Effects of climate-related risks and extreme events on health outcomes and health utilization of primary care in rural and remote areas: a scoping review

Sari Puspa Dewi; Rosny Kasim; I Nyoman Sutarsa; Arnagretta Hunter; Sally Hall Dykgraaf

doi:10.1093/fampra/cmac151

Effects of climate-related risks and extreme events on health outcomes and health utilization of primary care in rural and remote areas: a scoping review

Fam Pract. 2023 May 31;40(3):486-497. doi: 10.1093/fampra/cmac151.

Authors

Sari Puspa Dewi^{1

2}, Rosny Kasim¹, I Nyoman Sutarsa^{1

3}, Arnagretta Hunter¹, Sally Hall Dykgraaf¹

Affiliations

¹ Rural Clinical School, School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, Australia.
² Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Jatinangor, Indonesia.
³ Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Indonesia.

PMID: 36718099
DOI: 10.1093/fampra/cmac151

Abstract

Background: Rural populations are at risk of climate-related impacts due to ecological and geographical determinants, potentially leading to greater morbidity and health utilization. They are often highly dependent on primary care services. However, no rural- or primary care specific synthesis of these issues has ever been conducted. This review aimed to identify, characterize, and summarize existing research on the effects of climate-related events on utilization and health outcomes of primary care in rural and remote areas and identify related adaptation strategies used in primary care to climate-related events.

Methods: A scoping review following PRISMA-ScR guidelines was conducted, examining peer-reviewed English-language articles published up to 31 October 2022. Eligible papers were empirical studies conducted in primary care settings that involved climate-related events as exposures, and health outcomes or utilization as study outcomes. Two reviewers independently screened and extracted relevant information from selected papers. Data were analysed using content analysis and presented using a narrative approach.

Results: We screened 693 non-duplicate papers, of those, 60 papers were analysed. Climate-related events were categorized by type, with outcomes described in terms of primary, secondary, and tertiary effects. Disruption of primary care often resulted from shortages in health resources. Primary care may be ill-prepared for climate-related events but has an important role in supporting the development of community.

Conclusions: Findings suggest various effects of climate-related events on primary care utilization and health outcomes in rural and remote areas. There is a need to prepare rural and remote primary care service before and after climate-related events.

Keywords: adaptation strategies; climate change; health care utilization; health outcomes; primary health care; rural health.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Climate
Humans
Outcome Assessment, Health Care
Primary Health Care
Rural Health Services*
Rural Population