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Purpose of Review (1) To develop a framework for understanding the holistic effects of climate change on the Saami people; (2) to summarize the scientific evidence about the primary, secondary, and tertiary effects of climate change on Saami culture and Sápmi region; and (3) to identify gaps in the knowledge of the effects of climate change on health and well-being of the Saami. Recent Findings The Saami health is on average similar, or slightly better compared to the health of other populations in the same area. Warming climate has already influenced Saami reindeer culture. Mental health and suicide risk partly linked to changing physical and social environments are major concerns. Summary The lifestyle, diet, and morbidity of the Saami are changing to resemble the majority populations posing threats for the health of the Saami and making them more vulnerable to the adverse effects of climate change. Climate change is a threat for the cultural way of life of Saami. Possibilities for Saami to adapt to climate change are limited. . . . . . Keywords Climate change Saami people Reindeer herding Systematic review Public health Adaptation Introduction based reasons, continued regional economic development, and prolific utilization of natural resources constitute similar From the global perspective, the indigenous people in the threats to health, well-being as well as to the entire culture. Artic constitute potentially the most vulnerable population to The average temperature in the Arctic has already risen the effects of climate change for two reasons. They live in from the preindustrial period . The effects of climate close interaction with the natural environment and the climate change in the Polar Regions are expected to be globally the change and its effects to environmental conditions including most pronounced . Conditions in the Sápmi region have temperature are most impactful in the Arctic . Therefor, changed during postindustrial period, including the timing of indigenous people could be regarded as the first population snowmelt and the length of thermal seasons [3, 4]. indicators of the effects of harmful environmental condition Around 40 indigenous peoples inhabit the Arctic Region and change. From the perspective of the indigenous people, forming 10% of the total population in this region. The present climate change has been regarded as one of the most extensive article focusses on the Saami (in North Saami: Sámi), the threats to health and well-being . In addition to climate indigenous people living in the northern parts of Norway, change, environmental change related to natural and human- Sweden, Finland, and Kola Peninsula in Russia. Many of the phenomena related to the Saami are likely to be general- izable to the other indigenous populations. On the basis of a Topical Collection on Global Environmental Health and Sustainability priori knowledge, we hypothesized that the effects of climate change are likely to be holistic, influencing not just health and * Jouni J. K. Jaakkola well-being, but the entire culture. Our overall objective was to firstname.lastname@example.org elaborate the holistic effects of climate change on the Saami. Center for Environmental and Respiratory Health Research, In this study we use the term lifestyle according to Saami understanding. It University of Oulu, P. O. Box 5000, FI-90014 Oulu, Finland refers to, inter alia, Saami way of life, values, social structure, traditions, and Department of Social Sciences, University of Lapland, customs. It includes the tradition of Saami livelihoods, identity, and lingual Rovaniemi, Finland heritage and habitation pattern. 402 Curr Envir Health Rpt (2018) 5:401–417 The specific objectives of the study were (1) to develop a parasites, and host animals, and effects mediated by the aller- framework for understanding the holistic effects of climate gens and air pollutants are included in this category. The ter- change on the Saami people and Arctic indigenous people in tiary effects refer to wider scale of effects caused by intersec- general; (2) to summarize the scientific evidence about the tion of climate, politics, and ecology, both human and non- primary, secondary, and tertiary effects of climate change to human [12�� ]. Our framework in the Saami context is expand- Saami culture and to Sápmi region; and (3) to identify gaps in ed to cover cultural and social effects of climate change. the knowledge of the effects of climate change on health and Cultural and social effects are likely to influence health and well-being of the Saami. well-being. Figure 2a, b describes the different methodological ap- proaches to understand the factors effecting Saami health Methods and cultural well-being in a changing climate and the main forces driving the global change. Saami People Figure 2a describes the central research disciplines and research methods that applied to study the holistic effects The traditional settlement area is called Sápmi (land of the of climate change on Saami culture. Figure 2b describes Saami) in the North Saami language. The population of the ethno-ecological niche [13, 14]of Saami people and Saami people is estimated at 50,000–70,000 in Norway , the changing framework of their culture. The niche in- over 10,000 in Finland , 20,000–35,000 in Sweden [7�� ], cludes the individual and the siida that is kinship-based and 2000 in Russia . Approximately half of the Saami Saami communal structure that manages reindeer work in speak Saami as their native language. All Saami languages its own area. Each siida has its own pasture areas, but the are classified as endangered or highly endangered . siida system is very flexible . The cultural ecological Traditional Saami livelihoods include reindeer herding, fish- framework of the niche consists of the eallu (the reindeer) ing, hunting, handicrafts (duodji), and gathering. Reindeer and biodiversity. Saami people and culture are not isolated herding is the most viable livelihood. Many of the Saami but part of larger Saami community and national society reindeer-herding families are also involved in Saami handi- with its legislation, practices, education system, and juris- crafts, fishing, and gathering. In Sweden and Norway, practi- prudence. Climate change has been identified as a new cally only the Saami can practice reindeer herding. At present framework for Saami culture and livelihoods due to its many Saami are occupied outside