Mental Health Impacts of Climate Change Among Vulnerable Populations Globally: An Integrative Review

Understanding the psychological impact of flooding on older adults: A scoping review

Flooding is increasing in frequency and intensity as a function of climate change. Older populations are vulnerable to the physical and mental health impacts of flooding, having less ability to cope and fewer rescue possibilities compared to younger ages, with resulting mental health impacts. This scoping review, based on JBI Scoping Review Methodology, scoped and summarized the evidence for the psychological impacts of flooding on older adults. Electronic databases were searched for reports of direct or indirect experiences of flooding in older adults globally (mental health, well-being, emotional outcomes). Ten articles across four continents were included. Risk of bias analysis found that 80% of articles were of weak and 20% were of moderate quality. Most studies focused on depression (70%), posttraumatic stress (60%), and anxiety (20%) as outcomes. Over half considered additional impacts and protective factors. This small but growing literature base demonstrates that climate-related flooding affects the mental health of older adults, with associations between flooding, depression, and posttraumatic stress. Poor social support contributes to worse mental health outcomes, suggesting that helpful interventions might focus on enhancing resilience through building social networks. All studies reviewed were from high-income countries; more research is required with countries with lower income.

Loneliness in Advanced Life-Threatening Illness: An Integrative Review

CONTEXT

To inform supportive interventions, experiences of loneliness must be understood specifically from the perspective of those with advanced life-threatening illness and their caregivers.

OBJECTIVES

To identify the causes, experiences, and impacts of loneliness among adults with advanced life-threatening illnesses and caregivers, and which modifiable factors might mitigate loneliness.

METHODS

Systematic searching of six databases (CINHAL, Web of science, Cochrane central, Medline, HMIC and Proquest) was supplemented by backward citation searching from Jan 2014-Jan2024. This was followed by screening and selection based on the PRISMA extension for scoping reviews (PRISMA-ScR) guidelines. Studies were imported into NVivo version 1.6 for data management. An inductive approach was used to facilitate the synthesis. Quality assessment with diverse studies (QuADS) was used. The review protocol was registered with Prospero, ID: CRD42023493999.

RESULTS

Ninteen observational studies and 6 intervention studies were included in this review. Evidence confirms that the causes, impacts and outcomes of loneliness are multifaceted and interact dynamically. Risk factors on a micro level include psychological and existential factors such as emotional distress and fear of death; potentially modifiable factors include efforts to enhance communication and befriending programs. On meso level physical and social factors are risk factors such as symptom burden and social withdrawal, potentially modifiable factors include utilizing technology to make home an accessible place to maintain social connections. On a macro level environmental and societal risk factors include mobility restrictions and stigma; potentially modifiable factors include increasing societal engagement through community programs CONCLUSION: This integrative review will help healthcare providers, policymakers and the public understand the causes, experiences and impact of loneliness in adults with advanced life-threatening illnesses and their caregivers. The evidence suggests that an integrated approach that combines personal, social, and systemic efforts is needed which includes enhanced communication, targeted interventions, robust support systems, and community engagement. Rigorous research studies are required which include patient and public involvement from inception to completion to ensure that the study designs and methodologies are purposeful for those they intend to serve.

Climate change and health in the Arctic

AIM

Adverse human-driven environmental change, including the climate, is having an increasing impact on the Arctic environment and its ecosystems. There has been immense interest in understanding the health risks related to climate change in the Arctic region. In this article, we review recent evidence related to climate change and its impacts on the health of the Arctic population.

METHODS

We summarize current evidence related to primary, secondary and tertiary health effects in the Arctic. We explore a broad range of effects on health including increased exposure to extreme weather, impacts from changes in water quality, air quality, contaminant exposure, food systems and patterns of infectious diseases. We also briefly discuss mental health effects in the Arctic. We conclude by examining further challenges and opportunities for research in this field and advocate the need for adaptation options in the Arctic.

