Addressing COVID-19, Racial Inequity, and Climate Change

By CCHEP Staff - Linda Helland, Dan Woo, Dorette English, Meredith Milet  |  August 31, 2020

These are unprecedented times, with three inter-related and converging public health crises: the COVID-19 pandemic and the associated economic fall-out, severe racial and economic inequity, and climate change. All three expose systemic injustices across the spectrum of the economy and society.

The impacts of the pandemic parallel the types and scale of devastation we can expect from climate change, but on a compressed timeline. And the story is not new: those most vulnerable and facing inequities already, are hurt first and worst.

In California, nearly 13,000 people have died from the Coronavirus, and data and analysis point to a disproportionate level of harm falling on people of color and low-wealth communities. More people are dying from COVID-19 in US states with higher levels of income inequality.

According to the Centers for Disease Control & Prevention (PDF), "the population health impact of COVID-19 has exposed long-standing inequities that have systematically undermined the physical, social, economic, and emotional health of racial and ethnic minority populations and other population groups that are bearing a disproportionate burden of COVID-19." Due to these long-standing inequities, many Black, Indigenous, and People of Color (BIPOC) hold jobs that are less secure, have lower wages, and cannot be done from home. Similarly, these same populations are exposed to greater levels of air pollution and other climate-related exposures. Lungs damaged by air pollutants, particularly small particles, appear to be more susceptible to respiratory illnesses like COVID-19. Black Americans are exposed to 1.5 times more particulate matter, largely from fossil fuel sources, raising their rates of asthma and other respiratory and cardiovascular conditions (PDF).  

Due to historical and continuing systemic racism and related policies that limit access to health-protective resources and neighborhood conditions, and the chronic and toxic stress that experiencing racism can cause, Black, Native American, Native Hawaiian and other Pacific Islander, and Latinx communities are more likely to have chronic conditions that increase the risk of serious complications and death from not only COVID-19, but also from extreme heat or poor air quality associated with climate change. One in every 1,125 Black Americans has passed away due to the Coronavirus, compared with one in 2,450 White Americans. Indigenous, Pacific Islander, and Latinx Americans also have higher death rates than Whites. People already socially isolated face greater risk for physical and mental health harms from measures like physical distancing and stay-at-home orders, or from pandemic-induced job loss. Social isolation also increases vulnerability to climate-related events such as wildfires and heat waves.

Climate impacts are not taking a pause for the pandemic. Despite lowered global carbon emissions due to COVID-19 stay-at-home orders, greenhouse gas emissions are climbing back quickly as countries and states continue to reopen. January 2020 was the hottest January on record. This May equaled the hottest May on record, and it is virtually certain that 2020 will be among the top 5 hottest years on record. In recent months, there have been intense Arctic wildfires and a historic heat wave in Siberia. In the US, the 2020 Atlantic hurricane season started with an unprecedented nine named storms by the start of August. Wildfire season is well underway in the Western states, with wildfire smoke impacting not only those living closest to the fires but also communities hundreds of miles away. California is facing some of the largest wildfires in state history, in addition to record-breaking heat and rolling blackouts.

Responding to and recovering from climate-related impacts often requires many people in close proximity. Picture indoor shelters for people taking refuge from wildfires now presenting new risks from the Coronavirus. Or sheltering in place in 100-degree heat in an apartment without air conditioning. Think of inmate firefighters who live in congregate settings at higher risk for the spread of COVID; this is in the context of prison populations generally having more chronic conditions than people who are not incarcerated, and Black people continuing to be disproportionately imprisoned in California. 

Inequality, racism, and climate change are public health problems that can be addressed with public health solutions: utilizing a spectrum of preventive measures across community, organizational, institutional, media, economic, and policy spheres; done in partnership with other institutions that influence the social determinants of health such as law enforcement, education, transportation, housing, land use, finance, and natural resources; and all guided by community expertise.

Community-driven climate action strategies can benefit the COVID-19 response and deconstruct inequitable policies and systems to improve underlying living conditions, particularly in historically marginalized communities of color:

• Public health, safety, and other community investments can prioritize communities that have experienced chronic disinvestment, helping to reduce disproportionate levels of incarceration and displacement of lower-income residents of color, as well as build climate resilience.
  

• Affordable, healthy, and energy-efficient housing can provide safe places to avoid exposure to extreme temperatures and weather, as well as community-spread infectious diseases (or a place to self-quarantine or self-isolate if needed). Energy-efficient, weatherized homes can improve indoor air quality, reduce carbon emissions, and lower household utility bills.

• Land use changes that reduce auto-dependence can reduce carbon emissions and air pollution, enable more walking and cycling to reduce underlying chronic diseases (PDF), increase social cohesion, and may reduce traffic collisions and related injuries, thus freeing health care resources.

• Local/regional plant-based food production and distribution systems can reduce carbon emissions while helping supply healthy foods and prevent disruptions to food availability.

• Urban and community greening help clean the air, sequester emissions, and make it more safe and pleasant to walk and bike while physically distancing; having views of and access to nature benefit physical and mental health.

