Intergenerational inequities in exposure to climate extremes

Population-level effects of Hurricane Sandy on adolescent health

BACKGROUND

Disasters are increasing in frequency and intensity due to climate change. Youth are the largest and most vulnerable group exposed to disasters. More evidence is needed regarding how youth mental health and health behaviors vary based on disaster exposure, how mental health influences health behaviors, and how diverse groups of youth may be differentially affected.

METHODS

Using data from the Youth Risk Behavior Survey and Federal Emergency Management Agency, we examined the impact of Hurricane Sandy (2012) on mental health (sadness, suicidality) and health behaviors (substance use, physical activity, screen time, sexual behaviors) of 240,365 youth. Difference-in-differences regression analyses evaluated pre-disaster (2005-2011) and post-disaster (2013-2019) changes.

RESULTS

There were 83,442 (34.7 %) adolescents (51.2 % female, 18.1 % non-Hispanic White) located in 6 districts exposed to Hurricane Sandy and 156,923 (65.3 %) adolescents located in 13 non-exposed districts. Exposure was associated with differences in substance use, physical (in)activity, and risky sexual behaviors, but not mental health outcomes. Mental health did not moderate the association between disaster exposure and health behaviors. Hispanic adolescents and those identifying as Other races/ethnicities were most vulnerable to post-disaster negative health outcomes.

LIMITATIONS

Study limitations include questionnaire design, cross-sectional data, sampling, and possible response biases.

CONCLUSIONS

Findings provide critical information about youth mental health and health behaviors following disasters, as well as how youth may differ in their responses. Findings provide guidance for early identification and resource allocation for youth at higher risk for post-disaster health issues.

How do extreme weather events contribute to violence against children?

BACKGROUND

Only recently have research and policy begun to shine a light on the magnifying effects of EWEs (Extreme Weather Events) on children's exposure to violence. However, the links between EWEs and VAC (Violence against Children) remain under-theorised, poorly understood and often unacknowledged in policy and practice.

OBJECTIVE

Identify, synthesize and analyse available evidence on the central characteristics and factors influencing the relationship between VAC and EWEs.

METHODS

We conducted an extensive scoping review of the literature (academic and grey) to identify existing research and gaps in knowledge. Using flexible and iteratively developed search terms enabled us to identify direct violence - physical, sexual and emotional - and structural violence, rooted in inequitable and unjust systems and institutions.

RESULTS

The relationship between VAC and EWEs is linked to gender; climate-induced mobility or immobility; child labour; and health. We found that VAC can intensify during EWEs, but the nature of this relationship is contextually specific. The relationship between VAC and EWEs is rooted in historical injustices, global systems and structures, and therefore disproportionately affects those living in poverty.

CONCLUSION

Studies have uncovered how increasing social, economic and emotional pressures following EWEs increase children's violence risk exposure. This may occur in their homes or in relief shelters. The violence may involve peers, or forms of hazardous labour that young people are compelled into because of the sudden need for families to rebuild or help make ends meet. More knowledge is needed to inform integrated, context-specific and culturally sensitive plans to better protect children from the consequences of EWEs.

Climate emotions, thoughts, and plans among US adolescents and young adults: a cross-sectional descriptive survey and analysis by political party identification and self-reported exposure to severe weather events

BACKGROUND

Climate change has adverse effects on youth mental health and wellbeing, but limited large-scale data exist globally or in the USA. Understanding the patterns and consequences of climate-related distress among US youth can inform necessary responses at the individual, community, and policy level.

METHODS

A cross-sectional descriptive online survey was done of US youth aged 16-25 years from all 50 states and Washington, DC, between July 20 and Nov 7, 2023, via the Cint digital survey marketplace. The survey assessed: climate-related emotions and thoughts, including indicators of mental health; relational aspects of climate-related emotions; beliefs about who or what has responsibility for causing and responding to climate change; desired and planned actions in response to climate change; and emotions and thoughts about the US Government response to climate change. Respondents were asked whether they had been affected by various severe weather events linked to climate change and for their political party identification. Sample percentages were weighted according to 2022 US census age, sex, and race estimates. To test the effects of political party identification and self-reported exposure to severe weather events on climate-related thoughts and beliefs we used linear and logistic regression models, which included terms for political party identification, the number of self-reported severe weather event types in respondents' area of residence in the past year, and demographic control variables.

FINDINGS

We evaluated survey responses from 15 793 individuals (weighted proportions: 80·5% aged 18-25 years and 19·5% aged 16-17 years; 48·8% female and 51·2% male). Overall, 85·0% of respondents endorsed being at least moderately worried, and 57·9% very or extremely worried, about climate change and its impacts on people and the planet. 42·8% indicated an impact of climate change on self-reported mental health, and 38·3% indicated that their feelings about climate change negatively affect their daily life. Respondents reported negative thoughts about the future due to climate change and actions planned in response, including being likely to vote for political candidates who support aggressive climate policy (72·8%). In regression models, self-reported exposure to more types of severe weather events was significantly associated with stronger endorsement of climate-related distress and desire and plans for action. Political party identification as Democrat or as Independent or Other (vs Republican) was also significantly associated with stronger endorsement of distress and desire and plans for action, although a majority of self-identified Republicans reported at least moderate distress. For all survey outcomes assessed in the models, the effect of experiencing more types of severe weather events did not significantly differ by political party identification.

INTERPRETATION

Climate change is causing widespread distress among US youth and affecting their beliefs and plans for the future. These effects may intensify, across the political spectrum, as exposure to climate-related severe weather events increases.

FUNDING

Avaaz Foundation.

Heatwaves exacerbate pollen limitation through reductions in pollen production and pollen vigour

Increasingly frequent heat waves threaten the reproduction of flowering plants; compromising the future persistence, adaptive capacity, and dispersal of wild plant populations, and also the yield of fruit-bearing crop plants. Heat damages the development of sensitive floral organs and gametes, which inhibits pollen germination, pollen tube growth, and fertilization. However, the role of heat has not been integrated into the framework of pollen quantity and quality limitation and how heat influences the success of cross and self-pollination. We exposed developing flowers to either controlled temperature (25 °C:20 °C) or extreme heat (35 °C:20 °C) over 72 h. We then hand-pollinated them with either crossed or self-derived pollen from the same temperature treatment to determine the direct and interactive effects of simulated heatwaves on pollen tube growth and resulting seed set. We also collected anthers from virgin flowers to measure heat impacts on pollen production. Under cooler control temperatures pollen tube survival of self-derived pollen was approximately 27% lower than that of crossed pollen. Pollen tube survival in heat-treated cross-pollinated and heat-treated self-pollinated flowers were 71% and 77% lower compared to flowers cross-pollinated at control temperatures. These differences in pollen tube survival rate between heat-treated cross-pollinated and heat-treated self-pollinated flowers were insignificant. Furthermore, extreme heat reduced seed set by 87%, regardless of pollen origin, and also reduced pollen production during flower development by approximately 20%. Our results suggest flowers that develop during heatwaves are likely to experience exacerbated pollen quantity and quality limitation driven by changes in pollen production and pollen vigour. Heatwave-induced pollen limitation will likely reduce crop yields in agricultural systems, and depress mating and reproduction in wild plant species, the latter of which may hinder the adaptive capacity of plants to a rapidly changing world.

Empowering the younger generation increases their willingness for intergenerational reconciliation in the context of climate change

Climate change can evoke intergenerational conflict. Structural inequalities and their unequal impact on generations can increase perceptions of collective victimhood among the younger generation (< 30 years) and bear the risk of social tensions between the young and the elderly. An experimental study (N = 434) showed that younger people perceived an increased risk of future victimhood. In line with a needs-based approach, the young reported an increased desire to pursue agentic intergroup goals, indicating a heightened need for agency. However, when the young received empowering messages that affirmed their ingroup agency, their willingness to reconcile with the old generation increased, whereas informing them about non-agentic ingroup behavior did not affect reconciliation (between-subjects manipulation). While empowering messages from the outgroup ("Grannies for Future") that directly affirmed the young generations' agency for climate change mitigation as well as empowering messages from the ingroup that indirectly affirmed ingroup agency in domains unrelated to climate change both addressed the need for agency, only outgroup empowerment promoted intergenerational reconciliation. However, empowerment did not affect support for collective climate action. We discuss empowerment as an avenue for resolving intergroup conflict in the context of climate change and possible consequences for climate action and social change.

