Impacts of a changing climate and adverse weather events on individuals with spinal cord injury: a narrative review

Background:
Our climate is changing, with heatwaves, wildfires and hurricanes posing increased risks for individuals with a disability such as spinal cord injury (SCI). Despite growing recognition of disability-related climate risk, the specific challenges for individuals with SCI have not been well-documented.

Objective:
This narrative review aimed to broadly explore the literature describing the impacts of a changing climate (e.g., rising temperatures, adverse weather, etc.) on individuals with SCI. Methods: A structured search was conducted across five databases (PubMed, EMBASE, Scopus, Web of Science, CINAHL) and was supplemented by citation tracking to identify additional relevant studies. Twelve articles were analyzed thematically.

Results:
Three themes were identified. In terms of adverse weather events, individuals with SCI are physiologically (e.g., due to autonomic dysregulation) and physically (e.g., unable to evacuate or seek healthcare due to mobility issues) at risk, experiencing psychological impacts (e.g., anxiety). There was a mismatch between their perceived and actual preparedness for these events, placing themselves further at risk, due in part to climate skepticism and fatalism. The third theme was inequity and disability discrimination. As the research originates largely from the Global North, those living with SCI globally are generally underrepresented or excluded from climate adaptation policy development. SCI is also often considered with other ‘disabilities’ such as blindness and impaired mental capacity, masking climate impacts.

Conclusion:
Individuals with SCI experience several physiological, physical and psychological challenges in the face of increasing climate-related events. Addressing these challenges will require targeted, SCI-specific and inclusive strategies in clinical practice, education, and policy development.