A Study to assess the Knowledge regarding health problems related to climate change among peoples in selected community areas at Kollam

 

Ms. Arya.s1, Ms. Ashlin Sunny1, Ms. Ayisha Mohamed1, Ms. Badariyathul Sabira1, Ms. Biffy Ann Philip1, Mrs. Jyothilakshmi2

1Nursing Students, Bishop Benziger College of Nursing, Kollam

2Department of Community Health Nursing, Bishop Benziger College of Nursing, Kollam

*Corresponding Author E-mail:

 

ABSTRACT:

The project undertook was “A study to assess the knowledge regarding health problems related to climate change among people in selected community areas at kollam.” The objectives of the study were: To assess the knowledge regarding health problems related to climate change among people in selected community areas of Kollam.

·       To find out association between the demographic variables and knowledge score regarding health problems related to climate change among people in selected community areas of Kollam.

·       To prepare and distribute pamphlets regarding potential health problems related to climate change among people in selected community areas of Kollam.

A quantitative research approach was adopted for the study. The study was conducted among 30 peoples residing among selected community areas at Kollam. In order to assess the knowledge regarding health problems related to climate change among peoples in selected areas at Kollam, the study sample were selected by convenience sampling technique. The tool used for data collection consists of demographic preform and structured questionnaire, basic introduction of the study was given to the subjects. The analysis of the data was based on the objectives of the study using descriptive and inferential statistics. The major findings of the study were as follows: The findings of the present study showed that there is no significant association between knowledge and selected demographic variables like age, family, education, and source of information, type of house and water supply and significant association with demographic variable like occupation. The findings of the present study showed that out of 30 samples 40% of the people have inadequate knowledge, 20% have moderate knowledge, and 40% people have adequate knowledge regarding the health problems related to climate changes. Based on the findings the investigator have drawn implications which were of vital concerns in the field of nursing practice, nursing administration, nursing pattern, nursing education and for future development.

 

KEYWORDS: Assess; Knowledge; health problem; climate change; people

 

INTRODUCTION:

Climate is that long statistical expression of short weather. Climate can be defined as "expected weather”. When changes within the expected weather occur, we tend to decision these climate changes. They can be outlined by the variations between average climate at 2 separate times. Climate could amendment in several ways in which, over different time scales and at different geographical scales. In recent times, scientists have interest in global warming, because of mankind's impact on the climate system, through the effect of the natural greenhouse effect.

 

The overall state of the world climate is decided by the number of energy keep by the climate system, and in particular the balance between energy the Earth receives from the Sun and also the energy that the world releases back to house, called the global energy balance. How this energy balance is regulated depends upon the flows of energy inside the world climate system. Major causes of global climate change involve any method which will alter the world energy balance, and the energy flows within the climate system. Causes of global climate change embrace changes within the Earth’s orbit round the Sun, changes in the amount of energy coming from the Sun, changes in ocean circulation or changes in the composition of the atmosphere. Large volcanic eruptions will have an effect on the world climate over solely a number of years. By distinction, the movement of continents round the world over many a lot of years may also have an effect on world climate, however solely over these for much longer time scales.1

 

According to world health organization (WHO) about 77,000 deaths annually in Asia and Pacific are due to the direct and indirect effect of climate change, about half of the world total attributed to climate change.2 Developing country populations significantly in tiny island states, high mountain zones and in densely inhabited coastal areas, are thought-about to be notably vulnerable. Each of the last decades has been successively warmer than any preceding decade since 1850. Sea levels are rising, glaciers are melting and precipitation patterns are changing. Extreme whether events are becoming more intense and frequent, studies say.3

 