traditional livelihoods and far-reaching and holistic influences [16��, 17� ]. many, especially youth, have migrated to urban regions out- side Sápmi . Literature Search and Complementary Evidence Framework and Theory We conducted a systematic literature review on peer- The main proposition is that the global change driven by reviewed publications covering any articles on (1) Saami the anthropogenic climate change is influencing entire cul- people; (2) Saami reindeer herding; and (3) climate change tures of the indigenous populations in the Artic (Fig. 1). and its effects on the Saami and the Sápmi region. We We conceptualized the complex causal web schematically focused only on studies providing empirical research data, in Figs. 2 and 3. Figure 2a is an extension of the framework either qualitative or quantitative. The inclusion criteria of the Center for Environmental and Respiratory Health were that the article provided information on (1) Saami Research multidisciplinary research program established culture, health, well-being and/or livelihoods; and (2) the in 2009 . In the present form, “public health” appearing effects of climate change on the Sápmi and Saami liveli- in the center was replaced with “culture, well-being, and hoods. Keywords were selected based on tests of different health”. The arrows from Global change illustrate how the keywords in academic search engines. Articles published effects of global change are hypothesized to be mediated in 1990–2017 were included. through climate, air, water, and soil pollution, housing, and In addition to the systematic literature search, we in- life style. Figure 2a explains the multi-dimensional, direct cluded evidence from an ethnographic fieldwork conduct- and indirect effects of climate change to culture, well-be- ed by Dr. Näkkäläjärvi, which included interviews of 30 ing, and health. reindeer herders from four Saami communities in Finland We apply the proposition of Butler and Harley to divide the 2015–2017, during the conduct of this systematic review. health effects of climate change into the primary, secondary, These interviews provided important insight into the ho- and tertiary effects. The primary effects arise from the direct listic effects of climate change perceived by reindeer changes and impacts of the physical system. The secondary herders and it influenced the development of the theoret- effects arise due to alternations in the ecology of vectors, ical framework. Curr Envir Health Rpt (2018) 5:401–417 403 Fig. 1 Flowchart of the Keywords Search Engines - Saami, Sámi or Sami systematic literature search Ebsco Academic Search Premiere, 1901 records idenﬁed - Reindeer herding, husbandry or PubMed, Web of Science, Scopus pastoralism/and climate change 585 duplicates removed Abstracts excluded (n 967) 1316 arcles remaining for - other focus area (n 217) - abstract not according to inclusion criteria (n 719) abstract screening - not empirical (n 31) Arcles excluded (n 55) 349 arcles remaining for - arcle not according to inclusion criteria (n 46) full-text screening - other (n 9) 294 arcles for analysis Results way of life and reindeer herding . Saami language has a precise classification system for snow and knowledge of Literature Search and Characteristics of Studies snow is an important part of reindeer herder’s knowledge . Reindeer is important for Saami culturally and rein- Figure 1 present a flowchart of the search strategy. The pri- deer herding is means to maintain traditions, language, and mary search identified 294 studies, 126 conducted in Norway cultural identity in changing world. Reindeer herding, as (43%), 83 in Sweden (28%), 51 in Finland (17%), only 12 other traditional Saami livelihoods constitute important covered Russia (4%), and 22 were multinational (8%). Table 1 part of Saami well-being (see Fig. 4). Currently, reindeer provides an overview on main study topics. Most of the stud- herding is one of the driving forces together with other ies characterize the environment, culture, livelihoods, and herbivore on shaping the vegetation in Sápmi region ; health without any consideration of the role of climate change. however, in boreal area forestry and competing land uses, such as mining, infrastructure development, and tourism affect both vegetation and reindeer herding [21, 22]. Environment, Livelihoods, and Culture Although reindeer forage over 300 different plants in ad- dition to fungi, ground lichen is the main forage for rein- Traditional Saami settlement area includes both sub-arctic deer in winter. Lichen heaths are in heavily grazed areas and arctic areas with boreal forest, coastal areas, and large mountain regions with alpine vegetation. Snow covers the and in areas where forestry and reindeer grazing coexist degraded, but there are regional differences in grazing Sápmi area 8 months a year, and plays a central role in the climatic, ecological, and hydrological processes, and in the pressure [23–25]. Human activity influences the range ab GLOBAL CHANGE Climate change Saami culture LIVELIHOODS & ENVIRONMENT CLIMATE HOUSING LIFESTYLE AIR & SOIL POLLUTION Biodiversity COLD/HEAT Compeng WATER QUALITY CULTURE, WELL-BEING Societal framework land uses governance, Reindeer & HEALTH legislaon Cultural well-being of Anthropology Saami Environmental and Public Health Genecs Saami community - the siida Studies Natural science Medicine Health and well- EPIDEMIOLOGICAL QUALITATIVE META -ANALYSIS BURDEN OF DISEASE being of Saami individual METHODS METHODS ASSESSMENT Fig. 2 a Conceptual framework of the study. b Main factors influencing the health and well-being of Saami individual in reindeer-herding community 404 Curr Envir Health Rpt (2018) 5:401–417 Fig. 3 Local observations on the effects of climate change in Sápmi region based on the present systematic literature research and complementary fieldwork by Dr. Näkkäläjärvi selection of reindeer, and increase grazing pressure inside However, there are regional variations in different reindeer- the reindeer-herding area [26, 27], but there is also evi- herding models and in the use of new methods. Modernization dence that reindeers can locally habituate towards human has created social and economic pressures for the reindeer- activities . Predation influences significantly the mor- herding communities. Small proportion of Saami reindeer tality among reindeers, but the effects on the total reindeer herders is involved in tourism services, which provide better demography and