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There is concern in Australia that droughts substantially increase the incidence of suicide in rural populations, particularly among male farmers and their families. We investigated this possibility for the state of New South Wales (NSW), Australia between 1970 and 2007, analyzing data on suicides with a previously established climatic drought index. Using a generalized additive model that controlled for season, region, and long-term suicide trends, we found an increased relative risk of suicide of 15% (95% confidence interval, 8%–22%) for rural males aged 30–49 y when the drought index rose from the first quartile to the third quartile. In contrast, the risk of suicide for rural females aged >30 y declined with increased values of the drought index. We also observed an increased risk of suicide in spring and early summer. In addition there was a smaller association during unusually warm months at any time of year. The spring suicide increase is well documented in nontropical locations, although its cause is unknown. The possible increased risk of suicide during drought in rural Australia warrants public health focus and concern, as does the annual, predictable increase seen each spring and early summer. Suicide is a complex phenomenon with many interacting social, environmental, and biological causal factors. The relationship between drought and suicide is best understood using a holistic framework. Climate change projections suggest increased frequency and severity of droughts in NSW, accompanied and exacerbated by rising temperatures. Elucidating the relationships between drought and mental health will help facilitate adaptation to climate change.

Background: Increasing severe vegetation fires worldwide has been attributed to both global environmental change and land management practices. However there is little evidence concerning the population health effects of outdoor air pollution derived from biomass fires. Frequent seasonal bushfires near Darwin, Australia provide an opportunity to examine this issue. We examined the relationship between atmospheric particle loadings <10 microns in diameter (PM 10 ), and emergency hospital admissions for cardio-respiratory conditions over the three fire seasons of 2000, 2004 and 2005. In addition we examined the differential impacts on Indigenous Australians, a high risk population subgroup.

The mental health impact of drought is poorly quantified and no previous research has demonstrated a relationship between distress and explicit environmentally based measures of drought. With continuing climate change, it is important to understand what drought is and how it may affect the mental health. We quantified drought in terms of duration and intensity of relative dryness and identified drought characteristics associated with poor mental health to evaluate any vulnerability in rural and urban communities. Our methods involved analysis of 100-year longitudinal records of monthly rainfall linked to one wave (2007-2008) of the Household, Income and Labour Dynamics in Australia Survey. Cluster analysis was used to characterise different patterns of dryness and linear regression analysis was used to examine associations with participant distress, as well as the moderating role of rural locality. The results showed that, during a seven-year period of major and widespread drought, one pattern of relative dryness (extreme cumulative number of months in drought culminating in a recent period of dryness lasting a year or more) was associated with increased distress for rural but not urban dwellers. The increase in distress was estimated to be 6.22%, based on 95% confidence intervals. Thus, we show that it is possible to quantitatively identify an association between patterns of drought and distress.

Background: Air pollution in Darwin, Northern Australia, is dominated by smoke from seasonal fires in the surrounding savanna that burn during the dry season from April to November. Our aim was to study the association between particulate matter less than or equal to 10 microns diameter (PM 10 ) and daily emergency hospital admissions for cardio-respiratory diseases for each fire season from 1996 to 2005. We also investigated whether the relationship differed in indigenous Australians; a disadvantaged population sub-group.

Objective: We examined the association between validated bushfire smoke pollution events and hospital admissions in three eastern Australian cities from 1994 to 2007. Methods: Smoke events were defined as days on which bushfire smoke caused the 24-hour citywide average concentration of airborne particles to exceed the 99 th percentile of the daily distribution for the study period. We used a time-stratified case-crossover design to assess the association between smoke events and hospital admissions. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for cardiovascular and respiratory conditions on event days compared with non-event days. Models were adjusted for daily meteorology, influenza epidemics and holidays. Results: Smoke events occurred on 58 days in Sydney (population: 3,862,000), 33 days in Wollongong (population: 406,000) and 50 days in Newcastle (population: 278,000). In Sydney, events were associated with a 6% (OR=1.06, 95%CI=1.02-1.09) same day increase in respiratory hospital admissions. Same day chronic obstructive pulmonary disease admissions increased 13% (OR=1.13, 95%CI=1.05-1.22) and asthma admissions by 12% (OR=1.12, 95%CI=1.05-1.19). Events were also associated with increased admissions for respiratory conditions in Newcastle and Wollongong. Conclusions: Smoke events were associated with increased hospital admissions for respiratory but not cardiovascular conditions. Large populations are needed to assess the impacts of brief exposures. Implications: Public health impacts from bushfire pollution events are likely to increase in association with a warming climate and more frequent severe fire weather.

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The 2020 special report of the MJA-Lancet Countdown on health and climate change: lessons learnt from Australia's "Black Summer" (summary) The health professions are uniquely suited to integrate Australia's bushfire, COVID-19 and climate change response