Climate Change and Disaster

WHISE sits in a region that includes rural peri-urban areas impacted by natural disasters such as fire, flood and drought. The areas on the edge of Melbourne from Cardinia Shire through to the Mornington Peninsula have experienced the impact of climate change. Increasingly, the impact has been felt throughout other parts of our region which has had a flow on impact to urban areas.

The impact of climate change occurs across all aspects and all stages of a woman’s life. Indeed, climate change exacerbates the existing health disparities, inequalities and vulnerabilities (Asian-Pacific Resource & Research Centre for Women, 2017).

As noted by the United Nations Framework Convention on Climate Change (UNFCCC), women, especially those in poverty, face higher risks and experience a greater burden of climate change impacts. This is notably true for health impacts, making climate change a risk multiplier for gender-based health disparities. Both men and women are at risk for amplified health impacts.

(Sorensen, et al., 2018)

The risks to women are categorised, reported and listed through such organisations as the World Health Organisation, International Red Cross and the United Nations Framework on Climate Change. For women, the impacts include decreased life expectancy and disproportionate mortality, higher risk of physical, sexual and domestic violence (especially in the aftermath of disasters), amplified impact on mental health (increased risk with other overlapping factors such as socioeconomic and education level), and increased vulnerability through pregnancy (Sorensen, et al., 2018).

Impacts of Climate Change on Women

Globally, evidence suggests that specific impacts of climate change on women include (adapated from Alston, 2013):

greater likelihood of deaths and injury during natural disasters
higher levels of physical and mental health
a greater role in caring for sick and injured
higher levels of GBV (gender-based violence)
a greater role caring for sick children especially in relation to water-borne disease
a greater role in caring for elderly especially in relation to respiratory disease
greater likelihood of violence against women and breakdown of societal protections following disasters and climate events
disproportional risks of violence after natural disasters
a greater likelihood of loss of employment in tourism
fewer new employment opportunities
a greater likelihood that women will lose land rights
a higher rate of malnutrition as women tend to eat last
a greater burden of work collecting clean water
a heavier work burden collecting fuel
fewer roles in post-disaster reconstruction
less involvement in decision-making
a greater loss of status due to declining participation in post-reconstruction
higher levels of violence, and a loss of basic freedoms
a lack of participation in household/community decision-making
out-migration; relationship stress
a loss of traditional women’s knowledge and this a loss of status
declining socio-cultural cohesion of communities which have been disrupted/changed by climate change impacts

Climate change is recognised as a “threat multiplier”, meaning it escalates social, political and economic tensions in fragile and conflict-affected settings. As climate change drives conflict across the world, women and girls face increased vulnerabilities to all forms of gender-based violence, including conflict-related sexual violence, human trafficking, child marriage, and other forms of violence (such as domestic violence) (UN Women , 2022). Research has found that violence against women increases following disaster. For example, following Hurricane Katrina in the US, intimate partner violence increased four-fold (Anastario, et al., 2009); and following the Canterbury earthquake in New Zealand, police recorded a 53% increase in domestic violence call-outs (Lynch, 2010).

Studies have found that men and women do not report experiencing the same negative health consequences in the wake of an extreme event (World Health Organisation, 2014). A review of census information to examine the effects of natural disasters across 141 countries has shown that although everyone experiences hardship, on average more women than men are killed and have a lowered life expectancy (World Health Organisation, 2014). Furthermore, these effects are greater for women with a lower socio-economic status (World Health Organisation, 2014). These findings demonstrate how socially constructed and gender-specific vulnerabilities of women are negatively impacted by natural disasters.

Considering the impact of gender on our responses to climate change, we can see how these social constructs of gender have both a direct and an indirect impact on people’s lives. Specifically, this can be seen in how constructed norms, stereotypes and behaviours increase risk in climate change and its compounding impact on our environment.

Socially constructed roles also influence the individual disaster responses of men. Within Latino cultures, for instance, expectations of male “heroism” require men to act courageously, thus forcing them into risky behaviour patterns in the face of danger and making them more likely to die in an extreme event…In the South Asian context, social norms that regulate appropriate dress codes in accordance with notions of modesty may hinder women and girls from learning to swim, which can severely reduce their chances of survival in flooding disasters.

