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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.

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.

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.

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.

The purpose of this rapid scoping review was to map existing literature on risk communication strategies implemented by authorities and aimed at vulnerable immigrants in the context of pandemics.

Existing literature on the topic was charted in terms of its nature and volume by summarizing evidence regarding the communication strategies. Literature searches were conducted in Academic Search Premier and CINAHL, databases were searched from 2011 to present on March 31, 2021.

Five articles met the criteria and were included in this review, pointing at limited research in this area. The findings indicated that a close interaction between communication authorities and immigrants is important. Community education, building trust in communication sources, clear risk communication and inclusive decision-making among all were found to be important when communicating health risks to immigrants.

The primary limitation of this rapid scoping review is that the literature searches were conducted in only two databases, namely, Academic Search Premier and CINAHL. A wider search across several other databases could have given more profound results. Furthermore, some studies where immigrants were conceptualized as, for instance, “disadvantaged groups” might be overseen due to a choice of the search strategy used in this study. There are also certain limitations related to the studies included in this review.

Identifying efficient ways of conveying recommendations may further assist authorities and scientists in developing more effective health-related risk communication.

This study covered health-related risk communication in the context of pandemics, addressing the need to investigate different groups of immigrants and the challenges related to communicating risks to these groups.

Mombasa City in Kenya is one of the most vulnerable towns to flood risk due to its low-lying coastal location. Those at the highest risk in the city are households living in the flood-prone informal settlements. However, little is known about the perception of these vulnerable households to the flood risks and its health impacts, which is important for developing effective long-term adaptation strategies. The purpose of this paper is to examine the general perception of the residents regarding flood risks, its impact on their health and their adaptation strategies.

This study surveyed 390 randomly selected households in three informal settlements in the city of Mombasa using a semi-structured questionnaire. This was supplemented with six focus group discussions (FDGs) and six key informant interviews (KIIs).

The majority of respondent households perceive future flooding as high risk or severe with high negative health impact. Despite this, many do not evacuate their homes because they do not have alternative places to move to. Flooding was indicated to have had a negative physical and mental health impact on members of households. Although majority of households had taken some adaptation measures, most of these were short term, mainly due to financial constraints, lack of knowledge and government support. Perception of flood risk and gender were found to have a strong influence on taking long-term adaptation measures at the household level.

Reducing flood risk and averting its health consequences in flood-prone informal settlements require empowering and supporting those living in these areas with ability to initiate long-term adaptation measures and creating awareness about future risks.

This study provides evidence about how residents of flood-prone informal settlements perceive flood risk and how the exposures to perennial flooding impact their health. The paper augments existing knowledge of flood risk in poor urban neighborhoods of developing countries.

People with intellectual disability die prematurely and from avoidable causes. Innovative solutions and proactive strategies have been limited in addressing this disparity. This paper aims to detail the process of developing a risk stratification tool to identify those individuals who are higher risk of premature mortality.

This study used population health management principles to conceptualise a risk stratification tool for avoidable deaths in people with intellectual disability. A review of the literature examined the existing evidence of causes of death in people with intellectual disability. A qualitative methodology using focused groups of specialist clinicians was used to understand the factors that contributed towards avoidable deaths in people with intellectual disability. Delphi groups were used for consensus on the variables for inclusion in the risk stratification tool (Decision Support Tool for Physical Health).

A pilot of the Decision Support Tool for Physical Health within specialist intellectual disability service demonstrated effective utility and acceptability in clinical practice. The tool has also demonstrated good face and construct validity. A further study is currently being completed to examine concurrent and predictive validity of the tool.

To the best of the authors’ knowledge, this is the only study that has used a systematic approach to designing a risk stratification tool for identifying premature mortality in people with intellectual disability. The Decision Support Tool for Physical Health in clinical practice aims to guide clinical responses and prioritise those identified as at higher risk of avoidable deaths.

