Oregon Health & Science University, Portland, OR, USA.
American Board of Family Medicine, Washington, DC, USA.
J Prim Care Community Health. 2023 Jan-Dec;14:21501319231170585. doi: 10.1177/21501319231170585.
As recent extreme weather events demonstrate, climate change presents unprecedented and increasing health risks, disproportionately so for disadvantaged communities in the U.S. already experiencing health disparities. As patients in these frontline communities live through extreme weather events, socioeconomic and health stressors are compounded; thus, their healthcare teams will need tools to provide precision ecologic medicine approaches to their care. Many primary care teams are taking actionable steps to bring community-level socioeconomic data ("community vital signs") into electronic medical records, to facilitate tailoring care based on a given patient's circumstances. This work can be extended to include environmental risk data, thus equipping healthcare teams with an awareness of clinical and community vital signs and making them better positioned to mitigate climate impacts on health. For example, if healthcare teams can easily identify patients who have multiple chronic conditions and live in an urban heat island, they can proactively arrange to "prescribe" an air conditioner, heat pump, and/or air purifier. Or, when a severe storm/heat event/poor air quality event is predicted, they can take preemptive steps to get help to patients at high medical and socioeconomic risk, rather than waiting for them to arrive in the emergency department. Advances in health information technologies now make it technically feasible to integrate a wealth of publicly-available community-level data into EMRs. Efforts to bring this contextual data into clinical settings must be accelerated to equip healthcare teams to provide precision ecologic medicine interventions to their patients.
正如最近的极端天气事件所表明的那样，气候变化带来了前所未有的、日益增加的健康风险，而美国本已处于弱势地位、面临健康差距的社区受到的影响尤为严重。在这些前沿社区，当患者经历极端天气事件时，社会经济和健康压力会加剧；因此，他们的医疗团队将需要工具来为他们提供精准的生态医学方法。许多初级保健团队正在采取切实可行的步骤，将社区层面的社会经济数据（“社区生命体征”）纳入电子病历，以便根据特定患者的情况定制护理。这项工作可以扩展到包括环境风险数据，从而使医疗团队能够了解临床和社区生命体征，并使他们能够更好地减轻气候变化对健康的影响。例如，如果医疗团队能够轻松识别出患有多种慢性疾病且居住在城市热岛的患者，他们可以主动安排“开处方”安装空调、热泵和/或空气净化器。或者，当预测到严重风暴/高温事件/空气质量差事件时，他们可以采取预防措施，帮助高医疗和社会经济风险的患者，而不是等待他们到达急诊室。健康信息技术的进步现在使得将大量公共社区层面的数据整合到电子病历中在技术上成为可行的。必须加快将这些背景数据引入临床环境的努力，以使医疗团队能够为患者提供精准的生态医学干预措施。