Collapse, social tipping dynamics, and framing climate change

In this article, we claim that recent developments in climate science and renewable energy should prompt a reframing of debates surrounding climate change mitigation. Taken together, we argue that these developments suggest (1) global climate collapse in this century is a non-negligible risk, (2) mitigation offers substantial benefits to current generations, and (3) mitigation by some can generate social tipping dynamics that could ultimately make renewables cheaper than fossil fuels. We explain how these claims undermine familiar framings of climate change, wherein mitigation is understood as self-sacrifice that individuals and governments must be morally persuaded or incentivized to undertake.

Extreme events, educational aspirations, and long-term outcomes

The 2004 Indian Ocean tsunami was an extremely destructive event in Aceh, Indonesia, killing over 160,000 people and destroying infrastructure, homes, and livelihoods over miles of coastline. In its immediate aftermath, affected populations faced a daunting array of challenges. At the population level, questions of how the disaster affected children's and parents' aspirations for education and whether it permanently disrupted schooling progression are critical in understanding how shocks affect human capital in the short and long term. We use longitudinal data from the Study of the Tsunami Aftermath and Recovery (STAR) to examine how disaster exposure affects educational aspirations and eventual attainment. We find that damage to one's community depresses aspirations in the short term but that this weakens with time. With respect to educational attainment 15 years after the event, children's aspirations, parents' education, and family socioeconomic status are more important determinants of whether children complete high school and go on to tertiary schooling than disaster exposure. While these results likely reflect, at least in part, the successful post-tsunami reconstruction program, they also establish enormous resilience among survivors who bore the brunt of the tsunami.

"Older people will die of old age. I'll die of climate change": engaging children and young people in climate decision making for public health

BACKGROUND

The climate crisis is a significant risk to the health and wellbeing of children, young people, and future generations. While there are calls for children and young people's engagement in climate decision making, current power structures limit their participation. This paper aimed to understand children's perspectives about the impact of the climate crisis on their futures, their ability to influence climate decisions, and strategies and mechanisms to facilitate their greater engagement in decisions made about the climate crisis.

METHODS

Online in-depth interviews were conducted with n = 28 children (aged 12-16 years) across Australia. Photo elicitation techniques were used to prompt discussion about how the climate crisis impacted their futures, their ability to influence climate decisions, and strategies and mechanisms to engage them in climate decision making. A reflexive approach to thematic analysis was used to construct three themes from data. Images were analysed for ascribed meanings.

RESULTS

First, participants stated that they and future generations will inherit the climate crisis from older generations, specifically decision makers. Second, they described a need to address a range of age-related barriers that limit children and young people's engagement in climate decision making, including perceptions about their capabilities. Finally, they discussed strategies and mechanisms to embed children and young people's perspectives within climate decision making, including at civic and political levels.

CONCLUSIONS

Children and young people have the right to be involved in decisions made about the climate crisis which significantly impact their futures, including their health and wellbeing. They argue for structural changes to embed their views in climate decision making, and describe a range of engagement strategies and mechanisms to structure their perspectives and knowledge with decision making processes. Furthermore, genuine involvement of children and young people in climate discussions must avoid youthwashing and tokenistic participation. The public health community can help address barriers to youth participation in climate action and should actively engage and collaborate with children and young people to facilitate their political and democratic influence over the climate crisis. This involves making room and creating an accessible seat at the decision making table to ensure their perspectives are embedded in climate decisions.

Canopy cover and soil moisture influence forest understory plant responses to experimental summer drought

Extreme droughts are globally increasing in frequency and severity. Most research on drought in forests focuses on the response of trees, while less is known about the impacts of drought on forest understory species and how these effects are moderated by the local environment. We assessed the impacts of a 45-day experimental summer drought on the performance of six boreal forest understory plants, using a transplant experiment with rainout shelters replicated across 25 sites. We recorded growth, vitality and reproduction immediately, 2 months, and 1 year after the simulated drought, and examined how differences in ambient soil moisture and canopy cover among sites influenced the effects of drought on the performance of each species. Drought negatively affected the growth and/or vitality of all species, but the effects were stronger and more persistent in the bryophytes than in the vascular plants. The two species associated with older forests, the moss Hylocomiastrum umbratum and the orchid Goodyera repens, suffered larger effects than the more generalist species included in the experiment. The drought reduced reproductive output in the moss Hylocomium splendens in the next growing season, but increased reproduction in the graminoid Luzula pilosa. Higher ambient soil moisture reduced some negative effects of drought on vascular plants. Both denser canopy cover and higher soil moisture alleviated drought effects on bryophytes, likely through alleviating cellular damage. Our experiment shows that boreal understory species can be adversely affected by drought and that effects might be stronger for bryophytes and species associated with older forests. Our results indicate that the effects of drought can vary over small spatial scales and that forest landscapes can be actively managed to alleviate drought effects on boreal forest biodiversity. For example, by managing the tree canopy and protecting hydrological networks.

Healthcare Sustainability to Address Climate Change: Call for Action to the Infectious Diseases Community

The US healthcare system's contribution to greenhouse gas emissions and climate change is disproportionately high and harms the public. Several medical specialties are now reassessing how they can mitigate healthcare's harmful environmental impact. Healthcare sustainability is broadly defined as measures to decrease greenhouse gas emissions, waste, and other pollutants generated during the healthcare delivery process. Prior efforts and programs by infectious diseases (ID) professionals, such as antimicrobial stewardship and infection prevention and control can form a framework for ID professionals to help apply this expertise to healthcare environmental sustainability more broadly. This call to action proposes strategies for ID societies and professionals to incorporate climate change education for trainees, increase research and funding opportunities in healthcare sustainability, and calls for action by ID societies to champion system changes to decrease greenhouse gas emissions.

A systematic review of ambient heat and sleep in a warming climate

Climate change is elevating nighttime and daytime temperatures worldwide, affecting a broad continuum of behavioral and health outcomes. Disturbed sleep is a plausible pathway linking rising ambient temperatures with several observed adverse human responses shown to increase during hot weather. This systematic review aims to provide a comprehensive overview of the literature investigating the relationship between ambient temperature and valid sleep outcomes measured in real-world settings, globally. We show that higher outdoor or indoor temperatures are generally associated with degraded sleep quality and quantity worldwide. The negative effect of heat persists across sleep measures, and is stronger during the hottest months and days, in vulnerable populations, and the warmest regions. Although we identify opportunities to strengthen the state of the science, limited evidence of fast sleep adaptation to heat suggests rising temperatures induced by climate change and urbanization pose a planetary threat to human sleep, and therefore health, performance, and wellbeing.

Towards a novel biosphere in 2300: rapid and extensive global and biome-wide climatic novelty in the Anthropocene

Recent climate change has effectively rewound the climate clock by approximately 120 000 years and is expected to reverse this clock a further 50 Myr by 2100. We aimed to answer two essential questions to better understand the changes in ecosystems worldwide owing to predicted climate change. Firstly, we identify the locations and time frames where novel ecosystems could emerge owing to climate change. Secondly, we aim to determine the extent to which biomes, in their current distribution, will experience an increase in climate-driven ecological novelty. To answer these questions, we analysed three perspectives on how climate changes could result in novel ecosystems in the near term (2100), medium (2200) and long term (2300). These perspectives included identifying areas where climate change could result in new climatic combinations, climate isoclines moving faster than species migration capacity and current environmental patterns being disaggregated. Using these metrics, we determined when and where novel ecosystems could emerge. Our analysis shows that unless rapid mitigation measures are taken, the coverage of novel ecosystems could be over 50% of the land surface by 2100 under all change scenarios. By 2300, the coverage of novel ecosystems could be above 80% of the land surface. At the biome scale, these changes could mean that over 50% of locations could shift towards novel ecosystems, with the majority seeing these changes in the next few decades. Our research shows that the impact of climate change on ecosystems is complex and varied, requiring global action to mitigate and adapt to these changes. This article is part of the theme issue 'Biodiversity dynamics and stewardship in a transforming biosphere'. This article is part of the theme issue 'Ecological novelty and planetary stewardship: biodiversity dynamics in a transforming biosphere'.

