Background: South Asian populations are vulnerable to poor health outcomes associated with climate due to the region’s complex topography, poverty, lack of education, and population density. Physicians, being highly trusted members of society, can help mitigate climate change effects in their countries. Objectives: The present study assessed perceptions of physicians from four South Asian countries (Bangladesh, Bhutan, India, and Pakistan). We hypothesized that physicians from these countries will be aware and knowledgeable about health effects of climate change. Methods: We conducted a cross-sectional online survey of physicians between March and July 2022. Data of 201 physicians was analyzed using the Kruskal-Wallis test and Dunn’s post hoc method. Results: Physicians from four South Asian countries were attuned to the health risks associated with climate change. A majority of physicians (86.6%) believed that climate change would make health conditions in their countries more severe or frequent (Bangladesh 83.3%; Bhutan 70%; India 91% and Pakistan 90.8%). The most common health effect related to climate change was illnesses related to reduced outdoor air quality (54.3%). Common barriers to discuss climate change with patients from all four countries were physicians’ lack of knowledge (strongly agree, 13.8%; agree 47.7%) in how to approach the issue with patients, lack of time (strongly agree, 12%; agree, 48%) and their perception that patients were not interested in knowing about climate change (strongly agree, 8.6%; agree, 42.6%). More than half (56.2%) of the physicians reported no training (Bangladesh, 51.7%; Bhutan, 80%; India, 44.6%; Pakistan, 63.1%) and approximately 30% reported less than 20 hours of training (Bangladesh, 28.3%; Bhutan, 15.0%; India, 39.3%; Pakistan, 27.7%) in climate-change-related health effects. Conclusion: While additional large-scale research is needed to understand the trends observed in our pilot study, our findings identify the need to introduce interventions to improve physicians’ knowledge of the health impacts of climate crisis.
References
[1]
Agarwal, R., Balasundharam, V., Blagrave, P., Cerutti, M. E. M., Gudmundsson, R., & Mousa, R. (2021). Climate Change in South Asia: Further Need for Mitigation and Adaptation. International Monetary Fund. https://doi.org/10.5089/9781513590677.001
[2]
Ahmed, F. (2021). Incorporating Family Medicine Module in the Undergraduate Curriculum. Journal of Medical Sciences, 29, 65-66.
[3]
Ashraf Hussain, D., Chaudhary, M. N., Jafri, S. Z. H., Malik, S., & Ali, N. (2022). Climate Change and Its Impacts on Pakistan. Journal of Positive School Psychology, 6, 9195-9217.
[4]
Beyeler, N., & Salas, R. N. (2022). An Unequivocal Call to Climate Action for the Health Sector. BMJ, 376, Article No. o680. https://doi.org/10.1136/bmj.o680
[5]
Boland, T. M., & Temte, J. L. (2019). Family Medicine Patient and Physician Attitudes toward Climate Change and Health in Wisconsin. Wilderness & Environmental Medicine, 30, 386-393. https://doi.org/10.1016/j.wem.2019.08.005
[6]
Boland, T. M., & Temte, J. L. (2019). Family Medicine Patient and Physician Attitudestoward Climate Change and Health in Wisconsin. Wilderness & Environmental Medicine, 30, 386-393. https://doi.org/10.1016/j.wem.2019.08.005
[7]
Crowley, R. A., & Health and Public Policy Committee of the American College of Physicians (2016). Climate Change and Health: A Position Paper of the American College of Physicians. Annals of Internal Medicine, 164, 608-610. https://doi.org/10.7326/M15-2766
[8]
Dupraz, J., & Burnand, B. (2021). Role of Health Professionals Regarding the Impact of Climate Change on Health—An Exploratory Review. International Journal of Environmental Research and Public Health, 18, Article No. 3222. https://doi.org/10.3390/ijerph18063222
[9]
Eckstein, D., Künzel, V., & Schäfer, L. (2021). Global Climate Risk Index 2021. Who Suffers Most from Extreme Weather Events? Weather-Related Loss Events in 2019 and 2000 to 2019. Germanwatch.
