Assessing climate change and health provisions among staff in higher education institutions: A preliminary investigation

• To enhance the educational landscape, there is a need to integrate climate change and health topics into existing courses, especially those in environmental science, public health, and biology. This incorporation enriches the curriculum by infusing relevant content into estab- lished academic domains. • Pioneering the creation of new interdisciplinary courses dedicated to the exploration of cli- mate change and health is imperative. These courses should draw upon insights from various disciplines, fostering a holistic understanding of the multifaceted relationship between cli- mate change and health. • Establishing experiential learning opportunities, such as field trips and research projects, is crucial for a hands-on exploration of climate change and health topics. These opportunities provide students with real-world exposure and deepen their understanding through practical engagement. • To further enrich the educational experience, it is essential to develop avenues for students to directly engage with experts and practitioners in the field. This interaction facilitates a direct exchange of knowledge, insights, and experiences, enhancing students’ comprehen- sion of the complex issues at the intersection of climate change and health. • Facilitating meaningful conversations among students, faculty, and practitioners about the interconnectedness of climate change and health is vital. Creating spaces for dialogue fosters a collaborative learning environment, encouraging the exchange of perspectives and the development of well-rounded insights into the subject matter.

By implementing these recommendations, universities can not only address the identified challenges but also contribute significantly to preparing future professionals with a compre- hensive understanding of the critical nexus between climate change and health. Finally, greater provisions should be made for training, so that teaching staff and research- ers may become more familiar with the connections between climate change and health and, by doing so, feel encouraged to handle these issues in their study programmes and research. In PLOS ONE Climate change and health in HEIs PLOS ONE | https://doi.org/10.1371/journal.pone.0304019 May 21, 2024 17 / 21

this context, the establishment of partnerships between HEIs and public health organisations may prove fruitful, promoting collaboration and knowledge exchange on matters related to cli- mate change and health, to the advantage of current and future university students. This is supported by the fruitful cases studies presented, underscoring the transformative potential of using these examples as a guide for developing countries, thus promoting a cross-pollination of ideas and strategies, facilitating a more inclusive and collaborative approach to tackling shared issues on a global scale. Supporting information S1 Appendix. Study on climate change and health—Survey question. (DOCX) S1 Dataset. (XLSX) Acknowledgments This paper is part of the “100 papers to accelerate the implementation of the UN Sustainable Development Goals” initiative. Author Contributions Conceptualization: Walter Leal Filho. Formal analysis: Maria Alzira Pimenta Dinis, Javier Sierra. Investigation: Maria Gabriela Meirelles, Fernanda Carvalho. Methodology: Maria Alzira Pimenta Dinis, Amanda Lange Salvia, Javier Sierra. Supervision: Walter Leal Filho. Writing – original draft: Walter Leal Filho, Maria Alzira Pimenta Dinis, Amanda Lange Sal- via, Javier Sierra, Helena Vasconcelos, Claire Henderson-Wilson, Samo Diatta, T. V. Lakshmi Kumar, Maria Gabriela Meirelles, Fernanda Carvalho. Writing – review & editing: Walter Leal Filho, Amanda Lange Salvia. References 1. IPCC. Synthesis Report of the IPCC Sixth Assessment Report (AR6) Summary for Policymakers, Inter- governmental Panel on Climate Change. 2023.

2. Organization WH. Protecting human health from climate change (No. SEA-EH-570). WHO Regional Office for South-East Asia. 2011. 3. Trisos CH, Adelekan IO, Totin E, Ayanlade A, Efitre J, Gemeda A, et al. Africa. In: Change Climate 2022: Impacts, Adaptation and Vulnerability Contribution of Working Group II to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press; p. 1285– 1455. 4. Tong S, Ebi K. Preventing and mitigating health risks of climate change. Environ Res. 2019; 174:9–13. https://doi.org/10.1016/j.envres.2019.04.012 PMID: 31022612 5. Habibi P, Moradi G, Dehghan H, Moradi A, Heydari A. The impacts of climate change on occupational heat strain in outdoor workers: A systematic review. Urban Clim. 2021; 36:100770. 6. Moda HM, Filho WL, Minhas A. Impacts of Climate Change on Outdoor Workers and Their Safety: Some Research Priorities. Vol. 16, International Journal of Environmental Research and Public Health. 2019. https://doi.org/10.3390/ijerph16183458 PMID: 31533360 7. Anoopkumar AN, Aneesh EM. A critical assessment of mosquito control and the influence of climate change on mosquito-borne disease epidemics. Environ Dev Sustain. 2022; 24(6):8900–29. PLOS ONE Climate change and health in HEIs PLOS ONE | https://doi.org/10.1371/journal.pone.0304019 May 21, 2024 18 / 21

