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HEAL: Transformational Change for Environmental, Planetary, and Human Health

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Guest Editor
HEAL Global Research Centre, Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
Interests: climate change and health; air pollution; urban health; exposure assessment; risk and vulnerability assessment; sustainable development
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Guest Editor
University Centre for Rural Health, University of Sydney, Lismore, NSW 2480, Australia
Interests: indigenous health; health equity; health services; environmental health

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Guest Editor
School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD 4000, Australia
Interests: climate change and infectious disease transmission; GIS and spatiotemporal model; biostatistics; environmental epidemiology; development of early warning systems for infectious diseases
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Guest Editor
National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT 2601, Australia
Interests: indoor and outdoor air quality; volatile organic compounds; particulate matter; air filtration technologies; low emission building materials; consumer products

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Guest Editor
National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT 2601, Australia
Interests: climate change; extreme weather events; heat; bushfires; vulnerable population
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Guest Editor
School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
Interests: public health; health in all policies; health policy; research translation

Special Issue Information

Dear Colleagues,

Environmental and climate change pose great challenges to planetary and human health, including direct effects associated with exposure to bushfires, heatwaves, floods, and other extreme events, as well as indirect effects associated with food, water, housing, and energy insecurity, as well as infectious disease outbreaks. These direct and indirect impacts require cross-sectoral adaptation responses, as well as a drastic reduction in emissions. There is great potential for well-targeted mitigation and adaptation policies to reduce environmental impacts, and to protect and improve public health.

Interventions that target urban, rural, and remote health have the ability to help strengthen the resilience of communities and the health sector against environmental and climate change impacts. The respectful integration of indigenous knowledge systems and Western science and data is essential for this effort, recognizing that indigenous concepts of health holistically encompass connections to culture, family, language, community, and country. The translation of research into policy and practice in the health, environmental protection, planning, housing, transport, food, and energy sectors, as well as cross-sectoral collaboration and genuine community engagement, are crucial for achieving transformational changes towards a healthier, fairer, and more sustainable world.

This Special Issue of the International Journal of Environmental Research and Public Health aims to feature full-length articles, reviews, and communications from HEAL network and HEAL 2022 Conference: Transformational Changes for Environmental, Planetary, and Human Health, addressing novel research on this topic from an interdisciplinary point of view, including (but not limited to):

  • Indigenous health and knowledge translation;
  • Bushfires, air pollution, heatwaves, and other extreme events;
  • Health system resilience and sustainability;
  • Food, soil, and water security;
  • Biosecurity, COVID-19, and emerging infections;
  • Urban health, built environment, and nature-based solutions;
  • Rural and remote health;
  • Clean energy solutions;
  • At-risk populations and early life effects;
  • Data and decision support systems;
  • Science communication and risk perception;
  • Planetary health equity.

Prof. Dr. Sotiris Vardoulakis
Dr. Veronica Matthews
Prof. Dr. Wenbiao Hu
Dr. Nigel Goodman
Dr. Michael Tong
Dr. Carmel Williams
Guest Editors

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Keywords

  • climate change
  • environmental change
  • extreme events
  • public health
  • planetary health
  • health system resilience
  • community resilience
  • health equity

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Published Papers (6 papers)

