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. 2024 Jan 2;4(1):1.
doi: 10.1007/s44192-023-00055-0.

Impacts of compounding drought and heatwave events on child mental health: insights from a spatial clustering analysis

Kelly Sewell  1 , Sudeshna Paul  2 , Kelley De Polt  1   3 , Maggie M Sugg  4 , Ronald D Leeper  1 , Douglas Rao  1 , Jennifer D Runkle  5
Affiliations

Impacts of compounding drought and heatwave events on child mental health: insights from a spatial clustering analysis

Kelly Sewell et al. Discov Ment Health. .

Abstract

Background: Concurrent heatwave and drought events may have larger health impacts than each event separately; however, no US-based studies have examined differential mental health impacts of compound drought and heatwave events in pediatric populations.

Objective: To examine the spatial patterns of mood disorders and suicide-related emergency department (ED) visits in children during heatwave, drought, and compound heatwave and drought events. We tested whether the occurrence of compound heatwave and drought events have a synergistic (multiplicative) effect on the risk of mental health related outcomes in children as compared to the additive effect of each individual climate hazard. Lastly, we identified household and community-level determinants of geographic variability of high psychiatric burden.

Methods: Daily counts of psychiatric ED visits in North Carolina from 2016 to 2019 (May to Sept) for pediatric populations were aggregated at the county scale. Bernoulli cluster analyses identified high-risk spatial clusters of psychiatric morbidity during heatwave, drought, or compound heatwave and drought periods. Multivariate adaptive regression models examined the individual importance of household and community-level determinants in predicting high-risk clustering of mood disorders or suicidality across the three climate threats.

Results: Results showed significant spatial clustering of suicide and mood disorder risks in children during heatwave, drought, and compound event periods. Periods of drought were associated with the highest likelihood of spatial clustering for suicide and mood disorders, where the risk of an ED visit was 4.48 and 6.32 times higher, respectively, compared to non-drought periods. Compounding events were associated with a threefold increase in both suicide and mood disorder-related ED visits. Community and household vulnerability factors that most contributed to spatial clustering varied across climate hazards, but consistent determinants included residential segregation, green space availability, low English proficiency, overcrowding, no broadband access, no vehicle access, housing vacancy, and availability of housing units.

Conclusion: Findings advance understanding on the locations of vulnerable pediatric populations who are disproportionately exposed to compounding climate stressors and identify community resilience factors to target in public health adaptation strategies.

Keywords: Compounding climate hazards; Drought; Heatwave; Mood disorders; Pediatric mental health; Suicide.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Heatwave (a) and drought (b) event definitions. a Heatwaves were defined as having at least 3-days above the seasonally adjusted 90th percentile ending the last day above the 90th with 3 consecutive days below the threshold. b Drought events were defined at a weekly scale when D1 (moderate drought) conditions were reached and ended after three consecutive weeks below Moderate (D1) drought conditions
Fig. 2
Fig. 2
Total counts of a heatwave, b drought, and c compound heatwave and drought events by county in North Carolina, 2016–2019
Fig. 3
Fig. 3
High-risk clusters for A suicide attempts and B mood disorders in pediatric populations for heatwave, drought, and compound heatwave and drought events in North Carolina, 2016–2019
See this image and copyright information in PMC

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