Examining the mental health impacts of climate change on young people in Canada: a national cross-sectional survey.

BACKGROUND: Climate change poses a substantial threat to the mental wellbeing of young people. Population-level research is urgently needed to help inform policies and interventions to ensure that young people are not burdened by long-term mental health impacts from climate change. We sought to identify the prevalence, distribution, and factors associated with climate change-related mental and emotional health outcomes among young people (aged 13-34 years) in Canada. METHODS: This study is part of a larger cross-sectional survey, which examined mental and emotional health responses to climate change among individuals aged 13 years or older from across Canada. We used a multi-stage, multi-stratified random probability sampling procedure. Participants were randomly recruited through either an addressed letter or a telephone call. Online and telephone questionnaires were used to interview individuals in English, French, or Inuktitut between April 1, 2022, and March 31, 2023. Data were weighted by age and province using population estimates from Statistics Canada and analysed using descriptive statistics, factor analyses, and multivariable regression analyses. FINDINGS: The full survey included 2476 participants, with a subgroup of 409 young people. Of the 401 respondents who provided their gender identity, 215 (54%) identified as cisgender women, 167 (42%) identified as cisgender men, and 19 (5%) identified as non-binary. Preliminary results suggest that young people in Canada experience a wide range of climate-related emotional and mental health outcomes. More than 70% of respondents in the young people subgroup reported having at least mild levels of sadness, anger, worry, anxiety, concern, helplessness, hopelessness, or powerlessness related to climate change. The severity of climate-related emotional responses differed by gender, with non-binary respondents and cisgender women reporting higher average levels of distress than cisgender men. Regional differences were also observed, with northern regions and urban locations reporting more severe reactions. INTERPRETATION: This study builds on the understanding of the burden of climate change on the mental health of young people. If unaddressed, the impact of this burden could have long-standing and wide-reaching public health and related socioeconomic effects. FUNDING: Canadian Institutes of Health Research, ArcticNet, Social Sciences and Humanities Research Council Doctoral Fellowship, Izaak Walton Killam Memorial Scholarship, and Alberta Innovates Graduate Student Scholarship.

Estimating climate change and mental health impacts in Canada: A cross-sectional survey protocol.

Climate change has severe and sweeping impacts on mental health. Although research is burgeoning on mental health impacts following climate and weather extremes, less is known about how common these impacts are outside of extreme events. Existing research exploring the prevalence of psychosocial responses to climate change primarily examines university students and uses non-random sampling methods. Herein, our protocol outlines an approach to data collection, processing, and analysis to estimate the population prevalence, magnitude, and distribution of mental health responses to climate change in Canada. A cross-sectional survey of youth and adults aged 13 years and older in Canada will be administered over the course of one year. The questionnaire will take approximately 10 minutes to complete orally and will be administered in English, French, and Inuktitut. The survey will consist of six sections: (1) self-reported past experiences of climate change; (2) self-reported climate-related emotions; (3) self-reported past and current impacts, anticipatory impacts, and vicarious experiences; (4) self-reported subclinical outcomes; (5) self-reported behavioural responses; and (6) demographics. A multi-stage, multi-stratified random probability sampling method will be used to obtain a sample representative of the Canadian population. We will use two different modes of recruitment: an addressed letter sent by postal mail or a telephone call (landlines and cellular). Population-weighted descriptive statistics, principal component analysis, and weighted multivariable regression will be used to analyse the data. The results of this survey will provide the first national prevalence estimates of subclinical mental health responses to climate change outcomes of people living in Canada.

Climate change is impacting mental health in North America: A systematic scoping review of the hazards, exposures, vulnerabilities, risks and responses.

As climate change progresses, it is crucial that researchers and policymakers understand the ways in which climate-mental health risks arise through interactions between climate hazards, human exposure and social vulnerabilities across time and location. This scoping review systematically examined the nature, range and extent of published research in North America that investigates climate-mental health interactions. Five electronic databases were searched and two independent reviewers applied pre-determined criteria to assess the eligibility of articles identified in the search. Eighty-nine articles were determined to be relevant and underwent data extraction and analysis. The published literature reported on numerous exposure pathways through which acute and chronic climate hazards interacted with social vulnerabilities to increase mental health risks, including wellbeing, trauma, anxiety, depression, suicide and substance use. This review also highlights important gaps within the North American climate-mental health evidence base, including minimal research conducted in Mexico, as well as a lack of studies investigating climate-mental health adaptation strategies and projected future mental health risks. Further research should support effective preparation for and adaptation to the current and future mental health impacts of climate change. Such strategies could reduce health risks and the long-term mental health impacts that individuals and communities experience in a changing climate.