(World Health Organisation, 2014, p. 13)

Australian Context

Australia is impacted by climate change and its impact on women’s health is an emerging area for women’s health services. Evidence and practice tell us that gender plays a significant role in the way that climate change is experienced as well as its environmental impact (Whittenbury, 2013). Understanding the role that gender plays is important to reduce or prevent vulnerability and increase resilience following climate events (Alston, 2013).

In Australian disasters such as bushfires and floods, women may be left to care for children, the elderly and livestock while men are absent fighting fires or maintaining flood defences… Gender also affects experiences of slower onset change related to weather and climate such as drought and impacts of structural changes such as industry restructures.

(Whittenbury, 2013, pp. 208-209)

Despite available evidence, Australia has yet to fully appreciate or differentiate the varied impacts of climate change due to gender. Research has revealed that climate change has a gendered impact which is demonstrated in the negative changes in women’s health and wellbeing. Gender is a “critical factor in vulnerability to climate events” (Alston, 2013, p. 9).

Bushfires and Floods

As far back as 1992, there were indications that this phenomenon equally happens in Australia. Such reflections were captured in a 1992 symposium on Women in Emergencies and Disasters held in Queensland by the then Bureau of Emergency Services. To which policies and strategies were proposed to reduce gender inequality during emergencies and disasters (Fuller, 1993). This was followed in 1994 by a special edition of The Macedon Digest where three papers referred to increased domestic violence, one stating, “An increase in domestic violence is repeatedly found in post-disaster situations” (Honeycombe, 1993). In a second article, a social worker wrote that after the 1990 Charleville flood:

“Human relations were laid bare and the strengths and weaknesses in relationships came more sharply into focus. Thus, socially isolated women became more isolated, domestic violence increased, and the core of relationships with family, friends and spouses were exposed” (Dobson, 1993)

The lack of knowledge and research was brought into light after the Black Saturday bushfires in 2009, when no reliable statistics were available to document the effect of the disaster on domestic violence occurrences (Parkinson, et al., 2013). Neither the existing family violence services, Victoria Police, nor the Victorian Bushfire Case Management System could provide conclusive data, confirming the suspicion that few researchers undertake examining gender-based violence in disasters because it is both methodologically and practically difficult to study (Parkinson & Zara, 2013; Rosborough, et al., 2013).

In 2013, a first of its kind study examined the Black Saturday bushfires provided evidence of increased domestic violence. In was reported in the wake of the Black Saturday Bushfires in Victoria in 2009 there was an increase in the incidence of domestic violence against women during post-disaster recovery. It was found that community members, police, case managers, trauma psychologists and family violence workers empathised with the suffering of men who may have been heroes in the fires–and encouraged women to wait the trauma out (Parkinson & Zara, 2013).

Meanwhile a study in 2020 by Melbourne University shows women who were living in regions more severely affected by the 2009 fires experienced higher levels of violence than those in less severely affected areas (Molyneaux, et al., 2019). This research provided insight and preparation for the 2019-2020 bushfire crisis, in which experts braced for an imminent surge in domestic violence (Premier of Victoria, 2021).

“The 2020 bushfires were devastating for entire communities but for women the impacts have been even worse, with evidence telling us that the incidence of family violence increases during and after disasters”- Gabrielle Williams, Minister of Women 2021

Solutions

Reported practice of in-field service workers indicates that during times of extreme climate events/disaster, the use of women’s networks and existing community groups is crucial to recovery and resilience (Hargreaves, 2013). Solutions and capacity building require innovation, understanding and strengths-based approaches (Hargreaves, 2013).

The experience of DHS social workers has shown that is important to connect with people where they are. They won’t necessarily come asking for help – so farm visits, farm gate events, agricultural shows and other organised community events – where help seeking and response can be normalised – are important responses used by our department.

(Hargreaves, 2013, p. 280)

Creating resilience in community is about “being reactive (or resistance to change) or proactive, a process where the inevitability of change is accepted and new ways of adapting that are more sustainable are developed” (Alston, 2013, p. 179). The Intergovernmental Panel of Climate Change (2008 as cited in Alston, 2013) has defined resilience as:

The ability of a social or ecological system to absorb disturbances while retaining the same basic structure and ways of functioning, the capacity for self-organisation, and the capacity to adapt to stress and change.

