Date of Award

Fall 1-1-2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Advisor

Poghosyan, Hermine

Abstract

Background: The health impacts of climate change are shaped by a complex interplay of geopolitical, ecological, and socioeconomic forces. Climate events impose substantial personal and societal costs, draining resources and deepening existing vulnerabilities within communities. Yet few studies examine how these dynamics affect groups often overlooked in climate–health discourse, including LGBTQ+ individuals, informal caregivers, and older adults. Objective: To examine how individual, community, and structural-level factors influence both climate vulnerability (defined as susceptibility to adverse health impacts) and climate resilience (the capacity to adapt to and withstand climate-related stressors). Focusing on diverse adult populations in California, this dissertation aims to identify patterns of inequity and resilience across geographic and demographic contexts. Methodology: This dissertation employed cross-sectional analyses using data from the 2023 California Health Interview Survey (CHIS), supplemented with publicly available datasets from the U.S. Census. Logistic regression models were used to examine individual-level associations, while spatial analyses, including Geographically Weighted Regression (GWR), were conducted to examine geographic variation in climate-related mental health burden. Key Findings • Chapter 2 examined the intersection of LGBQ+ identity, housing insecurity, and climate related mental health burden, revealing greater vulnerability among bisexual, pansexual, and transgender or gender-expansive individuals. • Chapter 3 investigated the relationship between caregiving status and climate-related mental health burden, with a focus on how structural stressors may exacerbate risk. Findings indicated that caregivers, particularly those caring for older adults or experiencing caregiver-related financial strain, had markedly higher odds of reporting mental health impacts from climate events than non-caregivers. • Chapter 4 explored age-related differences in climate-related mental health burden and incorporated geospatial analyses to assess how community aging and wildfire proximity influence risk across California. Study findings challenged dominant climate–health narratives by showing that older adults reported lower levels of mental health burden, suggesting greater psychosocial climate resilience than often recognized. Spatial analyses, however, revealed that communities with larger proportions of older residents often faced higher predicted mental health burden across age groups, highlighting geographic disparities shaped by both demographic composition and structural context. Conclusion This dissertation presents climate-related mental health as a process shaped by interrelated systems. By focusing on aging, caregiving, and LGBTQ+ populations, it illustrates how structural exclusion influences both vulnerability and resilience. Findings highlight priority areas where investing in local systems and implementing place-based public health strategies can reduce climate vulnerability and strengthen community resilience across the life span.

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