Date of Award


Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Anna Rivara

Second Advisor

Nicola Hawley


Background: Greenhouse gas emissions have driven human-induced climate change, bringing several impacts to small island nations in the Pacific. Samoa, a small island developing state located in the south Pacific Ocean, is at disproportionate risk from impacts of climate change such as rising surface temperatures, rising sea levels, increases in frequency and degree of heavy precipitation events, and increases in the frequency of droughts. Simultaneously, Samoan populations possess a high prevalence of non-communicable diseases such as diabetes, heart disease, and hypertension. For multiple decades, the Government of Samoa has framed climate change as a key issue that threatens the lives, economies, and culture of Samoa. Hence, it has developed a myriad of climate adaptation policies over time to properly combat climate change impacts. Although the Samoan government’s climate change policies and programs often list the Samoan Ministry of Health (MoH) as a responsible party in carrying out climate policies, it is unclear how public health is incorporated in climate change policies or climate change messaging. This study aims to investigate 1) how policy stakeholders in Samoa conceptualize the impacts of climate change on Samoan populations, 2) how overall climate policies and messaging incorporate health messaging and data, and 3) how members of the Samoan community perceive climate change as a threat to their health and wellbeing.

Methods: Utilizing a convergent-parallel approach, we conducted a series of interviews and launched an online survey. Remote semi-structured interviews were conducted with n=5 climate policy stakeholders working within governmental, non-governmental, and intergovernmental positions in Samoa. Major question topics included (1) how climate change impacts are perceived by stakeholders who work at the policymaking level as it relates to health, the economy, or culture, and (2) how those perceptions are associated with the climate change actions that are carried out at the local, national, and regional/global level. Additionally, we implemented an online survey questionnaire (n=49 respondents) for community members in Samoa that explored general perceptions of climate change, health-related perceptions of climate change, assessed perceived health status, as well as probed the effect of various climate change-induced impacts on health status.

Results: Among the responses to stakeholder interviews we identified three major themes: 1) health, economic, and cultural impacts of climate change in Samoa; 2) national and global level politics of climate change action; and 3) funding structure for climate change mitigation, adaptation, and resilience projects. Survey results indicated that most respondents felt that climate change was real and currently happening, climate change is caused by a mixture of human activities and natural processes, and that the impacts of climate change will go on to affect population health outcomes in a number of ways. Most participants felt that climate change impacts like droughts, biodiversity loss, hotter surface temperatures, increased storms and floods, and rising sea levels, would have significant impacts on general physical and mental health, as well as driving increases in infectious disease occurrences and worsening chronic disease outcomes.

Discussion: In exploring how climate change perceptions, policies, and messaging campaigns enacted at the top-down level in Samoa incorporate public health messaging and response, as well as how members of the Samoan community perceive climate change as a threat to their health and wellbeing, we found that amongst intricate policy approaches to tackling climate change, health is not a foundational principle; however, members of the Samoan community are significantly concerned about how climate change impacts will affect personal and population health. Informed by our results, we present recommendations for future climate change policy enacted in Samoa. These findings additionally have implications for many future areas of research and policy that work to directly connect climate change to health outcomes.

Open Access

This Article is Open Access

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