A relationship between environmental degradation and mental health in rural Western Australia

Brighten up the Rainbow: Ecology-Based Group Work for LGBTQ+ People

This research was carried out as a pretest-posttest experimental study in order to evaluate the effect of ecology-based group work on 18 LGBTQ+ people living in different districts of Istanbul. The study group of the research carried out between July 2022 and August 2022 consists of 18 LGBTQ+ people, between the ages of 19-22. Study participants were randomly selected for each group and assigned to the experimental and control groups. In addition to the Personal Information Form, the Flourishing Scale, the Nature Relatedness Scale, and the Depression Stress and Anxiety Scale (DASS21) were applied to the study group as pretest-posttest. Socializing, hiking, gardening, and human-animal interaction activities were held in the group work sessions consisting of 6 sessions on Saturdays at 13.00. In addition to all these activities, some documentaries on ecology were also suggested for the participants to watch, to be discussed in different sessions. The collected data were analyzed in the SPSS 22.0 package program. At the end of the group work, it was observed that there was a significant difference in the total scores of the Flourishing Scale, the Nature Relatedness Scale, and Depression Stress and Anxiety Scale (DASS21) of LGBTQ+ people in the experimental group.

The influence of environment and Earnings on Prolonged existence and human fertility: A Deeper Dive into Asia's environmentally vulnerable nations

This study inspects the impact of environmental deterioration and income on longevity and fertility in Asian countries, specifically the nations that are highly vulnerable to extreme weather. The study examines the data, covering two decades from 2000 to 2019. The empirical conclusions of the panel ARDL-PMG and the CS-ARDL econometric models indicate that environmental degradation leads to a decline in birth rate and life expectancy, while a rising income has a significant influence over longevity. However, increasing per capita income alone cannot solve the problem of population crisis in climatically susceptible countries. Therefore, the sample countries must prioritize climate action and formulate climate-resilient policies to add more years to the lives of their citizens. Similarly, for increasing childbirth the sample nations need to make peace with nature. The outcomes of this study are strong enough, as both the models support each other's findings, producing similar significant outcomes.

Does environmental degradation matter for poverty? Clarifying the nexus between FDI, environmental degradation, renewable energy, education, and poverty in Morocco and Tunisia

Poverty is the curse for sustainable and equitable development worldwide by detreating environmental sustainability, economic instability, and inequality. However, as a remedy for poverty reduction, researchers over the past decade have examined the key macro determinants and established positive associations, implying the contributory role in poverty reduction. The study explores the environmental, energy, education, and foreign direct investment (FDI) effects on poverty reduction in Morocco and Tunisia from 1991 to 2020. We employed autoregressive distributed lagged (ARDL) and nonlinear ARDL frameworks to document the explanatory variables' elasticity on poverty reduction in both the long- and short-run horizons. According to linear assessment, the study documented that education, energy, and FDI support poverty reduction. At the same time, the cost of environmental degradation has a detrimental effect on poverty augmentation. Referring to asymmetric assessment, the study established a long-run asymmetric association between asymmetric shocks of education, FDI, and energy with poverty. For directional association, the study has implemented a casualty test with the Fourier TY causality test and revealed a bidirectional association between education and poverty, and energy and poverty. Moreover, the unidirectional casualty was unveiled between FDI and poverty, and poverty and environment.

The impact of cold spells on schizophrenia admissions and the synergistic effect with the air quality index

OBJECTIVES

Under current global climate conditions, there are insufficient studies on the health influences of cold spells, especially on mental health. This study aimed to examine the effect of cold spells on schizophrenia admissions and to analyze the potential interaction effect with the air quality index (AQI).

METHODS

Daily data on schizophrenia admissions and climatic variables in Hefei were collected from 2013 to 2019. Based on 20 definitions, the impacts of cold spells were quantified separately to find the most appropriate definition for the region, and meta-regression was used to explore the different effect sizes of the different days in a cold spell event. In addition, the potential interaction effect was tested by introducing a categorical variable, CSH, reflecting the cold spell and AQI level.

RESULTS

The cold spell defined by temperature below the 6th centile while lasting for at least three days produced the optimum model fit performance. In general, the risk of schizophrenia admissions increased on cold spell days. The largest single-day effect occurred on the 12th day with RR = 1.081 (95% CI: 1.044, 1.118). In a single cold spell event, the effect of the 3rd and subsequent days of a cold spell (RR = 1.082, 95% CI: 1.036, 1.130) was higher than that on the 2nd day (RR = 1.054, 95% CI: 1.024, 1.085). Similarly, the effect of the 2nd day was also higher than that of the 1st day (RR = 1.027, 95% CI: 1.012, 1.042). We found a synergistic effect between cold spells and high AQI in the male group, and the relative excess risk due to interaction (RERI) was 0.018 (95% CI: 0.005-0.030).

CONCLUSIONS

This study suggested that the impacts of cold spells should be considered based on the definition of the most appropriate for the region when formulating targeted measures of schizophrenia. The discovery of the synergistic effect was referred to help the selection of the timing of precautions for susceptible people.