RESULTS

We find that there is a large amount of literature that is focusing on the human health effects in the Arctic but there are still research gaps in terms of understanding these compared with those at lower latitudes. We point out the need for filling several of these knowledge gaps to project future health effects of climate change in the Arctic.

CONCLUSIONS

There is a need for integrated adaptation strategies in the Arctic that fully account for the health impacts and consider indigenous perspectives.

The prevalence and risk factors for post-traumatic stress disorder, depression and anxiety among older survivors post-earthquake: A systematic review and meta-analysis

BACKGROUND

The occurrence of PTSD, depression, and anxiety is notably high among older adults following an earthquake. This research aimed to assess the prevalence and determinants of mental health conditions among older survivors after an earthquake.

METHODS

The review was conducted in accordance with the PRISMA process. A comprehensive search was conducted across various databases including PubMed, EMBASE, Web of Science, Scopus, CINAHL, Cochrane Library, SinoMed, China National Knowledge Infrastructure (CNKI), the VIP Database for Chinese Technical Periodicals, and the Wan Fang Database for Chinese Periodicals for studies reporting on the prevalence of PTSD, depression, and anxiety among older survivors post-earthquake. Each database was searched from inception to August 1, 2023 each database, and updated the search on October 1, 2024. The random effects model was employed to conduct meta-analysis, and the I2 index was taken into account to evaluate heterogeneity among studies. A narrative synthesis was performed to identify the risk factors associated with these mental health conditions.

RESULTS

A total of 33 studies were analyzed in this meta-analysis, mainly from China, Japan, Nepal, and Mexico. The prevalence rates of PTSD, depression, and anxiety among older earthquake survivors were found to be 19.3 % (95 % CI [16.0-22.6 %]; I2 = 99.486 %, P = 0.000), 23.5 % (95 % CI [13.9-33.1 %]; I2 = 99.901 %, P = 0.000) and 10.9 % (95 % CI [6.7-15.1 %]; I2 = 99.287 %, P = 0.000), respectively. The identified major risk factors were categorized into four dimensions, including demographic variables (e.g., older age, chronic illness), pre-disaster mitigation variables (e.g., lack of insurance), responding in disaster variables (e.g., being injured, property damage) and post-disaster relief variables (e.g., inadequate psychological care, low levels of social/family support).

LIMITATIONS

The optimal cut-off for different screening tools may be sensitive to changes in the prevalence of older survivors post-earthquake. Furthermore, due to the heterogeneity of the studies, a narrative synthesis of risk factors was conducted.

CONCLUSIONS

The findings of this review may increase the awareness of the burden and risk factors associated with PTSD, depression, and anxiety in older survivors post-earthquake. It serves as a reference for the government in formulating recovery policies focusing on interventions, such as financial allocation, psychological treatment, and insurance claims. These policies aim to mitigate the long-term psychological effects on older survivors and ultimately lower the prevalence of mental health conditions.

An Overview of Climate Changes and Its Effects on Health: From Mechanisms to One Health

Human activities, primarily the burning of fossil fuels, widespread deforestation, soil erosion or machine-intensive farming methods, manufacturing, food processing, mining, construction, and the iron, cement, steel, and chemicals industries, have been the main drivers of the observed increase in Earth's average surface temperature and climate change. Rising global temperatures, extreme weather events, ecosystems disruption, agricultural impacts, water scarcity, problems in access to good quality water, food and housing, and profound environmental disruptions such as biodiversity loss and extreme pollution are expected to steeply increase the prevalence and severity of acute and chronic diseases. Its long-term effects cannot be adequately predicted or mitigated without a comprehensive understanding of the adaptive ecosystems. Studying the complex interaction between environmental aggressors and the resilient adaptive responses requires the exposomic and the One Health approaches. The problem is broad and affects the whole ecosystem, plants, pets, and animals in addition to humans. The central role of the epithelial barrier, microbiome, and diet as key pillars for an adaptive tolerogenic immune response should be explored for increasing resilience at the individual level. A radical change in mindset worldwide, with sustainable solutions and adaptive strategies and climate resilience and health equity policies at their center, should be achieved quickly through increased awareness based on solid scientific data.