How Did the Media Report the Mining Industry's Initial Response to COVID-19 in Inuit Nunangat? A Newspaper Review.

Mining in Inuit Nunangat relies on a southern Canada fly-in/fly-out (FIFO) and local workforce. The FIFO workforce, combined with existing social determinants of health, can create health risks to Inuit Nunangat. These risks were increased with COVID-19. As newspaper reporting can shape public opinion and policy actions regarding these COVID-19 risks, we systematically searched databases to identify newspaper articles during the initial phase of COVID-19 (i.e., articles published from 1 January to 30 June 2020). Descriptive statistics and qualitative thematic analysis were used to analyze the nature, range, and extent of included articles. Most included articles were published by Inuit Nunangat-based newspapers. Half the sources quoted were mining companies and most reported reactions to their initial response were negative. The most frequent topic was concern that an infected FIFO employee could transmit COVID-19 to a worksite and subsequently infect Inuit employees and communities. Inuit Nunangat-based newspapers were crucial in shaping the narrative of the initial response. National newspapers mainly focused on the takeover of TMAC™ during the pandemic, while Inuit Nunangat-based newspapers provided timely and locally-relevant pandemic information. Without Inuit Nunangat-based newspapers, the reporting would be from national and southern newspapers, which was less in-depth, less frequent, and less relevant to Inuit.

"Sewing Is Part of Our Tradition": A Case Study of Sewing as a Strategy for Arts-Based Inquiry in Health Research With Inuit Women.

In this article, we present a case study of sewing as a strategy for arts-based inquiry in health research, situated within a broader project that highlighted Nunavut Inuit women's childbirth experiences. Five focus groups were hosted as sewing sessions with pregnant women (N = 19) in Iqaluit, Nunavut (2017-2018). Women's reflections on the sessions, and the significance of sewing to Inuit, were integrated with researchers' critical reflections to examine the value of sewing as a strategy for arts-based inquiry within a focus group method: results related to the flexibility of the sessions; how collective sewing created space for voicing, sharing, and relating; sewing as a tactile and place-specific practice tied to Inuit knowledge and tradition; and lessons learned. Our results underscore the possibilities of arts-based approaches, such as sewing, to enhance data gathering within a focus group method and to contribute to more locally appropriate, place-based methods for Indigenous health research.

Are we walking the talk of participatory Indigenous health research? A scoping review of the literature in Atlantic Canada.

INTRODUCTION: Participatory research involving community engagement is considered the gold standard in Indigenous health research. However, it is sometimes unclear whether and how Indigenous communities are engaged in research that impacts them, and whether and how engagement is reported. Indigenous health research varies in its degree of community engagement from minimal involvement to being community-directed and led. Research led and directed by Indigenous communities can support reconciliation and reclamation in Canada and globally, however clearer reporting and understandings of community-led research is needed. This scoping review assesses (a) how and to what extent researchers are reporting community engagement in Indigenous health research in Atlantic Canada, and (b) what recommendations exist in the literature regarding participatory and community-led research. METHODS: Eleven databases were searched using keywords for Indigeneity, geographic regions, health, and Indigenous communities in Atlantic Canada between 2001-June 2020. Records were independently screened by two reviewers and were included if they were: peer-reviewed; written in English; health-related; and focused on Atlantic Canada. Data were extracted using a piloted data charting form, and a descriptive and thematic analysis was performed. 211 articles were retained for inclusion. RESULTS: Few empirical articles reported community engagement in all aspects of the research process. Most described incorporating community engagement at the project's onset and/or during data collection; only a few articles explicitly identified as entirely community-directed or led. Results revealed a gap in reported capacity-building for both Indigenous communities and researchers, necessary for holistic community engagement. Also revealed was the need for funding bodies, ethics boards, and peer review processes to better facilitate participatory and community-led Indigenous health research. CONCLUSION: As Indigenous communities continue reclaiming sovereignty over identities and territories, participatory research must involve substantive, agreed-upon involvement of Indigenous communities, with community-directed and led research as the ultimate goal.

How has Indigenous Health Research changed in Atlantic Canada over two decades? A scoping review from 2001 to 2020.

