Climate change projections and public health systems: Building evidence-informed connections

Factors Leading Municipal Authorities to Implement Preventive Interventions for Lyme Disease

The aim of this study is to document climate change adaptation interventions targeting Lyme disease at the municipal level in the province of Quebec (Canada). This exploratory study relies on the theory of planned behavior and certain constructs from the health belief model to identify the factors leading municipal authorities to implement preventive interventions for Lyme disease (PILD). Data were obtained from an online survey sent, during the summer of 2018, to municipal officers in 820 municipalities in Quebec, in all health regions where the population is at risk of contracting Lyme disease (response rate = 36%). The questionnaire was used to measure the implementation of PILD, the intention to implement these interventions, attitudes, perceived social pressure, perceived control (levers and barriers) over interventions, perceived effectiveness of preventive measures, risk, and perceived vulnerability. Results of structural equation analyses showed that attitudes were significantly associated with municipal authorities' intention to implement PILD, while the intention to implement PILD was a significant predictor of the implementation of PILD. Additional analyses showed that perceived barriers added a moderating effect in the intention-implementation relationship. The prediction of behaviors or practices that municipal authorities could implement to prevent Lyme disease will enable the evaluation over time of the evolution of Quebec municipalities' adaptation to Lyme disease. Moreover, the examination of the associations of specific psychosocial factors revealed important implications for the design of effective behavior-change interventions, which would allow health officials doing awareness work to create personalized interventions better suited to municipal officers and their specific contexts.

Why should public health agencies across Canada conduct climate change and health vulnerability assessments?

Climate change is increasingly impacting population health outcomes related to several areas of public health service delivery across Canada, and internationally. As a result, public health practitioners are increasingly looking for guidance on how to begin planning for and adapting to a myriad of health-related climate impacts. This paper outlines several benefits for local or regional health agencies in conducting climate change and health vulnerability assessments (CCHVAs), based on the author's experience in conducting two of Canada's first comprehensive assessments. These benefits include, but are not limited to establishing suitable baseline understandings of past, present, and future climate-related health risks; providing guidance on mechanisms to reduce health inequities that may be exacerbated by climate change; generating credibility for health agencies to engage with climate change and pursue collaborative, intersectoral relationships with a range of likely and unlikely allies; identifying suitable, cost-effective adaptation options in the form of public health programming; and encouraging decision-makers to produce proactive policy actions to redress potential climate impacts on population health. Completing a CCHVA can directly optimize health agencies' and their allies' efforts to respond to the health imperatives associated with climate change, while also fueling adaptation options that yield co-benefits across a variety of sectors.