Climatic Impacts on Drug Therapy Usage: A Comparative Study of Kurdish Populations in Sulaimani, Iraq, and Stockholm, Sweden
DOI:
https://doi.org/10.21928/uhdjst.v9n2y2025.pp39-60Keywords:
Climate Influence, Drug Therapy, Geographical Area, Medication Usage, Seasonal WeatherAbstract
The geographical area is influenced by climate impacts, which, in turn, affect the use of different drug therapies during seasonal weather fluctuations. Thus, this study investigates how geographical climate differences influence drug therapy usage by comparing two Kurdish populations residing in Sulaimani, Iraq, and Stockholm, Sweden. It also highlights significant variations in healthcare practices, demonstrating how environmental conditions shape medication patterns. Data collection was conducted through a structured online survey, covering sociodemographic factors, health behaviors, and medication practices, followed by statistical analysis using Python and SPSS. Geographic Information System (GIS) tools were applied to spatially analyze environmental variables across the two cities, enabling the validation of sampling locations and the statistical determination of optimal limitations for the sample collection dataset. In Stockholm, 73.33% of respondents reported that the cold and humid climate affected their health behavior, whereas in Sulaimani, 50.27% described the climate as moderate but highly variable. The study revealed that the key statistical values such as antibiotic usage were significantly higher in Sulaimani (38.03%) than Stockholm (14.00%, P < 0.001), indicating a more treatment-focused approach in Sulaimani versus a preventive focus in Stockholm. Similarly, painkiller usage was significantly higher in Sulaimani, correlating with climate-related seasonal illnesses. Meanwhile, multivitamin usage in Stockholm reached 44.67%, surpassing Sulaimani’s 37.77%, reflecting a stronger emphasis on preventive healthcare strategies in colder climates. These findings emphasize that climate, more than cultural differences, significantly influences drug therapy patterns. The study determines that healthcare strategies should integrate climate variability, prioritizing preventive care in colder climates and infection control in warmer regions. Finally, the study concludes with key findings and outlines directions for future research, emphasizing the need for further investigation into climate-adaptive healthcare approaches.
References
A. C. Krefis, M. Augustin, K. H. Schlünzen, J. Oßenbrügge and J. Augustin. “How does the Urban environment affect health and well-being? A systematic review”. Urban Science, vol. 2, no. 1, p. 21, 2018.
National Research Council, Division on Earth and Life Studies, Board on Earth Sciences and Resources, Committee on Identifying Data Needs for Place-Based Decision Making and Committee on Geography. Community and Quality of Life: Data Needs for Informed Decision Making. National Academies Press, United States, 2002.
P. Churski and R. Perdał. “Geographical differences in the quality of life in Poland: Challenges of regional policy”. Social Indicators Research, vol. 164, no. 1, pp. 31-54, 2022.
Z. Yang, B. Yang, P. Liu, Y. Zhang and X. C. Yuan. “Impact of temperature on physical and mental health: Evidence from China”. Weather Climate and Society, vol. 13, no. 4, pp. 709-727, 2021.
A. Lebano, S. Hamed, H. Bradby, A. Gil-Salmerón, E. Durá- Ferrandis, J. Garcés-Ferrer, F. Azzedine, E. Riza, P. Karnaki, D. Zota and A. Linos. “Migrants’ and refugees’ health status and healthcare in Europe: A scoping literature review”. BMC Public Health, vol. 20, no. 1, p. 1039, 2020.
S. C. Ng, C. N. Bernstein, M. H. Vatn, P. L. Lakatos, E. V. Loftus Jr., C. Tysk, C. O’Morain, B. Moum, J. F. Colombel and Epidemiology and Natural History Task Force of the International Organization of Inflammatory Bowel Disease (IOIBD). “Geographical variability and environmental risk factors in inflammatory bowel disease”. Gut, vol. 62, no. 4, pp. 630-649, 2013.
M. Kumar, P. Mazumder, S. Mohapatra, A. Kumar Thakur, K. Dhangar, K. Taki, S. Mukherjee, A. Kumar Patel, P. Bhattacharya, P. Mohapatra, J. Rinklebe, M. Kitajima, F. I. Hai, A. Khursheed, H. Furumai, C. Sonne and K. Kuroda. “A chronicle of SARS-CoV-2: Seasonality, environmental fate, transport, inactivation, and antiviral drug resistance”. Journal of Hazardous Materials, vol. 405, p. 124043, 2021.