Future malaria environmental suitability in Africa is sensitive to hydrology

Changes in climate shift the geographic locations that are suitable for malaria transmission because of the thermal constraints on vector Anopheles mosquitos and Plasmodium spp. malaria parasites and the lack of availability of surface water for vector breeding. Previous Africa-wide assessments have tended to solely represent surface water using precipitation, ignoring many important hydrological processes. Here, we applied a validated and weighted ensemble of global hydrological and climate models to estimate present and future areas of hydroclimatic suitability for malaria transmission. With explicit surface water representation, we predict a net decrease in areas suitable for malaria transmission from 2025 onward, greater sensitivity to future greenhouse gas emissions, and different, more complex, malaria transmission patterns. Areas of malaria transmission that are projected to change are smaller than those estimated by precipitation-based estimates but are associated with greater changes in transmission season lengths.

Longitudinal patterns of natural hazard exposures and anxiety and depression symptoms among young adults in four low- and middle-income countries

We estimated the effect of community-level natural hazard exposure during prior developmental stages on later anxiety and depression symptoms among young adults and potential differences stratified by gender. We analyzed longitudinal data (2002-2020) on 5585 young adults between 19 and 26 years in Ethiopia, India, Peru, and Vietnam. A binary question identified community-level exposure, and psychometrically validated scales measured recent anxiety and depression symptoms. Young adults with three exposure histories ("time point 1," "time point 2," and "both time points") were contrasted with their unexposed peers. We applied a longitudinal targeted minimum loss-based estimator with an ensemble of machine learning algorithms for estimation. Young adults living in exposed communities did not exhibit substantially different anxiety or depression symptoms from their unexposed peers, except for young women in Ethiopia who exhibited less anxiety symptoms (average causal effect [ACE] estimate = - 8.86 [95% CI: - 17.04, - 0.68] anxiety score). In this study, singular and repeated natural hazard exposures generally were not associated with later anxiety and depression symptoms. Further examination is needed to understand how distal natural hazard exposures affect lifelong mental health, which aspects of natural hazards are most salient, how disaster relief may modify symptoms, and gendered, age-specific, and contextual differences.

Disaster Plant Pathology: Smart Solutions for Threats to Global Plant Health from Natural and Human-Driven Disasters

Disaster plant pathology addresses how natural and human-driven disasters impact plant diseases and the requirements for smart management solutions. Local to global drivers of plant disease change in response to disasters, often creating environments more conducive to plant disease. Most disasters have indirect effects on plant health through factors such as disrupted supply chains and damaged infrastructure. There is also the potential for direct effects from disasters, such as pathogen or vector dispersal due to floods, hurricanes, and human migration driven by war. Pulse stressors such as hurricanes and war require rapid responses, whereas press stressors such as climate change leave more time for management adaptation but may ultimately cause broader challenges. Smart solutions for the effects of disasters can be deployed through digital agriculture and decision support systems supporting disaster preparedness and optimized humanitarian aid across scales. Here, we use the disaster plant pathology framework to synthesize the effects of disasters in plant pathology and outline solutions to maintain food security and plant health in catastrophic scenarios. We recommend actions for improving food security before and following disasters, including (i) strengthening regional and global cooperation, (ii) capacity building for rapid implementation of new technologies, (iii) effective clean seed systems that can act quickly to replace seed lost in disasters, (iv) resilient biosecurity infrastructure and risk assessment ready for rapid implementation, and (v) decision support systems that can adapt rapidly to unexpected scenarios. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY 4.0 International license.

Opportunities and challenges for financing women's, children's and adolescents' health in the context of climate change

Women, children and adolescents (WCA), especially in low-income and middle-income countries (LMICs), will bear the worst consequences of climate change during their lifetimes, despite contributing the least to global greenhouse gas emissions. Investing in WCA can address these inequities in climate risk, as well as generating large health, economic, social and environmental gains. However, women's, children's and adolescents' health (WCAH) is currently not mainstreamed in climate policies and financing. There is also a need to consider new and innovative financing arrangements that support WCAH alongside climate goals.We provide an overview of the threats climate change represents for WCA, including the most vulnerable communities, and where health and climate investments should focus. We draw on evidence to explore the opportunities and challenges for health financing, climate finance and co-financing schemes to enhance equity and protect WCAH while supporting climate goals.WCA face threats from the rising burden of ill-health and healthcare demand, coupled with constraints to healthcare provision, impacting access to essential WCAH services and rising out-of-pocket payments for healthcare. Climate change also impacts on the economic context and livelihoods of WCA, increasing the risk of displacement and migration. These impacts require additional resources to support WCAH service delivery, to ensure continuity of care and protect households from the costs of care and enhance resilience. We identify a range of financing solutions, including leveraging climate finance for WCAH, adaptive social protection for health and adaptations to purchasing to promote climate action and support WCAH care needs.

Cyclone Jasper's rains in the context of climate change

Cyclone Jasper struck northern Queensland in mid-December, 2023, causing extensive flooding stemming from torrential rain. Many stations reported rainfall totals exceeding 1 m, and a few surpassed 2 m, possibly making Jasper the wettest tropical cyclone in Australian history. To be better prepared for events like Jasper, it is useful to estimate the probability of rainfall events of Jasper's magnitude and how that probability is likely to evolve as climate warms. To make such estimates, we apply an advanced tropical cyclone downscaling technique to nine global climate models, generating a total of 27,000 synthetic tropical cyclones each for the climate of the recent past and that of the end of this century. We estimate that the annual probability of 1 m of rain from tropical cyclones at Cairns increases from about 0.8% at the end of the 20th century to about 2.3% at the end of the 21st, a factor of almost three. Interpolating frequency to the year 2023 suggests that the current annual probability of Jasper's rainfall is about 1.2%, about a 50% increase over that of the year 2000. Further analysis suggests that the primary causes of increasing rainfall are stronger cyclones and a moister atmosphere.

Advancing disability-inclusive climate research and action, climate justice, and climate-resilient development

Globally, more than 1 billion people with disabilities are disproportionately and differentially at risk from the climate crisis. Yet there is a notable absence of climate policy, programming, and research at the intersection of disability and climate change. Advancing climate justice urgently requires accelerated disability-inclusive climate action. We present pivotal research recommendations and guidance to advance disability-inclusive climate research and responses identified by a global interdisciplinary group of experts in disability, climate change, sustainable development, public health, environmental justice, humanitarianism, gender, Indigeneity, mental health, law, and planetary health. Climate-resilient development is a framework for enabling universal sustainable development. Advancing inclusive climate-resilient development requires a disability human rights approach that deepens understanding of how societal choices and actions-characterised by meaningful participation, inclusion, knowledge diversity in decision making, and co-design by and with people with disabilities and their representative organisations-build collective climate resilience benefiting disability communities and society at large while advancing planetary health.

