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Introduction

Climate change has been occurring since the mid-twentieth century, impacting the health of all people (CNA, 2017)
The industrial revolution was the time when greenhouse gas emissions began to rise (Diaz, 2004)
Rising emissions of greenhouse gases, carbon dioxide in particular, is contributing to warming of the atmosphere and ocean, increasing sea levels
Climate change is a direct consequence of human activity - without mitigation, these changes will persist (Pollock, Hoverter, Smith & Vargo, 2017)
Those who are most vulnerable in the first instance are affected the most by climate change (Lemery, Williams & Farmer, 2014)

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Research question

What effects does climate change have on the health of low-socioeconomic populations?

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Greenhouse gases (carbon dioxide, methane, nitrous oxide)

Greenhouse gases directly cause global warming, an increase in precipitation, the melting of the poles, and rising sea levels (EPA, 2017)
The burning of fossil fuels (natural gas, coal and oil), trees and wood products, and solid waste contribute to the emission of carbon dioxide into the atmosphere (EPA, 2017)
Methane is produced during coal, oil and natural gas production and transportation, decaying organic matter and agricultural influences (Diaz, 2004)

https://www.niwa.co.nz/news/niwa-says-greenhouse-gas-methane-rise-again

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Greenhouse gases (carbon dioxide, methane, nitrous oxide)

Nitrous oxide emission occurs during agricultural and industrial practices (EPA, 2017)
Human activities are increasing emissions of these gases, absorbing energy in the atmosphere and warming the earth as a whole (EPA, 2017)
Human initiated greenhouse gas emissions reflect significant energy use, economic activity and human population increase, particularly in high income countries (McMichael et al, 2012)

The natural and social environments that contribute to the well health of people are in danger of dysfunction (McMichael et al, 2012)

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Extreme weather events

The severity of weather events, for example heatwaves, storms and floods will worsen over time due to an increase in global temperature caused by climate change
Towns in coastal areas will be particularly vulnerable due to rising sea levels, which will increase the impact of flooding and storm surges (LUCL, 2009)
An increase in flood events globally is impacting on the health of communities in terms of physical injury and mortality (Hainesa, 2006)

https://www.odt.co.nz/news/dunedin/more-rain-flood-hit-dunedin

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Impact of extreme weather events on health

Flood events can result in hypothermia, drowning, and the spread of infectious disease (Smith & Woodward, 2014)
In some cases, floods can also lead to the spread of harmful chemicals (Hainesa, 2009)

Waterborne/infectious diseases can be contracted through physical contact or ingestion
Higher water temperatures and rainfall changes exacerbate water pollution (Smith & Woodward, 2014)
Dengue fever, malaria and diarrheal illness are highly sensitive to changing climate, due to the relationship between rising temperatures and pathogen maturation and replication rates (Costello, 2009)

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Impact of extreme weather events on health cont.

Adequate food sources are also under threat due to the negative impact of rising temperatures on farm crops, contributing to food shortages (Costello, 2009)
The communities which feel the impact of damage to food sources most significantly are already vulnerable to land degradation and population overgrowth, and a lack of food security will put these populations at further risk of mass hunger (OECD, 2017).

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Rising temperatures

A global increase in temperature has been responsible for a rise in mortality rates, in particular from cardiovascular and respiratory complications (LUCL, 2009)
People with pre-existing respiratory issues are vulnerable to extreme heat, linking the prevalence of respiratory illness in low-socioeconomic communities to health complications relating to increased temperatures (NACHD, 1998)
Once the body raises above the therapeutic temperature range, the risk of damage to organ function, loss of consciousness, and mortality increase (LUCL, 2009)

https://www.niwa.co.nz/climate/information-and-resources/drought-monitor/links

Global temperatures

http://www.bbc.co.uk/schools/gcsebitesize/geography/climate_change/describing_climatic_trends_rev1.shtml

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Low-socioeconomic communities

