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. 2010 Jun 22;20(4):668–680. doi: 10.1016/j.gloenvcha.2010.05.003

Table 3.

Conditions increasing sensitivity and constraining adaptive capacity of Aboriginal heath systems to climate change.

Determinant Sensitivity Adaptive capacity
Economic poverty Individual/household level: unhealthy activities, habitation in hazardous locations, poor nutrition Individual/household level: constrained access to finical resources, weakening of sharing networks
 Low household income, income disparity, high unemployment Institutional level: limited resources, other policy priorities



Technological capacity • Constraints to access to information on existing and new health risks limited • Ability to identify emerging risks, provide early warning, and develop proactive adaptation constrained
 Constraints to health care access, limited early warning/surveillance, high turnover of health personnel • Reluctance to seek medical advice • Reduced trust in medical system



Socio-political values and inequality • Cultural activities (traditional foods, camps etc) sensitive to climatic conditions • Reduced ability to effect needed change
 Marginalization, house overcrowding, food insecurity, cultural links to the land, history of oppression through medical system • High burden of ill-health • Directs political attention to other, non-climate related, issues
• Reluctance to seek medical advice • Adaptation may not be possible to cultural impacts which imply irreversible loss



Constrained institutional capacity • Constrained ability of heath systems to identify emerging risks • Limited long term strategic planning
 Jurisdictional conflict over health care provision, human and financial resource limits • Local understaffing • Limited institutional memory
• Lack of trust creates reluctance to seek medical advice • Jurisdictional ‘turf wars’
• Local capacity hampered by high staff turnover



Information deficit • Limited understanding of climate change-related health risks • Lack of knowledge on what to adapt to, available options, and how they would be developed and implemented
 Limited number of vulnerability assessments specifically at local levels