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As leaders of civil society, governments have a prime responsibility to communicate climate change information in order to motivate their citizens to mitigate and adapt. This study compares the approaches of the U.K. and Hong Kong governments. Although different in size and population, the United Kingdom and Hong Kong have similar climate change agendas to communicate to similarly educated and prosperous populations. The study finds that while both governments use similar means: policy, education, campaigns, internet, and social media, these have different characteristics, with different emphases in their climate change message. The United Kingdom’s top-down approach is more prominent in its legally binding policy and well-defined programs for adaptation and risk assessment. Hong Kong has more effectively embedded climate change education across the school curricula and has a more centralized and consistently branded campaign, with widespread use of visual language to connect the public to the problem. Hong Kong frames climate change as a science–society problem and has a greater focus on self-responsibility and bottom-up behavioral change. Thus, the U.K. and Hong Kong governments have polarized approaches to motivating their citizens into climate action. Moving forward, both governments should consider best practice elements of the other to develop their communication of climate change.

There has been renewed recognition that proactive strategies and interventions can address the social determinants of health, and the environmental health profession is well placed to effect positive change in many of these determinants. This qualitative research has revealed differences in the perceptions, experiences, and understandings of evidence-based practice among public health professionals from different backgrounds across different services in health care and local government in England. The absence of a strong tradition of evidence-based practice in environmental health appears to be a disadvantage in securing funding and playing a full role, as it has become the expectation in the new public health system. This has, at times, resulted in tensions between professionals with different backgrounds and frustration on the part of environmental health practitioners, who have a tradition of responding quickly to new challenges and “getting on with the job.” There is generally a willingness to develop evidence-based practice in environmental health; however, this will take time and investment.

Purpose – The purpose of this paper is to consolidate policy, research, evidence and good practice around strategies tackling fuel poverty and affordable warmth for older people aged over 60 to support the development of more effective services for this life course stage and to tackle physical and mental health inequalities. Design/methodology/approach – The authors consolidate current policy, research, evidence and examples of good practice in exploring effective interprofessional approaches that contribute to affordable warmth for older people through “desktop analysis”. The authors support this with qualitative data from Health and Wellbeing Boards (HWBs), health inequalities and environmental health from research comprising four longitudinal case studies in the Midlands and North of England over 18 months and semi-structured interviews with members and support officers. A total of 50 interviews were undertaken and 55 hours of HWB meetings observed. Findings – There are numerous older people living in fuel poverty. The depth of fuel poverty increases with age particularly the over 75s and physical and mental ill health are affected. There are an increasing number of tools to help estimate health care costs around the cost effectiveness of interventions and there is a real need for more local evidence about what is working well, how and why. However, there is no mandatory requirement for fuel poverty strategies and more creative local strategies are required taking organisational and interprofessional relationships into account. The emphasis in integrated care provides new impetus and scope to encourage preventative services but these new partnerships need to be effective in what is a complex policy environment. There is still a long way to go in places. The challenges of ageing are numerous, complex and not fully understood and sit across multiple policy areas. Originality/value – Fuel poverty strategies tend to be delivered on a geographical or income bases rather than by life course approach and a focus on older people. We need to focus more specifically on older people, a rapidly growing population and to better understand thermal properties of our ageing housing stock and how best to intervene to protect and improve health and safety. Emerging approaches need to overcome artificial statutory and non statutory divides and move towards sustainable, evidence based affordable warmth strategies for older people to protect and improve health.

Environmental health (EH) professionals have often spoken of the need to become more research active (Burke et al., 2002; McCarthy, 1996) and make their work more evidence based, but to date little has been written about how to achieve this in practice. This chapter is therefore written as an introductory guide to research for EH professionals, students, and policy makers. By developing your knowledge it is hoped you will feel more confident navigating the world of research; motivated towards making your own work more evidence based; and enthused about contributing to the evidence base from which others can learn. This chapter is not a research methods textbook, a step by step guide to research or evidence based environmental health, nor does it seek to make definitive statements about these complex areas. However it highlights the most important issues regarding research in environmental health, considers the importance of research to the environmental health profession and provides useful signposts towards further resources. The chapter is divided into three sections. The first defines evidence based environmental health and why it remains a priority for EH professionals. The second section explores the key stages of environmental health research and provides guidance on the development of your reading skills. The final section suggests ways to become more research active and evidence based, acknowledging the many challenges EH professionals face and concluding with a vision for evidence based environmental health. The chapter ends with an annex including a glossary of environmental health research terms, a list of references and suggested further reading.

Aims: The aim of the wider research was to explore Health and Wellbeing Boards (HWBs) during their early development stages, with a focus on health inequalities and the role of environmental health (EH). This article presents empirical findings relating to challenges facing the EH profession in the new English public health (PH) system and offers new practical suggestions as to how they might be overcome in relation to educating and training the new generation of EH practitioners (EHPs). Methods: Four case study HWBs in the Midlands and North of England were followed for 18 months from early 2012. In addition, EHPs and managers from each English region were interviewed. In total, 50 semi-structured interviews were carried out, around 55 h of HWB meetings were observed, and documents associated with HWBs such as strategies and minutes of meetings were collected. Data were analysed thematically, both inductively and deductively, using Atlas.ti. Results: EH is largely invisible in the new PH system due to a variety of internal and external factors, including existing skill sets and practices. There is a new imperative to move away from reliance on statutory functions for funding and to engage with wider PH issues and colleagues, requiring new skills of evaluation and a change in perception from being ‘doers’ to include a greater role as ‘thinkers’. This is being recognised by EHPs and managers, who are seeking ways to adapt to these new expectations. Conclusion: Recent changes to the English PH system have led to a period of reflection and the beginnings of adaptation in EH to overcome new challenges. Linked to this is a need for graduate training to prepare new practitioners to think critically, to thrive and become high-level managers of the future, while being technically competent. We suggest a new, enhanced role for Chartered Institute of Environmental Health (CIEH)–accredited universities in securing the future of the profession by supporting new graduates. Specifically, a mentoring scheme could be introduced for the practical training element for new practitioners. This would help to embed criticality and evaluation in practice, provide consistency in training, and overcome the disconnect between academia and practice.

ObjectivesTo thematically synthesise primary qualitative studies that explore challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries.DesignSystematic review and qualitative thematic synthesis.MethodsSearches of MEDLINE, EMBASE, PsycINFO, CINAHL and Web of Science. Search terms were combined for qualitative research, primary healthcare professionals, refugees and asylum seekers, and were supplemented by searches of reference lists and citations. Study selection was conducted by two researchers using prespecified selection criteria. Data extraction and quality assessment using the Critical Appraisal Skills Programme tool was conducted by the first author. A thematic synthesis was undertaken to develop descriptive themes and analytical constructs.ResultsTwenty-six articles reporting on 21 studies and involving 357 participants were included. Eleven descriptive themes were interpreted, embedded within three analytical constructs: healthcare encounter (trusting relationship, communication, cultural understanding, health and social conditions, time); healthcare system (training and guidance, professional support, connecting with other services, organisation, resources and capacity); asylum and resettlement. Challenges and facilitators were described within these themes.ConclusionsA range of challenges and facilitators have been identified for health professionals providing primary healthcare for refugees and asylum seekers that are experienced in the dimensions of the healthcare encounter, the healthcare system and wider asylum and resettlement situation. Comprehensive understanding of these challenges and facilitators is important to shape policy, improve the quality of services and provide more equitable health services for this vulnerable group.