关于气候变化如何损害原住民儿童福祉与健康的全球系统综述。
完整摘要 · 中文译文
背景：气候变化使全球健康状况恶化，其中原住民儿童是最脆弱的群体之一。尽管关于气候相关健康影响的研究不断增加，但原住民儿童独特的脆弱性仍然代表性不足。本综述首次系统性地综合了关于气候变化如何影响原住民儿童健康的全球证据。 方法：我们汇总了报告的直接由气候变化引起的原住民儿童健康结局。我们遵循PRISMA（系统综述和荟萃分析首选报告项目）指南，并采用了一个反思性框架，该框架考虑了研究者的立场性、原住民对健康的定义以及持续进行的原住民参与。我们于2025年3月2日对五个数据库进行了系统检索，并协作筛选了关于原住民儿童和孕妇气候相关健康结局的合格研究，使用混合方法评价工具对其进行评估。采用趋同整合综合方法绘制了暴露-结局模式，并指导了基于主题的叙述性分析。由于研究异质性，荟萃分析不可行。 结果：53项研究符合纳入标准，包括16项定性研究、23项定量非随机研究、6项定量描述性研究和8项混合方法设计。出现了五个主要健康结局：(i) 心理社会和文化福祉，(ii) 营养不良，(iii) 传染病，(iv) 围产期健康，以及(v) 发病率和死亡率。反映了原住民健康概念化的相互关联和关系性本质，大多数研究 涉及多种气候暴露和结局。心理社会与文化福祉是最具交叉性的主题，与所有其他健康领域相互关联。热暴露以及季节性和水文气候变异性是最常被关联的气候暴露。 结论：不同背景下的原住民儿童正在经历与气候相关的不良健康结局。本综述整合了证据基础，为制定植根于文化、基于优势的应对措施提供依据，这些措施应纳入原住民知识体系和年轻一代。推进这一领域需要更具地理多样性、分类更细且方法学更严谨的研究。
完整摘要 · 英文原文
BACKGROUND: Climate change worsens global health, with Indigenous children among the most vulnerable. Despite increasing research on climate-related health impacts, Indigenous children's unique vulnerabilities remain underrepresented. This is the first review to synthesise systematically the global evidence on how climate change impacts the health of Indigenous children. METHODS: We consolidated reported health outcomes directly caused by climate change in Indigenous children. We adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and followed a reflexive framework that considered researcher positionality, Indigenous definitions of health, and ongoing Indigenous engagement. We did a systematic search of five databases on 2 March 2025 and collaboratively screened eligible studies on climate-related health outcomes in Indigenous children and pregnant women, assessing them using the mixed-methods appraisal tool. A convergent integrated synthesis approach mapped exposure-outcome patterns and guided a theme-based narrative analysis. Meta-analysis was not feasible due to study heterogeneity. RESULTS: Fifty-three studies met inclusion criteria, comprising 16 qualitative, 23 quantitative non-randomised, 6 quantitative descriptive and 8 mixed-method designs. Five main health outcomes emerged: (i) psychosocial and cultural wellbeing, (ii) malnutrition, (iii) infectious diseases, (iv) perinatal health, and (v) morbidity and mortality. Reflecting the interconnected and relational nature of Indigenous health conceptualisations, most studies addressed multiple climate exposures and outcomes. Psychosocial and cultural wellbeing was the most cross-cutting theme, interconnected with all other health domains. Heat exposure and seasonal and hydroclimatic variability were the most frequently linked climate exposures. CONCLUSIONS: Indigenous children across diverse contexts are experiencing adverse climate-related health outcomes. Our review consolidates the evidence base to inform culturally grounded, strengths-based responses that engage Indigenous Knowledge systems and younger generations. Advancing this field requires more geographically diverse, disaggregated, and methodologically rigorous research.