climate change and public health pdf

Climate Change And Public Health Pdf

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Climate change, together with other natural and human-made health stressors, influences human health and disease in numerous ways. Some existing health threats will intensify and new health threats will emerge. Not everyone is equally at risk.

Global Climate Change and Public Health

Metrics details. Climate change is taking a toll on human health, and some leaders in the public health community have urged their colleagues to give voice to its health implications. Previous research has shown that Americans are only dimly aware of the health implications of climate change, yet the literature on issue framing suggests that providing a novel frame - such as human health - may be potentially useful in enhancing public engagement.

We conducted an exploratory study in the United States of people's reactions to a public health-framed short essay on climate change.

We tested the hypothesis that five of the six audience segments would respond positively to the essay on both dependent measures. There was clear evidence that two of the five segments responded positively to the public health essay, and mixed evidence that two other responded positively. There was limited evidence that the fifth segment responded positively.

Post-hoc analysis showed that five of the six segments responded more positively to information about the health benefits associated with mitigation-related policy actions than to information about the health risks of climate change. Presentations about climate change that encourage people to consider its human health relevance appear likely to provide many Americans with a useful and engaging new frame of reference. Information about the potential health benefits of specific mitigation-related policy actions appears to be particularly compelling.

We believe that the public health community has an important perspective to share about climate change, a perspective that makes the problem more personally relevant, significant, and understandable to members of the public.

Peer Review reports. Climate change is already taking a toll on human health in the United States [ 1 ] and other nations worldwide [ 2 ]. Unless greenhouse gas emissions worldwide are sharply curtailed - and significant actions taken to help communities adapt to changes in their climate that are unavoidable - the human toll of climate change is likely to become dramatically worse over the next several decades and beyond [ 3 ]. Globally, the human health impacts of climate change will continue to differentially affect the world's poorest nations, where populations endemically suffer myriad health burdens associated with extreme poverty that are being exacerbated by the changing climate.

As stated in a recent British Medical Journal editorial, failure of the world's nations to successfully curtail emissions will likely lead to a "global health catastrophe" [ 4 ]. These population segments disproportionately include racial, ethnic, and indigenous minorities [ 5 ]. While legislation to reduce U. The agency found that global warming poses public health risks - including increased morbidity and mortality - due to declining air quality, rising temperatures, increased frequency of extreme weather events, and higher incidences of food- and water-borne pathogens and allergens.

This finding comes as a relatively small group of public health professionals are working rapidly to better comprehend and quantify the nature and magnitude of these threats to human health and wellbeing [ 6 ]. This new but rapidly advancing public health focus has received minimal news media attention, even at internationally leading news organizations such as the New York Times [unpublished data].

It is not surprising therefore that the public also has yet to fully comprehend the public health implications of climate change. About half of American survey respondents, for example, selected "don't know" rather than "none," "hundreds," "thousands," or "millions" when asked the estimated number of current and future i. An earlier survey of Americans [ 10 ] demonstrated that most people see climate change as a geographically and temporally distant threat to the non-human environment.

Notably, not a single survey respondent freely associated climate change as representing a threat to people. Similarly, few Canadians, without prompting, can name any specific human health threat linked to climate change impacts in their country [ 8 ]. Cognitive research over the past several decades has shown that how people "frame" an issue - i. The polling data cited above [ 7 — 9 ] suggests that the dominant mental frame used by most members of the public to organize their conceptions about climate change is that of "climate change as an environmental problem.

This focus is also susceptible to a dominant counter frame that the best solution is to continue to grow the economy - paying for adaptive measures in the future when, theoretically, society will be wealthier and better able to afford them - rather than focus on the root causes of the environmental problem [ 13 ]. This economic frame likely leaves the public ambivalent about policy action and works to the advantage of industries that are reluctant to reduce their carbon intensity. Indeed, it is precisely the lack of a countervailing populist movement on climate change that has made policy solutions so difficult to enact [ 13 , 14 ].