[10]
Favilla, K., & Pita, T. (2020). “When Will Fieldwork Open up Again?” Beginning a Project in Pandemic Times. Fennia-International Journal of Geography, 198, 230-233. https://doi.org/10.11143/fennia.99203
[11]
Fraser, N., Bhattacharya, A., & Bhattacharya, B. (2001). Geography of a Himalayan Kingdom: Bhutan. Concept Publishing Company.
[12]
General Assembly of the World Medical Association (2014). World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. The Journal of the American College of Dentists, 81, 14-18.
[13]
Hathaway, J., & Maibach, E. W. (2018). Health Implications of Climate Change: A Review of the Literature about the Perception of the Public and Health Professionals. Current Environmental Health Reports, 5, 197-204. https://doi.org/10.1007/s40572-018-0190-3
[14]
International Organizations of Medical Sciences (CIOMS) (2017). International Ethical Guidelines for Health-Related Research Involving Humans. International Organizations of Medical Sciences.
[15]
Katzman, J. G., Tomedi, L. E., Herring, D., Jones, H., Groves, R., Norsworthy, K., Martin, C., Liu, J., Kazhe-Dominguez, B., & Arora, S. (2022). Educating Community Health Professionals about the Health-Related Effects of Climate Change through ECHO Telementoring. Journal of Primary Care & Community Health, 13, Article ID: 21501319221102033. https://doi.org/10.1177/21501319221102033
[16]
Kotcher, J., Maibach, E., Miller, J., Campbell, E., Alqodmani, L., Maiero, M., & Wyns, A. (2021). Views of Health Professionals on Climate Change and Health: A Multinational Survey Study. The Lancet Planetary Health, 5, e316-e323. https://doi.org/10.1016/S2542-5196(21)00053-X
[17]
Lehmkuhl, D. (2019). Climate Change and Its Significance in the Healthcare Community: History, Landmarks, and Major Players. Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz, 62, 546-555. https://doi.org/10.1007/s00103-019-02935-9
[18]
Ma, N., Jiang, J. H., Hou, K., Lin, Y., Vu, T., Rosen, P. E., Gu, Y., & Fahy, K. A. (2022). 21st Century Global and Regional Surface Temperature Projections. Earth and Space Science, 9, e2022EA002662. https://doi.org/10.1029/2022EA002662
[19]
Martinich, J., & Crimmins, A. (2019). Climate Damages and Adaptation Potential across Diverse Sectors of the United States. Nature Climate Change, 9, 397-404. https://doi.org/10.1038/s41558-019-0444-6
[20]
Pörtner, H.-O., Roberts, D. C., Adams, H., Adler, C., Aldunce, P., Ali, E., Begum, R. A., Betts, R., Kerr, R. B., & Biesbroek, R. (2022). Climate Change 2022: Impacts, Adaptation and Vulnerability. IPCC Sixth Assessment Report. IPCC.
[21]
Qureshi, R., Wijegoonewardene, P., & Andrades, M. (2018). Ten Years of MRCGP International South Asia: A Beacon of Excellence. British Journal of General Practice, 68, 336-337. https://doi.org/10.3399/bjgp18X697769
[22]
Rashid, H. E. (2019). Geography of Bangladesh. Routledge. https://doi.org/10.4324/9780429048098
[23]
Romanello, M., Di Napoli, C., Drummond, P., Green, C., Kennard, H., Lampard, P., Scamman, D., Arnell, N., Ayeb-Karlsson, S., & Ford, L. B. (2022). The 2022 Report of the Lancet Countdown on Health and Climate Change: Health at the Mercy of Fossil Fuels. The Lancet, 400, 1619-1654. https://doi.org/10.1016/S0140-6736(22)01540-9
[24]
Ryan, E. C., Dubrow, R. & Sherman, J. D. (2020). Medical, Nursing, and Physician Assistant Student Knowledge and Attitudes toward Climate Change, Pollution, and Resource Conservation in Health Care. BMC Medical Education, 20, Article No. 200. https://doi.org/10.1186/s12909-020-02099-0
[25]
Sambath, V., Narayan, S., Kumar, P., Kumar, P., & Pradyumna, A. (2022). Knowledge, Attitudes and Practices Related to Climate Change and its Health Aspects among the Healthcare Workforce in India—A Cross-Sectional Study. The Journal of Climate Change and Health, 6, Article ID: 100147. https://doi.org/10.1016/j.joclim.2022.100147
[26]
Sarfaty, M., Kreslake, J. M., Casale, T. B., & Maibach, E. W. (2016a). Views of AAAAI Members on Climate Change and Health. The Journal of Allergy and Clinical Immunology: In Practice, 4, 333-335. https://doi.org/10.1016/j.jaip.2015.09.018
[27]
Sarfaty, M., Kreslake, J., Ewart, G., Guidotti, T. L., Thurston, G. D., Balmes, J. R., & Maibach, E. W. (2016b). Survey of International Members of the American Thoracic Society on Climate Change and Health. Annals of the American Thoracic Society, 13, 1808-1813.
