ABSTRACT
Background The rise in extreme heat periods is a major public health challenge of climate change and the World Health Organization therefore recommends the implementation of heat health action plans (HHAPs). In Germany, HHAPs are not implemented in a comprehensive manner nor nationwide. Public health authorities have been identified as key actors with regards to heat and health. This study aims at assessing the role of public health services in the implementation of HHAPs in Germany. Methods First, a review of the scientific and grey literature on the role of public health services in heat adaptation in Europe was conducted. Second, a policy document analysis of the legislation of Germany's federal states for public health services and their potential role in the implementation of HHAPs was carried out. Finally, semi-structured interviews with selected experts from multiple sectors at the local, federal and national level on their perception of the role of public health services in the implementation of HHAPs in Germany were undertaken. Results Preliminary findings show that the legal framework for public health services in the different federal states addresses environmental health and civil protection to varying extents, but that climate change-specific health risks are barely mentioned. The expert interviews revealed perceived barriers for the public health services to implement HHAPs, notably with regards to personnel (e.g. competencies, time), organizational structures (e.g. financial resources, administrative structures, legal mandates) and competing other tasks (e.g. COVID-19 response). Facilitators included motivated individuals, funding opportunities for cross-sectoral collaboration and political support. Conclusions The role of public health services in HHAP implementation in Germany varies widely between the different geographic settings and is influenced by several factors at the individual, organizational and political level. Key messages Public health services can play an important role in heat adaptation, for example through coordinating the implementation of heat health action plans. Strong legal frameworks, sufficient organizational structures and well-trained personnel are important preconditions for an effective response by public health services to climate change challenges.
ABSTRACT
Background Global Health (GH) is receiving increasing attention, in Germany, Europe and internationally. Despite an increased demand, teaching on GH remains fragmented and heterogeneous in the university landscape in German-speaking countries. Moreover, there is a lack of common understanding of GH and interpretations range from GH as tropical medicine to GH as everything related to health. This project aims to develop (A) a framework of different GH concepts, as a basis for (B) a set of GH learning objectives for German-speaking countries. Methods A review of publications providing GH definitions was carried out. Following a concept analysis approach, we developed a general framework of different and partially overlapping GH understandings. Building on these results we conducted an overview of reviews on learning objectives and curricula for GH to develop a set of learning objectives. Results The general framework distinguishes between GH concepts describing GH as (1)a set of global health issues (e.g. COVID-19), (2) a global ideal to strive for, (3 + 4) any activities relating to said global health issues or ideals (e.g. all activities contributing to health equity), and (5) sets of activities meeting various characteristics (e.g. being transdisciplinary and transnational). Within each concept, multiple sets of axes allow a more granular distinction of the concepts (e.g. regarding the relation to public health and tropical medicine). The list of key learning objectives shows considerable overlap with widely accepted public health core competencies. Differences include e.g. a (stronger) emphasis on intercultural and interdisciplinary collaboration, globalisation and transnational determinants of health. Conclusions A systematic reflection on commonalities and differences in the understanding of GH is important for a shared understanding. Based on the GH learning objectives we will develop core competencies for GH, including through an online survey of GH experts. Key messages The GH:ADT framework of global health concepts supports a systematic reflection on and recognition of the multi-dimensional nature of Global Health. The learning objectives identified in the GH:ADT project can be a valuable tool for curriculum development.
ABSTRACT
In this article, members of the German Network of Young Professionals in Public Health, discuss the opportunities and challenges of the Health in All Policies (HiAP) approach, in view of the current COVID-19 pandemic. It outlines various perspectives, from the interaction and cooperation of different policy areas to the national Public Health Service.