城乡基层医疗人员对气候变化及其健康风险认知的差异

目的探究基层医疗人员对气候变化及其健康风险认知的城乡差异。方法采用分层随机整群抽样,抽取广东省21家城区和10家乡镇基层医疗卫生机构的医疗人员进行问卷调查,收集其基本信息和对气候变化及其健康风险的认知情况,通过卡方检验、秩和检验和logistic逐步回归分析探究气候变化认知的城乡差异。结果63.8%(468/733)的基层医疗卫生人员认同气候变化正在发生,55.4%(406/733)的人认为气候变化主要归因于人类活动。城区卫生人员对气候变化正在发生的认同程度高于乡镇,而城区与乡镇对气候变化发生原因的认知差异不明显。城区人员在高温热浪的健康风险认知上略高于乡镇,而对于气候变化与传染病关联的认知略低于乡镇,但差异不具有统计学意义。乡镇人员识别气候变化脆弱人群的能力略高于城区,差异具有统计学意义。此外,职称级别越高越能感知气候变化健康风险;临床医生相比于护士和公共卫生人员更认同气候变化正在发生且更能识别其发生原因。结论城区基层医疗卫生人员在气候变化正在发生的认同程度上略高于乡镇,但是乡镇医疗卫生人员比城区的更能识别脆弱人群。城区与乡镇基层医疗卫生人员对气候变化及其健康风险认知均不容乐观,应积极采取措施提升风险认知以增强其应对气候变化健康风险的能力。

Differences on the Perceptions of Climate Change and Health Risks among Urban and Rural Primary Healthcare Workers

Objectives To investigate the urban-rural differences on the perceptions of climate change and health risks among primary healthcare workers. Methods By stratified random cluster sampling,extracted all the healthcare workers from 21 urban and 10 rural primary healthcare institutions in Guangdong Province,and collected the basic information and the perceptions of climate change and its health risk through questionnaires. Chisquare test,Wilcoxon rank sum test and logistic stepwise regression analysis were used to explore the cognitive differences of climate change between urban and rural primary health workers. Results 63. 8%( 468/733) of primary healthcare workers agreed that climate change was happening,and 55. 4%( 406/733) believed that climate change was mainly attributable to human activities. Urban primary healthcare workers were more likely than rural counterparts to agree that climate change was happening. There was no obvious difference between urban and rural primary healthcare workers in recognizing the causes of climate change. In terms of the health risks of heat wave,urban primary healthcare workers had a slightly higher cognitive level than rural primary health workers,while in terms of the relationship between climate change and infectious diseases,the cognitive level of rural primary healthcare workers was slightly higher than urban primary healthcare workers,but the differences of both were not statistically significant.In the identification of vulnerable groups of climate change,rural primary healthcare workers had a higher cognitive level than urban primary healthcare workers,which was statistically significant. In addition,the higher professional title of primary healthcare workers,the higher their cognitive level of the health risk of climate change. Clinicians were more likely than nurses and public health practitioners to agree that climate change was happening and to understand the correct causes. Conclusions Urban primary healthcare workers were more likely than rural counterparts to agree that climate change was happening,while rural primary healthcare workers had a higher cognitive level than urban primary healthcare workers to identify vulnerable groups of climate change. No matter in urban or rural areas,the cognition of primary healthcare workers on climate change and its health risks was not optimistic,and measures should be taken to improve their cognition so as to enhance their ability to address health risks of climate change.