8. Bartlow AW, Manore C, Xu C, Kaufeld KA, Del Valle S, Ziemann A, et al. Forecasting Zoonotic Infec- tious Disease Response to Climate Change: Mosquito Vectors and a Changing Environment. Vol. 6, Veterinary Sciences. 2019. https://doi.org/10.3390/vetsci6020040 PMID: 31064099 9. Gubler DJ. The Global Emergence/Resurgence of Arboviral Diseases As Public Health Problems. Arch Med Res. 2002; 33(4):330–42. https://doi.org/10.1016/s0188-4409(02)00378-8 PMID: 12234522 10. Zermoglio F, Ryan SJ, Swaim M. Shifting burdens: malaria risk in a hotter Africa. Technical Report, United States Agency for International Development (USAID) and Adaptation Thought Leadership and Assessments (ATLAS) [Internet]. 2019. https://www.climatelinks.org/sites/default/files/asset/ document/2019_USAID_ATLAS_Shifting Burdens.pdf 11. Semakula HM, Song G, Achuu SP, Shen M, Chen J, Mukwaya PI, et al. Prediction of future malaria hot- spots under climate change in sub-Saharan Africa. Clim Change [Internet]. 2017; 143(3):415–28. Avail- able from: https://doi.org/10.1007/s10584-017-1996-y 12. Leedale J, Jones AE, Caminade C, Morse AP. A dynamic, climate-driven model of Rift Valley fever. Geospat Health [Internet]. 2016 Mar 31; 11(s1 SE-Original Articles). Available from: https://www. geospatialhealth.net/index.php/gh/article/view/394 https://doi.org/10.4081/gh.2016.394 PMID: 27063737 13. Ryan SJ, Lippi CA, Zermoglio F. Shifting transmission risk for malaria in Africa with climate change: a framework for planning and intervention. Malar J. 2020; 19(1):170. https://doi.org/10.1186/s12936-020-

03224-6 PMID: 32357890 14. Charlson F, Ali S, Benmarhnia T, Pearl M, Massazza A, Augustinavicius J, et al. Climate Change and Mental Health: A Scoping Review. Vol. 18, International Journal of Environmental Research and Public Health. 2021. https://doi.org/10.3390/ijerph18094486 PMID: 33922573 15. Cianconi P, Betrò S, Janiri L. The Impact of Climate Change on Mental Health: A Systematic Descriptive Review. Vol. 11, Frontiers in Psychiatry. 2020. https://doi.org/10.3389/fpsyt.2020.00074 PMID: 32210846 16. da Fonte CAM, Caridade SMM, Dinis MAP. Mental Health, Well-Being and Climate Change: Scope and Challenges. In: Leal Filho W, Vidal DG, Dinis MAP, editors. Climate Change and Health Hazards: Addressing Hazards to Human and Environmental Health from a Changing Climate [Internet]. Cham: Springer Nature Switzerland; 2023. p. 41–55. 17. Hickman C, Marks E, Pihkala P, Clayton S, Lewandowski RE, Mayall EE, et al. Climate anxiety in chil- dren and young people and their beliefs about government responses to climate change: a global sur- vey. Lancet Planet Health. 2021; 5(12):e863–73. https://doi.org/10.1016/S2542-5196(21)00278-3 PMID: 34895496 18. Romanello M, McGushin A, Di Napoli C, Drummond P, Hughes N, Jamart L, et al. The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future. The Lancet. 2021 Oct 30; 398(10311):1619–62. https://doi.org/10.1016/S0140-6736(21)01787-6 PMID: 34687662 19. McCowan T. The impact of universities on climate change: a theoretical framework [Internet]. 2020.

(Transforming Universities for a Changing Climate Working Paper Serie). Report No.: 2. https://www. academia.edu/download/64282439/Working paper, final.pdf 20. Lemons J. The Urgent Need for Universities to Comprehensively Address Global Climate Change Across Disciplines and Programs. Environ Manage [Internet]. 2011; 48(3):379–91. Available from: https://doi.org/10.1007/s00267-011-9699-z PMID: 21674254 21. Jeong JS, Gonza´ lez-Go´ mez D, Conde-Nu´ñez MC, Sa´nchez-Cepeda JS, Yllana-Prieto F. Improving Cli- mate Change Awareness of Preservice Teachers (PSTs) through a University Science Learning Envi- ronment. Vol. 11, Education Sciences. 2021. 22. Leal Filho W, Sima M, Sharifi A, Luetz JM, Salvia AL, Mifsud M, et al. Handling climate change educa- tion at universities: an overview. Environ Sci Eur [Internet]. 2021; 33(1):109. Available from: https://doi. org/10.1186/s12302-021-00552-5 PMID: 34603904 23. Leal Filho W, Aina YA, Dinis MAP, Purcell W, Nagy GJ. Climate change: Why higher education mat- ters? Science of The Total Environment [Internet]. 2023; 892:164819. Available from: https://www. sciencedirect.com/science/article/pii/S0048969723034423 https://doi.org/10.1016/j.scitotenv.2023. 164819 PMID: 37315612 24. Berkeley. Master’s in Global Health and Environment (MPH). 2023. 25. CISL. Climate change and human health [Internet]. 2019. https://www.cisl.cam.ac.uk/resources/ sustainability-horizons/july-2019/climate-change-and-human-health 26. Palmeiro-Silva YK, Ferrada MT, Flores JR, Cruz ISS. Climate change and environmental health in

