Climate Justice in Rural Southeastern United States: A Review of Climate Change Impacts and Effects on Human Health

Climate change and healthy ageing: An assessment of the impact of climate hazards on older people

Background

Climate change not only directly impacts older people's longevity but also healthy ageing, which is the process of maintaining physical and mental capacities while optimising functional abilities. The urgency to address both population ageing and climate change necessitates a rethink and assessment of the impact of climate change on older people. This includes identifying what can be done to anticipate, mitigate and adapt to climate change and engage older persons.

Methods

A review of climate change and healthy ageing forms the basis of evidence in this report. We developed a comprehensive search to assess current literature, combining terms related to ageing and climate change across four major data sets and assessing articles published up to the end of 2021.

Results

We summarised the current and future impact of climate change on older people and developed a framework identifying climate change impacts on older persons, recognising social and environmental determinants of healthy ageing. Major hazards and some key exposure pathways include extreme temperatures, wildfire, drought, flooding, storm and sea level rise, air quality, climate-sensitive infectious diseases, food and water insecurities, health and social care system displacement, migration, and relocation. Strategies to address climate change require interventions to improve systems and infrastructure to reduce vulnerability and increase resilience. As a heterogeneous group, older people's perceptions of climate change should be integrated into climate activism. Increasing climate change literacy among older people and enabling them to promote intergenerational dialogue will drive the development and implementation of equitable solutions. Pathways may operate via direct or indirect exposures, requiring longitudinal studies that enable assessment of exposures and outcomes at multiple time points, and analyses of cumulative impacts of hazards across the life course.

Conclusions

The lack of systematic reviews and primary research on the impact of most climate hazards, except for heat, on older people is apparent. Future research should include outcomes beyond mortality and morbidity and assess how older people interact with their environment by focusing on their capacities and optimising abilities for being and doing what they value.

Wildfires and climate justice: future wildfire events predicted to disproportionally impact socioeconomically vulnerable communities in North Carolina

Wildfire events are becoming increasingly common across many areas of the United States, including North Carolina (NC). Wildfires can cause immediate damage to properties, and wildfire smoke conditions can harm the overall health of exposed communities. It is critical to identify communities at increased risk of wildfire events, particularly in areas with that have sociodemographic disparities and low socioeconomic status (SES) that may exacerbate incurred impacts of wildfire events. This study set out to: (1) characterize the distribution of wildfire risk across NC; (2) implement integrative cluster analyses to identify regions that contain communities with increased vulnerability to the impacts of wildfire events due to sociodemographic characteristics; (3) provide summary-level statistics of populations with highest wildfire risk, highlighting SES and housing cost factors; and (4) disseminate wildfire risk information via our online web application, ENVIROSCAN. Wildfire hazard potential (WHP) indices were organized at the census tract-level, and distributions were analyzed for spatial autocorrelation via global and local Moran's tests. Sociodemographic characteristics were analyzed via k-means analysis to identify clusters with distinct SES patterns to characterize regions of similar sociodemographic/socioeconomic disparities. These SES groupings were overlayed with housing and wildfire risk profiles to establish patterns of risk across NC. Resulting geospatial analyses identified areas largely in Southeastern NC with high risk of wildfires that were significantly correlated with neighboring regions with high WHP, highlighting adjacent regions of high risk for future wildfire events. Cluster-based analysis of SES factors resulted in three groups of regions categorized through distinct SES profiling; two of these clusters (Clusters 2 and 3) contained indicators of high SES vulnerability. Cluster 2 contained a higher percentage of younger (<5 years), non-white, Hispanic and/or Latino residents; while Cluster 3 had the highest mean WHP and was characterized by a higher percentage of non-white residents, poverty, and less than a high school education. Counties of particular SES and WHP-combined vulnerability include those with majority non-white residents, tribal communities, and below poverty level households largely located in Southeastern NC. WHP values per census tract were dispersed to the public via the ENVIROSCAN application, alongside other environmentally-relevant data.

Population vulnerability to extreme cold days in rural and urban municipalities in ten provinces in Spain

BACKGROUND

The objective was to analyze whether there are differences in vulnerability to Extreme Cold Days (ECD) between rural and urban populations in Spain.

METHODOLOGY

Time series analysis carried out from January 1, 2000, through December 31, 2013. Municipalities with over 10,000 inhabitants were included from 10 Spanish provinces, classified into 42 groups by isoclimate and urban/rural character as defined by Eurostat criteria. The statistical strategy was carried out in two phases. First: It was analyzed the relationship between minimum daily temperature (Tmin) (source: AEMET) and the rate of daily winter mortality due to natural causes -CIE-10: A00 - R99- (source: National Statistics Institute). Then, It was determinated the threshold of Tmin that defines the ECD and its percentile in the series of winter Tmin (Pthreshold), which is a measure of vulnerability to ECD so that the higher the percentile, the higher the vulnerability. Second: possible explanatory variables of vulnerability were explored using Mixed Generalized Models, using 13 independent variables related to meteorology, environment, socioeconomics, demographics and housing quality.

