Flood- and Weather-Damaged Homes and Mental Health: An Analysis Using England's Mental Health Survey

Environmental pollution and extreme weather conditions: insights into the effect on mental health

Environmental pollution exposures, including air, soil, water, light, and noise pollution, are critical issues that may implicate adverse mental health outcomes. Extreme weather conditions, such as hurricanes, floods, wildfires, and droughts, may also cause long-term severe concerns. However, the knowledge about possible psychiatric disorders associated with these exposures is currently not well disseminated. In this review, we aim to summarize the current knowledge on the impact of environmental pollution and extreme weather conditions on mental health, focusing on anxiety spectrum disorders, autism spectrum disorders, schizophrenia, and depression. In air pollution studies, increased concentrations of PM2.5, NO2, and SO2 were the most strongly associated with the exacerbation of anxiety, schizophrenia, and depression symptoms. We provide an overview of the suggested underlying pathomechanisms involved. We highlight that the pathogenesis of environmental pollution-related diseases is multifactorial, including increased oxidative stress, systematic inflammation, disruption of the blood-brain barrier, and epigenetic dysregulation. Light pollution and noise pollution were correlated with an increased risk of neurodegenerative disorders, particularly Alzheimer's disease. Moreover, the impact of soil and water pollution is discussed. Such compounds as crude oil, heavy metals, natural gas, agro-chemicals (pesticides, herbicides, and fertilizers), polycyclic or polynuclear aromatic hydrocarbons (PAH), solvents, lead (Pb), and asbestos were associated with detrimental impact on mental health. Extreme weather conditions were linked to depression and anxiety spectrum disorders, namely PTSD. Several policy recommendations and awareness campaigns should be implemented, advocating for the advancement of high-quality urbanization, the mitigation of environmental pollution, and, consequently, the enhancement of residents' mental health.

Psychological impact of the Spring 2019 flood among adult population of Iran

BACKGROUND

From March to April 2019, a flood occurred in several regions of Iran. The most affected provinces were Golestan, Lorestan, and Khuzestan.

AIMS

The present study aimed to determine the prevalence and determinants of psychological distress and depression among the affected adult population 6 months after the event.

METHODS

A cross-sectional household survey with face-to-face interview was carried out on a random sample of 1,671 adults aged above 15 years living in the flood-affected areas from August to September 2019. We applied GHQ-28 and PHQ-9 for the assessment of psychological distress and depression, respectively.

RESULTS

The prevalence of psychological distress and depression were 33.6% (95% CI [29.5, 37.7]) and 23.0% (95% CI [19.4, 26.7]), respectively. Determinants of psychological distress were a history of mental disorders (Adjusted odds ratio [AOR] = 4.7), primary (AOR = 2.9) or high school (AOR = 2.4) education (vs. university), no compensation received (AOR = 2.1), high damage to assets (AOR = 1.8), the house flooded more than 1 m (AOR = 1.8), female gender (AOR = 1.8), and limited access to health care services (AOR = 1.8). Determinants of depression were unemployment (AOR = 5.3) or being a housewife (AOR = 2.7), a history of mental disorders (AOR = 4.1), high damage to assets (AOR = 2.5), no compensation received (AOR = 2.0), the house flooded more than 1 m (AOR = 1.8), limited access to health care services (AOR = 1.8), and high wealth index (AOR = 1.7).

CONCLUSION

The results of this study revealed a high prevalence of psychological distress and depression in the flood-affected adult population. The high-risk group, particularly flood victims who had a history of mental disorders, and those exposed to severe damages of flood, should be prioritized for screening, and mental health services.

[Nature and immune mechanisms of mental illnesses]

The impacts of nature and climate change on mental health are substantial but the underlying mechanisms are still poorly understood. The immune system in particular could play an important role. Therefore, the German Center for Mental Health (DZPG) in Munich will use state of the art model systems to elucidate the role of the immune system in the pathogenesis of mental disorders under altered environmental conditions and to develop preventive treatment strategies.

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.

