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Author: Solange M. Gould Publisher: ISBN: Category : Languages : en Pages : 131
Book Description
Climate change is a significant public health danger, with a disproportionate impact on low-income and communities of color that threatens to increase health inequities. Many important social determinants of health are at stake in California climate change policy-making and planning, and the distribution of these will further impact health inequities. Not only are these communities the most vulnerable to future health impacts due to the cumulative impacts of unequal environmental exposures and social stressors, they are also least likely to be represented in climate change decision-making processes. Therefore, it is imperative that public health and social equity advocates participate in climate change policy-making that protects and enhances the health and well-being of vulnerable communities. Regions have emerged as important policy-making arenas for both climate change and public health in California, because many drivers of climate change are also social determinants of health (e.g. land use, housing, and transportation planning); these play out regionally and are under regional governmental authority. However, the public health sector is not engaged adequately with climate change planning given the magnitude of risks and opportunities inherent for health. Examination of where public health and equity partners have engaged in regional climate change planning and policy-making may offer lessons for how to change the drivers of health inequities and climate change through this work. This dissertation examines why the public health sector in California is not more engaged with climate change work and regional scale planning given current threats to and opportunities for health, and whether and how public health and social equity stakeholders' participation in climate change solutions and regional scale planning can improve health and inequities outcomes and decision-making processes. The overarching goal of this research was to inform efforts to increase public health work on climate change and regional-scale planning, strengthen partnerships between public health, social equity, and climate change stakeholders, and formulate strategies that address climate change and health equity. The first chapter of this dissertation was conducted in conjunction with a study at the Center for Climate Change and Health at the Public Health Institute, where we conducted semi-structured in-depth interviews (n=113) with public health and climate change professionals and advocates. I performed structured coding and conducted inductive-deductive thematic analysis within and across respondent groups. I found that individual-level barriers to public health engagement with climate change include perceptions that climate change is not urgent, immediate, or solvable, and insufficient understanding of public health impacts, connections, and roles. Institutional barriers include a lack of public health capacity, authority, and leadership due to risk aversion and politicization of climate change; a narrow framework for public health practice; and professional compartmentalization. Opportunities include integrating climate change into current public health practice; providing support for climate solutions with health co-benefits; and communicating, engaging and mobilizing impacted communities and public health professionals. In the second chapter, I conducted two case studies of Sustainable Communities Strategies planning to achieve greenhouse gas reduction targets through integrated regional land use and transportation planning under California Senate Bill 375 (San Francisco Bay Area and Southern California). I used in-depth interviews (n=50) with SCS planning participants, public document review, and participant observation. I analyzed interviews using thematic analysis in an iterative inductive-deductive process. In both regions, climate change planning was a major lever for increasing the language, consideration, funding, and measurement of health impacts into the SCS plans. Public health's analytic skills and social determinants of health conceptual framework were valuable for both regional planning agencies and equity groups. Political context influenced the priority concerns, framing, and outcomes. Desire to improve public health was influential in both of these environments. In the Bay Area, a health equity frame promoted regional solutions that can improve health, equity, and climate change. In SCAG, a public health frame increased awareness, language, and future funding for active transportation. Public health was a less contested and commonly held value across diverse political jurisdictions that may be an entry point for future discussions of equity and climate change. In both regions, reform of regional governance processes was pursued to sustain institutionalization of health and equity concerns and improve regional democracy. I discuss implications and recommendations for engaging in multi-system integrated regional planning that can simultaneously improve climate change, health, and equity. In the third chapter, I analyze the same data as a case for understanding regional-scale public health, social equity, and regional planning staff efforts to slow climate change and improve social determinants of health and social equity. In both regions multi-year SCS planning processes, public health and equity stakeholder engagement was instrumental in getting health goals, targets, and indicators into plans. In the Bay Area, advocacy efforts yielded health and equity language in policies and implementation funding guidelines and changes to the basic governance structure. In SCAG, advocacy efforts yielded significant future funding for active transportation and more metrics to monitor the health and equity impacts of planning. Participants in the SCS planning process described their motivations for engaging at the regional level, the barriers to effective regional planning, the achievements of their engagement, and recommendations for improving future efforts. In the interviews, three main themes emerged related to the opportunities and challenges of working at the regional scale: (1) Building regional identity as a foundation for advancing health and equity; (2) The importance of governance structures for health and equity, and the need for regional governance reform; (3) The prospects and barriers of building regional coalitions both within public health networks and with regional equity partners. I discuss implications and recommendations for public health's engagement with regional planning agencies, creation of coalitions, and reforming of regional governance structures to sustain better consideration of climate change, health, and equity.
