化正在发生,但只有 53.6%相信其人为原因。热浪和传染病被高度认为是与气候变化有关的健康问题。对于需要加强个人和机构应对气候变化对健康影响的能力,存在强烈共识。受访者认为,教育公众、积极努力控制传染病媒介以及更加关注弱势人群的医疗保健非常重要。缺乏资金和有限的当地劳动力能力是采取行动的主要障碍。应通过可持续的政府资金和资源支持,将气候变化纳入基层医疗保健发展。

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