Mental and physical health trajectories of Australian adults following climate-related disasters

Authors: Ang Li¹, Mathew Toll ², Erika Martino³, Ilan Wiesel⁴, Ferdi Botha⁵, Rebecca Bentley²

1. NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia; Australian Research Council's Centre of Excellence for Children and Families Over the Life Course, Australia. Electronic address: ang.li5@unimelb.edu.au.
2. NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia; Australian Research Council's Centre of Excellence for Children and Families Over the Life Course, Australia.
3. NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia.
4. School of Geography, Earth and Atmospheric Sciences, Faculty of Science, The University of Melbourne, Australia; Australian Research Council's Centre of Excellence for Children and Families Over the Life Course, Australia.
5. Melbourne Institute of Applied Economic and Social Research, Faculty of Business and Economics, The University of Melbourne, Australia; Australian Research Council's Centre of Excellence for Children and Families Over the Life Course, Australia.

Summary:

Climate-related disasters have become a salient feature of Australian life in recent decades with these events becoming more frequent and intense. Research led by Ang Li and colleagues from the University of Melbourne examined the impact of climate-related disasters on physical and mental health of Australians between 2009-2019, the long-term patterns of vulnerability and recovery, and pre-disaster risk factors, using longitudinal data from the Household, Income and Labour Dynamics (HILDA) survey and group trajectory modelling. The analysis identified three classes of health trajectories: people with minimal impact, people with small impact and fast recovery, and people with high impact and slow recovery. They discovered that the majority of Australians affected by climate-related disasters experience minimal or minor effects on their mental and physical health, with rapid recoveries. However, for one-fifth of the population, disasters have a significant impact on their well-being during the disaster year, and they recover slowly.

Pre-existing mental and physical health conditions are the leading risk factor for inclusion in the high impact and slow recovery group. Having a pre-existing mental health (e.g., nervous, or mental illness) or physical condition (e.g., physical impairment, chronic pain, and chronic health conditions such as arthritis, asthma, heart disease, and dementia) increased the probability of falling into the most vulnerable group by 61% for mental health and 51% for physical health. There is likely a compounding effect for people with these pre-existing health conditions when faced with climate-related disasters, with additional stressors and limited adaptive capacity to respond to emergency situations.

Critically, the findings of this study have implications for preparedness and response to climate-related disasters. People's mental and physical health recovery is dependent on pre-disaster vulnerabilities in health, resource access, and capacities. Results on the distinct trajectory groups, pre-disaster predictors, disaster health impact, and long-term recovery provide important prognostic information for residents, communities, and service providers in areas prone to climate-related disasters about the planning and design of targeted prevention and recovery strategies for vulnerable groups.

Specifically, people with prior physical and mental health conditions, low household income, limited social engagement, residing in group households, or experiencing housing stress are more at risk from the negative health effects of disaster events. Identifying pre-disaster health risk factors could help inform planning, screening, and provision of health services required to reduce the impact of climate-related disaster and the vulnerabilities experienced by those most at risk. Pre-disaster social and structural vulnerabilities should be used to inform needs assessments for recovery and to target interventions and social infrastructure for climate resilience. These findings could assist policymakers and health practitioners to more effectively assist people most at risk and design prevention and response strategies to prevent the exacerbation of poor health and wellbeing.