Primary healthcare, climate-related health impacts and intercultural dialogue: bibliometric evidence of a fragmented research field.

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title: "Primary Healthcare, Climate Health, and Intercultural Dialogue: A Fragmented Research Field"

date: 2026-04-01

type: research-update

study_type: systematic_review

pubmed_id: "42876690"

journal: "Frontiers in Health Services"

TL;DR

A systematic bibliometric review of 745 full-text reports found that primary healthcare, climate-related health impacts, and intercultural dialogue have not yet formed an integrated research field. No included report addressed all three domains together. [B tier, bibliometric mapping of the literature, not an intervention study]

What the Study Found

Researchers set out to answer a structural question: do primary healthcare, climate-related health impacts, and intercultural dialogue form one body of research, or several loosely connected ones? To find out, they searched six databases (Scopus, Web of Science Core Collection, PubMed, SciELO, RCAAP, and Google Scholar) for records published between 2007 and March 2026 in English, Portuguese, or Spanish. Additional records came from exploratory searching and the lead author's personal library.

The searches returned 19,211 records, reduced to 13,816 after deduplication. After title and abstract screening, 801 reports were sought for retrieval, and 56 could not be obtained. That left 745 reports for full-text assessment. None of them met the full three-part framework the authors had defined, which required a study population of culturally diverse adult patients and primary care physicians, a climate-related health exposure, and an intercultural dialogue outcome relevant to the doctor-patient relationship. The strongest partial overlap was 64 reports that addressed only the population and outcome domains, leaving the climate dimension out entirely.

Keyword co-occurrence mapping in VOSviewer reinforced this pattern. The most consolidated thematic cluster centred on access to healthcare, cultural competence, primary healthcare, communication, migrant populations, and sociocultural diversity. Climate-related terms appeared more peripherally, were more recent in the literature, and were less tightly linked to the rest of the network. In other words, research on cultural competence and migrant health is well established, while the climate-health dimension is still emerging and largely disconnected from primary care and intercultural communication research.

The authors interpret these findings as evidence that the three domains remain "adjacent rather than integrated." They note that this is a descriptive result: bibliometric mapping shows where literatures overlap and where they do not, but it cannot establish causal relationships or measure the quality of individual studies in depth. The review also reports that its qualitative synthesis drew on a smaller subset of records than the full-text corpus used for the bibliometric analysis, so readers should keep the two numbers distinct.

What This Means for You

This study is a map of the research landscape, not a set of clinical recommendations, so its practical implications are mostly for researchers, educators, and policymakers. The key message is that the field has a documented gap.

For clinicians and trainees: Cultural competence training is a well-developed area of research, but the review suggests little existing work addresses how climate-related health risks are discussed in culturally diverse primary care encounters. Clinicians working with migrant or culturally diverse patients may find that climate-sensitive concerns are under-explored in standard training materials.

For researchers: The authors call for studies that directly examine how climate-sensitive health risks are recognised, communicated, and negotiated during intercultural primary care consultations. This is a concrete, unfilled research question.

For health planners: Climate adaptation policy in health services may benefit from drawing on the cultural competence literature, since the two areas currently run in parallel with limited cross-referencing.

Readers interested in how environmental and lifestyle factors connect to health more broadly can explore related topics such as Nature exposure and Hydration, though this review does not evaluate either.

Study Details

Attribute	Detail
Study type	Systematic bibliometric review
Sample size	Not reported (745 reports assessed at full text)
Journal	Frontiers in Health Services
PubMed ID	42876690
Registration	PROSPERO CRD420251038912
Databases searched	Scopus, Web of Science Core Collection, PubMed, SciELO, RCAAP, Google Scholar
Date range	1 January 2007 to 31 March 2026
Languages	English, Portuguese, Spanish
Mapping tools	Rayyan, Microsoft Excel, VOSviewer
Evidence tier	B (bibliometric mapping, not an interventional or outcome study)

Sources

1. Primary healthcare, climate-related health impacts and intercultural dialogue: bibliometric evidence of a fragmented research field. *Frontiers in Health Services*. PubMed. https://pubmed.ncbi.nlm.nih.gov/42876690/

2. PROSPERO registration CRD420251038912. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251038912

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