Section 330 of the Public Health Services Act authorizes health centers “to provide additional services necessary for the adequate support of primary health services including environmental health services, including- (I) the detection and alleviation of unhealthful conditions associated with (I) water supply; (II) chemical and pesticide exposures; (III) air quality.” Although many community health centers have long worked to address environmental health in their communities, there has been a dearth of attention on this topic. In connection to environmental health, recent awareness of the far-reaching impacts of climate change on water quality, air quality, and ultimately human health have brought this important issue to the fold.

Due to the immediate risks of climate change to public health and safety, the National Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences (PRAPARE®) team is raising awareness about the importance of addressing climate vulnerability and environmental health. In the last month alone, we have seen news coverage of community health centers facing the devastating Water Crisis in Mississippi, the unprecedented flooding in Kentucky, and the extreme heat waves in California. Unfortunately, these issues are part of a larger pattern. In recent years, the world has seen a significant number of severe weather occurrences, which can cost billions of dollars to address. Extreme weather events, which include excessive heat and heatwaves, wildfires, hurricanes, and heavy rains that lead to flooding, are becoming increasingly common across the globe. While the process of climate change is slow, the smallest increase in the Earth’s temperature and sea level are causing drastic consequences for individuals and communities. When temperatures soar in the summer, electric companies encourage consumers to conserve energy to avoid blackouts. When temperatures drop sharply or when regions see unusually heavy rainfall, communities with poor infrastructure or response services are especially vulnerable., Air pollution, water quality issues, changes in vector ecology, and food shortages are also intensified by climate change and pose severe implications for human health and well-being.

Furthermore, the structural and historical effects of racism, colonization, and other forms of oppression exacerbate the impacts of climate change and extreme weather on human health. Such policies and practices have led to people of color being disproportionately at-risk for environmental health hazards and climate change. In one example, communities of color face inequitable exposure to extreme heat. Research shows that communities that were historically redlined are on average 5 degrees, and up to 12 degrees, hotter in summer than areas that did not face such policies.

As exposure to climate change and extreme weather gain recognition as contributors to health inequity, it is crucial to deepen our understanding of how patients’ environments affect their health and well-being. Many community health centers have already taken impressive steps in mitigating impacts of climate change and environmental health in their communities. For example, Crescent Care in New Orleans, Louisiana is a leader of the Community Lighthouse initiative, a collection of community-based organizations. The initiative seeks to ensure all community members are within 15-minutes walking distance of a facility equipped with solar panels, back-up battery systems, and other alternate sources of power so that they can access air conditioning, heating, and other important resources during extreme weather events. Umma Community Clinic in Los Angeles, California collaborated with their community-based organizations to halt urban oil drilling in their area, which occurred in close proximity to a number of elementary schools. They also incorporated screening and services to help patients address the impacts of urban oil drilling on their health. Finally, Sixteenth Street Community Health Center in Milwaukee, Wisconsin created an in-house environmental health department to identify and treat lead exposure and restore the Kinnickinnic River watershed, with a focus on community engagement outside of the clinic walls. 

Stories of these community health centers inspire and encourage other community health centers and partner organizations to collect relevant data points related to the health impacts of climate vulnerability. This data could be used to advocate for upstream policy changes and environmental protections. Additionally, understanding the populations most at-risk may help health centers and partner organizations create more effective emergency preparedness plans. 

While the national PRAPARE® team is exploring adding a new domain to the screening tool focusing on Climate/Environmental Vulnerability, we would like to hear from you!  If you have a environmental health and impact story to share, email the National PRAPARE team at prapare@nachc.org.

Authors: Albert Ayson Jr., Gabrielle Penaranda, Kristine Cecile Alarcon (Association for Asian Pacific Community Health Organizations/AAPCHO), Jessica Hinshaw, Nalani Tarrant, Sarah Halpin, Yuriko de la Cruz (National Association of Community Health Centers/NACHC)