K. M. Cooper, C. McMahon, I. Fairweather and C. T. Elliott. “Potential impacts of climate change on veterinary medicinal residues in livestock produce: An Island of Ireland perspective”. Trends in Food Science Technology, vol. 44, no. 1, pp. 21-35, 2015.
A. O. Abhadionmhen, E. P. K. Imarenezor, A. C. Ogodo and A. A. Ahuchaogu. “Socioeconomic and cultural factors influencing traditional medicine (TM) use in Nigeria: A systematic mixed method review”. European Journal of Integrative Medicine, vol. 74, p. 102436, 2025.
D. O. Hasan, A. M. Aladdin, A. A. H. Amin, T. A. Rashid, Y. H. Ali, M. Al-Bahri, J. Majidpour, L. Batrancea and E. S. Masca. “Perspectives on the impact of E-learning pre-and post-COVID-19 pandemic-the case of the Kurdistan region of Iraq”. Sustainability, vol. 15, no. 5, p. 4400, 2023.
A. Pietraszek, S. Agrawal, M. Dróżdż, S. Makuch, I. Domański, T. Dudzik, K. Dudek and M. Sobieszczańska M. “Sociodemographic and health-related factors influencing drug intake among the elderly population”. International Journal of Environmental Research and Public Health, vol. 19, no. 14, p. 8766, 2022.
I. Badinski, A. Finkelstein, M. Gentzkow, and P. Hull. “Geographic Variation in Healthcare Utilization: The Role of Physicians”. NBER Working Paper31749, vol. 16, p. 1-10, 2023.
M. Dorn. “Medical geography in historical perspective (review)”. Bulletin of the History of Medicine, vol. 76, no. 3, pp. 617-619, 2002.
K. E. Jones, N. G. Patel, M. A. Levy, A. Storeygard, D. Balk, J. L. Gittleman and P. Daszak. “Global trends in emerging infectious diseases”. Nature, vol. 451, no. 7181, pp. 990-993, 2008.
Y. Palmeiro-Silva, R. Aravena-Contreras, J. Izcue Gana, R. González Tapia and I. Kelman. “Climate-related health impact indicators for public health surveillance in a changing climate: A systematic review and local suitability analysis”. The Lancet Regional Health Americas, vol. 38, p. 100854, 2024.
A. Udali, H. J. Persson, B. Talbot and S. Grigolato. “SAR data and harvesting residues: An initial assessment of estimation potential”. Earth, vol. 5, no. 4, pp. 945-962, 2024.
P. M. Polgreen and E. L. Polgreen. “Infectious diseases, weather, and climate”. Clinical Infectious Diseases, vol. 66, no. 6, pp. 815- 817, 2018.
W. Kisiała and I. Rącka. “Spatial and statistical analysis of Urban poverty for sustainable city development”. Sustainability, vol. 13, no. 2, p. 858, 2021.
V. S. Limaye, J. Vargo, M. Harkey, T. Holloway and J. A. Patz. “Climate change and heat-related excess mortality in the Eastern USA”. Ecohealth, vol. 15, no. 3, pp. 485-496, 2018.
S. M. Babin. “Weather and climate effects on disease background levels”. Johns Hopkins APL Tech Dig, vol. 24, no. 4, pp. 343-348, 2003.
L. P. Dawson, E. Andrew, Z. Nehme, J. Bloom, S. Cox, D. Anderson, M. Stephenson, J. Lefkovits, A. J. Taylor, D. Kaye, Y. Guo, K. Smith and D. Stub. “Temperature-related chest pain presentations and future projections with climate change”. Science of The Total Environment, vol. 848, p. 157716, 2022.
J. A. Patz, A. K. Githeko, J. P. McCarty, S. Hussein, U. Confalonieri and N. De Wet. “Climate change and infectious diseases”. Climate Change and Human Health Risks and Responses, vol. 2, pp. 103- 132, 2003.