Earth at risk: An urgent call to end the age of destruction and forge a just and sustainable future

Human development has ushered in an era of converging crises: climate change, ecological destruction, disease, pollution, and socioeconomic inequality. This review synthesizes the breadth of these interwoven emergencies and underscores the urgent need for comprehensive, integrated action. Propelled by imperialism, extractive capitalism, and a surging population, we are speeding past Earth's material limits, destroying critical ecosystems, and triggering irreversible changes in biophysical systems that underpin the Holocene climatic stability which fostered human civilization. The consequences of these actions are disproportionately borne by vulnerable populations, further entrenching global inequities. Marine and terrestrial biomes face critical tipping points, while escalating challenges to food and water access foreshadow a bleak outlook for global security. Against this backdrop of Earth at risk, we call for a global response centered on urgent decarbonization, fostering reciprocity with nature, and implementing regenerative practices in natural resource management. We call for the elimination of detrimental subsidies, promotion of equitable human development, and transformative financial support for lower income nations. A critical paradigm shift must occur that replaces exploitative, wealth-oriented capitalism with an economic model that prioritizes sustainability, resilience, and justice. We advocate a global cultural shift that elevates kinship with nature and communal well-being, underpinned by the recognition of Earth's finite resources and the interconnectedness of its inhabitants. The imperative is clear: to navigate away from this precipice, we must collectively harness political will, economic resources, and societal values to steer toward a future where human progress does not come at the cost of ecological integrity and social equity.

Projected decline in European bumblebee populations in the twenty-first century

Habitat degradation and climate change are globally acting as pivotal drivers of wildlife collapse, with mounting evidence that this erosion of biodiversity will accelerate in the following decades1-3. Here, we quantify the past, present and future ecological suitability of Europe for bumblebees, a threatened group of pollinators ranked among the highest contributors to crop production value in the northern hemisphere4-8. We demonstrate coherent declines of bumblebee populations since 1900 over most of Europe and identify future large-scale range contractions and species extirpations under all future climate and land use change scenarios. Around 38-76% of studied European bumblebee species currently classified as 'Least Concern' are projected to undergo losses of at least 30% of ecologically suitable territory by 2061-2080 compared to 2000-2014. All scenarios highlight that parts of Scandinavia will become potential refugia for European bumblebees; it is however uncertain whether these areas will remain clear of additional anthropogenic stressors not accounted for in present models. Our results underline the critical role of global change mitigation policies as effective levers to protect bumblebees from manmade transformation of the biosphere.

Climate Change and Children's Health: Building a Healthy Future for Every Child

Observed changes in temperature, precipitation patterns, sea level, and extreme weather are destabilizing major determinants of human health. Children are at higher risk of climate-related health burdens than adults because of their unique behavior patterns; developing organ systems and physiology; greater exposure to air, food, and water contaminants per unit of body weight; and dependence on caregivers. Climate change harms children through numerous pathways, including air pollution, heat exposure, floods and hurricanes, food insecurity and nutrition, changing epidemiology of infections, and mental health harms. As the planet continues to warm, climate change's impacts will worsen, threatening to define the health and welfare of children at every stage of their lives. Children who already bear higher burden of disease because of living in low-wealth households and communities, lack of access to high quality education, and experiencing racism and other forms of unjust discrimination bear greater risk of suffering from climate change hazards. Climate change solutions, advanced through collaborative work of pediatricians, health systems, communities, corporations, and governments lead to immediate gains in child health and equity and build a foundation for generations of children to thrive. This technical report reviews the nature of climate change and its associated child health effects and supports the recommendations in the accompanying policy statement on climate change and children's health.

Twenty-first-century demographic and social inequalities of heat-related deaths in Brazilian urban areas

Population exposure to heat waves (HWs) is increasing worldwide due to climate change, significantly affecting society, including public health. Despite its significant vulnerabilities and limited adaptation resources to rising temperatures, South America, particularly Brazil, lacks research on the health impacts of temperature extremes, especially on the role played by socioeconomic factors in the risk of heat-related illness. Here, we present a comprehensive analysis of the effects of HWs on mortality rates in the 14 most populous urban areas, comprising approximately 35% of the country's population. Excess mortality during HWs was estimated through the observed-to-expected ratio (O/E) for total deaths during the events identified. Moreover, the interplay of intersectionality and vulnerability to heat considering demographics and socioeconomic heterogeneities, using gender, age, race, and educational level as proxies, as well as the leading causes of heat-related excess death, were assessed. A significant increase in the frequency was observed from the 1970s (0-3 HWs year-1) to the 2010s (3-11 HWs year-1), with higher tendencies in the northern, northeastern, and central-western regions. Over the 2000-2018 period, 48,075 (40,448-55,279) excessive deaths were attributed to the growing number of HWs (>20 times the number of landslides-related deaths for the same period). Nevertheless, our event-based surveillance analysis did not detect the HW-mortality nexus, reinforcing that extreme heat events are a neglected disaster in Brazil. Among the leading causes of death, diseases of the circulatory and respiratory systems and neoplasms were the most frequent. Critical regional differences were observed, which can be linked to the sharp North-South inequalities in terms of socioeconomic and health indicators, such as life expectancy. Higher heat-related excess mortality was observed for low-educational level people, blacks and browns, older adults, and females. Such findings highlight that the strengthening of primary health care combined with reducing socioeconomic, racial, and gender inequalities represents a crucial step to reducing heat-related deaths.

A Germany-wide survey of caregiving professionals on climate change and mental health of children and adolescents - factors influencing their relevance rating of extreme weather event associated mental health impairments

INTRODUCTION

Climate change presents a significant risk for the mental and physical health of young people. In order to identify and properly care for potential mental health impairments from extreme weather events, the relevance of these impairments must be assessed as high by the professional groups providing care for children and adolescents. This raises the question of which factors influence the individual relevance assessment of caretaking professionals?

METHODS

Data was collected creating and conducting a Germany-wide online questionnaire via LimeSurvey. The questionnaire was addressed to professionals providing care for children and adolescents, in this case medical and therapeutic personnel as well as school and pedagogical personnel. Professional associations, chief physicians and school principals were contacted as multipliers and asked to forward the questionnaire to their members and staff. The data was analyzed using the R statistical software, and multiple linear regressions were performed to test the hypotheses.

RESULTS

Overall, 648 questionnaires were taken into analysis. Approximately 70% of the participants considered climate change-induced impacts on the mental health of children and adolescents due to extreme weather events as relevant. Experiencing heat, storm, heavy precipitation, flood/flooding, and/or avalanches/mudflows made a modest yet significant contribution to explaining higher relevance assessments. In contrast, there was no evidence to suggest that an urban working environment increases the relevance assessment.

CONCLUSION

The described influence of experiencing extreme weather events should not be regarded as the sole factor leading to higher relevance ratings. A more comprehensive understanding of the factors influencing relevance assessments is necessary to address key aspects of risk communication and increase risk awareness.

Integrating mental health into climate change education to inspire climate action while safeguarding mental health

Climate change is the greatest threat humanity faces, and puts at risk the mental health and wellbeing of children and young people. Climate change education must equip children and young people with the knowledge, skills and resilience to live in an uncertain future, sustainably take relevant climate action and work in climate careers. As attention on climate change education grows, this is a critical moment for the mental health community to ensure mental health and wellbeing considerations are embedded. Critically, appropriate integration of mental health can enable these very necessary goals of equipping children and young people to live and work in a future where climate change looms large. This paper explores why promoting good mental health and wellbeing and building psychological resilience can help achieve climate change education outcomes, and why not doing so risks harming children and young people's mental health. It also explores how integrating discussions about emotions, mental health, and coping strategies within climate change education can be a route into wider discussions about mental health, to support children and young people in the context of rising mental health needs. Learning from an existing approach to promoting good mental health and wellbeing in schools (the 'whole school approach') provides the opportunity to explore one avenue through which such an integrated approach could be implemented in practice. Identifying appropriate mechanisms to integrate mental health into climate change education will require co-design and research with educators and young people, and addressing systemic barriers facing the schools sector.

Impacts of compounding drought and heatwave events on child mental health: insights from a spatial clustering analysis

BACKGROUND

Concurrent heatwave and drought events may have larger health impacts than each event separately; however, no US-based studies have examined differential mental health impacts of compound drought and heatwave events in pediatric populations.