livelihood are debated. Losses are com- income and concurrently offers means to maintain traditional pensated for the reindeer herders [29, 30, 31� ]. livelihood [36–38]. Governance and market economy have Saami reindeer herding is distinctively inherited profession forced Saami to change their reindeer-herding model in Kola and kin-ties are important for reindeer management. . Peninsula. Industrialization has influenced Saami to abandon Reindeer herding is connected to Saami well-being so that the their culture [39, 40]. quality of life decrease if the livelihood is lost . Women Assimilation measures have caused significant loss of constitute a minority of full-time reindeer herders, being active- Saami language; but language revitalization measures have ly involved in reindeer-herding culture [34 ]. Evidence from improved the situation [8, 41]. The smallest Saami languages Sweden suggests that there are gender differences in the status alive have only few speakers and it is likely that language loss of reindeer herder, and different expectations for women . will continue in the near future. Traditional Saami home re- Saami reindeer herding has adopted new technology and gions are located in rural areas with sparse population. methods such as supplementary feeding. It is argued, that Outmigration to urban areas is an increasing trend, but the these changes have increased the adaptive capacity of reindeer potential effects of outmigration to demography, Saami socie- herding, but increased the dependence on subsidies [26, 36]. ty social, and culture have not yet been explored. Migrants are �� Curr Envir Health Rpt (2018) 5:401–417 405 Table 1 Published articles on Saami health and well-being by the main topic and country, 1990–2017 Topic Norway Sweden Finland Russia Total n Publication year n Publication year n Publication year n Publication year General health 20 1999, 2002–2016 3 2010–2013 2 1997, 2002 1 1999 26 Cause-specific mortality 3 2006–2009 5 2004–2012 5 1995–1999, 2008 0 13 Occupational health 0 – 42004–2008, 2017 5 1991–1994, 2006 0 9 Asthma and allergies 2 1999 and 2002 1 1991 0 3 Cardiovascular diseases 4 1998, 2013–2014 2 2004–2008 3 1995–1997, 2001 0 9 Diabetes 3 1998, 2016–2017 0 0 3 Cancer 1 2005 3 2002, 2008–2014 3 2002, 2010–2012 0 7 Genetic diseases and genetics 9 1992–1994, 2 2004, 2008 3 1998–2001 4 1997–1999, 2008–2017 18 2002–2008 Mental health 27 1998, 2000–2017 7 2010–2017 1 1994 0 35 Dental health 0 4 2006–2014 0 0 4 Environmental exposures 2 1999, 2014 3 1999, 2003–2009 1 1999 6 Nuclear fallout and radiation 4 1996, 2000–2015 4 1990–1999, 2014 2 2005–2010 0 10 Diet and lifestyle 9 1999–03, 2007–2017 7 1999, 2004–2013 2 1995 1 2008 18 Substance use 7 1990, 2002–2011 2 2011, 2015 0 9 Cultural well-being 16 1996–1998, 2003–2017 6 2006–2015 3 1995, 2010–2016 0 25 Discrimination 7 2008–2015 2 2011–2012 0 0 7 iolence 3 2015–2017 0 0 3 Health services 15 2005–2013 1 2013 1 2012 0 17 TOTAL 135 52 34 7 characterized as young and mostly female . Outmigration Saami Lifestyle and Well-Being influences the communal viability, coherence, and vitality of the traditional Saami regions, and poses challenges to the cul- It has been suggested that genetics together with Saami tradi- tural well-being of the migrants. tional lifestyle that includes significant physical activity and a Saami and their livelihoods are vulnerable and exposed to healthy diet including reindeer meat, fish, and berries have socioeconomic changes and top-down governance. Adaptive positive effects on the Saami health reducing the risk of chron- capacity of Saami reindeer herding is limited geographically ic diseases typically linked to western lifestyle [44–47]. and in terms of governance [31� , 43]. Small population size Unfortunately, there is evidence that the lifestyle is changing: and social and assimilative legacy pose serious challenges for Saami experience less physical activity and traditional diet is, the possibilities of Saami to maintain their culture and way of especially outside Saami core areas, being partly or complete- life in changing climate. ly replaced with western diet [48–51]. Saami women are in Fig. 4 Simplified presentation on causal effects of climate change to SAAMI WAY OF LIFE (LIFESTYLE), CULTURAL WELL-BEING & the health and cultural well-being REINDEER HERDING PRACTICES of Saami in Reindeer livelihood context PHYSICAL & MENTAL HEALTH DIET ECOLOGICAL NICHE CLIMATE CHANGE Snow and ice layer POLLUTION (heavy Vegetaon, fungi & trees metal, nuclear fallout, transboundary Soil polluon) 406 Curr Envir Health Rpt (2018) 5:401–417 general more obese than women population in the same area. estimated to pose a serious mental health risk and impact on Saami men are less obese than the other population in the suicidal behavior [63�� ]. same area . Obesity is a risk factor for pre-diabetes and Living in Saami core areas, involvement in reindeer diabetes mellitus. The findings indicate that if the cultural and herding, Saami as a native language, strong family ties and socioeconomic changes continue among Saami population communality, and possibility to maintain Saami culture and effecting the traditional lifestyle and diet, it is likely that dia- livelihoods increase Saami well-being [60–62, 64, 66]. betes mellitus will become a public health concern among Saami population. Change or loss in traditional diet also indi- Primary Effects of Climate Change cates change in cultural values, livelihoods, and lifestyle. Recent studies found no differences in the substance use Studies on the primary effects of climate change were focused between the Saami and the majority population in Norway on ongoing and past changes in the vegetation and climate and [53, 54] and Sweden [55, 56]. However, 50% of non-natural the climate scenarios (see Fig. 3) in Sápmi. Local observations deaths among Saami reindeer herders in Sweden occurred by reindeer herders and studies confirm that climate change under the influence of alcohol [57� ]. has already altered conditions in Sápmi region. The most In Northern Norway, the Saami were subjected to violence prominent are changes in snow cover and vegetation. The more than the general population; 22% Saami women experi- ethnographic interviews by Dr. Näkkäläjärvi provided evi- enced sexual violence . Several findings from Sweden and dence that observations on these changes are common and Norway indicate that a major part of Saami population has consistent among reindeer herders. Shrub expansion