{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:15:58Z","timestamp":1788419758966,"version":"build-2803163510"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Climate change is a significant global health threat with disproportionate impacts across the Global South and among marginalized populations. Migrants and refugees experience multiple intersecting vulnerabilities including conflict, poverty and limited access to healthcare that may increase vulnerability to climate-related health impacts. This study aimed to explore perceptions of climate change and its impacts on mental health among migrant communities on the Thailand-Myanmar border.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an exploratory qualitative study using focus group discussions (FGDs). Participants were rural migrant populations including pregnant women, adolescents, agricultural workers and healthcare workers living in Tak Province, Thailand. FGDs were audio-recorded, translated and analyzed thematically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 58 participants took part across eight FGDs. Participants\u2019 narratives centered around stressors they faced on account of their precarious legal status, financial insecurity and conflict-related trauma. Climate change was rarely raised spontaneously. Following direct prompts about climate change, participants described increasing exposure to extreme heat, flooding and environmental degradation which disrupted livelihoods and exacerbated existing hardship. The multiple stressors participants described interconnected to form a complex web of challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this conflict-affected, resource-constrained setting, climate change was rarely raised spontaneously as a life stressor. Against a backdrop of acute legal and economic stressors, climate-related distress may not be perceived as the most pressing concern. However, climate change may act as an indirect stressor through its impacts on livelihoods and exacerbation of structural precarity. Addressing the inter-related challenges of climate change, displacement, poverty and mental health requires integrative, climate-sensitive and migrant-inclusive health policies and care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1846043","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:41:31Z","timestamp":1788417691000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["They are all inter-related, like a cycle: an exploratory qualitative study of climate change, chronic stressors and mental health among displaced populations on the Thailand-Myanmar border"],"prefix":"10.3389","volume":"14","author":[{"given":"Gracia","family":"Fellmeth","sequence":"first","affiliation":[{"name":"National Perinatal Epidemiology Unit, Nuffield Department of Women\u2019s and Reproductive Health, University of Oxford","place":["Oxford, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"May Myo","family":"Thwin","sequence":"additional","affiliation":[{"name":"Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University","place":["Mae Sot, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper Ko Ko","family":"Aung","sequence":"additional","affiliation":[{"name":"Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University","place":["Mae Sot, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suphak","family":"Nosten","sequence":"additional","affiliation":[{"name":"Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University","place":["Mae Sot, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan San","family":"Wai","sequence":"additional","affiliation":[{"name":"Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University","place":["Mae Sot, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Nosten","sequence":"additional","affiliation":[{"name":"Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University","place":["Mae Sot, Thailand"]},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford","place":["Oxford, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaisiri","family":"Angkurawaranon","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Faculty of Medicine, Chiang Mai University","place":["Chiang Mai, Thailand"]},{"name":"Global Health and Chronic Conditions Research Centre, Chiang Mai University","place":["Chiang Mai, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Plugge","sequence":"additional","affiliation":[{"name":"Population Health Sciences, University of Southampton","place":["Southampton, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"McGready","sequence":"additional","affiliation":[{"name":"Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University","place":["Mae Sot, Thailand"]},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford","place":["Oxford, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref1","volume-title":"Climate Change 2023: Synthesis Report. Contribution of Working Groups I, II and III to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change","year":"2023"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2346","DOI":"10.1016\/S0140-6736(23)01859-7","article-title":"The 2023 report of the lancet countdown on health and climate change: the imperative for a health-centred response in a world facing irreversible harms","volume":"402","author":"Romanello","year":"2023","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"4486","DOI":"10.3390\/ijerph18094486","article-title":"Climate change and mental health: a scoping review","volume":"18","author":"Charlson","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s40572-020-00303-3","article-title":"Climate change and mental health","volume":"8","author":"Clayton","year":"2021","journal-title":"Curr Environ Health Rep"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2490524","DOI":"10.1080\/28324765.2025.2490524","article-title":"Towards a unified conceptual framework of eco-anxiety: mapping eco-anxiety through a scoping review","volume":"4","author":"Boivin","year":"2025","journal-title":"Cogent Ment Health"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"66","DOI":"10.5334\/aogh.4105","article-title":"Mental health impacts of climate change among vulnerable populations globally: an integrative review","volume":"89","author":"White","year":"2023","journal-title":"Ann Glob Health"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e217","DOI":"10.1016\/S2542-5196(20)30125-X","article-title":"Human mobility, climate change, and health: unpacking the connections","volume":"4","author":"McMichael","year":"2020","journal-title":"Lancet Planet Health"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1146\/annurev-publhealth-071421-045148","article-title":"Climatic