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Climate Change and Mental Health Course

Creative Policy Dialogues through Serious Fun – Humour and Acrobatics to Confront Climate and Mental Health

Japan’s Shinrin-yoku (Forest Bathing) as a Mental Health Intervention in an Era of Climate Change

Integrating Climate Change into Mental Health Policy in Vietnam

The Need for Mental Health Support for Environmental Defenders in the Philippines

Intervention North Carolina Healthy & Resilient Communities Initiative (NC HRCI)

PERSIST: Climate School Educational Intervention on Youth Climate Emotions

Stichting Klimaat Psychologie: For sustainable insights and green behavioral change

Mental Health Effects due to the Double burden of COVID-19 and Extreme Heat and Drought in Afghanistan

Responding to mental health challenges of flood-affected communities through technology-driven local solutions in Pakistan: The mPareshan Project

Addressing mental health and wellbeing in the context of climate change: Examples of interventions to inform future practice

Climate change is now recognised as contributing to an increasing number of emergencies globally, which are having substantial effects on mental health and wellbeing of affected populations. In this report, we give case studies of mental health and psychosocial support (MHPSS) activities linked to climate change-related emergencies in Bangladesh, Burkina Faso, Madagascar, Nigeria, Sierra Leone and Zimbabwe. The emergencies range from floods and cyclones to drought and food scarcity, often in complex humanitarian settings including conflict affected regions. A range of activities, based on the Inter-Agency Standing Committee Guidelines for MHPSS in emergency settings, are discussed, many of which also focus on inclusion of people with disabilities. These include preparedness and resilience building as well as responses such as provision of basic needs, strengthening community capacity to provide psychosocial support and mental health system strengthening. We conclude that meeting basic needs is an essential prerequisite to address mental distress, that MHPSS is an essential component of any climate change-related response, that advance preparedness and adaptation is a good investment, and that meaningful participation of people in the global South, particularly marginalised communities such as people with disabilities and the very poor, is essential for the transformative change needed in addressing climate change.

Cyclone Idai-related losses and the coping strategies of adolescent survivors in the Odzi community of Manicaland Province, Zimbabwe

Climate change has been identified as one of the leading threats to human health in Southern Africa. Climate change-induced natural disasters often leave behind a trail of destruction characterized by multidimensional losses such as loss of infrastructure, physical health, and psychological health. Adolescents are among the most vulnerable groups during and after a natural disaster. This article presents findings of a research whose aim was to establish cyclone Idai-related losses and postdisaster coping strategies among adolescent survivors. Based on qualitative data collected from 15 participants in the Odzi community of Manicaland Province in Zimbabwe, the article reveals that participants experienced diverse disaster-related losses, such as loss of independence and sense of control over their lives and general life satisfaction. The study notes that the impact of disaster-related losses had a toll on adolescents’ psychological, social, and physical well-being. From the study, it is established that in the aftermath of natural disasters, adolescents adopted two-pronged coping strategies, namely, personal coping strategies that include positive thinking and self-talk, and the utilization of social support such as instrumental and counseling support. This study suggests, among other recommendations, school-based training to equip adolescents with personal coping strategies.

A framework to assess forest-agricultural landscape management for socioecological well-being outcomes

Global demand for agricultural products continues to grow. However, efforts to boost productivity exacerbate existing pressures on nature, both on farms and in the wider landscape. There is widespread appreciation of the critical need to achieve balance between biodiversity and human well-being in rural tropical crop production landscapes, that are essential for livelihoods and food security. There is limited empirical evidence of the interrelationships between natural capital, the benefits and costs of nature and its management, and food security in agricultural landscapes. Agroforestry practices are frequently framed as win-win solutions to reconcile the provision of ecosystem services important to farmers (i.e., maintaining soil quality, supporting pollinator, and pest control species) with nature conservation. Yet, underlying trade-offs (including ecosystem disservices linked to pest species or human-wildlife conflicts) and synergies (e.g., impact of ecosystem service provision on human well-being) are seldom analysed together at the landscape scale. Here, we propose a systems model framework to analyse the complex pathways, with which natural capital on and around farms interacts with human well-being, in a spatially explicit manner. To illustrate the potential application of the framework, we apply it to a biodiversity and well-being priority landscape in the Southern Agricultural Growth Corridor of Tanzania, a public-private partnership for increasing production of cash and food crops. Our framework integrates three main dimensions: biodiversity (using tree cover and wildlife as key indicators), food security through crop yield and crop health, and climate change adaptation through microclimate buffering of trees. The system model can be applied to analyse forest-agricultural landscapes as socio-ecological systems that retain the capacity to adapt in the face of change in ways that continue to support human well-being. It is based on metrics and pathways that can be quantified and parameterised, providing a tool for monitoring multiple outcomes from management of forest-agricultural landscapes. This bottom-up approach shifts emphasis from global prioritisation and optimisation modelling frameworks, based on biophysical properties, to local socio-economic contexts relevant in biodiversity-food production interactions across large parts of the rural tropics.

Climate change, women’s workload in smallholder agriculture, and embodied political ecologies of undernutrition in northern Ghana

The burden of child undernutrition across Africa remains extraordinarily high. Among children under age five, chronic and acute undernutrition is responsible for more ill-health than any other cause. While climate change exacerbates the multiple burdens of undernutrition, we know very little about the embodied effects on women’s workload in agriculture and implications for feeding practices, especially for infants whose nutrition depends on mothers’ time. In this article, political ecologies of health, with its nested, place-based analysis, is used as a framework to address this knowledge gap. The study took place in Ghana’s Upper West Region, a semi-arid and resource-poor setting with higher undernutrition rates. In-depth interviews were conducted with smallholder farmers (n = 33) whose infants have sub-optimal growth, and key informants (n = 7) with expertise in nutrition and health. Findings from the study demonstrate how climate change puts pressure on women’s productive time, leading to poor child feeding practices and undernutrition. Ultimately, the article argues that there are hidden impacts of climate change on undernutrition. Global undernutrition interventions should therefore move beyond biomedical solutions to address these hidden impacts, some of which are social, gendered, and structural in nature.

Coping strategies for household food insecurity, and perceived health in an urban community in southern Mozambique: A qualitative study

In low- and middle-income countries, food insecurity (FI) is a living reality for many households, particularly among the most vulnerable groups. The burden of household FI in Mozambique and how FI and coping strategies relate to perceived health are unknown. This study investigated the lived experiences and coping strategies of food-insecure households, along with their perceived health. Altogether, 16 in-depth interviews were performed, audio-recorded, and transcribed verbatim. A qualitative content analysis was carried out and five themes emerged: lived experiences of FI, coping strategies used in situations of FI, food choices, climate change and food security, and FI and perceived health. A wide range of lived experiences and coping strategies were reported, including cooking whatever is available, skipping meals, receiving money or food from friends and relatives, eating unsafe and low-quality foods, taking on additional work, cooking least-preferred foods, and having a monotonous and less-nutritious diet. Furthermore, the participants reported emotional distress, anxiety and depression, substance use, and other negative health outcomes. Some had diagnoses of hypertension, diabetes or HIV/AIDS. The findings suggest the need for employment creation and women’s empowerment, as well as the implementation of appropriate policies and programmes to alleviate household FI.

Exploring multilevel social determinants of depressive symptoms for Tanzanian adolescents: Evidence from a cross-sectional study

BACKGROUND: Depression has substantial and enduring impacts for adolescents, particularly those living in poverty. Yet, evidence on its determinants in low-income countries remains scarce. We examined the social determinants of depressive symptoms for Tanzanian adolescents. METHODS: We used cross-sectional data for 2458 adolescents (aged 14-19), to describe associations with depressive symptoms within and across five domains-demographic, economic, neighbourhood, environmental and social-cultural-using linear mixed models. We estimated depressive symptoms using the 10-item Centre for Epidemiological Studies Depression Scale, which ranges from 0 to 30 and increases with additional symptoms. RESULTS: Factors associated with depressive symptoms in the fully adjusted models included experiencing five or more household economic shocks (β=2.40; 95% CI 1.48 to 3.32), experiencing droughts/floods (β=0.76; 95% CI 0.36 to 1.17), being in a relationship (β=1.82; 95% CI 1.30 to 2.33), and having moderate (β=1.26; 95% CI 0.80 to 1.71) or low (β=2.27; 95% CI 1.81 to 2.74) social support. Exclusive schooling was protective compared with being engaged in both school and paid work (β=1.07; 95% CI 0.05 to 2.61) and not engaged in either (β=0.73; 95% CI 0.24 to 1.22). Household size and relationship status were more important factors for girls, while employment status, and extreme precipitation were more important for boys. CONCLUSION: Mental health is associated with determinants from multiple domains. Results suggest that environmental shocks related to climate change contribute to poor mental health in adolescents, highlighting an important area for intervention and research.

Increased climate variability and sedentarization in Tanzania: Health and nutrition implications on pastoral communities of Mvomero and Handeni districts, Tanzania

African pastoralists are undergoing significant changes in livelihood strategies, from predominantly mobile pastoralism to agro-pastoralism in which both livestock raising and cultivation of crops are practiced, to agropastoralism combined with wage labor and petty trade. These changes often result in fixed settlements or a process known as sedentarization. Previous research indicates that sedentarization and increased climate variability are prominent forces shaping livelihood opportunities and constraints in East Africa, but the effects of these co-occurring processes have yet to be investigated. This paper develops theory, using qualitative data collected in Morogoro and Tanga Regions of Tanzania, explaining the relationships between climate variability, pastoral sedentarization, livelihood outcomes, and resulting nutritional status. We observed that the co-occurring processes of increased climate variability and sedentarization among pastoralists in these regions have dramatic impacts on communities’ economic prosperity, health status, and nutritional outcomes. Due to risks associated with climate and sedentarization, land tenure policies that allow continued practice of highly mobile livelihood strategies, namely, legal recognition of collective land rights, should be adopted.

The mental health outcomes of food insecurity and insufficiency in West Africa: A systematic narrative review

Background: Food insufficiency is a global pandemic affecting many people, especially those residing in developing countries. African countries have been affected by food insufficiency, which is mostly caused by drought or wars. Famine or food insufficiency has been reported to have an impact on the psychological health and quality of life of people affected. This review assessed the mental health outcomes of famine and food insufficiency in West Africa. Methods: A search of the published literature was conducted using PubMed, PsycExtra, Medline, and PsycINFO databases. The search was limited to papers published in English between the years 2010 and 2020. Two reviewers independently screened the titles and abstracts of the retrieved papers using pre-defined inclusion and exclusion criteria and a third reviewer resolved conflicts. Data were extracted and appraised using a data extraction form and an appraisal checklist. Results: A total of 81 papers were identified through the journal databases search. Out of the seven papers that met the inclusion criteria, six papers used cross-sectional designs and one paper used an experimental design. The six papers used quantitative approach for data collection, while the one paper used a qualitative technique. The evidence synthesized from this review indicated that exposure to food insecurity or insufficiency is associated with increased psychological distress including anxiety, sleeplessness, intellectual disability, general mental, and emotional instability. Conclusions: This review strongly highlights the need for further research across the sub-region. It further suggests that famine and food insufficiency are associated with significant mental health problems in adults and impacts the cognitive and intellectual development of children. Although there is paucity of literature about famine and its impact on mental health in West Africa, these findings are important for developing social policy initiatives for increasing food supply and mental health interventions for all ages.

The impact of food insecurity on mental health in Africa: A systematic review

In 2018, 676.1 million people in Africa (52.5% of the population) were moderately or severely food insecure. This exceptionally high prevalence continues to increase as Africa experiences conflict, climate change, and economic declines. When Sustainable Development Goal 2.1 set out to end hunger and ensure access to sufficient food, particularly for vulnerable populations, by 2030, food insecurity emerged as a global priority. Food insecurity has been hypothesized to negatively impact mental health, a stigmatized area of health in Africa for which care is often inaccessible. This systematic review examines existing literature on the relationship between food insecurity and mental health in Africa, where progress remains to be made on both fronts. A systematic search of seven databases (EMBASE, Web of Science, CINAHL, PsychINFO ProQuest, Medline Ovid, Scopus, and Nursing and Allied Health) was conducted. Results were limited to studies examining food insecurity and mental health, written in English and published between January 2000 and May 2020. After title, abstract, full-text review, and quality appraisal using tools from the National Heart, Lung, and Blood Institute, 64 studies remained. Findings were summarized using a narrative synthesis approach. Studies unanimously highlighted that food insecurity is associated with poor mental health. This relationship was dose-responsive and independent of the measured mental health outcome. Two highly represented groups in the literature were women around pregnancy and people affected by HIV/AIDS. Factors which mediated the relationship included age, sex, social interactions, physical health, seasonality, and rural residence. The findings suggest that the relationship is likely amplified in specific populations such as women and seniors, and interventions which target livelihood as opposed to income may be more effective. Further research is needed which compares food insecurity’s effect on mental health between at-risk populations, in order to guide resource allocation and context-specific policy making.

Maasai women hearing voices: Implications for global mental health

There is a sparse literature on women who hear voices globally, even though there are documented gendered dimensions of distress in the context of globalization and climate change and research indicates that trauma and psychosocial stress may be related to an increased prevalence of voice-hearing or auditory verbal hallucinations (AVHs). There is also a gap in the cultural phenomenology of voice-hearing in general, as well as idioms of distress for non-western peoples. This article presents results of a mixed methods study that: 1) estimated community prevalence of voice-hearing among Maasai women in northern Tanzania; 2) examined any demographic correlates and two specific hypothesized correlates (i.e., psychological stress and potentially traumatic events); and 3) engaged women in semi-structured interviews about their everyday lives and the phenomenological experience of voice-hearing. The prevalence of voice-hearing (39.4%) in this nonclinical sample (n = 71) was quite high compared to other studies in sub-Saharan Africa. Most women also reported high psychosocial stress and traumatic life events. They also talked about gendered conditions of social adversity in a context of rapid social, economic, and climate change. Women who reported hearing voices had a statistically significantly higher level of psychological distress, met criteria for severe psychological distress, and reported more potentially traumatic life events. In a logistic regression model, psychosocial stress predicted voice-hearing. The presence of distressing voices may offer a straightforward way to quickly identify people in the community experiencing the most extreme levels of psychosocial stress and traumatic events-a potentially simple but effective screening tool for health workers on the ground.

Activating transformation: Integrating interior dimensions of climate change in adaptation planning

The increasing number and complexity of urban risk and disasters have a significant bearing on the emotional and mental wellbeing of those who are exposed and hamper their responses. Nevertheless, current discourses and approaches to increase resilience tend to focus on broader socio-economic, physical and environmental systems. This reflects a failure by the academic and practitioner communities to consider the potential contribution of human interior dimensions in adaptation planning. Concomitantly, a growing body of knowledge highlights the need to bridge the gap between internal and external (systems) approaches for achieving sustainable transformations. Against this background, this article aims to increase knowledge on the operationalization of such more integrative approaches in marginal settings. Based on a case study of a flood adaptation project in Kibera, Kenya, we assess the need and potential ways to address interior dimensions in the context of project planning, design and implementation. We show how the integration of such dimensions occurs in existing adaptation projects and why this matters. On this basis, we provide methodological and operational recommendations regarding ways to support more integrative approaches that bridge subjective, intersubjective, objective and interobjective perspectives to support transformation.

Flood exposure and psychological distress among Ghanaian adults in flood-prone settings

Urban floods have long-term mental health implications, yet this subject remains largely neglected in flood-related studies. This paper examines the psychological distress (PD) of adults exposed to floods in Ghana. Cross-sectional data involving 767 flood-prone community-dwelling household heads aged ≥20 years were analyzed [mean = 47.3 years (SD = 13.7); males = 61.4%]. We used the Exposure to Flood-related Events Scale, and PD was assessed with the Kessler Psychological Distress Scale (K10). Ordinary Least Squares (OLS) regressions evaluated crude and adjusted associations of flood exposure with PD. The mean scores of PD (37[SD = 8]) and exposure to flood events (6[SD = 3]) significantly varied by age and sex (p < .05). After full adjustment for potential confounders, exposure to flood events was significantly and positively associated with PD index in the total sample (β = 0.030; p < .005), among male participants (β = 0.019; p < .05) and female participants (β = 0.048; p < .001). Furthermore, age-wise analysis revealed significant association of flood exposure with PD in young adults (β = 0.033; p < .001) but not in older adults (β = 0.048; p = .062). Exposure to floods increased the risk of PD. Policy and public health efforts to manage PD should include selective flood reduction interventions, including land use regulations and sustained public education.

Becoming flood insecure: Lessons from village level experiences in Tana Delta, Kenya

Floods affect the human security conditions of floodplain residents. The aim of this paper is to explore how residents of the Tana River Delta in Kenya become flood insecure. This paper utilises assemblage theory, particularly the principles of rhizomatic multiplicity to explain the concept of becoming flood insecure. It combines these rhizomatic multiplicity principles with disruptions to the pillars of human security which are becoming afraid, becoming wanting and becoming undignified and their composite conditions of human insecurity to create an analytical framework with which to understand becoming flood insecure. The study sources its data from Focus Group Discussions in 10 sampled villages in the Tana River Delta. The results reveal that becoming flood insecure is a rhizomatic multiplicity and that the pillars and conditions of human security that comprise it are heterogenous and interconnected. The results reveal the conditions of human insecurity in the Tana River Delta as personal, food, water, fuel, housing, health, environment, and political. They also reveal that while children become more flood insecure, they are also the most adaptive. Additionally, the results show that there are transitory conditions of human insecurity, food, housing health, to which people attempt to find local solutions and redundant conditions of human insecurity, political, health, water, personal and environment, to which people cannot find local solutions and public action is required.

Re-examining the effects of drought on intimate-partner violence

Droughts are associated with several societal ills, especially in developing economies that rely on rainfed agriculture. Recently, researchers have begun to examine the effect of droughts on the risk of Intimate-Partner Violence (IPV), but so far this work has led to inconclusive results. For example, two large recent studies analyzed comparable data from multiple sub-Saharan African countries and drew opposite conclusions. We attempt to resolve this apparent paradox by replicating previous analyses with the largest data set yet assembled to study drought and IPV. Integrating the methods of previous studies and taking particular care to control for spatial autocorrelation, we find little association between drought and most forms of IPV, although we do find evidence of associations between drought and women’s partners exhibiting controlling behaviors. Moreover, we do not find significant heterogeneous effects based on wealth, employment, household drinking water sources, or urban-rural locality.

Pastoral coping and adaptation climate change strategies: Implications for women’s well-being

Pastoral women in the semi-arid rangelands of East Africa are significantly burdened by the vulnerability to and responsibility for responding to changing climates. Consequently, understanding how adaptation and coping strategies impact pastoral women’s well-being is critical for supporting the climate resilience of communities and the landscapes on which they rely. We used a household survey, guided by a multi-dimensional framework of well-being, to investigate how the use of drought-related coping and adaptation strategies by Samburu households influenced livestock loss and women’s well-being in northern Kenya. Coping and adaptation strategies predicted numerous social-cognitive components of well-being, although not livestock loss. We conjecture these results are a product of a gendered division of labor within households and the community. We argue that interventions aimed at supporting drought resilience must consider the gendered implications of climate response strategies, multiple indicators for evaluation, and the influence of community and place.

Factors influencing the occurrence of flooding, risk and management strategies in Lagos, Nigeria

Human vulnerability to disasters poses a significant concern to water resources management. The present study examined the factors influencing the occurrence of flooding, risk and management strategies in Lagos, Nigeria. A set of questionnaires was administered to 400 respondents in four randomly selected settlements in Lagos State based on perception and observation methods. Descriptive and multivariate statistics and cartographic mapping techniques were employed for data analysis. The result indicates that the majority of the respondents live in a rented room and parlor. The significant flood risks include poor sanitation, a breeding site for mosquitoes, water contamination/waterborne diseases, and mental stress. Factors analysis explains 74.62% of the variance, indicating anthropogenic, natural, and institutional factors influencing flooding in the study area. The dominant flood management measures are clearance of drains, environmental sanitation, public awareness, training/education, while the significant steps taken by the government to ameliorate flooding challenges in the area include awareness, early warning, and education. The study concluded that there exists a significant difference in the factors influencing flooding across the settlements based on the ANOVA result given as: (DWSD F = 19.661, p < 0.05; RI = 41.104, p < 0.05; WIC = 18.123, p < 0.05; HWL = 37.481, p < 0.05; SD = 10.294, p < 0.05). The study contributes to knowledge using cartographic techniques to map the risks of flooding for easy understanding. The study has potential policy implications for planning and interventions in areas vulnerable areas. The study recommended monitoring of construction activities, enforcement of building codes, awareness campaigns, and early warning flood technology for sustainable flood management in the area.

Climate change-mediated heat stress vulnerability and adaptation strategies among outdoor workers

The study examined the effect of heat stress on the well-being of outdoor workers and their coping strategies. A cross-sectional survey study was conducted between September 2019 and December 2019 to collect data from outdoor workers including hawkers and traffic wardens from 13 urban areas (N = 322) and analyzed using SPSS v.23. The results of the study show that most of the outdoor workers were in a good health state based on their self-health assessment. However, the respondents expressed concerns and symptoms of heat stress including heat cramps, heat exhaustion, heat stroke and sleep disorders. The findings also show that male outdoor workers were 1.3 times more likely than females to be affected by heat stress. Respondents in their 20s were more likely to be affected by heat stress, as a result of temperatures and humidity conditions, than those in their 30s (OR = 0.389, CI = 0.158-0962) and 40s (OR = 0.395, CI = 0.147-1.063). Coping strategies identified include the use of breathable cotton attires, drinking a lot of water, hiding under shades and reducing outdoor activity intermittently.

Disaster psychology and psychological adaptation of disasters: Evidence from Riverine Islands (Char) of rural Bangladesh

Natural hazards disrupt the social-ecological system, causing much suffering, death, injury, and devastation of property and the environment. This study explores the factors influencing the disaster psychology and psychological adaptation of people living in disaster-vulnerable areas in Bangladesh. Data have been collected from 100 households in Bangladesh’s riverine island areas (char) of northern Bangladesh. Several criteria have been used to measure char dwellers’ disaster psychology (vulnerability concern, factor, and intensity) and psychological adaptation (weakness concern and emotional response). This study reveals that char dwellers perceived several hazards like floods (100%), riverbank erosion (83%), drought (29%), and earthquakes (14%). It is also found that females (88%) are more concerned about earthquakes than males (12%). The key vulnerability factors in the char areas are geographic position (100%), no access to migration (75%), resources (76%), housing (83%), training (18%), and alternative livelihood (24%). Flood and drought are identified as the most destructive hazards in char areas. Most household heads also felt anxiety (88%). fear (54%), helplessness, sadness, and anger due to natural hazards. The government should implement a context-specific disaster management plan to reduce household vulnerability and create livelihood opportunities in char areas to enhance char dwellers’ psychological resilience against disasters.

Climate change in Bangladesh: Meeting the mental health needs in times of crisis

Access to quality and affordable mental health care is not always available to disaster-prone countries experiencing climate change, which may result in psychological trauma. Although environmental support has been provided, the consequences of disasters have not been addressed within the mental health realm. Inadequate knowledge and practice about crisis responses for mental health was addressed in Bangladesh with the influx of Rohingya people escaping persecution. To provide mental health support, Crisis Preparedness for Mental Health (CPM-MH) was developed and implemented addressing the psychological consequences of traumatic events. CP M-MH has its foundation in post-trauma stabilization through establishment of psychological equilibrium providing proactive rather than reactive methods linked to positive mental health outcomes. With adoption of CPM-MH in Bangladesh addressing mental health needs after traumatic events, mental health damage experienced by manmade and natural disasters may be considered the best strategy to build coping skills and resiliency for further traumatic event.

Integration of mental health into emergency preparedness and response planning for the monsoon season in Bangladesh

The monsoon season in Bangladesh is an example of how climate-related events can have a significant impact on mental wellbeing of affected individuals and communities. In this field report, we reflect on the integration of mental health and psychosocial support (MHPSS) services into emergency preparedness efforts. The report aims to offer an understanding of the risk associated with the monsoon season on both refugees and host communities and how likely this risk could affect mental health and mental health services. The MHPSS working group in Cox’s Bazar identified four major areas resulting from the impact of the monsoon season: increased incidence of mental health and psychosocial problems, relocation of individuals and families from high-risk areas to safer locations, disrupted provision of mental health and psychosocial services, and lack of self-care knowledge and practice for the humanitarian staff. To mitigate these impacts, an emergency preparedness and response plan was developed and included a wide range of activities aiming to better coordinate and scale up mental health services during the monsoon season.

Mental health and climate change in Bangladesh

Climate change adversely impacts the health and well-being of billions of people worldwide and will increasingly do so over the next few decades. Although all populations are at risk, some are more vulnerable than others. It is therefore critical to increase resilience to climate-related risks and build the capacity of national health systems by considering climate risks in health policy and decision making, strengthening leadership and governance to address impacts, and implementing strategies to build climate-resilient health care systems.

Stressors and mental health in Bangladesh: Current situation and future hopes

Bangladesh is a densely populated emerging country in South Asia. Since its harsh independence war, it has suffered from repeated floods and other natural and man-inflicted disasters. Internal migration from rural areas to the urban centres has increased crowdedness, pollution and social conflicts. Furthermore, in recent years, the country has absorbed close to a million refugees from Myanmar. These stressors have been associated with an increase in mental disorders and symptoms with which the country is struggling. Lack of resources and a shortage of human capital have weakened the national capacity to efficiently respond to situational stressors or disasters. For assessment of stress-related mental health issues, information available from the Ministry of Health and the National Institute of Mental Health was collected and supplemented by external reports. It is promising that the government’s approach of responding to mental health needs only after the occurrence of a crisis has recently been replaced by the concept of total management through primary healthcare. There is a need for development of adequate infrastructure, logistics and workforce support, as well as establishment of multidisciplinary teams of management and clinical services. Collaboration of all related sectors of the government and an overall increase in government funding for mental health are essential.

Feeling solastalgia: A study of the effects of changing climate in rural India

Rural communities are dependent on their native environment for supporting their customs, traditions, and other rural activities. This study attempts to understand the effects of the changing climate on rural individuals by investigating their feelings and experiences of perceived changes in the home environment and village life. Thirty-four in-depth interviews were conducted during the months of May-June 2019 in two districts-Gaya and Jehanabad of South Bihar, India. The findings reveal that the rural population have experienced changes in climate such as a rise in the incidence of heatwaves, erratic rainfall patterns, delay in monsoon onset, early drying of water resources, and loss of particular tree and bird species. Worries and uncertainties of the rural population have emerged from the experiences of involuntary separation from traditional farm activities, forced adaptation strategies, loss of cultural and religious practices, and reduced self-worth in coping with the deteriorating environment. The changing climate instigates feelings of emotional distress, resulting in adverse mental health and psychological well-being outcomes. It is concluded that the changing climate is responsible for the loss of traditional village customs and nature-related cultural practices, subsequently inducing solastalgia among the rural population.

Vulnerabilities associated with slow-onset events (SoEs) of climate change: Multi-level analysis in the context of Pakistan

This paper explores physical, psychological, social, and institutional vulnerabilities associated with slow-onset events (SoEs) of climate change. Based on review of interdisciplinary research in the context of Pakistan, this paper reviews the relevance of multi-level vulnerabilities and how they exacerbate impacts of SoEs of climate change. The physical vulnerabilities of climate change have been relatively well researched; however, research on the psychological, social, and institutional vulnerabilities and their intersectional associations with SoEs have been rare. Therefore, this review highlights the need for understanding multi-level vulnerabilities of high-risk groups in Pakistan. This paper emphasizes the need to work with an integrated approach for vulnerabilities of marginalized subgroups such as gender (women’s marginalized status), socio-economic status (lower SES), displacement history, and migration background. Finally, we propose the need for inclusive policy building sensitive to the demands of vulnerable groups in Karachi and elsewhere in Pakistan. We hope that this multilevel and inclusive framework has the potential to guide practitioners, and especially those who are least prepared for the slow-onset events of climate change.

Climate rather than economic variables might have caused increase in US homicide but not suicide rates during the Great Depression

BACKGROUND: It is widely believed that during the Great Depression (1929-1933) there was a rise in suicidal rates which was causally related to the increase in unemployment. There are no studies on the effect the Great Depression had on homicidal rates METHODS: The data concerning suicide, homicide, economic and climatic variables for the years 1900-1940 for the whole of the US were gathered from the US Center for Disease Control, the Maddison Project, the National Bureau of Economic Research and the National Climatic Data Center. Time Series Analysis was performed. RESULTS: The results are inconclusive on the role of economic factors but preclude any role of climate on suicidal rates during the years 1900-1940 in the US. Suicidal rates might have a 24-years periodicity, however much longer time series are needed to confirm this. On the contrary they strongly suggest an effect of higher temperatures on homicidal rates after 1922. CONCLUSIONS: The results of the current study suggest a direct and clear effect of climate (higher temperatures) on the increasing homicidal rates in the US after 1922 but failed to establish a causal relationship between suicide rates and economic or climate variables. These should be considered together with increasing concerns on the possible effect of climate change on mental health.

At the water’s edge: Coastal settlement, transformative adaptation, and well-being in an era of dynamic climate risk

With accelerating climate change, US coastal communities are experiencing increased flood risk intensity, resulting from accelerated sea level rise and stronger storms. These conditions place pressure on municipalities and local residents to consider a range of new disaster risk reduction programs, climate resilience initiatives, and in some cases transformative adaptation strategies (e.g., managed retreat and relocation from highly vulnerable, low-elevation locations). Researchers have increasingly understood that these climate risks and adaptation actions have significant impacts on the quality of life, well-being, and mental health of urban coastal residents. We explore these relationships and define conditions under which adaptation practices will affect communities and residents. Specifically, we assess climate and environmental stressors, community change, and well-being by utilizing the growing climate change literature and the parallel social science literature on risk and hazards, environmental psychology, and urban geography work, heretofore not widely integrated into work on climate adaptation.

Food insecurity and compound environmental shocks in Nepal: Implications for a changing climate

Food insecurity is a key global health challenge that is likely to be exacerbated by climate change. Though climate change is associated with an increased frequency of extreme weather events, little is known about how multiple environmental shocks in close succession interact to impact household health and well-being. In this paper, we assess how earthquake exposure followed by monsoon rainfall anomalies affect food insecurity in Nepal. We link food security data from the 2016 Nepal Demographic and Health Survey to data on shaking intensity during the 2015 Gorkha earthquake and rainfall anomalies during the 2015 monsoon season. We then exploit spatial variation in exposure to the earthquake and monsoon rainfall anomalies to isolate their independent and compound effects. We find that earthquake exposure alone was not associated with an increased likelihood of food insecurity, likely due in part to effective food aid distribution. However, the effects of rainfall anomalies differed by severity of earthquake exposure. Among households minimally impacted by the earthquake, low rainfall was associated with increased food insecurity, likely due to lower agricultural productivity in drought conditions. Among households that experienced at least moderate shaking, greater rainfall was positively associated with food insecurity, particularly in steep, mountainous areas. In these locations, rainfall events disproportionately increased landslides, which damaged roads, disrupted distribution of food aid, and destroyed agricultural land and assets. Additional research on the social impacts of compound environmental shocks is needed to inform adaptation strategies that work to improve well-being in the face of climate change.

Lived-experience of women’s well-being in the cyclone shelters of coastal Bangladesh

Bangladesh is repeatedly threatened by tropical storms and cyclones, exposing one-third of the total population of the country. As a preparedness measure, several cyclone shelters have been constructed, yet a large proportion of the coastal population, especially women, are unwilling to use them. Existing studies have demonstrated a range of concerns that discourage women from evacuating and have explored the limitations of the shelters, but the experiences of female evacuees have not been apparent in these stories. This study explores the lived-experiences of women in the cyclone shelters of Bangladesh and discusses their health and well-being as evacuees in the shelters. Nineteen women from three extremely vulnerable districts of coastal Bangladesh were interviewed. Seven research themes were identified from the participants’ narratives using van Manen’s thematic analysis process. The most salient theme, being understood (as a woman), portrayed the quintessential image of these women, which subsequently influenced their vulnerability as evacuees. The next themes-being a woman during crisis, being in a hostile situation, being fearful, being uncertain, being faithful, and being against the odds-focused on the incidents they lived through which affected their physical and mental health and the emotions they felt as evacuees. The paper offers a deep inquiry into women’s experiences of well-being in the shelters and recognizes the significance of women’s voices to improve their experiences as evacuees.

Anxiety, depression, and post-traumatic stress a month after 2019 Cyclone Fani in Odisha, India

BACKGROUND: Early Identification of disaster victims with mental health problems may be useful, but information within a short period after a disaster is scarce in developing countries. This study examined anxiety, depression, and post-traumatic stress symptoms at 1 month following 2019 Cyclone Fani in Odisha, India. METHOD: Post-traumatic stress symptoms (PTSS) were assessed by the Primary care PTSD screen for DSM 5 (PC-PTSD-5), anxiety symptoms by the Generalised Anxiety Disorder (GAD-7), and depression by the Patient Health Questionnaire (PHQ-9). The survey included participants’ disaster experience e.g., evacuation, fear of death, injury, death in family, damage to house, difficulty for food, displacement, and effect on livelihood. RESULTS: Proportion of sample (n = 80) with probable PTSD was 42.9%, with severe anxiety was 36.7%, moderately severe depression was 16.5%, and severe depression was 3.8%. Suicidal cognitions were reported to increase by 14%. Comorbidity was common; with significant (P < 0.01) correlation between PTSS and anxiety (r = 0.69), depression (r = 0.596), and between anxiety and depression (r = 0.63). Damage of house and displacement were associated significantly with PTSD; evacuation and displacement with moderate and severe depression; and displacement with severe anxiety. No specific demographic factors were significantly linked to the psychiatric morbidities. CONCLUSION: A considerable proportion of victims had psychiatric morbidities at 1 month. Associated risk factors included housing damages, evacuation, and displacement, suggesting the need to improve the disaster-management process.

Is young age a risk factor for PTSD? Age differences in PTSD-symptoms after Hurricane Florence

Age differences in posttraumatic stress disorder (PTSD) are widely researched, but findings remain inconclusive. The mixed findings may in part result from sampling participants exposed to different trauma types at different times. Here, we controlled for this issue by sampling participants exposed to the same devastating hurricane. A total of 1.5 months after Hurricane Florence (T1), we asked 174 adults living in two severely affected states to describe their hurricane experience and fill in measures of PTSD and event centrality. Then, 7 months after the hurricane (T2), participants were reinvited to the survey, and 98 filled in the same questionnaire. The hurricane descriptions were coded for level of exposure severity. When controlling for trauma characteristics, including level of severity, younger age significantly predicted PTSD at T1 but not T2. When also controlling for event centrality, younger age predicted PTSD at both measurement times. Moreover, from T1 to T2, young adults significantly increased how severely they described their hurricane experience to be, whereas such amplification was absent in the older age groups. Overall, the findings provide some evidence that younger age increase vulnerability for PTSD and increase the perception of trauma severity over time.

Geographic variability of post-disaster mental health: Case study after the 2017 flood in Bangladesh

Every year Bangladesh faces enormous damages due to flooding. Facing these damages the Government adopts various recovery approaches. However, the psychological dimension of any disaster is generally overlooked in disaster management. Researchers have found that the spatial distribution of post-disaster mental health can help the authorities to apply recovery procedures where they are most needed. For this research, Posttraumatic Stress Checklist (PCL-5), Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to estimate posttraumatic stress, major depressive disorder and anxiety following three episodes of severe floods in 2017 that affected at least 8 million people. To better understand the spatial pattern of psychological vulnerability and reach a comprehensive scenario of post-disaster mental health, Moran’s I was applied for spatial autocorrelation and Pearson’s correlation and regression analysis for a study of the relationship between the psychological aspects. It was found that psychological vulnerability showed a spatial clustering pattern and that there was a strong positive linear relationship among psychological aspects in the study area. This research might help to adopt disaster management policies that consider the psychological dimension and spatial distribution of various psychological aspects to identify areas characterized by high vulnerability and risk so that they can be reached without delay.

Suicidal behavior and flood effects in Bangladesh: A two-site interview study

BACKGROUND: Bangladeshi flood survivors are reported with such higher mental disorders that are not ever observed in any other cohorts. Although there are a few studies that assessed mental disorders, suicide or suicidal behaviors are not investigated yet. Hence, the present study for the first time investigated suicidal behaviors and its relationship with socio-demographics, flood effects and psychopathology. METHODS: A cross-sectional interview study was carried out between November and December 2019, after 4/5 months of the flood occurrence. Two completely affected villages from two districts residing in two parts of the country were randomly selected (whereas Manikganj district was less affected by the recent flood compared to Kurigram), and a total of 348 flood survivors were interviewed (45.53 ± 14.85 years). Questions related to basic socio-demographics, flood effects, psychological impacts, and suicidal behaviors were asked in the interviews. RESULTS: In the total sample, 57.5% of flood survivors reported having suicidal ideation, whereas 5.7% and 2.0% madea suicide plan and suicide attempt, respectively. Within two study sites, participants belonging to Kurigram reported significantly higher suicidal ideation compared to Manikganj (84.8% vs 33.2%, χ (2) = 94.475, p<0.001). Belonging to a lower-class family, having less education, and less earning members in the family, being affected severely by the flood, suffering from depression, anxiety, and PTSD, and experiencing financial threat, and economic hardship were suicidal behavior risk factors in the total sample. CONCLUSION: Considering the present findings (ie, suicidality commensurately increases with flood effects), a multi-sectoral policy and its effective implementation should be adopted for alleviating the flood-related psychological burdens.

A survey of post-traumatic stress disorder, anxiety and depression among flood affected populations in Kerala, India

BACKGROUND: Globally, post traumatic stress disorder (PTSD) is one of the most common psychiatric illnesses following a disaster. We aimed to evaluate the relationship between the socio-economic and flood exposure factors with PTSD, depression and anxiety among the flood-affected populations in Kerala, India. METHODS: A cross-sectional household survey was conducted from November 2019 to January 2020 in Kozhikode district of Kerala, India. Adults (≥ 18 years), who were permanent residents and had been directly exposed to the flood, were invited to take part in the study. Individuals with a history of mental health issues and those who had other stressful situations in the past were excluded. The survey questionnaire was based on three screening tools: (1) PTSD Checklist for DSM-5 (PCL-5); (2) patient health questionnaire (PHQ-9); and (3) generalized anxiety disorder (GAD-7). Data included sociodemographic factors and flood exposure variables. The primary outcome variable was psychiatric morbidity (PTSD, anxiety and depression). RESULTS: A total of 276 respondents (150 males/126 females) participated in the study. A significant correlation was observed between total score on PCL-5 and GAD-7 (r=0.339, p=0.001) and PHQ-9 (r=0.262, p=0.001). Females had significantly higher total PTSD symptom severity scores (8.24±5.88 vs. 6.07±5.22; p=0.001), severity of symptoms of intrusion (4.66±3.60 vs. 3.69±3.20; p=0.04), increased level of anxiety (2.54±1.94 vs. 1.79±1.53; p=0.001) and depression (3.02±2.26 vs. 2.04±1.67; p=0.001) compared to males. However, the gender difference for PTSD symptoms disappeared when controlling for age. CONCLUSION: The findings of this survey revealed that the vast majority of respondents (92 percent females and 87 percent males) still had subclinical psychiatric symptoms one year after the flood. Therefore, tailored psychological interventions are warranted to counter the long-lasting impact of flooding on the mental health of individuals.

Screening for post-traumatic stress disorder among adolescents following floods – A comparative study from private and public schools in Kerala, India

INTRODUCTION: Disasters can have deep physical and psychological impact among survivors. An extraordinary southwest monsoon has unleashed floods and landslides in Kerala state in 2018. Adolescents are more vulnerable to psychological impairment after a disaster and trauma during initial stages of life can etch an indelible signature in the individual’s development and may lead to future disorders. OBJECTIVES: 1. To screen for PTSD and associated factors among adolescents 8 months post floods in selected schools in flood-affected areas of Alleppey district of Kerala 2. To compare the proportion of adolescents screened positive for PTSD in public and private schools. METHODOLOGY: A 3-month, Cross-sectional study was done among 670 adolescents in private and public schools using stratified sampling in Alleppey district. The study tool included a structured questionnaire that collected information on sociodemographics, flood-related variables, Trauma screening questionnaire and academic performance. RESULTS: The mean age of the participants was 16.03 ± 0.73 years with almost equal gender distribution. One-third of students reported flood-related damage to house/property, and a few lost their pets. Nearly 50% of the students reported that they still re-experience and get upsetting memories about flood events. The prevalence of probable PTSD noted to be 34.9%. We observed that 31% of students in public school screened positive for PTSD compared to 38.8% of private school students. (odds ratio = 1.409, CI 1.024-1.938). Male gender (Odds ratio = 1.503, CI 1.093-2.069), higher age (Odds ratio = 1.701, CI 1.120-2.585), damage during floods (Odds ratio = 2.566, CI 1.814-3.630), presence of morbidity (Odds ratio = 3.568, CI 1.888-6.743), camp stay (Odds ratio = 3.788, CI 2.364-6.067) and loss of pets (Odds ratio = 3.932, CI 2.019-7.657) were the factors significantly associated with PTSD. We noted a deterioration in academic performance in 45.9% of students who screened positive for PTSD. CONCLUSION AND RECOMMENDATIONS: High prevalence of stress disorder highlights the need for early identification and intervention for PTSD and including trained counsellors as a part of the disaster management team in future.

An approach to understanding the intrinsic complexity of resilience against floods: Evidences from three urban communities of Pakistan

Rapid and unplanned urbanization has resulted in the settlement and expansion of marginalized communities in flood-prone areas. Consequently, the devastating impacts of urban flooding have increased recently, further augmented by the changing climatic patterns resulting in more frequent flooding. However, to effectively enhance resilience at the community level, it is essential first to understand its components and indicators. This study proposed and tested a methodology to assess community resilience against urban flooding – 57 indicators of resilience were identified, which were classified into six domains, namely social, economic, infrastructural, institutional, natural, and psychological. The data was collected through a questionnaire survey in three com-munities of Rawalpindi, Sialkot, and Muzaffargarh cities in the province of Punjab, Pakistan. The data of resilience indicators were standardized, and an index-based approach was used to assess the community resil-ience in the six domains. The relative importance of each domain was evaluated through input from field experts translated into weights through the analytic hierarchy process method. Thereafter, overall community resilience was constructed, and statistical methods were employed to compare resilience and its domains. A significant difference in resilience was observed among the selected communities. Recommendations based on relative urgency, complexity, and impact were devised to help institutions make informed decisions to improve com-munity resilience against floods.

Differences in post-disaster mental health among Vietnamese and African Americans living in adjacent urban communities flooded by Katrina

Some communities recover more quickly after a disaster than others. Some differentials in recovery are explained by variation in the level of disaster-related community damage and differences in pre-disaster community characteristics, e.g., the quality of housing stock. But distinct communities that are similar on the above characteristics may experience different recovery trajectories, and, if so, these different trajectories must be due to more subtle differences among them. Our principal objective is to assess short-term and long-term post-disaster mental health for Vietnamese and African Americans living in two adjacent communities in eastern New Orleans that were similarly flooded by Hurricane Katrina. We employ data from two population-based cohort studies that include a sample of African American adults (the Gulf Coast Child and Family Health [GCAFH study]) and a sample of Vietnamese American adults (Katrina Impacts on Vietnamese Americans [KATIVA NOLA study]) living in adjacent neighborhoods in eastern New Orleans who were assessed near the second and thirteenth anniversaries of the disaster. Using the 12-Item Short Form Survey (SF-12) as the basis of our outcome measure, we find in multivariate analysis a significant advantage in post-disaster mental health for Vietnamese Americans over their African American counterparts at the two-year mark, but that this advantage had disappeared by the thirteenth anniversary of the Katrina disaster.

Climate change, fossil-fuel pollution, and children’s health

Current resources for evidence-based practice, March 2021

An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of men’s experiences of pregnancy loss and commentaries on reviews focused on the effects of perineal massage on perineal trauma and air pollution and heat exposure on birth outcomes.

Cascading disasters and mental health inequities: Winter storm Uri, COVID-19 and post-traumatic stress in Texas

Previous research on health effects of extreme weather has emphasized heat events even though cold-attributable mortality exceeds heat-attributable mortality worldwide. Little is known about the mental health effects of cold weather events, which often cascade to produce secondary impacts like power outages, leaving a knowledge gap in context of a changing climate. We address that gap by taking a novel “cascading disaster health inequities” approach to examine winter storm-associated post-traumatic stress (PTS) using survey data (n = 790) collected in eight Texas metro areas following Winter Storm Uri in 2021, which occurred against the backdrop of COVID-19. The incidence of storm-related PTS was 18%. Being Black (odds ratio [OR]: 6.6), Hispanic (OR: 3.5), or of another non-White race (OR: 4.2) was associated with greater odds of PTS compared to being White, which indicates substantial racial/ethnic inequities in mental health impacts (all p < 0.05). Having a disability also increased odds of PTS (OR: 4.4) (p < 0.05). Having piped water outages (OR: 1.9) and being highly impacted by COVID-19 (OR: 3.3) increased odds of PTS (both p < 0.05). When modelling how COVID-19 and outages cascaded, we compared householders to those with no outages and low COVID-19 impacts. PTS was more likely (p < 0.05) if householders had a water or power outage and high COVID-19 impacts (OR: 4.4) and if they had water and power outages and high COVID-19 impacts (OR: 7.7). Findings provide novel evidence of racial/ethnic inequities and cascading effects with regard to extreme cold events amid the COVID-19 pandemic.

Development and validation of an eating-related eco-concern questionnaire

Eco-concern, the distress experienced relating to climate change, is associated with mental health, yet no study has examined disordered eating related to eco-concern. This study developed and validated a 10-item scale assessing Eating-Related Eco-Concern (EREC). Participants (n = 224) completed the EREC, Climate Change Worry Scale (CCWS), and Eating Disorder Examination-Questionnaire (EDE-Q). Construct validity, convergent validity, and internal consistency were evaluated. Sex differences in EREC were evaluated using t-tests. Associations among the EREC, CCWS, and EDE-Q were evaluated using linear regression models. Sensitivity analyses were conducted in individuals below EDE-Q global score clinical cut-offs. Factor analysis suggested that all items loaded adequately onto one factor. Pearson’s correlation and Bland-Altman analyses suggested strong correlation and acceptable agreement between the EREC and CCWS (r = 0.57), but weak correlation and low agreement with the EDE-Q global score (r = 0.14). The EREC had acceptable internal consistency (α = 0.88). No sex difference was observed in the EREC in the full sample; females had a significantly higher mean score than males in sensitivity analysis. The EREC was significantly positively associated with the CCWS and EDE-Q global and shape concern scores, but not in sensitivity analysis. The EREC is a brief, validated scale that can be useful to screen for eating-related eco-concern.

The effect of average temperature on suicide rates in five urban California counties, 1999-2019: An ecological time series analysis

BACKGROUND: Suicide is among the top 10 leading causes of premature morality in the United States and its rates continue to increase. Thus, its prevention has become a salient public health responsibility. Risk factors of suicide transcend the individual and societal level as risk can increase based on climatic variables. The purpose of the present study is to evaluate the association between average temperature and suicide rates in the five most populous counties in California using mortality data from 1999 to 2019. METHODS: Monthly counts of death by suicide for the five counties of interest were obtained from CDC WONDER. Monthly average, maximum, and minimum temperature were obtained from nCLIMDIV for the same time period. We modelled the association of each temperature variable with suicide rate using negative binomial generalized additive models accounting for the county-specific annual trend and monthly seasonality. RESULTS: There were over 38,000 deaths by suicide in California’s five most populous counties between 1999 and 2019. An increase in average temperature of 1 °C corresponded to a 0.82% increase in suicide rate (IRR = 1.0082 per °C; 95% CI = 1.0025-1.0140). Estimated coefficients for maximum temperature (IRR = 1.0069 per °C; 95% CI = 1.0021-1.0117) and minimum temperature (IRR = 1.0088 per °C; 95% CI = 1.0023-1.0153) were similar. CONCLUSION: This study adds to a growing body of evidence supporting a causal effect of elevated temperature on suicide. Further investigation into environmental causes of suicide, as well as the biological and societal contexts mediating these relationships, is critical for the development and implementation of new public health interventions to reduce the incidence of suicide, particularly in the face increasing temperatures due to climate change.

The influence of personality traits on attitudes towards climate change – An exploratory study

This study used a trait-level approach to understanding pro-environmental behavior in the context of climate change. We asked 194 adult participants to report their belief in climate change and their risk perception and then tested the correlation between self-reported Big Five traits, trait-level anxiety, and empathy. Our analysis revealed that Openness, Perspective Taking, sex, and age correlate with climate change attitudes. These results increase our understanding of environmental challenges to the general public and offer implications for future research on how to execute pro-environmental strategies.

Well-being effects of extreme weather events in the United States

The increase in weather and climate disasters in recent years has prompted an interest in analyzing their consequences and the mitigation and adaptation measures that can help minimize their potentially large impacts on individuals’ welfare. We match thirtyone billion-dollar disasters with individual survey data from the Behavioral Risk Factor Surveillance System to estimate the effect of extreme weather events on the subjective well-being of U.S. residents. Our results indicate that natural disasters have a negative and robust impact on subjective well-being in the affected communities, and that, on average, this impact peaks 6 months after the event, and then decays over time. We then investigate the attenuating impact of health care access, flood insurance, and governmental assistance programs and find a partial compensating role for risk-transfer and relief measures. We also find that stronger emotional and social support mitigates the negative impact of natural disasters.

Predictive validity of the Seasonal Beliefs Questionnaire for discriminating between seasonal and nonseasonal major depressive disorder

The Seasonal Beliefs Questionnaire (SBQ) is a 26-item self-report measure of a winter seasonal affective disorder (SAD)-specific cognitive vulnerability consisting of maladaptive thoughts about the seasons, light availability, and weather conditions. In a known groups comparison, currently depressed adults with SAD had significantly higher SBQ scores than currently depressed adults with nonseasonal major depressive disorder (MDD) and healthy controls, and the MDD group had significantly higher SBQ scores than controls. Using that database, this study explored the predictive validity of using an SBQ cutoff score to differentiate SAD from MDD. Receiver operator characteristic curve analyses used SBQ total score to predict SAD versus MDD, SAD versus control, and MDD versus control status. The SBQ subscale combined score, derived from multivariable logistic regression with SBQ subscales, was examined as an alternative predictor. SBQ total score with a cutpoint of 132 had good predictive ability for distinguishing SAD from MDD (C-statistic = .792, sensitivity = .798, specificity = .794). The SBQ subscale combination score slightly improved predictive ability for the SAD/MDD distinction (C-statistic = .813), with better sensitivity (.930) but worse specificity (.571). In contrast, the score on a generic measure of depressogenic cognitive vulnerability, the Dysfunctional Attitudes Scale, was poor for differentiating SAD from MDD. SBQ total score was excellent in discriminating SAD cases from controls with a cutpoint of 121 (C-statistic = .962, sensitivity = .939, specificity .873), but had poor sensitivity for discriminating MDD cases from controls. Results support using the SBQ to screen for probable SAD in practice settings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Associations of short-term exposure to air pollution and increased ambient temperature with psychiatric hospital admissions in older adults in the USA: A case-crossover study

BACKGROUND: Little is known about the associations between ambient environmental exposures and the risk of acute episodes of psychiatric disorders. We aimed to estimate the link between short-term exposure to atmospheric pollutants, temperature, and acute psychiatric hospital admissions in adults aged 65 years and older in the USA. METHODS: For this study, we included all people (aged ≥65 years) enrolled in the Medicare programme in the USA who had an emergency or urgent hospital admission for a psychiatric disorder recorded between Jan 31, 2000, and Dec 31, 2016. We applied a case-crossover design to study the associations between short-term exposure to air pollution (fine particulate matter [PM(2·5)], ozone, and nitrogen dioxide [NO(2)]), ambient temperature, and the risk of acute hospital admissions for depression, schizophrenia, and bipolar disorder in this population. The percentage change in the risk of hospital admission and annual absolute risk differences were estimated. FINDINGS: For each 5°C increase in short-term exposure to cold season temperature, the relative risk of acute hospital admission increased by 3·66% (95% CI 3·06-4·26) for depression, by 3·03% (2·04-4·02) for schizophrenia, and by 3·52% (2·38-4·68) for bipolar disorder in the US Medicare population. Increased short-term exposure to PM(2·5) and NO(2) was also associated with a significant increase in the risk of acute hospital admissions for psychiatric disorders. Each 5 μg/m(3) increase in PM(2·5) was associated with an increase in hospital admission rates of 0·62% (95% CI 0·23-1·02) for depression, 0·77% (0·11-1·44) for schizophrenia, and 1·19% (0·49-1·90) for bipolar disorder; each 5 parts per billion (ppb) increase in NO(2), meanwhile, was linked to an increase in hospital admission rates of 0·35% (95% CI 0·03-0·66) for depression and 0·64% (0·20-1·08) for schizophrenia. No such associations were found with warm season temperature. INTERPRETATION: In the US Medicare population, short-term exposure to elevated concentrations of PM(2·5) and NO(2) and cold season ambient temperature were significantly associated with an increased risk of hospital admissions for psychiatric disorders. Considering the increasing burden of psychiatric disorders in the US population, these findings suggest that intervening on air pollution and ambient temperature levels through stricter environmental regulations or climate mitigation could help ease the psychiatric health-care burden. FUNDING: US National Institute of Environmental Health Sciences, US Environmental Protection Agency, and US National Institute on Aging.

Climate change anxiety and mental health: Environmental activism as buffer

A growing body of research has documented the phenomenon of climate change anxiety (CCA), defined broadly as negative cognitive, emotional, and behavioral responses associated with concerns about climate change. A recently validated scale of CCA indicated two subscales: cognitive emotional impairment and functional impairment (Clayton & Karazsia, 2020). However, there are few empirical studies on CCA to date and little evidence regarding whether CCA is associated with psychiatric symptoms, including symptoms of Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD), and whether engaging in individual and collective action to address climate change could buffer such relationships. This mixed methods study draws on data collected from a sample of emerging adult students (ages 18-35) in the United States (N = 284) to address these gaps. Results indicated that both CCA subscales were significantly associated with GAD symptoms, while only the Functional Impairment subscale was associated with higher MDD symptoms. Moreover, engaging in collective action, but not individual action, significantly attenuated the association between CCA cognitive emotional impairment and MDD symptoms. Responses to open-ended questions asking about participants’ worries and actions related to climate change indicated the severity of their worries and, for some, a perception of the insignificance of their actions relative to the enormity of climate change. These results further the field’s understanding of CCA, both in general and specifically among emerging adults, and suggest the importance of creating opportunities for collective action to build sense of agency in addressing climate change.

Coping profiles in the context of global environmental threats: A person-centered approach

Profound environmental changes will affect vast human populations, if not pose an existential threat to humanity, raising the question how individuals will adapt psychologically to address these changes and how they manage stress and anxiety in the face of chronic threats such as climate change. We propose that ecological coping (efforts to manage adaptational demands of a degrading environment) is an important construct. Our purpose is to use a person-centered approach to identify profiles of ecological coping and to determine how these profiles differ on mental health outcomes and pro-environmental behaviors in an online survey (N=334 U.S. adults). Using Latent Profile Analysis (LPA), we also investigate whether these profiles are explained based on general (demographics) or environment-specific (e.g., eco-stressors) factors. Results showed: (1) The identification of two profiles: Adaptive Approach Coping (P1; 69.46%) and Maladaptive Avoidance Coping (P2; 30.54%); (2) Environment-related factors (vs. health) are associated with the profiles; (3) All 6 environment-specific characteristics predicted profile membership. Future research and policy can use these profiles to develop interventions to increase pro-environmental engagement to address climate change.

