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.

Farmers globally face significant occupational stressors and are reported to experience high levels of depression, anxiety, burnout, suicide ideation, and suicide. While the impacts of high stress and poor mental health have been well-studied in the general population, and to some extent, in specific occupations, the impacts on farmers are understudied. The objective here was to explore the lived experience of high stress and (or) poor mental health in Canadian farmers, including the perceived impacts. Using a phenomenological approach within a constructivist paradigm, we conducted 75 one-on-one research interviews with farmers and people who work closely with farmers, in Ontario, Canada, between July 2017 and May 2018. We analysed the data via thematic analyses and identified four major themes. Participants described myriad negative impacts of farmers’ high stress and (or) poor mental health: (1) personally, (2) interpersonally, and (3) cognitively, which ultimately negatively impacted them (4) professionally, including consequences for productivity, animals, and farm success. The data described far-reaching, interconnected impacts of high stress and poor mental health on participants, the people and animals in their lives, and most aspects of their farming operations, financial viability, and success. Farmer stress, mental health, and well-being are important considerations in promoting sustainable, successful agriculture.

Farming is recognized as one of the most stressful occupations worldwide, with farmers experiencing heightened prevalences of chronic stress, depression, anxiety, and suicidality. However, there is limited research that has qualitatively examined gendered experiences of farmers’ mental health in Canada. This study explored Canadian farmers’ perspectives on mental health through a gendered lens to address this gap in knowledge. Seventy-five farmers and agricultural community members participated in semi-structured interviews centred on stress, mental health challenges, and help-seeking, conducted between 2017 and 2018. Data were analyzed thematically using a Gender-Based Analysis Plus (GBA+) approach. Three major themes were identified: identity, workload, and mental health support. Women farmers described persistent struggles to be recognized as “farmers,” highlighting how gender-assumptive language and agricultural norms undermined their identity and contributed to their mental distress. They also reported disproportionate workloads, often resulting in overwhelm, exhaustion, and diminished wellbeing. Finally, while men often positioned women as the preferred recipients of mental health education, women expressed that this expectation intensified their already heavy burden. Findings underscore that gendered roles and expectations in Canadian agriculture profoundly shape farmers’ mental health in that women’s contributions remain undervalued, and their mental health is further strained by both visible and invisible workloads and by expectations to safeguard family and community wellbeing.

Dans le Nord canadien, les changements climatiques ont des répercussions importantes sur la santé des gens et sur l’environnement. La surveillance de ces répercussions est souvent difficile, mais importante pour éclairer des mesures d’adaptation significatives. Le programme eNuk est un programme intégré de surveillance de l’environnement et de la santé dirigé par les Inuits à Rigolet, au Nunatsiavut, au Labrador. L’objectif de ce programme est de recueillir des renseignements complets pour aider les collectivités, les gouvernements et les décideurs politiques à réagir aux indicateurs environnementaux et sanitaires des changements climatiques. Une partie importante du programme est l’application eNuk, une application pour téléphone mobile. C’est un outil qui permet aux membres de la collectivité de consigner et de diffuser leurs observations sur les changements climatiques lorsqu’ils se trouvent dans leur collectivité et sur le territoire. Les données recueillies au moyen de l’application documenteront les répercussions des changements climatiques sur la vie, la santé et le bien-être des Inuits. Ces données aideront à orienter les mesures. Par exemple, un utilisateur peut enregistrer et partager un incident de glace de mer inhabituellement mince ou de piètres conditions de sentier. Ces renseignements peuvent aider les membres de la collectivité à prendre des décisions lorsqu’ils planifient leurs itinéraires, ce qui accroît leur sécurité. À long terme, le programme contribuera à une base de données de référence sur l’environnement et la santé pour Rigolet. Il enregistrera et préservera des connaissances inuites inestimables qui aideront à éclairer la prise de décisions, les politiques et les programmes. De plus, le programme eNuk appuiera l’adaptation aux changements climatiques dans la région et au-delà, grâce à des mesures fondées sur les valeurs, les connaissances et la science inuites.