undergraduate health degrees in Latin America. Rev Saude Publica. 2021 Apr 23; 55(SE-):17. https:// doi.org/10.11606/s1518-8787.2021055002891 PMID: 33909871 PLOS ONE Climate change and health in HEIs PLOS ONE | https://doi.org/10.1371/journal.pone.0304019 May 21, 2024 19 / 21

27. Stein S. Universities confronting climate change: beyond sustainable development and solutionism. High Educ (Dordr). 2023. 28. Ottersen OP, Frenk J, Horton R. The Lancet–University of Oslo Commission on Global Governance for Health, in collaboration with the Harvard Global Health Institute. The Lancet. 2011 Nov 5; 378 (9803):1612–3. https://doi.org/10.1016/S0140-6736(11)61617-6 PMID: 22055031 29. HAW. Sustainability and Climate Impact Management. 2023. 30. Amaral LP, Martins N, Gouveia JB. Quest for a sustainable university: a review. International Journal of Sustainability in Higher Education. 2015 Jan 1; 16(2):155–72. 31. Gruber JS, Rhoades JL, Simpson M, Stack L, Yetka L, Wood R. Enhancing climate change adaptation: strategies for community engagement and university-community partnerships. J Environ Stud Sci. 2017; 7(1):10–24. 32. NUS. Sustainability [Internet]. 2023. https://sustainability.nus.edu.sg/ 33. Wachholz S, Artz N, Chene D. Warming to the idea: university students’ knowledge and attitudes about climate change. International Journal of Sustainability in Higher Education. 2014 Jan 1; 15(2):128–41. 34. Hess DJ, Collins BM. Climate change and higher education: Assessing factors that affect curriculum requirements. J Clean Prod. 2018; 170:1451–8. 35. Reimers FM. The Role of Universities Building an Ecosystem of Climate Change Education BT—Edu- cation and Climate Change: The Role of Universities. In: Reimers FM, editor. Cham: Springer Interna- tional Publishing; 2021. p. 1–44.

42. Bromham L, Dinnage R, Hua X. Interdisciplinary research has consistently lower funding success. Nature. 2016; 534(7609):684–7. https://doi.org/10.1038/nature18315 PMID: 27357795 43. Arunrat N, Wang C, Pumijumnong N, Sereenonchai S, Cai W. Farmers’ intention and decision to adapt to climate change: A case study in the Yom and Nan basins, Phichit province of Thailand. J Clean Prod. 2017; 143:672–85. 44. Masud MM, Azam MN, Mohiuddin M, Banna H, Akhtar R, Alam ASAF, et al. Adaptation barriers and strategies towards climate change: Challenges in the agricultural sector. J Clean Prod. 2017; 156:698– 706. 45. Rajapaksa D, Islam M, Managi S. Pro-Environmental Behavior: The Role of Public Perception in Infra- structure and the Social Factors for Sustainable Development. Sustainability. 2018; 10(4):937. 46. Lee TM, Markowitz EM, Howe PD, Ko CY, Leiserowitz AA. Predictors of public climate change awareness and risk perception around the world. Nature Climate Change 2015 5:11. 2015; 5 (11):1014–20. 47. Poortinga W, Whitmarsh L, Steg L, Bo¨ hm G, Fisher S. Climate change perceptions and their individual- level determinants: A cross-European analysis. Global Environmental Change. 2019; 55:25–35. 48. Monroe MC, Plate RR, Oxarart A, Bowers A, Chaves WA. Identifying effective climate change educa- tion strategies: a systematic review of the research. Environ Educ Res [Internet]. 2019 Jun 3; 25 (6):791–812. Available from: https://doi.org/10.1080/13504622.2017.1360842 49. Leal Filho W. Introducing the International Climate Change Information Programme (ICCIP) BT—Uni-

versity Initiatives in Climate Change Mitigation and Adaptation. In: Leal Filho W, Leal-Arcas R, editors. Cham: Springer International Publishing; 2019. p. 3–11. PLOS ONE Climate change and health in HEIs PLOS ONE | https://doi.org/10.1371/journal.pone.0304019 May 21, 2024 20 / 21