RESULTS

The average Pthreshold was 18 %. The final model indicated that for each percentage point increase in unemployment, the vulnerability to ECD increased by 0.4 (0.2, 0.6) points. Also, with each point increase in rurality index, this vulnerability decreased by -6.1 (-2.1, -10.0) points. Although less determinant, other factors that could contribute to explaining vulnerability at the province level included minimum winter daily temperatures and the percentage of housing with poor insulation.

CONCLUSIONS

The vulnerability to ECD was greater in urban zones than in rural zones. Socioeconomic status is a key to understanding how this vulnerability is distributed. These results suggest the need to implement public health prevention plans to address ECD at the state level. These plans should be based on threshold temperatures determined at the smallest scale possible.

Addressing Capacity Constraints of Rural Local Health Departments to Support Climate Change Adaptation: Action Is Needed Now

Looming climate change health impacts among rural communities will require a robust health system response. To reduce health inequities and promote climate justice, rural local health departments (LHDs) must be adequately resourced and supported to engage in climate change mitigation and adaptation policy and program development and implementation. In the United States, small local tax bases, overreliance on revenue from fee-based services, and limited federal funding to support climate change and health programming, have left rural LHDs with limited and inflexible human, financial, and political capital to support engagement in local climate change activities. Because of the urgent demands stemming from climate change, additional investments and supports are needed to rapidly build the capacity and capability of rural LHDs. Federal and state approaches to public health funding should consider the unique climate change and health risks of rural communities. Further, cross-jurisdictional shared service arrangements and state-level support to build rural LHDs' technical capacity, and research on local impacts and culturally appropriate solutions, must be prioritized.

Effects of local factors on adaptation to heat in Spain (1983-2018)

The European Union is currently immersed in policy development to address the effects of climate change around the world. Key plans and processes for facilitating adaptation to high temperatures and for reducing the adverse effects on health are among the most urgent measures. Therefore, it is necessary to understand those factors that influence adaptation. The aim of this study was to provide knowledge related to the social, climate and economic factors that are related to the evolution of minimum mortality temperatures (MMT) in Spain in the rural and urban contexts, during the 1983-2018 time period. For this purpose, local factors were studied regarding their relationship to levels of adaptation to heat. MMT is an indicator that allows for establishing a relationship to between mortality and temperature, and is a valid indicator to assess the capacity of adaptation to heat of a certain population. MMT is obtained through the maximum daily temperature and daily mortality of the study period. The evolution of MMT values for Spain was established in a previous paper. An ecological, longitudinal and retrospective study was carried out. Generalized linear models (GLM) were performed to identify the variables that appeared to be related to adaptation. The adaptation was calculated as the difference in variation in MMT based on the average increase in maximum daily temperatures. In terms of adaptation to heat, urban populations have adapted more than non-urban populations. Seventy-nine percent (n = 11) of urban provinces have adapted to heat, compared to twenty-one percent (n = 3) of rural provinces that have not adapted. In terms of urban zones, income level and habituation to heat (values over the 95th percentile) were variables shown to be related to adaptation. In contrast, among non-urban provinces, a greater number of housing rehabilitation licenses and a greater number of health professionals were variables associated with higher increases in MMT, and therefore, with adaptation. These results highlight the need to carry out studies that allow for identifying the local factors that are most relevant and influential in population adaptation. More studies carried out at a small scale are needed.

Racial Disparities in Climate Change-Related Health Effects in the United States

PURPOSE OF REVIEW

Climate change is causing warming over most parts of the USA and more extreme weather events. The health impacts of these changes are not experienced equally. We synthesize the recent evidence that climatic changes linked to global warming are having a disparate impact on the health of people of color, including children.

RECENT FINDINGS

Multiple studies of heat, extreme cold, hurricanes, flooding, and wildfires find evidence that people of color, including Black, Latinx, Native American, Pacific Islander, and Asian communities are at higher risk of climate-related health impacts than Whites, although this is not always the case. Studies of adults have found evidence of racial disparities related to climatic changes with respect to mortality, respiratory and cardiovascular disease, mental health, and heat-related illness. Children are particularly vulnerable to the health impacts of climate change, and infants and children of color have experienced adverse perinatal outcomes, occupational heat stress, and increases in emergency department visits associated with extreme weather. The evidence strongly suggests climate change is an environmental injustice that is likely to exacerbate existing racial disparities across a broad range of health outcomes.

