Awareness and preparedness of health systems and emergency medicine systems to the climate change challenges and threats: an international survey.

Background and importance: Climate change is widely recognised as a critical public health challenge.

Objective: The objective of this study was to assess the awareness, preparedness and mitigation plans for climate change threats.

Design, settings and participants: A cross-sectional observational study targeting emergency medical societies in different countries was conducted between 15 February and 15 March 2024.

Intervention or exposure: The survey featured 16 closed questions on climate change awareness, preparedness and risks. Focus groups of 4-6 members were organised by country. Results were correlated to income levels, United Nations (UN) regional classification and the World Risk Index.

Outcome measure and analysis: The questions were ranked using a Likert-like scale from 0 to 9 (9 being the highest). Descriptive statistics used central tendency estimators, and inferential analysis used chi-square and Kruskal-Wallis tests, with the significance level set at P < 0.05.

Results: Forty-two focus groups responded, representing 36 countries: 21 (50%) high-income, seven (16.7%) low-income, five (11.9%) lower middle-income and nine (21.4%) upper middle-income countries, representing 31 of the 22 UN regions. According to the World Risk Index, the respondent countries belonged to the different categories as follows: very low risk, 6 (14%); low risk, 8 (19%); medium risk, 5 (12%); high risk, 8 (19%) and very high risk, 14 (34%). The estimated impact of climate change on national health systems had a mean score of 6.75 (SD = 2.16), while on Emergency Medical Systems was 6.96 (SD = 2.05). Overall, assessment and preparedness measures were reported by just 21.4 and 37.6% of respondents, respectively. Analysis by income did not show significant differences, with the exception of food supply. The main differences in the analysis by region were the risks of extreme weather events, vector-borne diseases and wildfires, whereas the World Risk Index was food and chain of supplies. Education and integration of health services were indicated by all as the main mitigation actions.

Conclusion: Geographical position and country risk index influence risk perception among focus groups more than income economy, with vector-borne diseases, extreme weather events and food shortages being the threats with the most variability. The most important actions identified to mitigate Climate Change effects are educational and strategic plans.