Journal Article Annotations
2022, 3rd Quarter

Climate Change

Annotations by Mary Burke, MD
October, 2022

Temperature impacts on hate speech online: evidence from 4 billion geolocated tweets from the USA.
Psychological responses, mental health, and sense of agency for the dual challenges of climate change and the COVID-19 pandemic in young people in the UK: an online survey study.
The Intersection of Immigrant and Environmental Health: A Scoping Review of Observational Population Exposure and Epidemiologic Studies.

PUBLICATION #1 — Climate Change

Temperature impacts on hate speech online: evidence from 4 billion geolocated tweets from the USA.

Annika Stechemesser, Anders Levermann, Leonie Wenz

Abstract: Lancet Planet Health. 2022 Sep;6(9):e714-e725. doi: 10.1016/S2542-5196(22)00173-5.

Background:
A link between weather and aggression in the offline world has been established across a variety of societal settings. Simultaneously, the rapid digitalisation of nearly every aspect of everyday life has led to a high frequency of interpersonal conflicts online. Hate speech online has become a prevalent problem that has been shown to aggravate mental health conditions, especially among young people and marginalised groups. We examine the effect of temperature on the occurrence of hate speech on the social media platform Twitter and interpret the results in the context of the interlinkage between climate change, human behaviour, and mental health.

Methods:
In this quantitative empirical study, we used a supervised machine learning approach to identify hate speech in a dataset containing around 4 billion geolocated tweets from 773 cities across the USA between May 1, 2014 and May 1, 2020. We statistically evaluated the changes in daily hate tweets against changes in local temperature, isolating the temperature influence from confounding factors using binned panel-regression models.

Findings:
The prevalence of hate tweets was lowest at moderate temperatures (12 to 21°C) and marked increases in the number of hate tweets were observed at hotter and colder temperatures, reaching up to 12·5% (95% CI 8·0-16·5) for cold temperature extremes (-6 to -3°C) and up to 22·0% (95% CI 20·5-23·5) for hot temperature extremes (42 to 45°C). Outside of the moderate temperature range, the hate tweets also increased as a proportion of total tweeting activity. The quasi-quadratic shape of the temperature-hate tweet curve was robust across varying climate zones, income quartiles, religious and political beliefs, and both city-level and state-level aggregations. However, temperature ranges with the lowest prevalence of hate tweets were centred around the local temperature mean and the magnitude of the increases in hate tweets for hot and cold temperatures varied across the climate zones.

Interpretation:
Our results highlight hate speech online as a potential channel through which temperature alters interpersonal conflict and societal aggression. We provide empirical evidence that hot and cold temperatures can aggravate aggressive tendencies online. The prevalence of the results across climatic and socioeconomic subgroups points to limitations in the ability of humans to adapt to temperature extremes.

Annotation

The finding:
Prior studies have shown that heat waves increase the expression of mental illnesses and worsen aggression. This study shows how this effect extends to online hate speech, which in turn has been linked to actual violence; the authors also report increases in hate speech during unusually cold periods. Analyses demonstrates these outcomes were not simply due to more time spent online during periods when the outdoor temperature is extreme and to be avoided.

Strength and weaknesses:
The researchers used a vast trove of online messages and were able to correct for a number of confounders. These findings held across all climate zones and socioeconomic strata. They used urban centers only which may undercount the impact in rural areas (that are particularly prone to adverse effects of climate change).

Relevance:
As clinicians we are dealing with an epidemic of mental illness including aggression, suicidality, and anxiety. Institutions, governments, and medical clinicians under-recognize the powerful role that unexpected temperature extremes play on our mental stability. C-L psychiatrists can include frank discussions with patients and communities about the role that heat and online hate speech play in worsening mental stability and ways to promote self-care.

PUBLICATION #2 — Climate Change

Psychological responses, mental health, and sense of agency for the dual challenges of climate change and the COVID-19 pandemic in young people in the UK: an online survey study.

Emma L Lawrance, Neil Jennings, Vasiliki Kioupi, Rhiannon Thompson, James Diffey, Ans Vercammen

Abstract: Lancet Planet Health. 2022 Sep;6(9):e726-e738. doi: 10.1016/S2542-5196(22)00172-3.

Background:
The COVID-19 pandemic and climate change are both significant and pressing global challenges, posing threats to public health and wellbeing. Young people are particularly vulnerable to the distress both crises can cause, but understanding of the varied psychological responses to both issues is poor. We aimed to investigate these responses and their links with mental health conditions and feelings of agency.

Methods:
We conducted an online survey between Aug 5 and Oct 26, 2020, targeting a diverse sample of young people (aged 16-24 years, n=530) in the UK. The survey was distributed using a combination of a survey panel (panel sample) and direct approaches to youth groups and schools who shared the survey with young people in their networks (community sample). We collected data on respondents’ psychological responses to both climate change and the COVID-19 pandemic, their sense of agency to respond to each crisis, and the range of impacts on their lives. We also collected demographics data and screened for mental health and wellbeing indicators. We used non-parametric tests for most statistical comparisons. For paired samples, we used Wilcoxon’s signed-rank test, and used Mann-Whitney U-tests or Kruskal-Wallis tests for two or more independent samples. Summed scale scores were considered as interval-level data and analysed with Student’s t tests and ANOVAs. Effect sizes are reported as Cohen’s d and partial eta-squared (η·²_p), respectively.