Significant efforts have been made over the past several years by public health organizations to raise awareness of the public health implications of climate change and prepare the public health workforce to respond, although as noted above, it is not clear the extent to which public health professionals, journalists, or most importantly, the public and policy makers have taken notice.

In the United States, National Public Health Week was themed "Climate Change: Our Health in the Balance," the Centers for Disease Control and Prevention created a Climate Change and Public Health program, and several professional associations assessed the public health system's readiness to respond to the emerging threat [ 15 — 17 ].

Globally, World Health Day was themed "Protecting Health from Climate Change," and the World Health Organization has developed a climate change and health work plan, the first objective of which is "raising awareness of the effects of climate change on health, in order to prompt action for public health measures" [ 18 ].

Several prominent medical journals have released special issues on climate change and health [ 19 — 21 ], and these and other medical journals [ 4 ] have issued strongly worded editorials urging health professionals to give voice to the health implications of climate change. An important assumption in these calls to action is that there may be considerable value in introducing a public health frame into the ongoing public - and policy - dialogue about climate change.

While there is indeed solid theoretical basis for this assumption, to the best of our knowledge there is not yet empirical evidence to support the validity of the assumption [ 22 ].

The purpose of this study therefore was to explore how American adults respond to an essay about climate change framed as a public health issue. Our hypothesis was that a public health-framed explanation of climate change would be perceived as useful and personally relevant by readers, with the exception of members of one small segment of Americans who dismiss the notion that human-induced climate change is happening.

We used two dependent measures in this hypothesis: a composite score based on respondent reactions to each sentence in the essay, and the overall valence of respondents' general comments made after reading the essay. Our study builds on previous research that identified six distinct segments of Americans, termed Global Warming's Six Americas [ 7 ].

The four segments in the middle of the continuum are likely to benefit most from a reframing of climate change as a human health problem because, to a greater or lesser degree, they are not yet sure that they fully understand the issue and are still, if motivated to do so, relatively open to learning about new perspectives.

Global Warming's Six Americas. A nationally representative sample of American adults classified into six unique audience segments based on their climate change-related beliefs, behaviors and policy preferences.

Between May and August , 74 adults were recruited to participate in semi-structured in-depth elicitation interviews that lasted an average of 43 minutes ranging from 16 to minutes and included the presentation of a public health framed essay on climate change. The recruitment process was designed to yield completed interviews with a demographically and geographically diverse group of at least 10 people from each of the previously identified "Six Americas" [ 7 ].

Four respondents were dropped from this study due to incomplete data, leaving a sample size of Audience segment status i. To achieve demographic diversity in the sample, we recruited an approximately balanced number of men and women, and an approximately balanced number of younger 18 to 30 , middle-aged 31 to 50 , and older 51 and older adults see Table 1. To achieve geographic diversity, we recruited participants in one of two ways.

Capitol, the Smithsonian Museum buildings, and the Lincoln Memorial ; and shoppers were interviewed at an "outlet" mall i. The outlet mall is more than an hour driving distance outside of Washington, DC and attracts shoppers from Maryland, Pennsylvania, and West Virginia, as well as visitors from further away who are driving the interstate freeway. The remaining study participants were recruited via email from among participants to a nationally representative survey that we conducted in Fall [ 7 ].

They were interviewed subsequently by telephone, after being mailed a copy of the test "public health essay" - described below - in a sealed envelope marked "do not open until asked to do so by the interviewer. George Mason University Human Subjects Review Board provided approval for the study protocol reference ; all potential respondents received written consent information prior to participation. The 70 study participants resided in 29 states.

Using U. In , the geographic distribution of the overall U. The majority of the interview was devoted to open-ended questions intended to establish the respondent's emotions, attitudes, beliefs, knowledge and behavior relative to global warming's causes and consequences. For example, respective open-ended questions asked alternatively if, how, and for whom global warming was a problem; how global warming is caused; if and how global warming can be stopped or limited; and what, if anything, an individual could do to help limit global warming.

