Determining the Public Health Impact of Climate Change: A National Study Using a Health Impact Assessment Approach in Wales.

Objective: Climate change is recognised as the biggest threat to global health of the 21st century and impacts on health and wellbeing through a range of factors. Due to this, the need to take action in order to protect population health and wellbeing is becoming ever more urgent. Methods: In 2019, Public Health Wales carried out a comprehensive mixed-method Health Impact Assessment (HIA) of climate change. Unlike other risk assessments, it appraised the potential impact of climate change on health and inequalities in Wales through participatory workshops, stakeholder consultations, systematic literature reviews and case studies. Results: The HIA findings indicate potential impacts across the wider determinants of health and wellbeing. For example, air quality, excess heat/cold, flooding, economic productivity, infrastructure, and community resilience. A range of impacts were identified across population groups, settings, and geographical areas. Conclusion: These findings can inform decision-makers to prepare for climate change plans and policies using an evidence-informed approach. The work has demonstrated the value of a HIA approach by mobilising a range of evidence through a transparent process, resulting in transferrable learning for others.

Laws, Policies, and Collective Agreements Protecting Low-wage and Digital Platform Workers During the COVID-19 Pandemic.

In the context of the COVID-19 pandemic, this commentary describes and compares shifting employment and occupational health social protections of low-wage workers, including self-employed digital platform workers. Through a focus on eight advanced economy countries, this paper identifies how employment misclassification and definitions of employees were handled in law and policy. Debates about minimum wage and occupational health and safety standards as they relate to worker well-being are considered. Finally, we discuss promising changes introduced during the COVID-19 pandemic that protect the health of low-wage and self-employed workers. Overall, we describe an ongoing "haves" and a "have not" divide, with on the one extreme, traditional job arrangements with good work-and-health social protections and, on the other extreme, low-wage and self-employed digital platform workers who are mostly left out of schemes. However, during the pandemic small and often temporary gains occurred and are discussed.

No clinic left behind: providing cost-effective in-services via distance learning.

Based on the successful pilot implementation of a Veterans Affairs Quality Enhancement Research Initiative (QUERI) aimed at increasing HIV testing throughout four local facilities and their associated satellite clinics, we expanded our efforts to deploy our methods to substantially more sites spanning six states. Our goal was to implement and examine the cost effectiveness of a distance-learning model to offer provider education to geographically remote (sub)facilities. We developed and implemented an equivalent interactive online version of our in-person presentation. Handouts were shipped to each site before the day of the in-service. Remote participants were receptive to this cost-effective form of provider activation. The technology functioned dependably; no presentation anomalies were encountered. Participants rated in-person presentations higher than online, however, mean scores for both methods were >80%. Online presentations were found to be considerably more affordable than in-person. These findings suggest that this alternate approach may offer a feasible alternative for a variety of subjects.