Air pollution, climate conditions and risk of hospital admissions for psychotic disorders in U.S. Residents

BACKGROUND: The physical environmental risk factors for psychotic disorders are poorly understood. This study aimed to examine the associations between exposure to ambient air pollution, climate measures and risk of hospitalization for psychotic disorders and uncover potential disparities by demographic, community factors. METHODS: Using Health Cost and Utilization Project (HCUP) State Inpatient Databases (SIDs), we applied zero-inflated negative binomial regression to obtain relative risks of hospitalization due to psychotic disorders associated with increases in residential exposure to ambient air pollution (fine particulate matter, PM(2.5); nitrogen dioxide, NO(2)), temperature and cumulative precipitation. The analysis covered all-age residents in eight U.S. states over the period of 2002-2016. We additionally investigated modification by age, sex and area-level poverty, percent of blacks and Hispanics. RESULTS: Over the study period and among the covered areas, we identified 1,211,100 admissions due to psychotic disorders. For each interquartile (IQR) increase in exposure to PM(2.5) and NO(2), we observed a relative risk (RR) of 1.11 (95% confidence interval (CI) = 1.09, 1.13) and 1.27 (95% CI = 1.24, 1.31), respectively. For each 1 °C increase of temperature, the RR was 1.03 (95% CI = 1.03, 1.04). Males were more affected by NO(2). Older age residents (≥30 yrs) were more sensitive to PM(2.5) and temperature. Population living in economically disadvantaged areas were more affected by air pollution. CONCLUSIONS: The study suggests that living in areas with higher levels of air pollutants and ambient temperature could contribute to additional risk of inpatient care for individuals with psychotic disorders.

Navigating supported employment and education services for youths during COVID-19 and severe weather events

In 2021, the British Columbia (BC) Interior experienced a series of unprecedented disasters, ranging from extreme heat and wildfires to catastrophic flooding and evacuations. Along with these severe weather events, BC was affected by COVID-19 outbreaks and public health restrictions. Despite these challenges, communities worked to ensure that youths who are at risk for increased mental health challenges continued to have access to services that promote well-being, such as individual placement and support programs for supported employment and education. This Open Forum presents program considerations and adaptations in Foundry Penticton, one of 12 province-wide integrated youth hubs, to ensure service delivery during acute and chronic disasters.

El Nino and children: Medium-term effects of early-life weather shocks on cognitive and health outcomes

The fact that shocks in early life can have long-term consequences is well established in the literature. This paper examines the effects of extreme precipitations on cognitive and health outcomes and shows that impacts can be detected as early as 2 years of age. Our analyses indicate that negative conditions (i.e., extreme precipitations) experienced during the early stages of life affect children’s physical, cognitive and behavioral development measured between 2 and 6 years of age. Affected children exhibit lower cognitive development (measured through language, working and long-term memory and visual-spatial thinking) in the magnitude of 0.15 to 0.19 SDs. Lower height and weight impacts are also identified. Changes in food consumption and diet composition appear to be key drivers behind these impacts. Partial evidence of mitigation from the delivery of government programs is found, suggesting that if not addressed promptly and with targeted policies, cognitive functioning delays may not be easily recovered.

Climate change, aging, and well-being: How residential setting matters

How do older people’s living environments influence their vulnerabilities to climate change? Much has been written about the physiological consequences of climate change for older individuals, particularly the dangers of increased incidence of severe heat. Less is known about how older people’s residential settings moderate their exposure to climate stressors, their particular sensitivities to the effects of climate change, or their capacities to respond to extreme events or adapt to long-term environmental changes. Drawing on literature in English, with a focus on work relevant to the United States, we examine how the housing, neighborhood, and urban or rural contexts in which older people live shape their experiences of climate change, moderating their exposure to risks related to climate change, sensitivity to those events and trends, and their capacities to adapt and recover. Older people face multiple life changes, making prioritizing climate readiness more challenging. They are also diverse, with different vulnerabilities and perceptions of risks and the ability to manage them. This paper lays out an agenda where additional research can inform policy and planning efforts aimed at reducing older individuals’ risk and building the capacity to adapt to climate change. The agenda includes understanding specific vulnerabilities and how older people and their housing providers are already responding.

Green enough ain’t good enough: Public perceptions and emotions related to green infrastructure in environmental justice communities

The concept of biophilic urban planning has inspired neighborhood greening projects in many older urban communities in the USA and beyond. The strengths (e.g., environmental management, biodiversity, heat island mitigation) and challenges (e.g., greenwashing, green gentrification) of such projects are well-documented. Additional research on the relationship between these projects and various social factors (e.g., public perceptions, feelings, and mental health and well-being) is necessary to better understand how people adapt to said projects while struggling to navigate other more pressing socioeconomic issues, especially in communities facing environmental injustice and health inequity. In this article, we focus on one aspect of biophilic urban planning-green stormwater infrastructure (GSI) (e.g., rain gardens, bio-swales, pervious pavements, and wildflower meadows)-in Waterfront South, a post-industrial neighborhood in Camden, NJ, USA, where residents have faced environmental injustices for decades. Our qualitative analysis of in-depth semi-structured interviews of sixteen residents offered a thorough insight into their perceptions and emotions regarding different types of urban GSI projects. Residents acknowledge the many benefits that GSI offers to combat the neighborhood’s social and environmental injustices, but they are cautious about the possibility of some projects prompting new issues and concerns within the community. Our findings reveal potential implications in GSI planning, research, and practice in this neighborhood and similar urban places elsewhere that have yet to undergo gentrification.

The Food Equity and Environmental Data Sovereignty (FEEDS) Project: Protocol for a quasi-experimental study evaluating a digital platform for climate change preparedness

BACKGROUND: Despite having the tools at our disposal to enable an adequate food supply for all people, inequities in food acquisition, distribution, and most importantly, food sovereignty, worsen food insecurity. The detrimental impact of climate change on food systems and mental health is further exacerbated by a lack of food sovereignty. We urgently require innovative solutions to enable food sovereignty, minimize food insecurity, and address climate change-related mental distress (ie, solastalgia). Indigenous communities have a wealth of Traditional Knowledge for climate change adaptation and preparedness to strengthen food systems. Traditional Knowledge combined with Western methods can revolutionize ethical data collection, engagement, and knowledge mobilization. OBJECTIVE: The Food Equity and Environmental Data Sovereignty (FEEDS) Project takes a participatory action, citizen science approach for early detection and warning of climate change impacts on food sovereignty, food security, and solastalgia. The aim of this project is to develop and implement a sustainable digital platform that enables real-time decision-making to mitigate climate change-related impacts on food systems and mental well-being. METHODS: Citizen science enables citizens to actively contribute to all aspects of the research process. The FEEDS Project is being implemented in five phases: participatory project planning, digital climate change platform customization, community-led evaluation, digital platform and project refinement, and integrated knowledge translation. The project is governed by a Citizen Scientist Advisory Council comprising Elders, Traditional Knowledge Keepers, key community decision makers, youth, and FEEDS Project researchers. The Council governs all phases of the project, including coconceptualizing a climate change platform, which consists of a smartphone app and a digital decision-making dashboard. Apart from capturing environmental and health-related big data (eg, weather, permafrost degradation, fire hazards, and human movement), the custom-built app uses artificial intelligence to engage and enable citizens to report on environmental hazards, changes in biodiversity or wildlife, and related food and mental health issues in their communities. The app provides citizens with valuable information to mitigate health-related risks and relays big data in real time to a digital dashboard. RESULTS: This project is currently in phase 1, with the subarctic Métis jurisdiction of Île-à-la-Crosse, Saskatchewan, Canada. CONCLUSIONS: The FEEDS Project facilitates Indigenous Peoples’ self-determination, governance, and data sovereignty. All citizen data are anonymous and encrypted, and communities have ownership, access, control, and possession of their data. The digital dashboard system provides decision makers with real-time data, thereby increasing the capacity to self-govern. The participatory action research approach, combined with digital citizen science, advances the cocreation of knowledge and multidisciplinary collaboration in the digital age. Given the urgency of climate change, leveraging technology provides communities with tools to respond to existing and emerging crises in a timely manner, as well as scientific evidence regarding the urgency of current health and environmental issues. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/31389.

Temperature and place associations with Inuit mental health in the context of climate change

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.

I believe this team will change how society views youth in disasters: The EnRiCH Youth Research Team: A youth-led community-based disaster risk reduction program in Ottawa, Canada

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.

Drivers and health implications of the dietary transition among Inuit in the Canadian Arctic: A scoping review

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.

Exploring climate emotions in Canada’s provincial north

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.

Climate change and Indigenous mental health in the Circumpolar north: A systematic review to inform clinical practice

Climate change is disproportionally impacting the Circumpolar North, with particular impacts among Indigenous populations. Environmental changes are felt in many aspects of daily life of Northern communities, including both physical and mental health. Thus, health institutions from around the Arctic must meet emerging needs, while the phenomenon remains marginal to their southern counterparts. In this systematic review, we aimed to review current scientific knowledge on the mental health impacts of climate change in Indigenous Peoples across the Circumpolar North. Seven databases were searched. Original peer-reviewed research articles were included if they addressed links between climate change and mental health in Arctic or Subarctic Indigenous Populations. After extraction, data were synthesized using thematic analysis. Of the 26 articles that met inclusion criteria, 16 focused on Canadian Inuit communities and 21 were exclusively qualitative. Being on the land was identified as a central determinant of wellbeing. Immediate impacts of climate change on mental health were felt through restricted mobility and disrupted livelihoods. Effects on mental health were further felt through changes in culture and identity, food insecurity, interpersonal stress and conflicts, and housing problems. Various ways in how communities and individuals are coping with these effects were reported. Understanding climate-related pathways of mental health risks in the Arctic is crucial to better identify vulnerable groups and to foster resilience. Clinicians can play a role in recognizing and providing support for patients affected by these disruptions. Policies sensitive to the climate-mental health relationship must be advocated for.

Physiological costs of undocumented human migration across the southern United States border

Political, economic, and climatic upheaval can result in mass human migration across extreme terrain in search of more humane living conditions, exposing migrants to environments that challenge human tolerance. An empirical understanding of the biological stresses associated with these migrations will play a key role in the development of social, political, and medical strategies for alleviating adverse effects and risk of death. We model physiological stress associated with undocumented migration across a commonly traversed section of the southern border of the United States and find that locations of migrant death are disproportionately clustered within regions of greatest predicted physiological stress (evaporative water loss). Minimum values of estimated evaporative water loss were sufficient to cause severe dehydration and associated proximate causes of mortality. Integration of future climate predictions into models increased predicted physiological costs of migration by up to 34.1% over the next 30 years.

Caregiving in U.S. Gulf states during natural disasters and COVID-19

OBJECTIVES: To ascertain common experiences and needs of a diverse group of caregivers challenged by hurricanes/floods and COVID-19. METHODS: In-depth interviews with unpaid caregivers in U.S. Southeast/Gulf Coast states who had experienced caregiving during a natural disaster and during COVID-19. RESULTS: Caregivers report challenges including daily living disruption, altered social supports, complicated health management, additional disaster planning, and emotional/financial impacts. Caregivers suggested helpful resources, policy options, and preparatory tools at individual, local, and health system levels to mediate discontinuity. CONCLUSIONS: Our data describe combined caregiver experiences of hurricanes/floods and the pandemic. Caregivers experience unique burdens related to care recipient diagnosis, location, and veteran status. Access to community supports varies as they manage the tasks required for care recipients’ health and safety. Our findings indicate the need for public health reinforcement of caregiving though caregiver pre-planning and targeted support. Bolstering understanding of communities’ caregiving capacity though first responder trainings and caregiver registries may enhance health and safety.

Compounding impacts of hazard exposures on mental health in Houston, TX

Natural and anthropogenic hazards are increasingly becoming commonplace due to climate change and population pressures. The state of Texas is particularly vulnerable to these hazards and is ranked first in the USA due to the immense variety and frequency of large-scale events. While much research has looked at the immediate impacts these incidents have on mental health, little research has addressed the effects of compounding and repeated exposure to hazards. This cross-sectional study (N = 1224) collected survey data from a representative sample within the Houston Metropolitan Statistical Area. Utilizing the 12 item Short Form Health Survey version 2, a general composite score assessing mental health was compared against the type and frequency of hazard exposures. Findings revealed an observed reduction in mental health scores as participants had repeated exposures to major disasters. Further, the only significant result (p < 0.001) in dictating a reduced mental health scores was repeat exposure to hazards even after adjusting for demographic data and socioeconomic variables. This research reveals the long-term mental impact hazard exposures can have and underscores the need for target public health interventions and engaged community efforts.

Pervious area change as surrogate to diverse climatic variables trends in the CONUS: A county-scale assessment

The increase in worldwide population is putting much pressure on the existent urban management plans. In this context, strategies and policies should be updated to conserve natural resources, but more importantly, to improve inhabitants’ well-being. Studies focusing on pervious areas have many potentials, particularly regarding the assessment of potential green infrastructures within the vicinities of cities. This study highlights the pervious area change between 2001 and 2016 within every county in the CONtiguous United States (CONUS) based on the National Land Cover Database (NLCD). The study found that 43 different counties can be considered dense. A statistical analysis is followed, highlighting the air temperature, wind speed, precipitation, solar radiation, and Normalized Difference Vegetation Index (NDVI) trends in five characteristic counties. These datasets were retrieved from diverse remote sensing and satellite platforms between 1980 and 2019. The main results also found that air temperature was significantly (at alpha = 0.95) increasing for the same period. The other climatic variables depict fluctuating and usually insignificant trends. Such information would benefit decisionand policy makers to focus their initiatives towards the most vulnerable counties while projecting different scenarios based on their current and historical conditions. Furthermore, this approach can be portable to other countries.

Global governance and climate stress of incarcerated women: The case of the U.S.

This paper takes the United States as a case study on the gendered implications of hyper-incarceration in the age of climate emergency. Prisons here are often located on toxic sites and constitute sources of contamination; climate change and global warming exacerbate these conditions. Incarcerated women and their communities are particularly affected. The female incarceration rate has skyrocketed, and women come to the carceral complex with unique histories of abuse, and higher rates of physical and mental illness. Researchers and policymakers need to address, analyse, and include incarcerated women’s experiences of climate stress in global policy mechanisms such as the UN Commission on the Status of Women (CSW) and the United Nations Rules for the Treatment of Women Prisoners and Non-custodial Measures for Women Offenders (“Bangkok Rules”). Abolition feminism and the voices of incarcerated women should meaningfully help connect the dots in the larger framework of the Sustainable Development Goals (SDGs).

Mechanisms of recovery: Community perceptions of change and growth following multiple disasters

INTRODUCTION AND PURPOSE: The geographic location of the Gulf South leaves communities in continuous threat, response, and recovery disaster cycles. Hurricane Katrina in 2005 provided an opportunity to study disaster mental health. Less than 5 years after the storm, many Hurricane Katrina survivors were impacted again by the Deepwater Horizon Gulf oil spill. Despite adversities impacting Gulf communities, over 90% of participants reported they were resilient. The purpose of this study was to improve the understanding of the mechanisms that contribute to strengths following adversity in communities affected by repeated disasters. Specifically, we focused on survivor perceptions of personal, spiritual, or community changes in efforts to describe community resilience and posttraumatic growth (PTG). METHODS: Participants were recruited through a quantitative survey and community flyers. Participants represented southeastern Louisiana, in areas impacted by hurricanes and the oil spill-for a total of five focus groups and 41 participants. Focus groups began by asking each participant to provide a brief overview of their disaster survival story and three additional guiding strengths-based questions. Data were transcribed using Dragon Speech Recognition software. A total of 963 unique responses were analyzed and coded. RESULTS: The following themes were identified: connectedness (n = 259), coping (n = 94), spirituality (n = 60), adaptability (n = 47), and self-reliance (n = 23). Participants noted a growth mindset from the disasters and also acknowledged coinciding negative experiences (n = 154) associated with community change and loss, where subthemes included change in connectedness (n = 97), crime (n = 26), and feeling like an outsider (n = 31). DISCUSSION AND IMPLICATIONS: These findings help scholars and mental health practitioners better understand the lived experiences of PTG in a community of survivors impacted by recurring traumatic experiences. In keeping with previous literature, PTG and negative experiences associated with trauma are not mutually exclusive, but occur simultaneously. Our results offer a holistic picture of coping with cumulative or repeated traumas and suggest that connectedness, coping, and spirituality provide important buffers to negative psychosocial outcomes.

Multi-scalar and multi-dimensional conceptions of social capital and mental health impacts after disaster: The case of Hurricane Harvey

While much research investigates how social capital relates to mental health after disasters, less work employs a multi-scalar, multi-dimensional social capital framework. This study applies such a construct to an analysis of novel survey data of approximately 1,000 rural and urban Texans after Hurricane Harvey struck the United States in August 2017. On the individual level, it finds that greater social support is linked to fewer mental health impacts, but that greater civic and organisational engagement is connected to greater mental health impacts. At the community level, it finds that neither a density of bridging social capital organisations nor of bonding social capital organisations is associated with poorer mental health, although a greater number of bonding organisations is related to negative mental health impacts on rural residents. The paper concludes by focusing on how individual and community social capital relationships with mental health are contingent on measurement, scale, and rural or urban location.

The effects of Hurricane Harvey on the physical and mental health of adults in Houston

Using data from the 2017-18 Health of Houston Survey, this study estimates the effect of Hurricane Harvey, the second costliest storm in the history of the United States, on the physical and mental health of adults living in Houston, Texas. The survey was fielded to a population-based probability sample whose data collection activities were interrupted and delayed by Hurricane Harvey. This interruption in data collection created a natural experiment that allowed for a comparison of community health before and after the storm. Following the storm, adults in Houston on average experienced an increase of 1.12 days a month of poor physical health and an increase of 1.31 days a month of poor mental health. These effects were most pronounced in parts of the city where structural damage from the storm was most severe.

Unexpected effects of expressive writing on post-disaster distress in the Hurricane Harvey Study: A randomized controlled trial in perinatal women

BACKGROUND: Expressive writing requires journaling stressor-related thoughts and feelings over four daily sessions of 15 min. Thirty years of research have popularized expressive writing as a brief intervention for fostering trauma-related resilience; however, its ability to surpass placebo remains unclear. This study aimed to determine the efficacy of expressive writing for improving post-traumatic stress symptoms in perinatal women who were living in the Houston area during major flooding caused by Hurricane Harvey. METHODS: A total of 1090 women were randomly allocated (1:1:1) to expressive writing, neutral writing or no writing. Interventions were internet-based. Online questionnaires were completed before randomization and at 2 months post-intervention. The primary outcome was post-traumatic stress symptoms, measured with the Impact of Event Scale-Revised; secondary outcomes were affective symptoms, measured with the 40-item Inventory of Depression and Anxiety Scales. Feelings throughout the intervention were reported daily using tailored questionnaires. RESULTS: In intention-to-treat analyses, no post-treatment between-group differences were found on the primary and secondary outcomes. Per-protocol analyses yielded similar results. A number of putative moderators were tested, but none interacted with expressive writing. Expressive writing produced greater feelings of anxiety and sadness during the intervention compared to neutral writing; further, overall experiences from the intervention mediated associations between expressive writing and greater post-traumatic stress at 2 months post-intervention. CONCLUSIONS: Among disaster-stricken perinatal women, expressive writing was ineffective in reducing levels of post-traumatic stress, and may have exacerbated these symptoms in some.

Association between repeated exposure to hurricanes and mental health in a representative sample of Florida residents

IMPORTANCE: During the past century, more than 100 catastrophic hurricanes have impacted the Florida coast; climate change will likely be associated with increases in the intensity of future storms. Despite these annual threats to residents, to our knowledge, no longitudinal studies of representative samples at risk of hurricane exposure have examined psychological outcomes associated with repeated exposure. OBJECTIVE: To assess psychosocial and mental health outcomes and functional impairment associated with repeated hurricane exposure. DESIGN, SETTING, AND PARTICIPANTS: In this survey study, a demographically representative sample of Florida residents was assessed in the 60 hours prior to Hurricane Irma (wave 1: September 8-11, 2017). A second survey was administered 1 month after Hurricane Irma (wave 2: October 12-29, 2017), and a third survey was administered after Hurricane Michael (wave 3: October 22 to November 6, 2018). Data were analyzed from July 19 to 23, 2021. EXPOSURE: Hurricanes Irma and Michael. MAIN OUTCOMES AND MEASURES: The main outcomes were posttraumatic stress symptoms (PTSS), global distress, worry about future events (generalized worries), and functional impairment. Path models were used to assess associations of individual-level factors (prior mental health, recent adversity), prior storm exposures (loss and/or injury, evacuation), and direct, indirect, and media-based exposures to hurricanes Irma and Michael with those outcomes. Poststratification weights were applied to facilitate population-based inferences. RESULTS: Of 2873 individuals administered the survey in wave 1, 1637 responded (57.0% completion rate) (894 [54.6%, weighted] women; mean [SD] age, 51.31 [17.50] years); 1478 in wave 2 (90.3% retention from wave 1) and 1113 in wave 3 (75.3% retention from wave 2) responded. Prior mental health ailments (b, 0.18; 95% CI, 0.07-0.28), prior hurricane-related loss and/or injury (b, 0.09; 95% CI, 0.02-0.17), hours of Hurricane Irma-related media exposure (b, 0.03; 95% CI, 0.02-0.04), being in an evacuation zone during Hurricane Irma and not evacuating (b, 0.14; 95% CI, 0.02-0.27), and loss and/or injury in Hurricane Irma (b, 0.35; 95% CI, 0.25-0.44) were positively associated with PTSS after Hurricane Irma; most associations persisted and were associated with responses to Hurricane Michael. Prior mental health ailments (b, 0.10; 95% CI, 0.03-0.17), hours of Hurricane Michael-related media exposure (b, 0.01; 95% CI, 0.003-0.02), hurricane Irma-related PTSS (b, 0.42; 95% CI, 0.34-0.50), recent individual-level adversity (b, 0.03; 95% CI, 0.005-0.05), being in an evacuation zone during Hurricane Irma and evacuating (b, 0.10; 95% CI, 0.002-0.19), and direct (b, 0.36; 95% CI, 0.16-0.55) and indirect (b, 0.12; 95% CI, 0.05-0.18) Hurricane Michael-related exposures were directly associated with Hurricane Michael-related PTSS. After Hurricane Michael, prior mental health ailments (b, 0.17; 95% CI, 0.06-0.28), and PTSS related to hurricanes Irma (b, 0.11; 95% CI, 0.001-0.22) and Michael (b, 0.58; 95% CI, 0.47-0.69) were associated with respondents’ functional impairment. Analogous analyses using global distress and generalized worries as mediators of functional impairment yielded a similar pattern of results. CONCLUSIONS AND RELEVANCE: In this survey study, repeated direct, indirect, and media-based exposures to hurricanes were associated with increased mental health symptoms among Florida residents who experienced hurricanes Irma and Michael, suggesting that people were sensitized to respond with more psychological symptoms over time. These results may inform targeted public health intervention efforts for natural disasters.

Faith factors, character strengths, and depression following Hurricane Michael

Natural disasters have increased exponentially in recent decades, imposing existential threats to humans. Yet, surprisingly little research has explored the role of religion and spirituality (R/S) and transcendence-related character strengths in post-disaster depression. Using data (N = 491) from victims of Category 5 Hurricane Michael, this study examined whether R/S factors and character strengths helped to buffer against post-disaster depressive symptoms. A hierarchical regression model revealed an inverse association of perceived spiritual support with depression, after adjusting for demographic and event-related factors; strength of faith and the use of prayer for coping were not significantly related with depression. Upon inclusion of character strengths into the model, those relationships changed dramatically. Hope and optimism negatively predicted depression, whereas strength of faith and prayer for coping did so positively. Follow-up moderation analyses found that victims reporting particularly high levels of R/S factors and particularly low levels of character strength experienced the most depressive symptoms. The findings suggest that the potential protection of R/S factors in disasters may actually be due to transcendence-related character strength factors.

Mental health impacts of Hurricane Harvey: Examining the roles of intimate partner violence and resilience

Prior research has found that the prevalence and severity of intimate partner violence (IPV) increase in communities experiencing a disaster. Less studied are the associations between IPV, disaster exposure, and mental health outcomes following disaster events. In the current study, authors examined the prevalence of IPV before and after Hurricane Harvey and the direct and indirect effects of risk (i.e., disaster exposure, IPV) and resilience on mental health outcomes using structural equation modeling with 382 adults. Results indicate that exposure to Hurricane Harvey was significantly associated with risk for IPV, posttraumatic stress (PTS) symptoms, and depression symptoms. In addition, IPV mediated the relationships between disaster exposure and PTS and depression symptoms. These findings support the need to incorporate IPV services and resources into disaster mental health services.

The stress before the storm: Psychological correlates of hurricane-related evacuation stressors on mothers and children

OBJECTIVE: Natural disasters, such as hurricanes, can contribute to the development of posttraumatic stress symptoms (PTSS), anxiety, and depression. Furthermore, mothers and children are especially vulnerable postdisasters. Despite the rise in the frequency of climate-related disasters and also the threat of disasters (e.g., storms that threaten but do not make landfall), little is known about how predisaster experiences are associated with mothers’ and children’s postdisaster psychological functioning. This study examined evacuation-related stressors as predictors of mothers’ and youths’ psychological functioning 3 months after Hurricane Irma. METHOD: Mothers (N = 535; 33% ethnic/racial minorities) from South Florida counties most affected by Hurricane Irma completed an online survey that assessed evacuation-related stressors (both pre- and posthurricane), hurricane exposure (i.e., life threat, loss/disruption), and posthurricane social support and mental health symptomatology (i.e., PTSS, anxiety, depression). Mothers of children aged 7-17 years (n = 226) also reported on their child’s psychological functioning. RESULTS: Using a risk and resilience model, evacuation stressors significantly predicted mothers’ and youths’ PTSS and symptoms of anxiety and depression, even after accounting for demographic factors, hurricane exposure, and availability of social support. Mothers of older children also reported significantly higher levels of PTSS, anxiety, and depression than mothers who only had young children (aged 6 or younger) at home. CONCLUSIONS: Evacuation experiences represent significant stressors that may put mothers and children at risk for PTSS and psychological distress. Resilience-building efforts should include efforts to better prepare families for prestorm evacuations, thereby reducing risk in mothers and youth and ultimately contributing to better psychosocial functioning. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Evacuation- and hurricane-related experiences, emotional distress, and their associations with mothers’ health risk behaviors

OBJECTIVE: Extreme weather events pose major risks to human health and have a greater psychological impact on women and parents, but little is known about how they affect health risk behaviors. This study evaluated how disaster-related experiences before, during, and after Hurricane Irma were associated with mothers’ health-risk behaviors, and the extent to which posttraumatic stress symptoms (PTSS) and depressive symptoms potentially mediated these relationships. METHOD: Mothers (N = 534; 33% underrepresented minorities) residing in Southern Florida completed an online survey about their evacuation experiences before and hurricane experiences during and after Irma. Mothers also completed measures of PTSS, depressive symptoms, and health risk behaviors (i.e., substance use, sedentary behaviors, and difficulty falling or staying asleep). Confirmatory factor analysis assessed the fit of the health-risk behavior indicators on a latent factor. Structural equation modeling evaluated relationships between variables. RESULTS: A one-factor model for health risk behaviors fit the data well. After controlling for income, loss and disruption after the storm and depressive symptoms were directly associated with mothers’ health risk behaviors. Before-the-storm evacuation stressors, actual life-threatening events during the storm, and loss and disruption after the storm were related to mothers’ PTSS and depressive symptoms and also associated with health risk behaviors indirectly via depressive symptoms. CONCLUSIONS: Stressful experiences before, during, and after hurricanes are associated with mothers’ health-risk behaviors via postevent emotional distress. Health interventions should include strategies that help parents cope with the impact of extreme weather events, both before and after such events occur. Mothers’ distress potentially could affect child health. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Associations between religious coping and long-term mental health in survivors of Hurricane Katrina

Weather-related disasters are increasing in both frequency and severity, which in turn increases the likelihood for the development of adverse mental health outcomes (Augustinavicius et al., 2021; CRED & UNDRR, 2015; NOAA National Centers for Environmental Information, 2020). Religion and spirituality are an accessible form of coping that many people turn to during and after weather-related disasters and may be especially valuable to survivors who face barriers to accessing mental health treatment or may not feel served by formal mental health institutions (Abu-Raiya & Pargament, 2015; Bryant-Davis & Wong, 2013). Researchers have drawn distinctions between positive religious coping (PRC) and negative religious coping (NRC), both conceptually and in their relation to mental health outcomes (Pargament et al., 2011). This study utilized data from the Resilience in Survivors of Katrina project, an ongoing longitudinal study of low-income, female, primarily Black Hurricane Katrina survivors, and drew on four waves of data from before the hurricane in 2005 through 2018 to explore the longitudinal relationship between religious coping and mental health outcomes. Multiple linear regression analyses revealed that NRC was a significant predictor of posttraumatic stress, b = .14, p < .05, whereas PRC was a significant predictor of posttraumatic growth, b = .22, p < .01. Future research should further examine associations between religious coping styles and later well-being as well as strategies for beneficial outcomes.

Christian religious affiliation is associated with less posttraumatic stress symptoms through forgiveness but not search for meaning after Hurricane Irma and Maria

This study examined the extent to which Christian religious affiliation promoted greater forgiveness and search for meaning and consequently may have mitigated posttraumatic stress disorder (PTSD) symptoms in the wake of the devastation and loss following two hurricanes in Puerto Rico in 2017. Participants included 511 surviving Puerto Ricans. Most were assigned “female” at birth, educated, Christian, and middle-aged. Participants completed measures of PTSD symptoms, search for meaning, forgiveness, and demographics. Path modeling showed that Christian religious affiliation was negatively associated with PTSD symptoms and was positively associated with forgiveness but not search for meaning. Forgiveness was negatively and search for meaning was positively associated with PTSD symptoms. Christian religious affiliation may stimulate forgiveness, which may be a crucial factor for coping with PTSD symptoms in a natural disaster context such as Hurricanes Irma and Maria in Puerto Rico.

Exploring the association between forgiveness, meaning-making, and post-traumatic stress symptoms: The case of Hurricane Maria in Puerto Rico

Prior research suggests that meaning-making and forgiveness are associated with lower post traumatic stress symptoms (PTSS) following exposure to trauma. Few studies have examined these factors in the aftermath of natural disasters. This study therefore aimed to investigate the relationship between meaning-making and forgiveness, and their association with PTSS after the 2017 Hurricane Maria in Puerto Rico. Bivariate correlations and hierarchical regression analyses indicated that meaning-making and forgiveness were negatively correlated with PTSS. Higher levels of “presence of meaning,” “self-forgiveness,” “forgiveness of others,” and “feeling forgiven by God” were significantly associated with lower levels of PTSS. Conversely, “search for meaning” was positively associated with PTSS. The results suggest the importance of meaning-making and forgiveness education for building and promoting well-being in the face of extreme stressors.

Long-term lower respiratory symptoms among world trade center health registry enrollees following Hurricane Sandy

Several studies showed an association between lower respiratory tract symptoms (LRS) and exposure to the 9/11 terrorist attack. However, few studies have examined the long-term impact of natural disasters on those with prior respiratory distress. The present study aims to assess the impact of Hurricane Sandy on persistent LRS among people exposed to the World Trade Center (WTC) terrorist attack. The analytic sample consisted of WTC Health Registry enrollees who completed survey waves 1, 3, and 4 and the Hurricane Sandy Survey and did not report LRS before the WTC terrorist attack. The log binomial was used to assess the association between the impact of Hurricane Sandy and persistent LRS. Of 3277 enrollees, 1111 (33.9%) reported persistent LRS post-Sandy. Participants of older age, males, lower household income, current smokers, and those with previous asthma were more likely to report persistent LRS. In separate adjusted models, multiple Sandy-related inhalation exposures (relative risk (RR): 1.2, 95% CI: 1.06-1.37), Sandy-related PTSD (RR: 1.27, 95% CI: 1.15-1.4), and Sandy LRS (RR: 1.64, 95% CI: 1.48-1.81) were associated with persistent LRS post-Sandy. Our findings suggest that respiratory protection is important for everyone performing reconstruction and clean-up work after a natural disaster, particularly among those with previous respiratory exposures.

Maternal stress and hair cortisol among pregnant women following Hurricane Florence

Natural disasters represent major stressors, resulting in psychological distress and physiological responses such as increased cortisol. During pregnancy, this impacts not only maternal well-being, but also fetal development. In 2018, Hurricane Florence caused extensive damage across the eastern United States. Studies indicated that compared to married pregnant women, unmarried pregnant women had higher risk of distress. Here we assess hair cortisol among a subsample of participants, and variations based on marital status. METHODS: We analyzed multiple stress measures among 37 participants who were pregnant during Hurricane Florence. We used questionnaires modeled on previous studies to assess hardship associated with the hurricane, psychological distress, sociodemographic characteristics, social support, and food security. We analyzed cortisol concentrations in proximal and distal hair sections, representing stress around the time of the disaster (distal) and 3-4 months following the disaster (proximal). We used linear regression to test relationships between hair cortisol and self-report stress measures, and variations based on marital status. RESULTS: Self-report measures of distress and hardship were similar among married and unmarried participants. Mean cortisol levels in distal and proximal sections were higher among unmarried participants. Controlling for confounding variables, hardship was not associated with hair cortisol. Distress predicted cortisol in distal sections (β = .482, p = .018), with a trend for proximal sections (β = .368, p = .055). Marital status was a significant predictor of distal (β = .388, p = .027) and proximal (β = .333, p = .047) hair cortisol, explaining 8.6%-11.7% of unique variance. CONCLUSIONS: Preexisting and intersecting risk factors likely place unmarried pregnant individuals at risk of stress during and following a disaster.

Maternal stress and social support during Hurricane Florence

In theoretical research on disaster vulnerability, access to resources is critical for optimal outcomes. Studying the impact of a hurricane on maternal stress can expand theories of disaster vulnerability. This is a cross-sectional mixed-methods prospective study of maternal stress during Hurricane Florence in the United States. Results from chi-squares compared the proportion of respondents who reported having support for a financial emergency were significant, specifically that higher income respondents indicated the ability to rely on someone in case of an emergency. A regression analysis indicated that social support was significant and negatively related to stress as a dependent variable, while evacuation status and pregnancy status were not significant predictors of stress. Five themes emerged from the overall qualitative data: concerns about infant feeding, evacuation logistics, general stress, family roles, and ‘other’ issues.

Post-traumatic stress symptomatology and displacement among Hurricane Harvey survivors

Exposure to natural disasters predisposes individuals to significant physical and mental health consequences. Research identifies a number of stressors important to determining what might exacerbate this exposure risk, as well as what types of social/psychological resources might help mitigate these negative outcomes. Using a targeted quota sample of adults (n = 316) interviewed two months after Hurricane Harvey made landfall on the Gulf Coast of Texas in August 2017, the present study examines the intersection of vulnerabilities, stressors, and resources and their relationship with post-traumatic stress symptomatology. Stress is high among this sampled group with over one-quarter of respondents reporting high enough symptoms to meet the clinical caseness criteria for PTSD. Results show significant variation across categorical groupings of post-traumatic stress symptoms; younger persons, nonwhites, and those displaced from their home during the storm were more likely to be found in the highest symptom count category. Regression results confirm the bivariate results and as hypothesized, stressors were associated with higher symptom reporting among respondents, and social and psychological resources were associated with lower symptom reporting. With one of the only studies to report these relationships between vulnerability, stressors, and resources in the post-disaster Harvey setting, our work underscores the importance of identifying who is at risk, what factors can potentially mitigate that risk, and just how severe the consequences can be for survivors requiring mental health services after a disaster. Clearly, more work is needed, particularly on the identification of resources acting as protection against the overwhelming circumstances of exposure to devastation and destruction caused by natural disasters.

Tropical cyclone exposures and risks of emergency medicare hospital admission for cardiorespiratory diseases in 175 urban United States counties, 1999-2010

BACKGROUND: Although injuries experienced during hurricanes and other tropical cyclones have been relatively well-characterized through traditional surveillance, less is known about tropical cyclones’ impacts on noninjury morbidity, which can be triggered through pathways that include psychosocial stress or interruption in medical treatment. METHODS: We investigated daily emergency Medicare hospitalizations (1999-2010) in 180 US counties, drawing on an existing cohort of high-population counties. We classified counties as exposed to tropical cyclones when storm-associated peak sustained winds were ≥21 m/s at the county center; secondary analyses considered other wind thresholds and hazards. We matched storm-exposed days to unexposed days by county and seasonality. We estimated change in tropical cyclone-associated hospitalizations over a storm period from 2 days before to 7 days after the storm’s closest approach, compared to unexposed days, using generalized linear mixed-effect models. RESULTS: For 1999-2010, 175 study counties had at least one tropical cyclone exposure. Cardiovascular hospitalizations decreased on the storm day, then increased following the storm, while respiratory hospitalizations were elevated throughout the storm period. Over the 10-day storm period, cardiovascular hospitalizations increased 3% (95% confidence interval = 2%, 5%) and respiratory hospitalizations increased 16% (95% confidence interval = 13%, 20%) compared to matched unexposed periods. Relative risks varied across tropical cyclone exposures, with strongest association for the most restrictive wind-based exposure metric. CONCLUSIONS: In this study, tropical cyclone exposures were associated with a short-term increase in cardiorespiratory hospitalization risk among the elderly, based on a multi-year/multi-site investigation of US Medicare beneficiaries ≥65 years.

Climate change is impacting mental health in North America: A systematic scoping review of the hazards, exposures, vulnerabilities, risks and responses

As climate change progresses, it is crucial that researchers and policymakers understand the ways in which climate-mental health risks arise through interactions between climate hazards, human exposure and social vulnerabilities across time and location. This scoping review systematically examined the nature, range and extent of published research in North America that investigates climate-mental health interactions. Five electronic databases were searched and two independent reviewers applied pre-determined criteria to assess the eligibility of articles identified in the search. Eighty-nine articles were determined to be relevant and underwent data extraction and analysis. The published literature reported on numerous exposure pathways through which acute and chronic climate hazards interacted with social vulnerabilities to increase mental health risks, including wellbeing, trauma, anxiety, depression, suicide and substance use. This review also highlights important gaps within the North American climate-mental health evidence base, including minimal research conducted in Mexico, as well as a lack of studies investigating climate-mental health adaptation strategies and projected future mental health risks. Further research should support effective preparation for and adaptation to the current and future mental health impacts of climate change. Such strategies could reduce health risks and the long-term mental health impacts that individuals and communities experience in a changing climate.

Health care access and health indicators in Puerto Rico pre- and post- Hurricane Maria: Behavioral risk factor surveillance system (2015-2019)

Hurricane Maria is regarded as one of the worst natural disasters in United States history as it devasted Puerto Rico (PR) in September 2017. This study compared population-based key health indicators among PR residents pre-and post-Hurricane Maria. We examined Behavioral Risk Factor Surveillance System (BRFSS) PR data from five survey years, including pre-and post-Hurricane Maria: 2015 (N = 4556), 2016 (N = 5765), 2017 (N = 4462), 2018 (N = 4814), and 2019 (N = 4958). The sample consisted of non-institutionalized adults aged ≥ 18 years with access to a landline or a cellular telephone. Using logistic regression we compared health care utilization, health behaviors, and outcomes pre-and post-Hurricane Maria. Models adjusted for age, sex, race, education, employment, income, and marital status (2017 = referent). Compared to 2017, post-hurricane participants were more likely to have a college degree or higher, be currently employed, and not married/partnered. Post-hurricane, participants were less likely to have health insurance coverage (2018 AOR, 95% CI: 0.75, 0.58-0.97) and had lower rates of diabetes (2018 AOR: 0.82, 0.70-0.96). The odds of being overweight/obese were lower pre-hurricane compared to 2017 (2015 AOR, 95% CI: 0.88, 0.79-0.97). There was no statistically significant difference in health behaviors across survey years. Results may suggest that PR residents with lower socioeconomic status and/or chronic illness were more likely to emigrate, resulting in a compositional change in the population post-hurricane. This analysis highlights the need for long-term follow-up of PR residents to better determine the impact of Hurricane Maria, and adequately design public health programs to address healthcare needs, access, and outcomes.

Growing inequities in mental health crisis services offered to indigent patients in Puerto Rico versus the US states before and after hurricanes Maria and Irma

OBJECTIVE: To assess changes in the availability of mental health crisis services in Puerto Rico relative to US states before and after Hurricanes Maria and Irma. DATA SOURCES/STUDY SETTING: National Mental Health Services Surveys conducted in 2016 and 2020. STUDY DESIGN: Repeated cross-sectional design. The independent variable was mental health facility location in Puerto Rico or a US state. Dependent variables were the availability of three mental health crisis services (psychiatric emergency walk-in services, suicide prevention services, and crisis intervention team services). DATA COLLECTION/EXTRACTION METHODS: The proportion and per 100,000 population rate of facilities offering crisis services were calculated. PRINCIPAL FINDINGS: The availability of crisis services at mental health facilities in Puerto Rico remained stable between 2016 and 2020. These services were offered less at indigent care facilities in Puerto Rico than US states (e.g., 38.2% vs. 49.5% for suicide prevention, p = 0.06) and the magnitude of difference increased following Hurricane Maria. CONCLUSIONS: There are disparities between Puerto Rico and US states in the availability of mental health crisis services for indigent patients.

Assessing international students’ vulnerability to hurricanes: University of Florida case study

Disaster research concerning the behavior of international students at U.S. institutions of higher education is very limited. The main objective of our study is to develop new knowledge about international student’s behavior at U.S. institutions of higher education in relation to hurricanes in order to enhance the overall campus crisis management. A mix of quantitative and qualitative methods was used to collect data from University of Florida (UF) main campus in Gainesville, Florida; UF administrative leaders committed to international students’ safety in emergencies were interviewed. In addition, 120 international students at UF were surveyed. The data analysis sought to provide insights into one main research question: In a disaster-context, what challenges do international students face that contribute to their vulnerability at UF main campus? Three main groups of challenges were found; Institutional challenges, Students’ well-being and daily challenges, and Disaster preparedness challenges. Moreover, considerable variations in students’ behavior were found among some demographics, including gender, ethnicity, housing, degree level, and previous hurricane experience. The research findings shed a light on a research area that has been under-investigated, and contribute to an increased understanding of international students’ vulnerabilities at U.S. institutions of higher education.

Assessing the feasibility and effectiveness of a linkage into mental health care program for adults affected by Hurricane Sandy

OBJECTIVE: Research indicates that greater exposure to Hurricane Sandy is associated with increased mental health difficulties. This study examined whether Project Restoration, a program that linked adults into mental health care (L2C), was effective in reducing post-Sandy mental health difficulties as compared to a cohort of adults matched on mental health difficulties that were not linked into post-Sandy mental health care. METHODS: Project Restoration participants (n = 52) with elevated self-reported mental health difficulties had the option to enroll into L2C. Project LIGHT (n = 63) used similar methodologies but did not have a L2C component and served as the matched control group. RESULTS: Multivariable modeling showed significant decreases in all mental health difficulties except for depression in the Project Restoration group, whereas there were no significant decreases in LIGHT. The decrease in anxiety from baseline to follow-up was significantly greater for Project Restoration as compared to LIGHT. CONCLUSION: Findings confirm the powerful impact community outreach and treatment have on reducing mental health difficulties after a disaster.

Mental health effects of Hurricane Sandy on older adults

OBJECTIVES: To examine whether hurricane exposure, lack of access to medical care (LAMC), and displacement during Hurricane Sandy were associated with PTSD and other mental health (MH) symptoms among older adult New York residents. METHODS: Participants (N = 411) were ≥60 years old at the time of survey data collection (1-4 years post-Sandy). Outcomes included PTSD, depression, and anxiety symptoms and stress. Hurricane exposure, displacement, and LAMC were primary predictors. RESULTS: Older adults with greater hurricane exposure had increased PTSD, anxiety, and stress symptoms. LAMC had a strong association (ORadj = 4.11) with PTSD symptoms but was not associated with other MH symptoms. Displacement was not associated with MH outcomes. DISCUSSION: This is the first study to examine exposure, displacement, and LAMC together and to examine their varying impacts on different MH outcomes among older adults post-hurricane. Findings support the importance of disaster preparedness interventions tailored to the MH needs of community-dwelling older adults.

Associations of hurricane exposure and forecasting with impaired birth outcomes

Early forecasts give people in a storm’s path time to prepare. Less is known about the cost to society when forecasts are incorrect. In this observational study, we examine over 700,000 births in the path of Hurricane Irene and find exposure was associated with impaired birth outcomes. Additional warning time was associated with decreased preterm birth rates for women who experienced intense storm exposures documenting a benefit of avoiding a type II forecasting error. A larger share of this at-risk population experienced a type I forecasting error where severe physical storm impacts were anticipated but not experienced. Disaster anticipation disrupted healthcare services by delaying and canceling prenatal care, which may contribute to storm-impacted birth outcomes. Recognizing storm damages depend on human responses to predicted storm paths is critical to supporting the next generation’s developmental potential with judicious forecasts that ensure public warning systems mitigate rather than exacerbate climate damages.

Experiences of pregnant women exposed to Hurricanes Irma and Maria in the US Virgin Islands: A qualitative study

INTRODUCTION: Hurricanes Irma and Maria made landfall in the US Virgin Islands (USVI) in 2017. To date, there is no published literature available on the experiences of pregnant women in the USVI exposed to these hurricanes. Understanding how hurricanes affect pregnant women is key to developing and executing targeted hurricane preparedness and response policies. The purpose of this study was to explore the experiences of pregnancy and birth among women in the USVI exposed to Hurricanes Irma and Maria. METHODS: We employed a qualitative descriptive methodology to guide sampling, data collection, and analysis. Semi-structured interviews of 30-60 min in length were conducted with a purposive sample of women (N = 18) in the USVI who were pregnant during or became pregnant within two months after the hurricanes. Interviews were transcribed verbatim and data managed in MAXQDA. Team members developed a codebook, applied codes for content, and reconciled discrepancies. We thematically categorized text according to a socioecological conceptual framework of risk and resilience for maternal-neonatal health following hurricane exposure. RESULTS: Women’s experiences were organized into two main categories (risk and resilience). We identified the following themes related to risk at 3 socioecological levels including: (1) individual: changes in food access (We had to go without) and stress (I was supposed to be relaxing); (2) household/community: diminished psychosocial support (Everyone was dealing with their own things) and the presence of physical/environmental hazards (I was really scared); and (3) maternity system: compromised care capacity (The hospital was condemned). The themes related to resilience included: (1) individual: personal coping strategies (Being calm); (2) household/community: mutual psychosocial and tangible support (We shared our resources); and (3) the maternity system: continuity of high-quality care (On top of their game). CONCLUSIONS: A socioecological approach provides a useful framework to understand how risk and resilience influence the experience of maternal hurricane exposure. As the frequency of the most intense hurricanes is expected to increase, clinicians, governments, and health systems should work collaboratively to implement hurricane preparedness and response plans that address pregnant women’s unique needs and promote optimal maternal-infant health.

A mixed-methods study after multiple disasters: September 11, 2001, world trade center terrorist attacks and Hurricane Sandy

OBJECTIVE: The aim of this study was to use a mixed-method analysis to investigate the associations between qualitative themes found in written responses and quantitative reported level of stress after Hurricane Sandy. METHODS: A survey was conducted among World Trade Center Health Registry enrollees 5-12 mo after Hurricane Sandy. This study included 1202 participants who completed the free-response section and answered the question on how stressful their experiences were with Hurricane Sandy and its aftermath. Content analysis was used to generate qualitative data. Mixed-methods analysis was performed using a 1-way analysis of variance test for bivariate comparisons of qualitative thematic codes and the quantitative outcome of mean Sandy stress scores. RESULTS: Seven themes emerged from the qualitative analysis. The themes of lack of information, negative emotional response, and financial stress had higher quantitative mean Sandy stress scores compared with other themes. The theme of patriotism/gratitude had an overall lower quantitative Sandy stress scores than other themes. CONCLUSIONS: Qualitative and mixed-methods research on mental health outcomes after a disaster add new depth and findings to the existing literature. Using such methodologies to identify modifiable factors, such as improving communication during a disaster, may confer better mental health outcomes after a disaster.

After Hurricane Maria: Effects of disaster trauma on Puerto Rican survivors on the U.S. Mainland

PURPOSE: In September 2017, Hurricane Maria devastated Puerto Rico. Houses were destroyed, millions of people lost power and access to clean water, and many roads were flooded and blocked. In the years following the storm, hundreds of thousands of people have left Puerto Rico and settled on the U.S. mainland. The purpose of this study is to examine the impact of disaster trauma among Puerto Rican adults who moved to the U.S. mainland after Hurricane Maria. METHOD: Participants were 319 adult Puerto Rican Hurricane Maria survivors on the U.S. mainland. Women comprised 71.2% of the sample. Data were collected between August 2020 and October 2021. Participants completed Spanish-language measures of hurricane-related trauma, perceived ethnic discrimination and negative context of reception on the U.S. mainland, language stress, depressive symptoms, anxiety, optimism, life satisfaction, and problem drinking. RESULTS: We estimated a structural equation model where hurricane trauma predicted cultural stress, which in turn predicted internalizing symptoms, optimism, and life satisfaction. Internalizing symptoms, optimism, and life satisfaction were specified as predictors of problem drinking. Results indicated that hurricane trauma predicted cultural stress. Cultural stress predicted internalizing symptoms, optimism, and life satisfaction. Internalizing symptoms predicted problem drinking. Hurricane trauma indirectly predicted internalizing symptoms through cultural stress and indirectly predicted problem drinking through cultural stress and internalizing symptoms. CONCLUSIONS: Traumatic experiences from the storm may predispose Puerto Rican Hurricane Maria survivors to perceive cultural stress on the U.S. mainland. In turn, cultural stressors may be associated with internalizing symptoms and alcohol problems. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Analyzing the long-term impact of post-disaster relocation and implications for disaster recovery policy

Formulating disaster responses that mitigate social inequalities is crucial because disasters disproportionately harm marginalized communities. This study seeks to inform more equitable post-disaster policies by examining how post-disaster residential outcomes relate to subsequent income and health outcomes among a sample of Hurricane Katrina survivors. Analyzing pre-hurricane survey data, three waves of survey data over 12-15 years post-disaster for 385 low-income women, as well as qualitative data from a subset of participants, we show that durable residence in counties previously shown to promote greater intergenerational socioeconomic advancement predicts higher income, but not better mental or self-rated health. Statistical control for prospectively collected, pre-disaster confounders, coupled with qualitative insights, suggest causal relationships between county-level opportunity and income. We further find that persis-tence in high opportunity counties was driven by family obligations, relationship changes, or access to job opportunities, not differences in individual priorities. Disaster policy should better support displaced survivors’ ability to access high opportunity areas.

Assessing short-term and long-term mental health effects among older adults after Hurricane Sandy

BACKGROUND: Few studies have evaluated the long-term effects of disasters on older adults. We examined if older individuals experienced increased mental health (MH) effects immediately and long-term after Hurricane Sandy and if these effects varied by socioeconomic status (SES), disease subtypes, number of comorbidities, and length of stay. METHODS: We identified older patients (≥64 years) with hospital admissions and Emergency Department (ED) visits (2001-2015) with primary diagnosis of MH diseases using the New York State discharged data. We quantified both short-term (immediately post-Sandy) and long-term effects (3-month, 1-year, 2-year, and 3-year) following Hurricane Sandy, and used the pre-Sandy period in the affected counties as the control period. Poisson regression was used to compare daily counts of MH cases overall and by multiple strata pre-/post Sandy. FINDINGS: Older individuals had significantly increased risk of MH ED visits immediately (32%), and 3-months, 1, 2, and 3-years after Sandy (2%, 9%, 15%, and 10%, respectively). MH hospital admissions did not increase immediately, but significantly increased by 8% a year later. Males and those with low SES had delayed, but increased risks of MH 1-3 years after Sandy (RRs range: 1.14-1.71). The top MH subtypes after Sandy were psychosis, mood disorders, substance abuse, suicide, and anxiety (RRs range: 1.12-2.62). After Sandy, patients with ≥8 comorbidities increased from 15% to >25%, along with their length of hospital stay. CONCLUSION: We found long-term adverse effects of MH after Sandy, especially among vulnerable populations, which may help plan future disaster preparedness and recovery efforts.

Association between adverse experiences during Hurricane María and mental and emotional distress among adults in Puerto Rico

OBJECTIVES: To evaluate the association between adverse experiences during Hurricane María and mental and emotional distress in Puerto Rico. METHODS: This cross-sectional study used baseline data from adult (30-75 years) participants of the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT). Enrolled individuals prior to COVID-19 who completed a 33-item questionnaire on Hurricane María-related experiences (sub-categorized as personal, service, or property losses), depression symptomatology, post-traumatic stress disorder (PTSD), and anxiety were included for analysis (n = 456). RESULTS: Most participants experienced fear for their family’s safety, damage to their home and personal items, communication outages, and water shortages. Each additional stressor was significantly associated with higher odds of depression symptoms, PTSD, and anxiety. Personal losses were significantly associated with higher likelihood of all outcomes, while services losses were associated with depression symptoms and anxiety; property loss was not significantly associated with any outcome. CONCLUSIONS: Adverse experiences during a major natural disaster are associated with mental and emotional distress. Strategies to minimize hardships during natural disasters, especially personal and service losses, are essential to preserve mental health. Post-disaster psychological support to individuals is crucial.

Burnout and self-perceived stress in workers in essential services after the impact of Hurricanes Irma and Maria

OBJECTIVE: To examine the levels of burnout and self-perceived stress in workers at the Puerto Rico Electric Power Authority, who experienced major disasters: Hurricanes Irma and Maria. METHODS: A quantitative descriptive cross-sectional study with a non-probabilistic convenience sample was conducted in workers at the Puerto Rico Electric Power Authority. A structured questionnaire was administered to a sample of 163 eligible participants, aged 21 years and older, who participated voluntarily. Using employees of the electric company, the study examined the relationships between burnout and several characteristics (years of employment, existing health conditions, and coping strategies) both before and after Hurricanes Irma and Maria. Burnout was assessed with Gil-Monte’s Spanish Burnout Inventory, and self-perceived stress was assessed with the 14-item Perceived Stress Scale. RESULTS: Before the hurricanes, 16.6% of the workers reported high levels of burnout syndrome, while, after the hurricanes, the proportion increased to one-fifth (20.9%). Prior to the 2 hurricanes, more than one-fourth (23.4%) of the sample reported being extremely stressed; after the hurricanes, that proportion increased to 55%. Factors such as years of employment, counseling, and self-perceived stress showed significant statistical associations (P < .05) with burnout. CONCLUSION: From a public health standpoint, priority should be given to this population, thereby preventing burnout and any other negative effects of the aftermath (i.e., the lengthy response, recovery, and reconstruction) of these kinds of major disaster.

