Editing IPCC:AR6/WGII/Cross-Chapter-Paper-6 (section)

=== CCP6.2.6 Human Health and Wellness in the Arctic ===

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Climate change continues to have wide-ranging physical human health risks in the Arctic, particularly for Indigenous Peoples ( ''high confidence'' ); however, future projections of physical risks are nascent. Climate change has already challenged food and nutritional security (CCP6.2.5). Climate change also creates safety concerns for those who access the land, ice and water for food, cultural and recreational purposes, with changing environmental conditions linked to injury and death ( [[#Durkalec--2014|Durkalec et al., 2014]] ; [[#Clark--2016a|Clark et al., 2016a]] ; [[#Clark--2016b|Clark et al., 2016b]] ; [[#Driscoll--2016|Driscoll et al., 2016]] ; [[#Brattland--2018|Brattland and Mustonen, 2018]] ). Foodborne disease risks are expected to increase in the Arctic, with warming temperatures linked to increased risk of microbial contamination of locally harvested foods ( [[#Grjibovski--2013|Grjibovski et al., 2013]] ; [[#Harper--2015|Harper et al., 2015]] ), chemical contamination of locally harvest foods ( [[#Hansen--2015|Hansen et al., 2015]] ; [[#Long--2015|Long et al., 2015]] ; [[#Alava--2017|Alava et al., 2017]] ), compromised structural integrity and utility of ice cellars used to store locally harvested meat ( [[#Nyland--2017|Nyland et al., 2017]] ; [[#Markon--2018|Markon et al., 2018]] ), and new challenges to traditional food preparation techniques ( [[#Shadrin--2021|Shadrin, 2021]] ). Waterborne disease risks have increased, with decreased drinking water quality and quantity, water treatment infrastructure failures and new waterborne pathogens emerging in the Arctic ( [[#Berner--2016|Berner et al., 2016]] ; [[#Thivierge--2016|Thivierge et al., 2016]] ; [[#Markon--2018|Markon et al., 2018]] ; [[#Yoder--2018|Yoder, 2018]] ; [[#Masina--2019|Masina et al., 2019]] ; [[#Sachal--2019|Sachal et al., 2019]] ; [[#Harper--2020|Harper et al., 2020]] ; [[#Mustonen--2021|Mustonen and]] [[#Shadrin--2021|Shadrin, 2021]] ). Emerging environmental exposures to pathogens is also a concern. In 2016, a Nenets boy and over 200,000 reindeer died from anthrax linked to warming environments ( [[#Ezhova--2021|Ezhova et al., 2021]] )—a risk which is projected to increase with climate change ( [[#Liskova--2021|Liskova et al., 2021]] ). Thawing permafrost increases smallpox risk in former nomadic campsites and graveyards ( [[#Mustonen--2021|Mustonen and]] [[#Shadrin--2021|Shadrin, 2021]] ; [[#Shadrin--2021|Shadrin, 2021]] ). Arctic health systems—which are often already stressed—will be further challenged by climate change ( [[#Harper--2015|Harper et al., 2015]] ; [[#Clark--2017|Clark and Ford, 2017]] ), especially in conjunction with other system shocks (e.g., COVID-19) (Cross-Chapter Box COVID in Chapter 7) ( [[#Zavaleta-Cortijo--2020|Zavaleta-Cortijo et al., 2020]] ). While physical health impacts have been observed, research examining future health projections or evaluating the efficacy of health adaptations is rare ( [[#Dobson--2015|Dobson et al., 2015]] ; [[#Harper--2020|Harper et al., 2020]] ; [[#Harper--2021|Harper et al., 2021]] ).

Climate change has negative, widespread and cumulative impacts on mental health in the Arctic, particularly for Indigenous Peoples ( ''very high confidence'' ) (Figure CCP6.3). Climate-sensitive mental health outcomes are complex, overlapping and interrelated, and have multiple direct and indirect pathways stemming from acute (e.g., major storms, flooding, wildfires) and chronic (e.g., temperature increases, sea ice loss, permafrost thaw) environmental conditions, and resulting disruptions to livelihoods, culture, food systems, social connections, health systems and economies ( [[#Cunsolo%20Willox--2013a|Cunsolo Willox et al., 2013a]] ; [[#Cunsolo%20Willox--2013b|Cunsolo Willox et al., 2013b]] ; [[#Cunsolo%20Willox--2014|Cunsolo Willox et al., 2014]] ; [[#Beaumier--2015|Beaumier et al., 2015]] ; [[#Durkalec--2015|Durkalec et al., 2015]] ; [[#Hamilton--2016|Hamilton et al., 2016]] ; [[#Clayton--2017|Clayton et al., 2017]] ; [[#Dodd--2018|Dodd et al., 2018]] ; [[#Jaakkola--2018|Jaakkola et al., 2018]] ; [[#Markon--2018|Markon et al., 2018]] ; [[#ITK--2019|ITK, 2019]] ; [[#Minor--2019|Minor et al., 2019]] ; [[#Middleton--2020a|Middleton et al., 2020a]] ; [[#Middleton--2020b|Middleton et al., 2020b]] ; [[#Feodoroff--2021|Feodoroff, 2021]] ).

