Scientific knowledge is often relied upon for informing crucial societal decisions. Where this knowledge is uncertain, and/or where these decision are made amidst a contexted political landscape, science tends to become the focus of intense scrutiny, as has been evident throughout the history of climate change politics. One consequence is that instead of "scientising" decision-making, science itself becomes more explicitly politicised. This thesis argues that in order to contribute to contemporary debates about the governance of science, it is essential to move beyond the question of whether or not policy-relevant scientific knowledge is credibly and to examine how scientific knowledge is made to be credible. Drawing upon the concept of co-production and other insights from Science & Technology Studies (STS), this thesis presents a detailed examination of how research into the health impacts of climate change (infectious diseases especially) gradually gained in prominence in both public health and climate change circles. Particular analytical attention is paid to an epistemic community of climate change and health (CCH) researchers, following the ways in which they interacted with global political entities such as the World Health Organization (WHO) and the Intergovernmental Panel of Climate Change (IPCC). Based upon in-depth interviews with actors intimately involved in CCH research, this thesis documents how the rise of CCH research influenced and was influenced by particular scientific and political contexts related to the governance of climate change as well as emerging infectious disease. The examination of a longstanding controversy surrounding CCH research reveals many socio-economic and political assumptions embedded in it, further demonstrating its contingency. However, despite that CCH research is both uncertain and contested, actors in the political world often need to know what the state-of-the-art of the field is. To examine the implications of this, the CCH controversy as treated by the assessment reports of the Intergovernmental Panel on Climate Change (IPPC) is explored. Although IPCC follows a complicated set of procedures aimed at ensuring scientific and political legitimacy, this thesis demonstrates that values and normative judgements are important components of scientific assessments, helping to co-construct particular science-policy orderings at the expense of alternative ones. Amidst ongoing debates about how to shore-up the credibility of climate change science and politics, this thesis argues that the way in which IPCC assessments are currently performed, as well as their tendency to present findings as "consensus", may undermine their political and scientific credibility.

The study examined organizational climate and turnover in the health sector of Ghana with particular reference to a case study on the country’s premier teaching hospital formally called Korle-Bu Teaching Hospital. In the light of high uncertainty in retention of healthcare workers in Ghana, despite the several interventions of government in providing incentives and infrastructure, the issue of employee turnover has attracted academic interest among several researchers globally and locally. Most researches on turnover related issues in the healthcare sector of Ghana have focused on the influence of employees’ overall job satisfaction. However, none has been able to neither explain nor investigate the influence of potent psychological features of the workplace on turnover. This study undertook a comprehensive review of the current state of employees’ turnover intentions in relation to the organizational climate and other working conditions prevalent at the Korle-Bu Teaching Hospital. The study was guided by the hypothesis that climate factors will emerge as a significant predictor of employees’ turnover intentions. A sample size of 80 employees was used for the study. Correlation and multiple regression analysis were used to analyze data obtained with a Likert scale designed questionnaire. The results of the study indicate that stress and organizational pride are the most proximal factors to employees’ intentions to quit. Further analysis identified influences on stress and organizational pride and pointed to management priorities for reducing employee turnover.

The study examined organizational climate and turnover in the health sector of Ghana with particular reference to a case study on the country’s premier teaching hospital formally called Korle-Bu Teaching Hospital. In the light of high uncertainty in retention of healthcare workers in Ghana, despite the several interventions of government in providing incentives and infrastructure, the issue of employee turnover has attracted academic interest among several researchers globally and locally. Most researches on turnover related issues in the healthcare sector of Ghana have focused on the influence of employees’ overall job satisfaction. However, none has been able to neither explain nor investigate the influence of potent psychological features of the workplace on turnover. This study undertook a comprehensive review of the current state of employees’ turnover intentions in relation to the organizational climate and other working conditions prevalent at the Korle-Bu Teaching Hospital. The study was guided by the hypothesis that climate factors will emerge as a significant predictor of employees’ turnover intentions. A sample size of 80 employees was used for the study. Correlation and multiple regression analysis were used to analyze data obtained with a Likert scale designed questionnaire. The results of the study indicate that stress and organizational pride are the most proximal factors to employees’ intentions to quit. Further analysis identified influences on stress and organizational pride and pointed to management priorities for reducing employee turnover.

