Geography Matters, But Evolving Success Factors for Nature-Oriented Health Tourism within Selected Alpine Destinations.

This paper analyzes the success factors of health tourism based on natural attractions in selected European spa and health destinations. The natural resources included in the offers, such as water, salt, and air, play a central role in this context, as their evidence-based effects have a high relevance for the health and wellbeing of tourists. Due to its specific geographical location and considering the threat of climate change, however, this offer is facing increasing challenges which make adaptation strategies necessary. In addition to a conceptional introduction to the topic, this paper contains a descriptive analysis of tourism statistics and the results from self-administered questionnaires with six selected representatives from alpine health destinations (DE, FR, IT, AT, CH, SI). The results show varying forms of health tourism based on natural attractions, which are also reflected in online marketing, with potential for optimization. The web research and the responses to the questionnaire revealed that evidence-based studies hardly play a role in promoting health touristic offers. Furthermore, climate change effects on natural attractions are considered extremely small and tend to prompt the development of new offers. Health destinations are advised to generate a clearer focus on the risks of climate change regarding natural resources.

Perception of climate change in patients with chronic lung disease.

BACKGROUND: Climate change affects human health. The respective consequences are predicted to increase in the future. Patients with chronic lung disease are particularly vulnerable to the involved environmental alterations. However, their subjective perception and reactions to these alterations remain unknown. METHODS: In this pilot study, we surveyed 172 adult patients who underwent pulmonary rehabilitation and 832 adult tourists without lung disease in the alpine region about their perception of being affected by climate change and their potential reaction to specific consequences. The patients' survey also contained the COPD Assessment Test (CAT) to rate the severity of symptoms. RESULTS: Most of the patients stated asthma (73.8%), COPD (9.3%) or both (11.0%) as underlying disease while 5.8% suffered from other chronic lung diseases. Patients and tourists feel equally affected by current climate change in general, while allergic subjects in both groups feel significantly more affected (p = 0.04). The severity of symptoms assessed by CAT correlates with the degree of feeling affected (p<0.01). The main disturbing consequences for patients are decreased air quality, increasing numbers of ticks and mosquitos and a rising risk for allergy and extreme weather events such as thunderstroms, while tourists are less disturbed by these factors. Increasing number of heat-days is of little concern to both groups. CONCLUSION: Overall patients are more sensitive to health-related consequences of climate change. Yet, the hazard of heat-days seems underestimated and awareness should be raised.