Background
Accelerating climate change poses escalating challenges to healthcare systems worldwide, placing healthcare workers at the frontline of acute climate-related events and longer-term systemic stressors. Understanding how climate-health literacy and attitudes shape healthcare workers’ adaptive practice and resilience is central to building climate-resilient health systems. This review synthesises global evidence on healthcare workers’ climate change-related health literacy and attitudes and examines factors influencing adaptive practice and resilience.

Methods
This scoping review followed the Joanna Briggs Institute methodology and is reported in accordance with PRISMA-ScR guidelines. Systematic searches were conducted in PubMed, MEDLINE, Scopus, Web of Science, EMBASE, CINAHL, and PsycINFO for English-language studies published between 2014 and 2025. Quantitative, qualitative, and mixed-methods studies examining HCWs’ climate-health literacy, beliefs and attitudes, adaptive practices, and multi-level barriers and facilitators to adaptive practice and resilience were included. Data were synthesised using descriptive and thematic approaches.

Results
Thirty-one studies from high-, middle-, and low-income settings were included. Climate-health literacy was widely examined, and HCWs generally recognised climate change as an escalating public health threat. Attitudes towards climate-health engagement were largely positive; however, translation of knowledge and concern into routine clinical, organisational, and system-level practice remained limited. Only a small number of studies explicitly examined resilience. Key facilitators of adaptive practice and resilience included competency-based education, leadership engagement, clear operational guidance, supportive workplace cultures, and cross-sector collaboration. Major barriers included fragmented governance, limited resources, workload pressures, and inequitable access to climate-health training.

Conclusion
Current evidence suggests that climate change is constraining healthcare workers’ adaptive capacity and resilience, while significant evidence gaps remain. Building climate-resilient health systems requires coordinated investment in workforce development, climate-health literacy, supportive governance, and organisational preparedness. Strengthening these foundations can enhance workforce resilience and support equitable, sustainable public health responses to climate-related health challenges.

Acknowledgements
The authors thank colleagues and peers who provided informal feedback and support during the development of this review. The authors also acknowledge the academic and institutional support provided by the Institute for Sustainable Futures, University of Technology Sydney.

Ambient temperature is an established public health risk, but its effects are not evenly distributed across populations. In Australia, previous multi-city evidence has shown that both heat and cold contribute to mortality, with cold accounting for a larger share of the overall burden. However, less is known about how these risks differ by age within Sydney over an extended period. This study examined associations between daily air temperature and age-specific all-cause mortality in Sydney from 2000 to 2019.

We analysed daily time-series data on all-cause mortality, stratified by age: 0–29, 30–54, 55–64, 65–74, and ≥75 years. A distributed lag nonlinear model with quasi-Poisson regression was applied to estimate cumulative temperature-mortality associations, allowing for delayed and nonlinear effects. Models controlled for long-term trends, day of week, relative humidity, and air pollution.

Our results indicated that the temperature-mortality relationship in Sydney was nonlinear and differed by age group. Mortality was concentrated among adults aged 75 years and above, but patterns of temperature sensitivity were variable across age groups. Colder-than-optimal temperatures appeared to show stronger and more consistent associations with mortality, particularly among the oldest age group. Heat-related relative risks were generally smaller, although increases were observed in selected younger and middle-to-older age groups. These findings indicate that heat vulnerability extends beyond the oldest age groups.

These findings provide Sydney-specific, age-differentiated evidence to inform targeted public health interventions and climate adaptation strategies, particularly those addressing cold-related risk and overlooked heat vulnerability in non-elderly populations.

Keywords: Temperature; Mortality; Age-specific risk; Sydney; Climate adaptation.

Climate extremes such as heatwaves and bushfires often occur concurrently, and exert a substantial burden on public health. They disproportionally affect at-risk populations, including those with respiratory or cardiovascular illness, the elderly, pregnant people, young children, First Nations people, those living with a disability and those in low-income households. Such health risks are projected to increase in a warming climate, particularly in urban areas where diverse communities are affected by heat islands, lack of green space, poor housing conditions and socio-economic disadvantage. Therefore, evidence-based interventions are urgently needed to mitigate health risks and vulnerabilities from exposure to bushfire smoke and extreme heat.

