Food insecurity is a significant public health problem for Indigenous peoples in Canada. A comprehensive literature review is needed to organize the evidence according to the 4 pillars of food security (i.e., availability, access, utilization, and stability) and identify gaps in the published literature on this topic. Therefore, in this scoping review we aimed to summarize the published research discussing any of the 4 pillars of food security among Indigenous peoples in Canada. We conducted a literature search of the following databases: Ovid Medline, EMBASE, Web of Science (Web of Knowledge), and CINAHL, as well as the Indigenous Studies Portal (up to June 19, 2021). Population-based studies of any design were included, except for review-style articles. Articles published in languages other than English were also excluded. Of the 4687 studies identified by the database searches, 91 met our inclusion criteria. Evidence from these studies indicates that all dimensions of food security among Indigenous peoples in Canada have been impacted. Lack of availability of both traditional and market foods is highlighted among Inuit and First Nation communities. Economic disadvantages, high food prices, and lack of access to transportation are major factors affecting the accessibility pillar of food security. Major factors affecting the utilization pillar of food security are the loss of traditional knowledge and skills, lack of knowledge on market foods, low quality of market foods, and food safety issues. Climate change has affected all 4 pillars of food security among Indigenous peoples. These findings suggest that resolving food insecurity issues among Indigenous peoples in Canada, especially those living in remote communities, requires a culturally specific integrated approach targeting food availability, food cost, food knowledge, food safety, and food quality.
BACKGROUND: Research shows that unhealthy diets and low physical activity are associated with high rates of obesity-linked chronic diseases amongst Nunavut Inuit. To provide contextual insights and deepen our understanding of the factors that underlie these lifestyle choices, we explored the perspectives of Nunavut Inuit on the barriers and enablers of healthy diets and physical activity participation in the community of Iqaluit. METHODS: One-on-one semi-structured photo-elicitation interviews were conducted with 16 participants of 18 years and over (10 women, six men). The interviews uncovered the participants’ perspectives on the factors influencing healthy diets and physical activity in their community. Interviews were audio-recorded, transcribed, and uploaded to QSR NVIVO Version 12. Data analysis was achieved using an inductive thematic approach. RESULTS: Six main factors were identified as barriers or enablers to energy balance-related behaviors: cost and affordability of healthy choices; availability of traditional foods and activities; weather conditions and climate change; infrastructure and community resources; social networks of family and friends; and effect of substance use. CONCLUSION: This study identified six broad areas that should be considered while mapping out interventions to reduce the burden of obesity-related chronic diseases in Nunavut communities.
OBJECTIVE: To investigate the relationships between fish/seafood consumption patterns and food security status among First Nations (FN) communities in Canada. We estimated the contribution of fish/seafood to daily nutrient requirements. Barriers to traditional food (TF) access including fish were summarized. METHODS: Data were collected by the First Nations Food, Nutrition and Environment Study (2008-2018). The sample of this participatory study comprised 6258 randomly selected FN adults. Fish/seafood consumption was estimated with a food frequency questionnaire. Food security status was assessed with the Household Food Security Survey Module. The contribution of fish/seafood to protein, n-3 fatty acid, vitamin (A, B12, D, niacin) and mineral (selenium, zinc) requirements was assessed by comparison to Dietary Reference Intakes. RESULTS: Regional differences were observed in fish/seafood consumption patterns and their relationship with food security status. In the eastern regions (Ontario, Quebec/Labrador and the Atlantic region), consumption of fish/seafood and other TF was significantly higher among food insecure compared with food secure FN participants. Severely food insecure men (particularly in British Columbia, Alberta, Quebec/Labrador and the Atlantic region) tended to eat a higher amount of TF, including fish/seafood, compared with food secure and moderately food insecure men, while no difference was observed in women. Fish/seafood provided good sources of selected nutrients. However, the high cost of harvesting equipment, industry-related activities and climate change reduce access to fish/seafood and other wildlife. CONCLUSION: Fish/seafood continues to be vital to the diet of FN communities. Focusing on policies that support FN increased access to fish/seafood has the potential to decrease food insecurity and support sustainable livelihoods. Future policies should focus on socio-economic determinants of food insecurity and support traditional harvesting and sustainable fisheries among FN communities.
Canada’s cities are leading the efforts to stem the harmful effects of the climate emergency on human health. Paul Webster reports from Toronto.
The built environment is a physical determinant of health essential to the planning and development of a more equitable society. Communities face growing challenges due to environmental stressors such as climate change, with vulnerable communities experiencing a disproportionate burden of adverse health outcomes. The interdependencies between urban planning and public health outcomes are inextricable, with respect to improving access to healthier built environments for vulnerable and marginalized groups. Widespread implementation of nature-based solutions, such as green infrastructure, provides a multi-functional strategy to support sustainable development, increase climate resilience, enhance ecological connectivity, and create healthier communities. A Health Equity Impact Assessment presents the findings of a participatory research study utilizing key informant interviews of public health unit professionals (eight) and a survey of green infrastructure volunteers and workers (36) on the impact of green infrastructure on individual and community mental and physical well-being, service use, and perceived unmet needs, using Ontario, Canada as a case study. Study findings indicate that where green infrastructure is both productive and publicly accessible, the benefits were significant for vulnerable populations. These benefits include increased social connectivity, skills development, and food security. Green infrastructure could be a viable strategy to address environmental stressors, improve health equity, and support localization of the UN Sustainable Development Goals (SDGs).
INTRODUCTION: Unintentional falls are a leading cause of injury-related hospital visits among Canadians, especially seniors. While certain meteorological conditions are suspected risk factors for fall-related injuries, few studies have quantified these associations across a wider range of age groups and with population-based datasets. METHODS: We applied a time-stratified case-crossover study design to characterize associations of highly-spatially-resolved meteorological factors and emergency department (ED) visits for falls, in Ontario, among those aged 5 years and older during the winter months (November to March) between 2011 and 2015. Conditional logistic models were used to estimate the odds ratios (ORs) and their 95% confidence intervals (CIs) for these visits in relation to daily snowfall accumulation, including single-day lags of up to one week before the visit, and daily mean temperature on the day of the visit. Analyses were stratified by age and sex. RESULTS: We identified 761 853 fall-related ED visits. The odds for these visits was increased for most days up to a week after a snowfall of 0.2 cm or greater (OR = 1.05-1.08) compared to days with no snowfall. This association was strongest among adults aged 30 to 64 years (OR = 1.16-1.19). The OR for fall-related ED visits on cold days (less than -9.4 °C) was reduced by 0.05 relative to days with an average daily temperature of 3.0 °C or higher (OR = 0.95; 95% CI: 0.94, 0.96), and this pattern was evident across all ages. There were no substantive differences in the strength of this association by sex. CONCLUSION: Snowfall and warmer winter temperatures were associated with an increased risk of fall-related ED visits during Ontario winters. These findings are relevant for developing falls prevention strategies and ensuring timely treatment.
BACKGROUND: Climate change has important implications for mental health globally. Yet, few studies have quantified the magnitude and direction of associations between weather and mental health-related factors, or assessed the geographical distribution of associations, particularly in areas experiencing rapid climatic change. This study examined the associations between air temperature variables and mental health-related community clinic visits across Nunatsiavut, Labrador, Canada, and the place-specific attributes of these associations. METHODS: Daily de-identified community clinic visit data were collected from the provincial electronic health recording system and linked to historical weather data (2012-2018). A multilevel, multivariable negative binomial regression model was fit to investigate associations between temperature variables and mental health-related community clinic visits across the region, adjusting for seasonality as a fixed effect and community as a random effect. A multivariable negative binomial model was then fit for each Nunatsiavut community, adjusting for seasonality. RESULTS: Mental health-related visits contributed to 2.4% of all 228,104 visit types across the study period; this proportion ranged from 0.6% to 11.3% based on community and year. Regionally, the incidence rate of mental health-related community clinic visits was greater after two weeks of warm average (i.e. above -5ᵒC) temperatures compared to temperatures below -5ᵒC (IRR(-5≤5ᵒC) = 1.47, 95% CI = 1.21-1.78; IRR(6≤15ᵒC) = 2.24, 95% CI = 1.66-3.03; IRR(>15ᵒC) = 1.73, 95% CI = 1.02-2.94), and the incidence rate of mental health-related clinic visits was lower when the number of consecutive days within -5 to 5ᵒC ranges (i.e. temperatures considered to be critical to land use) increased (IRR = 0.96; 95% CI = 0.94-0.99), adjusting for seasonal and community effects. Community-specific models, however, revealed that no two communities had the same association between meteorological conditions and the incidence rate of daily mental health-related visits. DISCUSSION: Regionally, longer periods of warm temperatures may burden existing healthcare resources and shorter periods of temperatures critical to land use (i.e. -5 to 5ᵒC) may present enjoyable or opportunistic conditions to access community and land-based resources. The heterogeneity found in temperature and mental health-related clinic visits associations across Nunatsiavut communities demonstrates that place quantitatively matters in the context of Inuit mental health and climate change. This evidence underscores the importance of place-based approaches to health policy, planning, adaptation, and research related to climate change, particularly in circumpolar regions such as Nunatsiavut where the rate of warming is one of the fastest on the planet.
SETTING: The Sendai Framework for Disaster Risk Reduction promotes an “all-of-society” approach to disaster risk reduction (DRR). Since 2013, the EnRiCH Research Lab has implemented a community-based, participatory program to promote youth development and engagement in DRR in Ottawa-Gatineau. The EnRiCH Youth Research Team used an existing community education program called the Enrichment Mini-Course Program as a framework to engage youth in DRR. We aim to share the implementation process and lessons learned from this innovative “all-of-society” approach to DRR. INTERVENTION: The EnRiCH Youth Research Team provides high school and university students with a platform to be heard on disaster and climate change issues. Youth are given opportunities to design and lead knowledge dissemination projects intended to educate members of the community about disaster prevention and preparedness. Students have opportunities to connect with academics, governmental and non-governmental organizations, and public health practitioners to share their ideas on youth participation in DRR in Canada. OUTCOMES: To date, this public health intervention has produced DRR training modules that can be used as curriculum support by teachers, a children’s book on earthquake preparedness, an educational video about youth participation in DRR, and several conference presentations. Members of the team have become well versed in disaster preparedness strategies. IMPLICATIONS: This program has demonstrated that youth can contribute to DRR through knowledge mobilization, and support public education about disaster preparedness. Offering this opportunity at a grassroots level can support participation by youth by allowing flexibility in design and adaptation to individual environmental and social contexts.