Recent climate emergencies in India includes the Cyclone Fani in Odisha (2019), cyclone ockhi in Sri Lanka and India (2017), Floods in Kerala (2018), a heat wave in Orissa (2004), a cold wave in Uttaranchal and Uttar Pradesh (2004), a tsunami affecting Tamil Nadu, Andhra, Kerala, and the Andaman-Nicobar Islands (2004) rains and floods in Maharashtra (2005) and cyclone in Andhra Pradesh (2004). In the wave of summer 2003 in Europe for instance, over 70,000 excess deaths were recorded.4 Cyclone ockhi was a strong tropical cyclone that devastated parts of Sri Lanka and India in 2017. The cyclone fashioned around November twenty one, 2017, within the Japanese Andaman Sea. Ockhi caused at least 245 fatalities, with 218 in India and 27 in Sri Lanka. About 550 people were reported missing due to the storm. The death toll in the ockhi cyclone in Kerala rose to 40 today with the recovery of two more bodies, even as search operations to trace the missing fishermen entered the 10th day. Meanwhile, a total of 250 fishermen, trapped in the high seas following the November 30 cyclone, returned to Kochi.4 Form eight August 2018, severe floods affected the Kerala, because of remarkably high rain throughout the monsoon season. It was the worst come Kerala in nearly a century over 483 individuals died, and fourteen are missing a few million individuals were exhausted. According to the Kerala government, one-sixth of the full population of Kerala had been directly full of the floods and connected incidents.5 High temperatures conjointly raise the amount of gas and different pollutants within the air that exacerbate vessel and respiratory illness. Urban pollution causes regarding 1.2 million deaths each year. Pollen and different aeroallergen levels are higher in extreme heat.6

 

More than half of the world's population lives inside sixty kilometre of the ocean. People could also be forced to manoeuvre, which in turn heightens the risk of a range of health effects, from mental disorders to communicable diseases. Increasingly variable rainfall patterns are likely to affect the supply of fresh water.6 A lack of safe water will compromise hygiene and increase the danger of diarrhol diseases, which kills 2.2 million people every year. In extreme cases, water scarcity leads to drought and famine.7 Climatic conditions powerfully have an effect on water-borne diseases and diseases transmitted through insects, snails or other cold blooded animals. Changes in climate are possible to elongate the transmission seasons of necessary vector borne diseases and to change their geographic vary. Climate change is projected to extend threats to human health.” Climate change can affect human health directly (e.g., impacts of thermal stress, death/injury in floods and storms) and indirectly through changes in the ranges of disease vectors (e.g., mosquitoes), water-borne pathogens, water quality, air quality, and food availability and quality. Global climate change isthereforea recent challenge to current efforts to shield human health.7

 

A cross-sectional study was conducted in Yogyakarta city, Java in Indonesia. A structured questionnaire wasused to collect data among 508 adolescents who were in the second grade of asenior high school. This study revealed that participants had a low andinconsistent understanding regarding climate change and its impact on health. Only about 5% of the participants assumed that the level of community seriousness about climate change was a very serious problem, while in the participants’ opinion, only about 7% of the respondents reckoned that climate change is a serious problem. The majority of participants said that they somewhat know the cause of climate change (79.53%), the consequence (53.94%), and the attempt to tackle climate change (59.45%). Most of them also believed that climate change is an unbreakable process due to their assumption that climate change is caused by a natural process (51.18%), not caused by human activity. 51.18% of respondents understood that CO2 has a high impact on climate change. Moreover, 77.36% of the respondents agreed that the industrial sector had a considerable contribution to climate change. More than 50% of the respondents disagreed with the statement that climate change evidence is not convincing. Besides, more than 60% of the respondents were aware that sea level rise and flood were kinds of climate change impact.8

 

A cross-sectional study was conducted to assess the knowledge and perceptions about the health impact of climate change among health science students at Haramaya University, Ethiopia. Quantitative methods were used to analyse the results. Over three quarters of scholars were aware health consequences of changes in climate amendment, with slightly higher rates in females than males, the percentage is from 60.7% in pharmacy students to 100% in environmental health and post-graduate public health students. Electronic mass media was reportedly the main source of information however the majority (87.7%) students expressed that their data was inadequate to completely perceive the general public health impacts of climate change. Students World Health Organization knew regarding climate variation were a lot of probably to understand it as a heavy health threat than people who were unaware of those impacts and additionally thought of their departments to be concerned about climate change ,a perception that was also significantly more common among students who obtained their information from the electronic mass media and schools. Using electronic mass media was considerably related to data concerning the health impacts of temperature change.9

 

OBJECTIVES:

The objectives of the study are:

·       To assess the knowledge regarding health problems related to climate change among people in selected community areas of Kollam.

·       To find out association between the demographic variables and knowledgescoreregardinghealth problems related to climate change among people in selected community areas of Kollam.

·       To prepare and distribute pamphlets regarding potential health problems related to climate change among people in selected community areas of Kollam.