• Transitioning away from polluting fuels such as coal, oil and gas reduces air pollution that compromises lungs and disproportionately harms communities of color and communities with limited financial resources.

• Safe, stable, living wage, low-carbon jobs where workers share decision-making can help prevent layoffs, keep workers connected to their jobs, and provide paid leave when workers are sick. These are particularly critical for essential workers (PDF). Jobs in the caring economy, including health care, elder care, child care, cleaning and housekeeping are also low-carbon, essential to health and well-being, often accomplished by women of color, yet often inadequately compensated.
  
  

Amid the global pandemic and movements striving for racial justice, there are some lessons we can learn in our response to climate change:

• We are all only as safe and healthy as our neighbors. That means our neighbors of all skin colors and backgrounds, those driving buses, cleaning hospital facilities, growing our food, working in distribution warehouses, as well as those in immigrant detention centers or incarcerated.

• Structural change and government planning are needed. Private profit-driven entities lacked incentive to prepare for an infectious pandemic, and in many cases lack incentive to reduce climate pollution.

• Public health infrastructure is critical. Investing resources up front to prevent harm saves lives, suffering, and significant amounts of money.
  

• Money and resources can be made available when the threat is widely recognized and accepted. Large-scale economic actions and financial investments can be mobilized when government and other sectors acknowledge and respond to systemic threats.

• In order to respond appropriately and effectively to threats, policy decisions and actions must be based on science and evidence.
  

• We're seeing inspiring grassroots examples of tangible mutual aid, neighbor to neighbor support, and moving displays of solidarity amid the pandemic. These networks will serve to build resilience to climate-related disasters too.
  
  

The purpose of resilience is not to build the capacity to endure more harm (PDF) among people facing inequities, but rather to change the conditions and systems that lead to disproportionate harm to some people. To do that, we apply an equity frame for resource allocation, prioritizing investment of resources (money, training, jobs, facilities, services, decision-making power) for people and communities who have faced injustices and disinvestment resulting in disproportionate health burdens – whether they be from COVID-19, racial injustice, or climate change.

What We Are Doing

CDPH is actively dedicating staff and resources to respond to the global pandemic, address institutional racism, and develop tools and guidance for reducing carbon emissions and building resilience to climate change impacts. We recognize our responsibility to rectify the legacy of institutional racism in the public health sector that has fostered or left in place racial health inequities.

The CDPH Racial and Health Equity (RHE) Initiative, led by the Office of Health Equity's Health in All Policies (HiAP) team is working to build a shared understanding of race and racism among CDPH staff, and provides tools so that CDPH staff can continue to advance a culture that challenges and abolishes institutional racism. Our Climate Change and Health Equity Program (CCHEP) incorporates racial equity as a central part of our work, including highlighting the climate impacts of racism and consulting across State government on health equity.

The CDPH Office of Health Equity's Health Equity Policy and Planning Unit—which houses CCHEP, HiAP, and the RHE Initiative—is deeply engaged with the COVID-19 response and recovery efforts, having seen redirections of all but one staff person at one point or another to work on California's COVID-19 response. CCHEP has refocused our work on the intersection of the pandemic and climate change. These efforts include:

• overseeing public health emergency contracts to community-based organizations led by and representing people disproportionately impacted by the pandemic including African Americans, Native Americans, Latinx people, immigrants, LGBTQ people, unhoused people, and more, funded by the CDC to respond to and address health equity priorities in the COVID-19 response and recovery;

• collaborating with other CDPH programs, community-based organizations, and community members to provide health equity input to the response and recovery;

• working with state agency partners to advance a COVID-19 response and recovery that can also advance health equity and state climate goals;

• utilizing social determinants of health and climate vulnerability data and mapping to identify populations more vulnerable to the impacts of COVID-19;

• supporting data collection and engagement of vulnerable populations in the response and recovery;

• compiling and disseminating resources and guidance regarding COVID-19 response and recovery, climate change, and health equity, such as protecting from wildfires and wildfire smoke, and extreme heat, coupled with protocols for preventing and reducing COVID-19 infections.
  
  

"Bouncing Forward"

Some people, weary of protocols to prevent Coronavirus infection, are yearning for a return to "normal." But "normality" includes African-American women having over three times the risk of maternal mortality of White women, over 100,000 Californians without a home (PDF), increasing climate emissions and increasing inequality. That is not something to go back to. Learning from the Movement Strategy Center, our program sees climate resilience as not simply people "bouncing back" after disasters and other climate-related events, because the underlying conditions of inequitable political power, participation in decision-making, and access to opportunities and resources will need to be changed in order to improve quality of life, health, and safety. Instead, communities seek to "bounce forward", to a racially just society, in a renewable, sustainable economy marked by inclusive participation in the policy decisions that affect daily life, before, during, and despite climate-related events and a global pandemic. We can employ a public health model to address these interlocking health crises and bounce forward to place where everyone can thrive.

To learn more, visit the CDPH Climate Change & Health Equity Program >>