Cascading disasters: The impact of Hurricane Maria and COVID-19 on post-disaster Puerto Rican migrants’ adaptation and integration in Florida

Based on data from 103 surveys of Puerto Rican migrants living in Florida and 54 in-depth interviews with a subgroup of them, we examine how Puerto Ricans who left the archipelago after Hurricane Maria have navigated settlement in their new homes. In this article, we observed and classified our participants’ descriptions of how they managed opportunities and challenges regarding education, employment, and social relations, the traditional benchmarks for the assessment of societal integration. We also observed how our participants described Covid-19’s interaction with these benchmarks. We found that our participants have experienced a series of cascading disasters since 2017-namely, Hurricane Maria, the earthquakes that affected Puerto Rico starting in late 2019, the humanitarian crises that followed both disasters, and now the global pandemic. These disasters, compounded with migration, have resulted in a process of adaptation to Florida in which social and labor-market integration and the ability to nurture social ties have been significantly diminished.

Exploring the impact of media use on wellbeing following a natural disaster

Media use can be beneficial in many ways, but little is known about how it might improve wellbeing outcomes following a traumatic natural disaster. Survivors (n = 491) of deadly Hurricane Michael, which struck the Florida (USA) coastline in 2018, completed an online survey, reporting indicators of post-traumatic growth (PTG) and stress (PTSS). A serial mediation model explored how hurricane-related stressors were related to both outcomes, as mediated by approach, avoidant, and support-seeking coping strategies and post-hurricane hedonic, eudaimonic, and self-transcendent media use as coping tools. Factors contributing to each type of post-hurricane media use were also explored. Results indicate that hurricane-related stressors were associated with PTG, serially mediated through approach coping strategies and self-transcendent media use, thus providing some of the first empirical evidence of the longer-term, beneficial wellbeing effects of media use on survivors of trauma. Additionally, hurricane-related stressors were associated with avoidant coping strategies, which were associated with increased eudaimonic media use. However, hedonic and eudaimonic media use were not associated with PTSS or PTG. Finally, factors known to be associated with media use were not predictive of post-hurricane media use, perhaps suggesting that media play a different role in survivors’ lives in the months following a traumatic event.

Home-based care and mental health during a disaster: A qualitative analysis

Disasters adversely affect individuals’ mental health; yet, research is scant on the mental health needs of frontline workers during and immediately after disasters. Our study explored this gap through the perspectives of home-based care providers (HBCP) who provided care during and after Hurricanes Irma and Harvey. In this qualitative study, five in-person focus groups were held between January and November 2019 with 25 HBCP drawn from home health care agencies in southern Florida and the Greater Houston Area. Four themes were identified using an abductive analytic approach: HBCPs’ disaster-related mental health needs; HBCP resilience in the context of disaster; psychological tensions associated with simultaneously caring for self, family, and patients; and supporting patients’ mental health needs during and after disaster. Our data suggest that HBCP may benefit from formal training and interventions to support their own mental health as well as that of their patients in the context of disasters.

Hurricane Florence and suicide mortality in North Carolina: A controlled interrupted time-series analysis

BACKGROUND: Natural disasters are associated with increased mental health disorders and suicidal ideation; however, associations with suicide deaths are not well understood. We explored how Hurricane Florence, which made landfall in September 2018, may have impacted suicide deaths in North Carolina (NC). METHODS: We used publicly available NC death records data to estimate associations between Hurricane Florence and monthly suicide death rates using a controlled, interrupted time series analysis. Hurricane exposure was determined by using county-level support designations from the Federal Emergency Management Agency. We examined effect modification by sex, age group, and race/ethnicity. RESULTS: 8363 suicide deaths occurred between January 2014 and December 2019. The overall suicide death rate in NC between 2014 and 2019 was 15.53 per 100 000 person-years (95% CI 15.20 to 15.87). Post-Hurricane, there was a small, immediate increase in the suicide death rate among exposed counties (0.89/100 000 PY; 95% CI -2.69 to 4.48). Comparing exposed and unexposed counties, there was no sustained post-Hurricane Florence change in suicide death rate trends (0.02/100 000 PY per month; 95% CI -0.33 to 0.38). Relative to 2018, NC experienced a statewide decline in suicides in 2019. An immediate increase in suicide deaths in Hurricane-affected counties versus Hurricane-unaffected counties was observed among women, people under age 65 and non-Hispanic black individuals, but there was no sustained change in the months after Hurricane Florence. CONCLUSIONS: Although results did not indicate a strong post-Hurricane Florence impact on suicide rates, subgroup analysis suggests differential impacts of Hurricane Florence on several groups, warranting future follow-up.

Individual response and recovery: A learning experience from Hurricane Maria

Situations faced in the advent of powerful hurricanes can be stressful for individuals due to the uncertainty they bring along. The consequences of these phenomena can leave individuals’ recovery in their own hands until order is re-established, and support can reach out to them. This work aims to develop a tool to guide individuals through their decision-making during a hurricane disaster and recovery, using the experience of Hurricane María. The tool is a classic inventory model adapted to monitor individual’s wellness through 48 hours after a hurricane arrival. This article presents the three stages followed in the development in this work: the assessment of individuals’ sentiments toward Hurricane María via an online questionnaire, the development of the mathematical model, and the creation of a prototype in the form of a mobile application. Each phase presents an important contribution: a summary of first-hand knowledge obtained from the reactions of individuals who survived Hurricane María, a novel modeling approach to the problem, and a convenient framework that synthesizes both previous components.

Long-term impact of Hurricane Sandy exposure on positive and negative affect: The role of perceived social support

OBJECTIVES: Natural disasters can have devastating, long-lasting effects on the mental health of older adults. However, few studies have examined associations among disaster exposure and positive and negative affect, and no longitudinal studies have investigated the extent to which predisaster perceived social support affects these associations. These analyses examine the associations among predisaster perceived social support, disaster exposure, and positive and negative affect experienced by community-dwelling older adults 4 years after Hurricane Sandy, controlling for predisaster affect. METHODS: Self-reported data collected before and after Hurricane Sandy from participants (aged 50-74 years) in the ORANJ BOWL panel (N = 2,442) were analyzed using linear regression models. RESULTS: Higher levels of peritraumatic stress experienced during Hurricane Sandy and greater hardship experienced after the storm were associated with more negative affect 4 years following the disaster. Higher perceived social support at baseline was related to more positive affect and less negative affect both before and after the hurricane. Social support did not moderate the effect of hurricane exposure on either positive or negative affect. DISCUSSION: Findings suggest that psychological effects may persist years after natural disasters and that more effective interventions may be needed during and after a disaster. While social support is critical to positive and negative affect in general, its buffering effects when disaster strikes may be limited.

Cumulative trauma from multiple natural disasters increases mental health burden on residents of Fort McMurray

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.

Mental health impacts of wildfire, flooding and COVID-19 on Fort McMurray school board staff and other employees: A comparative 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.

Unequal social vulnerability to Hurricane Sandy flood exposure

Disparities exist in post-disaster flooding exposure and vulnerable populations bear a disproportionate impact of this exposure. We describe the unequal burden of flooding in a cohort of New York residents following Hurricane Sandy and assess whether the likelihood of flooding was distributed equally according to socioeconomic demographics, and whether this likelihood differed when analyzing self-reported or FEMA flood exposure measures. Residents of New York City and Long Island completed a self-administered survey 1.5-4.0 years after the storm. Multivariable logistic regressions were performed to determine the relationship between sociodemographic characteristics and flood exposure. Participants (n = 1231) residing in areas of the lowest two quartiles of median household income experienced flooding the most often (FEMA/self-reported: <$40,298: 65.3%/42.0%, $40,298-$67,188: 43.3%/32.1%), and these areas contained the highest proportions of non-White participants (<$40,298: 39.1%, $40,298-$67,188: 36.6%) and those with ≤high school education (<$40,298: 35.5%, $40,298-$67,188: 33.6%). Both self-report (p < 0.05) and FEMA (p < 0.05) flood measures indicated that older participants were more likely to live in a household exposed to flooding, while those living in higher-income areas had decreased likelihood of flooding (p < 0.0001). Socioeconomic and age disparities were present in exposure to flooding during Hurricane Sandy. Future disaster preparedness responses must understand flooding from an environmental justice perspective to create effective strategies that minimize disproportionate exposure and its adverse outcomes.

Economic and mental health impacts of multiple adverse events: Hurricane Harvey, other flooding events, and the COVID-19 pandemic

OBJECTIVES: To assess the economic and mental health impacts of COVID-19 in the presence of previous exposure to flooding events. METHODS: Starting in April 2018, the Texas Flood Registry (TFR) invited residents to complete an online survey regarding their experiences with Hurricane Harvey and subsequent flooding events. Starting in April 2020, participants nationwide were invited to complete a brief online survey on their experiences during the pandemic. This study includes participants in the TFR (N = 20,754) and the COVID-19 Registry (N = 8568) through October 2020 (joint N = 2929). Logistic regression and generalized estimating equations were used to examine the relationship between exposure to flooding events and the economic and mental health impacts of COVID-19. RESULTS: Among COVID-19 registrants, 21% experienced moderate to severe anxiety during the pandemic, and 7% and 12% of households had difficulty paying rent and bills, respectively. Approximately 17% of Black and 15% of Hispanic households had difficulty paying rent, compared to 5% of non-Hispanic white households. The odds of COVID-19 income loss are 1.20 (1.02, 1.40) times higher for those who previously had storm-related home damage compared to those who did not and 3.84 (3.25-4.55) times higher for those who experienced Harvey income loss compared to those who did not. For registrants for whom Harvey was a severe impact event, the odds of having more severe anxiety during the pandemic are 5.14 (4.02, 6.58) times higher than among registrants for whom Harvey was a no meaningful impact event. CONCLUSIONS: Multiple crises can jointly and cumulatively shape health and wellbeing outcomes. This knowledge can help craft emergency preparation and intervention programs.

Birth outcomes, pregnancy complications, and postpartum mental health after the 2013 Calgary flood: A difference in difference analysis

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.

How do non-catastrophic natural disasters impact middle-aged-to-older persons? Using baseline Canadian longitudinal study on aging data to explore psychological outcomes associated with the 2013 Calgary Flood

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.

Evaluating community resilience and associated factors one year after the catastrophic Fort McMurray flood

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.

Evaluating the prevalence and correlates of major depressive disorder among residents of Fort McMurray, Canada, one year after a devastating flood

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.

Coastal cities in the southern US floodplains: An evaluation of environmental equity of flood hazards and social vulnerabilities

Few empirical studies have examined environmental equity (EE) within the context of flooding in the United States (US). This paper explores whether lower-income, minority, and vulnerable communities in cities are disproportionately impacted by flooding, as evidenced by Federal Emergency Management Agency (FEMA) designated flood zones. Tampa and Houston, both coastal cities in the US, were investigated to understand flood risk and related equity issues using Geographical Information System (GIS) and statistical analyses. Both approaches allowed us to extract and integrate information from flood hazard maps with census block group-level sociodemographic data. Dasymetric mapping (i.e., binary mapping approach) was performed to calculate population density. Both correlations and logistic regression were used to examine the relationships between sociodemographic characteristics of population and flood risk associated with FEMA flood zones. Our research findings do not suggest any racial and ethnic disparities; however, a measurable inequity is observed in exposure to flood risk across age groups, education level, and income status. Since these vulnerable groups are often unrecognized in hazard-related policy discourses (i.e., preparedness, response, and recovery), the ramifications of these research findings may have significant impacts on EE research relating to flood hazards and related policy formulations.

Older adults and social support in a disaster context: Did relocation matter for access to social network resources after the 2015 South Carolina flood?

OBJECTIVES: The aim of this study was to examine social network characteristics and social support (emotional and instrumental support) and to determine how those factors differed between relocating older adults and nonrelocating older adults who were affected by the 2015 flood in South Carolina. METHODS: Twenty-five community-dwelling elderly (CDE) were interviewed between December 2015 and May 2016 to learn about their experiences in the immediate aftermath of the flood. Ego-centric network data were collected with a focus on social network members and the types of flood-related support that these network members provided. RESULTS: Ten of 25 CDE relocated because of the flood. All CDE were more likely to receive social support from female network members and family members than from other acquaintances. Relocating CDE received significantly less emotional support in comparison to nonrelocating CDE. The odds of receiving instrumental support were higher, but nonsignificant, among relocating CDE in comparison to nonrelocating CDE. CONCLUSIONS: The findings around the support provision are concerning particularly because of the additional psychological burden that relocation can place on flood-affected, older adults. Recommendations for public health preparedness strategies are provided in addition to future research directions for examining the well-being of flood-affected, older adults.

Disaster stressors and psychological well-being in older adults after a flood

We examined the inoculation and stress sensitization explanations concerning mental health outcomes in 223 predominately middle-aged and older adults after a flood (M age = 49.6 years, SD = 17.7 years, range: 18-88 years). In multiple linear regression models, having flood damage was associated with higher levels of posttraumatic stress disorder (PTSD) and depressive symptoms, while social support was associated with fewer symptoms. Greater lifetime trauma and flood-related stress were associated with more symptoms of depression and PTSD, respectively. Older age was associated with more religious coping and fewer depressive and worry symptoms. Future directions for research on postdisaster vulnerabilities and resilience are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The association between child and parent psychiatric disorders in families exposed to flood and/or dioxin

Associations of disaster mental health sequelae between children and their parents have been demonstrated, but not using full diagnostic assessment. This study examined children and their parents after a series of disasters in 1982 to investigate associations of their psychiatric outcomes. Members of 169 families exposed to floods and/or dioxin or no disaster were assessed in 1986-1987 with structured diagnostic interviews. This vintage dataset collected several decades ago provides new information to this field because of the methodological rigor that is unparalleled in this literature. Disaster-related PTSD and incident postdisaster disorders in children were associated, respectively with disaster-related PTSD and incident postdisaster disorders in the chief caregiver and mother. More flood-only than dioxin-only exposed parents reported great harm by the disaster, but neither children nor parents in these two groups differed in incident psychiatric disorders. Although this study did not determine the direction of causal influences, its findings suggest that clinicians working with disaster-exposed families should work with children and adult members together, as their mental health outcomes may be intertwined.

Intersectoral approaches: The key to mitigating psychosocial and health consequences of disasters and systemic risks

PurposeThe current pandemic and ongoing climate risks highlight the limited capacity of various systems, including health and social ones, to respond to population-scale and long-term threats. Practices to reduce the impacts on the health and well-being of populations must evolve from a reactive mode to preventive, proactive and concerted actions beginning at individual and community levels. Experiences and lessons learned from the pandemic will help to better prevent and reduce the psychosocial impacts of floods, or other hydroclimatic risks, in a climate change context.Design/methodology/approachThe present paper first describes the complexity and the challenges associated with climate change and systemic risks. It also presents some systemic frameworks of mental health determinants, and provides an overview of the different types of psychosocial impacts of disasters. Through various Quebec case studies and using lessons learned from past and recent flood-related events, recommendations are made on how to better integrate individual and community factors in disaster response.FindingsResults highlight the fact that people who have been affected by the events are significantly more likely to have mental health problems than those not exposed to flooding. They further demonstrate the adverse and long-term effects of floods on psychological health, notably stemming from indirect stressors at the community and institutional levels. Different strategies are proposed from individual-centered to systemic approaches, in putting forward the advantages from intersectoral and multirisk researches and interventions.Originality/valueThe establishment of an intersectoral flood network, namely the InterSectoral Flood Network of Quebec (RIISQ), is presented as an interesting avenue to foster interdisciplinary collaboration and a systemic view of flood risks. Intersectoral work is proving to be a major issue in the management of systemic risks, and should concern communities, health and mental health professionals, and the various levels of governance. As climate change is called upon to lead to more and more systemic risks, close collaboration between all the areas concerned with the management of the factors of vulnerability and exposure of populations will be necessary to respond effectively to damages and impacts (direct and indirect) linked to new meteorological and compound hazards. This means as well to better integrate the communication managers into the risk management team.

Holding together after disaster: The role of social skills in strengthening family cohesion and resilience

Objective: This study investigated how a flooding disaster impacted family cohesion and resilience. Background: Disasters present challenges for families, often threatening family cohesion. Although there is extensive research on the impacts of disasters on mental health at the individual level, less is known about how family units recover from disasters, and how parental relationship dynamics and parent-child dynamics influence family functioning during and after such traumatic events. Method: Qualitative face-to-face interviews were conducted 1 year after the 2013 southern Alberta flood with 105 parents of children ages 17 years and under. Results: Findings reveal that families who experienced more loss were not necessarily more negatively impacted overall. Some families reported the flood caused them to grow further apart, whereas for others it brought them closer together. Those who reported that the flood brought them closer together demonstrated the following three main social skills: (a) communication, (b) conflict resolution, and (c) coping. Findings also reveal that families have higher levels of cohesiveness and resilience post-disaster when they exhibit these important skills. Conclusion: This research concludes that coming together as a family unit created a supportive space for families to process and reduce the stress generated by the flood event. Families who demonstrate and practice communication, conflict resolution, and coping in the face of challenging events like disasters are more cohesive and resilient.

Long-term mental health effects of a devastating wildfire are amplified by sociodemographic and clinical antecedents in college students

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.

Psychological symptoms among evacuees from the 2016 Fort McMurray wildfires: A population-based survey one year later

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.

Exploring indigenous ways of coping after a wildfire disaster in northern Alberta, Canada

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.

Feasibility and preliminary efficacy of a public mobile app to reduce symptoms of postdisaster distress in adolescent wildfire survivors: Sonoma rises

Impact Statement In October of 2017, Sonoma County, California, experienced devastating and historic wildfires and subsequent community trauma. This manuscript details the development, dissemination, and evaluation of a public mobile mental health app for wildfire survivors. Lessons learned are offered to contribute to the science and practice of using digital tools to conduct disaster mental health outreach and research. In October 2017, Northern California experienced devastating and historic wildfires leaving the community in need of support to foster emotional resilience during the recovery process. Adolescents represent a particularly vulnerable population in the wake of disaster, and digital mental health interventions may hold promise for reaching teens at scale. The present study examined the feasibility and efficacy of a mobile mental health app for disaster, Sonoma Rises. A multiple-baseline single-case experimental design (SCED) utilizing a research-enabled version of the app was employed with seven adolescents who experienced significant damage to their homes and schools in the wildfires. Participants completed daily mood ratings, weekly measures of posttraumatic stress symptoms, internalizing and externalizing symptoms, psychosocial functioning, and then pre-post-measures of anxiety, depression, wellbeing, sleep, academic engagement, and perceived social support as well as quantitative and qualitative measures of intervention satisfaction and feasibility. Sonoma Rises was found to be feasible in terms of engagement, satisfaction, and likelihood of recommending to a friend. During the study, another wildfire occurred and all participants underwent a prolonged mandated evacuation and were subject to a series of extended power outages. Uptake of the publicly available version of the Sonoma Rises app among the general population was modest but engagement among users was sustained. Lessons learned are offered to contribute to the science and practice of building, disseminating, and implementing digital tools to conduct more equitable disaster mental health outreach and research.

Educational experiences of children and youth with disabilities impacted by wildfires

Purpose This paper describes the educational experiences of children and youth (aged 3-20) with disabilities during school closures resulting from the 2017 Northern California wildfires. Students with disabilities are particularly vulnerable to the adverse impacts of disaster, yet the effects of school closures on these children remains understudied. This study identifies considerations for students with disabilities and their families post-disaster. Design/methodology/approach An inductive, qualitative approach was used for the study design, methodology and analysis. In-depth interviews were conducted with parents of 14 students with disabilities about their experiences during and following school closures. All of these children had missed between a week and over a month of school as a result of the wildfires. Thematic analysis was used to code data and identify four themes present across the data. Findings Our findings indicate that children and youth with disabilities experienced disruptions in school-based services; lost previously acquired skills; exhibited negative health and behavioral issues; had difficulties adapting to new, unfamiliar routines and were saddened by lost social connections. Additionally, findings pinpoint the importance of social connections while schools were closed, the benefits of resuming school which included access to responsive school staff, as well as challenges faced by children with disabilities and their families once schools reopened. Originality/value Families of children with disabilities, as illustrated in this study, often must transverse a different post-disaster landscape. Schools should assist them in navigating that landscape so students with disabilities can experience a more equitable return to education post-disaster.

Rising from the ashes by expanding access to community care after disaster: An origin story of the wildfire mental health collaborative and preliminary findings

In October of 2017 and 2019, Sonoma County California endured historic wildfires and subsequent community trauma. The Sonoma Wildfire Mental Health Collaborative was created to (a) democratize access to evidence-based mental health resources and services for personal recovery and long-term community resilience building, and to (b) measure the reach and efficacy of the strategies employed in order to create a knowledge base to inform disaster response in other communities. Offerings included a mind-body yoga program and training in Skills for Psychological Recovery (SPR) for counselors who wished to provide services to individuals impacted by the wildfires. An evaluation of the mental health strategies employed revealed that (a) the mind-body program was well-received, with a high degree of satisfaction and self-reported benefit among individuals who attended trauma-informed yoga classes and (b) counselors found SPR to be a practical, flexible short-term intervention for individuals in the aftermath of the wildfires and expressed moderate to high levels of intent to use it in practice. Importantly, the evaluation of the 2017 wildfire mental health response was compromised by the Kincade Fire in 2019, in which prolonged mandatory evacuations and power outages impacted response rates. The origin story is shared for how a community collaborative was built. Lessons learned are discussed and recommendations summarized so as to contribute to the science and practice of disaster mental health outreach. Impact Statement In October of 2017 and 2019, Sonoma County, California experienced devastating and historic wildfires and subsequent community trauma. This manuscript describes the origin story of the Wildfire Mental Health Collaborative and preliminary findings from two mental health interventions employed with wildfire survivors (trauma-informed yoga, Skills for Psychological Recovery). Lessons learned and recommendations are offered to guide future work in the science and practice of disaster mental health.

Health and social impacts of California wildfires and the deficiencies in current recovery resources: An exploratory qualitative study of systems-level issues

Background Wildfires in California have become more deadly and destructive in recent years, and four of the ten most destructive fires occurred in 2017 and 2018. Through interviews with service providers, this article explores how these recent wildfires have impacted surrounding communities and the role various recovery resources have played in responding to the short- and long-term health and social needs of survivors. Methods Using a purposive sampling methodology, we interviewed 21 health and social service personnel who assisted in wildfire recovery efforts in California in 2017 and 2018. The study participants worked or volunteered in medical facilities, social services agencies and philanthropy/nonprofit organizations located in communities affected by wildfires. Participants were asked about three common, overarching themes that fire-impacted communities navigate post-disaster: health issues, social issues, and response and recovery resources. Inductive coding was used to identify common subthemes. Results The two most frequently discussed social issues during interviews were housing and employment access. Mental and emotional well-being and access to health resources were identified as being the most challenging health concerns that survivors face post-disaster. Participants also identified the following private and public recovery resources that survivors use to attempt to restabilize following the fire: community support, county agencies, the Federal Emergency Management Agency (FEMA,) insurance companies and philanthropic organizations. However, participants noted that the cumulative impacts of these efforts still leave many of their patients and clients without the resources needed to restabilize emotionally, financially and physically. Finally, participants spoke about the community-wide, downstream impacts of wildfires, noting that “survivors” are not only those whose health is immediately compromised by the disaster. Conclusion Given the worsening wildfire seasons in California, we must increase our understanding of both the scope of the health and social issues that survivors navigate following a disaster, as well as the effectiveness and sustainability of recovery resources available to survivors. We must also understand the “ripple effect” that wildfires have on surrounding communalities, impacting housing access, social services, and health care access. More research and support, especially during the current COVID-19 pandemic, is urgently needed to improve our ability to support the health and social needs of wildfire survivors in the future.

Identifying protective socio-ecological factors for college students in California’s deadliest wildfire

Objectives: This case study examined multi-level social-ecological supports in promoting well-being through college students impacted by one of the deadliest wildfires in U.S. history.Participants: College students attending a large public university were surveyed (N = 354, M(age =) 22.7, 76.2% female, 61% white).Methods: Measures included demographics, individual factors (mindfulness, sleep problems), social support (emotional support, family support, and friendship), and sense of community. Multiple linear regression models on well-being were constructed.Results: Findings indicated that mindfulness, sleep disturbances, emotional support, family support, number of close friends, and sense of community were significant predictors of well-being.Conclusion: Findings highlight the importance of universities in proactively bolstering critical social-ecological needs of college students living in communities vulnerable to climate-change accelerated environmental disasters.

Understanding the concurrent risk of mental health and dangerous wildfire events in the COVID-19 pandemic

Little research has examined the mental health risks of concurrent disasters. For example, disasters like wildfires have been shown to have a strong association with psychological symptoms-the 2020 U.S. Western wildfire season was the worst on record and occurred while the country was still navigating the COVID-19 pandemic. We implemented two quasi-experimental analyses, an interrupted time series analysis, and a difference-in-difference analysis to evaluate the impacts of wildfires and COVID-19 on mental health crisis help-seeking patterns. Both methods showed no statistical association between exposure to wildfires and the seeking of mental health support during the COVID-19 pandemic. Results highlighted that 2020 wildfires were not associated with an acute increase in crisis texts for youth in the two months after the events, likely due to an already elevated text volume in response to the COVID-19 pandemic from March 2020 throughout the fall wildfire season (Aug to Oct 2020). Future research is needed outside of the context of the pandemic to understand the effects of extreme and concurrent climatic events on adolescent mental health, and targeted interventions are required to ensure youth and adolescents are receiving adequate support during these types of crisis events.

Psychological effects of the 2017 California wildfires on children and youth with disabilities

The psychological effects of disasters on children with disabilities are understudied, despite evidence towards increased risk for complications after other types of trauma exposure. This study investigated the experience of children and youth with disabilities exposed to the 2017 Northern California wildfires, with a particular focus on psychological reactions. In-depth interviews were conducted with parents of 14 children and youth with disabilities one year post-disaster. Thematic analysis was used to analyze the interviews. Parents described the wildfires as traumatic events for both themselves and their children. Children and youth exhibited stress, grief, and other emotional and behavioral reactions during evacuation, in the immediate aftermath, and one year post-disaster. Navigating disability-related needs, such as accessible housing, contributed to parent stress post-disaster. School and community-based mental health efforts are described, along with a call for increased attention to disaster-related reactions in children with developmental disabilities. Suggestions for improving preparedness and response efforts that better support children with disabilities and their families post-disaster are given.

Collective stressors affect the psychosocial development of young adults

Young adulthood is a critical developmental life stage and a period of enhanced vulnerability to stress. In 2020, young adults in Northern California were faced with a series of unforeseen, collective stressors: the COVID-19 pandemic, extreme wildfires, social tension associated with the murder of George Floyd, and a contentious election that culminated in an attack on the nation’s capital. In a natural experiment, we compared the psychosocial development of 415 young adults across 8 monthly assessment waves during 2020 to a control cohort (n = 465) who completed the same assessment protocol in 2019, prior to the onset of stressors. Results of latent growth curve models indicated that the 2020 cohort had less adaptive trajectories of affective well-being and lower levels and less adaptive trajectories of social functioning, suggesting detrimental effects of cumulative, collective stressors on the socio-emotional development of young adults.

Gender differences in usage and subjective appreciation of an online cognitive behavioral therapy for wildfire evacuees: Descriptive study

BACKGROUND: Based on the most common psychological difficulties of the evacuees from the 2016 Fort McMurray wildfires in Alberta, Canada, a therapist-guided cognitive behavioral self-treatment was developed. This study aimed to explore how gender influences the usage and subjective appreciation of the RESILIENT online treatment. METHODS: Our study included 81 English-speaking evacuees with significant posttraumatic symptoms, or with some posttraumatic symptoms accompanied by at least mild depression symptoms or subclinical insomnia, and who logged into the platform at least once. Various usage and subjective appreciation variables were analyzed, including number of completed sessions, number of logins, number of words per session, perceived efforts, perception of usefulness and intention to continue using the different strategies. RESULTS: No difference was detected in most objective usage indicators. The number of words written in sessions 7 and 10 was significantly greater for women than for men. Regarding subjective appreciation, men had a greater perception of having put strong efforts in the cognitive restructuring strategy, while women reported in a greater proportion that they wanted to continue using physical exercise as a behavioral activation strategy. CONCLUSIONS: Our study offers a first look into how women and men use online treatments, and what their preferences are.

Identifying risk factors for hospitalization with behavioral health disorders and concurrent temperature-related illness in New York State

Extreme temperature events are linked to increased emergency department visits, hospitalizations, and mortality for individuals with behavioral health disorders (BHD). This study aims to characterize risk factors for concurrent temperature-related illness among BHD hospitalizations in New York State. Using data from the NYS Statewide and Planning Research and Cooperative System between 2005-2019, multivariate log binomial regression models were used in a population of BHD hospitalizations to estimate risk ratios (RR) for a concurrent heat-related (HRI) or cold-related illness (CRI). Dementia (RR 1.65; 95% CI:1.49, 1.83) and schizophrenia (RR 1.38; 95% CI:1.19, 1.60) were associated with an increased risk for HRI among BHD hospitalizations, while alcohol dependence (RR 2.10; 95% CI:1.99, 2.22), dementia (RR 1.52; 95% CI:1.44, 1.60), schizophrenia (RR 1.41; 95% CI:1.31, 1.52), and non-dependent drug/alcohol use (RR 1.20; 95% CI:1.15, 1.26) were associated with an increased risk of CRI among BHD hospitalizations. Risk factors for concurrent HRI among BHD hospitalizations include increasing age, male gender, non-Hispanic Black race, and medium hospital size. Risk factors for concurrent CRI among BHD hospitalizations include increasing age, male gender, non-Hispanic Black race, insurance payor, the presence of respiratory disease, and rural hospital location. This study adds to the literature by identifying dementia, schizophrenia, substance-use disorders, including alcohol dependence and non-dependent substance-use, and other sociodemographic factors as risk factors for a concurrent CRI in BHD hospitalizations.

Health systems responsiveness in addressing indigenous residents’ health and mental health needs following the 2016 Horse River Wildfire in northern Alberta, Canada: Perspectives from health service providers

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.

Nurturing spiritual resilience to promote post-disaster community recovery: The 2016 Alberta wildfire in Canada

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.

Five years after the Fort McMurray wildfire: Prevalence and correlates of low resilience

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.

Building community resilience to disasters: A review of interventions to improve and measure public health outcomes in the northeastern United States

Climate change-related natural disasters, including wildfires and extreme weather events, such as intense storms, floods, and heatwaves, are increasing in frequency and intensity. These events are already profoundly affecting human health in the United States and globally, challenging the ability of communities to prepare, respond, and recover. The purpose of this research was to examine the peer-reviewed literature on community resilience initiatives in one of the most densely populated and economically important regions, the Northeastern United States, and to identify evidence-based interventions and metrics that had been field-tested and evaluated. This paper addresses two critical gaps in the literature: (1) what strategies or interventions have been implemented to build or enhance community resilience against climate change-related natural disasters; and (2) what metrics were used to measure community resilience as an outcome of those strategies or interventions? This review provides a succinct list of effective interventions with specific health outcomes. Community or state-level health officials can use the results to prioritize public health interventions. This review used existing database search tools to discover 205 studies related to community resilience and health outcomes. Methods set criteria to assess if interventions were able to measure and change levels of community resilience to the health impacts associated with a changing climate. Criteria included: (a) alignment with the United States’ National Preparedness Goal for reducing risks to human health and for recovering quickly from disasters; (b) derived from publicly available data sources; (c) developed for use by communities at a local scale; and (d) accessible to modestly resourced municipalities and county health agencies. Five (5) peer-reviewed, evidence-based studies met all of the selection criteria. Three of these articles described intervention frameworks and two reported on the use of standardized tools. Health-related outcomes included mental health impacts (PTSD/depression), mental stress, emergency preparedness knowledge, social capital skills, and emergency planning skills. The paper recommends the COAST project, COPEWELL Rubric for self-assessment, and Ready CDC intervention as examples of strategies that could be adapted by any community engaged in building community resilience.

Association between ambient heat and risk of emergency department visits for mental health among us adults, 2010 to 2019

IMPORTANCE: The implications of extreme heat for physical health outcomes have been well documented. However, the association between elevated ambient temperature and specific mental health conditions remains poorly understood. OBJECTIVE: To investigate the association between ambient heat and mental health-related emergency department (ED) visits in the contiguous US among adults overall and among potentially sensitive subgroups. DESIGN, SETTING, AND PARTICIPANTS: This case-crossover study used medical claims data obtained from OptumLabs Data Warehouse (OLDW) to identify claims for ED visits with a primary or secondary discharge psychiatric diagnosis during warm-season months (May to September) from 2010 through 2019. Claims for adults aged 18 years or older with commercial or Medicare Advantage health insurance who were living in 2775 US counties were included in the analysis. Emergency department visits were excluded if the Clinical Classifications Software code indicated that the visits were for screening for mental health outcomes and impulse control disorders. EXPOSURES: County-specific daily maximum ambient temperature on a continuous scale was estimated using the Parameter-Elevation Relationships on Independent Slopes model. Extreme heat was defined as the 95th percentile of the county-specific warm-season temperature distribution. MAIN OUTCOMES AND MEASURES: The daily incidence rate of cause-specific mental health diagnoses and a composite end point of any mental health diagnosis were assessed by identifying ED visit claims using primary and secondary discharge diagnosis International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes. Conditional logistic regression models were used to estimate the incidence rate ratio (IRR) and 95% CIs for the association between daily temperature and incidence rates of ED visits. RESULTS: Data from 3 496 762 ED visits among 2 243 395 unique individuals were identified (56.8% [1 274 456] women; mean [SD] age, 51.0 [18.8] years); of these individuals, 14.3% were aged 18 to 26 years, 25.6% were aged 27 to 44 years, 33.3% were aged 45 to 64 years, and 26.8% were aged 65 years or older. Days of extreme heat were associated with an IRR of 1.08 (95% CI, 1.07-1.09) for ED visits for any mental health condition. Associations between extreme heat and ED visits were found for specific mental health conditions, including substance use disorders (IRR, 1.08; 95% CI, 1.07-1.10); anxiety, stress-related, and somatoform disorders (IRR, 1.07; 95% CI, 1.05-1.09); mood disorders (IRR, 1.07; 95% CI, 1.05-1.09); schizophrenia, schizotypal, and delusional disorders (IRR, 1.05; 95% CI, 1.03-1.07); self-harm (IRR, 1.06; 95% CI, 1.01-1.12); and childhood-onset behavioral disorders (IRR, 1.11; 95% CI, 1.05-1.18). In addition, associations were higher among men (IRR, 1.10; 95% CI, 1.08-1.12) and in the US Northeast (IRR, 1.10; 95% CI, 1.07-1.13), Midwest (IRR, 1.11; 95% CI, 1.09-1.13), and Northwest (IRR, 1.12; 95% CI, 1.03-1.21) regions. CONCLUSIONS AND RELEVANCE: In this case-crossover study of a large population of US adults with health insurance, days of extreme heat were associated with higher rates of mental health-related ED visits. This finding may be informative for clinicians providing mental health services during periods of extreme heat to prepare for increases in health service needs when times of extreme heat are anticipated.

Impacts of weather abnormalities on to mental health problems related suicidal behaviours: An economic approach

This study aims to estimate the impacts of climate variation on suicide rates in the USA by using county-level data on temperature, and mental health-related suicides between 2011 and 2020. In addition to climate factors, several socio-economic factors such as uninsured population rate, access to mental health providers, and unemployment rate are included to estimate their impacts on suicides. The estimation is separately performed for female, male and overall groups. The results indicate that while there is limited evidence of the impact of precipitation on suicidal behaviours, the average daily minimum air temperature is an important determinant of the suicides in the US counties.

The association between drought conditions and increased occupational psychosocial stress among U.S. farmers: An occupational cohort study

BACKGROUND: Drought represents a globally relevant natural disaster linked to adverse health. Evidence has shown agricultural communities to be particularly susceptible to drought, but there is a limited understanding of how drought may impact occupational stress in farmers. METHODS: We used repeated measures data collected in the Musculoskeletal Symptoms among Agricultural Workers Cohort study, including 498 Midwestern U.S. farmers surveyed with a Job Content Questionnaire (JCQ) at six-month intervals in 312 counties from 2012 through 2015. A longitudinal linear mixed effects model was used to estimate the change in job strain ratio, a continuous metric of occupational psychosocial stress, during drought conditions measured with a 12-month standardized precipitation index. We further evaluated associations between drought and psychological job demand and job decision latitude, the job strain components, and applied a stratified analysis to evaluate differences by participant sex, age, and geography. RESULTS: During the growing season, the job strain ratio increased by 0.031 (95% CI: 0.012, 0.05) during drought conditions, an amount equivalent to a one-half standard deviation change (Cohen’s D = 0.5), compared to non-drought conditions. The association between drought and the job strain ratio was driven mostly by increases in the psychological job demand (2.09; 95% CI: 0.94, 3.24). No risk differences were observed by sex, age group, or geographic region. CONCLUSIONS: Our results suggest a previously unidentified association between drought and increased occupational psychosocial stress among farmers. With North American climate anticipated to become hotter and drier, these findings could provide important health effects data for federal drought early warning systems and mitigation plans.

The examination of mental toughness, sleep, mood and injury rates in an Arctic ultra-marathon

There is scarcity of research examining the physiological and psychological effects of ultra-endurance racing on athletes in extreme conditions. The purpose of the current study was to identify common injury patterns and illness, profile mood states and sleep patterns and finally examine the relationships between mental toughness, sleep, mood and injury rates during a 120 mile, three-day Arctic ultra-marathon. Twelve participants (3 females, 9 males) with a mean age of 42 ± 5.35 yrs participated in the study. Mental toughness was measured using the MT18 questionnaire. Injuries were clinically assessed and recorded each day. Temperatures ranged from -20 to -6 degrees Celsius throughout the race. Sleep quantity and mood state were recorded using the BRUMS questionnaire. 10 out of the 12 participants experienced injuries; almost half of the participants had injuries that carried over a number of days. Mean sleep duration over the three days was 4.07 h, with an average of 0.78 injuries per day. Significant changes in mood were recorded across the three days, specifically a reduction in vigour (p = .029) and increase in fatigue (p = .014). Neither sleep quantity nor mental toughness was correlated with injury rate. Interestingly, sleep quantity was not related to changes in mood, as previously shown in ultra-marathons. Mental toughness had a moderate negative correlation (p < 0.01) with depression (-.623), reduced anger (-.616), confusion (-.558), increased vigour (.497) and tension (-.420) during the race. Success in this type of event involves significant psychological and physiological preparation to minimize the effects of sleep deprivation and avoidance of injuries.

A biophilic wellbeing framework for positive indoor-outdoor connections in energy-efficient arctic buildings

This paper develops a biophilic wellbeing framework for positive indoor-outdoor connections in Arctic buildings to respond to occupants’ wellbeing and energy-efficiency requirements. Extreme cold weather and drastic photoperiods of Arctic climates could have adverse impacts on wellbeing and reduce connections with nature, i. e., identified as biophilia. Characteristics of positive relationships with extreme Arctic climatic stressors have not yet been comprehensively studied in terms of integrated wellbeing needs and energy efficiency requirements. This paper aims to articulate a fundamental wellbeing framework integrating thermal and photobiological needs with biophilic recommendations to characterize positive connections with Arctic climates for energy-efficient buildings. A scoping literature review is conducted to discuss occupants’ thermal and photobiological needs in relation to biophilic recommendations and Arctic climatic conditions. As a case study, shortcomings of existing building practices in Cambridge Bay, Nunavut, Canada, are studied regarding wellbeing, indoor-outdoor con-nections, and energy-efficiency needs. The proposed wellbeing framework for positive indoor-outdoor connec-tions in Arctic buildings integrates (i) thermal and (ii) photobiological indicators based on biophilic recommendations. The integrated wellbeing framework enables characterizing thermal and (photobiological) lighting adaptation scenarios responding to Arctic weather, daylighting, and photoperiods as well as energy efficiency. Intermediate spaces are also proposed as a prosing architectural solution to address the integrated wellbeing framework energy efficiency in arctic buildings. Overall, the proposed framework could help archi-tects, building designers, and stakeholders to develop further architectural solutions for positive, energy-efficient indoor-outdoor connections for Arctic buildings and occupants.

Mental health and air temperature: Attributable risk analysis for schizophrenia hospital admissions in arid urban climates

Health researchers have examined the physiological impacts of extreme air temperature on the human body. Yet, the mental health impacts of temperature have been understudied. Research has shown that the environment can create circumstances that exacerbate mental health issues. This may be particularly challenging for some of the fastest growing cities, located in hot, dry climates. Given the theoretical relationship between air temperature and mental health, we seek to measure the association between temperature and schizophrenia hospital admissions in an arid urban climate and quantify the associated public health burden. We collected 86,672 hospitalization records for schizophrenia from 2006 to 2014 in Maricopa County, Arizona, USA. Using a distributed lag non-linear model (DLNM), we tested for a statistical association between temperature and schizophrenia hospital admissions after controlling for year, season, weekends, and holidays. We calculated the cumulative attributable risk of nighttime temperature on schizophrenia for the entire dataset as well as among demographic subgroups. The relative risk of schizophrenia hospital admissions increased with both high and low temperatures. Statistical models using daily minimum temperature were more strongly associated with hospitalization than those using mean or maximum. Schizophrenia hospital admissions increased on days with minimum temperatures above 30 °C and below 3 °C, with some subgroups experiencing higher rates of hospitalization. The total fraction of schizophrenia hospital admissions attributable to non-optimal minimum temperature is 3.45 % (CI: -4.91-10.80 %) and high minimum temperature is 0.28 % (CI: -1.18-1.78 %). We found that non-whites and males appear to be at a slightly increased risk than the general population, although there did not appear to be a statistically significant difference. A conservative estimate of healthcare costs annually from non-optimal temperature attributed schizophrenia hospitalization is $1.95 million USD. Therefore, nighttime cooling strategies and efforts could increase the accessibility of shelters to reduce overnight exposure to extreme air temperature.

Dry landscapes and parched economies: A review of how drought impacts nonagricultural socioeconomic sectors in the US Intermountain West

From hampering the ability of water utilities to fill their reservoirs to leaving forests parched and ready to burn, drought is a unique natural hazard that impacts many human and natural systems. A great deal of research and synthesis to date has been devoted to understanding how drought conditions harm agricultural operations, leaving other drought-vulnerable sectors relatively under-served. This review aims to fill in such gaps by synthesizing literature from a diverse array of scientific fields to detail how drought impacts nonagricultural sectors of the economy: public water supply, recreation and tourism, forest resources, and public health. We focus on the Intermountain West region of the United States, where the decadal scale recurrence of severe drought provides a basis for understanding the causal linkages between drought conditions and impacts. This article is categorized under: Human Water & Value of Water Science of Water & Water Extremes.

New life through disaster: A thematic analysis of women’s experiences of pregnancy and the 2016 Fort McMurray wildfire

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.

Health research priorities for wildland firefighters: A modified Delphi study with stakeholder interviews

OBJECTIVES: The increase in global wildland fire activity has accelerated the urgency to understand health risks associated with wildland fire suppression. The aim of this project was to identify occupational health research priorities for wildland firefighters and related personnel. DESIGN: In order to identify, rank and rate health research priorities, we followed a modified Delphi approach. Data collection involved a two-stage online survey followed by semi-structured interviews. SETTING: British Columbia, Canada. PARTICIPANTS: Participants included any current or past wildland firefighter or individuals engaged in related roles. There were 132 respondents to the first survey. Responses to the first survey were analysed to produce 10 research topics which were ranked by 75 participants in the second survey (response rate: 84%). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the identification, ranking and level of agreement of research priorities through a two-round online survey. We contextualised these findings through deductive and inductive qualitative content analysis of semi-structured interviews. RESULTS: The most important research priorities identified were (% consensus): effects of smoke inhalation on respiratory health (89%), fatigue and sleep (80%), mental health (78%), stress (76%) and long-term risk of disease (67%). Interviews were completed with 14 individuals. Two main themes were developed from an inductive content analysis of interview transcripts: (1) understanding the dynamic risk environment; and (2) organisational fit of mitigation strategies. CONCLUSIONS: Participants expressed a general concern with the unknown mental and physical health impacts of their jobs, including the long-term risk of morbidity and mortality. Future research must address knowledge gaps in our understanding of the health impacts of wildland fire and work to develop appropriate mitigation strategies while considering the needs of workers and unpredictable workplace environment. TRIAL REGISTRATION NUMBER: Open Science Framework, https://osf.io/ugz4s/.

Does a prolonged hardship reduce life span? Examining the longevity of young men who lived through the 1930s Great Plains drought

The Great Plains drought of 1931-1939 was a prolonged socio-ecological disaster with widespread impacts on society, economy, and health. While its immediate impacts are well documented, we know much less about the disaster’s effects on distal human outcomes. In particular, the event’s effects on later life mortality remain almost entirely unexplored. Closing this gap would contribute to our understanding of the long-term effects of place-based stress. To help fill this gap, I use a new, massive, linked mortality dataset to investigate whether young men’s exposure to drought and dust storms in 341 Great Plains counties was linked to a higher risk of death in early-old age. Contrary to expectations, results suggest exposure to drought conditions had no obvious adverse effect among men aged 65 years or older at time of death-rather, the average age at death was slightly higher than for comparable men without exposure. This effect also appears to have been stronger among Plainsmen who stayed in place until the drought ended. A discussion of potential explanations for these counterintuitive results is provided.

Disproportionate impacts of wildfires among elderly and low-income communities in California from 2000-2020

Wildfires can be detrimental to urban and rural communities, causing impacts in the form of psychological stress, direct physical injury, and smoke-related morbidity and mortality. This study examined the area burned by wildfires over the entire state of California from the years 2000 to 2020 in order to quantify and identify whether burned area and fire frequency differed across Census tracts according to socioeconomic indicators over time. Wildfire data were obtained from the California Fire and Resource Assessment Program (FRAP) and National Interagency Fire Center (NIFC), while demographic data were obtained from the American Community Survey. Results showed a doubling in the number of Census tracts that experienced major wildfires and a near doubling in the number of people residing in wildfire-impacted Census tracts, mostly due to an over 23,000 acre/year increase in the area burned by wildfires over the last two decades. Census tracts with a higher fire frequency and burned area had lower proportions of minority groups on average. However, when considering Native American populations, a greater proportion resided in highly impacted Census tracts. Such Census tracts also had higher proportions of older residents. In general, high-impact Census tracts tended to have higher proportions of low-income residents and lower proportions of high-income residents, as well as lower median household incomes and home values. These findings are important to policymakers and state agencies as it relates to environmental justice and the allocation of resources before, during, and after wildfires in the state of California.

Psychological factors and social processes influencing wildfire smoke protective behavior: Insights from a case study in Northern California

The health impacts of wildfire smoke are an important and growing global issue, as extreme wildfire events are expected to increase in frequency and intensity throughout this century due to climate change. Research into individual protective health decision-making can elucidate how wildfire smoke exposure contributes to adverse health outcomes and aid in public health interventions to mitigate risks. In this study we investigate the role of psychological factors (threat and efficacy perceptions) and social processes (social norms and social support) in shaping protective behavior in response to wildfire smoke. Through semi-structured interviews of forty-five individuals in Northern California, we explore perceptions of threat and efficacy, social processes, and protective behaviors in response to wildfire smoke events between 2018 and 2020. We found that for many participants sensory experiences and engagement with wildfire smoke information were instrumental in forming perceptions of threat and efficacy. Three themes related to social processes emerged: interpreting information together, protecting vulnerable others, and questioning protective actions. Through these themes we show how social norms and social support interact in complex, non-linear ways to influence threat and efficacy perceptions, and directly affect protective health behavior. Finally, we propose a conceptual framework of wildfire smoke protective behavior. This study contributes to a growing body of knowledge within the disaster risk and protective health literatures related to wildfire smoke response. Our findings demonstrate how the study of psychological factors and social processes during natural hazards, like wildfire smoke events, is essential to understanding individual protective health decision-making pathways and ultimately, to developing a more comprehensive view of how individual actions affect exposure.

Houston hurricane Harvey health (Houston-3H) study: Assessment of allergic symptoms and stress after hurricane Harvey flooding

BACKGROUND: In August 2017, Hurricane Harvey caused unprecedented flooding across the greater Houston area. Given the potential for widespread flood-related exposures, including mold and sewage, and the emotional and mental toll caused by the flooding, we sought to evaluate the short- and long-term impact of flood-related exposures on the health of Houstonians. Our objectives were to assess the association of flood-related exposures with allergic symptoms and stress among Houston-area residents at two time points: within approximately 30 days (T1) and 12 months (T2) after Hurricane Harvey’s landfall. METHODS: The Houston Hurricane Harvey Health (Houston-3H) Study enrolled a total of 347 unique participants from four sites across Harris County at two times: within approximately 1-month of Harvey (T1, n = 206) and approximately 12-months after Harvey (T2, n = 266), including 125 individuals who participated at both time points. Using a self-administered questionnaire, participants reported details on demographics, flood-related exposures, and health outcomes, including allergic symptoms and stress. RESULTS: The majority of participants reported hurricane-related flooding in their homes at T1 (79.1%) and T2 (87.2%) and experienced at least one allergic symptom after the hurricane (79.4% at T1 and 68.4% at T2). In general, flood-exposed individuals were at increased risk of upper respiratory tract allergic symptoms, reported at both the T1 and T2 time points, with exposures to dirty water and mold associated with increased risk of multiple allergic symptoms. The mean stress score of study participants at T1 was 8.0 ± 2.1 and at T2, 5.1 ± 3.2, on a 0-10 scale. Participants who experienced specific flood-related exposures reported higher stress scores when compared with their counterparts, especially 1 year after Harvey. Also, a supplementary paired-samples analysis showed that reports of wheezing, shortness of breath, and skin rash did not change between T1 and T2, though other conditions were less commonly reported at T2. CONCLUSION: These initial Houston-3H findings demonstrate that flooding experiences that occurred as a consequence of Hurricane Harvey had lasting impacts on the health of Houstonians up to 1 year after the hurricane.

Exposures and behavioural responses to wildfire smoke

Pollution from wildfires constitutes a growing source of poor air quality globally. To protect health, governments largely rely on citizens to limit their own wildfire smoke exposures, but the effectiveness of this strategy is hard to observe. Using data from private pollution sensors, cell phones, social media posts and internet search activity, we find that during large wildfire smoke events, individuals in wealthy locations increasingly search for information about air quality and health protection, stay at home more and are unhappier. Residents of lower-income neighbourhoods exhibit similar patterns in searches for air quality information but not for health protection, spend less time at home and have more muted sentiment responses. During smoke events, indoor particulate matter (PM(2.5)) concentrations often remain 3-4× above health-based guidelines and vary by 20× between neighbouring households. Our results suggest that policy reliance on self-protection to mitigate smoke health risks will have modest and unequal benefits.

Evacuating First Nations during wildfires in Canada

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.

Climate change-related knowledge and attitudes among a sample of the general population in Egypt

INTRODUCTION: Identifying the public awareness and risk perception regarding climate change, are fundamental preliminary steps in determining gaps and paving the way for awareness campaigns that address climate change causes and counteraction mitigation measures. However, few studies were conducted in Egypt; thus, the researchers conducted the current cross-sectional study among a sample of the Egyptian population to identify general knowledge and perception about climate change and its effects, as well as attitudes toward mitigation measures. METHODS: An exploratory population-based electronic-open survey, was conducted among 527 members of the general population between January and April 2022, using a convenience sampling technique. A pre-tested 2-page (screen) electronic included three sections: sociodemographic characteristics, global warming/climate change-related knowledge, and attitude toward climate change mitigation. RESULTS: The average global warming knowledge score was 12 ± 3. More than 70% (71.1%) of the participants were knowledgeable (percentage score >70%). Approximately half of the enrolled participants (48.2%) agreed that everyone is vulnerable to the effects of global warming/climate change. More than three-quarters (78.3%) of the participants agreed that carbon emissions from vehicles and industrial methane emissions were the first factors that contributed to climate change, followed by the ozone holes (731%). Global warming/climate change-related knowledge was statistically higher in participants aged of >30 years, married participants, urban residents, highly educated individuals, and employed individuals (p-value ≤ 0.05). Approximately 80% of the participants agreed that responding to the questionnaire drew their attention to the topic of climate change and its effects. More than two-thirds of those polled agreed that increasing public transportation use could help mitigate the effects of climate change/global warming, followed by the materials used and the direction of construction. CONCLUSION: More than two-thirds of the participants were knowledgeable regarding climate change. Social media and the internet were the main sources of information. However, participants need to get the information in a different way that could help in changing their attitude positively toward the issue of climate change mitigation. The current study recommends the need for various initiatives that work should be launched.

The socio-ecological system of the pre-Sahara zone of Morocco: A conceptual framework to analyse the impact of drought and desertification

Drought and desertification have a significant impact on socio-ecological systems throughout the world, particularly in arid and semi-arid regions. In this context, the impact of desertification and drought was analyzed in the pre-Sahara of Morocco. Additionally, a new conceptual framework combining various variables under the context of drought and desertification impacts was developed. The study area has an arid climate and socio-ecological system-based oases. To achieve the goal of the research, a questionnaire was conceived and distributed to a sample of young people (n = 290 on desertification phenomena and n = 290 on drought). A bibliometric analysis was conducted using VOSViewer software to highlight the structure of research and the Likert technique was used as a statistical method to analyze the results. The findings revealed that the respondents reported that drought has a high impact on desertification and sand silting. Otherwise, mental health is highly at risk and drought affects strongly the revenue, yield, and land use. In terms of solutions, the respondents recorded water safe as the appropriate option to adapt to drought in this area. However, in terms of desertification, interviewees thought that temperature and wind have a very high impact on desertification. Roads are the most impacted by sand silting and desertification followed by irrigation canals, and settlements. Concerning the solutions, tourism has a moderate impact on desertification. Young people thereby are aware of the climatic factors and the psycho-socio-economic impacts. They are also able to identify the appropriate solutions to desertification and drought.

Social work post-disaster response in Iran: A case study of the 2019 mass flooding in Poldokhtar, Lorestan

Flash-flooding affected Iran in March 2019 causing the displacement of thousands of people. Social workers established a Child Friendly Space (CFS) and applied comprehensive case management to provide psychosocial support for people who were affected by flooding (PWAF) (n = 565) in a community in Poldokhtar, covering a period of 3 months. Outreach services, involving community-volunteers, providing counseling, establishing CFS, training PWAF for reducing violence, and preventing child abuse were essential social work post-disaster interventions to support vulnerable populations. The article reflects upon the often-neglected role of social workers in post-disaster settings, and brings new material for discussion from the unexplored field of Iranian social workers.

Assessment of perceptions of climate change and its causes and impacts on mental health and psychosocial wellbeing among a group of internally displaced persons in Iraq

Extreme weather conditions across Iraq influence people’s psychosocial wellbeing, particularly the wellbeing of internally displaced persons (IDPs). This research examines the perceptions of climate change, as well as its causes and impacts on the everyday lives of IDPs in Iraq, and what needs to be done to mitigate these impacts. Following a literature review, this study presents a survey developed and carried out by the International Organisation for Migration (IOM) with IDPs in Ninewa and Duhok camp settings to assess interest in climate change, the impacts of climate change on the IDP population, the observed importance of addressing climate change and what actions can be taken to mitigate such impacts. Key research findings illustrate that most IDPs (80%) have observed climate change in their lives and have been affected directly by climate change (74%). Apart from detailing these findings, the study presents the solutions suggested by the IDPs to address climate change impacts. Based on these suggestions, this study then introduces policy-relevant recommendations to enhance the psychosocial wellbeing of the IDPs across Iraq and support government authorities, national policymakers and humanitarian actors in responding to the needs of the affected population associated with the consequences of climate change.

