Foundation Health And Safety Answers – In recent years, a wealth of research has emerged linking climate change to negative health outcomes around the world. In 2021, a global group of medical researchers suggested that rising temperatures associated with climate change were the greatest threat to global public health. Illustrating the potential growing impacts of climate change, 2021 marked some of the most frequent and costly extreme weather events in the United States in the past decade. Climate and health risks related to climate change disproportionately impact historically marginalized and under-resourced groups, who have the fewest resources to prepare for and recover from these disasters. As climate-related events become more frequent, health and healthcare impacts will increase in both frequency and intensity. This letter provides an overview of the impacts of climate and climate change on health, identifies who is at increased risk of adverse health effects associated with climate and climate change, explains why the growing focus on climate change and health, and discusses recently efforts to address climate change and health equity.
Climate and weather can negatively affect individual and population health in several ways. The Centers for Disease Control and Prevention (CDC) notes that several climate factors, including rising temperatures, extreme precipitation, extreme weather, and rising sea levels, affect health through a variety of exposure pathways, including extreme heat, poor air quality, reduced food. and water quality, changes in infectious agents and population movement (Figure 1). These exposures can lead to adverse health outcomes such as heat-related illness and cardiopulmonary disease; food, water and vector-borne diseases and worse mental health and stress.
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While climate change poses threats to everyone’s health, people of color, low-income people, and other marginalized or high-need groups face disproportionate risks due to underlying inequities and structural racism and discrimination. The same factors that contribute to health inequalities affect climate vulnerability – the extent to which people or communities are at risk of experiencing the negative impacts of climate change.
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People of color face increased climate-related health risks compared to their white counterparts. As a result of historical and contemporary structural racism and discrimination, people of color are more likely to live in poverty; are exposed to environmental hazards; and have less access to health, economic and social resources; making them more at risk of adverse health impacts from climate compared to their white counterparts. Last year, the United States Environmental Protection Agency (EPA) found that racial and ethnic minorities are most likely to live in areas with the greatest projected increases in morbidity and mortality from climate change in temperature and air pollution. They were more likely to lose work hours and opportunities due to increased days with high temperatures. They were also most likely to live in areas with projected land loss due to sea level change, as well as living in coastal areas with the greatest projected increase in traffic delays due to high tides. E.g:
Immigrants in the US also face increased climate-related risks due to structural inequality. Immigrants are more likely than the US-born to work in environmentally hazardous occupations and live in public housing with limited access to heating or cooling infrastructure, making them more susceptible to climate-related health risks. Non-citizen immigrants account for more than four in ten farm workers in the United States. The data shows that between 1991 and 2006, agricultural workers involved in crop production died at a rate 20 times higher from heat-related illnesses compared to all American workers. Non-citizen immigrants are also more likely than citizens to be poor, which can add to the challenges of responding to and recovering from extreme weather events. For example, after Hurricane Harvey, immigrants were more likely than US-born residents to report job and income losses. While immigrants were less likely to experience home damage, among those who did, they were less likely to seek government disaster assistance. Nearly half (48%) of immigrants with home damage said they were worried about seeking help to bring attention to their or their families’ immigration status.
Low-income communities are likely to be disproportionately affected by climate change. People with low socioeconomic status are more likely to live in vulnerable housing, are exposed to environmental hazards, and have a more limited ability to prepare for or recover from extreme climate events. Low-income households are more likely to have high energy bills, a recent study found that 25% of low-income households could not afford to pay an energy bill in the past year, and nearly 13% could not -they were able to pay an energy bill last month. This inability to pay their bills increases the likelihood of having their utilities disconnected, which would increase their exposure to extreme weather and negative health consequences. In the event of extreme flooding and other weather conditions, residents of federally assisted housing are at increased risk of exposure to toxic waste and debris due to proximity to hazardous waste sites. A 2020 analysis found that 70 percent of the nation’s most hazardous waste sites are located within one mile of US Department of Housing and Urban Development (HUD) assisted housing projects. Low-income communities are also more likely to be adversely affected by natural disasters and other climate-related emergencies. Interviews with low-income survivors of Hurricane Katrina found that many survivors also reported experiencing emotional and mental trauma, barriers to access to care that resulted in serious and persistent gaps in care, living conditions unstable and serious financial concerns. Similarly, a survey of Puerto Ricans a year after Hurricane Maria found that those with lower incomes were more likely than higher-income residents to report housing-related challenges, including major damage or destruction to their home and conditions of insecure life.
Older adults are more sensitive to climate change for a variety of age-related reasons, including reduced thermoregulation and a greater burden of chronic disease and disability. Given age-related health changes, lower concentrations of air pollution and smaller changes in temperature may lead to adverse reactions. Analysis of fee-for-service Medicare data found that short-term exposure to air pollution was associated with increased annual hospitalizations and post-acute care and inpatient costs. Older people are also more likely to live alone and be socially isolated, putting them at increased risk of missing extreme weather warnings and potentially being unable to respond to weather disasters. Furthermore, over the past forty years, the number of older adults living in coastal communities has increased by 89%, which, combined with sea level rise, may put them at additional risk of being adversely affected by coastal flooding.
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In recent years, there has been an increase in the frequency and intensity of adverse climate-related events, with the potential to worsen health outcomes and increase health inequalities. The Intergovernmental Panel on Climate Change (IPCC) recently published its sixth report on climate change, noting that the risk to human health increases with each fractional increase in global temperature. In June 2021, the western United States experienced record heat waves, increasing the risk of heat injury, drought, and wildfires. In addition to the extreme heat, the past five years have included historic storm activity, with 2020 marking the second time in history that the National Oceanic and Atmospheric Administration (NOAA) topped the Atlantic storm list with 21 names. Researchers predict that Earth will experience an increase in its average temperature, weather variability, and the frequency and intensity of extreme weather events. A 2019 report by the Government Accountability Office found that the effects of climate change pose a threat to 60 percent of the hazardous waste sites known as Superfund sites in the country. In 2020, scientists reported that extreme coastal flooding would threaten more than 900 Superfund sites over the next 20 years. This can have harmful effects on nearby residents (especially low income and communities of color) by exposing them to toxic chemicals from flooding and runoff.
Changes in land use, rising ambient temperatures, and changes in weather patterns can affect the spread of infectious diseases. As temperatures rise, scientists project changes in mosquito abundance and the spread of mosquito-borne diseases that could increase people’s exposure to dengue, zika, yellow fever and other mosquito-borne diseases. Over the past twenty years, the mosquitoes that spread dengue fever in the United States have increased by 8.2 percent in response to rapidly rising temperatures. Temperature increases related to climate change have also helped expand the range of ticks, increasing the risk of contracting Lyme disease.
While addressing climate change would require a massive and sustained effort, the Biden administration has identified addressing climate change as a priority and has taken a variety of actions to mitigate the effects of climate change, including its effects on health care.
On January 27, 2021, President Biden announced an executive order addressing the climate crisis at home and abroad, emphasizing the need for a government-wide approach to addressing the climate crisis, including mainstreaming climate change at all levels of policymaking. In response to Biden’s executive order, the US Department of Health and Human Services (HHS) adopted its Climate Action Plan, including
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