Frontline clinic perspectives on climate change, human health, and resilience: a national cross-sectional survey

Abstract Background Frontline clinics - primary care clinics that predominantly serve low-income and socially disadvantaged communities - are facing increasing impacts from climate-related extreme events. This study evaluated staff perspectives at frontline clinics on the health risks of climate cha...

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Main Authors: Tess Wiskel, Thomas T. Miles, Mariel Fonteyn, Kristin Stevens, Chelsea Heberlein, Nathaniel Matthews-Trigg, Caleb Dresser, Aaron Bernstein
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Primary Care
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Online Access:https://doi.org/10.1186/s12875-024-02622-y
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author Tess Wiskel
Thomas T. Miles
Mariel Fonteyn
Kristin Stevens
Chelsea Heberlein
Nathaniel Matthews-Trigg
Caleb Dresser
Aaron Bernstein
author_facet Tess Wiskel
Thomas T. Miles
Mariel Fonteyn
Kristin Stevens
Chelsea Heberlein
Nathaniel Matthews-Trigg
Caleb Dresser
Aaron Bernstein
author_sort Tess Wiskel
collection DOAJ
description Abstract Background Frontline clinics - primary care clinics that predominantly serve low-income and socially disadvantaged communities - are facing increasing impacts from climate-related extreme events. This study evaluated staff perspectives at frontline clinics on the health risks of climate change, the impacts of extreme events on their clinics and patients, and their motivators to improve climate resiliency. Methods A national, cross-sectional survey was conducted of staff working at frontline clinics including administrators, case workers, and providers across the United States. Survey questions assessed clinic and respondent attributes, knowledge of health risks of climate change, preferences for climate change educational and operational resources, and clinic and patient climate impacts and resilience. The survey was distributed electronically to a convenience sample of primary care clinics and to the National Association of Community Health Centers (NACHC) and National Association of Free and Charitable Clinics (NAFC) listservs. Data was collected from September to November of 2021. Respondents were current staff who consented to the survey. Responses were collected via Qualtrics, and the statistical analysis was completed using Stata. Results A total of 430 surveys were completed representing clinics in 43 states. Most (82.0%) respondents reported human activities were causing climate change. Over half (52.8%) of respondents reported an operational disruption to their clinic from extreme events in the past 3 years, and another 54.4% had plans in place to address risks from extreme events. The most useful resources identified to improve operational resilience were checklists and planning guidance. Over half (52.0%) of respondents reported they were motivated to use these resources to improve clinic preparedness. Most (84.4%) providers and case workers reported that climate change impacted patient health, however only 36.2% discussed health risks with patients, with barriers including more pressing topics and time available. Another 55.7% of respondents reported they were motivated to learn ways to help patients prepare for extreme events. Conclusions Climate-related extreme events were reported to impact patient health and disrupt frontline clinic operations. Overcoming gaps in knowledge about climate change impacts on health and providing climate educational resources can engender motivation to improve clinic and patient resilience to climate change.
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spelling doaj-art-de141fdaec784ee48128ccdf8f6171dc2025-08-20T02:33:05ZengBMCBMC Primary Care2731-45532024-11-0125111110.1186/s12875-024-02622-yFrontline clinic perspectives on climate change, human health, and resilience: a national cross-sectional surveyTess Wiskel0Thomas T. MilesMariel FonteynKristin StevensChelsea Heberlein1Nathaniel Matthews-TriggCaleb Dresser2Aaron Bernstein3Department of Emergency Medicine, Beth Israel Deaconess Medical CenterHarvard T.H. Chan School of Public Health Center for Climate, Health, and the Global EnvironmentDepartment of Emergency Medicine, Beth Israel Deaconess Medical CenterHarvard Medical SchoolAbstract Background Frontline clinics - primary care clinics that predominantly serve low-income and socially disadvantaged communities - are facing increasing impacts from climate-related extreme events. This study evaluated staff perspectives at frontline clinics on the health risks of climate change, the impacts of extreme events on their clinics and patients, and their motivators to improve climate resiliency. Methods A national, cross-sectional survey was conducted of staff working at frontline clinics including administrators, case workers, and providers across the United States. Survey questions assessed clinic and respondent attributes, knowledge of health risks of climate change, preferences for climate change educational and operational resources, and clinic and patient climate impacts and resilience. The survey was distributed electronically to a convenience sample of primary care clinics and to the National Association of Community Health Centers (NACHC) and National Association of Free and Charitable Clinics (NAFC) listservs. Data was collected from September to November of 2021. Respondents were current staff who consented to the survey. Responses were collected via Qualtrics, and the statistical analysis was completed using Stata. Results A total of 430 surveys were completed representing clinics in 43 states. Most (82.0%) respondents reported human activities were causing climate change. Over half (52.8%) of respondents reported an operational disruption to their clinic from extreme events in the past 3 years, and another 54.4% had plans in place to address risks from extreme events. The most useful resources identified to improve operational resilience were checklists and planning guidance. Over half (52.0%) of respondents reported they were motivated to use these resources to improve clinic preparedness. Most (84.4%) providers and case workers reported that climate change impacted patient health, however only 36.2% discussed health risks with patients, with barriers including more pressing topics and time available. Another 55.7% of respondents reported they were motivated to learn ways to help patients prepare for extreme events. Conclusions Climate-related extreme events were reported to impact patient health and disrupt frontline clinic operations. Overcoming gaps in knowledge about climate change impacts on health and providing climate educational resources can engender motivation to improve clinic and patient resilience to climate change.https://doi.org/10.1186/s12875-024-02622-yClinic resiliencePrimary healthClimate changeExtreme weatherEducational resourcesHealthcare delivery
spellingShingle Tess Wiskel
Thomas T. Miles
Mariel Fonteyn
Kristin Stevens
Chelsea Heberlein
Nathaniel Matthews-Trigg
Caleb Dresser
Aaron Bernstein
Frontline clinic perspectives on climate change, human health, and resilience: a national cross-sectional survey
BMC Primary Care
Clinic resilience
Primary health
Climate change
Extreme weather
Educational resources
Healthcare delivery
title Frontline clinic perspectives on climate change, human health, and resilience: a national cross-sectional survey
title_full Frontline clinic perspectives on climate change, human health, and resilience: a national cross-sectional survey
title_fullStr Frontline clinic perspectives on climate change, human health, and resilience: a national cross-sectional survey
title_full_unstemmed Frontline clinic perspectives on climate change, human health, and resilience: a national cross-sectional survey
title_short Frontline clinic perspectives on climate change, human health, and resilience: a national cross-sectional survey
title_sort frontline clinic perspectives on climate change human health and resilience a national cross sectional survey
topic Clinic resilience
Primary health
Climate change
Extreme weather
Educational resources
Healthcare delivery
url https://doi.org/10.1186/s12875-024-02622-y
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