The study aims to test the efficacy of brief-caries risk assessment form with standard caries risk assessment form and to evaluate the application of caries risk assessment following American Academy of Pediatric Dentistry (AAPD) between brief and standard caries risk assessment on dental health status among preschool children.

Brief-caries risk assessment form was developed. Then, experimental study was conducted in public health center 54 among 70 patients (35 test and 35 control) from January to July 2019. Test group used brief-caries assessment form, and control group used standard form. Both groups received the same caries risk assessment criteria and management protocol from AAPD. At baseline, 3-month and 6-month follow-up, caries risk and dental health status (plaque index, cavitated caries lesion and non-cavitated caries lesion) were assessed. Data were analyzed by descriptive statistic, t-test, chi-square test, Fisher's exact test and repeated measures ANOVA.

Percentage of high caries risk decreased from baseline (93.9%: test and 96.9%: control) to 6-month follow-up (66.7%: test and 65.6%: control) in both groups, with no statistically significant differences between groups. Plaque index, cavitated caries lesion and non-cavitated caries lesion were not statistically significant differences between groups. Brief-caries assessment decreased times/visit from 10-15 minutes to 5 minutes.

Brief-caries assessment form decreased caries risk and prevented dental caries as the standard form. Using brief-caries assessment form could save time, is cost-effective and is appropriate for use in public health centers. However, a short follow-up time might have insufficient power to detect the differences between groups.

Air quality and its assessment in urban areas has become a necessity. This is attributed to the increasing air pollution in urban landscape from anthropogenic activities necessary for economic growth and development. This study investigates air quality and potential health risk posed from nitrogen dioxide (NO₂) to the residents of low town of Mohammedia city, Morocco.

The NO₂ concentration was measured on an hourly basis for the winter season of the year 2014, 2015 and 2016. The air quality was assessed in terms of Air Quality Index (AQI). Noncarcinogenic risk assessment was done to evaluate possible health risk to the inhabitant of low town from NO₂ exposure.

The maximum concentration reached 85–96 µg/m³ (at 6 p.m., 2014), 96–104 µg/m³ (7–9 p.m., 2015) and 102–117 (8–11 p.m., 2016). The AQI during maximum NO₂ levels (peak hours) ranged between 0–50 µg/m³ (good) to 51–100 µg/m³ (unhealthy for sensitive group). The risk quotient (RQ) was calculated for average daily intake and average hourly intake of NO₂. RQ was found to be less than 1 (no potential health risk, lifetime and hourly) for all three years. However, increase in RQ value from 0.84 (2014) to 0.98 (2016) indicates increase in potential health risk. Hence, policy and measures should be adopted to reduce the potential health risk.

This study is very first of its kind for the area and hence can serve as reference study for future works. Further studies are required to assess air pollution in other seasons (summer, spring, autumn), impact of climatic condition and parameters on air quality. Also, for direct impact assessment number of cases attributed to air pollution needs to be investigated.

Cruising is one of the industries most susceptible to the current COVID-19 health crisis, due to the closed environment and the contacts between cruisers and crewmembers. This study aims to understand if the perceived crowding and the health risk perception related to the pandemic situation might threaten passengers’ intentions to cruise. The study also examines corporate reputation and trust, as well as social motivation and self-confidence, as possible predictors of consumers’ intention to cruise.

The study is based on the development of a structured questionnaire submitted online via social media. Overall, 553 individuals’ responses were used for understanding the factors that can affect consumers’ intention to cruise by performing several regression models.

The results show that the perceived crowding related to the pandemic does not seem to influence people’s intention to cruise. On the contrary, trust in the cruise company, corporate reputation, cruisers’ self-confidence and research of social motivation are positive predictors of intention to cruise, thus reducing the perceived risk’s deterring impact. The importance of such factors differs in respect of repeat and not repeat cruisers.

The study presents several managerial implications as it analyses the variables that could help cruise management cope better with COVID-19’s negative impact.