Eco-anxiety: A q method analysis towards eco-anxiety attitudes in the United Arab Emirates

Humans are witnessing extreme events such as droughts, floods, heat waves, wildfires, and emergence of novel diseases causing unprecedented changes to our planet. These rapid changes coupled with a transparent world that enjoys access to information mean that today’s population is more aware and attentive about the progress of climate change. The purpose of this study is to discover attitudes towards new gained consciousness and the term Eco-anxiety. The American Psychological Association (APA) defines eco-anxiety as a ‘chronic fear of environmental doom’. To investigate this phenomenon, we use Q-methodology to analyse discourses on the topic. Thirty-nine people from four different stakeholder groups were surveyed. Five distinct discourses were generated covering the connection between environmental awareness and psychological well-being, coming to terms with emotional response to climate change, importance of climate change, awareness about eco-anxiety leading to a more positive outlook, and disbelief that eco-anxiety and climate change can affect mental well-being.

Indigenous peoples’ perceptions of their food system in the context of climate change: A case study of Shawi men in the Peruvian Amazon

Biodiversity and ecosystem conservation in the Amazon play a critical role in climate-change mitigation. However, institutional responses have had conflicted and complex relations with Indigenous peoples. There is a growing need for meaningful engagement with-and recognition of-the centrality of Indigenous peoples’ perceptions and understanding of the changes they are experiencing to inform successful and effective place-based adaptation strategies. To fill this gap, this study focuses on the value-based perspectives and pragmatic decision-making of Shawi Indigenous men in the Peruvian Amazon. We are specifically interested in their perceptions of how their food system is changing, why it is changing, its consequences, and how/whether they are coping with and responding to this change. Our results highlight that Shawi men’s agency and conscious envisioning of their future food system intersect with the effects of government policy. Shawi men perceive that the main driver of their food-system changes, i.e., less forest food, is self-driven population growth, leading to emotions of guilt and shame. During our study, they articulated a conscious belief that future generations must transition from forest-based to agricultural foods, emphasising education as central to this transition. Additionally, results suggest that the Peruvian government is indirectly promoting Shawi population growth through policies linking population size to improved service delivery, particularly education. Despite intentional Shawi moves to transition to agriculture, this results in a loss of men’s cultural identity and has mental-health implications, creating new vulnerabilities due to increasing climatic extremes, such as flooding and higher temperatures.

Effects of environmental and socioeconomic inequalities on health outcomes: A multi-region time-series study

The gradual increase in temperatures and changes in relative humidity, added to the aging and socioeconomic conditions of the population, may represent problems for public health, given that future projections predict even more noticeable changes in the climate and the age pyramid, which require analyses at an appropriate spatial scale. To our knowledge, an analysis of the synergic effects of several climatic and socioeconomic conditions on hospital admissions and deaths by cardiorespiratory and mental disorders has not yet been performed in Brazil. Statistical analyses were performed using public time series (1996-2015) of daily health and meteorological data from 16 metropolitan regions (in a subtropical climate zone in South America). Health data were stratified into six groups according to gender and age ranges (40-59; 60-79; and ≥80 years old) for each region. For the regression analysis, two distributions (Poisson and binomial negative) were tested with and without zero adjustments for the complete series and percentiles. Finally, the relative risks were calculated, and the effects based on exposure-response curves were evaluated and compared among regions. The negative binomial distribution fit the data best. High temperatures and low relative humidity were the most relevant risk factors for hospitalizations for cardiovascular diseases (lag = 0), while minimum temperatures were important for respiratory diseases (lag = 2 or 3 days). Temperature extremes, both high and low, were the most important risk factors for mental illnesses at lag 0. Groups with people over 60 years old presented higher risks for cardiovascular and respiratory diseases, while this was observed for the adult group (40-59 years old) in relation to mental disorders. In general, no major differences were found in the results between men and women. However, regions with higher urbanization levels presented risks, mainly for respiratory diseases, while the same was observed for cardiovascular diseases for regions with lower levels of urbanization. The Municipal Human Development Index is an important factor for the occurrence of diseases and deaths for all regions, depending on the evaluated group, representing high risks for health outcomes (the value for hospitalization for cardiovascular diseases was 1.6713 for the female adult group in the metropolitan region Palmas, and the value for hospitalization for respiratory diseases was 1.7274 for the female adult group in the metropolitan region Campo Mourão). In general, less developed regions have less access to adequate health care and better living conditions.

Happiness in the tropics: Climate variables and subjective wellbeing

Changes in climatic patterns are expected to have significant effects on health and wellbeing. However, the literature on the effect of climate on subjective wellbeing remains scant and existing studies focus mostly on developed countries or cross-country analyses. This paper aims to identify the relationship between climate conditions on happiness after controlling for individual and social characteristics. Ecuador, a geographically fragmented country with varying climate conditions across municipalities, constitutes an ideal case study to assess the effect of climate variables on happiness. We employ a cross-section analysis to identify the effect of temperature, precipitation and humidity on happiness. The paper shows that climate conditions constitute an important determinant of people’s subjective wellbeing. The results also suggest that income and education attenuate the effect of temperature on happiness and that substantial differences are observed depending on whether places are hot/humid or cold/dry.

A comparative analysis of urban and rural household water insecurity experiences during the 2011-17 drought in Ceara, Brazil

This article compares urban and rural household water insecurity experiences during the last major drought period (2011-17) in the semi-arid interior region of Ceara, Brazil. Using data from a household survey (N = 322), we determined that households in small urban areas are more and differently water insecure than rural counterparts. Factor analysis and an ordinal logistic regression pinpoint key dimensions, such as water distress, water-sharing and intermittency, contribute differently to water insecurity in rural and urban households. Policy recommendations are made.

The March 2015 catastrophic flood event and its impacts in the city of Copiapo (southern Atacama Desert). An integrated analysis to mitigate future mudflow derived damages

The March 2015 extraordinary hydrometeomlogical event in the Andes cordillera caused severe floods in the southern Atacama Desert. One of the most affected cities was CopiapO (northern Chile) located downstream of the junction between the CopiapO river and its ephemeral tributary Quebrada Paipote. This work analyses the features of this catastrophic flood and relates them with the identified impacts. A large volume of water mixed with fine sediments overflowed the tributary channel generating a flood that affected 72% of the urban area. The rheological (velocity, density and flow regime) and sedimentary features of the flow reveal the occurrence of massive mudflows that infilled the space available inside the buildings, buried the streets with a sandy mud deposit of more than 30 cm medium thickness and collapsed the sewer network. The post-event survey carried out by the Ministry of Housing and Urban Planning (MINVU) was used for the development of fragility curves that allows modelling the probability of damage. Results indicate that the greatest probability of building damage is generated by the accumulation of sediments instead of by the flow depth. On the other hand, once the very fine grain sediments of the top of the deposit dried up, it increased the concentration of post-event suspension particulate matter, causing a health issue. This work highlights the need to understand mudflow processes and their consequences in arid environments to improve urban planning and mitigate future damages since their impacts strongly affect infrastructures and communities.

The psychology of climate anxiety

This paper focuses on climate anxiety and its role in the psychology of climate change, compared with responses to the COVID-19 global pandemic. Four psychological hypotheses for why we do not act on climate change will be reviewed, and the role of anxiety for each, as well as potential solutions. Different types of climate anxiety both inside and outside the clinic will be explored, along with associated defence mechanisms and treatment.

Climate depression. Critical analysis of the concept

The aim of this paper is to discuss the challenge posed to mental health by climate change. Our inquiry is based on literature review and original qualitative studies. The data are collected from both desk research and in-depth interviews with participants belonging to following groups: high school and university students, young parents, activists, and psychotherapy patients. This paper also offers the critical review of contemporary terminology used for mental health problems and emotions appearing in the context of climate change, as well as the history of scientific interest in the issue at hand. The term and phenomenon of climate depression acquires aspecial focus, based on qualitative studies participants’ self-reports and main arguments critical to medicalization of emotions experienced when facing the climate crisis. The additional analysis of socio-political and cultural aspects of climate change and mental health concludes in establishing the urgent need for further research in the area, so as to gain multidimensional understanding necessary for providing adequate mental health services. It is very likely that it will be increasingly needed in the future.

A network approach to climate change anxiety and its key related features

Research has pointed to startling worldwide rates of people reporting considerable anxiety vis-à-vis climate change. Yet, uncertainties remain regarding how climate anxiety’s cognitive-emotional features and daily life functional impairments interact with one another and with climate change experience, pro-environmental behaviors, and general worry. In this study, we apply network analyses to examine the associations among these variables in an international community sample (n = 874). We computed two network models, a graphical Gaussian model to explore network structure, potential communities, and influential nodes, and a directed acyclic graph to examine the probabilistic dependencies among the variables. Both network models pointed to the cognitive-emotional features of climate anxiety as a potential hub bridging general worry, the experience of climate change, pro-environmental behaviors, and the functional impairments associated with climate anxiety. Our findings offer data-driven clues for the field’s larger quest to establish the foundations of climate anxiety.

The effects of climate change on child and adolescent mental health: Clinical considerations

PURPOSE OF REVIEW: We review recent literature on the effects of climate change on child and adolescent mental health and discuss treatment and engagement by clinicians. RECENT FINDINGS: Climate change affects child and adolescent mental health in many intersecting ways, including as a social and ecological determinant of health, a threat amplifier, and a source of trauma and distress. Single extreme weather events contribute to significant negative mental health consequences; however, subacute and chronic climate events also have mental health sequelae. Furthermore, awareness of the climate crisis is associated with emotional distress. Young people with pre-existing mental illness and lacking social support may be at elevated risk for climate change-related mental health effects. Climate activism is associated with resilience and positive development, but may also be a source of increased stress, particularly for marginalized youths. Climate change can affect the mental health of children and adolescents in complex and diverse ways. Sources of coping and resilience also vary greatly between individuals. Mental health clinicians must respond to this existential crisis by addressing research gaps in this area, obtaining relevant clinical training, educating their communities, and joining and supporting young people in their advocacy efforts.

Microbiome-driven proline biogenesis in plants under stress: Perspectives for balanced diet to minimize depression disorders in humans

According to the World Health Organization (WHO), depression is a leading cause of disability worldwide and a major contributor to the overall global burden of mental disorders. An increasing number of studies have revealed that among 20 different amino acids, high proline consumption is a dietary factor with the strongest impact on depression in humans and animals, including insects. Recent studies acknowledged that gut microbiota play a key role in proline-related pathophysiology of depression. In addition, the multi-omics approach has alleged that a high level of metabolite proline is directly linked to depression severity, while variations in levels of circulating proline are dependent on microbiome composition. The gut-brain axis proline analysis is a gut microbiome model of studying depression, highlighting the critical importance of diet, but nothing is known about the role of the plant microbiome-food axis in determining proline concentration in the diet and thus about preventing excessive proline intake through food consumption. In this paper, we discuss the protocooperative potential of a holistic study approach combining the microbiota-gut-brain axis with the microbiota-plant-food-diet axis, as both are involved in proline biogenesis and metabolism and thus on in its effect on mood and cognitive function. In preharvest agriculture, the main scientific focus must be directed towards plant symbiotic endophytes, as scavengers of abiotic stresses in plants and modulators of high proline concentration in crops/legumes/vegetables under climate change. It is also implied that postharvest agriculture-including industrial food processing-may be critical in designing a proline-balanced diet, especially if corroborated with microbiome-based preharvest agriculture, within a circular agrifood system. The microbiome is suggested as a target for selecting beneficial plant endophytes in aiming for a balanced dietary proline content, as it is involved in the physiology and energy metabolism of eukaryotic plant/human/animal/insect hosts, i.e., in core aspects of this amino acid network, while opening new venues for an efficient treatment of depression that can be adapted to vast groups of consumers and patients. In that regard, the use of artificial intelligence (AI) and molecular biomarkers combined with rapid and non-destructive imaging technologies were also discussed in the scope of enhancing integrative science outcomes, agricultural efficiencies, and diagnostic medical precisions.

Climate change effects on mental health: Are there workplace implications?

BACKGROUND: Climate change can negatively affect mental health, and poor mental health can negatively affect work. However, less is known about the relationship between mental health and workplace behaviours within the climate change context. AIMS: To explore existing literature relating to climate-induced mental ill-health as a potential predictor of workplace behaviours. METHODS: Scoping review, searching five databases for relevant literature using two separate search strategies. RESULTS: Only five studies with any relevant data were found. Results could not be easily synthesized because each of the five considered different work-related outcomes. However, the available data suggest that the psychological impact of extreme events could lead to increased job tension, higher turnover intentions and workplace hostility. Stress about extreme weather could also impede the ability to make essential work-related decisions and, for those who work in the environmental sector, concerns about climate could lead to overcommitment to work. There was some evidence that social support might lessen the effects of climate-induced stress on work outcomes. CONCLUSIONS: Very little literature considers the impacts of climate change on employees’ mental health and associated workplace function. The available evidence suggests there are potential negative impacts which may be mitigated by social support. It is important for future research to explore ways of supporting staff and fostering resilience.

Psychological impairment and extreme weather event (EWE) exposure, 1980-2020: A global pooled analysis integrating mental health and well-being metrics

Extreme Weather Events (EWEs) impose a substantial health and socio-economic burden on exposed populations. Projected impacts on public health, based on increasing EWE frequencies since the 1950s, alongside evidence of human-mediated climatic change represents a growing concern. To date, the impacts of EWEs on mental health remain ambiguous, largely due to the inherent complexities in linking extreme weather phenomena with psychological status. This exploratory investigation provides a new empirical and global perspective on the psychological toll of EWEs by exclusively focusing on psychological morbidity among individuals exposed to such events. Morbidity data collated from a range of existing psychological and well-being measures have been integrated to develop a single (“holistic”) metric, namely, psychological impairment. Morbidity, and impairment, were subsequently pooled for key disorders-, specifically PTSD, anxiety and depression. A “composite” (any impairment) post-exposure pooled-prevalence rate of 23% was estimated, with values of 24% calculated for depression and ⁓17% for both PTSD and anxiety. Notably, calculated pooled odds ratios (pOR = 1.9) indicate a high likelihood of any negative psychological outcome (+90%) following EWE exposure. Pooled analyses of reported risk factors (p < 0.05) highlight the pronounced impacts of EWEs among individuals with higher levels of event exposure or experienced stressors (14.5%) and socio-demographic traits traditionally linked to vulnerable sub-populations, including female gender (10%), previous history (i.e., pre-event) of psychological impairment (5.5%), lower socio-economic status (5.5%), and a lower education level (5.2%). Inherent limitations associated with collating mental health data from populations exposed to EWEs, and key knowledge gaps in the field are highlighted. Study findings provide a robust evidence base for developing and implementing public health intervention strategies aimed at ameliorating the psychological impacts of extreme weather among exposed populations.

A scoping review of interventions for the treatment of eco-anxiety

As climate change worsens and public awareness of its grave impact increases, individuals are increasingly experiencing distressing mental health symptoms which are often grouped under the umbrella term of eco-anxiety. Clear guidance is needed to enable mental health professionals to make informed choices of appropriate interventions and approaches in their eco-anxiety treatment plans. A scoping review was conducted to examine the current understanding of eco-anxiety and related intervention options and recommendations. The review included 34 records, 13 of which reflected specific psychological approaches. A thematic analysis of the content of the selected records yielded five major themes across interventions for individual and group treatment of eco-anxiety: practitioners’ inner work and education, fostering clients’ inner resilience, encouraging clients to take action, helping clients find social connection and emotional support by joining groups, and connecting clients with nature. Recommendations for treatment plans are to focus on holistic, multi-pronged, and grief-informed approaches that include eco-anxiety focused group work.

A multiple needs framework for climate change anxiety interventions

Climate change anxiety is a growing problem for individual well-being the world over. However, psychological interventions to address climate change anxiety may have unintended effects on outcomes other than individual well-being, such as group cohesion and pro-environmental behavior. In order to address these complexities, we outline a multiple needs framework of climate change anxiety interventions, which can be used to analyze interventions in terms of their effects on individual, social, and environmental outcomes. We use this framework to contextualize a systematic review of the literature detailing the effects of climate change anxiety interventions. This analysis identifies interventions centered around problem-focused action, emotion management, and enhancing social connections as those which have beneficial effects on the widest range of outcomes. It also identifies interventions that may have detrimental effects on one or more outcomes. We identify gaps where more research is required, including research that assesses the effects of climate change anxiety interventions on individual, social, and environmental outcomes in concert. An interactive website summarizes these insights and presents the results of the systematic review in a way that is, accessible to a range of stakeholders. The multiple needs framework provides a way to conceptualize the effectiveness of climate change anxiety interventions beyond their impact on individual well-being, contributing to a more holistic understanding of the effects of this global phenomenon. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Effect of natural disaster-related prenatal maternal stress on child development and health: A meta-analytic review

The evidence supporting the idea that natural disaster-related prenatal maternal stress (PNMS) influences the child’s development has been accumulating for several years. We conducted a meta-analytical review to quantify this effect on different spheres of child development: birth outcomes, cognitive, motor, physical, socio-emotional, and behavioral development. We systematically searched the literature for articles on this topic (2756 articles retrieved and 37 articles included in the systematic review), extracted the relevant data to calculate the effect sizes, and then performed a meta-analysis for each category of outcomes (30 articles included across the meta-analyses) and meta-regressions to determine the effect of some factors of interest on the association between PNMS and child development: type of PNMS (objective, psychological, cognitive, diet), type of natural disaster (ice storm, flood/cyclone), type of report (maternal, third-party observer, medical), timing of exposure (preconception exposure included or not) and child age at assessment (under 10 or 10 years and older). We found that PNMS significantly influences all spheres of child development. Higher PNMS levels were associated with longer gestational age, larger newborns, and higher BMI and adiposity levels, as well as worse cognitive, motor, socio-emotional, and behavioral outcomes.

Psychological resilience for climate change transformation: Relational, differentiated and situated perspectives

Responding to climate change requires radical transformations in social, political, economic and social-ecological systems. Recent research has argued that individuals can drive transformations at scale through changes in beliefs and values that affect political activity. We draw from sociological and psychological perspectives on mental health outcomes among survivors of violence and abuse, taking a gendered approach, to show how potential for individual transformation is differentially constructed through personal life trajectories and intersectional social relations. We also argue that being resilient and transforming is stressful and involves significant personal costs. In integrating this psychological perspective, we suggest a more equitable way to define the individual’s role in, and their responsibility for, sustainable, societal-scale shifts for climate change.

Review: The impact of climate change awareness on children’s mental well-being and negative emotions – A scoping review

BACKGROUND: Climate change is a threat to children’s physical health, but there are also implications for mental well-being. Additionally, children may experience negative emotional responses stemming from an overarching awareness of the imminent threats to the planet due to climate change. METHOD: Using a scoping review, we examined the impact of climate change awareness on children’s mental well-being and negative emotions. Our aim was to identify and describe the existing literature and highlight priorities for future research. Three specific objectives guided the review: (1) to identify and provide an overview of research regarding the impact of climate change awareness on children’s mental well-being and negative emotions; (2) to summarize and clarify the terminology related to climate change awareness and children’s mental well-being and negative emotions; and (3) to make recommendations for areas of future research. RESULTS: Thirty-three articles were included in a narrative synthesis. Many articles were reviews or editorials/commentaries. Of the empirical research, most were from Europe, North America, and Australia. The articles emphasized a large range of negative emotions that children felt about climate change, with anxiety and worry being the most researched and discussed. CONCLUSIONS: The research on the impact of awareness of climate change on children’s mental well-being and negative emotions is in its early phases. Efforts are needed to advance conceptual clarity and operationalize concepts. Additionally, there is a need for research into the impact of climate change awareness on children’s mental well-being and negative emotions among a greater diversity of people and places. Existing studies provide an encouraging basis from which to develop future research.

Effects of the global ecological crisis on the mental health of children and adolescents: An international perspective

Climate change has become a global emergency, which mental health effects are increasingly being described and understood. Children and adolescents, especially those in low income countries and minority communities, are particularly vulnerable to experience the worst impacts of climate change now and in the coming decades. Our group of early career mental health clinicians and researchers in nine culturally and socioeconomic different countries across three continents initiated a global, online discussion about the effects of climate change on the mental health of children and adolescents, based on literature and our professional experience. We identified a paucity of research and psychiatric education on the topic, and a need to advance global and local efforts in this direction. We also identified three main domains of mental health impact of climate change: direct, indirect, and through physical conditions. Our work offers a preliminary, up-to-date overview of the consequences of climate change on the mental health of children and adolescents, and provides recommendations to advance policies, public health efforts, research, education, and clinical care in the emerging area of ‘Climate Psychiatry’.

Emotional pathways to climate change responses

The first trigger to any form of personal and collective change begins with emotions. They influence whether and how our attention is drawn to stimuli, how we reflect upon those stimuli, and how we choose courses of action. Emotions are thus at the center of social responses to climate change. We offer a selective, interdisciplinary review of emotions research to inform the development of a hypothetical emotion-cognition model of climate change response, followed by exploration of the emotional precedents supporting three prevailing behavioral responses which support inaction: apathy, denial, and withdrawal. We then review research that can inform emotion triggers to pro-climate adaptive and mitigative action. We conclude with a discussion of two key research needs: intersectionality and interdisciplinarity. Addressing these needs will enhance our ability to respond to the climate emergency. This article is categorized under: Perceptions, Behavior, and Communication of Climate Change.

Fear for the future: Eco-anxiety and health implications, a systematic review

Background: Although there is no standard definition for eco-anxiety, most authors define it as people’s emotional reaction of concern, worry, anxiety, and fear in view of global Climate Change (CC) threats and concurrent environmental degradation. This systematic review was carried out to critically evaluate the evidence on eco-anxiety related to CC and its health implications in general populations. Methods: We performed a search for scientific articles in PubMed, Scopus, Embase, Web of Science, and Cochrane Central. Studies were included if they complied with the study objective. Selection of articles and data extraction were carried out independently by 2 reviewers. We used the Axis tool and JBI critical appraisal checklist to assess the quality of the studies. Results: A final sample of 12 articles was included in this review. The methodological quality of the studies was limited. A wide variety of eco-anxiety definitions was used in the different studies but further research is needed to provide conceptual clarity of the term eco-anxiety. Eco-anxiety was associated with functional impairment, symptoms of depression, anxiety, PTSD, stress and insomnia, lower self-rated mental health, and reluctance to have children. Moreover, habitual worry about global warming was associated with a pro-ecological worldview, a green self-identity and pro-environmental behavior, strongly suggesting a constructive nature. Indeed, pro -environmental behavior in the form of climate activism would buffer the impact of CCA cognitive-emotional impairment on MDD symptoms. However, sometimes engaging in pro-environmental behavior might not be successful in dealing with eco-anxiety, since individuals might perceive that their efforts do not help to mitigate the CC crisis. Conclusions: Results have to be interpreted with caution since the methodological quality of the studies was limited. However, they do suggest a link between eco-anxiety and negative mental health outcomes, mainly in younger generations, women, and poorer countries in the “Global South”. Eco-anxiety may constitute a stressor to mental health, particularly if coping mechanisms are not successfully developed.

Gendered effects of early childhood weather shocks on locus of control: Evidence from 28 agricultural countries

To what extent do socioeconomic conditions in early life shape individuals’ noncognitive skills? Using exogenous variation in the timing of weather shocks in 28 agricultural countries, I examine the impact of shocks in childhood on adult locus of control. The results show that experiencing rainfall shortages before age five causes individuals to believe that they cannot control their life outcomes. The impact is larger and persists longer for females, and the gender difference in the impact of weather shocks accounts for 21% of the gender difference in the adult locus of control. Rainfall shocks also decrease females’ political participation.

Governance of working landscapes: A conceptual framework

The working landscape approach is gaining rapid recognition for its potential to help address global environmental crises such as climate change and biodiversity loss and support social well-being. Yet, the working landscape approach still lacks a comprehensive conceptual framework to guide further research and practice. This article provides such a framework through a comprehensive review and synthesis of the governance dimension of working landscapes. The framework is built on five premises, including (1) the working landscape approach focuses on simultaneously achieving social well-being and environmental protection within the landscapes, (2) it is concerned with fostering collective action among multiple actors to deliver sustainable outcomes, (3) the social-ecological context affects and is affected by the working landscape in question, (4) five common elements-equity, facilitative leadership, local autonomy, incentives, and trust-are essential for facilitating collective action in working landscapes, and (5) collaborative and multilevel interactions enhance governance fit in working landscapes. Our framework focuses on the local scale and how the local is embedded within multilevel governance arrangements. This framework can guide empirical case studies on the working landscape approach, further its theoretical understanding, and contribute to enhancing policy aimed at increased social well-being and environmental protection.

How do children, adolescents, and young adults relate to climate change? Implications for developmental psychology

Climate change is an existential threat facing humanity on a global scale. To handle this problem, all societal actors, including young people, need to get involved. This narrative review focuses on what implications climate change has for research in developmental psychology. It is argued that how young people relate to climate change is closely associated with key issues dealt with in this research field. The aim of this article is to present an overview of research about young people and climate change concerning four interrelated topics: (a) climate change and mental well-being, (b) coping with climate change, (c) private-sphere pro-environmental behaviour as a form of pro-social development, and d) climate change and political socialization. The emphasis is on young people from middle childhood to early adulthood. Implications for future research are discussed, for instance, the need for more longitudinal and intervention studies.

Integrating land use, ecosystem service, and human well-being: A systematic review

Global change, population growth, and urbanization have been exerting a severe influence on the environment, including the social system and ecosystem. To find solutions based on nature, clarifying the complicated mechanisms and feedback among land use/land cover changes, ecosystem services, and human well-being, is increasingly crucial. However, the in-depth linkages among these three elements have not been clearly and systematically illustrated, present research paths have not been summarized well, and the future research trends on this topic have not been reasonably discussed. In this sense, the purpose of this paper is to provide an insight into how land use/land cover changes, ecosystem services, and human well-being are linked, as well as their relationships, interacting ways, applications in solving ecological and socioeconomic problems, and to reveal their future research trends. Here, we use a systematic literature review of the peer-reviewed literature to conclude the state of the art and the progress, emphasize the hotspot, and reveal the future trend of the nexus among the three aspects. Results show that (1) ecosystem services are generally altered by the changes in land use type, spatial pattern, and intensity; (2) the nexus among land use change, ecosystem services, and human well-being is usually used for supporting poverty alleviation, ecosystem health, biodiversity conservation, and sustainable development; (3) future research on land use/land cover changes, ecosystem services, and human well-being should mainly focus on strengthening multiscale correlation, driving force analysis, the correlation among different group characteristics, land use types and ecosystem service preferences, and the impact of climate change on ecosystem services and human well-being. This study provides an enhanced understanding of the nexus among the three aspects and a reference for future studies to mitigate the relevant problems.

Integrating positive psychology and spirituality in the context of climate change

In the context of climate change and its accompanying impact on stress and mental health, we argue that positive psychology (PP) may benefit from an integration of spirituality to better support people’s wellbeing. Starting with an overview of climate change’s impact on wellbeing and health, we explore the paradoxical and complex relationship between humans and nature. Following which, we will briefly define spirituality and present an evocative metaphor of the wave to portray the evolution of the field of PP. In our conclusive remarks, we argue that the field of PP has gradually become more open to integrate spirituality (since the first wave), as it evolves towards greater complexity (in its third wave). In addition to meaning, some spiritual perspectives potentially relevant to positive psychology facilitate an ecocentric view (i.e., eco-spiritualities) which allow for a better understanding of the paradoxical human-nature relationship, as we struggle to deal with the complex issues related to climate change.

Measuring negative emotional responses to climate change among young people in survey research: A systematic review protocol

INTRODUCTION: Many young people report experiencing negative emotional responses to their awareness of climate change and the threats it poses to their future. With that, an increasing number of survey instruments have been developed to examine young people’s negative emotional responses to their awareness of climate change. This report describes a protocol for a systematic review that aims to identify, synthesise and critically appraise how negative emotional responses to climate change among young people have been measured in survey research. The research questions addressed in this review are: (1) How has negative emotional responses to climate change been defined and measured among young people? (2) How do survey instruments measuring young people’s negative emotional responses to climate change vary in terms of reliability and validity? (3) What factors are associated with negative emotional responses to climate change among young people? METHODS AND ANALYSIS: Seven academic databases (CINAHL, ERIC, MEDLINE, PsycINFO, Web of Science, Scopus, and Environment Complete) will be searched to retrieve studies published between 1 January 2006 and 31 March 2022 and published in English. Studies including survey instruments that measure negative emotional responses among young people (aged 10-24 years) will be eligible for inclusion. Targeted journals will be hand-searched. This review will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines for systematic reviews. The methodological quality, in terms of reliability and validity, of the included studies will be assessed using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist for risk of bias of patient-reported outcome measures. To rate the quality of the instruments, we will use a modified Grading of Recommendations, Assessment, Development and Evaluations technique defined by the COSMIN guidelines. ETHICS AND DISSEMINATION: Ethical approval is not applicable for this study. We will disseminate the findings through publication in peer-reviewed journals and presentations. PROSPERO REGISTRATION NUMBER: CRD42022295733.

Measuring temporal instability of momentary affect, subjective health and symptom burden depending on environmental parameters-An ambulatory assessment study in persons with hay fever

Our ambulatory assessment study explores the impact of the weather on the mental well-being of people with increased susceptibility. Participants with hay fever (n = 28) were assessed three times a day over a period of two weeks. Self-reported assessments covered different indicators of mental well-being, including momentary affect, subjective health as well as symptom burden. Based on tracked time stamps and location information, the data was matched with concurrent observation data from weather stations. We applied multilevel analysis to identify the main effects of selected environmental parameters (temperature, precipitation, wind power, sunshine duration and relative humidity) on all indicators of subjective well-being. Results confirm the main effects of sunshine duration, relative humidity and temperature on momentary affect as well as of sunshine duration, relative humidity and precipitation on subjective health and symptom burden. However, influences of environmental parameters on momentary affect were quite small and do not differ from effects documented in previous research in healthy samples with non-increased susceptibility.

Mental health impacts of climate change on women: A scoping review

Climate change is the largest threat to human health of the twenty-first century. Women are disproportionately affected by climate change. While the physical health impacts of climate change are an active area of research, works related to the mental health impacts are less developed. Furthermore, the mental health impacts of climate change on women are a particular area of interest due to women’s disproportionately negative experiences with climate change and climate change-related events. Therefore, the purpose of this scoping review is to understand what is known from the existing literature regarding the mental health impacts of climate change on women. The methods for this review follow the Arksey and O’Malley framework for a scoping review. By searching databases for publications that discuss women, mental health, and climate change, and screening for relevant work, 20 studies that met inclusion criteria were included in the review. Themes derived from the reviewed studies include negative mental health outcomes, gender-based violence, burdens of care and responsibility, attachment to land and traditions, and the importance of intersectionality. From these findings, there is a clear need for climate policies on adaptation and mitigation to reflect women’s unique needs to ensure their health and safety.

Mortality management and climate action: A review and reference for using terror management theory methods in interdisciplinary environmental research

Global climate change awareness is increasing, but efforts to convey information can trigger undesirable behaviors, including denial, skepticism, and increased resource consumption. It is therefore essential to more fully investigate social-psychological responses to climate information and messaging if we are to prompt, support, and sustain pro-environmental behaviors. Yet consideration of these responses is typically absent from interdisciplinary environmental study designs. Of specific relevance is research using social psychology’s Terror Management Theory (TMT) showing that people’s efforts to repress mortality salience (MS) or awareness significantly influence their attitudes, beliefs, and behaviors. Research on MS’s influence on climate change beliefs is progressing but, to date, a systematic scoping review of the literature has been unavailable. Here, we provide such a review. We propose that TMT insights and methods should be better integrated into research designs to guide climate communications and to generate the comprehensive cultural and behavioral changes needed to address societies’ climate problems. We introduce a methodological framework for interdisciplinary researchers to incorporate TMT into their research designs and to help practitioners anticipate how their mortality-laden messaging could trigger unintentional social-psychological responses that degrade climate communication strategies. This article is categorized under: Perceptions, Behavior, and Communication of Climate Change > Behavior Change and Responses

Partnerships and cross-sector collaboration priorities to support climate research and policy: Proceedings of a workshop-in brief

As global mean temperatures rise and extreme climate and weather events increase in frequency and intensity, the severity of the climate situation and its potential impacts on human well-being – particularly of the world’s most vulnerable populations – strikingly evident. Research and policy responses to address climate change are required to meet U.S. targets set for the coming decades, which include a reduction of 50 to 52 percent of greenhouse gas emissions by 2030 and net-zero emissions by 2050. In coordination with other activities on climate, energy, and environmental and human health across the National Academies of Sciences, Engineering, and Medicine, the Government-University-Industry Research Roundtable convened a series of five workshops in June and July of 2021 to discuss opportunities for enhancing U.S. scientific and technological approaches to climate research and policy through cross-sector collaboration and partnerships, and to examine the impacts of climate policy on economic development, inequality, and international competitiveness. This document summarizes the presentations and discussions at the five workshops.

Positive emotions and climate change

Counteracting the worst effects of human-induced climate change is one of the most daunting challenges of our time. There has been an increased recognition of the important role that human emotions, in particular positive affect, play in shaping people’s climate change-relevant decision-making and collective action. Here, we briefly review the rapidly expanding body of empirical research on positive emotions and climate change, focusing on two distinct yet closely intertwined ways in which positive emotions come into play: as antecedents and as consequences of climate change-relevant engagement. Our review reveals that positive emotions are positively linked to and can promote productive engagement with climate change but also that there is no ‘one size fits all’ approach to incorporating emotion into engagement and communication efforts.

Positive youth development in the context of climate change: A systematic review

Climate change has been acknowledged as one of the most significant current threats for younger generations. However, few studies have focused on climate change impacts on youth and how they can be supported. The purpose of this systematic review is to emphasize that a developmental perspective is fundamental within the interdisciplinary studies concerning climate change. Specifically, we focus our research on how the Positive Youth Development framework may inform future approaches to promote adolescents’ and young adults’ well-being and engagement in the context of climate change. A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search comprised two databases, and a total of 13 articles were finally considered eligible for review. Data were analyzed using a narrative method. The results show that the Positive Youth Development theory is not yet directly embedded in existing studies concerning adolescents and young adults in the context of climate change, but some of its principles were identified. Examples are provided of how Positive Youth Development characteristics and constructs can enhance future research, practice, and policies. We highlight this framework as an innovative and promising approach in the context of climate change.

Psychometric properties of the climate change worry scale

Climate change worry involves primarily verbal-linguistic thoughts about the changes that may occur in the climate system and the possible effects of these changes. Such worry is one of several possible psychological responses (e.g., fear, anxiety, depression, and trauma) to climate change. Within this article, the psychometric development of the ten-item Climate Change Worry Scale (CCWS) is detailed in three studies. The scale was developed to assess proximal worry about climate change rather than social or global impacts. Study 1 provided evidence that the CCWS items were internally consistent, constituted a single factor, and that the facture structure of the items was invariant for men and women. The results from Study 1 also indicated a good fit with a Rasch model of the items. Study 2 affirmed the internal consistency of the CCWS items and indicated that peoples’ responses to the measure were temporally stable over a two-week test-retest interval (r = 0.91). Study 3 provided support for the convergent and divergent validity of the CCWS through its pattern of correlations with several established clinical and weather-related measures. The limitations of the studies and the possible uses of the CCWS were discussed. The current work represents a starting point.

Review: Ecological awareness, anxiety, and actions among youth and their parents – A qualitative study of newspaper narratives

BACKGROUND: Despite the growing impact of climate change on mental health, there have been few studies to date investigating how children and teenagers manage their ecological grief and eco-anxiety and how they can leverage it into environmental action. In this scoping review, we analyze lay press narratives about how youth respond to climate change to examine the dynamics between minors and adults around the evolving climate crisis. METHODS: We included articles published between 2018 and 2021 in six of the top ten American newspapers by circulation about young people during the climate crisis. The 131 articles we selected addressed the attitudes of children, adolescents, and parents toward the climate crisis. We conducted a qualitative analysis based on discourse analysis aided by NVivo software. RESULTS: Newspaper articles commonly categorized children, adolescents, and their respective perspectives and experiences around climate change along four patterns of discourse: (a) fierce young activists; (b) adultified children; (c) innocent victims; and/or (d) ultimate saviors. In turn, articles considered parents and adults in one of four paradigmatic ways: (a) experiencing eco-anxiety through parenthood; (b) taming children’s eco-anxiety; (c) criticizing youth-led activism; and/or (d) reimagining climate action as a source of meaning in the lives of young people. CONCLUSION: Through the framework of childism, or prejudice against children, we conceptualize immature ways for adults to respond to youths’ concerns as a defensive stance against overwhelming climate change anxiety. Alternatively, principles of existential psychology can help inform healthier and more productive responses from parents, clinicians, educators, and public health officials as they seek truthful yet supportive responses to address legitimate ecological threats that will disproportionately affect generations to come.

Short-term changes in meteorological conditions and suicide: A systematic review and meta-analysis

BACKGROUND: Suicide is a leading cause of death, particularly for young adults. Suicidal behaviours are influenced by a wide-range of personal, social, and cultural factors. Emerging evidence suggests that daily changes in meteorological conditions, including temperature, increases the risk of suicide. METHODS: We conducted a systematic review and meta-analysis of studies that examined associations between either daily, or weekly, variations for eight meteorological variables and suicide outcomes (attempts, or deaths). Meta-analytic methods were applied to derive summary measures of association using random effect models. We assessed the heterogeneity in these associations by region and biological sex. RESULTS: We identified 29 studies of suicide. Of these, 26 reported associations between temperature, while fewer studies reported on rain (n = 4), solar radiation (n = 4), humidity (n = 3), sunshine (n = 3), atmospheric pressure (n = 2), wind (n = 2) and cloud cover (n = 2). The overall relative risk for suicide deaths/attempts per 1 °C increase in ambient temperature was 1.016 (95% CI: 1.013-1.019). Subgroup analysis of temperature found stronger associations with suicide when using the maximum rather than the mean daily temperature, among men, and for completed suicides relative to attempts. Regionally, the strongest associations were found in the East Asia and Pacific region. While associations were found for solar radiation and cloud coverage and suicide, we did not undertake a meta-analysis for these exposures as it was not possible to standardize measures of association across studies. Statistically significant associations were not observed for other identified meteorological variables. CONCLUSIONS: Our findings suggest that daily increases in temperature increase the risk of suicide, particularly, among men and in the East Asia and Pacific region.

Climate change and mental health: A review of empirical evidence, mechanisms and implications

Anthropogenic climate change is an existential threat whose influences continue to increase in severity. It is pivotal to understand the implications of climate change and their effects on mental health. This integrative review aims to summarize the relevant evidence examining the harm climate change may have on mental health, suggest potential mechanisms and discuss implications. Empirical evidence has begun to indicate that negative mental health outcomes are a relevant and notable consequence of climate change. Specifically, these negative outcomes range from increased rates of psychiatric diagnoses such as depression, anxiety and post-traumatic stress disorder to higher measures of suicide, aggression and crime. Potential mechanisms are thought to include neuroinflammatory responses to stress, maladaptive serotonergic receptors and detrimental effects on one’s own physical health, as well as the community wellbeing. While climate change and mental health are salient areas of research, the evidence examining an association is limited. Therefore, further work should be conducted to delineate exact pathways of action to explain the mediators and mechanisms of the interaction between climate change and mental health.

Eco-anxiety in youth: An integrative literature review

Climate change-related eco-anxiety in young people has made headlines around the world, but most study of this phenomenon has been limited to adults. Eco-anxiety is still not well defined in the literature, but generally refers to distress, worry, or concern related to the climate change crisis. Young people will be chronologically more exposed to climate change-related harms and problems, and this may be causing increased eco-anxiety in this population. This literature review aimed to summarize the relevant works on eco-anxiety in young people, provide a critique of the literature, identify gaps, and discuss the relevance to nursing practice. A literature search using multiple databases and other sources was completed, using applicable key terms and resulted in 23 sources to inform the review. Key themes of eco-anxiety definition variation, hopelessness and burden in young people, and responses to eco-anxiety are discussed, and critical analysis is undertaken. The main conclusions include a broad working definition of eco-anxiety that does not pathologize the eco-anxiety experience but recognizes that it can cause suffering. Also discussed is the role of nurses in reducing the potential or actual suffering of youth through hope promotion, challenging binary thinking patterns, building emotional resilience, encouraging action or involvement in climate change spheres, and promoting climate justice and advocacy. Recommendations for further research are offered.

Climate shift and mental health adjustment

No abstract available.

Mental health and the global climate crisis

AIMS: Not only is nature essential for human existence, but many of its functions and contributions are irreplaceable. Studying the impact of these changes on individuals and communities, researchers and public health officials have largely focused on physical health. Our aim is to better understand how climate change also exacerbates many social and environmental risk factors for mental health and psychosocial problems, and can lead to emotional distress, the development of new mental health conditions and a worsening situation for people already living with these conditions. METHODS: We considered all possible direct and indirect pathways by which climate change can affect mental health. We built a framework which includes climate change-related hazards, climate change-related global environmental threats, social and environmental exposure pathways, and vulnerability factors and inequalities to derive possible mental health and psychosocial outcomes. RESULTS: We identified five approaches to address the mental health and psychosocial impacts of climate change which we suggest should be implemented with urgency: (1) integrate climate change considerations into policies and programmes for mental health, to better prepare for and respond to the climate crisis; (2) integrate mental health and psychosocial support within policies and programmes dealing with climate change and health; (3) build upon global commitments including the Sustainable Development Goals, the Paris Agreement and the Sendai Framework for Disaster Risk Reduction; (4) implement multisectoral and community-based approaches to reduce vulnerabilities and address the mental health and psychosocial impacts of climate change; and (5) address the large gaps that exist in funding both for mental health and for responding to the health impacts of climate change. CONCLUSIONS: There is growing evidence of the various mechanisms by which climate change is affecting mental health. Given the human impacts of climate change, mental health and psychosocial well-being need to be one of the main focuses of climate action. Therefore, countries need to dramatically accelerate their responses to climate change, including efforts to address its impacts on mental health and psychosocial well-being.

A scoping review of youth and young adults’ roles in natural disaster mitigation and response: Considerations for youth wellbeing during a global ecological crisis

BACKGROUND: Youth and young adults, ages 15-29, have been identified as assets in mitigation and management for natural disasters around the world. This study reviews the literature on disaster mitigation, response, and recovery following natural disasters with a focus on the engagement of youth and young adults. METHODS: The Arksey and O’Malley (2005) scoping review model was used to broadly summarize existing literature. A comprehensive electronic search was conducted using several databases. Keywords and index terms were searched using four concepts: (a) age (e.g., youth, young adult), (b) participation type (e.g., engagement, participation), (c) natural disaster type (e.g., hurricane, tsunami), and (d) disaster response type (e.g., planning, mitigation). RESULTS: The search yielded 214 articles published between 1990 and 2021. Of these articles, 19 met inclusion criteria. Identified literature focused on youth and young adults’ mitigation and recovery efforts responding to natural disasters in several different countries. Themes of young people’s participation or youth-led efforts focused on community mobilization and resilience (n = 5), youth empowerment and policy advocacy (n = 2), communication technology (n = 2), education-community partnerships (n = 9), and postdisaster rescue efforts (n = 1). CONCLUSIONS: With a changing climate and increased weather-related natural disasters, as well as in the context of a global health pandemic, community-based groups would benefit from learning from international efforts to engage young people in disaster mitigation and recovery efforts especially as it relates to promoting mental health and well-being.

Climate change impacts on mental health will lead to increased digitization of mental health care

PURPOSE OF REVIEW: The evidence for the impact of climate change on the mental health of individuals and communities is reviewed, and the literature on the importance of digital systems in reducing carbon emissions is addressed. RECENT FINDINGS: Most of the climate change impacts on mental health are disaster related, although recent literature on “eco-anxiety,” often described as anxiety about the long-term effects of climate change, is emerging. There is strong evidence that the use of telepsychiatry and digital approaches to mental health care can reduce carbon emissions by reducing travel for patients and providers as well as provide effective distance care in disasters. Hybrid care, asynchronous consultations, and care at home are all innovations that will further reduce carbon emissions. The COVID-19 pandemic has rapidly accelerated the digitization of psychiatry, and climate change will continue to drive these changes in the future. Much more research on these overlapping issues is required.

Climate emergency, young people and mental health: Time for justice and health professional action

Climate change is driving a public mental health crisis that disproportionately, and unjustly, affects the world’s young people. Despite the growing evidence for harm to the next generation, the medical community has largely been hesitant to take the next step and act on the evidence. We propose that the medical community has a responsibility to do more.Drawing from our interdisciplinary experience in paediatrics and psychiatry, we call for our profession to take the ‘leap’ beyond the walls of our clinics and laboratories, and take a courageous stance on the topic of climate change. We argue that the medical profession must adopt a broader conception of health and its determinants-or a ‘social lens’-if it is to move beyond rhetoric to action.Viewing climate change as a clear determinant of mental health opens up potential avenues of action, both as individual clinicians and as a profession as a whole. We offer the beginnings of a framework for action in the context of climate change and youth mental health, before calling for our profession to re-examine its role – and its very purpose – to better address the climate crisis.

Applications of peer support in disasters: Connecting in times of disaster

Disasters invariably result in a surge in demand for mental health services, and this surge quickly exceeds available mental health resources. The pursuit of alternative sources of psychological support for communities adversely affected by disasters has therefore been necessitated. This paper describes the application of an awarding-winner, empirically validated, model for psychological support and its applicability for enhancing community disaster mental health resources that are consistent with United Nations’ recommendations for a “whole society” approach to disaster mental health. The model utilises the concept of peer-based psychological support. Peer psychological support is defined as the utilisation of individuals specially trained in the provision of acute psychological crisis interventions and psychological first aid, but who do not possess professional-level training or licensure in one of the mental health disciplines. These peer-based crisis intervention services may be delivered telephonically, via the internet, or face-to-face. This model, referred to as Reciprocal Peer Support (RPS), is the peer support activity provided at Rutgers University Behavioural HealthCare (UBHC) National Center for Peer Support in a variety of peer programs. More than 20 years of peer support interventions have been reviewed and assessed to clarify the lessons learned for the application of RPS as a prime exemplar for the utilization of peer support during and after a disaster. The Cop 2 Cop, NJ Vet 2 Vet, and several other UBHC peer support programs, which conform to best practices criteria, have been created, sustained, and expanded based on the RSP principles discussed in this article. RPS and derivative applications for human-made disasters such as the terrorist events of 9/11/2001 as well as natural disasters such as Hurricane Katrina or the COVID- 19 pandemic represent platforms for the implementation of peer psychological support and the establishment of a peer-based continuum of psychological connection.

A bibliometric analysis of climate change risk perception: Hot spots, trends and improvements

Climate change is a global problem, and it is receiving increasing scientific attention due to its significant impact. To provide valuable insights for understanding and summarizing the research trends and prospects on climate change risk perception, this study takes a qualitative and quantitative analysis by using bibliometric tools. This analysis presents information related to authors, countries, institutions, journals, top cited publications, research hot spots, trends, and prospects. The analysis involved 4429 articles after rigorous screening and evaluated them on the risk perception of climate change in countries and the public. The majority of publications were published during the period of 2016-2022 (70.92%), with Climatic Change being the dominant journal and most research originating from the USA, England and Australia. The research content of this topic is primarily divided into several categories, including environmental sciences, atmospheric sciences, water resources and public health. The results showed that adaptation and vulnerability attract much attention. Finally, this paper identifies and discusses five research themes that should be further studied: determinants of perception, human behavior, human mental health risk, agriculture and adaptive strategy.

Climate change, food security, and health: Harnessing agroecology to build climate-resilient communities

Climate change threatens human health, food security, and ecological sustainability. In marginalized and vulnerable communities around the globe, there is a crucial need to initiate actions to reduce adverse climatic impacts and support sustainable development goals (SDGs), particularly on food and health. Climate change’s multidimensional and complex impact on food and health has prompted calls for an integrated, science-based approach that could simultaneously improve the environment and nourish development-constrained communities. This paper examines a transdisciplinary practice of agroecology that bridges the gap between science, practice, and policy for climate action. We also analyze the significance of agroecology in building climate-resilient communities through sustainable food systems. We assert that the marriage of science and local knowledge that addresses access inequities through agroecology can lessen the impact of climate change on rural communities to achieve healthier, more sustainable, and equitable food systems. Furthermore, a transformative agroecological paradigm can provide farmers with a host of adaptive possibilities leading to healthier communities, improved food security, and restored lands and forests that can sequester greenhouse gases. Based on our findings, we call on the science and policy communities to integrate agroecology as part of the broader strategic approach to climate change adaptation and mitigation.

Exploring two decades of research in community resilience: A content analysis across the international literature

INTRODUCTION: Community resilience (CR) has gradually become a hot topic in uncertain times, especially in the last five years. The current study presents a systematic review based on content analysis to present a knowledge graph of CR research over the last 20 years. METHODS: We use an approach of Leximancer to conduct the content analysis to explore the intellectual foundations, research context, topics, and methods of CR literature based on 583 published studies. RESULTS: The results show that framework research of CR is a hot topic throughout the last 20 years. In the first stage (from 2001 to 2015), CR connected with the themes of “framework, disaster, change, and model”. Comparatively, in the second stage (from 2016 to 2020), the themes of “social capital, capacity, and framework” are more salient connecting with CR. Additionally, the study detected that the key issues varied across countries. Specifically, research in the US focused on the social support dynamic, while in Australia, recovery from the disaster was the predominant theme. Furthermore, in the UK, studies mostly explore resilience issues in the background related to flooding. DISCUSSION: Our findings provide a comprehensive picture of CR research covering the last 20 years and put forward thoughts and recommendations for future resilience studies considering 1) obstacles within daily life, 2) resilience set within organizational perspectives, and 3) cultural context.

A global mental health opportunity: How can cultural concepts of distress broaden the construct of immobility?

(Im)mobility studies often focus on people on the move, neglecting those who stay, are immobile, or are trapped. The duality of the COVID-19 pandemic and the climate crisis creates a global mental health challenge, impacting the most structurally oppressed, including immobile populations. The construct of immobility is investigated in the context of socio-political variables but lacks examination of the clinical psychological factors that impact immobility. Research is beginning to identify self-reported emotions that immobile populations experience through describing metaphors like feeling trapped. This article identifies links in the literature between Cultural Concepts of Distress drawn from transcultural psychiatry and immobility studies. Feeling trapped is described in mental health research widely. Among (im)mobile people and non-mobility contexts, populations experience various mental health conditions from depression to the cultural syndrome, nervios. The connection of feeling trapped to CCD research lends itself to potential utility in immobility research. The conceptualisation can support broadening and deepening the comprehension of this global mental health challenge – how immobile populations’ experience feeling trapped. To broaden the analytical framework of immobility and incorporate CCD, evidence is needed to fill the gaps on the psychological aspects of immobility research.

A scoping review of climate change, climate-related disasters, and mental disorders among children in low- and middle-income countries

Children, particularly those living in low- and middle-income countries (LMICs), are highly vulnerable to climate change and its impacts. Our main objective was to conduct a scoping literature review to determine how exposure to climate change and climate-related disasters influences the presence of mental disorders among children in LMICs. We also aimed to identify gaps in this area of scholarship. We included studies of children in LMICs that had a climate change or climate-related disaster exposure and mental disorder outcome. Twenty-three studies were included in the final synthesis. Fourteen studies were conducted in China, three in India, two each in Pakistan and the Philippines, and one each in Namibia and Dominica. All studies assessed the association between a climate-related disaster exposure and a mental disorder outcome, while none explored broader climate change-related exposures. Post-traumatic stress disorder (n = 21 studies) and depression (n = 8 studies) were the most common mental disorder outcomes. There was considerable between-study heterogeneity in terms of sample size, follow-up length, and outcome measurement. Overall, the literature in this area was sparse. Additional high-quality research is required to better understand the impacts of climate-related disasters and climate change on mental disorders within this population to ultimately inform future policies and interventions.

Anticipated impacts of climate change on women’s health: A background primer

Due to human activities, atmospheric greenhouse gas levels have increased dramatically, leading to an increase in the global mean surface temperature by 1.1° Celsius. Unless we can achieve a significant reduction in emissions, the global mean surface temperature will continue to rise to a dangerous level. Adverse outcomes of this warming will include extreme weather events, a deterioration of food, water and air quality, decreased food security, and an increase in vector-borne infectious disease. Political and economic instability as well as mass population migration will result in reduced access to healthcare resources. Mitigation of and adaptation to climate change will be key determinants of humanity’s survival in the face of this existential crisis. Women will be more adversely affected by climate change than men, and pregnant persons will be particularly vulnerable. Particular differential impacts on women include higher heat and particulate-related morbidity and mortality; pregnancy risks including preterm birth, fetal growth lag, hypertensive disorders; and mental health impacts. To prepare for the climate crisis, it  is imperative for women’s healthcare providers to assist their patients through political advocacy, provide family planning services, and focus on nutrition and lifestyle counseling.

Are climate change and mental health correlated?

Climate change is one of the biggest challenges of our time and is likely to affect human beings in substantial ways. Recently, researchers started paying more attention to the changes in climate and their subsequent impact on the social, environmental and economic determinants of health, and the role they play in causing or exacerbating mental health problems. The effects of climate change-related events on mental well-being could be classified into direct and indirect effects. The direct effects of climate change mostly occur after acute weather events and include post-traumatic stress disorder, anxiety, substance abuse disorder, depression and even suicidal ideation. The indirect effects include economic losses, displacement and forced migration, competition over scarce resources and collective violence. The risk factors for developing those mental health issues include young age, female gender, low socioeconomic status, loss or injury of a loved one, being a member of immigrant groups or indigenous people, pre-existing mental illness and inadequate social support. However, in some individuals, especially those undisturbed by any directly observable effects of climate change, abstract awareness and acknowledgement of the ongoing climate crisis can induce negative emotions that can be intense enough to cause mental health illness. Coping strategies should be provided to the affected communities to protect their mental health from collapse in the face of climate disasters. Awareness of the mental health impacts of climate change should be raised, especially in the high-risk groups. Social and global attention to the climate crisis and its detrimental effects on mental health are crucial. This paper was written with the aim of trying to understand the currently, scientifically proven impact of climate change-related disasters on mental health and understanding the different methods of solving the problem at the corporate level, by trying to decrease greenhouse gas emissions to zero, and at the individual level by learning how to cope with the impacts of those disasters.