OBJECTIVE

To examine the spatial patterns of mood disorders and suicide-related emergency department (ED) visits in children during heatwave, drought, and compound heatwave and drought events. We tested whether the occurrence of compound heatwave and drought events have a synergistic (multiplicative) effect on the risk of mental health related outcomes in children as compared to the additive effect of each individual climate hazard. Lastly, we identified household and community-level determinants of geographic variability of high psychiatric burden.

METHODS

Daily counts of psychiatric ED visits in North Carolina from 2016 to 2019 (May to Sept) for pediatric populations were aggregated at the county scale. Bernoulli cluster analyses identified high-risk spatial clusters of psychiatric morbidity during heatwave, drought, or compound heatwave and drought periods. Multivariate adaptive regression models examined the individual importance of household and community-level determinants in predicting high-risk clustering of mood disorders or suicidality across the three climate threats.

RESULTS

Results showed significant spatial clustering of suicide and mood disorder risks in children during heatwave, drought, and compound event periods. Periods of drought were associated with the highest likelihood of spatial clustering for suicide and mood disorders, where the risk of an ED visit was 4.48 and 6.32 times higher, respectively, compared to non-drought periods. Compounding events were associated with a threefold increase in both suicide and mood disorder-related ED visits. Community and household vulnerability factors that most contributed to spatial clustering varied across climate hazards, but consistent determinants included residential segregation, green space availability, low English proficiency, overcrowding, no broadband access, no vehicle access, housing vacancy, and availability of housing units.

CONCLUSION

Findings advance understanding on the locations of vulnerable pediatric populations who are disproportionately exposed to compounding climate stressors and identify community resilience factors to target in public health adaptation strategies.

Children in All Policies (CAP) 2030 Citizen Science for Climate Change Resilience: a cross-sectional pilot study engaging adolescents to study climate hazards, biodiversity and nutrition in rural Nepal

Background

Young people will suffer most from climate change yet are rarely engaged in dialogue about it. Citizen science offers a method for collecting policy-relevant data, whilst promoting awareness and capacity building. We tested the feasibility and acceptability of engaging Nepalese adolescents in climate change and health-related citizen science.

Methods

We purposively selected 33 adolescents from two secondary schools in one remote and one relatively accessible district of Nepal. We contextualised existing apps and developed bespoke apps to survey climate hazards, waste and water management, local biodiversity, nutrition and sociodemographic information. We analysed and presented quantitative data using a descriptive analysis. We captured perceptions and learnings via focus group discussions and analysed qualitative data using thematic analysis. We shared findings with data collectors using tables, graphs, data dashboards and maps.

Results

Adolescents collected 1667 biodiversity observations, identified 72 climate-change related hazards, and mapped 644 geolocations. They recorded 286 weights, 248 heights and 340 dietary recalls. Adolescents enjoyed learning how to collect the data and interpret the findings and gained an appreciation of local biodiversity which engendered 'environmental stewardship'. Data highlighted the prevalence of failing crops and landslides, revealed both under- and over-nutrition and demonstrated that children consume more junk foods than adults. Adolescents learnt about the impacts of climate change and the importance of eating a diverse diet of locally grown foods. A lack of a pre-established sampling frame, multiple records of the same observation and spurious nutrition data entries by unsupervised adolescents limited data quality and utility. Lack of internet access severely impacted feasibility, especially of apps which provide online feedback.

Conclusions

Citizen science was largely acceptable, educational and empowering for adolescents, although not always feasible without internet access. Future projects could improve data quality and integrate youth leadership training to enable climate-change advocacy with local leaders.

Heatwaves and human sleep: Stress response versus adaptation

The World Meteorological Organization considers a heatwave as "a period of statistically unusual hot weather persisting for a number of days and nights". Accompanying the ongoing global climate change, sharp heatwave bouts occur worldwide, growing in frequency and intensity, and beginning earlier in the season. Heatwaves exacerbate the risk of heat-related illnesses, hence human morbidity and mortality, particularly in vulnerable elderly and children. Heat-related illnesses present a continuum from normothermic (prickly heat, heat edema, heat cramps, heat tetany) to hyperthermic syndromes (from heat syncope and heat exhaustion to lethal heat stroke). Heat stroke may occur through passive heating and/or exertional exercise. "Normal sleep", such as observed in temperate conditions, is altered during heatwaves. Brisk excessive heat bouts shorten and fragment human sleep. Particularly, deep N3 sleep (formerly slow-wave sleep) and REM sleep are depleted, such as in other stressful situations. The resultant sleep loss is deleterious to cognitive performance, emotional brain function, behavior, and susceptibility to chronic health conditions and infectious diseases. Our group has previously demonstrated that sleep constitutes an adaptive mechanism during climatic heat acclimatization. In parallel, artificial heat acclimation procedures have been proposed in sports and military activities, and for the elderly. Other preventive actions should be considered, such as education and urban heat island cooling (vegetation, white paint), thus avoiding energy-hungry air conditioning.

Associations between ambient temperature and pregnancy outcomes from three south Asian sites of the Global Network Maternal Newborn Health Registry: A retrospective cohort study

OBJECTIVE

Growing evidence suggests that environmental heat stress negatively influences fetal growth and pregnancy outcomes. However, few studies have examined the impact of heat stress on pregnancy outcomes in low-resource settings. We combined data from a large multi-country maternal-child health registry and meteorological data to assess the impacts of heat stress.

DESIGN

Retrospective cohort study.

SETTING

Three sites based in south Asia as part of the Global Network for Women's and Children's Health research in India (Belagavi and Nagpur) and Pakistan (Thatta).

POPULATION OR SAMPLE

Data from women enrolled between 2014 and 2020 in the Global Network's Maternal Newborn Health Registry (MNHR), a prospective, population-based registry of pregnancies, were used.

METHODS

A total of 126 273 pregnant women were included in this analysis. Daily maximal air temperatures (Tmax ) were acquired from local meteorological records. Associations between averages of daily maximal temperatures for each trimester and main outcomes were analysed using a modified Poisson regression approach.

MAIN OUTCOMES MEASURES

Incidence of stillbirth, preterm birth, low birthweight (<2500 g) or evidence of pregnancy hypertension or pre-eclampsia.

RESULTS

In the overall cohort, risk of preterm birth was positively associated with greater temperature in the second trimester (relative risk [RR] 1.05, 95% CI 1.02-1.07, p = 0.0002). Among individual sites, the risk of preterm birth was greatest in Nagpur (RR 1.07, 95% CI 1.03-1.11, p = 0.0005) and associated with second-trimester temperature. The overall risk of low birthweight was associated with ambient temperature in second trimester (RR 1.02, 95% CI 1.01-1.04, p = 0.01). The risk for LBW was associated with first-trimester heat in Thatta and with second-trimester heat in Nagpur. Finally, the overall risk of gestational hypertensive disease was associated with greater temperature in the third trimester among all sites (RR 1.07, 95% CI 1.02-1.12, p = 0.005) and was particularly significant for Nagpur (RR 1.13, 95% CI 1.05-1.23, p = 0.002). These findings highlight the increased risk of detrimental obstetric and neonatal outcomes with greater temperature.

CONCLUSION

In a multi-country, community-based study, greater risk of adverse outcomes was observed with increasing temperature. The study highlights the need for deeper understanding of covarying factors and intervention strategies, especially in regions where high temperatures are common.

Priorities for research to support local authority action on health and climate change: a study in England

BACKGROUND

Evidence is needed to support local action to reduce the adverse health impacts of climate change and maximise the health co-benefits of climate action. Focused on England, the study identifies priority areas for research to inform local decision making.

METHODS

Firstly, potential priority areas for research were identified from a brief review of UK policy documents, and feedback invited from public and policy stakeholders. This included a survey of Directors of Public Health (DsPH) in England, the local government officers responsible for public health. Secondly, rapid reviews of research evidence examined whether there was UK evidence relating to the priorities identified in the survey.