is occur- experienced ethnic discrimination and it has negative implica- ring rapidly in tundra and mountain range, and the tree line is tions to mental well-being and quality of life [59, 60]. Several moving north- and upwards [67, 68]. important cultural and social factors, such as living in Saami It is estimated that the days with snow cover are significant- core areas, involvement in reindeer herding, Saami as a native ly shortened, but regional differences can be important. Winter language, strong family ties, and communality, seem to pro- thaws, rain-on-snow and refreezing events that are projected to tect Saami from mental health problems and provide resilience increase creating ice crust [18, 69], and have a negative effect towards ethnic discrimination [60–62]. on reindeer pasture conditions, since reindeer cannot dig nu- trition underneath ice cover. Climate change increases the risk of wildfires that have negative health effects and result loss of Health and Well-Being pasture land. Climate change is projected to threaten the lichen ecosystems in high latitudes and increases competition with Several population-based epidemiologic studies have estimat- other vegetation, especially vascular plants , but on the ed cause-specific mortality and the occurrence of chronic dis- other hand, the predicted warming will decrease the cold pe- eases between the Saami and the majority population. Main riod and days with snow cover increasing utilization of other results are summarized in Table 2. The Saami health is on vegetation for forage . Predicted warming will increase average similar, or slightly better compared to the health of heat stress among humans and reindeer. Changes in precipita- other populations in the same area in Finland, Norway, and tion, increased heat stress, insect harassment, and changes in Sweden [7�� ]. snow conditions in winter have an effect on predation and Unfortunately, the findings also indicate that cultural and reindeer population dynamics [69, 70]. It is predicted that pro- language loss among Saami population due to assimilation ductivity of reindeer forage will probably increase, but the policies produces mental and social problems among Saami nutritive value and quality could decrease . and the burden is passed on to future generations . The Weather-related accidents were predicted to either decrease studies have also indicated that living outside Saami core area,  or increase . Based on the interviews, the risk for loose connection to Saami livelihoods and culture and loss of accidents has increased among reindeer herders. Changes in Saami language can increase mental health problems and de- the carrying capacity of ice, snow quality, and formation are crease resilience towards ethnic discrimination [61, 62]. likely to increase the risk for transport-related accidents and in Saami adolescents living outside Saami core areas use more the mountain region risk for avalanches can increase. Based practitioner’s services than Saami in the core area or peer on available knowledge, the primary health effects of climate living in the same area . This indicates that Saami are change are likely to increase among Saami reindeer herders. willing to seek help for their problems and living outside Saami reindeer-herding models differ regionally and vary Saami core areas brings health challenges for Saami. A new from semi-nomadic to local, and effects of climate change emerging threat for Saami mental health is hopelessness and and adaptation possibilities thus vary significantly. Based on fear for the future identified in a qualitative study among available evidence, it is not possible to estimate how the cli- Saami youth. Loss of Saami livelihood, weakened possibili- mate change influences different reindeer-herding models. Climate change is estimated to have both negative and ties to maintain Saami culture and poor legal status are Curr Envir Health Rpt (2018) 5:401–417 407 Table 2 Overview on the main results on Saami health and well-being References Study topic Results Discussion and trend [44, 46, 47, 57] Mortality Specific cause mortality among Saami and Recent findings are missing, however there seems to be non-Saami population in Sweden, Norway and a trend that cause-specific mortality is starting to Finland rather similar resemble general population , Sjölander P, Hassler S and Janlert U. Stroke Reindeer-herding Saami men had a lower risk of and acute myocardial infarction in the Swedish death from cardiovascular and gastrointestinal Sami population: Incidence and mortality in diseases and cancer in Sweden relation to income and level of education. Scand J Public Health 2008: 36(1): 84–91.Doi:https://doi. org/10.1177/1403494807085305.  Norum J and Nieder C. Socioeconomic Life expectancy Life expectancy greater among people living in characteristics and health outcomes in Sami Saami core areas in Norway compared with speaking municipalities and a control group in general population (females 79.5 and men northern Norway. Int J Circumpolar Health 2012: 72.0 years). In Sweden, the life-expectance was 71: 19127. Doi:10.3402/ijch.v71i0.19127. similar among the Saami and non-Saami populations [34, 57], Hassler S, Sjolander P, Johansson R, Occupational accidents and Off-road traffic-related deaths and accidents are Off-road traffic is essential for reindeer-herding work. Gronberg H and Damber L. Fatal accidents and health in reindeer herding more common among Saami compared with Although recent findings are missing, it seems that suicide among reindeer-herding Sami in Sweden. general population off-road related deaths are not increasing among Int J Circumpolar Health 2002: 63 Suppl 2: Saami population. 384–388; Pekkarinen A. Changes in reindeer-herding work and their effect on occupational accidents. Int J Circumpolar Health 2006: 65(4): 357–364.Doi:10.3402/ijch.v65i4.18125. Sjolander P, Daerga L, Edin-Liljegren A and Jacobsson L. Musculoskeletal symptoms and perceived work strain among reindeer herders in Sweden. Occupational Medicine-Oxford 2008: 58(8): 572–579. Doi:10.1093/occmed/kqn153. Other risks are musculoskeletal pain, mental stress Findings indicate that mental stress may become a and accidents in slaughtering. serious concern for reindeer-herding livelihood. Selnes A, Bolle R, Holt J and Lund E. Atopic Asthma and allergies Prevalence of asthma and allergies is increased Changes in traditional lifestyle and diet are likely to diseases in Sami and Norse schoolchildren living among the Saami children in Norway explain the trend. Trend is alarming, since atopic in northern Norway. Pediatric Allergy and diseases and asthma are major causes of morbidity. Immunology 1999: 10(3): 216–220. Doi:10.1034/j.1399-3038.1999.00032.x. Selnes A, Bolle R, Holt J and Lund E. Cumulative incidence of asthma and allergy in north Norwegian schoolchildren in 1985 and 1995. Pediatr Allergy Immunol 2002: 13(1): 58–63. Doi: 10.1034/j.1399-3038.2002.01009.x  Cardiovascular disease No significant differences in occurrence of The prevalence of cardiovascular diseases is effected cardiovascular disease among Saami in Norway. by way of life and diet and Saami with western Reindeer herding in Sweden Saami show lower lifestyle have higher risk for cardiovascular diseases. 