Just over a month ago, Americans lived in a different world—traveling to work, meeting up with friends and family, and shopping for food and other goods where and when needed. But the COVID-19 pandemic has ground all this activity to a halt. This pause in our way of life due to COVID-19 has reminded us that the pleasures and comforts of the modern era are not secured. Most importantly, the devastating health impact and economic fallout has shown us that, despite national prosperity, many people living in the margins are only one tragedy away from unemployment, illness, or death.
The current pandemic lays bare our decades-long disinvestment in public health and highlights the fragility of our health system, in which the outbreak of a single virus has swiftly overwhelmed the system’s ability to meet many patients’ basic needs.
While there hasn’t been a causal link established between the COVID-19 pandemic and climate change, the virus’s arrival serves as sort of a test run for the types of public health challenges that climate change is expected to bring. As our climate crisis charges forward without counter, its impacts on the stability of ecosystems will make public health crises, including pandemics like COVID-19, more common. And it will be increasingly difficult to lessen the human toll.
COVID-19 is a terrifying harbinger of future pandemics and disasters and their threat to people’s economic well-being, health, and, inevitably, their lives. As leaders work on emergency response and economic relief to dampen the health and economic impact of the pandemic, they must also think about how to transform the nation’s health and social systems so that they are prepared for the public health threats that are sure to come from climate change.
How Climate Change Impacts Public Health
According to the Intergovernmental Panel on Climate Change (IPCC), global warming will reach 1.5°C above pre-industrial levels between 2030 and 2052, if the current rate of anthropogenic warming continues. Many experts warn that we are dangerously steering toward the tipping point of irreversible changes and damage to the planet.
Climate change adversely influences health in a number of ways; it threatens food and water security, worsens air pollution, causes heat-related adverse effects on health and economic well-being, endangers our physical safety and mental health with severe weather events, and intensifies infectious disease.
The World Health Organization has warned that contagious diseases are on the increase due to climate change and “the combined impacts of rapid demographic, environmental, social, technological and other changes in our ways-of-living.” A warming climate and changing weather patterns—where sudden and extreme weather events are increasingly common—make our environments more hospitable to vectors of disease. Pandemics may occur more frequently and spread more easily, with communities made more vulnerable to poverty and migration, as well as the introduction of new zoonotic diseases and the proliferation of diseases that have ravaged for many years, such as malaria and HIV/AIDS.
As COVID-19 was spreading throughout the world, East Africa has faced locust swarms like never before, devastating crops and food supplies. Agriculture and livestock are not only threatened by insects and other vectors of disease welcomed by changing weather patterns; high levels of carbon dioxide, drought, floods, heat stress, and warmer waters also pose challenges to our global food supply—impacting crop yields, the nutritional quality of food, the health of livestock and fisheries, and the livelihoods of agricultural workers.
Americans have already seen their fair share of climate change impacts. Weather events such as hurricanes, droughts, floods, and tornadoes are increasing in frequency and severity. For example, researchers have also found that climate change helped power the extreme and destructive rainfall of Hurricane Maria. Wildfires, like those in California, worsens air quality—with adverse effects on health—displaces whole towns, and at times are addressed by planned blackouts that can endanger sick and older residents who rely on electricity for their medical equipment. These disasters put people in danger of physical injury; they also cause anxiety-related responses and contribute to chronic and serious mental health disorders.
The effects of climate change on public health and welfare are already present—and they harm our most vulnerable populations. Climate change is a risk amplifier, often affecting the social determinants of health and exacerbating socioeconomic, geospatial, and other social inequalities. Key determinants of disaster risk are social vulnerability and exposure, which help explain why even non-extreme events and chronic hazards can lead to extreme impacts.
Residential segregation has increased the vulnerabilities of Black communities to natural disasters by relegating Black Americans to areas of concentrated poverty—whose conditions and locations place individuals in harm—and creating communities which are less resilient to disaster. Scholars have connected social vulnerability to disaster to the discriminatory housing market; filtering and redlining practices in the real estate and mortgage industries led lower-income households to inhabit homes and neighborhoods that were physically deteriorated, with poor property values and poor resiliency to storms. Additionally, wealth inequality and inadequate financial resources leave many low-income Americans without insurance and resources to aid recovery. Housing markets, particularly in the South, tend to segregate minorities to low-lying, flood-prone, and amenity-poor urban areas while whites dominate higher-valued coastal properties. This phenomena can most clearly be seen in Louisiana; historic injustices came to a head with the devastating impact and subsequent mismanagement of Hurricane Katrina. These same vulnerabilities partially explain the high number of COVID-19 cases in Louisiana and other Southern states, especially among the African American community. Hurricanes Irma and Maria have also been important case studies in environmental injustice in Puerto Rico.
Wealth inequality and inadequate financial resources leave many low-income Americans without insurance and resources to aid recovery.
Each year, 200,000 Americans die prematurely due to air pollution. This is particularly concerning as communities of color, especially Black communities, bear the brunt of air pollution in this country. Lower-income neighborhoods also face disproportionately higher exposure to urban heat; air pollution contributes to these “urban heat islands,” which simultaneously worsens pollution as people increase their energy consumption to compensate for the heat island effect and cool their homes. The financial and environmental cost of energy falls heavily on people who disproportionately live with poor housing quality and insulation; the inability to afford air conditioning puts people at risk of heat exhaustion or stroke.