RESULTS

The brief policy review pointed to the importance of evidence in two broad areas: (i) community engagement in local level action on the health impacts of climate change and (ii) the economic (cost) implications of such action. The DsPH survey (n = 57) confirmed these priorities. With respect to community engagement, public understanding of climate change's health impacts and the public acceptability of local climate actions were identified as key evidence gaps. With respect to economic implications, the gaps related to evidence on the health and non-health-related costs and benefits of climate action and the short, medium and longer-term budgetary implications of such action, particularly with respect to investments in the built environment. Across both areas, the need for evidence relating to impacts across income groups was highlighted, a point also emphasised by the public involvement panel. The rapid reviews confirmed these evidence gaps (relating to public understanding, public acceptability, economic evaluation and social inequalities). In addition, public and policy stakeholders pointed to other barriers to action, including financial pressures, noting that better evidence is insufficient to enable effective local action.

CONCLUSIONS

There is limited evidence to inform health-centred local action on climate change. More evidence is required on public perspectives on, and the economic dimensions of, local climate action. Investment in locally focused research is urgently needed if local governments are to develop and implement evidence-based policies to protect public health from climate change and maximise the health co-benefits of local action.

Climate-related experiences and harms in the wake of the COVID-19 pandemic: results from a survey of 152,088 Mexican youth

The dual crises of COVID-19 and climate change are impacting the lives of adolescents and young people as they transition to adulthood in an uncertain world, yet they are often excluded from research and political discourse. We surveyed young people about their needs and experiences, critical to engaging them and designing effective programs and policies to address these intersecting harms. The 2022 round of a national online survey through the Violence Outcomes in COVID-19 Epoch (VoCes) Study surveyed 152,088 Mexican youth (15-24 years). Logistic regressions were implemented to identify characteristics associated with four climate responses (economic, work-related, receiving government support, or social network support). Overall, 8.1% of participants experienced a recent climate hazard, with major impacts including housing damage from floods, and crop/livestock losses from drought. Participants who experienced a climate hazard were more likely to have experienced a pandemic-related harm, suggesting a dual impact. Poor youth were more likely to report economic losses from both the pandemic and a climate event but least likely to receive government support. Economic effects from the pandemic are exacerbating climate-related harms, unequally threatening the poorest youth. Engaging young people in decision-making and supporting the most vulnerable youth is critical for the next generation to thrive.

Coping with climate change: The role of climate related stressors in affecting the mental health of young people in Mexico

Young people today are predicted to experience more climate change related stressors and harms than the previous generation, yet they are often excluded from climate research, policy, and advocacy. Increasingly, this exposure is associated with experience of common mental health disorders (CMD). The VoCes-19 study collected surveys from 168,407 young people across Mexico (ages 15-24 years) through an innovative online platform, collecting information on various characteristics including CMD and experience of recent climate harms. Logistic regression models were fit to explore characteristics associated with CMD. Structural equation models were fit to explore pathways between exposure, feeling of concern about climate change, and a sense of agency (meaning the respondent felt they could help address the climate crisis) and how these relate to CMD. Of the respondents, 42% (n = 50,682) were categorized as experiencing CMD, higher among those who experienced a climate stressor (51%, n = 4,808) vs those not experiencing climate stressors (41%, n = 43,872). Adjusting for key demographic characteristics, exposure to any climate event increased the odds of CMD by 50% (Odd Ratio = 1.57; 95% Confidence Interval (CI) 1.49, 1.64), highest for heatwaves. Specific climate impacts such as housing damage, loss of or inability to work, damage to family business, leaving school and physical health affected were adversely related to CMD, though for different climate hazards. More concern and less agency were related to CMD through different pathways, particularly for those exposed to recent events. Future research regarding the cumulative exposures to climate change, not just acute events but as an ongoing crisis, and various pathways that influence the mental health and well-being of young people must be clearly understood to develop programs and policies to protect the next generation.

Observational and model evidence together support wide-spread exposure to noncompensable heat under continued global warming

As our planet warms, a critical research question is when and where temperatures will exceed the limits of what the human body can tolerate. Past modeling efforts have investigated the 35°C wet-bulb threshold, proposed as a theoretical upper limit to survivability taking into account physiological and behavioral adaptation. Here, we conduct an extreme value theory analysis of weather station observations and climate model projections to investigate the emergence of an empirically supported heat compensability limit. We show that the hottest parts of the world already experience these heat extremes on a limited basis and that under moderate continued warming parts of every continent, except Antarctica, will see a rapid increase in their extent and frequency. To conclude, we discuss the consequences of the emergence of this noncompensable heat and the need for incorporating different critical thermal limits into heat adaptation planning.

Psycho-social factors associated with climate distress, hope and behavioural intentions in young UK residents

Although the UK has been relatively spared significant geophysical impacts of climate change, many people, youth in particular, are increasingly worried about climate change. The psychological distress associated with the (perceived) threat of climate change has been linked to poorer mental wellbeing but can also promote adaptive responses such as engagement in pro-environmental behaviour. In this mixed methods study, we delve deeper into the experience of 'climate distress' among UK residents aged 16-24 (N = 539). We conducted an online survey assessing general mental health, subjective wellbeing, and climate distress with existing scales. We also included novel questions assessing positive and negative life impacts of climate change, open-ended questions on aspirations and priorities for the future, and engagement in pro-environmental and climate actions. Our findings indicate that mental health factors may contribute to vulnerability to climate distress. Predictably, socio-psychological responses to climate change (i.e., frustration over inaction, lack of control, and shame or guilt about one's own contributions) were linked to higher scores on the climate distress scale. Negatively appraised climate change-related events (i.e., seeing an environment they care about change for the worse) were associated with higher climate distress. Individuals with high climate distress (10.1% of our sample) reported worrying about the impact of climate change on their own future more frequently than any other topic surveyed (including personal finance, career, relationships, politics). Both positive (hope/interest) and negative (anger/frustration) emotions inspired action-taking, especially climate activism, which was negatively predicted by guilt/shame and sadness/fear. Private-sphere pro-environmental actions appeared less driven by strong emotions. Overall, our findings present a more nuanced picture of climate distress in terms of emotional responses, behaviour, and mental health. Longitudinal research is urgently needed to understand how distress may change over time, and the conditions that lead to adaptive and maladaptive outcomes.

Africa and climate justice at COP27 and beyond: impacts and solutions through an interdisciplinary lens

Climate justice is not just a financial transaction to protect the environment. It needs to be seen as the protection of the most vulnerable in society after centuries of resource exploitation. African countries disproportionately face impacts of climate change on their environments, their economies, their resources and their infrastructure. This leads to greater vulnerability and increased exposure to the negative effects of a changing climate. In this article, we highlight the importance of climate justice and its role within the United Nations negotiations, and ultimately in concrete action. We discuss current climate impacts across key sectors in the African region, with a focus on health, infrastructure, food and water scarcity, energy and finance. All sectors are affected by climate change. They are interconnected and under threat. This triggers a ripple effect, where threats in one sector have a knock-on effect on other sectors. We find that the current set of intergovernmental institutions have failed to adequately address climate justice. We also contend that a siloed approach to climate action has proven to be ineffective. As we head towards the next set of negotiations (COP27), this paper argues that the economic and social conditions in Africa can be addressed through financial and collaborative support for adaptation and localised solutions, but that this will only be achieved if climate justice is prioritised by the decision makers. This needs to include a global-scale transition in how climate finance is assessed and accessed. Climate justice underpins real, effective and sustainable solutions for climate action in Africa.

Child and Adolescent Psychological Reactions to Climate Change: A Narrative Review Through an Existential Lens

PURPOSE OF REVIEW

A narrative review was conducted on research surrounding children's and adolescents' experiences of emotional and mental health and wellbeing in relation to climate change; we also explored potential connections to existential themes.

