Social and Emotional Wellbeing impacts of prolonged extreme heat driven by climate change: lived experiences of public housing residents in a regional community in Victoria, Australia.

The increasing pace of climate change is expected to give rise to more severe and more frequent adverse climate events. Significant amongst these is the increased frequency of prolonged periods of extreme heat, with concomitant impacts on human health. The existing literature on this topic focuses predominantly on the quantifiable physical health impacts of extreme heat; much less researched is its effect on social and emotional wellbeing. My research focuses on people residing in public housing in a community (pseudonym, ‘Sunset Country’) located in northwest Victoria, Australia, where severe heatwaves are a common occurrence. In Australia, there is no clear legislation around the provision of cooling in public housing. Hence, the health and wellbeing of public housing residents in Sunset Country are at serious risk during prolonged periods of extreme heat due to their having no means of keeping their homes cool or escaping the heat. The overall aim of my research was to explore the lived experiences of public housing residents living on Sunset Country, to understand how prolonged extreme heat exposure impacts their social and emotional wellbeing. Employing a qualitative methodological framework based on community engagement and participatory action research principles, I conducted eight focus groups and one in-depth interview with public housing residents living on Sunset Country and the service providers who support them. Using thematic analysis, I developed two major themes: first, that extreme heat impacts the emotional wellbeing of public housing residents (with subthemes around mood changes, inability to cope, anxiety, the exacerbation of mental health conditions and effects of insufficient sleep on school performance), and second, that extreme heat impacts the social wellbeing of public housing residents, with subthemes of social isolation, erosion of social cohesion, increased conflict and reduction in community safety). The participants’ lived experiences contribute to three overarching theories grounded in my data. Firstly, policies are not keeping up with the changing climate; despite significant increases in the severity of heatwaves, there have been no amendments to public housing policy addressing the need for cooling legislation. Secondly, there is an apparent misalignment of governmental rhetoric and action; public housing in Sunset Country may not be fit for habitation given the lack of protection against extreme heat, and thus perpetuates inequalities in the community. Finally, bureaucratic failings contribute to the cycle of disadvantage and disempowerment experienced by public housing residents, reducing individual agency. My research findings make a significant contribution to building knowledge around the previously underexplored relationship between extreme heat and social and emotional wellbeing. Based on the perspectives and concerns voiced by my participants, I provide several recommendations for action. These include the development of sustainable climate adaptation strategies and urgent policy action to improve public housing living standards, aligning with the United Nation’s Sustainable Development Goals. Research must endeavour to give voice to people already impacted by the effects of climate change to gain deeper and more holistic understandings of these issues and their social and emotional impacts. Lived experience knowledge can then be used to urgently develop appropriate climate adaptation strategies to effectively safeguard human health and prevent societal inequities from widening

Health, financial and environmental impacts of unnecessary vitamin D testing: a triple bottom line assessment adapted for healthcare

To undertake an assessment of the health, financial and environmental impacts of a well-recognised example of low-value care; inappropriate vitamin D testing. Design Combination of systematic literature search, analysis of routinely collected healthcare data and environmental analysis. Setting Australian healthcare system. Participants Population of Australia. Outcome measures We took a sustainability approach, measuring the health, financial and environmental impacts of a specific healthcare activity. Unnecessary vitamin D testing rates were estimated from best available published literature; by definition, these provide no gain in health outcomes (in contrast to appropriate/necessary tests). Australian population-based test numbers and healthcare costs were obtained from Medicare for vitamin D pathology services. Carbon emissions in kg CO2e were estimated using data from our previous study of the carbon footprint of common pathology tests. We distinguished between tests ordered as the primary test and those ordered as an add-on to other tests, as many may be done in conjunction with other tests. We conducted base case (8% being the primary reason for the blood test) and sensitivity (12% primary test) analyses. Results There were a total of 4 457 657 Medicare-funded vitamin D tests in 2020, on average one test for every six Australians, an 11.8% increase from the mean 2018–2019 total. From our literature review, 76.5% of Australia’s vitamin D tests provide no net health benefit, equating to 3 410 108 unnecessary tests in 2020. Total costs of unnecessary tests to Medicare amounted to >$A87 000 000. The 2020 carbon footprint of unnecessary vitamin D tests was 28 576 kg (base case) and 42 012 kg (sensitivity) CO2e, equivalent to driving ~160 000–230 000 km in a standard passenger car. Conclusions Unnecessary vitamin D testing contributes to avoidable CO2e emissions and healthcare costs. While the footprint of this example is relatively small, the potential to realise environmental cobenefits by reducing low-value care more broadly is significant

Homesickness at Home: A Scoping Review of Solastalgia Experiences in Australia

Solastalgia is a term used to describe the pain and distress experienced by those witnessing their home environments destroyed or changed in unwelcome ways. Solastalgia is expected to become more prominent as climate change worsens and transforms landscapes. This scoping review examines and maps the existing literature on solastalgia in Australia, particularly focusing on Aboriginal and Torres Strait Islander experiences. Four focus questions guided the review to explore how solastalgia is conceptualized, highlight risk and protective factors, and identify strategies for addressing solastalgia. Eighteen papers met the criteria for inclusion. Overall, our results show a minimal evidence base on solastalgia in Australia with an even greater gap in exploring solastalgia from Aboriginal and Torres Strait Islander perspectives. A strong connection to home environments was suggested as both a risk and protective factor for experiencing solastalgia. Aboriginal and Torres Strait Islander peoples are considered at risk due to intimate connections to home environments, and since the invasion, have experienced mental distress resulting from significant, damaging changes to landscapes and home environments. We recommend further exploration of lived experiences of solastalgia across a greater diversity of Australian contexts, particularly amongst Aboriginal and Torres Strait Islander peoples, including a focus on practical implications