Biological psychiatry in displaced populations: What we know, and what we need to begin to learn

Conflict and climate change continue to displace millions of people, who experience unique trauma and stressors as they resettle in host countries. Both children and adults who are forcibly displaced, or choose to migrate, experience posttraumatic stress disorder, anxiety, depression, and other mental health conditions at higher rates than the general population. This may be attributed to severe, cumulative stress and trauma (largely interpersonal traumas); discrimination and harassment in host countries; and structural barriers to accessing and addressing mental health concerns, including clinician availability, language barriers, cultural differences, geographic accessibility, health care access, and stigma. Despite high exposure to and clinical impact of such experiences, and despite representing 1% of the world population, forcibly displaced people are underrepresented in neuroscientific research. The availability of such literature and research findings is significant in understanding the unique genetic and cultural aspects of trauma- and stress-related mental health, advocacy, reducing stigma, informing prevention, and treatment. The present work aimed to explore how the field of neuroscience can address mental health equity for individuals who have been uprooted in relation to land, with a focus on refugee populations. We offer practical suggestions on how to improve research in this area and narrow the gap in knowledge.

Climate change and mental health research methods, gaps, and priorities: A scoping review

Research on climate change and mental health is a new but rapidly growing field. To summarise key advances and gaps in the current state of climate change and mental health studies, we conducted a scoping review that comprehensively examined research methodologies using large-scale datasets. We identified 56 eligible articles published in Embase, PubMed, PsycInfo, and Web of Science between Jan 1, 2000, and Aug 9, 2020. The primary data collection method used was surveys, which focused on self-reported mental health effects due to acute and subacute climate events. Other approaches used administrative health records to study the effect of environmental temperature on hospital admissions for mental health conditions, and national vital statistics to assess the relationship between environmental temperature and suicide rates with regression analyses. Our work highlights the need to link population-based mental health outcome databases to weather data for causal inference. Collaborations between mental health providers and data scientists can guide the formation of clinically relevant research questions on climate change.

Climate change impacts on the mental health and wellbeing of young people: A scoping review of risk and protective factors

BACKGROUND/RATIONALE: The impact of climate change on the mental health of young people is poorly understood. Emerging evidence suggests that exposure to climate change exerts a disproportionate mental health burden on young people. An understanding of the risk factors (RFs) and protective factors (PFs) that affect the likelihood of mental health impacts arising from exposure to climate change is required to support youth wellbeing. AIMS/OBJECTIVES: This review scopes the current research on what and how RFs and PFs are related to the mental health impacts of both direct and indirect exposure to climate change for young people. RFs and PFs were reviewed through the lens of ecological system theory. METHODS: We conducted systematic searches in four databases: PubMed, PsycInfo, Web of Science, and Scopus. Grey literature searches were conducted in ProQuest Dissertations, GreyLit.org, OpenGrey, and relevant organisations’ websites. We included 92 empirical studies focused on the RFs and PFs of the mental wellbeing under the impact of climate change of young people (0-24). We extracted data on study characteristics, type of climate change event, mental health outcomes, RFs and PFs, and associated ecological system level. RESULTS: The current evidence base focuses predominantly on young people’s experience of PTSD (k = 59), depression (k = 26), or anxiety (k = 17) mainly following exposure to singular climate change-related natural disaster events. Only four studies explored the impacts of climate change in general. Majority of the studies investigated RFs and PFs at the individual level and at the micro-system level. CONCLUSIONS: Several RFs and PFs were identified, such as coping strategies, family factors (e.g. parenting style), social support, community connection, and cultural identity. Positioning the mental health impacts of singular events within the broader context of ongoing and escalating climate change impacts will better inform the development of interventions that seek to build resilience among young people.

Climate change is an emerging threat to perinatal mental health

OBJECTIVE: In this discussion, we build the case for why climate change is an emerging threat to perinatal mental health. METHOD: A search of current literature on perinatal and maternal mental health and extreme weather events was conducted in PubMed/MEDLINE and Web of Science databases. Only articles focusing on maternal mental health were included in this narrative review. RESULTS: The perinatal period represents a potentially challenging timeframe for women for several reasons. Necessary role adjustments (reprioritization), changes in one’s ability to access pre-birth levels (and types) of social support, fluctuating hormones, changes in body shape, and possible complications during pregnancy, childbirth, or postpartum are just a few of the factors that can impact perinatal mental health. Trauma is also a risk factor for negative mood symptoms and can be experienced as the result of many different types of events, including exposure to extreme weather/natural disasters. CONCLUSION: While the concepts of “eco-anxiety,” “climate despair,” and “climate anxiety” have garnered attention in the mainstream media, there is little to no discussion of how the climate crisis impacts maternal mental health. This is an important omission as the mother’s mental health impacts the family unit as a whole.

Climate change, pollution, deforestation, and mental health: Research trends, gaps, and ethical considerations

Climate change, pollution, and deforestation have a negative impact on global mental health. There is an environmental justice dimension to this challenge as wealthy people and high-income countries are major contributors to climate change and pollution, while poor people and low-income countries are heavily affected by the consequences. Using state-of-the art data mining, we analyzed and visualized the global research landscape on mental health, climate change, pollution and deforestation over a 15-year period. Metadata of papers were exported from PubMed®, and both relevance and relatedness of terms in different time frames were computed using VOSviewer. Co-occurrence graphs were used to visualize results. The development of exemplary terms over time was plotted separately. The number of research papers on mental health and environmental challenges is growing in a linear fashion. Major topics are climate change, chemical pollution, including psychiatric medication in wastewater, and neurobiological effects. Research on specific psychiatric syndromes and diseases, particularly on their ethical and social aspects is less prominent. There is a growing body of research literature on links between mental health, climate change, pollution, and deforestation. This research provides a graphic overview to mental healthcare professionals and political stakeholders. Social and ethical aspects of the climate change-mental health link have been neglected, and more research is needed.

Critical psychologies and climate change

This article is a review of recent contributions in critical psychology and its close cousins, critical social psychology, critical community psychology and liberation psychology, to understand human response to climate change. It contrasts critical psychology with mainstream psychology in general terms, before introducing a critical psychological perspective on climate change. Central to this perspective is a critique of the framing of individual behaviour change as the problem and solution to climate change in mainstream psychology and a related emphasis on identifying ‘barriers’ to proenvironmental behaviour. This framework is argued to be reductive, obscuring or downplaying the influence of a range of factors in shaping predominant responses to climate change to date, including social context, discourse, power and affect. Currently, critical psychologies set out to study the relative contribution of these factors to (in)action on climate change. A related concern is how the psychological and emotional impacts of climate change impact unevenly on communities and individuals, depending on place-based, economic, geographic and cultural differences, and give rise to experiences of injustice, inequality and disempowerment. Critical psychology does not assume these to be overriding or inevitable psychological and social responses, however. Critical psychologies also undertake research and inform interventions that highlight the role of collective understanding, activism, empowerment and resistance as the necessary foundations of a genuine shift towards sustainable societies.

Demand-side solutions to climate change mitigation consistent with high levels of well-being

Mitigation solutions are often evaluated in terms of costs and greenhouse gas reduction potentials, missing out on the consideration of direct effects on human well-being. Here, we systematically assess the mitigation potential of demand-side options categorized into avoid, shift and improve, and their human well-being links. We show that these options, bridging socio-behavioural, infrastructural and technological domains, can reduce counterfactual sectoral emissions by 40-80% in end-use sectors. Based on expert judgement and an extensive literature database, we evaluate 306 combinations of well-being outcomes and demand-side options, finding largely beneficial effects in improvement in well-being (79% positive, 18% neutral and 3% negative), even though we find low confidence on the social dimensions of well-being. Implementing such nuanced solutions is based axiomatically on an understanding of malleable rather than fixed preferences, and procedurally on changing infrastructures and choice architectures. Results demonstrate the high mitigation potential of demand-side mitigation options that are synergistic with well-being. Evaluation of mitigation actions often focuses on cost and overlooks the direct effects on well-being. This work shows demand-side measures have large mitigation potential and beneficial effects on well-being outcomes.

Integrating solutions to adapt cities for climate change

Record climate extremes are reducing urban liveability, compounding inequality, and threatening infrastructure. Adaptation measures that integrate technological, nature-based, and social solutions can provide multiple co-benefits to address complex socioecological issues in cities while increasing resilience to potential impacts. However, there remain many challenges to developing and implementing integrated solutions. In this Viewpoint, we consider the value of integrating across the three solution sets, the challenges and potential enablers for integrating solution sets, and present examples of challenges and adopted solutions in three cities with different urban contexts and climates (Freiburg, Germany; Durban, South Africa; and Singapore). We conclude with a discussion of research directions and provide a road map to identify the actions that enable successful implementation of integrated climate solutions. We highlight the need for more systematic research that targets enabling environments for integration; achieving integrated solutions in different contexts to avoid maladaptation; simultaneously improving liveability, sustainability, and equality; and replicating via transfer and scale-up of local solutions. Cities in systematically disadvantaged countries (sometimes referred to as the Global South) are central to future urban development and must be prioritised. Helping decision makers and communities understand the potential opportunities associated with integrated solutions for climate change will encourage urgent and deliberate strides towards adapting cities to the dynamic climate reality.

A social-ecological perspective on climate anxiety in children and adolescents

Experiences of ‘climate anxiety’ are considered an adaptive response to a real threat, as well as a potential cause of impairment. To date, little attention has been paid to how children and adolescents may be uniquely predisposed to climate anxiety, despite being an age cohort particularly vulnerable to the impacts of climate change. This Review uses a social-ecological framework to identify the influences on climate anxiety for young people. We explore the directionality and interplay between individual factors, the physical environment and the influence of micro- (family, peers), meso- (school, community), exo- (government, media) and macro- (culture) systems on children’s and adolescents’ experience of climate anxiety. The Review highlights future research considerations and key issues relevant to professionals working with youth. Children and adolescents may be the age cohort most vulnerable to climate anxiety. This Review uses a social-ecological theoretical framework to outline how they are uniquely susceptible to climate anxiety and identify potential protective factors.

Knowledge gaps and future research needs for assessing the non-market benefits of nature-based solutions and nature-based solution-like strategies

Nature-Based Solutions (NBS) can be defined as solutions based on natural processes that meet societal challenges and simultaneously provide human well-being and biodiversity benefits. These solutions are envisioned to contribute to operationalizing sustainable development strategies, especially in the context of adaptation to climate change (e.g. flood risk reduction). In order to quantify NBS performance, ease their uptake and advocate for them as alternatives to “business-as-usual” infrastructures, a comprehensive, holistic valuation of their multiple benefits (multiple advantages and disadvantages) is needed. This entails quantifying non-market benefits for people and nature in addition to determining the (direct) cost-benefit of the risk-reduction measure. Despite the importance given to the assessment of non-tangible benefits for people and nature in the literature, systematic data collection on these dimensions seems to be missing. This study reviews publications that used stated preference methods to assess non-market human benefits of NBS and NBS-like strategies. Its aim is to highlight any biases or knowledge gaps in this kind of evaluation. Our results show that the valuation of non-tangible benefits of NBS (e.g. increased recreation and well-being, enhanced biodiversity) still suffers from a lack of common framing. Despite some steps being taken on enabling interconnected benefit assessments, unexploited opportunities concerning the integrated assessment of non-market human and nature benefits predominate. Moreover, the research to-date appears based on a case-to-case approach, and thus a shared holistic method does not emerge from the present literature, potentially delaying the uptake of NBS. We argue that future research could minimize missed opportunities by focusing on and systematically applying holistic benefits assessments. Methods based on stated preference surveys may help to ensure holistic approaches are taken, as well as contributing to their replicability and application when upscaling NBS.

Taxonomy for citizen actions on public health and climate change: A proposal

Facing complex issues such as climate change and its effects on public health require the participation of various actors. The research tool citizen science is one way for people to get involved. Through it, citizens collaborate with scientists to find solutions to problems in their territories. From a participatory work with citizens, we designed a taxonomy proposal, which can facilitate citizen and community action in suggesting research ideas. We expect stakeholders to use it to systematically classify and code initial questions and answers on public health and climate change issues. The development of this taxonomy integrates the global agenda of Sustainable Development Goals (SDG) in such a way that citizens not only help their communities but also, the direct fulfillment of SDGs such as Climate Action (SDG 13), indirectly impacting other SDGs – given their interdependent nature (SDG 3, SDG 5, SDG 6, SDG 7, SDG 11, SDG 12). The systematic classification and coding of citizens’ contributions worldwide will contribute to the large-scale organized collection of information to be analyzed in proposing better responses to reduce the impacts of climate change on health.

Global priorities for climate change and mental health research

BACKGROUND: Compared with other health areas, the mental health impacts of climate change have received less research attention. The literature on climate change and mental health is growing rapidly but is characterised by several limitations and research gaps. In a field where the need for designing evidence-based adaptation strategies is urgent, and research gaps are vast, implementing a broad, all-encompassing research agenda will require some strategic focus. METHODS: We followed a structured approach to prioritise future climate change and mental health research. We consulted with experts working across mental health and climate change, both within and outside of research and working in high, middle, and low-income countries, to garner consensus about the future research priorities for mental health and climate change. Experts were identified based on whether they had published work on climate change and mental health, worked in governmental and non-governmental organisations on climate change and mental health, and from the professional networks of the authors who have been active in the mental health and climate change space. RESULTS: Twenty-two experts participated from across low- and middle-income countries (n = 4) and high-income countries (n = 18). Our process identified ten key priorities for progressing research on mental health and climate change. CONCLUSION: While climate change is considered the biggest threat to global mental health in the coming century, tackling this threat could be the most significant opportunity to shape our mental health for centuries to come because of health co-benefits of transitioning to more sustainable ways of living. Research on the impacts of climate change on mental health and mental health-related systems will assist decision-makers to develop robust evidence-based mitigation and adaptation policies and plans with the potential for broad benefits to society and the environment.

Climate justice is central to addressing the climate emergency’s psychological consequences in the global south: A narrative review

The United Nations has signalled a ‘code red’, marking climate change as an existential threat for humanity. The world is rapidly warming, and the consequences of climate change include an increase and intensification in flooding, droughts, wildfires, and other traumatic exposures. Although countries in the Global South have contributed least to global warming, they are the most vulnerable owing to historical inequities. The concept of ‘climate justice’ recognises that historical racial discrimination, class disenfranchisement, political misrecognition, and other social injustices make surviving climate change and thriving within it more challenging. This narrative review considers the psychological consequences of the climate emergency through a climate justice lens. The article discusses the unequal exposures to psychological adversities, socio-historical barriers to adaptations and, finally, institutional betrayal that complicates the experience of psychological distress. The review concludes by pragmatically discussing how psychology could support climate justice ends.

Human responses and adaptation in a changing climate: A framework integrating biological, psychological, and behavioural aspects

Climate change is one of the biggest challenges of our times. Its impact on human populations is not yet completely understood. Many studies have focused on single aspects with contradictory observations. However, climate change is a complex phenomenon that cannot be adequately addressed from a single discipline’s perspective. Hence, we propose a comprehensive conceptual framework on the relationships between climate change and human responses. This framework includes biological, psychological, and behavioural aspects and provides a multidisciplinary overview and critical information for focused interventions. The role of tipping points and regime shifts is explored, and a historical perspective is presented to describe the relationship between climate evolution and socio-cultural crisis. Vulnerability, resilience, and adaptation are analysed from an individual and a community point of view. Finally, emergent behaviours and mass effect phenomena are examined that account for mental maladjustment and conflicts.

Reshaping ties to land: A systematic review of the psychosocial and cultural impacts of Pacific climate-related mobility

Global inaction on climate change is leading many Pacific peoples towards a reality separated from their ancestral lands. Yet, discussions of climate-related mobility often sideline Pacific understandings of well-being. This systematic qualitative review synthesizes the literature on the psychosocial and cultural impacts of climate-related mobility in the Pacific and outlines the methods employed in this field. We identified 36 relevant empirical studies from online databases and citations covering 28 cases of climate-related mobility. Our approach assessed studies against the Pacific Health Research Guidelines and the Critical Appraisal Skills Programme. We conducted a thematic synthesis of qualitative findings, recognizing social factors influencing acculturation and relationship to land as superordinate themes for both cross-border and internal mobility. Eleven sub-themes were identified as outcomes of cross-border and internal mobility. Overall, climate-related mobility shifted people’s relationships with their homelands, disrupting community and cultural continuities. People resisted disruptions through engaging with cultural practices, values, knowledge, and community life. Yet, even the least disruptive movements caused significant stress, suggesting that Pacific conceptualisations of well-being and land should be considered when developing climate policy.

Climate change, extreme events and mental health in the pacific region

PurposeThis paper aims to address a gap in investigating specific impacts of climate change on mental health in the Pacific region, a region prone to extreme events. This paper reports on a study on the connections between climate change, public health, extreme weather and climate events (EWEs), livelihoods and mental health, focusing on the Pacific region Islands countries. Design/methodology/approachThis paper deploys two main methods. The first is a bibliometric analysis to understand the state of the literature. For example, the input data for term co-occurrence analysis using VOSviewer is bibliometric data of publications downloaded from Scopus. The second method describes case studies, which outline some of the EWEs the region has faced, which have also impacted mental health. FindingsThe results suggest that the increased frequency of EWEs in the region contributes to a greater incidence of mental health problems. These, in turn, are associated with a relatively low level of resilience and greater vulnerability. The findings illustrate the need for improvements in the public health systems of Pacific nations so that they are in a better position to cope with the pressures posed by a changing environment. Originality/valueThis paper contributes to the current literature by identifying the links between climate change, extreme events, environmental health and mental health consequences in the Pacific Region. It calls for greater awareness of the subject matter of mental health among public health professionals so that they may be better able to recognise the symptoms and relate them to their climate-related causes and co-determinant factors.

Climate change and child health: A scoping review and an expanded conceptual framework

Climate change can have detrimental effects on child health and wellbeing. Despite the imperative for a fuller understanding of how climate change affects child health and wellbeing, a systematic approach and focus solely on children (aged <18 years) has been lacking. In this Scoping Review, we did a literature search on the impacts of climate change on child health from January, 2000, to June, 2019. The included studies explicitly linked an alteration of an exposure to a risk factor for child health to climate change or climate variability. In total, 2970 original articles, reviews, and other documents were identified, of which 371 were analysed. Employing an expanded framework, our analysis showed that the effects of climate change on child health act through direct and indirect pathways, with implications for determinants of child health as well as morbidity and mortality from a range of diseases. This understanding can be further enhanced by using a broader range of research methods, studying overlooked populations and geographical regions, investigating the costs and benefits of mitigation and adaptation for child health, and considering the position of climate change and child health within the UN Sustainable Development Goals. Present and future generations of children bear and will continue to bear an unacceptably high disease burden from climate change.

‘It’s not about having a back-up plan; it’s always being in back-up mode’: Rethinking the relationship between disability and vulnerability to extreme weather

This article presents an empirically driven critique of the predominant theoretical perspective concerning the relationship between disability and vulnerability that continues to underpin much of the scholarship focusing on the human geographies of environmental hazards and disasters, as well as policies and practices of Disaster Risk Reduction. Findings from a study involving semi-structured interviews from six case study sites in the United Kingdom examining responses to prolonged electricity outages during periods of extreme weather demonstrate that the simple equating of disability with vulnerability cannot be sustained. This is because people with disabilities were no less likely than those without disabilities to be able cope and adapt to challenges imposed by extreme weather. Furthermore, in instances where people with disabilities struggled to cope, this can be seen to result from social, physical, and structural constraints, rather than the presence of impairment per se. From this, we argue that the experiences of people with disabilities can be better understood from a relational perspective, which promotes consideration of local relations, interdependencies, and networks within which people with disabilities are embedded, and through which they engage with society and place. We conclude that UK Priority Service Register (PSR) emergency response systems, like other emergency response protocols utilised in other geographic locations and which uncritically equate disability with vulnerability, need to be replaced with an approach that recognises the capabilities and agency of people with disabilities and considers how social and environmental factors interrelate to produce vulnerabilities and enhance capabilities.

Health contexts of climate-induced migration: A scoping review

The past several decades have been marked by an increasing occurrence of climate events worldwide, and consequentially, there has been growing study of the health impacts in exposed populations. While a plethora of studies have investigated the impact of climate change on health or migration, there is a smaller body of literature where these three concepts overlap, and an even smaller proportion of these are qualitative studies. Thus, this review sought to assess the breadth of the available qualitative literature on climate change as a primary driver for migration and the related health contexts. Our findings highlight the nuances of climate-influenced migration decisions and the challenges experienced by populations who have left their homes because of climate change impacts. Further research should focus on the health experiences and migration decisions of those exposed to climate change hazards to identify appropriate multi-level interventions in disaster planning and response.

Cardiovascular diseases in natural disasters; A systematic review

INTRODUCTION: As a result of destruction and lack of access to vital infrastructures and mental stress, disasters intensify cardiovascular diseases (CVDs) and hence management of CVDs becomes more challenging. The aim of this study is investigating incidence and prevalence of CVDs, morbidity and mortality of CVDs, treatment and management of CVDs at the time of natural disasters. METHODS: In the present systematic review, the articles published in English language until 28. 11. 2020, which studied CVDs in natural disasters were included. The inclusion criteria were CVDs such as myocardial infarction (MI), acute coronary syndrome (ACS), hypertension (HTN), pulmonary edema, and heart failure (HF) in natural disasters such as earthquake, flood, storm, hurricane, cyclone, typhoon, and tornado. RESULT: The search led to accessing 4426 non-duplicate records. Finally, the data of 104 articles were included in quality appraisal. We managed to find 4, 21 and 79 full text articles, which considered cardiovascular diseases at the time of flood, storm, and earthquake, respectively. CONCLUSION: Prevalence of CVD increases after disasters. Lack of access to medication or lack of medication adjustment, losing home blood pressure monitor as a result of destruction and physical and mental stress after disasters are of the most significant challenges of controlling and managing CVDs. By means of quick establishment of health clinics, quick access to appropriate diagnosis and treatment, providing and access to medication, self-management, and self-care incentives along with appropriate medication and non-medication measures to control stress, we can better manage and control cardiovascular diseases, particularly hypertension.

The impact of wildfires on mental health: A scoping review

One of the many consequences of climate change is an increase in the frequency, severity, and, thus, impact of wildfires across the globe. The destruction and loss of one’s home, belongings, and surrounding community, and the threat to personal safety and the safety of loved ones can have significant consequences on survivors’ mental health, which persist for years after. The objective of this scoping review was to identify primary studies examining the impact of wildfires on mental health and to summarize findings for PTSD, depression, anxiety, and substance use. Literature searches on Pubmed and Embase were conducted in February and April of 2021, respectively, with no date restrictions. A total of 254 studies were found in the two database searches, with 60 studies meeting the inclusion criteria. Three other studies were identified and included based on relevant in-text citations during data abstraction. The results show an increased rate of PTSD, depression, and generalized anxiety at several times of follow-up post-wildfire, from the subacute phase, to years after. An increased rate of mental health disorders post-wildfire has been found in both the adult and pediatric population, with a number of associated risk factors, the most significant being characteristics of the wildfire trauma itself. Several new terms have arisen in the literature secondary to an increased awareness and understanding of the impact of natural disasters on mental health, including ecological grief, solastalgia, and eco-anxiety. There are a number of patient factors and systemic changes that have been identified post-wildfire that can contribute to resilience and recovery.

A systematic review of the impact of wildfires on sleep disturbances

Wildfires present a serious risk to humans as well as to the environment. Wildfires cause loss of lives, economic losses, expose people to personal as well as collective trauma, and compromise the mental health of survivors. Sleep disturbances are highly prevalent following a traumatic event; however, their prevalence is not well established amongst those confronted by natural disasters such as wildfires. The aim of this systematic review is to synthesise the empirical findings pertaining to wildfires and the prevalence of sleep disturbances in the general community affected by this natural disaster. We searched EBSCO, PsychINFO, Medline, SpringerLink, CINAHL Complete, EMBASE, PubMed, Scopus and Cochrane Library between January 2012 and March 2021. Five studies met the inclusion criteria. Findings from this systematic review suggest that sleep disturbances, assessed one to ten months following the fires, are highly prevalent in wildfire survivors, with insomnia (ranging between 63-72.5%) and nightmares (ranging between 33.3-46.5%), being the most prevalent sleep disturbances reported in this cohort. Results also highlight the significant associations between sleep disturbances and post-traumatic symptoms following the trauma of wildfires. There is a possible link between sleep disturbance prevalence, severity of, and proximity to fires.

Adapting the environmental risk transition theory for urban health inequities: An observational study examining complex environmental riskscapes in seven neighborhoods in Global North cities

Theories of epidemiologic transition analyze the shift in causes of mortality due to changes in risk factors over time, and through processes of urbanization and development by comparing risk factors between countries or over time. These theories do not account for health inequities such as those resulting from environmental injustice, in which minority and lower income residents are more likely to be exposed to environmental hazards or have less access to environmental goods. Neighborhoods with histories of environmental injustice are also at risk for gentrification as they undergo environmental improvements and new greening projects. We aimed to understand how environmental injustice, urban renewal and green gentrification could inform the understanding of epidemiologic risk transitions. We examined 7 case neighborhoods in cities in the United States and Western Europe which were representative in terms of city region and type, which 1) had experienced a history of environmental injustice and 2) exhibited evidence of recent processes of urban renewal and/or gentrification. In each city, we conducted semi-structured qualitative interviews (n = 172) with city representatives, activists, non-profits, developers and residents. Respondents reported health implications of traditional (heavy pollutants, poor social conditions), transitional (decontamination, new amenities), new (gentrification, access to amenities), and emerging (displacement, climate-related risks, re-emergence of traditional exposures) exposures. Respondents reported renewed, complexified and overlapping exposures leading to poor mental and physical health and to new patterns of health inequity. Our findings point to the need for theories of environmental and epidemiologic risk transitions to incorporate analysis of trends 1) on a city-scale, acknowledging that segregation and patterns of environmental injustice have created unequal conditions within cities and 2) over a shorter and more recent time period, taking into account worsening patterns of social inequity in cities.

Personal assessment of urban heat exposure: A systematic review

To fully address the multi-faceted challenges of urban heat, it is paramount that humans are placed at the center of the agenda. This is manifested in a recent shift in urban heat studies that aim to achieve a ‘human-centric’ approach, i.e. focusing on personalized characteristics of comfort, well-being, performance, and health, as opposed to the one-size-fits-all solutions and guidelines. The proposed article is focused on systematically reviewing personalized urban heat studies and detailing the objectives posed, methodologies utilized, and limitations yet to be addressed. We further summarize current knowledge and challenges in addressing the impact of personal heat exposure on human life by discussing the literature linked with urban heat studies at the human, building, and city scales. Lastly, this systematic review reveals the need for future evaluations focused on accuracy and standardization of human-centric data collection and analytics, and more importantly, addressing critical geographic and socio-economic knowledge gaps identified in the field.

Is there an association between hot weather and poor mental health outcomes? A systematic review and meta-analysis

BACKGROUND: Mental health is an important public health issue globally. A potential link between heat exposure and mental health outcomes has been recognised in the scientific literature; however, the associations between heat exposure (both high ambient temperatures and heatwaves) and mental health-related mortality and morbidity vary between studies and locations. OBJECTIVE: To fill gaps in knowledge, this systematic review aims to summarize the epidemiological evidence and investigate the quantitative effects of high ambient temperatures and heatwaves on mental health-related mortality and morbidity outcomes, while exploring sources of heterogeneity. METHODS: A systematic search of peer-reviewed epidemiological studies on heat exposure and mental health outcomes published between January 1990 and November 2020 was conducted using five databases (PubMed, Embase, Scopus, Web of Science and PsycINFO). We included studies that examined the association between high ambient temperatures and/or heatwaves and mental health-related mortality and morbidity (e.g. hospital admissions and emergency department visits) in the general population. A range of mental health conditions were defined using ICD-10 classifications. We performed random effects meta-analysis to summarize the relative risks (RRs) in mental health outcomes per 1 °C increase in temperature, and under different heatwaves definitions. We further evaluated whether variables such as age, sex, socioeconomic status, and climate zone may explain the observed heterogeneity. RESULTS: The keyword search yielded 4560 citations from which we identified 53 high temperatures/heatwaves studies that comprised over 1.7 million mental health-related mortality and 1.9 million morbidity cases in total. Our findings suggest associations between heat exposures and a range of mental health-related outcomes. Regarding high temperatures, our meta-analysis of study findings showed that for each 1 °C increase in temperature, the mental health-related mortality and morbidity increased with a RR of 1.022 (95%CI: 1.015-1.029) and 1.009 (95%CI: 1.007-1.015), respectively. The greatest mortality risk was attributed to substance-related mental disorders (RR, 1.046; 95%CI: 0.991-1.101), followed by organic mental disorders (RR, 1.033; 95%CI: 1.020-1.046). A 1 °C temperature rise was also associated with a significant increase in morbidity such as mood disorders, organic mental disorders, schizophrenia, neurotic and anxiety disorders. Findings suggest evidence of vulnerability for populations living in tropical and subtropical climate zones, and for people aged more than 65 years. There were significant moderate and high heterogeneities between effect estimates in overall mortality and morbidity categories, respectively. Lower heterogeneity was noted in some subgroups. The magnitude of the effect estimates for heatwaves varied depending on definitions used. The highest effect estimates for mental health-related morbidity was observed when heatwaves were defined as “mean temperature ≥90th percentile for ≥3 days” (RR, 1.753; 95%CI: 0.567-5.421), and a significant effect was also observed when the definition was “mean temperature ≥95th percentile for ≥3 days”, with a RR of 1.064 (95%CI: 1.006-1.123). CONCLUSIONS: Our findings support the hypothesis of a positive association between elevated ambient temperatures and/or heatwaves and adverse mental health outcomes. This problem will likely increase with a warming climate, especially in the context of climate change. Further high-quality studies are needed to identify modifying factors of heat impacts.

A comprehensive review of different types of green infrastructure to mitigate urban heat islands: Progress, functions, and benefits

Climate change and rapid urbanization increase/amplify urban heat islands (UHIs). Green infrastructure (GI) is an effective and popularly strategy used to moderate UHIs. This paper aims to better understand the progress of different GI types (urban parks, urban forests, street trees, green roofs, green walls) in mitigating UHIs, and what benefits they provide. Firstly, this paper used CiteSpace to analyze 1243 publications on the Web of Science from 1990 to 2021, then analyzed the function/regulation of ecosystem services/benefits and values of GI types in reducing UHIs. The historical review results show that research on all GI types showed rapid growth since 2013, and their GR increased rapidly. The highest-ranking keywords were urban heat island/heat island, climate/climate change/microclimate, and temperature/land surface temperature/air temperature. “Design,” “vegetation,” “quality,” and “reduction” are the top four strongest keyword bursts. The most published countries are the People’s Republic of China, USA, Australia, Germany, and Italy, and the top three institutions are the Chinese Academy of Sciences, Arizona State University, and the National University of Singapore. Landscape and Urban Planning, Building and Environment, Energy and Building, and Urban Forestry and Urban Greening are the most published journals. In urban areas, different GI types as a form of ecosystem hardware provide multiple functions (reduced land surface temperatures, lower building energy usage, improved thermal comfort and enhanced human health, reduced morbidity and mortality, etc.). GI thus provides a regulated ecosystem service to ameliorate UHIs primarily through temperature regulation and shade. At the same time, GI provides benefits and values (ecological, economic, social, and cultural) to humans and urban sustainable development. GI types determine the functions they provide, afford corresponding regulated ecosystem services, and provide benefits and values in a logical/recycle system. Overall, this review highlights the development and importance of GI, as well as the relationship of GI types and functions of regulating the ecosystem service benefits and values to mitigate UHI, and advances the study of climate change adaptation in cities.

How are nature based solutions helping in the greening of cities in the context of crises such as climate change and pandemics? A comprehensive review

Urban areas are expanding due to rural-urban migration and due to population increases. Their resilience is being challenged due to socio-political consequences of increasingly frequent and severe storms, due to climate changes, influx of human and animal refugees and as a consequence of the COVID-19 pandemic. The authors prepared a systematic literature of ways cities can be transformed into more resilient, and sustainable regions by creatively enhancing the quality and quantity of blue and green areas in and around them. The literature review was conducted to provide holistic insights into selection, implementation monitoring, assessment, and valuation of Nature-based Solutions in diverse urban regions. The authors reviewed no fewer than 298 articles from 109 academic journals and related sources, published within 1997-2020. The focus of the articles was upon ‘nature-based’ changes that are being implemented in urban areas, globally to enhance their resilience and the ‘quality-of-life’ of humans and other species. By implementing nature-based solutions, and complimentary ‘urban wilding’ approaches, urban areas and their hinterlands are expanding their ‘blue’ and ‘green’ areas and are thereby decreasing the ‘heat-island’ effects, while improving human health by surrounding them with rich bio-diversities of locally adapted, aquatic and terrestrial plants and animals. Although, many NBS options have been documented to be beneficial, their environmental, economic and social/psychological dimensions have not been adequately quantified, especially in the context of climate changes, and with regard to COVID-19. It is essential that the benefits of NBS are quantified with easily measurable outcomes, that are readily understood by practitioners, city policy-makers and members of community organizations, based upon specific geographical and climatological contexts. This will help them accelerate implementation of NBS and wilding into their urban systems. The reviewers found that more research is needed on anticipatory learning, backcasting and community participation to help to effectively implement the appropriate NBS for improving the sustainability of urban systems. The reviewers provide guidance for urban leaders to incorporate NBS into their policies and strategies to improve urban resilience and equity and to more effectively reduce impacts of climate change, population growth and pandemics. (C) 2020 Elsevier Ltd. All rights reserved.

Effect of co-exposure to heat and psychological stressors on sperm DNA and semen parameters

The present study aims to investigate the effects of co-exposure to heat and psychological stress on sperm DNA and semen parameters among male rats. The study was conducted on 40 healthy adult male Wistar rats. The rats were randomly categorized into four groups of same size consisting of a control group, a heat stress, psychological and co-exposure groups. The heat stress group was exposed to a temperature of 36 °C at 20% relative humidity. The psychological stress exposure group was subjected to three stressors including exposure to strobe light, noise and tilting cage. According the results,the co-exposure group had lower mean sperm parameters including sperm count (17.22 ± 4.22 10^6/ml), motility (42.63 ± 12.95 %), viability (48.50 ± 23.25 %), normal morphology (56 ± 7.5%), progressive motility (11.61 ± 7.81%), non-progressive motility (31.18 ± 7.77%), curvilinear velocity (24.11 ± 3.81 μm/s) and straight-line velocity (3.2 ± 1.4 μm/s) when compared with those of the other groups (P=0.001). Mean sperm immobility (57.36 ± 12.95%) and non-progressive motility (37.93 ± 11.15%) in the co-exposure group was higher compared to the other groups (P = 0.001 and P = 0.333, respectively). Assessment of damage to sperm DNA revealed that the heat exposure group had a higher percentage of sperm DNA damage (9.44 ± 6.80 %) compared to others (P=0.185). In case of all of exposure scenario, the chance that the semen quality decreased compared to the control group has been increased. In general the combined stress had a greater significant effect on sperm parameters compared to other exposure groups, except for DNA damage.

Extreme events and gender-based violence: A mixed-methods systematic review

The intensity and frequency of extreme weather and climate events are expected to increase due to anthropogenic climate change. This systematic review explores extreme events and their effect on gender-based violence (GBV) experienced by women, girls, and sexual and gender minorities. We searched ten databases until February, 2022. Grey literature was searched using the websites of key organisations working on GBV and Google. Quantitative studies were described narratively, whereas qualitative studies underwent thematic analysis. We identified 26 381 manuscripts. 41 studies were included exploring several types of extreme events (ie, storms, floods, droughts, heatwaves, and wildfires) and GBV (eg, sexual violence and harassment, physical violence, witch killing, early or forced marriage, and emotional violence). Studies were predominantly cross-sectional. Although most qualitative studies were of reasonable quality, most quantitative studies were of poor quality. Only one study included sexual and gender minorities. Most studies showed an increase in one or several GBV forms during or after extreme events, often related to economic instability, food insecurity, mental stress, disrupted infrastructure, increased exposure to men, tradition, and exacerbated gender inequality. These findings could have important implications for sexual-transformative and gender-transformative interventions, policies, and implementation. High-quality evidence from large, ethnographically diverse cohorts is essential to explore the effects and driving factors of GBV during and after extreme events.

Climate change and children’s mental health: A developmental perspective

Climate change is a major global public-health challenge that will have wide-ranging impacts on human psychological health and well-being. Children and adolescents are at particular risk because of their rapidly developing brain, vulnerability to disease, and limited capacity to avoid or adapt to threats and impacts. They are also more likely to worry about climate change than any other age group. Drawing on a developmental life-course perspective, we show that climate-change-related threats can additively, interactively, and cumulatively increase psychopathology risk from conception onward; that these effects are already occurring; and that they constitute an important threat to healthy human development worldwide. We then argue that monitoring, measuring, and mitigating these risks is a matter of social justice and a crucial long-term investment in developmental and mental health sciences. We conclude with a discussion of conceptual and measurement challenges and outline research priorities going forward.

Correlating heatwaves and relative humidity with suicide (fatal intentional self-harm)

Empirical evidence suggests that the effects of anthropogenic climate change, and heat in particular, could have a significant impact on mental health. This article investigates the correlation between heatwaves and/or relative humidity and suicide (fatal intentional self-harm) on a global scale. The covariance between heat/humidity and suicide was modelled using a negative binomial Poisson regression with data from 60 countries between 1979-2016. Statistically significant increases and decreases in suicide were found, as well as many cases with no significant correlation. We found that relative humidity showed a more significant correlation with suicide compared to heatwaves and that both younger age groups and women seemed to be more significantly affected by changes in humidity and heatwave counts in comparison with the rest of the population. Further research is needed to provide a larger and more consistent basis for epidemiological studies; to understand better the connections among heat, humidity and mental health; and to explore in more detail which population groups are particularly impacted and why.

Effects of extreme weather events on child mood and behavior

Extreme weather events (EWEs) are increasing in frequency and severity as the planet continues to become warmer. Resulting disasters have the potential to wreak havoc on the economy, infrastructure, family unit, and human health. Global estimates project that children will be disproportionately impacted by the changing climate – shouldering 88% of the related burdens. Exposure to EWEs in childhood is traumatic, with ramifications for mental health specifically. Symptoms of posttraumatic stress, depression, and anxiety have all been associated with childhood EWE exposure and have the potential to persist under certain circumstances. Conversely, many childhood survivors of EWE also demonstrate resilience and experience only transient symptoms. While the majority of studies are focused on the effects resulting from one specific type of disaster (hurricanes), we have synthesized the literature across the various types of EWEs. We describe psychological symptoms and behavior, the potential for long-term effects, and potential protective factors and risk factors. What this paper adds Climate change-related phenomena such as extreme weather events (EWEs) have the potential to impact mood and behavior in children. Posttraumatic stress (PTS) is the most common mental health consequence in child survivors of EWEs. PTS is often comorbid with depression and/or anxiety in this group.

The damage effect of heat stress and psychological stress combined exposure on uterus in female rats

AIMS: Explore the effects of heat stress and psychological stress combined exposure on the uterus and its underlying mechanisms. MAIN METHODS: Sixty female Sprague-Dawley rats were randomly assigned to four groups: control group, psychological stress group, high ambient temperature group, and high ambient temperature combined with psychological stress group. All treatments were administered for two weeks. During this period, the estrous cycle, body weights and rectal temperature were measured regularly. Then, ovarian weight coefficient, serum estradiol (E(2)) and progesterone (P) concentration, uterine histomorphological alterations, levels of tumor necrosis factor alpha (TNF-α), malondialdehyde (MDA) and superoxide dismutase (SOD), and the expressions of ovarian hormone receptors, leukemia inhibitory factor (LIF) and its receptor, homeobox gene A10 (HoxA10), Wnt5a, Wnt7a, β-catenin, and P-β-catenin(Y142) in the uterus and endometrium were detected. KEY FINDINGS: High temperature combined with psychological stress lead to body weight, body temperature, ovarian hormones and estrus cycle disorder, uterine gland ducts expansion and endometrial thickness reduction, and the decreased expression of endometrial receptivity markers (LIF and HoxA10). Further, disturbed expression of E(2) and P receptors in endometrium, elevated MDA and TNF-α levels, and decreased Wnt5a, Wnt7a and P-β-catenin(Y142) content were found. Our data suggested that co-exposure to high temperature and psychological stress could aggravate uterine damage probably by inducing ovarian hormonal disorder and the subsequent oxidative stress and inflammation, and reduce the endometrial function through suppressing Wnt signaling. SIGNIFICANCE: This will provide the scientific basis for improving female reproductive health, and preventing and treating reproductive disorders.

Mental health and community resilience among vulnerable populations affected by natural hazards: Protocol for scoping reviews

INTRODUCTION: Exposure to natural hazards such as fire, drought, floods, and earthquakes can have negative impacts on physical and mental health and wellbeing. The social and structural factors contributing to individual and community vulnerability also influence responses to disaster and the resulting consequences on health and wellbeing. Experiencing disasters like bushfires amplifies the impacts of inequality, magnifying existing disparities and contributing to additional psychological burdens of grief, trauma and adaptive challenge. There is a need to understand how vulnerability can influence responses to disaster, and to identify factors that develop and foster resilience in the context of increasing disasters and vulnerability. MATERIALS AND METHODS: This protocol will describe the methodology of two scoping reviews: the first will describe the mental health outcomes of vulnerable populations after droughts and bushfires; the second will identify and describe strategies that promote community resilience in vulnerable populations in the context of a disaster. A thorough search will be conducted in relevant databases. Studies will be limited to English language. The reviews will be reported using the 22-item checklist for the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Methodological quality of the included papers will be assessed using the Joanna Briggs Institute’s critical appraisal tools. RESULTS & CONCLUSIONS: The two scoping reviews described in this protocol will have broad relevance in the context of increasing and intensifying disasters, and will especially consider the compounded impact of disaster on vulnerable communities. Findings will contribute directly to the design and implementation of solutions to improve post-disaster health and wellbeing and community resilience.

Perceptual response and cognitive performance during exposure to extremely cold environments

Some extreme cold events have occurred in the past few years. Human perceptual responses and cogni-tive performances when exposed to extremely cold environments could be significantly influenced. Impaired cognition can result in human errors and other cascading impacts. This paper aims to investi-gate human thermal perception and cognitive performance in an extremely cold environment in a cli-matic chamber. The study involved and exposed twelve male participants who wore protective clothing (2.16 clo) to a-20 degrees C climate chamber. Critical parameters for evaluating human perceptual response and cognitive performance, including thermal sensation vote (TSV), thermal comfort vote (TCV), mood, health symptoms, and selective attention performance, were recorded and analyzed. The results showed that the TSV did not recover to the value before the cold exposure despite the subjects being rewarmed in a neutral environment for 40 min. The participants’ TSV reached the coldest after 20-25 min. Cold exposure increased discomfort, which required more than 40 min to recover. The extre-mely cold exposure resulted in increased tension, anger, confusion, decreased depression and fatigue. Anger and confusion had a strong correlation with tension-anxiety, and the correlation was stronger after recovery. The extremely cold exposure had a sustained impact on selective attention and heart rate. The reaction speed decreased by 36%. The results could be used to form recommendations to protect workers’ health and performance when exposed to extremely cold environments. (c) 2021 Elsevier B.V. All rights reserved.

Prenatal ambient temperature and risk for schizophrenia

OBJECTIVE: We conducted a systematic review of the published literature to test the hypothesis that maternal exposure to extremes of ambient temperatures during pregnancy is associated with the risk for psychiatric disorders or congenital malformations in offspring, both of which are indicative of perturbations of fetal neurodevelopment. METHOD: This study was conducted in accordance with the recommendations outlined in the Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting proposal. Electronic databases (Ovid MEDLINE, Ovid Embase, Ovid PsycINFO, Ovid Global Health, Web of Science, and Cochrane Library) were searched. Four independent reviewers selected studies with the following criteria: (1) prenatal maternal ambient temperature exposure; (2) outcome of offspring psychiatric disorder or congenital defects; (3) empirical study; (4) full-length article, no conference presentations or abstracts. RESULTS: Twenty-two studies met criteria and one was added from a reference list (n = 23). Of these, schizophrenia (n = 5), anorexia nervosa (n = 3) and congenital cardiovascular malformations (n = 6) studies were the most common. Each of these categories showed some evidence of association with an early pregnancy maternal ambient heat exposure effect, with other evidence for a late pregnancy cold effect. CONCLUSION: Some evidence supports a role for early pregnancy maternal exposure to extreme ambient heat in the development of psychiatric disorders, but large-scale, prospective cohort data on individual births is essential. Optimal studies will be conducted in seasonally variable climates, accounting for actual maternal residence over the pregnancy and at parturition, local environmental temperature records, and appropriate covariates, similar to studies identified by this systematic review for congenital malformations.

A review of the global climate change impacts, adaptation, and sustainable mitigation measures

Climate change is a long-lasting change in the weather arrays across tropics to polls. It is a global threat that has embarked on to put stress on various sectors. This study is aimed to conceptually engineer how climate variability is deteriorating the sustainability of diverse sectors worldwide. Specifically, the agricultural sector’s vulnerability is a globally concerning scenario, as sufficient production and food supplies are threatened due to irreversible weather fluctuations. In turn, it is challenging the global feeding patterns, particularly in countries with agriculture as an integral part of their economy and total productivity. Climate change has also put the integrity and survival of many species at stake due to shifts in optimum temperature ranges, thereby accelerating biodiversity loss by progressively changing the ecosystem structures. Climate variations increase the likelihood of particular food and waterborne and vector-borne diseases, and a recent example is a coronavirus pandemic. Climate change also accelerates the enigma of antimicrobial resistance, another threat to human health due to the increasing incidence of resistant pathogenic infections. Besides, the global tourism industry is devastated as climate change impacts unfavorable tourism spots. The methodology investigates hypothetical scenarios of climate variability and attempts to describe the quality of evidence to facilitate readers’ careful, critical engagement. Secondary data is used to identify sustainability issues such as environmental, social, and economic viability. To better understand the problem, gathered the information in this report from various media outlets, research agencies, policy papers, newspapers, and other sources. This review is a sectorial assessment of climate change mitigation and adaptation approaches worldwide in the aforementioned sectors and the associated economic costs. According to the findings, government involvement is necessary for the country’s long-term development through strict accountability of resources and regulations implemented in the past to generate cutting-edge climate policy. Therefore, mitigating the impacts of climate change must be of the utmost importance, and hence, this global threat requires global commitment to address its dreadful implications to ensure global sustenance.

Lifestyle and environmental factors may induce airway and systemic inflammation in firefighters

Health status depends on multiple genetic and non-genetic factors. Nonheritable factors (such as lifestyle and environmental factors) have stronger impact on immune responses than genetic factors. Firefighters work is associated with exposure to air pollution and heat stress, as well as: extreme physical effort, mental stress, or a changed circadian rhythm, among others. All these factors can contribute to both, short-term and long-term impairment of the physical and mental health of firefighters. Increased levels of some inflammatory markers, such as pro-inflammatory cytokines or C-reactive protein (CRP) have been observed in firefighters, which can lead to local, acute inflammation that promotes a systemic inflammatory response. It is worth emphasizing that inflammation is one of the main hallmarks of cancer and also plays a key role in the development of cardiovascular and respiratory diseases. This article presents possible causes of the development of an inflammatory reaction in firefighters, with particular emphasis on airway inflammation caused by smoke exposure.

Climate change, obesity, and COVID-19 – Global crises with catastrophic consequences. Is this the future?

Climate change and obesity were considered threats to our planet long before the onset of COVID-19. The recent pandemic has enhanced the global burden of both pre-existing crises. The aim of this narrative review is to explore the interaction between the three concurrent crises and the future of our planet should they not be dealt with accordingly. A PubMed and Google Scholar literature search was performed using different combinations of search strategies and using the keywords obesity , climate/temperature change , cold/hot temperatures , and COVID-19 . High global greenhouse gas (GHG) emissions link obesity and climate change as a result of the interplay between biological and behavioural factors. COVID-19 mitigation measures have indirectly impacted obesity and GHG emissions through the shift in dietary habits, restricted mobility, the impact on healthcare services, and enhanced psychological stress. Furthermore, COVID-19 has a more detrimental effect if acquired by an obese individual, with a higher chance of hospitalization and mechanical ventilation. This leads to higher GHG emissions and negative repercussions on the climate. A tri-directional relationship exists between obesity, climate change, and COVID-19. Various factors contribute to this relationship, but unless urgent global integrated action plans are implemented that target all three calamities, and not just COVID-19, a devastating and unsustainable future may ensue.

Climate change related depression, anxiety and stress symptoms perceived by medical students

Climate change has drastic consequences on human physical and mental health. However, research on the psychological effects of climate change awareness is still inconclusive. To examine the mental burden posed by climate change awareness and potential resilience factors, n = 203 medical students were surveyed about their awareness of the implications of climate change. Furthermore, well-established mental health questionnaires (PHQ-9, GAD-7, PTSS-10, PSQ-20) were presented twice, in their original form and in a modified version to specifically ask about the respective psychological burden regarding climate change. For identification of potential resilience factors, measures for attachment style (RQ), structural abilities (OPD-SF), and sense of coherence (SOC-13) were used. The results of our study suggest that medical students in Germany have an increased risk to suffer from mental health problems and predominantly experience significant perceived stress in regard to climate change. However, the reported stress does not yet translate into depressive, anxious, or traumatic symptoms. Climate-related perceived stress correlates negatively with potential resilience factors preventing the development of mental disorders such as attachment style, structural abilities, and sense of coherence.

Climate change anxiety assessment: The psychometric properties of the Polish version of the climate anxiety scale

The Climate Anxiety Scale (CAS) is a 13-item questionnaire for assessing climate anxiety (CA) as a psychological response to climate change. The CAS consists of two subscales, namely, cognitive impairment and functional impairment. This study aimed to validate the Polish version of the CAS. The sample included 603 respondents (344 females, 247 males, and 12 non-binary), aged 18-70 years (M = 25.32, SD = 9.59). Based on the exploratory factor analysis results, we proposed a 3-factor solution (i.e., intrusive symptoms, reflections on CA, and functional impairment), which seems to be theoretically more consistent with the content of the CAS statements. The confirmatory factor analysis showed that the original 2-factor solution and the 3-factor one had a satisfactory and a good fit to the data, respectively, as well as both were invariant across different gender, age, and educational level categories. Despite the fact that the 3-factor solution had the best-fit indices, we recommended to examine the CAS structure in different samples and use the overall CAS score in cross-cultural research. Cognitive and functional impairment subscales were positively correlated with personal experience of climate change, behavioral engagement, environmental identity, and environmental motives, but they were negatively correlated with climate change denial and sense of safety. The CAS subscales were correlated with depressive symptoms, but contrary to expectations, they were not associated with anxiety symptoms and any cognitive coping strategies. The Polish version of the CAS has satisfactory psychometric properties. Overall, we reported low CA levels in the Polish sample. Women and younger people experienced higher CA.

Climatic exposures in childhood and the risk of schizophrenia from childhood to early adulthood

BACKGROUND: Season of birth is a risk factor of schizophrenia, and it is possible that cumulative exposure to climatic factors during childhood affects the risk of schizophrenia. We conducted a cohort study among 365,482 persons born in Finland in 1990-1995 to examine associations of 10-year cumulative exposure to global solar radiation and ambient temperature in childhood with schizophrenia. METHODS: Data on schizophrenia diagnoses and sociodemographic factors from the Finnish population register and health care register were linked to daily meteorological data using residential information. The study population was followed from age 10 until the first schizophrenia diagnosis, death, emigration or December 31, 2017, whichever came first. Hazard ratios (HR) for the risk of schizophrenia were estimated using Cox proportional hazards model. RESULTS: Compared to the lowest quintile of global solar radiation or ambient temperature, growing up in the second highest quintile (Q4) was associated with greater risk of schizophrenia. These hazard ratios were attenuated after adjustment for parental mental disorder, parental education, parental income, area-level socioeconomic characteristics and urbanicity (HR = 1.29, 95 % CI 1.06-1.58 for radiation; HR = 1.24, 95 % CI, 1.02-1.52 for temperature). Continuous linear terms evaluated in secondary models suggested a greater risk of schizophrenia at greater childhood exposure to global radiation and ambient temperature, but these associations did not remain in fully adjusted models. CONCLUSIONS: We found no consistent evidence that cumulative exposure to sunlight and ambient temperature in childhood is associated with the risk of developing schizophrenia. Studies in other populations residing in different latitudes are needed.

Impact of meteorological factors on alcohol use disorders: A study in emergency departments

No data exist on the influence of meteorological factors on alcohol use disorders (AUD). The aim of this study was to investigate the relationship between meteorological factors and AUD. All patients who were admitted to an emergency department (ED) in the Paris-region for an alcohol-related condition were included using the Oscour database over the period January 1, 2015 to December 31, 2019. Meteorological data were collected by Meteo-France (French Weather service). All data were aggregated by week. We performed Pearson correlations between weather variables and the number of ED visits for AUD. We observed 98,748 ED visits for alcohol-related conditions over the study period. We found significant positive correlations between the number of alcohol-related ED visits and the mean temperature (r = 0.55; p = 1.87e^(-5), 95% Confidence Interval (CI) = 0.33, 0.72) and the duration of sunlight (r = 0.42; p = .0015, 95% CI = 0.17, 0.62). Negative correlations were also found significant with rain (r = -0.40; p = .0014, 95% CI = -0.62, -0.18), humidity (r = -0.41; p = .0023, 95% CI = -0.62, -0.16) and wind speed (r = -0.40; p = .0031, 95% CI = -0.60, -0.14). Emergency visits for AUD seem to increase with the temperature and duration of sunlight, and decrease with rain, humidity and wind speed. Further studies are needed on a larger scale and taking into account potential confounding factors to confirm these findings.

A wise person plants a tree a day before the end of the world: Coping with the emotional experience of climate change in Poland

It is now widely accepted that we are in a climate emergency, and the number of people who are concerned about this problem is growing. Yet, qualitative, in-depth studies to investigate the emotional response to climate change were conducted either in high-income, western countries, or in low-income countries particularly vulnerable to climate change. To our knowledge, there are no qualitative studies conducted in countries that share great barriers to decarbonization while being significant contributors to carbon emissions. Since climate change affects people globally, it is crucial to study this topic in a variety of socio-political contexts. In this work, we discuss views and reflections voiced by highly concerned residents of Poland, a Central European country that is a major contributor to Europe’s carbon emissions. We conducted 40 semi-structured interviews with Polish residents, who self-identified as concerned about climate change. A variety of emotions related to climate change were identified and placed in the context of four major themes: dangers posed by climate change, the inevitability of its consequences, attributions of responsibility, and commonality of concern. Our findings highlight a variety of often ambivalent and conflicting emotions that change along with the participant’s thoughts, experiences and behaviours. Furthermore, we describe a wide repertoire of coping strategies, which promoted well-being and sustained long-term engagement in climate action. As such, our work contributes to research on a broad array of climate-related emotions. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12144-022-03807-3.