OBJECTIVE: The current study undertook a systematic scoping review on the drivers and implications of dietary changes among Inuit in the Canadian Arctic. DESIGN: A keyword search of peer-reviewed articles was performed using PubMed, Web of Science, CINAHL, Academic Search Premier, Circumpolar Health Bibliographic Database and High North Research Documents. Eligibility criteria included all full-text articles of any design reporting on research on food consumption, nutrient intake, dietary adequacy, dietary change, food security, nutrition-related chronic diseases or traditional food harvesting and consumption among Inuit populations residing in Canada. Articles reporting on in vivo and in vitro experiments or on health impacts of environmental contaminants were excluded. RESULTS: A total of 162 studies were included. Studies indicated declining country food (CF) consumption in favour of market food (MF). Drivers of this transition include colonial processes, poverty and socio-economic factors, changing food preferences and knowledge, and climate change. Health implications of the dietary transition are complex. Micro-nutrient deficiencies and dietary inadequacy are serious concerns and likely exacerbated by increased consumption of non-nutrient dense MF. Food insecurity, overweight, obesity and related cardiometabolic health outcomes are growing public health concerns. Meanwhile, declining CF consumption is entangled with shifting culture and traditional knowledge, with potential implications for psychological, spiritual, social and cultural health and well-being. CONCLUSIONS: By exploring and synthesising published literature, this review provides insight into the complex factors influencing Inuit diet and health. Findings may be informative for future research, decision-making and intersectoral actions around risk assessment, food policy and innovative community programmes.
The mental and emotional dimensions of climate change are increasingly concerning as extreme events become more frequent and severe, ecosystem destruction advances, and people become more aware of climate impacts and injustices. Research on climate emotions has rapidly advanced over the last decade with growing evidence illustrating that climate emotions can impact health, shape climate action, and ought to be considered in climate change communication, education, and engagement. This paper explores, describes, and discusses climate emotions in the context of Canada’s Provincial North: a vast region characterized by a vulnerability to climate change, remoteness, political marginalization, diverse Indigenous populations, and economies/livelihoods tied to resource extraction. Using postal survey data collected in two Provincial North communities (Thunder Bay, Ontario, and Prince George, British Columbia; N = 627), we aim to (1) describe climate emotions experienced in the context of Canada’s Provincial North, including relationships among specific emotions; and (2) examine if socio-demographic variables (gender, age, and parenthood) show a relationship with climate emotions. Results show high levels of emotional response to climate change overall, with worry and frustration as those emotions reported by the highest percentage of participants. We also find significant difference in climate emotions between men and women. A methodological result was noted in the usefulness of the Climate Emotion Scale (CES), which showed high reliability and high inter-item correlation. A notable limitation of our data is its’ underrepresentation of Indigenous peoples. The findings contribute to a greater understanding of climate emotions with relevance to similar settings characterized by marginalization, vulnerability to climate change, urban islands within vast rural and remote landscapes, and economies and social identities tied to resource extraction. We discuss our findings in relation to the literature and outline future research directions and implications.
Widespread implementation of nature-based solutions like green infrastructure, provides a multi-functional strategy to increase climate resilience, enhance ecological connectivity, create healthier communities, and support sustainable urban development. This paper presents a decision-support framework to facilitate adoption of green infrastructure within communities using the Climate Change Local Adaptation Action Model (CCLAAM) developed for this purpose. It also presents an ecosystems-based approach to bridging the gap between climate change mitigation and adaptation actions in Ontario, Canada. Green infrastructure could be a viable strategy to address multiple climate change impacts and support the implementation of the UN Sustainable Development Goals (SDGs).
BACKGROUND: Fort McMurray, a city in northern Alberta, Canada, has experienced multiple traumatic events in the last five years, including the 2016 wildfire, the 2020 floods, and the COVID-19 pandemic. Traumatic events often lead to increased mental health burdens in affected communities. OBJECTIVE: To assess if the number of traumatic events experienced by residents of Fort McMurray correlates with the prevalence and severity of mental health issues experienced. METHODOLOGY: A cross-sectional study using an online survey questionnaire was used to gather demographic, trauma (wildfire, flooding, and COVID-19), and clinical information from the resident of Fort McMurray between April 24 to June 2 2021. Likely Generalized Anxiety Disorder (GAD), Major Depressive Disorder (MDD), Post-Traumatic Stress Disorder (PTSD) and low resilience were measured using standardised rating scales. Data were analyzed with SPSS version 26 using Chi-Square tests and multivariate regression analysis. RESULTS: Respondents who experienced COVID-19 and either flood or wildfire traumas (N = 101) were eleven times more likely to have GAD symptoms (OR: 11.39; 95% CI: 1.43-91.04), four times more likely to have likely MDD, (OR: 3.85; 95% CI: .995-14.90), ten times more likely to have likely PTSD (OR: 10.47; 95% CI: 1.28-85.67), and low resilience (OR: 10.56; 95% CI: 1.21-92.17). Respondents who experienced COVID-19, flooding, and wildfire traumas (N = 47) were eighteen times more likely to express GAD symptoms (OR: 18.30; 95% CI: 2.20-152.45) and more than eleven times likely to have likely PTSD (OR: 11.41; 95% CI: 1.34-97.37) in comparison to the respondents who experienced COVID-19 only trauma (N = 19). CONCLUSION: Measures to reduce climate change and associated natural disasters could reduce the impact of cumulative trauma and associated mental health burden in vulnerable populations. It is essential that more mental health resources are mobilised to support communities impacted by multiple natural disasters. HIGHLIGHTS: The number of traumatic disasters experienced in residents of Fort McMurray five years after the 2016 wildfires, a year after the 2020 flooding, and during the COVID-19 pandemic correlates with the prevalence and severity of the mental health conditions reported in this study.
BACKGROUND: Fort McMurray, a city in northern Alberta, Canada, has experienced multiple traumas in the last five years, including the 2016 wildfire, the 2020 floods, and the COVID-19 pandemic. Eighteen months after the wildfire, major depressive disorder (MDD), generalized anxiety disorder (GAD), and Post Traumatic Stress Disorder (PTSD) symptoms were elevated among school board employees in the city. OBJECTIVE: This study aimed to compare employees of the school board and other employees of Fort McMurray in respect to the impact the 2016 wildfires, the 2019 COVID pandemic, and the 2020 floods had on their mental health. METHODOLOGY: A quantitative cross-sectional survey was conducted in Fort McMurray from 24 April to 2 June 2021. Online questionnaires were administered through REDCap and were designed to capture socio-demographic characteristics, clinical as well as wildfire, COVID-19, and flooding-related variables. Mental health outcome variables were captured using self-reported standardized assessment scales. Data were analysed with descriptive statistics, Chi-square/Fisher’s Exact tests, and binary regression analysis. RESULTS: Of the 249 residents who accessed the online survey, 186 completed the survey, giving a response rate of 74.7%. Of these respondents, 93.5% (174) indicated their employment status and were included in the Chi-square analysis. Most of the respondents were female (86.2%, (150)), above 40 years (53.4%, (93)), and were in a relationship (71.3%, (124)). The prevalence values for MDD, GAD and PTSD among respondents were 42.4%, 41.0, and 36.8%, respectively. There was a statistically significant difference between employees of the school board and other employees with respect to likely PTSD prevalence (28% vs. 45%, respectively, p < 0.05), although with other factors controlled for, in a binary logistic regression model, employer type did not significantly predict likely PTSD. CONCLUSIONS: The study has established that likely PTSD symptoms were significantly higher in other employees compared to those of school board employees. Greater exposure to the traumatic events and a greater perceived lack of support from other employers might have contributed to the significantly higher prevalence of PTSD in other employees.
BACKGROUND: In June 2013, the city of Calgary, Alberta and surrounding areas sustained significant flooding which resulted in large scale evacuations and closure of businesses and schools. Floods can increase stress which may negatively impact perinatal outcomes and mental health, but previous research is inconsistent. The objectives of this study are to examine the impact of the flood on pregnancy health, birth outcomes and postpartum mental health. METHODS: Linked administrative data from the province of Alberta were used. Outcomes included preterm birth, small for gestational age, a new diagnoses of preeclampsia or gestational hypertension, and a diagnosis of, or drug prescription for, depression or anxiety. Data were analyzed using a quasi-experimental difference in difference design, comparing flooded and non-flooded areas and in affected and unaffected time periods. Multivariable log binomial regression models were used to estimate risk ratios, adjusted for maternal age. Marginal probabilities for the difference in difference term were used to show the potential effect of the flood. RESULTS: Participants included 18,266 nulliparous women for the pregnancy outcomes, and 26,956 women with infants for the mental health analysis. There were no effects for preterm birth (DID 0.00, CI: -0.02, 0.02), small for gestational age (DID 0.00, CI: -0.02, 0.02), or new cases of preeclampsia (DID 0.00, CI: -0.01, 0.01). There was a small increase in new cases of gestational hypertension (DID 0.02, CI: 0.01, 0.03) in flood affected areas. There were no differences in postpartum anxiety or depression prescriptions or diagnoses. CONCLUSION: The Calgary 2013 flood was associated with a minor increase in gestational hypertension and not other health outcomes. Universal prenatal care and magnitude of the disaster may have minimized impacts of the flood on pregnant women.
The objective of this study was to identify group-level health outcomes associated with the 2013 Calgary flood on Calgary participants (45-85 years of age) in the Canadian Longitudinal Study on Aging (CLSA). We compared baseline CLSA data collected on Calgary participants during the 6 months prior to and following the flood. Logistic regression models were created to explore whether select psychological outcomes were associated with the flood for participants categorized by evacuation status. Participants living in evacuated communities pre-flood had significantly lower levels of a diagnosed anxiety disorder than non-evacuated communities, which disappeared post-flood. Participants with higher household income were less likely to have post-traumatic stress disorder symptoms, worse self-rated mental health, and lower life satisfaction post-flood. Living alone reduced and female gender increased levels of perceived functional social support post-flood. Although natural disasters can shape research findings, the scope of the data being collected and the representativeness of impacted groups may challenge the ability to detect subtle impacts.