Mental Health Disorders Due to Disaster Exposure: A Systematic Review and Meta-Analysis

Natural disasters are complex, global issues that affect people individually, families, and communities, upsetting their emotional wellbeing. This research aims to comprehend the connections between disasters and their effects on mental health. We conducted a systemic review and meta-analysis on the effect of disasters on mental health disorders using defined search terms across three major databases. The search technique adhered to the PECO framework. The study locations were dispersed across Asia, Europe, and America. An electronic search was established in the Cochrane Central Register of Controlled Trials in the Cochrane Library, PubMed, and Medline databases. A random-effects meta-analysis was carried out. The I² statistic was used to explore heterogeneity. In the random-effects analysis, Tau-squared, τ², or Tau² evaluates the effects seen between the study variances. Publication bias was examined. The outcomes of the included studies on mental health issues (n = 48,170) brought on by catastrophic disasters were pooled using a random-effects meta-analysis. The three main mental health illnesses attributed to the disaster catastrophe in most studies were generalized anxiety disorder (GAD), depression, substance use, adjustment disorder, and post-traumatic stress disorder (PTSD). Storms, including cyclones and snowstorms, had an impact on 5,151 individuals. 38,456 people were harmed by flooding, and 4,563 people were affected by the earthquake. The included studies showed prevalence rates for mental health disorders ranging from 5.8% to 87.6%. The prevalence rates were between 2.2% and 84% for anxiety, 3.23% and 52.70% for depression, and 2.6% and 52% for PTSD, respectively. The point effect estimates of studies included the flood, storm/cyclone, and earthquake were 0.07 (95% confidence interval [CI]: 0.02-0.12), 0.18 (95% CI: 0.03-0.32), and 0.15 (95% CI: 0.03-0.27), respectively, which revealed a statistically significant positive effect (p-value: < 0.05) with a narrow 95% CI indicating more precise population estimates. However, the pooled effect estimates were not of a large effect size of 0.129 (95% CI: 0.05-0.20). This study found a link between disaster and poorer outcomes for mental health. The risk of psychological morbidity and fatalities increased with relocation and disruption of essential services. Flooding was the most frequent calamity. The "medium human development countries" were found to have the highest prevalence rate of mental health disorders in our meta-analysis. The "very high human development" and "high human development" nations, however, also had a higher prevalence rate of mental health disorders following catastrophic events. This study could aid in the creation of thorough strategies for the mitigation and avoidance of mental health problems during natural disasters. Increased community resilience, improved access to healthcare services, and a suitable mitigation strategy can all help to improve the situation of the disaster's vulnerable population.

Exploring the association between precipitation and hospital admission for mental disorders in Switzerland between 2009 and 2019

While several studies proved the relationship between increasing temperatures and poor mental health, limited evidence exists on the effect of other weather factors, such as precipitation. This study assessed the impact of precipitation on hospital admissions for mental disorders in Switzerland between 2009-2019. We defined different precipitation events based on the duration (daily precipitation ≥1mm for 2, 3, or 4 days; PP.2/PP.3/PP.4) and intensity (≥90th percentile for 2 consecutive days; PEP90.2). First, we conducted aggregated time-stratified case-crossover analysis in eight main Swiss cities with distributed lag models to assess the association up to 3 days after the exposure. Then, we pooled the estimates in each city using a multivariate random effects meta-analysis for all hospital admissions and by subgroups (sex, age, diagnosis). Evidence of an association between precipitation and hospital admission for mental disorders was not found in Switzerland (PP.2: 1.003[0.978-1.029]; PP.3: 1.005[0.985-1.026]; PP.4: 0.994[0.960-1.030]; PEP90.2: 1.000[0.953-1.050]). Although the results were highly uncertain, we found an indication of increasing risks of hospital admission with increasing intensity of precipitation in warmer seasons (PP.2: 1.001[0.971-1.032] vs PEP90.2: 1.014[0.955-1.078]), while the risks of hospital admission slightly increased by the duration in colder season (PP.2: 1.009[0.981-1.039]; PP.3: 1.008[0.980-1.036]; PP.4: 1.017[0.956-1.081]). Overall, risks tend to be higher in people aged < 65 years. Duration of the events may influence more than intensity in females, while opposite patterns were observed in males. Risks tended to be larger but still uncertain for schizophrenia, mood disorders, and adult personality disorders. An indication of a negative association was found in neurotic disorders and null risks in the remaining groups. Although our findings did not show a clear association between precipitation and mental disorders, further research is required to clarify the role of precipitation and the potential implications of climate change and extreme precipitation events on mental health.

The impact of natural disasters on household debt: evidence from 2014 China family panel studies

Based on data from the 2014 China Family Panel Studies, we investigate the causal relationship between natural disasters and household debt using ordinary least squares and propensity score matching. This paper found that natural disasters can not only increase the probability of households owning debt but also have a significant positive impact on the number of household debt. The results of heterogeneity analysis show that natural disasters have a greater impact on families with large sizes and high-consumption levels. Mechanism checks suggest that household income and individual's health are shown to be the potential mechanism through which the impact of natural disasters on household debt.

