Editing IPCC:AR6/SROCC/Chapter-3 (section)

===== 3.4.3.3.3 Health and wellbeing =====

For many polar residents, especially Indigenous peoples, the physical environment underpins social determinants of well-being, including physical and mental health. Changes to the environment impact most dimensions of health and well-being (Parlee and Furgal, 2012 <sup>[[#fn:r1904|1904]]</sup> ; Ostapchuk et al., 2015 <sup>[[#fn:r1905|1905]]</sup> ). Climate change consequences in polar regions (Sections 3.3.1.1, 3.4.1.2) have impacted key transportation routes (Gearheard et al., 2006 <sup>[[#fn:r1906|1906]]</sup> ; Laidler, 2006 <sup>[[#fn:r1907|1907]]</sup> ; Ford et al., 2013 <sup>[[#fn:r1908|1908]]</sup> ; Clark et al., 2016a <sup>[[#fn:r1909|1909]]</sup> ) and pose increased risk of injury and death during travel (Durkalec et al., 2014 <sup>[[#fn:r1910|1910]]</sup> ; Durkalec et al., 2015 <sup>[[#fn:r1911|1911]]</sup> ; Clark et al., 2016b <sup>[[#fn:r1912|1912]]</sup> ; Driscoll et al., 2016 <sup>[[#fn:r1913|1913]]</sup> ).

Foodborne disease is an emerging concern in the Arctic because warmer waters, loss of sea ice (Section 3.3.1.1) and resultant changes in contaminant pathways can lead to bioaccumulation and biomagnification of contaminants in key food species. While many hypothesised foodborne diseases are not well studied (Parkinson and Berner, 2009 <sup>[[#fn:r1914|1914]]</sup> ), foodborne gastroenteritis is associated with shellfish harvested from warming waters (McLaughlin et al., 2005 <sup>[[#fn:r1915|1915]]</sup> ; Young et al., 2015 <sup>[[#fn:r1916|1916]]</sup> ). Mercury presently stored in permafrost (Schuster et al., 2018 <sup>[[#fn:r1917|1917]]</sup> ) has potential to accumulate in aquatic ecosystems.

Climate change increases the risk of waterborne disease in the Arctic via warming water temperatures and changes to surface hydrology (Section 3.4.1.2) (Parkinson and Berner, 2009 <sup>[[#fn:r1918|1918]]</sup> ; Brubaker et al., 2011 <sup>[[#fn:r1910|1910]]</sup> ; Dudley et al., 2015 <sup>[[#fn:r1920|1920]]</sup> ). After periods of rapid snowmelt, bacteria can increase in untreated drinking water, with associated increases in acute gastrointestinal illness (Harper et al., 2011 <sup>[[#fn:r1921|1921]]</sup> ). Consumption of untreated drinking water may increase duration and frequency of exposure to local environmental contaminants (Section 3.4.3.2.3) or potential waterborne diseases (Goldhar et al., 2014 <sup>[[#fn:r1922|1922]]</sup> ; Daley et al., 2015 <sup>[[#fn:r1923|1923]]</sup> ). The potential for infectious gastrointestinal disease is not well understood, and there are concerns in relation to the safety of storage containers of raw water in addition to the quality of the source water itself (Goldhar et al., 2014 <sup>[[#fn:r1924|1924]]</sup> ; Wright et al., 2018 <sup>[[#fn:r1925|1925]]</sup> ; Masina et al., 2019 <sup>[[#fn:r1926|1926]]</sup> ).

Climate change has negatively affected place attachment via hunting, fishing, trapping and traveling disruptions, which have important mental health impacts (Cunsolo Willox et al., 2012 <sup>[[#fn:r1927|1927]]</sup> ; Durkalec et al., 2015 <sup>[[#fn:r1928|1928]]</sup> ; Cunsolo and Ellis, 2018 <sup>[[#fn:r1929|1929]]</sup> ). The pathways through which climate change impacts mental wellness in the Arctic varies by gender (Bunce and Ford, 2015 <sup>[[#fn:r1930|1930]]</sup> ; Ostapchuk et al., 2015 <sup>[[#fn:r1931|1931]]</sup> ; Bunce et al., 2016 <sup>[[#fn:r1932|1932]]</sup> ) and age (Petrasek-MacDonald et al., 2013 <sup>[[#fn:r1933|1933]]</sup> ; Ostapchuk et al., 2015 <sup>[[#fn:r1934|1934]]</sup> ). Emotional impacts of climate-related changes in the environment were significantly higher for women compared to men, linked to concern for family members (Ostapchuk et al., 2015 <sup>[[#fn:r1935|1935]]</sup> ). However, men are also vulnerable due to gendered roles in subsistence and cultural activities (Bunce and Ford, 2015 <sup>[[#fn:r1936|1936]]</sup> ). In coastal areas, sea ice means freedom for travel, hunting and fishing, so changes in sea ice affect the experience of and connection with place. In turn, this influences individual and collective mental/emotional health, as well as spiritual and social vitality according to relationships between sea ice use, culture, knowledge and autonomy (Cunsolo Willox et al., 2013a <sup>[[#fn:r1937|1937]]</sup> ; Cunsolo Willox et al., 2013b <sup>[[#fn:r1938|1938]]</sup> ; Gearheard et al., 2013 <sup>[[#fn:r1939|1939]]</sup> ; Durkalec et al., 2015 <sup>[[#fn:r1940|1940]]</sup> ; Inuit Circumpolar Council-Alaska (ICC-AK), 2015).

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