Toward the end of the interview, respondents were asked to read "a brief essay about global warming" see Appendix 1 , which was designed to frame climate change as a human health issue.

Respondents were also given a green and a pink highlighting pen and asked to "use the green highlighter pen to mark any portions of the essay that you feel are especially clear or helpful, and use the pink highlighter pen to mark any portions of the essay that are particularly confusing or unhelpful. When respondents finished the reading, they were asked to describe in an open-ended format their "general reaction to this essay.

For each portion of the essay they marked in green, they were subsequently asked: "What about each of these sentences was especially clear or helpful to you? Based on this review, we iteratively developed eight thematic categories that captured the range of statements made by respondents. Table 2 defines and describe these themes. Two graduate student coders were then trained to code each statement into one of the thematic categories.

The coders were also instructed to assess the overall valence of each respondent's statements - the first of our dependent measures - rating them as: -1 entirely negative comments ; 0 mixed, including both positive and negative comments ; or 1 entirely positive comments. Following standard content analysis procedures, we tested inter-coder agreement on approximately 50 statements, making sure that a full range of possible types of coding decisions were required of the coders.

To assess reliability, we used Krippendorff's alpha [ 24 , 25 ], a conservative measure that corrects for chance agreement among coders; a K-alpha of. For 7 of the 8 thematic categories, we achieved a reliability of. After establishing reliability, the two coders then went on to categorize the rest of the remaining statements from the sample of respondents. Composite scores were created for each of the four sections of the essay - the opening, the threat section, the benefit section, and the conclusion - by summing the sentence-specific scores in the section and dividing by the number of sentences.

A composite score for the entire essay - the second of the dependent measures in our hypothesis - was created by summing the sentence scores across each segment and dividing by the number of respondents per segment.

Population estimates, which can be taken solely as preliminary indicators given the non-probabilistic nature of our sampling, were estimated by weighting the mean values for each of the six segments according to its prevalence in the U. To test the between-segment differences in our dependent measures - overall reactions to the essay i. To test if the median response to the essay on each dependent measure was greater than zero i. Lastly, for both dependent measures, we used the Wilcoxon signed rank test to test our hypothesis that five of the six segments the Dismissive being the one exception would respond positively to the essay; the null hypothesis was that the median score for each of the five segments did not differ from zero.

The Wilcoxon signed rank test is appropriate for small sample sizes and non-normal distributions, both of which are the case for at least some segments in our data. Average valence of respondents' general essay comments. The mean valence of respondent comments when asked their general reactions to the public health essay by audience segment and by a national population estimate. Composite essay scores by segment. Scores reflect respondent average values by segment for the difference between the number of times each of 18 sentences were marked "especially clear or helpful" and "especially confusing or unhelpful" with a full range of possible values between 18 and Post-hoc - after examining the visualized data see Figures 4 , 5 and 6 - we decided to test for two possible main effects in the data.

To examine the possibility that the essay's later focus on the public health benefits of mitigation-related policy actions was seen by respondents as clearer and more useful than the essay's earlier focus on public health-related threats, we calculated the difference between the re-scaled by a factor of 10 average response to both the benefit and the threat sections and then used the Wilcoxon signed rank test to test, by segment, whether the median of these differences was greater than zero.

We then evaluated the overall main effect of the essay - across all segments - using the weighted t-test on the differences with weights corresponding to the frequencies of the segments in the population. Essay evaluations by sentence: Alarmed, Concerned and Cautious segments. Sentence-specific evaluations of the public health essay by respondents in the Alarmed, Concerned and Cautious segments and by a national population estimate.

The national population estimate was created by weighting the values for each of the six segments according to their relative proportion of American adults. Essay evaluations by sentence: Disengaged, Doubtful and Dismissive segments. Sentence-specific evaluations of the public health essay by respondents in the Disengaged, Doubtful and Dismissive segments and by a national population estimate.