 

REVIEW OF LITERATURE:

1.     IMPACT OF CLIMATE CHANGE ON HEALTH:

A community-based descriptive cross-sectional study of 1,019 rural respondents using a multistage sampling method for public perception of climate change and its impact on health and environment conducted in rural south western Nigeria in 2014.The research instrument used was a pretested, structured, interviewer-administered questionnaire. Results show that the mean age of respondents was 36.9 (±12.4) years. About 911 (89.4%) of respondents opined that there has been a change in climate in the last 10 years. Supernatural reasons were prominent among respondent-reported causes of climate change. Identified risky behavior contributing to climate change included smoking (10.7%), bush burning (33.4%), and tree felling (41.0%). Poor knowledge of causes but good knowledge of effects of climate change was found in this study. About two-thirds of respondents had a positive attitude to causes of climate change, while half had a positive attitude to the effects of climate change. Educational status (P<0.001, Kendall's τ-c=-0.042), occupational status (P<0.01, Kendall's τ-c=0.088), and attitude shows a significant association to causes of climate change. Again analysis was done by using logistic regression. The result showed that occupational status was significantly associated with likelihood of having a positive attitude, but educational status and marital status were not. Rural areas of Nigeria are vulnerable to the adverse effects of climate change. Respondents' poor knowledge but positive attitude to climate change calls for dissemination of adequate information on climate change in sustained health-promotion programs.10

 

·       The Intergovernmental panel on climate change report of 2007 concludes that climate change is estimated to increase threat to human health, mainly in lower income countries. It will have implications on food production, water supply, airquality, coastal settlements and human health. The continuing change of the climate can affect the basic elements required for maintaining good health; clean air, potable water, adequate food and shelter. At recent time, India reported an increase in the incidence of vector-borne diseases and a decrease in crop production, and also more frequent extreme weather events which could be attributed to changing climate. Respectively 2000 and 3000 deaths were estimated as an effect from heat-waves in Odisha in 1998 and in Andhra Pradesh in 2003.As the highest temperature rose to 46.3 degree Celsius which was 10 degrees above normal the Eastern Indian state of Odisha’s capital Bhubaneswar has a record with an unusual mercurial rise in summer in the month of June 200.Climate change is projected to bring changing rainfall patterns, increased temperatures, evaporation, and salinization of water sources through rising sea levels.The paper shows that linkages between climate change and human health are complex and multi-layered and predictions of the future health impacts of climate change are still uncertain. Over India, the annual mean temperature has increased in the past hundred years. Projection of the future climate change scenario shows catastrophic events will exhibit an increase in frequency and intensity resulting in enormous impact on human life in terms of death toll and disease epidemic.11

 

·       A study was conducted to identify the awareness and the impact of climate change, perceived by the young citizens in Malaysia by focusing on gender differences in 2014. Depending on a survey of 200 respondents from different public and private University’s students in Malaysia, this research used descriptive statistics and t-test to look into the research objective. The results revealed that, media can play an important role in the awareness of climate change. The choice of respondents included in the survey by using a structured questionnaire. Result shows that out of 200 male respondents (60%) made up the majority followed by female (40%). Most of the respondents were Malays (60%), followed by Chinese (35%) and Indian (5%). The majority of the respondent’s response came from students of private universities (70%) followed by public universities (30%). Most of the students were from undergraduate level (60%), followed by postgraduate (40%). In terms of their general belief about the climate change 70% of the respondents believed that the climate of their motherland has changed significantly in the last 10years. The interestingly majority of the respondents (80%) agreed that the issue of climate change and its discussion belonging all too scientific in nature. Even though a significant number of respondents (70%) think that climate change has several impacts on their personal and social function.12

 

·       A study was conducted to identify the impact of 2004 tsunami in the islands of Indian Ocean on 2011.Report shows that tsunami of 2004, caused by a 9.0 magnitude earthquake, was the most devastating tsunami in modern times. It affects 18 countries in Southeast Asia and Southern Africa, killing more than 250,000 people in a single day, and leaving more than 1.7 million homeless.13

 

