What can we do when the smoke rolls in? An exploratory qualitative analysis of the impacts of rural wildfire smoke on mental health and wellbeing, and opportunities for adaptation

Abstract

Background Extreme, prolonged wildfire smoke (WFS) events are becoming increasingly frequent phenomena across the Western United States. Rural communities, dependent on contributions of nature to people’s quality of life, are particularly hard hit. While prior research has explored the physical health impacts of WFS exposure, little work has been done to assess WFS impacts on mental health and wellbeing, or potential adaptation solutions. Methods Using qualitative methods, we explore the mental health and wellbeing impacts experienced by community members in a rural Washington State community that has been particularly hard hit by WFS in recent years, as well as individual, family, and community adaptation solutions. We conducted focus groups with residents and key informant interviews with local health and social service providers. Results Participants identified a variety of negative mental health and wellbeing impacts of WFS events, including heightened anxiety, depression, isolation, and a lack of motivation, as well as physical health impacts (e.g., respiratory issues and lack of exercise). Both positive and negative economic and social impacts, as well as temporary or permanent relocation impacts, were also described. The impacts were not equitably distributed; differential experiences based on income level, outdoor occupations, age (child or elderly), preexisting health conditions, housing status, and social isolation were described as making some residents more vulnerable to WFS-induced physical and mental health and wellbeing challenges than others. Proposed solutions included stress reduction (e.g., meditation and relaxation lessons), increased distribution of air filters, development of community clean air spaces, enhancing community response capacity, hosting social gatherings, increasing education, expanding and coordination risk communications, and identifying opportunities for volunteering. Findings were incorporated into a pamphlet for community distribution. We present a template version herein for adaptation and use in other communities. Conclusions Wildfire smoke events present significant mental health and wellbeing impacts for rural communities. Community-led solutions that promote stress reduction, physical protection, and community cohesion have the opportunity to bolster resilience amid this growing public health crisis.

The Mental Health and Well-being Effects of Wildfire Smoke: A Scoping Review

“…But the only studies that considered chronic exposure have been qualitative; longitudinal studies particularly of cumulative and chronic exposures are required (37,40,41,44). Finally, we found only one study that addressed community response to chronic wild re smoke (20). Needed are studies identifying actions, strategies, and interventions individuals, families and communities use to cope with wild re smoke events such as community gathering spaces, community monitoring, and clean air spaces (20).…”

“…The accelerating increase in wild res and the population smoke exposures calls for new priorities and approaches, too. Wild res are becoming chronic, multi-week events, as was seen in Australia in 2019 and California in 2020 (20). Residents of rural areas in Washington state (USA) call the summer wild re smoke season the "Fifth Season" "when smoke from wild res blankets North Central Washington for weeks or even months at a time."…”

“…Several studies in our review describe how persons experiencing wild re events had recurring negative thoughts about their experiences when confronted with reminders like the smell of smoke and images of smoke (33,40,42,48). Humphrey et al used focus groups and interviews to describe how extreme and persistent smoke events impact mental health and well-being in rural communities in Washington state (USA) (20). Participants discussed a diversity of emotional impacts and responses associated with persistent smoke events including worry, stress, guilt, depression, lack of motivation, hopelessness, and helplessness.…”

“…Interestingly, those who left the community during smoke events also reported feeling stress as well as guilt. The authors argue that the impacts of wild re smoke on mental health and well-being may be particularly problematic in rural communities, which tend to be "dependent on contributions of nature to people's quality of life" (20). When discussing pathways leading to anxiety, stress, and depression, key factors included experiencing physical health effects (such as respiratory effects), isolation, lack of physical exercise, and economic consequences.…”

“…These harms are unevenly distributed across subpopulations, with children, the elderly, women, racial and ethnic minorities, those living in low socioeconomic areas, and those with preexisting conditions at greatest risk (12)(13)(14)(15)(16)(17)(18)(19). Rural and Indigenous communities are also at heightened risk for health and wellbeing impacts of exposure to wild re smoke (20).…”