A Changing Home: A Cross-Sectional Study on Environmental Degradation, Resettlement and Psychological Distress in a Western German Coal-Mining Region

Unwelcome environmental changes can lead to psychological distress, known as “solastalgia”. In Germany, the open-pit mining of brown coal results in environmental changes as well as in the resettlement of adjacent villages. In this study, we investigated the risk of open-pit mining for solastalgia and psychological disorders (e.g., depression, generalized anxiety and somatization) in local communities. The current residents and resettlers from two German open-pit mines were surveyed concerning environmental stressors, place attachment, impacts and mental health status. In total, 620 people responded, including 181 resettlers, 114 people from villages threatened by resettlement and 325 people from non-threatened villages near an open-pit mine. All groups self-reported high levels of psychological distress, approximately ranging between 2−7.5 times above the population average. Respondents from resettlement-threatened villages showed the worst mental health status, with 52.7% indicating at least moderate somatization levels (score sum > 9), compared to 28% among resettlers. We observed a mean PHQ depression score of 7.9 (SD 5.9) for people from resettlement-threatened villages, 7.4 (SD 6.0) for people from not-threatened villages, compared to 5.0 (SD 6.5) for already resettled people (p < 0.001). In conclusion, the degradation and loss of the home environment caused by open-pit mining was associated with an increased prevalence of depressive, anxious and somatoform symptoms in local communities. This reveals a need for further in-depth research, targeted psychosocial support and improved policy frameworks, in favor of residents’ and resettlers’ mental health.

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.

Systematic review of quantitative studies assessing the relationship between environment and mental health in rural areas

OBJECTIVE

Physical and natural environments might strongly influence mental health and well-being. Many studies have examined this relationship in urban environments, with fewer focused on rural settings. The aim of this systematic review was to synthesise quantitative evidence for the relationship between environmental factors (drought, climate and extreme weather events, land use/environmental degradation, green space/vegetation, engagement in natural resource management activities) and mental health or well-being in rural areas.

DESIGN

Following a systematic search of three databases (PsycINFO, MEDLINE and Web of Science), 4368 articles were identified, of which 28 met eligibility criteria for inclusion in the review.

RESULTS

Poorer mental health and well-being was typically found to have an association with extreme climate or weather events and environmental degradation. The observed relationships were largely assessed at area-wide or community levels.

CONCLUSIONS

Studies examining the relationship between the environmental condition of land and mental health at an individual level, particularly within farms, are lacking. Addressing this gap in research requires interdisciplinary expertise and diverse methodology. Few studies examined the effects of natural resource management practices/principles or biodiversity on mental health. While there is evidence that extreme climate or weather events have a negative impact on mental health in rural areas, there remain considerable gaps in our knowledge of how rural environments influence mental health and well-being.

Spatially explicit analyses of environmental and health data to determine past, emerging and future threats to child health

BACKGROUND

Dire forecasts predict that an increasingly hostile environment globally will increase the threats to human health. Infants and young children are especially at risk because children are particularly vulnerable to climate-related stressors. The childhood diseases most affected, the breadth and magnitude of future health problems and the time frame over which these problems will manifest remain largely unknown.

OBJECTIVES

To review the possibility that spacially explicit analyses can be used to determine how climate change has affected children's health to date and whether these analyses can be used for future projections.

METHODS

As an example of whether these objectives can be achieved, all available Australian environmental and health databases were reviewed.

RESULTS

Environmental and health data in Australia have been collected for up to 30 years for the same spatial areas at 'Statistical Area level 1' (SA1) scale. SA1s are defined as having a population of between 200 and 800 people and collectively they cover the whole of Australia without gaps or overlap. Although the SA1 environmental and health data have been collected separately, they can be merged to allow detailed statistical analyses that can determine how climate change has affected the health of children.

CONCLUSIONS

The availability of environmental and health datasets that share the same precise spatial coordinates provides a pathway whereby past and emerging effects on child health can be measured and predicted into the future. Given that the future health and well-being of children is one of society's greatest concerns, this information is urgently needed.

Relationship between Land Use/Land-Use Change and Human Health in Australia: A Scoping Study

We undertook a scoping study to map the relevant evidence, summarise the findings, and to help identify gaps in the knowledge base on the relationship between land use/land-use change and human health in Australia. Our systematic search of the scientific literature for relevant articles up to August 2020 identified 37 articles. All 37 articles meeting our inclusion criteria were published after 2003. Zoonotic or vector-borne disease constituted the most common health outcome type studied. Agriculture/grazing was the land use/land-use change type most frequently represented in the literature, followed by coal seam gas extraction and open cut coal mining. The relationship between land use/land use change and human health in Australia, is not conclusive from the existing evidence. This is because of (1) a lack of comprehensive coverage of the topic, (2) a lack of coverage of the geography, (3) a lack of coverage of study types, and (4) conflicting results in the research already undertaken. If we are to protect human health and the ecosystems which support life, more high-quality, specific, end-user driven research is needed to support land management decisions in Australia. Until the health effects of further land use change are better known and understood, caution ought to be practiced in land management and land conversion.

Anxiety and resilience in the face of natural disasters associated with climate change: A review and methodological critique

In the past two decades, climate change-related natural disasters, such as hurricanes, floods, and droughts have become increasingly frequent and severe, impacting the emotional and psychological well-being of those who are directly or indirectly exposed to them. Despite great interest in understanding differences in anxiety and resilience in response to natural disasters, enthusiasm appears to outstrip empirical clarity, as there remains considerable ambiguity as to determinants of resilient or pathological outcomes following exposure to natural disasters. In addition, there are several major methodological limitations in climate change and related natural disaster research, including the use of univariate analyses, cross-sectional design, and retrospective measures. Keeping these limitations in mind, we first review literature examining the mental health outcomes of natural disasters. Findings suggest that, overall, resilience is more common than pathological outcomes. Second, we use a multi-dimensional framework of resilience to selectively review factors at the event, individual, as well as family and community levels that could help inform resilient or pathological outcomes. Finally, we consider key limitations and future directions for research and practice in the field of anxiety and resilience in response to climate disasters.

