Air Quality

Exploration of the mental health impacts of climate change for First Nations, Inuit, and Métis peoples is an emerging area of study and has focused primarily on the strong emotional and psychological responses experienced in the face of rapid ecological changes. For Inuit, these responses include intense feelings of anxiety, fear, stress, anger, sadness, disorientation, grief, loss and lament, increased drug and alcohol use, suicide ideation and attempts, violence, and decreased place-based mental solace (Cunsolo Willox, 2012a; Cunsolo Willox, 2012b; Cunsolo Willox et al., 2013a; Cunsolo Willox et al., 2013b; Petrasek MacDonald et al., 2013a; Petrasek MacDonald et al., 2013b; Ulturgasheva et al., 2014; Cunsolo Willox et al., 2015; Harper et al., 2015c; Bunce et al., 2016). As noted by Durkalec and colleagues (2015), climate change is reinforcing environmental dispossession for Inuit, compounding disruption and denigration of Inuit knowledge and ways of life. Research on the mental health impacts of climate change on First Nations and Métis peoples is more limited. One study focused on the impacts of a summer of wildfires on the health and well-being of four First Nations communities in the Northwest Territories. Participants in this study reported experiences of evacuation and isolation, as well as feelings of fear, stress, and uncertainty about the future (Dodd et al., 2018a; Dodd et al., 2018b).

Indigenous Services Canada provides funding for several targeted national strategies, including the National Aboriginal Youth Suicide Prevention Strategy, the National Native Alcohol and Drug Abuse Program, mental health counselling, and the Indian Residential Schools Mental Health Support Program (ISC, 2019c). Most of these programs are accessible to only a relatively small proportion of First Nations and Inuit12 and do not provide the range and quality of services required to address the complex mental health problems that exist in First Nations, Inuit, and Métis communities (Maar et al., 2009; Boksa et al., 2015). Greater cooperation is needed among federal, provincial, and territorial governments to ensure that these communities have sustainable, dedicated funding to meet the potentially growing need for mental health services in response to climate change impacts. Air Quality

Weather and climate can affect indoor and outdoor air quality and have impacts on human health (Kinney, 2008). Warming temperatures can increase levels of air pollutants (e.g., ground-level ozone, particulate matter) and the production of aeroallergens (e.g., pollens, molds) that are associated with a greater risk of cardiovascular and respiratory diseases, as well as premature death (Berry et al., 2014; Reid et al., 2016). First Nations, Inuit, and Métis peoples experience a disproportionate burden of chronic respiratory diseases, such as asthma13 and chronic obstructive pulmonary disease,14 compared to nonIndigenous people, and these diseases can become exacerbated by poor air quality (Gershon et al., 2014; Ospina et al., 2015; Carrière et al., 2017; PHAC, 2018a; Koleade et al., 2018). Higher rates of respiratory infections, such as bronchitis, bronchiolitis, pneumonia, and tuberculosis, are also reported for First Nations, Inuit, and Métis children (Kovesi, 2012; Konrad et al., 2013). The risks of exposure to poor air quality are greater for First Nations, Inuit, and Métis

12 Under current jurisdictional arrangements, federal funding for most mental health programs and services is provided for community-based services accessible to status First Nations living on reserve and Inuit living in Inuit communities. In smaller, remote communities, access to mental health services may be very limited or non-existent (Boksa et al., 2015). Additionally, nonstatus First Nations and Métis peoples are not currently entitled to these same services and benefits. 13 First Nations people living off reserve and Métis have rates of asthma 1.6 times higher than Canadian-born non- Indigenous peoples (PHAC, 2018a). 14 Indigenous populations have a prevalence rate of 6.5% for chronic obstructive pulmonary disease, compared to 4% for nonIndigenous populations in Canada (Bird et al., 2017).

peoples because of underlying health determinants such as poor housing conditions (e.g., homes in need of repair, overcrowding, poor ventilation, mold) in many communities, increased exposure to tobacco smoke and wood/ oil heating, and geographic proximity to forests that are prone to wildfires and consequent smoke (CIER, 2008; B.J. Stocks Wildfire Investigations Ltd., 2013; Dodd et al., 2018a; Dodd et al., 2018b).

© Credit: iStockPhoto.com, ID 817842116

Yellowknife’s Summer of Smoke, 2014

During the summer of 2014, the Yellowknife area experienced an extreme wildfire season referred to as the “Summer of Smoke.” These fires resulted in a massive spike in air pollution to dangerous levels, confining many residents indoors for extended periods of time (Howard et al., 2017; Dodd et al., 2018a; Dodd et al., 2018b). The poor air quality associated with this wildfire season negatively affected First Nations communities, particularly children and the elderly. For example, the fire season corresponded to significant increases in emergency room visits for respiratory problems (42% over previous years), especially among children up to 4 years old (114% over previous years), as well as more cases of cough, pneumonia, and asthma (Dodd et al., 2018a). Confinement indoors during fires, disruptions in land-based activities, and physical inactivity also contributed to mental health impacts such as stress, anxiety, and depression. “All that smoke we breathed in, where are you to go? It’s not only me. It’s the babies and the Elders. And then the vegetation and the runoff from the smoke and the rain all affects the ecosystem right to the water.” 15

To counteract cabin fever and physical inactivity, the First Nations communities of Kakisa and N’Dilo planned alternative physical and social activities to get away from persistent smoke, including hosting activities at the community hall that promoted physical activity among children and provided opportunities for community members to socialize. In Yellowknife, user fees were waived for recreational centres to encourage indoor physical activities. A documentary of the communities’ experiences, entitled Summer of Smoke, can be found at https://vimeo.com/373958783

15 Quote from Roxane Landry, Dene, Fort Providence from Summer of Smoke https://vimeo.com/373958783.