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[[File:021ad55e0b030cdb7a3e982f3dd1bef3 IPCC_AR6_WGII_Figure_CCP6_003.png]]

'''Figure CCP6.3 |''' '''The pathways through which climate change impacts mental and emotional health in the Arctic.'''

Negative mental health outcomes from climate change include: emotional reactions (e.g., sadness, fear, anger, distress and anxiety); psychosocial outcomes (e.g., depression, post-traumatic stress disorder and generalised anxiety); experiences with grief and loss (i.e., ecological grief); increased drug and alcohol usage, family stress and domestic violence; increased suicide ideation and suicides; loss of cultural knowledge and continuity, disruptions to intergenerational knowledge transfer; and deterioration and loss of place-based identities and connections (i.e., solastalgia) ( [[#Cunsolo%20Willox--2013a|Cunsolo Willox et al., 2013a]] ; [[#Cunsolo%20Willox--2013b|Cunsolo Willox et al., 2013b]] ; [[#Cunsolo%20Willox--2014|Cunsolo Willox et al., 2014]] ; [[#Durkalec--2015|Durkalec et al., 2015]] ; [[#Harper--2015|Harper et al., 2015]] ; [[#Cunsolo--2018|Cunsolo and Ellis, 2018]] ; [[#Hayes--2018|Hayes et al., 2018]] ; [[#Jaakkola--2018|Jaakkola et al., 2018]] ; [[#Markon--2018|Markon et al., 2018]] ; [[#Minor--2019|Minor et al., 2019]] ; [[#Middleton--2020a|Middleton et al., 2020a]] ; [[#Feodoroff--2021|Feodoroff, 2021]] ).

The negative mental health impacts from climate change are amplified among those most reliant on the environment for subsistence and livelihoods, those who already face chronic physical or mental health issues, and those facing socioeconomic inequities and marginalisation, particularly for Indigenous Peoples ( ''high confidence'' ). These climate change related mental health impacts are unequally distributed ( [[#Cunsolo%20Willox--2014|Cunsolo Willox et al., 2014]] ; [[#Minor--2019|Minor et al., 2019]] ), and may vary by gender ( [[#Beaumier--2015|Beaumier et al., 2015]] ; [[#Harper--2015|Harper et al., 2015]] ; [[#Feodoroff--2021|Feodoroff, 2021]] ) and age ( [[#Petrasek%20MacDonald--2013|Petrasek MacDonald et al., 2013]] ; [[#Ostapchuk--2015|Ostapchuk et al., 2015]] ; [[#Petrasek%20MacDonald--2015|Petrasek MacDonald et al., 2015]] ; [[#Kowalczewski--2018|Kowalczewski and Klein, 2018]] ).

Climate change will increase mental health risks in the Arctic in the future ( ''medium confidence'' ). Future risks include exposures to severe weather events and changing precipitation patterns, sea ice loss, wildfires and changing place attachment, as well as disruptions to underlying determinants of mental health and social support networks ( [[#Cunsolo%20Willox--2014|Cunsolo Willox et al., 2014]] ; [[#Cunsolo--2018|Cunsolo and Ellis, 2018]] ; [[#Markon--2018|Markon et al., 2018]] ; [[#Council%20of%20Canadian%20Academies--2019|Council of Canadian Academies, 2019]] ; [[#ITK--2019|ITK, 2019]] ; [[#Middleton--2020a|Middleton et al., 2020a]] ; [[#Middleton--2020b|Middleton et al., 2020b]] ).

There is ''limited evidence'' assessing adaptation options that effectively reduce climate-related mental health risks, but developing or enhancing access to mental health resources and infrastructure is critical, such as land-based healing programmes, enhanced access to culturally appropriate mental health resources, and climate-specific counselling services to support individual and community psychosocial resilience, particularly among Arctic Indigenous Peoples ( [[#Cunsolo--2018|Cunsolo and Ellis, 2018]] ; [[#Middleton--2020a|Middleton et al., 2020a]] ). Incorporating a climate-sensitive mental health lens into mitigation and adaptation planning holds potential for increasing mental health and resilience in the Arctic, as well as supporting other social, economic and cultural co-benefits.

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