Climate change anxiety and sleep problems in the older adults

OBJECTIVES

Climate change has an impact on the prevalence of insufficient sleep and sleep disorders. This study aimed to examine climate change anxiety and sleep problems in older adults individuals.

METHOD

This descriptive and cross-sectional study was carried out with 664 participants between July 9 and September 10, 2024. A Personal Information Form, the Climate Change Anxiety Scale, and the Insomnia Severity Index were used for data collection. In the data analysis, independent samples t-test and one-way analysis of variance were used to compare demographic variables with the climate change anxiety scale and insomnia severity index.

RESULTS

The mean age of the participants was 71.49 ± 6.21 years and more than half of the participants were female (54.4%). The mean score of the participants on the Climate Change Anxiety Scale was 1.68 ± 0.80 and their mean score on the Insomnia Severity Index was 12.56 ± 6.91. There was a positive correlation between the Climate Change Anxiety Scale and the Insomnia Severity Index (r = 0.26, p = 0.00). The insomnia variable explained 7% of the change in the Climate Change Anxiety score (R2 = 0.07, p = 0.00).

CONCLUSION

Older adults experience anxiety and sleep problems regarding climate change and sleep problems in older adults increase as climate change anxiety increases.

Climate change and suicide epidemiology: a systematic review and meta-analysis of gender variations in global suicide rates

Background

Climate change is reshaping public health, introducing extreme weather conditions and environmental stressors-such as high temperatures, atmospheric pollution, desertification, and storms (rain, thunder, and hail)-that critically impact mental health. Evidence increasingly links these factors to higher rates of suicide-related outcomes, including suicidal ideation, attempts, and self-harm. Such interactions underscore the importance of understanding how climate-driven mental health risks vary by environmental factor and gender, as gender-specific vulnerabilities shape responses to climate stressors.

Methods

By April 16, 2024, we conducted a comprehensive search of PubMed, Web of Science, Cochrane Library, PsycINFO, Scopus, ProQuest, and Embase. Two researchers independently reviewed studies and collected demographic data, systematically tracking and recording rates of suicidal ideation, suicide attempts, suicide deaths, self-harm, and anxiety. Data were rigorously cross-verified for accuracy and consistency.

Results

The meta-analysis demonstrated significant associations between climate change variables and mental health outcomes. High temperatures and air pollution were linked to increased suicide attempts (OR: 1.40, 95% CI: 1.34-1.45) and suicide deaths (OR: 1.51, 95% CI: 1.44-1.58), particularly among males. Conversely, atmospheric pollution and desertification correlated with a reduced likelihood of suicidal ideation (OR: 0.73, 95% CI: 0.63-0.85). These findings highlight gender-specific mental health impacts, with females exhibiting higher rates of anxiety and self-harm, underscoring the urgent need for targeted interventions addressing climate-induced mental health risks.

Conclusions

This systematic review and meta-analysis reveal significant gender-specific mental health impacts of climate change, with females experiencing higher rates of anxiety, self-harm, and suicidal ideation, while males show greater incidences of suicide attempts and deaths. These findings emphasize the urgent need for targeted interventions and the integration of mental health services into climate policies to address these gender disparities.

Systematic review registration

This study is registered with PROSPERO [PROSPERO (york.ac.uk)] under the identifier [CRD42024534961].

Beyond the storms: Exploring predictors of posttraumatic stress and posttraumatic growth among survivors of hurricanes Irma and Maria in Puerto Rico

Background

Within disaster-affected communities, residents' exposures and post-disaster mental health outcomes can vary widely. Yet, few studies have explored the relationship between such diverse disaster-related exposures and posttraumatic growth (PTG) in a Puerto Rican context.

