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Canada regularly faces environmental public health (EPH) disasters. Given the importance of evidence-based, risk-informed decision-making, we aimed to critically assess the integration of EPH expertise and research into each phase of disaster management. In-depth interviews were conducted with 23 leaders in disaster management from Canada, the United States, the United Kingdom, and Australia, and were complemented by other qualitative methods. Three topics were examined: governance, knowledge creation/translation, and related barriers/needs. Data were analyzed through a four-step content analysis. Six critical success factors emerged from the analysis: blending the best of traditional and modern approaches; fostering community engagement; cultivating relationships; investing in preparedness and recovery; putting knowledge into practice; and ensuring sufficient human and financial resources. Several promising knowledge-to-action strategies were also identified, including mentorship programs, communities of practice, advisory groups, systematized learning, and comprehensive repositories of tools and resources. There is no single roadmap to incorporate EPH expertise and research into disaster management. Our findings suggest that preparation for and management of EPH disaster risks requires effective long-term collaboration between science, policy, and EPH practitioners at all levels in order to facilitate coordinated and timely deployment of multi-sectoral/jurisdictional resources when and where they are most needed.

Au printemps 2017 et 2019, plus 300 municipalités du Québec ont été confrontées à de graves inondations qui ont provoqué d’importants dommages aux propriétés, aux biens personnels de milliers de citoyens et à plusieurs infrastructures municipales. Dans le contexte des inondations de 2019, il faut toutefois souligner l’importante différence entre celles vécues par la municipalité de Sainte-Marthe-sur-le-Lac et celles survenues dans les autres municipalités du Québec. À Sainte-Marthe-sur-le-Lac, les inondations ont été soudaines, et rapides, car elles ont été provoquées par la rupture d’une digue. Ce sinistre, de nature anthropique, a occasionné la relocalisation d’urgence de plusieurs centaines de familles. Quant aux autres municipalités, c’est la crue printanière qui a généré des inondations fluviales, un sinistre de cause naturelle, dont l’ampleur et la durée ont dépassé les précédents évènements historiques, y compris ceux de 2017. Lors de ces inondations, les municipalités et divers partenaires gouvernementaux (CIUSSS/CISSS, MSP, SQ…) et certains organismes bénévoles en sécurité civile (Croix-Rouge Canadienne, Armée du Salut, Ambulance St-Jean, etc.), ont déployé leurs intervenants afin d’apporter leur aide et leur soutien aux municipalités et aux personnes sinistrées. Des centaines de policiers, pompiers, employés municipaux, gestionnaires, chefs d’équipe, militaires, intervenants psychosociaux, bénévoles spécialisés en recherche et sauvetage ou en soutien émotionnel ont alors travaillé sans relâche pour assurer la sécurité des personnes et des biens, mais pour aussi amortir, autant que possible, les impacts psychosociaux inévitablement causés par ce type de sinistre. Ce rapport synthèse présente le point de vue d’une centaine d’intervenants, provenant de différentes régions du Québec qui ont contribué à la gestion et la coordination des efforts pour orchestrer la réponse nécessaire lors des inondations de 2019. Ils ont été invités à documenter les stratégies mises en place à court et à moyen terme qui, selon leurs observations, ont contribué à : •Augmenter le sentiment de sécurité des sinistrés ; •Diminuer leur niveau d’anxiété et d’isolement ; et •Prévenir la détérioration de leur état de santé physique et psychologique.

Emergencies and disasters typically affect entire communities, cause substantial losses and disruption, and result in a significant and persistent mental health burden. There is currently a paucity of evidence on safe and effective individual- and community-level strategies for improving mental health before, during, and after such events. In October 2018, the World Health Organization (WHO) Centre for Health Development (WHO Kobe Centre) convened a meeting bringing together leading Asia Pacific and international disaster research experts. The expert meeting identified key research needs in five major areas, one being “Psychosocial management before, during, and after emergencies and disasters”. Experts for this research area identified critical gaps in observational research (i.e., the monitoring of long-term psychological consequences) and interventional research (i.e., the development and evaluation of individual- and community-level interventions). Three key research issues were identified. First, experts underscored the need for a standardized and psychometrically robust instrument that classified the mental health/psychosocial risk of people within both a clinical and community setting. Then, the need for a standardization of methods for prevention, screening, diagnosis, and treatment for affected people was highlighted. Finally, experts called for a better identification of before, during, and after emergency or disaster assets associated with greater community resilience.

