The IHACC project is based upon three research pillars:

Research Pillar 1

Integrated, Community-Based Surveillance Systems

The need for enhanced surveillance is the most commonly identified health-related adaptation strategy. Surveillance is an important component of climate change adaptation because it builds on existing infrastructure, skills, and capacity. However, existing systems often are not adequately equipped to detect and respond to climate change. 

How can we adapt surveillance approaches to act as early warning systems for climate health events?
How can we engage communities in development & implementation of surveillance & early warning systems?


Pillar 1 grapples with these questions by developing an integrated participatory, community-based surveillance system to collect data to understand, respond to, and reduce negative climate-health outcomes in Indigenous communities in Canada, Uganda, and Peru. Incorporating Indigenous knowledge is important for Indigenous communities, who are often inadequately engaged in surveillance systems, leading to low participation, relevance, and data quality. Despite Canada’s international leadership in integrated environment and health surveillance, research on this topic in Indigenous communities in Canada and abroad are sparse.

Our surveillance systems will use participatory methods, involving the development of “networks of human observers” to make systematic observations, and to place these into cultural context. The surveillance systems created in each region will focus on climate/weather signals, environmental change, and related health outcomes, but will differ by region to reflect local context and Indigenous knowledge.

To co-develop and prioritize culturally-appropriate, locally-relevant, and sustainable response plans, we will also:

  • Develop novel surveillance tools

  • Collect high quality longitudinal data to characterize climate-health associations

  • Work with end-users

Research Pillar 2

Climate Change & Indigenous Health Futures

Traditionally, studies examine retrospective associations to understand climate change vulnerability; however, an important component of adaptation is the ability to look forward and plan in light of projected climate impacts.

What proportion of health outcomes will be attributable to changes in climate in the near future?

Pillar 2 responds to this question by estimating, for the near future (10-20 years), the frequency, magnitude,  distribution, and determinants of health outcomes associated with climate change in partner regions and communities. Scenario planning is an approach for longer-term planning that, in this research, will project how future climate changes might impact various health outcomes.

To conduct this pioneering work, we will use participatory, mixed qualitative and quantitative methods to create scenarios that model future climate change impacts using 4 steps:

  1. Use participatory, qualitative methods to capture IK to characterize what weather trends are locally important for different outcomes (e.g. specific temperature or precipitation trends important for food systems and health);

  2. Identify spatio-temporal associations between weather and health outcomes using quantitative modelling;

  3. Interrogate downscaled climate models to project how these specific weather patterns might change in the short-term (10-20 years); and

  4. Co-develop climate-health scenarios with communities and partners, and co-produce adaptation options that integrate Indigenous knowledge.

Research Pillar 3

Place-Based Pathways to Health Adaptation

Challenges to Indigenous health and wellbeing are projected to increase with climate change, and communities will have to adapt. 

But, will adaptation strategies and options be able to offset climate change impacts?

Pillar 3 tackles this question by identifying, evaluating, and prioritizing potential policies, programs, and initiatives at community, regional, and national levels that can serve to reduce vulnerability and strengthen resilience to the effects of climate change on Indigenous health in partnering communities.

Adaptation refers to policies and strategies to reduce climate change vulnerability and support resilience.These responses may be reactive or anticipatory, ranging from addressing the underlying social determinants of vulnerability to designing interventions to a known risk, and encompass actions at various scales. The importance of adaptation is recognized by decision makers in general, and our study regions in particular.

This pillar will build upon longstanding collaborations with communities and decision makers in all 3 regions by:

  1. Identifying and evaluating climate-health adaptations occurring formally or informally at multiple scales (e.g. health registries, surveillance, early warning systems, emergency preparedness, and existing and planned health policies and practices)

  2. Developing a conceptual framework to identify key characteristics by which selected policies, programs, and initiatives across sectors can be evaluated vis a vis vulnerability reduction

  3. Developing an analytical framework to structure the evaluation.

The framework will be an important output for academia and decision makers, provide a basis for comparing adaptations within and across scales, and build upon our considerable work in this area.