Despite the severity of COVID-19’s impact on the cruise industry, no studies have yet focussed on how the current pandemic situation may influence customers’ intention to cruise in the future.

The study aimed to evaluate the effectiveness of the Healthy e-Elderly People Intervention (HEPI) mobile application in reducing the physical health effects caused by smartphone usage.

This randomized controlled trial involved elderly volunteers residing in different regions of Thailand and using smartphones. The samples included 33 participants in each control and intervention group. The intervention group received the HEPI application with reminder messages, while the control group received the HEPI application without reminder messages. Assessments were conducted at baseline, follow-up 1 (four weeks after the last reminder messages) and follow-up 2 (12 weeks after the last reminder messages). Data analyses (i.e descriptive statistics, independent sample t-tests and repeated-measures analysis of variance) were used to obtain the overall mean change difference between the intervention and control groups at different time points (per-protocol analysis). The priorities of physical health risk were assessed using Health Risk Matrix.

The HEPI mobile application significantly improved knowledge, attitudes and practice scores in both the HEPI with and without reminder messages. The mean physical health risk score in both control and intervention groups was radically decreased from baseline to follow-up 1; lower physical health scores suggested lower health risk.

Increased duration of smartphone usage by elderly individuals in Thailand may result in a risk of developing several serious health conditions. The HEPI application with reminder messages could be used as a tool to benefit smartphone users and would further benefit from a booster after four weeks of intervention.

This study examined the risk factors associated with hypertension in Bhutan.

The cross-sectional data of 30,889 adults from the National Health Survey of Bhutan was used in this study. Multivariable regression accounting for the complex survey design was performed to identify the risk factors. The backward elimination approach was applied in the multivariable analysis.

The prevalence of hypertension was 17%. Increasing age, being female, being previously married, higher wealth status, past alcohol use, having diabetes, loneliness, health service use and low vegetable intake was associated with increased hypertension risk, whereas, higher education level, being employed and residing in the eastern region was associated with reduced risk. Age, gender, education, wealth status, diabetes status, loneliness and health service use were common factors in all the regions. Marital status and vegetable intake were associated with hypertension in the western and central regions, and alcohol use in the eastern and central regions.

Affecting around one-sixth of the population, hypertension is a significant public health problem in Bhutan. Interventions to improve health education and access, motivate healthy lifestyles, and reduce harmful alcohol use, and strategies to create health-promoting social and built environments are needed to curb the hypertension epidemic and its consequences.

The extraction of natural resources has long been part of economic development in small islands. The damage to environment and health is extensive, even rendering once productive islands virtually uninhabitable. Rather than providing long-term benefits to the population or to the environment, the culture of “extractivism” – a nonreciprocal approach where resources are removed and used with little care or regard to consequences – has instead left many in far more fragile circumstances, increasingly dependent on external income. The purpose of this paper is to show how continued extractivism in small islands is contributing to global climate change and increasing climate risks to the local communities.

Through a series of case studies, this paper examines the history of extractivism in small islands in Oceania, its contribution to environmental degradation locally and its impacts on health.

It examines how extractivism continues today, with local impacts on environment, health and wellbeing and its much more far-reaching consequences for global climate change and human health. At the same time, these island countries have heightened sensitivity to climate change due to their isolation, poverty and already variable climate, whereas the damage to natural resources, the disruption, economic dependence and adverse health impacts caused by extractivism impart reduced resilience to the new climate hazards in those communities.

This paper proposes alternatives to resource extractivism with options for climate compatible development in small islands that are health-promoting and build community resilience in the face of increasing threats from climate change.

Extractivism is a new concept that has not previously been applied to understanding health implications of resource exploitation thorough the conduit of climate change. Small-island countries are simultaneously exposed to widespread extractivism, including of materials contributing to global climate change, and are among the most vulnerable to the hazards that climate change brings.