·       A survey method study was conducted among 238 children from the class’s sixth to tenth standard to find out the impact of tsunami disaster among children during the months of May – July; 2005.The study was conducted at Little Flower High School, Melmanakudy, Kanyakumari. The violent tsunami waves have brought about tremendous loss to life and properties of the people, particularly to the fishermen folk in the areas of Tamil Nadu, Andhra Pradesh and Kerala. It was seen that the impact of tsunami on the children was incredible, subsequent to the disaster. The tools used were Impact of Event Scale (Child Version). Results show that the age of the respondents ranged from ten to 18 years. The children suffered from multiple losses. Intrusion and avoidance was equally present among the children. 14

 

·       An aftermath analysis study was conducted to assess the ockhi cyclone and its impact in the kanyakumari district of southern Tamil Nadu, India on 2018.The origin of ockhi can be tracked to an area of low pressure that formed in the eastern Andaman Sea on 21stnovember 2017. Ochki caused severe damages to structures properties and also claimed the lives of least 218 people in the kanyakumaridistrict. An integrated remote sensing and geographic information system study has been conducted to estimate the impact of ockhi on Landuse and Landover of kanyakumaridistrict.Landsat 8 imageries of pre and post ockhiwere compared and changes made by cyclone ockhi has been estimated in this study.15

 

2.     KNOWLEDGE REGARDING HEALTH PROBLEMS RELATED TO CLIMATE CHANGE

·       A cross sectional study was conducted in 2014 to assess knowledge and attitude of nurses regarding potential impact of climate change on public health in central of china. The study aimed to determine attitude and knowledge of nurses regarding climate change and their role on addressing health related impacts of climate change in central China. The nurses were randomly selected from hospitals in central of china and they were asked to complete a questionnaire about climate change. The data was analyzed using descriptive statistical analysis method. The result of the study shows majority of nurses (76%) knew about the climate change would affect public health. But more than half of the nurses did not recognize their work could also affect the development of climate change; 83–96% of the nurses would like to learn the knowledge about climate change. 16

 

·       A study aimed to compute the knowledge and perceptions of medical, public health, and nursing students regarding climate change and its impactsand to identify associations between the knowledge and perceptions were conducted in China from April to May in 2017.The data were gathered by a nationwide cross-sectional survey of 1387 students sampled among five different regional universities in China. The knowledge and perceptions of the participants were collected by self-administered questionnaires and found that most respondents believed that climate change is generally “bad” (83%) and not good for human health (88%), while 67% trusted that climate change is controllable. The vast majority of respondents recognized that illness conditions resulting from poor quality of air (95%), heat stress (93%), and extreme events of weather (91%) as potential effectof climate change. Only 39% recognized that malnutrition as a consequence of food deprivation resulting from climate change. Around 58% of respondents were able to correctly identify the causes of climate change. The result shows that the characteristics of participants of the 1387 respondents, 69% were 21–22 years old and 67% were female. The majority (>80%) estimated their health status as good or very good. The nursing students were more likely to be female (p < 0.01) and reported lower household income.17

 

·       A study was conducted in eastern Uttar Pradesh, India in 2011 regarding knowledge and passive adaptation to climate change that an attempt to use group information collected on climate change from farmers to address a key question related to climate change policy: How to encourage farmers to adapt to climate change? Farmers’ perception of and adaptation to climate change were investigated using content analysis and group information. Climatic and agriculture information collected through secondary sources are then compared with the findings. The study is depended on both primary and secondary information. Primary information was collected through the focus group method. Results suggest that though farmers were aware of long-term changes in climatic factors (temperature and rainfall) they were unable to identify these changes as climate change. Farmers also have knowledge of risks generated by climate variability and extreme climatic events. However, farmers were not taking concrete steps in dealing with perceived climatic changes, although we find out that farmers are changing their agricultural and farming practices. At last, the paper suggested some policy interventions to scale up adaptation to climate change in Indian agriculture. 18

 