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Research

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13 pages, 966 KiB  
Article
Association between High Ambient Temperatures and Road Crashes in an Australian City with Temperate Climate: A Time-Series Study, 2012–2021
by Yannan Li, Blesson Mathew Varghese, Jingwen Liu, Peng Bi and Michael Tong
Int. J. Environ. Res. Public Health 2023, 20(11), 6000; https://doi.org/10.3390/ijerph20116000 - 30 May 2023
Cited by 1 | Viewed by 2026
Abstract
(1) Background: High ambient temperatures are associated with increased morbidity and mortality rates, and some evidence suggests that high temperatures increase the risk of road crashes. However, little is known regarding the burden of road crashes attributable to no-optimal high temperatures in Australia. [...] Read more.
(1) Background: High ambient temperatures are associated with increased morbidity and mortality rates, and some evidence suggests that high temperatures increase the risk of road crashes. However, little is known regarding the burden of road crashes attributable to no-optimal high temperatures in Australia. Therefore, this study examined the effects of high temperatures on road crashes using Adelaide in South Australia as a case study. (2) Methods: Ten-year daily time-series data on road crashes (n = 64,597) and weather during the warm season (October–March) were obtained between 2012 and 2021. A quasi-Poisson distributed lag nonlinear model (DLNM) was used to quantify the cumulative effect of high temperatures over the previous five days. The associations and attributable burden at moderate and extreme temperature ranges were computed as relative risk (RR) and attributable fraction. (3) Results: There was a J-shaped association between high ambient temperature and the risk of road crashes during the warm season in Adelaide, and pronounced effects were observed for minimum temperatures. The highest risk was observed at a 1 day lag and lasting for 5 days. High temperatures were responsible for 0.79% (95% CI: 0.15–1.33%) of road crashes, with moderately high temperatures accounting for most of the burden compared with extreme temperatures (0.55% vs. 0.32%). (4) Conclusions: In the face of a warming climate, the finding draws the attention of road transport, policy, and public health planners to design preventive plans to reduce the risk of road crashes attributable to high temperatures. Full article
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11 pages, 774 KiB  
Article
Effects of Heatwaves on Hospital Admissions for Cardiovascular and Respiratory Diseases, in Southern Vietnam, 2010–2018: Time Series Analysis
by Nguyen Thi Trang Nhung, Le Tu Hoang, Tran Thi Tuyet Hanh, Luu Quoc Toan, Nguyen Duc Thanh, Nguyen Xuan Truong, Nguyen Anh Son, Hoong Van Nhat, Nguyen Huu Quyen and Ha Van Nhu
Int. J. Environ. Res. Public Health 2023, 20(5), 3908; https://doi.org/10.3390/ijerph20053908 - 22 Feb 2023
Cited by 6 | Viewed by 2214
Abstract
This study investigated the associations between heatwaves and daily hospital admissions for cardiovascular and respiratory diseases in two provinces in Viet Nam known to be vulnerable to droughts during 2010–2018. This study applied a time series analysis with data extracted from the electronic [...] Read more.
This study investigated the associations between heatwaves and daily hospital admissions for cardiovascular and respiratory diseases in two provinces in Viet Nam known to be vulnerable to droughts during 2010–2018. This study applied a time series analysis with data extracted from the electronic database of provincial hospitals and meteorological stations from the corresponding province. To eliminate over-dispersion, this time series analysis used Quasi-Poisson regression. The models were controlled for the day of the week, holiday, time trend, and relative humidity. Heatwaves were defined as the maximum temperature exceeding P90th over the period from 2010 to 2018 during at least three consecutive days. Data from 31,191 hospital admissions for respiratory diseases and 29,056 hospitalizations for cardiovascular diseases were investigated in the two provinces. Associations between hospital admissions for respiratory diseases and heatwaves in Ninh Thuan were observed at lag 2, with excess risk (ER = 8.31%, 95% confidence interval: 0.64–16.55%). However, heatwaves were negatively associated with cardiovascular diseases in Ca Mau, which was determined amongst the elderly (age above 60), ER = −7.28%, 95%CI: −13.97–−0.08%. Heatwaves can be a risk factor for hospital admission due to respiratory diseases in Vietnam. Further studies need to be conducted to assert the link between heat waves and cardiovascular diseases. Full article
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Review

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16 pages, 2802 KiB  
Review
Identifying Environmental Impact Factors for Sustainable Healthcare: A Scoping Review
by Marieke Sijm-Eeken, Monique Jaspers and Linda Peute
Int. J. Environ. Res. Public Health 2023, 20(18), 6747; https://doi.org/10.3390/ijerph20186747 - 12 Sep 2023
Cited by 10 | Viewed by 4950
Abstract
The healthcare industry has a substantial impact on the environment through its use of resources, waste generation and pollution. To manage and reduce its impact, it is essential to measure the pressures of healthcare activities on the environment. However, research on factors that [...] Read more.
The healthcare industry has a substantial impact on the environment through its use of resources, waste generation and pollution. To manage and reduce its impact, it is essential to measure the pressures of healthcare activities on the environment. However, research on factors that can support these measurement activities is unbalanced and scattered. In order to address this issue, a scoping review was conducted with the aims of (i) identifying and organizing factors that have been used to measure environmental impact in healthcare practice and (ii) analyzing the overview of impact factors in order to identify research gaps. The review identified 46 eligible articles publishing 360 impact factors from original research in PubMed and EBSCO databases. These factors related to a variety of healthcare settings, including mental healthcare, renal service, primary healthcare, hospitals and national healthcare. Environmental impacts of healthcare were characterized by a variety of factors based on three key dimensions: the healthcare setting involved, the measurement component or scope, and the type of environmental pressure. The Healthcare Environmental Impact Factor (HEIF) scheme resulting from this study can be used as a tool for selecting measurable indicators to be applied in quality management and as a starting point for further research. Future studies could focus on standardizing impact factors to allow for cross-organization comparisons and on expanding the HEIF scheme by addressing gaps. Full article
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25 pages, 1408 KiB  
Review
Impacts of Climate Change on Health and Health Services in Northern New South Wales, Australia: A Rapid Review
by Grace W. Lee, Kristina Vine, Amba-Rose Atkinson, Michael Tong, Jo Longman, Alexandra Barratt, Ross Bailie, Sotiris Vardoulakis, Veronica Matthews and Kazi Mizanur Rahman
Int. J. Environ. Res. Public Health 2023, 20(13), 6285; https://doi.org/10.3390/ijerph20136285 - 3 Jul 2023
Cited by 9 | Viewed by 10867
Abstract
Climate change is exposing populations to increasing temperatures and extreme weather events in many parts of Australia. To prepare for climate challenges, there is a growing need for Local Health Districts (LHDs) to identify potential health impacts in their region and strengthen the [...] Read more.
Climate change is exposing populations to increasing temperatures and extreme weather events in many parts of Australia. To prepare for climate challenges, there is a growing need for Local Health Districts (LHDs) to identify potential health impacts in their region and strengthen the capacity of the health system to respond accordingly. This rapid review summarised existing evidence and research gaps on the impact of climate change on health and health services in Northern New South Wales (NSW)—a ‘hotspot’ for climate disaster declarations. We systematically searched online databases and selected 11 peer-reviewed studies published between 2012–2022 for the Northern NSW region. The most explored health outcome was mental health in the aftermath of floods and droughts, followed by increased healthcare utilisation due to respiratory, cardiovascular and mortality outcomes associated with bushfire smoke or heat waves. Future research directions were recommended to understand: the compounding impacts of extreme events on health and the health system, local data needs that can better inform models that predict future health risks and healthcare utilisation for the region, and the needs of vulnerable populations that require a whole-of-system response during the different phases of disasters. In conclusion, the review provided climate change and health research directions the LHD may undertake to inform future adaptation and mitigation policies and strategies relevant to their region. Full article
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Other