X. Wu, Y. Lu, S. Zhou, L. Chen and B. Xu. “Impact of climate change on human infectious diseases: Empirical evidence and human adaptation”. Environment International, vol. 86, pp. 14-23, 2016.
A. Silversides. “CMA opposes gender discrimination against doctors”. Canadian Medical Association Journal, vol. 181, p. E311, 2008.
J. C. Semenza and B. Menne. “Climate change and infectious diseases in Europe”. The Lancet Infectious Diseases, vol. 9, no. 6, pp. 365-375, 2009.
F. Messaoudene, S. Boukraa, S. C. Boubidi, A. Guerzou and A. Ouahabi. “Human cutaneous leishmaniasis in North Africa and its threats to public health: A statistical study focused on Djelfa (Algeria)”. Microorganisms, vol. 11, no. 10, p. 2608, 2023.
J. E. Bloom, Z. Nehme, E. Andrew, L. P. Dawson, H. Fernando, S. Noaman, M. Stephenson, D. Anderson, V. Pellegrino, S. Cox, J. Lefkovits, W. Chan, D. M. Kaye, K. Smith and D. Stub. “Hospital characteristics are associated with clinical outcomes in patients with cardiogenic shock”. Shock, vol. 58, no. 3, pp. 204-210, 2022.
T. Hartig, R. Catalano and M. Ong. “Cold summer weather, constrained restoration, and the use of antidepressants in Sweden”. Journal of Environmental Psychology, vol. 27, no. 2, pp. 107-116, 2007.
J. Talib and S. Ahmed. “Main effect of climate on geographical distribution of asthma in Sulaimani province”. Journal of Garmian University, vol. 6, no. 2, pp. 10-20, 2019.
C. Astolphi Lima, S. Alsunaidi, S. Lowe, D. B. Hogan, L. Dennett, C. A. Jones and S. Yamamoto. “Exploring the influence of weather variability and climate change on health outcomes in people living with dementia: A scoping review protocol”. PLoS One, vol. 19, no. 6, p. e0304181, 2024.
R. Basu and J. M. Samet. “Relation between elevated ambient temperature and mortality: A review of the epidemiologic evidence”. Epidemiologic Reviews, vol. 24, no. 2, pp. 190-202, 2002.
H. Eng and J. B. Mercer. “Seasonal variations in mortality caused by cardiovascular diseases in Norway and Ireland”. Journal of Cardiovascular Risk, vol. 5, no. 2, pp. 89-95, 1998.
F. Amuakwa-Mensah, G. Marbuah and M. Mubanga. “Climate variability and infectious diseases nexus: Evidence from Sweden”. Infectious Disease Modelling, vol. 2, no. 2, pp. 203-217, 2017.
L. P. Dawson, E. Andrew, Z. Nehme, J. Bloom, S. Biswas, S. Cox, D. Anderson, M. Stephenson, J. Lefkovits, A. J. Taylor, D. Kaye, K. Smith and D. Stub. “Association of socioeconomic status with outcomes and care quality in patients presenting with undifferentiated chest pain in the setting of universal health care coverage”. Journal of the American Heart Association, vol. 11, no. 7, p. e024923, 2022.
A. S. Zakey, M. M. Abdel-Wahab, J. B. C. PETTERSSON, M. J. Gatari and M. Hallquist. “Seasonal and spatial variation of atmospheric particulate matter in a developing megacity, the Greater Cairo, Egypt”. Atmosfera, vol. 21, no. 2, pp. 171-189, 2008.
A. J. McMichael. “Extreme weather events and infectious disease outbreaks”. Virulence, vol. 6, no. 6, pp. 543-547, 2015.
A. Jutla, E. Whitcombe, N. Hasan, B. Haley, A. Akanda, A. Huq, M. Alam, R. B. Sack and R. Colwell. “Environmental factors influencing epidemic cholera”. The American Society of Tropical Medicine and Hygiene, vol. 89, no. 3, pp. 597-607, 2013.
M. Neira, K. Erguler, H. Ahmady-Birgani, N. D. Al-Hmoud, R. Fears, C. Gogos, N. Hobbhahn, M. Koliou, L. G. Kostrikis, J. Lelieveld, A. Majeed, S. Paz, Y. Rudich, A. Saad-Hussein, M. Shaheen, A. Tobias and G. Christophides. “Climate change and human health in the Eastern Mediterranean and Middle East: Literature review, research priorities and policy suggestions”. Environmental Research, vol. 216, p. 114537, 2023.