Those with chronic diseases such as ischemic heart disease and diabetes, prevalent in low-socioeconomic communities, are particularly vulnerable to heat related climate changes, increasing their risk for severe illness or death (NACHD, 1998)
Poorer communities also often live on vulnerable land areas due to affordability, including homes on hills prone to landslides and homes next to rivers or in low lying areas, posing a high risk for flooding (The World Bank, 2015)
There is recent evidence that suggests underlying inequalities in terms of financial and physical assets; access to adequate healthcare; education and opportunities, contribute to the vulnerability of populations to climate hazards (DESA, 2016)

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Low-socioeconomic communities

Low income communities who have less access to resources are suffering greatly, despite their minimal contribution to climate change, with a carbon footprint of approximately 3% (LUCL, 2009)
Poor access to resources and education, poor health behaviours, and an overall poor uptake of health services contributes to vulnerability (National Advisory Committee on Health and Disability, 1998)
Poverty is becoming more widespread in many countries around the world (OECD, 2017)

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Climate change and nursing

Nurses are in a crucial position where they have access to the public and are able to provide climate change education of the effects it has on health (CNA, 2017)
Nurses need to be expert resources for individuals, families and communities to be able to educate in climate change health and the related delivery of care (Leffers et al, 2017)
Health promotion is a way that nurses can help people to take control of their health taking into account their physical, social and mental wellbeing
There are a variety of efforts that nurses can undertake in practice to expand their influence in the mitigation of climate change through engagement with the individual and community (Leffers et al, 2017)

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Climate change and nursing

Educating the public on climate change is a challenge for nurses and nursing students as there are no reported competencies which guide nursing practice in relation to climate change
Nurses in leadership roles often have limited knowledge regarding the relationship between nursing practice and climate events (Leffers et al, 2017)
It has been argued that recognition of environmental challenges and issues have been ignored as a focus has been solely placed on the pursuit of equity, and the urgency for environmental attention has been undermined by social norms, customs and law (Patrick et al, 2011).

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Recommendation 1:

Educating nurses

Nurses need to be educated about climate change, and competencies developed to reflect the important role nurses play in environmental related health care
This will ensure they can provide climate change health education and promotion to individuals, families and communities (Leffers et al, 2017)
In nursing education, integration of climate change information is needed to expand students’ knowledge around the negative impacts of climate change, and the associated policies and role of advocacy in nursing
Nurses can provide climate change education, undertaking research, advocating for practices that support healthy environments including the use of products and technology in practice that support the protection of the environment (CNA, 2017)

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Recommendation 2: Educating the public

If climate change is viewed as a personal risk rather than an environmental risk, people are more likely to engage in the change of health behaviour (Weems & Subramaniam, 2017)
Primary health nurses can play a big role in climate change education due to their heavy involvement amongst communities (Goodman, 2013)
Nurses can provide education on greenhouse gas minimisation activities e.g. cycling to work instead of driving
Nurses can demonstrate their own commitment to sustainable practice and reducing climate change through simple actions in clinical settings e.g. being mindful about wasting resources (Goodman, 2013)

https://www.hrc.co.nz/your-rights/human-rights/our-work/global-goals/protect-planet/

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References

A. Hainesa, R.S. Kovatsa , D. Campbell-Lendrumb, C. Corvalanb. (2006). Climate change and human health: Impacts, vulnerability and public health. Elsevier: UK.

Canadian Nurses Association (CNA). (2017). Climate change and health. Canadian Nurses Association: Canada.

Costello A, et al. (2009). Managing the health effects of climate change. The Lancet Commissions: London.

In text: LUCL, 2009.

Department of Economic and Social Affairs (DESA). (2016). World Economic and Social Survey 2016 Climate Change Resilience: An Opportunity for Reducing Inequalities. Retreived from https://wess.un.org/wp-content/uploads/2016/06/WESS_2016_Report.pdf

Diaz, J. (2004). The public health impact of global climate change. Lippincott Williams & Wilkins, Inc.

Goodman, B. (2013). Role of the nurse in addressing the health effects of climate change.

Nursing Standard. 27, 35, 49-56.