50. Ludin NA, Junedi MM, Affandi NAA, Ibrahim MA, Sopian K, Teridi MAM, et al. Energy efficiency action plan for a public hospital in Malaysia. Alam Cipta. 2019; 12(Special Issue 1):73–9. 51. Vogel C., Schwaibold U., & Misser S. ‘Teaching and Learning for Climate Change’–The Role of Teacher Materials and Curriculum Design in South Africa. Southern African Journal of Environmental Education. 2015; 31:78–97. 52. Muula A. Training Needs Assessment in climate change, gender and health for health workers in Malawi. In: Muula Adamson S., Rumbidzai Mlewah CS, editor. Training Needs Assessment in Climate Change, Gender and Health. 2016. 53. Omrani O El, Dafallah A, Paniello Castillo B, Amaro BQRC, Taneja S, Amzil M, et al. Envisioning plane- tary health in every medical curriculum: An international medical student organization’s perspective. Med Teach. 2020 Oct 2; 42(10):1107–11. https://doi.org/10.1080/0142159X.2020.1796949 PMID: 32757869 54. IFMSA. Student Exchange Program [Internet]. 2023. https://ifmsa.org/student-exchange-program/ 55. Yale. Climate Change and Health Certificate [Internet]. 2023. https://ysph.yale.edu/cchcert/program/ curriculum/ 56. University of Miami. Master of Science in Climate and Health [Internet]. 2023. https://bulletin.miami. edu/graduate-academic-programs/medicine/public-health/ms-climate-health/#text. 57. American Association of Colleges of Nursing. Nursing and Climate Change: Impact, Urgency, and Engagement [Internet]. 2022. https://www.aacnnursing.org/Professional-Development/Webinar-Info/ sessionaltcd/WF22_11_17

58. The University of Sydney. Climate change, human health and social impacts node [Internet]. 2017. https://www.sydney.edu.au/medicine-health/our-research/research-centres/climate-change-human- health-and-social-impacts-node.html 59. Australian National University. Sample research projects [Internet]. 2023. https://health.anu.edu.au/ research/sample-research-projects 60. University of Nairobi. Public engagement on the impacts of human behavior on planetary health [Inter- net]. 2022. https://icca.uonbi.ac.ke/latest-news/public-engagement-impacts-human-behavior- planetary-health 61. Columbia University. Global Consortium on Climate and Health Education. 2017. 62. University of Colorado. Consortium takes lead on studying climate change effects on health [Internet]. 2016. https://news.cuanschutz.edu/news-stories/cu-consortium-takes-lead-studying-climate-change- effects-health 63. University of Washington. Center for Health and the Global Environment (CHanGE) [Internet]. 2023. https://www.washington.edu/research/research-centers/center-health-global-environment-change/ 64. Heidelberg Institute of Global Health. E-learning formats on climate change and health for higher educa- tion, health staff and policy makers. 2022. 65. Nieder J, Nayna Schwerdtle P, Sauerborn R, Barteit S. Massive Open Online Courses for Health Worker Education in Low- and Middle-Income Countries: A Scoping Review. Vol. 10, Frontiers in Public Health. 2022. https://doi.org/10.3389/fpubh.2022.891987 PMID: 35903395

66. Johns Hopkins. Climate and Health Certificate Program [Internet]. 2022. https://publichealth.jhu.edu/ academics/climate-and-health-certificate-program 67. Blom IM, Rupp I, de Graaf IM, Kapitein B, Timmermans A, Sperna Weiland NH. Putting planetary health at the core of the medical curriculum in Amsterdam. Lancet Planet Health. 2023 Jan 1; 7(1):e15–7. https://doi.org/10.1016/S2542-5196(22)00316-3 PMID: 36608942 68. Amsterdam UMC. Amsterdam Public Health [Internet]. 2023. https://www.amsterdamumc.org/en/ research/institutes/amsterdam-public-health.htm 69. University of Tokyo. Other Publications [Internet]. 2023. https://ir3s.ifi.u-tokyo.ac.jp/en/publications/ others/index.html 70. Komiyama H, Takeuchi K. Sustainability science: building a new discipline. Sustain Sci. 2006; 1(1):1–6. 71. UOC-UPF-ISGlobal. Salut Planetària (UOC-UPF-ISGlobal) [Internet]. 2023. https://www.isglobal.org/ documents/10179/32883/Planetary+Health+cat/6eeae5af-9bea-450f-ae62-8cbf374804b5 72. USP. Sau´de Global e Sustentabilidade [Internet]. 2023. https://www.fsp.usp.br/pos/programas/saude- global-e-sustentabilidade/ 73. University of Ghana. Bachelor of Public Health [Internet]. 2023. https://publichealth.ug.edu.gh/ programmes/undergraduate-programmes PLOS ONE Climate change and health in HEIs PLOS ONE | https://doi.org/10.1371/journal.pone.0304019 May 21, 2024 21 / 21