INTRODUCTION: Indigenous communities across Canada report that transformations in Indigenous health research are needed, where the benefits of research shift intentionally, collaboratively, and with transparency from the researchers directly to Indigenous communities and partners. Despite its challenges and potential for harm, research, if done ethically and with respect and partnership, can be a force for change and will strengthen the efficacy of data on Indigenous Peoples' health and wellbeing. PURPOSE: To characterize the nature, range, and extent of Indigenous health research in Atlantic Canada, and to identify gaps. METHODS: Eleven databases were searched using English-language keywords that signify Indigeneity, geographic regions, health, and Indigenous communities in Atlantic Canada between 2001 and May 2020. All references were reviewed independently by two reviewers. Of the 9056 articles identified, 211 articles were retained for inclusion. Data were extracted using a collaboratively developed data charting form. RESULTS: Indigenous health research in Atlantic Canada has increased over time, covering a diverse range of health topics. The main areas of research included climate change, child and youth health, and food and water security, with the majority of research deriving from Newfoundland and Labrador. Rates of reported community engagement remain relatively low and steady between 2001 and 2020, however there was an increase in researchers seeking Indigenous ethics approvals for such engagement. CONCLUSIONS: This scoping review synthesizes 20 years of Indigenous health research in Atlantic Canada. The results indicate that although there are increases in Indigenous ethics approvals, there is more work needed to ensure that Indigenous Peoples lead, design, and benefit from research conducted in their homelands.

Temperature and place associations with Inuit mental health in the context of climate change.

BACKGROUND: Climate change has important implications for mental health globally. Yet, few studies have quantified the magnitude and direction of associations between weather and mental health-related factors, or assessed the geographical distribution of associations, particularly in areas experiencing rapid climatic change. This study examined the associations between air temperature variables and mental health-related community clinic visits across Nunatsiavut, Labrador, Canada, and the place-specific attributes of these associations. METHODS: Daily de-identified community clinic visit data were collected from the provincial electronic health recording system and linked to historical weather data (2012-2018). A multilevel, multivariable negative binomial regression model was fit to investigate associations between temperature variables and mental health-related community clinic visits across the region, adjusting for seasonality as a fixed effect and community as a random effect. A multivariable negative binomial model was then fit for each Nunatsiavut community, adjusting for seasonality. RESULTS: Mental health-related visits contributed to 2.4% of all 228,104 visit types across the study period; this proportion ranged from 0.6% to 11.3% based on community and year. Regionally, the incidence rate of mental health-related community clinic visits was greater after two weeks of warm average (i.e. above -5ᵒC) temperatures compared to temperatures below -5ᵒC (IRR-5≤5ᵒC = 1.47, 95% CI = 1.21-1.78; IRR6≤15ᵒC = 2.24, 95% CI = 1.66-3.03; IRR>15ᵒC = 1.73, 95% CI = 1.02-2.94), and the incidence rate of mental health-related clinic visits was lower when the number of consecutive days within -5 to 5ᵒC ranges (i.e. temperatures considered to be critical to land use) increased (IRR = 0.96; 95% CI = 0.94-0.99), adjusting for seasonal and community effects. Community-specific models, however, revealed that no two communities had the same association between meteorological conditions and the incidence rate of daily mental health-related visits. DISCUSSION: Regionally, longer periods of warm temperatures may burden existing healthcare resources and shorter periods of temperatures critical to land use (i.e. -5 to 5ᵒC) may present enjoyable or opportunistic conditions to access community and land-based resources. The heterogeneity found in temperature and mental health-related clinic visits associations across Nunatsiavut communities demonstrates that place quantitatively matters in the context of Inuit mental health and climate change. This evidence underscores the importance of place-based approaches to health policy, planning, adaptation, and research related to climate change, particularly in circumpolar regions such as Nunatsiavut where the rate of warming is one of the fastest on the planet.

SOS! Summer of Smoke: a retrospective cohort study examining the cardiorespiratory impacts of a severe and prolonged wildfire season in Canada's high subarctic.