BACKGROUND: Resilience after natural disasters is becoming an increasingly key area of research. In April 2020, parts of Fort McMurray were affected by severe floods. The flooding caused the loss of properties, evacuation of some residents, and effects on their mental health. OBJECTIVE: This study explores the prevalence and associated factors between flood experience and low resilience a year after the 2020 floods in Fort McMurray. METHOD: Data collection was accomplished one year after the flood, from 24 April to 2 June 2021, using an online survey. The data were analyzed with SPSS version 25 using univariate analysis with the chi-squared test and binary logistic regression analysis. RESULTS: The prevalence of low resilience was 37.4%. Respondents under 25 years were nearly 26 times more likely to show low resilience (OR = 0.038; 95% CI 0.004-0.384) than respondents 40 years and above. Responders with a history of depression (OR = 0.258 95% CI: 0.089-0.744) and a history of anxiety (OR = 0.212; CI 95% 0.068-0.661) were nearly four to five times more likely to show low resilience than those without a history. Similarly, respondents willing to receive mental health counselling (OR = 0.134 95% CI: 0.047-0.378) were 7.5 times more likely to show low resilience. Participants residing in the same house before the flood were almost 11 times more likely to show low resilience (OR = 0.095; 95% CI 0.021-0.427) than those who relocated. Participants who received support from the Government of Alberta were less likely to express low resilience than those who received no or limited support (OR = 208.343; 95% CI 3.284-13,218.663). CONCLUSION: The study showed a low resilience rate among respondents following the 2020 flooding in Fort McMurray. Factors contributing to low resilience include age, history of depression or anxiety, and place of residence after the flood. After the flood, receiving support from the government was shown to be a protective factor. Further studies are needed to explore robust risk factors of low resilience and measures to promote normal to high resilience among flood victims in affected communities.
OBJECTIVE: This study assessed the prevalence and correlates of depression following the April 2020 flooding in Fort McMurray. METHODOLOGY: A cross-sectional study design. Questionnaires were self-administered through an anonymous, online survey. Data collected included sociodemographics, flooding-related variables, clinical information, and likely major depressive disorder (MDD) using PHQ-9 scoring. Data were analyzed using descriptive statistics, the chi-square test, and logistic regression at P = < 0.05. RESULTS: Of the 186 respondents who completed the survey, 85.5% (159) of the respondents were females, 14.5% (27) were males, 52.7% (98) were above 40 years of age, and 94% (175) were employed. The prevalence of mild to severe depression among the respondents was 53.7% (75). Respondents who reported that they are unemployed are 12 times more likely to have a moderate to severe depression (OR = 12.16; 95% CI: 1.08-136.26). Respondents who had previously received a mental health diagnosis of MDD are five times more likely to have moderate to severe depression (OR = 5.306; 95% CI: 1.84-15.27). CONCLUSION: This study suggests that flooding could impact the psychosocial and mental health of affected people. There is a need to reassess the existing guidelines on emergency planning for flooding to reduce its impacts on mental health and identify where research can support future evidence-based guidelines.
Objectives: The aim of this study is to assess prevalence of major depressive disorder (MDD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD) in students of Keyano College 18 months after a wildfire and to determine the predictors of likely MDD, GAD, and PTSD in the respondents. Methods: A quantitative cross-sectional survey was used to collect data through self-administered, paper-based questionnaires to determine likely MDD, GAD, and PTSD using the PHQ 9, GAD-7, and the PTSD Checklist for DSM 5, Part 3, respectively. Data were analyzed with SPSS version 20 (IBM Corp, Armonk, NY) using univariate analysis with chi-square tests. Results: Eighteen months after the wildfire, the 1-month prevalence rates for MDD, GAD, and PTSD among the college students were 23.4%, 18.7%, and 11.0%, respectively. There were statistically significant associations between multiple sociodemographic variables and the likelihood respondents presented with MDD, GAD, and PTSD 18 months after the wildfire. There were also associations between the likely MDD, GAD, and PTSD and abuse/dependence on alcohol and substances in respondents at 18 months. Conclusion: Our study has established prevalence rates for MDD, GAD, and PTDS among college students 18 months after the Fort McMurray wildfires. Further studies are needed to explore the impact of college-based mental health interventions on the long-term mental health effects of the wildfires.
Background: The 2016 wildfires in Fort McMurray (Alberta, Canada) led to a massive displacement of 88,000 people and destroyed 2,400 homes. Although no direct human fatality resulted, many individuals feared for their lives or those of their loved ones. Objectives: (1) To estimate the prevalence of post-traumatic stress, major depressive, insomnia, generalized anxiety, and substance use disorders in the adult population of Fort McMurray 1 year after the evacuation; (2) To identify pre-, peri-, and post-disaster correlates of mental health disorders. Methods: A phone survey using random digit sampling was used to survey evacuees. A total of 1,510 evacuees (response rate = 40.2%, 55.5% women, mean age = 44.11, SD = 12.69) were interviewed between May 9th and July 28th, 2017. Five validated scales were administered: the PTSD Symptoms Checklist (PCL-5), the Insomnia Severity Index (ISI), the depression and anxiety subscales of the Patient Health Questionnaire (PHQ-9, GAD-7), and the CAGE Substance Abuse Screening Tool. Results: One year after the wildfires, 38% had a probable diagnosis of either post-traumatic stress, major depressive, insomnia, generalized anxiety, or substance use disorder, or a combination of these. Insomnia disorder was the most common, with an estimated prevalence of 28.5%. Post-traumatic stress, major depressive and generalized anxiety disorders were almost equally prevalent, with similar to 15% each. The estimated prevalence of substance use disorder was 7.9%. For all five mental health disorders, having a mental health condition prior to the fires was a significant risk factor, as well as having experienced financial stress or strain due to the economic decline already present in Fort McMurray. Five post-disaster consequences were significant predictors of four of the five disorders: decrease in work, decrease in social life, poorer current health status, increase in drug and alcohol use, and higher level of stress experienced since the fires. Conclusion: One year after the fires, more than one third of the evacuees had clinically significant psychological symptoms, including those of insomnia, post-traumatic stress, depression, anxiety, and substance use. This study helped identify individuals more at risk for mental health issues after a natural disaster and could guide post-disaster psychosocial support strategies.
In May 2016, a wildfire devastated a northern region of Alberta, Canada, resulting in negative consequences on physical and mental stress, social relationships, and overall resilience among Indigenous residents. Research on coping and managing stress following a disaster has failed to incorporate unique characteristics from Indigenous perspectives. Sharing circles were held in urban and rural community settings to capture: (a) Indigenous perspectives of coping, (b) individual and collective strengths that helped Indigenous residents and communities to cope during and after the wildfire, and (c) intergenerational experiences of coping from stress among Indigenous residents. Indigenous residents’ experience with coping from the wildfire was shaped by: (a) heightened physical and emotional stress, (b) existing structural inequities, and (c) strong community cohesion and connection to culture. An unexpected outcome of this research was the therapeutic value of the sharing circles for participants to share their experience.
BACKGROUND: Wildfires emit many carcinogenic pollutants that contaminate air, water, terrestrial, and indoor environments. However, little is known about the relationship between exposure to wildfires and cancer risk. We aimed to assess the associations between residential exposure to wildfires and the incidence of several cancer outcomes (lung cancer, brain cancer, non-Hodgkin lymphoma, multiple myeloma, and leukaemia) in Canada. METHODS: We did a population-based observational cohort study of participants in the 1996 Canadian Census Health and Environment Cohort. The 1996 Canadian Census Health and Environment Cohort is a nationally representative sample of Canadian adults, followed up for cancer incidence and mortality from 1996 to 2015. For this analysis, we excluded participants who lived in major Canadian cities (with a population size greater than 1·5 million people), recent immigrants, and individuals younger than 25 years or 90 years of age or older at baseline. Exposures to wildfires were assigned on the basis of area burned within a 20 km or 50 km radius of residential locations and updated for annual residential mobility. Multivariable Cox proportional hazards models were used to estimate associations between exposure to wildfires and specific cancers associated with carcinogenic compounds released by wildfires, including lung and brain cancer, non-Hodgkin lymphoma, multiple myeloma, and leukaemia, adjusted for many personal and neighbourhood-level covariates. FINDINGS: Our analyses included more than 2 million people followed up for a median of 20 years, for a total of 34 million person-years. Wildfire exposure was associated with slightly increased incidence of lung cancer and brain tumours. For example, cohort members exposed to a wildfire within 50 km of residential locations in the past 10 years had a 4·9% relatively higher incidence (adjusted hazard ratio [HR] 1·049, 95% CI 1·028-1·071) of lung cancer than unexposed populations, and a 10% relatively higher incidence (adjusted HR 1·100, 1·026-1·179) of brain tumours. Similar associations were observed for the 20 km buffer size. Wildfires were not associated with haematological cancers in this study, and concentration-response trends were not readily apparent when area burned was modelled as a continuous variable. INTERPRETATION: Long-term exposure to wildfires might increase the risk of lung cancer and brain tumours. Further work is needed to develop long-term estimates of wildfire exposures that capture the complex mixture of environmental pollutants released during these events. FUNDING: Canadian Institute for Health Research and Fonds de recherche du Quebec.
