*4.3. Health and Safety*

Given that climate change influences the mortality of the elderly through elevated temperatures and air pollution, there is a need for age-specific temperatures and air pollution projection studies to be undertaken in the Caribbean to determine the predicted mortality burden of these changes within a heating climate (Chen et al. 2020). Studies have shown that in countries such as San Paulo, Brazil, as well as China and Crete, the prevalence of heat waves pose a significant threat to some of the most sensitive populations, such as the elderly, with the estimated heat-wave elderly-related mortality rate rising to 587 deaths per 100,000 residents per year in Brazil with exponential growth in the years of life lost to the elderly in China, and a strong correlation between the mortality of the elderly with both ambient temperature and humidity in Crete, Greece (Diniz et al. 2020; Huang et al. 2018; Tsekeri et al. 2020).

Notwithstanding the outcomes experienced by the elderly and other vulnerable groups in these countries, in the Caribbean, at the intuitional level, there is a need for municipalities within each town or district within their own local government office or regional cooperation office to design strategies that manage how the elderly in their respective communities' experience and manage heat-related

risks through enhancing their adaptation work. Such adaptation measures, like those implemented in Baden-Wurttemberg, Germany, could also target general practitioners and nurses who tend to the medical needs of elderly clients by providing supplementary emergency medical training to treat heat-related conditions (Herrmann and Sauerborn 2018). Such training would allow general practitioners in the Caribbean to better check for cardiovascular (ischemic heart disease) and respiratory ailments (heat stroke, exhaustion, and asthma) while monitoring how the use of certain drugs such as blood pressure medications, antihistamines, and decongestants, used to treat hypertension, asthma and allergies and changes in extreme temperatures, can cause heat intolerance.

Like the elderly, homeless and destitute people in the Caribbean are also known to suffer from the negative effects of extreme temperatures and, in some instances, heat waves. However, there remains very little empirical research, as well as adaptation and mitigation plans, documenting their experiences with climate change events such as extreme temperature, flooding, droughts, pollution, and vector-borne diseases.

Often the homeless, such as those in Australia and India, and like the Caribbean, may be more vulnerable to heat stress and other conditions resulting from changes in their living environment. For this reason, these groups are more likely to suffer from dehydration and heat stress symptoms and may even die from hunger (Every et al. 2021; Islam 2022). For this reason, what is needed in the Caribbean, in such a case, is for the state and non-governmental organizations to make available safe and clean forms of drinking water for the homeless alongside safe forms of housing, information on heat stress symptoms through outreach programs, and to provide greater access to housing units, and shelters which are aimed at the homeless population.

### *4.4. Climate Change Adaptation for the Elderly, Disabled and Homeless*

Given that many countries may not have specific climate change adaptation and mitigation plans which are focused on the needs of the elderly, the disabled, and the homeless in society, what is needed in the Caribbean are risk assessment and communication studies which concentrate on vulnerable groups such as the elderly, disabled and the homeless, to determine how they perceive the impact that climate change is likely to have on their health and response to extreme weather conditions (Bi et al. 2020).

In this way, Caribbean environmental agencies can learn from and follow in the footsteps of countries like China and Japan, who are already ahead of most countries in ensuring that, even with the occurrence of climate change events, the most vulnerable in society can continue to lead a healthy lifestyle which is both sustainable and productive, while designing effective communication strategies to meet the needs of these groups.

For example, in the case of Tokyo, Japan, Park et al. (2021) explained that the use of more advanced mapping techniques, such as fine-scale heat mapping, is an essential component in the design of adaptation strategies when it comes to dealing with the intensity of heat exposure experienced by the elderly residing in urban areas. The use of spatial patterns of heating, if adapted to the Caribbean, would allow for not only greater comparisons to be made but help environmentalists and policymakers in the Caribbean identify where the hotspots of heat exposure by the elderly occur and how large they are expected to grow in the future.

Further to this, given that climate change impacts the livelihoods of elderly, disabled, and the homeless in a significant way, it is expected that during and after climate change events, the ability of some economically actively elderly and disabled people may be constrained either through the loss of jobs, or their reduced ability to undertake tasks at work due to financial and personal constraints. Further to this, continued joblessness, together with the loss of income and housing, are also contributing factors to people becoming homeless. Thus, it is important to develop employment programs that are targeted toward retired and unemployed elders, as well as persons who are disabled, to strengthen their earning capacity.

#### *4.5. Research and Development*

Additionally, besides the individual and institutional economic costs associated with the impacts of climate change on the elderly, disabled, and the homeless, it is noted that within the environmental research literature, there is a significant lack of country-specific studies that examine the impact of climate change events on these vulnerable groups, particularly for the Caribbean (Kwon 2020; Kinay et al. 2018). For this reason, it is not likely that the direct effects of climate change diseases and the negative outcomes caused by climate change events, such as extreme temperatures, are recorded in the Caribbean. This hinders the implementation of policy measures promoting the adaptation of vulnerable groups such as the elderly, homeless, and disabled to climate change events since few studies produced in the Caribbean empirically examine the impact that climate change has on these communities (Kosanic et al. 2022).