A promising intervention for reducing such exposure is ‘community resilience centres’: cooler spaces with cleaner air, created in existing public buildings in high-risk areas. Funded by NHMRC, the ClimateRes project explores the potential health benefits of community resilience centres during extreme climate events. It aims to assess how effectively selected public buildings reduce exposure to heat and smoke, improve health benefits and lower costs, and identify implementation challenges and scalability opportunities in rapidly growing and high-risk suburbs of Western Sydney and Canberra.

Through a series of community-based workshops, stakeholder interviews and focus group discussions, development of screening tools and vulnerability indicators, the project identifies key generalisable building, location, accessibility, ventilation and other characteristics of community centres that can better protect the public from heatwaves and bushfire smoke. Deployment of environmental sensors (monitoring indoor/outdoor PM2.5, CO2, temperature, humidity) enables assessment of the protective effect of the building envelope and air filtration systems in a variety of public buildings, such as libraries and community clubs. The project provides recommendations and guidelines for local governments and public health authorities seeking to identify and implement community resilience centres for Australian population groups at higher risk.

Background
Open waterways represent a major contributor to drowning in Australia, with recent increased incidents associated with changing environmental conditions and recreational patterns. Traditional incident-based approaches do not adequately capture exposure, often using crude population rates, and limiting prevention and resource allocation. This study developed and evaluated a geospatial exposure-based model to support system-level drowning prevention prioritisation across inland and coastal waterways in Victoria, Australia.
Methods
A mixed-methods, iterative approach was used to develop and evaluate the model. Multiple datasets were integrated to develop the model, including historical drowning records, spatial waterway data, land management parcels, Australian Bureau of Statistics geography, and recreational exposure proxies derived from activity datasets. Spatial analyses generated relative risk estimates across inland and coastal environments. Stakeholder engagement and evaluation was embedded throughout model development, including online and in-person workshops with over 100 participants from government, emergency management, land managers, and aquatic safety organisations. A targeted hybrid evaluation session involving operational and policy stakeholders further assessed model usability and relevance. A survey was also conducted utilising interactive maps to determine final model development.
Results
The model identified high-risk waterbodies that were not apparent from incident data alone, highlighting the importance of incorporating exposure into risk assessment. Stakeholders confirmed the model’s conceptual validity, operational relevance, and applicability for cross-sector planning. The approach supported prioritisation of prevention, preparedness, and mitigation activities, and informed development of an enhanced model incorporating further relevant geospatial datasets.
Conclusions
This study demonstrates the value of integrating geospatial data and cross-sector expertise to inform evidence-based, place-based drowning prevention. The model provides a scalable framework for improving decision making, optimising resource allocation and strengthening coordination across sectors. This systems-level approach supports more targeted, proactive public health interventions, contributing to safer environments and reduced drowning in open water environments.

Current corporatised food systems in Australia are dominated by unhealthy foods, which collectively have a high environmental footprint. Policy efforts to support good nutrition, health and environmental sustainability will require a coherent approach to regulating food environments and the food industry across multiple government sectors. The study aimed to 1) identify Australian federal and selected state government policies that shape food company behaviour; and 2) identify opportunities to improve alignment between these policies and the government’s stated commitments for addressing nutrition and environmental sustainability. Method: Government websites were systematically searched to identify Australian federal and selected state policies that shape food company behaviour in relation to food environments. Documents were analysed for their inclusion of nutrition and health, environmental sustainability and economic concepts, and their alignment with existing government commitments, using food systems frameworks. Results: 101 policies (54 federal, 47 state) were identified, with more than half (59/101) from outside the health and environment sectors, and most (67/101) not specific to the food industry. Nutrition, health and environmental sustainability were rarely explicitly addressed in industry, trade and finance policies. Where nutrition, health and/or environmental sustainability concepts were included, they were generally addressed through separate policy instruments, with few considering these issues simultaneously. Policy objectives were frequently misaligned with government commitments, with economically-oriented policies in particular conflicting with nutrition and health goals. Conclusions: Coherence could be improved by systematically embedding existing government nutrition, health and environmental sustainability commitments across the broad array of policies shaping the food industry and food environments. Cross-sectoral policy mapping provides a transferable approach for identifying opportunities to strengthen coherence between commercial food systems and government commitments for planetary and human health.