Exploring the Drivers of Irrigator Mental Health in the Murray–Darling Basin, Australia

There has been little work conducted on how landholders’ farm management approaches and financial capital (specifically (i) farm method such as organic farming and (ii) financial profitability) may impact mental health. In particular, there is emerging evidence that an increase in natural farm capital and environmental conditions may improve farmers’ wellbeing. We used a 2015–2016 survey, which randomly sampled 1000 irrigators from the southern Murray–Darling Basin, to model the drivers of irrigators’ psychological distress. Results highlight that worsening financial capital (namely, lower farmland value, higher farm debt, lower percentage of off-farm income, lower productivity change over the past five years, and lower net farm income) was the most statistically significant factor associated with increased irrigator distress. In addition, there was some evidence that being a certified organic irrigator was also associated with lower psychological distress; however, it was only weakly significant in our overall model, with the most significance within the horticultural industry model. Contrary to expectations, drought and water scarcity were not the main drivers of psychological distress in the time-period studied, with their influence seemingly through reducing financial capital as a whole.

Linking Water Scarcity to Mental Health: Hydro–Social Interruptions in the Lake Urmia Basin, Iran

Alterations of water flows resulting from the manifestation of powerful hydro–social imaginaries often produce an uneven distribution of burdens and benefits for different social groups or regions, reflecting their social and political power. Marginalized regions can suffer manufactured territorialized water scarcity, which disturbs the natural, economic and socio-political order of water users, and as this article shows, inevitably affects their psychological wellbeing. Set in the context of the surroundings of Lake Urmia in Iran, once one of the largest hypersaline lakes in the world and now a severely degraded ecosystem mainly as a result of water overuse in its watershed, this article explores how and through which pathways this manufactured water scarcity impacted the mental health of the water users in the region. The research findings reveal that alterations in this local hydro–social territory and the resulting biophysical, financial and social changes, as well as impacts on physical health of water users, relate to chronic psychological stress, social isolation, intra-community conflicts, despair, hopelessness, depression and anxiety.

Voices from the landscape: Storytelling as emergent counter-narratives and collective action from northern BC watersheds

The 'Ecohealth and Watersheds in Northern BC'' project, situated in a resource rich, settler colonial context, generated three digital stories at the request of the project's Steering Committee members that sought to connect health, environment, and community. Three Steering Committee members championed these stories from their distinct watersheds, resulting in emergent counter-narratives that respond directly to their social-ecological contexts. Nested in literature on blue and green spaces, we present and examine the process of storytelling as emergent counter-narrative and how these narratives challenge us to think of blue and green spaces in interconnected and nuanced ways.

Water insecurity and gendered risk for depression in rural Uganda: a hotspot analysis

Background

Water insecurity is linked to depression in low- and middle-income countries (LMICs), though it remains unclear how geospatial clustering of water insecurity in rural regions is associated with risk for depression.

Methods

We conducted a population-based survey of a rural parish in southwestern Uganda (N = 1603) to evaluate the joint geospatial clustering of water insecurity and risk for depression among men and women living in rural Uganda.

Results

Geospatial clustering of self-reported water insecurity and depressive symptoms was found to be present among both men and women. Depression hotspots were more often observed near water insecurity hotspots among women, relative to men. Multivariable regression revealed that residing in a water insecurity hotspot significantly increased risk for depressive symptoms among women, but not among men.

Conclusions

Residing in a water insecurity hotspot is associated with greater risk for probable depression among women, but not among men, pointing to the need for focused depression screening among women residing in water insecure households.

Psychological health challenges of the hill-tracts region for climate change in Bangladesh

The aim of this paper is to provide an overview of the deleterious effects of climate change on psychological health of the Hill-Tracts and government to deal with these adverse psychological health impacts. Although knowledge is still limited about the connections between climate change and psychological health, the evidence is indicating that impacts can be felt at both the individual and community levels, with psychological health outcomes ranging from psychological distress, depression, and anxiety, to increased addictions and suicide rates. Drawing from 125 in-depth interviews conducted between January 2015 and October 2016 with community members and local and regional health professionals, participants reported that climate change was negatively impacting psychological health and well-being. The results stated that climate change enhanced the possibility of an increased drug, family stress, alcohol use, amplified previous traumas, psychological health stressors, and were implicated in increased potential for suicide ideation of the Hill-Tracts region in Bangladesh. These exploratory findings indicate that climate change is becoming an additional psychological health stressor for Hill-Tracks' dwellers in Bangladesh.

