Pathways to strengthen the climate resilience of health systems in the Peruvian Amazon by working with Indigenous leaders, communities and health officers.

Background: Indigenous knowledge and responses were implemented during the COVID-19 pandemic to protect health, showcasing how Indigenous communities participation in health systems could be a pathway to increase resilience to emergent hazards like climate change. This study aimed to inform efforts to enhance climate change resilience in a health context by: (1) examining if and how adaptation to climate change is taking place within health systems in the Peruvian Amazon, (2) understanding how Indigenous communities and leaders' responses to climatic hazards are being articulated within the official health system and (3) to provide recommendations to increase the climate change resilience of Amazon health systems.

Methods: This study was conducted among two Peruvian Amazon healthcare networks in Junin and Loreto regions.

Monitoring climate change vulnerability in the Himalayas.

Longitudinal assessment of climate vulnerability is essential for understanding the complex factors affecting how people experience and respond to climate change. We report on the first longitudinal assessment of climate vulnerability in the Himalayan region, exploring the evolving landscape, perceptions, and experiences of communities of climate change impacts, vulnerability, and adaptation in Kashmir over an 8-year period from 2017 to 2024. We provide the Himalayan Re-study Framework (HRF) to monitor, characterise, and conceptualise climate change in the Himalayas.

Diarrheal disease and associations with water access and sanitation in Indigenous Shawi children along the Armanayacu River basin in Peru.

Introduction: Diarrheal disease, particularly in children under 5 years old, remains a global health challenge due to its high prevalence and chronic health consequences. Public health interventions that reduce diarrheal disease risk include improving access to water, sanitation, and hygiene. Although Peru achieved the 2015 Millennium Development Goal (MDG) indicators for water access, less progress was achieved on sanitation.

Policy responses to COVID-19 in Sri Lanka and the consideration of Indigenous Peoples.

COVID-19 has had uneven impacts on health and well-being, with Indigenous communities in the Global South facing some of the highest risks. Focusing on the experience of Sri Lanka, this study identifies key policy responses to COVID-19, documents how they evolved over two years of the pandemic, and examines if and how government responses have addressed issues pertaining to Indigenous Peoples. Drawing upon an analysis of policy documents (n = 110) and interviews with policymakers (n = 20), we characterize seven key policy responses implemented by the Sri Lankan government: i) testing for and identifying COVID-19; ii) quarantine procedures; iii) provisional clinical treatments; iv) handling other diseases during COVID-19; v) movement; vi) guidelines to be adhered to by the general public; and vii) health and vaccination.

Indigenous peoples and the COVID-19 pandemic: a systematic scoping review.

Past influenza pandemics including the Spanish flu and H1N1 have disproportionately affected Indigenous Peoples. We conducted a systematic scoping review to provide an overview of the state of understanding of the experience of Indigenous peoples during the first 18 months of the COVID-19 pandemic, in doing so we capture the state of knowledge available to governments and decision makers for addressing the needs of Indigenous peoples in these early months of the pandemic. We addressed three questions: (a) How is COVID-19 impacting the health and livelihoods of Indigenous peoples, (b) What system level challenges are Indigenous peoples experiencing, (c) How are Indigenous peoples responding? We searched Web of Science, Scopus, and PubMed databases and UN organization websites for publications about Indigenous peoples and COVID-19.

Interactions between climate and COVID-19.

In this Personal View, we explain the ways that climatic risks affect the transmission, perception, response, and lived experience of COVID-19. First, temperature, wind, and humidity influence the transmission of COVID-19 in ways not fully understood, although non-climatic factors appear more important than climatic factors in explaining disease transmission. Second, climatic extremes coinciding with COVID-19 have affected disease exposure, increased susceptibility of people to COVID-19, compromised emergency responses, and reduced health system resilience to multiple stresses.

Sea level rise risks and societal adaptation benefits in low-lying coastal areas.

Sea level rise (SLR) will increase adaptation needs along low-lying coasts worldwide. Despite centuries of experience with coastal risk, knowledge about the effectiveness and feasibility of societal adaptation on the scale required in a warmer world remains limited. This paper contrasts end-century SLR risks under two warming and two adaptation scenarios, for four coastal settlement archetypes (Urban Atoll Islands, Arctic Communities, Large Tropical Agricultural Deltas, Resource-Rich Cities).

Monitoring the dynamic vulnerability of an Arctic subsistence food system to climate change: The case of Ulukhaktok, NT.

Vulnerability to climate change is highly dynamic, varying between and within communities over different timescales. This paper draws upon complex adaptive systems thinking to develop an approach for capturing, understanding, and monitoring climate vulnerability in a case study from northern Canada, focusing on Inuit food systems. In the community of Ulukhaktok, Northwest Territories, we followed 10 hunters over a 2-year period, asking them to document their harvesting activities and discuss their lived experience of harvesting under changing environmental and societal conditions.

The effects on public health of climate change adaptation responses: a systematic review of evidence from low- and middle-income countries.

Climate change adaptation responses are being developed and delivered in many parts of the world in the absence of detailed knowledge of their effects on public health. Here we present the results of a systematic review of peer-reviewed literature reporting the effects on health of climate change adaptation responses in low- and middle-income countries (LMICs). The review used the 'Global Adaptation Mapping Initiative' database (comprising 1682 publications related to climate change adaptation responses) that was constructed through systematic literature searches in Scopus, Web of Science and Google Scholar (2013-2020).

