Publications by authors named "Ruth Etzel"

The global landscape of professional training in environmental health, encompassing ecological public health or environmental public health, lacks consistent global implementation for training programs for public health practitioners, clinical professionals, and individuals across various disciplines, as well as standardized curricula for undergraduates. This training gap is related to the overall lack of capacity in addressing the population impacts of the triple challenge of pollution, biodiversity loss, and climate change, impeding the worldwide transition to and development of ecological sustainability. This paper reviews existing approaches and their potential to address implementation challenges within the necessarily tight timescale.

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Unsustainable globalisation of economic activities, lifestyles and social structures has contributed to environmental degradation, posing major threats to human health at the local and global levels. All these problems including climate change, pollution, and biodiversity loss represent challenges that are unlikely to be met with existing approaches, capabilities and tools. This article acknowledges the need for well-prepared practitioners from many walks of life to contribute to environmental public health (EPH) functions thus strengthening society's capacity and capability to respond effectively and in a timely manner to such complex situations and multiple challenges.

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Recognition of the importance to environmental epidemiology of ethical and philosophical deliberation led, in 1996, to the establishment of Ethics Guidelines for the profession. In 1999, these guidelines were adopted by the International Society for Environmental Epidemiology. The guidelines were revised in 2012 and again in 2023 to ensure continued relevance to the major issues facing the field.

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Climate change is already impacting children's health in a variety of ways. Indian children are among the most severely affected; they are experiencing respiratory illnesses from air pollution, heat-related illnesses, malnutrition, vector- and water-borne diseases; and mental health problems such as post-traumatic stress disorder from weather disasters. There is a need to increase awareness and capacity building among paediatricians for understanding the impact of climate change on the health of children and educating parents about preventive measures.

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The climate crisis is a major public health threat for children, disproportionately affecting the most vulnerable populations. Climate change causes a myriad of health issues for children, including respiratory illness, heat stress, infectious disease, the effects of weather-related disasters, and psychological sequelae. Pediatric clinicians must identify and address these issues in the clinical setting.

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Climate change poses an existential threat to children's health. Divestment of ownership stakes in fossil fuel companies is one tool available to pediatricians to address climate change. Pediatricians are trusted messengers regarding children's health and therefore bear a unique responsibility to advocate for climate and health policies that affect children.

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Two tendencies have emerged in environmental epidemiology that hamper the translation of research findings into prevention of environmental hazards. One is the increased focus on highlighting weaknesses of epidemiology research that is clearly meant to explain away the research conclusions and weaken their possible implications for interventions to control environmental hazards. Another is the voluminous amount of information sharing that involves a substantial amount of misinformation, as part of the ongoing infodemic.

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Public health measures necessary to counteract the coronavirus disease 2019 (COVID-19) pandemic have resulted in dramatic changes in the physical and social environments within which children grow and develop. As our understanding of the pathways for viral exposure and associated health outcomes in children evolves, it is critical to consider how changes in the social, cultural, economic, and physical environments resulting from the pandemic could affect the development of children. This review article considers the environments and settings that create the backdrop for children's health in the United States during the COVID-19 pandemic, including current threats to child development that stem from: A) change in exposures to environmental contaminants such as heavy metals, pesticides, disinfectants, air pollution and the built environment; B) changes in food environments resulting from adverse economic repercussion of the pandemic and limited reach of existing safety nets; C) limited access to children's educational and developmental resources; D) changes in the social environments at the individual and household levels, and their interplay with family stressors and mental health; E) social injustice and racism.

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In the course of the COVID-19 pandemic, it has become clear that primary healthcare systems play a critical role in clinical care, such as patient screening, triage, physical and psychological support and also in promoting good community advice and awareness in coordination with secondary healthcare and preventive care. Because of the role of social and environmental factors in COVID-19 transmission and burden of disease, it is essential to ensure that there is adequate coordination of population-based health services and public health interventions. The COVID-19 pandemic has shown the primary and community healthcare (P&CHC) system's weaknesses worldwide.

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Use of Children as Soldiers.

Pediatr Clin North Am

April 2021

A child soldier is a person less than 18 years of age who/has been recruited/used by an armed force/armed group in any capacity, including but not limited to children, boys and girls, used as fighters, cooks, porters, messengers, spies, or for sexual purposes. Complex consequences on both physical and mental health are reported among child soldiers. One-third to one-half of these children may have clinically significant symptoms of post-traumatic stress disorder.

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