- The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment
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finding 9.3 : social-determinants-health-interact-climate-factors-affect-health-risk
Climate change threatens the health of people and communities by affecting exposure, sensitivity, and adaptive capacity [High Confidence]. Social determinants of health, such as those related to socioeconomic factors and health disparities, may amplify, moderate, or otherwise influence climate-related health effects, particularly when these factors occur simultaneously or close in time or space [High Confidence].
This finding is from chapter 9 of The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment.
Process for developing key messages: The chapter was developed through technical discussions of relevant evidence and expert deliberation by the report authors at several workshops, teleconferences, and email exchanges. The authors considered inputs and comments submitted by the public, the National Academies of Sciences, and Federal agencies. For additional information on the overall report process, see Appendices 2–3.
The author team identified a number of populations affected by climate change health impacts, including communities of color and low-income, immigrant, and limited English proficiency groups; Indigenous populations; children and pregnant women; older adults; certain occupational groups; persons with disabilities; and persons with chronic medical conditions. This list of populations was identified to reflect current understandings related to how the health of particular groups of people or particular places are affected by climate change in the United States. While not exhaustive, these populations of concern are those most commonly identified and discussed in reviews of climate change health impacts on vulnerable populations. In this chapter, the order of these populations is not prioritized. While there are other populations that may be threatened disproportionately by climate change, the authors focused the sections of this chapter on populations for which there is substantive literature. In addition to this chapter’s summary of vulnerable populations, each of the health outcome chapters in the report includes discussion of populations of concern. Some populations may be covered more extensively in these other chapters; for instance, homeless populations are discussed in Chapter 8: Mental Health, as the literature on this population focuses primarily on mental health.
Description of evidence base: The literature is consistent and the results are compelling that social determinants of health, such as those related to socioeconomic factors and health disparities, will contribute to the nature and extent of vulnerability and health effects due to climate change. The following factors illustrate the depth of the literature supporting the conclusions above regarding the relationship between climate change health threats, vulnerability (comprised of exposure, sensitivity, and adaptive capacity), and social determinants of health:
- Occupation: where workers are at risk due to their place of employment or the nature of their duties.e3439854-edb7-4acd-9e4f-b6ae0477f688
- Time spent in risk-prone locations: There is an extensive literature base and broad consensus to support a finding that locations that experience greater risks include urban heat islands where exposed populations are likely to have limited adaptive capacity due to poor housing conditions, and inability to use or to afford air conditioning.5f587662-8664-420f-8045-196e2bb7ec0d e4c07020-0c97-4a6c-ab4a-1859aaebd5ab 4695344e-33e4-457d-a4e8-514481c7befe e1e7b92a-1577-49c8-a0f2-cc26c902ce14 6177fcba-e6ac-48c8-aed7-ef5eed7b1b9c 7818b29f-2953-47e8-a632-808c7e50dc55 6a74b0ff-705b-433e-8b26-59b7284cca88 ea6394c5-29f9-4e05-a003-a7fe1294d1ca 5a4bb405-7848-4441-bd59-025b30f94dc5 .
- Economic status: In the literature, a significant relationship has been observed that links people living in poverty with being less likely to have adequate resources to prepare for or respond to extreme events or to access and afford necessary health or supportive services to cope with climate-related health impacts.cec7574a-87d4-4dff-8aa2-3e2789a06c6a 1a488f7f-f7ff-4118-9422-2775c2159f49 2af35408-ef20-45b7-841b-39c7540c22ae 778c3796-1d2c-46c0-a5c7-506a77a1a6f3 11eb3961-5327-4c18-8c5c-b22750b3880b 2306dc6d-f95a-46e2-bf28-300083f31dec
- Condition of infrastructure: Deteriorating infrastructure exposes people to increased health risks. The literature is consistent and of good quality to support a finding that persons who evacuate may be hampered by damage to transportation, utilities, and medical or communication facilities and by a lack of safe food or drinking water supplies.de5b6f9d-388d-4f67-8115-ad5fca6a95d5 e839bc70-12c5-48fa-9083-798cf367eefc 65736c68-a5c9-44e8-acb7-879ef878a275 9096905c-dc99-46c1-ac2c-2e5f8d58f8d9
- Disparities in health conditions: Health disparities contribute to the sensitivity of people to climate change. Numerous studies indicate increased sensitivity and health risk for people with chronic or preexisting medical or psychological illnesses, people of certain age or stage of life; and people with compromised mobility or cognitive functioning.471f2ed8-ece8-4d87-8b6d-8127a844cc28 97e4aaa4-e1b1-4b9e-b048-702147fbd52d bc2afe1f-2d94-413a-a1c7-f7d3868751ed Social determinants of health contributing to disparities in rates of these conditions increase sensitivity of affected populations.790066eb-6672-4c48-a51f-00c762173ed1 71cceabc-45d8-4b40-bb94-30755e6db7d3 97e4aaa4-e1b1-4b9e-b048-702147fbd52d bc2afe1f-2d94-413a-a1c7-f7d3868751ed
Health risks and vulnerability may increase in locations or instances where combinations of social determinants of health that amplify health threats occur simultaneously or close in time or space.a6491512-ba32-470d-934e-44c3b13d8b96 8ddfda37-f9e3-4848-aa97-6f5eb0704765 For example, people with limited economic resources living in areas with deteriorating infrastructure are more likely to experience disproportionate impacts and are less able to recover following extreme events,77ffab8c-05b9-42ab-bd76-22a19abfb429 fbc277e8-499f-4e93-9c33-1df56a674e71 increasing their vulnerability to climate-related health effects.