Author: Solange M. Gould Publisher: ISBN: Category : Languages : en Pages : 131
Book Description
Climate change is a significant public health danger, with a disproportionate impact on low-income and communities of color that threatens to increase health inequities. Many important social determinants of health are at stake in California climate change policy-making and planning, and the distribution of these will further impact health inequities. Not only are these communities the most vulnerable to future health impacts due to the cumulative impacts of unequal environmental exposures and social stressors, they are also least likely to be represented in climate change decision-making processes. Therefore, it is imperative that public health and social equity advocates participate in climate change policy-making that protects and enhances the health and well-being of vulnerable communities. Regions have emerged as important policy-making arenas for both climate change and public health in California, because many drivers of climate change are also social determinants of health (e.g. land use, housing, and transportation planning); these play out regionally and are under regional governmental authority. However, the public health sector is not engaged adequately with climate change planning given the magnitude of risks and opportunities inherent for health. Examination of where public health and equity partners have engaged in regional climate change planning and policy-making may offer lessons for how to change the drivers of health inequities and climate change through this work. This dissertation examines why the public health sector in California is not more engaged with climate change work and regional scale planning given current threats to and opportunities for health, and whether and how public health and social equity stakeholders' participation in climate change solutions and regional scale planning can improve health and inequities outcomes and decision-making processes. The overarching goal of this research was to inform efforts to increase public health work on climate change and regional-scale planning, strengthen partnerships between public health, social equity, and climate change stakeholders, and formulate strategies that address climate change and health equity. The first chapter of this dissertation was conducted in conjunction with a study at the Center for Climate Change and Health at the Public Health Institute, where we conducted semi-structured in-depth interviews (n=113) with public health and climate change professionals and advocates. I performed structured coding and conducted inductive-deductive thematic analysis within and across respondent groups. I found that individual-level barriers to public health engagement with climate change include perceptions that climate change is not urgent, immediate, or solvable, and insufficient understanding of public health impacts, connections, and roles. Institutional barriers include a lack of public health capacity, authority, and leadership due to risk aversion and politicization of climate change; a narrow framework for public health practice; and professional compartmentalization. Opportunities include integrating climate change into current public health practice; providing support for climate solutions with health co-benefits; and communicating, engaging and mobilizing impacted communities and public health professionals. In the second chapter, I conducted two case studies of Sustainable Communities Strategies planning to achieve greenhouse gas reduction targets through integrated regional land use and transportation planning under California Senate Bill 375 (San Francisco Bay Area and Southern California). I used in-depth interviews (n=50) with SCS planning participants, public document review, and participant observation. I analyzed interviews using thematic analysis in an iterative inductive-deductive process. In both regions, climate change planning was a major lever for increasing the language, consideration, funding, and measurement of health impacts into the SCS plans. Public health's analytic skills and social determinants of health conceptual framework were valuable for both regional planning agencies and equity groups. Political context influenced the priority concerns, framing, and outcomes. Desire to improve public health was influential in both of these environments. In the Bay Area, a health equity frame promoted regional solutions that can improve health, equity, and climate change. In SCAG, a public health frame increased awareness, language, and future funding for active transportation. Public health was a less contested and commonly held value across diverse political jurisdictions that may be an entry point for future discussions of equity and climate change. In both regions, reform of regional governance processes was pursued to sustain institutionalization of health and equity concerns and improve regional democracy. I discuss implications and recommendations for engaging in multi-system integrated regional planning that can simultaneously improve climate change, health, and equity. In the third chapter, I analyze the same data as a case for understanding regional-scale public health, social equity, and regional planning staff efforts to slow climate