Methods

To address this gap, we used data from the Preparedness to Reduce Exposures and Diseases Post-hurricanes and Augment Resilience (PREPARE) study, a cohort of mainly Hispanic Puerto Ricans who experienced Hurricanes Maria and Irma in 2017. This analysis focused on 484 individuals who completed structured interviews 20 to 34 months after the hurricanes. We evaluated the associations between five different disaster exposures (e.g., financial, home damage, personal health, and familial health), posttraumatic stress (PTS), and PTG and its five domains (personal strength, new possibilities, improved relationships, spiritual growth, and appreciation of life), controlling for demographic, geographic, and social factors.

Results

In multivariable models, higher total disaster score was associated with higher levels of both PTS and PTG (2.91 and 3.87, respectively). Personal health impacts were consistently associated with higher levels on all PTG subscales, ranging from 0.89 to 1.94, which was not the case for other exposures. Specifically, home damage was associated with higher levels on all PTG subscales except spiritual growth, and financial and familial health impacts were associated with greater identification with new possibilities and appreciation of life only.

Conclusion

These findings provide novel evidence that different disaster-related exposures have distinct associations with the different PTG domains in Puerto Rico. These findings can inform future efforts to address post-disaster mental health ailments by bolstering different aspects of PTG.

Impact of climate change, biodiversity loss, and pollution on the incidence and manifestation of depressive and anxiety disorders

PURPOSE OF REVIEW

Climate change, biodiversity loss, and pollution present a major threat to health. Although emphasis has been put on physical health impacts, evidence on the mental health consequences is now also accumulating quickly. Given the rapid developments in the field, this article provides an expert opinion on the emerging research.

RECENT FINDINGS

Umbrella reviews are adding more high-level evidence on the associations of environmental crises and mental health. Individual studies are focusing on specific aspects of environmental crises and mental health, shedding light on potential direct links between climate change and mental health. Further studies are aiming to quantify individual burden and societal cost of the environmental crises and mental health nexus and to identify those most at risk for negative mental health outcomes. Many studies focus on eco-emotions, attempting to characterize them further, provide tools for quantification, and to determine their effect on functioning.

SUMMARY

Although the accumulating research on the impacts of environmental change on depression and anxiety is filling important knowledge gaps, important questions remain, for example concerning the risk factors for the development of mental health disorders caused by ecological crises, tailored preventive strategies, and concerning the effects of biodiversity loss on mental health. Health systems need to further develop responses to these environmental crises.

Examining the associations between emotionally charged reactions toward climate change and self-care, quality of life among older adults, coping mechanisms, and pro-environmental practices

AIM

To examine the associations between emotionally charged reactions to climate change, self-care, quality of life among older adults, coping mechanisms, and pro-environmental practices.

BACKGROUND

Older adults often face unique challenges in coping with climate change and its detrimental effect on self-care and quality of life. They may be particularly vulnerable to this pressing global issue.

METHOD

A multi-center, descriptive, correlational approach from three governorates in Egypt. A convenience sample of 609 older adults answered the Inventory of Climate Emotions, the Older People's Quality of Life-Brief, the Self-care Ability Scale for the Elderly, the Pro-Environmental Practices Assessment, and the Coping Scale with Climate Change.

RESULTS

The overall emotionally charged reactions to the idea of climate change showed a negative correlation with both the older adults' QoL total score (r = -.762) and the Self-care Ability Scale (r = -.775), yet a positive correlation with Pro-environmental Practices (r = .692) and Coping Strategies (r = .992). The regression analyses revealed that emotions explain a substantial variance in the older adult's quality of life (85.6%) and self-care (79.7%), as well as their pro-environmental actions (72%) and coping strategies (38.8%).

RECOMMENDATIONS AND IMPLICATIONS

The research underscores climate change's significant emotional and psychological ramifications on older adults, yielding valuable insights for geriatric nursing practice. The findings can facilitate the development of precise interventions to promote self-care, bolster coping strategies, and advocate for pro-environmental conduct among older adults. Understanding these associations can contribute to the enhancement of quality of life and the fortification of resilience. The research implications may offer pivotal guidance for geriatric nursing education, clinical protocols, and community initiatives dedicated to fortifying older adults' mental well-being, contending with the repercussions of climate change.

