De Sario Manuela, de'Donato Francesca, Michelozzi Paola
Dipartimento di Epidemiologia del Servizio Sanitario Regionale del Lazio, ASL Roma 1, Roma;
Dipartimento di Epidemiologia del Servizio Sanitario Regionale del Lazio, ASL Roma 1, Roma.
Epidemiol Prev. 2025 Mar-Jun;49(2-3):8-29. doi: 10.19191/EP25.2-3.S1.037.
public health aims to promote a health-centred approach in all policies, even in adaptation and mitigation policies for climate change.
to provide a critical summary on legislations, policies and case studies at international, national and local level and to assess the implementation of the "health lens", in support of researchers and workers on environment and health.
document review on legislations, policies and case studies, focusing on mitigation of urban health island and sustainable mobility.
a policy and legislation review was carried out from institutional websites at European and local level. Sustainable urban mobility plans (SUMP) and energy and climate action plans (SECAP) were retrieved for the cities included in the Climactions project (Genoa, Turin, Bologna, Rome, Bari, Palermo) from local authorities' websites. Best practices of urban heat island mitigation and sustainable mobility were searched from European platforms (Climate adapt, Urban mobility observatory -- ELTIS, EIT Urban Mobility) to obtain a critical picture of adaptation and mitigation options in cities.
the review shows a large number of legislations, plans, and programmes on adaptation and mitigation both at European and Italian level with a gap between planned and actually implemented actions also due to the lack of dedicated economic resources. There is also an inequal level of implementation among Italian regions, with some criticalities, for example, in the citizen participatory process within the strategic environmental assessment of SUMPs, SECAPs, and adaptation plans. At the local level, in the last decade, several best practices of urban heat island mitigation and sustainable mobility were experienced in different sectors including new urban green space infrastructures, albedo enhancement measures, car-pooling apps, incentives to active mobility, temporary streets liberation, and a combination of measures within adaptation plans such as London Climate Action Plan and Barcelona Superblock programme. Only few measures were health centred embedding public health into urban planning (e.g., the London plan based on the 'healthy streets' approach) suggesting health benefits for the population.
the recent increase in regulations and policies at European and national level is not paralleled by real progresses in climate actions, despite the constant growth of annual emissions. Therefore, there is the need to accelerate the fossil fuel emission mitigation while promoting adaptation to be ready to counteract actual and future climate related risks. Health workers such as paediatricians, family doctors, epidemiologists can advocate the transition and support the citizens and youth engagement in climate-related decision making.
公共卫生旨在倡导在所有政策中都采取以健康为中心的方法，即便在气候变化适应与减缓政策中亦是如此。
对国际、国家和地方层面的立法、政策及案例研究进行批判性总结，并评估“健康视角”的实施情况，以支持环境与健康领域的研究人员及工作者。
对立法、政策及案例研究进行文献综述，重点关注城市健康岛的缓解及可持续交通。
从欧洲和地方层面的机构网站开展政策与立法综述。从地方当局网站获取了“气候行动”项目（热那亚、都灵、博洛尼亚、罗马、巴里、巴勒莫）所涵盖城市的可持续城市交通规划（SUMP）以及能源与气候行动计划（SECAP）。从欧洲平台（气候适应、城市交通观测站——ELTIS、欧洲创新与技术研究院城市交通）搜索城市热岛缓解及可持续交通的最佳实践，以全面了解城市的适应与缓解方案。
综述表明，欧洲和意大利层面在适应与缓解方面有大量的立法、规划和项目，但由于缺乏专项经济资源，计划行动与实际实施之间存在差距。意大利各地区的实施水平也不均衡，例如在SUMP、SECAP及适应计划的战略环境评估中的公民参与过程存在一些关键问题。在地方层面，过去十年里，不同领域出现了一些城市热岛缓解及可持续交通的最佳实践，包括新的城市绿地基础设施、反照率增强措施、拼车应用程序、鼓励积极出行、临时街道开放以及伦敦气候行动计划和巴塞罗那超级街区项目等适应计划中的综合措施。只有少数措施是以健康为中心，将公共卫生纳入城市规划（例如基于“健康街道”方法的伦敦规划），显示出对民众的健康益处。
尽管年排放量持续增长，但欧洲和国家层面近期法规和政策的增加并未伴随气候行动的实际进展。因此，有必要在促进适应以应对当前和未来与气候相关风险的同时，加速减少化石燃料排放。儿科医生、家庭医生、流行病学家等卫生工作者可以倡导这种转变，并支持公民和青年参与与气候相关的决策。
