Temperature and place associations with Inuit mental health in the context of climate change

• Published in: Environmental research 2021-07, Vol.198, p.111166, Article 111166
• Main Authors: Middleton, Jacqueline, Cunsolo, Ashlee, Pollock, Nathaniel, Jones-Bitton, Andria, Wood, Michele, Shiwak, Inez, Flowers, Charlie, Harper, Sherilee L.
• Format: Article
• Language: English
• Subjects: Climate change; Inuit; Mental health; Place; Temperature
• ISSN: 0013-9351; 1096-0953
• DOI: 10.1016/j.envres.2021.111166

Climate change has important implications for mental health globally. Yet, few studies have quantified the magnitude and direction of associations between weather and mental health-related factors, or assessed the geographical distribution of associations, particularly in areas experiencing rapid climatic change. This study examined the associations between air temperature variables and mental health-related community clinic visits across Nunatsiavut, Labrador, Canada, and the place-specific attributes of these associations. Daily de-identified community clinic visit data were collected from the provincial electronic health recording system and linked to historical weather data (2012–2018). A multilevel, multivariable negative binomial regression model was fit to investigate associations between temperature variables and mental health-related community clinic visits across the region, adjusting for seasonality as a fixed effect and community as a random effect. A multivariable negative binomial model was then fit for each Nunatsiavut community, adjusting for seasonality. Mental health-related visits contributed to 2.4% of all 228,104 visit types across the study period; this proportion ranged from 0.6% to 11.3% based on community and year. Regionally, the incidence rate of mental health-related community clinic visits was greater after two weeks of warm average (i.e. above -5ᵒC) temperatures compared to temperatures below -5ᵒC (IRR-5≤5ᵒC = 1.47, 95% CI = 1.21–1.78; IRR6≤15ᵒC = 2.24, 95% CI = 1.66–3.03; IRR>15ᵒC = 1.73, 95% CI = 1.02–2.94), and the incidence rate of mental health-related clinic visits was lower when the number of consecutive days within −5 to 5ᵒC ranges (i.e. temperatures considered to be critical to land use) increased (IRR = 0.96; 95% CI = 0.94–0.99), adjusting for seasonal and community effects. Community-specific models, however, revealed that no two communities had the same association between meteorological conditions and the incidence rate of daily mental health-related visits. Regionally, longer periods of warm temperatures may burden existing healthcare resources and shorter periods of temperatures critical to land use (i.e. −5 to 5ᵒC) may present enjoyable or opportunistic conditions to access community and land-based resources. The heterogeneity found in temperature and mental health-related clinic visits associations across Nunatsiavut communities demonstrates that place quantitatively matters in the context of Inuit mental heal