Climate Change and Mental Health: A Review of Empirical Evidence, Mechanisms and Implications

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

Understanding the long-term impact of flooding on the wellbeing of residents: A mixed methods study

As the effects of climate change become more visible, extreme weather events are becoming more common. The effects of flooding on health are understood but the long-term impact on the well-being of those affected need to be considered. This mixed methods secondary analysis of a cross-sectional survey examined the extent to which being flooded in the past is associated with ongoing concerns about flooding. Survey data were collected from residents in Hull 11 years after the initial flooding event. Respondents were asked about the floods in 2007 and their current level of concern about flooding. Ordinal logistic regression explored the effect of age and tenancy status as predictors of current concern. Textual data were analyzed using thematic content analysis. Responses were received from 457 households, of whom 202 (48%) were affected by flooding in 2007. A fifth of respondents were very concerned about future flooding. Those who were not flooded were significantly less concerned about the risk of future flooding (U = 33391.0, z = 5.89, p < 0.001). Those who reported negative health and wellbeing effects from the floods were significantly more concerned about future flooding than those whose health was not affected (U = 7830.5, z = 4.43, p < 0.001). Whilst some residents were reassured by the introduction of new flood alleviation schemes, others did not feel these were adequate, and worried about the impact of climate change. The financial and emotional impacts of the floods still resonated with families 11 years after the event, with many fearing they would not cope if it happened again. Despite the 2007 floods in Hull happening over a decade ago, many of those affected continue to experience high levels of anxiety when storms are forecast. Residents feel powerless to protect themselves, and many remain unconvinced by the presence of new flood alleviation schemes. However, with the ongoing threat of climate change, it may be that other residents are unrealistic in their expectation to be ‘protected’ from flood events. Therefore, public health agencies need to be able to mobilize organizations to come together to pro-actively support families affected by flooding, to ensure those in need do not fall through the gaps of public healthcare delivery.

The Impact of Climate Change on Mental Health and Emotional Wellbeing: A Narrative Review of Current Evidence, and its Implications

Converging global evidence highlights the dire consequences of climate change for human mental health and wellbeing. This paper summarises literature across relevant disciplines to provide a comprehensive narrative review of the multiple pathways through which climate change interacts with mental health and wellbeing. Climate change acts as a risk amplifier by disrupting the conditions known to support good mental health, including socioeconomic, cultural and environmental conditions, and living and working conditions. The disruptive influence of rising global temperatures and extreme weather events, such as experiencing a heatwave or water insecurity, compounds existing stressors experienced by individuals and communities. This has deleterious effects on people's mental health and is particularly acute for those groups already disadvantaged within and across countries. Awareness and experiences of escalating climate threats and climate inaction can generate understandable psychological distress; though strong emotional responses can also motivate climate action. We highlight opportunities to support individuals and communities to cope with and act on climate change. Consideration of the multiple and interconnected pathways of climate impacts and their influence on mental health determinants must inform evidence-based interventions. Appropriate action that centres climate justice can reduce the current and future mental health burden, while simultaneously improving the conditions that nurture wellbeing and equality. The presented evidence adds further weight to the need for decisive climate action by decision makers across all scales.

Climate Change Related Catastrophic Rainfall Events and Non-Communicable Respiratory Disease: A Systematic Review of the Literature

Climate change is increasing the frequency and intensity of extreme precipitation events, the impacts of which disproportionately impact urban populations. Pluvial flooding and flooding related sewer backups are thought to result in an increase in potentially hazardous human-pathogen encounters. However, the extent and nature of associations between flooding events and non-communicable respiratory diseases such as chronic bronchitis, asthma, and chronic obstructive pulmonary disease (COPD) are not well understood. This research seeks to characterize the state of research on flooding and NCRDs through a systematic review of the scientific literature. We conducted a systematic search of PubMed, Web of Science, and Scopus for published scholarly research papers using the terms flooding, monsoon, and tropical storm with terms for common NCRDs such as asthma, COPD, and chronic bronchitis. Papers were included if they covered research studies on individuals with defined outcomes of flooding events. We excluded review papers, case studies, and opinion pieces. We retrieved 200 articles from PubMed, 268 from Web of Science and 203 from Scopus which comprised 345 unique papers. An initial review of abstracts yielded 38 candidate papers. A full text review of each left 16 papers which were included for the review. All papers except for one found a significant association between a severe weather event and increased risk for at least one of the NCRDs included in this research. Our findings further suggest that extreme weather events may worsen pre-existing respiratory conditions and increase the risk of development of asthma. Future work should focus on more precisely defining measure of health outcomes using validated tools to describe asthma and COPD exacerbations. Research efforts should also work to collect granular data on patients’ health status and family history and assess possible confounding and mediating factors such as neighborhood water mitigation infrastructure, housing conditions, pollen counts, and other environmental variables.

