The FICCAH Study: Addressing the Fossil fuel Industry’s role in driving Climate Change And Health inequalities: A multi-method youth participatory project using a structural racism lens

Research question What would a youth-led strategy addressing the role of the fossil fuel industry in driving climate change and health inequalities in England include? Background Climate change is a powerful determinant of poor physical and mental health across the life-course.

Driven by reliance on fossil fuels, children and young people are particularly vulnerable to the mental health impacts of climate change, such as climate-related anxiety.

Young people are at the forefront of climate action locally and globally, with increasing evidence that this can help support their mental health. Climate-related health impacts also fall disproportionately on racially minoritised* people.

If left unaddressed, health inequalities from climate change can place additional strain on health and care services and cost the UK economy an estimated £20 billion per year by 2050.

Research gap The growing recognition of the central role of the fossil fuel industry in driving health inequalities from climate change has led to calls for a coordinated public health response. This provides an opportunity for research on what patients and the public want.

This study takes a structural racism lens, acknowledging that racism operates in systems and institutions, including in research processes.

Racially minoritised* and young people are disproportionately impacted by climate change yet are frequently excluded from research. Therefore, this study aims to elevate their voices throughout.

Proposal I plan to bring together minority ethnic young people (aged 14-18-years), health professionals, and community groups, using a range of methods to: Review: Conduct a realist review of existing evidence to identify the mechanisms of change in advocacy interventions involving young people.

Understand: Explore, through qualitative methods, young people's understanding of the links between fossil fuels, climate change, and health inequalities.

I will conduct focus group discussions in secondary schools and colleges near fossil fuel sites (e.g., gasworks, power plants, and road expansion projects) in London and the North West of England.

Strategise: Co-develop an evidence-based advocacy strategy to combat climate change and health inequalities with young people, using youth participatory action research methods.

Evaluate: Investigate, through qualitative methods, the impact of being involved in youth participatory action research, including whether it alleviates or increases climate anxiety.

Patient and public involvement I developed this proposal with input from over 20 Experts by Experience (e.g., young people affected by climate change), clinicians, researchers, and charity representatives.

Two lead Experts by Experience, a Youth Advisory Panel, and Steering Group will be involved throughout the Fellowship, and young people will be co-researchers at various points.

Anticipated impact and dissemination An evidence-based, youth-led strategy for a multi-level public health response to climate-related health inequalities will be shared with relevant stakeholders. Young people will determine how, where, and with whom to share the findings. Outputs may include videos, infographics, and public events.

An advocacy training workshop and toolkit will be delivered to participants. *I have defined minoritised as individuals and populations, including numerical majorities, whose collective power has been eroded through the targeting of identity in active processes that sustain hierarchies.