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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.

Introduction:In July 2013, a train carrying 72 cars of crude oil derailed in the town of Lac-Mégantic (Eastern Townships, Quebec, Canada). This disaster provoked a major conflagration, explosions, 47 deaths, the destruction of 44 buildings, the evacuation of one-third of the local population, and an unparalleled oil spill. Notwithstanding the environmental impact, many citizens of this town and in surrounding areas have suffered and continue to suffer substantial losses as a direct consequence of this catastrophe.Problem:To tailor public health interventions and to meet the psychosocial needs of the community, the Public Health Department of Eastern Townships has undertaken repeated surveys to monitor health and well-being over time. This study focuses on negative psychosocial outcomes one and two years after the tragedy.Methods:Two cross-sectional surveys (2014 and 2015) were conducted among large random samples of adults in Lac-Mégantic and surrounding areas (2014: n = 811; 2015: n = 800), and elsewhere in the region (2014: n = 7,926; 2015: n = 800). A wide range of psychosocial outcomes was assessed (ie, daily stress, main source of stress, sense of insecurity, psychological distress, excessive drinking, anxiety or mood disorders, psychosocial services use, anxiolytic drug use, gambling habits, and posttraumatic stress symptoms [PSS]). Exposure to the tragedy was assessed using residential location (ie, six-digit postal code) and intensity of exposure (ie, intense, moderate, or low exposure; from nine items capturing human, material, or subjective losses). Relationships between such exposures and adverse psychosocial outcomes were examined using chi-squares and t-tests. Distribution of outcomes was also examined over time.Results:One year after the disaster, an important proportion of participants reported human, material, and subjective losses (64%, 23%, and 54%, respectively), whereas 17% of people experienced intense exposure. Participants from Lac-Mégantic, particularly those intensely exposed, were much more likely to report psychological distress, depressive episode, anxiety disorders, and anxiolytic drug use, relative to less-exposed ones. In 2015, 67% of the Lac-Mégantic participants (76% of intensely exposed) reported moderate to severe PSS. Surprisingly, the use of psychosocial services in Lac-Mégantic declined by 41% from 2014 to 2015.Conclusion:The psychosocial burden in the aftermath of the Lac-Mégantic tragedy is substantial and persistent. Public health organizations responding to large-scaling disasters should monitor long-term psychosocial consequences and advocate for community-based psychosocial support in order to help citizens in their recovery process.

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.

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.

Renforcer la capacité d’intervention et d’adaptation en santé publique nécessite d’améliorer l’efficacité des systèmes d’alerte précoce vis-à-vis des risques climatiques en évolution. Ceci implique des ajustements aux activités en cours, voire de modifier les façons de faire au sein des organisations et entre les organisations en augmentant, notamment, leurs collaborations. L’interdisciplinarité au service de la santé publique est donc de mise.

La construction de l’acceptabilité sociale, conçue comme le jugement collectif des populations à l’endroit d’une politique ou d’un projet donné, s’appuie parfois sur la participation des acteurs sociaux concernés aux discussions éclairant la prise de décision publique. Les instances de démocratie intermédiaires où sont déployés divers dispositifs participatifs jouent ainsi un rôle de premier plan quant à l’émergence de l’acceptabilité. Or, la question des effets des processus participatifs sur les dynamiques d’acceptabilité sociale demeure aujourd’hui peu étudiée, que ce soit par les travaux sur l’acceptabilité sociale ou ceux portant sur la participation publique. À partir de projets soulevant des préoccupations de nature environnementale, ce numéro spécial puise à l’intersection de ces deux champs théoriques en vue d’analyser l’impact des dispositifs de démocratie participative sur la prise de décision et la construction de l’accessibilité sociale. Les contributions permettent ainsi de réfléchir à la façon dont les instances de démocratie intermédiaires contribuent ou non à l’acceptabilité sociale. De manière plus spécifique, elles explorent l’institutionnalisation du concept comme nouvelle norme de gestion publique, les effets des processus participatifs déployés dans ces instances sur l’acceptabilité d’un projet donné, de même que les effets sur les décisions finales. En somme, la réflexion proposée dans ce numéro permet de voir dans quelle mesure les dispositifs participatifs offrent les conditions d’un débat constructif permettant de mieux canaliser les conflits sociétaux que suscitent certains projets industriels ou politiques publiques, en vue de construire des compromis qui se projettent dans une vision d’avenir du développement.

The environmental justice research on urban–rural exposure to flooding is underdeveloped and few empirical studies have been conducted in China. This study addresses this gap by exploring the probabilities of exposure to floods (10-, 20-, and 50-year) and examining the relationship between vulnerable groups and flooding in Nanjing, an important central city on the Yangtze River. Statistical analysis is based on multivariable generalised estimating equation (GEE) models that describe sociodemographic disparities at the census-tract level. The results revealed that (1) highly educated people in the urban centre are more likely to live in areas with high flood risk because of the abundance of education resources, and employment opportunities are concentrated in the urban centre. (2) Natives in suburban areas are more likely to live in flood-prone areas due to their favourable ecological environments near rivers and lakes. (3) Women in rural areas are more likely to live in high-flood-risk zones because most of the men are migrant workers. These findings highlight the urgent need to develop mitigation strategies to reduce flood exposure, especially in districts with high proportions of socially disadvantaged people. The linkages between rural and urban areas need to be strengthened in order to reduce flood exposure.