Mental Health Services Utilization by the Population That Suffered Water Supply Interruption Following Mariana Dam Failure (Brazil)

OBJECTIVE

Disasters may have major impacts to mental health and to the utilization of mental health services (MHS). Moreover, these effects may be worsened by the preclusion of access to basic services following the event. The aim of this study is to evaluate the utilization of public MHS by the population that suffered water supply interruption following the Mariana Dam Failure in Brazil, 2015.

METHODS

We conducted an Interrupted Time Series analyzing secondary health data from the municipalities that faced water supply interruption, comparing it to data from the other municipalities of Minas Gerais state.

RESULTS

We found a higher immediate (RR: 1.78; 95% CI: 1.25-2.53) and gradual (RR: 1.05; 95% CI: 1.03-1.06) change in the rate of mental health visits (MHV) in the affected population following the event, whereas there was an immediate fall (RR: 0.41; 95% CI: 0.29-0.59) followed by a higher gradual increase (RR: 1.04; 95% CI: 1.02-1.06) in the rate of hospital admissions (HA) in the affected population.

CONCLUSION

The results suggest that there was an increase in the utilization of public MHS by the population that suffered water supply interruption following the disaster.

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.

Impact of Natural Disasters on Mental Health: A Cross-Sectional Study Based on the 2014 China Family Panel Survey

Mental health problems are a leading cause of disability in both developed and developing countries, and the consequences of mental health disorders for individuals, families, and society as a whole could be severe and costly. To supplement relevant research and provide insightful policy suggestions to families, government and societies, this study investigates the nexus between natural disasters and mental health for middle-aged and older adults in rural China. Based on data of 8721 observations from the 2014 China Family Panel Studies, we estimate the effects of natural disasters on mental health using ordinary least squares and propensity score matching. Our findings suggest that natural disasters have a significant negative effect on middle-aged and older adults' mental health in the case of rural China. This effect is heterogeneous depending on individuals' education level and their agricultural production status. Finally, individuals' happiness and life satisfaction are shown to be the potential mechanism through which the effect of natural disasters on mental health operates.

Public Perceptions of Climate Change and Its Health Impacts: Taking Account of People's Exposure to Floods and Air Pollution

Climate change-related exposures such as flooding and ambient air pollution place people’s health at risk. A representative UK survey of adults investigated associations between reported flooding and air pollution (in the participants’ local area, by the participant personally, and/or by family and close friends) and climate change concerns (CCC) and perceptions of its health impacts (PIH). In regression analyses controlling for socio-demographic factors and health status, exposure was associated with greater CCC and more negative PIH. Compared to those with low CCC, participants who reported local-area exposure were significantly more likely to be fairly (OR 2.07, 95%CI 1.26, 3.40) or very concerned (OR 3.40, 95%CI 2.02, 5.71). Odds of greater CCC were higher for those reporting personal and/or family exposure (‘fairly concerned’: OR 2.83, 95%CI 1.20, 6.66; ‘very concerned’: OR 4.11, 95%CI 1.69, 10.05) and for those reporting both local and personal/family exposure (‘fairly concerned’: OR 3.35, 95%CI 1.99, 5.63; ‘very concerned’: OR 6.17, 95%CI 3.61, 10.55). For PIH, local exposure significantly increased the odds of perceiving impacts as ‘more bad than good’ (1.86, 95%CI 1.22, 2.82) or ‘entirely bad’ (OR 1.88; 95%CI 1.13, 3.13). Our study suggests that public awareness of climate-related exposures in their local area, together with personal exposures and those of significant others, are associated with heightened concern about climate change and its health impacts.