Following the 2016 Horse River Wildfire in northern Alberta, the provincial health authority, the ministry of health, non-profit and charitable organizations, and regional community-based service agencies mobilized to address the growing health and mental health concerns among Indigenous residents and communities through the provision of services and supports. Among the communities and residents that experienced significant devastation and loss were First Nation and Metis residents in the region. Provincial and local funding was allocated to new recovery positions and to support pre-existing health and social programs. The objective of this research was to qualitatively describe the health systems response to the health impacts following the wildfire from the perspective of service providers who were directly responsible for delivering or organizing health and mental wellness services and supports to Indigenous residents. Semi-structured qualitative interviews were conducted with 15 Indigenous and 10 non-Indigenous service providers from the Regional Municipality of Wood Buffalo (RMWB). Interviews were transcribed verbatim and a constant comparative analysis method was used to identify themes. Following service provider interviews, a supplemental document review was completed to provide background and context for the qualitative findings from interviews. The document review allowed for a better understanding of the health systems response at a systems level following the wildfire. Triangulation of semi-structured interviews and organization report documents confirmed our findings. The conceptual framework by Mirzoev and Kane for understanding health systems responsiveness guided our data interpretation. Our findings were divided into three themes (1) service provision in response to Indigenous mental health concerns (2) gaps in Indigenous health-related services post-wildfire and (3) adopting a health equity lens in post-disaster recovery. The knowledge gained from this research can help inform future emergency management and assist policy and decision makers with culturally safe and responsive recovery planning. Future recovery and response efforts should consider identifying and addressing underlying health, mental health, and emotional concerns in order to be more effective in assisting with healing for Indigenous communities following a public health emergency such as a wildfire disaster.
The 2016 Alberta wildfire, the largest insured natural disaster in Canada, led to a mass evacuation of residents of Fort McMurray, a small city in northern Alberta. The wildfire resulted in significant damages to housing and community infrastructure. The entire community was displaced for several weeks. Post-disaster, community members experienced individual and collective trauma, and other negative mental health impacts in response to the significant losses and grief they endured. Spirituality has been found to be a major protective factor in facilitating resiliency and recovery following the experience of disaster. Nonetheless, little focus has been directed toward how spirituality can strengthen and empower community capacity and growth during post-disaster recovery. Our study explored various meanings and concerns, along with tools and strategies that helped to nurture spiritual resilience and well-being among residents of Fort McMurray following the Alberta wildfire. Data were collected through interviews and focus group discussions with community influencers working to support long-term recovery efforts in the city. Participants identified a number of spiritual resources such as a strong sense of belonging, a shared positive outlook, faith and hope, compassion, and sense of gratitude, which contributed to increased resilience and positive health and well-being and helped them to support families and communities in the post disaster recovery period. Our findings indicate that spiritual values and beliefs can play a significant role in building resilience and promoting individual and communal healing and recovery post-disaster. These findings have important implications for post-disaster recovery strategies, as they highlight the need to ensure supports for interventions and initiatives that strengthen a collective sense of identity and social cohesion, informed by communal norms and beliefs, including programs and resources which support opportunities for reflexivity to foster shared healing and ongoing recovery processes.
BACKGROUND: The Fort McMurray wildfire of 3 May 2016 was one of the most devastating natural disasters in Canadian history. Although resilience plays a crucial role in the daily functioning of individuals by acting as a protective shield that lessens the impact of disasters on their mental well-being, to date little is known about the long-term impact of wildfires on resilience and associated predictors of low resilience. OBJECTIVES: The objective of the study was to assess the prevalence and predictors of resilience among residents of Fort McMurray five years after the wildfires. METHOD: This was a quantitative cross-sectional study. A self-administered online survey which included standardized rating scales for resilience (BRS), anxiety (GAD-7), depression (PHQ-9), and post-traumatic stress disorder (PTSD)(PCL-C) was used to determine the prevalence of resilience as well as its demographic, clinical, and wildfire-related predictors. The data were collected between 24 April and 2 June 2021 and analyzed using the Statistical Package for Social Sciences (SPSS) version 25 using univariate analysis with a chi-squared test and binary logistic regression analysis. RESULTS: A total of 186 residents completed the survey out of 249 who accessed the online survey, producing a response rate of 74.7%. Most of the respondents were females (85.5%, 159), above 40 years of age (81.6%, 80), employed (94.1%, 175), and in a relationship (71%, 132). Two variables-having had PTSD symptoms (OR = 2.85; 95% CI: 1.06-7.63), and age-were significant predictors of low resilience in our study. The prevalence of low resilience in our sample was 37.4%. CONCLUSIONS: Our results suggest that age and the presence of PTSD symptoms were the independent significant risk factors associated with low resilience five years after the Fort McMurray wildfire disaster. Further research is needed to enhance understanding of the pathways to resilience post-disaster to identify the robust predictors and provide appropriate interventions to the most vulnerable individuals and communities.
OBJECTIVE: The aim of this study was to describe the incidence of heat-related illness among workers in British Columbia (BC), Canada, 2001-2020. METHODS: Cases of heat-related illness occurring among workers aged 15 years and older were identified from accepted lost-time claims from WorkSafeBC, the provincial workers’ compensation board. Incidence rates were calculated using monthly estimates of the working population from Statistics Canada’s Labour Force Survey as the denominator. RESULTS: Between 2000 and 2020, there were 528 heat-related illness claims, corresponding to a rate of 1.21 (95% confidence interval, 1.10-1.31) claims per 100,000 workers. Eighty-four percent of claims occurred between June and August. Rates were higher among male workers, younger workers, and among those working in occupations related to primary industry; trades, transport, and equipment operators; and processing, manufacturing, and utilities. CONCLUSIONS: In BC, lost-time claims for heat-related illness occurred disproportionately among certain subgroups of the workforce.
SETTING: Planning and designing thermally comfortable outdoor spaces is increasingly important in the context of climate change, particularly as children are more vulnerable than adults to environmental extremes. However, existing playground standards focus on equipment and surfacing to reduce acute injuries, with no mention of potential negative health consequences related to heat illness, sun exposure, and other thermal extremes. The goal of this project was to develop proposed guidelines for designing thermally comfortable playgrounds in Canada for inclusion within the CAN/CSA-Z614 Children’s playground equipment and surfacing standard. INTERVENTION: The project to develop guidance for thermally comfortable playgrounds was initiated with a municipal project in Windsor, Ontario, to increase shade, vegetation, and water features at parks and playgrounds to provide more comfortable experiences amid the increased frequency of hot days (≥30°C). The lack of available information to best manage environmental conditions led to a collaborative effort to build resources and raise awareness of best practices in the design of thermally comfortable playgrounds. OUTCOMES: A group of multidisciplinary experts developed technical guidance for improving thermal comfort at playgrounds, including a six-page thermal comfort annex adopted within a national playground and equipment standard. The annex has been used by Canadian schools in a competition to design and implement green playgrounds. IMPLICATIONS: Both the technical report and the thermal comfort annex provide increased awareness and needed guidance for managing environmental conditions at playgrounds. Thermally safe and comfortable play spaces will help ensure that Canada’s playgrounds are designed to minimize environmental health risks for children.
Urban areas have complex thermal distribution. We examined the association between extreme temperature and mortality in urban Ontario, using two temperature data sources: high-resolution and weather station data. We used distributed lag non-linear Poisson models to examine census division-specific temperature-mortality associations between May and September 2005-2012. We used random-effect multivariate meta-analysis to pool results, adjusted for air pollution and temporal trends, and presented risks at the 99th percentile compared to minimum mortality temperature. As additional analyses, we varied knots, examined associations using different temperature metrics (humidex and minimum temperature), and explored relationships using different referent values (most frequent temperature, 75th percentile of temperature distribution). Weather stations yielded lower temperatures across study months. U-shaped associations between temperature and mortality were observed using both high-resolution and weather station data. Temperature-mortality relationships were not statistically significant; however, weather stations yielded estimates with wider confidence intervals. Similar findings were noted in additional analyses. In urban environmental health studies, high-resolution temperature data is ideal where station observations do not fully capture population exposure or where the magnitude of exposure at a local level is important. If focused upon temperature-mortality associations using time series, either source produces similar temperature-mortality relationships.
INTRODUCTION: Mean daily temperatures in Canada rose 1.7°C between 1948 and 2016, and the frequency, severity, and duration of extreme heat events has increased. These events can exacerbate underlying health conditions, bringing patients to emergency departments (EDs). This retrospective analysis assessed the impact of temperature and humidex on ED volume and length of stay (LOS). METHODS: LOS is an indicator of ED overcrowding and system performance. Using daily maximum temperatures and humidex values, this study investigated the impact of mean 3-d temperatures and humidex preceding ED presentation on the median and maximum ED LOS and patient volume in 2 community hospitals in Montreal, Quebec, during the summer months of 2016 to 2018. Data were analyzed with 1-way analysis of variance with post hoc Fisher least significant difference tests and Spearman correlation tests. RESULTS: The mean maximum temperature and humidex were 26.1°C and 30.4°C, respectively (n=276 d). Mean 3-d temperatures ≥30°C were associated with higher daily ED volumes in both hospitals (138 vs 121, P=0.002 and 132 vs 125, P=0.03) and with increased median LOS at 1 hospital (8.9 vs 7.6 h, P=0.03). Mean 3-d humidex ≥35 was associated with higher daily ED volumes at both hospitals as well (136 vs 123, P=0.01 and 133 vs 125, P=0.009) with an increased median LOS at 1 hospital (8.6 vs 6.9 h, P=0.0001) with humidex values of 25 to 29.9°C. CONCLUSIONS: Heat events were associated with increased ED presentations and LOS. This study suggests that a warming climate can impede emergency service provision by increasing the demand for and delaying timely care.
Due to climate change, heat events in Canada have become more extreme in intensity and frequency and will continue to do so according to the Intergovernmental Panel on Climate Change’s global predictions. Environmental justice research has indicated that extreme heat exposure disproportionally affects socio-economically disadvantaged populations in cities. The objective of this research was to determine whether such a phenomenon exists in Montreal, Canada. Temperature data were obtained through in-situ sensors and governmental weather stations, while census data were retrieved from Statistics Canada through the Census mapper. Correlation tests were run between temperature and five demographic and socio-economic variables measured inside a 500 m buffer around the temperature sensors. The variables included Indigenous Peoples (IND), people of 65 years old and over (Over 65), people between 25 and 64 years old without a high school degree (No HS), and low-income (LI). A positive correlation was found for LI and No HS (p < 0.05). A regression test performed with interpolated temperature and the demographic and socio-economic variables across the study area revealed no significant correlation due to spatial heterogeneity.