Transforming Life: A Broad View of the Developmental Origins of Health and Disease Concept from an Ecological Justice Perspective

The influential scientist Rene J. Dubos (1901–1982) conducted groundbreaking studies concerning early-life environmental exposures (e.g., diet, social interactions, commensal microbiota, housing conditions) and adult disease. However, Dubos looked beyond the scientific focus on disease, arguing that “mere survival is not enough”. He defined mental health as fulfilling human potential, and expressed concerns about urbanization occurring in tandem with disappearing access to natural environments (and elements found within them); thus modernity could interfere with health via “missing exposures”. With the advantage of emerging research involving green space, the microbiome, biodiversity and positive psychology, we discuss ecological justice in the dysbiosphere and the forces—financial inequity, voids in public policy, marketing and otherwise—that interfere with the fundamental rights of children to thrive in a healthy urban ecosystem and learn respect for the natural environment. We emphasize health within the developmental origins of health and disease (DOHaD) rubric and suggest that greater focus on positive exposures might uncover mechanisms of resiliency that contribute to maximizing human potential. We will entrain our perspective to socioeconomic disadvantage in developed nations and what we have described as “grey space”; this is a mental as much as a physical environment, a space that serves to insidiously reinforce unhealthy behavior, compromise positive psychological outlook and, ultimately, trans-generational health. It is a dwelling place that cannot be fixed with encephalobiotics or the drug-class known as psychobiotics.

An Ecosystems and Vulnerable Populations Perspective on Solastalgia and Psychological Distress After a Wildfire

We studied the relationship between psychological distress and relative resource and risk predictors, including loss of solace from the landscape (solastalgia), one year after the Wallow Fire, in Arizona, United States. Solastalgia refers to the distress caused by damage to the surrounding natural environment and it has not been examined for its relationship to psychological health. Doing so opens avenues of research that inquire into how land management might be able to support improved community resilience and psychological health outcomes after a wildfire. In 2012, we conducted a household survey mailed to all 1387 households in the five communities surrounding the fire. The Kessler Psychological Distress Scale assessed psychological distress. In the multivariate analysis, higher solastalgia score and an adverse financial impact of the fire were associated with clinically significant psychological distress. Annual household income ≥ $80,000 and a higher family functioning score were associated with less psychological distress. Part-time residents were no more likely to have psychological distress than full-time residents. We conclude that dramatic transformation of a landscape by an environmental event such as a wildfire can reduce its value as a source of solace. These results call for novel post-wildfire community recovery interventions that wed forest management and community psychology.

Rural Mental Health Ecology: A Framework for Engaging with Mental Health Social Capital in Rural Communities

The mental health of people in rural communities is influenced by the robustness of the mental health ecosystem within each community. Theoretical approaches such as social ecology and social capital are useful when applied to the practical context of promoting environmental conditions which maximise mental health helping capital to enhance resilience and reduce vulnerably as a buffer for mental illness. This paper explores the ecological conditions that affect the mental health and illness of people in rural communities. It proposes a new mental health social ecology framework that makes full use of the locally available unique social capital that is sufficiently flexible to facilitate mental health helping capital best suited to mental health service delivery for rural people in an Australian context.

Plastic debris in the coastal environment: The invincible threat? Abundance of buried plastic debris on Malaysian beaches

Studies on marine debris have gained worldwide attention since many types of debris have found their way into the food chain of higher organisms. Thus, it is crucial that more focus is given to this area in order to curb contaminations in sea food. This study was conducted to quantify plastic debris buried in sand at selected beaches in Malaysia. Marine debris was identified according to size range and distribution, and this information was related to preventive actions to improve marine waste issues. For the purpose of this study, comparison of plastic waste abundance between a recreational beach and fish-landing beaches was also carried out, since the different beach types represent different activities that produce debris. Six beaches along the Malaysian coastline were selected for this study. The plastic types in this study were related to the functions of the beach. While recreational beaches have abundant quantities of plastic film, foamed plastic including polystyrene, and plastic fragment, fish-landing beaches accumulated line and foamed plastic. A total of 2542 pieces (265.30 g m(-2)) of small plastic debris were collected from all six beaches, with the highest number from Kuala Terengganu, at 879 items m(-2) on Seberang Takir Beach, followed by Batu Burok Beach with 780 items m(-2). Findings from studies of Malaysian beaches have provided a clearer understanding of the distribution of plastic debris. This demonstrates that commitments and actions, such as practices of the 'reduce, reuse, recycle' (3R) approach, supporting public awareness programmes and beach clean-up activities, are essential in order to reduce and prevent plastic debris pollution.

Climate Change, Drought and Human Health in Canada

Droughts have been recorded all across Canada and have had significant impacts on individuals and communities. With climate change, projections suggest an increasing risk of drought in Canada, particularly in the south and interior. However, there has been little research on the impacts of drought on human health and the implications of a changing climate. A review of the Canadian, U.S. and international literature relevant to the Canadian context was conducted to better define these impacts and adaptations available to protect health. Drought can impact respiratory health, mental health, illnesses related to exposure to toxins, food/water security, rates of injury and infectious diseases (including food-, water- and vector-borne diseases). A range of direct and indirect adaptation (e.g., agricultural adaptation) options exist to cope with drought. Many have already been employed by public health officials, such as communicable disease monitoring and surveillance and public education and outreach. However, gaps exist in our understanding of the impacts of short-term vs. prolonged drought on the health of Canadians, projections of drought and its characteristics at the regional level and the effectiveness of current adaptations. Further research will be critical to inform adaptation planning to reduce future drought-related risks to health.