Communities in rural and remote areas tend to have less capacity to adapt and experience a higher burden from climate change is higher (Alston, 2013). Those without resources to adapt also include the unemployed, those who are dependent on voluntary services, the elderly, people with a disability and their carers, young people who are not able to afford education, and women (Alston, 2013). Thus, the framework of intersectionality can be applied as a practice for analysing those at-risk within climate change.

Role of health promotion and primary prevention in women’s health in climate change and disaster

There is a strong legacy in primary prevention and support for women and their health in disaster. Research led by the Gender and Disaster Pod (Women’s Health in the North, Women’s Health Goulburn North East and Monash University Disaster Resilience Initiative) has shown that responses to natural disaster need to have a gender lens and that emergency management planning policy, decision making and service delivery needs to consider gender inequalities.

Primary prevention and health promotion for women’s health needs to also:

Strengthen organisations’ capacity to challenge gender stereotypes, and address gender inequalities after natural disaster, particularly as it relates to the increase prevalence/risk of family violence
Support recovery and emergency workers to identify family violence after natural disaster
Work with communities building on evidence as well as “where people are at”, using partnership and network structures to build resilience and reduce risks of vulnerability to climate change and natural disasters.

Health promotion practice for climate change has only recently started to develop. Professional bodies and researchers in the field are advocating for “multi-strategy health promotion interventions” that build on current approaches (Smith & Capon, 2011, p. S3). Emerging evidence on health promotion suggests that the uncertainty and scale of climate change and disasters will require new approaches and frameworks (Patrick, et al., 2011). A key foundation of health promotion is creating supportive environments, meaning, to recognise “the inextricable links between people and their environment constitutes the basis for a socioecological approach to health” (World Health Organisation, 1986). Therefore, cross-discipline approaches and transferable competencies that draw on a range of skills will be required to address the scale of the climate change challenge (Patrick, et al., 2011). Based on personal accountability and congruence to one’s own ecological impact, health promotion and primary prevention practitioners will need to recognise the intersectionality of perspectives and experiences that communities bring to the shared climate change challenge.

An emerging group of academics and public policy officers in public health have identified how health promotion can mitigate risks and vulnerability within the context of broader climate change policy:

Climate change presents many health challenges but taking action to minimise its impacts through adaptation and mitigation is an opportunity to improve health.

(Hime, et al., 2018, p. 4)

Climate change policies provide a mandate for enacting a variety of public health and social programs, but there are many potential barriers to implementation. Complex causal chains between climate change and health will necessitate unfamiliar stakeholders working together. The issue of climate change and health must compete with numerous other health priorities; it may be perceived that climate change is an issue for the far future.

(Hime, et al., 2018, p. 5)

Overall, the trend for health promotion and primary prevention practitioners is the acknowledgement that work undertaken to address the health impacts of climate change will focus on and move towards “building adaptive capacity and resilience and mitigate climate change … to promote health” (Hime, et al., 2018, p. 1).

COVID-19 – The gendered impact of pandemics

Drawing on the evidence internationally and locally, we know that gender plays a role in how the pandemic impacts lives. During COVID-19 in Australia we learnt that:

Lessons from previous pandemics (for instance Zika virus) and evidence from disasters shows that the move to gender stereotypes and norms can intensify. This can lead to women having less access to power and decision making than men, including access to services and health care.
Gender segregation of the caring professions of early childhood education, teaching, aged care and nursing has seen women workers shouldering a significant burden of care for the community during the pandemic (Gender Equality Victoria, 2020)
Many female-dominated industries, such as teaching where women workers account for 85% and 68% of the primary and secondary teaching workforce, respectively, have been required to provide primary care during the pandemic with insufficient access to Personal Protective Equipment (PPE), such as face masks and hand sanitiser (Gender Equality Victoria, 2020)
Part-time workers were more likely to lose hours during the recession than full-time workers. Most part-time workers in Australia are women, whereas most full-time workers are men (Wood, et al., 2021).
Despite the fact that more women lost jobs during the crisis, most recipients of the Government’s JobKeeper wage subsidy were men.22 Women were more likely to miss out on the JobKeeper payment because casual employees who had been with their employer for less than 12 months were deemed ineligible (Wood, et al., 2021).
Since early 2020, there has been growing concern about the impact of the COVID-19 pandemic on family, domestic and sexual violence (FDSV). The impacts of a pandemic can be wide-ranging and situational stressors, such as victims and perpetrators spending more time together, or increased financial or economic hardship, can be associated with increased severity or frequency of violence (The Lookout, 2020; Nancarrow, 2020; Payne, et al., 2022).