Such insufficient research is likely to have a negative influence on the design, practice, and implementation of climate change policies concerning this segment of vulnerable people, as the research undertaken may not be either supportive or inclusive of the needs of these people. Furthermore, the exclusion of these vulnerable persons in the design of climate change policies could create an unstable policy environment, reducing the dissemination and uptake of research. This issue, together with issues of limited grant funding and limited engagement with policymakers, practitioners, and intermediaries, could, unfortunately, discourage researchers from undertaking good quality climate change research focusing on vulnerable populations that are robust and ethical and can inform policymaking. For this reason, there is a dearth of case studies that examine these issues in the Caribbean.

What is needed, in this instance, is greater investment in conducting empirical research studies and a case study approach, which examines the health effects of climate change on the homeless, elderly, and disabled in the Caribbean. The findings of such studies could be integrated and used in the policy implementation process of adaptation and mitigation plans. The collection of relevant data, and the production of empirical research studies, are imperative to the successful implementation of these policies because their lack of evidence is often highlighted as the main barrier to undertaking such studies. Should greater data be collected and analyses be undertaken, it would illustrate how climate change events influence the ability of the elderly to adapt to such situations with the need for more social safety nets (Rhoades et al. 2016).

Further to this, within the literature, there is a great need for climate change research to be more compassionate in terms of its conceptualization of human vulnerability (Eriksen 2022). Instead of describing the disabled, elderly, and homeless as victims of climate change, they could be viewed as the experts on adaptation and mitigation strategies that are geared toward their specific vulnerable group. Such a reimagining of the roles and insights of the disabled and the vulnerable concerning climate change events could reduce their exclusion and promote greater inclusion in the design of environmental and climate change policies (Larrington-Spencer et al. 2021).

Moreover, the experiences and needs of vulnerable communities in response to climate change events are often clumped together and generalized within the literature. Strambo et al. (2021) explained that such a practice should be stopped in each vulnerable group, such as the disabled, homeless, and elderly, who all have multiple identities with different needs that all intersect with each other. As the systematic scoping review method implemented by Kidd et al. (2021b) revealed, in the case of the impact that climate change has on homelessness, this topic is severely under-developed, and is insufficient in its current form to adequately address or even inform mitigation and adaptation plans.

### **5. Conclusions**

Small Island Developing States (SIDS) are vulnerable to climate change events because of their nature and geographical location. Many dwelling places are located along the coast in the direct path of adverse weather events, such as storms and hurricanes, which wreak havoc on landfall. The vulnerable populations of the elderly, homeless, and disabled are inappropriately affected because of already present health issues, social isolation, mobility, limited access to services, and psychological issues. Stakeholders and the Government of the day must recognize the social and economic implications of these vulnerable populations and seek to address these as soon as possible. Mitigation and adaptation plans are necessary and must be prioritized to ensure that the risks to these groups are minimized and that an element of safety and security ensues. The fundamental human rights of these groups are in question

concerning climate change and its events. Awareness and education are integral as a means of support and recognition of these groups. There must be action and intervention undertaken to protect the lives of these vulnerable populations.

Some of the most important economic implications that climate change is likely to have on the elderly, disabled, and homeless groups in the Caribbean include (1) the elderly and the homeless might not have a sufficient household income to put in place mitigation measures in cases of severe weather conditions, (2) the movement of the elderly and the disabled could be severely impacted by severe weather conditions as different modes of transportation become limited and inaccessible during extreme flooding and rainfall, (3) the health of the homeless population is likely to worsen during periods of excessive rainfall, as they may have limited access to safe housing and clean drinking water, (4) the destruction of green spaces during climate change events can negatively impact the health outcomes of older people, leading to a rise in chronic health conditions.

The findings from this study show that not only do climate change events have a significant and often irreversible impact on the elderly, disabled, and homeless groups in the Caribbean, but their exclusion from climate change policies, and empirical research studies, can mask greater societal problems in the Caribbean like unequal opportunities, discrimination, ableism, gentrification, and ageism. The findings of this study provide several avenues for several unique pieces of future research to be undertaken, such as examining the link between gentrification and climate change in the Caribbean, as well as looking at the role which ageism plays in climate change discussions in the aging Caribbean region.

**Author Contributions:** Conceptualization, D.D.J. and R.A.D.; Methodology, D.D.J. and R.A.D.; Formal Analysis, D.D.J. and R.A.D.; Investigation, D.D.J. and R.A.D.; Resources, D.D.J. and R.A.D.; Writing—Original Draft Preparation, D.D.J. and R.A.D.; Writing—Review and Editing, D.D.J. and R.A.D. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Conflicts of Interest:** The authors declare no conflict of interest.

#### **References**


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