RECENT FINDINGS

Children and adolescents represent a vulnerable group in relation to experiencing negative mental health impacts due to climate change. Further, this population experiences a wide range of emotions in relation to climate change, with most research reporting on worry and anxiety. Several studies that explored associations between such emotions and mental health outcomes found positive associations. Additionally, research suggests that there is an existential underpinning to how climate change is experienced by children and adolescents. Although important contributions have been made in recent years, knowledge gaps remain. An understanding of the psychological responses children and adolescents have in relation to climate change is needed to inform practice and policy. This may be supported by an existential framework.

Protecting Children's Environmental Health in a Changing Climate: A Model Collaboration of the Maternal and Child Health Section and the Environment Section of APHA

PURPOSE

The complexities of modern civilization, coupled with challenges including systemic racism and climate change-related impacts, compel public health professionals to break down silos and collaborate towards the shared goals of protecting the wellbeing of current and future generations. This article highlights the growing collaboration between the Maternal and Child Health (MCH) and the Environment (ENV) Sections of the American Public Health Association (APHA) as members bring their collective focus to the protection of children's and pregnant people's environmental health.

DESCRIPTION

The MCH Section and the Children's Environmental Health (CEH) Committee of the ENV Section are collaborating on efforts to: inform key stakeholders?including public health and health care professionals, child care professionals, families, and youth?about environmental hazards and climate change impacts to children's and pregnant people's health and wellbeing; and provide tools and guidance about how to best protect these groups and how to advocate for climate action. The CEH Committee embraces a health equity paradigm and intentionally centers environmental, racial, and social justice as integral to effective children's health and climate change initiatives.

ASSESSMENT

Projects to date include multiple joint sessions about children's environmental health and climate change at APHA's annual meetings, publications and various children's environmental health tools and resources, including a toolkit and lesson plan that equips public health professionals to provide guest lectures at their local high schools on climate change and health, and educational materials for caregivers on extreme heat, wildfires, and ticks and mosquitos.

CONCLUSION

This collaboration could serve as a replicable model that can be applied to other interdisciplinary efforts seeking strategic partnerships to address complex health issues.

Climate Change and Substance-Use Behaviors: A Risk-Pathways Framework

Climate change is undermining the mental and physical health of global populations, but the question of how it is affecting substance-use behaviors has not been systematically examined. In this narrative synthesis, we find that climate change could increase harmful substance use worldwide through at least five pathways: psychosocial stress arising from the destabilization of social, environmental, economic, and geopolitical support systems; increased rates of mental disorders; increased physical-health burden; incremental harmful changes to established behavior patterns; and worry about the dangers of unchecked climate change. These pathways could operate independently, additively, interactively, and cumulatively to increase substance-use vulnerability. Young people face disproportionate risks because of their high vulnerability to mental-health problems and substance-use disorders and greater number of life years ahead in which to be exposed to current and worsening climate change. We suggest that systems thinking and developmental life-course approaches provide practical frameworks for conceptualizing this relationship. Further conceptual, methodological, and empirical work is urgently needed to evaluate the nature and scope of this burden so that effective adaptive and preventive action can be taken.

The role of chronological age in climate change attitudes, feelings, and behavioral intentions: The case of null results

Past research has stressed the role of age and generation in climate change discourse, worries, and willingness to act. Therefore, the present paper aimed to examine the role of chronological age (as an arbitrary factor, which represents ageism) in lay people's climate change-related attitudes, feelings, and behavioral intentions. Two experiments in different countries, Australia and Israel, were conducted for this purpose. The first study examined the impact of the age of the speaker, who provides information about the climate crisis and the second examined the impact of the age of the group being blamed for the situation. Outcome variables included perceived responsibility and motivation for the current climate situation in study 1 and perceived climate change-related attitudes, feelings, and behavioral intentions in study 2. In study 1 (n = 250, Australia), the age of the speaker, a climate activist, varied randomly to test the hypothesis that a younger activist would be more influential and increase motivation and responsibility to act compared to an older activist. In study 2 (n = 179, Israel), the age (young vs. old) of the group identified as being responsible for the climate crisis varied randomly, to test the hypothesis that people would be more willing to identify older people as being responsible for the current climate situation, and this would impact climate change-related attitudes, feelings, and behavioral intentions. Both studies resulted in null effects. Additionally, there was no interaction between the age of the respondent and the age of the source of the message or the age group being blamed by the message. The present study has failed to show that strategies that emphasize intergenerational conflict and ageism impact people's attitudes, feelings, and behavioral intentions towards the current climate situation. This possibly can serve as an instigator for strategies that emphasize intergenerational solidarity, rather than conflict, as a guiding principle in future campaigns that advocate climate change adaptation and mitigation measures.

Natural environments, psychosocial health, and health behaviors in a crisis - A scoping review of the literature in the COVID-19 context

The COVID-19 outbreak led to major restrictions globally, affecting people's psychosocial health and their health behaviors. Thus, the purpose of this scoping review was to summarize the available research regarding nature and health in the COVID-19 context. Keywords relating to natural environments and COVID-19 were combined to conduct a systematic online search in six major databases. Eligibility criteria were a) published since 2020 with data collected in the COVID-19 context b) peer-reviewed, c) original empirical data collected on human participants, d) investigated the association between natural environments and psychosocial health or health behaviors, and e) English, German, or Scandinavian languages. Out of 9126 articles being screened, we identified 188 relevant articles, representing 187 distinct studies. Most research focused on adults in the general population and was predominantly conducted in the USA, Europe, and China. Overall, the findings indicate that nature may mitigate the impact of COVID-19 on psychological health and physical activity. Through a systematic thematic analysis of the extracted data, three primary themes were identified: 1) type of nature assessed, 2) psychosocial health and health behaviors investigated, and 3) heterogeneity in the nature-health relationship. Research gaps in the COVID-19 context were identified regarding I) nature characteristics that promote psychosocial health and health behaviors, II) investigations of digital and virtual nature, III) psychological constructs relating to mental health promotion, IV) health-promoting behaviors other than physical activity, V) underlying mechanisms regarding heterogeneity in the nature-health relationship based on human, nature, and geographic characteristics, and VI) research focusing on vulnerable groups. Overall, natural environments demonstrate considerable potential in buffering the impact of stressful events on a population level on mental health. However, future research is warranted to fill the mentioned research gaps and to examine the long-term effects of nature exposure during COVID-19.

Mixed Signals in Child and Adolescent Mental Health and Well-Being Indicators in the United States: A Call for Improvements to Population Health Monitoring

Policy Points Social indicators of young peoples' conditions and circumstances, such as high school graduation, food insecurity, and smoking, are improving even as subjective indicators of mental health and well-being have been worsening. This divergence suggests policies targeting the social indicators may not have improved overall mental health and well-being. There are several plausible reasons for this seeming contradiction. Available data suggest the culpability of one or several common exposures poorly captured by existing social indicators. Resolving this disconnect requires significant investments in population-level data systems to support a more holistic, child-centric, and up-to-date understanding of young people's lives.

Australian young people's perceptions of the commercial determinants of the climate crisis

There is increasing public health focus on how corporate practices impact population health and well-being. While the commercial determinants of the climate crisis pose serious threats to human and planetary health, governments largely seek to balance climate action with economic imperatives. Global stakeholders recognize that young people have important voices in influencing climate responses. However, few studies have investigated young people's perceptions of the commercial determinants of the climate crisis. A qualitatively led online survey of n = 500 young Australians (15-24 years) investigated their understanding of corporate responses to the climate crisis, factors that influenced these responses and strategies to respond. A reflexive approach to thematic analysis was used. Three themes were constructed from the data. First, young people perceived that corporate responses to the climate crisis focussed on soft options and lacked meaningful action. Second, they stated that these responses were largely influenced by economic imperatives rather than planetary health, with policy levers needed to implement environmentally responsible corporate practices. Third, young people perceived that systems needed change to create demand for a cleaner environment, leading to improved practices. Young people have a clear understanding of the commercial determinants of the climate crisis and associated threats to population health. They recognize that corporate practices (and consumer demand) will not change without significant policy and structural change. Public health and health promotion stakeholders should work alongside young people to influence decision-makers to address harmful corporate behaviours.

