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This study aimed at evaluating the efficacy of an online CBT intervention with limited therapist contact targeting a range of posttraumatic symptoms among evacuees from the 2016 Fort McMurray wildfires. One hundred and thirty-six residents of Fort McMurray who reported either moderate PTSD symptoms (PCL-5 ≥ 23) or mild PTSD symptoms (PCL-5 ≥ 10) with moderate depression (PHQ-9 ≥ 10) or subthreshold insomnia symptoms (ISI ≥ 8) were randomized either to a treatment (n = 69) or a waitlist condition (n = 67). Participants were on average 45 years old, and mostly identified as White (82%) and as women (76%). Primary outcomes were PTSD, depression, and insomnia symptoms. Secondary outcomes were anxiety symptoms and disability. Significant Assessment Time × Treatment Condition interactions were observed on all outcomes, indicating that access to the treatment led to a decrease in posttraumatic stress (F[1,117.04] = 12.128, p = .001; d = .519, 95% CI = .142–.895), depression (F[1,118.29] = 9.978, p = .002; d = .519, 95% CI = .141–.898) insomnia (F[1,117.60] = 4.574, p = .035; d = .512, 95% CI = .132–.892), and anxiety (F[1,119.64] = 5.465, p = .021; d = .421, 95% CI = .044–.797) symptom severity and disability (F[1,111.55] = 7.015, p = .009; d = .582, 95% CI = .200–.963). Larger effect sizes (d = 0.823–1.075) were observed in participants who completed at least half of the treatment. The RESILIENT online treatment platform was successful to provide access to specialized evidence-based mental health care after a disaster.

Studies show associations between prenatal maternal stress (PNMS) and child autism, with little attention paid to PNMS and autism in young adulthood. The broad autism phenotype (BAP), encompassing sub-clinical levels of autism, includes aloof personality, pragmatic language impairment and rigid personality. It remains unclear whether different aspects of PNMS explain variance in different BAP domains in young adult offspring. We recruited women who were pregnant during, or within 3 months of, the 1998 Quebec ice storm crisis, and assessed three aspects of their stress (i.e., objective hardship, subjective distress and cognitive appraisal). At age 19, the young adult offspring (n = 33, 22F / 11M) completed a BAP self-report. Linear and logistic regressions were implemented to examine associations between PNMS and BAP traits. Up to 21.4% of the variance in BAP total score and in BAP three domains tended to be explained by at least one aspect of maternal stress, For example, 16.8% of the variance in aloof personality tended to be explained by maternal objective hardship; 15.1% of the variance in pragmatic language impairment tended to be explained by maternal subjective distress; 20.0% of the variance in rigid personality tended to be explained by maternal objective hardship and 14.3% by maternal cognitive appraisal. Given the small sample size, the results should be interpreted with caution. In conclusion, this small prospective study suggests that different aspects of maternal stress could have differential effects on different components of BAP traits in young adults.

Abstract Studies have shown that prenatal maternal stress (PNMS) affects brain structure and function in childhood. However, less research has examined whether PNMS effects on brain structure and function extend to young adulthood. We recruited women who were pregnant during or within 3 months following the 1998 Quebec ice storm, assessed their PNMS, and prospectively followed‐up their children. T1‐weighted magnetic resonance imaging (MRI) and resting‐state functional MRI were obtained from 19‐year‐old young adults with ( n  = 39) and without ( n  = 65) prenatal exposure to the ice storm. We examined between‐group differences in gray matter volume (GMV), surface area (SA), and cortical thickness (CT). We used the brain regions showing between‐group GMV differences as seeds to compare between‐group functional connectivity. Within the Ice Storm group, we examined (1) associations between PNMS and the atypical GMV, SA, CT, and functional connectivity, and (2) moderation by timing of exposure. Primarily, we found that, compared to Controls, the Ice Storm youth had larger GMV and higher functional connectivity of the anterior cingulate cortex, the precuneus, the left occipital pole, and the right hippocampus; they also had larger CT, but not SA, of the left occipital pole. Within the Ice Storm group, maternal subjective distress during preconception and mid‐to‐late pregnancy was associated with atypical left occipital pole CT. These results suggest the long‐lasting impact of disaster‐related PNMS on child brain structure and functional connectivity. Our study also indicates timing‐specific effects of the subjective aspect of PNMS on occipital thickness.