Detecting and classifying eco-anxiety: development of clinical cut-off scores for the climate change anxiety scale

BACKGROUND

Climate change anxiety, that is worry and fear in relation to the awareness of the impacts of climate change, is widely observed around the world. Some evidence suggests that while climate change anxiety can, at times, be adaptive, a growing body of research has reported that climate change anxiety is also related to a range of negative mental health outcomes and psychological distress. Currently, however, there is limited ability to assess for elevated levels of climate change anxiety and to identify those who may need support. The present study, therefore, aimed to develop clinical cut-off scores on a measure of climate change anxiety.

METHODS

A largely representative sample of Australian young adults (aged 16-25 years) completed measures of psychological distress (Depression, Anxiety and Stress Scale-21) and the Climate Change Anxiety Scale. Markers of clinically meaningful psychological distress - elevated depression, anxiety, and stress symptoms-were used to classify cases. Receiver Operating Characteristics analyses were performed to assess the predictive ability of the indicators of psychological distress (mild, moderate, severe, and extremely severe thresholds of anxiety, depression, and stress symptoms) for detecting climate change anxiety and to ascertain optimal cut-off scores.

RESULTS

The Area Under the Curve was acceptable to moderate for detecting climate change anxiety across all analyses. Across symptom severity thresholds and markers of psychological distress, based on consideration of balancing sensitivity and specificity, results consistently suggested that a cut-score of 21 was indicative of mild-moderate climate change anxiety, with a cut-off score of 23 indicating severe-extremely severe climate change anxiety.

CONCLUSIONS

The proposed cut-offs can feasibly be used to identify those with elevated climate change anxiety. Use of these cut-off scores can inform research as well as be used to guide screening, assessment, and inform clinical practice. Results also highlight a high rate of climate change anxiety in young adults.

Association between climate change and patient health outcomes: a mixed-methods systematic review

INTRODUCTION

Climate change poses significant threats to the environment, biodiversity, and socioeconomic stability worldwide. Its impact on human health, particularly within healthcare systems, is growing in concern. Nurses, as front-line healthcare workers, play a crucial role in addressing climate-related health risks. However, there is a gap in understanding nursing perspectives on climate change and its implications for patient health outcomes.

AIM

To synthesize empirical evidence on the association between climate change and patient health outcomes from a nursing perspective.

METHODS

A mixed-methods systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search was carried out in January 2024 in six scientific databases including CINAHL, PubMed, Scopus, ProQuest, Web of Science, and OVID Nursing. Studies focusing on climate change and patient health outcomes from a nursing perspective were included. Data extraction, quality appraisal, and synthesis were performed systematically.

RESULTS

The systematic review included 18 studies of a mainly quantitative nature. Three main themes emerged as follows: Climate Healthcare Interplay; Future Nurses as Agents of Change; and Navigating Sustainability Challenges in Nursing. These themes highlighted nurses' awareness of the interrelation between climate and health, the need for environmental education in nursing, and the challenges that hinder sustainable nursing practices.

CONCLUSION

This review underscores the importance of integrating climate change topics into nursing education and fostering organizational support for sustainable nursing practices. Addressing these challenges is essential for nurses to mitigate the health risks posed by climate change effectively.

Impact of climate change on women mental health in rural hinterland of Pakistan

Background

Climate change significantly impacts global well-being, with rural and agricultural communities, particularly women, bearing a disproportionate burden. In Pakistan's Malakand Division, women face increased mental health challenges due to environmental stressors such as temperature rise, extreme weather, and environmental degradation. These stressors are expected to exacerbate issues like stress, anxiety, and depression. Understanding their effects on rural women's mental health is crucial for developing effective intervention strategies.