Analysis of vulnerability to heat in rural and urban areas in Spain: What factors explain Heat's geographic behavior?

INTRODUCTION

There is currently little knowledge and few published works on the subject of vulnerability to heat in rural environments at the country level. Therefore, the objective of this study was to determine whether rural areas are more vulnerable to extreme heat than urban areas in Spain. This study aimed to analyze whether a pattern of vulnerability depends on contextual, environmental, demographic, economic and housing variables.

METHODS

An ecological, longitudinal and retrospective study was carried out based on time series data between January 01, 2000 and December 31, 2013 in 42 geographic areas in 10 provinces in Spain. We first analyzed the functional relationship between the mortality rate per million inhabitants and maximum daily temperature (Tmax). We then determined the summer temperature threshold (Pthreshold) (June-September) at which increases in mortality are produced that are attributable to heat. In a second phase, based on Pthreshold, a vulnerability variable was calculated, and its distribution was analyzed using mixed linear models from the Poisson family (link = log). In these models, the dependent variable was vulnerability, and the independent variables were exposure to high temperatures, aridity of the climate, deprivation index, percentage of people over age 65, rurality index, percentage of housing built prior to 1980 and condition of dwellings.

RESULTS

Rurality was a protective factor, and vulnerability in urban areas was six times greater. In contrast, risk factors included aridity (RR = 5.89 (2.26 15.36)), living in cool summer zones (2.69 (1.23, 5.91)), poverty (4.05 (1.91 8.59)) and the percentage of dysfunctional housing (1.13 (1.04 1.24)).

CONCLUSIONS

Rural areas are less vulnerable to extreme heat than the urban areas analyzed. Also, population groups with worse working conditions and higher percentages of dwellings in poor conditions are more vulnerable.

Climate Change and State of the Science for Children's Health and Environmental Health Equity

INTRODUCTION

Climate change is impacting the physical and mental health of children and families. This is a state of the science update regarding the impacts of climate change for pediatric-focused health care providers and advanced practice registered nurses.

METHOD

Using an equity lens, the authors reviewed and synthesized current literature regarding the adverse impacts of climate change.

RESULTS

The poor and communities of color are disproportionately impacted by climate change. Physical health impacts include increased vector and water-born infectious diseases, increases in asthma and respiratory infections, and undernutrition. Social disruptions lead to human trafficking. Climate change is associated with mental health concerns, including anxiety and posttraumatic stress after natural disasters.

DISCUSSION

As clinicians, pediatric-focused providers, and advanced practice registered nurses should use multipronged and interdisciplinary approaches to address or prevent the adverse impacts of climate change. Advocacy at all government levels is necessary to safeguard children and vulnerable populations.

Factors That Influence Climate Change-Related Mortality in the United States: An Integrative Review

Global atmospheric warming leads to climate change that results in a cascade of events affecting human mortality directly and indirectly. The factors that influence climate change-related mortality within the peer-reviewed literature were examined using Whittemore and Knafl’s framework for an integrative review. Ninety-eight articles were included in the review from three databases—PubMed, Web of Science, and Scopus—with literature filtered by date, country, and keywords. Articles included in the review address human mortality related to climate change. The review yielded two broad themes in the literature that addressed the factors that influence climate change-related mortality. The broad themes are environmental changes, and social and demographic factors. The meteorological impacts of climate change yield a complex cascade of environmental and weather events that affect ambient temperatures, air quality, drought, wildfires, precipitation, and vector-, food-, and water-borne pathogens. The identified social and demographic factors were related to the social determinants of health. The environmental changes from climate change amplify the existing health determinants that influence mortality within the United States. Mortality data, national weather and natural disaster data, electronic medical records, and health care provider use of International Classification of Disease (ICD) 10 codes must be linked to identify climate change events to capture the full extent of climate change upon population health.

Environmental Justice in the American Public Health Context: Trends in the Scientific Literature at the Intersection Between Health, Environment, and Social Status

Although various governmental entities in the USA are required to consider environmental justice (EJ) impacts of their actions during decision-making, socially vulnerable groups continue to be disproportionately exposed to environmental hazards. Tools and programs to quantify and mitigate environmental injustices are limited by existing data, which may not capture the full range of health disparities exacerbated by the complex interactions between environmental exposures and social stressors. In this study, we analyzed how the scientific literature approaches EJ issues in the USA. We searched PubMed for journal articles discussing at least one sociodemographic or environmental variable in the context of cumulative impacts and analyzed the relative frequency with which various EJ topics were studied. Our findings indicate that demographic variables are commonly used in epidemiologic studies, though some areas (e.g., age) are better studied than others. Similarly, occupational exposure and ambient air pollution were more studied than other types of exposures. Word frequency analyses revealed which toxicants and health outcomes are the most frequently studied. In addition, temporality analyses showed that the rate of occupational publications rose rapidly in the 1970-1980s and has since plateaued, while other publication rates increased two decades later and are still on the rise. Cumulative impacts are considered in a relatively small portion of journal articles across all topics; nevertheless, they have seen an exponential climb in the last decade. A more equitable distribution of scientific efforts might be needed for a better distribution of funding, policy-making efforts, and other resources to socially and environmentally vulnerable communities.

