HSC 340 Quiz 3 (weeks 10, 11, 12)

Institutional Powers and authorities

(e.g. corporations, governments) make decisions that impact the physical environment and shape the societal distribution of health-promoting resources and opportunities

assessment for mental health infrastructure

- Does the community have a plan to serve people in need after a shock/disaster? - Does the community have the capacity to serve the potential increased needs of people as climate impacts grow? - Currently, can all community members access the mental health care they need? - What are the gaps, and what areas of service may need to be augmented?

Vulnerability and Resilience Among Communities Experiencing Vulnerability and Inequity

- Not all individuals or all communities are equally affected by climate change. Climate change vulnerability is the degree to which people and places are at risk from the impacts of climate change, and also takes into account how well they can cope with those impacts. - Climate change resilience is essentially the flip side of vulnerability. It is "the ability to survive, recover from, and even thrive in changing climatic conditions

Factors that contribute to exposure

- SES -> poverty = more exposure to hazards - infrastructure -> buildings, transportation, utilities, healthcare, communication, how stable are these systems to climate change, additionally, what makes a system more vulnerable - pre-existing medical conditions -> individuals not aware of health threats or unable to take protective actions

Fundamentals of Health Equity and Climate Change

- climate change exacerbates existing health and social inequities - interventions that act on upstream shared systemic causes can most effectively address both climate change and health inequities - building political and economic power and voice are essential components of climate resilience

Social determinants of health

- economic stability -> employment, income, expenses, debt, medical bills, support - neighborhood and physical environment -> housing, transportation, safety, parks, playgrounds, walkability, zip code/geography - education -> literacy, language, early childhood education, vocational training, higher education - food -> hunger, access to healthy options - Community and social context -> social integration, support systems, community engagement, discrimination, stress - health care system -> health coverage, provider availability, provider linguistic and cultural competency, quality of care

climate and health messages

- establish or trigger an "environmental frame" to remind people that our health and well-being depend on clean air and water, healthy food, and a stable climate - state your values to allow people to connect your message with shared values such as fairness, opportunity, protection, preparedness, equality, responsibility, leaving the world a better place for our children - state the problem and solution clearly so that your audience understands the need for unified societal action, and specifically what you want them to do and when you want them to do it - affirm that scientists agree that climate change is real, human caused, harmful, and solvable environmental trigger + solution + values + scientists agree = climate and health message

WHO

- estimates that 99 % of disease burden from climate change occurs in developing countries - 88 % of which are children under 5 - 1980-2013 2.52 million deaths globally due to climate related disasters 51 % of which occurred in 49 least developed countries

additional climate communication tips

- make climate change salient - convey urgency - recognize complexity and uncertainty - offer hope - acknowledge complicity - interrupt the spiral of silence

Factors that contribute to exposure

- occupation -> outdoor workers emergency responders - time spent in risk-prone areas - response to extreme events -> ability to evacuate or shelter-in-place

Fundamentals of Health Equity and Climate Change

- root causes and upstream drivers of climate change and health inequities are often same -> the health risks and impacts of climate change are not equally or fairly distributed across people, communities or nations

why LHDS?

- see impacts as its happening -> vulnerabilities expressed at an individual level, lhds work with individuals to improve health - duty to protect health and provide a trusted and credible voice - deep connections to the communities that are most impacted by climate change

Populations of concern

- some groups face a number of stressors related to both climate and non climate related factors - social stressors - economic stressors - health stressors - can occur simultaneously or consecutively

Populations of concern

- the vulnerability of any given group is a function of its sensitivity to climate change related to health risks, its exposure to those risks and its capacity for responding to or coping with climate variability and change - exposure + sensitivity = potential impact + adaptive capacity = vulnerability

climate communication tips

1. climate messages and communications strategies that integrate community knowledge, values and beliefs can build narrative of positive, transformational change 2. communications serve to support strategies 3. make it normal to support societal climate action instead of placing blame on the individual 4. ensure communications are culturally appropriate 5. use media format for your target audience

race and ethnicity in air quality and health equity

11.2% of African Americans are currently diagnosed with asthma, compared to the 7.7% of whites, nearly 1 in 2 latinos live in counties that frequently violate clean air and ozone standards

food deserts in food security and health equity

13.5 million people in the U.S. have low access to a supermarket, 82% of whom live in urban areas

response and recovery

20% of individuals who were directly exposed to a traumatic event develop chronic levels of psychological dysfunction, which may not get better or be resolved. those who are actively involved in climate change adaptation experience appreciable health and well-being benefit from such engagement, they become more resilient to it