Methodology

This study employs quantitative methodologies to assess the impact of climate change on the mental health of rural women in Malakand Division, focusing on Dir Upper, Dir Lower, and Shangla districts. A cross-sectional design was used, with a sample size of 600 women selected through multistage cluster sampling for geographic representation. Data were collected using structured questionnaires addressing stress, anxiety, and community dynamics. Data were analyzed using multiple regression, structural equation modeling (SEM), ANOVA, and logistic regression.

Results

The results revealed that climate change factors-temperature increase (β = 0.42, p < 0.01), extreme weather events (β = 0.36, p < 0.01), precipitation changes (β = 0.31, p < 0.05), and environmental degradation (β = 0.28, p < 0.05)-significantly impacted rural women's mental health. High levels of stress (72%), anxiety (68%), and depression (56%) were reported. Social support (β = -0.45, p < 0.01), community cohesion (β = -0.37, p < 0.05), access to resources (β = -0.39, p < 0.01), and cultural norms (β = -0.33, p < 0.05) were key factors mitigating the effects of climate stress. Gender disparities were evident, with women showing higher mental health challenges compared to men in similar conditions.

Conclusion

The study concludes that climate change significantly exacerbates mental health issues for rural women. It highlights the need for gender-sensitive, community-based interventions that address both climate adaptation and mental health. Strengthening community resilience, improving access to resources, and investing in healthcare and education are vital for enhancing well-being in the face of climate change.

The relationship between climate change and mental health: a systematic review of the association between eco-anxiety, psychological distress, and symptoms of major affective disorders

BACKGROUND AND OBJECTIVES

The adverse impacts of climate change on mental health is a burgeoning area, although findings are inconsistent. The emerging concept of eco-anxiety represents distress in relation to climate change and may be related to mental health. The aim of this study was to explore the relationship between eco-anxiety with validated mental health outcomes, specifically psychological distress and symptoms of major affective disorders.

DESIGN

Systematic review.

METHODS

EBSCO, ProQuest, and Web of Science databases were searched to February 2024 for studies of adult samples quantifying eco-anxiety (exposure, i.e. fear, worry or anxiety in relation to climate change) and symptoms of psychological distress and major affective disorders (outcomes), as assessed by validated measures.

RESULTS

Full text review of 83 studies was performed, and k = 35 studies were included in the review (N = 45 667, 61% female, Mage 31.2 years). Consistently, eco-anxiety showed small to large positive correlations with mental health outcomes of psychological distress, depression symptoms, anxiety symptoms, and stress symptoms. However, results regarding post-traumatic stress disorder symptoms and pathological worry were mixed. Stronger associations were observed where eco-anxiety was operationalised as 'anxiety' rather than 'worry'.

CONCLUSIONS

Findings underscore that eco-anxiety is related to psychological burden. Greater consideration of eco-anxiety in assessment and treatment is needed in clinical practice and further policy development is warranted at the intersection of climate and health to address the mental health challenges posed by climate change.

Digital Mental Health Innovations in the Face of Climate Change: Navigating a Sustainable Future

Climate change poses substantial challenges to mental health, with increased frequency of extreme weather events and environmental degradation exacerbating stress, anxiety, trauma, and existential concerns. Digital innovations, particularly artificial intelligence and digital phenotyping, offer promising avenues to mitigate climate-related mental health burdens. The integration of digital tools into climate-related mental health care necessitates careful consideration of issues of access to and adoption of solutions. Future research should evaluate the effectiveness and scalability of digital interventions to address the mental health impacts of climate change through collaborative efforts involving clinicians, environmental health specialists, bioethicists, policy makers, and technology developers.

Environmental sustainability in intensive care: the path forward. An ESICM Green Paper

PURPOSE

The European Society of Intensive Care Medicine (ESICM) Green Paper aims to address the challenge of environmental sustainability in intensive care and proposes actionable strategies for integrating sustainability into intensive care unit (ICU) stakeholder actions.

METHODS

The ESICM Executive Committee appointed a task force of topic experts and ESICM committee representatives to develop the ESICM Green Paper. The task force convened biweekly from January to June 2024, identifying key domains for environmental sustainability and prioritizing actions. Drafts were iteratively refined and approved by the ESICM Executive Committee.