Mental health issues related to climate change in Poland – Polish psychologists’ and psychotherapists’ perspective

Aim: The aim of the first Polish pilot study was to conduct an initial analysis of the occurrence of mental issues related to such experiences as: fear, worry, sense of loss and grief in connection with climate change and ecology. The consequences of climate and environmental changes for physical health are increasingly well-documented. In contrast, psychosocial changes due to climate change and, in particular, the impact on mental health, remain unrecognized. Material and method: Psychologists and psychotherapists were asked to share their clinical experience in diagnosing and treatment of patients reporting climate change-related mental symptoms. Climate change-related mental issues were operationalized as clinically significant symptoms meeting the criteria for anxiety and depressive disorders or adjustment disorders, and are known in literature as a solastalgia and ecological anxiety. The collection of data with the use of an on-line survey started lasted 4 months. Results: Issues relating to ecology and climate change were present both in the contents of patient concerns (48.6% of respondents) and in patients’ hypotheses regarding their symptoms (16.7% of respondents) in the past 6 months of the respondents’ clinical work. Mental health professionals considered psychoeducation (62.5%), psychological support (73.6%), short-term psychotherapy (45.8%) and self-help groups (40.3%) to be appropriate mental health support interventions. Discussion: The presented study provides evidence that mental health issues related to climate change are recognized by Polish psychologists and psychotherapists. The professionals can need comprehensive knowledge of climate-related mental health, including appropriate interventions. Conclusions: These findings may be a ground for designing further research on this topic.

Climate changes, natural resources depletion, COVID-19 pandemic, and Russian-Ukrainian war: What is the impact on habits change and mental health?

Climate Change, Natural Resources Depletion, COVID-19, and Wars are some of the great challenges of our time. The consequences will affect psychological well-being and could have a harmful impact on mental health. This study aimed to assess the level of preoccupation and fears surrounding issues of the 21st-century and the implication for psychological well-being of the general population from Central/Southern Italy among different age groups. A questionnaire that included sociodemographic characteristics, topics formulated ad-hoc about preoccupation, fears, habits, and willingness to change habits in the future related to the 21st-century challenges, and the Depression Anxiety Stress Scales 21 (DASS-21) was administered online. A sample of 1831 participants (61% F; mean age 47.71 ± 17.30) was obtained. Results showed that young adults and older adults, respectively, reported greater and less psychological well-being. Young adults reported higher scores for preoccupation, changing habits, and willingness to change habits in the future, while older adults reported the lowest scores except for changing habits, also controlling for gender. Results for this variable, as well as correlations between the many variables described, rely on the specificity of age, and 21st-century challenges. Moreover, the main fears related to the 21st-century concerns were different based on both age and gender. In conclusion, the various stresses of the 21st-century discussed in this study have a relationship with personal well-being, and it is important to consider potential global mental health issues resulting from these stressors.

Brexit, COVID-19 and climate change: Mapping the impact of the ‘triple challenge’ on health and well-being in Wales

Brexit, COVID-19 and climate change pose challenges of national and global importance. They continue to have impacts across the economy, society, health, and the environment, all of which are determinants of health and well-being. Between 2018 and 2021, Public Health Wales undertook three Health Impact Assessments (HIA) in relation to the impact of the challenges in Wales. Based on these, work has been carried out to map the synergies across the ‘Triple Challenge’. This paper highlights the commonalities in the impact of the three challenges for Wales, discusses the process carried out, learns from it and proposes actions that can be taken to mitigate harm. Results indicate the three components of the Triple Challenge must not be viewed as separate silos as they have cumulative multi-faceted impacts. This affects some population groups more negatively than others and present a ‘Triple Challenge’ to nation states in the UK and Europe. A HIA approach can enable a range of stakeholders to critically view similar challenges not just as single issues but as a holistic whole to mobilise action.

Envisioning carbon-smart and just urban green infrastructure

To address the inter-connected climate and biodiversity crises, it is crucial to understand how multifunctional urban green infrastructure (UGI) is perceived to contribute to carbon neutrality, biodiversity, human well-being, and justice outcomes in cities. We explore how urban residents, including youth, associate carbon-related meanings with multifunctional UGI and how these meanings relate to co-benefits to biodiversity, well-being, and broader sustainability outcomes. Our findings are based on a survey distributed among urban residents of Helsinki, Finland (n = 487) and reveal how carbon-related meanings of UGI manifest at different levels of abstraction, agency, and scale, and incorporate community values and concerns attributed to the planning, features, functions, and transformational dimensions of UGI. Core carbon-related meanings of UGI emphasize either actions towards sustainability, carbon neutrality, biodiversity, or unfamiliarity towards such meanings. Perceived justice concerns and the socio-demographic contexts of the respondents covaried with carbon-related meanings associated with UGI. The results illustrate community perceptions of how it is not only possible, but rather expected, that multifunctional UGI is harnessed to tackle climate change, human well-being, and biodiversity loss in cities. Challenges for implementing the carbon-related benefits of UGI include navigating the different expectations placed on UGI and including residents with diverse socio-economic backgrounds during the process. Our findings contribute to a holistic understanding of how multifunctional UGI can help bridge policy agendas related to carbon neutrality, biodiversity protection, and human well-being that cities can implement when aiming for sustainable, just, and socially acceptable transitions towards a good Anthropocene.

Implementing nature-based solutions in urban spaces in the context of the sense of danger that citizens may feel

Cities are facing the challenges of climate change. The application of nature-based solutions (NBS) to the urban structure is often mentioned in climate change adaptation strategies. In an effort to ensure the greatest possible well-being of citizens in the form of environmentally positive elements, the opinions of citizens are forgotten. This paper presents the results of research focusing on the feelings of unsafety associated with the application of NBS elements directly into the urban structure. In two pilot areas (Ostrava (CZ) and the part of Upper Silesian agglomeration (PL)) the feelings of the inhabitants and the possible feeling of fear or danger in the application of NBS were investigated. In Ostrava, a questionnaire survey was conducted in relation to specific elements of the NBS without discussion of specific locations. In the Upper Silesian agglomeration, residents’ feelings about specific NBS were surveyed at specific locations using guided interviews. Both approaches resulted in the identification of elements of concern. Respondents who discussed a specific location had a better understanding of the urban context and worried less. The two approaches demonstrated the need to communicate with residents before finalizing the design of a particular public space and the desirability of discussing site-specific issues with citizens.

Adolescents’ thoughts and feelings about the local and global environment: A qualitative interview study

BACKGROUND: Despite a recent increase in engagement with environmental issues among young people, their impact upon adolescent mental health and wellbeing is not yet fully understood. Therefore, this study aimed to explore adolescents’ thoughts and feelings about current environmental issues. METHODS: Semi-structured interviews were conducted with a convenience sample of 15 UK-based adolescents aged 14-18?Çëyears (66.7% female). Transcripts were inductively thematically analysed by the interviewing researcher and two adolescent co-researchers, with priority given to the co-researchers’ impressions to strengthen interpretations of the personal experiences of the interviewees. RESULTS: Six themes were identified: the local environment, efficacy, challenging emotions, information, hindrances and perceptions of the future. The local environment was found to affect adolescents positively and negatively. Factors including greenspace and fresh air had a positive impact, and factors including noise and litter had a negative impact. Most participants reported feeling disempowered to personally influence environmental problems but were engaged with them and felt that trying to make a difference was beneficial for their wellbeing. Adolescents largely reported negative expectations about the environment’s future. CONCLUSION: The UK adolescents interviewed appeared to be very engaged and emotionally affected by a perceived lack of care towards the environment, locally and globally. It is therefore imperative to amplify young people’s voices and involve them in influencing environmental policy, for the benefit of young people and the planet. Further research should quantify the extent to which environmental issues affect young people’s mental health and identify factors that could prevent or alleviate distress.

Climate change and adventure guiding: The role of nature connection in guide wellbeing

Ecological challenges are quickly shaping the future of the tourism industry with an increasing focus on how to develop more sustainable adventure tourism practises. Adventure guides play an important role in this transition and in shaping client experiences, however there is a need to better understand how climate change may have important impacts on guides’ wellbeing. This study explored adventure guides’ experiences of nature connectedness and potential links between climate change, nature connexion, and wellbeing for adventure guides. Semi-structured qualitative interviews (x = 11) with adventure guides were analysed using reflexive thematic analysis to explore these relationships. Adventure guides reported experiencing meaningful connexions and relationships with the natural environments in which they worked, while also highlighting why not all types of nature nor time spent outdoors facilitated this connexion. Guides that reported being more connected to nature also reported a higher sense of environmental responsibility, and guides described how this often created “ethical dilemmas” in seeking to resolve tensions between their deep connexion to nature and unsustainable practises that their guiding work often entailed. Analysis also highlighted the value and wellbeing guides derived from sharing their love of nature with clients. These findings expand emerging theoretical models of adventure guide wellbeing, and suggest a range of practises that can support a more ecologically sustainable adventure tourism industry.

Conceptualising eco-anxiety using an existential framework

There is a lack of conceptual clarity regarding the nature of distress caused by confrontations with climate change as a generalised or global phenomenon (distress often labelled ‘eco-anxiety’). However, existing literature has suggested that existential concerns might be central to the experience. This article explores and conceptualises the experience of eco-anxiety through semi-structured interviews with 15 self-selecting adults. Data were analysed using thematic analysis, which utilised an existential framework – consisting of the concerns of death, meaning, isolation, and freedom/responsibility – in a theory-driven analysis of interview transcripts. Participants’ experiences were conceptualised by four themes derived from the existential framework and six subthemes. Climate change was equated with death or loss and associated with guilt, anger, isolation, powerlessness, and chronic uncertainty about what to do as well with challenges to meaning in life. The study indicates that distress about climate change is a diverse and distressing phenomenon that can be appropriately conceptualised through an existential lens. Implications of this are discussed for climate and clinical psychology.

Current understanding of the impact of climate change on mental health within UK parliament

There is growing evidence that climate change is linked to adverse mental health outcomes, with both direct and indirect impacts already being felt globally, including within the United Kingdom (UK). With the UK parliament tasked with passing legislation to mitigate against and adapt to climate change, it is well placed to take a lead in implementing policies that reduce the impact of climate change on mental health and even provide mental health benefits (e.g., by increasing access to green space). The extent to which the UK parliament considers the relationship between climate change and mental health in its decision-making was previously unknown. We report, through quantitative thematic analysis of the UK Hansard database, that the UK parliament has only infrequently made links between climate change and mental health. Where links have been made, the primary focus of the speeches were around flooding and anxiety. Key mental health impacts of climate change reported in the academic literature, such as high temperature and suicides, or experiences of eco-anxiety, were found to be missing entirely. Further, policies suggested in UK parliament to minimise the impact of climate change on mental health were focused on pushing adaptation measures such as flood defences rather than climate mitigation, indicating potential missed opportunities for effective policies with co-benefits for tackling climate change and mental health simultaneously. Therefore, this research suggests a need to raise awareness for UK policymakers of the costs of climate inaction on mental health, and potential co-benefits of climate action on mental health. Our results provide insight into where links have and have not been made to date, to inform targeted awareness raising and ultimately equip policymakers to protect the UK from the increasingly large impacts of climate change on mental health.

Domain-specific consideration of future consequences: Further evidence using academic attainment data

A number of recent studies have demonstrated that adolescents consider the future consequences (CFC) of behaviours domain-specifically. In other words, rather than being a “future orientated person,” it appears that the orientation varies within individuals, depending on the domain in question. The present study matched data gathered in Scottish school children (N = 451) on consideration of four future domains (Health and Well-being, Finances, Academics, and Global Warming) with sociodemographic and academic attainment data provided by Local Government. Results showed that deprivation was significantly related to academic attainment, and that this relationship was partially mediated by the combined effects of academic self-efficacy and on consideration of future consequences-academic. Further, domain specificity was supported by the fact that scores for consideration of future consequences-health and well-being,-finance, and-global warming did not partially mediate the deprivation-attainment relationship. The study identifies two variables which may contribute to closing the poverty-related attainment gap.

Early climate change indicators in the Arctic: A geographical perspective

Climate change is continuing to impact the social-ecological systems of polar regions. Climate models project substantial warming above the global average and high rates of environmental change in polar regions, but local impacts remain uncertain. These rapid alterations will affect biophysical, economic, and sociocultural conditions. This research aims to uncover early climate change indicators through climate model projections and individuals’ perceptions by focusing on a sample of 39 municipalities north of the Arctic Circle in Norway, Sweden, Finland, and northwestern Russia. The study employs an exploratory sequential approach by combining representations of climate model projections in a geographic information system (GIS) with qualitative analysis from semi-structured interviews with local officials involved in planning decisions for each municipality. And, second, the study combined perceptions of early climate change indicators and their subsequent challenges and opportunities with regional climate projections. Results indicate an overall geographic ‘match’ between climate model projections and perceptions, but differences between north-to-south, coast-to-interior, and national perspectives are notable. Some of these differences point to the roles of nationally, regionally, and locally embedded geographies, producing a multitude of lived experiences. The implications of this study are relevant to global communities experiencing varying climate change risk perception from coastal-versus-interior regions.

Effects of changes in seasonal weather patterns on the subjective well-being in patients with cad enrolled in cardiac rehabilitation

Objective: We examined whether seasonal and monthly variations exist in the subjective well-being of weather-sensitive patients with coronary artery disease (CAD) during cardiac rehabilitation. Methods: In this cross-sectional study, 865 patients (30% female, age 60 +/- 9) were recruited within 2-3 weeks of treatment for acute coronary syndrome and during cardiac rehabilitation. The patients completed the Palanga self-assessment diary for weather sensitivity (PSAD-WS) daily, for an average of 15.5 days. PSAD-WS is an 11-item (general) three-factor (psychological, cardiac, and physical symptoms) questionnaire used to assess weather sensitivity in CAD patients. Weather data were recorded using the weather station “Vantage Pro2 Plus”. Continuous data were recorded eight times each day for the weather parameters and the averages of the data were linked to the respondents’ same-day diary results. Results: Weather-sensitive (WS) patients were found to be more sensitive to seasonal changes than patients who were not WS, and they were more likely to experience psychological symptoms. August (summer), December (winter), and March (spring) had the highest numbers of cardiac symptoms (all p < 0.001). In summary, peaks of symptoms appeared more frequently during the transition from one season to the next. Conclusion: This study extends the knowledge about the impact of atmospheric variables on the general well-being of weather-sensitive CAD patients during cardiac rehabilitation.

Effects of green plants on the indoor environment and wellbeing in classrooms-a case study in a Swedish school

Many schools in Sweden lack a proper indoor environment due to, e.g., poor thermal-envelope properties, overcrowded classes, poor visual appearance and insufficient ventilation. This study aims to explore the integration of a large number of indoor green plants into classrooms’ environments. This case study consists of three parts: measurements of the indoor environment including a final energy model, a questionnaire to the pupils with questions about their well-being and qualitative interviews with teachers. The case was two classrooms in a secondary education facility in central Sweden with an average annual temperature of 3 degrees C and a long and dark winter period with snow. The results showed 10% lower CO2 and slightly higher and more stable temperatures due to the green plants. Worries about climate change and war among the pupils decreased after several months with the plants and worry about infectious disease increased. The teachers experienced fresher air from the plants and used the plant stands for a flexible classroom design. The conclusion is that indoor plants have the potential to contribute to a better indoor environment, but due to the high number of uncontrolled variables (including the effect of COVID-19) in measurements of real-life conditions, more studies are needed.

Encounters with climate change and its psychosocial aspects through performance making among young people

In this article we argue that drama can provide complementary knowing for climate change education and shed light on the complexity of related psychosocial issues. We bring together an interdisciplinary understanding of eco-anxiety, psychosocial responses to climate change, and drama education. We draw on performance narratives created with young people in Finland and explore the psychosocial dynamics of climate change education. Three key themes are discussed in more detail in relation to education: 1) psychosocial dynamics; 2) alienation; 3) tragedy. The performance workshops provided a safe and creative space for exploring young people’s thoughts and images related to climate anxiety. Many relevant but often silenced issues became visible and were lived through in the process of performance making. This seemed to be fruitful both to the performers, teachers, and researchers, and suggests future, longer-term work would prove beneficial for engaging with these issues.

From climate anxiety to climate action: An existential perspective on climate change concerns within psychotherapy

With the growing body of knowledge climate change stands out as one of the most important contemporary problems. The Intergovernmental Panel on Climate Change confirms the urgent necessity to reduce greenhouse gases emission, as the window to address the problem is becoming narrow. Rising temperatures and bushfires, melting glaciers and droughts make the acceleration of climate change evident, and citizens around the globe are increasingly worried about the magnitude of the problem. In this article, we propose an existential perspective on climate change-related concerns. Although environmental worries are legitimate, they sometimes cause severe anxiety and distress so aggravated as to be discussed within the framework of psychotherapy. In the course of this research, we examine the experiences of 10 Swedish psychotherapy clients addressing their climate concerns within treatment. We engage them into in-depth conversations about the experience of climate anxiety and inquire about the individual pathways toward recovery. Moreover, we propose the existential perspective as a tool to understand such experiences. We aim to address all existential concerns, as described in Ernesto Spinelli’s themes of existence framework: death anxiety, spatiality, temporality, meaning, relatedness, authenticity, freedom, and responsibility. All of the above are present in participants’ reports of climate anxiety. In conclusion, we emphasize the value of introducing existential perspective to practitioners working with clients experiencing climate distress.

Identifying types of eco-anxiety, eco-guilt, eco-grief, and eco-coping in a climate-sensitive population: A qualitative study

BACKGROUND: Climate change is one of the greatest challenges of the 21st century and it can affect mental health either directly through the experience of environmental traumas or indirectly through the experience of emotional distress and anxiety about the future. However, it is not clear what possible subtypes of the emerging “psychoterratic” syndromes such as eco-anxiety, eco-guilt, and eco-grief exist, how much distress they may cause, and to what extent they facilitate ecofriendly behavior. METHODS: We analyzed semi-structured interviews (N = 17) focusing on the thoughts, emotions, and behaviors related to climate change by using a combination of inductive and deductive qualitative methods. RESULTS AND CONCLUSIONS: The interviews revealed six eco-anxiety components, eight types of eco-guilt, and two types of eco-grief that help to understand the multifactorial nature of these phenomena. The six categories of coping strategies are in line with traditional coping models, and they are linked in various ways to pro-environmental behavior and the management of negative emotions. The results can help practitioners to gain a deeper understanding of emotions related to climate change and how to cope with them, and researchers to develop comprehensive measurement tools to assess these emotions.

Living conditions and mental wellness in a changing climate and environment: Focus on community voices and perceived environmental and adaptation factors in Greenland

BACKGROUND: Climate change is a major global challenge, especially for Indigenous communities. It can have extensive impacts on peoples’ lives that may occur through the living environment, health and mental well-being, and which are requiring constant adaptation. OBJECTIVES: The overall purpose of this research was to evaluate the impacts of climate change and permafrost thaw on mental wellness in Disko Bay, Greenland. It contained two parts: multidisciplinary fieldwork and a questionnaire survey. The aim of the fieldwork was to learn about life and living conditions and to understand what it is like to live in a community that faces impacts of climate change and permafrost thaw. For the questionnaire the aim was to find out which perceived environmental and adaptation factors relate to very good self-rated well-being, quality of life and satisfaction with life. ANALYSIS: Fieldwork data was analyzed by following a thematic analysis, and questionnaire data statistically by cross-tabulation. First, the associations between perceived environmental and adaptation factors were studied either by the Pearson χ(2) test or by Fisher’s exact test. Second, binary logistic regression analysis was applied to examine more in depth the associations between perceived environmental/adaptation variables and self-rated very good well-being, satisfaction with life and quality of life. The binary logistic regression analysis was conducted in two phases: as univariate and multivariate analyses. RESULTS: Nature and different activities in nature were found to be important to local people, and results suggest that they increase mental wellness, specifically well-being and satisfaction with life. Challenges associated with permafrost thaw, such as changes in the physical environment, infrastructure and impacts on culture were recognized in everyday life. CONCLUSIONS: The results offer relevant information for further plans and actions in this field of research and at the policy level. Our study shows the importance of multidisciplinary research which includes the voice of local communities.

Meaning-making in a context of climate change: Supporting agency and political engagement

Responding effectively to climate change requires an understanding of what shapes people’s individual and collective sense of agency and responsibility towards the future. It also requires transforming this understanding into political engagement to support systems change. Based on a national representative survey in Sweden (N 1,237), this research uses the novel SenseMaker methodology to look into these matters. More specifically, in order to understand the social and institutional prerequisites that must be in place to develop inclusive climate responses, we investigate how citizens perceive their everyday life and future, and the implications for their sense of responsibility, agency, and political engagement. Our research findings show how citizens perceive and act on climate change (individually, cooperatively, and by supporting others), their underlying values, beliefs, emotions and paradigms, inter-group variations, and obstacles and enablers for change. The findings reveal that, in general, individual and public climate action is perceived as leading to improved (rather than reduced) wellbeing and welfare. At the same time, climate anxiety and frustration about structural and governance constraints limit agency, whilst positive emotions and inner qualities, such as human-nature connections, support both political engagement and wellbeing. Our results shed light on individual, collective, and structural capacities that must be supported to address climate change. They draw attention to the need to develop new forms of citizen involvement and of policy that can explicitly address these human interactions, inner dimensions of thinking about and acting on climate change, and the underlying social paradigms. We conclude with further research needs and policy recommendations.

Young people’s engagement with climate change issues through digital media – A content analysis

BACKGROUND: The reporting of climate change issues through social media can influence young people’s mental health and engagement. However, there has been little research undertaken directly with young people in relation to social and digital media’s reporting of climate change, and how this is experienced by young people. METHOD: This study aimed to explore the interface between climate change and social media reporting for young people. A two-stage iterative approach to recruitment and data collection included an initial qualitative stage (N=28), consisting of open-ended questions about social media’s reporting of climate change issues. The second stage (N=23) included further open-ended questions and 10 Likert-Scale questions. Overall, 51 young people 16-25-years-old opted to take part (M=11; F=40). Descriptive statistics and an inductive data-driven content analysis are reported. RESULTS: Overall, 95% of the participants reported that they had the personal skills to cope with climate change reporting on social media. Most participants stated that coverage on the climate increased ‘climate change anxiety’ but not their overall mental health difficulties. A four-stage experiential process of observing social media’s reporting of climate change, feeling emotionally affected by the reporting, critically apprising the content and feeling motivated to engage in climate change activism emerged from the content analysis. The participants discussed experiences of digital media, rather than solely social media, in their accounts. CONCLUSIONS: The participants recommended changes to climate change reporting and increasing access to education about climate change issues to reduce anxiety and enhance motivation for positive personal engagement. Involving young people in conversations and education about climate change were seen as protective factors for mental health and enablers for motivation. Motivation, agency and pathways for positive change were associated with hopefulness.

Nature and well-being in seven European cities: The moderating effect of connectedness to nature

Well-being is transversal to different urban-related challenges such as increasing urbanization or adaptation to the effects of climate change. One possible response to these challenges is the use of nature in cities. The aim of this study is to investigate how the objective quantity of natural space near the home, the perception of these natural elements, and their perceived availability, moderated by the effect of connectedness to nature, could explain levels of well-being. A survey was conducted among a sample of 1343 participants living in seven European cities. Data were collected online via a questionnaire. Indicators of the objective quantity of urban natural space based on remotely sensed satellite imagery were also used. Regression models highlight the association between well-being and perceived amount of nature, accessibility to a community garden, and level of connectedness to nature. A moderating and negative effect of connectedness to nature on the association between the perceived quantity of nature and well-being was also identified. Perception of nature seems to be a better indicator of well-being than the objective one. Results highlight the importance of the social dimension of collective gardens in enhancing well-being. Connectedness to nature could facilitate appropriation of natural elements and its effects on well-being.

High temperatures trigger suicide mortality in Brussels, Belgium: A case-crossover study (2002-2011)

BACKGROUND: Temperature may trigger the risk of suicide, however, the extent and shape of the associations show geographical variation. Here, we investigate the short-term effects of temperature on suicide deaths occurring in Brussels between January 1st, 2002 and December 31st, 2011. METHODS: We conducted a bidirectional time-stratified case-crossover study with cases being suicide deaths occurring among Brussels residents aged 5 years or older. Cases were matched by day of the week with control days from the same month and year. The exposure was the daily average temperature measured at the Uccle station (Brussels) and obtained from the Belgian Royal Meteorological Institute. We combined conditional logistic regression with distributed lag non-linear models (DLNM) to obtain one week (lag 0-6) cumulative risk ratios (RR) and their 95% confidence intervals (CI) for the effects of moderate and extreme cold (5th and 1st percentiles of temperature, respectively) and moderate and extreme heat (95th and 99th percentiles of temperature, respectively), relative to the median temperature. RESULTS: In total, 1891 suicide deaths were included. The median temperature was 11.6 °C, moderate and extreme cold temperatures were 0 and -3.1 °C, respectively, and moderate and extreme high temperatures were 20.9 and 24.4 °C, respectively. The cumulative risk of suicide mortality was almost twice higher among lags 0 to 6 for both moderate and extreme heat, relative to the period median temperature (e.g. moderate heat RR = 1.80 CI:1.27-2.54). No statistically significant associations were observed for cold temperatures. CONCLUSIONS: In Brussels, a western European city with temperate climate, high temperatures may trigger suicide deaths up to one week later. In the context of climate change, adaptation strategies must take into consideration the effects of temperature on mental health.

How to reduce individuals’ ecological footprint without harming their well-being: An application to Belgium

Human activities are a key driver of many environmental problems the world is facing today, including climate change, the disruption of biogeochemical cycles, and biodiversity loss. Behavioural changes at the individual and household level are needed to reduce humanity’s environmental impact, but people also need the capacity to behave in a sustainable way. If their well-being is negatively impacted or if behaving sustainably is too time consuming or too expensive, people might be less inclined to change their behaviour. In this article, we look at the determinants of different types of pro-environmental behaviour and how these are associated with their experienced levels of well-being. More specifically, we focus on the determinants of behaviours that influence both the ecological footprint (EF) and satisfaction with life. In our analysis we include socio-demographic characteristics and a number of psychological antecedents of pro-environmental behaviour (PEB). The data we use was collected in Flanders (Belgium) and allows us to calculate the EF of each respondent individually. Our main conclusions are threefold. First, even if individuals are provided with opportunities to behave in a more sustainable way, they do not always do so (e.g., richer people on average have a higher EF). Efforts could be put in place at the collective side (e.g., public infrastructure) to stimulate people to reduce their environmental impact. Second, as we distinguish seven EF components, we are able to show differential effects of each of the determinants. Third, the association between PEB and satisfaction with life is not strong: only the type of housing is significantly associated with satisfaction with life. Related to that, the psychological antecedents of PEB are only associated with the EF, not with satisfaction with life.

Climate anxiety in Germany

OBJECTIVES: This study aimed to clarify the level and the correlates of climate anxiety in Germany. STUDY DESIGN: This was a quota-based online survey. METHODS: We used data collected in mid-March 2022 from a sample of the general adult population (n = 3091 individuals aged 18-74 years; March 2022). Climate anxiety was quantified using the Climate Anxiety Scale (ranging from 1 to 7, with higher scores corresponding to higher levels of climate anxiety). RESULTS: The average level of climate anxiety in Germany was 2.0 (standard deviation [SD]: 1.2). It differed between subgroups (e.g. individuals aged 18-29 years: 2.4, SD: 1.3; individuals aged 65-74 years: 1.8, SD: 1.0). Log-linear regressions showed that climate anxiety was higher among younger individuals (β = -0.005, P < .001), full-time employed individuals (compared with retired individuals, β = 0.07, P < .01), individuals without chronic conditions (compared with individuals with at least one chronic conditions, β = -0.08, P < .001), individuals already vaccinated against COVID-19 (compared with individuals not vaccinated against COVID-19, β = 0.10, P < .001), individuals with higher levels of coronavirus anxiety (β = 0.06, P < .001), and individuals with greater fear of a conventional war (β = 0.09, P < .001). CONCLUSIONS: Our study showed a rather low level of climate anxiety. It also revealed some correlates of greater climate anxiety such as higher levels of coronavirus anxiety or greater fear of war. Knowledge about the correlates may assist in addressing individuals at risk for high levels of climate anxiety.

Investigating the association between temperature and hospital admissions for major psychiatric diseases: A study in Greece

Evidence has emerged regarding the role of seasonality and several meteorological parameters on bipolar disorder, schizophrenia and depression. We investigated the relationship between ambient and apparent temperature and hospital admissions of major psychiatric diseases in a psychiatric clinic of a General Hospital situated in Northern Greece during 2013-19. Temperature data was provided by the National Observatory of Athens and diagnosis for psychotic, schizophrenic, manic and bipolar and unipolar depression were retrieved from medical records. A total of 783 admissions were recorded. Poisson regression models adjusted for time trends were applied to analyze the impact of temperature on monthly admissions. A summer peak was observed for the bipolar disorder, irrespectively of substance/alcohol use status. Seasonality emerged also for psychotic and schizophrenic patients with a through in winter. An increase of 1 °C in either ambient or apparent temperature was associated with an increase 1-2% in the monthly admissions in most outcomes under investigation. Alcohol and drug abuse did not modify this effect. Although our results indicate effects of temperature on psychiatric admissions, they are not consistent across subgroups populations and need to be replicated by other methodologically superior studies.

Climate change, trauma and mental health in Italy: A scoping review

BACKGROUND: Climate change is having significant impacts on health and mental health across Europe and globally. Such effects are likely to be more severe in climate change hotspots such as the Mediterranean region, including Italy. OBJECTIVE: To review existing literature on the relationship between climate change and mental health in Italy, with a particular focus on trauma and PTSD. METHODS: A scoping review methodology was used. We followed guidance for scoping reviews and the PRISMA Extension for Scoping Reviews (PRISMA-ScR) checklist. We searched for literature in MEDLINE, Global Health, Embase and PsycINFO. Following screening, data was extracted from individual papers and a quality assessment was conducted. Given the heterogeneity of studies, findings were summarized narratively. RESULTS: We identified 21 original research articles investigating the relationship between climate change and mental health in Italy. Climate change stressors (heat and heatwaves in particular) were found to have several negative effects on various mental health outcomes, such as a higher risk of mortality among people with mental health conditions, suicide and suicidal behaviour and psychiatric morbidity (e.g. psychiatric hospitalization and symptoms of mental health conditions). However, there is little research on the relationship between climate change and trauma or PTSD in the Italian context. CONCLUSIONS: More attention and resources should be directed towards understanding the mental health implications of climate change to prevent, promote, and respond to the mental health needs of Italy and the wider Mediterranean region. HIGHLIGHTS: • Climate change stressors in Italy were found to have detrimental impacts on various mental health outcomes, such as psychiatric mortality and morbidity. • Little research on the relationship between climate change stressors and PTSD exists in Italy.

Media exposure to climate change, anxiety, and efficacy beliefs in a sample of Italian university students

The climate crisis poses a serious threat to the health and well-being of individuals. For many, climate change knowledge is derived from indirect exposure to information transmitted through the media. Such content can elicit a variety of emotional responses, including anger, sadness, despair, fear, and guilt. Worry and anxiety are especially common responses, usually referred to as “climate anxiety”. The main objectives of this study were to analyze how exposure to climate change through the media relates to climate anxiety and individual and collective self-efficacy, and to evaluate the relationship between climate anxiety and efficacy beliefs. A total of 312 Italian university students (aged 18-26 years) participated in the research by filling out an anonymous questionnaire. Participants reported being exposed several times per week to information about climate change, especially from social media, newspapers, and television programs. Moreover, the results showed that the attention paid to information about climate change was not only positively related to climate anxiety, but also to individual and collective self-efficacy. Most notably, participants’ efficacy beliefs were found to be positively related to climate anxiety. This somewhat controversial finding stresses that, in the context of pro-environmental behavior changes, a moderate level of anxiety could engender feelings of virtue, encouraging people to rethink actions with negative ecological impacts.

Associations between mental health, lifestyle factors and worries about climate change in Norwegian adolescents

Climate change is a serious global health threat that has an impact on young people’s lives and may influence their mental health. Since the global climate strike movement, many adolescents have expressed worries about climate change. Thus, the aim of this study is to examine the prevalence of worries about climate change, and factors associated with worries about climate change, in a representative sample of Norwegian adolescents. Data were retrieved from Ungdata, an annual nationwide online youth survey. Adolescents (n = 128,484) from lower and upper secondary school participated in the study. Data were analysed descriptively and with logistic regression. Most of the adolescents were not worried or a little worried about climate change. Girls, pupils who had at least one parent with higher education and pupils from urban areas were more inclined to worry about the climate. Adolescents who worried about the climate had more symptoms of depression than those who were less worried. While worry about climate change may constitute an additional burden for adolescents experiencing depressive symptoms, such worry can also be seen to reflect climate-friendly values.

A qualitative study to explain the factors influencing mental health after a flooding

Background: Children and adolescents are considered to be particularly vulnerable to the psychological effects of climate change, such as extreme weather events. What are the protective factors and stressors for the mental health of the young population after extreme weather events in Germany? Methods: Nine semi-structured interviews with representatives of occupational groups providing care to children, adolescents, and political stakeholders were conducted in Simbach am Inn, a German town affected by flooding in 2016. The interviews were analyzed using qualitative content analysis according to Mayring. Results: The interviews show that the parents’ dealing with what they had experienced and the concern for their relatives were the most influential stressors for children and adolescents. As protective factors, they felt that conversations with familiar people and restoring a certain “normality” were particularly important. The interviewees described both, the time of the flooding, and the time after the initial state of shock had subsided, as particularly stressful. Consequently, the experts reported on children and adolescents acutely complaining of fear, helplessness, and extreme tension. Nevertheless, the demand for psychological care increased only slightly after the flooding in Simbach am Inn. Conclusion: The social environment of children and adolescents is essential for their psychological well-being after an extreme weather event. Research, especially on children and adolescents who have already been affected, must increase in order to be able to describe influencing factors even more precisely, to protect individuals from adverse mental health effects, and to identify healthcare requirements.

Information, experience, and willingness to mitigate mental health consequences from flooding through collective defence

Demand for reducing mental health impacts from flooding through collective flood defence is elicited using a contingent valuation method with a sequential hypothetical scenario, which accounts for human resilience and experience. A two-step model fits the survey data: it combines a binary sample selection rule to distinguish protesters and participants with a Tobit model to accommodate true zero responses among participants. Results show that non-symptoms-specific information on mental health risk may bias the willingness to pay downward. Risk-averse individuals who have taken self-insurance protection measures are willing to pay for additional protection through collective defence. Feelings, such as worries and anxiety related to flooding, drive the demand, which supports the risk-as-feelings hypothesis for mental health protection from flooding. Inexperience rather than experience of flooding is found to increase demand, which indicates that individual mental resilience to flooding may increase after an event as posited by the inoculation hypothesis.

Multilevel social mechanisms of post-disaster depression

This exploratory study empirically shows how community social capital is related to post-disaster depression, whereas most disaster mental health research has focused on posttraumatic stress disorder. We tested the validity of earlier found multilevel social and individual mechanisms of posttraumatic stress for symptoms of post-disaster depression. We used data (n = 231) from a community study after a flood in Morpeth (2008), a rural town in northern England. At the salutary community level, our multilevel analyses showed that, in communities with high social capital, individuals employ less individual social support and coping effort, which protects individuals from developing symptoms of depression. Yet, on the ‘dark’ individual level of our model, we found that perceiving the disaster as less traumatic after a year was related to more feelings of depression in contrast to previous findings for posttraumatic stress. Our explanation of this finding is that, when the appraisal of the disaster as threatening fades into the background, individuals may perceive the full scope of the disaster aftermath and start to feel depressed. We also found that more social support is related to more depression. Although depressed people may attract or receive more social support, this social support can paradoxically become disabling by reinforcing a sense of dependence, thereby undermining self-esteem and leading to feelings of helplessness. Our results imply that to curb post-disaster depression, boosting community level social capital may be an important starting point for building resilience. At the same time, interventionists need to identify risk groups for whom the stressful experience becomes less intrusive and who experience the burden of dependency on an unequal relationship with ones’ social inner circle.

Neuroticism and PTSD symptoms: Gender moderates the mediating effect of peritraumatic emotions and dissociation

OBJECTIVE: Gender differences in posttraumatic stress disorder (PTSD) prevalence and severity are well established; there is also growing evidence that men and women develop PTSD symptoms differently. This article aims to examine gender differences in the relationship between PTSD symptoms and personality traits according to the Five Factor model (FFM), based on the data from different studies conducted in Poland. METHOD: The meta-analysis method and path analyses were conducted on the data from seven studies, including 1,182 women and 1,150 men. Five studies were carried out among motor vehicle accident survivors, one from fire and flood victims. All of the studies had a cross-sectional design. RESULTS: All FFM traits were significantly related to PTSD symptoms. Neuroticism showed the strongest relationship. Further analyses revealed a moderated mediation of this relationship: It was stronger for men and mediated by peritraumatic emotions and dissociation for women. CONCLUSIONS: The results indicate that PTSD development is mediated by peritraumatic factors, but this mediation is moderated by gender. Men with higher Neuroticism are at particular risk of developing PTSD. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Study of the links between emotional regulation strategies and sense of place in the expression of symptoms of post-traumatic stress disorder in flood victims

Many risk factors for PTSD have been identified in flood victims. Yet, some have been under-explored, like cognitive coping, which has been identified as a risk factor for PTSD for other traumatic events. Moreover, while flooding can affect places that are important to individuals (e.g. their home and neighbourhood), the role of sense of place in PTSD has been neglected. The objective of this research is to investigate the potential role of under-explored individual and situational risk factors in PTSD in flood victims. To this end, the following var-iables were measured in 79 French flood victims: sense of place (with sense of place scale), cognitive coping (with CERQ), and PTSD (with PCL-5). Results showed that the more individuals use inappropriate cognitive emotional regulation strategies, the more attached they are to their home and city, and the higher their PTSD scores. These results can help to target vulnerable people and improve care.

Resilience after natural disasters: The process of harnessing resources in communities differentially exposed to a flood

Background: Disasters negatively impact mental health and well-being. Studying how people adapt and recover after adversity is crucial for disaster preparedness and response. Objective: This study examined how differentially affected communities harness their resources to adapt to the aftermath of a flood. We predicted that stronger individual, interpersonal, and community resources protect against psychosocial resource loss and, through that, are related to fewer symptoms of posttraumatic stress and depression and higher life satisfaction. We also predicted that these effects would be stronger in a flooded community, compared to a threatened, but non-flooded community. Method: Participants were randomly sampled community members from two neighbouring municipalities. One municipality was severely flooded during the 2014 floods in South East Europe (affected community, n (a) = 223), the other was threatened but not flooded (comparison community, n (c) = 224). Interviews were conducted one and a half years after the disaster using the Connor-Davidson Resilience Scale 10-item version, the Multidimensional Scale of Perceived Social Support, the Community Resources Scale, the Psychosocial Resource Loss Scale, the PTSD Checklist for DSM-5, the Center for Epidemiological Studies Depression Scale Revised and the Satisfaction with Life Scale. Results: Stronger individual, interpersonal, and community resources were found to be related to better post-disaster outcomes directly and indirectly through psychosocial resource loss. In the affected community, interpersonal resources and community social capital and engagement were stronger predictors of positive adaptation. In the comparison community, community economic development and trust in community leadership were more important. Conclusion: This study provides evidence that people affected by disasters can harness their individual, interpersonal, and community resources to recover and adapt. Post-disaster interventions should aim to strengthen family and community ties, thus increasing available social support and community connectedness.

Dynamic psychotherapy as a PTSD treatment for firefighters: A case study

In Portugal, forest fires are responsible for disasters that tend to be repeated annually, leading to dramatic consequences, such as those that have occurred in 2017, with the destruction of hundreds of houses and the deaths of dozens of people. Firefighters who are exposed to these potentially traumatic events are considered a high-risk group for the development of stress-related disorders. The aim of this study was to monitor the progress of two firefighters with symptoms of post-traumatic stress disorder (PTSD) treated through dynamic psychotherapy (DP) and to assess the feasibility of implementing this intervention within fire departments. A female firefighter and a male firefighter, with similar sociodemographic characteristics and PTSD symptom severity, were selected to verify the treatment applicability for both genders. The symptomatology changes were assessed through a set of instruments (PHQ-15, PCL-5, BSI, DASS, and CALPAS-P) applied every three months over 15 months (including pre-treatment, treatment period, and post-treatment). DP seemed to be an effective treatment for PTSD symptoms, with patients showing a state of increasing improvement even after the end of treatment. The acceptability to firefighters, the treatment adherence, the therapeutic alliance, and the reduction in PTSD symptoms suggest feasibility for implementing this intervention inside the Portuguese fire departments.

Contemporary flood risk perceptions in England: Implications for flood risk management foresight

Although England has been experiencing major floods dating back thousands of years, the hazard is increasing in frequency and intensity, exacerbated by climate risks with potentially serious consequences. Despite attempts to mitigate climate risks (manifested via recurrent flooding) in line with international disaster risk reduction agendas, the impacts/effects of floods continue to increase in England. This is partly due to negligence in inculcating contemporary flood risk perceptions (FRP) into climate risk management (CRM) strategies. This research aims to investigate contemporary FRM in England through a qualitative case study approach in Wainfleet All Saints in Lincolnshire County that experienced unprecedented floods in June 2019. Empirical investigation was conducted with the flood-affected community members and flood managers with oversight of CRM in the region. Key findings reveal the June 2019 floods had both tangible and intangible impacts for the affected community with dreadful effects. Challenges to CRM revealed issues around limited funding; climate changes’ potential to increase flood risk and low community perception of their own risks reflected in poor/none-preparedness for contemporary floods. The multi-agency response to the June 2019 floods was found to be positive, albeit with a few concerns. Based on the analysis of the findings, a series of policy recommendations are proffered with the aim to spur organisational/institutional resilience to CRM. This article underscores the relevance to continuously include contemporary FRP into CRM strategies especially to enhance community participation and involvement in mitigating their own risks.

Managed retreat in response to flooding: Lessons from the past for contemporary climate change adaptation

Managed retreat is increasingly advocated as a means to promote resilience and adaptation to climate change. However, there are various uncertainties and challenges associated with the impacts of displacement and attachments to place. In this context, it is useful to study past examples of relocation to understand how these challenges have been addressed. This paper draws on a case study relocation scheme which took place in Ireland following major flooding in 1954. This represented a radical and comprehensive approach to relocation which sought to address the root causes of vulnerability. The analysis shows that this comprehensive approach was made possible through a connection between managed retreat and land reform. The scheme also faced opposition linked to attachments to place and property. This led to compromises and a failure to fully address the effects of flooding on livelihoods but contributed to resilience through ensuring that family and community ties remained intact. The paper’s distinctive contributions are its analysis of the requirements of transformative approaches to adaptation and relocation, its identification of challenges associated with place and property even in the context of such transformative approaches, and its adding of historical depth to contemporary debates on climate adaptation.

A qualitative exploration of the psychological impacts of living with the uncertainty of persistent flood risk

OBJECTIVES: Flooding is associated with increased psychological morbidity; however, the impact of living with the uncertainty of flood risk has not been explored. The aim of this study was to generate insight into individual experiences of living with persistent flood risk, how it affects psychological well-being, and the forms of support deemed appropriate to mitigate psychological risks. STUDY DESIGN: A qualitative study was conducted using semistructured interviews with participants who lived in a persistent flood risk area in Nottinghamshire, UK. METHODS: 40 participants were interviewed. The study adopted an interpretivist constructionist position, and the transcripts were analysed using inductive thematic analysis. RESULTS: Persistent flood risk was seen as a significant stressor, regardless of previous flood history. Some participants reported anxiety in anticipation of a future flood event and demonstrated low self-efficacy, with subsequent feelings of helplessness in responding to flood risk. Individuals who lacked acceptance of flood risk displayed higher anxiety and lower resilience. Recognition of flood risk as a psychological stressor was requested in future support. CONCLUSIONS: Living with the uncertainty of persistent flood risk can have significant psychological impacts. Interventions that facilitate the empowerment of individuals living with persistent flood risk may strengthen psychological resilience.

Green regeneration for more justice? An analysis of the purpose, implementation, and impacts of greening policies from a justice perspective in Lodz Stare Polesie (Poland) and Leipzig’s inner east (Germany)

Greening and green regeneration have been developed as a major strategy for improving quality of life in cities and neighbourhoods. Greening policies and projects are being applied at both the citywide and the neigh-bourhood level for various reasons, such as adaptation to climate change and the improvement of housing and living conditions as well as wellbeing and health. Urban policies, plans, and programmes have increasingly employed greening strategies to make urban neighbourhoods more attractive, to improve quality of life, and to provide residents with recreational space. At the same time, greening is increasingly “exploited” by market -oriented regeneration and construction strategies. The new critical debates on eco-gentrification-or distribu-tional, procedural, and interactional injustices-are discussing emerging conflicts or trade-offs between green regeneration and the social or housing market impacts, as well as analysing the role of greening and green regeneration with respect to the (re)production of socio-spatial inequalities and injustices.Set against this background, our paper provides a comparative analysis of two cases-L acute accent odz acute accent Stare Polesie (Poland) and Leipzig’s inner east (Germany)-and has a threefold purpose: first, it seeks to analyse in-terconnections between greening policies and justice concerns. To operationalise the aforementioned in-terconnections, we will, second, develop an operational model that looks at interconnections as a process and applies a justice perspective that focuses on a multidimensional, intersectional, relational, and context-and policy-sensitive understanding of justice. Third, the paper seeks to detect how a contrasting comparison can help us to come to a better and more comprehensive understanding of the interconnections between green regen-eration and justice. The study itself builds on primary research about the two cases from earlier projects.

How to deal with sleep problems during heatwaves: Practical recommendations from the European Insomnia Network

Heatwaves are occurring more frequently and are known to affect particularly night-time temperatures. We review here literature on how night-time ambient temperature changes affect body temperature and sleep quality. We then discuss how these temperature effects impact particularly vulnerable populations such as older adults, children, pregnant women, and those with psychiatric conditions. Several ways of dealing with sleep problems in the context of heatwaves are then suggested, adapted from elements of cognitive behavioural therapy for insomnia, with more specific advice for vulnerable populations. By better dealing with sleep problems during heatwaves, general health effects of heatwaves may be more limited. However, given the sparse literature, many links addressed in this review on sleep problems affected by temperature changes should be the focus of future research.

Association of daily temperature with suicide mortality: A comparison with other causes of death and characterization of possible attenuation across 5 decades

Suicide is one of the leading causes of death in young adults in many Western countries. We examined the short-term association of temperature with cause-specific mortality, comparing suicide with other causes of death and describing possible attenuation of associations with temperature across decades. We considered all deaths that occurred in France between 1968 and 2016. For each cause of death, we conducted a 2-stage meta-analysis of associations with daily temperature. We stratified the association across time periods. A total of 502,017 deaths by suicide were recorded over 49 years. Temperature was monotonically associated with suicide mortality. The strongest association was found at lag 0 days. The relative risk of suicide mortality at the 99th (compared with the 1st) temperature percentile was 1.54 (95% confidence interval, 1.46, 1.63). Among all causes of death, suicide was the only cause displaying a monotonic trend with temperature and ranked seventh for heat-related mortality; 2 other causes of death implying the nervous system ranked third and fourth. Associations with temperature attenuated between the 1968-1984 and 1985-2000 periods for all-cause mortality and suicide mortality, without clear further attenuation in the 2001-2016 period. The robust short-term monotonic association between temperature and suicide risk could be considered in heat effects- and suicide-related prevention campaigns.

Indicators of climate risk in the UK at different levels of warming

Assessments of the impacts of climate change are typically made using climate scenarios based on assumptions about future emissions of greenhouse gases, but policymakers and climate risk communicators are increasingly asking for information on impacts at different levels of warming. This paper provides this information for a set of indicators of climate risks in the UK for levels of warming up to 4 degrees C above pre-industrial levels. The results show substantial increases in climate risks at 2 degrees C, which is often inferred in the media to be a ‘safe’ level of climate change. In a 2 degrees C world, the chance of a heatwave is doubled, and the frequency of heat stress affecting people, crops and animals can be increased by a factor of five. Cooling degree days more than double, wildfire danger can increase by 40%-70%, the frequency of agricultural and water resources droughts doubles in England, and flood frequency in Wales increases by 50%. At 4 degrees C the increases in risk are considerably greater: heatwaves occur in virtually every year. The frequency of cold weather extremes reduces, but is not eliminated, with increasing warming. The rate of change in an indicator with warming varies across the UK. For temperature-based indicators this reflects variability in current climate, but for rainfall-based indicators reflects variations in the change in climate. Most indicators show a generally linear increase in risk with level of warming (although the change in risk from now is around 2.4 times higher in a 4 degrees C world than a 2 degrees C world because of warming experienced so far). However, some indicators-particularly relating to heat extremes-show a highly non-linear increase with level of warming. The range in change in indicator at a given level of warming is primarily caused by uncertainty in the estimated regional response of to increasing forcing.

Exposures to psycholeptics, psychoanaleptics, and cardiovascular drugs reported to the pic erfurt during heat waves from 2003 to 2018

Psycholeptics, psychoanaleptics, and cardiovascular drugs alter individual tolerance to extreme heat. To explore the influence of heat waves on their toxicity in acute overdose, we retrospectively analyzed all human exposures to psycholeptics and psychoanaleptics (PLAexp) as well as cardiovascular drugs (CVDexp) registered by the Poisons Information Center (PIC) Erfurt between June to September of the years 2003 to 2018 for frequency, age groups, sex, circumstances of exposure, and symptom severity. The results of the non-heat years (NHY) 2004-2005 and 2007-2014 (average air temperature June-September 16.2 °C) were compared to the results of the heat years (HY) 2003, 2006 and 2015-2018 (average air temperature June-September 17.5 °C). In total, 13,191 cases (HY 5,117; NHY 8,074) of PLAexp and 2,960 cases (HY 1,168; NHY 1,792) of CVDexp were registered. During HY, accidental PLAexp (11.2% versus 9.7%) and CVDexp (40.6% versus 36.8%) were more often seen. Severe symptoms were less frequent in PLAexp (4.4% versus 6.3%) and CVDexp (3.3% versus 4.9%). Although in HY, no higher rates of moderate or severe PLAexp and CVDexp were detected than in NHY, patients with these medications should be observed carefully during heat waves because of affected body’s usual cooling mechanisms.

Aggressive incidents in psychiatric hospitals on heat days

This study explores the relationship between temperature and the number of aggressive incidents and coercive interventions in the years 2007-2019 in six psychiatric hospitals in the south of the Germany with a total of 1007 beds. The number of aggressive incidents among 164 435 admissions was significantly higher on ‘heat days’ (≥30°C). Furthermore, there was a dose-response relationship between the number of aggressive incidents and increasing temperature. In contrast, the number of coercive interventions was not related to temperature. Considering the background of global warming, rising temperature could result in more frequent aggressive behaviour during in-patient treatment of psychiatric patients.

The need for collective awareness of attempted suicide rates in a warming climate

Background: Climate factors may offer a stronger explanation of the variations in suicide rates compared with economic variables, even in the case of patients admitted involuntarily. Aims: We assessed the role of temperature as a determinant of the increased prevalence of suicide attempts (SA). Method: The sample comprised all cases of hospitalization for SA at the Psychiatric Clinic of the IRCCS Ospedale Policlinico San Martino between August 2013 and July 2018. For ambient temperature, data were provided by the Meteorological Observatory of the University of Genoa. Results: We noted a peak in suicides that was typically found in late spring and early summer due to global warming. Limitations: Other environmental/psychological factors contributing to the onset of an acute clinical event were not considered. The cross-sectional design of the study is another limitation. Conclusion: Further studies are needed to clarify the impact of climatic factors on suicide behavior and implement early intervention and preventive strategies for mental health.

Discovering emotional patterns for climate change and for the COVID-19 pandemic in university students

The global crises of climate change and of the COVID-19 pandemic are straining young peoples’ mental health and their mitigation behaviours. We surveyed German-speaking university students aged 18 to 30 years on their negative emotions regarding both crises repeatedly before and during the COVID-19 crisis. Different emotional patterns emerged for climate change and for COVID-19 with negative emotions regarding COVID-19 increasing during the pandemic. We were further able to differentiate between emotional responses associated with impaired wellbeing and those associated with mitigation efforts. Our findings emphasise the need to focus on a mixture of highly inactivating and activating emotions regarding COVID-19 as they are associated with both reduced wellbeing and mitigation behaviours. The findings broaden the understanding of how young adults react to the burden of two global crises and what role negative emotions play.

Association of environmental and socioeconomic indicators with serious mental illness diagnoses identified from general practitioner practice data in England: A spatial bayesian modelling study

BACKGROUND: The evidence is sparse regarding the associations between serious mental illnesses (SMIs) prevalence and environmental factors in adulthood as well as the geographic distribution and variability of these associations. In this study, we evaluated the association between availability and proximity of green and blue space with SMI prevalence in England as a whole and in its major conurbations (Greater London, Birmingham, Liverpool and Manchester, Leeds, and Newcastle). METHODS AND FINDINGS: We carried out a retrospective analysis of routinely collected adult population (≥18 years) data at General Practitioner Practice (GPP) level. We used data from the Quality and Outcomes Framework (QOF) on the prevalence of a diagnosis of SMI (schizophrenia, bipolar affective disorder and other psychoses, and other patients on lithium therapy) at the level of GPP over the financial year April 2014 to March 2018. The number of GPPs included ranged between 7,492 (April 2017 to March 2018) to 7,997 (April 2014 to March 2015) and the number of patients ranged from 56,413,719 (April 2014 to March 2015) to 58,270,354 (April 2017 to March 2018). Data at GPP level were converted to the geographic hierarchy unit Lower Layer Super Output Area (LSOA) level for analysis. LSOAs are a geographic unit for reporting small area statistics and have an average population of around 1,500 people. We employed a Bayesian spatial regression model to explore the association of SMI prevalence in England and its major conurbations (greater London, Birmingham, Liverpool and Manchester, Leeds, and Newcastle) with environmental characteristics (green and blue space, flood risk areas, and air and noise pollution) and socioeconomic characteristics (age, ethnicity, and index of multiple deprivation (IMD)). We incorporated spatial random effects in our modelling to account for variation at multiple scales. Across England, the environmental characteristics associated with higher SMI prevalence at LSOA level were distance to public green space with a lake (prevalence ratio [95% credible interval]): 1.002 [1.001 to 1.003]), annual mean concentration of PM2.5 (1.014 [1.01 to 1.019]), and closeness to roads with noise levels above 75 dB (0.993 [0.992 to 0.995]). Higher SMI prevalence was also associated with a higher percentage of people above 24 years old (1.002 [1.002 to 1.003]), a higher percentage of ethnic minorities (1.002 [1.001 to 1.002]), and more deprived areas. Mean SMI prevalence at LSOA level in major conurbations mirrored the national associations with a few exceptions. In Birmingham, higher average SMI prevalence at LSOA level was positively associated with proximity to an urban green space with a lake (0.992 [0.99 to 0.998]). In Liverpool and Manchester, lower SMI prevalence was positively associated with road traffic noise ≥75 dB (1.012 [1.003 to 1.022]). In Birmingham, Liverpool, and Manchester, there was a positive association of SMI prevalence with distance to flood zone 3 (land within flood zone 3 has ≥1% chance of flooding annually from rivers or ≥0.5% chance of flooding annually from the sea, when flood defences are ignored): Birmingham: 1.012 [1.000 to 1.023]; Liverpool and Manchester: 1.016 [1.006 to 1.026]. In contrast, in Leeds, there was a negative association between SMI prevalence and distance to flood zone 3 (0.959 [0.944 to 0.975]). A limitation of this study was because we used a cross-sectional approach, we are unable to make causal inferences about our findings or investigate the temporal relationship between outcome and risk factors. Another limitation was that individuals who are exclusively treated under specialist mental health care and not seen in primary care at all were not included in this analysis. CONCLUSIONS: Our study provides further evidence on the significance of socioeconomic associations in patterns of SMI but emphasises the additional importance of considering environmental characteristics alongside socioeconomic variables in understanding these patterns. In this study, we did not observe a significant association between green space and SMI prevalence, but we did identify an apparent association between green spaces with a lake and SMI prevalence. Deprivation, higher concentrations of air pollution, and higher proportion of ethnic minorities were associated with higher SMI prevalence, supporting a social-ecological approach to public health prevention. It also provides evidence of the significance of spatial analysis in revealing the importance of place and context in influencing area-based patterns of SMI.