Natural environments, ancestral diets, and microbial ecology: is there a modern "paleo-deficit disorder"? Part I

Famed microbiologist René J. Dubos (1901-1982) was an early pioneer in the developmental origins of health and disease (DOHaD) construct. In the 1960s, he conducted groundbreaking experimental research concerning the ways in which early-life experience with nutrition, microbiota, stress, and other environmental variables could influence later-life health outcomes. He also wrote extensively on potential health consequences of a progressive loss of contact with natural environments (now referred to as green or blue space), arguing that Paleolithic experiences have created needs, particularly in the mental realm, that might not be met in the context of rapid global urbanization. He posited that humans would certainly adapt to modern urban landscapes and high technology, but there might be a toll to be paid in the form of higher psychological distress (symptoms of anxiety and depression) and diminished quality of life. In particular, there might be an erosion of humanness, exemplified by declines in altruism/empathy. Here in the first of a two-part review, we examine contemporary research related to natural environments and question to what extent Dubos might have been correct in some of his 50-year-old assertions.

Environmental correlates of mental health measures for women in Western Australia

A recent study in Western Australia identified area level associations between soil salinisation and hospital admissions for depression. Our study assessed the quantitative relationship between mental health measures at the individual level and location specific environmental measurements on salinity, as well as two other indicators of environmental degradation and change: land surface temperature and normalised difference vegetation index, a proxy for rainfall. Location-specific environmental measurements were linked to individual mental health scores of women in three age cohorts from the Australian Longitudinal Study on Women's Health using a geographic information system. Bayesian geostatistical linear regression models were developed to assess associations between environmental exposures and mental health scores of women. In contrast to previous studies using area level measures, our study found no associations between individual level measurements of mental health scores for women in south-west Western Australia and salinity, LST or NDVI.

The psychosocial impact of the environmental damage caused by the MT Merapi eruption on survivors in Indonesia

The eruption of Indonesia's Mount Merapi volcano in 2010 caused extensive environmental degradation. Settlements and hundreds of hectares of farmlands were buried under volcanic ash. Until now, there has been no research on the psychosocial impact of living in an environment damaged by a volcanic eruption. We studied and compared the psychosocial impact of environmental damage on volcano survivors from two subdistricts-Cangkringan and Pakem. Cangkringan survivors affected by the 2010 eruption continue to live in a damaged environment. The Pakem subdistrict was damaged by eruptions of Mt Merapi in the 1990s but there is no recent damage to their environment. The Indonesian-Environmental Distress Scale (I-EDS), a translated revision of the original Environmental Distress Scale (EDS), was used to collect data. Exploratory statistical methods and multivariate linear regression analyses were performed to examine the relative contributions of demographic variables on the psychosocial impact of living in an environment damaged by volcanic eruption. A total of 348 survivors of the Mt Merapi eruption participated in the survey. The mean I-EDS score for Cangkringan district was 15.8 (SD 1.6; range 11.8-19.8) compared to 14.6 (SD 1.3; range 11.8-18.3) for Pakem district (P < 0.001). This result was confirmed by multiple linear regression analysis showing further that older respondents (P < 0.001), unemployed and retired respondents (P = 0.007), and respondents with no formal school education (P = 0.037) had lower I-EDS scores compared to the respective reference groups. Survivors of the Mt Merapi eruption who continue to live in the environment damaged by the 2010 volcanic eruption experience environmental distress. Relevant interventions should target those from low sosioeconomic groups to deal with the distress.

Dwelling within political violence: Palestinian women's narratives of home, mental health, and resilience

Political violence is increasingly played out within everyday civilian environments, particularly family homes. Yet, within the literature on political violence and mental health, the role of threats to home remains under-explored. Using focus group data from 32 Palestinian women, this paper explores the implications of violations to the home within political violence. Threats to the privacy, control, and constancy of the family home - key dimensions of ontological security (Giddens, 1990) emerged as central themes in women's narratives. Surveillance, home invasions, and actual or threatened destruction of women's home environments provoked fear, anxiety, grief, humiliation, and helplessness, particularly as women struggled to protect their children. Women also described how they mobilized the home for economic, familial and cultural survival. Study findings illuminate the impact of threats to intimate environments on the well-being of women and their families living with chronic political violence, and underscore the importance of attention to violations of place and home in research on civilian experiences of and responses to political violence.

What are the research needs for the field of disaster nursing? An international Delphi study

BACKGROUND

Internationally there is an increasing amount of peer-reviewed literature pertaining to disaster nursing. The literature includes personal anecdotes, reflections, and accounts of single case studies. Furthermore, issues such as the willingness of nurses to assist in disasters, the role of nurses in disasters, leadership, competencies, and educational preparedness for nurses have been the focus of the literature.

AIM

The aim of this research was to determine the international research priorities for disaster nursing.

METHOD

This research used a three-round Delphi technique. The first round used a face-to-face workshop to generate research statements with nursing members of the World Association for Disaster and Emergency Medicine (WADEM). The second and third rounds included the ranking of statements on a 5-point Likert scale with nursing members of WADEM and the World Society of Disaster Nursing (WSDN). Statements that achieved a mean of four or greater were considered a priority and progressed.

RESULTS

Participants were from multiple countries. Research statements were generated in the areas of: education, training, and curriculum; psychosocial; strategy, relationship, and networking; and clinical practice. Psychosocial aspects of disaster nursing ranked the highest, with five statements appearing in the top ten research areas, followed by statements relating to: education, training, and curriculum; clinical practice; and finally, strategy, relationship, and networking.

CONCLUSIONS

Future disaster nursing research should focus on the area of psychosocial aspects of disaster nursing, in particular, both the psychosocial needs of a disaster-affected community and the psychosocial wellbeing of nurses who assist in disaster health activities.

