At Ground Zero—Emergency Units in Low‐ and Middle‐Income Countries Building Resilience for Climate Change and Human Health

Abstract

Climate change is harming human health with disproportionate impacts on vulnerable populations. As extreme weather events are projected to increase, acute care services-the primary access point for patients during a disaster-will be increasingly stressed. The authors seek to assess current efforts to build resilience against climate-related events in emergency units in low-and middle-income countries (LMICs). A systematic review was done using Ovid Medline, Embase, Cochrane, and Global Health (CABI), combining LMICs, climate change, emergency care, and resilience terms. LMIC emergency units serve as a ground zero during times of disaster, yet countries have a myriad of emergency care systems, with varied stages of development and a limited capacity for surges in demand. There was little evidence and a paucity of standardization methods for building healthcare facility/system resilience. This study provides policy recommendations for strengthening LMIC emergency care systems to protect lives and advance health equity.

Climate change and emergency care in Africa: A scoping review

“…Furthermore, there is a gap in the types of climate-related disasters (droughts, fires, dust) as well as the countries represented in the included literature. Results align with other studies [19] , [20] , [21] , [22] , [23] , [24] , which necessitate urgent attention to preparing health systems and health care professionals in low- and middle-income countries (LMICs) to address the health effects of climate change.…”

The structural and social determinants of Alzheimer's disease related dementias

“…In addition, policies promulgated to address air pollution and climate change (e.g., congestion charging and low‐emission vehicles) can result in differential access to affordable housing and transportation 21 . The ensuing climate change has also engendered new public health and humanitarian crises by wiping out crops, reducing economic gross domestic product, igniting inflation, and increasing the risk of and morbidity and mortality from infectious (e.g., vibrio) and noncommunicable diseases (e.g., pulmonary and cardiovascular conditions) 22 . Residents in low‐ to middle‐income countries and marginalized US communities are often too under‐resourced to respond to acute crises, which, in combination with other adverse exposures from the macrosystem, exacerbates the chronic stressors the residents endure.…”

“…21 The ensuing climate change has also engendered new public health and humanitarian crises by wiping out crops, reducing economic gross domestic product, igniting inflation, and increasing the risk of and morbidity and mortality from infectious (e.g., vibrio) and noncommunicable diseases (e.g., pulmonary and cardiovascular conditions). 22 Residents in low-to middle-income countries and marginalized US communities are often too under-resourced to respond to acute crises, which, in combination with other adverse exposures from the macrosystem, exacerbates the chronic stressors the residents endure. Marginalized and vulnerable populations already experience health inequities, and, with exosystem exposures like climate change, they face multidimensional deprivation.…”

Only One Earth: Global health and climate justice on world environment day and beyond

“…Krieger (2020, p. 8) urges public health and medical institutions, agencies, and organizations “to foster links between work supporting democratic governance, tackling the climate crisis, and health equity.” Maibach et al (2021) and Lauriola et al (2021) underscore the individual and collective roles of health professionals and organizations in advancing equitable climate and health policies locally and globally. Rublee et al (2021) systematically review efforts to build resilience against climate‐related events in emergency units in low‐ and middle‐income countries (LMICs) and provide policy recommendations for strengthening these emergency care systems to protect lives and advance health equity. Relatedly, medical equipment use itself is estimated to comprise 72% of the global healthcare climate footprint, including waste and greenhouse emissions.…”