The climate crisis not only has significant impacts on biodiversity and the physical health of humans, but its ramifications are also affecting people’s mental health. Eco-anxiety, or the emotions that emerge with the awareness of climate change and the apprehension of its detrimental effects, has been investigated in adults and adolescents, but much less attention has been given to the impacts on children’s mental health and well-being. Initial evidence confirms that youth are significantly concerned about climate change, but few studies have investigated the resulting emotional responses of children and the role of their parents in tempering these, especially using qualitative methodologies. The present study used a descriptive qualitative design with a convenience sample of parents and child dyads, assessed separately. Children’s ( n = 15, ages 8–12 years) experiences were explored using semi-structured interviews and their parents’ ( n = 12) perceptions were captured using a survey with closed and open-ended questions. A reflexive thematic analysis was used to analyze the interview data, and content analysis was used to investigate parent-child experiences. Three themes emerged from the thematic analysis: 1. children’s understanding of climate change, 2. their emotional reaction to climate change, and 3. their coping mechanisms to deal with these emotions. The comparative content analysis revealed that parents who were aware that their children had concerns about climate change, had children who used more adaptive coping mechanisms. The results of this qualitative study contribute to a better understanding of children’s emotional experience of the awareness of climate change in Canada and how they cope with these emotions. Furthermore, the results provide insight into the role parents might play in helping their children cope with their feelings.

Prenatal stress alters fetal programming, potentially predisposing the ensuing offspring to long-term adverse health outcomes. To gain insight into environmental influences on fetal development, this QF2011 study evaluated the urinary metabolomes of 4-year-old children (n = 89) who were exposed to the 2011 Queensland flood in utero. Proton nuclear magnetic resonance spectroscopy was used to analyze urinary metabolic fingerprints based on maternal levels of objective hardship and subjective distress resulting from the natural disaster. In both males and females, differences were observed between high and low levels of maternal objective hardship and maternal subjective distress groups. Greater prenatal stress exposure was associated with alterations in metabolites associated with protein synthesis, energy metabolism, and carbohydrate metabolism. These alterations suggest profound changes in oxidative and antioxidative pathways that may indicate a higher risk for chronic non-communicable diseases such obesity, insulin resistance, and diabetes, as well as mental illnesses, including depression and schizophrenia. Thus, prenatal stress-associated metabolic biomarkers may provide early predictors of lifetime health trajectories, and potentially serve as prognostic markers for therapeutic strategies in mitigating adverse health outcomes.

Abstract Background The Canadian government’s response to the ongoing COVID-19 pandemic included the implementation of several restrictive measures since March 2020. These actions sought to decrease social contact and increase physical distancing, including that within universities. Such constraints were required to impede the transmission of the virus; however, concerns remain about their impact on the sexual and intimate relationships of university employees and students. Aim This study examined the associations between COVID-19–related stress and sexual frequency, sexual satisfaction, and relationship satisfaction, also testing the mediating role of psychological distress. Methods The models were tested with Canadian data collected from university employees and students in 2 phases: the first wave in April-May 2020 (T1; n = 2754) and the second wave in November-December 2021 (T2; n = 1430), 18 months afterward. Participants completed self-report questionnaires online. Path analyses were performed to test the associations of the mediation models. Outcomes The principal outcomes included psychological distress determined via the Patient Health Questionnaire–4, relationship satisfaction measured via the Dyadic Adjustment Scale, and sexual satisfaction and sexual frequency ascertained through a single item each. Results Overall, COVID-19–related stress was associated with higher psychological distress, which in turn was related to lower sexual frequency, sexual satisfaction, and relationship satisfaction. Similar results were obtained with T1 and T2 data, indicating the mediating effect of psychological distress. Clinical Implications These findings increase scholarly comprehension of the negative associations between stress/distress and sexual and romantic relationships. Sexuality and close relationships are vital to the quality of human life; thus, targeted interventions should be developed to reduce COVID-19–related stress and its impact on sexual and romantic relationships to mitigate the long-term influences of this unique global challenge. Strengths and Limitations To our knowledge, this study is the first to use a large sample size and replicate findings in 2 waves. Nonetheless, it is limited by the use of cross-sectional data. Longitudinal studies with the same participants are mandated to better understand the evolution of these outcomes. Conclusion COVID-19–related stress and psychological distress were found among participating university students and employees and were associated with lower sexual satisfaction, sexual frequency, and intimate relationship satisfaction. These results were observed at the early onset of the pandemic and 18 months afterward, suggesting that the stress generated by the pandemic were not mere reactions to the onset of the pandemic but persisted over time.