·       An observational study was conducted at the Medical College in Pune city, Medical students from all years of M.B.B.S from January to April in 2011. A self-administered, pre-tested, questionnaire was used. Responses were evaluated that, a total of 250 medical students were included in this study. The objectives of this study were, at first to assess the awareness regarding climate change and its health hazards among the medical students and second to recommend the awareness campaigns regards to climate change and its health hazards for students based on the results. Total 246 (98.40%) students stated that global climate is changing, while 245 (98%) students opined that human activities are contributing to climate change. Newspaper and magazines (78.20%) was the commonest source of informationabout climatechange. Majority of them commented that deforestation and industrial and vehicular pollution contribute most to climate change. Health-related issues are priority for climate change prevention strategy according to 47.50% of the students. According to 65.10% students, result shows that direct physical hazards of extreme climatic events are most important health-related impact of climate change, and it is followed by natural disaster-related health hazards (43.50%), waterborne diseases (27.60%), vector-borne diseases (17.60%), and malnutrition (10%).Statistically significant difference was found between year of MBBS of the students and the knowledge regarding United Nations Federation on Climate Change, according to Kyoto protocol (χ2 = 7.85, P = 0.02), and Intergovernmental Panel on Climate Change (χ2 = 12.77, P = 0.002). A significant difference was founded between the awareness about health impact of climate change at different places (χ2 = 11.25, P = 0.001) 19

 

MATERIALS AND METHOD:

Methods:

A quantitave approach is used in that the research design is adopted for the study is survey design. The setting will be pallithottam community area situated at kollam. The populations in the study include residents in selected villages at kollam. Convenience sampling used in this study.

 

Tools / instruments:

The instruments used for the present study are demographic proforma and structured questionnaire which were validated by the experts.

 

Data collection:

Data will be collected after obtaining prior administrative permission and informed consent from residents. The tools for data collection procedure are demographic proforma including age, type of family, education, occupation, type of house and water supply

 

The data collection was conducted on 25-01-2019. The setting for the study was Don Bosco and Century nagars of Pallitthottam, Kollam. The data collected after obtaining administrative approval and permission from authorities of Bishop Benziger community Health CenterPallithottam. The subjects were collected based on inclusion and exclusion criteria. The people who are residing in Pallithottam were selected. A total of 30 sample were selected using convenience sampling technique. The investigator introduced him to the subjects and purpose of the study was explained to them. Confidentiality was assured and a written consent was obtained. Structured knowledge questionnaire was used to find out the knowledge regarding the potential health problems related to climate changes among people. After conducting the study, pamphlets were given to people to increase their knowledge regarding potential health problems related to climatic changes. The data collected were compiled for analysis.

.

Data analysis:

The researcher will analyse the data by using descriptive and inferential statistics based on the objectives and hypothesis of the study. To compute the data, a master data sheet was prepared by the investigator.

 

 

FINDINGS OF THE STUDY:

SECTION A

Description of samples according to their demographic variables.

 

This section deals with the percentage wise distribution of samples according to demographic variables such as age, family type, education, source of information, occupation, type of house and water supply.

 

Figure 1: Bar diagram showing percentage wise distribution of samples according to their age                                                    N=30

 

The data presented in figure 1 shows that out of 30 samples 13.33% are the age between 25-30, 10% are belongs to 31-35 age and 76.66% are age above 35

 

Figure 2: Cylinder diagram showing percentage wise distribution of samples according to their family type.                                N=30

 

The data presented in figure 2 shows that out of 30 samples, 53.33% were belongs to nuclear family and 46.66% were belongs to joint family.

 

 

Figure 3: The cylinder diagram showing percentage wise distribution of samples according to their educational status. N=30

 

Figure 3 shows that out of 30 samples, 66.66% had education below SSLC, 23.33% had education SSLC and 10% were higher secondary.

 

Figure 4: Bar diagram showing percentage wise distribution of samples according to their source of information.                     N=30

 

The data presented in figure 4 shows that out of 30 samples, 83.33% were get information from television, 13.33% get information from newspaper and 3.3% get information from radio.

 

Figure 5: Cylinder diagram showing percentage wise distribution of samples according to their occupation.                                N=30

 

The data presented in figure 5 shows that out of 30 samples 50% were fisher man and 50% were others includes carpenter, kooli workers etc.

 

The data depicted in figure 6 shows that out of 30 samples 66.66% were lives in terraced house, 6.66% have tiled, 20% were in sheet and 6.66% were lives in thatched house.

The figure 7 shows that out of 30 samples, 3.33% gets water supply from well, 53.33% get water from pipe line, 36.66% used tube well and 6.66% gets water from other sources like common well, pond etc.

 

Section B: Description of knowledge regarding health problems related to climate change among peoples in the selected community areas kollam.