RESULTS

Climate change will impact activities in intensive care in many ways, but also the impact of ICU activities on the environment is considerable; drivers for this include extensive resource use and waste generation in ICUs from energy consumption, use of disposable items, and advanced therapies for critically ill patients. The ESICM Green Paper outlines a structured approach for ICUs to reduce their environmental impact, emphasizing energy efficiency, waste reduction, and sustainable procurement. Furthermore, it endorses the need for awareness and education among healthcare professionals, integration of sustainability into research, and sustainable policies within scientific societies.

CONCLUSIONS

The ESICM Green Paper reviewed the relevance of climate change to intensive care and provided suggestions for clinical practice, research, education, and ESICM organizational domains. It underscores that reducing intensive care's ecological footprint can coexist with high-quality patient care. Promoting a resilient, responsible healthcare system is a joint responsibility of all ICU stakeholders.

Mental health amid climate crisis: A narrative review

The global community is currently facing a pressing challenge posed by climate change, which is profoundly impacting both human life and biodiversity. This encompasses issues such as rising global temperatures, heightened sea levels, amplified ultraviolet radiation exposure, more frequent and intense natural calamities, and the subsequent health risks. Additionally, mental health is also being impacted by these environmental changes. This review thoroughly examines the mental health consequences of climate change in various settings and among vulnerable populations, with a particular emphasis on India.

The Impact of Climate Change on Immunity and Gut Microbiota in the Development of Disease

According to the definition provided by the United Nations, "climate change" describes the persistent alterations in temperatures and weather trends. These alterations may arise naturally, such as fluctuations in the solar cycle. Nonetheless, since the 19th century, human activities have emerged as the primary agent for climate change, primarily attributed to the combustion of fossil fuels such as coal, oil, and gas. Climate change can potentially influence the well-being, agricultural production, housing, safety, and employment opportunities for all individuals. The immune system is an important interface through which global climate change affects human health. Extreme heat, weather events and environmental pollutants could impair both innate and adaptive immune responses, promoting inflammation and genomic instability, and increasing the risk of autoimmune and chronic inflammatory diseases. Moreover, climate change has an impact on both soil and gut microbiome composition, which can further explain changes in human health outcomes. This narrative review aims to explore the influence of climate change on human health and disease, focusing specifically on its effects on the immune system and gut microbiota. Understanding how these factors contribute to the development of physical and mental illness may allow for the design of strategies aimed at reducing the negative impact of climate and pollution on human health.

Climate Change Perception and Mental Health. Results from a Systematic Review of the Literature

Climate change is one of the main global challenges and influences various aspects of human health. Numerous studies have indeed demonstrated an association between extreme climate-related events and physical and mental health outcomes, but little is still known about the association between the perception/awareness of climate change and mental health. In accordance with the PRISMA 2020 guidelines, a search was conducted on PubMed and Scopus. The protocol was registered on PROSPERO. The included studies were original observational studies published in English, reporting the association between the perception/awareness of climate change and mental health. A total of 3018 articles were identified. A total of 10 observational studies were included. The period covered in the included studies ranged between 2012 and 2022. Climate change perception is consistently associated with adverse mental health effects across different types of estimates. In particular, the studies identified an association between a higher level of perception/awareness of climate change and depression, anxiety, eco-anxiety, stress, adjustment disorder, substance use, dysphoria, and even thoughts of suicide. Qualitative data underscore the impact on daily activities, contributing to feelings of loss and suicidal ideation. Moreover, climate change perception correlates with lower well-being and resilience. The association between awareness of climate change and mental health is a complex and still poorly explored phenomenon. The main limitations are the high heterogeneity in terms of exposure assessment and data reporting, which hinders quantitative analysis. These results show that climate change perception impacts mental health. Better understanding the phenomenon represents an opportunity to inform public health interventions that promote mental well-being.