Findings:
After excluding 18 suspected bots and 94 incomplete responses, 530 responses were retained for analysis. Of the 518 respondents who provided demographic data, 63% were female, 71·4% were White, and the mean family affluence score was 8·22 (SD 2·29). Most participants (n=343; 70%) did not report a history of diagnosis or treatment for a mental health disorder, but mental health scores indicated a common experience of (relatively mild) symptoms of anxiety, depression, and stress. Although UK youth reported more life disruption and concern for their future due to the COVID-19 pandemic, climate change was associated with significantly greater distress overall, particularly for individuals with low levels of generalised anxiety. The COVID-19 pandemic was more associated with feelings of anxiety, isolation, disconnection, and frustration; distress around loss and grief; and effects on quality of life. Climate change was more likely to evoke emotions such as interest and engagement, guilt, shame, anger, and disgust. The greater distress attributed to climate change overall was due, in particular, to higher levels of guilt, sense of personal responsibility, and greater distress triggered by upsetting media coverage. Agency to address climate change was associated with greater climate distress, but pandemic-related distress and agency were unrelated.

Interpretation:
The COVID-19 pandemic and climate change are affecting the wellbeing of UK young people in distinct ways, with implications for health service, policy, and research responses. There is a need for mental health practitioners, policy makers, and other societal actors to account for the complex relationship between climate agency, distress, and mental wellbeing in young people.

Annotation

The finding:
The climate crisis emerged as a major impact on the mental well-being of global youth—as demonstrated by Hickman et al. and annotated here in Q4 of 2021. This article examined the impact of COVID and the climate crisis on youth in the UK and so is an interesting follow-up to that earlier study. The youth surveyed expressed greater levels of distress around the climate crisis as well as greater sense of agency. Respondents’ level of distress did not typically reach a severity warranting a clinical diagnosis. While they were more directly impacted by COVID at the time of the survey, and reported that COVID interfered more directly with their daily well-being, respondents nevertheless reported greater anxiety related to climate change with climate-specific anxiety increasing in proportion to overall anxiety. On the positive side, youth reported greater interest and agency with the climate crisis. The article highlights the role clinicians can play in harnessing that engagement to support mental resilience in the face of deteriorating climate conditions.

Strength and weaknesses:
The numbers surveyed were large and the careful breakdown of negative emotions allows a nuanced understanding of the experience of the youth surveyed. The authors tried to recruit from diverse communities with stipends for participation to reduce self-selection bias. However, the study only looked at youth in the UK and ran early during the pandemic, when countries were still wrestling with a major public health crisis.

Relevance:
Keep listening for the ways that existential fear for the future is impacting your younger patients!

PUBLICATION #3 — Climate Change

The Intersection of Immigrant and Environmental Health: A Scoping Review of Observational Population Exposure and Epidemiologic Studies.

Kelvin C Fong, Seulkee Heo, Chris C Lim, Honghyok Kim, Alisha Chan, Whanhee Lee, Rory Stewart, Hayon Michelle Choi, Ji-Young Son, Michelle L Bell

Abstract: Environ Health Perspect. 2022 Sep;130(9):96001. doi: 10.1289/EHP9855. Epub 2022 Sep 2.

Background:
Transnational immigration has increased since the 1950s. In countries such as the United States, immigrants now account for $> 15 %$ of the population. Although differences in health between immigrants and nonimmigrants are well documented, it is unclear how environmental exposures contribute to these disparities.

Objectives:
We summarized current knowledge comparing immigrants’ and nonimmigrants’ exposure to and health effects of environmental exposures.

Methods:
We conducted a title and abstract review on articles identified through PubMed and selected those that assessed environmental exposures or health effects separately for immigrants and nonimmigrants. After a full text review, we extracted the main findings from eligible studies and categorized each article as exposure-focused, health-focused, or both. We also noted each study’s exposure of interest, study location, exposure and statistical methods, immigrant and comparison groups, and the intersecting socioeconomic characteristics controlled for.

Results:
We conducted a title and abstract review on 3,705 articles, a full text review on 84, and extracted findings from 50 studies. There were 43 studies that investigated exposure (e.g., metals, organic compounds, fine particulate matter, hazardous air pollutants) disparities, but only 12 studies that assessed health disparities (e.g., mortality, select morbidities). Multiple studies reported higher exposures in immigrants compared with nonimmigrants. Among immigrants, studies sometimes observed exposure disparities by country of origin and time since immigration. Of the 50 studies, 43 were conducted in North America.

Discussion:
The environmental health of immigrants remains an understudied area, especially outside of North America. Although most identified studies explored potential exposure disparities, few investigated subsequent differences in health effects. Future research should investigate environmental health disparities of immigrants, especially outside North America. Additional research gaps include the role of immigrants’ country of origin and time since immigration, as well as the combined effects of immigrant status with intersecting socioeconomic characteristics, such as race/ethnicity, income, and education attainment. https://doi.org/10.1289/EHP9855.

Annotation

The finding:
There is insufficient research into environmental impacts on immigrant health, even as immigration rises with cascading climate disasters. This review summarizes research reporting that immigrants tend to have higher exposure to toxins with associated negative health outcomes, and to live in areas vulnerable to flooding (one study). The paper’s Tables 1 and 2 richly summarize the disparities in environmental exposures and health outcomes adversely affecting immigrants. For example, immigrants are more likely to have greater exposure to heavy metals and toxic organic compounds, air pollution, and PM2.5; less access to green spaces; and an increased likelihood of living in flood risk areas. Immigrants differentially experience certain negative health outcomes include a higher incidence of birth defects and mortality associated with PM2.5.

Strength and weaknesses:
The researchers did not distinguish immigration status from socioeconomic status, and the majority of studies were from the US even though immigration is now a global crisis

Relevance:
The article points to future directions for research as well as policy. C-L psychiatrists working with immigrants should be attentive to the health consequences of these environmental disparities.