Aim: The aim of the study was to investigate the health effect on and adaptation of the elderly affected by floods in the Lat Krabang District, Bangkok, Thailand in 2011.Methods: A cross-sectional descriptive study was conducted. Data were collected from 290 elderly participants who were affected by the floods using questionnaires.Results: The elderly participants had previous experience with flooding, but the massive flooding in 2011 was the most severe compared to any other experiences in the past. Physical health effects included muscle pain (35.2%), athlete’s foot (28.3%), and skin rash (23.1%). The psychological health effects (24.3%) encountered included insomnia, constant stress and tension, attention deficit, and discontentment. Most elderly (89.3%) decided not to relocate thinking they could still live at home, but they were concerned about the safety of their property. In regards to preparation for the flood, they prepared consumer goods, medication, and emergency kits. In addition, they kept abreast with news on television and public announcements in the community. They also helped clear the drainage system and prepared contact information of children, relatives, and government offices in case they needed assistance. Finally, to reduce possible damage to the property, they moved their belongings to high places, built sandbag walls, raised the house level, and prepared a water pump.Conclusion: The 2011 Thailand floods had adverse effects on physical and psychological health of the elderly people. To ensure better management for this vulnerable group, plans to respond to possible disasters need to be devised by relevant agencies to reduce flood-related health impacts.

AbstractAlthough environmental justice (EJ) research in the United States has traditionally focused on technological hazards such as air pollution or hazardous waste, the adverse and unequal impacts of Hurricane Katrina have prompted researchers to examine the EJ implications of natural events such as hurricanes and floods. This paper contributes to this emerging literature on EJ and social vulnerability to natural hazards by analyzing racial/ethnic and socioeconomic inequities in the distribution of flood risk exposure in the Miami Metropolitan Statistical Area (MSA), Florida—one of the most hurricane-prone areas in the world and one of the most ethnically and socioeconomically diverse MSAs in the United States. Although previous studies have relied exclusively on the 100-year floodplain to assess the spatial extent of flood exposure, this study makes a systematic distinction between different types of flood zones on the basis of both the probability (100-year versus 500-year versus low/no risk) of flood...

Carlisle in northwest England suffered its worse floods for more than 180 years in 2005. A study, reported here, was undertaken to assess the health and social impacts of these floods via in‐depth, taped individual and focus‐group interviews with people whose homes had been flooded and with agency workers who helped them. Respondents spoke of physical health ailments, psychological stress, water health‐and‐safety issues related to the floods, and disputes with insurance and construction companies, which they felt had caused and exacerbated psychological health problems. Support workers also suffered from psychological stress. Furthermore, it was found that people had low expectations of a flood and were not prepared. The findings are presented in five sections covering flood risk awareness, water contamination issues, physical health, mental health, and impact on frontline support workers. The discussion focuses on the implications of the findings for policy and practice vis‐à‐vis psychological health provision, contamination issues, training and support for frontline support workers, matters relating to restoration, and preparation for flooding.

Cet article vise à partager les résultats préliminaires du projet de recherche « Les travailleuses sociales cinq ans après l’implantation de la réforme Barrette : standardisation de la pratique ou nouvelles normes locales des établissements? ». Ce projet de recherche a pour but de mieux comprendre la mise en oeuvre de la réforme du système de santé et des services sociaux de 2015 au Québec. De juin à décembre 2022, près de 60 personnes participantes ont accepté de répondre à un entretien semi-dirigé. La très grande majorité d’entre elles détiennent plus de dix ans d’expérience, ce qui permet de comprendre l’avant et l’après réforme Barrette et de saisir les effets de cette réforme sur les équipes de travail, mais aussi sur la prestation des services fournis à la population. L’analyse initiale des données met en lumière la poursuite, voire l’accentuation, de la perspective descendante (top down) du processus décisionnel, de la reddition de comptes par le biais de mesures quantitatives et de l’harmonisation des services s’illustrant en standardisation des pratiques, en dépit des particularités territoriales inhérentes aux différentes régions du Québec. Par rapport à notre recherche précédente, force est de constater que les méthodes de la nouvelle gestion publique se sont accentuées au sein du réseau de la santé et des services sociaux, qualifié de « maison des fous » par plusieurs personnes participantes.