C. Pfister and D. Krämer. “The Relaunch of Historical Climate Impact Research-a Timely Challenge for Historical Climatology”; 2011. Available from: https://boris.unibe.ch/id/eprint/12334 [Last accessed on 2025 May 01].
F. Zanasi and R. Conte Keivabu. “Extreme temperatures and morbidity in old age in Europe”. Vienna Yearbook of Population Research, vol. 22, pp. 1-28, 2024.
H. Khraishah, B. Alahmad, R. L. Ostergard Jr., A. AlAshqar, M. Albaghdadi, N. Vellanki, M. M. Chowdhury, S. G. Al-Kindi, A. Zanobetti, A. Gasparrini and S. Rajagopalan. “Climate change and cardiovascular disease: Implications for global health”. Nature Reviews Cardiology, vol. 19, no. 12, pp. 798-812, 2022.
M. A. Mohammad, S. Koul, R. Rylance, O. Fröbert, J. Alfredsson, A. Sahlén, N. Witt, T. Jernberg, J. Muller and D. Erlinge. “Association of weather with day-to-day incidence of myocardial infarction: A SWEDEHEART nationwide observational study”. JAMA Cardiology, vol. 3, no. 11, pp. 1081-1089, 2018.
S. Holmberg, A. Rignell-Hydbom, C. H. Lindh, B. A. Jönsson, A. Thelin and L. Rylander. “High levels of vitamin D associated with less ischemic heart disease - a nested case-control study among rural men in Sweden”. Annals of Agricultural and Environmental Medicine, vol. 24, no. 2, pp. 288-293, 2017.
M. G. Abrignani, A. Lombardo, A. Braschi, N. Renda and V. Abrignani. “Climatic influences on cardiovascular diseases”. World J Cardiology, vol. 14, no. 3, pp. 152-169, 2022.
H. R. Rossi. “The Association of Endometriosis on Body Size, Pain Perception, Comorbidity and Work Ability in the Northern Finland Birth cohort 1966: Long-Term Effects of Endometriosis on Women’s Overall Health”. Oulun Yliopisto, University of Oulu; 2021. Available from: https://urn.fi/urn: isbn:9789526230023 [Last accessed on 2025 May 01].
M. E. Keim. “Building human resilience the role of public health preparedness and response as an adaptation to climate change”. American Journal of Preventive Medicine, vol. 35, no. 5, pp. 508- 516, 2008.
K. L. Ebi, P. Berry, D. Campbell-Lendrum, G. Cissé, J. Hess, N. Ogden and R. Schnitter. “Health System Adaptation to Climate Variability and Change”. Washington, DC: Global Center on Adaptation; 2019. Available from: https://gca.org/wp/content/uploads/2020/12/ healthsystemadaptationtoclimatevariabilityandchange_0.pdf [Last accessed on 2025 May 01].
S. R. Mohammed-Taha, A. M. Aladdin, A. I. Mustafa, D. O. Hasan, R. K. Muhammed and T. A. Rashid. “Analyzing the impact of the pandemic on insomnia prediction using machine learning classifiers across demographic groups”. Network Modeling Analysis in Health Informatics and Bioinformatics, vol. 14, no. 1, p. 51, 2025.
U. Jørgensen. “Mapping and navigating transitions-the multi-level perspective compared with arenas of development”. Research Policy, vol. 41, no. 6, pp. 996-1010, 2012.
R. J. Johnston. City and Society: An Outline for Urban Geography. Routledge, England, UK, 2013.
C. I. Hussein, H. Q. Rasul and D. A. M. A. Al Manmi. “Environmental justice in water quality: Sulaimani city as a case study”. The Scientific Journal of Cihan University Sulaimaniya, vol. 7, no. 2, pp. 72-97, 2023.
S. S. Mohammed, H. Q. Rasul and H. D. Mohammed. “GIS-based spatial analysis of the evolution of residential developments; A case-study of Sulaimani city, Iraq,” Kurdistan Journal of Applied Research, vol. 8, no. 2, pp. 9-32, 2024.
