A story of (in)coherence: climate adaptation for health in South African policies.

Climate adaptation strengthens and builds the resilience of health systems to future climate-related shocks. Adaptation strategies and policies are necessary tools for governments to address the long-term impacts of climate change and enable the health system to respond to current impacts such as extreme weather events. Since 2011 South Africa has national climate change policies and adaptation strategies, yet there is uncertainty about: how these policies and plans are executed; the extent to which health policies include adaptation; and the extent of policy coherence across sectors and governance levels. A policy document analysis was conducted to examine how South African climate change, development and health policy documents reflect the health adaptation response across national and Western Cape levels and to assess the extent of coherence across key health and environment sector policy documents, including elements to respond to health-related climate risks, that can support implementation. Our findings show that overall there is incoherence in South African climate adaptation within health policy documents. Although health adaptation measures are somewhat coherent in national level policies, there is limited coherence within Western Cape provincial level documents and limited discussion on climate adaptation, especially for health. Policies reflect formal decisions and should guide decision-makers and resourcing, and sectoral policies should move beyond mere acknowledgement of adaptation responses to a tailored plan of actions that are institutionalized and location and sector specific. Activities beyond documents also impact the coherence and implementation of climate adaptation for health in South Africa. Clear climate risk-specific documents for the health sector would provide a stronger plan to support the implementation of health adaptation and contribute to building health system's resilience.

A Descriptive Analysis of the Scientific Literature on Meteorological and Air Quality Factors and COVID-19.

The role of meteorological and air quality factors in moderating the transmission of SARS-CoV-2 and severity of COVID-19 is a critical topic as an opportunity for targeted intervention and relevant public health messaging. Studies conducted in early 2020 suggested that temperature, humidity, ultraviolet radiation, and other meteorological factors have an influence on the transmissibility and viral dynamics of COVID-19. Previous reviews of the literature have found significant heterogeneity in associations but did not examine many factors relating to epidemiological quality of the analyses such as rigor of data collection and statistical analysis, or consideration of potential confounding factors. To provide greater insight into the current state of the literature from an epidemiological standpoint, the authors conducted a rapid descriptive analysis with a strong focus on the characterization of COVID-19 health outcomes and use of controls for confounding social and demographic variables such as population movement and age. We have found that few studies adequately considered the challenges posed by the use of governmental reporting of laboratory testing as a proxy for disease transmission, including timeliness and consistency. In addition, very few studies attempted to control for confounding factors, including timing and implementation of public health interventions and metrics of population compliance with those interventions. Ongoing research should give greater consideration to the measures used to quantify COVID-19 transmission and health outcomes as well as how to control for the confounding influences of public health measures and personal behaviors.

Social Determinants of Health and COVID-19 Behaviors and Beliefs Toward Immunizations Among Latinxs.

INTRODUCTION: Sixty million Latinxs make up 26.4% of all COVID-19 cases in the United States. It is uncertain whether behaviors and beliefs of immunizations among Latinxs is influenced by social determinants of health. The purpose of this study was to examine how social determinants of health predict COVID-19 behaviors and beliefs toward immunization among Latinxs. METHODS: In this exploratory study, 11 chapters from the National Association of Hispanic Nurses collaborated to recruit participants. The CDC National 2009 H1N1 Flu Survey was adapted to measure behaviors and beliefs about immunizations of COVID-19. The Health Access Survey was used to measure social determinants of health. Instruments were available in both Spanish and English. RESULTS: Participants (n=228) with higher education and health insurance tended to have less worry about taking the vaccine. Access to resources and practicing COVID-19 protective factors was positively associated. Alternative medicine and use of COVID-19 protective factors were negatively associated. Exposure to drugs and violence was associated with a decrease in likelihood to pursue a vaccine. CONCLUSIONS: Latinx need education about COVID-19 and vaccinations. Access to health care services must be available. Results highlight the importance of careful measurement when assessing social determinants of health among Latinx.

Nursing workforce diversity: Promising educational practices.

BACKGROUND: Nursing workforce diversity is a national priority for providing culturally competent care and contributing to improved health equity. While nurses from underrepresented populations are increasing in the nursing workforce, the distribution of nurses in the United States is still not representative of the population. PURPOSE: The purpose of this paper is to describe the current state of workforce diversity in Western states and identify promising practices from programs located in Arizona, California, Colorado, and Oregon that are focused on improving nursing workforce diversity. METHODS: Four innovative programs to address nursing workforce diversity are presented. Each project has unique situations and approaches to improving admission, retention, and graduation of students underrepresented in nursing. Similar approaches each project used include holistic admission review, academic and student support, financial support, and mentoring. CONCLUSIONS: These projects contribute to knowledge development related to improving nursing workforce diversity for other colleges, universities, and states to consider. Improving nursing workforce diversity is a priority issue that could lead, through collective impact, to resolving health inequities nationally.