OBJECTIVES: To determine healthcare service utilisation for cardiorespiratory presentations and outpatient salbutamol dispensation associated with 2.5 months of severe, unabating wildfire smoke in Canada's high subarctic. DESIGN: A retrospective cohort study using hospital, clinic, pharmacy and environmental data analysed using Poisson regression. SETTING: Territorial referral hospital and clinics in Yellowknife, Northwest Territories, Canada. PARTICIPANTS: Individuals from Yellowknife and surrounding communities presenting for care between 2012 and 2015. MAIN OUTCOME MEASURES: Emergency room (ER) presentations, hospital admissions and clinic visits for cardiorespiratory events, and outpatient salbutamol prescriptions RESULTS: The median 24-hour mean particulate matter (PM2.5) was fivefold higher in the summer of 2014 compared with 2012, 2013 and 2015 (median=30.8 µg/m3), with the mean peaking at 320.3 µg/m3. A 10 µg/m3 increase in PM2.5 was associated with an increase in asthma-related (incidence rate ratio (IRR) (95% CI): 1.11 (1.07, 1.14)) and pneumonia-related ER visits (IRR (95% CI): 1.06 (1.02, 1.10)), as well as an increase in chronic obstructive pulmonary disease hospitalisations (IRR (95% CI): 1.11 (1.02, 1.20). Compared with 2012 and 2013, salbutamol dispensations in 2014 increased by 48%; clinic visits for asthma, pneumonia and cough increased; ER visits for asthma doubled, with the highest rate in females, in adults aged ≥40 years and in Dene people, while pneumonia increased by 57%, with higher rates in males, in individualsaged <40 years and in Inuit people. Cardiac variables were unchanged. CONCLUSIONS: Severe wildfires in 2014 resulted in extended poor air quality associated with increases in health resource utilization; some impacts were seen disproportionately among vulnerable populations, such as children and Indigenous individuals. Public health advisories asking people to stay inside were inadequately protective, with compliance possibly impacted by the prolonged exposure. Future research should investigate use of at-home air filtration systems, clean-air shelters and public health messaging which addresses mental health and supports physical activity.

Climate change and health in North America: literature review protocol.

BACKGROUND: Climate change is a defining issue and grand challenge for the health sector in North America. Synthesizing evidence on climate change impacts, climate-health adaptation, and climate-health mitigation is crucial for health practitioners and decision-makers to effectively understand, prepare for, and respond to climate change impacts on human health. This protocol paper outlines our process to systematically conduct a literature review to investigate the climate-health evidence base in North America. METHODS: A search string will be used to search CINAHL®, Web of Science™, Scopus®, Embase® via Ovid, and MEDLINE® via Ovid aggregator databases. Articles will be screened using inclusion/exclusion criteria by two independent reviewers. First, the inclusion/exclusion criteria will be applied to article titles and abstracts, and then to the full articles. Included articles will be analyzed using quantitative and qualitative methods. DISCUSSION: This protocol describes review methods that will be used to systematically and transparently create a database of articles published in academic journals that examine climate-health in North America.

"We're people of the snow:" Weather, climate change, and Inuit mental wellness.

Rapid environmental change due to climate change impacts Inuit mental wellness by altering the relationships between people, place, livelihoods, and culture. Little is known, however, about how fluctuations in weather contribute to the experience of place and the connection to mental wellness in Inuit communities. This study aimed to characterize the importance of changes in weather among Inuit, and how these changes influence mental health and wellness in the context of climate change. Data were drawn from a community-driven and Inuit-led study in the Nunatsiavut region of Labrador, Canada. In-depth interviews (n = 116 people) were conducted between November 2012 to May 2013 in the five Nunatsiavut communities. Qualitative data were thematically analyzed using a constant comparative method. Results indicated that weather impacted mental wellness through three key pathways: 1) shaping daily lived experiences including connection to place and other determinants of wellbeing; 2) altering mood and emotion on a transient basis; and 3) seasonally influencing individual and community health and wellbeing. These results demonstrate the immediate role weather has in shaping mental wellness in Nunatsiavut. In turn, this understanding of the climate-mental wellness relationship points to multiple pathways for action on climate adaptation policy and programming, and underscores the need for more culturally-specific and place-based investigations to appropriately respond to the mental health impacts of climate change.

Mapping the maternal health research landscape in Nunavut: A systematic search & critical review of methodology.

Nunavut's maternal healthcare system is characterized by rapid transition from community-based birth to a practice of obstetric evacuation and institutionalized birth. Given calls for Inuit self-determination in research, maternal health research - which informs healthcare practices and policies - may need to be conducted differently, using different research methodologies, to include Inuit women's voices and lived experiences. In light of these calls, this article systematically synthesized the published maternal health literature in Nunavut and critically examined reported research methods. This systematic search and critical review involved a comprehensive database search and multi-level eligibility screening conducted by two independent reviewers. Data on the temporal, geographic, methodological, and topical range of studies were extracted, then descriptive statistics were calculated to summarize these data. A hybrid inductive and deductive qualitative analysis of the full-text articles was conducted to critically analyze research methodology. The initial search yielded 2656 distinct articles and twenty-eight articles met the inclusion criteria. These articles were published from 1975 to 2016, mostly used quantitative research methodology (71.4%), were written from clinical perspectives (57.1%), and focused on maternity care (53.6%). Emergent themes related to both the contributions and areas for growth of research methodology in the conceptualization, initiation, implementation, reporting, and knowledge mobilization stages of the research process. This review revealed opportunities for maternal health researchers to: redress the ongoing impacts of colonization; further include Inuit definitions of health and perspectives on birth in study designs; explore new methodologies that resonate with Inuit ways of knowing; continue (re)aligning research with community priorities; and move from consultation and collaborative partnership in research to Inuit leadership and data ownership. Indeed, this review illustrates that at each step of the research process, opportunity exists for Inuit perspectives and active involvement to shape and define maternal health research in Nunavut.