Introduction:Public health emergency management involves the timely translation of relevant evidence and effective coordination of diverse actors. In practice, this can be challenging in the absence of a common framework for action among diverse actors.Aim:To apply an Integrated Knowledge Translation (iKT) approach throughout the development of a conceptual framework and performance measurement indicators for public health emergency preparedness (PHEP), to ensure knowledge generated is relevant and useful to the field.Methods:The iKT approach was initiated by identifying a research question based on priorities from the field. The two phases of the study used participatory research methods as well as active engagement with potential end users at key study milestones. The Structured Interview Matrix (SIM) facilitation technique for focus groups and an expert panel using Delphi methodology were used to define the PHEP framework and performance measurement indicators, respectively. An advisory committee was assembled consisting of potential end-users of the research, in senior positions in applied and decision-making roles.Results:iKT was an essential component for this applied public health project, contributing to and enhancing the relevance of the knowledge generated. iKT contributed to the following: broad national engagement and interest in the study, successful recruitment in both phases, and engagement with decision-makers. This multi-dimensional participatory approach successfully generated knowledge that was important to the field demonstrated by relevance to practice and policy in jurisdictions across Canada. Furthermore, the approach fostered building resilience in local and national communities through collaboration.Discussion:The iKT approach was essential to generating knowledge that is relevant and useful to the field, mainly to promote health system preparedness and resilience. Future research to study the implementation of knowledge will be important to continue addressing the knowledge-to-action gap in health emergency management research.

Les inondations de 2017 et 2019 au Québec ont affecté respectivement 293 et 240 municipalités. Ces inondations ont généré une cascade d’évènements stressants (stresseurs primaires et secondaires) qui ont eu des effets sur la santé mentale de la population et retardé le processus de rétablissement des individus. Cette période de rétablissement peut s’échelonner sur plusieurs mois voire plusieurs années. Cette étude s’inscrit dans la spécificité de la recherche mixte mise de l’avant à travers trois stratégies de recherche, réalisées de façon séquentielle : 1) sondage populationnelle réalisé auprès de 680 personnes, 2) analyse de documents produits par les organisations participant au processus de rétablissement social des sinistrés, ou sur des analyses externes portant sur ces interventions de rétablissement et 3) entrevues semi-dirigées auprès de 15 propriétaires occupants ayant complété une demande d’indemnisation à la suite des inondations de 2019 et auprès de 11 professionnels et gestionnaires participant au processus de rétablissement social. Les entrevues semi-dirigées et les questionnaires complétés par les personnes sinistrées lors des inondations de 2019 démontrent que les principales sources de stress ayant des impacts sur la santé et le bien-être des répondants sont : 1) l’absence d’avertissement et la vitesse de la montée des eaux; 2) l’obligation de se relocaliser et la peur d’être victime de pillage; 3) le manque de solidarité et d’empathie de la part de certains employés du MSP; 4) la gestion des conflits familiaux; 5) la gestion de problèmes de santé nouveaux ou préexistants; 6) la complexité des demandes d’indemnisation; 7) la lourdeur et les délais des travaux de nettoyage ou de restauration; 8) les indemnités inférieures aux coûts engendrés par l’inondation; 9) les pertes matérielles subies, particulièrement ceux d’une valeur de plus de 50 000 $; et 10) la diminution anticipée de la valeur de sa résidence. À cela s’ajoute l’insatisfaction à l’égard du programme d’indemnisation du gouvernement du Québec (PGIAF) qui fait plus que doubler la prévalence des symptômes de stress post-traumatique. Les inondations entraînent également une perte de satisfaction ou de bien-être statistiquement significative. La valeur monétaire de cette perte de jouissance peut être exprimée en équivalent salaires. En moyenne, cette diminution du bien-être équivaut à une baisse de salaire de 60 000$ pour les individus ayant vécu une première inondation et à 100 000$ pour les individus ayant vécu de multiples inondations. Ces résultats suggèrent que les coûts indirects et intangibles représentent une part importante des dommages découlant des inondations. Ce projet de recherche vise également à analyser l’application du PGIAF et son influence sur les stresseurs vécus par les sinistrés dans le contexte de la pandémie de COVID-19. La principale recommandation de cette étude repose sur une analyse de documents, un sondage populationnel et des entrevues semi-dirigées. Ainsi, s’attaquer à la réduction de principaux stresseurs nécessite 1) d’améliorer la gouvernance du risque d’inondation, 2) d’intensifier la communication et le support aux sinistrés, et 3) de revoir les mécanismes d’indemnisation existants.

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

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