Seasonality, climate change, and food security during pregnancy among Indigenous and non-Indigenous women in rural Uganda: Implications for maternal-infant health.

Background: Climate change is expected to decrease food security globally. Many Indigenous communities have heightened sensitivity to climate change and food insecurity for multifactorial reasons including close relationships with the local environment and socioeconomic inequities which increase exposures and challenge adaptation to climate change. Pregnant women have additional sensitivity to food insecurity, as antenatal undernutrition is linked with poor maternal-infant health.

Sewing and Inuit women's health in the Canadian Arctic.

Traditional Inuit cultural values and practices are integral to an Inuit understanding of health. We examine the role of sewing in Inuit women's health in the Canadian Arctic in a case study of Ulukhaktok, Northwest Territories, Canada. An analysis of data collected using semi-structured interviews with 30 Inuit women reveals that sewing contributes to participant's health and the collective health of the community in several ways including: pride and sense of accomplishment; cultural identity; relaxation, decompression, and socialization; and spirituality and healing.

Participatory Modeling of Water Vulnerability in Remote Alaskan Households Using Causal Loop Diagrams.

Despite perceptions of high water availability, adequate access to sufficient water resources remains a major challenge in Alaska. This paper uses a participatory modeling approach to investigate household water vulnerability in remote Alaska and to examine factors that affect water availability and water access. Specifically, the work asks: how do water policy stakeholders conceptualize the key processes that affect household water vulnerability in the context of rural Alaska? Fourteen water policy stakeholders participated in the modeling process, which included defining the problem of household water vulnerability and constructing individual causal loop diagrams (CLDs) that represent their conceptualization of household water vulnerability.

Climate change and community fisheries in the arctic: A case study from Pangnirtung, Canada.

Coastal fishery systems in the Arctic are undergoing rapid change. This paper examines the ways in which Inuit fishers experience and respond to such change, using a case study from Pangnirtung, Canada. The work is based on over two years of fieldwork, during which semi-structured interviews (n = 62), focus group discussions (n = 6, 31 participants) and key informant interviews (n = 25) were conducted.

Evaluating the effectiveness of hazard mapping as climate change adaptation for community planning in degrading permafrost terrain.

Permafrost in northern Canada is susceptible to degradation due to rapid climate change, with hazard mapping promoted as an important activity to guide sustainable community adaptation and planning. This paper presents a framework for evaluating permafrost mapping exercises designed to inform climate change adaptation actions. We apply the framework using a case study of the Incorporating Climate Change into Land Development-Terrain Analysis project (ICCiLD).

An integrative climate change vulnerability index for Arctic aviation and marine transportation.

Climate change vulnerability research methods are often divergent, drawing from siloed biophysical risk approaches or social-contextual frameworks, lacking methods for integrative approaches. This substantial gap has been noted by scientists, policymakers and communities, inhibiting decision-makers' capacity to implement adaptation policies responsive to both physical risks and social sensitivities. Aiming to contribute to the growing literature on integrated vulnerability approaches, we conceptualize and translate new integrative theoretical insights of vulnerability research to a scalable quantitative method.

The Impacts of Climate and Social Changes on Cloudberry (Bakeapple) Picking: a Case Study from Southeastern Labrador.

The traditional subsistence activities of Indigenous communities in Canada's subarctic are being affected by the impacts of climate change, compounding the effects of social, economic and political changes. Most research has focused on hunting and fishing activities, overlooking berry picking as an important socio-cultural activity and contributor to the diversity of food systems. We examined the vulnerability of cloudberry (referred to as 'bakeapple' consistent with local terminology) picking to environmental changes in the community of Cartwright, Labrador using semi-structured interviews ( = 18), field surveys, and satellite imagery.

What role can unmanned aerial vehicles play in emergency response in the Arctic: A case study from Canada.

This paper examines search and rescue and backcountry medical response constraints in the Canadian Arctic and potential for unmanned aerial vehicles (UAV) to aid in response and preparedness. Semi-structured interviews (n = 18) were conducted with search and rescue responders, Elders, and emergency management officials to collect data on current emergency response and potential for UAV use. UAV test flights (n = 17) were undertaken with community members.

Enabling local public health adaptation to climate change.

Local public health authorities often lack the capacity to adapt to climate change, despite being on the 'front lines' of climate impacts. Upper-level governments are well positioned to create an enabling environment for adaptation and build local public health authorities' capacity, yet adaptation literature has not specified how upper-level governments can build local-level adaptive capacity. In this paper we examine how federal and regional governments can contribute to enabling and supporting public health adaptation to climate change at the local level in federal systems.

How are perceptions associated with water consumption in Canadian Inuit? A cross-sectional survey in Rigolet, Labrador.

Concerns regarding the safety and aesthetic qualities of one's municipal drinking water supply are important factors influencing drinking water perceptions and consumption patterns (i.e. sources used and daily volume of consumption).

Water quality and health in northern Canada: stored drinking water and acute gastrointestinal illness in Labrador Inuit.

One of the highest self-reported incidence rates of acute gastrointestinal illness (AGI) in the global peer-reviewed literature occurs in Inuit communities in the Canadian Arctic. This high incidence of illness could be due, in part, to the consumption of contaminated water, as many northern communities face challenges related to the quality of municipal drinking water. Furthermore, many Inuit store drinking water in containers in the home, which could increase the risk of contamination between source and point-of-use (i.