[28]
Sarfaty, M., Mitchell, M., Bloodhart, B., & Maibach, E. W. (2014). A Survey of African American Physicians on the Health Effects of Climate Change. International Journal of Environmental Research and Public Health, 11, 12473-12485. https://doi.org/10.3390/ijerph111212473
[29]
Scheerens, C., Bekaert, E., Ray, S., Essuman, A., Mash, B., Decat, P., De Sutter, A., Van Damme, P., Vanhove, W., & Lietaer, S. (2021). Family Physician Perceptions of Climate Change, Migration, Health, and Healthcare in Sub-Saharan Africa: An Exploratory Study. International Journal of Environmental Research and Public Health, 18, Article No. 6323. https://doi.org/10.3390/ijerph18126323
[30]
Sen, B., Dhimal, M., Latheef, A. T., & Ghosh, U. (2017). Climate Change: Health Effects and Response in South Asia. BMJ, 359, Article No. j5117. https://doi.org/10.1136/bmj.j5117
[31]
Sheffield, P. E., Durante, K. T., Rahona, E., & Zarcadoolas, C. (2014). Emerging Roles of Health Care Providers to Mitigate Climate Change Impacts: A Perspective from East Harlem, New York. Health and Human Rights, 16, 113-121.
[32]
Singh, B. B., Singh, M., & Singh, D. (2021). An Overview of Climate Change Over South Asia: Observations, Projections, and Recent Advances. In R. B. Singh, S. Chatterjee, M. Mishra, & A. J. de Lucena (Eds.), Practices in Regional Science and Sustainable Regional Development (pp. 263-277). Springer. https://doi.org/10.1007/978-981-16-2221-2_12
[33]
Spate, O. H. K., & Learmonth, A. T. A. (2017). India and Pakistan: A General and Regional Geography. Routledge. https://doi.org/10.4324/9781315266053
[34]
Vasantha Raju, N., & Harinarayana, N. (2016). Online Survey Tools: A Case Study of Google Forms. In National Conference on Scientific, Computational & Information Research Trends in Engineering. GSSS-IETW.
[35]
Watts, N., Amann, M., Arnell, N., Ayeb-Karlsson, S., Belesova, K., Boykoff, M., Byass, P., Cai, W., Campbell-Lendrum, D., & Capstick, S. (2019). The 2019 Report of The Lancet Countdown on Health and Climate Change: Ensuring That the Health of a Child Born Today Is Not Defined by a Changing Climate. The Lancet, 394, 1836-1878. https://doi.org/10.1016/S0140-6736(19)32596-6
[36]
Wei, J., Hansen, A., Zhang, Y., Li, H., Liu, Q., Sun, Y., & Bi, P. (2014). Perception, Attitude and Behavior in Relation to Climate Change: A Survey among CDC Health Professionals in Shanxi Province, China. Environmental Research, 134, 301-308. https://doi.org/10.1016/j.envres.2014.08.006
[37]
World Health Organization (2018). COP24 Special Report: Health and Climate Change. World Health Organization.
[38]
World Health Organization (2021). COP26 Health Programme: Country Commitments. World Health Organization.
[39]
Xie, E., de Barros, E. F., Abelsohn, A., Stein, A. T., & Haines, A. (2018). Challenges and Opportunities in Planetary Health for Primary Care Providers. The Lancet Planetary Health, 2, e185-e187. https://doi.org/10.1016/S2542-5196(18)30055-X