Heat-related mortality is an increasingly important public health burden that is expected to worsen with climate change. In addition to long-term trends, there are also interannual variations in heat-related mortality that are of interest for efficient planning of health services. Large-scale climate patterns have an important influence on summer weather and therefore constitute important tools to understand and predict the variations in heat-related mortality. METHODS: In this article, we propose to model summer heat-related mortality using seven climate indices through a two-stage analysis using data covering the period 1981-2018 in two metropolitan areas of the province of Québec (Canada): Montréal and Québec. In the first stage, heat attributable fractions are estimated through a time series regression design and distributed lag nonlinear specification. We consider different definitions of heat. In the second stage, estimated attributable fractions are predicted using climate index curves through a functional linear regression model. RESULTS: Results indicate that the Atlantic Multidecadal Oscillation is the best predictor of heat-related mortality in both Montréal and Québec and that it can predict up to 20% of the interannual variability. CONCLUSION: We found evidence that one climate index is predictive of summer heat-related mortality. More research is needed with longer time series and in different spatial contexts. The proposed analysis and the results may nonetheless help public health authorities plan for future mortality related to summer heat.
BACKGROUND: British Columbia, Canada, was impacted by a record-setting heat dome in early summer 2021. Most households in greater Vancouver do not have air conditioning, and there was a 440% increase in community deaths during the event. Readily available data were analyzed to inform modifications to the public health response during subsequent events in summer 2021 and to guide further research. METHODS: The 434 community deaths from 27 June through 02 July 2021 (heat dome deaths) were compared with all 1,367 community deaths that occurred in the same region from 19 June through 09 July of 2013-2020 (typical weather deaths). Conditional logistic regression was used to examine the effects of age, sex, neighborhood deprivation, and the surrounding environment. Data available from homes with and without air conditioning were also used to illustrate the indoor temperatures differences. RESULTS: A combined index of material and social deprivation was most predictive of heat dome risk, with an adjusted odds ratio of 2.88 [1.85, 4.49] for the most deprived category. Heat dome deaths also had lower greenness within 100 m than typical weather deaths. Indoor temperatures in one illustrative home without air conditioning ranged between 30°C and 40°C. CONCLUSIONS: Risk of death during the heat dome was associated with deprivation, lower neighborhood greenness, older age, and sex. High indoor temperatures likely played an important role. Public health response should focus on highly deprived neighborhoods with low air conditioning prevalence during extreme heat events. Promotion of urban greenspace must continue as the climate changes.
INTERVENTION: Ontario’s Harmonized Heat Warning and Information System (HWIS) brings harmonized, regional heat warnings and standard heat-health messaging to provincial public health units prior to periods of extreme heat. RESEARCH QUESTION: Was implementation of the harmonized HWIS in May 2016 associated with a reduction in emergency department (ED) visits for heat-related illness in urban locations across Ontario, Canada? METHODS: We conducted a population-based interrupted time series analysis from April 30 to September 30, 2012-2018, using administrative health and outdoor temperature data. We used autoregressive integrated moving average models to examine whether ED rates changed following implementation of the harmonized HWIS, adjusted for maximum daily temperature. We also examined whether effects differed in heat-vulnerable groups (≥65 years or <18 years, those with comorbidities, those with a recent history of homelessness), and by heat warning region. RESULTS: Over the study period, heat alerts became more frequent in urban areas (6 events triggered between 2013 and 2015 and 14 events between 2016 and 2018 in Toronto, for example). The mean rate of ED visits was 47.5 per 100,000 Ontarians (range 39.7-60.1) per 2-week study interval, with peaks from June to July each year. ED rates were particularly high in those with a recent history of homelessness (mean rate 337.0 per 100,000). Although rates appeared to decline following implementation of HWIS in some subpopulations, the change was not statistically significant at a population level (rate 0.04, 95% CI: -0.03 to 0.1, p=0.278). CONCLUSION: In urban areas across Ontario, ED encounters for heat-related illness may have declined in some subpopulations following HWIS, but the change was not statistically significant. Efforts to continually improve HWIS processes are important given our changing Canadian climate.
Heat-related mortality (HRM) is increasing because of the climate change and urbanization leading to extreme heat events. This paper summarizes the results of the excess mortality attributed to excessive heat events in two largest cities in Canada, Toronto and Montreal, during three heat wave periods. We present an application of a fine-resolution, urban-mesoscale model to assess the impacts of heat and heat mitigation strategy on heat death. The Weather Research and Forecasting model (WRF) is coupled with a multi-layer of the Urban Canopy Model (ML-UCM) to assess the impacts of heat and heat mitigation strategy on heat-related death. The background albedo of 0.2 for urban surfaces are respectively increased to 0.65, 0.60, and 0.45 for roofs, walls, and grounds. The changes of the air mass category, ambient and apparent temperatures interpret the impacts of extreme heat and the potential of increasing surface albedo (ISA) on HRM. Here, the calculations and estimations of HRM is based on the data obtained from Canadian Environmental Health Atlas (CEHA) indicating an average of 120 heat-induced deaths in Toronto and Montreal. ISA affords a reduction in air temperature (1-2 degrees C), a decrease in dew point temperature (0.2-0.5 degrees C), and a slight increase in near-surface wind speed (-0.01 to-0.4 m/s). Increase in albedo shifts days into more benign conditions by nearly 60%. The HRM will lessen by 3-7%, pointing that seven to eighteen lives could be saved. Cooling the urban climate will improve discomfort index, lessen the impacts of elevated temperature, enhance human thermal comfort, and decrease HRM to some significant extent. (c) 2020 Elsevier B.V. All rights reserved.
BACKGROUND: Climate change, driven by human activity, is rapidly changing our environment and posing an increased risk to human health. Local governments must adapt their cities and prepare for increased periods of extreme heat and ensure that marginalized populations do not suffer detrimental health outcomes. Heat warnings traditionally rely on outdoor temperature data which may not reflect indoor temperatures experienced by individuals. Smart thermostats could be a novel and highly scalable data source for heat wave monitoring. OBJECTIVE: The objective of this study was to explore whether smart thermostats can be used to measure indoor temperature during a heat wave and identify houses experiencing indoor temperatures above 26°C. METHODS: We used secondary data-indoor temperature data recorded by ecobee smart thermostats during the Quebec heat waves of 2018 that claimed 66 lives, outdoor temperature data from Environment Canada weather stations, and indoor temperature data from 768 Quebec households. We performed descriptive statistical analyses to compare indoor temperatures differences between air conditioned and non-air conditioned houses in Montreal, Gatineau, and surrounding areas from June 1 to August 31, 2018. RESULTS: There were significant differences in indoor temperature between houses with and without air conditioning on both heat wave and non-heat wave days (P<.001). Households without air conditioning consistently recorded daily temperatures above common indoor temperature standards. High indoor temperatures persisted for an average of 4 hours per day in non-air conditioned houses. CONCLUSIONS: Our findings were consistent with current literature on building warming and heat retention during heat waves, which contribute to increased risk of heat-related illnesses. Indoor temperatures can be captured continuously using smart thermostats across a large population. When integrated with local heat health action plans, these data could be used to strengthen existing heat alert response systems and enhance emergency medical service responses.
SETTING: In 2018, a regional health authority in British Columbia (BC) initiated a multi-year project to support planning and response to extreme heat. Climate projections indicate that temperatures in the southern interior of BC will continue to increase, with concomitant negative impacts on human health. Successful climate change adaptation must include cross-sectoral action, inclusive of the health sector, to plan for and respond to climate-related events, including extreme heat. INTERVENTION: The objective of this project was to support the development and implementation of a Heat Alert and Response System (HARS) in a small, rural community. The health authority facilitated collaboration among provincial and local governments, community organizations, and First Nations partners to assess community assets, draft a plan for extreme heat, and prepare for a community-supported response during heat events. OUTCOMES: Stakeholders expressed the importance of utilizing existing partnerships and community resources, such as physical and procedural infrastructure, in which to embed the HARS. It was imperative that the plan be simple, concise, and considerate of the community’s unique context. Educational materials and a tailored method of dissemination were important for collective and individual risk mitigation. IMPLICATIONS: A community-driven approach that utilized existing assets allowed for integration of HARS within municipal response plans and established infrastructure. The result is a sustainable public health intervention that has the potential to mitigate the negative health effects of extreme heat. Knowledge acquired through this initiative is informing similar HARS planning processes in other rural BC communities.
The Canadian Arctic has a long history with diarrheal disease, including outbreaks of campylobacteriosis, giardiasis, and salmonellosis. Due to climate change, the Canadian Arctic is experiencing rapid environmental transformation, which not only threatens the livelihood of local Indigenous Peoples, but also supports the spread, frequency, and intensity of enteric pathogen outbreaks. Advances in diagnostic testing and detection have brought to attention the current burden of disease due to Cryptosporidium, Campylobacter, and Helicobacter pylori. As climate change is known to influence pathogen transmission (e.g., food and water), Arctic communities need support in developing prevention and surveillance strategies that are culturally appropriate. This review aims to provide an overview of how climate change is currently and is expected to impact enteric pathogens in the Canadian Arctic.
Canadians face an emerging threat of Lyme disease due to the northward expansion of the tick vector, Ixodes scapularis. We evaluated the degree of I. scapularis population establishment and Borrelia burgdorferi occurrence in the city of Ottawa, Ontario, Canada from 2017-2019 using active surveillance at 28 sites. We used a field indicator tool developed by Clow et al. to determine the risk of I. scapularis establishment for each tick cohort at each site using the results of drag sampling. Based on results obtained with the field indicator tool, we assigned each site an ecological classification describing the pattern of tick colonization over two successive cohorts (cohort 1 was comprised of ticks collected in fall 2017 and spring 2018, and cohort 2 was collected in fall 2018 and spring 2019). Total annual site-specific I. scapularis density ranged from 0 to 16.3 ticks per person-hour. Sites with the highest density were located within the Greenbelt zone, in the suburban/rural areas in the western portion of the city of Ottawa, and along the Ottawa River; the lowest densities occurred at sites in the suburban/urban core. B. burgdorferi infection rates exhibited a similar spatial distribution pattern. Of the 23 sites for which data for two tick cohorts were available, 11 sites were classified as “high-stable”, 4 were classified as “emerging”, 2 were classified as “low-stable”, and 6 were classified as “non-zero”. B. burgdorferi-infected ticks were found at all high-stable sites, and at one emerging site. These findings suggest that high-stable sites pose a risk of Lyme disease exposure to the community as they have reproducing tick populations with consistent levels of B. burgdorferi infection. Continued surveillance for I. scapularis, B. burgdorferi, and range expansion of other tick species and emerging tick-borne pathogens is important to identify areas posing a high risk for human exposure to tick-borne pathogens in the face of ongoing climate change and urban expansion.