The psychological effects of COVID-19 spread in young Canadian adults

BACKGROUND AND AIM

The novel coronavirus disease 2019 (COVID-19) not only threatens physical health but also psychological well-being. As a result of the pandemic, increased mental health burdens have been recorded in young adults around the world. We sought to understand the association of stressors related to the COVID-19 pandemic with symptoms of psychological and emotional distress in young Canadian adults.

METHOD

Questionnaire respondents were asked about the extent to which they were personally impacted by COVID-19, and symptoms related to depression, anxiety, post-traumatic disorder, and emotional distress.

RESULTS

Of 84 respondents, most identified as female (74%; 62/84). Overall, 61% (51/84) reported experiencing symptoms of psychological distress related to depression, anxiety, or post-traumatic stress disorder (PTSD); specifically, 43% (36/84) reported anxiety-related symptoms, 33% (28/84) reported depression-related symptoms, and 6% (5/84) reported PTSD-related symptoms. Individuals with family in settings high risk for COVID-19 infection and individuals who received government aid with a reduction in income were 4.30-fold and 2.80-fold more likely, respectively, to experience symptoms of psychological distress (95% CI 1.31-14.14; p = .013 and 95% CI 1.08-7.25; p = .038, respectively). Visits to social media daily to hourly for COVID-19 related news resulted in a 3.24-fold increase in the likelihood of experiencing depression-related symptoms (95% CI 1.26-8.35; p = .020).

CONCLUSION

We demonstrate a necessity to focus on alleviating the mental health burdens and contributing stressors within young Canadian adults. Though the mental health burdens are currently exacerbated by the effects of the COVID-19 pandemic, they may persist after the pandemic ends if left unaddressed.

Coping with Antarctic demands: Psychological implications of isolation and confinement

Working in extreme environments requires a wide range of cognitive, psychological and social competences. Antarctica represents one of the most challenging habitats to work in due to its aridity, extremely cold weather, and isolated conditions. This study aimed to assess mood variations and coping strategies, as well as their possible modulation by group dynamics in a crew at the Belgrano II Argentine Antarctic Station throughout 1 year of confinement. Thirteen members of the Argentine Army completed emotional, coping and social dynamics questionnaires bimonthly in March, May, July, September and November. Results showed a significant decline in social dynamics scales, evidenced by decreases in perceived peer and hierarchical support. Additionally, coping strategies displayed a drop in mature defence throughout the expedition. A positive correlation was found between social support and recovery from stress. Our results highlight the importance of interpersonal relationships in psychological adjustment to isolation and extreme environments.

Recurrent Home Flooding in Detroit, MI 2012-2020: Results of a Household Survey

Household flooding has wide ranging social, economic and public health impacts particularly for people in resource poor communities. The determinants and public health outcomes of recurrent home flooding in urban contexts, however, are not well understood. A household survey was used to assess neighborhood and household level determinants of recurrent home flooding in Detroit, MI. Survey activities were conducted from 2012 to 2020. Researchers collected information on past flooding, housing conditions and public health outcomes. Using the locations of homes, a "hot spot" analysis of flooding was performed to find areas of high and low risk. Survey data were linked to environmental and neighborhood data and associations were tested using regression methods. 4803 households participated in the survey. Flooding information was available for 3842 homes. Among these, 2085 (54.26%) reported experiencing pluvial flooding. Rental occupied units were more likely to report flooding than owner occupied homes (Odd ratio (OR) 1.72 [95% Confidence interval (CI) 1.49, 1.98]). Housing conditions such as poor roof quality and cracks in basement walls influenced home flooding risk. Homes located in census tracts with increased percentages of owner occupied units (vs. rentals) had a lower odds of flooding (OR 0.92 [95% (CI) 0.86, 0.98]). Household factors were found the be more predictive of flooding than neighborhood factors in both univariate and multivariate analyses. Flooding and housing conditions associated with home flooding were associated with asthma cases. Recurrent home flooding is far more prevalent than previously thought. Programs that support recovery and which focus on home improvement to prevent flooding, particularly by landlords, might benefit the public health. These results draw awareness and urgency to problems of urban flooding and public health in other areas of the country confronting the compounding challenges of aging infrastructure, disinvestment and climate change.