Public health effects associated with rising temperatures resulting from global climate change are expected to increase significantly in this century. Projecting future heat-related mortality is challenging due to considerable uncertainties, and national-level, large-scale impacts under the latest greenhouse gas emission scenarios remain largely unexplored. Here I estimate excess heat-related mortality in the continental United States and in 50 largest metropolitan areas in China in the 2050s under two Representative Concentration Pathways (RCPs) emission scenarios: RCP4.5 and RCP8.5. Using model-simulated future and present climate variables that were dynamically downscaled by regional meteorology models, this study quantifies the potential increase in heat-related mortality during the warm season (May-September) in mid-century relative to the base period of 2000s. The projections are based on an integrated assessment framework that combines high-resolution climate model outputs, location specific temperature-mortality relationships, population projections and baseline mortality rates. Heat mortality risk estimates for both countries are derived from systematic reviews of current literature on temperature-mortality relationships. Potential human adaptation is likely to decrease heat-related mortality in the future. I evaluate future adaptation assumption with a scenario analysis based on empirical evidence of adaptation to heat in both countries. Findings from this study will provide valuable information to support climate policy decision making and heat-related risk management in both countries and globally

Valley fever, or coccidioidomycosis, is a disease caused by the Coccidioides immitis and Coccidioides posadasii fungal species that dwell in the soil but can become airborne and infect a human or mammalian host through their respiratory tract. Disease rates in the western U.S. have significantly increased over the past two decades, creating an emerging public health burden. Studies have been conducted that attempt to elucidate the association between environmental conditions and the growth and dispersal of the pathogen, yet the specific ecology of and environmental precursors to the disease remain uncertain. This research project investigates the relationship between environmental variables and valley fever by modeling the spatial and temporal dynamics of the disease using varying techniques. Chapter 1 discusses relevant literature before discussing the challenges associated with studying valley fever. Chapter 2 analyzes the temporal relationships between valley fever and climatic variables, focusing on Kern County, California, an understudied region in the U.S. where valley fever is highly endemic. Chapter 3 focuses on a regional spatial analysis using ecological niche modeling to better understand the environmental factors that influence the overall spatial distribution of valley fever in the U.S. Finally, combining both spatial and temporal components, Chapter 4 uses a hierarchical Bayesian spatio-temporal model to investigate the patterns and drivers of this disease, focusing on state of California, which saw an approximate 200% increase in cases from 2014 to 2018. Cumulatively, this work offers new insights on relationships between climate, landcover, and valley fever disease risk. Significant findings include climate variables explaining up to 76% of valley fever variability in Kern County, California, the significance of both climatic and landcover variables in characterizing the geographic distribution of the disease, and identification of patterns increasing risk in geographic regions of California not currently considered highly endemic. These findings advance scholarly understandings of valley fever's environmental disease drivers. The results of this research can be applied by public health officials in the allocation of surveillance and public education resources, focusing upon regions that are most likely to encounter the illness. / Doctor of Philosophy / Valley fever is a fungal disease that causes illness in over ten thousand people in the western U.S. every year. Disease rates have been increasing for the past two decades for unknown reasons, although previous research suggests that climatic variations are likely contributing factors. This research evaluated environmental factors with hypothesized relationships to valley fever disease rates. First, this dissertation explored time-series relationships between climatic factors and valley fever incidence in an understudied county in California. Research findings identified that climatic factors including precipitation from previous seasons and temperature were significantly associated with valley fever incidence in this county. Second, this dissertation assessed where valley fever is found in the western U.S. The likely spatial distribution for the disease was mapped and environmental variables influential to this distribution were identified; they included both climate and landcover variables. Finally, a model was developed to analyze patterns of disease risk in California that considered both space and time, and environmental risk factors potentially contributing to the observed patterns were assessed. Counties with increased risk were identified and significant environmental relationships with valley fever risk were confirmed. The results of this research can be applied by public health officials in allocating surveillance and public education resources, focusing upon regions that are most likely to encounter the illness.