Environmental stress, minority status, and local poverty: Risk factors for mental health in Berlin’s inner city

This study examines whether climate change-associated environmental stressors, including air and noise pollution, local heat levels, as well as a lack of surrounding greenspace, mediate the effects of local poverty on mental health, using the 28-item General Health Questionnaire. We recruited 478 adults who were representative of eleven of Berlin’s inner-city neighborhoods. The relationship of individual-level variables, neighborhood-level sociodemographic and environmental data from the Berlin Senate (Department for Urban Development, Building and Housing) to mental health was assessed in a multilevel model using SPSS. We found that neither local exposure to environmental stressors, nor available greenspace as a protective factor, mediated the effects of local poverty on variance in mental health (all p values > 0.2). However, surrounding greenspace (r = -0.24, p < 0.001), nitrogen dioxide levels (r = 0.10, p < 0.05), noise pollution (rho = 0.15, p < 0.01), and particle pollution (r = 0.12, p < 0.001) were associated with local poverty, which, more strongly than individual factors, accounted for variance in mental health (β = 0.47, p < 0.001). Our analysis indicates that the effects of local poverty on mental health are not mediated by environmental factors. Instead, local poverty was associated with both an increased mental health burden and the exposure to climate-related environmental stressors.

A multi-country comparative analysis of the impact of COVID-19 and natural hazards in India, Japan, the Philippines, and USA

Several countries have been affected by natural hazards during the COVID-19 pandemic. The combination of the pandemic and natural hazards has led to serious challenges that include financial losses and psychosocial stress. Additionally, this compound disaster affected evacuation decision making, where to evacuate, volunteer participation in mitigation and recovery, volunteer support acceptance, and interest in other hazard risks. This study investigated the impact of COVID-19 on disaster response and recovery from various types of hazards, with regard to preparedness, evacuation, volunteering, early recovery, awareness and knowledge of different types of hazards, and preparedness capacity development. This study targets hazards such as Cyclone Amphan in India, the Kumamoto flood in Japan, Typhoon Rolly in the Philippines, and the California wildfires in the U.S. This study made several recommendations, such as the fact that mental health support must be taken into consideration during COVID-19 recovery. It is necessary to improve the genral condition of evacuation centers in order to encourage people to act immediately. A pandemic situation necessitates a strong communication strategy and campaign with particular regard to the safety of evacuation centers, the necessity of a lockdown, and the duration required for it to reduce the psychological impact. Both national and local governments are expected to strengthen their disaster risk reduction (DRR) capacity, which calls for the multi-hazard management of disaster risk at all levels and across all sectors.

Impact of climate factors, especially temperature and relative humidity on mood fluctuations in bipolar spectrum disorder

Effects of extreme precipitation on hospital visit risk and disease burden of depression in Suzhou, China

Background The purpose of this study was to explore the impact of extreme precipitation on the risk of outpatient visits for depression and to further explore its associated disease burden and vulnerable population. Methods A quasi-Poisson generalized linear regression model combined with distributed lag non-linear model (DLNM) was used to investigate the exposure-lag-response relationship between extreme precipitation (>= 95th percentile) and depression outpatient visits from 2017 to 2019 in Suzhou city, Anhui Province, China. Results Extreme precipitation was positively associated with the outpatient visits for depression. The effects of extreme precipitation on depression firstly appeared at lag4 [relative risk (RR): 1.047, 95% confidence interval (CI): 1.005-1.091] and lasted until lag7 (RR = 1.047, 95% CI: 1.009-1.087). Females, patients aged >= 65 years and patients with multiple outpatient visits appeared to be more sensitive to extreme precipitation. The attributable fraction (AF) and numbers (AN) of extreme precipitation on outpatient visits for depression were 5.00% (95% CI: 1.02-8.82%) and 1318.25, respectively. Conclusions Our findings suggested that extreme precipitation may increase the risk of outpatient visits for depression. Further studies on the burden of depression found that females, aged >= 65 years, and patients with multiple visits were priority targets for future warnings. Active intervention measures against extreme precipitation events should be taken to reduce the risk of depression outpatient visits.

Displaced by climate and disaster-induced relocations: Experiences of cascading displacement in Fiji and the Philippines

Disasters and climate-related risks displace millions of people each year. Planned relocation is one strategy used to address displacement and is increasingly being analyzed for the potential opportunities and challenges it creates for relocated people. However, little attention has been paid to the secondary impacts of planned relocations, and how they influence the risk, vulnerability and well-being of other groups, particularly people who live on the land that is selected for relocation sites, or in neighboring areas. This paper explores how current and potential future planned relocations in Fiji and the Philippines redistribute vulnerabilities to non-target communities who previously lived on, or alongside, relocation site land. The notion of cascading displacement is introduced to illustrate a serious consequence of planned relocations in which insecurity and displacement are re-created and perpetuated due to a failure to consider the needs of non-target groups who are directly disadvantaged by relocation processes. Insights from this paper may be used to inform future relocation policy and practice for more equitable and sustainable outcomes for all involved. This article is protected by copyright. All rights reserved.

Climate change, mental health and wellbeing: Privileging pacific peoples’ perspectives – phase one

Impacts of climate change in the Pacific are far reaching and include effects on mental health and wellbeing. Pacific concepts around the interrelation of these global giants are yet to be described. The aim of this study was to seek consensus amongst Pacific mental health and/or climate change experts on key principles underpinning mental health and wellbeing, and climate change, and the intersection of the two, for Pacific peoples. The Delphi method included forming a panel of 70 experts. Two rounds of online questionnaires sought their views on mental health and wellbeing, and climate change and the impact upon Pacific peoples. Of the panel 86% identified with one or more Pacific ethnicities. Six themes emerged, 92% of items reached consensus and 36% reached strong consensus of >95%. Recurring subthemes included culture and spirituality, family and community, connection to ancestors, connection to the environment, resilience, disasters, livelihoods, government, education, workforce, migration and stigma. This is the first time these concepts have been explored and described for, and by Pacific peoples in this format. It is a necessary first step towards development of responses in preparedness of mental health services, in the Pacific region, and Aotearoa New Zealand.

Climate disasters and subjective well-being among urban and rural residents in Indonesia

Climate disasters pose a risk to residents’ well-being globally. However, information about the impact of climate disasters among urban and rural residents remains lacking, especially in Indonesia. This study aims to fill the gap by investigating the impact of climate disaster on subjective well-being based on urban and rural typology model. The data were cross-sectional, involving 7110 Indonesian residents who had experienced climate disasters, 3813 from urban areas and 3297 from rural areas. An ordered probit model was employed to estimate the impact of climate disasters on subjective well-being (i.e., happiness and life satisfaction). In general, the empirical results show that climate disasters do not significantly affect the happiness of Indonesian residents, but they significantly and negatively impact their life satisfaction. Further analysis reveals that climate disasters impact urban and rural residents differently. The subjective well-being of rural residents is more severely affected than those living in urban areas. Further estimation also indicated that climate disaster significantly reduces residents’ subjective well-being at the lowest income level for both rural and urban residents. Our finding confirms that rural residents remain the most vulnerable to the impacts of climate change.

Acute-stage mental health symptoms by natural disaster type: Consultations of Disaster Psychiatric Assistance Teams (DPATS) in Japan

This study analyzed the support activities that the Disaster Psychiatric Assistance Team (DPAT) in Japan provided following four previous disasters (a volcanic eruption, a mudslide, a flood, and an earthquake) to identify links between the disaster type and the characteristics of acute stage mental disorders observed. Using Disaster Mental Health Information Support System database records of consultations with patients supported by the DPAT during the survey period from 2013 (when DPAT was launched) to 2016, we performed cross-tabulations and investigated significant differences using chi-squared tests. For expected values less than 5, Fisher’s exact test was performed. Frequently occurring acute-stage symptoms after a disaster include anxiety, sleep problems, mood and affect, and physical symptoms. The affected population characteristics, victim attributes, severity of damage sustained, and evacuation status were the chief factors that influenced acute-stage mental health symptoms. The psychiatric symptoms detected in our study together with the results of diagnoses are important for determining the types of early interventions needed during the acute stage of a disaster. By sharing baseline mental health information, together with disaster-related characteristics highlighted in this study, mental health providers are better able to predict future possible mental disorders and symptoms.

Ambient temperature and external causes of death in Japan from 1979 to 2015: A time-stratified case-crossover analysis

BACKGROUND: Although substantial evidence suggests that high and low temperatures are adversely associated with nonaccidental mortality, few studies have focused on exploring the risks of temperature on external causes of death. OBJECTIVES: We investigated the short-term associations between temperature and external causes of death and four specific categories (suicide, transport, falls, and drowning) in 47 prefectures of Japan from 1979 to 2015. METHODS: We conducted a two-stage meta-regression analysis. First, we performed time-stratified case-crossover analyses with a distributed lag nonlinear model to examine the association between temperature and mortality due to external causes for each prefecture. We then used a multivariate meta-regression model to combine the association estimates across all prefectures in Japan. In addition, we performed stratified analyses for the associations by sex and age. RESULTS: A total of 2,416,707 external causes of death were included in the study. We found a J-shaped exposure-response curve for all external causes of death, in which the risks increased for mild cold temperatures [20th percentile; relative risk (RR) = 1.09 (95% confidence interval [CI]: 1.05,1.12)] and extreme heat [99th percentile; RR = 1.24 (95% CI: 1.20, 1.29)] compared with those for minimum mortality temperature (MMT). However, the shapes of the exposure-response curves varied according to four subcategories. The risks of suicide and transport monotonically increased as temperature increased, with RRs of 1.35 (95% CI: 1.26, 1.45) and 1.60 (95% CI: 1.35, 1.90), respectively, for heat, whereas J- and U-shaped curves were observed for falls and drowning, with RRs of 1.14 (95% CI: 1.03, 1.26) and 1.95 (95% CI: 1.70, 2.23) for heat and 1.13 (95% CI: 1.02, 1.26) and 2.33 (95% CI: 1.89, 2.88) for cold, respectively, compared with those for cause-specific MMTs. The sex- and age-specific associations varied considerably depending on the specific causes. DISCUSSION: Both low and high temperatures may be important drivers of increased risk of external causes of death. We suggest that preventive measures against external causes of death should be considered in adaptation policies. https://doi.org/10.1289/EHP9943.

Enhancing the resilience and well-being of rural poor to climate risks: Are the economic functions of social protection enough?

As climate change accelerates, adaptive social protection programmes are becoming increasingly more popular than conventional social assistance programmes, since they are seen to enhance people’s resilience and well-being outcomes. Despite this upsurge, little is known about the impacts of adaptive programmes on resilience and well-being outcomes as compared to conventional programmes. This paper examines the economic functions that both types of social protection programmes offer through empirical studies in two climate-vulnerable zones in Bangladesh. By operationalising a simplified analytical framework to comprehend subjective resilience, the qualitative data reveal that the adaptive programme is more effective in enhancing beneficiaries’ perceived resilience to climate risks. Regrettably, neither programme is found to contribute much significantly in terms of enabling beneficiaries to achieve the desired well-being outcomes that one might expect to see. The paper offers rich insights into the design components of the programmes, affording an on-the-ground understanding of their implications for resilience and well-being.

Does active transport create a win-win situation for environmental and human health? The moderating effect of leisure and tourism activity

Although active transport contributes to environmental and human health, only limited research has been conducted on what makes people participate in active transport in tourism-related contexts. To fill this gap, research was conducted on theoretically conceptualized relationships between pro-social behavior on active transport, air quality, climate change mitigation, and health with a moderator of leisure and tourism activity. In order to collect data, an online survey was conducted targeting Korean cyclists and walkers, and PLS-SEM and deep learning were applied for data analysis. Results revealed that pro-social behavior on active transport has a great effect on perceived air quality. Health is strongly influenced by pursuing climate change mitigation and a strong impact of active transport on health was identified. There were greater effects between pro-social behavior and air quality as well as pro-social behavior and climate change mitigation for those engaged in active transport for tourism than for leisure, while the leisure group has a stronger relationship between pro-social behavior and health than for tourism. The results are valuable for encouraging active transport behavior.

Exploring multiple pathways and mediation effects of urban environmental factors for suicide prevention

Public health is threatened by air pollution and high temperature, especially in urban areas and areas impacted by climate change. Well-designed urban forms have co-benefits on promoting human health and mediating atmospheric environment-related threats (e.g., high temperature and air pollution). Previous studies overlooked these mediating effects of urban form on suicide mortality. This study used partial least squares modeling and countywide data in Taiwan to identify the crucial influences and pathways of urban environment, socioeconomic status, and diseases on suicide mortality. The model considered the impact of the characteristics of urban form (i.e., urban development intensity, land mix, and urban sprawl), urban industrial status (i.e., industrial level), urban greening (i.e., green coverage), disease (i.e., important diseases morbidity of human immunodeficiency virus [HIV], cerebrovascular disease [CVD], chronic liver disease and cirrhosis [CLDC], nephritis, nephrotic syndrome and nephrosis [NNSN], malignant tumor [MT]), socioeconomic status (i.e., income level and aging population rate), and the atmospheric environment (i.e., air pollution and high temperature) on suicide mortality. Optimizing land mix and minimizing urban development intensity and urban sprawl have been found to reduce suicide mortality. The mediating effect of urban form on suicide mortality originated from air pollution and high temperature, and mediating air pollution was greater than high temperature. Furthermore, industrial level, important diseases (HIV, CVD, CLDC, NNSN, and MT) morbidity, an aging population rate, air pollution, and high temperature were associated with an increase in suicide mortality, whereas green coverage and income level were associated with a reduction in suicide rates. The findings demonstrate that appropriate urban policy and urban planning may lower suicide mortality, be useful strategies for suicide prevention, and be a foundation for building a healthy city. Moreover, this study provides clarity on the complex relationship of suicide and the urban environment while identifying crucial factors.

Living with flux in the Philippines: Negotiating collective well-being and disaster recovery

Anthropogenic climate change poses huge challenges to humanity. The frequency and magnitude of extreme weather is increasing. As more attention turns to disaster preparedness and recovery, it is worth recognising that many communities have a long history of living with the flux of planetary dynamism. They are experienced in negotiating collective well-being with one another and with the earth. Other communities have less experience and know-how and have had to adopt more experimental approaches. In this paper we draw on planetary social thought and critical disaster studies to re-think disaster recovery. We present stories of communities in the Philippines differently negotiating collective well-being in the face of climate uncertainty.

Predicting the number of hospital admissions due to mental disorders from air pollutants and weather condition descriptors using stacked ensemble of Deep Convolutional models and LSTM models (SEDCMLM)

Air pollution has negative impact on health status of the population. Several previous studies have been assessed the short-term and/or long-term effect of air pollutants on different diseases. An important sign of increasing the number of new people suffering from a disease or worsening the disease among the persons is increasing the hospitalization rate due to the disease. Increasing the incidence rate or severity of mental disorders which leads to patient hospitalization due to these types of diseases have negative impacts on the socio-economic aspects on the affected countries. Therefore, predicting the hospitalization rate due to mental disorders in advance may be helpful for health institutions to be prepared for dealing with these situations. Thus, the main aim of this study is proposing a novel stacked ensemble of Deep Convolutional neural network model and long short-term memory model (SEDCMLM) to predict the number of hospitalizations due to psychological disorders from the air pollutants and weather condition descriptors. This study considers all mental disorders included in International Statistical Classification of Diseases and Related Health Problems (ICD-10). Previous studies have shown that weather descriptors are highly correlated with air pollution. Therefore, we consider both of them as input variables in this study. Input variables include air pollutant indices and weather condition descriptors gathered in range of March 21, 2014 to 1/18/2017 from Tehran Air Quality Control Company (AQCC) and Meteorological Organization of Iran, respectively. The experimental results show that SEDCMLM outperforms the compared models for psychological hospitalization prediction and it leads to desirable performance with Root Mean Square Error (RMSE) of 1.62, Mean Absolute Error (MAE) of 1.48 and Mean R-2 of 0.91. The short-term effect of air pollution on the number of admissions due to mental disorders are investigated for 1 to 10 previous days. It is shown that the best performance of the prediction models is obtained while considering data of 2e4 previous days. Moreover, considering air pollutants, weather descriptors and the number of psychological hospitalization in the previous days can lead to the best performance for predicting the number of psychological patient admissions in the current day. According to the experimental results, air pollutants are good predictors for number of patient admissions due to mental disorders per day Therefore, it is recommended to use policies for reducing the level of air pollutants. (c) 2020 Elsevier Ltd. All rights reserved.

Exploring climate-driven non-economic loss and damage in the Pacific Islands

Non-economic loss and damage induced by climate change in the Pacific Islands region has been reported as fears of cultural loss, deterioration of vital ecosystem services, and dislocation from ancestral lands, among others. This paper undertakes an in-depth systematic review of literature from the frontlines of the Pacific Islands to ascertain the complexities of non-economic loss and damage from climate change. We synthesise knowledge to date on different but inter-connected categories of non-economic loss and damage, namely: human mobility and territory, cultural heritage and Indigenous knowledge, life and health, biodiversity and ecosystem services, and sense of place and social cohesion. Identifying gaps and possibilities for future research agendas is presented. Synthesising knowledge to date and identifying remaining gaps about non-economic loss and damage is an important step in taking stock of what we already know and fostering action and support for addressing loss and damage in the years to come.

Understanding and responding to climate-driven non-economic loss and damage in the Pacific Islands

Communities throughout the Pacific Islands region have experienced, and will continue to experience, extensive non-economic loss and damage (NELD) from climate change. Assessments of loss and damage, however, often fall short on their coverage of these non-economic dimensions, which can distort our understanding of climate change impacts, discount the experiences of some and skew future decision-making. This paper explores how stakeholders in the Pacific Islands understand NELD and what they perceive to be the best ways of responding to it. An open-ended questionnaire was used to collect qualitative and quantitative data from representatives from governments, donors and development partners, civil society, intergovernmental organisations, and relevant others. This study found that NELD in the Pacific Islands is understood, perceived and experienced through the lens of intangible values, identity and cultural landscapes, and this is encapsulated by a typology with eight interconnected core dimensions. These eight dimensions include: health and wellbeing, ways of being, future ways of being, cultural sites and sacred places, Indigenous and local knowledge, life sustaining tools, biodiversity and ecosystem services, and connection to land and sea. NELD is complex, entangled and interconnected, thereby significantly undermining entire socio-ecological systems. Moving forward, responding to NELD in the Pacific Islands region will require a comprehensive approach that protects, conserves and restores complex socio-ecological systems, and provides opportunities to work through loss and damage by means of education and training, safeguarding knowledge systems, community activities, cultural connection and maintenance, and strong relationships with land and sea.

Enhancing emotional resilience in the face of climate change adversity: A systematic literature review

Australians have experienced repetitive exposure to climate change adversity (either in-person or through televised exposure from media and internet sources). As these events become more prevalent and severe, developing, and implementing strategies to enhance emotional resilience at individual, community, and government levels is beneficial. This literature review examines one way of addressing this issue: enhancement of societal emotional resilience capabilities that can minimize negative impacts of climate change adversity upon emotional wellbeing. The study also offers an initial exploration of climate change adversity and emotional resilience. A systematic literature review identified key research themes. Subsequent findings identified policy and framework recommendations aimed at supporting emotional resilience in communities. Such strategies should focus on community preparedness through needs-based assessments and community engagement, fostering knowledge-building pathways and ongoing collaboration among system levels to address a diversity of community needs. These systematic approaches would ensure the accessibility and appropriateness of relevant supports by establishing frameworks that are regularly monitored, evaluated, and promoted.

Climate change risk and terror management theory

Being intrinsically associated with death-related themes (e.g. decay, destruction, lack of control, chaos), communicating climate change risks may elicit thoughts in an audience about their own mortality – potentially invoking terror management responses. This study examined individual differences in death-thought accessibility (DTA) amongst Australian university students (N=241) after exposure to information about climate change impacts, to predict climate change risk perceptions. It was posited that information about the impacts of climate change would lead to worldview defence (a terror management strategy) via increasing death-related thoughts. Although climate change salience did not invoke DTA, there was evidence that choosing not to complete word-fragments in a death-related manner reflected a high death-defensive response, rather than low-DTA. Compared with a control condition, climate change salience participants’ risk perceptions shifted liberally. The function of death-related thoughts depended on the individual’s climate change beliefs. Climate-deniers with high-DTA in the climate change salience condition showed greater risk perceptions compared to those with high-DTA in the control condition. Risk perceptions did not change as a function of DTA amongst climate-acceptors. A general implication was that climate change communications, may not produce counterproductive terror management outcomes as has been previously hypothesized. Rather they may motivate more realistic attitudes, such as perceiving climate change as high-risk, even amongst climate-deniers. From a policy perspective, to maximise acceptance, climate change information may benefit from being presented within frameworks that support individuals important personal worldviews.

Disempowering emotions: The role of educational experiences in social responses to climate change

The process of learning about climate change is not simply cognitive. It is also an emotional encounter that may have enduring effects. To date, little research has attended to the emotional significance of childhood learning experiences of climate change in adult lives and in social responses to climate change. We report a qualitative study exploring the variety, complexity, and the post-school significance of affective experiences of climate change schooling. We interviewed 21 young adults (18-24 years) in Tasmania, Australia, with diverse educational backgrounds and diverse levels of interest in and opinions about climate change. Applying an interpretivist framework, we analysed the tangled and interrelated emotions evident in participant reflections on educational encounters with climate change. Three overarching themes were identified: ‘stripped of power’, ‘stranded by the generation gap’ and ‘daunted by the future’. In contrast to discourses of education as empowering, a majority of participants (n = 16) told of feeling disempowered by their educational encounters with climate change. They described being overwhelmed by an experience of limited agency and power. Participants also identified a generational gap that left them feeling abandoned by older adults, with associated feelings of anger and betrayal. Finally, affective experience of climate change schooling had ongoing significance for participants as they sought to make life choices in the shadow of a frightening future. These findings provide insight into the interaction of facts and feelings in public engagements with climate change. A lack of integration of cognitive and affective experience in climate change schooling may have lasting effects in adult attitudes and behaviours, and related social dynamics of distrust and division, related to this issue. In this study, young adult participants recounted childhood experiences of being powerless, betrayed and afraid in learning about climate change as significant formative encounters in their ongoing understanding of climate change.

Emotions of the anthropocene across Oceania

As human activities have destabilised life on Earth, a new geological era is upon us. While there is a myriad of challenges that have emerged because of such human-driven planetary changes, one area of investigation that requires ongoing scholarly attention and scientific debate is the emotions of the Anthropocene. The emotional, mental, and psychological burdens induced by rapid and unprecedented change must be understood to better reflect the experiences of people around the globe and to initiate conversations about how emotions may be used for transformative change and effective politics. This paper aims to provide insights into the types of emotions that are emerging in Oceania as the Anthropocene unfolds. To do this, we draw on several data sets: questionnaire results with visitors of Mt Barney Lodge in the World Heritage Gondwana area in Queensland, Australia; another questionnaire with Pacific Island “experts” engaged in climate change, development, and disaster risk management work; interviews with locals living in the Cook Islands; and various spoken, written, and visual art from the Pacific. Bringing these data sets together allows us to explore a diversity of experiences, perspectives, and emotional responses to the Anthropocene from participants across Oceania. We found that acute and slow-onset weather events, experiences of direct loss and change, a perceived lack of agency or control over futures, and a sense of injustice triggered emotions including fear, stress, anxiety, exhaustion, sadness, grief, anger, frustration, helplessness, worry, but also empowerment. These results are critical for the first step of acknowledging and naming the emotions that are emerging in Oceania, such that they can then be worked through, and may be used for transformative change, effective politics, and agency over futures.

Minding environment, minding workers: Environmental workers’ mental health and wellbeing

Climate change and environmental degradation caused by human activities are having an irrefutable impact on human health, particularly mental health. People working in the environment sector are confronted with these impacts daily. This exploratory study was conducted as a response to concern in the sector about rising levels of worry and distress, and a need for organizational knowledge about effective workplace mental health strategies. Using evidenced-based frameworks for workplace mental health and wellbeing, the study focused on the relationship between climate change, environmental degradation and mental health issues for this sector. This Australian-based exploratory qualitative study was guided by participatory research approaches. Maximum variation and criterion sampling strategies were applied to engage environmental sector senior managers (n = 8) in individual/paired interviews, followed by online focus group sessions with frontline employees (n = 9). Qualitative thematic analysis techniques were used in an iterative process, combining inductive and deductive strategies. Data was triangulated and interpretation was finalized with reference to literature and a workplace mental health promotion framework. Interview data provided new perspectives on the interconnectivity between risk and protective factors for mental health. Workers were motivated by commitment and values to continue their work despite experiencing increasing levels of trauma, ecological grief, and stress due to overwork and ecological and climate change crises. The findings highlight the need for integrated health promotion approaches that acknowledge the complex interactions between risk and supportive factors that influence mental health in this sector.

Longitudinal relations between climate change concern and psychological wellbeing

Concerns about the effects of climate change are mainstream, and the climate crisis might have greater psychological impact on younger people. We hypothesise that climate concern will have detrimental links with psychological wellbeing over time, and that this association will be more pronounced among younger adults. We test our pre-registered predictions using two waves of an annual national probability panel study-the New Zealand Attitudes and Values Survey (N = 13,453). Cross-lagged models examining effects within the same individuals over time indicated that climate concern predicted a small residual increase in psychological distress, but not in life satisfaction, one year later. However, there was no evidence that the associations varied across age. These longitudinal findings indicate a novel link between climate concern and psychological distress, which is apparent across the adult lifespan.

Climate change-related worry among Australian adolescents: An eight-year longitudinal study

BACKGROUND: Worry about climate change may be associated with poorer mental health but also with greater political engagement. We determined trajectories of climate change-related worry over adolescence and whether these were associated with depression symptoms and greater engagement with news and politics in late adolescence. METHODS: At ages 10-11, 12-13, 16-17 and 18-19 years, adolescents participating in the Kindergarten cohort of the Longitudinal Study of Australian Children rated their worry about climate change. At age 18-19 years, participants reported on depression symptoms and engagement with news and politics. Latent profile analysis determined trajectories of climate change-related worry across all time points (N=2244). Linear regression analyses examined the association between trajectories and outcomes at 18-19 years. RESULTS: Thirteen per cent (n=290) of adolescents had high persistent worry. The largest proportions had moderate (n=559, 24.9%) or increasing worry (n=546, 24.3%), followed by persistent low worry (n=376, 16.8%), slightly decreasing worry (n=297, 13.2%) and steeply decreasing worry (n=176, 7.8%). Adolescents with high persistent worry had higher depression symptoms at age 18-19 years compared to the moderate group, while those with increasing worry did not. The high persistent and increasing worry groups reported greater engagement with news and politics across several measures. CONCLUSION: This is the first study to track climate-related worry and outcomes in young people across adolescence. A substantial number of Australian adolescents experience high or increasing worry about climate change, which is associated with greater societal engagement.

Coping and adapting to climate change in Australia: Yoga perspectives

Scientists caution against ignoring human-induced climate change and related health repercussions, with a growing body of literature highlighting the mental health effects of climate change and the importance of understanding coping and adaptation strategies. Less is known, however, about sustainable personal practices fortifying mental health in the context of climate change. The present study sought to investigate how long-term yoga practitioners (yoga therapists or yoga teachers) in Australia with a lived experience of climate change-related events are coping and adapting. The aim was to better understand participants’ reports of climate change-related experiences and how yoga influences their mental health and choices in the face of climate change. Eleven in-depth telephone interviews were conducted and analyzed using an interpretive phenomenological methodology. Participants reported that their ongoing relationship with yoga influences how they cope with climate change-related stressors and their being-in-the-world, and how concern for all life bolsters their responses to climate change. The results illustrate the part yoga may play in supporting long-term practitioners to prepare for, cope with, and respond to climate change events and impacts. Offering inclusive, interdisciplinary yoga therapy and community-based networks fostering ethical living and response flexibility may prove beneficial not only for the mental health and coping ability of participants, but for the planet.

Hope, coping and eco-anxiety: Young people’s mental health in a climate-impacted Australia

(1) Background: In Australia, young people are one of the most vulnerable populations to the mental health impacts of climate change. The aim of this article was to explore mental health promotion issues related to climate change for young people in Australia. (2) Methods: An exploratory mixed-method approach, co-led by young people, was used to engage young people living in Australia aged 18-24 years in semi-structured interviews (N = 14) and an online survey (N = 46). Data were analysed thematically and with descriptive statistics. (3) Results: Findings indicated that negative impacts included worry, eco-anxiety, stress, hopelessness/powerlessness and feelings of not having a voice. Several mediating factors, in particular social media engagement, highlighted the duality of mental health impacts for young people’s mental health. Positive impacts of climate action included feeling optimistic and in control. (4) Conclusions: This exploratory study contributes to an emerging field of public health research on young people’s mental health in a climate-impacted Australia. Climate change is a significant concern for young people, and it can negatively affect their mental health. The findings can inform the design of public health interventions that raise awareness of climate change-related mental health issues among young people and promote their participation in nature-based interventions, climate action and empowering social media engagement.

The pandemic is not occurring in a vacuum: The impact of COVID-19 and other disasters on workforce mental health in Australia

OBJECTIVE: Prior to coronavirus disease (COVID-19), many Australians experienced extreme bushfires, droughts, and floods. A history of experiencing these events might be a risk factor for increased psychological distress during COVID-19. This study aimed to provide insight into the mental health of Australian workers during the initial COVID-19 outbreak, with an additional focus on whether previous disaster exposure and impact from that disaster is a risk factor for increased psychological distress. METHODS: A snowball recruitment strategy was used. Participants (n = 596) completed an online survey, which included the Depression Anxiety Stress Scales-21, and questions related to mental health and disaster exposure. RESULTS: Overall, 19.2%, 13.4%, and 16.8% of participants were experiencing moderate to extremely severe depression, anxiety, and stress symptoms, respectively. Multiple regression found that higher depression, anxiety, and stress symptoms were associated with a pre-existing mental health diagnosis; only higher stress symptoms were associated with having experienced a disaster, with impact, in addition to COVID-19. CONCLUSIONS: People who have experienced impact from an additional disaster might need additional support to protect their mental health during COVID-19. A focus on the cumulative mental health impacts of multiple disasters and the implications for organizational communities where recovery work is undertaken, such as schools and workplaces, is needed.

Immediate and delayed effects of climatic factors on hospital admissions for schizophrenia in Queensland Australia: A time series analysis

BACKGROUND: Evidence of immediate and delayed effects of climatic drivers on hospital admissions for schizophrenia is limited and inconsistent. We aimed to assess the association between climatic factors and daily hospital admissions for schizophrenia in Queensland, Australia. METHODS: Daily hospital admissions for schizophrenia from January 1, 1996 to December 31, 2015 in all private and public hospitals of Queensland were obtained from Queensland Health. The association between climatic factors and hospital admissions for schizophrenia were analysed using Generalised Linear Models with Poisson distribution (GLM) and Distributed Lag non-linear Models (DLNM) across different climatic zones. RESULTS: In South East Queensland, only daily mean temperature showed an immediate negative effect on schizophrenia admissions (RR 0.93, 95%CI 0.90-0.98, p value < 0.001). For other regions, the adverse effect of temperature on hospital admissions was not significant, however, relative humidity (North: RR 1.01, 95%CI 1.00-1.02, p = 0.05) and air pressure (North: RR 1.03, 95%CI 1.00-1.05, p = 0.04; South West: RR 1.01, 95%CI 1.00-1.02, p = 0.05) had an immediate and positive effect on hospital admissions. Moreover, climatic factors had some delayed effects on schizophrenia admissions in different regions of Queensland, i.e. temperature over 0-4 lag days (South East: RR 0.97, 95%CI 0.94-0.98, p = 0.05; South West: RR 0.96, 95%CI 0.94-0.98, p = 0.01), relative humidity over 0-7 lag days (North: RR 0.95, 95%CI 0.92-0.98, p = 0.01; Central: RR 1.02, 95%CI 1.00-1.03, p = 0.05) and rainfall over 0-21 lag days (North: RR 1.03, 95%CI 1.01-1.04, p = 0.01). Meta-analysis showed significant pooled delayed effects of temperature (0-15 days lag: RR 0.95, 95% CI 0.93-0.98, p value < 0.001), relative humidity (0-7 days: RR 0.96, 95%CI 0.92-0.99, p < 0.001); rainfall (0-21 lag days: RR 1.03, 95%CI 1.01-1.04, p < 0.001) and air pressure (0-7 days lag: RR 1.02, 95%CI 1.00-1.04, p < 0.001) on schizophrenia admissions in Queensland. DISCUSSION: As this is the largest study from Australia and also internationally to extensively examine both short term and delayed association between climatic factors and daily admissions for schizophrenia, the results of the study indicate that climate plays an important role in the sudden exacerbation of acute episodes of schizophrenia. Thus, preventive measures could be taken to reduce the severity of symptoms as well as hospital admissions due to schizophrenia during vulnerable periods.

Explainable deep learning predictions for illness risk of mental disorders in Nanjing, China

Epidemiological studies have revealed the associations of air pollutants and meteorological factors with a range of mental health conditions. However, little is known about local explanations and global understanding on the importance and effect of input features in the complex system of environmental stressors – mental disorders (MDs), especially for exposure to air pollution mixture. In this study, we combined deep learning neural networks (DLNNs) with SHapley Additive exPlanation (SHAP) to predict the illness risk of MDs on the population level, and then provided explanations for risk factors. The modeling system, which was trained on day-by-day hospital outpatient visits of two major hospitals in Nanjing, China from 2013/07/01 through 2019/02/28, visualized the time-varying prediction, contributing factors, and interaction effects of informative features. Our results suggested that NO(2), SO(2), and CO made outstanding contributions in magnitude of feature attributions under circumstances of mixed air pollutants. In particular, NO(2) at high concentration level was associated with an increase in illness risk of MDs, and the maximum and mean absolute SHAP value were approximated to 10 and 2 as a local and global measure of feature importance, respectively. It presented a marginally antagonistic effect for two pairs of gaseous pollutants, i.e., NO(2) vs. SO(2) and CO vs. NO(2). In contrast, CO and SO(2) displayed the opposite direction of feature effects to the rise of observed concentrations, but an apparent synergistic effect was obviously captured. The primary risk factors driving a sharp increase in acute attack or exacerbation of MDs were also identified by depicting prediction paths of time-series samples. We believe that the significance of coupling accurate predictions from DLNNs with interpretable explanations of why a prediction is completed has broad applicability throughout the field of environmental health.

Exploring the effects of natural capital depletion and natural disasters on happiness and human wellbeing: A study in China

Since recent climate change has caused more natural disasters (NDs) than ever before, there is a worldwide concern that this could have both short-term and long-term economic and health consequences. This is perhaps the first attempt to explore the effects of natural capital (NC) and NDs on the human health and wellbeing of China over the period 1993-2020. The study has compiled data from World Bank, World Value Survey, UNDP, EM-DAT, and IMF for analysis. The empirical analysis is done by using the autoregressive distributed lag model. Empirical results prove that NC has a positive and significant effect on happiness, health, and human wellbeing in the long run. The results also show that NDs significantly reduce happiness and human wellbeing in the long run. The results recommend some important policy implications.

Gaming to cope: Applying network analysis to understand the relationship between posttraumatic stress symptoms and internet gaming disorder symptoms among disaster-exposed Chinese young adults

Research has demonstrated that posttraumatic stress disorder (PTSD) is associated with internet-related problematic behaviors. However, studies have not explored the linkage between PTSD symptoms and internet gaming disorder (IGD) symptoms. The current study aimed to investigate the relationship between posttraumatic stress symptoms (PTSS) and IGD symptoms via network analysis. We conducted a cross-sectional study with 341 Chinese young adults directly exposed to a typhoon and examined the network structure of PTSS and IGD symptoms, along with bridge symptoms, to elucidate how they co-occur. Results indicated that ‘avoiding external reminders’ and ‘anhedonia’ were identified as the most central symptoms in the PTSD network, whereas ‘preoccupation,’ ‘gaming despite harms’, and ‘loss of control’ ranked highest on centrality in the IGD network. Two bridge symptoms emerged within the combined PTSD and IGD network model: ‘concentration difficulties’ and ‘conflict due to gaming’ from among the PTSS and IGD symptoms, respectively. These findings reveal novel associations between PTSS and IGD symptoms and provide an empirically-based hypothesis for how these two disorders may co-occur among individuals exposed to natural disasters.

Arts-based psychosocial training after the Yolanda typhoon in the Philippines

This study focuses on an arts-based mental health and psychosocial support (MHPSS) intervention in the form of TOT (training of trainers) conducted under the auspices of IsraAID in the aftermath of the Yolanda typhoon in the Philippines in 2013. Interviews were conducted with 10 female education and healthcare professionals, who also made drawings of their experiences. The goal was to better understand how they evaluated the training program, both for themselves and their communities. Analysis of the interviews and drawings, based on the principles of Consensual Qualitative Research (CQR), identified three main domains: (1) Supportive and inhibiting factors for participants in the training course; (2) Supportive and inhibiting factors with respect to the participants’ implementation of the training goals in their local communities; (3) Perceptions of the benefits of the training program for the participants and their communities. The discussion centers on the value of the creative process, the importance of the group in the training course and in the context of multiculturalism, and the impact these factors in interventions applying the TOT model.

Measurement and community antecedents of positive mental health among the survivors of Typhoons Vamco and Goni during the COVID-19 crisis in the Philippines

The present study examined the measurement and antecedents of positive mental health in people who concurrently experienced two disasters of different nature (i.e., typhoons and COVID-19 crisis), focusing on the survivors of typhoons Vamco and Goni that hit the Philippines in November 2020, during the COVID-19 pandemic. First, we investigated the psychometric prop-erties of Mental Health Continuum-Short Form (MHC-SF), a well-validated measure of positive mental health dimensions (i.e., emotional, social, and psychological well-being) by: 1) comparing the structural validity of three measurement models including a single-factor, bifactor, and three-factor solutions of positive mental health; 2) looking into the criterion validity through corre-lating the MHC-SF subscales with relevant measures; and 3) calculating for item reliability. Second, we examined the mediating role of social responsibility in the positive influence of community resilience on the three dimensions of positive mental health. Using 447 participants, with ages ranging from 18 to 70 years old, confirmatory factor analysis showed that compared to the single-factor and the bifactor models, the intercorrelated three-factor model of MHC-SF has the best model fit and most stable factor loadings. MHC-SF subscales correlated with relevant measures indicating criterion validity and yielded excellent internal consistency for all subscales. Additionally, results showed that social responsibility mediated the positive impact of community resilience on emotional, social, and psychological well-being of Filipinos in times of great ad-versities. The findings were discussed within the context of extreme weather events and the COVID-19 crisis in the Philippines, highlighting implications on disaster preparedness and mental health policies at the community level.

Remembering the super-typhoon: Some, but not all, qualities of first-hand survivor memories of natural disaster are similar to near death experience and flashbulb memory accounts

The strongest storm in Philippines history, super-typhoon Haiyan, barreled through central Philippines in 2013 and left a high death toll and extensive destruction in its wake. Past studies have investigated Fading Affect Bias (FAB) in extremely negative situations like the death of a loved one and found that the FAB generally occurs in those extreme situations, but this study is the first to assess FAB in first-hand memories for a natural disaster survival situation. The FAB phenomenon is the tendency for emotional intensity associated with negative memories for events to fade over time and emotional intensity for positive events stays relatively stable over time. Researchers collected memories for the super-typhoon from survivors three years after the event. Results showed that negative emotional intensity for the event faded after the event. Emotion in comparison positive memories for non-typhoon events did not fade, and emotion in comparison negative memories faded, following results in several other FAB studies. The Positive and Negative Affect Scale (PANAS) was used as an initial assessment of mood before the study began, and PANAS scores reliably predicted current emotional intensity scores. Memory vividness and emotional intensity in first-hand accounts of a natural disaster experience behave like vividness and intensity in flashbulb memories, but details in first-hand accounts are similar to the amount of details in memories of near-death experiences. How memory rehearsal behaves in relation to time elapsed since event has yet to be captured for first-hand survival experiences.

The lived experience of victims of catastrophic coastal erosion: A cycle of impact, consequence and recovery

OBJECTIVES: Environmental hazards are part of the Earth’s natural cycle and are ongoing within human history. When vulnerable situations meet environmental hazards, disasters occur where human and natural costs could be enormous. This study aimed to explore the experiences of the victims of coastal erosion during the monsoon season. METHODS: Seven victims of catastrophic coastal erosion in the Kollam District of Kerala, India, were interviewed from December 2013 to February 2014. The study followed Edmond Husserl’s descriptive phenomenological method. RESULT: These interviews constituted the primary data source. Three main themes with eleven subthemes emerged from these data. The main themes were impact, consequences and recovery. The subthemes were living in constant fear, escaping from the catastrophe; cataclysmic sea waves and their tumultuous behaviour, instant damage and destruction, the epoch of losses; agony and suffering; homelessness-helplessness-sleeplessness mixed with fear; government aid only in dreams; haunting memories; never-ending daily needs; first home and native land; and the desire to go back to the site of the disaster. CONCLUSION: From the derived themes, a phenomenon associated with coastal erosion evolved. The phenomenon is termed “Catastrophic coastal erosion: A cycle of impact, consequences, and recovery.”

Aberrant white matter microstructure evaluation by automated fiber quantification in typhoon-related post-traumatic stress disorder

Super typhoons can lead to post-traumatic stress disorder (PTSD), which can adversely affect a person’s mental health after a disaster. Neuroimaging studies suggest that patients with PTSD may have post-exposure abnormalities of the white matter. However, little is known about these defects, if they are localized to specific regions of the white matter fibers, or whether they may be potential biomarkers for PTSD. Typhoon survivors with PTSD (n = 27), trauma-exposed controls (TEC) (n = 33), and healthy controls (HCs) (n = 30) were enrolled. We used automated fiber quantification (AFQ) to process the participants’ DTI and compared diffusion metrics among the three groups. To evaluate diagnostic value, we used support vector machine (SVM) and a random forest (RF) classifier to build a machine learning model. White matter fiber segmentation between the three groups was found to be statistically significant for the fractional anisotropy (FA) value of the right anterior thalamic radiation (ATR) (26-50 nodes) and right uncinate fasciculus (UF) (60-72 nodes) (FDR correction, p < 0.05). By analyzing the characteristics of the machine learning model, the two most important variables were the right ATR and right UF for differentiating PTSD and trauma-exposed controls (TEC) from the healthy controls (HC). In addition, the left cingulum cingulate and left UF were the most critical variables in the differentiation of PTSD and TEC. AFQ with machine learning can localize abnormalities in specific regions of white matter fibers. These regions may be used as a diagnostic biomarker for PTSD.

Evaluation of gray matter reduction in patients with typhoon-related posttraumatic stress disorder using causal network analysis of structural MRI

BACKGROUND: The structural changes recent-onset posttraumatic stress disorder (PTSD) subjects were rarely investigated. This study was to compare temporal and causal relationships of structural changes in recent-onset PTSD with trauma-exposed control (TEC) subjects and non-TEC subjects. METHODS: T1-weighted magnetic resonance images of 27 PTSD, 33 TEC and 30 age- and sex-matched healthy control (HC) subjects were studied. The causal network of structural covariance was used to evaluate the causal relationships of structural changes in PTSD patients. RESULTS: Volumes of bilateral hippocampal and left lingual gyrus were significantly smaller in PTSD patients and TEC subjects than HC subjects. As symptom scores increase, reduction in gray matter volume began in the hippocampus and progressed to the frontal lobe, then to the temporal and occipital cortices (p < 0.05, false discovery rate corrected). The hippocampus might be the primary hub of the directional network and demonstrated positive causal effects on the frontal, temporal and occipital regions (p < 0.05, false discovery rate corrected). The frontal regions, which were identified to be transitional points, projected causal effects to the occipital lobe and temporal regions and received causal effects from the hippocampus (p < 0.05, false discovery rate corrected). CONCLUSIONS: The results offer evidence of localized abnormalities in the bilateral hippocampus and remote abnormalities in multiple temporal and frontal regions in typhoon-exposed PTSD patients.

Intergenerational effects of posttraumatic stress symptoms in family: The roles of parenting behavior, feelings of safety, and self-disclosure

This study examined the effects of parents’ posttraumatic stress symptoms (PTSS) and parenting behaviors, children’s feelings of safety, and children’s self-disclosure on children’s PTSS, to elucidate the mechanisms underlying intergenerational effect of PTSS. Three months after the Super Typhoon Lekima occurred in China, August 2019, self-report questionnaires were used to investigate 866 Chinese parent-child dyads (children’s mean age was 10.55 years, 52.2% were boys; parents’ mean age was 37.99 years, 23.2% were fathers) in the area most affected by the typhoon. The results found that parents’ PTSS may have disrupted the provision of emotionally warm parenting, in turn reducing children’s feelings of safety and limiting their self-disclosure, ultimately increasing the severity of children’s PTSS. This suggested that the mechanisms underlying the intergenerational effect of PTSS between parents and children involve the combined role of parents’ emotionally warm parenting, children’s feelings of safety, and children’s self-disclosure.

Gendered aspects of long-term disaster resilience in Victoria, Australia

Research conducted in 2018 documented the disaster experiences of 56 women and men in Australia aged between 18 and 93 years. This paper draws out the gendered factors that affected their resilience, and in so doing, begins to address the dearth of research related to gendered aspects of long-term disaster resilience. It is unique in capturing the voices of survivors who spoke of events 9 years after the 2009 Black Saturday fires and of earlier fires and floods in Victoria more than 50 years ago, including the 1983 Ash Wednesday fires. Over decades, gendered expectations of men and women significantly hindered resilience. Men spoke of the long-term cost to them of demands to ‘be strong’ in the worst of disasters and reasons they were reluctant to seek help afterwards. Women spoke of their contributions holding a lesser value and of discrimination. Discussions of violence against women and children after disaster, and suicide ideation in anticipation of future disasters offered critical insights. Protective factors identified by informants were not wholly intrinsic to their character but were also physical, such as essential resources provided in the immediate aftermath, and psychological and community support offered in the long-term. Factors that helped resilience departed from the ‘masculine’ model of coping post-disaster by moving away from a refusal to admit trauma and suffering, to community-wide resilience bolstered by widespread emotional, social and psychological support. Genuine community planning for disasters before they strike builds trust and offers insights for emergency management planners.

Moderating effect of personal and community resilience on the relationship between disaster trauma, disaster conflict, economic loss, and post-traumatic stress disorder

OBJECTIVE: This study aimed to investigate the effects of disaster trauma, disaster conflict, and economic loss on posttraumatic stress disorder (PTSD), and to verify the moderating effect of personal and community resilience in these relationships. The data of 1914 people, aged 20 or above, who had experienced natural disasters (earthquake, typhoon, flooding) were used. METHODS: Hayes’s (2013) PROCESS macro (Model 1) was conducted to verify the moderation effect of personal and community resilience between PTSD and disaster trauma, disaster conflict, and economic loss. RESULTS: Disaster trauma, disaster conflict, and economic loss were found to be positively related to PTSD. Personal and community resilience were negatively related to PTSD. Resilience had a moderating effect on the relationship between disaster trauma, economic loss, and PTSD. However, there was no moderating effect on the relationship between disaster conflict and PTSD. Community resilience had a moderating effect on the relationship between economic loss and PTSD. However, there was no moderating effect on the relationship between disaster trauma, disaster conflict, and PTSD. CONCLUSIONS: The results suggest that personal and community resilience could be used for prevention and therapeutic interventions for disaster victims who experience PTSD.

Disaster risks management through adaptive actions from human-based perspective: Case study of 2014 flood disaster

In Malaysia, floods are often considered a normal phenomenon in the lives of some communities, which can sometimes cause disasters to occur beyond expectations, as shown during the flood of 2014. The issue of flood disasters, which particularly impacts SDG 13 of the integrated Sustainable Development Goals (SDGs), still lacks widespread attention from sociology researchers in Malaysia. Similarly, questions related to the welfare of victims, especially in regards to aspects of disaster management from a humanitarian perspective, are still neglected. This study aims to identify the adaptive actions through a solution from a humanitarian perspective in managing flood disaster risks. For the purpose of obtaining data, this study used a qualitative approach with a case study design. Data were collected using in-depth interviews and non-participant observation methods. A total of ten experts, consisting of the flood management teams involved in managing the 2014 flood disaster in Hulu Dungun, Terengganu, Malaysia, were selected through a purposive random sampling method. The results showed that adaptive actions in managing flood disaster risks from a humanitarian point of view include the provision of social support, collective cooperation from the flood management teams, and adaptation efforts after the floods.

Exposure to risk and experiences of river flooding for people with disability and carers in rural Australia: A cross-sectional survey

OBJECTIVES: In this paper, we explore the exposure to risk and experiences of people with disability and carers during a flooding event and the subsequent mental health impacts. DESIGN: A cross-sectional survey between September and November 2017. Binary logistic regression models were used to investigate associations between the mental health of people with disability and carers and their exposure to the flood. Inductive content analysis was used to analyse qualitative data. SETTING: Flood-affected communities in the rural area of Northern Rivers, New South Wales, Australia, 6 months after river flooding in 2017. PARTICIPANTS: People over 16 years and a resident in the Northern Rivers at the time of the flood were invited to participate. Using a purposive, snowballing sampling technique participants were drawn from a wide range of socioeconomic backgrounds and had experienced different degrees of flood exposure. RESULTS: Of 2252 respondents, there were 164 people with disability and 91 carers. Both groups had increased odds of having their home flooded (people with a disability: OR 2.41 95% CI 1.71 to 3.39; carers: OR 1.76 95% CI 1.10 to 2.84). On evacuation, respondents reported inaccessible, conflicting and confusing information regarding flood warnings. Essential services such as healthcare and social services were disrupted (people with a disability: OR 3.98 95% CI 2.82 to 5.60; carers 2.17 95% CI 1.33 to 3.54) and access to safe and mould free housing post flood event was limited. After taking sociodemographic factors into account, respondents with a disability and carers had greater odds of probable post-traumatic stress disorder compared with other respondents (people with a disability: 3.32 95% CI 2.22 to 4.96; carers: 1.87 95% CI 1.10 to 3.19). CONCLUSION: Our findings show the profound impact and systemic neglect experienced by people with disability and carers during and after the 2017 flood event in the Northern Rivers. As people with disability will take longer to recover, they will require longer-term tailored supports and purposeful inclusion in flood preparedness and recovery efforts.

Insurance issues as secondary stressors following flooding in rural Australia—a mixed methods study

Flood events can be dramatic and traumatic. People exposed to floods are liable to suffer from a variety of adverse mental health outcomes. The adverse effects of stressors during the recovery process (secondary stressors) can sometimes be just as severe as the initial trauma. Six months after extensive flooding in rural Australia, a survey of 2530 locals was conducted focusing on their flood experiences and mental health status. This mixed methods study analysed (a) quantitative data from 521 respondents (21% of total survey respondents) who had insurance coverage and whose household was inundated, 96 (18%) of whom reported an insurance dispute or denial; and (b) qualitative data on insurance-related topics in the survey’s open comments sections. The mental health outcomes were all significantly associated with the degree of flood inundation. The association was strong for probable PTSD and ongoing distress (Adjusted Odds Ratios (AORs) with 95% confidence intervals 2.67 (1.8-4.0) and 2.30 (1.6-3.3), respectively). The associations were less strong but still significant for anxiety and depression (AORs 1.79 (1.2-2.7) and 1.84 (1.2-2.9)). The secondary stressor of insurance dispute had stronger associations with ongoing distress and depression than the initial flood exposure (AORs 2.43 (1.5-3.9) and 2.34 (1.4-3.9), respectively). Insurance was frequently mentioned in the open comment sections of the survey. Most comments (78% of comments from all survey respondents) were negative, with common adverse trends including dispute/denial, large premium increases after a claim, inconsistencies in companies’ responses and delayed assessments preventing timely remediation.

Do gender and age affect an individual’s sense of coherence? An environmental psychology perspective of flood survivals in Indonesia

There is substantial evidence that in the aftermath of a disaster, an individual’s sense of coherence (SOC) plays an important role in promoting one’s sense of well-being. The SOC is regarded as a core component of the salutogenic model of mental health. Disaster survivors are frequently subjected to traumatic experience and have higher psychological distress prevalence rates than people in the general population. The present study aimed to investigate possible socio-demographic differences (gender and age) on the sense of coherence (SOC) among disaster survivors in Indonesia. A total of 194 respondents (71 male and 123 females) from across the country participated in the online survey. A factorial ANOVA using JASP was conducted to investigate the main effects of gender and age groups and the interaction effect of these variables on the SOC level. The findings were two folds, age group variance was significantly associated with the SOC, while gender did not significantly associate with the SOC. The main effect of Age groups was F (2, 962.773) = 4.307, p = 0.005, indicating a significant difference of SOC between young adult, middle adult, and late adult groups.

The 2018 Japan Floods increased the frequency of Yokukansan prescriptions among elderly: A retrospective cohort study

OBJECTIVE: The impact of the 2018 Japan Floods on prescriptions of Yokukansan was evaluated. METHODS: This was a retrospective cohort study based on the National Database of Health Insurance Claims which covers all the prescriptions issued in Japan. Participants were patients aged 65 or older who received any medical care at medical institutions located in the three most-severely affected prefectures between 1 year before and after the disaster. We analyzed the number of new prescriptions of Yokukansan and other Kampo drugs among those who had not been prescribed any Kampo for 1 year before the disaster. Kaplan-Meier analysis and a Cox proportional hazards model were used to evaluate the risk of the disaster for a new prescription. RESULTS: Subjects comprised 1,372,417 people (including 12,787 victims, 0.93%). The hazard ratio (HR) of the disaster for Yokukansan prescriptions was 1.49 [95% confidence intervals (CI): 1.25-1.78], and 1.54 (95% CI: 1.29-1.84) in the crude and age-sex adjusted model, respectively. The HR of the disaster for prescription of other Kampo drugs in the crude and adjusted model was 1.33 (95% CI: 1.27-1.39), and 1.32 (95% CI: 1.27-1.38), respectively. The magnitude of increase of victims prescribed Yokukansan (31.4%) was statistically higher than for those prescribed other Kampo drugs (19.3%) (p < 0.001). CONCLUSION: The disaster increased prescriptions of both Yokukansan and other Kampo drugs among elderly victims. The increase was more remarkable in Yokukansan than other Kampo drugs. Clinicians and policymakers should be aware of the increased need for Yokukansan in times of natural disaster.

