Abstract
To facilitate resilience to a changing climate, it is necessary to go beyond quantitative studies and take an in-depth look at the functioning of health systems and the variety of drivers shaping its effectiveness. We clarify the factors determining the effectiveness of the Estonian health system in assessing and managing the health risks of climate change. Document analyses, expert interviews with key informants from health systems whose responsibilities are relevant to climate change, and analysis of a population-based survey conducted in 2015, indicate that the health effects of climate change have not been mainstreamed into policy. Therefore, many of the potential synergistic effects of combining information on health systems, environment, and vulnerable populations remain unexploited. The limited uptake of the issue of climate change-related health risks may be attributed to the lack of experience with managing extreme weather events; limited understanding of how to incorporate projections of longer-term health risks into policies and plans; unclear divisions of responsibility; and market liberal state approaches. Minority groups and urban dwellers are placing strong pressure on the health system to address climate change-related risks, likely due to their lower levels of perceived control over their physical wellbeing. The results have implications for national, community, and individual resilience in upper-middle income countries in Eastern Europe.
Highlights
It is expected that the health risks of climate change will increase globally, with increases in morbidity and mortality from selected climate-sensitive health outcomes, putting additional pressures on health systems [1,2]
We take an in-depth look at health and rescue systems in Estonia, because they will play a key role in climate adaptation policies in connection with the EU climate change strategy [10]
The material analysed was used as background material for compiling the strategy “Climate Change Adaption Development Plan until 2030” that was ratified by the Estonian parliament in 2017 [70]
Summary
It is expected that the health risks of climate change will increase globally, with increases in morbidity and mortality from selected climate-sensitive health outcomes, putting additional pressures on health systems [1,2]. Researchers have been urged to pay more attention to the role of the nation state in climate governance, as these actors have the legitimacy and resources to develop long-term visions, stimulate and oversee local approaches, and carry forward adaptation programs, e.g., [4]. In their analysis of health adaptation initiatives in ten Organization for Economic Co-operation and Development (OECD). Countries, Austin et al concluded that national governments play a key role in health adaptation to climate change, but there are competing views on what responsibilities and obligations this will—or. We take an in-depth look at health and rescue systems in Estonia, because they will play a key role in climate adaptation policies in connection with the EU climate change strategy [10]
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