ABSTRACT Large-scale disasters can disproportionately impact different population groups, causing prominent disparity and inequality, especially for the vulnerable and marginalized. Here, we investigate the resilience of human mobility under the disturbance of the unprecedented ‘720’ Zhengzhou flood in China in 2021 using records of 1.32 billion mobile phone signaling generated by 4.35 million people. We find that although pluvial floods can trigger mobility reductions, the overall structural dynamics of mobility networks remain relatively stable. We also find that the low levels of mobility resilience in female, adolescent and older adult groups are mainly due to their insufficient capabilities to maintain business-as-usual travel frequency during the flood. Most importantly, we reveal three types of counter-intuitive, yet widely existing, resilience patterns of human mobility (namely, ‘reverse bathtub’, ‘ever-increasing’ and ‘ever-decreasing’ patterns), and demonstrate a universal mechanism of disaster-avoidance response by further corroborating that those abnormal resilience patterns are not associated with people’s gender or age. In view of the common association between travel behaviors and travelers’ socio-demographic characteristics, our findings provide a caveat for scholars when disclosing disparities in human travel behaviors during flood-induced emergencies.

Government employees, municipal officials, and communities in South Africa have grappled with post-apartheid environmental challenges, such as floods, droughts, severe storms, and wildfires. These disasters are a result of both natural and human activities. The government implemented different policies and strategies after 1994 to address these issues. While acknowledging some success in managing these disasters with the current adaptive measures, the frequency and intensity of disasters have increased, causing significant damage to life and property, particularly among the vulnerable population. This paper uses qualitative and quantitative data collection approaches to explore possible systematic and structural weaknesses in addressing post-disaster situations in South Africa. Floods appear to be the most frequent natural disaster in South Africa. The paper uncovered the fact that disaster management is a multi-sectoral and multidisciplinary field. Although various institutional arrangements exist, they do not seem appropriate for assisting vulnerable groups. While officials have made some progress in implementing post-disaster projects, challenges still hinder sustainability. Furthermore, regrettably, despite the level of success in addressing disasters, most measures have failed to achieve the intended results for a variety of reasons. The consolidated long-term measures suggested by the participants yielded a proposed ‘South African Floods Post-Disaster Checklist or Model’, which was non-existent in South Africa. By implementing more effective and efficient post-disaster measures, the proposed tool can help policymakers and strategic partners standardise post-disaster resilience and adaptive capacity in various sectors’ sustainability contexts.

Abstract Watershed resilience is the ability of a watershed to maintain its characteristic system state while concurrently resisting, adapting to, and reorganizing after hydrological (for example, drought, flooding) or biogeochemical (for example, excessive nutrient) disturbances. Vulnerable waters include non-floodplain wetlands and headwater streams, abundant watershed components representing the most distal extent of the freshwater aquatic network. Vulnerable waters are hydrologically dynamic and biogeochemically reactive aquatic systems, storing, processing, and releasing water and entrained (that is, dissolved and particulate) materials along expanding and contracting aquatic networks. The hydrological and biogeochemical functions emerging from these processes affect the magnitude, frequency, timing, duration, storage, and rate of change of material and energy fluxes among watershed components and to downstream waters, thereby maintaining watershed states and imparting watershed resilience. We present here a conceptual framework for understanding how vulnerable waters confer watershed resilience. We demonstrate how individual and cumulative vulnerable-water modifications (for example, reduced extent, altered connectivity) affect watershed-scale hydrological and biogeochemical disturbance response and recovery, which decreases watershed resilience and can trigger transitions across thresholds to alternative watershed states (for example, states conducive to increased flood frequency or nutrient concentrations). We subsequently describe how resilient watersheds require spatial heterogeneity and temporal variability in hydrological and biogeochemical interactions between terrestrial systems and down-gradient waters, which necessitates attention to the conservation and restoration of vulnerable waters and their downstream connectivity gradients. To conclude, we provide actionable principles for resilient watersheds and articulate research needs to further watershed resilience science and vulnerable-water management.