Climate change: the next challenge for public mental health?

Climate change is increasingly recognized as one of the greatest threats to human health of the 21st century, with consequences that mental health professionals are also likely to face. While physical health impacts have been increasingly emphasized in literature and practice, recent scholarly literature indicates that climate change and related weather events and environmental changes can profoundly impact psychological well-being and mental health through both direct and indirect pathways, particularly among those with pre-existing vulnerabilities or those living in ecologically sensitive areas. Although knowledge is still limited about the connections between climate change and mental health, evidence is indicating that impacts may be felt at both the individual and community levels, with mental health outcomes ranging from psychological distress, depression and anxiety, to increased addictions and suicide rates. Drawing on examples from diverse geographical areas, this article highlights some climate-sensitive impacts that may be encountered by mental health professionals. We then suggest potential avenues for public mental health in light of current and projected changes, in order to stimulate thought, debate, and action.

A systematic review of the health and well-being benefits of biodiverse environments

Recent ecosystem service models have placed biodiversity as a central factor in the processes that link the natural environment to health. While it is recognized that disturbed ecosystems might negatively affect human well-being, it is not clear whether biodiversity is related to or can promote "good" human health and well-being. The aim of this study was to systematically identify, summarize, and synthesize research that had examined whether biodiverse environments are health promoting. The objectives were twofold: (1) to map the interdisciplinary field of enquiry and (2) to assess whether current evidence enables us to characterize the relationship. Due to the heterogeneity of available evidence a narrative synthesis approach was used, which is textual rather than statistical. Extensive searches identified 17 papers that met the inclusion criteria: 15 quantitative and 2 qualitative. The evidence was varied in disciplinary origin, with authors approaching the question using different study designs and methods, and conceptualizations of biodiversity, health, and well-being. There is some evidence to suggest that biodiverse natural environments promote better health through exposure to pleasant environments or the encouragement of health-promoting behaviors. There was also evidence of inverse relationships, particularly at a larger scale (global analyses). However, overall the evidence is inconclusive and fails to identify a specific role for biodiversity in the promotion of better health. High-quality interdisciplinary research is needed to produce a more reliable evidence base. Of particular importance is identifying the specific ecosystem services, goods, and processes through which biodiversity may generate good health and well-being.

Human health impacts of ecosystem alteration

Human activity is rapidly transforming most of Earth's natural systems. How this transformation is impacting human health, whose health is at greatest risk, and the magnitude of the associated disease burden are relatively new subjects within the field of environmental health. We discuss what is known about the human health implications of changes in the structure and function of natural systems and propose that these changes are affecting human health in a variety of important ways. We identify several gaps and limitations in the research that has been done to date and propose a more systematic and comprehensive approach to applied research in this field. Such efforts could lead to a more robust understanding of the human health impacts of accelerating environmental change and inform decision making in the land-use planning, environmental conservation, and public health policy realms.

Health effects of drought: a systematic review of the evidence

Introduction. Climate change projections indicate that droughts will become more intense in the 21 century in some areas of the world. The El Niño Southern Oscillation is associated with drought in some countries, and forecasts can provide advance warning of the increased risk of adverse climate conditions. The most recent available data from EMDAT estimates that over 50 million people globally were affected by drought in 2011. Documentation of the health effects of drought is difficult, given the complexity in assigning a beginning/end and because effects tend to accumulate over time. Most health impacts are indirect because of its link to other mediating circumstances like loss of livelihoods. Methods. The following databases were searched: MEDLINE; CINAHL; Embase; PsychINFO, Cochrane Collection. Key references from extracted papers were hand-searched, and advice from experts was sought for further sources of literature. Inclusion criteria for papers summarised in tables include: explicit link made between drought as exposure and human health outcomes; all study designs/methods; all countries/contexts; any year of publication. Exclusion criteria include: drought meaning shortage unrelated to climate; papers not published in English; studies on dry/arid climates unless drought was noted as an abnormal climatological event. No formal quality evaluation was used on papers meeting inclusion criteria. Results. 87 papers meeting the inclusion criteria are summarised in tables. Additionally, 59 papers not strictly meeting the inclusion criteria are used as supporting text in relevant parts of the results section. Main categories of findings include: nutrition-related effects (including general malnutrition and mortality, micronutrient malnutrition, and anti-nutrient consumption); water-related disease (including E coli, cholera and algal bloom); airborne and dust-related disease (including silo gas exposure and coccidioidomycosis); vector borne disease (including malaria, dengue and West Nile Virus); mental health effects (including distress and other emotional consequences); and other health effects (including wildfire, effects of migration, and damage to infrastructure). Conclusions. The probability of drought-related health impacts varies widely and largely depends upon drought severity, baseline population vulnerability, existing health and sanitation infrastructure, and available resources with which to mitigate impacts as they occur. The socio-economic environment in which drought occurs influences the resilience of the affected population. Forecasting can be used to provide advance warning of the increased risk of adverse climate conditions and can support the disaster risk reduction process. Despite the complexities involved in documentation, research should continue and results should be shared widely in an effort to strengthen drought preparedness and response activities.

