The health impacts of climate change are not felt equally, and some populations are at higher risk than others.106 Low-income communities and some communities of color are often already overburdened with poor environmental conditions and are disproportionately affected by, and less resilient to, the health impacts of climate change.106,107,108,109,110 The health risks of climate change are expected to compound existing health issues in Native American and Alaska Native communities, in part due to the loss of traditional foods and practices, the mental stress from permanent community displacement, increased injuries from lack of permafrost, storm damage and flooding, smoke inhalation, damage to water and sanitation systems, decreased food security, and new infectious diseases (Ch. 15: Tribes; Ch. 26: Alaska).111,112
Across all climate risks, children, older adults, low-income communities, some communities of color, and those experiencing discrimination are disproportionately affected by extreme weather and climate events, partially because they are often excluded in planning processes.113 Other populations might experience increased climate risks due to a combination of exposure and sensitivity, such as outdoor workers, communities disproportionately burdened by poor environmental quality, and some communities in the rural Southeastern United States (Ch. 19: Southeast).114,115,116
Additional populations with increased health and social vulnerability typically have less access to information, resources, institutions, and other factors to prepare for and avoid the health risks of climate change. Some of these communities include poor people in high-income regions, minority groups, women, pregnant women, those experiencing discrimination, children under five, persons with physical and mental illness, persons with physical and cognitive disabilities, the homeless, those living alone, Indigenous people, people displaced because of weather and climate, the socially isolated, poorly planned communities, the disenfranchised, those with less access to healthcare, the uninsured and underinsured, those living in inadequate housing, and those with limited financial resources to rebound from disasters.107,109,117,118 Figure 14.2 depicts some of the populations vulnerable to weather, climate, and climate change.
Building Resilient Communities
Projections of climate change-related changes in the incidence of adverse health outcomes, associated treatment costs, and health disparities can promote understanding of the ethical and human rights dimensions of climate change, including the disproportionate share of climate-related risk experienced by socially marginalized and poor populations. Such projections can also highlight options to increase population resilience.119,120,121 The ability of a community to anticipate, plan for, and reduce impacts is enhanced when these efforts build on other environmental and social programs directed at sustainably and equitably addressing human needs.122 Resilience is enhanced by community-driven planning processes where residents of vulnerable and impacted communities define for themselves the complex climate challenges they face and the climate solutions most relevant to their unique vulnerabilities.110,123,124,125 A flood-related disaster in central Appalachia in spring 2013 highlighted how community-based coping strategies related to faith and spirituality, cultural values and heritage, and social support can enhance resilience post-disaster.126
Communities in Louisiana and New Jersey, for example, are already experiencing a host of negative environmental exposures coupled with extreme coastal and inland flooding. Language-appropriate educational campaigns can highlight the effectiveness of ecological protective measures (such as restoring marshes and dunes to prevent or reduce surge flooding) for increasing resilience. Resilience also can be built by creating institutional readiness, recognizing the importance of resident mobility (geographic movements at various scales such as commuting, migration, and evacuation), acknowledging the importance and support of social networks (such as family, church, and community), and facilitating adaptation to changing conditions.127,128