Cryptosporidium and Giardia in locally harvested clams in Iqaluit, Nunavut.

High prevalences of Cryptosporidium and Giardia were recently found in enteric illness patients in the Qikiqtaaluk region of Nunavut, Canada, with a foodborne, waterborne or animal source of parasites suspected. Clams (Mya truncata) are a commonly consumed, culturally important and nutritious country food in Iqaluit; however, shellfish may concentrate protozoan pathogens from contaminated waters. The goal of this work was to investigate clams as a potential source of Cryptosporidium and Giardia infections in residents in Iqaluit, Nunavut. The objectives were to estimate the prevalence and genetically characterize Cryptosporidium and Giardia in locally harvested clams. Clams (n = 404) were collected from Iqaluit harvesters in September 2016. Haemolymph (n = 328) and digestive gland (n = 390) samples were screened for Cryptosporidium and Giardia via PCR, and amplified products were further processed for sequence analyses for definitive confirmation. Giardia DNA was found in haemolymph from 2 clams, while Cryptosporidium was not detected. The two Giardia sequences were identified as zoonotic Giardia enterica assemblage B. The overall prevalence of Giardia in clams near Iqaluit was low (0.6%) compared with other studies in southern Canada and elsewhere. The presence of Giardia DNA in clams suggests human or animal faecal contamination of coastal habitat around Iqaluit in shellfish harvesting waters. Results from this study are intended to inform public health practice and planning in Inuit Nunangat.

The need for community-led, integrated and innovative monitoring programmes when responding to the health impacts of climate change.

In Northern Canada, climate change has led to many acute and interrelated health and environmental impacts experienced among Inuit populations. Community-based monitoring, in which community members participate in monitoring initiatives using various forms of technology, is a key strategy increasingly used to detect, monitor and respond to climate change impacts. To better understand the landscape of existing environmental and health monitoring programmes mobilising different technologies and operating in the North we conducted a review that used environmental scan methodologies to explore and contextualise these programmes. We consulted with academic researchers with experience in community-led monitoring, conducted systematic searches of grey and peer-reviewed literature, and conducted a secondary search for environment-health mobile-phone applications. Following specific criteria, we identified 18 monitoring programmes using information and communication technologies in the North, and three global monitoring mobile-phone applications, which cumulatively monitored 74 environment and health indicators. Several themes emerged, including the need for: (1) community leadership, (2) indicators of environment and/or human health and (3) innovative technology. This synthesis supports the development of community-led, environment-health monitoring programmes that use innovative technology to monitor and share information related to the health implications of climate change in and around Indigenous communities throughout the Circumpolar North.

Collaborative approaches to wellness and health equity in the Circumpolar North: Introduction to the Special Issue.

This special issue brings together a series of papers that were presented at the Northern, Rural, and Remote Health Conference in Labrador, Canada. In this collection, scholars and community leaders use local examples to explore some of the most pressing issues in Circumpolar health: Indigenous self-determination in health care and health research; access to traditional medicines; language and identity; youth engagement; mental health; climate change; and health technology. Recognizing the dynamic ways that these topics were raised at the conference, we've included a diverse slate of papers: from commentary essays and case studies, to primary research and evidence synthesis. The goal of this special issue is to bridge local insights, innovations, and varied forms of evidence from the Circumpolar North, with global conversations about health equity, health system transformation, and the rights of Indigenous peoples. This editorial provides an overview of the conference and an introduction to the scholarship that emerged from it.

At-a-glance - Climate change impacts on health and wellbeing in rural and remote regions across Canada: a synthesis of the literature. / Aperçu - Les effets des changements climatiques sur la santé et le bien-être dans les régions rurales et éloignées au Canada : synthèse documentaire.