Abstract Objective Despite Canada being an important energy producer, not all Canadians can access or afford adequate levels of energy services at home to meet their needs, maintain healthy indoor temperatures, and live a decent life—a situation known as energy poverty. Depending on the measure, 6–19% of Canadian households face energy poverty. Health risks associated with energy poverty are documented in countries with milder climates. This study explores, for the first time in the Canadian context, the association between energy poverty and health. Methods Cross-sectional data are from the 2018 Canadian Housing Survey. Analyses are conducted on a sample weighted to represent 14 million Canadian households. The associations between expenditure-based and self-reported measures of energy poverty and self-rated general and mental health were assessed using logistic regression models, adjusted for potential confounding variables. Results The odds of rating one’s general (OR: 1.48; 95%CI: 1.29, 1.70) and mental (OR: 1.21; 1.04, 1.41) health as poor are significantly higher for Canadian adults in households with a high share of energy expenditure to income. The likelihood of poor general and mental health was significantly higher for those dissatisfied with the energy efficiency of their dwelling, and with their ability to maintain a comfortable temperature both in the winter and in the summer. Conclusion Exposure to energy poverty is associated with significantly increased likelihood of poor general and mental health. Given the high proportion of Canadian households facing energy poverty, with demonstrated implications for population health, tackling energy poverty is essential for an equitable energy transition and for climate resilience. , Résumé Objectif Bien que le Canada soit un important producteur d’énergie, entre 6 % et 19 % des ménages canadiens, selon la mesure retenue, sont en précarité énergétique, une situation qui survient lorsqu’un ménage n’a pas les moyens ou l’accès à des services énergétiques résidentiels adéquats pour maintenir une température ambiante confortable, répondre à ses besoins et vivre dans la dignité. Les risques socio-sanitaires associés à la précarité énergétique sont documentés dans des pays au climat tempéré. Cette étude explore, pour la première fois dans le contexte canadien, l’association entre la précarité énergétique et la santé. Méthodes Les données transversales proviennent de l’Enquête canadienne sur le logement de 2018. Les associations entre différentes mesures de précarité énergétique (mesures basées sur les dépenses des ménages et auto-rapportées) et la santé générale et mentale perçue sont estimées à l’aide de modèles de régression logistique ajustés pour des variables de confusion potentielles. Les analyses sont réalisées sur un échantillon pondéré pour représenter 14 millions de ménages. Résultats Les probabilités de déclarer une mauvaise santé générale (OR : 1,48; IC95% : 1,29-1,70) et mentale (OR : 1,21; 1,04-1,41) sont significativement plus élevées pour les adultes canadiens dont le ménage consacre une part importante de son revenu aux coûts énergétiques. Elles sont aussi significativement plus élevées pour ceux qui déclarent être insatisfaits avec l’efficacité énergétique de leur logement et de leur capacité à maintenir une température confortable en hiver et en été. Conclusion Vivre en situation de précarité énergétique est associée à des probabilités accrues de déclarer une mauvaise santé générale et mentale chez les adultes canadiens. En raison de la proportion élevée de ménages canadiens confrontés à la précarité énergétique et des effets socio-sanitaires que cette situation engendre, lutter contre la précarité énergétique est essentiel pour une transition énergétique équitable et pour la résilience climatique.

Abstract Background Climate change (CC) adaptation is considered a priority for Caribbean Small Islands Developing States (SIDS), as these territories and communities are considered particularly vulnerable to climate-related events. The primary health care (PHC) system is an important actor in contributing to climate change adaptation. However, knowledge on how PHC is prepared for CC in Caribbean SIDS is very limited. The objective of this paper is to discuss health adaptation to climate change focusing on the PHC system. Methods We explored the perspectives of PHC professionals in Dominica on climate change. Focus group discussions (FGDs) were conducted in each of the seven health districts in Dominica, a Caribbean SIDS, between November 2021 and January 2022. The semi-structured interview guide was based on the Essential Public Health Functions: assessment, access to health care services, policy development and resource allocation. Data coding was organized accordingly. Results Findings suggest that health care providers perceive climate change as contributing to an increase in NCDs and mental health problems. Climate-related events create barriers to care and exacerbate the chronic deficiencies within the health system, especially in the absence of high-level policy support. Healthcare providers need to take a holistic view of health and act accordingly in terms of disease prevention and health promotion, epidemiological surveillance, and ensuring the widest possible access to health care, with a particular focus on the ecological and social determinants of vulnerability. Conclusion The Primary Health Care system should be a key actor in designing and operationalizing adaptation and transformative resilience. The Essential Public Health Functions should integrate social and climate and ecological determinants of health to guide primary care activities to protect the health of communities. This indicates a need for improved research on the linkages between climate events and health outcomes, surveillance, and development of plans that are guided by contextual knowledge in the SIDS.

With the advent of the COVID-19 pandemic, in-person social interactions and opportunities for accessing resources that sustain health and well-being have drastically reduced. We therefore designed the pan-Canadian prospective COVID-19: HEalth and Social Inequities across Neighbourhoods (COHESION) cohort to provide a deeper understanding of how the COVID-19 pandemic context affects mental health and well-being, key determinants of health, and health inequities.

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.