408 Curr Envir Health Rpt (2018) 5:401–417 Table 2 (continued) References Study topic Results Discussion and trend incidences of cardiovascular diseases than other Saami. Broderstad AR and Melhus M. Prevalence of Diabetes mellitus and pre No ethic differences in the prevalence of diabetes There are regional differences and livelihood-related metabolic syndrome and diabetes mellitus in diabetes mellitus among Saami compared with other risks on the relative risk and prevalence of diabetes Sami and Norwegian populations. The populations in the same area in Norway. mellitus among Saami population. SAMINOR - A cross-sectional study. BMJ Open 2016: 6(4). Doi::10.1136/bmjopen-2015-009474. Naseribafrouei A, Eliassen B, Melhus M and Broderstad AR. Ethnic difference in the prevalence of pre-diabetes and diabetes mellitus in regions with Sami and non-Sami populations in Norway - the SAMINOR1 study. Int J Circumpolar Health 2016: 75(1): 31697. Doi:10.3402/ijch.v75.31697. Edin-Liljegren A, Hassler S, Sjölander P and Daerga L. Risk factors for cardiovascular diseases among Swedish Sami--a controlled cohort study. Int J Circumpolar Health 2004: 63 Suppl 2: 292–297. Hassler S, Soininen L, Sjolander P and Pukkala, P. Cancer Overall risk of cancer does not differ significantly Cancer among the Sami--a review on the from the general population. Saami on Sweden Norwegian, Swedish and Finnish Sami have higher risk for ovarian cancer, Skolt Saami populations. Int J Circumpolar Health 2008: in Finland and Swedish Saami have higher risk 67(5): 421–432. Doi:10.3402/ijch.v67i5.18351. for stomach cancer Harbo, H. F., Utsi, E., Lorentzen, Å. R., Kampman, Neurological diseases Prevalence of MS lower among Saami than in M. T.,Celius,E.G.,Myhr,K.etal.,Low Norwegian population frequency of the disease-associated DRB1*15-DQB1*06 haplotype may contribute to the low prevalence of multiple sclerosis in Sami. Tissue Antigens, 2007: 69: 299–304. doi:10.1111/j.1399-0039.2007.00803.x Findings indicate that loss of traditional livelihoods, [46, 57, 63] Mental health Increased risk of suicide among the Saami men in Silviken A, Haldorsen T and Kvernmo S. Suicide Sweden, Norway, and Finland. Mental health of Saami language, living outside Saami core areas and among Indigenous Sami in Arctic Norway, Saami adolescents and Saami in reindeer herding socioeconomic pressure from surrounding society 1970–1998. Eur J Epidemiol 2006: 21(9): is a concern. In general, risk for suicide among seem to expose Saami to mental health problems. 707–713. Doi:10.1007/s10654-006-9052-7 Saami adolescents is slightly elevated compared Findings indicate that the trend is increasing. with other population. However, there are no ethnic differences on actual suicide attempts. Alinaghizadeh H, Tondel M and Walinder R. Cancer Nuclear fallout Main source of 137Cesium exposure for Saami is Levels are significantly reduced also in most incidence in northern Sweden before and after the reindeer meat and parts. contaminated areas in Sápmi. Chernobyl nuclear power plant accident. Radiat The epidemiologic studies rule out any major effect Environ Biophys 2014: 53(3): 495–504. of the nuclear fallout on cancer incidence among Doi:10.1007/s00411-014-0545-6.; the exposed population. However, the prevention Mehli H, Skuterud L, Mosdøl A and Tønnessen A. measures have effected the diet, economy, social The impact of Chernobyl fallout on the Southern life and livelihoods of Saami Curr Envir Health Rpt (2018) 5:401–417 409 Table 2 (continued) References Study topic Results Discussion and trend Saami reindeer herders of Norway in 1996. Health Phys 2000: 79(6): 682–690. [48–50] Diet and lifestyle Saami traditional diet and lifestyle seem to protect Findings indicate that Saami lifestyle and diet is Saami from lifestyle diseases changing to resemble the majority population. Change or loss in traditional diet also indicates change in cultural values, livelihoods and lifestyle [55, 56] Substance use There are no significant ethnic differences on the use of substances [52, 61, 64]. Cultural well-being Strong Saami ethnic identity seems to be important Cultural well- being of Saami is associated with for physical and mental health of Saami. environmental relationship, traditions, livelihoods, Saami language, living in Saami core areas, social network and kin. [58, 60–62] Discrimination and violence Saami have been subjected to discrimination and However, Saami with strong ethnic identity have high violence more than general population resilience towards discrimination. Daerga L, Sjölander P, Jacobsson L and Access to social and health The findings indicate that the Saami have equal However, Saami speakers have reported lower Edin-Liljegren A. The confidence in health care services and implications to access to social and health services and similar satisfaction and communication difficulties in health and social services in northern Sweden – a health outcome health outcomes compared with reference services comparison between reindeer-herding Sami and population the non-Sami majority population. Scandinavian Journal of Public Health 2012: 40(6): 516–522. Doi:10.1177/1403494812453971; Norum J and Nieder C.Socioeconomic characteristics and health outcomes in Sami speaking municipalities and a control group in northern Norway. Int J Circumpolar Health 2012: 71: 19127. Doi:10.3402/ijch.v71i0.19127; Nystad T, Melhus M and Lund E. Sami speakers are less satisfied with general practitioners’ services. Int J Circumpolar Health 2008: 67(1): 114–121.Doi: 10.3402/ijch.v67i1.18246 410 Curr Envir Health Rpt (2018) 5:401–417 positive effects for reindeer herding. However, the net balance boreal forest to new areas creating land-use competition and is