• Energy Research

The potential impacts of climate change on human health in sub-Saharan Africa are wide-ranging, complex, and largely adverse. The region's Indigenous peoples are considered to be at heightened risk given their relatively poor health outcomes, marginal social status, and resource-based livelihoods; however, little attention has been given to these most vulnerable of the vulnerable. This paper contributes to addressing this gap by taking a bottom-up approach to assessing health vulnerabilities to climate change in two Batwa Pygmy communities in rural Uganda. Rapid Rural Appraisal and PhotoVoice field methods complemented by qualitative data analysis were used to identify key climate-sensitive, community-identified health outcomes, describe determinants of sensitivity at multiple scales, and characterize adaptive capacity of Batwa health systems. The findings stress the importance of human drivers of vulnerability and adaptive capacity and the need to address social determinants of health in order to reduce the potential disease burden of climate change.

This exploratory study used participatory methods to identify, characterize, and rank climate-sensitive health priorities in Nunatsiavut, Labrador, Canada.A mixed method study design was used and involved collecting both qualitative and quantitative data at regional, community, and individual levels. In-depth interviews with regional health representatives were conducted throughout Nunatsiavut (n = 11). In addition, three PhotoVoice workshops were held with Rigolet community members (n = 11), where participants took photos of areas, items, or concepts that expressed how climate change is impacting their health. The workshop groups shared their photographs, discussed the stories and messages behind them, and then grouped photos into re-occurring themes. Two community surveys were administered in Rigolet to capture data on observed climatic and environmental changes in the area, and perceived impacts on health, wellbeing, and lifestyles (n = 187).Climate-sensitive health pathways were described in terms of inter-relationships between environmental and social determinants of Inuit health. The climate-sensitive health priorities for the region included food security, water security, mental health and wellbeing, new hazards and safety concerns, and health services and delivery.The results highlight several climate-sensitive health priorities that are specific to the Nunatsiavut region, and suggest approaching health research and adaptation planning from an EcoHealth perspective.

As climate change impacts are felt around the globe, people are increasingly exposed to changes in weather patterns, wildlife and vegetation, and water and food quality, access and availability in their local regions. These changes can impact human health and well-being in a variety of ways: increased risk of foodborne and waterborne diseases; increased frequency and distribution of vector-borne disease; increased mortality and injury due to extreme weather events and heat waves; increased respiratory and cardiovascular disease due to changes in air quality and increased allergens in the air; and increased susceptibility to mental and emotional health challenges. While climate change is a global phenomenon, the impacts are experienced most acutely in place; as such, a sense of place, place-attachment, and place-based identities are important indicators for climate-related health and adaptation. Representing one of the first qualitative case studies to examine the connections among climate change, a changing sense of place, and health in an Inuit context, this research draws data from a multi-year community-driven case study situated in the Inuit community of Rigolet, Nunatsiavut, Canada. Data informing this paper were drawn from the narrative analysis of 72 in-depth interviews conducted from November 2009 to October 2010, as well as from the descriptive analysis of 112 questionnaires from a survey in October 2010 (95% response rate). The findings illustrated that climate change is negatively affecting feelings of place attachment by disrupting hunting, fishing, foraging, trapping, and traveling, and changing local landscapes-changes which subsequently impact physical, mental, and emotional health and well-being. These results also highlight the need to develop context-specific climate-health planning and adaptation programs, and call for an understanding of place-attachment as a vital indicator of health and well-being and for climate change to be framed as an important determinant of health.

This paper presents the results of an exploratory study working with two Amazonian communities in Peru to identify key climate-related health risks from the perspective of local residents, and characterize how these risks are experienced and managed. The work adopts a vulnerability-based approach and utilizes participatory methodologies to document and examine local perspectives on vulnerability and adaptive capacity. Thirty nine community members were engaged in participatory photography (photovoice), and rapid rural appraisal workshops were conducted with a total 40 participants. Contextual information was obtained from 34 semi-structured interviews with key informants and participant observation during fieldwork. Three climate-related health risks were identified by the communities as pressing issues (food insecurity, water insecurity, and vector-borne disease), all of which are climate-dependent and reported to be being affected by observed changes in climatic conditions. Sensitivity to these risks is high due to social and economic disadvantages which force people to live in suboptimal conditions, partake in dangerous activities, and engage in unhealthy behaviors. Traditional approaches to health and strong social networks are important in moderating health risks, but are placed under increasing stress in the context of local social and economic changes due to larger scale influences, including resource development, deforestation, and changing social relations.

Climate change is expected to cause changes in precipitation quantity, intensity, frequency and duration, which will subsequently alter environmental conditions and might increase the risk of waterborne disease. The objective of this study was to describe the seasonality of and explore associations between weather, water quality and occurrence of infectious gastrointestinal illnesses (IGI) in two communities in Nunatsiavut, Canada. Weather data were obtained from meteorological stations in Nain (2005-2008) and Rigolet (2008). Free-chlorine residual levels in drinking water were extracted from municipal records (2005-2008). Raw surface water was tested weekly for total coliform and E. coli counts. Daily counts of IGI-related clinic visits were obtained from health clinic registries (2005-2008). Analysis of weather and health variables included seasonal-trend decomposition procedures based on Loess. Multivariable zero-inflated Poisson regression was used to examine potential associations between weather events (considering 0-4 week lag periods) and IGI-related clinic visits. In Nain, water volume input (rainfall + snowmelt) peaked in spring and summer and was positively associated with levels of raw water bacteriological variables. The number of IGI-related clinic visits peaked in the summer and fall months. Significant positive associations were observed between high levels of water volume input 2 and 4 weeks prior, and IGI-related clinic visits (P < 0.05). This study is the first to systematically gather, analyse and compare baseline data on weather, water quality and health in Nunatsiavut, and illustrates the need for high quality temporal baseline information to allow for detection of future impacts of climate change on regional Inuit human and environmental health.

Global climate change and its impact on public health exemplify the challenge of managing complexity and uncertainty in health research. The Canadian North is currently experiencing dramatic shifts in climate, resulting in environmental changes which impact Inuit livelihoods, cultural practices, and health. For researchers investigating potential climate change impacts on Inuit health, it has become clear that comprehensive and meaningful research outcomes depend on taking a systemic and transdisciplinary approach that engages local citizens in project design, data collection, and analysis. While it is increasingly recognised that using approaches that embrace complexity is a necessity in public health, mobilizing such approaches from theory into practice can be challenging. In 2009, the Rigolet Inuit Community Government in Rigolet, Nunatsiavut, Canada partnered with a transdisciplinary team of researchers, health practitioners, and community storytelling facilitators to create the Changing Climate, Changing Health, Changing Stories project, aimed at developing a multi-media participatory, community-run methodological strategy to gather locally appropriate and meaningful data to explore climate-health relationships. The goal of this profile paper is to describe how an EcoHealth approach guided by principles of transdisciplinarity, community participation, and social equity was used to plan and implement this climate-health research project. An overview of the project, including project development, research methods, project outcomes to date, and challenges encountered, is presented. Though introduced in this one case study, the processes, methods, and lessons learned are broadly applicable to researchers and communities interested in implementing EcoHealth approaches in community-based research.