Quantifying generational and geographical inequality of climate change

We relate greenhouse gas emissions and global warming experienced over a lifetime by individual birth cohorts, resolved by world regions. We reveal outstanding geographical inequality between high- and low-emission regions corresponding to the nations of the Global North and Global South, respectively. Additionally, we highlight the inequality different birth cohorts (generations) experience regarding the burden of recent and ongoing warming temperatures as a time-delayed consequence of past emissions. We achieve precise quantification of the number of birth cohorts and populations who see a difference between Shared Socioeconomic Pathways (SSPs), emphasizing the potential for action and the chances for improvement that exist under the different scenarios. The method is designed to realistically display inequality, as it is experienced by people while motivating action and change needed to achieve emission reduction to reduce climate change and generational and geographical inequality simultaneously.

'I don't really associate climate change with actual people's health': a qualitative study in England of perceptions of climate change and its impacts on health

OBJECTIVES

The health impacts of climate change are increasing, but qualitative evidence on people's perceptions is limited. This qualitative study investigated people's perceptions of climate change and its impacts on health.

STUDY DESIGN

This was an online study using semistructured interviews.

METHODS

A total of 41 semistructured interviews were conducted in 2021 with members of the public aged ≥15 years living in England, recruited via community-based groups. Data were analysed using reflexive thematic analysis.

RESULTS

Participants were concerned about climate change, which was often perceived as extreme weather events happening elsewhere. Changes in the UK's seasons and weather patterns were noted, but participants were uncertain whether these changes resulted from climate change. Participants often struggled to identify health impacts of climate change; where health impacts were described, they tended to be linked to extreme weather events outside the United Kingdom and their associated threats to life. The mental health impacts of such events were also noted.

CONCLUSIONS

The study found that most participants did not perceive climate change to be affecting people's health in England. This raises questions about whether framing climate change as a health issue, an approach advocated for countries less exposed to the direct effects of climate change, will increase its salience for the British public.

The impact of climate change on atopic dermatitis and mental health comorbidities: a review of the literature and examination of intersectionality

Climate change, fueled by increasing concentrations of greenhouse gases, is associated with rising temperatures, extreme weather events, increased aeroallergen production, and air pollution. Our understanding that many inflammatory cutaneous diseases carry important mental health comorbidities is expanding. Simultaneously, the detrimental impacts of climate change on human health are now widely recognized as a global public health crisis. Importantly, these climate-associated phenomena exacerbate the environmental triggers of atopic dermatitis (AD) and are also associated with amplification of comorbid mental health conditions in AD including depression, anxiety, trauma-related disorders, and psychotic spectrum disorders. This review is the first to examine the nexus of climate change, atopic dermatitis, and mental health comorbidities and emphasizes the disproportionate impacts of climate change in vulnerable and marginalized populations.

Maternal nutritional status modifies heat-associated growth restriction in women with chronic malnutrition

Rapid changes in the global climate are deepening existing health disparities from resource scarcity and malnutrition. Rising ambient temperatures represent an imminent risk to pregnant women and infants. Both maternal malnutrition and heat stress during pregnancy contribute to poor fetal growth, the leading cause of diminished child development in low-resource settings. However, studies explicitly examining interactions between these two important environmental factors are lacking. We leveraged maternal and neonatal anthropometry data from a randomized controlled trial focused on improving preconception maternal nutrition (Women First Preconception Nutrition trial) conducted in Thatta, Pakistan, where both nutritional deficits and heat stress are prevalent. Multiple linear regression of ambient temperature and neonatal anthropometry at birth (n = 459) showed a negative association between daily maximal temperatures in the first trimester and Z-scores of birth length and head circumference. Placental mRNA-sequencing and protein analysis showed transcriptomic changes in protein translation, ribosomal proteins, and mTORC1 signaling components in term placenta exposed to excessive heat in the first trimester. Targeted metabolomic analysis indicated ambient temperature associated alterations in maternal circulation with decreases in choline concentrations. Notably, negative impacts of heat on birth length were in part mitigated in women randomized to comprehensive maternal nutritional supplementation before pregnancy suggesting potential interactions between heat stress and nutritional status of the mother. Collectively, the findings bridge critical gaps in our current understanding of how maternal nutrition may provide resilience against adverse effects of heat stress in pregnancy.

The burden of heatwave-related preterm births and associated human capital losses in China

Frequent heatwaves under global warming can increase the risk of preterm birth (PTB), which in turn will affect physical health and human potential over the life course. However, what remains unknown is the extent to which anthropogenic climate change has contributed to such burdens. We combine health impact and economic assessment methods to comprehensively evaluate the entire heatwave-related PTB burden in dimensions of health, human capital and economic costs. Here, we show that during 2010-2020, an average of 13,262 (95%CI 6,962-18,802) PTBs occurred annually due to heatwave exposure in China. In simulated scenarios, 25.8% (95%CI 17.1%-34.5%) of heatwave-related PTBs per year on average can be attributed to anthropogenic climate change, which further result in substantial human capital losses, estimated at over $1 billion costs. Our findings will provide additional impetus for introducing more stringent climate mitigation policies and also call for more sufficient adaptations to reduce heatwave detriments to newborn.

Associations of climate variability driven by El Niño-southern oscillation with excess mortality and related medical costs in Chinese elderly

Climate variability driven by El Niño-Southern Oscillation (ENSO) is a significant public health concern in parallel with global population aging; however, its role in healthy aging is less studied. We examined the longitudinal impacts of ENSO exposure on excess mortality and related medical costs in the elderly from 23 provinces of China. A total of 27,533 non-accidental all-cause deaths were recorded in 30,763 participants during 1998-2018. We found that both low and high levels of ENSO metrics over lags of 0-12 months were associated with increased mortality risks. Specifically, comparing the 10th percentile (-1.8) and 90th percentile (2.0) multivariate El Niño index (MEI) levels to the reference level with the minimum effect of MEI exposure, the risk of mortality was 1.87 (95 % confidence interval [CI], 1.75, 2.00) and 4.89 (95 % CI, 4.36, 5.49), respectively. ENSO exposure was also positively related to medical costs. Further, the associations were stronger among drinkers, lower-income participants, and those with higher blood pressure and heart rate measured at the most recent follow-ups. Our results suggested that ENSO exposure was capable of heightening mortality risks and medical burden among older elderly adults, highlighting that climate variability driven by ENSO could be a crucial determinant of healthy aging.

Reimagining Children's Rights in the US

IMPORTANCE

The US faces a pivotal moment of opportunity and risk regarding issues affecting children (aged 0-17 years). Although the US remains the only United Nations member state to not have ratified the Convention on the Rights of the Child (CRC), a child rights framework is essential for child health professionals seeking to advance many issues affecting children in the US. The Reimagining Children's Rights project (2020-2021) conducted an in-depth environmental scan of relevant literature and policy analysis using the Three Horizons design process to assess strategies that could advance the rights and well-being of children in the US. The project was overseen by a steering committee and informed by an advisory committee composed of youth leaders and experts in children's rights, advocacy, health, law, and a range of child-specific issues (eg, youth justice, early childhood development), who provided expert input on strategic considerations for advancing children's rights.

OBSERVATIONS

Seven findings about advancing children's rights in the US are notable, all reflecting current gaps and opportunities for using a whole-child rights framework in the US, even without formal adoption of the CRC. Actionable strategies, tactics, and tools to leverage sustainable change in the multitude of issue areas can advance the current state of children's rights. High-potential strategies for catalyzing advancement of children's rights include youth activism, innovations in governance and accountability, legislative action, impact litigation, place-based initiatives, education and public awareness, alignment with other children's movements, and research. The child rights framework is unifying and adaptive to future unforeseen challenges.

CONCLUSIONS AND RELEVANCE

Children's rights provide a powerful, synergistic framework for child health professionals-in partnership with youth and other leaders-to increase equity and protect the rights and well-being of all children in the US.