likely to vary significantly regionally depending on geogra- opening new possibilities for forestry. phy, local climate, environment, adaptation and mitigation measures, competing land uses, social system, and Saami pop- Adaptation and Mitigation ulation, reindeer-herding models, governance, and socioeco- nomic factors. Climate adaptation and mitigation were approached in the identified studies from two perspectives: (1) adaptation in rein- deer herding to the adverse effects of climate change and (2) Secondary Effects of Climate Change reindeer as a tool for climate adaptation. We could not identify any studies that discussed how the whole Saami culture and Our search identified only a few studies on the secondary other livelihoods could adapt to the climate change. Findings effects of climate change. Northern-Atlantic Oscillation indicate that adaptation possibilities are limited and available (NAO) produces mild winter weather that creates difficult measures are flexible use of pasture land, use of vast environ- pasture conditions for reindeer. The NAO incidents are ex- mental knowledge, herding, provide nutrition with supplemen- pected to increase in future and climate is likely to become tary feeding, or fell trees to gain reindeer access to arboreal more variable in Sápmi region . The NAO incidents have lichen. Human-animal relationship and reindeer-herding tradi- a negative effect to the winter survival of reindeer. Based on tions form a basis for adaptation measures [31� , 43, 80]. There evidence from fieldwork, the increased NAO incidents have is evidence that adaptation measures have cultural effects. contributed to the changes in reindeer-herding practices. Reindeer herders fear that the use of supplementary nutrition Warm winters will promote the development of animal para- changes profoundly their cultural livelihood , and similar site outbreaks among reindeers and parasite species are mov- concerns have been raised on the use of GPS-technology on ing northward . Based on available evidence, the most reindeer . Based on fieldwork data, supplementary feeding prominent secondary effects are increased outbreaks of and GPS use are means for adaptation in difficult conditions, animal-borne diseases, indications are that milder weather but they have also important cultural effects and may erode the and less snow cover promote the spread of new diseases north- cultural knowledge of the reindeer herder, which can reduce wards [73–75]. Warm winters also promote the survival of the adaptive capacity of reindeer-herding culture in the future. geometrid moths that is one of the main drivers for vegeta- Reindeer become tamer due to the use of supplementary nu- tional change in Sápmi. Increase in precipitation increases trition and it affects the range selection of the reindeers. erosion and risks for accidents. Reindeer grazing can mitigate the effects of climate Arctic snow cover is a storage for contaminants and heavy change, especially in tundra. Reindeer grazing can protect metal pollution and reduced snow day cover and increased the tundra biome from shrubification and tree line encroach- precipitation can expose humans to these pollutants . ment [68, 83] . Incentive grazing in summer increases surface albedo, delays snowmelt and decreases the ground from Tertiary Effects heating in snowmelt season [84�� ]. Reindeer in fact is a key species for the environment and Saami inhabiting the area. The effects of climate change on the environment and liveli- hood are likely to influence the future expectations, which may induce mental health problems. Climate change had cre- Discussion ated fear for future and together with socioeconomic and gov- ernance pressure these can be overwhelming. The fear is fo- Figure 5 summarizes our analysis of the main factors affecting cused on the future of Saami culture and way of life and health and well-being of Saami and Sápmi in the changing disappearance of cultural knowledge and traditions. Herders climate based on available data and application of theoretical have reported on increased stress, anxiety, worrying, and de- framework (Fig. 2a). pression [16�� , 31� , 35, 76, 77]. Climate change adaptation and opening new resources can Environmental and Cultural Change limit the adaptation possibilities in Sami reindeer herding by diminishing pastures. Hydropower development has influ- A recently published meta-analysis suggests that climate enced significantly Saami reindeer herding and culture  change is having profound disruptive effects at local levels and climate change is likely to change conditions more favor- and that local observations can make an important contribu- able for hydropower development . Wind power develop- tion to understanding the pervasiveness of climate change on ment is already affecting the range selection of reindeer and to ecosystems and societies [17� ]. Indigenous communities from the rights of Saami [27, 79] and increased temperatures will the Arctic have reported that weather conditions have been increase the productivity of boreal forest and expansion of less predictable in the past decades [85, 86]. Our findings Curr Envir Health Rpt (2018) 5:401–417 411 Primary eﬀects Secondary eﬀects Ter ary eﬀects Extreme weather events Changes in livelihood Changes in the distribu on of - Storms, ﬂoods, landslides, forest ﬁres, models / loss of Western lifestyle diseases animal and vector-borne diseases avalanches livelihoods for humans and reindeer Increased risk for Thawing accidents permafrost Loss of language / loss Change of lingual knowledge Growth of molds knowledge Release of agents Heatwaves Nega ve mental health Higher levels of ozone, eﬀects Chronic disease mortality pollutants, pollen and aeroallergens in the air Climigra on / Social eﬀects / changes in Nega ve eﬀect to reindeer social culture well-being and health Asthma & allergies Change Infrastructure Lan Changes in industries / forestry / security Changes in weather pa erns of the ﬁsh stocks and Increased risk for temperature sea currents environmental Climate adapta on / Changes in pasture governance catastrophes Eﬀect to living Changes in ﬂora and fauna Possibili es for cultural Changes in reindeer Eﬀect to reindeer behavior demography & mortality Resources for duodji, Cultura Ecosyste Changes in the ecological base of the Saami and cultural well-being of the Saami Fig. 5 Main factors affecting health and well-being of Saami and Sápmi in the changing climate based on available data