Z. M. J. Altaee and M. J. Al-Ani. “Urban renewal as a tool of cities sustainability Sulaimani as a case study-North Iraq”. Periodicals of Engineering and Natural Sciences (PEN), vol. 8, no. 2, pp. 971- 990, 2020.
S. H. Amin Ahmad. “Impact of climate change on heating and cooling energy consumption in Sulaimani city/Iraq-Kurdistan region”. Journal of Garmian University, vol. 9, no. 2, pp. 498-508, 2022.
K. D. Muslih and A. M. Abbas. “Climate of Iraq”. Springer, Berlin, pp. 19-47, 2024.
S. H. Al Jarah, B. Zhou, R. J. Abdullah, Y. Lu and W. Yu. “Urbanization and Urban sprawl issues in city structure: A case of the Sulaymaniah Iraqi Kurdistan region”. Sustainability, vol. 11, no. 2, p. 485, 2019.
L. Vogiazides and H. Mondani. “Neighbourhood trajectories in Stockholm: Investigating the role of mobility and in situ change”. Applied Geography, vol. 150, p. 102823, 2023.
H. Engström. “Influences of Urban Geometry on Local Climate a Case Study of the City of Stockholm.” University of Gothenburg, Göteborg; 2023. Available from: https://gupea.ub.gu.se/ handle/2077/77321 [Last accessed on 2025 May 01].
K. Błażejczyk, J. Baranowski, G. Jendritzky, A. Błażejczyk, P. Bröde and D. Fiala. “Regional features of the bioclimate of Central and Southern Europe against the background of the Köppen- Geiger climate classification”. Geographia Polonica, vol. 88, no. 3, pp. 439-453, 2015.
D. Magnusson. “Impact of Different Land Uses on Local Climate in the Stockholm Region”. University Of Gothenburg, Gothenburg; 2023. Available from: https://gupea.ub.gu.se/handle/2077/77373 [Last accessed on 2025 May 01].
D. O. Hasan and A. M. Aladdin. “Sleep-related consequences of the COVID-19 pandemic: A survey study on insomnia and sleep apnea among affected individuals”. Insights in Public Health Journal, vol. 5, no. 2, 2025.
D. Khanna, C. Peltzer, P. Kahar and M. S. Parmar. “Body mass index (BMI): A screening tool analysis”. Cureus, vol. 14, p. e22119, 2022.
R. Azen and C. M. Walker. Categorical Data Analysis for the Behavioral and Social Sciences. 2nd ed. Routledge, New York , 2021.
A. A. H. Amin, A. M. Aladdin, D. O. Hasan, S. R. Mohammed- Taha and T. A. Rashid. “Enhancing algorithm selection through comprehensive performance evaluation: Statistical analysis of stochastic algorithms,” Computation, vol. 11, no. 11, p. 231, 2023.
A. M. Aladdin, J. M. Abdullah, K. O. M. Salih, T. A. Rashid, R. Sagban, A. Alsaddon, A. Chhabra, S. Vimal and I. Banerjee. “Fitness-dependent optimizer for IoT healthcare using adapted parameters: A case study implementation”. In: Practical Artificial Intelligence for Internet of Medical Things, CRC Press, United States, 2023, pp. 45-61.
H. S. Abdulla and A. M. Aladdin. “Enhancing design and authentication performance model: A multilevel secure database management system”. Future Internet, vol. 17, no. 2, p. 74, 2025.
D. O. Hassan and B. A. Hassan. “A comprehensive systematic review of machine learning in the retail industry: Classifications, limitations, opportunities, and challenges”. Neural Computing and Applications, vol. 37, no. 4, pp. 2035-2070, 2025.
A. M. Aladdin and T. A. Rashid. “Leo: Lagrange Elementary Optimization”. [arXiv Preprint] arXiv:2304.05346; 2023.
R. Mohammed, N. K. Al-Salihi, T. A. Rashid, A. M. Aladdin, M. Mohammadi and J. Majidpour. “Artificial cardiac conduction systemsimulating heart function for advanced computational problem solving”. In: Multi-Objective Optimization Techniques, CRC Press, United States, p. 314-339, 2025.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Shena Ali Faris, Pakiza Aziz Saied
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