Table 1: Frequency and percentage distribution of knowledgeregarding health problems among peoples.            N=30

Score

Score range

Frequency

Percentage

0-9

Inadequate

12

40%

10-11

Moderate

6

20%

12-20

Adequate

12

40%

 

The data presented in table 1 shows that out of 30 samples 40% peoples had inadequate knowledge,20% had moderate knowledge and 40% had adequate knowledge regarding health problems related to climate change.

 

Figure 6: Bar diagram showing percentage wise distribution of samples according to their type of house.                                N=30 

 

Figure 7: Cylinderdiagram showing percentage wise distribution of samples according to their water supply.                              N=30

 

SECTION C: Association between knowledge regarding health problems related to climate change among people and selected demographic variables such as age, familytype, education, source of information, occupation, type of house and water supply.

 

Table 2: Association between knowledge and selected demographic variables.

Sl No

Variables

Knowledge

Df

 

Chi squarevalue

Level of

Significance

Inadequate

Moderate

Adequate

1.                     

Age in years

 

25-30

2

0

2

4

3.0

NS

 

30-35

2

1

1

 

>35

1

10

4

2.                     

Family

 

Nuclear

8

5

3

2

1.44

NS

 

Joint

4

6

4

3.                     

Education

 

<SSLC

8

8

4

4

0.549

NS

 

SSLC

3

2

2

 

HSS

1

1

1

4.                     

Source of information

 

Television

11

11

3

4

2.106

NS

 

Newspaper

2

1

1

 

Radio

0

1

0

5.                     

Occupation

 

Fisherman

5

8

2

2

3.892

S

 

Others

7

3

5

6.                     

Type of house

 

Terraced

6

11

3

6

11.343

NS

 

Tiled

2

0

0

 

Sheet

4

0

2

 

Thatched

2

0

0

7.                     

Water supply

 

Well

0

0

1

6

7.759

NS

 

Pipeline

6

6

4

 

Tube well

6

3

2

 

Others

0

2

0

NS=Not significant

S= Significant

 

Table2:

The association was computed by using chi square test. It was inferred that in demographic variable such as age the calculated value is 12.59 which is greater than the tabulated value 3.0, family the calculated value is 5.99 and the tabulated value is 1.44, Education the calculated value is 9.49 which is greater than tabulated value 0.549, Source of information the calculated value is 9.49 which is greater than tabulated value 2.106, in occupation the calculated value is 5.99 which is lesser than the tabulated value is3.892, type of house the calculated value 13.59 is greater than the tabulated value is 11.343 and the water supply calculated value 12.59 is greater than the tabulated value is 7.759. It was inferred that the present study the showedno significant associationbetween age, Family, educational status, Source of information, and Type of house (calculated value greater than table value at 0.05 level of significance). There is a significant association between pretest knowledge and demographic variables like occupation. The chi square value of occupation (X2value= 4.13) is lesser than the table value at 0.05 level of significance so there is significant association with demographic variable like occupation and knowledge at 0.05 level of significance.

 

CONCLUSION:

The present study aimed to assess the knowledge regarding health problems related to climate change in selected community areas at Kollam. The findings of the present study showed that out of 30 samples 40% of the people have inadequate knowledge, 20% have moderate knowledge, and 40% people have adequate knowledge regarding the health problems related to climate changes. The findings of the present study showed that there is no significant association between knowledge and selected demographic variables like age, family, education, and source of information, type of house and water supply and significant association with demographic variable like occupation

 

RECOMMENDATIONS:

Based upon the study findings, the following recommendations were made for the future study:

·       A similar kind of study can be conducted in construction workers.

·       The same study can be conducted for large group.

·       A structured teaching programme can be planned for a large group.

·       Study can be conducted using other strategies such as manual, computer assisted instruction, STP and video assisted teaching programme and self teaching module

 

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3.      J.P Maira and A.Gur, Indian Journal of occupational and environmental medicine, Climate change and health -why should India be considered?  Available from: www.bioline.org.br

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5.      Kerala India flood 2018- Nasa Earth Science Disaster Programme. Available from: https://disasters.nasa.gov

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Received on 28.11.2019          Modified on 26.12.2019

Accepted on 09.01.2020   © A&V Publications all right reserved

Int. J. Nur. Edu. and Research. 2020; 8(2):210-218.

DOI: 10.5958/2454-2660.2020.00046.0