Health professional societies and researchers call for the integration of climate change into health counselling. However, the scientific evidence and conceptual grounding of such climate-sensitive health counselling (CSHC) remains unclear. We conducted a scoping review identifying scientific articles on the integration of climate change into communication between health professionals and patients in health-care settings. Scientific databases (Web of Science, PubMed, and Google Scholar) were searched from inception until Nov 30, 2022. 97 articles were included, of which 33 represented empirical research, and only two evaluated the effects of CSHC. More than half of the articles originated from the USA and addressed physicians. We introduce a conceptual framework for CSHC, which elaborates on aims, content areas, and communication strategies, and establishes the guiding principle of integrating CSHC into routine activities of health care. This framework supports health professionals in implementing CSHC and enables researchers to conceptualise intervention studies investigating how CSHC can contribute to the health of patients and the planet.

Heat health impacts (HHI) on the elderly are a growing concern in the face of climate change and aging populations. General practitioners (GPs) have an important role in health care for the elderly. To inform the development of effective prevention measures, it is important to investigate GPs’ perceptions of HHI. Twenty four qualitative expert interviews were conducted with GPs and analyzed using the framework approach. GPs were generally aware of heat health impacts, focusing on cardiovascular morbidity and volume imbalances. Perceptions of mortality and for instance impacts on respiratory diseases or potentially risky drugs in heat waves partly diverged from findings in literature. GPs judged the current relevance of HHI differently depending on their attitudes towards: (i) sensitivity of the elderly, (ii) status of nursing care and (iii) heat exposure in Baden-Württemberg. Future relevance of HHI was perceived to be increasing by most GPs. The main cause identified for this was population aging, while impacts of climate change were judged as uncertain by many. GPs’ perceptions, partly diverging from literature, show that GPs’ knowledge and awareness on HHI and climate change needs to be strengthened. However, they also emphasize the need for more research on HHI in the ambulant health care setting. Furthermore, GPs perceptions suggest that strong nursing care and social networks for elderly are major elements of a climate resilient health system.

Climate change is the greatest threat to global health in the twenty first century, yet combating it entails substantial health co-benefits. Physicians and other health professionals have not yet fully embraced their responsibilities in the climate crisis, especially about their communication with patients. While medical associations are calling on physicians to integrate climate change into health counselling, there is little empirical evidence about corresponding perceptions of patients. This study aimed to explore primary care patients' perceptions of climate-sensitive health counselling. From July to December 2021, 27 qualitative interviews with patients were conducted and analysed using thematic analysis. A purposive sampling technique was applied to identify patients who had already experienced climate-sensitive health counselling in Germany. Patients' perceptions of climate-sensitive health counselling were characterised by a high level of acceptance, which was enhanced by stressing the link between climate change and health, being credible concerning physician's own climate-friendly lifestyle, building upon good therapeutic relationships, creating a sense of solidarity, and working in a patient centred manner. Challenges and risks for acceptance were patients' disinterest or surprise, time constraints, feared politicisation of consultations, and evoking feelings of guilt and shame. These findings suggest that primary care patients can accept climate-sensitive health counselling, if it follows certain principles of communication, including patient-centredness. Our findings can be useful for developing communication guidelines, respective policies as well as well-designed intervention studies, which are needed to test the health and environmental effects of climate-sensitive health counselling.

This paper investigates households’ preferences to reduce their carbon footprint (CF) measured in carbon dioxide equivalents (CO₂e). It assumes that a substantial CF reduction of households is essential to reach the 1.5 °C goal under the Paris Agreement. Data was collected in four mid-size cities in France, Germany, Norway, and Sweden. Quantitative data was obtained from 308 households using a CF calculator based on a questionnaire, and a simulation game. The latter investigated households’ preferences when being confronted with the objective to reduce their CF by 50 percent by 2030 in a voluntary and forced scenario. Our results show that the greater the CO₂e-reduction potential of a mitigation action, the less willing a household was to implement that action. Households preferred actions with moderate lifestyle changes foremost in the food sector. Voluntarily, households reached a 25% footprint reduction by 2030. To reach a substantial reduction of 50 percent, households needed to choose actions that meant considerable lifestyle changes, mainly related to mobility. Given our results, the 1.5 °C goal is unlikely to be realizable currently, unless households receive major policy support. Lastly, the strikingly similar preferences of households in the four European cities investigated seem to justify strong EU and international policies.

Zusammenfassung Hitzewellen erhöhen Morbiditäts- und Mortalitätsraten, insbesondere älterer, pflegebedürftiger Menschen. Durch den Klimawandel wird sich die Zahl der Hitzewellen in Deutschland bis Ende des Jahrhunderts verdreifachen. Zudem wächst der Anteil der Risikopatienten durch den demografischen Wandel. Daher haben Bund und Länder Empfehlungen zu Hitzeaktionsplänen entwickelt, in denen auch die Ärzteschaft an der Prävention hitzebedingter Gesundheitsschäden beteiligt werden soll. Ärzte sollten sich und ihr Team zunächst für das Thema sensibilisieren. Zudem sollten sie Risikopatienten und deren Angehörige über Risiken und Präventionsmaßnahmen informieren. Im Sommer bedarf es der kritischen Arzneimittelprüfung, da Medikamentenanwendungen in Hitzewellen Abkühlungsmechanismen behindern, die Pharmakokinetik der Wirkstoffe sich verändern kann und unerwünschte Arzneimittelwirkungen gehäuft auftreten. Aufgrund seiner zentralen Stellung im Gesundheitswesen sollte der Arzt sich an der Koordinierung guter pflegerischer Versorgung und Intensivierung sozialer Kontakte in Hitzewellen beteiligen.