Developing an exploratory framework linking Australian Aboriginal peoples' connection to country and concepts of wellbeing

Aboriginal people across Australia suffer significant health inequalities compared with the non-Indigenous population. Evidence indicates that inroads can be made to reduce these inequalities by better understanding social and cultural determinants of health, applying holistic notions of health and developing less rigid definitions of wellbeing. The following article draws on qualitative research on Victorian Aboriginal peoples’ relationship to their traditional land (known as Country) and its link to wellbeing, in an attempt to tackle this. Concepts of wellbeing, Country and nature have also been reviewed to gain an understanding of this relationship. An exploratory framework has been developed to understand this phenomenon focusing on positive (e.g., ancestry and partnerships) and negative (e.g., destruction of Country and racism) factors contributing to Aboriginal peoples’ health. The outcome is an explanation of how Country is a fundamental component of Aboriginal Victorian peoples’ wellbeing and the framework articulates the forces that impact positively and negatively on this duality. This review is critical to improving not only Aboriginal peoples’ health but also the capacity of all humanity to deal with environmental issues like disconnection from nature and urbanisation.

Potential changes in disease patterns and pharmaceutical use in response to climate change

As climate change alters environmental conditions, the incidence and global patterns of human diseases are changing. These modifications to disease profiles and the effects upon human pharmaceutical usage are discussed. Climate-related environmental changes are associated with a rise in the incidence of chronic diseases already prevalent in the Northern Hemisphere, for example, cardiovascular disease and mental illness, leading to greater use of associated heavily used Western medications. Sufferers of respiratory diseases may exhibit exacerbated symptoms due to altered environmental conditions (e.g., pollen). Respiratory, water-borne, and food-borne toxicants and infections, including those that are vector borne, may become more common in Western countries, central and eastern Asia, and across North America. As new disease threats emerge, substantially higher pharmaceutical use appears inevitable, especially of pharmaceuticals not commonly employed at present (e.g., antiprotozoals). The use of medications for the treatment of general symptoms (e.g., analgesics) will also rise. These developments need to be viewed in the context of other major environmental changes (e.g., industrial chemical pollution, biodiversity loss, reduced water and food security) as well as marked shifts in human demographics, including aging of the population. To identify, prevent, mitigate, and adapt to potential threats, one needs to be aware of the major factors underlying changes in the use of pharmaceuticals and their subsequent release, deliberately or unintentionally, into the environment. This review explores the likely consequences of climate change upon the use of medical pharmaceuticals in the Northern Hemisphere.

Suicide and drought in New South Wales, Australia, 1970-2007

There is concern in Australia that droughts substantially increase the incidence of suicide in rural populations, particularly among male farmers and their families. We investigated this possibility for the state of New South Wales (NSW), Australia between 1970 and 2007, analyzing data on suicides with a previously established climatic drought index. Using a generalized additive model that controlled for season, region, and long-term suicide trends, we found an increased relative risk of suicide of 15% (95% confidence interval, 8%-22%) for rural males aged 30-49 y when the drought index rose from the first quartile to the third quartile. In contrast, the risk of suicide for rural females aged >30 y declined with increased values of the drought index. We also observed an increased risk of suicide in spring and early summer. In addition there was a smaller association during unusually warm months at any time of year. The spring suicide increase is well documented in nontropical locations, although its cause is unknown. The possible increased risk of suicide during drought in rural Australia warrants public health focus and concern, as does the annual, predictable increase seen each spring and early summer. Suicide is a complex phenomenon with many interacting social, environmental, and biological causal factors. The relationship between drought and suicide is best understood using a holistic framework. Climate change projections suggest increased frequency and severity of droughts in NSW, accompanied and exacerbated by rising temperatures. Elucidating the relationships between drought and mental health will help facilitate adaptation to climate change.

Spatial analysis of suicide mortality in Australia: investigation of metropolitan-rural-remote differentials of suicide risk across states/territories

Studies of suicide epidemiology in regions of Australia have been conducted, but the spatial pattern in the whole country has not been fully investigated. This study aimed at visualizing the sex-specific suicide pattern over the country from 2004 to 2008, and studying the metropolitan-rural-remote differentials of suicide across all states/territories. We applied a Poisson hierarchical model to yield smoothed sex specific, age standardized mortality ratios of suicide in all postal areas, and compiled the age-standardized suicide rates across different levels of remoteness and different jurisdictions. We identified the area variation of suicide risk across states/territories, and metropolitan-rural-remote differential with rates higher in rural and remote areas for males. Spatial clusters of some high risk postal areas were also identified. Socio-economic deprivation, compositional factors, high risks for Indigenous people and low access to mental health service are the underlying explanations of the elevation of suicide risk in some areas. These findings suggest that it is important to take geographical variations in suicide risk into account in national policy making. Particular suicide prevention interventions might be targeted at males living in remote areas, and some localized areas in metropolitan zones.

"From this place and of this place:" climate change, sense of place, and health in Nunatsiavut, Canada

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.

Kind-Making, objectivity, and political neutrality; the case of Solastalgia

Politics and science, it is customarily and broadly assumed, should not mix. I investigate a purported "new mental illness" arising from psychological stress associated with environmental damage. Previous assessments have concluded that the diagnosis of "solastalgia", which is clearly intended to advance a political agenda, may thereby lack scientific validity. Building on work by Ian Hacking and Nelson Goodman, and drawing comparisons with the history of "political medicine"--in particular, the scientific study of Child Abuse and Sudden Infant Death Syndrome--I argue that the political consequences of such a diagnosis may plausibly help to justify it as a distinct objective scientific kind, by demarcating it from alternative classifications. That science should be objective, then, does not require that it be politically neutral.