change and improve social determinants of health and social equity. In both regions multi-year SCS planning processes, public health and equity stakeholder engagement was instrumental in getting health goals, targets, and indicators into plans. In the Bay Area, advocacy efforts yielded health and equity language in policies and implementation funding guidelines and changes to the basic governance structure. In SCAG, advocacy efforts yielded significant future funding for active transportation and more metrics to monitor the health and equity impacts of planning. Participants in the SCS planning process described their motivations for engaging at the regional level, the barriers to effective regional planning, the achievements of their engagement, and recommendations for improving future efforts. In the interviews, three main themes emerged related to the opportunities and challenges of working at the regional scale: (1) Building regional identity as a foundation for advancing health and equity; (2) The importance of governance structures for health and equity, and the need for regional governance reform; (3) The prospects and barriers of building regional coalitions both within public health networks and with regional equity partners. I discuss implications and recommendations for public health's engagement with regional planning agencies, creation of coalitions, and reforming of regional governance structures to sustain better consideration of climate change, health, and equity.
Author: Tamanna Rahman Publisher: ISBN: Category : Languages : en Pages : 266
Book Description
It is widely recognized that climate change poses a serious challenge to the field of public health due to the changing frequency and severity of impacts faced by local communities, however, addressing climate change provides the opportunity to implement solutions that build healthy, equitable, and climate-resilient communities. The public health sector works closely with local governments and community partners to address health inequities of environmental change by developing and implementing policies and programs that prioritize health, and often these activities align with climate mitigation and adaptation measures. Local health departments (LHDs) are often at the front lines working with communities disproportionately affected by climate change, therefore the public health sector has a critical role to play in advancing and mobilizing support for health-based climate change strategies that improve health outcomes, address inequities, and reduce greenhouse gas emissions. California's strategy to reinvest cap-and-trade funds into climate change mitigation and adaptation activities, known as the California Climate Investments (CCI), offers a significant opportunity for the public health sector to integrate health consideration into local climate mitigation and adaptation efforts, however, there has been limited public health sector engagement at the local level. The work presented here evaluates the CCI through a public health practice lens to identify opportunities to increase LHD engagement in the CCI at the local level to ensure that climate action strategies integrate public health consideration and promote environmental health equity. The first section provides a critical review of the literature on climate change vulnerability assessment frameworks to examine the potential climate change-related health impacts within the context of Los Angeles County to inform climate change adaptation planning. The next sections focus on the CCI to identify opportunities to increase LHD engagement and integrate public health consideration in the implementation of CCI funded projects. First, selected CCI program guidelines and publicly available documents were coded and analyzed to examine the programmatic alignment between CCI program requirements and foundational LHD activities to identify opportunities for LHDs to engage and actively support partner organizations. Next, interviews were conducted with selected LHD personnel and key respondents to identify best practices of LHD engagement in urban greening and community forestry initiatives funded through the CCI. Document analysis and interviews demonstrated that there are opportunities for LHD engagement, however, barriers exist. Lack of information about LHD eligible to apply, limited requirements for LHD engagement, and insufficient awareness of LHDs about the CCI limit public health sector engagement at the local level. Recommendations to address these barriers include increasing outreach to LHDs, establishing a more robust role for LHDs, increasing the climate adaptation component of the CCI programs to provide opportunity for greater LHD engagement. California's approach to implementing the cap-and-trade program and reinvesting auction proceeds in local climate action initiatives to benefit vulnerable communities provides a model for other jurisdictions. As other states look to cap-and-trade, it is critical that California pushes innovation and sets the example of how to effectively integrate public health sector engagement in all levels of climate action to reduce greenhouse gas emissions, help communities adapt to climate change, and advance environmental health equity so that communities can thrive and become climate-resilient.