Key messages

Addressing climate change and health inequities requires transformational change in our systems and communities

race and ethnicity in drought and health equity

African American and filipino populations are at increased risk of contracting dust-related coccidiodomycosis (valley fever). 80% of U.S. farmworkers identify as hispanic which is more vulnerable to economic impacts extended drought

race and ethnicity in wildfires and health equity

African americans have higher rates of asthma and CDV disease that increases sensitivity to the health effects of smoke

Three areas of action for LHD's - 1

Assessment and Surveillance - include health and social inequities when doing assessments - Improve data collection - Highlight inequities and identify root causes - Use community-based participatory research or "citizen science" or "community science"

What can we as public health professionals do and specifically what can LHDs do?

Building resilience to climate change and addressing social and health inequities requires addressing the systemic causes of these challenges through collaboration and shared decision-making with impacted communities, community-based organizations, and other stakeholders across sectors

Key messages

Climate change and health inequities share the same root causes

Key messages

Climate change disproportionately impacts the health of low-income communities and communities of color

Communities of Color, Low Income, Immigrants, and Limited English Proficiency Groups

Higher likelihood: - living in risk-prone areas (such as urban heat islands, isolated rural areas, or coastal and other flood-prone areas) - Areas with older or poorly maintained infrastructure - Areas with an increased burden of air pollution - Relatively greater incidence of chronic medical conditions - Limited access to healthcare, education due to high rates of poverty - Social isolation related to language difficulties - Cultural barriers, racism, hesitant to seek help

Three areas of action for LHD's - 2

Intersectoral Collaboration - Build awareness of the connection between the social determinants of health, and the shared systems that create inequities and contribute to climate change - Include climate, health, and equity language and data in jurisdiction plans, budgets, and assessments - Work across sectors to agree upon common language related to climate change, health, and equity

Local Health Departments

LHD's must apply the same foundational public health tools and approached that are used to address any emergent health crisis, grounded in core public health values such as equity, prevention, and preparedness Climate change is an emergent health crisis

Health equity

Systems, social and structural inequities, and institutional power impact our environment, living conditions, behavior, and how we function as a society

solastagia

a form of mental or existential distress caused by environmental change

Adaptive Capacity

ability to adjust to hazards

strengths in individual resilience

active coping maintains an awareness of one's own thoughts and appraisals, and behavioral dimensions. Involvement in a faith community has been cited as positive factor for mental health. Encourages the boost of personal preparedness for disaster, includes things like food, water, medication, and personal items that bring comfort

community engagement in a community (building resilience)

adaptation and resilience planning is most likely to succeed if the community is involved

Biological sensitivities

age, gender, life stage, disability

occupation factors in food security and health equity

agricultural workers are often undocumented and poorly paid, and at risk of climate-related illness. declines in crop yields result in job and economic losses for agricultural workers and farming communities. warmer temperatures are expanding the territory of certain crop pests, leading to higher use of toxic herbicides and pesticides resulting in pesticide-related illnesses

Systems

are a collection of parts—physical structures, people, and organizations—that interact to provide an important function

race and ethnicity in extreme heat and health equity

as of 2013, African Americans were 52%, asians were 32%, and hispanics were 21% more likely to live in heat vulnerable areas in the U.S. compared to whites

role of local health departments in combating change, health, and equity

assessment and surveillance, intersectional collaboration, community engagement and education

individual level (building resilience)

built with coping and self-regulation, and community social support networks. most people come through adversity with positive adjustment and without psychopathology

results of psychological and emotional stressors due to the threat of climate change

caused by the exposure to dire information, can interfere with our ability to think rationally, plan our behavior, and consider alternative actions

age factors in air quality and health equity

children are particularly sensitive as their respiratory systems are developing and air pollution can cause permanent damage

climate solutions benefit mental health (con't part 2)

clean energy reduces health burdens, children exposed to higher levels of urban pollution are more likely to develop attention problems, anxiety, depression, and lower brain function. clean energy provides an opportunity to protects populations of concern, like children

loss of personally important places

climate change irrevocably changes people's lived landscapes, large numbers are likely to experience a feeling that they losing a place that is important to them, aka solastalgia