Some species of Culicoides Latreille (Diptera: Ceratopogonidae) can be pests as well as pathogen vectors, but data on their distribution in Ontario, Canada, are sparse. Collecting this baseline data is important given ongoing, accelerated alterations in global climate patterns that may favor the establishment of some species in northern latitudes. Culicoides spp. were surveyed using UV light traps over two seasons in 2017 and 2018 at livestock farms in southern Ontario, Canada. Two Culicoides spp. not previously recorded in Canada were identified, C. bergi and C. baueri, representing new country and provincial records. Unlike some congenerics, these two species are not currently recognized as vectors of pathogens that pose a health risk to humans, livestock or wildlife in North America. However, the possibility that these Culicoides species may have recently expanded their geographic range, potentially in association with climate and/or landscape changes, warrants ongoing attention and research. Furthermore, our results provoke the question of the potential undocumented diversity of Culicoides spp. in Ontario and other parts of Canada, and whether other Culicoides spp. may be undergoing range expansion. The current and future distributions of Culicoides spp., and other potential vectors of human, agricultural, and wildlife health significance, are important to identify for proper disease risk assessment, mitigation, and management.
Given the climate crisis and its cumulative impacts on public health, effective communication strategies that engage the public in adaptation and mitigation are critical. Many have argued that a health frame increases engagement, as do visual methodologies including online and interactive platforms, yet to date there has been limited research on audience responses to health messaging using visual interventions. This study explores public attitudes regarding communication tools focused on climate change and climate-affected Lyme disease through six focus groups (n = 61) in rural and urban southern Manitoba, Canada. The results add to the growing evidence of the efficacy of visual and storytelling methods in climate communications and argues for a continuum of mediums: moving from video, text, to maps. Findings underscore the importance of tailoring both communication messages and mediums to increase uptake of adaptive health and environmental behaviours, for some audiences bridging health and climate change while for others strategically decoupling them.
The tick vector of Lyme disease, Ixodes scapularis, is currently expanding its geographical distribution northward into southern Canada driving emergence of Lyme disease in the region. Despite large-scale studies that attributed different factors such as climate change and changes in land use to the geographical expansion of the tick, a comprehensive understanding of local patterns of tick abundance is still lacking in that region. Using a newly endemic periurban nature park located in Quebec (Canada) as a model, we explored intra-habitat patterns in tick distribution and their relationship with biotic and abiotic factors. We verified the hypotheses that (1) there is spatial heterogeneity in tick densities at the scale of the park and (2) these patterns can be explained by host availability, habitat characteristics and microclimatic conditions. During tick activity season in three consecutive years, tick, deer, rodent and bird abundance, as well as habitat characteristics and microclimatic conditions, were estimated at thirty-two sites. Patterns of tick distribution and abundance were investigated by spatial analysis. Generalised additive mixed models were constructed for each developmental stage of the tick and the relative importance of significant drivers on tick abundance were derived from final models. We found fine-scale spatial heterogeneity in densities of all tick stages across the park, with interannual variability in the location of hotspots. For all stages, the local density was related to the density of the previous stage in the previous season, in keeping with the tick’s life cycle. Adult tick density was highest where drainage was moderate (neither waterlogged nor dry). Microclimatic conditions influenced the densities of immature ticks, through the effects of weather at the time of tick sampling (ambient temperature and relative humidity) and of the seasonal microclimate at the site level (degree-days and number of tick adverse moisture events). Seasonal phenology patterns were generally consistent with expected curves for the region, with exceptions in some years that may be attributable to founder events. This study highlights fine scale patterns of tick population dynamics thus providing fundamental knowledge in Lyme disease ecology and information applicable to the development of well-targeted prevention and control strategies for public natural areas affected by this growing problem in southern Canada.
BACKGROUND: Despite scientific evidence that climate change has profound and far reaching implications for public health, translating this knowledge in a manner that supports citizen engagement, applied decision-making, and behavioural change can be challenging. This is especially true for complex vector-borne zoonotic diseases such as Lyme disease, a tick-borne disease which is increasing in range and impact across Canada and internationally in large part due to climate change. This exploratory research aims to better understand public risk perceptions of climate change and Lyme disease in order to increase engagement and motivate behavioural change. METHODS: A focus group study involving 61 participants was conducted in three communities in the Canadian Prairie province of Manitoba in 2019. Focus groups were segmented by urban, rural, and urban-rural geographies, and between participants with high and low levels of self-reported concern regarding climate change. RESULTS: Findings indicate a broad range of knowledge and risk perceptions on both climate change and Lyme disease, which seem to reflect the controversy and complexity of both issues in the larger public discourse. Participants in high climate concern groups were found to have greater climate change knowledge, higher perception of risk, and less skepticism than those in low concern groups. Participants outside of the urban centre were found to have more familiarity with ticks, Lyme disease, and preventative behaviours, identifying differential sources of resilience and vulnerability. Risk perceptions of climate change and Lyme disease were found to vary independently rather than correlate, meaning that high climate change risk perception did not necessarily indicate high Lyme disease risk perception and vice versa. CONCLUSIONS: This research contributes to the growing literature framing climate change as a public health issue, and suggests that in certain cases climate and health messages might be framed in a way that strategically decouples the issue when addressing climate skeptical audiences. A model showing the potential relationship between Lyme disease and climate change perceptions is proposed, and implications for engagement on climate change health impacts are discussed.
OBJECTIVES: We aimed to characterize polycyclic aromatic hydrocarbons (PAHs) in the breathing zone and on the skin of wildland firefighters and to assess their contribution to urinary 1-hydroxypyrene (1-HP) over repeated firefighting rotations. We asked if improved skin hygiene or discretionary use of an N95 mask would reduce absorption. METHODS: In collaboration with wildfire services of two Canadian provinces, Alberta and British Columbia (BC), we recruited wildland firefighters from crews willing to be followed up over successive rotations and to be randomly assigned to normal practice, enhanced skin hygiene (ESH), or ESH plus discretionary use of an N95 mask. We collected spot urine samples at the beginning and end of up to four rotations/firefighter. On designated fire days, as close as possible to the end of rotation, we collected skin wipes from the hands, throat, and chest at the beginning and end of the fire day and, in BC, start of fire-day urine samples. Volunteers carried air monitoring pumps. Participants completed questionnaires at the beginning and end of rotations. Exposure since the start of the fire season was estimated from fire service records. Urinary 1-HP was analyzed by LC-MS-MS. Analysis of 21 PAHs on skin wipes and 27 PAHs from air sampling was done by GC-MS-MS. Statistical analysis used a linear mixed effects model. RESULTS: Firefighters in Alberta were recruited from five helitack crews and two unit crews, and in BC from two unit crews with 80 firefighters providing data overall. The fire season in BC was very active with five monitored fire days. In Alberta, with more crews, there were only seven fire days. Overall, log 1-HP/creatinine (ng/g) increased significantly from the start (N = 145) to end of rotation (N = 136). Only three PAHs (naphthalene, phenanthrene, and pyrene) were found on >20% of skin wipes. PAHs from 40 air monitoring pumps included 10 PAHs detected on cassette filters (particles) and 5 on sorbent tubes (vapor phase). A principal component extracted from air monitoring data represented respiratory exposure and total PAH from skin wipes summarized skin exposure. Both routes contributed to the end of rotation urinary 1-HP. The ESH intervention was not demonstrated to effect absorption. Allocation of an N95 mask was associated with lower 1-HP when modeling respiratory exposure (β = -0.62, 95% CI -1.15 to -0.10: P = 0.021). End of rotation 1-HP was related to 1-HP at the start of the next rotation (β = 0.25, 95% CI 0.12 to 0.39: P < 0.001). CONCLUSIONS: Exposures to PAHs during firefighting were significant, with samples exceeding the American Conference of Governmental Industrial Hygienists Biological Exposure Index for 1-HP suggesting a need for control of exposure. PAH exposure accumulated during the rotation and was not fully eliminated during the break between rotations. Both respiratory and skin exposures contributed to 1-HP. While improved skin hygiene may potentially reduce dermal absorption, that was not demonstrated here. In contrast, those allocated to discretionary use of an N95 mask had reduced 1-HP excretion. Wildland firefighters in North America do not use respiratory protection, but the results of this study support more effective interventions to reduce respiratory exposure.
BACKGROUND: On May 3, 2016, residents of Fort McMurray Wood Buffalo, Alberta were evacuated due to an uncontrolled wildfire. The short-notice evacuation had destabilizing consequences for residents, including changes in routines, loss of control, and increased uncertainty. These consequences were especially detrimental to women who were pregnant or pre-conception during the evacuation. Pregnant and pre-conception women are particularly susceptible to a vast range of negative consequences during and post natural disasters, including elevated stress and higher incidence of pregnancy complications including gestational diabetes mellitus, pregnancy induced hypertension and C-section. The aim of this study was to understand the experiences, perceived stress and resilience of women who were pregnant during the wildfire. As well as to explore potential interventions to promote the health and enhance resilience of pregnant women and to assist in recovery after exposure to a natural disaster or other traumatic events. METHODS: A qualitative thematic analysis of 16 narratives penned by pregnant women and recounted in Ashley Tobin’s compilations 93/88,000 and 159 More/ 88,000: Stories of Evacuation, Re-Entry and the In-Between was conducted. RESULTS: Analysis revealed five key themes: (1) experience of stress responses due to personal and external factors, (2) social connectedness and support as a facilitator of resilience, (3) performance of resilience-enhancing activities, (4) the roles of pregnancy and motherhood in the experiences of loss and resilience, and (5) the importance of home. CONCLUSION: Pregnant women have unique barriers that may negatively impact them during a natural disaster or other form of stressful event. They may benefit from assistance with navigating role transition during pregnancy, training in stress management strategies, and writing interventions to build resiliency and begin the process of recovery from trauma.