Essay evaluations by section opening, threat, benefits, closing. Average section-specific evaluations of the public health essay by respondents in each of the six audience segments and by a national population estimate. Note: Scores reflect the difference between the number of sentences within each section marked by a respondent as "especially clear or helpful" and those marked as "especially confusing or unhelpful" with those values averaged across the number of sentences per section and rescaled by a factor of The national population estimate was created by weighting the mean values for each of the six segments according to their relative proportion of American adults.

Lastly, to examine for the possibility that the concluding framing section of the essay was perceived by respondents as clearer and more useful than the opening framing section, we calculated the difference between the re-scaled average response to both the opening and the concluding sections and then used the Wilcoxon signed rank test to test, by segment, whether the median of these differences was greater than zero.

We then evaluated the overall main effect - across all segments - using the weighted t-test on the differences with weights corresponding to the frequencies of the segments in the population.

The average valence scores - on a scale of 1 to -1 - spanned from. The average sentence-specific composite scores - on a scale of 18 to - ranged from 9.

Reframing climate change as a public health issue: an exploratory study of public reactions

The current debate about energy policy in Australia is firmly centred on energy costs and reliability. These are prominent issues for public health, given the morbidity and mortality related to heatwaves and cold weather, especially in disadvantaged communities. However, this policy discourse neglects the more significant health effects arising from global climate change GCC associated with fossil energy use. GCC is potentially the defining challenge to public health in the 21st century. Life on earth is dependent on naturally occurring greenhouse gases GHGs , especially methane and carbon dioxide CO 2 , which are modulated by a complex carbon cycle. Predictions about the future effects of GCC are more difficult, given the intricacies of local climates, the complex interrelationships of changes and the varying scenarios of GHG emission.

Part of the Respiratory Medicine book series RM, volume 7. Pulmonary physicians and scientists currently have minimal capacity to respond to climate change and its impacts on health. The extent to which climate change influences the prevalence and incidence of respiratory morbidity remains largely undefined. However, evidence is increasing that climate change does drive respiratory disease onset and exacerbation as a result of increased ambient and indoor air pollution, desertification, heat stress, wildfires, and the geographic and temporal spread of pollens, molds and infectious agents. Preliminary research has revealed climate change to have potentially direct and indirect adverse impacts on respiratory health. Published studies have linked climate change to increases in respiratory disease, including the following: changing pollen releases impacting asthma and allergic rhinitis, heat waves causing critical care-related diseases, climate driven air pollution increases, exacerbating asthma and COPD, desertification increasing particulate matter PM exposures, and climate related changes in food and water security impacting infectious respiratory disease through malnutrition pneumonia, upper respiratory infections. High level ozone and ozone exposure has been linked to idiopathic pulmonary fibrosis, lung cancer, and acute lower respiratory infection.

How Climate Change Impacts Health

Metrics details. Climate change is taking a toll on human health, and some leaders in the public health community have urged their colleagues to give voice to its health implications. Previous research has shown that Americans are only dimly aware of the health implications of climate change, yet the literature on issue framing suggests that providing a novel frame - such as human health - may be potentially useful in enhancing public engagement.

Table of contents

Climate change is affecting the health of Americans. As the climate continues to change, the risks to human health will grow, exacerbating existing health threats and creating new public health challenges. Percent who rarely or never discuss climate change with family and friends [3] : Percent of people who said they themselves had given the issue little or no thought [4] : Number of days of extreme heat, with temperatures above the 98th percentile of computed maximum temperature for locations by By

Not a MyNAP member yet? Register for a free account to start saving and receiving special member only perks. E xtreme heat can be fatal, and hurricanes and tornadoes cause injuries and damage infrastructure. Air pollution can be linked to respiratory illness, and drought can lead to malnutrition. These are just a few examples of how weather and climate can influence human health. Climate change has the potential to affect any health outcome that is sensitive to environmental conditions.

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