Geography

coastlines, forests, riverbanks. You may not identify as vulnerable due to biological sensitivities, but location can play an important role in identifying vulnerability

individuals with disabilities in sea level and health equity

cognitive, hearing, physical, and mobility impairments may impede safe evacuation during flooding events

climate and health communications

communicating about climate change and health requires the same public health communications skills that local health departments deploy every day in communicating about other complex public health issues

location factors in wildfires and health equity

communities and households at the wild land-urban interface where human-boil environments are adjacent to areas of wild vegetation are at greater risks of wildfires

economic disparity in a community (building resilience)

communities cope better with an acute event when economic disparity is reduced and the needs of the economically vulnerable are attended to in advance. they can alleviate some-long term impacts with post-disaster planning, particularly targeting lower resourced communities that tend to be harder hit materially and emotionally

community level (building resilience)

communities with poor infrastructure are more vulnerable to physical impacts of climate change which affects mental health

three areas of action for LHDs

community engagement and education. conduct outreach to local environmental justice groups, community based organizations (CBO), and community leaders, make an effort to meet CBO or community partners to develop understanding on priorities. recognize and acknowledge power dynamics between community members and gov employees. include community members in decisions. established fair and supportive mechanisms for participation

Exposure

contact between person and climate stressor

Sensitivity

degree in which person is affected

strong community networks

easily developed in neighborhoods with spaces and organizations that bring people together, such as community centers, parks, and a streetscape of shops and sidewalks. training people who will serve the community during a disaster can limit the long-term negative psychological consequences and trauma of acute events

Stressor

events or trends (climate change hazards) that increase vulnerability to health effects

Health equity

everyone has a fair and just opportunity to be as healthy as possible

elderly (populations of concern)

experiences consequences to their physical health, mobility, and difficulty managing trauma in response to a disaster

emergency workers and first responders (Populations of concern)

exposed to deaths, injuries, diseases, and mental stress caused by climate and weather-related disasters, PTSD rates among first responders range from 13% to 18% up to four years after their experiences

agricultural workers in drought and health equity

farmers and communities are more vulnerable to the adverse economic impacts of drought

climate solutions benefit mental health (con't)

green spaces diminish stress, parks and green corridors have been connected to improved air quality and can increase mental well-being. trees sequester carbon, and green spaces absorb less heat compared to cement and buildings. more time with nature shows significantly lower stress levels and reduce stress related illness

more disruptions of mental health and well-being due to extreme weather events

harmful to people experiencing recurring disasters - cumulative psychological harms, involve a loss of life, resources, or social support and social networks or events that involve extensive relocation and life disruption

rural communities in extreme heat and health equity

heat-related mortality is 3% higher in rural areas, potentially linked with less access to health care services, greater proportions of elderly people, more outdoor occupations, fewer media to share heat information, and less access to AC and transportation

homeless people (populations of concern)

high rates of mental illness and very vulnerable to the effects of extreme heat depending on the geographical location, 30% of these people suffer from some form of mental illness

effects of mental health and well-being due to extreme heat

increased incidence of disease and death, aggressive behavior, violence, and suicide and increases hospital and emergency room admissions for those with mental or psychiatric conditions

tribal communities in food security and health equity

indigenous communities that practice hunting, subsistence farming and fishing, and are thus vulnerable to climate change impacts on local game, farming and aquatic habitats. rising sea levels will also threaten freshwater and saltwater habitats

Effects of mental health and well-being due to drought

interaction of environmental and social stressors disrupts lives, functioning of individuals, households, and communities

health insurance factors in air quality and health equity

lack of coverage and health care can result in poorly managed disease for those with respiratory or CDV diseases

chronic illness in drought and health equity

lack of safe drinking water can exacerbate pre-existing renal disease

poverty in air quality and health equity

low income communities are more likely to have increased exposure to air pollution such as proximity to roadways and polluting industries, lack of green space, and urban heat islands

socioeconomic status in wildfires and health equity

low-income households are less likely to have disaster insurance and less resources to help them cop from property loss

poverty in sea level and health equity

low-income households are less likely to have disaster insurance, less able to recover from flooding and property loss associated with sea level rise, and have fewer. resources to relocate

poverty factors in food security and health equity

low-income people have less ability to absorb rising food prices and may be forced to choose between food and other necessities. food insecurity is associated with risk for diabetes and hypertension