and application of theoretical framework and fieldwork support these observations. The environmental changing to resemble the majority populations posing threats changes affecting flora and fauna are projected to continue in for both the physical and mental health of the Saami, increas- the Arctic (Table 3). ing general morbidity, and making them more vulnerable to The melting sea ice and opening of new resources for ex- the adverse health effects of climate change. Changes in life- traction  increase the risk for environmental accidents and style and diet expose Saami to cardiovascular disease. are likely to increase land-use competition limiting the possi- Increased climate change-related heat exposure is associated bilities for Saami to adapt to the climate change and possibil- with an increase in cardiac events and especially elderly are ities to maintain their traditional livelihoods. vulnerable . We have identified that the livelihood chang- The most important traditional game for the Saami is wil- es may have direct effects on the physical health and cultural low ptarmigan (Lagopus lagopus). A recent study suggests well-being of the Saami, which need to studied further and that predation-ptarmigan interactions have changed, most taken into consideration in governance. likely due to climate change. Ptarmigans are vulnerable to Projected changes in temperature are likely to increase the the temperature fluctuations, increased precipitation, and pop- risk of adverse secondary health risks both to Saami and rein- ulation declines are likely to occur in changing climate . deer. Disease outbreaks of pathogens transmitted by ticks and Fishing is important to both inland and coastal Saami, and voles could emerge in previous non-endemic geographic areas especially in coastal area fishing is a viable livelihood . [73, 94]. Infectious diseases are likely to have more outbreaks It is projected that changes in temperature effect the move- in changing climate and expand to new territories into the ment, location, and demography of fish stock . However, north [74, 95]. Increase in precipitation and flooding events how these changes are likely to influence Saami fishing cul- couldcreate conditions favorable formoldgrowthinhomes ture, is not known. and this may result in an increase in mold-related disorders and allergies. A new emerging health threat especially in Russian Health Perspectives Arctic is the melt of permafrost and release of pathogens . According to AMAP human health report, human expo- Saami are considered to be highly adapted to Arctic conditions sure to most POPs and metals is declining across many parts  but it is possible that socioeconomic and lifestyle changes of the Arctic but interactions between climate change and have negative effects on adaptive capacity. Our analysis sug- contaminant transport have the potential to change human gests that the lifestyle, diet, and morbidity of the Saami is exposure in the Arctic significantly . 412 Curr Envir Health Rpt (2018) 5:401–417 Table 3 Key literature and results on primary, secondary and tertiary effects of climate change to Sápmi region and Saami people Article Primary effects Secondary effects Tertiary effects Mitigation Adaptation Dobler et al. Regional climate change projections Projections on temperature, for the Barents region. Earth System Dynamics cloudiness and precipitation Discussions: 2016: 1–22. in the Barents region DOI:10.5194/esd-2016-27. Furberg et al. Facing the limit of resilience: Perception of primary effects of Adverse mental health and Flexibility and technology perceptions of climate change among reindeer climate change to winter cultural effects of climate means for adaptation herding Sami in Sweden. Global Health Action conditions change 2011: 4: 1–11. DOI:10.3402/gha.v4i0.8417. Lof A. Examining limits and barriers to climate Perception of primary effects of Governance limits possibilities change adaptation in an Indigenous reindeer climate change to winter for adaptation herding community. Clim Dev 2013: 5(4): conditions 328–339. DOI:10.1080/17565529.2013.831338. Pape R. and Loffler J. Climate change, land use Projected effects of climate Adaptation possibilities conflicts, predation and ecological degradation as change to conditions relevant challenges for reindeer husbandry in northern for reindeer herding Europe: what do we really know after half a century of research? Ambio 2012: 41(5): 421-434DOI:10.1007/s13280-012-0257-6 Parkinson A.J. and Evengård B. Climate change, its Risk for accidents and health Potential changes in Adverse mental health effects impact on human health in the Arctic and the threats from extreme weather vector-borne and and diet and lifestyle public health response to threats of emerging events infectious diseases changes increasing risk for infectious diseases. Global Health Action 2009: lifestyle diseases 2: 88–90. Tryland M. Are we facing new health challenges and Effects of changing climate to Reindeer parasite and Adaptation in reindeer herding diseases in reindeer in Fennoscandia? Rangifer reindeer demography, diseases outbreaks with supplementary feeding 2012: 32(1): 35–47. pastures and condition and technology Vowles et al. Expansion of deciduous tall shrubs but Effects of climate change to Herbivore is potentially of great not evergreen dwarf shrubs inhibited by reindeer vegetation (shrubification) importance for shaping arctic in Scandes mountain range. Journal of Ecology shrub expansion and its 2017: 105(6): 1547–1561. associated ecosystem effects Doi:10.1111/1365-2745.12753. Eliasson et al. Identification of development areas in Opening of new a warming Arctic with respect to natural development areas in resources, transportation, protected areas, and warming climate geography. Futures 2017: 85: 14–29. Doi:10.1016/j.futures.2016.11.005. Willox et al. Examining relationships between Climate change is likely an climate change and mental health in the emerging mental health Circumpolar North. Reg Environ Change 2015: challenge for Circumpolar 15(1): 169–182. Indigenous populations DOI:10.1007/s10113-014-0630-z. Cohen et al. Effect of reindeer grazing on snowmelt, Summer reindeer herding can albedo and energy balance based on satellite data delay snowmelt, increase analyses. Remote Sens Environ 2013: 135: surface albedo and to 107–117 Doi: /10.1016/j.rse.2013.03.029. decrease the ground heating in the snowmelt season. Curr Envir Health Rpt (2018) 5:401–417 413 A major contributor to mental