Leffers, J., McDermott Levy, R., Nicholas, P., Sweeney, C. (2017). Mandate for the Nursing Profession to Address Climate Change Through Nursing Education. Sigma Theta Tau International: USA.

Lemery, J., Williams, C., & Farmer, P. (2014). Editorial: The great procrastination. Health and Human Rights, 16, 1–3.

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References

McMichael, C., Barnett, J., McMichael, A. (2012). An Ill Wind? Climate Change, Migration, and Health. Environmental Health Perspectives: Australia.

Mollins, J. (2018). Science-educated indigenous girls, women can help communities combat climate change. Retreived from https://news.globallandscapesforum.org/26054/science-educated-indigenous-girls-women-can-help-communities-combat-climate-change/

National Advisory Committee on Health and Disability. (1998). A Report from the National Advisory Committee on Health and Disability (National Health Committee). Wellington: New Zealand.

OECD. (2017). Poverty and Climate Change Reducing the Vulnerability of the Poor through Adaptation. Retrieved from http://www.oecd.org/env/cc/2502872.pdf

Patrick, R., Capetola, T., Nuttman, S., & Townsend, M. (2011). Health promotion and climate change: exploring the core competencies required for action. Retrieved from

https://academic.oup.com/heapro/article/27/4/475/656428

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References

Smith, K. & Woodward, A. (2014). Human Health: Impacts, Adaptation, and Co-Benefits. Cambridge University: Cambridge/New York.

The World Bank. (2015). Climate change efforts to end poverty. Retrieved from

http://www.worldbank.org/en/news/feature/2015/02/06/climate-change-complicates-efforts-end-poverty

Weems, C. & Subramaniam, P. (2017). Reframing Climate Change for Environmental Health. Journal of Environmental Health: New York.

United States Environmental Protection Agency (2017). Overview of greenhouse gases. Retreived from https://www.epa.gov/ghgemissions/overview-greenhouse-gases

In text: EPA, 2017.

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Pecot model

PECOT Category	Information relating to question	Explanation
Population	Low-socioeconomic groups who have less access to world resources.	This population is particularly vulnerable to the effects of climate change due to their limited resources. Their poor health is greatly influenced by high carbon production in wealthy countries.
Exposure (intervention)	Areas of low-socioeconomic populations whose health had been negatively impacted on through direct events of climate change.	By looking at the literature, the impact climate change has on the health of low-socioeconomic groups can be identified, and links can be made between human activities and climate change which cause these health issues.
Comparison/control	The comparison between the health low-socioeconomic and high-socioeconomic populations in relation to climate change.	Through this comparison, inequalities can be identified and explored to develop an understanding on why low-socioeconomic groups are more vulnerable to the effects of climate change, and what can be done to reduce this harm to their health.
Outcome	Improvements to the overall health of lower socio-economic groups if changes are made to mitigate climate change.	Reducing emissions to mitigate climate change can improve the health of lower-socioeconomic populations through safer, healthier environments.

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Rationale

A digital slideshow presentation was chosen as it enables easy sharing of the information content electronically, for example via email to students for learning purposes. It is also an effective medium for presenting the information through brief yet informative sentences and relevant images which link to the information content, and the presenter is able to show the slides and add information verbally that is not already displayed on the slides. They also provide structure to the presentation by the slides being in specific order, allowing logical flow of information to be delivered to the audience. By clicking through the slides one by one, each section of the presentation is able to be focused on, allowing for further thought and discussion. A slide-show presentation is easy to see and read due to its large size on the screen, and is visually appealing through effective colour use, for example white text on a dark screen. With the overall intention of learning about climate change and health, this slideshow aims to act as an aid in delivering information in a simplistic yet engaging way.

References

National Conference of State Legislatures. (2018). Tips for making effective powerpoint presentations. Retrieved from http://www.ncsl.org/legislators-staff/legislative-staff/legislative-staff-coordinating-committee/tips-for-making-effective-powerpoint-presentations.aspx

Vanderbilt University. (2018). Making better PowerPoint presentations. Retreived from https://cft.vanderbilt.edu/guides-sub-pages/making-better-powerpoint-presentations/