Breathing unequally through recurrent haze: community resilience and environmental health equity in Sarawak, Malaysian Borneo

Abstract

Background Recurrent haze is a persistent environmental health concern in Malaysian Borneo, arising from landscape and peatland fires and subsequent smoke transport under climate- and weather-sensitive conditions. Communities may differ in their capacity to prepare for and respond collectively to haze because access to protective resources, services, information and institutional support varies across settings. This study examined variation in perceived community haze resilience and its equity-relevant determinants among adults in Sarawak, Malaysian Borneo.

Methods We conducted a community-based cross-sectional study from June 2024 to May 2025 among 481 adults using multistage stratified cluster sampling. We measured community haze resilience across four domains: connection and caring, resources, transformative potential, and disaster management. Explanatory variables covered geographical, sociodemographic, household, health, psychosocial and informational factors. Independent-samples t-tests, one-way analysis of variance and Pearson correlations examined unadjusted associations. Hierarchical multiple linear regression with HC3 robust standard errors assessed adjusted associations and incremental explained variance; adjusted marginal means compared resilience across zones and settlement types.

Results Mean (SD) total resilience was 63.20 (7.86). Resilience differed across Sarawak zones (F=22.09, p<0.001, η²=0.085) and settlement types (F=9.53, p<0.001, η²=0.038), with urban respondents reporting lower mean resilience than suburban and rural respondents. At their entry step, haze-related psychosocial and informational factors increased explained variance by 35.2 percentage points; the final model explained 46.7% of variance (adjusted R²=0.442). Higher haze knowledge was positively associated with resilience (B=1.26, 95% CI 0.98-1.55). Greater risk normalisation (B=-0.40, 95% CI -0.66 to -0.14), perceived economic and mobility costs (B=-0.53, 95% CI -0.87 to -0.18), and larger household size (B=-0.47, 95% CI -0.81 to -0.13) were associated with lower resilience. Compared with urban respondents, suburban (B=5.31, 95% CI 3.31-7.30) and rural respondents (B=2.18, 95% CI 0.63-3.73) had higher adjusted resilience.

Conclusions Perceived community resilience to recurrent haze varied across geographical and settlement contexts in the communities studied. Differences were associated with settlement context, household capacity, knowledge, risk normalisation and practical barriers, supporting an environmental health equity perspective. Preparedness strategies may benefit from targeted risk communication, support for vulnerable households and measures that reduce barriers to exposure reduction and collective response.