Background We studied the impact of fine particulate matter (PM2.5) exposure due to a remote wildfire event in the Pacific Northwest on daily outpatient respiratory and cardiovascular physician visits during wildfire (24-31 August, 2015) and post-wildfire period (1-30 September, 2015) relative to the pre-wildfire period (1-23 August, 2015) in the city of Calgary, Canada. Methods A quasi-Poisson regression model was used for modelling daily counts of physician visits due to PM2.5 while adjusting for day of the week (weekday versus weekend or public holiday), wildfire exposure period (before, during, after), methane, relative humidity, and wind direction. A subgroup analysis of those with pre-existing diabetes or hypertension was performed. Results An elevated risk of respiratory disease morbidity of 33% (relative risk: RR) [95% confidence interval (CI): 10%-59%] and 55% (95% CI: 42%-69%) was observed per 10 mu g/m(3) increase in PM2.5 level during and after wildfire, respectively, relative to the pre-wildfire time period. Increased risk was observed for children aged 0-9 years during (RR = 1.57, 95% CI: 1.21-2.02) and after the wildfire (RR = 2.11, 95% CI: 1.86-2.40) especially for asthma, acute bronchitis and acute respiratory infection. The risk of physician visits among seniors increased by 11% (95% CI: 3%-21%), and 19% (95% CI: 7%-33%) post-wildfire for congestive heart failure and ischaemic heart disease, respectively. Individuals with pre-existing diabetes had an increased risk of both respiratory and cardiovascular morbidity in the post-wildfire period (RR = 1.35, 95% CI: 1.09-1.67; RR = 1.22, 95% CI: 1.01-1.46, respectively). Conclusions Wildfire-related PM2.5 exposure led to increased respiratory condition-related outpatient physician visits during and after wildfires, particularly for children. An increased risk of physician visits for congestive heart failure and ischaemic heart disease among seniors in the post-wildfire period was also observed.
The increasing incidence of extreme wildfire is becoming a concern for public health. Although long-term exposure to wildfire smoke is associated with respiratory illnesses, reports on the association between short-term occupational exposure to wildfire smoke and lung function remain scarce. In this cross-sectional study, we analyzed data from 218 Royal Canadian Mounted Police officers (mean age: 38 & PLUSMN; 9 years) deployed at the Fort McMurray wildfires in 2016. Individual exposure to air pollutants was calculated by integrating the duration of exposure with the air quality parameters obtained from the nearest air quality monitoring station during the phase of deployment. Lung function was measured using spirometry and body plethysmography. Association between exposure and lung function was examined using principal component linear regression analysis, adjusting for potential confounders. In our findings, the participants were predominantly male (71%). Mean forced expiratory volume in 1 s (FEV1), and residual volume (RV) were 76.5 & PLUSMN; 5.9 and 80.1 & PLUSMN; 19.5 (% predicted). A marginal association was observed between air pollution and higher RV [beta: 1.55; 95% CI: -0.28 to 3.37 per interquartile change of air pollution index], but not with other lung function indices. The association between air pollution index and RV was significantly higher in participants who were screened within the first three months of deployment (2.80; 0.91 to 4.70) than those screened later (-0.28; -2.58 to 2.03), indicating a stronger effect of air pollution on peripheral airways. Acute short-term exposure to wildfire-associated air pollutants may impose subtle but clinically important deleterious respiratory effects, particularly in the peripheral airways.
This paper presents findings from an online survey that explored public experiences of wildfire smoke, public health advisory information, risk perceptions, and protective actions in response to wildfire smoke in western Canada. Most respondents had wildfire smoke experiences lasting several days with decreased visibility, and many had difficulty breathing and changes to their health. While a majority of respondents were aware of the Air Quality Health Index and how to respond on a high risk day, some did not. Most respondents perceived the risk from wildfire smoke during their most recent experience to be extreme, severe, or moderate, with only 20% perceiving low risk from wildfire smoke. Wildfire smoke experiences affected risk perceptions, and female respondents perceived the risk from wildfire smoke to be higher in comparison to male respondents. Most respondents took protective actions during their most recent exposure to wildfire smoke, with the most popular measures including keeping windows and doors shut, and limiting time spent outdoors. Perceptions of wildfire smoke risks, experiencing health impacts from wildfire smoke, sex and highest level of education, and firefighting experience influenced protective actions. Recommendations to improve public health during wildfire smoke events and future research are included.
First Nation reserves in Canada are at high risk from wildfires, with many evacuated every year. There is a need to understand how First Nations are affected by wildfire evacuations to identify ways to reduce negative impacts. The First Nations Wildfire Evacuation Partnership has conducted research to explore evacuation experiences of seven First Nations in three Canadian provinces. This paper presents findings from research across the seven First Nations. Results show that few participating First Nations had an up to date emergency plan tailored to their community, which contributed to challenges during the evacuation. Family separation, insufficient information, and worries about losing their house caused considerable distress for evacuees. Wildfire smoke health impacts occurred, particularly for those who had pre-existing health conditions. Social and financial support, if available, helped evacuees during and after their evacuation. Several years after First Nations return home after a wildfire evacuation, lingering distress continues and some First Nations were still experiencing fiscal challenges as a result of the evacuation. Recommendations for reducing negative impacts of wildfire evacuations on First Nations people are discussed.
BACKGROUND: In the rapidly shifting Canadian climate, an ageing population, and increased migration, a greater understanding of how local climate and air pollution hazards impact older adults and immigrant populations will be necessary for mitigating and adapting to adverse health impacts. OBJECTIVES: To explore the reported health impacts of climate change and air pollution exposures in older adults and immigrant people living in Canada, identify known factors influencing risk and resilience in these populations and gaps in the literature. METHODS: We searched for research focused on older adults and immigrants living in Canada, published from 2010 onward, where the primary exposures were related to climate or air pollution. We extracted data on setting, exposures, health outcomes, and other relevant contextual factors. RESULTS AND DISCUSSION: We identified 52 eligible studies, most focused in Ontario and Quebec. Older people in Canada experience health risks due to climate and air pollution exposures. The extent of the risk depends on multiple factors. We found little information about the climate- and air pollution-related health impacts experienced by immigrant communities. CONCLUSIONS: Further research about climate- and air pollution-related exposures, health, and which factors promote or reduce resiliency in Canada’s older adults and immigrant communities is necessary.
Floods and evacuations due to flooding can increase vulnerability and affect community resilience. This article examines how the Kashechewan First Nation, located in the flood-prone Subarctic southwestern James Bay region of Canada, is affected by the frequent risk of spring flooding. Kashechewan, an isolated and remote Indigenous community, is located along the Albany River in northern Ontario. Kashechewan First Nation has been evacuated 14 times to at least 22 host communities across Ontario since 2004 (consecutively from 2004 to 2008 and 2012-2019) because of actual flooding events or flooding risk and the potential failure of the dike that surrounds the community. Through a collaboration with the First Nation, qualitative semi-structured interviews were completed with 41 participants. Results show that spring flood risk has significantly increased the community’s physical and socio-cognitive vulnerability. Flooding frequently impacts community infrastructure, traditional spring hunting and harvesting, and the local economy. It also significantly increases the stress and anxiety of residents every year as spring approaches. Dealing with the regular flooding risk and recurring emergency experiences have improved the community’s disaster preparedness and coping capacity, but residents’ evacuation experiences negatively affect their well-being during and after the evacuations. The short-term responses to the physical vulnerability of people frequently experiencing the elevated hazards risks help increasing specific resilience-building and coping capacity in the short-run. However, such short-term responses can also produce greater vulnerability in the long-term. Similarly, if the long-term adaptation responses for resilience-building do not consider the short-term coping capacities and community-specific ground realities, they can significantly increase the physical vulnerability of residents.
The application of green infrastructure presents an opportunity to mitigate rising temperatures using a multi-faceted ecosystems-based approach. A controlled field study in Toronto, Ontario, Canada, evaluates the impact of nature-based solutions on near surface air temperature regulation focusing on different applications of green infrastructure. A field campaign was undertaken over the course of two summers to measure the impact of green roofs, green walls, urban vegetation and forestry systems, and urban agriculture systems on near surface air temperature. This study demonstrates that multiple types of green infrastructure applications are beneficial in regulating near surface air temperature and are not limited to specific treatments. Widespread usage of green infrastructure could be a viable strategy to cool cities and improve urban climate.
Emergency managers (EMs) and Emergency Social Services Directors (ESSDs) are essential service providers who fulfill critical roles in disaster risk reduction. Despite being positioned throughout all levels of government, and in the private sector, EMs and ESSDs fulfill roles which occur largely behind the scenes. The purpose of this phenomenological study was to explore the roles of EMs and ESSDs from different regions across Canada. Specifically, we wanted to understand their perceptions of barriers, vulnerabilities and capabilities within the context of their roles. EMs (n = 15) and ESSDs (n = 6) from six Canadian provinces participated in semi-structured telephone interviews. Through content analysis, five themes and one model were generated from the data: 1) Emergency management is not synonymous with first response, 2) Unrealistic expectations for a “side-of-desk” role, 3) Minding the gap between academia and practice with a ‘whole-society’ approach, 4) Personal preparedness tends to be weak, 5) Behind the scenes roles can have mental health implications. We present a model, based on these themes, which makes explicit the occupational risks that EMs and ESSDs may encounter in carrying out the skills, tasks, and roles of their jobs. Identification of occupational risks is a first step towards reducing vulnerabilities and supporting capability. This is particularly relevant in our current society as increased demands placed on these professionals coincides with the increasing frequency and severity of natural disasters due to climate change and the emergence of the world wide COVID-19 pandemic.