Author: National Academies of Sciences, Engineering, and Medicine Publisher: National Academies Press ISBN: 0309452961 Category : Medical Languages : en Pages : 583
Book Description
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Author: US Global Change Research Program Publisher: Simon and Schuster ISBN: 1510726217 Category : Science Languages : en Pages : 999
Book Description
As global climate change proliferates, so too do the health risks associated with the changing world around us. Called for in the President’s Climate Action Plan and put together by experts from eight different Federal agencies, The Impacts of Climate Change on Human Health: A Scientific Assessment is a comprehensive report on these evolving health risks, including: Temperature-related death and illness Air quality deterioration Impacts of extreme events on human health Vector-borne diseases Climate impacts on water-related Illness Food safety, nutrition, and distribution Mental health and well-being This report summarizes scientific data in a concise and accessible fashion for the general public, providing executive summaries, key takeaways, and full-color diagrams and charts. Learn what health risks face you and your family as a result of global climate change and start preparing now with The Impacts of Climate Change on Human Health.
Author: Nimish Biloria Publisher: Springer Nature ISBN: 303132840X Category : Medical Languages : en Pages : 386
Book Description
This book has a primary focus on inclusions for solutions to problems and not just more on the nature of the current and emerging problems that most other competing titles present. The book is also a true global representation of challenges and opportunities that have been encountered, addressed, and critiqued from a wide variety of contributors rather than academicians per se. In doing so, rather than focusing on techno-centric prowess and associated case studies of the west (as is the case in most competing titles), the book also equally emphasizes upon the vulnerabilities and mitigating solutions being developed and tested in the under-developed and developing nations. Besides this, the book also acquires an ‘Equity’ oriented focus and hints upon sustainable, inclusive modes of shaping our built environment throughout the contributing chapters. The book is also unique in the way it combines the chosen themes to provide a holistic coverage of the broader determinants of urban health and wellbeing, thus being better positioned to address SDG3 within one compact volume. The book also differs from a typical conference proceeding or a non-peer reviewed book since the book’s highly theme specific approach is curated by a scientific peer review committee to carefully maintain diversity of contributions to the book. Cities have a profound power to support or hinder human health and wellbeing in countless ways. Achieving greater health equity has emerged in recent years as a key priority and consideration when designing cities to promote health and wellbeing, although there is a dearth of evidence and practical examples of research translation to guide cities and communities. The book accordingly exemplifies a pluralistic approach to achieving urban health equity which recognises and addresses critical aspects of geography, age, race, background, socioeconomic status, disability, gender etc. With interdisciplinary science clearly pointing to the role of the neighbourhood environment as one of the most important health determinants, this book will undoubtedly lead the next generation of urban health actors to build contextually responsive, equitable, empathic cities to benefit residents around the world. The book, rather than being focused purely on academic propositions for building equitable cities, offers a unique multi-stakeholder perspective by collaborating with the International Society for Urban Health’s 18th International Conference on Urban Health. This unique collaboration allows access to hundreds of scientists, architects, urbanists, multilaterals, policymakers, non-profit leaders, and grassroots organizers. The book captures the voices and concerns of such diverse cross-sectoral professionals and showcases findings that turn evidence into action and impact in communities around the world. Chapter 14 is available open access under a Creative Commons Attribution 4.0 International License via link.springer.com.
Author: National Academies of Sciences Engineering and Medicine Publisher: ISBN: 9780309685061 Category : Languages : en Pages :
Book Description
The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.
