by Stephanie Cleland
In February, Medical Advocates for Healthy Air (MAHA) attended and tabled at the 41st Annual Minority Health Conference in Chapel Hill. The inspiring keynotes and interesting side sessions emphasized how much work is still needed to achieve health equity. Discussions with attendees about the work of Clean Air Carolina and MAHA shone a light on the increasing need to include environmental health, especially climate health, in the minority health conversation.
During his keynote, Dr. Abdul El-Sayed posed the question “How do we build the space where people stay healthy instead of spending our time on the space where we fix people once unhealthy?” In the face of climate change, building an environment where people stay healthy is more important than ever, especially for minority groups. In North Carolina, and across the world, communities of color will be disproportionately affected by climate change and will be less able to adapt or recover from its impacts. Already, people of color in this state are more likely to live in areas with limited access to the resources needed for a healthy life. The issues these communities face today will only be exacerbated by climate change.
As a result of climate change, North Carolina will experience more extreme heat as our summers become longer and hotter. 2019 was North Carolina’s hottest year on record. As temperatures rise, so does the risk of severe illness such as heat exhaustion and heatstroke. In North Carolina, white households make approximately $20,000 more a year than black households, meaning that black households are often less able to afford air conditioning or rent a home with good insulation. In cities communities of color are also more likely to suffer from the “heat island” effect, where concrete and asphalt magnify temperatures.
People with certain pre-existing health conditions, such as obesity, are also more vulnerable to the effects of extreme heat. This threatens to exacerbate existing socioeconomic disparities – in North Carolina, approximately 30% of white adults are obese, compared to more than 40% of black adults. All of these factors, combined with many more, put people of color at higher risk of heat-related illness, a risk that will only become more severe with rising temperatures driven by climate change.
In addition to rising temperatures, climate change will lead to increases in air pollution and the frequency and severity of natural disasters, both of which will disproportionately impact communities of color. Already in North Carolina, black children under age 18 are more likely to suffer from asthma; 22% of North Carolina’s black children have been diagnosed with asthma, compared to only 15% of white children. Asthma is closely linked to air pollution exposure, so this difference will only become more pronounced as air quality worsens with climate change. And as the North Carolina coast sees more and more hurricane and flood events, communities of color will be hit hardest. In the aftermath of Hurricanes Florence and Michael, black individuals were more likely to suffer from income loss and property damage, both of which have a direct impact on health. Adding insult to injury, they have also been more likely to be denied government assistance for disaster recovery than white individuals.
Climate change is a minority health issue and is on track to becoming one of the biggest social determinants of health. Unless governments, non-profits, and community-level organizations invest in improving the environments where people of color live and enable these communities to adapt and recover from climate change impacts, it will be impossible to achieve health equity.
To address these health disparities, both locally in North Carolina and globally, we need to merge climate health and minority health, recognizing how the two are interconnected. Environmental and public health professionals across multiple sectors must work together to address these critical health issues in a changing world. MAHA will continue to engage in conversations on the role of climate change in minority health in order to work towards a future where climate health and minority health are considered in tandem.