6735 What is the impact of climate change on child health and healthcare services globally? An international survey of paediatric healthcare professionals

Objectives To gain insight and engagement with those currently experiencing the effects of climate change (CC) on child health and healthcare services globally. Methods An online survey was conducted. Invitations to participate were emailed to international RCPCH members and shared on social media and with relevant networks. The survey was split into six domains (32 questions): demographics/workplace, CC impacts on determinants of health and access to healthcare, morbidity and workload, and awareness of CC policies and guidelines. Both direct questions and free-text opportunities were used. Data collection was open between 21/07/23–20/09/23. Responses were analysed using descriptive statistics. Results 137 healthcare professionals from 50 countries responded. The majority were doctors (86%) from community, primary care, secondary, and tertiary settings. Countries represented wide geographical distribution across Asia(18), Africa(12), Europe(10), North America(6), South America(2) and the Antipodes(2). Twenty-five were 'high- income', 7 'upper-middle', 11 'lower-middle' and 6 'low-income'.1 Seven were in the top-20 countries of the UNICEF Climate Change Risk Index.2 84% of respondents reported deterioration in children's health due to CC. The top three factors listed were poor outdoor air quality (66%), heatwaves (65%), and vector- borne diseases (45%). Access to healthcare was felt to be impacted by 46%, predominantly due to road destruction by floods, damage/delay to medication supplies and transport limitation by wildfires. 73% respondents considered morbidity was higher, particularly infectious, diarrhoeal, and respiratory diseases as well as direct effects of heat, malnutrition, and mental health presentations with children less than 5 years of age most vulnerable. Additional concerns voiced in free text were reduced school attendance, reduced outdoor exercise in heatwaves and internal and external country migration. Regarding health services, 46% reported increased workload. 30% stated their workplace had made adaptations for CC, but only 6% acknowledged specific funding. Less than half respondents were aware of WHO guidance on climate resilience and less than 1/3 of the Intergovernmental Panel on Climate Change. Limitations include small sample size and the risk of self-selection bias. Conclusion Our survey provides useful insights into a range of CC health-related problems affecting children, young people, and health professionals worldwide. Patterns of disease and ill-health related to CC reflect previous publications,3 4 but these data could help sensitise individual countries to identify their greatest needs and to focus advocacy and collaboration. Awareness of resources and designated funding appear low, highlighting the need for education and a more concerted approach to adaptation, mitigation, and campaigning. References Hamadeh N, et al. New world bank country classifications by income level: 2022–2023. New world bank country classifications by income level: 2022–2023. July 2022. UNICEF. The climate crisis is a child rights crisis: introducing the children's climate risk index. New York: 2021. Ali H, et al. The climate crisis is also a child rights crisis. Arch Dis Child 2022; 107(5):417–418. doi: 10.1136/archdischild-2021-323027. Helldén D, et al. Climate change and child health: a scoping review and an expanded conceptual framework. The Lancet Planetary Health 2021; 5(3):E164-E175. doi:10.1016/S2542-5196(20)30274-6.