Behavioural change interventions encouraging clinicians to reduce carbon emissions in clinical activity: a systematic review

Abstract Background Clinical activity accounts for 70–80% of the carbon footprint of healthcare. A critical component of reducing emissions is shifting clinical behaviour towards reducing, avoiding, or replacing carbon-intensive healthcare. The objective of this systematic review was to find, map and assess behaviour change interventions that have been implemented in healthcare settings to encourage clinicians to reduce greenhouse gas emissions from their clinical activity. Methods Studies eligible for inclusion were those reporting on a behaviour change intervention to reduce carbon emissions via changes in healthcare workplace behaviour. Six databases were searched in November 2021 (updated February 2022). A pre-determined template was used to extract data from the studies, and risk of bias was assessed. The behaviour change techniques (BCTs) used in the interventions were coded using the BCT Taxonomy. Results Six full-text studies were included in this review, and 14 conference abstracts. All studies used a before-after intervention design. The majority were UK studies (n = 15), followed by US (n = 3) and Australia (n = 2). Of the full-text studies, four focused on reducing the emissions associated with anaesthesia, and two aimed at reducing unnecessary test ordering. Of the conference abstracts, 13 focused on anaesthetic gas usage, and one on respiratory inhalers. The most common BCTs used were social support, salience of consequences, restructuring the physical environment, prompts and cues, feedback on outcome of behaviour, and information about environmental consequences. All studies reported success of their interventions in reducing carbon emissions, prescribing, ordering, and financial costs; however, only two studies reported the magnitude and significance of their intervention’s success. All studies scored at least one item as unclear or at risk of bias. Conclusion Most interventions to date have targeted anaesthesia or pathology test ordering in hospital settings. Due to the diverse study outcomes and consequent inability to pool the results, this review is descriptive only, limiting our ability to conclude the effectiveness of interventions. Multiple BCTs were used in each study but these were not compared, evaluated, or used systematically. All studies lacked rigour in study design and measurement of outcomes. Review registration The study was registered on Prospero (ID number CRD42021272526) (Breth-Petersen et al., Prospero 2021: CRD42021272526)

Aboriginal Population and Climate Change in Australia: Implications for Health and Adaptation Planning

The health impacts of climate are widely recognised, and extensive modelling is available on predicted changes to climate globally. The impact of these changes may affect populations differently depending on a range of factors, including geography, socioeconomics and culture. This study reviewed current evidence on the health risks of climate change for Australian Aboriginal populations and linked Aboriginal demographic data to historical and projected climate data to describe the distribution of climate-related exposures in Aboriginal compared to non-Aboriginal populations in New South Wales (NSW), Australia. The study showed Aboriginal populations were disproportionately exposed to a range of climate extremes in heat, rainfall and drought, and this disproportionate exposure was predicted to increase with climate change over the coming decades. Aboriginal people currently experience higher rates of climate-sensitive health conditions and soci-oeconomic disadvantages, which will impact their capacity to adapt to climate change. Climate change may also adversely affect cultural practices. These factors will likely impact the health and well-being of Aboriginal people in NSW and inhibit measures to close the gap in health between Aboriginal and non-Aboriginal populations. Climate change, health and equity need to be key considerations in all policies at all levels of government. Effective Aboriginal community engagement is urgently needed to develop and implement climate adaptation responses to improve health and social service preparedness and secure environmental health infrastructure such as drinking water supplies and suitably managed social housing. Further Aboriginal-led research is required to identify the cultural impacts of climate change on health, including adaptive responses based on Aboriginal knowledges

Correction:Aboriginal Population and Climate Change in Australia: Implications for Health and Adaptation Planning(Int. J. Environ. Res. Public Health, (2022), 19, (7502), 10.3390/ijerph19127502)

Error in Figures 2c and 3a In the original publication [1], there was an error in Figure 2c containing a map ofclimate exposures with bar charts indicating relative exposure by category across Aboriginal and non-Aboriginal populations. The exposures in Figure 2c were projected additional days exceeding 35˚C annually, 2020–2039. There was also an error in Figure 3a containing a map of annual days with Macarthur Forest Fire Danger Index exceeding 50 (i.e., “severe” fire danger), with bar charts indicating relative exposure by category across Aboriginal and non-Aboriginal populations for historical data between 1990 and 2009. During publication, formatting changes of the accepted manuscript occurred. The categories in the bar charts in Figures 2c and 3a were incorrect. The corrected Figures 2 and 3 appear below. There are no changes to the text in the manuscrip

sj-pdf-1-aic-10.1177_0310057X231212211 - Supplemental material for Exploring anaesthetists’ views on the carbon footprint of anaesthesia and identifying opportunities and challenges for reducing its impact on the environment

Supplemental material, sj-pdf-1-aic-10.1177_0310057X231212211 for Exploring anaesthetists’ views on the carbon footprint of anaesthesia and identifying opportunities and challenges for reducing its impact on the environment by Matilde Breth-Petersen, Alexandra L Barratt, Forbes McGain, Justin J Skowno, George Zhong, Andrew D Weatherall, Katy JL Bell and Kristen M Pickles in Anaesthesia and Intensive Care</p