and environmental change, migration, and health","volume":"44","author":"McMichael","year":"2023","journal-title":"Annu Rev Public Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1038\/s44168-024-00133-1","article-title":"Climate-induced migration in the global south: an in depth analysis","volume":"3","author":"Almulhim","year":"2024","journal-title":"npj Clim Action"},{"key":"ref10","volume-title":"Mental Health of Refugees and Migrants: Risk and Protective Factors and Access to Care","year":"2023"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"101443","DOI":"10.1016\/j.lanplh.2026.101443","article-title":"Framing climate change, migration, and health as a syndemic","volume":"10","author":"Schwerdtle","year":"2026","journal-title":"Lancet Planet Health"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1186\/s44263-025-00224-z","article-title":"International migrant workers, heat exposure, and climate change: a systematic review of health risks and protective interventions","volume":"3","author":"van der Horst","year":"2025","journal-title":"BMC Glob Public Health"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"2500747","DOI":"10.1080\/28324765.2025.2500747","article-title":"The mental health impact of the climate and ecological crisis on vulnerable populations in Africa","volume":"4","author":"Lewins","year":"2025","journal-title":"Cogent Ment Health"},{"key":"ref14","volume-title":"Myanmar\u2019s Enduring Polycrisis: Four Years into a Tumultuous Journey","year":"2025"},{"key":"ref15","first-page":"276","volume-title":"The Armed Conflict Survey 2025","year":"2025"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s13031-025-00668-y","article-title":"Conflict exposure and mental health: a survey of adolescent girls and young women in Myanmar post the 2021 coup d\u2019\u00e9tat","volume":"19","author":"Pearson","year":"2021","journal-title":"Confl Heal"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1186\/s12884-015-0517-0","article-title":"Pregnant migrant and refugee women's perceptions of mental illness on the Thai-Myanmar border: a qualitative study","volume":"15","author":"Fellmeth","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1186\/s12978-018-0522-7","article-title":"Adolescents' perceptions and experiences of pregnancy in refugee and migrant communities on the Thailand-Myanmar border: a qualitative study","volume":"15","author":"Asnong","year":"2018","journal-title":"Reprod Health"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1136\/bmj.311.7000.299","article-title":"Qualitative research: introducing focus groups","volume":"311","author":"Kitzinger","year":"1995","journal-title":"BMJ"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual Res Psychol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"100396","DOI":"10.1016\/j.lansea.2024.100396","article-title":"Post-traumatic stress, depression, and anxiety during the 2021 Myanmar conflict: a nationwide population-based survey","volume":"26","author":"Fan","year":"2024","journal-title":"Lancet Reg Health Southeast Asia"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1186\/s13031-025-00730-9","article-title":"Understanding the mental health impact of internally displaced persons (IDPs) and their support networks in southeastern Myanmar post-military coup: a qualitative study","volume":"19","author":"Tun","year":"2025","journal-title":"Confl Heal"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1192\/bji.2022.14","article-title":"Mental health and climate change in Africa","volume":"19","author":"Atwoli","year":"2022","journal-title":"BJPsych Int"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.worlddev.2018.01.002","article-title":"The effects of climate variability on psychological well-being in India","volume":"106","author":"Pailler","year":"2018","journal-title":"World Dev"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e0002152","DOI":"10.1371\/journal.pgph.0002152","article-title":"Pathways from climate change to emotional wellbeing: a qualitative study of Kenyan smallholder farmers living with HIV","volume":"3","author":"Beyeler","year":"2023","journal-title":"PLoS Glob Public Health"},{"key":"ref27","article-title":"Local experiences and perceptions of climate change during Myanmar\u2019s violent rupture","volume":"7","author":"Kyed","year":"2026","journal-title":"IJBS"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"782811","DOI":"10.3389\/fpubh.2022.782811","article-title":"Impacts of climate change and heat stress on farmworkers' health: a scoping review","volume":"10","author":"El Khayat","year":"2022","journal-title":"Front Public Health"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"2662","DOI":"10.3390\/ijerph16152662","article-title":"Mapping the solastalgia literature: a scoping review study","volume":"16","author":"Galway","year":"2019","journal-title":"Int J Environ Res Public Health"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1086\/382250","article-title":"An anthropology of structural violence","volume":"45","author":"Farmer","year":"2004","journal-title":"Curr Anthropol"},{"key":"ref31","volume-title":"Slow Violence and the Environmentalism of the Poor","author":"Nixon","year":"2011"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/S0140-6736(23)00919-4","article-title":"Envisioning environmental equity: climate change, health, and racial justice","volume":"402","author":"Deivanayagam","year":"2023","journal-title":"Lancet"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"e58","DOI":"10.1016\/S2542-5196(18)30004-4","article-title":"Connecting planetary health, climate change, and migration","volume":"2","author":"Sch\u00fctte","year":"2018","journal-title":"Lancet Planet Health"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"S257","DOI":"10.4103\/ipj.ipj_33_24","article-title":"Geopsychiatry: climate change, migration, and mental health","volume":"33","author":"Anantapong","year":"2024","journal-title":"Ind Psychiatry J"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"17455057251400070","DOI":"10.1177\/17455057251400070","article-title":"Facing the future: the nexus between climate change and women's health","volume":"21","author":"Ameyaw","year":"2025","journal-title":"Womens Health"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1846043\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:41:33Z","timestamp":1788417693000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1846043\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":35,"alternative-id":["10.3389\/fpubh.2026.1846043"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1846043","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"article-number":"1846043"}}