ABSTRACT

The study assesses the extent to which public health is integrated into European national and urban climate change adaptation policy and planning. We analyse national adaptation documents from the 27 European Union member states and interview city-level experts (n = 17) on the integration of three categories of adaptation efforts: general efforts to minimize health impacts related to climate change, targeted efforts to enhance resilience in health systems, and supportive efforts to foster the potential of the first two categories. At a national level, general efforts to address vector-borne diseases and heat-related illness are covered comprehensively, whereas efforts addressing several climate-related health risks are neglected (e.g. water-borne diseases, injuries from extreme weather and cardiopulmonary health) or overlooked (e.g. malnutrition and mental health). Targeted efforts to inform policy decisions, such as carrying out research, risk monitoring and assessments, are often described in detail, but efforts to manage day-to-day health care delivery and emergency situations receive little attention. At the urban level, health issues receive less attention in climate adaptation policy and planning. If health topics are included, they are often described as indirect benefits of adaptation efforts in other sectors and not perceived as the priority of the involved authorities. This effectively means that general and targeted efforts are the responsibility of other sectoral departments, while supportive efforts are the responsibility of the national government or external organizations. As a result, at an urban level, climate-related health system adaptation is not a policy aim in its own right, and many potentially high health risks are being ignored. In order for health risks to be better integrated into adaptation policy and planning, it is critical to interconnect national and urban levels, reduce sectoral thinking and welcome external expertize and facilitate large-scale data collection and sharing of health and climate indicators.

• Key policy insights

• We recommend focussing on cooperatively drafting strategies for integrating health issues into climate policy and planning with stakeholders at the national and urban levels, in different policy sectors and in society.

• Policy planners can build on the strengths of adaptation documents from other countries or cities and take note of any weaknesses.

• We advocate to foster co-benefits for health and climate action of various adaptation measures (e.g. by promoting active mobility and urban greenery, health impacts related to heat, (mental and physical) stress and air pollution are reduced).

• Large-scale data collection and sharing of health and climate indicators should be facilitated to support learning and pro-active decision-making.

摘要

该研究评估了公共卫生融入欧洲国家和城市气候变化适应政策和规划的程度。我们分析了来自 27 个欧盟成员国的国家适应文件并采访了城市级专家（n = 17) 关于整合三类适应工作：尽量减少与气候变化相关的健康影响的一般性努力、增强卫生系统复原力的有针对性的努力以及促进前两类潜力的支持性努力。在国家层面，解决媒介传播疾病和热相关疾病的一般努力得到了全面涵盖，而解决若干气候相关健康风险的努力却被忽视（例如水传播疾病、极端天气造成的伤害和心肺健康）或被忽视（例如营养不良和心理健康）。为政策决策提供信息的有针对性的努力，例如开展研究、风险监测和评估，通常被详细描述，但管理日常医疗保健服务和紧急情况的努力很少受到关注。在城市层面，健康问题在气候适应政策和规划中受到的关注较少。如果包括健康主题，它们通常被描述为其他部门适应工作的间接好处，而不被视为有关当局的优先事项。这实际上意味着一般性和针对性的努力是其他部门的责任，而支持性的努力是国家政府或外部组织的责任。因此，在城市层面，与气候相关的卫生系统适应本身并不是一项政策目标，许多潜在的高健康风险被忽视了。为了将健康风险更好地纳入适应政策和规划，将国家和城市层面相互联系起来至关重要，

• 关键政策见解

• 我们建议侧重于与国家和城市层面、不同政策部门和社会的利益相关者合作起草战略，将健康问题纳入气候政策和规划。

• 政策规划者可以借鉴其他国家或城市适应文件的优势，并注意任何弱点。

• 我们提倡促进各种适应措施对健康和气候行动的协同效益（例如，通过促进积极的流动性和城市绿化，减少与热、（精神和身体）压力和空气污染相关的健康影响）。

• 应促进健康和气候指标的大规模数据收集和共享，以支持学习和主动决策。