Climate Change Awareness, Physical and Psychological Impacts, and Urban Environmental Stressors in Five Cities of Myanmar

Abstract

Climate change is a major public health challenge affecting physical health, psychological wellbeing, and quality of life. Urban environmental stressors such as traffic congestion, population density, urban heat, air pollution, reduced green spaces, and infrastructure limitations may intensify these impacts. This cross-sectional study investigated climate-change awareness and perceived physical and psychological impacts among 591 residents of Yangon, Mandalay, Naypyidaw, Monywa, and Myitkyina, Myanmar, and explored contextual contributors through a supplementary survey of local  representatives. Residents were recruited using convenience sampling through community networks, social contacts, educational institutions, and online distribution; because recruitment was not based on a defined sampling frame, a response rate could not be calculated. Climate awareness, physical impact, and psychological impact were assessed using three-item domains scored on five point Likert scales. Internal consistency of each domain was assessed using Cronbach’s alpha [0.705 – 0.715]. Differences among cities were analyzed using the Kruskal–Wallis test with Dunn–Bonferroni post hoc comparisons, and high-impact versus lower-impact city groups were compared using the Mann–Whitney U test with appropriate effect-size estimates. Multiple linear regression identified factors associated with physical and psychological impact scores. Climate awareness, physical impact, and psychological impact differed significantly among cities (all p < 0.001). Awareness was higher in lower-urbanization cities, whereas physical and psychological impacts were higher in higher-urbanization cities. Residence in higher-urbanization cities remained independently associated with greater physical impact (β = −0.332, p < 0.001) and psychological impact (β = −0.329, p < 0.001) after adjustment for demographic factors. Local representatives identified transportation congestion, carbon emissions, urban density, reduced green spaces, air pollution, urban heat, and flooding
related infrastructure problems as important contextual stressors. The findings indicate substantial climate-related disparities across Myanmar cities and support climate-responsive urban planning, sustainable transportation, green infrastructure, air-quality management, and targeted climate-health communication. 

The higher-urbanization versus lower-urbanization group differences were small for awareness (r = 0.20) and medium for physical (r = 0.34) and psychological (r = 0.31) impacts. The regression models explained 13.6% of the variance in physical impact and 10.7% in psychological impact, indicating that urban context was an important correlate but explained only part of the observed burden.