Dans le cadre de la mise en œuvre du Plan d’action 2013-2020 sur les changements climatiques du Québec, le ministère de la Santé et des Services sociaux du Québec a mandaté l’Institut national de santé publique du Québec afin de mener une étude exploratoire portant sur les impacts psychosociaux vécus chez les travailleurs à la suite de quatre événements météorologiques extrêmes qui s’accentueront avec les changements climatiques, soit les vagues de chaleur, les inondations, les tempêtes et les feux de forêt. Cette étude exploratoire visait à examiner brièvement la littérature et les connaissances de différents acteurs-clés afin de proposer par la suite des projets de recherche plus importants et qui répondent aux besoins et aux enjeux des milieux de travail et de la santé publique au Québec. Elle a mis en évidence que les événements météorologiques extrêmes étudiés peuvent entraîner des impacts psychosociaux chez les travailleurs, mais les connaissances sur ces impacts varient grandement selon l’événement. Les impacts psychosociaux chez les travailleurs ont été plus documentés dans la littérature scientifique pour les tempêtes et l’ont été de façon moins importante pour les inondations et les feux de forêt et négligeable pour les vagues de chaleur. Les travailleurs des services de la première ligne (comme les intervenants municipaux, les policiers, les pompiers, et les professionnels de la santé qui interviennent auprès des sinistrés, le personnel des services de travaux publics, etc.) et les agriculteurs font partie des populations de travailleurs qui ont été les plus étudiées. Les impacts psychologiques négatifs comme de l’épuisement, de la fatigue, de la détresse psychologique, de l’anxiété, de la colère et de la tristesse ont été plus souvent rapportés dans la littérature que les impacts sociaux. Il existe des facteurs de risque organisationnels (ex. : surcharge de travail, le manque de formation, de ressources matérielles, de personnels disponibles) et personnels (ex. : le fait d’être sinistré, le manque de contact avec les membres de la famille), communs à plusieurs événements et types de travailleurs, et qui peuvent aggraver les impacts psychosociaux vécus chez les travailleurs. Il existe aussi des facteurs de protection (ex. : reconnaissance ou gratitude, résilience individuelle, soutien social et efficacité collective). Il est important de consulter des acteurs clés pour bonifier les connaissances de la littérature scientifique. Dans le cadre de cette étude, les consultations avec des acteurs clés ont permis d’identifier de nouveaux travailleurs vulnérables, d’en apprendre davantage sur les caractéristiques de certains événements météorologiques extrêmes et de réaliser que les impacts psychosociaux vécus à la suite de ceux-ci pouvaient être positifs. L’acquisition de connaissances sur les impacts psychosociaux vécus chez les travailleurs à la suite des inondations est un des sujets qui répond aux besoins et aux enjeux des milieux de travail et de la santé publique au Québec.<br/><br/>

Coastal socio-ecological systems are complex adaptive systems with nonlinear changing properties and multi-scale dynamics. They are influenced by unpredictable coastal hazards accentuated by the effects of climate change, and they can quickly be altered if critical thresholds are crossed. Additional pressures come from coastal activities and development, both of which attracting stakeholders with different perspectives and interests. While coastal defence measures (CDMs) have been implemented to mitigate coastal hazards for centuries, a lack of knowledge and tools available to make informed decision has led to coastal managers favouring the choice of seawalls or rock armours with little consideration for socio-ecological systems features, and stakeholders’ priorities. Though it is not currently widely applied in coastal zone management, multicriteria decision analysis (MCDA) is a tool that can be useful to facilitate decision making. PROMETHEE, an outranking method, was chosen to support the multicriteria decision analysis for the evaluation of CDMs in the context of four study sites characterized by distinct environmental features. The aim was to determine the relevance and benefits of a MCDA by integrating coastal zone stakeholders in a participatory decision-making process in order to select CDMs that are better adapted to the whole socio-ecological system. First, in a series of five workshops, stakeholders were asked to identify and weigh criteria that were relevant to their local conditions. Second and third, CDMs were evaluated in relation to each criterion within the local context, then, hierarchized. Initial results show that vegetation came first in three of the four sites, while rock armour ranked first in the fourth site. A post-evaluation of the participatory process indicated that the weighting phase is an effective way to integrate local knowledge into the decision-making process, but the identification of criteria could be streamlined by the presentation of a predefined list from which participants could make a selection. This would ensure criteria that are standardized, and in a format that is compatible with the MCDA. Coupled with a participatory process MCDA proved to be a flexible methodology that can synthetize multiple aspects of the problem, and contribute in a meaningful way to the coastal engineering and management decision-making process.

The environmental management literature suggests that resilience is key to managing complex systems and reducing vulnerability resulting from uncertainty and unexpected change. Yet, flood risk management (FRM) has emerged largely from a culture of resistance. This paper takes the pulse of the current state of FRM research, with a focus on how the scholarly community has approached governance for flood resilience. Our analysis of the FRM journal literature identified 258 articles addressing governance and flooding, resilience and adaptation. Five main research themes emerged from these articles, addressing a variety of issues, but mostly lacking the degree of integration needed to address the social‐ecological complexity of FRM. Overall, research supporting the governance of FRM for resilience lacks integration, and methods of mitigating this lack of integration are poorly studied. We conclude with a discussion about the nature and scope of FRM research for resilience, and identify opportunities for more integrative FRM research that is more tightly coupled with policy and practice.

Cette stratégie oriente les activités scientifiques d'Environnement et Changement climatique Canada afin de favoriser un avenir plus vert et plus durable. Elle met l'accent sur nos gens, nos valeurs et nos priorités tournées vers l'avenir en tant que ministère fédéral à vocation scientifique.