Impact of the 2018 Japan floods on benzodiazepine use: A longitudinal analysis based on the national database of health insurance claims

PURPOSE: Natural disaster has an impact on mental health. The 2018 Japan Floods, which took place in July 2018 were one of the largest water disasters in Japan’s recorded history. We aimed to evaluate the change in the number of benzodiazepine prescriptions by physicians before and after the disaster. METHODS: A retrospective cohort study based on the National Database of Health Insurance Claims was conducted in the flood-stricken areas between July 2017 and June 2019. The subjects were divided between victims and non-victims according to certification by local governments. Members of both groups were then categorized into three groups based on their pre-flood use of benzodiazepines: non-user, occasional user, and continuous user. Difference-in-differences (DID) analysis with a logistic regression model was conducted to estimate the effect of the disaster among victims by comparing the occurrence of benzodiazepine prescriptions before and after the disaster. RESULTS: Of 5,000,129 people enrolled, 31,235 were victims. Among all participants, the mean prescription rate for benzodiazepines in victims before the disaster (11.3%) increased to 11.8% after the disaster, while that in non-victims (8.3%) decreased to 7.9%. The DID analysis revealed that benzodiazepine prescription among victims significantly increased immediately after the disaster (adjusted ratio of odds ratios (ROR) 1.07: 95% confidence interval 1.05-1.11), and the effect of the disaster persisted even 1 year after the disaster (adjusted ROR 1.2: 95% confidence interval 1.16-1.24). CONCLUSION: The flood increased the number of benzodiazepines prescriptions among victims, and the effect persisted for at least 1 year.

Exploring well-being in the work and livelihoods of local people during the 2011 flood in Thailand

Thailand has faced many flooding crises, especially in 2011, which caused widespread damage to indus-trial parks and community zones. However, the nega-tive consequences of flooding on the local people and workers in industrial zones have been little studied. This study focuses on the impacts of flooding after 2011 on the well-being of residents in industrial zones in terms of their work and livelihoods. Community -based research was used to explore the effects of floods on 647 respondents who worked in Rojana Indus-trial Park (N = 247) and those who lived around the park (N = 400). A questionnaire survey was con-ducted in February 2020. The results showed adverse impacts on the economy, accommodation, and well-being of both the local inhabitants and workers, whose monthly incomes and overtime jobs decreased signif-icantly compared to before the disaster. However, lo-cal people suffered more from low incomes than work-ers of the company, as the employees’ work status was maintained during the crisis. Japanese company cul-ture is investigated as a factor in the higher resilience and recovery levels of company employees than the Rojana community. In addition, the workers were evacuated to other accommodations until the com-pany recovered, while locals remained in their flooded homes. In addition, most respondents reported that mental health impacts were more likely to affect their mental health. For effective recovery and flood risk management, the government should follow up on em-ployment, accommodation, and livelihood after a sud-den flood, especially for the local people. A greater understanding of community risk, community engage-ment, and awareness-raising activities can enhance readiness, response, recovery, and resilience in disas-ter management by government, businesses, and local communities.

Preferences of vulnerable social groups for ecosystem-based adaptation to flood risk in Central Vietnam

Developing countries are increasingly impacted by floods, especially in Asia. Traditional flood risk man-agement, using structural measures such as levees, can have negative impacts on the livelihoods of social groups that are more vulnerable. Ecosystem-based adaptation (EbA) provides a complementary approach that is potentially more inclusive of groups that are commonly described as more vulnerable, such as the poor and women. However, there is a lack of disaggregated and quantitative information on the potential of EbA to support vulnerable groups of society. This paper provides a quantitative analysis of the differ-ences in vulnerability to flooding as well as preferences for EbA benefits across income groups and gen -der. We use data collected through a survey of households in urban and rural Central Vietnam which included a discrete choice experiment on preferences for ecosystem services. A total of 1,010 households was surveyed during 2017 through a random sampling approach. Preferences are measured in monetary and non-monetary terms to avoid issues that may arise from financial constraints faced by respondents and especially the more vulnerable groups. Our results reveal that lower income households and women are overall more vulnerable than their counterparts and have stronger preferences for the majority of the EbA benefits, including flood protection, seafood abundance, tourism, and recreation suitability. These findings strongly indicate that EbA is indeed a promising tool to support groups of society that are espe-cially vulnerable to floods. These results provide crucial insights for future implementation of EbA pro-jects and for the integration of EbA with goals targeted at complying with the Sendai Framework and Sustainable Development Goals. (c) 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Building social resilience after the 2014 flood disaster

The 2014 flood disaster has brought physical destruction, damage as well as social disruption that caused normal life to become less stable. A state of social equilibrium needs to be restored through effective restoration solutions to normalise life after the disaster. This qualitative research aims to identify two main issues, namely social disruption and social resilience, by utilising a case study of the 2014 flood disaster in Hulu Dungun, Terengganu. A total of 15 victims were selected using the purposive sampling method based on a set of defined criteria-the data collection method comprised of in-depth interviews and non-participant observation. The data were analysed through thematic analysis techniques. The results showed that the disruption suffered by the victims included disruption of social roles, the uncertainty of employment, instability of social routine, and collective trauma. However, the availability of social resilience had enabled the victims to rebuild their lives after flood disasters and restore the ‘normal’ or ‘stable’ situations of social equilibrium. The research is expected to contribute to environmental sociology that has yet to receive widespread attention from sociological researchers in Malaysia. This research is a meaningful effort towards promoting and increasing the environmental sociology study, which to date, remains disoriented.

Comparison between sentiments of people from affected and non-affected regions after the flood

Floods have become the most prevalent natural disaster in the world. Understanding the emotional impact of floods on people helps reduce negative mass incidents and contributes to the implementation of disaster prevention and mitigation. This study collected online discussions related to the great flood in the middle and lower reaches of the Yangtze River basin in China in 2020. Then, we obtained the sentiments of people and the deep thoughts behind their negative sentiment through the dictionary sentiment analysis and the LDA topic modeling, counting them according to the regions. The overall sentiment of Internet users during this flood was neutral, and the posts showing negative sentiment were mostly from the affected areas. People in the affected areas were highly concerned about personal safety and property, whose negative emotions were directed towards the flood prevention work and the relocation of affected people.

Direct shock experience vs. Tangential shock exposure: Indirect effects of flood shocks on well-being and preferences

With extreme weather events on the rise, the question of how witnessing adverse weather events may affect individuals’ perception, and consequently their subjective well-being, gains in relevance. To identify events that have been witnessed, i.e., tangential exposure to a weather shock, satellite-based data on flooding is linked to an extensive household panel survey from rural Southeast Asia. Contrasting direct shock experience with tangential shock exposure, we find that mere proximity to a potentially adverse shock, without reporting any actual direct shock experience, could be sufficient to reduce subjective well-being. This effect is not only restricted to the present but can also impinge on expected future well-being dynamics. Eventually, such a persistent effect from witnessing a weather shock may have further politico-economic repercussions, for instance, by altering support for redistribution policies.

Psychological distress and adolescents’ cyberbullying under floods and the COVID-19 pandemic: Parent-child relationships and negotiable fate as moderators

Since the outbreak of coronavirus disease 2019 (COVID-19), adolescents in 70 countries have suffered the COVID-19 pandemic and flood disasters simultaneously. Although antecedent cyberbullying variables have attracted significant research attention, the effects of psychological distress and the potential mechanisms of cyberbullying among adolescents under multiple disasters remains unclear. Based on social-ecological system theory, this study examines the moderating effects of parent-child relationships and the negotiable fate on the relationship between psychological distress and cyberbullying. A total of 1204 middle school students (52.4% boys) who suffered from floods and the COVID-19 pandemic from Zhengzhou City, China, are the participants. The results reveal that psychological distress was positively related to adolescent cyberbullying during a disaster. Parent-child relationships and negotiable fate significantly moderate the relationship between psychological distress and cyberbullying. Specifically, high parent-child relationships and a high negotiable fate could protect adolescents from the negative effects of psychological distress of cyberbullying. For adolescents with low or high parent-child relationships and low negotiable fate, the links between psychological distress and cyberbullying are stronger. These findings underline the significance of considering the interaction of psychological distress, parent-child relationships, and negotiable fate when examining adolescents’ cyberbullying during disasters.

Interactive effects of cold spell and air pollution on outpatient visits for anxiety in three subtropical Chinese cities

BACKGROUND: Although low temperature and air pollution exposures have been associated with the risk of anxiety, their combined effects remain unclear. OBJECTIVE: To investigate the independent and interactive effects of low temperature and air pollution exposures on anxiety. METHOD: Using a case-crossover study design, the authors collected data from 101,636 outpatient visits due to anxiety in three subtropical Chinese cities during the cold season (November to April in 2013 through 2018), and then built conditional logistic regression models based on individual exposure assessments [temperature, relative humidity, particulate matter (PM(2.5), PM(10)), sulfur dioxide (SO(2)), and nitrogen dioxide (NO(2))] and twelve cold spell definitions. Additive-scale interactions were assessed using the relative excess risk due to interaction (RERI). RESULTS: Both cold spell and air pollution were significantly associated with outpatients for anxiety. The effects of cold spell increased with its intensity, ranging from 8.98% (95% CI: 2.02%, 16.41%) to 15.24% (95% CI: 6.75%, 24.39%) in Huizhou. Additionally, each 10 μg/m(3) increase of PM(2.5), PM(10), NO(2) and SO(2) was associated with a 1.51% (95% CI: 0.61%, 2.43%), 1.58% (95% CI: 0.89%, 2.28%), 13.95% (9.98%, 18.05%) and 11.84% (95% CI: 8.25%, 15.55%) increase in outpatient visits for anxiety. Synergistic interactions (RERI >0) of cold spell with all four air pollutants on anxiety were observed, especially for more intense cold spells. For particulate matters, these interactions were found even under mild cold spell definitions [RERI: 0.11 (95% CI: 0.02, 0.21) for PM(2.5), and 0.24 (95% CI: 0.14, 0.33) for PM(10)]. Stratified analyses yielded a pronounced results in people aged 18-65 years. CONCLUSIONS: These findings indicate that both cold spell and air pollution are important drivers of the occurrence of anxiety, and simultaneous exposure to these two factors might have synergistic effects on anxiety. These findings highlight the importance of controlling air pollution and improving cold-warning systems.

Coping styles and mental health outcomes of community members affected by Black Summer 2019-20 bushfires in Australia

The aim of this study was to investigate coping styles, posttraumatic stress, and mental health symptoms among a sample of community members affected by 2019-20 Australian bushfires. Using a convenience sampling approach, an online survey was used to assess a range of coping strategies, posttraumatic stress and symptoms of depression, anxiety, and stress among the affected community members of Black Summer bushfires. The results revealed that study participants reported moderate symptoms of depression and stress, and severe levels of anxiety. Additionally, participants reported use of both approach and avoidance coping strategies following the bushfire event as well as experiencing symptoms of posttraumatic stress, such as having intrusive thoughts and symptoms of avoidance and hyperarousal. Despite the durability of many individuals, others remain affected by the event and there is evidence there may be longer term mental health consequences of the bushfires for some people. Given these findings, it is imperative that mental health services be readily available for people in the bushfire-affected areas. Mental health nurses have an important role to play in supporting individuals affected by disasters. Awareness of the short- and long-term impacts of disasters on the mental health of people is paramount for mental health nurses.

Mental health effects of the Gangwon wildfires

BACKGROUND: The April 2019 wildfires in Gangwon Province, South Korea forced the evacuation of 1500 individuals and cost more than $100 million in damages, making it the worst wildfire disaster in Korean history. The purpose of this paper was to investigate the mental health effects on survivors following the wildfires. METHODS: Between April and May 2019, outreach psychological support services were delivered to people impacted by the wildfires. Post-disaster psychological responses using a checklist and the Clinical Global Impression Scale-Severity (CGI-S) were evaluated for 206 wildfires survivors. The CGI-S was administered consequently at 1, 3, and 6 months after baseline measurement. RESULTS: Among four response categories, somatic responses (76.2%) were most frequently observed among the wildfire survivors. Specifically, insomnia (59.2%), anxiety (50%), chest tightness (34%), grief (33%), flashbacks (33%), and depression (32.5%) were reported by over 30% of the participants. The mean CGI-S scores were significantly decreased at 1 month (mean score = 1.94; SE = 0.09) compared to baseline (mean score = 2.94; SE = 0.08) and remained at the decreased level until 6 months (mean score = 1.66; SE = 0.11). However, participants with flashbacks showed significantly higher CGI-S scores compared to those without flashback at 6 months. CONCLUSIONS: Wildfire survivors have various post-disaster responses, especially somatic responses. While most participants’ mental health improved over time, a few of them may have experienced prolonged psychological distress after 6 months. Flashbacks were particularly associated with continuing distress. These results suggest that the characteristics of responses should be considered in early phase intervention and in follow-up plans for disaster survivors.

Evaluating wildfire exposure: Using wellbeing data to estimate and value the impacts of wildfire

This paper estimates the wellbeing effects of the 2009 Black Saturday Bushfires, the deadliest wildfire event in Australia’s known history. Using subjective wellbeing data from a nationally representative longitudinal study and adopting an individual fixed-effects approach, our results identify a significant reduction in life satisfaction for individuals residing in close proximity of the wildfires. The negative wellbeing effect is valued at A$52,300. This corresponds to 80% of the average annual income of a full-time employed adult in the state of Victoria. The satisfaction domain most negatively affected is how safe the person feels, and the group most affected are people with low social support. A delayed adverse mental health effect is also identified.

Run air-conditioning all day: Adaptation pathways to increasing heat in the Northern Territory of Australia

Average global temperatures and frequencies of heat waves are increasing with detrimental effects on health and wellbeing. This study presents a case study from two cities in the Northern Territory with the aim of exploring if and how people make deliberate adaptations to cope with increasing heat. Results show that 37% of all respondents made adjustments, with the most common being increased use of air-conditioning (65% of those responding to heat), followed by staying inside more often (22%) and passive cooling through modifications of house and garden (17%). Young people increasingly refrain from outside activities as temperatures increase. We also found that adaptive capacity was a function of education, long-term residency, home ownership and people’s self-rated wellbeing. Homeowners were more likely to adjust their living environment to the heat and renters less so. Being a property owner was commonly associated with the installation of solar panels to pay for high energy bills needed to run air-conditioning. Those who had solar panels at home were about ten times more likely to use air-conditioning more frequently in response to increasing heat. Our results confirm a growing dependence on artificially controlled environments to cope with heat in cities.

Association between daily ambient temperature and drug overdose in Tokyo: A time-series study

BACKGROUND: Previous studies have reported that high ambient temperature is associated with increased risk of suicide; however, the association has not been extensively investigated with drug overdose which is the most common method of unsuccessful suicidal behavior in Japan. Therefore, this study aims to examine the short-term association between daily mean temperature and the incidence of self-harm attempts by drug overdose in Tokyo, Japan. METHODS: We collected the emergency ambulance dispatch data and daily meteorological data in Tokyo from 2010 to 2014. A quasi-Poisson regression model incorporating a distributed lag non-linear function was applied to estimate the non-linear and delayed association between temperature and drug overdose, adjusting for relative humidity, seasonal and long-term trends, and days of the week. Sex, age and location-specific associations of ambient temperature with drug overdose was also estimated. RESULTS: 12,937 drug overdose cases were recorded during the study period, 73.9% of which were female. We observed a non-linear association between temperature and drug overdose, with the highest risk observed at 21 °C. The highest relative risk (RR) was 1.30 (95% Confidence Interval (CI): 1.10-1.67) compared with the risk at the first percentile of daily mean temperature (2.9 °C) over 0-4 days lag period. In subgroup analyses, the RR of a drug overdose at 21 °C was 1.36 (95% CI: 1.02-1.81) for females and 1.07 (95% CI: 0.66-1.75) for males. Also, we observed that the risk was highest among those aged ≥65 years (RR = 2.54; 95% CI: 0.94-6.90), followed by those aged 15-34 years (RR = 1.25; 95% CI: 0.89-1.77) and those aged 35-64 years (RR = 1.15; 95% CI: 0.78-1.68). There was no evidence for the difference in RRs between urban (23 special wards) and sub-urban areas in Tokyo. CONCLUSIONS: An increase in daily mean temperature was associated with increased drug overdose risk. This study indicated the positive non-linear association between temperature and incomplete attempts by drug overdose. The findings of this study may add further evidence of the association of temperature on suicidal behavior and suggests increasing more research and investigation of other modifying factors.

Association between ambient temperature and intentional injuries: A case-crossover analysis using ambulance transport records in Japan

BACKGROUND: Epidemiological studies based on mortality and crime data have indicated that short-term exposure to higher temperature increases the risk of suicide and violent crimes. However, there are few studies on non-fatal intentional injury, especially on non-fatal self-harm which is much more common than suicide. OBJECTIVES: We aimed to clarify how short-term exposure to temperature is associated with emergency ambulance transport caused by intentional injuries including acts of self-harm and assault. METHOD: We applied a time-stratified case-crossover design using a conditional quasi-Poisson regression model for each of the 46 prefectures. All temperatures were converted to percentile value for each prefecture, to account for the varied climate across Japan. A Distributed Lag Non-Linear Model was used to explore the temperature percentile and lag pattern. The prefecture-specific results were combined using a meta-analysis with the random effects model. RESULT: Between 2012 and 2015, the number of acts of self-harm and assault across all 46 prefectures totaled 151,801 and 95,861, respectively. We found that as the temperature increased, the relative risk (RRs) for both self-harm and assault behaviors increased in a nearly linear manner. The pooled relative risk at the 99th percentile temperature for self-harm behavior was 1.11 (95% CI: 1.07, 1.15) compared with the risk at the 1st percentile temperature, and that for assault was 1.12 (95% CI: 1.08, 1.16) at lag 0. The RRs were highest at lag0 and less than 1 at lag7-20. CONCLUSION: The present study found that short-term exposure to higher temperature promotes the risk of emergency ambulance transport due to acts of self-harm and assault. The lag pattern indicates a possible “displacement” effect. These results suggest that exposure to high temperatures may potentially function as a trigger for intentional injuries.

Main and added effects of heatwaves on hospitalizations for mental and behavioral disorders in a tropical megacity of Vietnam

Vietnam is highly vulnerable to climate change-related extreme weather events such as heatwaves. This study assesses the association between heatwaves and hospitalizations due to mental and behavioral disorders (MBDs) in Ho Chi Minh City (HCMC). We collected daily MBD hospital admissions data at the HCMC Mental Health Hospital from 2017 to 2019. Heatwaves effects were characterized into the main effect (i.e., the intensity of temperature during heatwaves) and the added effect (i.e., the duration of heatwaves). Time series Poisson regression coupled with a distributed lag linear model (DLM) was used to quantify the 14-day lags effect of heatwaves. Confounders including long-term trend, seasonality, days of the week, holidays, and relative humidity were included in the model. Heatwaves increased all-cause MBD hospitalization by 62% (95%Cl, 36-93%) for the main effect and by 8% (95% Cl, - 3% to 19%) for the added effect. Noticeably, the group aged 18-60 years old was affected by the main effect of the heatwave, while the group aged 61 years and older was affected by the added effect of the heatwave. The effects of heatwaves differed among groups of MBD hospitalizations. The mental and behavioral disorder group due to psychoactive substance use was significantly affected by the main effect of heatwaves (RR:2.21; 95%Cl:1.55-3.15). The group of schizophrenia, schizotypal and delusional disorders were highly vulnerable towards both the main and the added effect of heatwaves with RR = 1.50 (95%CI, 1.20-1.86) and RR = 1.14 (95%CI, 1.01-1.30), respectively.

The effect of thermal discomfort on human well-being, psychological response and performance

The effect of thermal discomfort on human well-being and performance was studied in the field office, and an attempt was made to elucidate its psychological mechanism. Thirty participants were recruited to perform subjective evaluations and performance tests under 5 different conditions (25 degrees C, 27 degrees C, 29 degrees C, 31 degrees C, 33 degrees C). During the experiment, the air temperature was considered as an independent variable and other parameters were kept at the same level. The results show that thermal discomfort can lead to poor comfort and reduced performance, and people report that many sick building syndrome symptoms are intensified, showing more negative emotions and reducing their motivation. When people’s thermal sensation vote is -0.13, the best performance can be obtained. But the changes in human performance are not only caused by objective environmental factors, but also by psychological factors such as emotion and motivation. When people’s negative emotions decrease or their motivations increase, performance will also increase.

Analysis of the impact of urban summer high temperatures and outdoor activity duration on residents’ emotional health: Taking hostility as an example

The combined effect of global warming and the heat island effect keeps the temperature of cities rising in the summer, seriously threatening the physical and mental health of urban residents. Taking the area within the Sixth Ring Road of Beijing as an example, based on Landsat remote sensing images, meteorological stations, and questionnaires, this study established a relational model between temperature and hostility and then analyzed the changes in the emotional health risk (hostility) in the study area and the mechanism of how outdoor activity duration influences hostility. Results show that: (1) the area within the Sixth Ring Road of Beijing had a higher and higher temperature from 1991 to 2020. Low-temperature areas gradually shrank, and medium- and high-temperature areas extended outwards from the center. (2) The threat of high temperature to residents’ hostility gradually intensified-the sphere of influence expanded, low-risk areas quickly turned into medium-high-risk areas, and the level of hostility risk increased. Level 1 risk areas of hostility had the most obvious reduction-a 74.33% reduction in area proportion; meanwhile, Level 3 risk areas had the most significant growth-a 50.41% increase in area proportion. (3) In the first 120 min of outdoor activities under high temperature, residents’ hostility was negatively correlated with outdoor activity duration; after more than 120 min, hostility became positively correlated with duration. Therefore, figuring out how temperature changes influence human emotions is of great significance to improving the living environment and health level of residents. This study attempts to (1) explore the impact of temperature changes and outdoor activity duration on hostility, (2) evaluate residents’ emotional health risk levels affected by high temperature, and (3) provide a theoretical basis for the early warning mechanism of emotional health risk and the planning of healthy cities.

Health risk assessment and influencing factors analysis of high temperatures on negative emotions

The emotional health of urban residents has been seriously threatened by frequent and normalized heat waves. This study constructed the VI-level assessment standard for emotional health risk using data from satellite images, meteorological sites, questionnaire surveys, and statistical yearbooks to assess the effect of high temperatures on negative emotions in Hangzhou. The results showed that the morphological changes of urban high-temperature areas were aggregated from a cross-shape to a large patch shape, then dispersed into cracked patch shapes. Additionally, the health risk of daytime negative emotions peaked at the VI-level from 1984 to 2020, and the influence level of the typical period risk increased by 1-2 levels compared with the daytime. Additionally, driven by urban spatial structure policies, the risk pattern of emotional health expanded outward from a single center into multiple centers. The emotional health risk level rose and then descended in urban centers, and the innovation industries drove the variation tendency of hot spots. Furthermore, high educational background, employment, and couples living together were critical variables that could alleviate the emotional health risk to the middle-aged and elderly population. This study aimed to optimize the urban spatial structure and alleviate residents’ emotional health hazards for healthy urban planning.

Association between sequential extreme precipitation-heatwaves events and hospitalizations for schizophrenia: The damage amplification effects of sequential extremes

OBJECTIVES: In the context of frequent global extreme weather events, there are few studies on the effects of sequential extreme precipitation (EP) and heatwaves (HW) events on schizophrenia. We aimed to quantify the effects of the events on hospitalizations for schizophrenia and compare them with EP and HW alone to explore the amplification effect of successive extremes on health loss. METHODS: A time-series Poisson regression model combined with a distributed lag non-linear model was applied to estimate the association between sequential EP and HW events (EP-HW) and schizophrenia hospitalizations. The effects of EP-HW with different intervals and intensities on the admission of schizophrenia were compared. In addition, we calculated the mean attributable fraction (AF) and attributable numbers (AN) per exposure of extreme events to reflect the amplification effect of sequential extreme events on health hazards compared with individual extreme events. RESULTS: EP-HW increased the risk of hospitalization for schizophrenia, with significant effects lasting from lag0 (RR and 95% CI: 1.150 (1.041-1.271)) to lag11 (1.046 (1.000-1.094)). Significant associations were found in the subgroups of male, female, married people, and those aged≥ 40 years old. Shorter-interval (0-3days) or higher-intensity EP-HW (both precipitation ≥ P97.5 and mean temperature ≥ P97.5) had a longer lag effect compared to EP-HW with longer intervals or lower intensity. We found that the mean AF and AN caused by each exposure to EP-HW (AF: 0.074% (0.015%-0.123%); AN: 4.284 (0.862-7.118)) were higher than those induced by each exposure to HW occurring alone (AF:0.032% (0.004%-0.058%); AN:1.845 (0.220-3.329)). CONCLUSIONS: Sequential extreme precipitation-heatwaves events significantly increase the risk of hospitalizations for schizophrenia, with greater impact and disease burden than independently occurring extremes. The impact of consecutive extremes is supposed to be considered in local sector early warning systems for comprehensive public health decision-making.

Heat-attributable hospitalisation costs in Sydney: Current estimations and future projections in the context of climate change

The association between heat and diseases has been extensively reported. However, its associated healthcare costs and attributable fraction due to heat were scarcely explored. The aim of this study was to estimate hospitalisation costs attributable to heat in Sydney, and to project future costs under climate change scenarios. Using a distributed lag nonlinear model, this study estimated heat-attributable hospitalisation costs in Sydney; and using 2010-2016 data as baseline, future costs for 2030s and 2050s were estimated under three climate change scenarios depending on greenhouse gas emissions – Representative Concentration Pathway (RCP)2.6, RCP4.5, and RCP8.5. Higher temperatures were found to be associated with increased hospitalisation costs. About 8-9% of the total hospitalisation costs were attributable to heat. The total costs attributable to heat over the baseline period 2010-2016 were estimated to be AU$252 million, with mental health hospitalisation making the largest contribution. Hospitalisation costs are estimated to increase substantially to AU$387-399 million in the 2030s, and AU$506-570 million by midcentury under different climate change scenarios. Urgent action is required to reduce heatattributable illness in our communities, particularly for mental health conditions. Relevant preparations including healthcare workforce capacity building and resource allocation are needed to deal with these challenges in the context of climate change.

Impact of temperature on physical and mental health: Evidence from China

Climate may significantly affect human society. Few studies have focused on the temperature impact on residents’ health, especially mental health status. This paper uses 98 423 observations in China to study the relationship between temperature and health, based on the China Family Panel Studies survey during 2010-16. We analyze the health effects of extreme hot and cold weather and compare the effects under different social demographic factors including gender, age, and income. We find that temperature and health status exhibit a nonlinear relationship. Women and low-income households are more likely to be impacted by extreme cold, whereas men, the elderly, and high-income households are more sensitive to extreme heat. Our results highlight the potential effects of extreme temperatures on physical and mental health and provide implications for future policy decisions to protect human health under a changing climate.

Temporal trends of the association between extreme temperatures and hospitalisations for schizophrenia in Hefei, China from 2005 to 2014

OBJECTIVE: We aimed to examine the temporal trends of the association between extreme temperature and schizophrenia (SCZ) hospitalisations in Hefei, China. METHODS: We collected time-series data on SCZ hospitalisations for 10 years (2005-2014), with a total of 36 607 cases registered. We used quasi-Poisson regression and distributed lag non-linear model (DLNM) to assess the association between extreme temperature (cold and heat) and SCZ hospitalisations. A time-varying DLNM was then used to explore the temporal trends of the association between extreme temperature and SCZ hospitalisations in different periods. Subgroup analyses were conducted by age (0-39 and 40+ years) and gender, respectively. RESULTS: We found that extreme cold and heat significantly increased the risk of SCZ hospitalisations (cold: 1st percentile of temperature 1.19 (95% CI 1.04 to 1.37) and 2.5th percentile of temperature 1.16 (95% CI 1.03 to 1.31); heat: 97.5th percentile of temperature 1.37 (95% CI 1.13 to 1.66) and 99th percentile of temperature 1.38 (95% CI 1.13 to 1.69)). We found a slightly decreasing trend in heat-related SCZ hospitalisations and a sharp increasing trend in cold effects from 2005 to 2014. However, the risk of heat-related hospitalisation has been rising since 2008. Stratified analyses showed that age and gender had different modification effects on temporal trends. CONCLUSIONS: The findings highlight that as temperatures rise the body’s adaptability to high temperatures may be accompanied by more threats from extreme cold. The burden of cold-related SCZ hospitalisations may increase in the future.

Impact of COVID-19 on lifestyle and mental wellbeing in a drought-affected rural Australian population

INTRODUCTION: The SARS-CoV-2 (COVID-19) pandemic has caused unprecedented social and economic disruption, accompanied by the enactment of a multitude of public health measures to restrain disease transmission. These public health and social measures have had a considerable impact on lifestyle and mental wellbeing, which has been well studied with metropolitan populations. However, limited literature concerning such effects on a selectively rural population is presently available. Additionally, the use of a standardised scoring system for lifestyle may be valuable for an overall assessment of lifestyle that may be incorporated into clinical practice. METHODS: This study examined the associations between psychological distress and changes in SNAPS health behaviours (smoking, nutrition, alcohol, physical activity, sleep) since the onset of COVID-19 in Australia. A cross-sectional anonymous survey was distributed online to adults in the Western New South Wales Primary Health Network in August 2020 and included measures of psychological distress, income, disposition and lifestyle factors during the pandemic as well as changes to lifestyle due to COVID-19. A novel Global Lifestyle Score (GLS) was generated as a holistic assessment of lifestyle across multiple domains. RESULTS: The survey was completed by 304 individuals (modal age group 45-54 years, 86.8% female). High distress on the Kessler-5 scale was present in over one-third of participants (n=95, 33.7%). Detrimental change was reported for sleep (22.7%), nutrition (14.5%), alcohol (16.7%), physical exercise (34.0%) and smoking (24.7%) since the onset of the pandemic. Changes in sleep, nutrition, physical activity and smoking were associated with distress. Participants with a poor lifestyle (GLS) during the pandemic were significantly more distressed. Perceived COVID-19 impact was associated with high distress, drought impact and loss of income. Participants who reported negative impact from both COVID-19 and drought were significantly more distressed than those reporting a negative impact from drought alone or neither event. CONCLUSION: High rates of distress among rural Australians during the COVID-19 pandemic was linked to low GLS, worsening lifestyles and loss of income. Healthy lifestyle strategies should be considered by health professionals for the management of crisis-related distress. Further research may explore the impact of COVID-19 on a larger study population with a greater proportion of male participants and to examine the effect of modifying lifestyle factors in reducing distress in the context of a stressor such as this pandemic.

Why are some drought-affected farmers less distressed than others? The association between stress, psychological distress, acceptance, behavioural disengagement and neuroticism

OBJECTIVE: To identify the modifiable psychological and behavioural coping strategies associated with low levels of psychological distress, independent of more stable personality and demographic factors, in a sample of farmers who reported being exposed to a recent stressful event during an extended drought. DESIGN/SETTING/PARTICIPANTS: Three hundred and nine South Australian, drought-affected grain, sheep and/or cattle farmers completed printed or online questionnaires. Only those who reported experiencing a stressful event in the past month that they rated ≥7 on a scale ranging from 1 (not stressful at all) to 10 (extremely stressful) were included in the analyses (n = 175, 65.06%). Participants ranged in age from 24 to 85 years and 40% were female. MAIN OUTCOME MEASURES: Psychological distress was measured using the Kessler Psychological Distress Scale, and coping strategies were measured using a situational version of the COPE inventory. Five personality factors (extraversion, neuroticism, openness, conscientiousness and agreeableness) were assessed using the Quickscales-R. RESULTS: In the final multivariable model, distress was elevated among individuals reporting higher neuroticism and behavioural disengagement, and lower in individuals reporting greater use of acceptance. These 3 variables explained 44% of the variance in distress. CONCLUSION: Farmers recently exposed to a significant stressor, who used acceptance as a coping strategy, did not engage in behavioural disengagement and scored low on neuroticism, were least likely to experience distress. Given the stability of personality factors, interventions that foster farmers’ use of acceptance and prevent behavioural disengagement as coping strategies might assist them with the management of future stressors, particularly in times of drought.

Farming women, distress and drought: Intra-actions and entanglements with matter

Farming women have rarely been the focus of scholarly work on drought and/or distress. This article focuses on farming women’s lived experience of drought and distress, drawing on a participatory filmmaking project created by a small group of farming women from Southern Australia. Feminist materialism and Barad’s (2003) concept of ‘intra-action’ provides a useful lens to examine both the film as an artefact as well as the discussions among the women during its creation. Intra-action enables an exploration of how farming women’s bodies come into being as distressed in moments of time through and with drought as a complex constellation of multiple ‘matter’. The film and narratives show distressed bodies emerging with dust, wind, objects and the suffering of non-human animals. For these women, distress emerges from hearing, sensing, seeing and feeling the irritation of dirt splattered against window panes, the emotional pain and economic consequences of topsoil blowing across paddocks and as feed becomes hard to source, the recognition of the suffering of sheep. The power of these animate and inanimate ‘things’-windmills, windows, troughs, work boots, animals and soil-were sensorily entangled with women’s bodies. For farming women, distress materialises within their bodies through processes of intra-action in their more-than-human worlds.

Modelling the relationship between rainfall and mental health using different spatial and temporal units

Drought is thought to impact upon the mental health of agricultural communities, but studies of this relationship have reported inconsistent results. A source of inconsistency could be the aggregation of data by a single spatiotemporal unit of analysis, which induces the modifiable areal and temporal unit problems. To investigate this, mental health-related emergency department (MHED) presentations among residents of the Wheat Belt region of Western Australia, between 2002 and 2017, were examined. Average daily rainfall was used as a measure of drought. Associations between MHED presentations and rainfall were estimated based on various spatial aggregations of underlying data, at multiple temporal windows. Wide variation amongst results was observed. Despite this, two key features were found: Associations between MHED presentations and rainfall were generally positive when rainfall was measured in summer months (rate ratios up to 1.05 per 0.5 mm of daily rainfall) and generally negative when rainfall was measured in winter months (rate ratios as low as 0.96 per 0.5 mm of daily rainfall). These results demonstrate that the association between drought and mental health is quantifiable; however, the effect size is small and varies depending on the spatial and temporal arrangement of the underlying data. To improve understanding of this association, more studies should be undertaken with longer time spans and examining specific mental health outcomes, using a wide variety of spatiotemporal units.

Assessing and mapping human well-being for sustainable development amid drought and flood hazards: Dadu river basin of China

Drought and flood are two of the most destructive natural disasters with the most significant impact and greatest losses in the Dadu River basin (DRB). However, their impacts on people’s life have not attracted enough attention from scholars. In this study, the Standardized Precipitation Index (SPI) describing the drought/flood situation and the Composite Index of Human Well-being (CIHW) are calculated, and a framework is further constructed to assess the impacts of drought and flood disasters on human well-being in the DRB. The results show that the annual and seasonal SPI in the DRB generally exhibit an increasing trend in fluctuations during 2000-2009, indicating a wetting climate in this basin. Overall, the upper reaches of the DRB have experienced an evolution of flood-drought-flood state transition, where the variation amplitude of the SPI in the western sub-basin is greater than that in the eastern sub-basin. In addition, the lower reaches of the DRB have suffered more dramatic and periodic changes from the drought/flood disasters in terms of the SPI. For human well-being during 2000-2019, Maerkang City in the upper reaches, Kangding City in the middle reaches, and Shimian County in the lower reaches of the DRB are at a relatively higher level, with the CIHW decreasing from administrative centers to the around. Moreover, the CIHW over the whole basin increases gradually from 2000 to 2019. The SPI has significantly negative effects on different capitals, following a descending order of financial, social, physical, human and natural capitals. The counties of the basin are divided into four groups, namely the group with high disaster risks and high human well-being, the group with high disaster risks and low human well-being, the group with low disaster risks and high human well-being, and the group with low disaster risks and low human well-being. The panel regression results suggest that the construction of water conservancy facilities, the financial inputs in agriculture and meteorology, and the educational level have positive impacts on human well-being, but the impacts differ from different groups. The construction of water conservancy facilities has highly significant impacts on human well-being in all groups; the education level has no significant impact on the group with high disaster risk and high human well-being, which has not passed the significance test; while the financial inputs in agriculture and meteorology have relatively higher impacts on the whole basin and on the group with low disaster risk and low human well-being compared with other groups. Therefore, it is suggested that the negative impacts of drought and flood disasters can be mitigated through strengthening infrastructure construction, responding appropriately to climate change, avoiding disasters at the source of major projects and improving the disaster prevention and mitigation systems.

Measurement of climate change anxiety and its mediating effect between experience of climate change and mitigation actions of Filipino youth

Objective: This study aimed to 1) investigate the psychometric properties of the Climate Change Anxiety Scale or CCAS (Clayton & Karazsia, 2020) and 2) examine the mediating role of climate change anxiety on the link between experience of climate change and behavioural engagement in climate mitigation in Filipino youth. Method: A total of 452 Filipino adolescents responded to the survey (Mean Age = 19.18, SD = .99). Results: A modified two-factor model of the CCAS displayed superior fit relative to the other three models tested. Confirmatory factor analysis in Phase 1 yielded a stable two-factor structure with strong factor loadings and good internal consistency. In Phase 2, cognitive-emotional, but not the functional impairment component of climate anxiety, showed a mediating effect on the relationship between experience of climate change and behavioural engagement in climate mitigation. Conclusions: This study is the first to demonstrate that CCAS subscales have distinct mediating roles in linking Filipino adolescents’ experience of climate change and mitigation behaviours. Further validation of the CCAS is recommended, as well as further research on the factors that can promote environment-friendly behaviours in Filipino youth.

How effectively do drought indices capture health outcomes? An investigation from rural Australia

Drought is a global threat to public health. Increasingly, the impact of drought on mental health and wellbeing is being recognized. This paper investigates the relationship between drought and well-being to determine which drought indices most effectively capture well-being outcomes. A thorough understanding of the relationship between drought and well-being must consider the (i) three aspects of drought (duration, frequency, and magnitude); (ii) different types of drought (meteorological, agricultural, etc.); and (iii) the individual context of specific locations, communities, and sectors. For this reason, we used a variety of drought types, drought indices, and time windows to identify the thresholds for wet and dry epochs that enhance and suppress impacts to well-being. Four postcodes in New South Wales (NSW), Australia, are used as case studies in the analysis to highlight the spatial variability in the relationship between drought and well-being. The results demonstrate that the relationship between drought indices and well-being outcomes differs temporally, spatially, and according to drought type. This paper objectively tests the relationship between commonly used drought indices and wellbeing outcomes to establish whether current methods of quantifying drought effectively capture well-being outcomes. For funding, community programs, and interventions to result in successful adaptation, it is essential to critically choose which drought index, time window, and well-being outcome to use in empirical studies. The uncertainties associated with these relationships must be accounted for, and it must also be realized that results will differ on the basis of these decisions.

Latent profiles of psychological status among populations cumulatively exposed to a flood and the recurrence of the COVID-19 pandemic in China

Henan Province in Central China was hit by unprecedented, rain-triggered floods in July 2021 and experienced a recurrence of the COVID-19 pandemic. The current study aims to identify the latent profiles of psychological status and acceptance of change among Henan residents who have been cumulatively exposed to these floods and the COVID-19 pandemic. A total of 977 participants were recruited. Latent profile analysis (LPA) was used to explore underlying patterns of psychological status (i.e., perceived risk of the COVID-19 pandemic, post-traumatic stress symptoms, anxiety and rumination) and acceptance of change. The predictors were evaluated with multinomial logistic regression. LPA identified four patterns of psychological status and acceptance of change: high distress/high acceptance (5.1%), moderate distress/moderate acceptance (20.1%), mild distress/mild acceptance (45.5%), and resilience (29.3%). The additive impact of the floods and COVID-19 pandemic and negative emotion during the floods were the risk factors, while flood coping efficacy, trust, and a closer psychological distance change were the protective factors. The present study therefore provides novel evidence on psychological status after both a natural disaster and a major public health event. The cumulative effects of the floods and the COVID-19 pandemic may have heightened the risk of post-disaster maladaptation. A complex relationship between psychological outcomes and acceptance of change was also found. The findings of this study thus provide a foundation for both disaster management and psychological assistance for particular groups.

Association of ambient ozone exposure with anxiety and depression among middle-aged and older adults in China: Exploring modification by high temperature

Anxiety and depression are severe public health problems worldwide. The effects of ozone exposure on anxious and depressive symptoms remain largely unknown, especially in China. We evaluated the associations between ozone exposure and depression and anxiety among middle-aged and older adults across China. A multi-center community-based repeated measurement study among middle-aged and older adults was conducted from 2017 to 2018 in 11 provinces in China. The status of depression and anxiety was measured using Patient Health Questionnaire-9 (PHQ-9) and the generalized anxiety disorder seven-item (GAD-7) scale at the cut-off point of five, respectively. Concentrations of multiple ozone metrics were collected from real-time monitoring stations. The multilevel logistic regression model with random intercept was used to evaluate the effects of ambient ozone on anxiety and depression over different exposure windows. After adjusting for potential confounders, a 10 mu g /m(3) increase in the three months moving average of ozone was associated with the risk of anxiety [odds ratio (OR) = 1.25; 95% confidence interval (CI): 1.15; 1.37] and depression (OR = 1.17; 95% CI: 1.08; 1.27). A significantly positive modification effect of temperature on associations between ozone and anxiety was also found, while there is no interaction for depression. Exposure-response curves showed that there may be a threshold for the effect of ozone exposure on anxiety and depression over the three months moving average concentrations, with similar patterns observed at different temperature levels. People over 65 years old were at significantly higher risks of ozone-associated depression, while anxiety was more strongly associated with ozone in hypertensive patients. Our study supports the theory that anxiety and depression is associated with mid-term ozone exposure in China, and temperatures significantly enhanced their associations. These findings may have significant implications for promoting prevention activities regarding mental disorders and approaches in reducing the disease burden by simultaneously controlling air pollution and mitigating climate change.

Associations between self-reported respiratory symptoms and non-specific psychological distress following exposure to a prolonged landscape fire

We investigated the association between respiratory symptoms and psychological distress in the context of a prolonged smoke event, and evaluated whether smoke exposure, or pre-existing respiratory and mental health conditions, influenced the association. Three thousand ninety-six residents of a rural town heavily exposed to smoke from the 6-week Hazelwood coal mine fire, and 960 residents of a nearby unexposed town, completed Kessler’s psychological distress questionnaire (K10) and a modified European Community Respiratory Health Survey. Logistic regression models evaluated associations between distress and respiratory symptoms, with interactions fitted to evaluate effect modification. Smoke exposed participants reported higher levels of distress than those unexposed, and participants reporting respiratory symptoms recorded higher levels of distress than participants without respiratory symptoms, irrespective of exposure. 5-unit increments in K10 scores were associated with 21%-48% increases in the odds of reporting respiratory symptoms. There were significant interactions with pre-existing asthma, chronic obstructive pulmonary disease and mental health conditions, but not with smoke exposure. Although participants with pre-existing conditions were more likely to report respiratory symptoms, increasing distress was most strongly associated with respiratory symptoms among those without pre-existing conditions. Communities exposed to landscape fire smoke could benefit from interventions to reduce both psychological and respiratory distress.

Nature connectedness in the climate change context: Implications for climate action and mental health

A sense of psychological connectedness with the natural world has important benefits for global health. In a time of environmental crisis, however, it may also be accompanied by mental health risks. We used national survey data collected after a severe Australian bushfire season (N = 3,875) to test a path model of the relationships between nature connectedness, worry about climate change, individual and collective climate action, and psychological distress (depression, anxiety, stress). We found that nature connectedness was positively associated with climate worry that, in turn, was positively associated with climate action and psychological distress. Whereas taking individual climate action was associated with reduced psychological distress, taking collective climate action had the opposite effect. Our findings provide new insights into potential processes underlying the association between nature connectedness and mental health in the climate change context and point to an urgent need to protect the well-being of people engaging in collective climate action.

An exploration of the trajectory of psychological distress associated with exposure to smoke during the 2014 hazelwood coal mine fire

Due to climate change, catastrophic events such as landscape fires are increasing in frequency and severity. However, relatively little is known about the longer-term mental health outcomes of such events. Follow-up was conducted of 709 adults exposed to smoke from the 2014 Hazelwood mine fire in Morwell, Victoria, Australia. Participants completed two surveys evaluating posttraumatic distress, measured using the Impact of Events Scale-Revised (IES-R), three and six years after the mine fire. Mixed-effects regression models were used to evaluate longitudinal changes in distress. IES-R total scores increased on average by 2.6 points (95%CI: 1.2 to 3.9 points) between the two survey rounds, with increases across all three posttraumatic distress symptom clusters, particularly intrusive symptoms. This increase in distress was evident across all levels of fine particulate matter (PM(2.5)) exposure to the mine fire smoke. Age was an effect modifier between mine fire PM(2.5) exposure and posttraumatic distress, with younger adults impacted more by exposure to the mine fire. Greater exposure to PM(2.5) from the mine fire was still associated with increased psychological distress some six years later, with the overall level of distress increasing between the two survey rounds. The follow-up survey coincided with the Black Summer bushfire season in south-eastern Australia and exposure to this new smoke event may have triggered distress sensitivities stemming from exposure to the earlier mine fire. Public health responses to disaster events should take into consideration prior exposures and vulnerable groups, particularly younger adults.

Explainable gated recurrent unit to explore the effect of co-exposure to multiple air pollutants and meteorological conditions on mental health outcomes

Mental health conditions have the potential to be worsened by air pollution or other climate-sensitive factors. Few studies have empirically examined those associations when we faced to co-exposures, as well as interaction effects. There would be an urgent need to use deep learning to handle complex co-exposures that might interact in multiple ways, and the model performance reinforced by SHapely Additive exPlanations (SHAP) enabled our predictions interpretable and hence actionable. Here, to evaluate the mixed effect of short-term co-exposure, we conducted a time-series analysis using approximately 1.47 million hospital outpatient visits of mental disorders (i.e., depressive disorder-DD, Schizophrenia-SP, Anxiety Disorder-AD, Bipolar Disorder-BD, Attention Deficit and Hyperactivity Disorder-ADHD, Autism Spectrum Disorder-ASD), with matched meteorological observations from 2015 through 2019 in Nanjing, China. The global insights of gated recurrent unit model revealed that most of input features with similar effect size caused the illness risk of SP and ASD increase, and most markedly, 73% of relative humidity, 44.6 µg/m(3) of NO(2), and 14.1 µg/m(3) of SO(2) at 5-year average level associated with 2.27, 1.14, and 1.29 visits increase for DD, SP, and AD, respectively. Both synergic and antagonistic effect among informative paired-features were distinguished from local feature dependence. Interestingly, variation tendencies of excessive visits of bipolar disorder when atmospheric pressure, PM(2.5), and O(3) interacted with one another were inconsistent. Our results provided added qualitative and quantitative support for the conclusion that short-term co-exposure to ambient air pollutants and meteorological conditions posed threats to human mental health.

Health and human wellbeing in China: Do environmental issues and social change matter?

How to mitigate greenhouse gas emission and achieve human development remain major sustainability issues, particularly in China. Empirical research on the effects of climate warming and social change on human health and wellbeing is quite fragmented. This study examines the impact of environmental issues and social changes on health and human wellbeing using a time series data of China from 1991 to 2020. Findings show that environmental issues have a negative impact on health and human wellbeing in long run. While the internet is a form of social change that tends to improve health and human wellbeing in the long run. FDI exerts a positive effect on human health, but it does not improve wellbeing in the long run. In contrast, financial development does not improve human health but it has a significant positive impact on wellbeing in the long run. Our empirical insights have important implications for achieving human wellbeing through the pursuit of environmental sustainability and social change.

Association between short-term nitrogen dioxide exposure and outpatient visits for anxiety: A time-series study in Xi’an, China

As the most common mental disorder, anxiety heavily damages human mental health and leads to heavy health burdens. However, evidence concerning the impact of NO2 on anxiety is limited. In this study, we aimed to further explore the association between short-term NO2 exposure and anxiety outpatient visits in Xi’an, a city located in Northwest China with relatively heavy air pollution. Daily data of anxiety outpatient visits, air pollutants (PM2.5, PM10, SO2, NO2, CO, and O-3), and meteorological conditions (daily mean temperature and relative humidity) from 2013 to 2019 were gathered. Then generalized additive models (GAM) was adopted to investigate the relationship between short-term NO2 exposure and the number of anxiety outpatient visits after controlling for long-term effects, holiday effects, day of the week, and weather conditions. The results showed that NO2 exposure was positively correlated with the number of daily anxiety outpatient visits: A 10 mu g/m(3) increase of NO2 concentration corresponded to 1.94% (95%CI: 1.19%, 2.68%) and 3.72% (95%CI: 2.35%, 5.08%) increase in anxiety outpatient visits at lag 1 and lag 07, respectively. Such a relationship showed gender differences (more obvious in females) but no age differences. More interestingly, the association between NO2 and anxiety outpatient visits showed to be more obvious during cool seasons than during warm seasons. In summary, short-term ambient NO2 exposure, especially during cool seasons, may be related to a higher risk of anxiety outpatient visits.

Climate change and mental health impacts among Dalit communities in southwestern Bangladesh

The Impacts of Climate Change on Mental Health of Tribal Communities in Jharkhand

Research and Action Agenda on Climate Change and Mental Health for Small Farmers and Fisher Peoples

Our Lands, Our Minds: Research and Action Agenda on Indigenous Mental Health in a Changing Climate

Connecting Climate Minds Hub

Climate Change and Mental Health: An Introductory Toolkit for Researchers

Youth Research and Action Agenda: Vulnerability and Resilience in the Generation Inheriting the Climate Crisis

Women paying the health cost of the climate crisis

Mental Health and Our Changing Climate: Children and Youth Report 2023

Integrated approach to building community mental health resilience in response to Cyclone Mocha in Myanmar

Copernicus Health Hub

The influence of the urban environment on mental health during the COVID-19 pandemic: Focus on air pollution and migration-a narrative review

The coronavirus disease 2019 (COVID-19) pandemic caused a crisis worldwide, due to both its public health impact and socio-economic consequences. Mental health was consistently affected by the pandemic, with the emergence of newly diagnosed psychiatric disorders and the exacerbation of pre-existing ones. Urban areas were particularly affected by the virus spread. In this review, we analyze how the urban environment may influence mental health during the COVID-19 pandemic, considering two factors that profoundly characterize urbanization: air pollution and migration. Air pollution serves as a possibly risk factor for higher viral spread and infection severity in the context of urban areas and it has also been demonstrated to play a role in the development of serious mental illnesses and their relapses. The urban environment also represents a complex social context where minorities such as migrants may live in poor hygienic conditions and lack access to adequate mental health care. A global rethinking of the urban environment is thus required to reduce the impact of these factors on mental health. This should include actions aimed at reducing air pollution and combating climate change, promoting at the same time a more inclusive society in a sustainable development perspective.

The interplay between social and ecological determinants of mental health for children and youth in the climate crisis

Children and youth are showing increasing levels of mental health distress due to the climate crisis, characterized by feelings of sadness, guilt, changes in sleep and appetite, difficulty concentrating, solastalgia, and disconnection from land. To gain a deeper understanding of the relationship between climate change and children and youth’s mental health, we conducted a rapid review and a thematic analysis of the results in NVivo 12. Our findings show that children and youth experience a plethora of direct and indirect effects from climate change and this impacts their mental wellbeing in diverse and complex ways. Young people also have varied perceptions of climate change based on their social locations and many are dealing with feelings of immense worry and eco-anxiety. The mental health impacts of climate change on children/youth are tied to Social Determinants of Health (SDoH) but also need to be understood in relation to the Ecological Determinants of Health (EDoH). Through an eco-social lens, this paper explores these conceptual issues and uses them to provide a framework for understanding the interplay of social and ecological determinants of mental health for children/youth.

The nature buffer: The missing link in climate change and mental health research

The connections between climate change and mental health are well known (Berry et al., Int J Publ Health 55(2):123-132, 2010; Clayton and Manning 2018; Kim et al., J Environ Sci Health C 32(3):299-318, 2014). Research also points to the positive impacts of nature on mental health, well-being, and attention (Capaldi et al., Int J Wellbeing 5(4):1-16, 2015; Kaplan and Kaplan 1989; Tillmann et al., J Epidemiol Community Health 72(10):958-966, 2018). However, no empirical research has examined how degradation of nature as a result of climate change can impact the mental health benefits that nature provides. This paper first reviews the existing research on the negative mental health consequences of climate change and the benefits of nature exposure for stress, mental health, and well-being. The connection between these two lines of research is examined in order to fully understand the impacts of climate change on mental health. Suggestions for future research are included.

Seeing with Empty Eyes’: A systems approach to understand climate change and mental health in Bangladesh

Bangladesh’s unique climate vulnerability is well-investigated but the mental health impacts of climate change remain relatively unexplored. Three databases were searched for English primary qualitative studies published between 2000 and 2020. Out of 1202 publications, 40 met the inclusion criteria. This systematic review applies a systems approach to further understand Bangladesh’s ‘climate-wellbeing’ network. The literature indicates diverse factors linking environmental stress and mental ill-health including four key themes: (1) post-hazard mental health risks, (2) human (im)mobility, (3) social tension and conflict, and (4) livelihood loss and economic hardship. This systems analysis also revealed that people’s mental wellbeing is strongly mediated by socio-economic status and gender. The article illustrates how multiple pathways may amplify stress, anxiety, violence, and psychological damage. Greater recognition of the ‘climate-wellbeing’ connections, and incorporation of mental health in current climate action and policy frameworks, will be an effective way to achieve a more sustainable future.

Climate change and mental health

PURPOSE OF REVIEW: This essay reviews evidence for the current and potential effects of climate change on mental health. RECENT FINDINGS: A growing body of research demonstrates not only that the extreme weather events associated with a changing climate can impair mental health, in particular leading to increases in depression and post-traumatic stress disorder, but also that more gradual changes in climatic conditions, such as rising temperatures and reduced air quality, are also harmful to mental health. In addition, there is increasing evidence that a significant proportion of people might be experiencing a harmful level of anxiety associated with their perception of climate change. Mental health impacts of climate change have the potential to affect a significant proportion of the population. More research is needed to document the extent of these impacts as well as the best options for mitigating and treating them.

Climate change and mental health: A scoping review

Climate change is negatively impacting the mental health of populations. This scoping review aims to assess the available literature related to climate change and mental health across the World Health Organisation’s (WHO) five global research priorities for protecting human health from climate change. We conducted a scoping review to identify original research studies related to mental health and climate change using online academic databases. We assessed the quality of studies where appropriate assessment tools were available. We identified 120 original studies published between 2001 and 2020. Most studies were quantitative (n = 67), cross-sectional (n = 42), conducted in high-income countries (n = 87), and concerned with the first of the WHO global research priorities-assessing the mental health risks associated with climate change (n = 101). Several climate-related exposures, including heat, humidity, rainfall, drought, wildfires, and floods were associated with psychological distress, worsened mental health, and higher mortality among people with pre-existing mental health conditions, increased psychiatric hospitalisations, and heightened suicide rates. Few studies (n = 19) addressed the other four global research priorities of protecting health from climate change (effective interventions (n = 8); mitigation and adaptation (n = 7); improving decision-support (n = 3); and cost estimations (n = 1)). While climate change and mental health represents a rapidly growing area of research, it needs to accelerate and broaden in scope to respond with evidence-based mitigation and adaptation strategies.

A framework for mental health and psychosocial support in radiological and nuclear emergencies