Background: Workers in outdoor occupations are expected to be at high risk of increased morbidity and mortality, and diminished productivity, as a result of global warming in the 21st century. A previous modelling study of geographic variations in heat-related mortality risk in projected U.S. populations mid-century showed the states of Tennessee, Kentucky and North Carolina to be highly vulnerable. Methods: Under both the RCP4.5 and RCP8.5 emissions scenarios of IPCC AR5, we evaluate the effect of future warming on estimated Wet Bulb Globe Thermometer (WBGT) temperatures using model-simulated future climate variables that were dynamically downscaled by a regional meteorology model for years 2049-2052. Select Appalachian counties in the three states that are presently dependent upon agricultural crop production are the focus of this analysis. Results: Using predicted WBGT temperatures, together with estimated work loads for hand harvesting of crops, alterations in work-rest routines under heat stress prevention guidelines are presented. Conclusions: Assumptions needed to translate these altered work-rest routines into measures of productivity and economic loss are discussed. Issues in extending the modelling to heat-related morbidity and mortality in outdoor worker populations are considered in terms of data gaps and major sources of uncertainty.

This study explored the relationship between patients' Health Locus of Control and their perceptions about the nature of their physician-patient relationship. The Locus of Control Scale and the Multidimensional Health Locus of Control Scale were implemented to measure the degree of personal control individuals attribute to their health. The Health Care Climate Questionnaire was used to measure the perceived physician support. The predicted result of the study was that patients who exhibit a higher degree of internal health locus of control would report better relationships with their physicians. This hypothesis was confirmed; there was a positive relationship between Internal health Locus of Control and the Health Care Climate questionnaire. Also, a significant relationship between the Powerful Others subscale of the health Locus of Control and perceived physician support was established.

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Bien que les impacts des changements climatiques se ressentent de plus en plus, une réponse concertée tarde à voir le jour à l’international. Pour surmonter ces impasses diplomatiques, plusieurs considèrent que la mobilisation de la population pourrait être la clé. C’est pourquoi un nombre croissant de chercheurs se penchent sur l’étude des cadrages des changements climatiques. Ces études suggèrent qu'il serait effectivement possible d'influencer la volonté d'agir des citoyens selon la présentation de l’information. Cependant, peu d'études expérimentales ont été menées, notamment au Canada. Pour combler cette lacune, la présente étude visait à identifier les meilleures façons de communiquer au sujet des changements climatiques actuellement au Québec afin de favoriser l'engagement de la population. Plus précisément, nous souhaitions voir si le fait d'informer la population des impacts sanitaires locaux des changements climatiques augmenterait son soutien aux politiques climatiques, et ce, en diminuant la distance psychologique des changements climatiques. Nous avons donc mené un sondage expérimental en utilisant un échantillon par quotas d'adultes québécois (n = 3 900). Les participants ont été répartis au hasard, soit dans un groupe contrôle qui n'a reçu aucune information, soit dans l'un des groupes de traitement qui a lu un bref essai sur les impacts économiques ou sanitaires des changements climatiques au Québec attribué à l'un des messagers suivants : médecin, économiste, climatologue ou écologiste. Les participants devaient répondre à des questions avant et immédiatement après la lecture de chaque essai. En analysant les différents groupes, nous avons observé que, même si l'exposition au cadrage santé n'a pas augmenté le soutien aux politiques climatiques dans notre échantillon, elle a diminué la distance psychologique des changements climatiques (β = -0.036; IC 95 % -0.060,-0.012; p<0.01). Ce résultat est prometteur, car la diminution de la distance psychologique des changements climatiques pourrait effectivement favoriser l'engagement de la population. / Although our knowledge of the impacts of climate change is growing, a concerted international response is slow to emerge. According to many, we could overcome these diplomatic impasses by increasing political pressure through public engagement. Researchers are now studying how to frame climate change to influence citizens' beliefs and willingness to take action. However, few experimental studies have been conducted, particularly in Canada. To fill this gap, this study aimed to identify the best ways of communicating climate change currently in Quebec to foster greater engagement among the general population. More precisely, we wanted to see if informing the population on the local health impacts of climate change would increase their support for climate policies by diminishing the psychological distance of climate change. Hence, we conducted an experimental survey using a quota sample of Quebec adults (n = 3 900). Participants were randomly assigned to either a control group that received no additional information or to one of the treatment groups that read a brief essay on the economic or health impacts of climate change in Quebec that was attributed to one of the following messengers: a doctor, economist, climate scientist, or environmentalist. Participants answered questions before and immediately after reading their assigned treatment. In the regression analysis, we found that, even though exposure to a health message did not increase climate policy support, it did decrease the psychological distance of climate change (β = -0.036; 95 % CI -0.060,-0.012; p<0.01). This result is promising as diminishing the psychological distance of climate change could indeed foster greater public engagement.