A survey of 15,000 women administrated by Australian Institute of Criminology (Boxall, et al., 2020) found two thirds of women who experienced physical or sexual violence by a current or former cohabiting partner since the start of the COVID-19 pandemic said the violence had started or escalated in the three months prior to the survey.
1 in 10 (9.6%) women had experienced physical violence from their partner since the beginning of the COVID-19 pandemic.
One in 4 women (26%) who had experienced physical or sexual violence in the 12 months since the start of the pandemic said they had been unable to seek assistance on at least one occasion due to safety concerns. (Boxall, et al., 2020).

The pandemic compounds the already inconsistent access to sexual and reproductive health services (particularly contraception and abortion services).

Maintaining services to Emergency response of COVID-19 outbreak also means that resources for sexual and reproductive health services may be diverted to deal with the outbreak, contributing to a rise in maternal and newborn mortality, increased unmet need for contraception, and increased number of unsafe abortions and sexually transmitted infections.

(UNFPA, March 2020)

COVID-19 saw women to be significantly more likely than men to have experienced negative mental health impacts, such as higher levels of depression, anxiety and stress (ABS, 2021), and increased frequency and severity of family and sexual violence (Crime Statistics Agency, 2020; ABS, 2021). However, these statistics likely underrepresent the true rates of violence and poor health following disaster; women typically sacrifice their own needs and put others first which means they are less likely to report domestic violence following a disaster or it may be unrecorded due to stretched support services.

Interviews with service providers show that women who experience gender-based violence “may experience other symptoms and seek professional help for those symptoms” (Whittenbury, 2013). It is therefore important that recovery and support workers are aware and alert to the likely increase in abuse, isolation and exclusion that many women experience in the wake of a disaster (Gender & Disaster Pod, 2010).

Role of health promotion and primary prevention in women’s health in the pandemic

What became immediately clear during the COVID-19 pandemic, is that the role of primary prevention and health promotion dropped away. Primary prevention workforces tended to be redeployed in an understandable shoring-up of resources to mitigate significant risk to the health system.

Nonetheless, the need to ensure that the key messages on gender equality and the impact of the pandemic on women’s health and wellbeing was still vital. Ongoing support to build capacity, capability and resilience of workforce at times of disaster is also important.

Health Messaging

During public health emergencies, people need to know what health risks they face and what actions they can take to protect their health and lives. Accurate information provided early, often, and in languages and channels that people understand, trust and use, enables people to make choices and take actions to protect themselves, their families and communities from threatening health hazards (World Health Organisation, 2017). For WHISE, the role of being able to coordinate effective messaging built on evidence in a timely way, was a priority during the start of COVID-19.

The World Health Organisation’s guidance on communicating risk in public health emergencies tells us that emergency risk communication highlights the importance of building trust and engaging with organisations. Specifically, the World Health Organisation (2017) have advised that communication at times of emergency needs to:

Build trust by linking communication to services in transparent, timely and easy to understand way. 
Deliver to impacted populations.
Be empowering (allow populations to take action) 
Occur across multiple platforms.
Communicate uncertainties – for instance, what authorities know and what is not known and what information if forthcoming.
Build alliances and partnerships with those in the community who have public trust so that key information can be effectively distributed.

The World Health Organisation’s (2017) guidance also states that there is strong evidence that emergency risk communication should be integrated into all planning and have a key role in emergency leadership teams.  

In terms of practice, it is clear from evidence that multiple methods of message distribution should be used across networks as part of an integrated strategy.

Risk should not be explained in technical terms, as this is not helpful for promoting risk mitigation behaviours.
Consistent messages should come from different information sources. 
Messages should be released early in the outbreak.
Messages should promote specific actions people can realistically take to protect their health.
Messages need to arise from and be adapted to cultural contexts. 
Messages need to be reviewed and reshaped periodically as the emergency evolves (World Health Organisation, 2017).

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