The development of a participatory assessment technique for infrastructure: Neighborhood-level monitoring towards sustainable infrastructure systems

Climate change and increasing natural disasters coupled with years of deferred maintenance have added pressure to infrastructure in urban areas. Thus, monitoring for failure of these systems is crucial to prevent future impacts to life and property. Participatory assessment technique for infrastructure provides a community-based approach to assess the capacity and physical condition of infrastructure. Furthermore, a participatory assessment technique for infrastructure can encourage grassroots activism that engages residents, researchers, and planners in the identification of sustainable development concerns and solutions. As climate change impacts disproportionately affect historically disenfranchised communities, assessment data can further inform planning, aiming to balance the distribution of public resources towards sustainability and justice. This paper explains the development of the participatory assessment technique for infrastructure that can provide empirical data about the condition of infrastructure at the neighborhood-level, using stormwater systems in a vulnerable neighborhood in Houston, Texas as a case study. This paper argues for the opportunity of participatory methods to address needs in infrastructure assessment and describes the ongoing project testing the best use of these methods.

Commonalities between Disaster and Climate Change Risks for Health: A Theoretical Framework

Disasters and climate change have significant implications for human health worldwide. Both climate change and the climate-sensitive hazards that result in disasters, are discussed in terms of direct and indirect impacts on health. A growing body of literature has argued for the need to link disaster risk reduction and climate change adaptation. However, there is limited articulation of the commonalities between these health impacts. Understanding the shared risk pathways is an important starting point for developing joint strategies for adapting to, and reducing, health risks. Therefore, this article discusses the common aspects of direct and indirect health risks of climate change and climate-sensitive disasters. Based on this discussion a theoretical framework is presented for understanding these commonalities. As such, this article hopes to extend the current health impact frameworks and provide a platform for further research exploring opportunities for linked adaptation and risk reduction strategies.

Trends, application and future prospectives of microbial carbonic anhydrase mediated carbonation process for CCUS

Growing industrialization and the desire for a better economy in countries has accelerated the emission of greenhouse gases (GHGs), by more than the buffering capacity of the earth's atmosphere. Among the various GHGs, carbon dioxide occupies the first position in the anthroposphere and has detrimental effects on the ecosystem. For decarbonization, several non-biological methods of carbon capture, utilization and storage (CCUS) have been in use for the past few decades, but they are suffering from narrow applicability. Recently, CO₂ emission and its disposal related problems have encouraged the implementation of bioprocessing to achieve a zero waste economy for a sustainable environment. Microbial carbonic anhydrase (CA) catalyses reversible CO₂ hydration and forms metal carbonates that mimic the natural phenomenon of weathering/carbonation and is gaining merit for CCUS. Thus, the diversity and specificity of CAs from different micro-organisms could be explored for CCUS. In the literature, more than 50 different microbial CAs have been explored for mineral carbonation. Further, microbial CAs can be engineered for the mineral carbonation process to develop new technology. CA driven carbonation is encouraging due to its large storage capacity and favourable chemistry, allowing site-specific sequestration and reusable product formation for other industries. Moreover, carbonation based CCUS holds five-fold more sequestration capacity over the next 100 years. Thus, it is an eco-friendly, feasible, viable option and believed to be the impending technology for CCUS. Here, we attempt to examine the distribution of various types of microbial CAs with their potential applications and future direction for carbon capture. Although there are few key challenges in bio-based technology, they need to be addressed in order to commercialize the technology.

Climate Change and Underserved Communities

Climate change is the greatest global health threat of the twenty-first century, yet it is not widely understood as a health hazard by primary care providers in the United States. Aside from increasing displacement of populations and acute trauma resulting from increasing frequency of natural disasters, the impact of climate change on temperature stress, vector-borne illnesses, cardiovascular and respiratory illnesses, and mental health is significant, with disproportionate impact on underserved and marginalized populations. Primary care providers must be aware of the impact of climate change on the health of their patients and advocate for adaptation and mitigation policies for the populations they serve.