Planetary Health in Health Services Research

>In development

Planetary HealthData linkage

The dramatic effects of the climate crisis have recently become apparent in Europe. Images of the floods in Germany in July 2021 are still present. In addition, the extreme heatwave in 2019 and droughts in 2018 and 2019 also highlight the impact of climate change and the consequences for our health. Climate models predict that such extreme weather events will increase in the coming years. However, these events do not only pose a threat to health, but also the changing climatic conditions such as generally milder temperatures throughout the year entail new health risks. The WHO has recognized the great danger posed by climate change to our health and speaks of climate change as the greatest health threat to humankind.

With the term »Planetary Health« a new discipline has been established in recent years. The base of the concept is the idea that human health depends on the health of planet Earth. It is necessary to prepare the health sector (providers, infrastructure, patients) for changing disease patterns and emergency situations in order to counter the effects of climate change, which can no longer be prevented today (»Manage the unavoidable!«). At the same time, it is important for the health sector to uncover climate change mitigation potentials in order to mitigate climate change as far as possible (»Avoid the unmanageable!«).

A large number of health effects triggered by the consequences of climate change can be named. A list of examples follows:

Extreme weather events

• Acute danger to life
• In the case of severe thunderstorms: There is an increased release of particles and pollen in the atmosphere after thunderstorms to which asthmatics react particularly strongly. Studies found an accumulation of asthma attacks.   
• Illnesses caused by drinking water contaminated with pollutants or other pathogens.
• Mental illnesses: Post-traumatic stress disorder (PTSD), depression, anxiety, solastalgia

Heat events

• Increased risk of heart attacks and other problems of the cardiovascular system
• Heat strokes and collapses, and dehydration with long-term risk of thrombosis
• Heat stroke can also increase the risk of acute kidney disease
• In the long term, periods of heat can cause decompensation of pre-existing conditions
• Drug interactions if medication regimen is not adjusted for air temperature
• Panic attacks as a result of the general air warming

Increased UV radiation

• Increased incidence of skin cancer

Formation of ground-level ozone during an accumulation of hot days

• In some cases, ozone gas can penetrate into lung tissue, causing tissue damage and inflammation. This leads to respiratory and cardiovascular diseases.

Increased and longer pollen flights due to the rise in mean air temperature

• Allergy season starts earlier and lasts longer
• Increased pollen formation due to the increase in CO2 in the air causes stronger allergy reactions
• Settlement of new plant species and spread of allergenic plants aggravates the situation of allergic persons

Settlement and multiplication of vectors due to more favorable temperatures

• Occurrence of (new) infectious diseases

General change of the living environment

• Suicides
• »Ecoanxiety«: the fear caused by people being constantly surrounded by the threatening problems related to climate change.
• »Ecoparalysis«: the feeling of helplessness to do anything about the effects of climate change.

Health services research with routine data offers versatile opportunities in the context of Planetary Health. On the one hand, the prevalence of diseases at certain weather events or in certain weather periods can be studied. On the other hand, the development of disease courses or incidences over a long period of time can be mapped and related to climate development data. On the basis of available diagnoses and data on sociodemographic characteristics of patients, risk groups can be identified. Linking routine data with climate data also offers the possibility of identifying health risks due to climate changes, which enables improved care planning. Preventive measures can also be derived using the information from the data, and demand planning can be adapted to utilization patterns. Geographical mapping plays a special role: by linking health data with climate data on a small scale, it is possible to compare regions within Germany and identify risk areas for specific disease patterns during certain climate events.

Duration: 2023–2023
Project partners: In development
Methods: Regional Analyses
Topics: Planetary Health, Population health, Topic development
Data: Data linkage, Claims data, Geo data