Intergenerational equity

means that fundamental rights and interests of future generations must be treated with equal value as the rights and interests of those living today

race and ethnicity in food security and health equity

more common in people of color and those living in poverty, 12.3% of U.S. households were food insecure in 2016, 22.5% of African American households, 18.5% of hispanic households, 10.7% of non-hispanic households, while only 9.3% of white households

urban heat islands

more likely to occur in low income and communities of color, they are dense areas with fewer trees, less green space, more buildings, high energy use, and numerous asphalt and concrete where night temperatures can be 22*F warmer than surrounding areas

tribal communities in wildfires and health equity

native and alaskan Americans living near forests are at increased risk of displacement, smoke-exposure, injury, and property loss

tribe communities in drought and health equity

native communities already face impacts of long-term drought, they are more likely to lack access to clean and potable drinking water

tribal communities in sea level and health equity

native communities that practice subsistence farming and fishing are particularly vulnerable to the impacts of sea level rise, including saline intrusion, on crops and freshwater ecosystems and fisheries

pregnant women in food insecurity and health equity

nutrition is essential to healthy pregnancy, nursing and newborn outcomes, poor nutrition is associated low birth weight and other adverse outcomes

working conditions in extreme heat and health equity

outdoor workers are at greater risk, from 1992-2006 heat-related deaths were 20x higher among crop workers in the U.S. population. occupational heat stress and chronic dehydration may lead to chronic kidney disease among outdoor workers

outdoor work factors in air quality and heath equity

outdoor workers, especially those who participate in heavy physical activity, are at higher risk due to air pollution

personal dispositional characteristics in individual resilience

people who feel positive about their ability to overcome a source of stress and trauma do better than those with lower self-efficacy, they tend to do better who are less able to regulate their thinking, emotions, and actions

climate solutions benefit mental health

physically commuting to places (bike, walk, etc.) enhances a sense of well-being, those who do improve their physical health and also experience lower stress levels than car commuters

geographic factors in sea level rise and health equity

populations that reside in coastal area are most impacted by sea level rise

women, pregnant women, and postpartum mothers (population of concern)

post-disaster stress symptoms are more common in women, climate hazards can all contribute to the emotional stress women have while pregnant, nursing, or responsible for young children

Social and structural inequalities

refers to the historical disenfranchisement and unequal distributions of power, money, and resources that are often associated with class, race, ethnicity, place, immigration status, gender, and sexual orientation

rural communities in drought and health equity

rural communities are disproportionately reliant on small water systems or drinking water wells, which increases the risk of water shortages or exposure to contaminated water

climate change communication

réponses to extreme climate change include heightened risk perceptions, preoccupation, general anxiety, pessimism, helplessness, eroded sense of self and collective control, stress, distress, sadness, loss and guilt

Adaptive Capacity

same factors that contribute to exposure or sensitivity also influence adaptive capacity to climate variability and change. - accessibility to infrastructure - demographic and social chanracteristics (skills, knowledge, experience, social cohesion, networks)

compounding stress

stress that can be tolerable for someone with many sources of support, but enough to serve as a tipping point for those who have fewer resources or who are already experiencing other stressors

impacts to your mental health from physical changes in the environment

stress, anxiety, depression, PTSD

Vulnerability

tendency or predisposition to be adversely affected by climate related health effects, and encompass three elements : exposure, sensitivity and adaptive capacity

Risk

the potential for consequences to develop where something of value to our health is at stake and where the outcome is uncertain

children (population of concern)

they are dependent on others for care and a significant predictor of mental health and well-being in a child is the mental health status of the primary giver, they are particularly at risk for distress and anxiety

chronic illness factors in sea level and health equity

those with illnesses such as or other respiratory conditions are more vulnerable to indoor air pollution and mold illness from excess moisture or flooding

poverty in drought and health equity

those with limited financial resources are vulnerable to food and water insecurity from rising food and water prices from drought

chronic illness in air quality and health equity

those with pre-existing conditions, like asthma and CDV diseases are at greater risk of disease exacerbation due to air pollution

impacts on individual and societal health, mental health, and well-being from extreme weather events

trauma from disasters, anxiety and PTSD, grief/bereavement, increased substance use or misuse, and suicidal thoughts

legal status factor in wildfires and health equity

undocumented families are not eligible for FEMA. immigrants may have less access to evacuation shelters and other relief services due to cultural and language barriers, they may also fear legal repercussions of seeking services

age factor in wildfires and health equity

very young and very old people are more sensitive to air quality impacts of wildfires, children's developing respiratory systems puts them at higher risk

gentrification and displacement in sea level and health equity

wealthier homeowners are moving to higher ground, displacing lower income communities that have been redlined from beachfront neighborhoods