health among Arctic indig- indicators and lack of standardization of different methods enous populations is chronic psychosocial stress linked to rap- . However, it can be argued that based on available evi- id socioeconomic development and this development is ex- dence, the health of Saami is relatively good or better when pected to accelerate due to climate change [98, 99]. Our find- compared on a general level to other indigenous peoples glob- ings support these observations. ally, but overview on cultural well-being and metal health of Climate adaptation and mitigation actions such as wind Saami is missing. More research and development of a mon- power or hydropower development may increase the stress itoring system are needed to understand the health and cultural and mental pressure among the Saami and increase pasture well-being of Saami in changing climate taking into consider- competition. Therefor, climate adaptation and mitigation mea- ation Saami values and traditions and major drivers for change. sures should take into account possible effects to the health and well-being of Saami. Saami are indigenous people and international covenants Conclusion obligate the states to protect Saami culture and way of life for future. Health and well-being are basic human rights but in The multidisciplinary methodology presented here to theorize indigenous context culturally meaningful life is a human rights and understand how climate change effects all aspect of Saami question. Currently there is not sufficient information to appro- life is central for monitoring the effects and finding ways for priately assess health and cultural well-being among the culturally sustainable adaptation. Cultural well-being in the Saami, and therefor, it is challenging to evaluate whether inter- Saami context depends on social community and kinship national human rights obligations are met and to what extent structure, environmental relationship, and traditional liveli- adaptation to climate change will be culturally sustainable. hoods, and ultimately, possibility to maintain Saami ethnicity Thus, evaluation and long-term monitoring of Saami health and language. Loss of language, culture, and living in urban and cultural well-being is crucial. Development of a monitor- areas expose Saami to lifestyle changes that can have negative ing system is urgent. This study has elaborated the existing implications for mental and physical health. knowledge on the relations between environment, culture and Saami have been a study object for centuries in different health and on the influences of climate change to culture and disciplines, nonetheless holistic analysis is missing on the sta- health of Saami, and shown that the evidence base is limited. tus and capacities of Saami people to survive and adapt in Saami communities around Sápmi face many socioeco- changing climate. The warming climate and new insight call nomic challenges that threaten their possibilities to maintain for a new, comprehensive assessment of the effects of climate their culture and identity. These multi-stress factors weaken change to Sápmi and Saami culture and projected outlook for the possibilities of Saami to adapt to climate change and main- the future. However, climate change has already influenced tain their culture. According to the fieldwork data, climate Saami culture substantially. Outmigration can in future change change poses risk for reindeer health and health of reindeer to climigration and have a profound effect on the Saami culture herders in terms of increased risks for accidents and future and viability of traditional Saami home region. Saami popula- health prospects. Most prominent health effects are the mental tion is small and number of Saami that speak Saami as native health effects: increased stress, concern over the future of language is even smaller. Societal changes and assimilation Saami way of live and pressures to abandon traditional policies have contributed the loss of language and cultural Saami lifestyle. Also literature search support these findings. knowledge and made Saami people even more vulnerable to Our analysis suggests that climate change brings both en- the negative and cumulative effects of climate change. vironmental, economic, cultural and social effects on reindeer A crucial challenge for the future of Saami people and herding as economic livelihood and as cultural way of life. vulnerability among the Saami is the small population size, Comparison of the health and well-being of Saami to the dispersed settlement, and urbanization that limits the possibil- health of other indigenous people is possible only at a general ities for cultural adaptation in the changing climate. level. Comprehensive population-based studies and registry- based data are missing—in Nordic countries ethnic registries Compliance with Ethical Standards are forbidden—and hence, even the definition of a Saami is being disputed. The most comprehensive overview on the Conflicts of Interest Jouni Jaakkola and Suvi Juntunen report that this health of indigenous and tribal people was published in study was partly funded by Finnish Cultural Foundation (Arahat project). 2016. The study used general indicators—such as life expec- The summary of the main findings in this article will be made available for the Saami communities in North Saami language. Klemetti tancy and infant mortality—available from registries, exclud- Näkkäläjärvi reports grants and personal fees from Wihuri foundation, ing morbidity and mental health. The analysis shows that di- during the conduct of the study. rect comparison of health of indigenous peoples is not possi- ble, because of different status and legal interpretation of in- Human and Animal Rights This article does not contain any studies digenousness, differences in data collection methods and with human or animal subjects performed by any of the authors. 414 Curr Envir Health Rpt (2018) 5:401–417 Open Access This article is distributed under the terms of the Creative 12.�� Butler CD, Harley D. Primary, secondary and tertiary effects of Commons Attribution 4.0 International License (http:// eco-climatic change: the medical response. Postgrad Med J. creativecommons.org/licenses/by/4.0/), which permits unrestricted use, 2010;84(1014):230–23. 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Current Environmental Health Reports – Springer Journals
Published: Oct 22, 2018
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