BACKGROUND: To monitor the adoption of climate change adaptive behaviors in the population, public health authorities have to conduct national surveys, which can help them target vulnerable subpopulations. To ensure reliable estimates of the adoption of these preventive behaviors, many data collection methods are offered by polling firms. The aim of this study was to compare a telephone survey with a web survey on Lyme disease with regard to their representativeness. METHODS: The data comes from a cross-sectional study conducted in the Province of Québec (Canada). In total, 1003 people completed the questionnaire by telephone and 956 filled in a web questionnaire. We compared the data obtained from both survey modes with the census data in regard to various demographic characteristics. We then compared the data from both samples in terms of self-reported Lyme disease preventive behaviors and other theoretically associated constructs. We also assessed the measurement invariance (equivalence) of the index of Lyme disease preventive behaviors across the telephone and web samples. RESULTS: Findings showed that neither the telephone nor the web panel modes of data collection can be considered more representative of the target population. The results showed that the proportion of item non-responses was significantly higher with the web questionnaire (5.6%) than with the telephone survey (1.3%), and that the magnitude of the differences between the two survey modes was nil for 19 out of the 30 items related to Lyme disease, and small for 11 of them. Results from invariance analyses confirmed the measurement invariance of an index of adaptation to Lyme disease, as well as the mean invariance across both samples. CONCLUSIONS: Our results suggested that both samples provided similar estimates of the level of adaptation to Lyme disease preventive behaviors. In sum, the results of our study showed that neither survey mode was superior to the other. Thus, in studies where adaptation to climate change is monitored over time, using a web survey instead of a telephone survey could be more cost-effective, and researchers should consider doing so in future surveys on adaptation to climate. However, we recommend conducting a pretest study before deciding whether to use both survey modes or only one of them.
The 2016 Alberta wildfires resulted in devastating human, socio-economic, and environmental impacts. Very little research has examined pediatric resilience (5-18 years) in disaster-affected communities in Canada. This article discusses the effects of the wildfire on child and youth mental health, community perspectives on how to foster resilience postdisaster, and lessons learned about long-term disaster recovery by drawing on data collected from 75 community influencers following the 2016 Alberta wildfires. Community influencers engaged in the delivery of services and programs for children, youth, and families shared their perspectives and experiences in interviews (n = 30) and in focus group sessions (n = 35). Using a purposive and snowball sampling approach, participants were recruited from schools, community organizations, not-for-profit agencies, early childhood development centers, and government agencies. The results show that long-term disaster recovery efforts require sustained funding, particularly in meeting mental health and well-being. Implications and recommendations are provided.
BACKGROUND: Outdoor workers are at risk of prolonged and high solar ultraviolet radiation (UVR) exposure, which is known to cause skin cancer. The objectives of this study were to characterize the UVR exposure levels of outdoor workers in Alberta, Canada, and to investigate what factors may contribute to their exposure. METHODS: This study collected objective solar UVR measurements from outdoor workers primarily in Alberta during the summer of 2019. Workers were recruited via the management or health and safety teams from building trade unions and employers. Calibrated, electronic UVR dosimeters were worn by workers on their hardhats, wrists, or lapels for five working days. Data on workers’ demographics, jobs, sun protection behaviors, and personal risk factors were collected using questionnaires, and meteorological data for each sampling day were noted. Mean daily exposure measured as the standard erythemal dose (SED) was calculated and compared to the international occupational exposure limit guideline (1.3 SED). Marginal models were developed to evaluate potential determinants of occupational solar UVR exposure. RESULTS: In total, 883 measurements were collected from 179 workers. On average, workerswere exposed to 1.93 SED (range: 0.03-16.63 SED) per day. Just under half of workers (45%) were exposed to levels exceeding the international exposure limit guideline. In the bivariate analyses, landscape and maintenance workers, as well as trade and recreation workers, had the highest levels of exposure (average: 2.64 and 1.84 SED, respectively). Regional variations were observed, with the “other” cities/regions (outside of Edmonton and Calgary) experiencing the highest average levels (2.60 SED). Workers who placed the dosimeters on their hardhats experienced higher levels compared to the other groups. Exposure was highest on sunny and mixed days. Education, trade, city, dosimeter placement, forecast, hair colour, and number of hours outside were included in the final exposure model, of which trade, dosimeter placement, forecast, and number of hours outside at work were statistically significant. CONCLUSIONS: Exposure to elevated solar UVR levels is common among outdoor workers in Alberta. The study findings can help inform future monitoring studies and exposure reduction initiatives aimed at protecting workers.
Vector-borne diseases are expected to be introduced, establish or expand geographically in Canada under climate change. The ability to prioritize diseases is critical because there are limited resources to address all risks and the decision to focus on one or a group of infectious diseases can come at the expense of not addressing others. As a result, the ability to conduct the prioritization in a transparent, auditable and in as objective a manner as possible is critical to ensure that the choices made are defendable. The objectives of this work were to develop a multicriteria decision analysis (MCDA) tool to prioritize vector-borne diseases of public health importance in Canada under current and projected climate. MCDA, an approach drawn from the decision sciences, is a valuable tool for decision-making when multiple criteria need to be considered. When considering all the criteria equally, Eastern equine encephalitis ranks as the highest priority non-endemic disease followed by Powassan virus disease, La Crosse encephalitis, Rocky Mountain Spotted Fever, Plague, Chikungunya virus infection and St. Louis encephalitis disease. In the case of endemic diseases: Cache Valley virus disease ranks highest, followed by Lyme disease, West Nile virus, Babesiosis and Human granulocytic anaplasmosis. The tool has the ability to also generate rankings for different stakeholders with different priorities thereby contributing significantly to the decision making process.
Climate change is predicted to increase the frequency and intensity of floods in the province of Quebec, Canada. Therefore, in 2015, to better monitor the level of adaptation to flooding of Quebec residents living in or near a flood-prone area, the Quebec Observatory of Adaptation to Climate Change developed five indices of adaptation to flooding, according to the chronology of events. The present study was conducted 4 years later and is a follow-up to the 2015 one. Two independent samples of 1951 (2015) and 974 (2019) individuals completed a questionnaire on their adoption (or non-adoption) of flood adaptation behaviors, their perception of the mental and physical impacts of flooding, and their knowledge of the fact that they lived in a flood-prone area.The results of the study demonstrated the measurement invariance of the five indices across two different samples of people over time, ensuring that the differences (or absence of differences) observed in flood-related adaptive behaviors between 2015 and 2019 were real and not due to measurement errors. They also showed that, overall, Quebeckers’ flood-related adaptive behaviors have not changed considerably since 2015, with adaptation scores being similar in 2019 for four of the five flood indices. Moreover, the results indicated an increase in self-reported physical and mental health issues related to past flooding events, as well as a larger proportion of people having consulted a health professional because of these problems. Thus, this study provides a better understanding of flood adaptation in Quebec over the past 4 years and confirms that the five adaptive behavior indices developed in 2015 are appropriate tools for monitoring changes in flood adaptation in the province. Finally, our results showed that little has changed in Quebeckers’ adoption of adaptive behaviors, highlighting the need for awareness raising in order to limit the impacts that climate change will have on the population.
BACKGROUND: Vibrio growth in the environment is related to sea surface temperature (SST). The incidence of human Vibrio illness increased sharply in British Columbia (BC) between 2008 and 2015 for unknown reasons, culminating in the largest outbreak of shellfish-associated Vibrio parahaemolyticus (Vp) in Canadian history in 2015. Our objective was to assess the relationship between SST and Vibrio illness in BC, Canada during 1992-2017 and assess the role of SST and other environmental factors in the 2015 Vp outbreak. METHODS: Cases of Vibrio infection reported to the BC Centre for Disease Control during 1992-2017 were used. SST data were obtained from NOAA and NASA. We assessed changes in incidence trend of annual Vibrio cases during 1992-2017 using a Poisson regression. We assessed the correlation between annual Vibrio cases and the average annual maximum SST using a Spearman rank-order correlation. We modeled the association between weekly Vp case counts, SST and other environmental factors during 2007-2017 using a Poisson regression. RESULTS: There was a significant increase in Vibrio cases between 2008 and 2015 (annual slope?=?0.163, P?
Climate change and natural resource exploitation can affect Indigenous people’s well-being by reducing access to ecosystem services, in turn impeding transmission of traditional knowledge and causing mental health problems. We used a questionnaire based on the Environmental Distress Scale (EDS) and the Connor-Davidson Resilience Scale (CD-RISC-10) to examine the impacts of environmental changes on 251 members of four Indigenous communities in the eastern Canadian boreal forest. We also considered the potential mitigating effects of sociodemographic characteristics (i.e., age, gender, parenthood, and time spent on the land) and protective factors (i.e., health, quality of life, resilience, life on the land, life in the community, and support from family and friends). Using linear regression, model selection, and multi-model inference, we show that the felt impacts of environmental changes increased with age but were lower for participants with higher quality of life. The effect of resilience was opposite to expectations: more resilient participants felt more impacts. This could be because less resilient individuals ceased to go on the land when environmental changes exceeded a given threshold; thus, only the most resilient participants could testify to the impacts of acute changes. Further research will be needed to test this hypothesis.
Smoke from wildfires contains many air pollutants of concern and epidemiological studies have identified associations between exposure to wildfire smoke PM(2.5) and mortality and respiratory morbidity, and a possible association with cardiovascular morbidity. For this study, a retrospective analysis of air quality modelling was performed to quantify the exposure to wildfire-PM(2.5) across the Canadian population. The model included wildfire emissions from across North America for a 5-month period from May to September (i.e. wildfire season), between 2013 and 2015 and 2017-2018. Large variations in wildfire-PM(2.5) were noted year-to-year, geospatially, and within fire season. The model results were then used to estimate the national population health impacts attributable to wildfire-PM(2.5) and the associated economic valuation. The analysis estimated annual premature mortalities ranging from 54-240 premature mortalities attributable to short-term exposure and 570-2500 premature mortalities attributable to long-term exposure, as well as many non-fatal cardiorespiratory health outcomes. The economic valuation of the population health impacts was estimated per year at $410M-$1.8B for acute health impacts and $4.3B-$19B for chronic health impacts for the study period. The health impacts were greatest in the provinces with populations in close proximity to wildfire activity, though health impacts were also noted across many provinces indicating the long-range transport of wildfire-PM(2.5). Understanding the population health impacts of wildfire smoke is important as climate change is anticipated to increase wildfire activity in Canada and abroad.