Health impacts of climate change on smallholder farmers

The health of smallholder farmers is crucial for ensuring food and nutritional security for two billion people. However, their health is in jeopardy for several reasons including challenges from climate change impacts. Using a narrative literature review supported by field observations and informal interviews with key informants in India, Bangladesh and Malawi, this paper identifies and discusses the health impacts of climate change under four categories: (i) communicable diseases, (ii) non-communicable diseases, (iii) mental health, and (iv) occupational health, safety and other health issues. The health impacts of climate change on smallholder farmers will hamper the realization of many of the United Nations' Sustainable Development Goals, and a series of recommendations are made to regional and country governments to address the increasing health impacts of accelerating climate change among smallholder farmers.

From Precision Metapharmacology to Patient Empowerment: Delivery of Self-Care Practices for Epilepsy, Pain, Depression and Cancer Using Digital Health Technologies

To improve long-term outcomes of therapies for chronic diseases, health promotion and lifestyle modifications are the most promising and sustainable strategies. In addition, advances in digital technologies provide new opportunities to address limitations of drug-based treatments, such as medication non-adherence, adverse effects, toxicity, drug resistance, drug shortages, affordability, and accessibility. Pharmaceutical drugs and biologics can be combined with digital health technologies, including mobile medical apps (digital therapeutics), which offer additional clinical benefits and cost-effectiveness. Promises of drug+digital combination therapies are recognized by pharmaceutical and digital health companies, opening opportunities for integrating pharmacotherapies with non-pharmacological interventions (metapharmacology). Herein we present unique features of digital health technologies which can deliver personalized self-care modalities such as breathing exercises, mindfulness meditation, yoga, physical activity, adequate sleep, listening to preferred music, forgiveness and gratitude. Clinical studies reveal how aforementioned complimentary practices may support treatments of epilepsy, chronic pain, depression, cancer, and other chronic diseases. This article also describes how digital therapies delivering “medicinal” self-care and other non-pharmacological interventions can also be personalized by accounting for: 1) genetic risks for comorbidities, 2) adverse childhood experiences, 3) increased risks for viral infections such as seasonal influenza, or COVID-19, and 4) just-in-time stressful and traumatic circumstances. Development and implementation of personalized pharmacological-behavioral combination therapies (precision metapharmacology) require aligning priorities of key stakeholders including patients, research communities, healthcare industry, regulatory and funding agencies. In conclusion, digital technologies enable integration of pharmacotherapies with self-care, lifestyle interventions and patient empowerment, while concurrently advancing patient-centered care, integrative medicine and digital health ecosystems.

Negative emotions about climate change are related to insomnia symptoms and mental health: Cross-sectional evidence from 25 countries

Climate change threatens mental health via increasing exposure to the social and economic disruptions created by extreme weather and large-scale climatic events, as well as through the anxiety associated with recognising the existential threat posed by the climate crisis. Considering the growing levels of climate change awareness across the world, negative emotions like anxiety and worry about climate-related risks are a potentially pervasive conduit for the adverse impacts of climate change on mental health. In this study, we examined how negative climate-related emotions relate to sleep and mental health among a diverse non-representative sample of individuals recruited from 25 countries, as well as a Norwegian nationally-representative sample. Overall, we found that negative climate-related emotions are positively associated with insomnia symptoms and negatively related to self-rated mental health in most countries. Our findings suggest that climate-related psychological stressors are significantly linked with mental health in many countries and draw attention to the need for cross-disciplinary research aimed at achieving rigorous empirical assessments of the unique challenge posed to mental health by negative emotional responses to climate change.

Extreme weather events in europe and their health consequences - A systematic review

BACKGROUND

Due to climate change, the frequency, intensity and severity of extreme weather events, such as heat waves, cold waves, storms, heavy precipitation causing wildfires, floods, and droughts are increasing, which could adversely affect human health. The purpose of this systematic review is therefore to assess the current literature about the association between these extreme weather events and their impact on the health of the European population.

METHODS

Observational studies published from January 1, 2007 to May 17, 2020 on health effects of extreme weather events in Europe were searched systematically in Medline, Embase and Cochrane Central Register of Controlled Trials. The exposures of interest included extreme temperature, heat waves, cold waves, droughts, floods, storms and wildfires. The health impacts included total mortality, cardiovascular mortality and morbidity, respiratory mortality and morbidity, and mental health. We conducted the systematic review following PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis). The quality of the included studies was assessed using the NICE quality appraisal checklist (National Institute for Health and Care Excellence).