New information and remaining uncertainties: A wide range of non-climate factors are expected to interact with climate change health impacts to determine population vulnerability, all with some degree of uncertainty. The extent to which social determinants of health individually and collectively affect the different components of vulnerability is, in many cases, not well understood and not readily amenable to measurement or quantification. Assessing the extent and nature of non-climate impacts as compared to impacts related to climate change is limited by data availability. Many studies of climate change vulnerability have limited geographic scope or focus on single events in particular locations, which makes drawing national-level conclusions more challenging.
Assessment of confidence based on evidence: Based on the evidence presented in the peer-reviewed literature, there is high confidence that climate change threatens the health of people and communities by affecting exposure, sensitivity, and adaptive capacity. This conclusion takes into account the consistent evidence presented in multiple studies regarding the causes of vulnerability to climate-related health effects and the role of social determinants of health. There is high confidence based on many peer-reviewed studies that social determinants of health, such as those related to socioeconomic factors and health disparities, may amplify, moderate, or otherwise influence climate-related health effects across populations of concern, and the evidence presented is of good quality, consistent, and compelling.
- Parental limited English proficiency and health outcomes for children with special health care needs: A systematic review (11eb3961)
- Health care access, use of services, and experiences among undocumented Mexicans and other Latinos (1a488f7f)
- The impact of limited English proficiency on asthma action plan use (2306dc6d)
- Immigration status and use of health services among Latina women in the San Francisco Bay Area (2af35408)
- CDC Health Disparities and Inequalities Report — United States, 2011 (4695344e)
- Climate Change and Children’s Health—A Call for Research on What Works to Protect Children (471f2ed8)
- The racial/ethnic distribution of heat risk–related land cover in relation to residential segregation (5a4bb405)
- Neighborhood microclimates and vulnerability to heat stress (5f587662)
- The Built Environment, Climate Change, and Health (6177fcba)
- Growing Old in a Changing Climate: Meeting the Challenges of an Ageing Population and Climate Change (65736c68)
- Health of the homeless and climate change (6a74b0ff)
- Summer temperature variability and long-term survival among elderly people with chronic disease (71cceabc)
- Variations in healthcare access and utilization among Mexican immigrants: The role of documentation status (778c3796)
- Poverty and disasters in the United States: A review of recent sociological findings (77ffab8c)
- National Healthcare Disparities Report 2013 (7818b29f)
- A multicounty analysis identifying the populations vulnerable to mortality associated with high ambient temperature in California (790066eb)
- Evaluation of a Heat Vulnerability Index on Abnormally Hot Days: An Environmental Public Health Tracking Study (8ddfda37)
- Trends in heat-related mortality in the United States, 1975–2004 (9096905c)
- Chronic disease and disasters: Medication demands of Hurricane Katrina evacuees (97e4aaa4)
- Neighborhood effects on heat deaths: Social and environmental predictors of vulnerability in Maricopa County, Arizona (a6491512)
- The impact of disasters on populations with health and health care disparities (bc2afe1f)
- Fear of discovery among Latino immigrants presenting to the emergency department (cec7574a)
- Identifying Vulnerable Subpopulations for Climate Change Health Effects in the United States (de5b6f9d)
- Excess hospital admissions during the July 1995 heat wave in Chicago (e1e7b92a)
- Climate change and occupational safety and health: Establishing a preliminary framework (e3439854)
- Climate Change and Extreme Heat Events (e4c07020)
- Monitoring and Analysis of Sand Dune Movement and Growth on the Navajo Nation, Southwestern United States. Fact Sheet Number 3085 (e839bc70)
- The climate gap: environmental health and equity implications of climate change and mitigation policies in California—a review of the literature (ea6394c5)
- Disaster disparities and differential recovery in New Orleans (fbc277e8)
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