This article provides a synthesis of the forthcoming first order draft of the Canadian Government's National Assessment on Climate Change 'Rural and Remote' chapter, highlighting key health concerns from the literature associated with climate change in rural and remote regions, as well as existing and future adaptation strategies. To support the health and wellbeing of those experiencing the negative effects of climate change, and utilizing systematic search processes, this synthesis article highlights the importance of considering the specific socio-cultural, economic, and geographic elements and existing expertise of individuals and communities in rural and remote regions.

Climate change negatively impacts the health and wellbeing of individuals and communities in rural and remote regions in Canada. Key health concerns from the National Assessment on Climate Change 'Rural and Remote' include the exacerbation of issues associated with food and water security, chronic illness, infectious disease, unintentional injury and death, and mental health. Although specific characteristics increase climate change vulnerability of rural and remote regions, many strengths within these regions support resilience to climate change. Focusing on climate change adaptation, as well as realizing co-benefits from climate change mitigation, presents important opportunities for the health sector.

Les changements climatiques ont des effets nocifs sur la santé et le bien-être des habitants et des collectivités des régions rurales et éloignées du Canada. Les principales préoccupations en matière de santé mises en évidence dans le chapitre « Collectivités rurales et éloignées ¼ de l'Évaluation nationale des changements climatiques incluent l'exacerbation de problèmes liés à la sécurité des aliments et de l'eau, aux maladies chroniques, aux maladies infectieuses, aux blessures et décès accidentels et à la santé mentale. Bien que diverses caractéristiques spécifiques des collectivités rurales et éloignées soient à l'origine de leur vulnérabilité aux changements climatiques, ces régions disposent aussi de nombreux atouts soutenant leur résilience vis-à-vis de ces changements. Se centrer sur l'adaptation aux changements climatiques et prendre la mesure des avantages connexes résultant de l'atténuation de ces changements offre des opportunités au secteur de la santé.

Weather, environmental conditions, and waterborne Giardia and Cryptosporidium in Iqaluit, Nunavut.

Indigenous communities in the Arctic often face unique drinking water quality challenges related to inadequate infrastructure and environmental contamination; however, limited research exists on waterborne parasites in these communities. This study examined Giardia and Cryptosporidium in untreated surface water used for drinking in Iqaluit, Canada. Water samples (n = 55) were collected weekly from June to September 2016 and tested for the presence of Giardia and Cryptosporidium using microscopy and polymerase chain reaction (PCR). Exact logistic regressions were used to examine associations between parasite presence and environmental exposure variables. Using microscopy, 20.0% of samples tested positive for Giardia (n = 11) and 1.8% of samples tested positive for Cryptosporidium (n = 1). Low water temperatures (1.1 to 6.7 °C) and low air temperatures (-0.1 to 4.5 °C) were significantly associated with an increased odds of parasite presence (p = 0.047, p = 0.041, respectively). These results suggest that surface water contamination with Giardia and Cryptosporidium may be lower in Iqaluit than in other Canadian regions; however, further research should examine the molecular characterization of waterborne parasites to evaluate the potential human health implications in Northern Canada.

Responding to Climate and Environmental Change Impacts on Human Health via Integrated Surveillance in the Circumpolar North: A Systematic Realist Review.

Environments are shifting rapidly in the Circumpolar Arctic and Subarctic regions as a result of climate change and other external stressors, and this has a substantial impact on the health of northern populations. Thus, there is a need for integrated surveillance systems designed to monitor the impacts of climate change on human health outcomes as part of broader adaptation strategies in these regions. This review aimed to identify, describe, and synthesize literature on integrated surveillance systems in Circumpolar Arctic and Subarctic regions, that are used for research or practice. Following a systematic realist review approach, relevant articles were identified using search strings developed for MEDLINE® and Web of Science™ databases, and screened by two independent reviewers. Articles that met the inclusion criteria were retained for descriptive quantitative analysis, as well as thematic qualitative analysis, using a realist lens. Of the 3431 articles retrieved in the database searches, 85 met the inclusion criteria and were analyzed. Thematic analysis identified components of integrated surveillance systems that were categorized into three main groups: structural, processual, and relational components. These components were linked to surveillance attributes and activities that supported the operations and management of integrated surveillance. This review advances understandings of the distinct contributions of integrated surveillance systems and data to discerning the nature of changes in climate and environmental conditions that affect population health outcomes and determinants in the Circumpolar North. Findings from this review can be used to inform the planning, design, and evaluation of integrated surveillance systems that support evidence-based public health research and practice in the context of increasing climate change and the need for adaptation.