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Unsustainable globalisation of economic activities, lifestyles and social structures has contributed to environmental degradation, posing major threats to human health at the local and global levels. All these problems including climate change, pollution, and biodiversity loss represent challenges that are unlikely to be met with existing approaches, capabilities and tools. This article acknowledges the need for well-prepared practitioners from many walks of life to contribute to environmental public health (EPH) functions thus strengthening society’s capacity and capability to respond effectively and in a timely manner to such complex situations and multiple challenges. It envisions a new EPH practice addressing questions on: Why do this? What needs to be addressed? Who will do it? How can it be implemented? This article focuses on the main challenging EPH issues worldwide and how they could be addressed using a conceptual framework for training. A companion article shows how they have been tackled in practice, providing ideas and experiences.

The global landscape of professional training in environmental health, encompassing ecological public health or environmental public health, lacks consistent global implementation for training programs for public health practitioners, clinical professionals, and individuals across various disciplines, as well as standardized curricula for undergraduates. This training gap is related to the overall lack of capacity in addressing the population impacts of the triple challenge of pollution, biodiversity loss, and climate change, impeding the worldwide transition to and development of ecological sustainability. This paper reviews existing approaches and their potential to address implementation challenges within the necessarily tight timescale. Spreading of best practice appears feasible even without substantial additional resources, through the reorientation of current practices via comprehensive multi-disciplinary training programs. By adopting international best practices of training in environmental health, the focus in training and education can shift from future decision-makers to enhancing the competencies of current professionals and their institutions.

Abstract Background The fields of environment and health are both interdisciplinary and trans-disciplinary, and until recently had little engagement in social networking designed to cross disciplinary boundaries. The EU FP6 project HENVINET aimed to establish integrated social network and networking facilities for multiple stakeholders in environment and health. The underlying assumption is that increased social networking across disciplines and sectors will enhance the quality of both problem knowledge and problem solving, by facilitating interactions. Inter- and trans-disciplinary networks are considered useful for this purpose. This does not mean that such networks are easily organized, as openness to such cooperation and exchange is often difficult to ascertain. Methods Different methods may enhance network building. Using a mixed method approach, a diversity of actions were used in order to investigate the main research question: which kind of social networking activities and structures can best support the objective of enhanced inter- and trans-disciplinary cooperation and exchange in the fields of environment and health. HENVINET applied interviews, a role playing session, a personal response system, a stakeholder workshop and a social networking portal as part of the process of building an interdisciplinary and trans-disciplinary network. Results The interviews provided support for the specification of requirements for an interdisciplinary and trans-disciplinary network. The role playing session, the personal response system and the stakeholder workshop were assessed as useful tools in forming such network, by increasing the awareness by different disciplines of other’s positions. The social networking portal was particularly useful in delivering knowledge, but the role of the scientist in social networking is not yet clear. Conclusions The main challenge in the field of environment and health is not so much a lack of scientific problem knowledge, but rather the ability to effectively communicate, share and use available knowledge for policy making. Structured social network facilities can be useful by policy makers to engage with the research community. It is beneficial for scientists to be able to integrate the perspective of policy makers in the research agenda, and to assist in co-production of policy-relevant information. A diversity of methods need to be applied for network building: according to the fit-for-purpose-principle. It is useful to know which combination of methods and in which time frame produces the best results. Networking projects such as HENVINET are created not only for the benefit of the network itself, but also because the applying of the different methods is a learning tool for future network building. Finally, it is clear that the importance of specialized professionals in enabling effective communication between different groups should not be underestimated.

Abstract Background The expectation that climate change will further exacerbate extreme weather events such as heatwaves is of primary concern to policymakers and scientists. Effective governance is fundamental to preparedness for and response to such threats. This paper explores the governance structures of European heat health action plans and provides insights into key stakeholders, roles, responsibilities and collaboration. Methods This was a two-phase qualitative study, in which we complemented a desk review of 15 European national heat health action plans (NHHAPs) with, after obtaining informed consent, 68 interviews in nine countries with key informants involved in the development, implementation and/or evaluation of these NHHAPs. A thematic analysis was used to analyze the NHHAPs inductively. This analysis focused on three themes: identifying key stakeholders, defining and assigning roles and collaboration among stakeholders. The iteratively created codebook was then applied to the analysis of the key informant interviews. All analyses were done using NVivo 10 qualitative analysis software. Results The majority of the NHHAPs have governance as one of their main objectives, to support the coordination of actions and collaboration among involved stakeholders. There are, however, significant differences between plan and practice. On the basis of the available data, we have little insight into the process of stakeholder identification, but we do find that most countries involve the same types of stakeholders. Roles are mainly defined and assigned in relation to the alert levels of the warning system, causing other role aspects and other roles to be vague and ambiguous. Collaboration is key to many NHHAP elements and is mainly experienced positively, though improvements and new collaborations are considered. Conclusions Our findings show a need for a more deliberate and structured approach to governance in the context of NHHAPs. A cross-sectoral approach to the identification of key stakeholders can facilitate a broader preparedness and response to heatwaves. Roles and responsibilities of stakeholders should be defined and assigned more clearly to avoid confusion and to improve effective implementation. To this extent, we identify and describe seven key roles and potential stakeholders to which these roles are usually assigned. Finally, also collaboration among stakeholders can benefit from a cross-sectoral approach, but also formal structures can be beneficial.

Children today are particularly vulnerable to direct and indirect health effects of climate change. Exposure to health hazards related to climate change will increase in the future. These health impacts increasingly pose additional challenges for the health care system, both in curative treatment and in preventive care. This paper therefore examines whether health care facilities for children and adolescents (“pediatric settings”) in Germany are adequately preparing for the impact of climate change on children's health. For this purpose, we combine the results of two studies that investigated the relevance assessment of climate change-related health effects on children's health and the level of information on this topic among pediatricians (n = 408) and parents (n = 292). In addition, a narrative literature review was conducted. We have found that parents' need for information on this topic is currently not being met by pediatricians, as the topics of climate change and health are inadequately addressed in pediatric settings in Germany. Thus, there is a gap between the demand for information and the lack of supply that needs to be closed. To close the gap between parents' need for information on the impact of climate change on children's health and pediatricians' insufficient provision of information, more training materials, more trained staff and more climate change and health information resources are needed in pediatric settings. In order to provide all parents with evidence-based knowledge, the communication of the complex health effects should be readily accessible and target group-oriented.