There are many more examples of the unequal distribution of environmental hazards and their negative impact on the health and wellbeing of low-income and communities of color in the United States. Present-day racial and socioeconomic health disparities are influenced by a variety of environmental determinants of health, as well: concentrated poverty; income inequality and segregation; exposure to environmental toxins; exposure to violence; inadequate access to healthy foods; and fewer and lower quality institutional resources, such as child care, schools, and recreational facilities.
As the COVID-19 pandemic has paralyzed the world, early evidence already shows the virus as having a disproportionate impact on communities of color and low-income populations. New research has linked air pollution to higher rates of deaths due to COVID-19. Long-standing inequities have made these groups—who comprise much of the nation’s frontline and essential workers—more vulnerable and exposed to the negative health and economic impacts of this disease. These groups are also the least protected: the most likely to be uninsured or underinsured, lose incomes or their jobs, have less wealth, and have chronic health conditions. They are the least able to cope with the costs of this and any future disasters.
As the climate crisis worsens, it will bring one emergency after another, converging catastrophes that deal cascades of failures to the systems we depend on to ensure people’s physical, mental, social, and financial well-being. Trade-offs will be made as health concerns compete for priority and resources. The exponential curve of COVID-19’s spread mirrors how the damage of climate change will play out; ignoring the destructive processes and vulnerabilities exposed over time will only cause them to increase exponentially and exact greater damage. And while climate change affects us all, it is the most marginalized among us who has and will suffer the most.
Where to Start on Public Health Preparedness
The National Health Security Preparedness Index (NHSPI) is an annual assessment of the country’s health and preparedness for managing health emergencies. In 2018, the United States scored a 7.1 on 10 point scale, with variation across states. We know from our overwhelmed hospital systems, calls to flatten the curve, and limited testing and contact tracing ability that we need improvements to our public health system. Preparedness, where people are less susceptible to the consequences of disaster, will require a comprehensive approach, addressing social and environmental determinants of health at the personal, community, and public policy levels. Here are some ways we can promote health equity and build resilient communities:
- Address health disparities and improve the social determinants of health. We must ensure and strengthen policies and programs that reduce poverty (such as safety net programs like the Supplemental Nutrition Assistance Program and unemployment insurance), and policies that improve working and living conditions (such as paid sick leave, paid family leave, and child care).
- Achieve universal health care coverage. Health care is vital to ensure access to preventive screenings and care and life-saving treatment. Quality, culturally sensitive, and affordable care are essential.
- Adopt the many and multi-sectoral recommendations of the Trust for America’s Health to comprehensively improve our nation’s public health system and strengthen its preparedness and ability to respond to emergencies. It includes stronger coordination across public health departments, environmental agencies, and community organizations. Such was vital and lacking in our current pandemic; community groups have also been key in providing relief on the front lines and need greater support.
Of course, many of these solutions may prevent the negative health effects of climate change, but do not necessarily slow its rate. We also need large-scale solutions that mitigate climate change, such as an overhaul of our energy system and investments in sustainable infrastructure and green jobs. We also need to pass legislation, such as the Environmental Justice for All Act, that addresses the unequal effects of environmental issues on marginalized communities and support a just transition. Recovery can also have climate considerations, such as Obama’s investment in clean energy in his stimulus plan during the last recession. These measures are crucial to limit the changes to the climate system that threaten people’s health.
A Wake-Up Call
On this anniversary of Earth Day, we cannot gather and demonstrate as we would each year. However, we can reflect on the lessons COVID-19 teaches us on society’s vulnerabilities, the importance of science-informed leadership, and possibilities for large-scale mobilization of resources to tackle a common enemy.
Our current pandemic is a wake-up call to how pandemics, disaster, and other climate-influenced and environmental health challenges threaten to upend our lives—and in unequal ways. As a recession looms in the horizon and people long for a return to normalcy, some things must be acknowledged: Many, prior to the pandemic, lived in immense insecurity and they deserve the health and financial well-being lacking in that normal. Furthermore, climate change is our new normal; the COVID-19 pandemic and its consequences should not be viewed as an aberration, but rather an opportunity that grants us the insight and urgency to build a more resilient future. There may have been a bipartisan effort to address the health and economic fallout of the pandemic, but the partisan split over environmental provisions of the relief packages and rolling back of environmental protections highlight the dissonance in our leaders’ conception of emergency and our continued struggle to mobilize political will and resources to tackle the largest existential threat of our lifetime.
Our current pandemic is a wake-up call to how pandemics, disaster, and other climate-influenced and environmental health challenges threaten to upend our lives—and in unequal ways.
A re-opening of the country, an economic recovery, and an approved vaccine should not lead us into a false sense of security. As the disruptions and devastation of COVID-19 stare us in the face, we must ask ourselves: Are we willing to go through another massive transformation of our everyday life? Are we willing to continue putting our most vulnerable communities in danger of disease, poverty, and death? Are we ready to live in a constant state of emergency?
Source photo: Roads surrounding the Tidal Basin and National Mall are closed to all traffic due to concerns with the spread of the coronavirus in Washington, DC. Source: Drew Angerer/Getty Images