Author: Ellen Elisabeth Kersten Publisher: ISBN: Category : Languages : en Pages : 109
Book Description
This dissertation examines whether spatial measures of health determinants and health outcomes are being used appropriately and effectively to improve the health of marginalized populations in the United States. I concentrate on three spatial measures that have received significant policy and regulatory attention in California and nationally: access to healthful foods, climate change, and housing quality. I find that measures of these health determinants have both significant limitations and unrealized potential for addressing health disparities and promoting health equity. I define spatial triage as a process of using spatial data to screen or select place-based communities for targeted investments, policy action, and/or regulatory attention. Chapter 1 describes the historical context of spatial triage and how it relates to ongoing health equity research and policy. In Chapter 2, I evaluate spatial measures of community nutrition environments by comparing data from in-person store surveys against data from a commercial database. I find that stores in neighborhoods with higher population density or higher percentage of people of color have lower availability of healthful foods and that inaccuracies in commercial databases may produce biased measures of healthful food availability. Chapter 3 focuses on spatial measures of climate change vulnerability. I find that currently used spatial measures of "disadvantaged communities" ignore many important factors, such as community assets, region-specific risks, and occupation-based hazards that contribute to place-based vulnerability. I draw from examples of successful actions by community-based environmental justice organizations and reframe "disadvantaged" communities as sites of solutions where innovative programs are being used to simultaneously address climate mitigation, adaptation, and equity goals. In Chapter 4, I combine electronic health records, public housing locations, and census data to evaluate patterns of healthcare utilization and health outcomes for low-income children in San Francisco. I find that children who live in redeveloped public housing are less likely to have more than one acute care hospital visit within a year than children who live in older, traditional public housing. These results demonstrate how integrating patient-level data across hospitals and with data from other sectors can identify new types of place-based health disparities. Chapter 5 details recommendations for analytic, participatory, and cross-sector approaches to guide the development and implementation of more effective health equity research and policy.
Author: MIRIAM ZOFITH. ZUK Publisher: ISBN: Category : Languages : en Pages : 290
Book Description
A tale of two cities. The Mason-Dixon line. The Berlin Wall. Fresnans have evoked a variety of metaphors to describe the spatial divide between the rich, clean and white neighborhoods in the north and the southern areas housing the poor, polluting industries and communities of color that has characterized urban development in the city since its inception. The narrative explaining this spatial inequality has been remarkably consistent over time - sprawl fueled by aggressive developers, corrupt city councilmen and the market pushed the city limits ever farther northeast, abandoning the older neighborhoods to the south where the poor and immigrant communities settled and were too disorganized to counter the government's neglect. The spatial concentration of the poor, people of color and unwanted land uses can be seen in cities around the country and is identified by public health scholars to be a key driver of the disparities in health between racial and socio-economic groups. City governments are increasingly returning to their core and investing in New Urbanist and Smart Growth strategies to transform these older, more densely developed neighborhoods as the drive for environmental sustainability, walkable neighborhoods, and the attraction of creative urban residents grows. The potential effects of such efforts on the health and wellbeing of the existing residents, however, remains under explored. This dissertation asks if and how the new planning paradigms that use public health as a goal and organizing principle significantly change planning practice and lead to the re-distribution of environmental risks and resources to reduce health disparities? I investigate this question through three case studies of in Fresno a) a downtown revitalization plan, b) the general plan update, and c) a foundation based community development effort to increase the power of South Fresno residents to engage in planning. Following a year of fieldwork I find that everyone is talking about healthy neighborhoods, however for whom and how to achieve them appear to be quite different. While community groups seek to improve the living conditions of the poor residents of South Fresno and ensure their ability to stay in a revitalized downtown, planners are focusing on attracting wealthier residents and actively avoiding any talk about equity, affordable housing and public investment. Thus, although health seems to be providing a unifying framework in terms of a vision for the physical environment, it does not ultimately resolve the inherent tensions between community and economic development.
Author: Solange M. Gould
Author: Solange M. Gould
Author: Tamanna Rahman
Author: National Academies of Sciences, Engineering, and Medicine
Author: US Global Change Research Program
Author: Nimish Biloria
Author: National Academies of Sciences Engineering and Medicine
Author: Ellen Elisabeth Kersten
Author: 
Author: MIRIAM ZOFITH. ZUK
Author: California Conference of Directors of Environmental Health