title: Making the links: do we connect climate change with health? A qualitative case study from Canada.
abstract: BACKGROUND
  Climate change has been described as the biggest global health threat of the 21st century. Typically framed as an environmental issue, some suggest this view has contributed to public ambivalence and hence a lack of public engagement. The lack of understanding of climate change as a significant environmental health risk on the part of the lay public represents a significant barrier to behaviour change. We therefore need to think about reframing the impact of climate change from an environmental to a health issue. This paper builds on calls for increased understanding of the public's views of human health risks associated with climate change, focusing on facilitators and barriers to behaviour change.
  
  
  METHODS
  Semi-structured in-depth interviews (n = 22) with residents of the Golden Horseshoe region of Southern Ontario were conducted between August 2010 and January 2011. Topics included individual and community health, climate change, and facilitators and barriers to behaviour change.
  
  
  RESULTS
  Few participants recognized the role of the environment in the context of either individual and community health. When asked about health concerns specific to their community, however, environmental issues were mentioned frequently. Health effects as possible impacts of global environmental change were mentioned by 77% of participants when prompted, but this link was not described in great detail or within the context of impacting their communities or themselves. Participants were willing to act in environmentally friendly ways, and possible incentives to undertake behaviour change such as decreasing cost were described. Health co-benefits were not identified as incentives to engaging in mitigative or adaptive behaviours.
  
  
  CONCLUSIONS
  The results support recent calls for reframing the impact of climate change from an environmental to a public health issue in order to increase public engagement in adaptive and mitigative behaviour change. While previous research has touched on public awareness of the human health risks of climate change, we have further explored the attitude-action link through the examination of facilitators and barriers to behaviour change.
authors.affiliation: Department of Geography and Environmental Management, Faculty of Environment, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada. fcardwel@uwaterloo.ca
authors.forename: Francesca S
authors.initials: FS
authors.lastname: Cardwell
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Elliott
mesh_terms: D000328:Adult; D000368:Aged; D057231:Climate Change; D004782:Environmental Health; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D011639:Public Opinion; D036301:Qualitative Research; D018570:Risk Assessment; D055815:Young Adult