Determinants of mental health and well-being within rural and remote communities

BACKGROUND

The individual and contextual factors influencing current mental health and well-being within rural communities are poorly understood.

METHODS

A stratified random sample of adults was drawn from non-metropolitan regions of NSW, Australia. One-quarter (27.7%) of the 2,639 respondents were from remote/very remote regions. An aggregate measure of current well-being was derived from levels of distress and related impairment (Kessler-10 LM), self-reported overall physical and mental health, functioning, satisfaction with relationships, and satisfaction with life. Multivariate methods investigated the contributions to current well-being of demographic/dispositional factors, recent events and social support, individual exposure to rural adversity, and district/neighbourhood level characteristics.

RESULTS

Respondents from very remote regions tended to be younger and have lower education. Univariate associations were detected between well being and exposure to rural adversity (greater drought-related worry, lower perceived service and support availability, greater number of years living in the current district). Multivariate analysis (n = 2,462) accounted for 41% of the variance in well-being scores. The major contributing variables were dispositional factors (trait neuroticism, marital status), recent adverse events and indices of social support. However, no additional effects were detected for district-level variables (drought severity, regional socioeconomic categorisation, population change). Similar associations were detected using the K-10 alone as the outcome measure.

CONCLUSIONS

The chief determinants of current well being were those reflecting individual level attributes and perceptions, rather than district-level rural characteristics. This has implications for strategies to promote well being within rural communities through enhancing community connectedness and combating social isolation in the face of major adversities such as drought.

The psychological impact of chronic environmental adversity: Responding to prolonged drought

The health effects of chronic environmental adversity have received insufficient attention, particularly those associated with the psychological impact of drought. Resilience or adaptive response to drought has received even less attention than vulnerability factors. This research examined factors associated with drought impact in rural and remote Australian communities. In 2008 postal surveys were completed by 302 adults (mean age 53 years; 57% female, 77% married) living in rural areas of prolonged drought exposure. Outcome measures were: (i) psychological distress (Kessler 10) and (ii) an index of concern or worry about drought. A range of predictor variables were assessed: adaptability (hopefulness, neuroticism), other adverse events, personal support and community connectedness, and sense of place, as a measure of connection to the local environment. Predictors of drought related worry differed from those associated with psychological distress levels. The former included socio-economic factors (living on a farm [Odds Ratio, OR 3.09], current employment [OR 3.64]), personal psychological characteristics (neuroticism [OR 1.29]), and greater connection with the environment (sense of place [OR 1.05]). On the other hand, psychological distress was associated chiefly with personal factors, such as higher neuroticism [OR 1.92], lower levels of hopefulness [OR 0.28], and lower perceived social support and community connectedness [OR 0.39]. Practical financial, employment and family factors were identified as important elements of drought impact, as to a lesser extent was sense of place, reflecting a confrontation with the consequences of chronic environmental degradation, while personal hopefulness may help mitigate the psychological impact of such adversity.

Climate change and farmers' mental health: risks and responses

Climate change is exacerbating climate variability, evident in more frequent and severe weather-related disasters, such as droughts, fires, and floods. Most of what is known about the possible effects of climate change on rural mental health relates to prolonged drought. But though drought is known to be a disproportionate and general stressor, evidence is mixed and inconclusive. Over time, like drought other weather-related disasters may erode the social and economic bases on which farming communities depend. Rural vulnerability to mental health problems is greatly increased by socioeconomic disadvantage. Related factors may compound this, such as reduced access to health services as communities decline and a "stoical" culture that inhibits help-seeking. Australia has the world's most variable climate and is a major global agricultural producer. Yet despite Australia's (and, especially, rural communities') dependence on farmers' well-being and success, there is very little-and inconclusive-quantitative evidence about farmers' mental health. The aim of this review is to consider, with a view to informing other countries, how climate change and related factors may affect farmers' mental health in Australia. That information is a prerequisite to identifying, selecting, and evaluating adaptive strategies, to lessen the risks of adverse mental health outcomes. The authors identify the need for a systematic epidemiology of the mental health of farmers facing increasing climate change- related weather adversity.

The hidden health burden of environmental degradation: disease comorbidities and dryland salinity

Previous studies have linked poor mental human health with environmental degradation, but none have assessed additional diseases that may co-exist with these mental disorders. In previous work, depression was found to be associated with a major form of environmental degradation; dryland salinity. However, little is known about diseases co-morbid with depression in this environmental setting. In rural Australia, dryland salinity is a major form of environmental degradation contributing widely to deterioration and non-viability of farmland. Using georeferenced health record data, Bayesian spatial methods were used to determine the relationship between dryland salinity and a range of human health outcomes. Initial modelling found an increased relative risk for asthma, suicide and ischaemic heart disease in relation to dryland salinity (adjusted for Indigenous and socio-economic status). However, in this follow-up study, a further evaluation of the role of co-morbidities in this population revealed that: (i) the presence of depression was consistently linked to residence in areas with high salinity and (ii) the association of asthma, suicide and heart disease with salinity was most likely attributable to the co-morbidity of the conditions with depression. Given the predicted increase in dryland salinity and the elevated relative risk of depression in impacted areas, the relative risk of the co-morbid conditions can be expected to increase in rural areas in the future, further adding to the burden of disease associated with environmental degradation.