Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario - Canada's most populous province - include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials.
Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention.
Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%), severe weather (68%) and poor air-quality (57%). Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies.
This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into policies and programs, while higher levels of government must improve efforts to support local adaptation and provide the capacity through which local adaptation can succeed.
The gradient in health inequalities reflects a relationship between health and social circumstance, demonstrating that health worsens as you move down the socio-economic scale. For more than a decade, the Norwegian National government has developed policies to reduce social inequalities in health by levelling the social gradient. The adoption of the Public Health Act in 2012 was a further movement towards a comprehensive policy. The main aim of the act is to reduce social health inequalities by adopting a Health in All Policies approach. The municipalities are regarded key in the implementation of the act. The SODEMIFA project aimed to study the development of the new public health policy, with a particular emphasis on its implementation in municipalities.
In the SODEMIFA project, a mixed-methods approach was applied, and the data consisted of surveys as well as qualitative interviews. The informants were policymakers at the national and local level.
Our findings indicate that the municipalities had a rather vague understanding of the concept of health inequalities, and even more so, the concept of the social gradient in health. The most common understanding was that policy to reduce social inequalities concerned disadvantaged groups. Accordingly, policies and measures would be directed at these groups, rather than addressing the social gradient.
A movement towards an increased understanding and adoption of the new, comprehensive public health policy was observed. However, to continue this process, both local and national levels must stay committed to the principles of the act.
This study was designed to explain changes in work ability through occupational and life-style factors.
Work ability was measured by an index describing workers' health resources in regard to their work demands. The work factors mainly included physical and mental demands, social organization and the physical work environment. The life-style factors covered smoking, alcohol consumption, and leisure-time physical exercise. The first questionnaire study was done in 1981 and it was repeated in 1992. The subjects (N = 818) were workers in the 44- to 51-year-old age group in the beginning of the study who were active during the entire follow-up. The improvement and, correspondingly, the decline in work ability were analyzed by logistic regression models.
Both the improvement and the decline in work ability were associated more strongly with changes in work and life-style during the follow-up than with their initial variation. The model for improved work ability included improvement of the supervisor's attitude, decreased repetitive movements at work, and increased amount of vigorous leisure-time physical exercise. Deterioration in work ability was explained by a model which included a decrease in recognition and esteem at work, decrease in workroom conditions, increase in standing at work, and decrease in vigorous leisure-time physical exercise.
Social relations at work can promote or impair the work ability of elderly workers. Although the work ability of elderly workers generally declined with aging, both older and younger workers were also able to improve their work ability.
This paper presents and discusses status, challenges and future developments of Health in All Policies (HiAP) in Norway. Within the frames of the identified challenge of creating coordinated and durable policies and practices in local government, it discusses The Norwegian HiAP policy. More specifically, the paper identifies status and challenges for instituting firmer political and administrative attention to population health and health equity across administrative sectors and levels, and discusses how national authorities may stimulate more coordinated and durable HiAP policies and practices in the future.
This study explored and measured the presence, content and growth of municipal no-smoking by-laws and examined factors related to differences in by-law breadth and comprehensiveness.
By-laws from each jurisdiction across Ontario were collected and scored relative to their breadth and restrictiveness using the Asbridge-O'Grady Index. Kruskal-Wallis analysis of variance was used to compare the distributions of municipal characteristics among the regulatory level of municipal smoking legislation.
Twenty-three percent of Ontario municipalities (215/951) had enacted smoking by-laws by the end of 1998 compared to 18% (169/951) in 1994. Larger municipalities tend to be significantly more restrictive than smaller municipalities.
No-smoking legislation has become more extensive and restrictive in Ontario since the passage of the 1994 Tobacco Control Act. There was little legislative variability among the regions that contained tobacco-producing municipalities and those that did not.
State of the Environment (SOE) reporting is an emerging municipal management tool designed to monitor and increase awareness of the current status, changes and trends in the condition of the local environment. A multifaceted investigation was undertaken to examine municipal SOE reporting in Canada and to identify barriers to its widespread implementation. Highlights of the case study and survey components are summarized and a conceptual model for municipal SOE reporting is proposed. Overall, the study revealed considerable interest in environmental reporting, however, the lack of common municipal indicators, organizing frameworks and environmental data accessible at the local level impedes its widespread implementation. Future needs to enhance SOE reporting include: development of common municipal indicators, including environmental sustainability indicators; enhancement of the compatibility of SOE reporting frameworks across municipal, provincial and national levels; and re-examination of the data collected by diverse levels of government to optimize their utilization at the local level.
Association between lowered endothelial function measured by peripheral arterial tonometry and cardio-metabolic risk factors - a cross-sectional study of Finnish municipal workers at risk of diabetes and cardiovascular disease.
The aim of this cross-sectional study was to determine the association between lowered endothelial function measured by peripheral arterial tonometry (PAT) and cardio-metabolic risk factors. The study population consisted of Finnish municipal workers who were at risk of diabetes or cardiovascular disease and who had expressed a need to change their health behaviour.
A total of 312 middle-aged municipal workers underwent a physical medical examination and anthropometry measurements. Levels of total cholesterol, HDL cholesterol, triglycerides, fasting glucose, glycated haemoglobin, and high sensitivity C-reactive protein were taken from the blood samples. PAT measured the increase in digital pulse volume amplitude during reactive hyperemia, and the index of endothelial function, F-RHI, was defined as the ratio of post-deflation amplitude to baseline amplitude.
In the linear regression model, male sex was associated with lower F-RHI. In sex-adjusted linear regression models, each of the variables; waist circumference, fasting glucose, glycated hemoglobin, triglycerides, body fat percentage, body mass index, current smoking, and impaired fasting glucose or diabetes were separately associated with lower F-RHI, and HDL cholesterol and resting heart rate were associated with higher F-RHI.HDL cholesterol, sex, body mass index, and current smoking entered a stepwise multivariable regression model, in which HDL cholesterol was associated with higher F-RHI, and smoking, male sex and body mass index were associated with lower F-RHI. This model explains 28.3% of the variability in F-RHI.
F-RHI is associated with several cardio-metabolic risk factors; low level of HDL cholesterol, male sex, overweight and smoking being the most important predictors of a lowered endothelial function. A large part of variation in F-RHI remains accounted for by unknown factors.
Cites: Circulation. 2008 May 13;117(19):2467-7418458169