RESULTS

The search yielded 1472 articles, of which 35 met the inclusion criteria and were included in our review. Studies regarding five extreme weather events (extreme heat events, extreme cold events, wildfires, floods, droughts) were found. A positive association between extreme heat/cold events and overall, cardiovascular and respiratory mortality was reported from most studies. Wildfires are likely to increase the overall and cardiovascular mortality. Floods might be associated with the deterioration of mental health instead of mortality. Depending on their length, droughts could have an influence on both respiratory and cardiovascular mortality. Contradictory evidence was found in heat-associated morbidity and wildfire-associated respiratory mortality. The associations are inconclusive due to the heterogeneous study designs, study quality, exposure and outcome assessment.

CONCLUSIONS

Evidence from most of the included studies showed that extreme heat and cold events, droughts, wildfires and floods in Europe have negative impacts on human health including mental health, although some of the associations are not conclusive. Additional high-quality studies are needed to confirm our results and further studies regarding the effects of other extreme weather events in Europe are to be expected.

Threats to Mental Health and Well-Being Associated with Climate Change

Climate change is a contributor to extreme weather events and natural disasters. The mental health effects of climate change are multifaceted, with post-traumatic stress disorder and depression predominant. This paper aims to describe the impact of climate change on mental health conditions, including risk and protective factors related to the expression of mental health conditions post-disaster, as well as a discussion of our local experience with a devastating wildfire to our region within Canada. The risk of the development of mental health conditions post-disaster is not equally distributed; research has consistently demonstrated that specific risk factors (e.g., gender, socioeconomic status and education, pre-existing mental health symptomatology), are associated with increased vulnerability to mental health conditions following natural disasters. There are multiple strategies that must be undertaken by communities to enhance adjustment and coping post-disaster, including improved access to care, inter-agency cooperation, enhanced community resiliency, and adequate preparation.

Effect of Extreme Weather Events on Mental Health: A Narrative Synthesis and Meta-Analysis for the UK

Extreme weather events are increasing in frequency and severity as a consequence of climate change and pose a significant threat to population mental health. This is the case even in temperate regions such as the United Kingdom (UK) where flooding and heat waves are forecast to become more common. We conducted a systematic review to quantify the prevalence and describe the causes of common mental health problems in populations exposed to extreme weather events in the UK. We searched Web of Science, EMBASE and PsycINFO for studies that measured the prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD) in populations exposed to extreme weather events in the UK, published up to 12 December 2019. We included 17 studies, four of which were included in meta-analyses to determine the point prevalence of common mental health problems in the period within 12 months following extreme weather events. The point prevalence was 19.8% for anxiety (k = 4; n = 1458; 95% CI 7.42 to 32.15), 21.35% for depression (k = 4; n = 1458; 95% CI 9.04 to 33.65) and 30.36% for PTSD (k = 4; n = 1359; 95% CI 11.68 to 49.05). Key factors that affected mental ill health in people exposed to flooding were water depth and absence of flood warnings. Displacement from home underscored the narratives associated with people's perceptions of the impact of flooding. The high prevalence of common mental health problems suggests that the prevention of mental ill health in populations at risk or exposed to extreme weather events should be a UK public health priority.

Future Temperature Extremes Will Be More Harmful: A New Critical Factor for Improved Forecasts

There is increasing evidence that extreme weather events such as frequent and intense cold spells and heat waves cause unprecedented deaths and diseases in both developed and developing countries. Thus, they require extensive and immediate research to limit the risks involved. Average temperatures in Europe in June-July 2019 were the hottest ever measured and attributed to climate change. The problem, however, of a thorough study of natural climate change is the lack of experimental data from the long past, where anthropogenic activity was then very limited. Today, this problem can be successfully resolved using, inter alia, biological indicators that have provided reliable environmental information for thousands of years in the past. The present study used high-resolution quantitative reconstruction data derived from biological records of Lake Silvaplana sediments covering the period 1181-1945. The purpose of this study was to determine whether a slight temperature change in the past could trigger current or future intense temperature change or changes. Modern analytical tools were used for this purpose, which eventually showed that temperature fluctuations were persistent. That is, they exhibit long memory with scaling behavior, which means that an increase (decrease) in temperature in the past was always followed by another increase (decrease) in the future with multiple amplitudes. Therefore, the increase in the frequency, intensity, and duration of extreme temperature events due to climate change will be more pronounced than expected. This will affect human well-being and mortality more than that estimated in today's modeling scenarios. The scaling property detected here can be used for more accurate monthly to decadal forecasting of extreme temperature events. Thus, it is possible to develop improved early warning systems that will reduce the public health risk at local, national, and international levels.