Climate Change Adaptive Capacity as Modified by Identity, Experience and Health Status in the Eastern Caribbean

Abstract

As health systems evolve in the face of climate change impacts, residents of the Eastern Caribbean small island states remain especially vulnerable to compromised health status. This study explored adaptive capacity as well as pro-health attitudes and behaviors among residents, age 15 to 75 years, in St. Kitts & Nevis between 2015 and 2019. Bivariate and multivariate logistic regressions were used to assess the likelihoods of capacity building across community members. Of 392 survey participants, at least 35% reported impacts of storms, droughts, high heat or vector borne diseases in their community. The most commonly reported adaptive behaviors were spending less time outdoors (52%), employing additional water storage (54%), taking cooler baths (57%), reducing clothing layers (59%), relying on natural ventilation (60%), and using air conditioning (AC) or fan (80%). Persons 30 years and older were more likely to initiate health-protective home repairs (OR: 2.37; 95%CI: 1.53, 3.69), eliminate mosquito breeding sites (OR: 2.63; 95%CI: 1.73, 4.02), install pest barriers (OR: 2.08; 95%CI: 1.38, 3.16), or wear less clothing (OR: 2.01; 95%CI: 1.31, 3.11) than younger residents. LGBTQ persons were more likely to initiate health-protective home repairs (OR: 2.17; 95%CI: 1.20, 3.85), eliminate mosquito breeding sites (OR: 2.70; 95%CI: 1.52, 5.00), reduce clothing layers (OR: 2.33; 95%CI: 1.22, 4.55), or use sunscreen (OR: 2.17; 95%: 1.06, 4.17) than non-LGBTQ individuals. Health professionals were more likely to initiate health-centric home repairs (OR: 7.58; 95%CI: 4.24, 14.02), eliminate mosquito breeding sites (OR: 6.45; 95%CI: 3.56, 12.22), physically intervene to help someone threatened by extreme weather (OR: 4.08; 95%CI: 2.31, 7.21), or install pest barriers (OR: 8.51; 95%CI: 4.26, 18.99) relative to non-health professionals. Results reflect the critical importance of demographics - sex, sexuality, age, and profession - as a modifier of risk perception and management.