Objective: Ross River virus (RRV) is the most commonly notified vector borne disease in Australia. This study aimed to explore the relationship between ambient temperature and RRV burden at Statistical Area Level 3 (SA3) from 2000–2023 using distributed lag non linear models (DLNM).

Methods: Disease notification data were obtained from the Australian Government Department of Health, and climate data from the Queensland Government Long Paddock publicly available datasets. DLNMs combined with generalised linear models were used to examine monthly lagged effects of maximum temperature (Tmax) and minimum temperature (Tmin) on RRV risk at the SA3 level. Relative risks were estimated at the 75th, 90th and 95th percentiles of the local temperature distribution relative to the median, and risk maps were generated for these percentiles.

Preliminary results: RRV risk varied for Tmax and Tmin across local percentiles. Tmax was associated with higher risk in eastern coastal areas of Australia (including Queensland, New South Wales, Victoria and South Australia) at the 75th, 90th and 95th percentiles, with relative risks around 2.5 times compared with the local median. In contrast, elevated Tmin was associated with higher risk in oceanic temperate southern coastal and adjacent inland regions of New South Wales, Victoria and South Australia, particularly at the 95th percentile (RR ≈2.3).

Conclusion: Ambient temperature is associated with increased RRV risk around optimal conditions for vector proliferation, with higher burden observed in coastal and temperate regions of Australia. The higher risks identified in southern coastal areas may reflect the influence of a changing climate and underscore the need for climate responsive surveillance and vector control.

Keywords: Temperature, Ross River Virus, Climate change, Burden of Disease, Alphavirus

Climate change is the single greatest threat to global public health. In the years ahead, even with a rapid acceleration of global mitigation efforts, climate change will increase pressures on the natural and social systems that support population health and wellbeing. The Australian Centre for Disease Control recently launched the national Climate and Health Reference Manual and Guideline. This national toolkit of resources provides Australian health system organisations with tailored information on climate hazard indicators, climate and health guidance and climate risk assessment templates. Health sector practitioners can use this information to understand and manage the current and projected climate risks impacting population health and healthcare services, infrastructure, workforces and supply chains. Climate hazard information is aggregated for 53 health districts across Australia and presented in reports and an online interactive dashboard. 29 climate hazard indicators have been developed across six climate hazard categories; heat and humidity, fire, drought, storm, rainfall and flood and coastal inundation. Each climate hazard indicator is reported across three-time horizons; baseline, mid-century (2050) and late century (2085) and for two climate emission scenarios (middle of the road and reasonable worst case scenario). This presentation will provide an introduction to the Climate and Health Reference Manual and Guideline with practical demonstrations on how attendees can access and use the online interactive dashboard and supporting risk assessment templates.

Extreme heat is an escalating public health threat in Australia, with heatwaves now the leading cause of death from natural hazards. In Victoria, rising temperatures disproportionately impact older adults, people with chronic conditions, low-income households, people with disability, and culturally and linguistically diverse (CALD) communities. This project implemented a community health service-led Heat Health Initiative to improve awareness, prevention, and adaptive capacity among vulnerable populations.

Delivered by Your Community Health over the 2025–2026 summer and funded by Darebin City Council, the initiative embedded heat health outreach within routine service delivery settings, including clinical waiting rooms and community group programs. A bilingual community engagement officer provided culturally responsive accessible education and practical cooling resources through a combination of brief opportunistic conversations and structured group sessions.

Key messages focussed on hydration, cooling the home, reducing exposure during peak heat, recognising early signs of heat-related illness, and checking on vulnerable others. The initiative also connected participants to energy hardship supports and concessions, addressing cost-of-living barriers that directly influence heat safety and health risk.

The program reached 291 participants through 100 individual or small-group interactions and six structured group sessions. Eighty-nine percent of evaluation respondents (47) reported increased confidence in understanding how heat affects health (compared to 18 percent at baseline). Participants reported intended behaviour changes including using cooling aids, environmental adjustments such as shading and ventilation, and improved energy management strategies. Notably, 59 percent identified energy affordability as a key barrier to safe heat adaptation.

Embedding heat health outreach within community health services, combined with practical supports, significantly improves heat-health literacy and intended protective behaviours. The program demonstrates the effectiveness of integrating climate risk education into routine service delivery to reach vulnerable populations. This scalable model highlights how community health services can strengthen equitable climate adaptation and reduce preventable heat-related illness.