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31 pages, 10208 KiB  
Case Report
Healthy Patients, Workforce and Environment: Coupling Climate Adaptation and Mitigation to Wellbeing in Healthcare
by Mark de Souza, Aunty Bilawara Lee and Stephen Cook
Int. J. Environ. Res. Public Health 2023, 20(22), 7059; https://doi.org/10.3390/ijerph20227059 - 13 Nov 2023
Viewed by 4179
Abstract
Climate change threatens the health of all Australians: without adaptation, many areas may become unlivable, in particular the tropical north. The Northern Territory (NT) health workforce is already under colliding operational pressures worsened by extreme weather events, regional staff shortages and infrastructure that [...] Read more.
Climate change threatens the health of all Australians: without adaptation, many areas may become unlivable, in particular the tropical north. The Northern Territory (NT) health workforce is already under colliding operational pressures worsened by extreme weather events, regional staff shortages and infrastructure that is poorly adapted to climate change. The H3 Project (Healthy Patients, Workforce and Environment) explores nature-based interventions in the NT health sector aiming to strengthen the resilience and responsiveness of health infrastructure and workforce in our climate-altered future. The H3 Project engaged the health workforce, climate researchers and the wider community, in recognition that meaningful and timely climate action requires both organization-led and grassroots engagement. We recruited campus greening volunteers and sustainability champions to Royal Darwin Hospital (RDH) to develop strategies that enhance climate adaptation, build climate and health literacy, and incentivize active mobility. We implemented low-cost biophilic design within the constraints of legacy healthcare infrastructure, creating cool and restorative outdoor spaces to mitigate the impacts of heat on RDH campus users and adapt to projected warming. This case study demonstrated substantial cooling impacts and improved local biodiversity and hospital campus aesthetics. We collaborated with Indigenous healers and plant experts to harness the synergy between Aboriginal people’s traditional knowledge and connectedness to land and the modern concept of biophilic design, while seeking to improve hospital outcomes for Indigenous patients who are both disconnected from their homelands and disproportionately represented in NT hospitals. Full article
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7 pages, 302 KiB  
Perspective
Climate-Related Natural Disasters: Reflections on an Agenda for Rural Health Research
by Ross Bailie
Int. J. Environ. Res. Public Health 2023, 20(8), 5553; https://doi.org/10.3390/ijerph20085553 - 18 Apr 2023
Cited by 5 | Viewed by 1998
Abstract
The increasing frequency and severity of climate-related disasters will exacerbate the health inequities that already exist between people living in rural communities and those living in urban areas. There is a need to improve understanding of the differences in the impacts on and [...] Read more.
The increasing frequency and severity of climate-related disasters will exacerbate the health inequities that already exist between people living in rural communities and those living in urban areas. There is a need to improve understanding of the differences in the impacts on and needs of rural communities, in order that policy, adaptation, mitigation, response and recovery efforts meet the needs of those who are most affected by flooding and who have the fewest resources to mitigate the impact and adapt to the increased flood risk. This paper is a reflection by a rural-based academic on the significance and experience of community-based flood-related research, with a discussion of the challenges and opportunities for research on rural health and climate change. From an equity perspective, there is a need for all analyses of national and regional datasets on climate and health to, wherever possible, examine the differential impacts and policy and practice implications for regional, remote and urban communities. At the same time, there is a need to build local capacity in rural communities for community-based participatory action research, and to enhance this capacity through building networks and collaborations between different researchers based in rural areas, and between rural- and urban-based researchers. We should also encourage the documentation, evaluation and sharing of experience and lessons from local and regional efforts to adapt to and mitigate the impacts of climate change on health in rural communities. Full article
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