Katarzyna Alderman

Impact of the 2011 Queensland floods on the use of tobacco, alcohol and medication.

In particular, we sought to assess the association between direct exposure to flooding and the use of tobacco, alcohol and medication. A representative sample of 3,000 residents (aged 18 years and over) was randomly selected from 12 electorates within the greater Brisbane region identified as flood-affected. The survey included questions related to the level of exposure that residents experienced (including questions about damage to outside property, living space, removal of parts of household, damage to vehicles, and friends or relative moving in for at least 48 hours as a result of the floods), general health status (including tobacco, alcohol and medication usage), mental health status and socio-demographic characteristics. Given the low-risk nature of the survey, we did not include questions related to inter-personal violence. Multivariable logistic regression models were used to examine the impact of the floods on the self-reported use of tobacco, alcohol and medication. In all analyses, substance usage was treated as the response variable with self-reported flood impacts as an independent variable. The models were adjusted for gender, age and income. Responses were received from 960 invited residents (response rate: 32%) – a similar rate to those found in other disaster-related studies where continuing disaster recovery and trauma may restrict people’s capacity to respond. 14 There were slightly more female respondents (56.4%) than male (43.6%), with the mean age of respondents being 51 years (SD=16.5 years). In terms of exposure to flooding, 10.6% (n=100) of respondents reported some form of direct flood impact. Table 1 shows the results of the logistic regression analyses. There were consistent results between the univariate and adjusted models, with direct flood impact found to be a significant risk factor for increased usage for all substance groups. Specifically, residents that reported direct flood impact were more likely to increase their tobacco (OR 4.5, 95% CI 1.8-11.1), alcohol (OR 5.2, 95% CI 1.8-11.8) and medication (OR 5.1, 95% CI 1.9-13.5) usage. The findings of this study support the notion that direct exposure to the 2011 Queensland floods resulted in an increase in alcohol and tobacco usage, along with an increase in flood-related medication uptake. It is important that public health organisations integrate intervention measures for alcohol and tobacco use into related mental health programs, in order to minimise the negative health effects of floods and other disasters.

Motivators and Barriers to Incorporating Climate Change-Related Health Risks in Environmental Health Impact Assessment

Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA), there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within an EHIA framework. Practitioners expressed concern over a number of factors relating to the current EHIA methodology and the inclusion of climate change-related health risks. These concerns related to the broad scope of issues that would need to be considered, problems with identifying appropriate health indicators, the lack of relevant qualitative information that is currently incorporated in assessment and persistent issues surrounding stakeholder participation. It was suggested that improvements are needed in data collection processes, particularly in terms of adequate communication between environmental and health practitioners. Concerns were raised surrounding data privacy and usage, and how these could impact on the assessment process. These findings may provide guidance for government and industry bodies to improve the assessment of climate change-related health risks.